| 1. |
- Pajalic, Oleg, 1964, et al.
(författare)
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An evaluation by elderly people living at home of the prepared meals distributed by their municipality - a study with focus on the Swedish context.
- 2015
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Ingår i: Global journal of health science. - : Canadian Center of Science and Education. - 1916-9744 .- 1916-9736. ; 7:3, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- Prepared meals distributed by municipalities is a service to elderly people, or persons with health related impairments, who live in their own home, have difficulties preparing their own food and cannot meet their food requirements in any other way. This study aimed to provide a brief picture of how elderly people living at home perceive the food they receive through their municipal food service and what is important to them. The data was collected using questionnaires. 274 out of 276 participants answered the questionnaire (n=173 women 62% and n=101 man 37%). The data was analyzed using Principal Component Analysis (PCA). The results showed that the elderly persons receiving meals through the service were often satisfied, especially with the size of the portions and the delivery time. Those who had been using the food delivery service for a longer time were not satisfied with the alternative dishes they were been offered. There was no significant difference between the views of either gender. Further, those who were receiving special food were, in general, unsatisfied with the meals delivered. Development of the food distribution service by systematic quality insurance and interactive knowledge exchange between the producers and consumers seems to be a way to promote a more holistic and individual adjusted service. Evaluation of the municipal FD service is a powerful tool that can contribute to the development of this service. The food service can be improved and consequently even the quality of life and health of its receivers. The present survey should be revisited and developed in order to detect differences between genders.
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| 2. |
- Pajalic, Zada, et al.
(författare)
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Women's education and profession midwifery in Nordic countries
- 2019
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Ingår i: Journal of Health Sciences. - : University of Sarajevo Faculty of Health Sciences. - 2232-7576 .- 1986-8049. ; 9:3, s. 127-135
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Forskningsöversikt (refereegranskat)abstract
- Introduction: Help at birth is one of the historically oldest volunteers supports that a woman has offered to another woman. One of the reasons for high maternal and infant mortality was identified as a lack of basic medical knowledge among the woman who helped during birth and this required immediate action to secure the survival of nations. When the Church and government made demands for education and professional license, the voluntary help at birth transformed into an educated and paid profession for women. The study aimed to describe the evolution of women’s education and the midwifery profession in Nordic countries from the 1600s until today. Methods: Historical and contemporary documents, research and grey literature, are drawn together to provide a historical description of the midwifery professional development and education in Nordic countries. Results: In the Nordic countries, governments from the 1600s had significant problems with high maternal and infant mortality. Most vulnerable were unmarried women and their children. To change the trend, northern countries had been inspired by France, Holland, England, and Germany, which had introduced education and a professional license for midwives. The targeted and systematic investment in midwifery education, followed by industrialization and welfare development in Nordic countries, has resulted in one of the highest survival rates for mothers and infants in the world today. In parallel with this, it has created the first female paid profession in history. Today, midwifery education is at the university level in all Nordic countries, and the certified midwife is responsible for pre- and post-natal care and normal birth. In Sweden, Norway, and Iceland, the midwife’s responsibility also includes contraception counseling and prescription of drugs for birth control purposes. Conclusions: The education and professional licenses have contributed to a progressively improved care of birth women and infants. The professional and licensed midwife is positioned in society as an essential player in the current development of pre- and post-natal care. Furthermore, the graduated and licensed midwife positioned herself as the first paid professional female profession in modern history.
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| 3. |
- Pajalic, Zada, et al.
