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| 2. |
- Boström, Katrin, et al.
(författare)
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Living with a chronic deteriorating disease : the trajectory with muscular dystrophy over ten years.
- 2004
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Ingår i: Disability and rehabilitation. - 1464-5165. ; 26:23, s. 1388-1398
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of the study was to elucidate experiences of living with muscular dystrophy in terms of consequences for activity over 10 years. METHODS: The study population was identified in a prevalence study in a county of Sweden. Forty-six persons of this cohort with MD were interviewed. A qualitative research approach was chosen. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) was used for categorization. RESULTS: Nearly all the subjects experienced a deterioration of physical capacity. Most obvious were the restrictions on mobility and increased fatigue and feebleness. The persons described psychosocial consequences of the muscular dystrophy as well as stigma when the disability had become more obvious. In spite of reported distress several persons experienced better psychological adaptation over time. The image of the future was often dark but several focus on today and avoid thoughts about the future. ICF showed some limitation with regard to temporal aspects, emotions and the subjective perspective. CONCLUSIONS: The knowledge of the trajectory with MD is important in order to offer the best possible treatment and support. Repeated assessment by ICF can serve as a valuable source of such knowledge, and a development of the classification would increase its usefulness in future analysis of functioning and disability.
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| 3. |
- Eggers, Kai, et al.
(författare)
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Diagnostic value of serial measurement of cardiac markers in patients with chest pain : limited value of adding myoglobin to troponin I for exclusion of myocardial infarction
- 2004
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Ingår i: American Heart Journal. - 0002-8703. ; 148:4, s. 574-581
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Despite improved laboratory assays for cardiac markers and a revised standard for definition of myocardial infarction (AMI), early detection of coronary ischemia in unselected patients with chest pain remains a difficult challenge.METHODS:Rapid measurements of troponin I (TnI), creatine kinase MB (CK-MB), and myoglobin were performed in 197 consecutive patients with chest pain and a nondiagnostic electrocardiogram for AMI. The early diagnostic performances of these markers and different multimarker strategies were evaluated and compared. Diagnosis of AMI was based on European Society of Cardiology/American College of Cardiology criteria.RESULTS:At a given specificity of 95%, TnI yielded the highest sensitivity of all markers at all time points. A TnI cutoff corresponding to the 10% coefficient of variation (0.1 microg/L) demonstrated a cumulative sensitivity of 93% with a corresponding specificity of 81% at 2 hours. The sensitivity was considerably higher compared to CK-MB and myoglobin, even considering patients with a short delay until admission. Using the 99th percentile of TnI results as a cutoff (0.07 microg/L) produced a cumulative sensitivity of 98% at 2 hours, but its usefulness was limited due to low specificities. Multimarker strategies including TnI and/or myoglobin did not provide a superior overall diagnostic performance compared to TnI using the 0.1 microg/L cutoff.CONCLUSION:A TnI cutoff corresponding to the 10% coefficient of variation was most appropriate for early diagnosis of AMI. A lower TnI cutoff may be useful for very early exclusion of AMI. CK-MB and in particular myoglobin did not offer additional diagnostic value.
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| 4. |
- Gustafsson, Margareta, et al.
(författare)
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Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury
- 2003
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Ingår i: Journal of Hand Surgery - British and European Volume. - 0266-7681. ; 28:4, s. 332-338
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to estimate the incidence of trauma-related distress and mood disorders in the early stages after acute traumatic hand injuries and identify characteristics associated with these reactions. Data were obtained from 112 patients by means of mailed questionnaires and medical records. Nearly half of the patients had increased levels of intrusive and avoidance symptoms, indicating trauma-related distress. One-third showed signs of a mood disorder. Mood disorders were associated with the need for help with activities of daily living, pain and avoidance symptoms. The study showed that emotional problems in the early stages after injury are related to the consequences of both the injury and the traumatic experience. Negative reactions to the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observation of the reactions to the sight of the hand could help to identify patients in need of psychological support.
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| 5. |
- Nygren, Tobias, et al.
