| 1. |
- Persson, Jessica, et al.
(författare)
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Oral Care Cards as a Support in Daily Oral Care of Frail Older Adults: Experiences and Perceptions of Professionals in Nursing and Dental Care-A Qualitative Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601 .- 1661-7827. ; 19:15
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Tidskriftsartikel (refereegranskat)abstract
- Frail older adults often have poor oral health. In Sweden, oral care cards are designed to be used as an interprofessional tool for documenting the oral health status of older adults with extensive care needs and to describe oral care recommendations. The aim of this study was to explore nursing and dental professionals' experiences and perceptions of oral care cards. Nursing and dental care staff were interviewed in groups or individually. The recorded data were transcribed verbatim and analyzed using qualitative content analysis. A theme emerged: Navigating an oral care responsibility that is not anchored in the nursing and dental care context. The theme was elucidated in three categories: "Accessibility and usefulness", "Coordination between nursing and dental care", and "Ethical approach". The participants perceived a lack of surrounding frameworks and collaboration concerning oral care and the use of oral care cards. An oral care card could ideally facilitate interprofessional and person-centered oral care. However, oral health does not seem to have found its place in the nursing care context. Further research is needed to investigate how oral care cards ought to be developed and designed to support oral health care work.
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| 2. |
- Rawshani, Nina, et al.
(författare)
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Could ten questions asked by the dispatch center predict the outcome for patients with chest discomfort?
- 2016
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 209, s. 223-225
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: From 2009 to 2010, approximately 14,000 consecutive persons who called for the EMS due to chest discomfort were registered. From the seventh month, dispatchers ask 2285 patient ten pre-specified questions. We evaluate which of these questions was independently able to predict an acute coronary syndrome (ACS), life-threatening condition (LTC) and death.METHODS: The questions asked mainly dealt with previous history and type of symptoms, each with yes/no answers. The dispatcher took a decision on priority; 1) immediately with sirens/blue light; 2) EMS on the scene within 30min; 3) normal waiting time.We examined the relationship between the answers to these questions and subsequent dispatch priority, as well as outcome, in terms of ACS, LTC and all-cause mortality.RESULTS: 2285 patients (mean age 67years, 49% women) took part, of which 12% had a final diagnosis of ACS and 15% had a LTC. There was a significant relationship between all the ten questions and the priority given by dispatchers. Localisation of the discomfort to the center of the chest, more intensive pain, history of angina or myocardial infarction as well as experience of cold sweat were the most important predictors when evaluating the probability of ACS and LTC. Not breathing normally and having diabetes were related to 30-day mortality.CONCLUSIONS: Among individuals, who call for the EMS due to chest discomfort, the intensity and the localisation of the pain, as well as a history of ischemic heart disease, appeared to be the most strongly associated with outcome.
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| 3. |
- Olsson, Maivor, et al.
(författare)
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Assessment of Distress and Quality of Life : A Comparison of Self-Assessments by Outpatients with a Schizopsychotic Illness and the Clinical Judgment of Nurses
- 2015
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Ingår i: Archives of Psychiatric Nursing. - : Saunders Elsevier. - 0883-9417 .- 1532-8228. ; 29:5, s. 284-289
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate how self-assessments of perceived distress and quality of life in patients with schizopsychotic illness are associated with nurse assessments of symptoms, function and life situation. Data were obtained through interviews that used evidence-based rating and visual analogue self-rating scales. Descriptive statistics, correlation and regression analyses were used to process the data. The results demonstrated that the patient self-ratings did not correlate with the nurse assessments, and the perceived distress was not affected by remission status. The findings indicate that patient self-assessments are not a sufficient basis for decisions regarding appropriate treatment interventions.
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| 4. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Partitioning reference values for several subpopulations using cluster analysis
- 2007
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Ingår i: Clinical chemistry and laboratory medicine. - : Walter de Gruyter. - 1434-6621 .- 1437-4331. ; 45:8, s. 1026-1032
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A crucial question when developing reference intervals is whether different subpopulations need their own reference interval or if a single joint reference interval can be used. It is reasonable to use partitioned reference intervals in situations where a single interval results in considerable variation in sensitivity between subpopulations. The aim of partitioning is to harmonize the sensitivity of the reference intervals, i.e., to make the sensitivity similar for all patients, regardless of patient characteristics. Statistical criteria to identify when partitioning is adequate have been developed over the last two decades. These criteria are applicable when considering two subpopulations, but recently a procedure for considering several subpopulations has been developed. When several subpopulations are considered, there is a possibility that some subpopulations could form a group or cluster that could share a common reference interval. However, there is no formal systematic approach to indicate how to divide these subpopulations into clusters. The aim of this study was to suggest such a systematic approach for clustering. METHODS: A clustering technique was applied to data including several subpopulations. The technique is based on measuring the distance between separated reference limits and successively pooling subpopulations divided by short distances. A cluster is defined by a group of subpopulations that are close to each other and that differ from subpopulations in another cluster. A cluster recruits new subpopulations as long as the subpopulations can be pooled without violating a partitioning criterion. CONCLUSIONS: We have suggested a procedure for partitioning a number of Gaussian (or Gaussian-transformable) subpopulations into clusters. This is the only formalized procedure indicating how to analyze several subpopulations and identify a suitable number of groups and reference intervals. Using a computer program developed for partitioning issues, the approach was easy to adopt.
