| 11. |
- Book, Christina, et al.
(författare)
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Changes in body composition after 2 years with rheumatoid arthritis
- 2011
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 40:2, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Rheumatoid arthritis (RA) is associated with cardiovascular disease (CVD). Possible predictors for CVD are early changes in body composition. We therefore evaluated changes in lean body mass (LBM), lean mass of arms and legs (LMAL), total body fat mass (BFM), and truncal fat distribution (FD) after 2 years with RA and possible predictors. Methods: We registered 63 (45 women) RA patients with disease duration of <= 12 months at baseline and after 2 years. Disease Activity Score using 28 joint counts (DAS28), Health Assessment Questionnaire (HAQ) score, body mass index (BMI), comorbidities, smoking, and medications were recorded. Total and regional lean mass and fat mass were measured with dual energy X-ray absorptiometry (DXA). The data were compared with 63 age- and gender-matched controls. Results: LBM and LMAL at baseline in RA patients were significantly lower in men (p = 0.020 and 0.002, respectively) compared to matched controls. Truncal FD was non-significantly increased in RA patients (women p = 0.133, men p = 0.119). The age-related deterioration with decreased LBM after 2 years (p = 0.002 in women and men) and increased BFM (p < 0.001) and truncal FD (p = 0.020) in women were all significantly less pronounced in RA patients than in matched controls. Conclusions: In patients with early RA and after initiation of therapy, the age-related deterioration with decreasing LBM and increasing truncal FD was lower than in control subjects in this observational study. These potentially harmful alterations seem to be modifiable factors in patients with early RA.
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| 12. |
- Bökberg, Christina, et al.
(författare)
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Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews
- 2014
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Ingår i: BMC Health Services Research. - London : Springer Science and Business Media LLC. - 1472-6963. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers' views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden. Methods: The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life). Results: The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care. Conclusions: The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages.
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| 13. |
- Bökberg, Christina, et al.
(författare)
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Professional care providers and stakeholders’ views of best practice in the care for persons with dementia in Sweden
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S369-S370
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Dementia implies progressive loss of mental and physical functions during the trajectory of the disease (Porter & Kaplan, 2012). Persons with dementia need involvement of various and several care providers throughout the stages of dementia, and more knowledge is needed about best practice strategies in this complexity of care (Gurner, 2001). The aim of the study was to explore professional care providers and stakeholders’ views of best practice in concepts of information, collaboration and communication in the care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu.
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| 14. |
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| 15. |
- Bökberg, Christina, et al.
(författare)
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Professional care providers and stakeholders’ views of best practice in the chain of care for persons with dementia in Sweden
- 2013
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Ingår i: Nordic Advances in Health Care Sciences Research. ; , s. 98-98
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Konferensbidrag (refereegranskat)abstract
- Background: To meet the increasing needs for persons with dementia and their relatives a well-functioning health care system in which resources are used optimally is needed. For this to be achieved requires strategy and planning of synergies between the different cares providers. This study will explore professional caregivers’ and stakeholders’ views of best practice in terms of information, collaboration and communication in dementia care.Aim: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice in concepts of information, collaboration and communication throughout the trajectory of care from diagnosis to end of life care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.
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| 16. |
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| 17. |
- Chorell, Elin, et al.
