| 1. |
- Abbasi, Seyed H, et al.
(författare)
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Ethnic differences in the risk factors and severity of coronary artery disease : a patient-based study in Iran
- 2018
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Ingår i: Journal of Racial and Ethnic Health Disparities. - : Springer Berlin/Heidelberg. - 2197-3792 .- 2196-8837. ; 5:3, s. 623-631
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Tidskriftsartikel (refereegranskat)abstract
- Background Diverse ethnic groups may differ regarding the risk factors and severity of coronary artery disease (CAD). This study sought to assess the association between ethnicity and CAD risk and severity in six major Iranian ethnic groups.Methods In this study, 20,165 documented coronary artery disease patients who underwent coronary angiography at a tertiary referral heart center were recruited. The demographic, laboratory, clinical, and risk factor data of all the patients were retrieved. The Gensini score (an indicator of CAD severity) was calculated for all, and the risk factors and severity of CAD were compared between the ethnical groups, using adjusted standardized residuals, Kruskal–Wallis test, and multivariable regression analysis.Results The mean age of the participants (14,131 [70.1%] men and 6034 [29.9%] women) was 60.7 ± 10.8 years. The Fars (8.7%) and Gilak (8.6%) ethnic groups had the highest prevalence of ≥4 simultaneous risk factors. The mean Gensini score was the highest for the Gilaks (77.1 ± 55.9) and the lowest among the Lors (67.5 ± 52.8). The multivariable regression analysis showed that the Gilaks had the worst severity (β 0.056, 95% CI 0.009 to 0.102; P = 0.018), followed by the Torks (β 0.032, 95% CI 0.005 to 0.059; P = 0.020). Meanwhile, the Lors showed the lowest severity (β −0.087, 95% CI −0.146 to −0.027; P = 0.004).Conclusions This study found that there was heterogeneity in CAD severity and a diverse distribution in its well-known traditional risk factors among major Iranian ethnic groups.
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| 2. |
- Abbasi, Seyed H, et al.
(författare)
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Gender Differences in the Risk of Coronary Artery Disease in Iran
- 2012
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Ingår i: Iranian Journal of Public Health. - 0304-4556. ; 41:3, s. 36-47
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Tidskriftsartikel (refereegranskat)abstract
- Background: Given gender differences in the risk of coronary artery disease (CAD), the present study sought to investigate these dissimilarities amongst patients who underwent angiography at a major, tertiary heart hospital in Iran. Methods: Between 2005 and 2010, 44,820 patients who underwent coronary angiography were enrolled in a registry. Pre-procedural data such as demographics, CAD risk factors, presenting symptoms, and laboratory tests, as well as postprocedural data were collected. The data were, subsequently, compared between the men and women. Results: Out of the 44,820 patients (16,378 women), who underwent coronary angiography, 37,358 patients (11,995 women) had CAD. Amongst the CAD patients, the females were not only significantly older, less educated, and more overweight than were the males but also had higher levels of triglyceride, cholesterol, low-density lipoprotein, highdensity lipoprotein, and fasting blood sugar (P< 0.001). Of all the risk factors, hypertension and diabetes mellitus showed the strongest association in our female CAD patients (OR=3.45, 95%CI: 3.28-3.61 and OR=2.37, 95%CI: 2.26- 2.48, respectively). Acute coronary syndrome was more prevalent in the men (76.1% vs. 68.6%, P< 0.001), and chronic stable angina was more frequent in the females (31.4% vs. 23.9%, P< 0.001). With respect to post-procedural recommendations, the frequency of recommendations for non-invasive modalities was higher in the females (20.1% vs. 18.6%, P< 0.001). Conclusion: Hypertension and diabetes mellitus had the strongest association with CAD in our female patients. In the extensive CAD patients, medical treatment was recommended to the women more often.
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| 3. |
- Abbasi, Seyed Hesameddin, et al.
(författare)
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Mortality from Acute Coronary Syndrome: Does Place of Residence Matter?