(författare)
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Computer-based training program for health- and acre professionals involved in breastfeeding support, an intervention project that involve decision makers, professionals and care users
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- There is an urgent need to facilitate the development of more effective breastfeeding support strategies. The desired research will focus on knowledge-based service innovation that include intervention in form of computer-based training program aimed for training of health and care professionals involved in breastfeeding support. The intervention in the proposed study will contribute to more effective adoption of new knowledge in healthcare organisations. Further, the proposed project will be organised as an interdisciplinary and crosswise sectorial collaboration and will be customized at a national and international level, by involving decision-makers, researchers, health care professionals and care users. Ambition with this project is to contribute to increased breastfeeding frequency by increasing competence in professional support in related healthcare services and midwife education program. There is also an urgent need for evidence based technical solutions as a professional support for the professionalsto more effectively implement new research in practice. This project will contribute health care with high quality and resource use. The overall aim for the project is to implement and evaluate new innovative solutions in order to improve long-term strategies for professional support and quality of care, related to knowledge-based breastfeeding support. The design method for the project is longitudinal randomized controlled intervention trial. The intervention will be computer-based training education program developed in collaboration with decision-makers, professionals and researchers. Data will be gained before and after intervention by using: Breastfeeding attitudes among counselling health professionals (An instrument based on WHO standards was developed to measure breastfeeding attitudes), Mother-to-infant Relation and Feelings (MIRF) scale and Mother-Perceived-Professional-Professional support (MoPPS) scale. For successful intervention, it is important that decision-makers are involved in the researchprocess, so that suggested changes can be possible if they actively participate and encourage the project as well as the adoption of research results in practice. Involvement of stakeholders in the research demand facilitation of the research process. This can enable cooperation by using project management techniques as co-counselling and clinical reflection. The outcome of the project will be multiple may be placed in a regional, national, international or global context. Firstly, the project will contribute to development of knowledge-based professionals’ competence with focus on to support breastfeeding from first breastfeeding time, to minimise usage of infant formula during first week of life, longer exclusive- and predominant breastfeeding and stronger connection between mother and child. This topic will fit with theme Nutrition and Lactation.
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| 4. |
- 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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| 5. |
- Nyberg, Maria, et al.
(författare)
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The meal as a performance : Food and meal practices beyond health and nutrition
- 2018
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Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 38:1, s. 83-107
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Tidskriftsartikel (refereegranskat)abstract
- The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to investigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman's concept of performance as a theoretical framework together with Bourdieu's thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi-structured interviews were conducted with 14 elderly people (aged between 67 and 87 years) and meal observations were carried out with 11 of these people. Participants were found to manage food and meal practices by continuously adjusting and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the facąde and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as 'fuel' where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance.
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| 6. |
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| 7. |
- Buckley, Sarah, et al.
(författare)
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Maternal and newborn plasma oxytocin levels in response to maternal synthetic oxytocin administration during labour, birth and postpartum : a systematic review with implications for the function of the oxytocinergic system
- 2023
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The reproductive hormone oxytocin facilitates labour, birth and postpartum adaptations for women and newborns. Synthetic oxytocin is commonly given to induce or augment labour and to decrease postpartum bleeding.AIM: To systematically review studies measuring plasma oxytocin levels in women and newborns following maternal administration of synthetic oxytocin during labour, birth and/or postpartum and to consider possible impacts on endogenous oxytocin and related systems.METHODS: Systematic searches of PubMed, CINAHL, PsycInfo and Scopus databases followed PRISMA guidelines, including all peer-reviewed studies in languages understood by the authors. Thirty-five publications met inclusion criteria, including 1373 women and 148 newborns. Studies varied substantially in design and methodology, so classical meta-analysis was not possible. Therefore, results were categorized, analysed and summarised in text and tables.RESULTS: Infusions of synthetic oxytocin increased maternal plasma oxytocin levels dose-dependently; doubling the infusion rate approximately doubled oxytocin levels. Infusions below 10 milliunits per minute (mU/min) did not raise maternal oxytocin above the range observed in physiological labour. At high intrapartum infusion rates (up to 32 mU/min) maternal plasma oxytocin reached 2-3 times physiological levels. Postpartum synthetic oxytocin regimens used comparatively higher doses with shorter duration compared to labour, giving greater but transient maternal oxytocin elevations. Total postpartum dose was comparable to total intrapartum dose following vaginal birth, but post-caesarean dosages were higher. Newborn oxytocin levels were higher in the umbilical artery vs. umbilical vein, and both were higher than maternal plasma levels, implying substantial fetal oxytocin production in labour. Newborn oxytocin levels were not further elevated following maternal intrapartum synthetic oxytocin, suggesting that synthetic oxytocin at clinical doses does not cross from mother to fetus.CONCLUSIONS: Synthetic oxytocin infusion during labour increased maternal plasma oxytocin levels 2-3-fold at the highest doses and was not associated with neonatal plasma oxytocin elevations. Therefore, direct effects from synthetic oxytocin transfer to maternal brain or fetus are unlikely. However, infusions of synthetic oxytocin in labour change uterine contraction patterns. This may influence uterine blood flow and maternal autonomic nervous system activity, potentially harming the fetus and increasing maternal pain and stress.
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| 8. |
- Nyberg, Maria, et al.
