| 1. |
- Aad, G., et al.
(författare)
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- 2012
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swepub:Mat__t (refereegranskat)
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| 2. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 3. |
- Hogenkamp, Pleunie S, et al.
(författare)
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Acute sleep deprivation increases portion size and affects food choice in young men.
- 2013
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 1873-3360 .- 0306-4530. ; 38:9, s. 1668-1674
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Tidskriftsartikel (refereegranskat)abstract
- Acute sleep loss increases food intake in adults. However, little is known about the influence of acute sleep loss on portion size choice, and whether this depends on both hunger state and the type of food (snack or meal item) offered to an individual. The aim of the current study was to compare portion size choice after a night of sleep and a period of nocturnal wakefulness (a condition experienced by night-shift workers, e.g. physicians and nurses). Sixteen men (age: 23±0.9 years, BMI: 23.6±0.6kg/m(2)) participated in a randomized within-subject design with two conditions, 8-h of sleep and total sleep deprivation (TSD). In the morning following sleep interventions, portion size, comprising meal and snack items, was measured using a computer-based task, in both fasted and sated state. In addition, hunger as well as plasma levels of ghrelin were measured. In the morning after TSD, subjects had increased plasma ghrelin levels (13%, p=0.04), and chose larger portions (14%, p=0.02), irrespective of the type of food, as compared to the sleep condition. Self-reported hunger was also enhanced (p<0.01). Following breakfast, sleep-deprived subjects chose larger portions of snacks (16%, p=0.02), whereas the selection of meal items did not differ between the sleep interventions (6%, p=0.13). Our results suggest that overeating in the morning after sleep loss is driven by both homeostatic and hedonic factors. Further, they show that portion size choice after sleep loss depend on both an individual's hunger status, and the type of food offered.
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| 4. |
- Jung, Christian, et al.
(författare)
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A comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention
- 2019
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Ingår i: Journal of critical care. - : W B SAUNDERS CO-ELSEVIER INC. - 0883-9441 .- 1557-8615. ; 52, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed.Methods: In total, 5063 VIPs were induded in this analysis, 922 were admitted after elective surgery or intervention, 4141 acutely, with 402 after acute surgery. Differences were calculated using Mann-Whitney-U test and Wilcoxon test. Univariate and multivariable logistic regression were used to assess associations with mortality.Results: Compared patients admitted after acute surgery, patients admitted after elective surgery suffered less often from frailty as defined as CFS (28% vs 46%; p < 0.001), evidenced lower SOFA scores (4 +/- 5 vs 7 +/- 7; p < 0.001). Presence of frailty (CFS >4) was associated with significantly increased mortality both in elective surgery patients (7% vs 12%; p = 0.01), in acute surgery (7% vs 12%; p = 0.02).Conclusions: VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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| 5. |
- Adelsjö, Igor
(författare)
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Medication communication with older adults experiencing chronic illness and polypharmacy
- 2023
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Populations in many high-income countries are ageing, with an ever-increasing proportion of the population aged 65 years or older. Despite increasingly better health in older people, susceptibility to chronic illness increase with age. As life expectancy increases, the length of time people can live with chronic illness increases correspondingly, mainly due to improved medication treatments. Decreased number of hospital beds per capita and length of stay in hospital has gained primary care an increasing role in the healthcare system, with higher demands on patients and their knowledge and abilities to manage medications and self-management.Aim: The overarching aim of this thesis was to explore how medication regimens are communicated in primary care consultations and in written discharge letters.Methods: In Study I, passive participant observations of primary care consultations were audio-recorded, transcribed and analysed using content analysis. Study II had a convergent mixed methods design. An assessment matrix, constructed based on previous research, was used to assess and quantify discharge letter content. The quantified discharge letter content, questionnaires and register data were used to calculate correlations between discharge letter content and readmission rate as well as self-rated quality of care transition. Finally, associations between discharge letter content and time to readmission were calculated both univariable and multivariable. In addition to discharge letter content, several other potential independent variables were included in the multivariable analysis.Results: Both studies show that physicians were prone to give information about medications and blood-samples or other examinations performed in advance to the consultation (Study I) or during the hospital admission (Study II). The physicians were, however, less prone to inform patients about self-management and lifestyle changes, symptoms to be aware of, and what to do in case they would appear. Communication was occasionally hindered by misunderstandings, e.g., when vague expressions or words with ambiguous meaning was used. Ambiguities e.g., arose due to dialectal disparity. Although physicians mainly communicated in plain language with patients, medication names imposed a significant problem for patients and in communication about medications. Discharge letter content was not associated to readmissions, the only significant predictor variables for time to readmission were previous admission the past 180 days and birth outside the Nordic countries. Discharge letters with more content were, on the other hand, correlated to worse self-estimated quality of care transition from hospital to home (Study II).Conclusions: Physicians informed patients about tests and examinations performed in the past time, and comprehensive information was provided about medications, both during consultations and in discharge letters. However, information about symptoms to be aware of and measures to take in case they would appear was scarce in consultations and discharge letters. In conversations where lifestyle changes were raised, the topic was quickly dropped without recommendations or offering support if the patient showed unconcern. Lifestyle changes in relation to chronic illness and medications were rarely discussed. Improved lifestyle as a means of reducing the need for medications was not discussed or informed about in discharge letters. Discharge letter content did not have any impact on readmissions.
