| 1. |
- Sundin, Karin, et al.
(författare)
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Suffering from care as expressed in the narratives of former patients in somatic wards
- 2000
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 14:1, s. 16-22
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Tidskriftsartikel (refereegranskat)abstract
- To illuminate patients' experiences of suffering from care, ten former patients in somatic wards narrated a desirable care episode (n = 39) and an undesirable care episode (n = 51). The interviews were analysed using a phenomenological hermeneutic method inspired by Ricoeur's philosophy. Four themes were found: having a good rest, suffering through, searching for autonomy and being cared for by attentive and committed staff. The findings were interpreted in light of Eriksson's description of suffering, which describes three kinds of suffering: 'suffering of life', 'suffering of illness' and 'suffering of caring'. Although not mentioned explicitly, it was evident that cases of suffering from care were indicated in the patients' narratives. The themes were related to the patients' states of health, their experience of the care situation and their descriptions of themselves, and could be understood as related to the acts of the 'drama of suffering' described by Eriksson. The study highlights the need for the patient to find a co-actor in the drama of suffering in order to prevent suffering from care, i.e. prevent hindrance to the patient in her/his struggle against the 'suffering of illness' and the 'suffering of life'. The patients must be seen as the directors of their own dramas of suffering.
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| 2. |
- Knutsson, Anders, et al.
(författare)
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Postprandial responses of glucose, insulin and triglycerides : Influence of the timing of meal intake during night work
- 2002
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Ingår i: Nutrition and Health. - : SAGE Publications. - 0260-1060 .- 2047-945X. ; 16, s. 133-141
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to study the postprandial responses of glucose, insulin and triglycerides to meal intake at different clock times during night work. Eleven night shift working nurses participated. Identical test meals were ingested at 19:30, 23:30 and 03:30, and contained 440 kcal/ 1860 kJ of energy (33 E% fat, 51 E% carbohydrate, 16 E% protein). The food intake was standardized three days before the first test meal. Blood samples were drawn just before the test meals were ingested and thereafter at 30, 60, 90, 120, 180 and 240 minutes. The postprandial responses were estimated as the total area under the curve (AUC) and significance testing was done using repeated measures ANOVA. The highest insulin level was found after meal intake at 23:30, and the lowest after meal intake 03:30. The glucose response showed the same pattern. The insulin response to food intake in night working nurses is more pronounced in the night compared with morning and evening. The results would have implications for metabolic and cardiovascular disorders in night workers.
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| 3. |
- Öhman, Marcus, et al.
(författare)
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Slagging tendencies of wood pellet ash during combustion in residential pellet burners
- 2004
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Ingår i: Biomass and Bioenergy. - Oxford : Elsevier BV. - 0961-9534 .- 1873-2909. ; 27:6, s. 585-596
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Tidskriftsartikel (refereegranskat)abstract
- Ash related problems have more than occasionally been observed in pellet burners during the last years. These problems can lead to reduced accessibility of the combustion systems as well as bad publicity for the market. The objectives of the present work were to; (i) evaluate how different raw materials for pellets affect the accessibility of the existing burner equipment, (ii) determine which of the ash forming element(s) that could be responsible for the deposit/slagg formation and, (iii) estimate the critical slagging temperature for the different raw materials. Stored and fresh materials from sawdust, logging residues and bark were used as raw material in three different pellet burners. The results showed that the slagging properties were relatively sensitive to the variations in total ash content and ash forming elements of the fuel. It is therefore recommended that ash rich fuels like bark and logging residues should not be used in the existing residential pellet burners. Both fuel and burner type affected the amounts of ash deposit produced. The degree of sintering (i.e. the strength of the deposits) was mostly affected by the fuel composition. Subsequent controlled sintering test of the produced deposits/slags showed critical slagging temperatures of about 850-900°C for stored bark and about 1000°C for fresh bark and stored and fresh materials from sawdust and logging residues. The results further indicated that the Si-content in the fuel correlated (relatively) well to the sintering tendencies in the burners. Chemical equilibrium models were used to interpret the experimental findings, and good quantitative agreements between modelling and experimental results were generally obtained. © 2004 Elsevier Ltd. All rights reserved.
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| 4. |
- Larsson-Lund, Maria, et al.
(författare)
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Incorporating or resisting assistive devices : Different approaches to achieving a desired occupational self-image
- 2003
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Ingår i: OTJR (Thorofare, N.J.). - : SAGE Publications. - 1539-4492 .- 1938-2383. ; 23:2, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to enhance the understanding of how people with disabilities experience the meaning of their assistive devices in their occupations and how they act on their experiences. Seventeen participants were interviewed and data were analyzed using a qualitative approach. The participants' experiences showed that they reacted differently to the manifold and often contradictory meaning of assistive devices. The analysts organized the participants' reactions into three categories: pragmatic users, ambivalent users, and reluctant users. The differences between the participants were understood as representing different adaptive approaches to achieve desired occupational self-images. Thus, the assistive devices were not in themselves important, but were merely a means to achieve a desired self-image. The findings reflect that the participants' experiences of using assistive devices reveal meanings about their use that go beyond the traditional medical perspective that focuses on the role of assistive devices as compensation for physical impairment
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| 5. |
- Larsson-Lund, Maria, et al.