- 2022
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Ingår i: Journal of Teheran University Heart Center. - : Tehran University of Medical Sciences. - 1735-8620 .- 2008-2371. ; 17:2, s. 56-61
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Tidskriftsartikel (refereegranskat)abstract
- Background: Current evidence shows inequality in the outcomes of rural and urban patients treated at their place of residence. This study compared in-hospital mortality between rural and urban patients with acute coronary syndrome (ACS) to find whether there were differences in the outcome and received treatment.Methods: Between May 2007 and January 2018, patients admitted with ACS were included. The patients’ demographic, clinical, and laboratory data, as well as their in-hospital medical courses, were recorded. The association between place of residence (rural/urban) and in-hospital mortality due to ACS was evaluated using logistic regression adjusted for potential confounders.Results: Of 9088 recruited patients (mean age =61.30±12.25 y; 5557 men [61.1%]), 838 were rural residents. A positive family history of coronary artery disease (P=0.003), smoking (P=0.002), and hyperlipidemia (P=0.026), as well as a higher body mass index (P=0.013), was seen more frequently in the urban patients, while the rural patients had lower education levels (P<0.001) and higher unemployment rates (P=0.009). In-hospital mortality occurred in 135 patients (1.5%): 10 rural (1.2%) and 125 urban (1.5%) patients (P=0.465). The Firth regression model, used to adjust the effects of possible confounders, showed no significant difference concerning in-hospital mortality between the rural and urban patients (OR, 1.57; 95% CI, 0.376 to 7.450; P=0.585).Conclusion: This study found no significant differences in receiving proper treatment and in-hospital mortality between rural and urban patients with ACS.
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| 4. |
- Abbasi, Seyed, et al.
(författare)
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Socioeconomic status and in hospital mortality of acute corony syndrome: Can education and occupation serves as preventive measures?
- 2015
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Ingår i: International Journal of Preventive Medicine. - : Medknow. - 2008-7802 .- 2008-8213. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Socioeconomic status (SES) can greatly affect the clinical outcome of medical problems. We sought to assess the in‑hospital mortality of patients with the acute coronarysyndrome (ACS) according to their SES.Methods: All patients admitted to Tehran Heart Center due to 1st‑time ACS between March 2004 and August 2011 were assessed. The patients who were illiterate/lowly educated (≤5 years attained education) and were unemployed were considered low‑SES patients and those who were employed and had high educational levels (>5 years attained education) were regarded as high‑SES patients. Demographic, clinical, paraclinical, and in‑hospital medical progress data were recorded. Death during the course of hospitalization was considered the end point, and the impact of SES on in‑hospital mortality was evaluated.Results: A total of 6246 hospitalized patients (3290 low SES and 2956 high SES) were included (mean age = 60.3 ± 12.1 years, male = 2772 [44.4%]). Among them, 79 (1.26%) patients died. Univariable analysis showed a significantly higher mortality rate in the low‑SES group (1.9% vs. 0.6%; P < 0.001). After adjustment for possible cofounders, SES still showed a significant effect on the in‑hospital mortality of the ACS patients in that the high‑SES patients had a lower in‑hospital mortality rate (odds ratio: 0.304, 95% confidence interval: 0.094–0.980; P = 0.046).Conclusions: This study found that patients with low SES were at a higher risk of in‑hospital mortality due to the ACS. Furthermore, the results suggest the need for increased availability of jobs as well as improved levels of education as preventive measures to curb the unfolding deaths owing to coronary artery syndrome.
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| 5. |
- Ahonen-Jonnarth, Ulla, et al.
(författare)
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Organic acids produced by mycorrhizal Pinus sylvestris exposed to elevated aluminium and heavy metals concentrations
- 2000
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Ingår i: New Phytologist. - : Wiley. - 0028-646X .- 1469-8137. ; 146:3, s. 557-567
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Tidskriftsartikel (refereegranskat)abstract
- A cultivation method was developed to enable exposure of ectomycorrhizal plants with intact extramatrical mycelium to solutions containing different concentrations of aluminium or heavy metals. Pinus sylvestris seedlings colonized by Suillus variegatus (two isolates), Rhizopogon roseolus or Paxillus involutus (two isolates) were used. Seedlings were transferred to Petri dishes containing glass beads and exposed to elevated concentrations of Al, Cd, Cu, or Ni in two ways: immediately following transfer; and after allowing mycorrhizal seedlings to develop an extraradical mycelium that colonized the interface between the upper surface of the beads and the metal-containing solution. Production of organic acids in mycorrhizal and non-mycorrhizal systems was measured by withdrawing samples from the solution and analyzing by HPLC. In most experiments, levels of oxalic acid were significantly higher in mycorrhizal treatments than in non-mycorrhizal controls. The measured levels of organic acids were variable, but the results obtained suggest that production of oxalic acid is stimulated by exposure to elevated Al in mycorrhizal seedlings colonized by S. variegatus and R. roseolus. Elevated Al concentrations also increased oxalic acid production by non-mycorrhizal seedlings significantly in two of four Al experiments performed, but the measured concentrations were significantly lower than in corresponding mycorrhizal treatments in both cases. Malonic acid was found in the culture solution of non-mycorrhizal had P. involutus-colonized seedlings, but only trace amounts were found in S. variegatus or R. roseolus-infected seedlings. Citric, shikimic, lactic, acetic, propionic, fumaric, formic, iso-butyric and butyric acid were found in variable concentrations. Production of oxalic acid by seedlings ColoniZed by S. variegatus BL or P. involutus was not stimulated by exposure to 0.44 μM Cd or 17 μM Ni. Exposure to 0.157 mM CU in two separate experiments using P. involutus 87.017 and two strains of S. variegatus (BL and 159) appeared to stimulate production of oxalic acid irrespective of mycorrhizal status or species.