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| 6. |
- Adelsjö, Igor, et al.
(författare)
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The impact of discharge letter content on unplanned hospital readmissions within 30 and 90 days in older adults with chronic illness - a mixed methods study
- 2024
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundCare transitions are high-risk processes, especially for people with complex or chronic illness. Discharge letters are an opportunity to provide written information to improve patients' self-management after discharge. The aim of this study is to determine the impact of discharge letter content on unplanned hospital readmissions and self-rated quality of care transitions among patients 60 years of age or older with chronic illness.MethodsThe study had a convergent mixed methods design. Patients with chronic obstructive pulmonary disease or congestive heart failure were recruited from two hospitals in Region Stockholm if they were living at home and Swedish-speaking. Patients with dementia or cognitive impairment, or a "do not resuscitate" statement in their medical record were excluded. Discharge letters from 136 patients recruited to a randomised controlled trial were coded using an assessment matrix and deductive content analysis. The assessment matrix was based on a literature review performed to identify key elements in discharge letters that facilitate a safe care transition to home. The coded key elements were transformed into a quantitative variable of "SAFE-D score". Bivariate correlations between SAFE-D score and quality of care transition as well as unplanned readmissions within 30 and 90 days were calculated. Lastly, a multivariable Cox proportional hazards model was used to investigate associations between SAFE-D score and time to readmission.ResultsAll discharge letters contained at least five of eleven key elements. In less than two per cent of the discharge letters, all eleven key elements were present. Neither SAFE-D score, nor single key elements correlated with 30-day or 90-day readmission rate. SAFE-D score was not associated with time to readmission when adjusted for a range of patient characteristics and self-rated quality of care transitions.ConclusionsWhile written summaries play a role, they may not be sufficient on their own to ensure safe care transitions and effective self-care management post-discharge.Trial registrationClinical Trials. giv, NCT02823795, 01/09/2016.
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| 7. |
- Adelsjö, Igor, et al.
(författare)
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The impact of discharge letter content on unplanned hospital readmissions within 30 and 90 days in patients with chronic illness
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To determine the impact of discharge letter content on unplanned hospital readmissions within 30 and 90 days, and to identify correlations between discharge letter content and quality of care transitions among patients with chronic illness.Design: A convergent mixed methods design.Methods: Discharge letters from 154 patients recruited to a randomised controlled trial were coded using an assessment matrix and deductive content analysis. The assessment matrix was based on a literature review performed to identify key elements in discharge letters that facilitate a safe care transition to home. The coded key elements were transformed into a quantitative variable of 'discharge letter score'. Bivariate correlations between discharge letter score and quality of care transition as well as unplanned readmissions within 30 and 90 days were calculated. Lastly, a multivariable Cox proportional hazards model was used to investigate associations between discharge letter score and time to readmission.Results: All discharge letters contained at least five of eleven key elements. In less than four percent, all eleven key elements were present. Neither discharge letter score nor single key elements correlated with 30-day or 90-day readmission rate. Discharge letter score was not associated with time to readmission when adjusted for a range of patient characteristics and self-rated quality of care transitions.Conclusion: Discharge letter score is not correlated with either 30-day or 90-day readmission rate or with time to readmission at 90 days, when patient characteristics are adjusted for.Implications for the profession and patient care: Written discharge summaries are not enough to facilitate safe care transitions and self-management after discharge. A person-centred approach, providing written and verbal information to patients, encouraging patient involvement soon after discharge, may be needed to avoid readmission.
