| 1. |
- Acosta, Stefan, et al.
(författare)
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Engaging patients and caregivers in establishing research priorities for aortic dissection
- 2019
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 7, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to establish the top 10 research uncertainties in aortic dissection together with the patient organization Aortic Dissection Association Scandinavia using the James Lind Alliance concept. Methods: A pilot survey aiming to identify uncertainties sent to 12 patients was found to have high content validity (scale content validity index = 0.91). An online version of the survey was thereafter sent to 30 patients in Aortic Dissection Association Scandinavia and 45 caregivers in the field of aortic dissection. Research uncertainties of aortic dissection were gathered, collated and processed. Results: Together with research priorities retrieved from five different current guidelines, 94 uncertainties were expressed. A shortlist of 24 uncertainties remained after processing for the final workshop. After the priority-setting process, using facilitated group format technique, the ranked final top 10 research uncertainties included diagnostic tests for aortic dissection; patient information and care continuity; quality of life; endovascular and medical treatment; surgical complications; rehabilitation; psychological consequences; self-care; and how to improve prognosis. Conclusion: These ranked top 10 important research priorities may be used to justify specific research in aortic dissection and to inform healthcare research funding decisions.
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| 2. |
- Ayala, Marcelo, 1965
(författare)
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No effects of mitomycin-C in primary trabeculectomies in Sweden
- 2018
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Ingår i: Sage Open Medicine. - : SAGE Publications. - 2050-3121. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the results of a long-term follow-up after two different types of surgical techniques: trabeculectomy with or without mitomycin-C. Materials and methods: This study is a retrospective chart review of patients operated on with a primary trabeculectomy at the Eye Department of the Skaraborg Hospital, Skovde, Sweden. Complete success was defined as intraocular pressure 18mmHg (criterion 1) or intraocular pressure reduction 30% (criterion 2) without eye drops postoperatively. Qualified success was defined using the same criteria (1 and 2), but patients were treated or untreated with eye-drops. Results: A total of 167 patients were included in this retrospective study, 83 patients in the no-mitomycin-C group and 84 patients in the mitomycin-C-treated group. No significant difference was found in intraocular pressure reduction between the mitomycin-C and no-mitomycin-C group (t-test; p=0.19). Complete success using criterion 1 was 66.2% in no-mitomycin-C and 62.8% in mitomycin-C (p=0.88); success using criterion 2 was 76.6% in the no-mitomycin-C and 64.2% in the mitomycin-C group (p=0.21). Qualified success using criterion 1 was 71.4% in the no-mitomycin-C and 74.4% in the mitomycin-C group (p=0.84); success using criterion 2 was 80.0% in the no-mitomycin-C and 84.4% in the mitomycin-C group. All included patients were born in Sweden. Conclusion: Mitomycin-C seems to add no benefits to intraocular pressure reduction after primary trabeculectomies in a Swedish population.
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| 3. |
- Benkel, Inger, et al.
(författare)
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Challenging conversations with terminally ill patients and their loved ones: Strategies to improve giving information in palliative care
- 2014
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 2:2050312114532456
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to explore the skills and strategies employed by professionals when having difficult conversations to provide information to loved ones as part of palliative care. Method: A qualitative design was chosen with in-depth interviews with nurses, assistant nurses and doctors a Hospital in Sweden and were analysed using content analysis. Results: The interviews produced examples of strategies used by professionals when imparting difficult information to patient and loved ones. The results fell into three areas: ‘Who is giving information’, ‘Structuring the conversation’ and ‘Different ways to convey a difficult message’. Conclusion: Using conversational skills and strategies in combination with a carefully planned structure appeared to facilitate difficult conversations with patients and loved ones. Further research is required, related to the specific circumstances in which the conversation takes place.
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| 4. |
- Benkel, Inger, et al.
(författare)
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Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situation
- 2020
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Ingår i: Sage Open Medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Chronic diseases have an impact on and change patient's lives which means that they need to find ways to cope with the new situation. The aim was to describe how the chronic disease has influenced patients' views of their life situation. Methods: The study was quantitative in design with data collected using a semi-structured questionnaire. Descriptive statistics were used to compare similarities and differences between patients with asthma-allergy, diabetes mellitus, cancer and inflammatory rheumatoid arthritis. Results: Changes in their life were experienced as a negative outcome for the majority of participants. Support can be in the form of interpersonal support from various persons, but also from activities and beliefs/religion. Family and friends as well as healthcare professionals were identified as being most supportive. Sadness and worry were the most common emotions among the participants and their surrounding networks. Conclusion: People with a chronic disease have to live with the consequences the disease has for their life situation. They need to find strategies to cope with the negative outcome in their new life. Support from their own network and healthcare professionals can be helpful in the new life situation.
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| 5. |
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| 6. |
- Bjorvatn, Afsaneh, et al.
(författare)
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Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark
- 2020
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.
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| 7. |
- Boman, Åse, 1957-, et al.
(författare)
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Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background
- 2017
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Ingår i: Sage Open medicine. - : SAGE Publications. - 2050-3121 .- 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.
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| 8. |
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| 9. |
- Chi, PC, et al.
(författare)
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The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda
- 2018
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 6, s. 2050312117753631-
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Tidskriftsartikel (refereegranskat)abstract
- Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. Conclusion: The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system.
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| 10. |
- Dang, LVP, et al.
(författare)
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Characterization of envelope sequence of HIV virus in children infected with HIV in Vietnam
- 2020
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 2050312120937198-
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Tidskriftsartikel (refereegranskat)abstract
- HIV is characterized by high levels of genetic variability, including increased numbers of heterogeneous sequences of the envelope region. Therefore, studying genetic variability of HIV in relation to viral replication might facilitate prognosis of disease progression.Methods:The study was designed as cross-sectional; data and samples of participants collected and analyzed env genes were obtained from 23 children enrolled by Vietnam National Children’s Hospital.Results:Substantial mutations in the C2 region were found in patients with high levels of viral replication while changes in the C3 region were mostly found in patients with low viral load. In the V1 region, we found profound amino acid modifications in patients with low HIV viral loads in contrast to the V2 sequence, where we identified single point mutations in patients with increased HIV viral load. The V3 region was relatively homogeneous, while profound deletions in the V4 region were detected in patients with increased viral replication.Conclusion:Our results suggest that genetic variations in different regions of the HIV envelope sequence, including both conserved C2 and C3 and variable V1/V2 and V4 regions, might be involved in increased viral infectivity and replication capacity. Such knowledge might help improve prediction of HIV progress and treatment in patients.
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| 11. |
- Demeke, Chilot Abiyu, et al.
