| 1. |
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| 2. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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A person-centered education for adolescents with type 1 diabetes - a randomized controlled trial
- 2019
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 20:7, s. 986-996
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Young people with type 1 diabetes and their parents need to receive person-centred education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centred communication and reflection education model that can be used in educational programmes for young people with type 1 diabetes.OBJECTIVE: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents.METHODS: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for twelve months. The intervention group (n=37) attended seven group training sessions over a period of five months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring.RESULTS: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at twelve months, favouring the intervention group (62 vs. 70 mmol/mol, p=0.009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after twelve months (p=0.019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy.CONCLUSIONS: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centred care in adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved.
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| 3. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method : a qualitative study
- 2017
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Ingår i: BMJ Open Diabetes Research & Care. - : BMJ. - 2052-4897. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.
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| 4. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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Does treatment with an insulin pump improve glycaemic control in children and adolescents with type 1 diabetes? : A retrospective case-control study
- 2015
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 16:7, s. 546-553
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate long-term effects on glycaemic control, ketoacidosis, serious hypoglycaemic events, insulin requirements, and body mass index standard deviation scores (BMI-SDS) in children and adolescents with type 1 diabetes starting on continuous subcutaneous insulin infusion (CSII) compared with children and adolescents treated with multiple daily injections (MDI).METHODS: This retrospective case-control study compares 216 patients starting CSII with a control group on MDI (n = 215), matched for glycated hemoglobin (HbA1c), sex, and age during a 2-yr period. Variables collected were gender, age, HbA1c, insulin requirement, BMI, BMI-SDS, ketoacidosis, and serious hypoglycaemic events.RESULTS: In the CSII group there was an improvement in HbA1c after 6 and 12 months compared with the MDI group. For boys and girls separately the same effect was detected after 6 months, but only for boys after 12 months. The incidence of ketoacidosis was higher in the CSII group compared with the MDI group (2.8 vs. 0.5/100 person-yr). The incidences of severe hypoglycaemic episodes per 100 person-yr were three in the CSII group and six in the MDI group (p < 0.05). After 6, 12, and 24 months, the insulin requirement was higher in the MDI group.CONCLUSIONS: This study shows that treatment with CSII resulted in an improvement in HbA1c levels up to 1 yr and decreased the number of severe hypoglycaemic events, but the frequency of ketoacidosis increased. The major challenge is to identify methods to maintain the HbA1c improvement, especially among older children and teenagers, and reduce the frequency of ketoacidosis.
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| 5. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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Parent's perception of their children's health, quality of life and burden of diabetes : testing reliability and validity of 'Check your Health' by proxy.
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 31:3, s. 497-504
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test the validity and reliability of the 'Check your Health by proxy' instrument in parents to children with diabetes aged 8-17 years.METHODS: One hundred and ninety-one caregivers and their children, aged 8-17 years, were included. All completed the 'Check your Health' questionnaire measuring quality of life and burden of diabetes, DISABKIDS self- or proxy version, and 45 completed the same questionnaires 2 weeks later.RESULTS: Test-retest reliability on the 'Check your Health' questionnaire by proxy was moderate to strong (r = 0.48-0.74), p < 0.002). Convergent validity was weak to moderate (r = 0.15-0.49, p < 0.05). The instrument showed acceptable discriminant validity. Parents reported lower scores than the children on emotional health and social relations and higher scores on physical and emotional burden and higher burden on quality of life. Poorer social relationships and quality of life were associated with higher reported disease severity. The diabetes burden domain of the questionnaire correlated to perceived severity of diabetes and to perceived health. Discriminant validity showed that poorer social relationships and quality of life were associated with higher severity of the disease. The diabetes burden domain of 'Check your Health' by proxy showed discriminant validity on perceived severity of diabetes.CONCLUSIONS: The instrument 'Check your Health' by proxy showed acceptable psychometric characteristics in parents to young people (8-17 years of age) with diabetes. We also concluded that parents reported that their children had lower health and higher burden of diabetes than the children did, and it correlated to reported disease severity.
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| 6. |
- Haas, Josephine, et al.
