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Sökning: swepub > Umeå universitet > Tidskriftsartikel > (1995-1999) > (1998)

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  • Hellzén, Ove, et al. (författare)
  • From optimism to pessimism : A case study of a psychiatric patient
  • 1998
  • Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 7:4, s. 360-370
  • Tidskriftsartikel (refereegranskat)abstract
    • This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a fifty year old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. The data collection using five methods occurred during a 21 months period. Results of the content analyses processes identified four distinct but indiscreet phases of the patient’s complex condition. The medical and nursing care was categorised in three approaches: optimistic, strategic and resigned. The results raise the question whether there is action that is without any meaning as an expression of the patient´s wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his "real" self. His experience was that of a splintered world.
  • Ahlm, Clas, et al. (författare)
  • Prevalence of antibodies specific to Puumala virus among farmers in Sweden
  • 1998
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - 0355-3140. ; 24:2, s. 104-108
  • Tidskriftsartikel (refereegranskat)abstract
    • Serological evidence confirmed that the exposure of humans to Puumala virus is firmly restricted to the northern and central parts of Sweden. In addition the evidence indicated that, in this region, farming is associated with an increased risk of contracting hantavirus infection.
  • Hellström, Olle, et al. (författare)
  • Doctors' attitudes to fibromyalgia : a phenomenological study
  • 1998
  • Ingår i: Scandinavian Journal of Social Medicine. - Taylor & Francis. - 0300-8037. ; 26:3, s. 232-237
  • Tidskriftsartikel (refereegranskat)abstract
    • Besides specific technical skills, successful encounters with patients require an understanding of the many ways in which patients may express themselves. This qualitative study reports on the clinical experiences of doctors when meeting patients with fibromyalgia (FM). Ten strategically chosen rheumatologists and 10 GPs in central Sweden were interviewed. The interviews were taped, transcribed and analysed in accordance with the empirical, phenomenological, psychological method. The analyses indicate that doctors try to comply with the wishes and demands of patients, and at the same time avoid perceptions of personal frustration. They are inclined to be objective and to act instrumentally, apparently in order to keep in touch with what gave biomedical meaning to an otherwise incomprehensible phenomenon. The meaning structures revealed by doctors' descriptions of FM and of relating to FM patients were characterized mainly by the way in which the doctors were (i) managing their clinical uncertainty, (ii) adhering to the biomedical paradigm, (iii) prioritizing diagnostics, (iv) establishing an instrumental relationship, and (v) avoiding recognizing FM as a possible biomedical anomaly.
  • Klefbeck, B, et al. (författare)
  • Obstructive sleep apneas in relation to severity of cervical spinal cord injury.
  • 1998
  • Ingår i: Spinal Cord. - 1362-4393. ; 36:9, s. 611-628
  • Tidskriftsartikel (refereegranskat)abstract
    • Thirty-three subjects (28 men, five women) with complete or incomplete cervical cord injury representing a wide range of neurological impairment were investigated with regard to the prevalence of Obstructive Sleep Apnea (OSA). The relation between OSA and neurological function, respiratory capacity, body mass index and symptoms associated with OSA were studied. Overnight sleep recordings employed combined oximetry and respiratory movement monitoring. Pulmonary function tests included static and dynamic spirometry, maximal static inspiratory and expiratory pressures at the mouth. The subjects answered a questionnaire concerning sleep quality and tiredness. The prevalence of OSA was 15% (5/33) in this nonobese cervical cord injury study population. Nine percent of the subjects (3/33) fulfilled the criteria for obstructive sleep apnea syndrome, but daytime sleepiness or fatigue were also common in subjects without OSA. There was an inverse correlation between oxygen desaturation index and American Spinal Injury Association (ASIA) motor score in the subjects with complete injury, while there was no such correlation in the whole study group. There were significant correlations between maximal inspiratory and expiratory pressures and vital capacity and between ASIA motor score and vital capacity.
  • Skold, C, et al. (författare)
  • Simultaneous Ashworth measurements and electromyographic recordings in tetraplegic patients.
  • 1998
  • Ingår i: Archives of Physical Medicine and Rehabilitation. - Elsevier. - 0003-9993. ; 79:8, s. 959-965
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: A recent prevalence study of 353 spinal cord injured (SCI) individuals in the greater Stockholm area showed problematic spasticity in 30% of this population. To treat spasticity, the evaluation becomes crucial. The modified Ashworth scale (MAS) is the clinically most-used scale to grade degree of spasticity. This study evaluated whether the MAS correlated with electromyographic (EMG) recordings of muscle activity.STUDY DESIGN: This cross-sectional study was performed at an outpatient clinic that has the responsibility to do a standardized, yearly follow-up of all SCI patients in the greater Stockholm area. Thirty-eight SCI individuals met the inclusion criteria; 15 of the 38 were randomly selected for the study. They were all motor-complete tetraplegic men; mean age was 33 years and mean time since injury was 9 years. Spasticity evaluation was performed by flexing and extending the knees during simultaneous EMG recordings and MAS assessment of the thigh muscle activity.RESULTS: Eighty percent of the individual EMG recordings correlated significantly with the corresponding Ashworth measurements. The spastic resistance, as measured both clinically and electromyographically, was stronger and lasted longer during extension than flexion movements. Spearman coefficients for correlation of quantitative spasticity measures with MAS grades were calculated. EMG and clinical measures of spasticity were more closely correlated for flexion movements. Among EMG parameters, duration of movement-associated electrical activity invariably correlated significantly with the MAS grades (p < .05). Furthermore, Ashworth measurements of movement-associated spasticity showed a positive correlation with the EMG parameters mean, peak, and start to peak of electrical activity. Each increasing grade on the MAS corresponded to increasing myoelectric activity levels for each movement.CONCLUSION: EMG parameters were significantly positively correlated with simultaneous MAS measurements of the spastic muscle contraction. The Ashworth scale may therefore accurately reflect the movement-provoked spasticity in motor-complete tetraplegic patients.