(författare)
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Impact of probiotic feeding during weaning on the serum lipid profile and plasma metabolome in infants
- 2013
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Ingår i: British Journal of Nutrition. - : Cambridge University Press. - 0007-1145 .- 1475-2662. ; 110:1, s. 116-126
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Tidskriftsartikel (refereegranskat)abstract
- The gut microbiome interacts with the host in the metabolic response to diet, and early microbial aberrancies may be linked to the development of obesity and metabolic disorders later in life. Probiotics have been proposed to affect metabolic programming and blood lipid levels, although studies are lacking in infants. Here, we report on the lipid profile and global metabolic response following daily feeding of probiotics during weaning. A total of 179 healthy, term infants were randomised to daily intake of cereals with (n 89) or without (n 90) the addition of Lactobacillus paracasei ssp. paracasei F19 (LF19) 108 colony-forming units per serving from 4 to 13 months of age. Weight, length and skinfold thickness were monitored. Venous blood was drawn at 5·5 and 13 months of age for analysis of the serum lipid profile. In a subsample, randomly selected from each group, GC-time-of-flight/MS was used to metabolically characterise plasma samples from thirty-seven infants. A combination of multi- and univariate analysis was applied to reveal differences related to LF19 treatment based on 228 putative metabolites, of which ninety-nine were identified or classified. We observed no effects of probiotic feeding on anthropometrics or the serum lipid profile. However, we detected significantly lower levels of palmitoleic acid (16 : 1) (P < 0·05) and significantly higher levels of putrescine (P < 0·01) in LF19-treated infants. Palmitoleic acid is a major MUFA strongly linked to visceral obesity, while putrescine is a polyamine with importance for gut integrity. Whether the observed differences will have long-term health consequences are being followed.
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| 18. |
- Doverhag, Christina, 1979, et al.
(författare)
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Galectin-3 contributes to neonatal hypoxic-ischemic brain injury.
- 2010
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Ingår i: Neurobiology of disease. - : Elsevier BV. - 1095-953X .- 0969-9961. ; 38:1, s. 36-46
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Tidskriftsartikel (refereegranskat)abstract
- Inflammation induced by hypoxia-ischemia (HI) contributes to the development of injury in the newborn brain. In this study we investigated the role of galectin-3, a novel inflammatory mediator, in the inflammatory response and development of brain injury in a mouse model for neonatal HI. Galectin-3 gene and protein expression was increased after injury and galectin-3 was located in activated microglia/macrophages. Galectin-3 deficient mice (gal3-/-) were protected from injury particularly in hippocampus and striatum. Microglia accumulation was increased in the gal3-/-mice but accompanied by decreased levels of total matrix metalloproteinase (MMP)-9 and nitrotyrosine. The protection and increase in microglial infiltration was more pronounced in male gal3-/-mice. Trophic factors and apoptotic markers did not significantly differ between groups. In conclusion, galectin-3 contributes to neonatal HI injury particularly in male mice. Our results indicate that galectin-3 exerts its effect by modulating the inflammatory response.
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| 19. |
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| 20. |
- Engström, Maria, 1958-, et al.
(författare)
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Fatigue and cognitive effort in multiple sclerosis: an fMRI study
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Despite recent advances in therapy and diagnosis, fatigue remains a mayor challenge in multiple sclerosis (MS). To further the understanding of the neural underpinnings of fatigue, we undertook a study using functional magnetic resonance imaging (fMRI) to investigate neural networks that may be affected by MS-related fatigue. Twelve MS patients and 12 age- and sex matched controls were administered the Fatigue Impact Scale (FIS) to assess clinically significant fatigue, and underwent a neuropsychological examination. The participants performed a working memory task (Daneman’s ‘Reading Span’ task) while being monitored by means of a 1.5 T Philips Achieva MR scanner. We have previously shown that this task triggers an executive network comprising frontal and parietal areas typically involved in working memory. In addition, the task engages a core network involving the anterior insula and the anterior cingulate cortex. This latter network may be implicated in allocation of mental resources and monitoring of the present state of the individual. There were two main findings. MS participants evidenced less activation than controls in the anterior cingulate and the left parietal cortex (Brodmann area 7) and more activation in left hemisphere language areas as well as the anterior insula. The second main finding was that clinical ratings of fatigue were strongly correlated with activity in wide areas of the core network, as well as posterior language areas. We take this finding to indicate that fatigue is related to compensatory involvement of the core network, and that excess activity in the core network possibly could be used as an objective marker of fatigue in MS.
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