| 1. |
- Samokhin, Alexander, et al.
(författare)
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Stationary iteration methods for solving 3D electromagnetic scattering problems
- 2013
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Ingår i: Applied Mathematics and Computation. - : Elsevier BV. - 0096-3003 .- 1873-5649. ; 222, s. 107-122
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Tidskriftsartikel (refereegranskat)abstract
- Generalized Chebyshev iteration (GCI) applied for solving linear equations with nonselfadjoint operators is considered. Sufficient conditions providing the convergence of iterations imposed on the domain of localization of the spectrum on the complex plane are obtained. A minimax problem for the determination of optimal complex iteration parameters is formulated. An algorithm of finding an optimal iteration parameter in the case of arbitrary location of the operator spectrum on the complex plane is constructed for the generalized simple iteration method. The results are applied to numerical solution of volume singular integral equations (VSIEs) associated with the problems of the mathematical theory of wave diffraction by 3D dielectric bodies. In particular, the domain of the spectrum location is described explicitly for low-frequency scattering problems and in the general case. The obtained results are discussed and recommendations concerning their applications are given. (C) 2013 Elsevier Inc. All rights reserved.
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| 2. |
- Johansson, Ingvor, et al.
(författare)
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Disturbed sleep, fatigue, anxiety and depression in myocardial infarction patients
- 2010
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 9:3, s. 175-180
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Tidskriftsartikel (refereegranskat)abstract
- Background: Disturbed sleep has been linked to increased morbidity, mortality and depression and worsened health-related quality of life in patients with chronic illness. Few studies of readjustment after coronary artery disease have explicitly focused on sleep disturbance. Aim: To explore associations between disturbed sleep, fatigue, anxiety and depression, and to assess to what extent fatigue four months post-MI could be explained. Method: The sample included 204 consecutive patients, ≤ 80 years of age who answered questionnaires about disturbed sleep, fatigue, anxiety and depression four months after MI. Results: The variables anxiety, depression and disturbed sleep were all associated with fatigue. The regression model accounted for 46% of the variance in fatigue with depression and disturbed sleep as predictors. Infarct size measured by conventional biochemical markers, left ventricle ejection fraction and history of previous MI were not correlated with disturbed sleep, fatigue, anxiety or depression. Conclusions: From knowledge about associations between disturbed sleep, fatigue, anxiety and depression after MI, cardiac nurses could be trained to observe such symptoms. Optimal care for sleep disturbance may include actions to reduce anxiety and depression as well as self-care advices about sleep hygiene in order to improve sleep quality and reduce fatigue. © 2009 European Society of Cardiology.
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| 3. |
- Rojas, Yerko, 1978-, et al.
(författare)
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Early life circumstances and male suicide : A 30-year follow-up of a Stockholm cohort born in 1953
- 2010
-
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 70:3, s. 420-427
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Tidskriftsartikel (refereegranskat)abstract
- This study analyses the relationship between early life circumstances and suicide during adolescence and young adulthood among men in a Stockholm birth cohort born in 1953. Relevant variables were derived from Durkheim's proposition of social integration and suicide and Merton's strain theory of deviance. The links between our background variables and suicide were estimated with rare events logistic regression, a statistical method specially developed for situations in which rare events are endemic to the data. We found that self-rated loneliness at age 12–13 as an indicator of social isolation, school absenteeism at the same age as an indicator of school integration, and growing up in a family which received means-tested social assistance at least once during the period 1953–1965 as an indicator of childhood poverty, were statistically related to subsequent suicide risk between 1970 and 1984. Furthermore, following Bourdieu's rereading of Durkheim's Suicide, we argue that social isolation and school integration can be seen as important forms of deprivation, since “social integration” can also be understood in terms of “social recognition”. This view emphasises the importance of taking the emotional and social poverty of children just as seriously as their material poverty when it comes to suicide.
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| 4. |
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| 5. |
- Edvinsson, Sören, 1953-, et al.
(författare)
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The practice of birth control and historical fertility change : Introduction
- 2010
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Ingår i: The History of the Family. - : Elsevier. - 1081-602X .- 1873-5398. ; 15:2, s. 117-124
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Tidskriftsartikel (refereegranskat)abstract
- This introduction discusses the contributions in the special issue. The articles present results concerning the practice of birth control, mainly at the family level. They represent different analytical approaches where both interviews, letters, surveys and micro-level data have been used. The European fertility decline has made a fundamental change to the societies in the 20th and 21st centuries. Birth control spreads rapidly. Research in this field requires both qualitative and quantitative studies, where both approaches contribute to different perspectives on the transition. The articles in the issue discuss several themes in relation to birth control, of which three are developed in the introduction. These are gender and fertility, gender and health and finally how to control fertility. The presented results demonstrate the importance of including gender in the analyses of the fertility decline. A gender perspective makes it natural to consider historical persons as agents. It is also necessary to acknowledge that we should not treat the married couple as a single unit. They may have conflicting interests, something that several of the articles illustrate. One aspect we would like to emphasize is how health problems can influence the will to have more children and this affects birth control. This is a theme that in different forms is taken up by several of the authors. Finally, families practiced birth control with several different methods that also changed throughout the married years, thus demonstrating a flexibility that is often overlooked in conventional methods for the analysis of fertility.
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| 6. |
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| 7. |
- Hult, Carl, 1953-, et al.
(författare)
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Timing of retirement and mortality : A cohort study of Swedish construction workers
- 2010
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Ingår i: Social Science and Medicine. - : Elsevier. - 0277-9536 .- 1873-5347. ; 70:10, s. 1480-1486
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies indicate that early retirement per se may have a negative effect on health to such an extent that it increases mortality risk. One type of early retirement often referred to in these studies is retirement with disability pension/benefit. Given the overall objective of disability benefit programmes - to help the disabled live socially and economically satisfactory lives, freed from exposure to employment health hazards and thus avoid further declines in health - the finding is challenging. This paper examined the relationship between timing of retirement and mortality using a cohort of Swedish construction workers. The mortality risk of disability pensioners - excluding those with diagnoses normally connected to increased mortality - was compared with the risk of those continuing to work. Although initial indications were in line with earlier results, it became obvious that the increased mortality risk of disability pensioners did not depend on early retirement per se but on poor health before early retirement not explicitly recognized in the diagnosis on which the disability pension rested. The results indicate that there are no general differences in mortality depending on timing of retirement. Future studies of mortality differences arising from working or not working must sufficiently control for health selection effects into the studied retirement paths.
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| 8. |
- Höjer, Ingrid, 1953, et al.
(författare)
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Procedures when young people leave care : Views of 111 swedish social services mangers
- 2011
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 33:12, s. 2452-2460:33, s. 2452 - 2460
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Tidskriftsartikel (refereegranskat)abstract
- In western societies, there is a general tendency towards a protracted transition to adulthood for young people, who thereby may become increasingly dependent on support from family. Young people leaving a placement in out-of-home care often lack such support, and will thus have a disadvantageous position compared to their peers. With the purpose of looking into the procedures when young people leave a placement in out-of-home care, telephone interviews were performed with 111 managers of social service units in two Swedish regions (West Sweden, and Stockholm Region), using a structured interview schedule. Answering rate was 99.1%. Only 6% of the managers had information of the young people's whereabouts once they had left care. 86-88% had general support programmes for all young people concerning housing, employment etc. but only 2-4% had specific programmes for young people leaving care. A majority of the managers were attentive of the difficulties the young people leaving care may encounter, but displayed little awareness of the consequences of a prolonged transition to adulthood, and the need for continued support after leaving care. Several managers referred to the general support of the Swedish welfare state, meaning that young people leaving care had the same access to support as all other young people in Sweden. Consequently, young people leaving care are at risk of being invisible in the welfare system and facing a compressed transition to adulthood.
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| 9. |
- Östman, Bengt, 1953-, et al.