(författare)
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Occupational life in the home environment : the experiences of people with disabilities
- 2004
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Ingår i: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie. - : SAGE Publications. - 0008-4174. ; 71:4, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need to empirically explore the occupational engagement of people with disabilities to support the development of occupational therapy interventions. PURPOSE: This study describes how people with disabilities experience their occupational lives in their home environment. METHOD: Thirteen people with physical disabilities living at home were interviewed and data were subsequently analysed using a constant comparative method. RESULTS: The findings showed that interactions between the individuals and their environment influenced their experiences of engaging in occupations and the meaning of their home. Occupations formed three categories: always performed with others, occasionally disrupted or deprived. These were particularly related to the social support that was provided under different conditions. This condition formed a central category: access to social support for occupations. Their experiences of performing occupations in the home also formed another central category: transformed meaning of the home. PRACTICE IMPLICATIONS: By understanding enabling conditions as well as barriers to occupational engagement, effective occupational therapy interventions can be developed to support the occupational lives of people with disabilities
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| 6. |
- Lundbäck, Bo, et al.
(författare)
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Not 15 But 50% of smokers develop COPD?—Report from the Obstructive Lung Disease in Northern Sweden Studies
- 2003
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 97:2, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevalence of chronic obstructive pulmonary disease (COPD) according to guidelines of today seems considerably higher than has been reported also in recent literature.Aim: To estimate the prevalence of COPD as defined by British Thoracic Society (BTS) criteria and the recent global initiative for chronic obstructive lung disease (GOLD) criteria. Further aims were to assess the proportion of underdiagnosis and of symptoms in subjects with COPD, and to study risk factors for COPD.Methods: In 1996, 5892 of the Obstructive Lung Disease in Northern Sweden (OLIN) Study's first cohort could be traced to a third follow-up survey, and 5189 completed responses (88%) were received corresponding to 79% of the original cohort from December 1985. Of the responders, a random sample of 1500 subjects were invited to a structured interview and a lung function test, and 1237 of the invited completed a lung function test with acceptable quality.Results: In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, while it was 14% according to the GOLD criteria. The absolutely dominating risk factors were increasing age and smoking, and approximately a half of elderly smokers fulfilled the criteria for COPD according to both the BTS and the GOLD criteria. Family history of obstructive airway disease was also a risk factor, while gender was not. Of those fulfilling the BTS criteria for COPD, 94% were symptomatics, 69% had chronic productive cough, but only 31% had prior to the study been diagnosed as having either chronic bronchitis, emphysema, or COPD. The corresponding figures for COPD according GOLD were 88, 51, and 18%.Conclusions: In ages >45 years, the prevalence of COPD according to the BTS guidelines was 8%, and it was 14% according to the GOLD criteria. Fifty percent of elderly smokers had developed COPD. The large majority of subjects having COPD were symptomatic, while the proportion of those diagnosed as having COPD or similar diagnoses was small.
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| 7. |
- Brus, Elisabet, et al.
(författare)
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Bed agglomeration characteristics of biomass fuels using blast-furnace slag as bed material
- 2004
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Ingår i: Energy & Fuels. - Washington, D.C. : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 18:4, s. 1187-1193
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Tidskriftsartikel (refereegranskat)abstract
- Agglomeration of bed material may cause severe operating problems during fluidized bed combustion. The attack or coating layers that are formed on the bed particles during combustion play an important role in the agglomeration process. To reduce bed agglomeration tendencies, alternative bed materials may be used. In this paper, bed agglomeration characteristics during the combustion of biomass fuels using a relatively new bed material (iron blast-furnace slag) as well as ordinary quartz sand were determined. Controlled agglomeration tests lasting 40 h, using five representative biomass fuels (bark, olive residue, peat, straw, and reed canary grass) were conducted in a bench-scale fluidized bed. The bed materials and agglomerates were analyzed using SEM/EDS and X-ray diffraction. Chemical equilibrium calculations were performed to interpret the experimental findings. The results showed that blast-furnace slag had a lower tendency to agglomerate than quartz sand for most of the fuels. The quartz particles showed an inner attack layer more often than did the blast-furnace slag. The blast-furnace slag had a lower tendency to react with elements from the fuel. The outer coating layer had similar characteristics and thickness for both bed materials when the same fuel was combusted. However, the inner attack layer thickness was larger for quartz particles. SEM/EDS analyses of the agglomerates showed that the inner Ca-K-silicate-rich attack layer was responsible for the agglomeration of quartz sand. The composition of blast-furnace slag agglomerate was similar to the outer coating layer. Chemical equilibrium calculations showed that the original composition of the blast-furnace slag was close to the equilibrium composition, and hence there was no major driving force for reactions between that bed material and K and Ca from the fuel. The homogeneous silica-rich attack layer (with a low melting temperature) was not formed to the same extent for blast-furnace slag, thus explaining the lower bed agglomeration tendency.