(författare)
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Comparative analysis of the effectiveness of narrow-spectrum versus broad-spectrum antibiotics for the treatment of childhood pneumonia
- 2021
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The main objective of this study was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalized with community-acquired pneumonia (CAP) at the University of Gondar Referral Hospital, Gondar, Ethiopia. Methods: Institutional-based retrospective chart review was conducted at the University of Gondar Referral Hospital (GURH) pediatrics ward from I February 2016 to 30 April 2016. The collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were done to present the basic features and summary of the data set. In addition, binary logistics and multivariable logistic regression analysis were conducted to test for an association between the dependent and independent variables. A P value of <0.05 was taken to declare statistical significance at a 95% confidence interval. Result: A total of 147 patients with CAP were included in the study. Seven different treatment regimens were employed for the 147 children hospitalized. About 63 (42.9%) of the study participants received a narrow-spectrum antibiotic and 84 (57.1%) received a broad-spectrum antibiotic. There was no significant difference between the broad and narrow spectrum treatment groups in main treatment outcomes. The median length of stay (LOS) for the study population was 3 days. The median LOS was shorter among those receiving narrow-spectrum therapy compared with those receiving broad-spectrum therapy. Treatment dose and duration of therapy were significantly associated with treatment outcome (P<0.0001 and P=0.003), respectively. Conclusion: The effectiveness of narrow-spectrum therapy is similar to that of broad-spectrum therapy for children hospitalized with CAP. Treatment regimens for children with community-acquired pneumonia should be selected based on their safety profile and their tendency for antibiotic resistance.
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| 12. |
- Dorell, Åsa, et al.
(författare)
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Expressed emotions and experiences from relatives regarding having a family member living in a nursing home for older people
- 2019
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Ingår i: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to describe the topics relatives with a family member in a nursing home for older persons choose to talk about and focus on when participating in a nurse-led “Family Health Conversations” intervention. Family Health Conversations consisted of a series of three nurse-led conversations with each family, with a 2-week interval between meetings.Methods: The Family Health Conversations meetings were tape-recorded and analyzed using qualitative content methods. The participants were relatives of family members living in a nursing home for older persons in a municipality in Sweden.Results: The findings showed how the relatives talked about their suffering and difficulties concerning the new situation. The relatives talked about frustration and sadness together in a new way, with a focus on how to manage the future. They also wished that they had been offered an opportunity to talk about this with nurses earlier in the illness trajectory.Conclusion: The relatives had a significant need to talk about their experiences together within the family and together with the nurses. Nurses have an especially important task in supporting relatives having a family member living in a nursing home.
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| 13. |
- Ekström, Henrik, et al.
(författare)
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The association between loneliness, social isolation, and sleep disturbances in older adults: A follow-up study from the Swedish good aging in Skåne project
- 2024
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Ingår i: SAGE Open Medicine. - 2050-3121. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this follow-up study was to investigate whether loneliness and social isolation in a sample of olderadults, mean age of 67.4 years at baseline examination, were associated with sleep disturbances at re-examination at a mean age of 76.4 years.Methods: The study sample consisted of 2897 participants. Data on loneliness, social isolation, and sleep disturbanceswere collected through questionnaires and medical examinations. Logistic regression models were constructed to identifyassociations between levels of loneliness and social isolation at baseline and sleep disturbances at follow-up. Sociodemographic and health-related confounding factors were controlled for in the models.Results: Sleep disturbances were reported by 25.6% (95% CI: 24.0%–27.2%) at baseline and 23.7% (95% CI: 22.1%–25.3%)at re-examination. Odds ratios for sleep disturbances at re-examination in relation to not being lonely or socially isolatedwere as follows: single occasions of loneliness (OR: 1.37, 95% CI: 1.05–1.78), recurring periods/constant loneliness (OR:1.92, 95% CI: 1.01–1.99), less severe social isolation (OR: 1.18, 95% CI: 0.78–1.79), and severe social isolation (OR: 1.88,95% CI: 1.01–3.49).Discussion: Sleep disturbances are common among older adults and are associated with loneliness and social isolation.Healthcare professionals should be aware of the potential effects of loneliness and social isolation when investigating sleep disturbances in older adults.
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| 14. |
- Elgzyri, Targ, et al.
(författare)
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Healing below the ankle is possible in patients with diabetes mellitus and a forefoot gangrene
- 2021
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Forefoot gangrene in patients with diabetes is a severe form of foot ulcers with risk of progress and major amputation. No large cohort studies have examined clinical characteristics and outcome of forefoot gangrene in patients with diabetes. The aim was to examine clinical characteristics and outcome of forefoot gangrene in patients with diabetes admitted to a diabetic foot centre. Methods: Patients with diabetes and foot ulcer consecutively presenting were included if they had forefoot gangrene (Wagner grade 4) at initial visit or developed forefoot gangrene during follow-up at diabetic foot centre. Patients were prospectively followed up until final outcome, either healing or death. The median follow-up period until healing was 41 (3-234) weeks. Results: Four hundred and seventy-six patients were included. The median age was 73 (35-95) years and 63% were males. Of the patients, 82% had cardiovascular disease and 16% had diabetic nephropathy. Vascular intervention was performed in 64%. Fifty-one patients (17% of surviving patients) healed after auto-amputation, 150 after minor amputation (48% of surviving patients), 103 had major amputation (33% of surviving patients) and 162 patients deceased unhealed. Ten patients were lost at follow-up. The median time to healing for all surviving patients was 41 (3-234) weeks; for auto-amputated, 48 (10-228) weeks; for minor amputated, 48 (6-234) weeks; and for major amputation, 32 (3-116) weeks. Conclusion: Healing without major amputation is possible in a large proportion of patients with diabetes and forefoot gangrene, despite these patients being elderly and with extensive co-morbidity.
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| 15. |
- Glenngård, Anna, et al.
(författare)
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Does increased standardisation in health care mean less responsiveness towards individual patients expectations? : A register based study in Swedish primary care
- 2017
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Ingår i: SAGE Open. - : SAGE Publications. - 2158-2440 .- 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Objective:We explore whether standardisation in health care based on evidence on group level and a public health perspective is in conflict with responsiveness towards individual patient’s expectations in Swedish primary care.Methods:Using regression analysis, we study the association between patient views about providers’ responsiveness and indicators reflecting provider’s adherence to evidence-based guidelines, controlled for characteristics related to providers, including patient mix and degree of competition facing providers. Data were taken from two Swedish regions in years 2012 and 2013.Results:Patients’ views about responsiveness are positively correlated with variables reflecting provider’s adherence to evidence-based guidelines regarding treatment of elderly and risk groups, drug reviews and prescription of antibiotics. A high overall illness, private ownership and a high proportion of all visits being with a doctor are positively associated with patient views about responsiveness. The opposite relation was found for a high social deprivation among enrolled individuals and size of practice. There was no systematic variation with respect to the degree of competition facing providers.Conclusion:Results suggest that responsiveness towards individual patient expectations is compatible with increased standardisation in health care. This is encouraging for health care providers as they are challenged to balance increased demands from both patients and payers.