(författare)
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Coenzyme Q10 supplementation and exercise-induced oxidative stress in humans
- 2012
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Ingår i: Nutrition (Burbank, Los Angeles County, Calif.). - : Elsevier BV. - 0899-9007 .- 1873-1244. ; 28:4, s. 403-417
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The theoretically beneficial effects of coenzyme Q10 (Q10) on exercise-related oxidative stress and physical capacity have not been confirmed to our knowledge by interventional supplementation studies. Our aim was to investigate further whether Q10 supplementation at a dose recommended by manufacturers influences these factors. Methods: Using a randomized, double-blind, controlled design, we investigated the effect on physical capacity of 8 wk of treatment with a daily dose of 90 mg of Q10 (n = 12) compared with placebo (n = 11) in moderately trained healthy men 19 to 44 y old. Two days of individualized performance tests to physical exhaustion were performed before and after the intervention. Primary outcomes were maximal oxygen uptake, workload, and heart rate at the lactate threshold. Secondary outcomes were creatine kinase, hypoxanthine, and uric acid. Results: No significant differences between the groups were discerned after the intervention for maximal oxygen uptake (-0.11 L/min, 95% confidence interval 0.31 to 0.08, P = 0.44), workload at lactate threshold (6.3 W, 13.4 to 25.9, P = 0.36), or heart rate at lactate threshold (2.0 beats/min, -4.9 to 8.9, P = 0.41). No differences between the groups were detected for hypoxanthine or uric acid (serum markers of oxidative stress) or creatine kinase (a marker of skeletal muscle damage). Conclusion: Although in theory Q10 could be beneficial for exercise capacity and in decreasing oxidative stress, the present study could not demonstrate that such effects exist after supplementation with a recommended dose.
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| 10. |
- Bech-Hanssen, Odd, 1956, et al.
(författare)
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Pressure reflection in the pulmonary circulation in patients with severe mitral regurgitation indicates adverse postoperative outcome.
- 2013
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Ingår i: European Journal Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940 .- 1873-734X. ; 44:6, s. 1037-1044
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Severe pulmonary hypertension (PH) is a known risk factor in valvular surgery. In the present study, we hypothesized that the assessment of pressure reflection (PR) in the pulmonary circulation, indicating increased pulmonary vascular resistance, might improve the identification of patients with increased morbidity and mortality following surgery for severe mitral regurgitation. METHODS: A total of 103 patients without atrial fibrillation were divided into three groups: Group 1 (n = 48), patients without PR; Group 2 (n = 36), patients with PR and pulmonary artery systolic pressure (PASP) ≤60 mmHg and Group 3 (n = 19), patients with PR and PASP >60 mmHg. Three variables related to PR were selected: the acceleration time in the right ventricular outflow tract (RVOT), the interval between peak velocity in the RVOT and peak tricuspid regurgitant jet velocity and the right ventricular pressure increase after peak RVOT velocity. RESULTS: There were no differences between groups in age, ejection fraction, need for coronary bypass grafting or creatinine. Patients with PR (Groups 2 and 3) had more use of vasoactive drugs (overall P < 0.0001, Group 1 vs Group 2 P = 0.018). The proportion of patients with >24 h in the intensive care unit was 27% in Group 1, 54% in Group 2 and 84% in Group 3 (overall P < 0.0001, Group 1 vs Group 2 P = 0.006). The in-hospital mortality in patients without PR (n = 49) was 0% compared with 10.9% in patients with PR (P = 0.029). CONCLUSIONS: Echocardiography assessment of PR in the pulmonary circulation and severe PH may identify patients with adverse outcome following mitral surgery.
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| 11. |
- Bengtsson, Jonas, et al.
(författare)
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Sexual function after failed ileal pouch-anal anastomosis
- 2011
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Ingår i: Journal of Crohn's and Colitis. - : Elsevier. - 1873-9946. ; 5:5, s. 407-414
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Tidskriftsartikel (refereegranskat)abstract
- Background and AimsFailure of ileal pouch-anal anastomosis (IPAA) occurs in around 10% of the patients. Compared to patients with functioning pouches, health related quality of life is deteriorated after failure. Sexual function in patients with pouch failure is however poorly studied.The aim was to study sexual function in patients with pelvic pouch failure; patients with functioning pouches were used as controls. The hypothesis was that patients with pouch failure have worse sexual function.Methods36 patients with pouch failure were compared with 72 age and sex-matched controls with ulcerative colitis and functioning pouches. The patients answered a set of questionnaires concerning sexual function (Female Sexual Function Index [FSFI] and International Index of Erectile Function [IIEF]), body image (BIS-scale) and health-related quality of life (SF-36).ResultsBoth women and men with pouch failure scored lower than controls in the FSFI and IIEF questionnaires. However, none of the observations were statistically significant. The scores in the failure group (for both sexes) were below the cut-off level for sexual dysfunction. Scores for the BIS instrument were significantly lower for both sexes in the failure group. Women and men in the failure group scored lower than the controls in all domains of the SF-36, however statistically significant only for the social function domain in men.ConclusionsThe hypothesis, that a failed IPAA is associated with worse sexual function, was not confirmed. Compared to patients with functioning pouches, patients with pouch failure have inferior body image.
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| 12. |
- Black, R. R., et al.
(författare)
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Emission factors for PCDD/PCDF and dl-PCB from open burning of biomass
- 2012
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 38:1, s. 62-66
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Tidskriftsartikel (refereegranskat)abstract
- The Stockholm Convention on Persistent Organic Pollutants includes in its aims the minimisation of unintentional releases of polychlorinated dibenzo-dioxins and dibenzofurans (PCDD/PCDF) and dioxin like PCB (dl-PCB) to the environment Development and implementation of policies to achieve this aim require accurate national inventories of releases of PCDD/PCDF/dl-PCB. To support this objective, the Conference of Parties established a process to review and update the UNEP Standardized Toolkit for Identification and Quantification of Dioxin and Furan Releases. An assessment of all emission inventories was that for many countries open burning of biomass and waste was identified as the major source of PCDD/PCDF releases. However, the experimental data underpinning the release estimates used were limited in number and, consequently, confidence in the accuracy of the emissions predictions was low. There has been significant progress in measurement technology since the last edition of the Toolkit in 2005. In this paper we reassess published emission factors for release of PCDD/PCDF and dl-PCB to land and air.In total, four types of biomass and 111 emission factors were assessed. It was found that there are no systematic differences in emission factors apparent between biomass types or fire classes. The data set is best described by a lognormal distribution. The geometric mean emission factors (EFs) for releases of PCDD/PCDF to air for the four biomass classes used in the Toolkit (sugarcane, cereal crops, forest and savannah/grass) are 1.6 mu g TEQ(t fuel)(-1), 0.49 mu g TEQ(t fuel)(-1), 1.0 mu g TEQ(t fuel)(-1) and 0.4 mu g TEQ(t fuel)(-1), respectively. Corresponding EFs for release of PCDD/PCDF to land are 3.0 ng TEQ (kg ash)(-1), 1.1 ng TEQ (kg ash)(-1), 1.1 ng TEQ (kg ash)(-1) and 0.67 ng TEQ (kg ash)(-1). There are now also sufficient published data available to evaluate EFs for dl-PCB release to air for sugarcane, forest and grass/savannah; these are 0.03 mu g TEQ (t fuel)(-1), 0.09 mu g TEQ (t fuel)(-1) and 0.01 mu g TEQ (t fuel)(-1), respectively. The average EF for dl-PCB release to land is 0.19 ng TEQ (kg ash)(-1). Application of these EFs to national emissions of PCDD/PCDF for global estimates from open burning will lower previous estimates of PCDD/PCDF releases to air and to land by 85% and 90%, respectively. For some countries, the ranking of their major sources will be changed and open burning of biomass will become less significant than previously concluded.
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| 13. |
- Bracale, A., et al.
