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  • Sandberg, Jonas, et al. (författare)
  • The hard thing is the changes : The importence of continuity for older men caring for thir wifes
  • 2007
  • Ingår i: Quality in Ageing: Policy, Practice and research. - 1471-7794. ; 8:2, s. 5-15
  • Tidskriftsartikel (refereegranskat)abstract
    • Few studies have been conducted into the contextual and relational aspects of male caregiving that include analysis by gender and family relationships. The aim was to gain understanding of the experience of older men as caregivers for an ill spouse. A narrative approach was adopted for this study. Interviews were conducted with three older men between 65 and 78 years, who had been caring for their wives for between one and 12 years. Two main categories emerged: taking on a new and unfamiliar role, and learning to live with the new role. The results also show how the men seek to maintain continuity in their relationships with the wives they are caring for. The findings can be understood in the light of a major life transition of how older men providing care for a spouse create new roles and how they cope with the changes in the marital relationship. A sense of continuity in the process of caring is important for men to help them find the strength to continue as caregivers.
  • Adolfsson, J, et al. (författare)
  • Clinical characteristics and primary treatment of prostate cancer in Sweden between 1996 and 2005 : Data from the national prostate cancer register in Sweden
  • 2007
  • Ingår i: Scandinavian Journal of Urology and Nephrology. - Stockholm : Taylor & Francis. - 0036-5599. ; 41:6, s. 456-477
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. The incidence of prostate cancer is rising rapidly in Sweden and there is a need to better understand the pattern of diagnosis, tumor characteristics and treatment. Material and methods. Between 1996 and 2005, all new cases of adenocarcinoma of the prostate gland were intended to be registered in the National Prostate Cancer Register (NPCR). This register contains information on diagnosing unit, date of diagnosis, cause of diagnosis, tumor grade, tumor stage according to the TNM classification in force, serum prostate-specific antigen (PSA) levels at diagnosis and primary treatment given within the first 6 months after diagnosis. Results. In total, 72 028 patients were registered, comprising >97% of all pertinent incident cases of prostate cancer in the Swedish Cancer Register (SCR). During the study period there was a considerable decrease in median age at the time of diagnosis, a stage migration towards smaller tumors, a decrease in median serum PSA values at diagnosis, a decrease in the age-standardized incidence rate of men diagnosed with distant metastases or with a PSA level of >100 ng/ml at diagnosis and an increase in the proportion of tumors with Gleason score ≤6. Relatively large geographical differences in the median age at diagnosis and the age-standardized incidence of cases with category T1c tumors were observed. Treatment with curative intent increased dramatically and treatment patterns varied according to geographical region. In men with localized tumors and a PSA level of <20 ng/ml at diagnosis, expectant treatment was more commonly used in those aged ≥75 years than in those aged <75 years. Also, the pattern of endocrine treatment varied in different parts of Sweden. Conclusions. All changes in the register seen over time are consistent with increased diagnostic activity, especially PSA testing, resulting in an increased number of cases with early disease, predominantly tumors in category T1c. The patterns of diagnosis and treatment of prostate cancer vary considerably in different parts of Sweden. The NPCR continues to be an important source for research, epidemiological surveillance of the incidence, diagnosis and treatment of prostate cancer
  • Holmer, Helene, et al. (författare)
  • Non-fatal stroke, cardiac disease, and diabetes mellitus in hypopituitary patients on hormone replacement including growth hormone.
