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| 2. |
- Beck, Ingela, et al.
(author)
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Applying a palliative care approach in residential care: Effects on nurse assistants' work situation.
- 2015
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In: Palliative & Supportive Care. - 1478-9515. ; 13:3, s. 543-553
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Journal article (peer-reviewed)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership. Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110). Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased. Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
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| 3. |
- Colmorn, Lotte B., et al.
(author)
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The Nordic Obstetric Surveillance Study: a study of complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery
- 2015
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 94:7, s. 734-744
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Journal article (peer-reviewed)abstract
- Objective: To assess the rates and characteristics of women with complete uterine rupture, abnormally invasive placenta, peripartum hysterectomy, and severe blood loss at delivery in the Nordic countries. Design: Prospective, Nordic collaboration. Setting: The Nordic Obstetric Surveillance Study (NOSS) collected cases of severe obstetric complications in the Nordic countries from April 2009 to August 2012. Sample and methods: Cases were reported by clinicians at the Nordic maternity units and retrieved from medical birth registers, hospital discharge registers, and transfusion databases by using International Classification of Diseases, 10th revision codes on diagnoses and the Nordic Medico-Statistical Committee Classification of Surgical Procedure codes. Main outcome measures: Rates of the studied complications and possible risk factors among parturients in the Nordic countries. Results: The studied complications were reported in 1019 instances among 605362 deliveries during the study period. The reported rate of severe blood loss at delivery was 11.6/10000 deliveries, complete uterine rupture was 5.6/10000 deliveries, abnormally invasive placenta was 4.6/10000 deliveries, and peripartum hysterectomy was 3.5/10000 deliveries. Of the women, 25% had two or more complications. Women with complications were more often >35years old, overweight, with a higher parity, and a history of cesarean delivery compared with the total population. Conclusion: The studied obstetric complications are rare. Uniform definitions and valid reporting are essential for international comparisons. The main risk factors include previous cesarean section. The detailed information collected in the NOSS database provides a basis for epidemiologic studies, audits, and educational activities.
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| 4. |
- Ekroos, Johan, et al.
(author)
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Effects of landscape composition and configuration on pollination in a native herb : a field experiment
- 2015
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In: Oecologia. - : Springer Science and Business Media LLC. - 0029-8549 .- 1432-1939. ; 179:2, s. 509-518
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Journal article (peer-reviewed)abstract
- Bumble bee abundance in agricultural landscapes is known to decrease with increasing distance from seminatural grasslands, but whether the pollination of bumble-bee-pollinated wild plants shows a similar pattern is less well known. In addition, the relative effects of landscape composition (landscape heterogeneity) and landscape configuration (distance from seminatural grassland) on wild plant pollination, and the interaction between these landscape effects, have not been studied using landscape-level replication. We performed a field experiment to disentangle these landscape effects on the pollination of a native herb, the sticky catchfly (Lychnis viscaria), while accounting for the proportion of oilseed rape across landscapes and the local abundance of bee forage flowers. We measured pollen limitation (the degree to which seed set is pollen-limited), seed set, and seed set stability using potted plants placed in landscapes that differed in heterogeneity (composition) and distance from seminatural grassland (configuration). Pollen limitation and seed set in individual plants did not respond to landscape composition, landscape configuration, or proportion of oilseed rape. Instead, seed set increased with increasing local bee forage flower cover. However, we found within-plant variability in pollen limitation and seed set to increase with increasing distance from seminatural pasture. Our results suggest that average within-plant levels of pollen limitation and seed set respond less swiftly than the within-plant variability in pollen limitation and seed set to changes in landscape configuration. Although landscape effects on pollination were less important than predicted, we conclude that landscape configuration and local habitat characteristics play larger roles than landscape composition in the pollination of L. viscaria.
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| 5. |
- Jakobsson, Anna, et al.