(författare)
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A new joint sliding-window ESPRIT and DFT scheme for waveform distortion assessment in power systems
- 2012
-
Ingår i: Electric Power Systems Research. - : Elsevier BV. - 0378-7796 .- 1873-2046. ; 88, s. 112-120
-
Tidskriftsartikel (refereegranskat)abstract
- This paper proposes a novel scheme that jointly employs a sliding-window ESPRIT and DFT for estimating harmonic and interharmonic components in power system disturbance data. In the proposed scheme, separate stages are utilized to estimate the voltage fundamental component, harmonics and interharmonics. This includes the estimation of the fundamental component from lowpass filtered data using a sliding-window ESPRIT, of harmonics from a sliding-window DFT with a synchronized window, and of interharmonics from the residuals by applying the sliding-window ESPRIT. Main advantages of the approach include high resolution and accuracy in parameter estimation and significantly reduced computational cost. Experiments and comparisons are made on both synthetic and measurement data. Results have shown the effectiveness and efficiency of the proposed scheme.
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| 14. |
- Cao, Zhi-Guo, et al.
(författare)
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Particle size : A missing factor in risk assessment of human exposure to toxic chemicals in settled indoor dust
- 2012
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Ingår i: Environment International. - : Elsevier. - 0160-4120 .- 1873-6750. ; 49, s. 24-30
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Tidskriftsartikel (refereegranskat)abstract
- For researches on toxic chemicals in settled indoor dust, selection of dust fraction is a critical influencing factor to the accuracy of human exposure risk assessment results. However, analysis of the selection of dust fraction in recent studies revealed that there is no consensus. This study classified and presented researches on distribution of toxic chemicals according to dust particle size and on relationship between dust particle size and human exposure possibility. According to the literature, beyond the fact that there were no consistent conclusions on particle size distribution of adherent fraction, dust with particle size less than 100 mu m should be paid more attention and that larger than 250 mu m is neither adherent nor proper for human exposure risk assessment. Calculation results based on literature data show that with different selections of dust fractions, analytical results of toxic chemicals would vary up to 10-fold, which means that selecting dust fractions arbitrarily will lead to large errors in risk assessment of human exposure to toxic chemicals in settled dust. Taking into account the influence of dust particle size on risk assessment of human exposure to toxic chemicals, a new methodology for risk assessment of human exposure to toxic chemicals in settled indoor dust is proposed and human exposure parameter systems to settled indoor dust are advised to be established at national and regional scales all over the world.
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| 15. |
- Delaine, Tamara, 1981, et al.
(författare)
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A structure activity relationship study of geranial derivatives
- 2012
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Ingår i: Contact Dermatitis 11th congress of the European society of contact dermatitis (ESCD) 13-16 june 2012, Malmö, Sweden. - : Wiley. ; 66:Suppl. 2
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Konferensbidrag (refereegranskat)abstract
- Background: Fragrances are common causes of contact allergy. Skin exposure to geranial is frequent since citral (mixture of geranial and neral) is commonly used in fragrances and flavors and is considered as a moderate allergen. Previous studies according to the local lymphnodeassay (LLNA)in micehaverevealed large variations in the sensitizing capacity of different geranial derivatives. Objectives: For a better understanding of these variations, a structure-activity relationship (SAR) study on a series of derivatives of geranial was carried out. Methods: The chemical reactivity of the compounds towards a model peptide was investigated using LC-MS. The adduct formation and the non-reacted peptide depletion were monitored. Adducts formed with model amino acids were investigated and structural determination was performed. Additional derivatives were synthesized and their sensitization potencies were evaluated in relation to their physicochemical and reactivity properties. Results: Most of the derivatives were shown to bind covalently to the cysteine residue of the model peptide. The percentage of depletion of the non-reacted peptide ranged from 0% to 100% after 24 hr, constant rate of depletion revealed a large difference between the fastest and lowest reacting derivatives. These resultswere congruent with the skin sensitization potencies obtained with the LLNA. Conclusions: A good correlation between the reactivity and the sensitizing potency was observed. Small changes in the chemical structure of geranial result in significant differences in sensitizing capacity and chemical reactivity. Conflicts of interest: The authors have declared no conflicts.
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| 16. |
- Granéli, Cecilia, 1981, et al.
(författare)
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Novel markers of osteogenic and adipogenic differentiation of human bone marrow stromal cells identified using a quantitative proteomics approach.
- 2014
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Ingår i: Stem cell research. - : Elsevier BV. - 1876-7753 .- 1873-5061. ; 12:1, s. 153-165
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Tidskriftsartikel (refereegranskat)abstract
- Today, the tool that is most commonly used to evaluate the osteogenic differentiation of bone marrow stromal cells (BMSCs) in vitro is the demonstration of the expression of multiple relevant markers, such as ALP, RUNX2 and OCN. However, as yet, there is no single surface marker or panel of markers which clearly defines human BMSCs (hBMSCs) differentiating towards the osteogenic lineage. The aim of this study was therefore to examine this issue. Stable isotope labeling by amino acids in cell culture (SILAC)-based quantitative proteomics was utilized to investigate differently expressed surface markers in osteogenically differentiated and undifferentiated hBMSCs. Labeled membrane proteins were analyzed by mass spectrometry (MS) and 52 proteins with an expression ratio above 2, between osteogenically differentiated and undifferentiated cells, were identified. Subsequent validation, by flow cytometry and ELISA, of the SILAC expression ratios for a number of these proteins and investigations of the lineage specificity of three candidate markers were performed. The surface markers, CD10 and CD92, demonstrated significantly increased expression in hBMSCs differentiated towards the osteogenic and adipogenic lineages. In addition, there was a slight increase in CD10 expression during chondrogenic differentiation. Furthermore, the expression of the intracellular protein, crystalline-αB (CRYaB), was only significantly increased in osteogenically differentiated hBMSCs and not affected during differentiation towards the chondrogenic or adipogenic lineages. It has been concluded from the present results that CD10 and CD92 are potential markers of osteogenic and adipogenic differentiation and that CRYaB is a potential novel osteogenic marker specifically expressed during the osteogenic differentiation of hBMSCs in vitro.
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| 17. |
- Hedin, Lena, et al.
(författare)
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Settling into a new home as a teenager : about establishing social bonds in different types of foster families in Sweden
- 2011
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409 .- 1873-7765. ; 33:11, s. 2282-2289
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Tidskriftsartikel (refereegranskat)abstract
- This paper provides a glimpse into young people's experiences and understandings of everyday life during their initial stages of placement in various types of foster families. The way family interactions strengthen or weaken the social bond between foster youth and foster family is focused upon. In this study the young people in kinship foster families reported the strongest social bonds to their foster families and the adolescents in traditional foster families the weakest. This is in line with previous research. However, youth in network foster families with whom they were not so close prior to placement also reported rather strong social bonds to the foster family, which is not well known. Including network foster families in the study sheds light on the importance of adolescents' active involvement and agency in choosing their foster family. Examples of family interactions which seem to be crucial in strengthening social bonds, also in traditional foster families, are e.g. fair treatment by other family members, mutual family activities, negotiating to find solutions, and, which is not so well known, humorous joking and laughing together. (C) 2011 Elsevier Ltd. All rights reserved.
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| 18. |
- Henoch, Ingela, 1956, et al.
(författare)
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Training Intervention for Health Care Staff in the Provision of Existential Support to Patients With Cancer : A Randomized, Controlled Study
- 2013
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier. - 0885-3924 .- 1873-6513. ; 46:6, s. 785-794
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Tidskriftsartikel (refereegranskat)abstract
- Context: When a patient receives a cancer diagnosis, existential issues become more compelling. Throughout the illness trajectory, patients with cancer are cared for in oncology wards, by home care teams or in hospices. Nurses working with these patients are sometimes aware of the patients' existential needs but do not feel confident when discussing these issues.Objectives: To determine the effects of a training intervention, where the focus is on existential issues and nurses' perceived confidence in communication and their attitude toward caring for dying patients.Methods: This was a randomized, controlled trial with a training intervention comprising theoretical training in existential issues combined with individual and group reflection. In total, 102 nurses in oncology and hospice wards and in palliative home care teams were randomized to a training or non-training group. Primary outcomes, confidence in communication, and attitude toward the care of dying patients were measured at baseline, immediately after the training, and five to six months later.Results: Confidence in communication improved significantly in the training group from baseline (before the training) to both the first and second follow-up, that is, immediately after the training and five months later. The attitude toward caring for the dying did not improve in the training group.Conclusion: This study shows that short-term training with reflection improves the confidence of health care staff when communicating, which is important for health care managers with limited resources. Further studies are needed to explore how patients experience the communication skills of health care staff after such training.