  • 2007
  • Ingår i: J Clin Endocrinol Metab. - 0021-972X. ; 92:9, s. 3560-3567
  • Tidskriftsartikel (refereegranskat)abstract
    • Context: The impact of long-term GH replacement on cerebrovascular and cardiovascular diseases and diabetes mellitus in hypopituitary patients is unknown. Objective: The incidence of nonfatal stroke and cardiac events, and prevalence of type 2 diabetes mellitus (T2D) and cardioprotective medication were compared between cohorts of GH-deficient (GHD) patients and population controls. Design and Participants: The incidence of nonfatal stroke and cardiac events was estimated retrospectively from questionnaires in 750 GHD patients and 2314 matched population controls. A prevalence of T2D and cardioprotective medication was recorded at the distribution of questionnaires. Time since first pituitary deficiency to start of GH therapy was 4 and 2 yr, and time on GH therapy was 6 yr for GHD women and men, respectively. Results: Lifelong incidence of nonfatal stroke was tripled in GHD women and doubled in GHD men, but a decline was seen in both genders during periods after first pituitary hormone deficiency and GHD, during which most patients had GH therapy. The lifelong incidence of nonfatal cardiac events declined in GHD men during first pituitary hormone deficiency and GHD periods. GHD women had a higher prevalence of T2D and lipid-lowering medication, whereas GHD men had a higher prevalence of antihypertensive medication. Conclusions: The declined risks of nonfatal stroke in both genders and of nonfatal cardiac events in GHD men during periods on GH replacement may be caused by prescription of cardioprotective drugs and 6-yr GH replacement. GHD women had an increased prevalence of T2D, partly attributed to higher body mass index and lower physical activity. Copyright © 2007 by The Endocrine Society.
  • Almqvist, Roland, et al. (författare)
  • Management Control of Health :  - the Swedish examples
  • 2007
  • Ingår i: Work Health and Management Control. - Stockholm : Thomson Fakta. - 978-91-7610-272-5 ; s. 291-318
  • Bokkapitel (övrigt vetenskapligt)abstract
    • Management control practices have spread to areas other than formerly occupied by traditional management accounting techniques. In this chapter, results from a number of development projects regarding management control of health are presented. The purpose of the chapter is to assess the proposed health statement models in Sweden as leading or lagging management control systems: (1) How are health statements used in the organizations? (2) Could health statements be an effective device to develop management control practices with the aim of improving health? The research has been performed through longitudinal studies including in-depth interviews and observations made over a three-year period. The empirical findings are analyzed using a two-dimensional matrix comprising diagnostic reporting routines and interactive management control functions. Tentative conclusions indicate that the proposed health statement models are mainly based on diagnostic control with a focus on lagging indicators, but there are examples of the successful integration of health statement models with management control models when certain criteria of change are fulfilled.
  • Berglund, Karin, et al. (författare)
  • Entrepreneurship and Conscientization in Processes of Regional Development
  • 2007
  • Ingår i: Entrepreneurship and Regional Development. - 0898-5626. ; 19:6, s. 499-525
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper is based upon a regional development project in a 'vulnerable' Swedish region consisting of three municipalities. At a first glance, this is a region in decline that is lacking in entrepreneurial initiatives. During a crucial time period the project 'Diversity in Entrepreneurship' ( DiE) was launched to help the region to become more entrepreneurial and inclusive. An underlying logic was built into the project, which is associated with the critical pedagogy of Paolo Freire. From a Freirean perspective regions lacking in entrepreneurship could be reconsidered emphasizing that the entrepreneurial initiatives are always there - latent - however restrained by certain discourses; in this case a dominant enterprise discourse. Above all the enterprise discourse suppresses the ability for particular groups in society to view themselves as entrepreneurs. The purpose of this paper is to introduce Freire's critical pedagogical perspective to entrepreneurship and regional development. An episode illustrating how the enterprise discourse suppresses an equality discourse, introduced by way of the DiE-project, makes the point of departure for discussing the process of 'conscientization', which refers to a type of learning that is focused on perceiving and exposing contradictions and to take action against the oppressive elements of reality ( Freire 1970). Some key Freirean ideas or concepts are explained, first as they were expressed by Freire and then applied to entrepreneurship and regional development. It is then discussed how these concepts found their expressions in the project. The critical pedagogic perspective not only emphasizes an entrepreneurial potential in every individual, but it also gives an idea of what kind of processes could release entrepreneurial initiatives among those who do not view themselves as entrepreneurs.