(författare)
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Guided self-determination-young versus standard care in the treatment of young females with type 1 diabetes : study protocol for a multicentre randomized controlled trial
- 2017
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Female adolescents with type 1 diabetes mellitus (T1DM) have the most unsatisfactory glycaemic control of all age groups and report higher disease burden, poorer perceived health, and lower quality of life than their male counterparts. Females with T1DM face an excess risk of all-cause mortality compared with men with T1DM. New methods are needed to help and support young females with T1DM to manage their disease. A prerequisite for successful diabetes management is to offer individualized, person-centred care and support the patient's own motivation. Guided self-determination (GSD) is a person-centred reflection and problem-solving method intended to support the patient's own motivation in the daily care of her diabetes and help develop skills to manage difficulties in diabetes self-management. GSD has been shown to improve glycaemic control and decrease psychosocial stress in young women with T1DM. The method has been adapted for adolescents and their parents, termed GSD-young (GSD-Y). The aim of this study was to evaluate whether an intervention with GSD-Y in female adolescents with T1DM leads to improved glycaemic control, self-management, treatment satisfaction, perceived health and quality of life, fewer diabetes-related family conflicts, and improved psychosocial self-efficacy.METHODS/DESIGN: This is a parallel-group randomized controlled superiority trial with an allocation ratio of 1:1. One hundred female adolescents with T1DM, 15-20 years of age, and their parents (if < 18 years of age), will be included. The intervention group will receive seven individual GSD-Y education visits over 3 to 6 months. The control group will receive standard care including regular visits to the diabetes clinic. The primary outcome is level of glycaemic control, measured as glycosylated haemoglobin (HbA1c). Secondary outcomes include diabetes self-management, treatment satisfaction, perceived health and quality of life, diabetes-related family conflicts, and psychosocial self-efficacy. Data will be collected before randomization and at 6 and 12 months.DISCUSSION: Poor glycaemic control is common in female adolescents and young adults with T1DM. Long-standing hyperglycaemia increases the risks for severe complications and may also have an adverse impact on the outcome of future pregnancies. In this study, we want to evaluate if the GSD-Y method can be a useful tool in the treatment of female adolescents with T1DM.TRIAL REGISTRATION: Current controlled trials, ISRCTN57528404 . Registered on 18 February 2015.
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| 7. |
- Lexén, Jenny, et al.
(författare)
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Rekommendationer för utsortering av textilier med farliga ämnen ur kretsloppet
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I textilier som finns på marknaden idag finns en stor mängd kemiska ämnen. För att åstadkomma kretslopp som både är resurseffektiva och så långt som möjligt fria från farliga ämnen behöver risken för att särskilt farliga ämnen och ämnen med andra oönskade egenskaper recirkuleras klargöras.I den här rapporten har en litteratursammanställning gjorts och utifrån den befintliga informationen presenteras olika förslag till rekommendationer/scenarier för utsortering av textilier. Syftet med projektet var att identifiera om det finns specifika produktgrupper inom textil på marknaden som inte bör materialåtervinnas efter att de har samlats in på grund av att de innehåller farliga ämnen. Projektet syftar även till att ta fram förslag till konkreta rekommendationer för hur de identifierade produktgrupperna ska sorteras. Projektet har även haft en referensgrupp med representanter från branschen som bland annat har kommit med kommentarer på de föreslagna scenarierna.Kemikalier i textil kan delas in i grupper beroende på vilken funktion ämnena avser att uppfylla. På grundval av hälso- och miljöfarliga egenskaper och potential att föras vidare vid återvinning av textil har ett antal grupper identifierats som särskilt viktiga att beakta, till exempel färgämnen, antibakteriella ämnen och mjukgörare.I dagsläget finns det inte tillräckligt med information tillgängligt kring innehåll av farliga ämnen i enskilda textilier som når avfallsledet för att det ska gå att göra välgrundade beslut kring vilka textilier som bör sorteras ut på grund av dess innehåll av farliga ämnen. Vissa av ämnena kan också förekomma i ett mycket brett spektra av textilier vilket i princip gör en utsortering omöjlig.Vid fiberåtervinning vill man ha olika typer av fiber separat sorterade, därför är det önskvärt att sortera utefter fibertyp och möjligtvis sedan efter användningsområde (produkttyp) (Norlin, Re:newcell 2015). Det spelar också in vad den återvunna råvaran ska användas till. Olika användning ställer olika krav på innehållet i materialet. En generell svårighet dock är att alla produkter av samma fiber och för samma användningsområde inte behöver innehålla samma kemikalier.I rapporten beskrivs fem olika rekommendationer/scenarier för utsortering av textil baserat på olika stort fokus på giftfrihet respektive resurseffektivitet. Samtliga förslag baseras på att det är produktgrupper som kan antas innehålla farliga ämnen som sorteras ut i olika utsträckning. Stort fokus på giftfrihet innebär utsortering av en stor mängd produktgrupper vilket ger en begränsad mängd textil till återvinning och troligtvis utsortering av sådant som ur andra synpunkter skulle ha kunnat återvinnas. Scenarierna baseras till stor del på utsorteringsbehov vid mekanisk återvinning av textil.
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| 8. |
- Lindholm, Ljubica, et al.