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| 5. |
- Leinweber, Julia, et al.
(författare)
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Developing a woman-centered, inclusive definition of positive childbirth experiences : A discussion paper
- 2023
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Ingår i: Birth. - : John Wiley & Sons. - 0730-7659 .- 1523-536X. ; 50:2, s. 362-383
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research.Aim To formulate an inclusive woman-centered definition of a positive childbirth experience.Methods A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women’s feedback (n = 42).Results The following definition was formulated: “A positive childbirth experience refers to a woman’s experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman’s psychosocial well-being.”Conclusions This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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| 6. |
- Lindgren, Erik, 1980, et al.
(författare)
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Analysis of industrial X-ray computed tomography data with deep neural networks
- 2021
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Ingår i: Proceedings of SPIE - The International Society for Optical Engineering. - : SPIE. - 0277-786X .- 1996-756X. ; 11840
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Konferensbidrag (refereegranskat)abstract
- X-ray computed tomography (XCT) is increasingly utilized industrially at material- and process development as well as in non-destructive quality control; XCT is important to many emerging manufacturing technologies, for example metal additive manufacturing. These trends lead to increased needs of safe automatic or semi-automatic data interpretation, considered an open research question for many critical high value industrial products such as within the aerospace industry. By safe, we mean that the interpretation is not allowed to unawarely or unexpectedly fail; specifically the algorithms must react sensibly to inputs dissimilar to the training data, so called out-of-distribution (OOD) inputs. In this work we explore data interpretation with deep neural networks to address: robust safe data interpretation which includes a confidence estimate with respect to OOD data, an OOD detector; generation of realistic synthetic material aw indications for the material science and nondestructive evaluation community. We have focused on industrial XCT related challenges, addressing difficulties with spatially correlated X-ray quantum noise. Results are reported on training auto-encoders (AE) and generative adversarial networks (GAN), on a publicly available XCT dataset of additively manufactured metal. We demonstrate that adding modeled X-ray noise during training reduces artefacts in the generated imperfection indications as well as improves the OOD detector performance. In addition, we show that the OOD detector can detect real and synthetic OOD data and still model the accepted in-distribution data down to the X-ray noise levels.
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| 7. |
- Uvnäs-Moberg, Kerstin, et al.
(författare)
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Maternal plasma levels of oxytocin during physiological childbirth : a systematic review with implications for uterine contractions and central actions of oxytocin
- 2019
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Oxytocin is a key hormone in childbirth, and synthetic oxytocin is widely administered to induce or speed labour. Due to lack of synthetized knowledge, we conducted a systematic review of maternal plasma levels of oxytocin during physiological childbirth, and in response to infusions of synthetic oxytocin, if reported in the included studies.METHODS: An a priori protocol was designed and a systematic search was conducted in PubMed, CINAHL, and PsycINFO in October 2015. Search hits were screened on title and abstract after duplicates were removed (n = 4039), 69 articles were examined in full-text and 20 papers met inclusion criteria. As the articles differed in design and methodology used for analysis of oxytocin levels, a narrative synthesis was created and the material was categorised according to effects.RESULTS: Basal levels of oxytocin increased 3-4-fold during pregnancy. Pulses of oxytocin occurred with increasing frequency, duration, and amplitude, from late pregnancy through labour, reaching a maximum of 3 pulses/10 min towards the end of labour. There was a maximal 3- to 4-fold rise in oxytocin at birth. Oxytocin pulses also occurred in the third stage of labour associated with placental expulsion. Oxytocin peaks during labour did not correlate in time with individual uterine contractions, suggesting additional mechanisms in the control of contractions. Oxytocin levels were also raised in the cerebrospinal fluid during labour, indicating that oxytocin is released into the brain, as well as into the circulation. Oxytocin released into the brain induces beneficial adaptive effects during birth and postpartum. Oxytocin levels following infusion of synthetic oxytocin up to 10 mU/min were similar to oxytocin levels in physiological labour. Oxytocin levels doubled in response to doubling of the rate of infusion of synthetic oxytocin.CONCLUSIONS: Plasma oxytocin levels increase gradually during pregnancy, and during the first and second stages of labour, with increasing size and frequency of pulses of oxytocin. A large pulse of oxytocin occurs with birth. Oxytocin in the circulation stimulates uterine contractions and oxytocin released within the brain influences maternal physiology and behaviour during birth. Oxytocin given as an infusion does not cross into the mother's brain because of the blood brain barrier and does not influence brain function in the same way as oxytocin during normal labour does.
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| 8. |
- Khorram-Manesh, Amir, 1958, et al.