  • Westgren, N, et al. (författare)
  • Quality of life and traumatic spinal cord injury.
  • 1998
  • Ingår i: Archives of Physical Medicine and Rehabilitation. - Elsevier. - 0003-9993. ; 79:11, s. 1433-1439
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To determine associations between major outcome variables after traumatic spinal cord injury (SCI) and quality of life (QL).SUBJECTS: Of a total population of 353 SCI patients, 320 participated, 261 men and 59 women living in the greater Stockholm area: 124 were tetraplegic, 176 were paraplegic, and 20 had no classified level. Mean age was 42 years (range, 17 to 78).METHOD: The Swedish SF-36 Health Survey was used to assess QL. The SF-36 is a self-administered questionnaire containing 36 items, divided into 8 multi-item dimensions, covering physical function, physical and emotional role function, social function, bodily pain, mental health, vitality and overall evaluation of health. Neurologic, general medical, and psychosocial variables were obtained from the Stockholm Spinal Cord Injury Study (SSCIS) data base. QL indices were analyzed for the SCI group as a whole, as well as for subgroups. Descriptors for subgroups were demographic variables, presence or absence of common medical problems, and subjective evaluation of the degree of impact of the medical problem on well-being/daily activities.RESULTS: QL in individuals with SCI was significantly lower in all subscales as compared with a normative population. No difference in QL was seen in subgroups according to extent of lesion, with the exception of physical functioning. Several medical complications such as neurogenic pain, spasticity, and neurogenic bladder and bowel problems were associated with lower QL scores.SUMMARY: QL, as defined by SF-36, is better in persons injured many years ago, as compared with those recently injured, suggesting an adaptive process operating over a long period. The presence of complicating medical problems, such as severe pain, problematic spasticity, and incontinence, seem to have more negative effects on QL than the extent of SCI as such.
  • Gustafsson, Jörgen, et al. (författare)
  • The influence of hyperfine structure and isotope shift on the detection of Rb by 2f-wavelength modulation diode laser absorption spectrometry : experimental verification of simulations
  • 1998
  • Ingår i: Spectrochimica Acta Part B - Atomic Spectroscopy. - Elsevier. - 0584-8547. ; 52:14, s. 1895-1905
  • Tidskriftsartikel (refereegranskat)abstract
    • This work presents an experimental verification of a previously developed methodology for simulation of the 2f-wavelength modulation diode laser absorption spectrometry technique (2f-WM-DLAS) when the influence of hyperfine structure, isotope shift and collisional broadening and shift of an atomic transition is taken into account [J. Gustafsson, D. Rojas and O. Axner, Spectrochim. Acta, 52B, 1937-1953 (1997)]. The pilot element in the simulations was Rb, detected at the 780 nm 5s S-2(1/2) - 5p P-2(3/2) transition, in low-pressure cells and atmospheric-pressure reservoirs (e.g. graphite furnaces). This experimental investigation verifies that the simulations are able to predict, with good accuracy, experimental 2f-WM signals from Rb atoms under both low-pressure, room-temperature conditions and atmospheric-pressure, high-temperature conditions. This implies that the previously published simulation methodology can be used for predicting and optimizing 2f-WM signal strengths and shapes from Rb atoms (and thereby presumably also from other atoms) under a variety of pressure and temperature conditions.
  • Ilver, D, et al. (författare)
  • Helicobacter pylori adhesin binding fucosylated histo-blood group antigens revealed by retagging
  • 1998
  • Ingår i: Science. - The American Association for the Advancement of Science. - 1095-9203. ; 279:5349, s. 373-377
  • Tidskriftsartikel (refereegranskat)abstract
    • The bacterium Helicobacter pylori is the causative agent for peptic ulcer disease. Bacterial adherence to the human gastric epithelial lining is mediated by the fucosylated Lewis b (Leb) histo-blood group antigen. The Leb-binding adhesin, BabA, was purified by receptor activity-directed affinity tagging. The bacterial Leb-binding phenotype was associated with the presence of the cag pathogenicity island among clinical isolates of H. pylori. A vaccine strategy based on the BabA adhesin might serve as a means to target the virulent type I strains of H. pylori.
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