| 1. |
- Åström, Monica, 1941-, et al.
(författare)
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Life before and after Stroke : Living Conditions and Life Satisfaction in Relation to a General Elderly Population
- 1992
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Ingår i: Cerebrovascular Diseases. - : S. Karger. - 1015-9770 .- 1421-9786. ; 2:1, s. 28-34
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Tidskriftsartikel (refereegranskat)abstract
- Living conditions and life satisfaction before and after stroke were assessed in 80 patients with acute stroke (mean age 73 years). The results were compared with a general elderly population. Already prior to their stroke the patients had more health problems, lower functional ability, more passive leisure time and lower global life satisfaction. Low life satisfaction was associated with dependence in the activities of daily living (ADL). Economic resources, social network and psychiatric morbidity before stroke did not differ from the general elderly population. At 3 months of follow-up, almost half of the patients reported low life satisfaction, compared to only 2% in the national sample. Major depression and ADL dependence were associated with low life satisfaction after stroke. We conclude that much of the disability and handicap seen in stroke patients is present already before the stroke. Stroke-related deterioration of ADL performance, major depression and social disintegration after stroke interact to further reduce life satisfaction for the stroke victims and their families.
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| 2. |
- Åström, Monica, 1941-, et al.
(författare)
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Psychosocial function and life satisfaction after stroke
- 1992
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Ingår i: Stroke. - : American Heart Association. ; 23:4, s. 527-531
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Tidskriftsartikel (refereegranskat)abstract
- This prospective study was designed to describe different aspects of psychosocial function after stroke and the development of changes over time. A major aim has been to identify mental, functional, and social factors associated with low life satisfaction late after stroke.Social network, functional ability, leisure-time activities, experience of ill health, major depression, and life satisfaction were assessed repeatedly over 3 years in a population-based sample of 50 long-term survivors of stroke (mean age 71.4 years).Compared with a general elderly population, patients 3 years poststroke had more psychiatric symptoms, lower functional ability, and reduced life satisfaction. Contacts with children were maintained over the 3-year follow-up period, whereas contacts with friends and neighbors declined early after stroke and remained lower than in the general elderly population (p less than 0.05). When time dependency was analyzed, activities of daily living and somatic/neurological symptoms were found to change little after 3 months, while psychiatric symptoms showed changes later. Between 3 and 12 months poststroke, the prevalence of major depression decreased, leisure-time activities and social contacts were partly resumed, and life satisfaction improved (p less than 0.01). Once good life satisfaction was restored it was maintained, and poor life satisfaction at 1 year remained poor for the entire 3 years.It is concluded that major depression early after stroke, functional disability, and an impaired social network interact to reduce life satisfaction for the long-term survivors of stroke.
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| 3. |
- Andersson, Liselott, et al.
(författare)
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Depression and anxiety during pregnancy and six months postpartum : a follow-up study
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:8, s. 937-944
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To investigate the relationship between antenatal and postpartum depression and anxiety and to explore associated maternal characteristics. METHODS: From a population-based sample of 1,555 women attending two obstetric clinics in Sweden, all women with an antenatal psychiatric diagnosis (n = 220) and a random selection of healthy women (n = 500) were contacted for a second assessment three to six months postpartum. The Primary Care Evaluation of Mental Disorders was used for evaluation on both occasions. RESULTS: Fewer cases of depressive and/or anxiety disorders were prevalent postpartum compared with the second trimester screening. Depression and/or anxiety were prevalent in 16.5% of postpartal women versus 29.2% of pregnant women. There was a significant shift from a majority of subthreshold diagnoses during pregnancy to full Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) diagnoses during the postpartum period. A history of previous psychiatric disorder, living single, and obesity were significantly associated with a new-onset postpartum psychiatric disorder. The absence of a previous psychiatric disorder was significantly associated with a postpartum recovery of depression or anxiety. CONCLUSIONS: Depression and anxiety appear to be less common postpartum than during pregnancy.
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| 4. |
- Andersson, Liselott, et al.