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| 19. |
- Herlitz, Johan, 1949, et al.
(författare)
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Symptoms of chest pain and dyspnoea during a period of 15 years after coronary artery bypass grafting.
- 2010
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Ingår i: European journal of cardio-thoracic surgery. - : Elsevier. - 1873-734X .- 1010-7940. ; 37:1, s. 112-118
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe changes in chest pain and dyspnoea during a period of 15 years after coronary artery bypass grafting (CABG) and to define factors at the time of operation that were associated with the occurrence of these symptoms after 15 years. DESIGN: Prospective observational study in western Sweden. SUBJECTS: All patients who underwent first-time CABG, without simultaneous valve surgery, between 1 June 1988 and 1 June 1991. There were no exclusion criteria. FOLLOW-UP: All patients were followed up prospectively for 15 years. The evaluation of symptoms took place through postal questionnaires prior to and 5, 10 and 15 years after the operation. RESULTS: Totally, 2000 patients were included in the survey and 904 (45%) of them survived to 15 years. Among these 904 survivors, the percentage of patients with chest pain increased from 44% to 50% between the 5- and 15-year follow-up (p=0.004). The percentage of patients who reported symptoms of dyspnoea increased from 60% after 5 years to 74% after 15 years (p<0.001). Factors at the time of surgery that independently tended to predict chest pain after 15 years were higher age (p=0.04) and prolonged duration of symptoms prior to surgery (p=0.04). Predictors of dyspnoea after 15 years were higher age (p<0.0001), the use of inotropic drugs at the time of surgery (p=0.001), a history of diabetes (p=0.01) and obesity (p=0.01). CONCLUSION: After CABG, relief from chest pain and dyspnoea is generally maintained over a long period of time. Eventually, however, functional-limiting symptoms tend to recur and about half the patients report symptoms of chest pain, while three-quarters report dyspnoea after 15 years. Even if no clear predictor of chest pain was found at the time of surgery, age, the use of inotropic drugs, diabetes and obesity predicted dyspnoea.
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| 20. |
- Karlfeldt Fedje, Karin, 1977, et al.
(författare)
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Removal of hazardous metals from MSW fly ash-An evaluation of ash leaching methods
- 2010
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Ingår i: Journal of Hazardous Materials. - : Elsevier BV. - 1873-3336 .- 0304-3894. ; 173:1-3, s. 310-317
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Tidskriftsartikel (refereegranskat)abstract
- Incineration is a commonly applied management method for municipal solid waste (MSW). However, significant amounts of potentially hazardous metal species are present in the resulting ash, and these may be leached into the environment. A common idea for cleaning the ash is to use enhanced leaching with strong mineral acids. However, due to the alkalinity of the ash, large amounts of acid are needed and this is a drawback. Therefore, this work was undertaken in order to investigate some alternative leaching media (EDTA, ammonium nitrate, ammonium chloride and a number of organic acids) and to compare them with the usual mineral acids and water. All leaching methods gave a significant increase in ash specific surface area due to removal of soluble bulk (matrix) compounds, such as CaCO3 and alkali metal chlorides. The use of mineral acids and EDTA mobilised many elements, especially Cu, Zn and Pb, whereas the organic acids generally were not very effective as leaching agents for metals. Leaching using NH4NO3 was especially effective for the release of Cu. The results show that washing of MSW filter ash with alternative leaching agents is a possible way to remove hazardous metals from MSW fly ash.
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| 21. |
- Lundin, Lisa, et al.
(författare)
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The effect of developing nations' municipal waste composition on PCDD/PCDF emissions from open burning
- 2013
-
Ingår i: Atmospheric Environment. - : Elsevier. - 1352-2310 .- 1873-2844. ; 79, s. 433-441
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Tidskriftsartikel (refereegranskat)abstract
- Open burning tests of municipal waste from two countries, Mexico and China, showed composition-related differences in emissions of polychlorinated dibenzodioxins and dibenzofurans (PCDDs/PCDFs). Twenty-six burn tests were conducted, comparing results from two laboratory combustion facilities. Waste was shredded to isolate composition-specific effects from those due to random waste orientation. Emissions ranged from 5 to 780 ng toxic equivalent/kg carbon burned (ng TEQ (kg C-b)(-1)) with an average of 140 ng TEQ (kg C-b)(-1) (stdev = 170). The waste from Mexico (17 ng TEQ (kg C-b)(-1)) had a statistically lower average emission factor than waste from China (240 ng TEQ (kg C-b)(-1). This difference was attributed primarily to waste composition differences, although one time-integrated combustion quality measure, Delta CO/Delta CO2, showed statistical significance between laboratories. However, waste composition differences were far more determinant than which laboratory conducted the tests, illustrated using both statistical techniques and comparison of cross-over samples (wastes tested at both facilities). Comparison of emissions from previous waste combustion tests in Sweden and the U.S.A, showed emission factors within the range of those determined for Mexico and China waste. For laboratory-scale combustion, existing emission factors and test methodologies are generally applicable to both developed and developing countries.
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| 22. |
- Marquer, Laurent, et al.
(författare)
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Holocene changes in vegetation composition in northern Europe: why quantitative pollen-based vegetation reconstructions matter
- 2014
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 90, s. 199-216
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Tidskriftsartikel (refereegranskat)abstract
- We present pollen-based reconstructions of the spatio-temporal dynamics of northern European regional vegetation abundance through the Holocene. We apply the Regional Estimates of VEgetation Abundance from Large Sites (REVEALS) model using fossil pollen records from eighteen sites within five modern biomes in the region. The eighteen sites are classified into four time-trajectory types on the basis of principal components analysis of both the REVEALS-based vegetation estimates (RVs) and the pollen percentage (PPs). The four trajectory types are more clearly separated for RVs than PPs. Further, the timing of major Holocene shifts, rates of compositional change, and diversity indices (turnover and evenness) differ between RVs and PPs. The differences are due to the reduction by REVEALS of biases in fossil pollen assemblages caused by different basin size, and inter-taxonomic differences in pollen productivity and dispersal properties. For example, in comparison to the PPs, the RVs show an earlier increase in Corylus and Ulmus in the early-Holocene and a more pronounced increase in grassland and deforested areas since the mid-Holocene. The results suggest that the influence of deforestation and agricultural activities on plant composition and abundance from Neolithic times was stronger than previously inferred from PPs. Relative to PPs, RVs show a more rapid compositional change, a largest decrease in turnover, and less variable evenness in most of northern Europe since 5200 cal yr BP. All these changes are primarily related to the strong impact of human activities on the vegetation. This study demonstrates that RV-based estimates of diversity indices, timing of shifts, and rates of change in reconstructed vegetation provide new insights into the timing and magnitude of major human distribution on Holocene regional, vegetation, feature that are critical in the assessment of human impact on vegetation, land-cover, biodiversity, and climate in the past. (C) Elsevier Ltd.All tights reserved.
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| 23. |
- Niklasson, Ida B, 1982, et al.