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| 16. |
- Gunnarsson, Thordur, et al.
(författare)
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Eight-year outcome after invasive treatment of infrainguinal intermittent claudication : A population-based analysis from the Swedish vascular register (Swedvasc)
- 2020
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Invasive treatment of infrainguinal intermittent claudication is controversial, and long-term outcomes are scarce. The study aim was to evaluate 8 years results regarding new vascular interventions on index and contralateral limb, hospitalization, mortality, and amputation in 775 patients revascularized for infrainguinal intermittent claudication in 2009. Methods: Data on new vascular interventions retrieved from the Swedish vascular register (Swedvasc) were linked to the Inpatient Register and Cause of Death Register with information on hospitalizations, primary discharge diagnoses according to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), deaths, causes of death, and amputations. Results: During 8 years of follow-up, 486 new vascular interventions were performed. Patients were admitted for a total of 4662 hospitalizations and spent 25,970 days in hospital. Between 79% and 99% of surviving subjects were hospitalized each year. During follow-up, 311 (40.1%) patients died. The most common causes of hospitalization and death were cerebrovascular disease, ischemic heart disease, or other diseases of the circulatory system, causing 47.5% of hospitalizations and 42.4% of deaths. Seventy-seven major lower limb amputations were performed in 52 patients. Conclusion: As patients undergoing invasive treatment of infrainguinal intermittent claudication have high morbidity and mortality, during 8 years of follow-up, the indication for invasive treatment should be carefully weighed against concomitant comorbidities and the timing of this treatment optimized with regard to the patient’s possibilities to enjoy positive treatment effects on quality of life.
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| 17. |
- Hemminki, Kari, et al.
(författare)
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Thalassemia and sickle cell anemia in Swedish immigrants : Genetic diseases have become global
- 2015
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Some 15% of the Swedish population is born outside Sweden, originating from all continents of the world. Thalassemia and sickle cell anemia constitute the most common inherited recessive disorders globally and they are endemic in areas of Africa and Asia, origins of many immigrants to Sweden. We aimed at investigating the origins of the Swedish sickle cell and thalassemia patients.METHODS: Patients were identified using data from the Swedish Hospital Discharge Register since 1987 and from the Outpatient Register since 2001 up to year 2010.RESULTS: A total of 3064 persons were diagnosed with thalassemia. The incidence was highest, 62.9/100,000 for immigrants from Thailand, followed by Iraqis (47.1/100,000); the rate was 0.7/100,000 among those born in Sweden. The total number of sickle cell anemia patients was 584 and the highest rate of 13.0/100,000 was found for Sub-Saharan immigrants. For thalassemia, 363 of the patients were siblings, while for sickle cell anemia, 180 were siblings.CONCLUSIONS: The data showed that >90% of sickle cell and thalassemia patients were first- or second-generation immigrants to Sweden and the endemic regions for these were the origins of immigrants with the highest incidence. Global immigration provides global challenges to national health care systems.
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| 18. |
- Holm, Alexander, et al.
(författare)
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Patients' perspective on prostatic artery embolization : A qualitative study
- 2021
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Ingår i: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 9, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe the patients' experience of undergoing prostatic artery embolization.Methods: A retrospective qualitative interview study was undertaken with 15 patients of mean age 73 years who had undergone prostatic artery embolization with a median duration of 210 min at two medium sized hospitals in Sweden. The reasons for conducting prostatic artery embolization were clean intermittent catheterization (n = 4), lower urinary tract symptoms (n = 10) or haematuria (n = 1). Data were collected through individual, semi-structured telephone interviews 1-12 months after treatment and analysed using qualitative content analysis.Results: Four categories with sub-categories were formulated to describe the results: a diverse experience; ability to control the situation; resumption of everyday activities and range of opinions regarding efficacy of outcomes. Overall, the patients described the procedure as painless, easy and interesting and reported that while the procedure can be stressful, a calm atmosphere contributed to achieving a good experience. Limitations on access to reliable information before, during and after the procedure were highlighted as a major issue. Practical ideas for improving patient comfort during the procedure were suggested. Improved communications between treatment staff and patients were also highlighted. Most patients could resume everyday activities, some felt tired and bruising caused unnecessary worry for a few. Regarding functional outcome, some patients described substantial improvement in urine flow while others were satisfied with regaining undisturbed night sleep. Those with less effect were considering transurethral resection of the prostate as a future option. Self-enrolment to the treatment and long median operation time may have influenced the results.Conclusions: From the patients' perspective, prostatic artery embolization is a well-tolerated method for treating benign prostate hyperplacia.
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| 19. |
- Höglund, Odd, et al.
(författare)
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Chromogranin A and cortisol at intraoperative repeated noxious stimuli : surgical stress in a dog model
- 2015
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Biomarkers representing sympathetic tone and the surgical stress response are measured to objectively evaluate surgical techniques and anaesthetic protocols. If a part of the intraoperative procedure is repeated on the contralateral organ, one animal may potentially serve as its own control and, if so, may minimize the problem of individual differences of the stress response to anaesthesia and surgery. This study aimed to investigate the use of chromogranin A for measurement of the intraoperative sympathetic tone. Additional aims were to investigate chromogranin A and cortisol as indicators of the intraoperative surgical stress response caused by repeated noxious stimuli in dogs subjected to ovariohysterectomy and thereby to investigate the possibility of one dog serving as its own control. Methods: Experiments were carried out on 10 dogs subjected to ovariohysterectomy. Perioperative blood samples (0-6) were collected after premedication, immediately before induction of anaesthesia (0), after induction of anaesthesia and before incision (1), before (2) and after (3) removal of the first ovary, after a 15-min pause before removal of the second ovary (4), after removal of the second ovary (5) and after closing the abdomen (6). Plasma chromogranin A and cortisol were analysed. Results: Plasma chromogranin A did not change. Plasma cortisol concentration did not change between before anaesthesia and opening of the abdomen. Plasma cortisol increased at removal of the first ovary. Cortisol did not change at removal of the second ovary but remained increased compared to initial sample. Conclusion: The results suggest chromogranin A is a poor indicator of intraoperative sympathetic tone during elective surgery in dogs. Cortisol measurement was useful for assessment of intraoperative noxious stimuli. However, at these test conditions, neither plasma chromogranin A nor plasma cortisol was useful for assessment of repeated intraoperative noxious stimuli where one dog served as its own control..
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| 20. |
- Inci, Kamuran, et al.