(författare)
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Effect of lipid bilayer properties on the photocycle of green proteorhodopsin
- 2015
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Ingår i: Biochimica et Biophysica Acta - Bioenergetics. - : Elsevier BV. - 0005-2728 .- 1879-2650. ; 1847:8, s. 698-708
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Tidskriftsartikel (refereegranskat)abstract
- The significance of specific lipids for proton pumping by the bacterial rhodopsin proteorhodopsin (pR) was studied. To this end, it was examined whether pR preferentially binds certain lipids and whether molecular properties of the lipid environment affect the photocycle. pR's photocyde was followed by microsecond flash-photolysis in the visible spectral range. It was fastest in phosphatidylcholine liposomes (soy bean lipid), intermediate in 3-[(3-cholamidopropyl) dimethylammonio] propanesulfonate (CHAPS): 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) bicelles and in Triton X-100, and slowest when pR was solubilized in CHAPS. In bicelles with different lipid compositions, the nature of the head groups, the unsaturation level and the fatty acid chain length had small effects on the photocycle. The specific affinity of pR for lipids of the expression host Eschetichia coil was investigated by an optimized method of lipid isolation from purified membrane protein using two different concentrations of the detergent N-dodecyl-beta-D-maltoside (DDM). We found that 11 lipids were copurified per pR molecule at 0.1% DDM, whereas essentially all lipids were stripped off from pR by 1% DDM. The relative amounts of copurifled phosphatidylethanolamine, phosphatidylglycerol, and cardiolipin did not correlate with the molar percentages normally present in E. coil cells. The results indicate a predominance of phosphatidylethanolamine species in the lipid annulus around recombinant pR that are less polar than the dominant species in the cell membrane of the expression host E. coli.
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| 9. |
- Lindholm, Maria, et al.
(författare)
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Occupational safety and health challenges of home care personnel
- 2019
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Ingår i: Proceedings of the Vision Zero Summit 2019. ; , s. 160-163
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Konferensbidrag (refereegranskat)abstract
- Care personnel often have musculoskeletal disorders and sleep disturbances. In this study, aquestionnaire was utilized to identify occupational safety and health (OSH) challenges andassociations with possible sleep disturbances among home care personnel. The questionnairewas given to 19 workplaces in the Stockholm County in 2017, and 469 employees answered.Preliminary results show that among identified OSH challenges were high psychosocial andphysical workload, and dissatisfaction with the leadership. Lack of satisfaction with the work,dissatisfaction with the leadership, high qualitative demands and pain disorders were significantlyassociated with sleep disturbances. The results support the importance of promoting a goodorganizational work environment in the home care services.
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| 10. |
- Malmborg, Petter, et al.
(författare)
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Presentation and progression of childhood-onset inflammatory bowel disease in northern Stockholm County
- 2015
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Ingår i: Inflammatory Bowel Diseases. - : Wolters Kluwer. - 1078-0998 .- 1536-4844. ; 21:5, s. 1098-1108
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Tidskriftsartikel (refereegranskat)abstract
- Background: Some studies have suggested that childhood-onset inflammatory bowel disease (IBD) is characterized by extensive intestinal involvement and rapid progression to complications. Here, we report the presentation and progression of patients diagnosed with IBD during childhood in a population-based cohort from northern Stockholm County.Methods: Medical records for all 280 patients diagnosed in the period 1990-2007 with childhood-onset IBD in northern Stockholm County were followed until 2011 (median follow-up time, 8.8 yr). Disease phenotypes were classified according to the Paris pediatric IBD classification.Results: Among the 74 patients with ulcerative colitis, 72% presented with pancolitis. Among the 200 patients with Crohn's disease (CD), 75% presented with colitis. Complicated disease behavior was observed in 18% of patients with CD by end of follow-up. Extension of the disease territory was observed in 22% of patients with ulcerative colitis and 15% of patients with CD. The cumulative risk of intra-abdominal surgery after 10 years was 8% (95% confidence interval, 4%-20%) for ulcerative colitis and 22% (95% confidence interval, 15%-28%) for patients with CD. Nonmucosal healing at 1 year was associated with a complicated disease course in patients with CD (hazard ratio = 14.56; 95% confidence interval, 1.79-118.68; P = 0.01).Conclusions: Patients with childhood-onset IBD were characterized by extensive colitis that was relatively stable over time and associated with a relatively low risk of complications and abdominal surgery. Our findings confirm the more extensive disease location in pediatric IBD but did not identify the proposed dynamic and aggressive nature of the childhood-onset phenotype. The association of nonmucosal healing with a complicated disease course suggests that endoscopy should guide treatment intensity in childhood-onset CD.
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| 11. |
- Nilsson, Stefan, 1972, et al.