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| 6. |
- An, Siwen, et al.
(författare)
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Signal-to-Noise Ratio Optimization in X-ray Fluorescence Spectrometry for Chromium Contamination Analysis
- 2021
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Ingår i: Talanta. - : Elsevier BV. - 0039-9140 .- 1873-3573. ; 230
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Tidskriftsartikel (refereegranskat)abstract
- In most cases, direct X-ray fluorescence (XRF) analysis of solutions entails technical difficulties due to a high X-ray scattering background resulting in a spectrum with a poor signal-to-noise ratio (SNR). Key factors that determine the sensitivity of the method are the energy resolution of the detector and the amount of scattered radiation in the energy range of interest. Limiting the width of the primary spectrum by the use of secondary targets, or filters, can greatly improve the sensitivity for specific portions of the spectrum. This paper demonstrates a potential method for SNR optimization in direct XRF analysis of chromium (Cr) contamination. The suggested method requires minimal sample preparation and achieves higher sensitivity compared to existing direct XRF analysis. Two states of samples, fly ash and leachate from municipal solid waste incineration, were investigated. The effects of filter material, its absorption edge and filter thickness were analyzed using the combination of Monte Carlo N-Particle (MCNP) code and energy-dispersive XRF spectrometry. The applied filter removes primary photons with energies interfering with fluorescence photons from the element of interest, thus results in lower background scattering in the spectrum. The SNR of Cr peak increases with filter thickness and reaches a saturation value when further increased thickness only increases the measurement time. Measurements and simulations show that a Cu filter with a thickness between 100 μm and 140 μm is optimal for detecting Cr by taking into account both the SNR and the exposure time. With direct XRF analysis for solutions, the limit of quantitation (LOQ) of the achieved system was 0.32 mg/L for Cr, which is well below the allowed standard limitation for landfills in Sweden. This work shows that XRF can gain enough sensitivity for direct monitoring to certify that the Cr content in leachate is below environmental limits.
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| 7. |
- Andersson, Erik P., 1984-, et al.
(författare)
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Physiological responses and performance factors for double-poling and diagonal-stride treadmill roller-skiing time-trial exercise
- 2023
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Ingår i: European Journal of Applied Physiology. - : Springer. - 1439-6319 .- 1439-6327. ; 123:11, s. 2495-2509
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare physiological responses between a self-paced 4-min double-poling (DP) time-trial (TTDP) versus a 4-min diagonal-stride (DS) time-trial (TTDS). The relative importance of peak oxygen uptake (V ˙ O2peak), anaerobic capacity, and gross efficiency (GE) for projection of 4-min TTDP and TTDS roller-skiing performances were also examined. Methods: Sixteen highly trained male cross-country skiers performed, in each sub-technique on separate occasions, an 8 × 4-min incremental submaximal protocol, to assess individual metabolic rate (MR) versus power output (PO) relationships, followed by a 10-min passive break and then the TTDP or TTDS, with a randomized order between sub-techniques. Results: In comparison to TTDS, the TTDP resulted in 10 ± 7% lower total MR, 5 ± 4% lower aerobic MR, 30 ± 37% lower anaerobic MR, and 4.7 ± 1.2 percentage points lower GE, which resulted in a 32 ± 4% lower PO (all P < 0.01). The V ˙ O2peak and anaerobic capacity were 4 ± 4% and 30 ± 37% lower, respectively, in DP than DS (both P < 0.01). The PO for the two time-trial (TT) performances were not significantly correlated (R 2 = 0.044). Similar parabolic pacing strategies were used during both TTs. Multivariate data analysis projected TT performance using V ˙ O2peak, anaerobic capacity, and GE (TTDP, R 2 = 0.974; TTDS, R 2 = 0.848). The variable influence on projection values for V ˙ O2peak, anaerobic capacity, and GE were for TTDP, 1.12 ± 0.60, 1.01 ± 0.72, and 0.83 ± 0.38, respectively, and TTDS, 1.22 ± 0.35, 0.93 ± 0.44, and 0.75 ± 0.19, respectively. Conclusions: The results show that a cross-country skier’s “metabolic profile” and performance capability are highly sub-technique specific and that 4-min TT performance is differentiated by physiological factors, such as V ˙ O2peak, anaerobic capacity, and GE.