  • Cornelissen, C, et al. (författare)
  • Global negative vegetation feedback to climate warming responses of leaf litter decomposition rates in cold biomes
  • 2007
  • Ingår i: Ecology Letters. - 1461-023X. ; 10:7, s. 619-627
  • Tidskriftsartikel (refereegranskat)abstract
    • Whether climate change will turn cold biomes from large long-term carbon sinks into sources is hotly debated because of the great potential for ecosystem-mediated feedbacks to global climate. Critical are the direction, magnitude and generality of climate responses of plant litter decomposition. Here, we present the first quantitative analysis of the major climate-change-related drivers of litter decomposition rates in cold northern biomes worldwide. Leaf litters collected from the predominant species in 33 global change manipulation experiments in circum-arctic-alpine ecosystems were incubated simultaneously in two contrasting arctic life zones. We demonstrate that longer-term, large-scale changes to leaf litter decomposition will be driven primarily by both direct warming effects and concomitant shifts in plant growth form composition, with a much smaller role for changes in litter quality within species. Specifically, the ongoing warming-induced expansion of shrubs with recalcitrant leaf litter across cold biomes would constitute a negative feedback to global warming. Depending on the strength of other (previously reported) positive feedbacks of shrub expansion on soil carbon turnover, this may partly counteract direct warming enhancement of litter decomposition.
  • Ehnfors, Margareta, et al. (författare)
  • Kvalitetsindikatorer för prevention av undernäring
  • 2007
  • Ingår i: Kvalitetsindikatorer inom omvårdnad. - Stockholm : Gothia. - 9789172055193 - 978-91-7205-519-3 ; s. 155-165
  • Bokkapitel (populärvet., debatt m.m.)abstract
    • En självklar del i sjuksköterskans ansvar är att ständigt utveckla omvårdnadsarbetet i syfte att förbättra vården för patienter och vårdtagare. Med hjälp av en indikator, eller ett kvalitetsmått, kan vårdens resultat och genomförande följas och mätas. I boken presenteras förslag på kvalitetsindikatorer inom olika omvårdnasområden. Syftet är att ge verktyg för registrering, utvärdering och förbättring av omvårdnadskvaliteten. Förhoppningen är att boken ska motivera sjuksköterskor att använda kvalitetsindikatorer så att omvårdnaden kan beskrivas och utvärderas. Denna femte upplaga är utökad med en kvalitetsindikator för fall och fallskadeprevention.
  • Fornäs, Johan, 1952-, et al. (författare)
  • Consuming Media : Communication, Shopping and Everyday Life
  • 2007
  • Bok (övrigt vetenskapligt)abstract
    • Inspired by Walter Benjamin-s classical Arcades Project, Consuming Media is a pioneering exploration of the interface between communication, shopping and everyday life. Based on a six-year -intersectional- ethnographic fieldwork by over a dozen scholars on a specific site, it analyses the links between media and consumption in contemporary urban culture and public space. The book is organized into ten chapters. The first two chapters introduce key ideas and theories. In the next four chapters, four large media circuits are scrutinized. The final four chapters discuss the results in terms of intermedial relations, time, space and power. The book thus offers a new foundation for understanding media use, consumption and the fate of urban public space in late modernity
  • Johansson, Björn, et al. (författare)
  • Visual and optical performance of the akreos adapt advanced optics and tecnis Z9000 intraocular lenses - Swedish multicenter study
  • 2007
  • Ingår i: JOURNAL OF CATARACT AND REFRACTIVE SURGERY. - 0886-3350. ; 33:9, s. 1565-1572
  • Tidskriftsartikel (refereegranskat)abstract
