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| 54. |
- Hjelmfors, Lisa, et al.
(författare)
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Optimizing of a question prompt list to improve communication about the heart failure trajectory in patients, families, and health care professionals
- 2020
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 19:1, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of this study was to optimize a Question Prompt List which is designed to improve communication about the heart failure trajectory among patients, family members, and health care professionals. Methods Data were collected in a two-round Delphi survey and a cross-sectional survey, including patients with heart failure, their family members, and health care professionals working in heart failure care in Sweden and the Netherlands. Acceptability for and demand of the Question Prompt List were assessed. Results A total of 96 patients, 63 family members and 26 health care professionals participated in the study. Regarding acceptability, most of the original questions were found to be relevant by the participants for inclusion in the Question Prompt List but some cultural differences exist, which resulted in two versions of the list: a Swedish version including 33 questions and a Dutch version including 38 questions. Concerning demand, participants reported that they were interested in discussing the questions in the revised Question Prompt List with a physician or a nurse. Few patients and family members reported that they were worried by the questions in the Question Prompt List and hence did not want to discuss the questions. Conclusions This Question Prompt List has successfully been adapted into a Swedish version and a Dutch version and includes questions about the HF trajectory which patients, their families, and health care professionals perceived to be relevant for discussion in clinical practice. Overall, patients and family members were not worried about the content in the Question Prompt List and if used in accordance with patients' and family members' preferences, the Question Prompt List can help to improve communication about the heart failure trajectory.
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| 55. |
- Hjelmfors, Lisa, et al.
(författare)
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Patient-Nurse Communication about Prognosis and End-of-Life Care
- 2015
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Ingår i: Journal of Palliative Medicine. - : MARY ANN LIEBERT, INC. - 1096-6218 .- 1557-7740. ; 18:10, s. 865-871
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although several studies advise that discussions about prognosis and end-of-life care should be held throughout the whole heart failure (HF) trajectory, data is lacking on the prevalence and practice of such discussions in HF care. Objective: The study objective was to explore how often and why HF nurses in outpatient clinics discuss prognosis and end-of-life care in the context of patient education. Methods: This was a descriptive and comparative study. Participants were HF nurses from Swedish and Dutch HF outpatient clinics. Measurements were taken via a survey for both quantitative and qualitative data. Additional data was collected via open-ended questions and analyzed with content analysis. Results: Two hundred seventy-nine nurses registered 1809 patient conversations using a checklist. Prognosis and end-of-life care were among the least frequently discussed topics, whereas symptoms of HF was discussed most often. Prognosis was discussed with 687 patients (38%), and end-of-life care was discussed with 179 patients (10%). Prognosis and end-of-life care were discussed more frequently in The Netherlands than in Sweden (41% versus 34%, pless than0.001, 13% versus 4%, pless than0.001). The nurses did not always recognize prognosis and end-of-life care discussions as a part of their professional role. Conclusions: Currently, patient-nurse communication about prognosis and end-of-life care does not seem to be routine in patient education in HF clinics, and these discussions could be included more often. The reasons for nurses to discuss these topics were related to clinical routines, the patients situation, and professional responsibilities. To improve future care, communication with patients needs to be further developed.
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| 56. |
- Holmberg, Lars, et al.
(författare)
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Prenatal diagnosis of hemophilia B by an immunoradiometric assay of factor IX
- 1980
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Ingår i: Blood. - 0006-4971. ; 56:3, s. 397-401
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Tidskriftsartikel (refereegranskat)abstract
- An immunoradiometric assay of factor IX was developed based on homologous antibodies that arose in a hemophilic patient. With this assay, 11 of 12 patients with severe hemophilia B had factor IX antigen levels below 1 U/dl and 6 patients with mild hemophilia B had various levels. Factor IX antigen in 8 fetuses (16th-20th gestational week) aborted for therapeutic reasons ranged from 1.8 to 10.0 U/dl. Six amniotic fluids contained 0.28-1.2 U/dl factor IX antigen. Using the immunoradiometric assay, we could diagnose hemophilia B prenatally in one fetus at risk. No factor IX antigen (< 0.2 U/dl) was detectable in the fetoscopic sample. After termination of the pregnancy, analysis of blood from the abortus confirmed the diagnosis of severe hemophilia B. We conclude that very sensitive immunologic assays, such as the one described here, will prove useful in prenatal diagnosis of severe hemophilia B, since determination of factor IX activity in fetoscopic samples is unrealiable because of possible contamination with thromboplastic material.
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| 57. |
- Humpel, C, et al.