(författare)
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Cinnamyl alcohol oxidizes rapidly upon air exposure
- 2013
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 68:3, s. 129-138
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Tidskriftsartikel (refereegranskat)abstract
- Background. Cinnamyl alcohol and cinnamal are frequent fragrance contact allergens. Both are included in the European baseline fragrance mix I, which is used for screening of contact allergy in dermatitis patients. Objectives. The aim of this study was to investigate the autoxidation of cinnamyl alcoholandtoidentifytheoxidationproductsformedonairexposure.Wealsowantedto evaluate the effect of autoxidation on the sensitization potency of cinnamyl alcohol. Methods. Samples of commercially available cinnamyl alcohol with and without purificationwereexposedtoair,andtheautoxidationwasfollowedbychemicalanalysis. Theanalysiswasperformedwithmassspectrometry(LC/MS/MS).Sensitizationpotencies ofcompoundsweredeterminedwiththemurinelocallymphnodeassay(LLNA)inmice. Results. Chemical analysis showed that the concentration of cinnamyl alcohol in the air-exposed samples decreased rapidly over time, and that autoxidation products were formed. Cinnamal, epoxy cinnamyl alcohol and cinnamic acid were identified as oxidation products. According to our study, cinnamal and epoxy cinnamyl alcohol were thefirstautoxidation productsformed. Theepoxy cinnamyl alcohol wasshowntobethe oxidation product with the highest sensitization potency. The analysis of our samples of commercially available cinnamyl alcohol showed that there was already a content of 1.5% cinnamal at the start of the autoxidation experiments. Conclusion. Cinnamylalcoholreadilyautoxidizesuponairexposure,andformsstrong sensitizers as determined by the LLNA. Cinnamal was formed in the largest amounts, showingthatcinnamalisnotonlyformedviabioactivation,ashaspreviouslybeenshown. A highly sensitizing epoxide was also identified and quantified in the oxidation mixture.
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| 24. |
- Nylinder, Josefine, 1974, et al.
(författare)
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Modelling uncertainty for nitrate leaching and nitrous oxide emissions based on a Swedish field experiment with organic crop rotation
- 2011
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Ingår i: Agriculture, Ecosystems & Environment. - : Elsevier BV. - 0167-8809 .- 1873-2305. ; 141:1-2, s. 167-183
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Tidskriftsartikel (refereegranskat)abstract
- High uncertainties are common in detailed quantification of the N budget of agricultural cropping systems. The process-based CoupModel, integrated with the parameter calibration method known as Generalized likelihood uncertainty estimation (GLUE), was used here to define parameter values and estimate an N budget based on experimental data from an organic farming experiment in south-west Sweden. Data on nitrate (NO3-) leaching and nitrous oxide (N2O) emissions were used as a basis for quantifying N budget pools. A complete N budget with uncertainties associated with the different components of the N cycle compartments for two different fields (B2 and B4) is presented. Simulated N2O emissions contributed 1-2% of total N output, which corresponded to 7% and 8.7% of total N leaching for B2 and B4, respectively. Measured N2O emissions contributed 3.5% and 10.3% of total N leaching from B2 and B4, respectively. Simulated N inputs (deposition, plant N fixation and fertilisation) and outputs (emissions, leaching and harvest) showed a relatively small range of uncertainty, while the differences in N storage in the soil exhibited a larger range of uncertainty. One-fifth of the GLUE-calibrated parameters had a significant impact on simulated NO3- leaching and/or N2O emissions data. Emissions of N2O were strongly associated with the nitrification process. The high degree of equifinality indicated that a simpler model could be calibrated to the same field data.
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| 25. |
- Rasmusson, Bodil, et al.
(författare)
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Child-centered social work practice : three unique meanings in the context of looking after children and the assessment framwork in Australia, Canada and Sweden
- 2010
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Ingår i: Children and youth services review. - New York : Pergamon Press. - 0190-7409 .- 1873-7765. ; 32:3, s. 452-459
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores different orientations to child-centered social work as conveyed in the training materials and guidelines of Looking After Children and Assessment Framework in Australia, Canada and Sweden. ‘Child centered’ is shaped by contextual factors and influences social work practices. We found differences in these approaches as needs based and/or rights based and in relation to how each emphasizes the three P's — Provision, Protection and Participation. Substantial differences were identified both in how references to a child-centered approach appear in theoretical frameworks, values, motives and use of concepts in training materials and guidelines, and in the instructions given as to how to apply these approaches. It appears that Australia balances needs and rights, while Canada is more needs-oriented and Sweden more rights-oriented. Swedish materials show a more explicit emphasis on participation than Australian and Canadian materials. Differences between the three countries indicate the importance of structural, contextual factors shaping orientations to child-centered practice.
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| 26. |
- Rosén, Christoffer, 1986, et al.
(författare)
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Cerebrospinal fluid biomarkers in cardiac arrest survivors.
- 2014
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Ingår i: Resuscitation. - : Elsevier BV. - 1873-1570 .- 0300-9572. ; 85:2, s. 227-232
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the levels of various cerebrospinal fluid (CSF) biomarkers related to neuronal damage, inflammation and amyloid β (Aβ) metabolism in patients resuscitated after an out-of-hospital cardiac arrest (CA).
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| 27. |
- Scheers, Nathalie, 1974, et al.
(författare)
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Proposing a Caco-2/HepG2 cell model for in vitro iron absorption studies
- 2014
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Ingår i: Journal of Nutritional Biochemistry. - : Elsevier BV. - 0955-2863 .- 1873-4847. ; 25:7, s. 710-715
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Tidskriftsartikel (refereegranskat)abstract
- The Caco-2 cell line is well established as an in vitro model for iron absorption. However, the model does not reflect the regulation of iron absorption by hepcidin produced in the liver. We aimed to develop the Caco-2 model by introducing human liver cells (HepG2) to Caco-2 cells. The Caco-2 and HepG2 epithelia were separated by a liquid compartment, which allowed for epithelial interaction. Ferritin levels in cocultured Caco-2 controls were 21.7 +/- 10.3 ng/mg protein compared to 7.7 +/- 5.8 ng/mg protein in monocultured Caco-2 cells. The iron transport across Caco-2 layers was increased when liver cells were present (8.1% +/- 1.5% compared to 3.5% +/- 2.5% at 120 mu M Fe). Caco-2 cells were exposed to 0, 80 and 120 mu M Fe and responded with increased hepcidin production at 1201 mu M Fe (3.6 +/- 0.3 ng/ml compared to 2.7 +/- 0.3 ng/ml). The expression of iron exporter ferroportin in Caco-2 cells was decreased at the hepcidin concentration of 3.6 ng/ml and undetectable at external addition of hepcidin (10 ng/ml). The apical transporter DMT1 was also undetectable at 10 ng/ml but was unchanged at the lower concentrations. In addition, we observed that sourdough bread, in comparison to heat-treated bread, increased the bioavailability of iron despite similar iron content (53% increase in ferritin formation, 97% increase in hepcidin release). This effect was not observed in monocultured Caco-2 cells. The Caco-2/HepG2 model provides an alternative approach to in vitro iron absorption studies in which the hepatic regulation of iron transport must be considered. (c) 2014 The Authors. Published by Elsevier Inc.
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| 28. |
- Sigström, Robert, 1982, et al.
(författare)
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A population-based study on phobic fears and DSM-IV specific phobia in 70-year olds.
- 2011
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Ingår i: Journal of anxiety disorders. - : Elsevier BV. - 1873-7897 .- 0887-6185. ; 25:1, s. 148-53
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Tidskriftsartikel (refereegranskat)abstract
- This population-based study reports on the prevalence and characteristics of specific phobia (SP) and phobic fears in an elderly population. A representative population sample of Swedish 70-year-olds without dementia (N = 558) was examined using semi-structured interviews. Phobic fears included fear of animals, natural environment, specific situations, blood-injection-injury and 'other'. Mental disorders, including SP, were diagnosed according to DSM-IV. Phobic fears (71.0% vs. 37.9%) and SP (13.8% vs. 4.5%) were more common in women than in men. Among those with phobic fears, more than 80% reported onset before age 21. Of those with SP, 35.7% had another DSM-IV diagnosis compared to 8.5% of those reporting no fear. Fear of specific situations and 'other' fears were related to SP and other anxiety disorders. SP was related to lower global functioning. We conclude that specific phobia in the elderly should receive attention from health professionals as it is common and associated with a decrease in global functioning.