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| 8. |
- Andreassen Devik, Siri, et al.
(författare)
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Meanings of being old, living on one's own and suffering from incurable cancer in rural Norway
- 2013
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Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 17:6, s. 781-787
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to explore and understand the lived experience of older people living alone and suffering from incurable cancer in rural Norway. Methods and sample: Narrative interviews were conducted with five older people with incurable cancer (three women and two men, aged 71-79), receiving outpatient and life-prolonging chemotherapy and living alone in their homes in rural areas. A phenomenological hermeneutical approach was used to interpret the meaning of the lived experience. Key results: Four main themes were found: enduring by keeping hope alive, becoming aware that you are on your own, living up to expectations of being a good patient and being at risk of losing one's identity and value. Enduring this situation means struggling with terminal illness and facing death in a brave manner, and replacing former ways of living. The process of providing treatment may threaten dignity and cause additional distress. Conclusions: These results show a complex and comprehensive situation where physical symptoms and emotions are interwoven. Further the results describe how the ways of suffering caused by the manner in which care is delivered, suffering related to the cancer disease and existential suffering, may increase each other's impact. The social and rural context calls for special attention as the patients may lack recourses to gain sufficient care. Their comfort depends to a large extent on the health professionals' sensitivity. © 2013 Elsevier Ltd.
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| 9. |
- Andreassen Devik, Siri, et al.
(författare)
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Nurses’ experiences of compassion when giving palliative care at home
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:1, s. 194-205
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Tidskriftsartikel (refereegranskat)abstract
- Background: Compassion is seen as a core professional value in nursing and as essential in the effort of relieving suffering and promoting well-being in palliative care patients. Despite the advances in modern healthcare systems, there is a growing clinical and scientific concern that the value of compassion in palliative care is being less emphasised.Objective: This study aimed to explore nurses’ experiences of compassion when caring for palliative patients in home nursing care. Design and participants: A secondary qualitative analysis inspired by hermeneutic circling was performed on narrative interviews with 10 registered nurses recruited from municipal home nursing care facilities in Mid-Norway. Ethical considerations: The Norwegian Social Science Data Services granted permission for the study (No. 34299) and the re-use of the data.Findings: The compassionate experience was illuminated by one overarching theme: valuing caring interactions as positive, negative or neutral, which entailed three themes: (1) perceiving the patient’s plea, (2) interpreting feelings and (3) reasoning about accountability and action, with subsequent subthemes.Discussion: In contrast to most studies on compassion, our results highlight that a lack of compassion entails experiences of both negative and neutral content.Conclusion: The phenomenon of neutral caring interactions and lack of compassion demands further explorations from both a patient – and a nurse perspective.
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| 10. |
- Andreassen Devik, Siri, et al.
(författare)
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"Picking up the pieces" - Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area
- 2015
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa Healthcare. - 1748-2623 .- 1748-2631. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Rural home nursing care is a neglected area in the research of palliative care offered to older cancer patients. Because access to specialized services is hampered by long distances and fragmented infrastructure, palliative care is often provided through standard home nursing services and delivered by general district nurses. This study aimed to illuminate the lived experience and to interpret the meaning of receiving home nursing care when being old and living with advanced cancer in a rural area in Norway. Narrative interviews were conducted with nine older persons, and a phenomenological hermeneutic approach was used to interpret the meaning of the lived experience. The analysis revealed three themes, each with subthemes: being content with what one gets, falling into place, and losing one's place. The phrase picking up the pieces was found useful to sum up the meaning of this lived experience. The three respective themes refer to how the pieces symbolize the remaining parts of life or available services in their environment, and how the older persons may see themselves as pieces or bricks in a puzzle. A strong place attachment (physical insideness, social insideness, and autobiographical insideness) is demonstrated by the informants in this study and suggests that the rural context may provide an advantageous healthcare environment. Its potential to be a source of comfort, security, and identity concurs with cancer patients’ strong desire for being seen as unique persons. The study shows that district nurses play an essential role in the provision of palliative care for older rural patients. However, the therapeutic value of being in one's familiar landscape seems to depend on how homecare nurses manage to locate it and use it in a more or less person-centred manner. Communication skills and attentiveness to psychosocial aspects of patient care stand out as important attributes for nursing in this context.
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