(författare)
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Air bubbles are released by thoracic endograft deployment: An in vitro experimental study
- 2016
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Embolic stroke is a dreaded complication of thoracic endovascular aortic repair. The prevailing theory about its cause is that particulate debris from atherosclerotic lesions in the aortic wall are dislodged by endovascular instruments and embolize to the brain. An alternative source of embolism might be air trapped in the endograft delivery system. The aim of this experimental study was to determine whether air is released during deployment of a thoracic endograft. Methods: In an experimental benchtop study, eight thoracic endografts (five Medtronic Valiant Thoracic and three Gore TAG) were deployed in a water-filled transparent container drained from air. Endografts were prepared and deployed according to their instructions for use. Deployment was filmed and the volume of air released was collected and measured in a calibrated syringe. Results: Air was released from all the endografts examined. Air volumes ranged from 0.1 to 0.3 mL for Medtronic Valiant Thoracic and from <0.025 to 0.04 mL for Gore TAG. The largest bubbles had a diameter of approximately 3 mm and came from the proximal end of the Medtronic Valiant device. Conclusion: Air bubbles are released from thoracic endografts during deployment. Air embolism may be an alternative cause of stroke during thoracic endovascular aortic repair.
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| 21. |
- Ivarsson, Bodil, et al.
(författare)
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Coping, social support and information in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension : A 2-year retrospective cohort study
- 2018
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 6, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are severe diseases with complicated treatment that need care at specialist clinics. The aim was to investigate changes in the patients' perceptions on coping, social support and received information when attending a newly started nurse-coordinated pulmonary arterial hypertension-outpatient clinic.Methods: The present study was a descriptive, questionnaire-based cohort study including 42 adult patients. To evaluate coping, the Pearlin Mastery Scale was used. Social support, information and health-related quality of life were measured using Social Network and Support Scale, QLQ-INFO25 and the EQ-5D.Results: Attending the pulmonary arterial hypertension-outpatient clinic increased coping ability (Mastery Scale) significantly (baseline 16.0 ± 3.3 points vs 2-year follow-up 19.6 ± 5.2 points, p < 0.001) while there was no difference in social network and support or in perception of received information after. Patients who improved their coping ability (67%) were younger, had better exercise capacity, experienced better health-related quality of life and were more satisfied with received information about treatment and medical tests than those who reduced the coping ability. There was no difference in gender, diagnosis, time since diagnose, pulmonary arterial hypertension-specific treatment, education level or civil status between the two groups.Conclusion: This study suggests that the pulmonary arterial hypertension-team, in partnership with the patient, can support patients to take control of their disease and increase their health-related quality of life.
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| 22. |
- Ivarsson, Bodil, et al.
(författare)
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Experiences of supportive care when waiting for a lung re-transplantation
- 2017
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Ingår i: SAGE Open. - : SAGE Publications. - 2158-2440 .- 2050-3121. ; 5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs.METHODS: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation.RESULTS: The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown.CONCLUSION: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.
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| 23. |
- Kamwesiga, JT, et al.
(författare)
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Cultural adaptation and validation of Stroke Impact Scale 3.0 version in Uganda: A small-scale study
- 2016
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 4, s. 2050312116671859-
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Tidskriftsartikel (refereegranskat)abstract
- Knowledge is scarce about the impact of stroke in Uganda, and culturally adapted, psychometrically tested patient-reported outcome measures are lacking. The Stroke Impact Scale 3.0 is recommended, but it has not been culturally adapted and validated in Uganda. Objective: To culturally adapt and determine the psychometric properties of the Stroke Impact Scale 3.0 in the Ugandan context on a small scale. Method: The Stroke Impact Scale 3.0 was culturally adapted to form Stroke Impact Scale 3.0 Uganda ( in English) by involving 25 participants in three different expert committees. Subsequently, Stroke Impact Scale 3.0 Uganda from English to Luganda language was done in accordance with guidelines. The first language in Uganda is English and Luganda is the main spoken language in Kampala city and its surroundings. Translation of Stroke Impact Scale 3.0 Uganda ( both in English and Luganda) was then tested psychometrically by applying a Rasch model on data collected from 95 participants with stroke. Results: Overall, 10 of 59 (17%) items in the eight domains of the Stroke Impact Scale 3.0 were culturally adapted. The majority were 6 of 10 items in the domain Activities of Daily Living, 2 of 9 items in the domain Mobility, and 2 of 5 items in the domain Hand function. Only in two domains, all items demonstrated acceptable goodness of fit to the Rasch model. There were also more than 5% person misfits in the domains Participation and Emotion, while the Communication, Mobility, and Hand function domains had the lowest proportions of person misfits. The reliability coefficient was equal or larger than 0.90 in all domains except the Emotion domain, which was below the set criterion of 0.80 (0.75). Conclusion: The cultural adaptation and translation of Stroke Impact Scale 3.0 Uganda provides initial evidence of validity of the Stroke Impact Scale 3.0 when used in this context. The results provide support for several aspects of validity and precision but also point out issues for further adaptation and improvement of the Stroke Impact Scale.
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| 24. |
- Karlsson, Linn, et al.
(författare)
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Associations between psychological factors and the effect of home-based physical exercise in women with chronic neck and shoulder pain.
- 2016
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Ingår i: SAGE open medicine. - : Sage Publications. - 2050-3121. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise is often used in the treatment of chronic neck and shoulder muscle pain. It is likely that psychological aspects have an impact on the results of exercise-based treatments.OBJECTIVES: (1) To examine the associations between psychological factors and the effect of a home-based physical exercise intervention. (2) To examine differences in psychological factors at baseline between (a) subjects who continued in the trial and those who did not and (b) subjects who completed the intervention and those who did not.METHOD: A total of 57 women with chronic neck and shoulder pain were included in a home-based exercise intervention trial. Pain intensity, disability, and psychological factors (anxiety and depression symptoms, catastrophizing, fear-avoidance beliefs, self-efficacy, and pain acceptance) were measured at baseline, after 4-6 months, and after 1 year of exercise. Associations between the psychological factors and changes in pain intensity and disability were analysed, as well as differences in psychological factors at baseline between subjects who continued in and completed the intervention, and those who did not.RESULTS: Associations between positive changes in pain intensity and disability were found for low fear-avoidance beliefs and low-pain self-efficacy at baseline. In addition, fear-avoidance beliefs at baseline were higher in the subjects who dropped out of the intervention than in those who continued. Pain acceptance at baseline was higher in the subjects who completed the intervention at the end of the trial.CONCLUSION: Particularly, fear-avoidance beliefs and pain self-efficacy should be taken into consideration when implementing home-based physical exercise as treatment for chronic neck pain. In addition, high pain acceptance might improve the adherence to prescribed exercise.
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| 25. |
- Kjellström, Barbro, et al.