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| 29. |
- Sorar, Idris, et al.
(författare)
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Electrochromism of DC magnetron sputtered TiO2 : Role of film thickness
- 2014
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Ingår i: Applied Surface Science. - : Elsevier. - 0169-4332 .- 1873-5584. ; 318, s. 24-27
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Tidskriftsartikel (refereegranskat)abstract
- Titanium dioxide films were prepared by reactive DC magnetron sputtering and the role of the film thick-ness d on the electrochromism was analyzed for 100 < d < 400 nm. The best properties were obtainedfor the thickest films, which yielded a mid-luminous transmittance modulation of 58% and a corre-sponding coloration efficiency of 26.3 cm2/C. The films were amorphous according to X-ray diffractionmeasurements and showed traces of adsorbed water as revealed by infrared spectroscopy.
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| 30. |
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| 31. |
- Stenhamre, Hanna, et al.
(författare)
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Nanosized fibers' effect on adult human articular chondrocytes behavior.
- 2013
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Ingår i: Materials science & engineering. C, Materials for biological applications. - : Elsevier BV. - 1873-0191 .- 0928-4931. ; 33:3, s. 1539-1545
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Tidskriftsartikel (refereegranskat)abstract
- Tissue engineering with chondrogenic cell based therapies is an expanding field with the intention of treating cartilage defects. It has been suggested that scaffolds used in cartilage tissue engineering influence cellular behavior and thus the long-term clinical outcome. The objective of this study was to assess whether chondrocyte attachment, proliferation and post-expansion re-differentiation could be influenced by the size of the fibers presented to the cells in a scaffold. Polylactic acid (PLA) scaffolds with different fiber morphologies were produced, i.e. microfiber (MS) scaffolds as well as nanofiber-coated microfiber scaffold (NMS). Adult human articular chondrocytes were cultured in the scaffolds in vitro up to 28 days, and the resulting constructs were assessed histologically, immunohistochemically, and biochemically. Attachment of cells and serum proteins to the scaffolds was affected by the architecture. The results point toward nano-patterning onto the microfibers influencing proliferation of the chondrocytes, and the overall 3D environment having a greater influence on the re-differentiation. In the efforts of finding the optimal scaffold for cartilage tissue engineering, studies as the current contribute to the knowledge of how to affect and control chondrocytes behavior.
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| 32. |
- Tinghög, Petter, et al.
(författare)
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Migration and mortality trajectories : a study of individuals born in the rural community of Överkalix, Sweden
- 2011
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Ingår i: Social Science and Medicine. - Oxford : Elsevier. - 0277-9536 .- 1873-5347. ; 73:5, s. 744-751
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Tidskriftsartikel (refereegranskat)abstract
- Migration may result in exposure to factors that are both beneficial and harmful for good health. How the act of migration is associated with mortality, or whether the socio-economic condition of migrants prior to migration influences their mortality trajectory, is not well understood. In the present study, a cohort of 413 randomly selected individuals born in the rural community of Överkalix, Sweden, between 1890 and 1935 were followed from birth to either death or old age. Around 50% of the study-population moved away from Överkalix at one time or another. To adjust for a potential bias resulting from self-selection among the migrants, the father’s occupational status was used together with parents’ and grandparents’ longevity. Overall, migration could not be shown to predict mortality when the backgrounds of the migrants were taken into account. Nonetheless, socio-economic background conditions appeared to moderate the association, decreasing the mortality rates for migrants with relatively good pre-migratory socio-economic conditions, while increasing it for migrants with poorer pre-migratory conditions. However, further scrutiny revealed that this effect modification mainly affected the female migrants’ mortality. In conclusion, the study suggests that there is no general association between migration and mortality, but that migrants with better socio-economic resources are more likely to improve their mortality trajectories than migrants with poorer resources. Better pre-migratory conditions hence appear to be important for avoiding health-adverse circumstances and gaining access to health beneficial living conditions when moving to foreign environments – especially for women.
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| 33. |
- Wallinder, Andreas, 1977, et al.
(författare)
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Early results in transplantation of initially rejected donor lungs after ex vivo lung perfusion: a case-control study.
- 2014
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Ingår i: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. - : Oxford University Press (OUP). - 1873-734X. ; 45:1, s. 40-45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: An increasing number of studies have shown that ex vivo lung perfusion (EVLP) is safe and that rejected donor lungs can be resuscitated and used for lung transplantation (LTx). Early clinical outcomes in patients transplanted with reconditioned lungs at our centre were reviewed and compared with those of contemporary non-EVLP controls. METHODS: During 18 months starting January 2011, 11 pairs of donor lungs initially deemed unsuitable for transplantation underwent EVLP. Haemodynamic (pulmonary flow, vascular resistance and artery pressure) and respiratory (peak airway pressure and compliance) parameters were analysed during evaluation. Lungs that improved (n = 11) to meet International Society of Heart and Lung Transplantation criteria were transplanted and compared with patients transplanted with non-EVLP lungs (n = 47) during the same time period. RESULTS: Donor lungs were initially rejected due to either inferior PaO2/FiO2 ratio (n = 9), bilateral infiltrate on chest X-ray (n = 1) or ongoing extra corporeal membrane oxygenation (n = 1). The donor lungs improved from a mean PaO2/FiO2 ratio of 27.9 kPa in the donor to a mean of 59.6 kPa at the end of the EVLP (median improvement 28.4 kPa, range 21.0-50.7 kPa). Two single lungs were deemed unsuitable and not used for LTx. Eleven recipients from the regular waiting list underwent either single (n = 3) LTx or double (n = 8) LTx with EVLP-treated lungs. The median time to extubation (12 (range, 3-912) vs 6 (range, 2-1296) h) and median intensive care unit (ICU) stay (152 (range, 40-625) vs 48 (range, 22-1632) h) were longer in the EVLP group (P = 0.05 and P = 0.01, respectively). There were no differences in length of hospital stay (median 28 (range 25-93) vs 28 (18-209), P = 0.21). Two patients in the EVLP group and 6 in the control group had primary graft dysfunction >Grade 1 at 72 h postoperatively. Three patients in the control group died before discharge. All recipients of EVLP lungs were discharged alive from hospital. CONCLUSIONS: The use of EVLP seems safe and indicates that lungs otherwise refused for LTx can be recovered and subsequently used for transplantation, although time to extubation and ICU stay were longer for the EVLP group.
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| 34. |
- Akbarin, Morvarid, et al.
(författare)
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Being a close relative of a patient with a left ventricular assist device
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:1, s. 64-68
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Tidskriftsartikel (refereegranskat)abstract
- Background: Every year in Sweden, between five and ten patients receive a mechanical heart pump due to grave heart failure. One such pump is the left ventricle assist device (LVAD). At home they need much support from their family. Aim: To investigate the close relatives' experience of their role in relation to patients with an LVAD. Methods: An exploratory study using unstructured interviews with six close relatives of patients with an LVAD. The interviews consisted of one open question: 'What is it like to be the close relative of a patient with an LVAD?' The interviews were analysed using thematic content analysis. Results: The time before LVAD surgery was described as a time of emotional ups and downs, and compared to 'being on an emotional rollercoaster ride'. The nearest relatives were in shock, felt anxiety and uncertainty, and wished to be near the patient. The time after surgery was described as a period in which they had to 'cope with the new situation.' During this period, the staff was experienced as a resource and the relatives described feelings of gratitude, willpower, and acceptance. The stay at home with a person with an LVAD was described as a 'new orientation phase' with limited freedom and the need for respite care. The interviewees expressed the need for support, especially once the patient was at home. Conclusion: It is important to also offer long-term professional support to the nearest relatives of patients with an LVAD.
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| 35. |
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| 36. |
- Andersson, E. K., et al.