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| 8. |
- Edlund, Agneta, et al.
(författare)
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Delirium before and after operation for femoral neck fracture
- 2001
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Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 49:10, s. 1335-1340
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to investigate the differences between preoperative and postoperative delirium regarding predisposing, precipitating factors and outcome in older patients admitted to hospital with femoral neck fractures.DESIGN: A prospective clinical assessment of patients treated for femoral neck fractures.SETTING: Department of orthopedic surgery at Umeå University Hospital, Sweden.PARTICIPANTS: One hundred one patients, age 65 and older admitted to the hospital for treatment of femoral neck fractures.MEASUREMENTS: The Organic Brain Syndrome (OBS) Scale.RESULTS: Thirty patients (29.7%) were delirious before surgery and another 19 (18.8%) developed delirium postoperatively. Of those who were delirious preoperatively, all but one remained delirious postoperatively. The majority of those delirious before surgery were demented, had been treated with drugs with anticholinergic properties (mainly neuroleptics), had had previous episodes of delirium, and had fallen indoors. Patients who developed postoperative delirium had perioperative falls in blood pressure and had more postoperative complications such as infections. Male patients were more often delirious both preoperatively and postoperatively. Patients with preoperative delirium were more often discharged to institutional care and had poorer walking ability both on discharge and after 6 months than did patients with postoperative delirium only.CONCLUSIONS: Because preoperative and postoperative delirium are associated with different risk factors it is necessary to devise different strategies for their prevention.
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| 9. |
- Michaelson, Peter, et al.
(författare)
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Factors predicting pain reduction in chronic back and neck pain after multimodal treatment.
- 2004
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 20:6, s. 447-454
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To determine whether treatment related pain reduction on the short- and long-term is predicted by different baseline variables, and with different accuracy, in patients with chronic low back pain as compared with those with chronic neck pain. DESIGN AND METHODS: A single blinded prospective cohort study based on patients with chronic musculoskeletal pain in the lower back (N = 167) or the neck (N = 136) who completed a 4-week multimodal rehabilitation program. At admission, each patient was evaluated on 17 potential predictors, including pain characteristics and physical, sociodemographic, and psychosocial-behavioral variables. Changes in self-reported pain intensity in the lower back or the neck between the pretreatment evaluation and those performed immediately after, and 12 months after the rehabilitation program, were assessed. RESULTS: Logistic regression models revealed that change in pain intensity could be predicted with good specificity but with poor sensitivity both for patients with chronic low back pain and chronic neck pain. Significant predictors among the neck pain patients were high endurance, low age, high pain intensity, few other symptoms, low need of being social, to do things with others, and to be helped, along with optimistic attitudes on how the pain will interfere with daily life. Among the low back pain patients, high pain intensity, low levels of pain severity, and high affective distress were important predictors. Variables such as sex, sick leave history, working status, accident, pain duration, and depressive symptoms demonstrated no predictive value. Short- and long-term pain outcome was equally predictable and predicted by almost the same variables. CONCLUSIONS: Patients who reported unchanged or increased pain after multimodal treatment could be predicted with good accuracy, whereas those who reported decreased pain were more difficult to identify. Treatment-related pain alteration in chronic low back pain seems to be predicted by partly different variables than in chronic neck pain.
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| 10. |
- Paulson, Margareta, et al.
(författare)
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Struggling for a Tolerable Existence : The meaning of Men's Lived Experiences of Living With Pain of Fibromyalgia Type
- 2002
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Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 12:2, s. 238-249
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain is a major health problem in Sweden because of its consequences in daily life. Fourteen men with fibromyalgia-type pain were interviewed regarding their experiences. A phenomenological hermeneutic method was used to interpret the transcribed interviews. Three major themes emerged: experiencing the body as an obstruction, being a different man, and striving to endure. Overall, the meaning of men's lived experience of chronic pain was experienced as change in the body, self, and relationships. Striving to live life required achieving balance during both calm and difficult phases of the illness--struggling for a tolerable existence. Information from this study could provide guidelines for health care staff members to give empathic and supportive care to men living with a long-term illness.
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