(författare)
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Respiratory rate modulation improves symptoms in patients with pulmonary hypertension
- 2021
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are chronic diseases with a severe symptom burden. Common symptoms are dyspnoea at light activity and general fatigue that limits daily activities. Respiratory modulation by device-guided breathing decreased symptoms in patients with heart failure. The aim of this pilot study was to investigate if respiratory modulation could improve symptoms of dyspnoea in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension.Method: Adult patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension with symptoms of dyspnoea at rest or light activity performed home-based respiratory modulation by device-guided breathing 20 min a day for 3 months. Patients were on stable disease-specific treatment ⩾3 months and willing to undergo all study procedures. Dyspnoea score, World Health Organization class, physical status, N-terminal pro b-type natriuretic peptide, quality of life, respiratory rate and 6-min walk distance were assessed before and after 3 months with respiratory modulation.Results: Nine patients with pulmonary arterial hypertension and five with chronic thromboembolic pulmonary hypertension completed the study protocol. Mean age was 71 ± 14 years, and 11 were women. After 3 months of respiratory modulation, dyspnoea score (-0.6, p = 0.014), respiratory rate at rest (-3 breaths/min, p = 0.013), World Health Organization class (-0.3, p = 0.040), quality of life (EuroQol Visual Analogue Scale +5 points, not significant) and decreased N-terminal pro b-type natriuretic peptide (-163 ng/L, p = 0.043) had improved. The fatigue and respiratory rate after the 6-min walk decreased while the 6-min walk distance remained unchanged.Conclusion: Patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension that used device-guided breathing for 3 months improved symptoms of dyspnoea and lowered the respiratory rate at rest and after exercise.
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| 26. |
- Lundman, Berit, et al.
(författare)
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Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults
- 2019
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Ingår i: SAGE Open Medicine. - : SAGE Open. - 2050-3121. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Inner Strength has been described as a human resource that promotes well-being linked to health. The aim of this study was to explore how Inner Strength and its four dimensions are manifested in interviews in a group of middle-aged healthy women and men.Methods: Retrospective reflective interviews with middle-aged healthy women (n = 5) and men (n = 4) selected from a population study were content analysed deductively.Results: The following themes and their constituents were found in the respective dimensions of the Model of Inner Strength. Firmness: having a drive to act, being purposeful, having trust in one’s competence, and having a positive view of life. Connectedness: being in community, receiving and giving support, and, receiving and giving care. Creativity: changing unsatisfactory life situations, seeing new opportunities, and realizing dreams. Stretchability: balancing between options, and extending oneself.Conclusions: Expressions that were interpreted as belonging to Inner Strength could be referred the different dimensions of Inner Strength. The Model of Inner Strength is suitable for analysing Inner Strength among middle-aged men and women. The findings indicate that Inner Strength can be identified in human beings’ narratives if asked for.
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| 27. |
- Lunnemar, Petter, et al.
(författare)
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An analysis of central venous catheter-related bloodstream infections in patients treated in a Swedish Covid-19 intensive care unit
- 2024
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Ingår i: SAGE Open Medicine. - : SAGE PUBLICATIONS INC. - 2050-3121. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Catheter-related bloodstream infection is a well-known, severe complication of central venous catheter insertion. Studies that have evaluated the coronavirus disease 2019 pandemic's influence on the incidence of catheter-related bloodstream infection in intensive care units are limited. Therefore, we conducted a retrospective study on catheter-related bloodstream infection in coronavirus disease 2019 intensive care unit with previously documented low incidence rates to evaluate the pandemic's impact. Objectives: To evaluate the impact of the coronavirus disease 2019 pandemic on catheter-related bloodstream infection incidence in the intensive care unit. Methods: All central venous catheter-inserted patients aged >= 18 years admitted to the intensive care unit with coronavirus disease 2019 pneumonia were included. The primary outcome was the incidence of catheter-related bloodstream infection, and the secondary outcome was the detection of catheter-related bloodstream infection-causative microorganisms. Results: During the pandemic's first year, 124 patients were admitted, and 203 central venous catheters were inserted. Two patients developed catheter-related bloodstream infection. The incidence of catheter-related bloodstream infection was 0.79/1000 catheter days. The microorganisms responsible for catheter-related bloodstream infection were Staphylococcus epidermidis and Escherichia coli. Conclusion: This study revealed a low incidence of catheter-related bloodstream infection in the coronavirus disease 2019-intensive care unit, thus suggesting that coronavirus disease 2019 is not a risk factor for catheter-related bloodstream infection and indicating the high resilience of well-established routines aimed at catheter-related bloodstream infection prevention.
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| 28. |
- Malm, K., et al.
(författare)
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Quality of life in patients with established rheumatoid arthritis: A phenomenographic study
- 2017
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Ingår i: Sage Open Medicine. - Thousand Oaks, CA : SAGE Publications. - 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patients with rheumatoid arthritis perceive reduced quality of life in several domains, such as physical health, level of independence, environment and personal beliefs, compared with the healthy population. There is an increasing interest in quality of life in clinical and medical interventions. Few studies have explored patients' individual conceptions of quality of life, and interviews can thus complement quantitative studies. There is a need for a deeper understanding of the patients' experiences of quality of life, with regard to living with a long-term condition such as rheumatoid arthritis. The aim of this study was to explore the variation of ways in which patients with established rheumatoid arthritis understand the concept of quality of life. Methods: The study had a qualitative design with a phenomenographic approach, which was used to describe variations in how individuals experience their quality of life. The study is based on interviews with 22 patients with established rheumatoid arthritis enrolled in the BARFOT (better anti-rheumatic pharmacotherapy) study. Results: The concept of quality of life could be understood in three different ways: (I) independence in terms of physical functioning and personal finances, (2) empowerment in how to manage life and (3) participation as an experience of belonging in a social context. Conclusion: The different conceptions of quality of life reflect the complexity in the concept, including physical, psychological and social aspects. This complexity is important to have in mind when health professionals support patients in enhancing their quality of life.
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| 29. |
- Mortazavi, Rebecca, et al.