(författare)
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Conceptions of caring among a group of coronary care nurses
- 2014
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 13, s. S62-S62
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: During the last decade fundamental changes have taken place at coronary care units (CCUs) with regard to medical treatment and advanced technology in order to improve care for patients with coronary heart disease. In the past, caring in a coronary care context was described in qualitative studies mostly from the patients’ point of view. Coronary care nurses (CCNs) are considered to play a crucial role in this care although research into nurses’ conceptions of caring in this area is still scarce. Extended knowledge from the CCNs’ perspective could be of help in developing and implementing new, nurse-led interventions in a coronary care context. Aim: This study aims to describe the conceptions of caring among a group of coronary care nurses. Methods: This is an interview study. Phenomenographic interviews with open-ended questions were conducted with 21 purposefully sampled CCNs from CCUs at two different county hospitals. The audio-taped interviews took place between March and May 2013 and the data consist of 365 double-spaced pages. The age of the CCNs ranged from 23 to 63 years, the length of experience working as a registered nurse ranged from 1 to 42 years and experience as a CCN ranged from 0.5 to 27 years. A phenomenographic analysis according to the steps described by åkerlind was used. The interviews were read several times in order to gain an overall impression of the data. The central elements of the CCNs’ responses that focus on ’what’ and ’how’ were identified, condensed and summarised as a preliminary means of understanding a phenomenon. Similar responses were carefully grouped or classified and a comparison of the categories was made in order to establish the borders between them. The descriptive categories were created on the basis of similarities and differences. An iterative process was used throughout the data analysis to check interpretation against the interviews that had been transcribed verbatim and the description categories. The description categories were used to develop an ‘outcome space’ that described the wholeness of the findings. Results: The analysis is ongoing. At the beginning of 2014 we expect to present preliminary results and answer questions about qualitatively different conceptions of caring found among a group of CCNs working in CCUs and how the different conceptions of these individuals can be understood.
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| 37. |
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| 38. |
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| 39. |
- Arenhall, Eva, 1974-, et al.
(författare)
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The male partners' experiences of the intimate relationships after a first myocardial infarction
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:2, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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| 40. |
- Astin, Felicity, et al.
(författare)
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Education for nurses working in cardiovascular care: A European survey
- 2014
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 13:6, s. 532-540
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses represent the largest sector of the workforce caring for people with cardiovascular disease in Europe. Little is known about the post-registration education provided to nurses working within this specialty. The aim of this descriptive cross sectional survey was to describe the structure, content, teaching, learning, assessment and evaluation methods used in post-registration cardiovascular nurse education programmes in Europe.Method: A 24-item researcher generated electronic questionnaire was sent to nurse representatives from 23 European countries. Items included questions about cardiovascular registered nurse education programmes.Results: Forty-nine respondents from 17 European countries completed questionnaires. Respondents were typically female (74%) and educated at Masters (50%) or doctoral (39%) level. Fifty-one percent of the cardiovascular nursing education programmes were offered by universities either at bachelor or masters level. The most frequently reported programme content included cardiac arrhythmias (93%), heart failure (85%) and ischaemic heart disease (83%). The most common teaching mode was face-to-face lectures (85%) and/or seminars (77%). A variety of assessment methods were used with an exam or knowledge test being the most frequent. Programme evaluation was typically conducted through student feedback (95%).Conclusion: There is variability in the content, teaching, learning and evaluation methods in post-registration cardiovascular nurse education programmes in Europe. Cardiovascular nurse education would be strengthened with a stronger focus upon content that reflects current health challenges faced in Europe. A broader view of cardiovascular disease to include stroke and peripheral vascular disease is recommended with greater emphasis on prevention, rehabilitation and the impact of health inequalities.
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| 41. |
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| 42. |
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| 43. |
- Berben, L, et al.
(författare)
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Which interventions are used by healthcare professionals to enhance medication adherence in cardiovascular patients? : A survey of current clinical practice
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:1, s. 14-21
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Tidskriftsartikel (refereegranskat)abstract
- Background Complex medication regimens are often required to manage cardiovascular diseases. As non-adherence, which can have severe negative outcomes, is common among cardiovascular patients, various interventions to improve adherence should be implemented in daily practice.Aim To assess which strategies cardiovascular nurses and allied health professionals utilize to (1) assess patients' adherence to medication regimen, and (2) enhance medication adherence via educational/cognitive, counseling/behavioral, and psychological/affective interventions.Method A 45-item questionnaire to assess adherence assessment and interventional strategies utilized by health care professionals in daily clinical practice was distributed to a convenience sample of attendants of the 10th Annual Spring Meeting of the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions conference in Geneva (Switzerland) in March 2010. Respondents not in direct clinical practice were excluded. Descriptive statistics were used to describe practice patterns regarding adherence management.Results Of 276 distributed questionnaires, 171 (62%) were returned, of which 34 (20%) were excluded as respondents performed no direct patient care. Questioning patients about non-adherence during follow-up was the most frequently reported assessment strategy (56%). Educational/cognitive adherence enhancing interventions were used most frequently, followed by counseling/behavioral interventions. Psychological/affective interventions were less frequently used. The most frequent intervention used was providing reading materials (66%) followed by training patients regarding medication taking during inpatient recovery (48%). Slightly over two-thirds (69%) reported using a combination of interventions to improve patient's adherence.Conclusion Educational interventions are used most in clinical practice, although evidence shows they are less effective than behavioral interventions at enhancing medication adherence.
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| 44. |
- Bergman, Eva, et al.
(författare)
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Meaningfulness is not the most important component for changes in sense of coherence
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 11:3, s. 331-338
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Tidskriftsartikel (refereegranskat)abstract
- Background Sense of coherence is a theoretical construct which is used to measure the degree to which a person finds the world comprehensible, manageable and meaningful.Aim The main aim of the present study was to assess the hypothesis of Antonovsky that meaningfulness is the most crucial component in sense of coherence. The second aim was to explore the importance of its components and factors at baseline on sense of coherence changes and if the findings can be used in cardiac rehabilitation.Methods One hundred patients, who suffered a primary myocardial infarction were followed during two years. The instruments used were; sense of coherence questionnaire-13, 12-item short-form health survey questionnaire, the Seattle Angina Questionnaire and Health Curve.Results Thirty-nine percent of the participants fulfilled Antonovsky's hypothesis. Comprehensibility and the baseline factors of smoking, alcohol use, marital status and disease perception proved to be of importance for sense of coherence changes over time.Conclusion The hypothesis that meaningfulness is the most crucial component in sense of coherence is rejected for patients with primary myocardial infarction. Comprehensibility is more important than meaningfulness for changes in sense of coherence. Nurses therefore have an important task to increase comprehensibility and sense of coherence by providing information and knowledge about myocardial infarction and lifestyle changes at an early stage. The information should be given in an individualized and easily understandable way from a salutogenic perspective, which means to identify and work with factors that can contribute to preserving and promoting health.
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| 45. |
- Bergman, Eva, et al.
(författare)
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The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction : a long-term follow-up study
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 11:3, s. 276-283
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Tidskriftsartikel (refereegranskat)abstract
- Background: After being through a myocardial infarction (MI), a severe recovery period ensues for the patient. Longterm follow-ups are helpful, but what this should include differs between patients. Today there is no established approach to identify needs for support after an MI. Aim: The aim was to describe sense of coherence (SOC) over time in relation to sex, as well as further SOC in relation to quality of life (QoL) and treatment satisfaction in patients with an MI. Methods. This study had an observational and longitudinal design and followed 18 women and 60 men with an acute MI for 49-67 months after the onset of MI. Instruments used were the SOC-13 and the Seattle Angina Questionnaire. Results: Women scored lower SOC than men. A main effect of time was shown for comprehensibility which increased significantly from baseline to the long-term follow-up. Women increased from a lower level to an equal level as men at the long-term follow-up. The total SOC was significantly associated with QoL and treatment satisfaction. Conclusion: High comprehensibility and high SOC give the patient a better basis to handle life after MI. Thus, healthcare professionals should keep in mind that SOC and especially comprehensibility have meaning for the patient's ability to handle her or his recovery. Healthcare professionals need to together with the patient identify and work with lifestyle factors that contribute to increased comprehensibility about the disease, which gives the patient the foundation to preserve and promote her or his health both in the short and long term.
