| 1. |
- Andersson, Benita, 1951-, et al.
(författare)
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Temporal Profile of Ultrastructural Changes in Cortical Neurons after a Compression Lesion
- 2006
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Ingår i: Physiological Research. - : Institute of Physiology of the Czech Academy of Sciences. - 0862-8408 .- 1802-9973. ; 55:3, s. 339-348
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Tidskriftsartikel (refereegranskat)abstract
- We studied the occurrence of apoptosis and secondary delayed cell death at various time points in the penumbra zone, which is the target for therapeutic intervention after stroke. A compression lesion was induced in the right sensory motor cortex of rat brains. At 0.5, 1, 3, 6, 12, 24, 48 and 72 h after lesioning, motor functions were evaluated by behavioral tests, and cortical layers IV and V were examined by electron microscopy. Behavioral recovery was observed at 48 h after lesioning. At 0.5-1 h in the lesioned area, the neuropil was expanded and contained affected cells. Apoptotic cells were found between 0.5-72 h, and at 12 h, 47.3 % of the total cell number was apoptotic cells. On the contralateral side, cells showed an enlarged endoplasmic reticulum at 3 h, indicating secondary delayed cell death. Our results show that a compression lesion is a useful model for studying ultrastructural changes in injured cells. The lesion results in the penumbra zone with apoptotic cell death between 0.5-72 h. As secondary delayed cell death occurred on the contralateral side at three hours after lesioning might be the time period during which injured, but still viable, neurons can be targets for acute treatment.
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| 2. |
- Antai, Diddy, et al.
(författare)
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Inequities in Under-Five Mortality in Nigeria : Differentials by Religious Affiliation of the Mother
- 2009
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Ingår i: Journal of religion and health. - : Springer Science and Business Media LLC. - 0022-4197 .- 1573-6571. ; 48:3, s. 290-304
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Tidskriftsartikel (refereegranskat)abstract
- Observations in Nigeria have indicated polio vaccination refusal related to religion that ultimately affected child morbidity and mortality. This study assessed the role of religion in under-five (0-59 months) mortality using a cross-sectional, nationally representative sample of 7,620 women aged 15-49 years from the 2003 Nigeria Demographic and Health Survey and included 6,029 children. Results show that mother's affiliation to Traditional indigenous religion is significantly associated with increased under-five mortality. Multivariable modelling demonstrated that this association is explained by differential use of maternal and child health services, specifically attendance to prenatal care. To reduce child health inequity, these results need to be incorporated in the formulation of child health policies geared towards achieving a high degree of attendance to prenatal care, irrespective of religious affiliation.
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| 3. |
- Birgegård, Andreas, et al.
(författare)
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Anorexic self-control and bulimic self-hate : differential outcome prediction from initial self-image
- 2009
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Ingår i: International Journal of Eating Disorders. - : Wiley. - 0276-3478 .- 1098-108X. ; 42:6, s. 522-530
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE:: The study investigated initial self-image (structural analysis of social behavior) and its relation to 36-month outcome, among patients with anorexia nervosa and bulimia nervosa. Hypotheses were that degree of different aspects of self-image would predict outcome in the groups. METHOD:: Participants were 52 patients with anorexia and 91 with bulimia from a longitudinal naturalistic database, and outcome measures included eating disorder and psychiatric symptoms and a general outcome index. Stepwise regression was used to investigate which self-image variables were related to outcome, and multiple regression contrasted the groups directly on each obtained predictor. RESULTS:: Consistent with hypotheses, in bulimia degree of self-hate/self-love moderately predicted outcome, whereas self-control-related variables powerfully predicted outcome in anorexia. CONCLUSION:: It is important to focus on self-image in the treatment of both diagnostic groups, but especially in anorexia nervosa, where control-submission interactions between patient and therapist should be handled with care.
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| 4. |
- Björck, Caroline, et al.
(författare)
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Negative self-image and outcome in eating disorders : results at 3-year follow-up.