(författare)
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Empowered and engaged : Group exercise for adolescent depression – perspectives from adolescents, parents and healthcare professionals
- 2024
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Ingår i: SAGE Open Medicine. - Thousand Oaks, CA : Sage Publications. - 2050-3121. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Depression is increasing and is a leading cause of disease burden among adolescents. Available evidence-based treatments with medication or psychotherapy have modest effects. Aerobic exercise is a hopeful alternative as an augmenter or a stand-alone treatment. Qualitative studies have shown that participants in group exercise for adolescent depression experienced improved mood and a sense of achievement, commitment and empowerment. This study aimed to explore not only adolescents’ but also parents’ and healthcare professionals’ experiences of a group exercise intervention for adolescents with depression. Methods: Nine adolescents who had participated in a group aerobic exercise intervention for 12 weeks, eight parents and two healthcare professionals were interviewed. We used a latent qualitative content analysis with an inductive approach that resulted in nine sub-categories, three categories and an overarching theme. Results: The experiences of a group exercise intervention for adolescents with depression were expressed in the overarching theme ‘Group exercise for adolescent depression promotes empowerment and engagement in everyday life’, based on three categories: exercise alleviates depressive symptoms, exercise contributes to balance in life and exercise promotes self-esteem. However, there was variation in our results, in that not all participants experienced improvements from exercising. Adolescents described more varied experiences, while parents and healthcare professionals mainly expressed positive views. Conclusions: Our findings suggest that group exercise for adolescent depression promotes empowerment and engagement in everyday life, according to adolescents, and more clearly so according to parents and healthcare professionals. © The Author(s) 2024.
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| 30. |
- Peterson, Magnus, 1966-, et al.
(författare)
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Vibrotactile perception on the sole of the foot in an older group of people with normal glucose tolerance and type 2 diabetes
- 2020
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 8, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate vibrotactile sense in an older group of people with normal glucose tolerance and type 2 diabetes relative to other sensory tests.Methods: Vibration perception thresholds on the sole of the foot (Multifrequency vibrametry and Biothesiometer) were compared to the results from evaluation of touch (monofilament), electrophysiology (sural nerve) and thermal sensation (Thermotest®).Results: Vibration perception and temperature thresholds, as well as sural nerve function, differed between normal glucose tolerance and type 2 diabetes. Measuring vibration perception thresholds at lower frequencies with multifrequency vibrametry versus biothesiometer provided correlations similar to sural nerve amplitude. Temperature thresholds correlated with vibration perception thresholds and sural nerve function. Monofilaments revealed pathology in only a few participants with type 2 diabetes.Conclusions: In an older group of people, vibration perception thresholds show a correlation similar to sural nerve amplitude on tactile and non-tactile surfaces. Measuring a vibration perception threshold on a tactile surface in type 2 diabetes provides no clear advantage over measuring it on the medial malleolus. In older type 2 diabetes subjects, both large and small diameter nerve fibers are affected.
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| 31. |
- Qvarfordt, Maria, 1982-, et al.
(författare)
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Factors influencing physical activity in patients with early rheumatoid arthritis : A mixed-methods study.
- 2019
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Ingår i: SAGE Open Medicine. - Thousand Oaks, CA : Sage Publications. - 2050-3121. ; 7, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The goal of this study was to provide a greater understanding of physical activity in patients with early rheumatoid arthritis. The aim was twofold: first to explore if physical activity was associated with factors in the clinical picture of rheumatoid arthritis in this patient group, and second, to explore factors influencing physical activity in patients with early rheumatoid arthritis.Methods: A total of 66 patients with early rheumatoid arthritis were included in the study. A sequential explanatory mixed-methods design was used, where quantitative data from a questionnaire were analysed with Mann-Whitney, post hoc Kruskal-Wallis and χ2 test in order to detect differences between groups, and find possible associations between physical activity and independent variables, such as disease activity, health-related quality of life and physical function. Qualitative data were collected in a follow-up questionnaire with open-ended questions that focused on factors influencing physical activity.Results: Associations between physical activity, disease activity and health-related quality of life were seen in patients with early rheumatoid arthritis together with strong negative correlations between physical activity and physical function. Patients on sick leave showed the strongest associations between disease-related variables and lower levels of physical activity. The findings from the qualitative analysis showed that physical limitations, awareness as a motivational factor and external environment factors influenced physical activity in patients with early rheumatoid arthritis.Conclusion: The results showed a complex underlying motive where physical, psychological and environmental factors influenced the physical activity in patients with early rheumatoid arthritis. In order to provide more effective health interventions, it is important to consider the complex nature of practicing physical activity, where a person-centred approach should be considered. Factors such as physical limitations, economic aspects and time for practicing physical activity should be included in the person-centred approach.
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| 32. |
- Raykar, NP, et al.
(författare)
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Assessing the global burden of hemorrhage: The global blood supply, deficits, and potential solutions
- 2021
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 9, s. 20503121211054995-
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Tidskriftsartikel (refereegranskat)abstract
- There is a critical shortage of blood available for transfusion in many low- and middle-income countries. The consequences of this scarcity are dire, resulting in uncounted morbidity and mortality from trauma, obstetric hemorrhage, and pediatric anemias, among numerous other conditions. The process of collecting blood from a donor to administering it to a patient involves many facets from donor availability to blood processing to blood delivery. Each step faces particular challenges in low- and middle-income countries. Optimizing existing strategies and introducing new approaches will be imperative to ensure a safe and sufficient blood supply worldwide.
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| 33. |
- Ruergård, Anna, et al.
(författare)
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Results of minimally invasive Achilles tendon scraping and plantaris tendon removal in patients with chronic midportion Achilles tendinopathy : A longer-term follow-up study
- 2019
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment with ultrasound and colour Doppler–guided minimally invasive Achilles tendon scraping and plantaris tendon removal has shown promising short-term results in patients with chronic painful midportion Achilles tendinopathy.Methods: In a follow-up study, 182 consecutive patients (241 tendons) who had undergone Achilles tendon scraping and plantaris tendon removal were contacted on telephone by an independent investigator. The patients who answered the telephone call were included, and they answered a questionnaire on telephone and then also sent their written answers. The questionnaire included information about patient satisfaction with the result of the treatment, time to return to full Achilles tendon loading activity, and a pain score (Visual Analogue Scale-VAS).Results: The follow-up period was 5.8 years (mean) (range of 2–13 years) after surgery. Altogether, 110 patients (136 Achilles tendons), 52 years (mean)(range 18-73) old at surgery could be reached and were included. In total, 81 tendons were operated with the Achilles scraping procedure alone, and for 55 Achilles operations also a plantaris tendon removal was performed. For 93% of the operated tendons, the patients were satisfied with the surgical outcome and the VAS had decreased from 74 preoperatively to 8 postoperatively. Nine male patients (9 tendons), five operated with scraping + plantaris removal, had remaining tendon pain during loading and were not satisfied. Their VAS score ranged from 22 to 91. For 21% of the operated tendons, some occasional mild discomfort not preventing from full tendon loading, was reported. There were no differences in pain reduction and satisfaction rates between men and women, and between Achilles scraping alone and scraping plus plantaris removal.Conclusion: Ultrasound and colour Doppler–guided surgical Achilles tendon scraping and plantaris tendon removal in patients with chronic painful midportion Achilles tendinopathy show remaining good clinical outcomes and high satisfaction rates in this longer-term follow-up.
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| 34. |
- Shayesteh, Alexander, et al.