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| 46. |
- Bolse, Kärstin, et al.
(författare)
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Healthcare professionals experiences of delivering care to patients with an implantable cardioverter defibrillator
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - London : Elsevier / SAGE Publications (UK and US): 12 month Embargo. - 1474-5151 .- 1873-1953. ; 12:4, s. 346-352
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Tidskriftsartikel (refereegranskat)abstract
- Background: An implantable cardioverter defibrillator (ICD) is a technical device used in the treatment of ventricular arrhythmias. After an ICD implantation, the entire life situation of the patient their next of kin can be affected psychologically and socially. Healthcare professionals play a vital role in providing educational counselling, support and technical follow-up of the device, but little is known about their experiences. less thanbrgreater than less thanbrgreater thanAim: This paper describes the experiences of Swedish healthcare professionals in delivering care to patients with an ICD. less thanbrgreater than less thanbrgreater thanMethods: A qualitative, descriptive design based on a phenomenographic approach was used. Data were collected through interviews with 12 specialist ICD nurses and 12 physicians, representing 16 ICD implantation centres in Sweden. less thanbrgreater than less thanbrgreater thanFindings: Two descriptive categories comprising seven subcategories emerged. Striving to provide competent care comprised the subcategories: providing access to care, improving ones qualifications and individualising care. Striving to infuse confirmation incorporated the subcategories: promoting independence, providing existential support, mediating security and comprising needs of next of kin. less thanbrgreater than less thanbrgreater thanConclusions: The healthcare professionals described how they wished to develop the care further. Both nurses and physicians were consistent in wanting to provide competent and confirming care based on a holistic perspective with high accessibility to the ICD team. The findings describe how healthcare professionals strive to provide professional clinical care in order to give the patients tools to handle their life situation. They suggested that more structured education and counselling according to guidelines should be provided. They also highlighted the need to increase their own competence by improving their knowledge and skills.
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| 47. |
- Brink, Eva, 1952
(författare)
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Fatigue after myocardial infarction – to be considered more fully in cardiovascular nursing
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 11:Suppl 1
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Konferensbidrag (refereegranskat)abstract
- Purpose: The aim of the present study was to investigate the influences of fatigue, sense of coherence and optimism on health-related quality of life (HRQL) in persons who have been treated for myocardial infarction one year after hospitalisation. Methods: The sample consisted of 98 persons, 33 women and 65 men (response rate, 74%) with a mean (SD) age of 67.88 (9.93) years. They had been treated for myocardial infarction in a coronary care unit at a Swedish rural hospital. Now, they participated in a 1-year follow-up study including questionnaires about fatigue, sense of coherence, optimism and HRQL (SF-36). Correlation and regression analyses were performed to explore relationships between variables and to identify variables that best explained the variance of the physical component score (PCS) and the mental component score (MCS) of HRQL. Results: The two regression models for analyses of PCS and MCS included fatigue, sense of coherence and optimism, controlling for age and gender. The results showed that the explained variance of PCS was 47.4%, F(5, 91) = 16.43 and that fatigue (p < 0.001) and sense of coherence (p < 0.05) contributed significantly to the variance. The explained variance of MCS was 48.9%, F(5, 91) = 17.44 and fatigue (p < 0.001) and optimism (p < 0.01) contributed significantly to the variance. Conclusion: Experiences of fatigue after myocardial infarction will have negative influences on both the physical and mental dimensions of HRQL. Compared to sense of coherence and optimism, fatigue was found to be a stronger predictor of HRQL. Clearly, it is time to take patients who suffer from post-myocardial infarction fatigue seriously. It is of vital importance to develop and evaluate fatigue relief strategies in cardiovascular nursing.
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| 48. |
- Broström, Anders, 1963-, et al.
(författare)
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Gender differences in respiratory disturbance, sleep and daytime sleepiness in hypertensive patients with different degrees of obesity
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 12:2, s. 140-149
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHypertension (HT) and obesity have both been linked to obstructive sleep apnoea (OSA). Difficulties have been described in identifying patients with OSA in primary care, causing low referral rates to sleep clinics. Increased knowledge about gender-specific characteristics and symptoms may help to identify patients.AimThe aim was to describe gender differences regarding undiagnosed OSA, self-rated sleep, insomnia and daytime sleepiness in middle-aged primary care patients with HT and different degrees of obesity.MethodsA cross-sectional design was used and 394 patients (52.5% women), mean age 57.8 years (SD 6.7 years), with HT (BP >140/90 mmHg) were included. Clinical examinations, respiratory recordings and self-rated scales regarding OSA symptoms, sleep, insomnia and daytime sleepiness were used. Body mass index (BMI) was classified according to the criteria from the National Institutes of Health.ResultsPre-obesity and obesity classes I and II were seen among 53%, 26% and 8% of the men and 37%, 19% and 14% of the women, respectively. Occurrence of mild, moderate and severe OSA increased significantly across the BMI classes for both genders (p<0.01). Ninety percent of the men and 80% of the women in obesity class II had OSA. Insomnia was prevalent in obese patients. Other clinical variables did not differ between BMI classes or genders.ConclusionThe occurrence of overweight/obesity and OSA was high among both genders. A high BMI might be a convenient clinical marker for healthcare personnel to identify hypertensive patients with possible OSA in need of further evaluation and treatment.
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| 49. |
- Brännström, Margareta, et al.
(författare)
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A new model for integrated heart failure and palliative advanced homecare : rationale and design of a prospective randomized study
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 12:3, s. 269-275
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Tidskriftsartikel (refereegranskat)abstract
- Background: Guidelines have concluded that there is a great need for new models of integrated care, e.g. heart failure and palliative care, in order to facilitate equality of care for dying patients, regardless of diagnosis. We found no evidence in the literature concerning the advantages and effects of integrated heart failure and palliative advanced home care for patients with severe chronic heart failure.Aim: The primary aim is to study the effects of integrated Palliative advanced homecarRE and heart FailurE caRE (PREFER) on patients' symptom burden, quality of life, and activities of daily living (ADL) as compared to usual care.Method: Prospective, randomized study with an open-evaluation PROBE design. Optimally treated outpatients with chronic heart failure of varying aetiologies in New York Heart Association classes III-IV will be eligible to participate.Conclusion: The PREFER study is designed to investigate whether a new concept of managing patients with severe chronic heart failure by integrating palliative homecare and active heart failure treatment will reduce symptom burden, increase quality of life and ADL, and reduce the number of hospitalizations in patients with severe chronic heart failure.
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| 50. |
- Brännström, Margareta, et al.
(författare)
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Physicians' experiences of palliative care for heart failure patients
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:1, s. 64-69
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although heart disease is the single most common cause of death knowledge about palliative care for this group of patients is deficient.AIM: The aim of this study was to describe physicians' experiences of palliative care for heart failure patients.METHODS: Fifteen physicians at a medical geriatrics clinic were interviewed. The interviews were analysed using thematic content analysis.RESULTS: The results show that the physicians are confronted with patients with an unpredictable disease trajectory, including patients with severe symptoms, uncertainty about anticipating the course of dying and encountering close relative's anxiety and frustration. The physicians face difficult situations regarding whether to continue or withdraw care and medical treatment which means deciding concerning 'active' medical treatment, cardio pulmonary resuscitation and an implantable cardioverter-defibrillator (ICD). The physicians acknowledge the necessity for better structured follow-ups and cooperation with outpatient settings. They recognize that there is a lack of follow-ups and continuity of care and treatment at the hospital, involving their passing on or retaining responsibility for the patients' medical care.CONCLUSION: From the physicians' view clarification of who is principally responsible for the patient's medical care, being involved throughout the disease trajectory and cooperating more closely with palliative care services are necessary to further improve the way in which care is delivered to patients dying of heart failure.
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