    • PurposeTo compare the subjective visual and objective optical performance of 2 aspherical intraocular lenses (IOLs), the Akreos Adapt Advanced Optics (AO) (Bausch & Lomb, Inc.) and the Tecnis Z9000 (Advanced Medical Optics, Inc.).SettingFour university hospitals in Sweden.MethodsThis study comprised 80 patients, 20 each from 4 university hospital centers in Sweden. All patients had bilateral clear corneal phacoemulsification with implantation of an Akreos Adapt AO IOL in 1 eye and Tecnis Z9000 IOL in the other eye according to a randomization protocol. Preoperatively, 90% contrast Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity was measured and the mesopic pupil sizes were determined. Ten to 12 weeks postoperatively, 12.5% and 90% contrast ETDRS visual acuities and photopic and mesopic Functional Acuity Contrast Test chart contrast sensitivities were determined. Wavefront analysis was performed with the Zywave II aberrometer (Bausch & Lomb, Inc.), and a questionnaire on the subjective quality of vision was completed by each patient.ResultsThe Akreos AO IOL and Tecnis Z9000 IOL produced similar high- and low-contrast visual acuities as well as photopic and mesopic contrast sensitivities. The Tecnis Z9000 IOL resulted in lower spherical aberrations of the eye (mean 0.05 ± 0.13 μm versus 0.35 ± 0.13 μm root mean square, 6.0 mm pupil) (P<.001); however, the Akreos AO IOL provided a larger depth of field (mean 1.22 diopter [D] ± 0.48 [SD] versus 0.86 ± 0.50 D, 6.0 mm pupil) (P<.001). Patient satisfaction was generally high, although 68.8% of the patients reported some type of visual disturbance postoperatively. Twenty-eight percent of patients reported better subjective visual quality in the Akreos AO eye and 14%, in the Tecnis Z9000 eye (P<.0001). Accordingly, 33% perceived more visual disturbances in the Tecnis Z9000 eye and 11%, in the Akreos AO eye (P<.0001).ConclusionsMaximum reduction of spherical aberration did not maximize subjective visual quality. The higher perceived quality of vision with the Akreos AO IOL could be because of differences in depth of field, IOL material, or IOL design.
  • Mamhidir, Anna-Greta, et al. (författare)
  • Weight increase in patients with dementia, and alteration in meal routines and meal environment after integrity promoting care
  • 2007
  • Ingår i: JOURNAL OF CLINICAL NURSING. - 0962-1067. ; 16:5, s. 987-996
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS: To follow weight changes in patients with moderate and severe dementia and analyse how these changes related to biological and psychological parameters after staff education and support in integrity promoting care. A further aim was to describe meal environment and routines relative to the intervention. BACKGROUND: Weight loss in patients with dementia and in particular Alzheimer's disease is common. The aetiology appears multifactorial with the meal environment and a decreased independence while eating among the factors. METHOD: Over a three-month intervention period, an integrity-promoting care training programme was conducted with the staff of a long-term ward. Alzheimer's disease patients, 18 from an intervention ward and 15 from a control ward were included and possible effects were evaluated. Weighing was conducted at the start and after completion of the intervention. Weight changes were analysed in relation to psychological and biochemical parameters. In addition, the staff wrote diaries about, for example changes made in the environment and in their work. RESULTS: The most prominent difference observed was weight increases in 13 of 18 patients compared with two of 15 patients in the control ward. No weight changes were related to the type of dementia. The individual weight changes correlated significantly to changes in the intellectual functions. Relationships between weight change, increased motor function and increased appetite were non-significant. There was no significant relationship between weight changes and changes in biochemical parameters. According to the staff, increased contact with the patients and a more pleasant atmosphere resulted when the meal environment and routines were changed. RELEVANCE TO CLINICAL PRACTICE: Weight gain in patients with moderate and severe dementia was achieved by adjusting the meal environment to the individual's needs. Staff education was profitable, as increased competence seemed to promote individually adapted feeding situations. Ensuring good meal situations need to be given high priority.
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