(författare)
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Impostor phenomenon is a common feature among individuals with primary hyperhidrosis
- 2024
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary hyperhidrosis consists of excessive focal sweating. Affected individuals camouflage the sweating on their body, avoiding stigmatisation. Hence, misrepresentation in social interactions is a common feature in patients with hyperhidrosis. The aim of this study was to investigate impostor phenomenon, perfectionism, self-compassion, stress and anxiety among individuals with primary hyperhidrosis.Methods: A cross-sectional study was conducted at our clinic among 100 participants with axillary and palmar primary hyperhidrosis. The questionnaire contained a hyperhidrosis part and Perceived Stress Scale-4, Generalised Anxiety Disorder Scale-2, Clinical Perfectionism Questionnaire-6, Self-Compassion Scale Short form and Clance Impostor Phenomenon Scale. Descriptive statistics was used for analyses of categorical variables. As data were normally distributed independent t-test and one-way analysis of variance with post hoc Tukey test were used to compare the mean values for the questionnaires with other variables. Pearson's correlation was used, and a forward multiple linear regression model was performed to predict presence of impostor phenomenon with gender, age and other scales in this study.Results: Impostor phenomenon occurred in almost half of our patients (48%) with hyperhidrosis. While feelings of impostor phenomenon were more common in women, there was no difference between gender regarding its intensity levels (p = 0.07). In addition, we found a significant (p < 0.001) negative correlation between impostor phenomenon and self-compassion, while feelings of impostor phenomenon increased with stress, anxiety and perfectionism (p < 0.001).Conclusions: Feelings of impostor phenomenon was found in 48% of individuals with hyperhidrosis which indicates that it is a common feature in this patient group. Future research is warranted regarding the prevalence of impostor phenomenon in hyperhidrosis and other medical conditions, among men and women, seeking medical healthcare. Psychological interventions in hyperhidrosis may be beneficial both for the individual and in public health, by facilitating management of patients' daily lives and saving considerable resources in healthcare regarding pharmacological interventions and medical consultations.
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| 35. |
- Sjöholm, Hanna, 1975-, et al.
(författare)
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Exploring possible risk factors for time to first fall and 6-month fall incidence in persons with acute stroke
- 2022
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Ingår i: SAGE Open Medicine. - Mannheim, Germany : SAGE Open. - 2050-3121. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:The aim was to explore how the time to the first fall and 6-month fall incidence relates to rapidly and easily collected data in persons with acute stroke.Methods:Out of consecutively admitted patients with stroke at three stroke units, 284 with at least one follow-up were included in this prospective cohort study. During 6 months following discharge, participants reported falls using a diary and monthly phone calls. Data about participants’ characteristics, functions, and activities were collected during hospital stay and analyzed in relation to time to first fall by Cox regression and fall incidence by negative binomial regression.Results:Use of ⩾9 medications, paresis in arms, paresis in legs (National Institutes of Health Stroke Scale), impaired protective reactions in sitting (Postural Reactions Test), and limitations in self-care (Barthel Index) were decisive risk factors for time to first fall. Limitations in mobility (Step Test, 30-s Chair Stand Test) were decisive risk factors for high fall incidence (p < 0.0005).Conclusion:Several easily collected participant characteristics, functions, and activities were identified as risk factors for falls. The findings emphasize the width of assessments that can be used for the identification of individuals at risk for falls and that the risk factors vary in different strata of the population. These results are important when developing multivariate risk models. The risk factors differed in part when analyzing the time to the first fall and 6-month fall incidence.
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| 36. |
- Sjöwall, D, et al.
(författare)
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No effects of a long-term physical activity intervention on executive functioning among adolescents
- 2019
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 7, s. 2050312119880734-
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Tidskriftsartikel (refereegranskat)abstract
- We investigated whether a school-based physical activity intervention would lead to improvements in working memory, inhibition and cognitive flexibility in adolescents aged 13–15 years. Methods: The adolescents at the active school ( n = 108) participated in an intervention that included increased physical activity for 20 min/day, focused on aerobic activity with low cognitive demands for an entire school year. The adolescents at the control school ( n = 59) received no extra physical activity. At the beginning (baseline) and end (follow-up) of the school year, the participants performed tests of executive function (working memory, inhibition and cognitive flexibility) and performed tests of physical fitness and health. Results: There was no change in executive functioning at follow-up when comparing the schools. However, only 46% complied with the intervention. When non-compliers were excluded from the analyses, the results remained the same, except for a small but significant increase in working memory for the active school as compared to the control school. Conclusion: These results indicate that compliance with the intervention was low and that aerobic exercise with low cognitive load does not produce improvements in executive functioning.
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| 37. |
- Skär, Lisa, et al.
(författare)
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Health-related quality of life and sense of coherence among people with obesity : Important factors for health management
- 2014
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study was to evaluate whether health-related quality of life and levels of sense of coherence among people with obesity are correlated with body mass index, age, and gender. Methods: A cross-sectional, descriptive research design was used. Subjects (n = 157) were selected from a sample of participants in an ongoing survey and had a body mass index >30 kg/m2. Data were collected using the Short Form-36 Health Survey and the Sense of Coherence Scale. Results: The mean body mass index of women was higher than that of men. Compared to men, a greater proportion of women had a low sense of coherence. There was a significant relationship between low physical health and high body mass index. Female gender and older age correlated with a low sense of coherence and showed a significant association with high body mass index. Conclusion: To increase the health-related quality of life, people with obesity need support to help manage their life situation based on their individual needs and personal resources.
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| 38. |
- Smidfelt, Kristian, et al.
(författare)
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Routine open abdomen treatment compared with on-demand open abdomen or direct closure following open repair of ruptured abdominal aortic aneurysms: A propensity score-matched study
- 2019
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Ingår i: Sage Open Medicine. - : SAGE Publications. - 2050-3121. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate whether a strategy of treatment with a primarily open abdomen improves outcome in terms of mortality and major complications in patients treated with open repair for a ruptured abdominal aortic aneurysm compared to a strategy of primary closure of the abdomen. Design: Retrospective cohort study. Methods: Patients treated with a primarily open abdomen at a centre where this strategy was routine in most ruptured abdominal aortic aneurysm patients were compared to a propensity score-matched control group of patients who had the abdomen closed at the end of the primary operation in a majority of the cases. Results: In total, 79 patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm at Sahlgrenska University Hospital were compared to a propensity score-matched control group of 148 patients. The abdomen was closed at the end of the procedure in 108 (73%) of the control patients. There was no difference in 30-day mortality between patients treated with a primarily open abdomen at Sahlgrenska University Hospital and the controls, 21 (26.6%) versus 49 (33.1%), p = 0.37. The adjusted odds ratio for mortality at 30 days was 0.66 (95% confidence interval: 0.35-1.25) in patients treated with a primarily open abdomen at Sahlgrenska University Hospital compared to the controls. No difference was observed between the groups regarding 90-day mortality, postoperative renal failure requiring renal replacement therapy, postoperative intestinal ischaemia necessitating bowel resection or postoperative bleeding requiring reoperation. Conclusions: The study did not show any survival advantage or difference in major complications between patients treated with a primarily open abdomen after open repair for ruptured abdominal aortic aneurysm and propensity-matched controls where the abdomen was primarily closed in a majority of the cases.