- 2007
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Ingår i: Eating Behaviors. - : Elsevier BV. - 1471-0153 .- 1873-7358. ; 8:3, s. 398-406
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Negative self-image has been hypothesised to be of aetiological significance in eating disorders; however, its relationship to outcome remains unclear. The present study examined the relationship between self-image and follow-up status in a heterogeneous sample of eating disorder patients (N=246). METHODS: Patients were assessed at intake and after 36 months. Self-image was measured using SASB, and a general outcome measure was calculated comprising eating disorder symptoms, occupational status, interpersonal relationships and general psychopathology. RESULTS: SASB self-hate was the most important variable for predicting poor outcome, followed by occupational status, interpersonal relationships, eating disorder symptoms, SASB self-emancipation and general psychiatric symptoms. Together these variables predicted 23% of the variance in outcome. DISCUSSION: High levels of self-hate may increase the risk of poor outcome in eating disorders by adversely affecting interpersonal relationships and making it difficult for patients to engage in treatment.
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| 5. |
- Björck, Caroline, et al.
(författare)
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Self-image and treatment drop-out in eating disorders
- 2008
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Ingår i: Psychology and Psychotherapy. - Leicester, UK : British Psychological Society. - 1476-0835 .- 2044-8341. ; 81:1, s. 95-104
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Drop-out from treatment is a serious problem in eating disorders which remains poorly understood. The present study investigated whether self-image and interpersonal theory could help to explain why eating disorder patients drop out of treatment. Method: Intake data on eating disorder patients who terminated treatment prematurely (N=54) were compared with patients who had completed treatment (N=54) and those who were still in treatment after 12 months (N=54). Self-image was assessed using the structural analysis of social behaviour (SASB), and comparisons were made on demographic and clinical variables. Results: Patients who dropped out had initially presented with less negative self-image and fewer psychological problems compared with remainers. Low levels of SASB self-blame discriminated drop-outs from completers and remainers and significantly predicted treatment drop-out. Discussion: Drop-out in eating disorders appears to be a complex phenomenon, not necessarily as pathological as often assumed. There may be important differences in the treatment goals of drop-outs and therapists; patients who drop out may be choosing to disengage at a time when symptom improvement creates space for closer examination of interpersonal issues.
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| 6. |
- Björk, Tabita, et al.
(författare)
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What happened to the ones who dropped out? Outcome in eating disorder patients who complete or prematurely terminate treatment
- 2009
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Ingår i: European eating disorders review. - New York : Wiley. - 1072-4133 .- 1099-0968. ; 17:2, s. 109-119
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: There is a lack of knowledge about the outcome of eating disorder patients who terminate treatment prematurely. The present study followed-up eating disorder patients who had previously dropped out of treatment and examined clinical status 36 months after intake. METHOD: Dropouts (n = 30) were compared with treatment completers (n = 52) on diagnostic status, clinical symptoms, psychosocial adjustment and treatment satisfaction at follow-up. Patterns of change from intake to follow-up within groups, as well as between groups, were explored. RESULTS: No significant differences were found between groups at follow-up, except for more treatment dissatisfaction reported among dropouts. When patterns of change were examined between groups, patients who completed treatment were found to have made significantly greater changes (less eating disorder symptoms, less psychological problems and more positive self-image) compared to dropouts. DISCUSSION: Although no significant differences in outcome were found between dropouts and completers, greater clinical improvement was found among those who completed treatment. The dropouts examined in this study did well despite premature termination of treatment. Clinical and research implications are discussed.
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| 7. |
- Bos (Sparén), Elisabeth, et al.
(författare)
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District nurses' experience of supervising nursing students in primary health care : A pre- and post-implementation questionnaire study.
- 2009
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 9:6, s. 361-366
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Tidskriftsartikel (refereegranskat)abstract
- Nursing students go through clinical supervision in primary health care settings but district nurses' (DNs) circumstances when supervising them are only briefly described in the literature. The aim of this study was to investigate DNs experience of supervising nursing students before and after the implementation of a new supervision model. Ninety-eight (74%) DNs answered a questionnaire before and 84 (65%) after implementation of the new supervision model. The study showed that DNs in most cases felt that conditions for supervision in the workplace were adequate. But about 70% lacked training for the supervisory role and 20% had no specialist district nurse training. They also experienced difficulty in keeping up-to-date with changes in nurse education programmes, in receiving support from the university and from their clinic managers, and in setting aside time for supervision. Improvements after the implementation of a new model chiefly concerned organisation; more DNs stated that one person had primary responsibility for students' clinical practice, that information packages for supervisors and students were available at the health care centres, and that conditions were in place for increasing the number of students they supervised. DNs also stated that supervisors and students benefited from supervision by more than one supervisor. To conclude, implementation of a new supervision model resulted in some improvements.