(author)
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Distance-dependent effects of invasive Lupinus polyphyllus on pollination and reproductive success of two native herbs
- 2015
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In: Basic and Applied Ecology. - : Elsevier BV. - 1439-1791 .- 1618-0089. ; 16:2, s. 120-127
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Journal article (peer-reviewed)abstract
- A comprehensive understanding of the effects of invasive plants on native species requires identification of both the mechanisms of interaction and the spatial scale over which they act. Indirect interactions involving mobile organisms such as pollinators are likely to be scale-dependent, yet most studies examining effects of invasive species on pollination of native plants have considered effects across a single distance between interacting species. We examined the effects of the invasive herb Lupinus polyphyllus on pollination of two native herbs using multiple distances between the invasive and the natives. We recorded pollinator visitation and seed production in the native herbs Lotus corniculatus and Lychnis viscaria at 0, 5 m or 200 m away from L. polyphyllus. To reduce the influence of confounding factors, we used experimentally established populations of the invasive and potted individuals of the natives. In the immediate vicinity to L. polyphyllus, visitation to L. corniculatus was higher than 200 m away, and seed production per flower was higher than 5 m and 200 m away. In L. viscaria, bumblebee visitation was higher adjacent to L. polyphyllus than 5 m and 200 m away, but total pollinator visitation and reproductive success did not vary with distance. The results indicate that L. polyphyllus facilitates pollination of the native plants, and that this occurs at a very local spatial scale as effects dropped off already at a distance of 5 m. Presence of L. polyphyllus could benefit both pollinators and pollination of native herbs, and these positive effects should be considered along with likely negative effects due to resource competition. Moreover, the results illustrate the necessity to consider scale-dependent effects when assessing the impact of invasive flowering plants on native pollination interactions.
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| 6. |
- Jakobsson, Anna
(author)
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Paper presentation abstract: The multiple meanings and cultural aspects of the own-home garden in the early 20th century Sweden
- 2015
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Conference paper (peer-reviewed)abstract
- Gardening has multiple meanings depending on where and how it is performed as well as what purpose it is attributed. This paper will discuss the meanings and cultural aspects of own-home gardens in the early 20th century Swedish urban context. Stately loans were paid out in order for people to be able to build houses with gardens, so called own-homes, in the countryside or in the outskirts of cities in the early 1900s. A home of one's own, with a garden, had a positive effect on health and social well-being according to the Swedish Own-Home Committee. Other aims were to establish self-sufficiency and economic independence. A common strive for independence, sharing the joys and difficulties of home ownership and cultivating the plots of land established identity. Gardening also withheld and strengthened identity after the houses were built. Sharing both knowledge and crops are examples of that. The garden also enabled the authorities' visions of health,social wellbeing and the strengthening of family values. Another aspect of meaning of the own-home garden was making sense of the rural in copying the food production of the farm in smaller scale. It was also a way to maintain a contact with the past and the older generation's way of life in the countryside. Engagement in the landscape physically, mentally and socially via cultivating the gardens created a strong sense of place, purpose and meaning. Therefore it is important to add, not only the material heritage and value of the own-home gardens, but also the immaterial values of those gardens when discussing sustainable urban development. Apart from that the old gardens already are a part of the ecological values and green structure, their pedagogical and social values described above are valuable resources to take into consideration when discussing strategies for urban development, densification or conservation. Keywords: place-making, own-home garden, self-sufficiency, identity
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| 7. |
- Jakobsson, Hedvig E, et al.
(author)
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The composition of the gut microbiota shapes the colon mucus barrier.
- 2015
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In: EMBO reports. - : EMBO. - 1469-3178 .- 1469-221X. ; 16, s. 164-177
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Journal article (peer-reviewed)abstract
- Two C57BL/6 mice colonies maintained in two rooms of the same specific pathogen-free (SPF) facility were found to have different gut microbiota and a mucus phenotype that was specific for each colony. The thickness and growth of the colon mucus were similar in the two colonies. However, one colony had mucus that was impenetrable to bacteria or beads the size of bacteria-which is comparable to what we observed in free-living wild mice-whereas the other colony had an inner mucus layer penetrable to bacteria and beads. The different properties of the mucus depended on the microbiota, as they were transmissible by transfer of caecal microbiota to germ-free mice. Mice with an impenetrable mucus layer had increased amounts of Erysipelotrichi, whereas mice with a penetrable mucus layer had higher levels of Proteobacteria and TM7 bacteria in the distal colon mucus. Thus, our study shows that bacteria and their community structure affect mucus barrier properties in ways that can have implications for health and disease. It also highlights that genetically identical animals housed in the same facility can have rather distinct microbiotas and barrier structures.
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| 8. |
- Jakobsson, Maija, et al.