(författare)
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Emergency Management and Preparedness Training for Youth (EMPTY) : The Results of the First Swedish Pilot Study
- 2018
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Ingår i: Disaster Medicine and Public Health Preparedness. - : Cambridge University Press (CUP). - 1935-7893 .- 1938-744X. ; 12:6, s. 685-688
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the impact of a simulation training in raising a group of young students' personal and situational awareness in disasters and emergencies.METHODS: In total, 25 young students participated in two simulation scenarios representing two actual events, fire, and shooting, using a combination of two validated simulation training (Emergency Management and Preparedness Training for Youth [EMPTY]). The changes in their knowledge and awareness were evaluated by using questionnaires and the whole simulation was evaluated by three independent observers and a reference group.RESULTS: New concepts of emergency management, for example, evacuation, and barricading, could be trained in a safe environment. There was a significant increase in students' personal and situational awareness and their active engagement in the management of emergencies.CONCLUSION: EMPTY could raise the youth basic knowledge and ability to understand the concept of preparedness by being mentally prepared, available for collaboration, gaining a higher confidence, understanding the physical and psychological consequences of a major incident and the importance of their own safety. (Disaster Med Public Health Preparedness. 2018; page 1 of 4).
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| 9. |
- Hoppe, Michael, 1969, et al.
(författare)
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Is cord blood hepcidin influenced by the low-grade acute-phase response occurring during delivery? : A small-scale longitudinal study
- 2019
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Ingår i: The Journal of Maternal-Fetal & Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 32:13, s. 2166-2172
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To measure serum hepcidin in late pregnancy and in cord blood, and to analyze relationship between hepcidin, interleukin-6 and biomarkers of fetal iron status.MATERIALS AND METHODS: Data from 15 uncomplicated singleton pregnancies were analyzed longitudinally in trimester 3 (T3) and at birth.RESULTS: In T3, S-ferritin (median 14 µg/L) and transferrin (median 4.0 g/L) indicated low iron status, whereas the median soluble transferrin receptor (sTfR) was 4.0 mg/L, ie within the reference interval. Median T3 S-hepcidin was 7.8 ng/mL. Later on in cord blood, ferritin concentration (180 µg/L) were significantly higher, transferrin concentration (1.8 g/L) were significantly lower, and both sTfR (4.7 mg/L) and S-hepcidin concentrations (30.5 ng/mL) were significantly higher than maternal T3 concentrations. At the same time, cord blood interleukin-6 indicated an activated acute-phase reaction. In T3, after logarithmic transformation, there was a significant correlation between S-hepcidin and both S-ferritin (r = 0.691) and sTfR (r = -0.825). There was also a significant correlation between S-ferritin and both sTfR (r = -0.729) and transferrin (r = 0.549) in T3.CONCLUSIONS: Although S-ferritin, S-hepcidin, and sTfR were correlated during pregnancy, these relationships were not apparent in umbilical cord blood. Further, cord blood interleukin-6 indicated an activated acute-phase response, and sTfR, which is known to be unaffected by inflammation, indicated a low iron status in cord blood. Thus, instead of representing an enhanced iron status, the data appear to suggest that hepcidin and ferritin in cord blood may be influenced by the low-grade acute-phase response that occurs during delivery.
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| 10. |
- Christiansen, Mats, med. lic. 1972-, et al.
(författare)
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Unscripted sexual practices : Sexual health of men having sex with men after prostate cancer treatment
- 2022
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Konferensbidrag (refereegranskat)abstract
- Purpose: The purpose of the study was to describe the sexual health of men having sex with men after prostate cancer treatment.Methods: A snowball sampling was conducted via clinicians and gatekeepers to the community. After consenting to participate, a semi-structured interview was conducted based on a questionnaire related to symptoms and issues and the help asked for and received. The interviews were approximately one hour and took place via digital platforms. The interviews were transcribed verbatim and then analyzed using content analysis. The following themes emerged during the analysis: A predominant heteronormative care, A situation of suffering and possibilities, A window of peer support system emerged.Results: The men described how their sexuality had been severely affected by their treatments. Bodily changes with decreased penis size, difficulties maintaining an erection, and less pleasure from anal sex. However, they also described the benefit of being men who had sex with men. They described being accustomed to exploring new ways of expressing and exploring their sexualities due to a lack of sexual scripts. The prostate cancer treatment had given them a new reason to explore new sexualities and sexual practices. In contacts with urology and oncology departments, both physicians and nurses, the men described a heteronormative environment. Albeit same-sex partners could be asked for in intake notes, no one reflected on what non-penovaginal sexuality could look like. Therefore, getting the appropriate care for the men after prostate cancer treatment did not involve erectile dysfunction medications was challenging. Instead, their friends and ability to find alternative ways to valid information became important.Conclusion: The result shows that predominantly heteronormative care exists for men who have sex with men. The new insight of the treatment is regarded as a situation of suffering and new possibilities. To conclude, men who have sex with men describe care that was well-meaning but heteronormative. The men described being men having sex with men as something that had made them explore unscripted sexual practices and had given them a broader sexual repertoire that was helpful for their sexual health. Furthermore, the support they received emerged from a peer support system in their private life.
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