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| 8. |
- Cai, Lina, et al.
(författare)
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Genome-wide association analysis of type 2 diabetes in the EPIC-InterAct study
- 2020
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Ingår i: Scientific Data. - : Nature Publishing Group. - 2052-4463. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Type 2 diabetes (T2D) is a global public health challenge. Whilst the advent of genome-wide association studies has identified >400 genetic variants associated with T2D, our understanding of its biological mechanisms and translational insights is still limited. The EPIC-InterAct project, centred in 8 countries in the European Prospective Investigations into Cancer and Nutrition study, is one of the largest prospective studies of T2D. Established as a nested case-cohort study to investigate the interplay between genetic and lifestyle behavioural factors on the risk of T2D, a total of 12,403 individuals were identified as incident T2D cases, and a representative sub-cohort of 16,154 individuals was selected from a larger cohort of 340,234 participants with a follow-up time of 3.99 million person-years. We describe the results from a genome-wide association analysis between more than 8.9 million SNPs and T2D risk among 22,326 individuals (9,978 cases and 12,348 non-cases) from the EPIC-InterAct study. The summary statistics to be shared provide a valuable resource to facilitate further investigations into the genetics of T2D.
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| 9. |
- Flockhart, Mikael, et al.
(författare)
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A simple model for diagnosis of maladaptations to exercise training
- 2022
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Ingår i: Sports Medicine Open. - : Springer. - 2198-9761 .- 2199-1170. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The concept of overreaching and super compensation is widely in use by athletes and coaches seeking to maximize performance and adaptations to exercise training. The physiological aspects of acute fatigue, overreaching and non-functional overreaching are, however, not well understood, and well-defined negative physiological outcomes are missing. Instead, the concept relies heavily on performance outcomes for differentiating between the states. Recent advancements in the field of integrated exercise physiology have associated maladaptations in muscular oxidative function to high loads of exercise training.Method: Eleven female and male subjects that exercised regularly but did not engage in high-intensity interval training (HIIT) were recruited to a 4-week long training intervention where the responses to different training loads were studied. Highly monitored HIIT sessions were performed on a cycle ergometer in a progressive fashion with the intent to accomplish a training overload. Throughout the intervention, physiological and psychological responses to HIIT were assessed, and the results were used to construct a diagnostic model that could indicate maladaptations during excessive training loads.Results: We here use mitochondrial function as an early marker of excessive training loads and show the dynamic responses of several physiological and psychological measurements during different training loads. During HIIT, a loss of mitochondrial function was associated with reduced glycolytic, glucoregulatory and heart rate responses and increased ratings of perceived exertion in relation to several physiological measurements. The profile of mood states was highly affected after excessive training loads, whereas performance staled rather than decreased. By implementing five of the most affected and relevant measured parameters in a diagnostic model, we could successfully, and in all the subjects, identify the training loads that lead to maladaptations.Conclusions: As mitochondrial parameters cannot be assessed without donating a muscle biopsy, this test can be used by coaches and exercise physiologists to monitor adaptation to exercise training for improving performance and optimizing the health benefits of exercise. Clinical trial registry number NCT04753021 . Retrospectively registered 2021-02-12.
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| 10. |
- Flockhart, Mikael, et al.
(författare)
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Excessive exercise training causes mitochondrial functional impairment and decreases glucose tolerance in healthy volunteers.
- 2021
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Ingår i: Cell Metabolism. - : Cell Press. - 1550-4131 .- 1932-7420. ; 33:5, s. 957-970
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Tidskriftsartikel (refereegranskat)abstract
- Exercise training positively affects metabolic health through increased mitochondrial oxidative capacity and improved glucose regulation and is the first line of treatment in several metabolic diseases. However, the upper limit of the amount of exercise associated with beneficial therapeutic effects has not been clearly identified. Here, we used a training model with a progressively increasing exercise load during an intervention over 4 weeks. We closely followed changes in glucose tolerance, mitochondrial function and dynamics, physical exercise capacity, and whole-body metabolism. Following the week with the highest exercise load, we found a striking reduction in intrinsic mitochondrial function that coincided with a disturbance in glucose tolerance and insulin secretion. We also assessed continuous blood glucose profiles in world-class endurance athletes and found that they had impaired glucose control compared with a matched control group.
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