(författare)
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Expression of nerve growth factor, brain-derived neurotrophic factor and neurotrophin-3 mRNAs in human cortical xenografts
- 1995
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Ingår i: Journal of neural transplantation & plasticity. - : Hindawi Limited. - 0792-8483. ; 5:4, s. 257-64
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Tidskriftsartikel (refereegranskat)abstract
- Trophic factors play an important role in the development of neurons and glia. In order to study the involvement of neurotrophins in human cortical development, human fetal parietal cortical tissue, obtained after early elective abortions, was transplanted to cortical cavities in immunosuppressed rats. Usingin situhybridization it was demonstrated that nerve growth factor, brain-derived neurotrophic factor and neurotrophin-3 mRNAs are expressed in developing human cortical xenografts. We conclude that neurotrophins may play a role in human cortical development and rat-derived astroglial cells could be involved in establishing reciprocal “permissive sites”.
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| 58. |
- Jaarsma, Tiny, et al.
(författare)
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Exploring factors related to non-adherence to exergaming in patients with chronic heart failure
- 2021
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Ingår i: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:6, s. 4644-4651
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Tidskriftsartikel (refereegranskat)abstract
- AimsThis study aimed to explore factors related to non-adherence to exergaming in patients with heart failure.Methods and resultsData from patients in the exergame group in the HF-Wii trial were used. Adherence to exergaming was defined as playing 80% or more of the recommended time. Data on adherence and reasons for not exergaming at all were collected during phone calls after 2, 4, 8, and 12 weeks. Logistic regression was performed between patients who were adherent and patients who were non-adherent. Secondly, a logistic regression was performed between patients who not exergamed at all and patients who were adherent to exergaming. Finally, we analysed the reasons for not exergaming at all with manifest content analysis. Almost half of the patients were adherent to exergaming. Patients who were adherent had lower social motivation [odds ratio (OR) 0.072; 95% confidence interval (CI) 0.054-0.095], fewer sleeping problems (OR 0.84; 95% CI 0.76-0.092), and higher exercise capacity (OR 1.003; 95% CI 1.001-1.005) compared with patients who were non-adherent. Patients who not exergamed at all had lower cognition (OR 1.18; 95% CI 1.06-1.31) and more often suffered from peripheral vascular disease (OR 3.74; 95% CI 1.01-13.83) compared with patients who were adherent to exergaming. Patients most often cited disease-specific barriers as a reason for not exergaming at all.ConclusionsA thorough baseline assessment of physical function and cognition is needed before beginning an exergame intervention. It is important to offer the possibility to exergame with others, to be able to adapt the intensity of physical activity.
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| 59. |
- Jakobsson, Kristina, et al.
(författare)
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Radiological changes in asbestos cement workers
- 1995
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Ingår i: Occupational and Environmental Medicine. - 1470-7926. ; 52:1, s. 20-27
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE--To explore associations between exposure to asbestos cement dust and radiographic findings in lung parenchyma and pleura. METHODS--Radiographs from 174 blue collar workers and 29 white collar workers from an asbestos cement plant formed one part of the study. Progression of small opacities was further studied in those 124 blue collar workers, for whom two radiographs taken after the end of employment were available. The median readings from five readers who used the full ILO 1980 classification were used. As exposure indices, time since start of employment, duration of employment, cumulative exposure, and average intensity of asbestos exposure were used. The influence of age and smoking was also considered in multiple logistic regression analyses. RESULTS--Small opacities (profusion > or = 1/0) were closely correlated with time related exposure variables, and showed weaker association with intensity based exposure variables. The odds ratio (OR) for small opacities was equal to 2.8 (90% CI 1.2, 6.7) in the > 30 f(fibre)-y/ml group, compared with those in the 0-10 f-y/ml group. Progression of at least two minor ILO categories after the end of employment was seen in 20%. Also, pleural thickening was closely related to time. By contrast, costophrenic angle obliterations were not associated with the time related variables, but closely associated with the intensity of asbestos exposure, and tended to occur during employment. The OR was 4.5 (90% CI 1.3, 15) in the > 2 f/ml group, compared with those in the 0-1 f/ml group. CONCLUSIONS--In these workers, exposed mainly to chrysotile but also to small amounts of amphibole, the risk of radiographically visible parenchymal abnormality was substantially increased and strongly dependent on time related exposure variables. Progression was found long after the end of exposure. The findings on costophrenic angle obliterations, supposed to be sequelae of benign pleural effusions, were consistent with an immediate reaction triggered by intense asbestos exposure.
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| 60. |
- Jakubovics, N.S., et al.
(författare)
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Interactions of mitis group streptococci with sialic acid receptors
- 2006
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Ingår i: International Congress Series 1289. - : Elsevier B.V.. ; , s. 275-278
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- The serine-rich repeat glycoprotein Hsa in Streptococcus gordonii Challis mediates bacterial cell interactions with fetuin, glycocalicin, fibronectin and human platelets. Different strains of S.gordonii vary markedly in their adhesion levels to sialylated proteins, while other mitis group streptococci have distinct patterns of recognition of sialylated or desialylated receptor oligosaccharides. 2005 Elsevier B.V. All rights reserved.
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