(författare)
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Eating Difficulties, Nutrition, Meal Preferences and Experiences Among Elderly : A Literature Overview From a Scandinavian Context
- 2015
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Ingår i: Journal of Food Research. - : Canadian Center of Science and Education. - 1927-0887 .- 1927-0895. ; 4:1, s. 22-37
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Tidskriftsartikel (refereegranskat)abstract
- The risk of malnutrition increases with ageing, resulting in poorer health and higher risk of disease. Eating difficulties are important risk factors for malnutrition. Moreover, independence in relation to food and meals is highly rated by the elderly and has been associated with health and well-being. The purpose of this literature overview was to provide insights into nutritional status, food choice and preferences as well as the meal situations of home-living elderly (65+) people with motoric eating difficulties focusing on Scandinavia. The overall aim is to support independence and to prevent malnutrition. Nutritional status in the elderly was found to be negatively influenced by motoric eating difficulties including problems with manipulating food on the plate and transporting food to the mouth. Motoric eating difficulties may result in practical simplifications such as use of pre-prepared meals, less advanced cooking, and omission of certain meal constituents in order to avoid e.g. mismanagement and spillage. Eating difficulties are often accompanied by feelings of guilt and shame. Choosing smaller portions, reducing the number of eating episodes and not cooking independently have been associated with a higher risk of malnutrition. The nutritional effects of eating difficulties may be exacerbated by diminished chemosensory functions. Furthermore, both past and present food preferences should be considered in order to meet nutritional needs and meal satisfaction. Development of refined and socially accepted eating aids, in combination with tasty and nutritious products, is important in order to promote healthy and independent living among home-living elderly with motoric eating difficulties.
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| 9. |
- Pajalic, Zada, et al.
(författare)
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How the professionals can identify needs for improvement and improve Food Distribution service for the home-living elderly people in Sweden : an action research project
- 2013
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 3:8, s. 29-40
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Tidskriftsartikel (refereegranskat)abstract
- Background: Making changes to municipal social care and service has been found to be challenging to realise and highly multifaceted. The aim of this study was to describe how the professionals can identify needs for improvement and improve Food Distribution (FD) service for the home-living elderly people in Sweden.Methods: This study is part of a larger project with an action research approach focusing on to municipal FD to older people living in their own home in Sweden. The professionals involved in FD invited the first author to assist them in this process. The study participants were comprised of the following groups: “The Identification focus group” that identified need for improvement of FD (n= 5); “The Action focus group” that planned and choose suitable ‘action’ for improvement (n=5); “The First Evaluation group” (n=4) that evaluated the content of planned improvement and finally “The Second Evaluation group” (n=29) that evaluated the changes following improvement. The data was gathered and analysed by Story Dialogue Method.Results: The need to update and increase the FD recipient’s knowledge in nutrition by sending them informative letters was found to be an important area to focus on. The information letters (n=1700) were distributed to the all FD recipients in six municipalities in southern Sweden during April 2011. The results were evaluated during May 2011. The overall general estimation was that the content of the letters indicated that this was a suitable method for gaining information to make a nutrition competence update. Following this, “The Action focus group” decided: firstly, to continue preparing and distributing information letters to all FD recipients to be sent out twice a year, and secondly: to make the information letters accessible on the websites of the six municipalities and county councils involved.Conclusions: This study showed that systematic work inspired by an action research approach with motivated and involved participants can be beneficial and a starting point for the process of change in municipal service and care practice. The major conclusion of the study was that systematic reflection over everyday practice can be the vehicle for the future change of practice. The research process and the findings have implications for nursing, care of the elderly and gerontology.
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| 10. |
- Pajalic, Zada, 1967-, et al.
(författare)
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The experiences of elderly people living at home related to their receiving meals distributed by a municipality in Sweden
- 2012
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Ingår i: Journal of Food Research. - : Canadian Center of Science and Education. - 1927-0887 .- 1927-0895. ; 1:1, s. 68-78
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to describe the experiences of elderly people, living at home who receive hot meals that are distributed by their municipality. Qualitative content analysis was used to analyse the (n=13) interviews. The results showed that feelings of dependency, loneliness and gratitude were expressed by the participants in the study related to their meals being delivered home. Dependency was expressed as not having influence over the food products the meals were made from. Loneliness was expressed as being isolated and being confined at home alone due to difficulties getting out of the house, which was associated with the costs of taxis transportation. Gratitude was expressed by the sincere thanks for the possibility of receiving traditional meals delivered daily.The major conclusion of the study was the indication that greater attention should be paid to meet both the practical and psychological needs of elderly people.
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