(författare)
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Implications of antenatal depression and anxiety for obstetric outcome
- 2004
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Ingår i: Obstetrics and Gynecology. - : Lippincott Williams & Wilkins. - 0029-7844 .- 1873-233X. ; 104:3, s. 467-476
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the obstetric outcome and health care consumption during pregnancy, delivery, and the early postpartum period in an unselected population-based sample of pregnant women diagnosed with antenatal depressive and/or anxiety disorders, compared with healthy subjects. METHODS: Participants were 1,495 women attending 2 obstetric clinics in Northern Sweden. The Primary Care Evaluation of Mental Disorders was used to evaluate depressive and anxiety disorders in the second trimester of pregnancy. To assess demographic characteristics, obstetric outcome, and complications, the medical records of the included women were reviewed. RESULTS: Significant associations were found between depression and/or anxiety and increased nausea and vomiting, prolonged sick leave during pregnancy and increased number of visits to the obstetrician, specifically, visits related to fear of childbirth and those related to contractions. Planned cesarean delivery and epidural analgesia during labor were also significantly more common in women with antenatal depression and/or anxiety. CONCLUSION: There is an association between antenatal depressive and/or anxiety disorders and increased health care use (including cesarean deliveries) during pregnancy and delivery.
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| 5. |
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| 6. |
- Andersson, Liselott, et al.
(författare)
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Point prevalence of psychiatric disorders during the second trimester of pregnancy: a population-based study.
- 2003
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 0002-9378 .- 1097-6868. ; 189:1, s. 148-154
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study was undertaken to determine the point prevalence of psychiatric disorders during the second trimester of pregnancy in a population-based sample of pregnant women. STUDY DESIGN: Participants were 1795 consecutive pregnant women attending routine ultrasound screening at two obstetric clinics in Northern Sweden during 1 year. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used for evaluating. RESULTS: Overall, 1734 (96.6%) of the women filled in the PRIME-MD patient questionnaire. Psychiatric disorders were present in 14.1% of the women. Major depression was prevalent in 3.3% of patients and minor depression in 6.9% of patients. Anxiety disorders were encountered in 6.6% of patients. Women with psychiatric disorders displayed significantly more somatic symptoms and more pronounced fear of childbirth. Among diagnosed patients, only 5.5% had some form of treatment. CONCLUSION: The prevalence of mood and anxiety disorders in this unselected population of pregnant women was high and the majority of the women were found to be undiagnosed and untreated.
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| 7. |
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| 8. |
- Engström, Christer, et al.
(författare)
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Relationship between prophylactic effect of lithium therapy and family history of affective disorders
- 1997
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Ingår i: Biological Psychiatry. - 0006-3223 .- 1873-2402. ; 42:6, s. 425-433
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Tidskriftsartikel (refereegranskat)abstract
- Lithium therapy response and age of onset (AOO) were studied in 98 patients with bipolar affective disorder (BPAD) who were divided into subgroups depending on type of family history of affective disorders. The highest (33.0 years) and lowest (25.5 years) age of onset were found in nonfamilial patients and in familial patients with a first-degree relative of BPAD, respectively. Nonfamilial patients showed the best response to lithium. There were 0.9 episodes/year off lithium compared to 0.3 episodes/year on lithium (an 88% decrease). A poorer response (a 71% decrease; a reduction from 1.39 episodes per year off lithium to 0.65 on lithium) was found in familial patients with a first-degree relative of BPAD. Differences in serum lithium values between the groups could not explain the observed differences. Thus, familial patients showed a more severe manifestation of the disease with an earlier AOO and a lower prophylactic effect of lithium.
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| 9. |
- Eriksson, Monica, 1952-, et al.
(författare)
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Meaning of wellness in caring science based on Rodgers's evolutionary concept analysis
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - West Sussex : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:1, s. 185-99
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Tidskriftsartikel (refereegranskat)abstract
- Background: Wellness is a holistic, multidimensional, and process-oriented property on a continuum. It has been used interchangeably with and is undifferentiated from concepts such as health and well-being without an in-depth clarification of its theoretical foundations and a reflection on its meaning. The concept of wellness is frequently used, but its definition remains unclear. Aim: To conceptually and theoretically explore the concept of wellness to contribute to a deeper understanding in caring science. Method: Rodgers' evolutionary concept analysis was applied to the theoretical investigation of data from publications of international origins. The focus was on antecedents, attributes, consequences, surrogate and related terms, and contextual references. A literature search was performed through a manual review of reference lists and an online search in CINAHL and PubMed via EBSCO, and in ProQuest. Abstracts were examined to identify relevant studies for further review. The inclusion criteria were peer-reviewed papers in English; papers published in scientific journals using the surrogate terms ‘wellness’, ‘health’, ‘health care’, and ‘health care and wellness’; and papers discussing and/or defining the concept of wellness. Twenty-six studies met the inclusion criteria. Results: Based on the findings from this concept analysis, a definition of wellness was developed: ‘a holistic and multidimensional concept represented on a continuum of being well that goes beyond health’. Implications for nursing practice were correspondingly presented. Conclusion: Wellness is defined as a holistic and comprehensive multidimensional concept represented on a continuum of being well, that goes beyond health. It calls attention by applying the salutogenic perspective to health promotion in caring science. It is strongly related to individual lifestyle and health behaviour and is frequently used interchangeably with health and well-being without an in-depth clarification of its theoretical foundation.