(författare)
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Perceived flavour changes in white wine after tasting blue mould cheese
- 2002
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Ingår i: Food Service Technology. - 1471-5732. ; 2:4, s. 163-171
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Tidskriftsartikel (refereegranskat)abstract
- The object of this study was to evaluate by descriptive sensory analysis how the sensory perception of dry white wines was affected by prior tasting of blue mould cheese. Trained assessors profiled five commercial white wines before and after tasting each of two blue mould cheeses. The study showed that descriptive sensory analysis could be used to quantify changes in the perception of white wines after the consumption of cheese. For all five wines the main findings were that most of the intensities of perceived flavours and acidity decreased after tasting blue mould cheese.
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| 6. |
- Tellström, Richard, et al.
(författare)
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Food culture as a political tool : meal construction during the Swedish EU-chairmanship 2001
- 2003
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Ingår i: Food Service Technology. - 1471-5732. ; 3:2, s. 89-96
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to analyse how the European Union (EU) ministerial meals during Sweden's EU-chairmanship 2001 were devised, and how the official representatives of Sweden chose to interpret and present a national image based on local and regional food identities. The manufacture of the Swedish culinary profile was compared with the same process during Finland's EU-chairmanship 1999 and Denmark's EU-chairmanship 2002. Sixteen professionals involved in the decision-making process in the three countries were interviewed in 2001 and 2002. The regional food profile chosen in Sweden supported different political goals such as the idea of the production of local food and local economic development. Local and regional food culture had a broad and open definition, but the decisions as to what constituted local and regional food culture as served at the ministerial meals were made at the top political level. The central decision-making process transformed the concept of a typical local and regional food culture into a political tool serving political goals, with the end product presented at different EU-ministerial meals.
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| 7. |
- Widar, Marita, et al.
(författare)
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Coping with long-term pain after a stroke
- 2004
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Ingår i: Journal of Pain Symptom and Management. - 0885-3924. ; 27:3, s. 215-225
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.
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| 8. |
- Widar, Marita, et al.
(författare)
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Disability after a stroke and the influence of long-term pain on everyday life
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318. ; 16:3, s. 302-310
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Tidskriftsartikel (refereegranskat)abstract
- Pain after a stroke is a symptom often forgotten, unnoticed although it is reported to be a great problem in care. The aim of this study was to describe disability after a stroke and how long-term pain influences everyday life according to the Multidimensional Pain Inventory - Swedish language version (MPI-S) and to test the reliability of this instrument. Forty-three persons were investigated 2 years after the stroke incident: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain mainly in the shoulder and 10 with tension-type headache. Data collection was performed through the MPI-S and a questionnaire regarding assistive devices, also structured interviews based on the Activities of Daily Living (ADL) staircase and the Self-report impairment questionnaire. The results show that the persons suffered moderate to severe pain. Almost half were dependent in ADL. The most often reported impairments and use of assistive devices concerned mobility and/or motion. This was most frequent in persons with nociceptive pain. There were significant differences in persons with central pain and nociceptive pain compared with tension-type headache with regard to mobility- and/or motion-related activities. No statistical differences emerged between age, gender, different types of pain and the MPI-S scales, nor any significant differences in degree of pain as between different types of pain according to the Self-report impairment questionnaire. The reliability analysis of the MPI-S shows good homogeneity in all scales except Interference, Life Control and Affective Distress. This is the first study with MPI-S on mainly older persons and on stroke patients, thus further research is needed on this instrument as well as on which specific activities evoke the pain. This is in order to offer adequate treatment, care and support to persons with pain after a stroke.
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| 9. |
- Widar, Marita, et al.
(författare)
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Health-related quality of life in persons with long-term pain after a stroke.
- 2004
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Ingår i: Journal of Clinical Nursing. - 0962-1067. ; 13:4, s. 497-505
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke. AIM: The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status. DESIGN: This study has a design combining qualitative and quantitative methods. METHODS: Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used. RESULTS: The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women. CONCLUSION: The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care. RELEVANCE TO CLINICAL PRACTICE: Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.
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| 10. |
- Widar, Marita, et al.
(författare)
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Long-term pain conditions after a stroke
- 2002
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Ingår i: Journal of Rehabilitation Medicine. - 1650-1977. ; 34:4, s. 165-170
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.
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