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| 39. |
- Svane, Jeff Kirk, et al.
(författare)
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Staff experiences with strategic implementation of clinical health promotion : A nested qualitative study in the WHO-HPH Recognition Process RCT
- 2018
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Health promotion is on the global agenda. The risks targeted include smoking, hazardous alcohol consumption, nutrition and insufficient physical activity. Implementation of clinical health promotion, however, remains a major challenge. While several processes, models and frameworks for strategic implementation exist, very few have been tested in randomized designs. Testing a strategic implementation process for clinical health promotion was only recently attempted via a randomized clinical trial on the World Health Organization Health Promotion Hospitals Recognition Process. The randomized clinical trial showed that the process improved central parts of implementation. To complement these findings, this nested qualitative study aimed to explore experiences and perceptions of staff and managers, who had completed the process, and generate hypotheses for improvements.Methods: We interviewed a purposeful sample of 45 key informants from four countries, who worked at clinical departments and had undertaken the World Health Organization Health Promotion Hospitals implementation process. The informants included 14 managers, 14 medical doctors, 13 nurses and 4 other clinical staff. Interview transcripts were analyzed using qualitative content analysis and an inductive approach to coding and categorization supported by QSR NVivo.Results: The informants' experiences and perceptions centered around four global themes concerning (1) awareness, cultural re-orientation and integration; (2) learnings; (3) normalization and legitimacy and (4) a more evidence-based, structured and systematic approach to clinical health promotion. Informants were positive toward the implementation process, although it was sometimes challenging. The suggested improvements to increase acceptability related to the patient survey, time consumption, translation, tailoring to local circumstances and in-advance training.Conclusions: Managers and staff were positive toward the World Health Organization Health Promotion Hospitals process, which was perceived to bring about positive changes and learnings. The findings also suggest that the implementation process may be improved by minor adjustments to process elements and design. It is our recommendation to use the process in clinical departments to further implementation of clinical health promotion.
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| 40. |
- Woisetschläger, Mischa, 1974-, et al.
(författare)
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Selection of risk assessment methods for osteoporosis screening in postmenopausal women with low-energy fractures : A comparison of fracture risk assessment tool, digital X-ray radiogrammetry, and dual-energy X-ray absorptiometry
- 2022
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Ingår i: SAGE Open Medicine. - : SAGE PUBLICATIONS INC. - 2050-3121. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Objectives:Fracture liaison services are designed to identify patients needing osteoporosis treatment after a fracture. Some fracture liaison service designs involve a prescreening step, for example, fracture risk assessment tool (FRAX®). Another possible prescreening tools are bone mass density assessment in the acute setting. The aim of this study was to assess the effectiveness of prescreening tools.Methods:In the present prospective cohort study, women aged >55 years with a radius fracture were included. Patients were recruited at the emergency department after experiencing their fracture. All patients performed fracture risk assessment by fracture risk assessment tool, and bone mass density assessment by digital X-ray radiogrammetry and dual-energy X-ray absorptiometry (prescreening steps) as well as full routine evaluation at the osteoporosis unit (endpoint). The main outcome measures were sensitivity, specificity, predictive values, and area under the curve.Results:Forty-one women were recruited (mean age: 70 ± 8 years). Of these, 54% fulfilled the treatment indication criteria of osteoporosis after a full examination. Fracture risk assessment tool without bone mass density (cutoff ⩾ 15%) for prescreening patients had a high sensitivity (90%) but a low area under the curve (0.50) and specificity (16%). The highest area under the curve (0.73) was found prescreening with bone mass density assessment (dual-energy X-ray absorptiometry or digital X-ray radiogrammetry) having a sensitivity of 59%–86% and specificity of 61%–90%.Conclusion:This study, though small, raises questions regarding the effectiveness of using a prescreening step in fracture liaison services for high-risk individuals. In this cohort, FRAX® without bone mass density had a low precision, with a risk of both underestimating and overestimating patients requiring treatment. Bone mass density assessment in the acute setting could improve the precision of prescreening. Further investigations on the effectiveness and health economics of prescreening steps in fracture liaison services are needed.
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- Zouini, Btissame, et al.
(författare)
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Somatic health and its association with negative psychosocial factors in a sample of Moroccan adolescents
- 2019
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Adolescence is a distinct developmental phase characterized by multiple physical and psychological changes andby an increased vulnerability to somatic and mental health problems. These risk and vulnerability factors are part of a complexbiopsychosocial matrix, encompassing multiple factors, such as inherited biological determinants and psychological, societal,and cultural influences, which affect an adolescent's overall wellbeing. In Morocco, similar to other developing countries,adolescents (young people aged from 15 to 19years) constitute a substantial proportion of the population (almost 9%).However, studies about adolescents' health in developing countries are scarce. In this study, we describe adolescents' somatichealth in a sample of high school students from the city of Tetouan, Morocco, and investigate how negative psychosocialfactors, such as parental alcohol use problems and/or the experience of abuse, may influence them.Methods: The study sample included 655 adolescents (315 boys and 340 girls, M=16.64years, range=15–18years) fromconviniently selected classes of four high schools in the city of Tetouan in Morocco. The students responded to a survey thatassessed the prevalence of somatic complaints/disorders. They also indicated whether they had ever experienced physicaland/or psychological abuse and whether they had parents with alcohol use problems.Results: More than half of the adolescents suffered from headaches and one-third had substantial problems with diarrhea orconstipation. Both problems were more common in female students. The third most frequent somatic problem, affecting onein four in both genders, was allergy. Almost one-third of Moroccan adolescents (significantly more boys than girls; p=0.004)reported no somatic complaints. In adolescents who reported parental alcohol use problems and/or experience of physicaland/or psychological abuse, the prevalence of several somatic complaints (epilepsy, migraine, headache, diarrhea/constipation,gluten intolerance, allergy, and skin or thyroid disease) increased highly significantly compared to the adolescents whoreported no such psychosocial environmental factors.Conclusion: The results suggest that only 3 in 10 urban-living Moroccan adolescents are free of somatic complaints, whilethe majority suffer from some somatic problems, most often headaches and diarrhea/constipation. The association of certainnegative psychosocial factors with adolescents' somatic health suggests the need of a holistic approach to the treatment of affectedadolescents.
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