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| 10. |
- Heinakroon, Monica, et al.
(författare)
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Utvärdering av praktiska spricklängdsmätningar efter torkning i enzons längdcirkulationstorkar
- 1992
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Här har virke i tjocklekarna 63 mm och 75 mm och i bredder mellan 125 och 225 mm torkats i enzons längdcirkulationstorkar. Det visar sig fullt möjligt att torka 75 mm furu och få en låg relativ medelspricklängd. I den statistiska behandlingen separeras de sprickfria plankorna från de med sprickor. Den stora mängden mätdata härrör från sågverk inom Iggesundskoncernen.
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| 11. |
- Malm, Joakim, et al.
(författare)
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UTVÄRDERING AV SI-VERKSAMHETEN VID LUNDS UNIVERSITET 2016/17
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Samverkansinlärning/Supplemental Instruction (SI) är en pedagogisk metod som syftar till att öka genomströmningen i svåra kurser. Metoden uppstod i USA vid University of Missouri Kansas City i mitten på 1970-talet och har därefter spridits till mer än 1500 högre lärosäten i ett trettiotal länder (Martin, 2008). Kort kan SI sägas vara ett studentdrivet komplement till ordinarie undervisning vid högre utbildning. Material i en kurs bearbetas tillsammans i en studiegrupp genom diskussion och grupparbeten under ledning av en äldre student – den s.k. SI-ledaren. Samverkansinlärning kom till Lunds universitet 1994 och har fått stor spridning på universitetet. Lund universitet utgör också ett nav för SI både i Sverige (SI finns på ca 15 svenska högre lärosäten) och i Europa och är också platsen för det nordeuropeiska SI-centret som ansvarar för utbildning och uppföljning i området på uppdrag av det internationella SI-centret i USA. Denna rapport sammanfattar resultaten från en utvärdering av SI-verksamheten vid Lunds universitet under läsåret 2016/17. SI-programmet vid Lunds universitet är omfattande med verksamhet på sex av universitetets fakulteter. Totalt har vi årligen ca 230 verksamma SIledare i ett sjuttiotal kurser. Organisationen av SI varierar mellan de olika fakulteterna. En ytterlighet finns vid LTH och naturvetenskaplig fakultet där verksamheten är starkt centraliserad. Den andra ytterligheten är vid samhällsvetenskaplig fakultet där SI-verksamheten är decentraliserad till de olika ämnena. Det som förenar de olika verksamhetsansvariga är den entusiasm som finns för SI-konceptet samt de dedikerade studenter som är SI-ledare. Närvaron på SI-möten är relativt god. Totalt har vi över 4000 studenter vid Lunds universitet som nyttjar SI varje år och en närvaro kring 30 % av kursregistrerade i snitt. Antalet deltagare på ett SI-möte ligger kring 10 i medeltal med en standardavvikelse kring 5 studenter, vilket ger goda förutsättningar för produktiva SI-möten generellt sett. De utvärderingar som gjorts av sambandet mellan SI-närvaro och kursresultat antyder att aktivt deltagande på SI ökar chanserna till ett bra resultat på kursen oavsett ämne. En specialundersökning i en kurs i matematik antyder också att alla studenter verkar gynnas av att gå på SI oavsett förkunskapsnivå. Enkätutvärderingar bland deltagarna antyder att den främsta drivkraften att delta på SI är att förstå kursmaterialet oavsett ämne och fakultet. Strategiska motiv som att klara kursen är normalt underordnade även om detta varierar beroende på fakultet/ämne. Det är roligt att konstatera att studiesocial interaktion mestadels värderas högt som motiv att delta på SI. Arbetsmiljön på SI upplevs som bra (lätt att fråga, lättsam, positiv och stödjande atmosfär samt lagom tempo) och generellt verkar mötena följa SI-metodiken väl. Oavsett fakultet verkar majoriteten av deltagarna känna att SI-mötena hjälper dem i deras kursarbete. De får en bättre förståelse av vad som förväntas av dem i kursen, ett ökat intresse för ämnet samt stöd i kursarbetet. De allra flesta verkar känna att de får en betydligt djupare förståelse för det kursmaterial man går igenom på SI-mötena. Dessutom upplever många att de sannolikt kommer att förbättra sitt kursresultat genom deltagande på SI. Detta antagande stödjs också som nämnts ovan av SI-närvaro och examinationsstatistik från kurser och ju högre SI närvaro desto bättre verkar det gå oavsett ämnesområde. Att döma av deltagarnas enkätsvar är det inte bara kursen med tillhörande SI som gynnas av SI-deltagande. Flera generella