(author)
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Emergency peripartum hysterectomy: results from the prospective Nordic Obstetric Surveillance Study (NOSS)
- 2015
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 1600-0412 .- 0001-6349. ; 94:7, s. 745-754
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Journal article (peer-reviewed)abstract
- Objective: To assess the prevalence and risk factors of emergency peripartum hysterectomy. Design:Nordic collaborative study. Population605362 deliveries across the five Nordic countries. Methods: We collected data prospectively from patients undergoing emergency peripartum hysterectomy within 7days of delivery from medical birth registers and hospital discharge registers. Control populations consisted of all other women delivering on the same units during the same time period. Main outcome measures: Emergency peripartum hysterectomy rate. Results: The total number of emergency peripartum hysterectomies reached 211, yielding an incidence rate of 3.5/10000 (95% confidence interval 3.0-4.0) births. Finland had the highest prevalence (5.1) and Norway the lowest (2.9). Primary indications included an abnormally invasive placenta (n=91, 43.1%), atonic bleeding (n=69, 32.7%), uterine rupture (n=31, 14.7%), other bleeding disorders (n=12, 5.7%), and other indications (n=8, 3.8%). The delivery mode was cesarean section in nearly 80% of cases. Previous cesarean section was reported in 45% of women. Both preterm and post-term birth increased the risk for emergency peripartum hysterectomy. The number of stillbirths was substantially high (70/1000), but the case fatality rate stood at 0.47% (one death, maternal mortality rate 0.17/100000 deliveries). Conclusions: A combination of prospective data collected from clinicians and information gathered from register-based databases can yield valuable data, improving the registration accuracy for rare, near-miss cases. However, proper and uniform clinical guidelines for the use of well-defined international diagnostic codes are still needed.
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| 9. |
- Jakobsson, Stina, et al.
(author)
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Cardiovascular secondary prevention in high-risk patients : a randomized controlled trial sub-study
- 2015
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In: BMC Cardiovascular Disorders. - : BioMed Central. - 1471-2261 .- 1471-2261. ; 15
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Journal article (peer-reviewed)abstract
- Background: Enhanced cardiovascular secondary preventive follow-up is needed to improve adherence to recommended low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) levels. Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of recurrent events. Secondary prevention is therefore essential in these patients.Methods: Patients with acute coronary syndrome, stroke, or transient ischemic attack were randomized to nurse-based telephone follow-up (intervention) or usual care (control). LDL-C and BP were measured at 1 month (baseline) and 12 months post-discharge. Intervention patients with above-target values at baseline received medication titration to achieve treatment goals. Values measured for control patients were given to the patient’s general practitioner for assessment.Results: The final analyses included 225 intervention and 215 control patients with DM or CKD. Among patients with above-target baseline values, the following 12-month values were recorded for intervention and control patients, respectively: LDL-C, 2.2 versus 3.0 mmol/L (p < 0.001); and median systolic BP (SBP), 140 versus 145 mmHg (p = 0.26). Among patients with above-target values at baseline, 52.3% of intervention patients reached target LDL-C values at 12 months versus 21.3% of control patients (absolute difference of 30.9%, 95% CI 16.1 to 43.8%), and there was a non-significant trend of more intervention patients reaching target SBP (49.4% versus 36.8%; absolute difference of 12.6%, 95% CI -1.7 to 26.2%).Conclusions: Cardiovascular secondary prevention with nurse-based telephone follow-up was more effective than usual care in improving LDL-C levels 12 months after discharge for patients with DM or CKD.
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| 10. |
- Johansson, Malin E V, 1971, et al.
(author)
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Normalization of Host Intestinal Mucus Layers Requires Long-Term Microbial Colonization
- 2015
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In: Cell Host & Microbe. - : Elsevier BV. - 1931-3128 .- 1934-6069. ; 18:5, s. 582-592
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Journal article (peer-reviewed)abstract
- The intestinal mucus layer provides a barrier limiting bacterial contact with the underlying epithelium. Mucus structure is shaped by intestinal location and the microbiota. To understand how commensals modulate gut mucus, we examined mucus properties under germ-free (GF) conditions and during microbial colonization. Although the colon mucus organization of GF mice was similar to that of conventionally raised (Convr) mice, the GF inner mucus layer was penetrable to bacteria-sized beads. During colonization, in which GF mice were gavaged with Convr microbiota, the small intestine mucus required 5 weeks to be normally detached and colonic inner mucus 6 weeks to become impenetrable. The composition of the small intestinal microbiota during colonization was similar to Convr donors until 3 weeks, when Bacteroides increased, Firmicutes decreased, and segmented filamentous bacteria became undetectable. These findings highlight the dynamics of mucus layer development and indicate that studies of mature microbe-mucus interactions should be conducted weeks after colonization.
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