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| 8. |
- Burström, Bo, et al.
(författare)
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Equitable child health interventions : the impact of improved water and sanitation on inequalities in child mortality in Stockholm, 1878 to 1925.
- 2005
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Ingår i: American Journal of Public Health. - 0090-0036 .- 1541-0048. ; 95:2, s. 208-216
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Tidskriftsartikel (refereegranskat)abstract
- Today, many of the 10 million childhood deaths each year are caused by diseases of poverty--diarrhea and pneumonia, for example, which were previously major causes of childhood death in many European countries. Specific analyses of the historical decline of child mortality may shed light on the potential equity impact of interventions to reduce child mortality. In our study of the impact of improved water and sanitation in Stockholm from 1878 to 1925, we examined the decline in overall and diarrhea mortality among children, both in general and by socioeconomic group. We report a decline in overall mortality and of diarrhea mortality and a leveling out of socioeconomic differences in child mortality due to diarrheal diseases, but not of overall mortality. The contribution of general and targeted policies is discussed.
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| 9. |
- Canvin, Krysia, et al.
(författare)
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Can I risk using public services? Perceived consequences of seeking help and health care among households living in poverty: qualitative study
- 2007
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Ingår i: Journal of Epidemiology and Community Health. - : BMJ. - 0143-005X .- 1470-2738. ; 61:11, s. 984-989
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To improve understanding of how families living in adverse conditions perceive their encounters with public services and how past experiences influence current and future attempts to seek help.Design: Qualitative interviews with adult members of households living in poverty in deprived areas, plus observations conducted in the surrounding neighbourhoods and service settings.Participants: Purposive sample of 25 adults living in a deprived area, on welfare benefits.Setting: Eight sites in disadvantaged areas in Merseyside, North Wales, London and Greater Manchester in 2004/05.Results: Participants generally perceived public services as a source of distrust and a potential risk to well-being. Encounters with a range of services were perceived as risky in terms of losing resources, being misunderstood or harshly judged, and carrying the ultimate threat of losing custody of their children. Participants perceived that they were subjected to increasing levels of surveillance, with fear of “being told on” by neighbours, in addition to service providers, adding to anxiety. Adverse consequences included avoiding child health and social services, anxiety and self-imposed isolation.Conclusions: Approaching services was perceived as akin to taking a gamble that might or might not result in their needs being met. Faced with this “choice”, participants employed strategies to minimise the risks that on the surface may appear risky to health. If public services are to succeed in providing support to disadvantaged families, greater efforts are needed to build trust and demonstrate understanding for the strategies these families use to maintain their well-being against formidable odds.
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| 10. |
- Canvin, Krysia, et al.
(författare)
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Tales of the unexpected? Hidden resilience in poor households in Britain
- 2009
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 69:2, s. 238-245
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Tidskriftsartikel (refereegranskat)abstract
- Society tends to have low expectations for the health, employment, and family stability of people living in poverty and disadvantage, reinforced by a body of research focused on risk factors and negative outcomes. This ‘deficit model’ has pervaded policy and interventions to tackle inequalities in health, in particular in relation to area-based initiatives to improve the health of socio-economically disadvantaged communities. In contrast, the study presented here adopts a positive approach, specifically that of resilience, which we conceptualise as: the process of achieving positive and unexpected outcomes in adverse conditions. Taking account of the critiques of resilience research, we aimed to discover what could be learnt from a health inequalities policy perspective about resilience in poor households in Britain if: a) the voices of people experiencing hardship were heard; b) resilience was conceptualised as a process, rather than as a an individual trait; and c) the social context and conditions that helped or hindered that process of resilience were identified. We interviewed 25 adults with experience of material adversity and 18 social welfare workers with experience of working with people in these circumstances, as well as recording observations at the 13 fieldwork sites in England and Wales. The study provided many “tales of the unexpected” from participants living in disadvantaged circumstances. The participants recounted how they coped with very difficult situations, their achievements in these circumstances, the transitions they had made in their lives and what had helped them along the way. These transitions often occurred contrary to participants' and others' expectations. Interactions that promoted these transitions included family and community support, respectful attitudes and behaviour of service providers, and the chances offered to them to engage in activities that bolstered self-esteem. Recognition of such resilience, however, should complement, rather than detract from, wider societal efforts to reduce the material deprivation in which too many people within the population live.
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