färdigheter tränas som bör gynna studenter i studier i andra kurser utan SI. Många deltagare upplever att färdigheter som problemlösningsförmåga, kritiskt tänkande, lagsamverkan och samarbete, presentation inför andra och sätt att studera utvecklats genom att delta på SI. Dessutom får flera ett förbättrat självförtroende i sina studier samt ett ökat nätverk av studiekamrater. Tidigare studier vid LTH antyder att de som deltagit på SI också presterar bättre i andra kurser utan SI och att de är mindre benägna att göra studieavbrott och tar ut examen i högre utsträckning (Malm, Bryngfors, & Mörner, 2012; Malm, Bryngfors, & Mörner, 2015; Malm, Bryngfors, & Fredriksson, 2017). Deltagarnas svar på frågan med ”Vad tycker du är det bästa med SI-mötena?” betonar möjligheten till diskussion och social interaktion, en god studiemiljö samt förståelseinriktad studietid. Detta gäller oavsett ämnesområde. Vad kan då förbättras med SI-mötena? Några antyder att strukturen/effektiviteten på mötena kan vara bristande. Detta kan i sin tur bero av att stödet för SI-ledare i form av observationer och handledning inte alltid fungerar som det skall. Detta är något att titta närmare på inom universitetet. Annat som kan förbättras med SI-verksamheten är att man vill ha fler möten, mer tid till mötena eller bättre schematider. Internationellt anses det ofta att SI-ledarna är de största ”vinnarna” i SI-konceptet pga de ledarskaps- och grupphanteringsfärdigheter de erhåller. Detta antyds även i enkätutvärderingarna för SI-ledare vid Lunds universitet. SI-ledarna verkar dessutom få ett bättre självförtroende, djupare förståelse av kursämnet samt bli bättre på att prata inför andra. Både deltagare och SI-ledare är generellt nöjda med sina möten.
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| 12. |
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| 13. |
- Olsson, Tommy, et al.
(författare)
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Hypercortisolism revealed by the dexamethasone suppression test in patients with acute ischemic stroke
- 1989
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Ingår i: Stroke. - : American Heart Association. ; 20:12, s. 1685-1690
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Tidskriftsartikel (refereegranskat)abstract
- Using the dexamethasone suppression test, we studied the activity of the hypothalamicpituitary-adrenal axis within the first week after onset in 62 patients with acute ischemic stroke. Compared with two control groups (one comprising 25 elderly patients with various acute medical disorders and the other comprising 33 80-year-old volunteers), stroke patients had higher postdexamethasone cortisol levels (p=0.08 and /?=0.001, respectively). By multiple regression analysis, high postdexamethasone cortisol levels in the stroke patients were significantly associated with proximity of the lesion to the frontal pole of the brain (p=0.008) and with disorientation (p=0.03), whereas no association with major depression was seen. Many stroke patients are exposed to hypercortisolism, which may have negative consequences upon organ functions. The extent to which dexamethasone administration suppresses cortisol levels seems to be determined mainly by the site of brain lesion and cannot be used as an indicator of major depression early after stroke.
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| 14. |
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| 15. |
- Spitzer, Robert, et al.
(författare)
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Coprophagy in moose: A first observation
- 2023
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Ingår i: Ecology and Evolution. - : Wiley. - 2045-7758. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Coprophagy, the eating of feces, has been documented in a wide range of species but appears to be rare or difficult to detect in deer (Cervidae). Here, we report the first observation of coprophagy in moose Alces alces, which was recorded using camera collars on free-ranging moose in Norway. The footage shows an instance of allocoprophagy by an adult female moose in spring (May). We summarize the current knowledge about coprophagy in deer and briefly discuss potential drivers and possible implications for disease transmission. Further research is needed to determine whether coprophagy occurs frequently in moose and whether this behavior is positive (e.g., increased intake of nutrients) or negative (increased infection by parasites or pathogens).