(författare)
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The Faces Emotional Coping Scale as a self-reporting instrument for coping with needle-related procedures : An initial validation study with children treated for type 1 diabetes
- 2017
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Ingår i: Journal of Child Health Care. - : SAGE Publications. - 1367-4935 .- 1741-2889. ; 21:4, s. 392-403
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine the concurrent and content validity, sensitivity and inter-rater reliability of the Faces Emotional Coping Scale (FECS) to evaluate the children's anticipation of the level of emotional coping in conjunction with a venepuncture. A total of 153 children with type 1 diabetes and 86 of their parents participated in the study. The age of the children, 76 of whom were boys, ranged from 7 to 18 years. The child and his or her parent reported the child's coping ability, and the child reported the pain intensity and unpleasantness of a venepuncture. The child also wrote a short narrative about his or her experience of the needle procedure. The FECS correlated negatively with the Coloured Analogue Scale and the Facial Affective Scale and positively with the FECS by proxy. The narratives of 90 children correlated negatively with the FECS. Younger children reported significantly lower scores than older children did regarding their ability to cope with a venepuncture. The children's scores on the FECS showed good agreement with the parents' scores. In this study, the FECS was deemed valid for measuring children's ability to cope with their emotions when undergoing needle-related procedures like venepuncture.
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| 12. |
- Petersson, Lena, 1968-, et al.
(författare)
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Professionernas farhågor om införandet av eJournal inom vuxenpsykiatrin i Region Skåne
- 2016
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Ingår i: Book of Abstracts.
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Konferensbidrag (refereegranskat)abstract
- Hösten 2015 var Region Skåne först i Sverige med att lägga till patientjournaler från psykiatrin till invånartjänsten eJournal. Genom tjänsten, har alla patienter i den vuxenpsykiatriska vården i Region Skåne tillgång till sin journal via nätet. Det finns lite kunskap om hur professioner na inom den psykiatriska vården förväntar sig att deras arbete kommer att påverkas av den ökade transparens som patienternas tillgång till sin journal via internet innebär. Syftet med detta paper är att undersöka hur socionomer, läkare, psykologer och sjuksköterskor i vuxenpsykiatrin i Region Skåne förväntar sig att patienternas tillgång till eJournal kommer att förändra villkore n för det egna professionella arbetet. Empirin som presenteras härrör från en webbenkät som skickades till samtliga anställda inom vuxenpsykiatrin i Region Skåne strax före införandet av tjänsten. Svarsfrekvensen på enkäten var 29% och fördelningen mellan de olika personalkategorierna överensstämmer väl med andelen anställda i varje personalgrupp. Analysen visar dels att förväntningarna skiljersigmellan de olika professionerna och dels att professionerna förväntar sig att eJournal kommer att påverka deras legitimitet, makten över journalen som arbetsverktyg samt patienternas förtroende för dem.
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| 13. |
- Zetterlund, Eva-Lena, et al.
(författare)
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Determination of loss of consciousness: a comparison of clinical assessment, bispectral index and electroencephalogram: An observational study
- 2016
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Ingår i: European Journal of Anaesthesiology. - : Lippincott Williams & Wilkins. - 0265-0215 .- 1365-2346. ; 33:12, s. 922-928
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDComputer-processed algorithms of encephalographic signals are widely used to assess the depth of anaesthesia. However, data indicate that the bispectral index (BIS), a processed electroencephalography monitoring system, may not be reliable for assessing the depth of anaesthesia.OBJECTIVEThe aim of this study was to evaluate the ability of the BIS monitoring system to assess changes in the level of unconsciousness, specifically during the transition from consciousness to unconsciousness, in patients undergoing total intravenous anaesthesia with propofol. We compared BIS with the electroencephalogram (EEG), and clinical loss of consciousness (LOC) defined as loss of verbal commands and eyelash reflex.DESIGNThis was an observational cohort study.SETTINGUniversity Hospital Linkoping, University Hospital orebro, Finspang Hospital and Kalmar Hospital, Sweden from October 2011 to April 2013.PATIENTSA total of 35 ASA I patients aged 18 to 49 years were recruited.INTERVENTIONSThe patients underwent total intravenous anaesthesia with propofol and remifentanil for elective day-case surgery. Changes in clinical levels of consciousness were assessed by BIS and compared with assessment of stage 3 neurophysiological activity using the EEG. The plasma concentrations of propofol were measured at clinical LOC and 20 and 30min after LOC.MAIN OUTCOME MEASURESThe primary outcome was measurement of BIS, EEG and clinical LOC.RESULTSThe median BIS value at clinical LOC was 38 (IQR 30 to 43), and the BIS values varied greatly between patients. There was no correlation between BIS values and EEG stages at clinical LOC (r=-0.1, P=0.064). Propofol concentration reached a steady state within 20min.CONCLUSIONThere was no statistically significant correlation between BIS and EEG at clinical LOC. BIS monitoring may not be a reliable method for determining LOC.CLINICAL TRIALS REGISTRYThis trial was not registered because registration was not mandatory at the time of the trial.
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