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| 16. |
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| 17. |
- Åström, Monica, 1941-
(författare)
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Depression after stroke
- 1993
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Both stroke and depression are major health problems in the elderly. In this study, the prevalence of major depression after stroke was investigated in a well-defined sample of acute stroke patients (n=80), followed up at 3 months, 1 year, 2 and 3 years after the stroke event. Links to biological and psychosocial factors were examined. Hypercortisolism was studied by the dexamethasone suppression test and compared with healthy elderly. Living conditions (including demographic caracteristics, economic resources, health, functional ability, activity/leisure, social network) and life satisfaction were described before and after stroke in relation to a general elderly population.Demographic caracteristics, economic resources, social network and psychiatric morbidity prestroke did not differ from the general elderly population. Already prior to the stroke, patients reported more health problems and lower functional ability in many aspects of daily life, more passive leisure time and a lower global life satisfaction. After stroke, contacts with children were maintained, whilst contacts outside the family declined and remained lower than in the general elderly population. Stroke involved a marked reduction in global life satisfaction. Poor life satisfaction at 1 year remained poor for the entire three years; these stroke victims had a higher frequency of major depression early after stroke.The prevalence of major depression was 25% at the acute stage, 31% at 3 months, decreased to 16% at 1 year, was 19% at 2 years and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in self-care ability and loss of social contacts outside the family were the most important predictors at 3 months. From 1 year onwards, loss of social contacts contributed most to depression and at 3 years also cerebral atrophy. Sixty percent of patients with early depression (0-3 months) had recovered at 1 year; those not recovered at 1 year had a high risk of chronicitation.Hypercortisolism as measured by the dexamethasone suppression test was associated with major depression late (3 years) but not early (0-3 months) after stroke. At 3 years, the dexamethasone suppression test had a sensitivity of 70%, a specificity of 97%, a positive predictive value of 88%, a negative predicitive value of 91%, and a diagnostic accuracy of 90%. Nonsuppression of dexamethasone at 3 months was a significant predictor of major depression at 3 years.
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| 18. |
- Åström, Monica, 1941-, et al.
(författare)
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Different linkage of depression to hypercortisolism early versus late after stroke : A 3-year longitudinal study
- 1993
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Ingår i: Stroke. - : American Heart Association. - 0039-2499 .- 1524-4628. ; 24:1, s. 52-57
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Tidskriftsartikel (refereegranskat)abstract
- Using the dexamethasone suppression test, we studied the suppressibility of the cortisol axis and its clinical determinants at various time points after stroke. A major aim was to examine the dexamethasone test as a diagnostic tool for the diagnosis of major depression in stroke patients.The dexamethasone suppression test, major depression, functional ability, and disorientation were assessed in a cohort of 70 patients with acute stroke and after 3 months (n = 63) and 3 years (n = 43).Early after stroke, 24% of the patients were nonsuppressors, with about the same proportion at 3 months (22%) and 3 years (21%). None of the controls (17 healthy elderly volunteers) were nonsuppressors. High cortisol levels early after stroke were significantly associated with functional impairment (r = 0.35; p = 0.003) and disorientation (r = 0.27; p = 0.03). Three years after stroke, high postdexamethasone cortisol levels were significantly associated with major depression (r = 0.57; p < 0.001). The sensitivity of the dexamethasone test was 70% and the specificity 97%. In a longitudinal analysis of the long-term survivors (n = 42), postdexamethasone cortisol values at 3 months predicted major depression at 3 years.Hypercortisolism is associated with major depression late (3 years) but not early (0-3 months) after stroke. Patients with hypercortisolism 3 months after stroke are at risk of major depression later in the course and warrant careful follow-up from a psychiatric viewpoint.
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| 19. |
- Åström, Monica, 1941-, et al.
(författare)
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Major depression in stroke patients : A 3-year longitudinal study
- 1993
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Ingår i: Stroke. - : American Heart Association. - 0039-2499 .- 1524-4628. ; 24:7, s. 976-982
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: This prospective study was designed to examine the contributions of neurobiological, functional, and psychosocial factors to major depression after stroke. In addition, the prevalence and longitudinal course of major depression were studied. METHODS: Major depression, functional ability, and social network were assessed repeatedly for a period of 3 years in a population-based cohort of 80 patients with acute stroke (mean age, 73 years). Cerebral atrophy and brain lesion parameters were determined from computed tomographic scans performed acutely and after 3 years. RESULTS: The prevalence of major depression was 25% at the acute stage and approximately the same at 3 months (31%). It decreased to 16% at 12 months, was 19% at 2 years, and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in activities of daily living was the most important predictor at 3 months. From 12 months on, the patient's having few social contacts outside the immediate family contributed most to depression, and at 3 years cerebral atrophy also contributed. At 1 year, 60% of the patients with early depression (0 to 3 months) had recovered; those not recovered at this follow-up had a high risk of development of chronic depression. CONCLUSIONS: The study has provided evidence of a differentiation of factors likely to be implicated in the development of depression after stroke based or the period of time since the stroke event.
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