| 1. |
- Norrhall, Maria Fässberg, 1968, et al.
(författare)
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A feasible lifestyle program for early intervention in patients with chronic obstructive pulmonary disease (COPD): a pilot study in primary care.
- 2009
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Ingår i: Primary care respiratory journal : journal of the General Practice Airways Group. - : Springer Science and Business Media LLC. - 1475-1534. ; 18:4, s. 306-12
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate the feasibility of a lifestyle program for early intervention in patients with COPD in a primary care population. METHODS: The study was performed in a Primary Health Care Centre in Western Sweden. During a four-week period, all smokers between 40-70 years of age were invited to answer a questionnaire and to perform spirometry. The intervention program included a specially designed smoking cessation program and programs for physical activity and diet. RESULTS: 84 smokers were included. 42% fulfilled the criteria for COPD. All of the COPD patients were in GOLD stage I and II. Among the COPD subjects, 38% were underweight and 56% had a low fat-free mass - both together indicating malnutrition and the need for nutritional treatment. By the end of the intervention program, 47% of the COPD patients had stopped smoking. CONCLUSIONS: The intervention program was feasible and effective with a very high smoking cessation rate.
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| 2. |
- Thorn, Jörgen, 1965, et al.
(författare)
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Management of chronic obstructive pulmonary disease (COPD) in primary care: a questionnaire survey in western Sweden.
- 2008
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Ingår i: Primary care respiratory journal : journal of the General Practice Airways Group. - : Springer Science and Business Media LLC. - 1471-4418. ; 17:1, s. 26-31
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess the primary care management of chronic obstructive pulmonary disease (COPD) in relation to COPD guidelines. METHOD: A postal questionnaire was sent out to all Primary Health Care Centres (PHCCs) in western Sweden (n=232). The response rate was 75%. RESULTS: A majority of the PHCCs had a nurse and physician responsible for COPD care. They used spirometry equipment regularly, but only 50% reported that they calibrated it at least weekly. Less than 30% of the PHCCs reported access to a dietician, occupational therapist or physiotherapist. There was a structured smoking cessation program in 50% of the PHCCs. Larger PHCCs were more likely to use spirometry equipment regularly and to have specific personnel for COPD care. CONCLUSION: There is a need to establish structured programs for COPD care including smoking cessation programs for COPD patients with special trained staff. Larger PHCCs have a better infrastructure for providing guideline-defined COPD care.
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| 3. |
- Adolfsson, Jörgen, et al.
(författare)
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Identification of Flt3(+) lympho-myeloid stem cells lacking erythro-megakaryocytic potential: A revised road map for adult blood lineage commitment
- 2005
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Ingår i: Cell. - : Elsevier (Cell Press). - 0092-8674 .- 1097-4172. ; 121:2, s. 295-306
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Tidskriftsartikel (refereegranskat)abstract
- All blood cell lineages derive from a common hematopoietic stem cell (HSC). The current model implicates that the first lineage commitment step of adult pluripotent HSCs results in a strict separation into common lymphoid and common myeloid precursors. We present evidence for a population of cells which, although sustaining a high proliferative and combined lympho-myeloid differentiation potential, have lost the ability to adopt erythroid and megakaryocyte lineage fates. Cells in the Lin-Sca-1+c-kit+ HSC compartment coexpressing high levels of the tyrosine kinase receptor Flt3 sustain granulocyte, monocyte, and B and T cell potentials but in contrast to Lin-Sca-1(+)ckit(+)Flt3(-) HSCs fail to produce significant erythroid and megakaryocytic progeny. This distinct lineage restriction site is accompanied by downregulation of genes for regulators of erythroid and megakaryocyte development. In agreement with representing a lymphoid primed progenitor, Lin(-)Sca-l(+)c-kit(+)CD34(+)Flt3(+) cells display upregulated IL-7 receptor gene expression. Based on these observations, we propose a revised road map for adult blood lineage development.
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| 4. |
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| 5. |
- Bergh, Håkan, 1958, et al.
(författare)
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Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years.
- 2007
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Ingår i: Public health. - : Elsevier BV. - 0033-3506. ; 121:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To find predictive factors for long-term sick leave (SL) and disability pension (DP) among frequent attenders (FAs) and normal attenders (NAs) in primary health care. STUDY DESIGN: A cohort study with follow-up over 5 years. METHODS: Groups of FAs and NAs were followed over 5 years. Information about background, situation, sociodemography, life events, social support and sense of coherence were gathered at baseline. Multiple logistic regression analysis was used to determine the influence of each variable on long-term SL and receipt of a DP. RESULTS: During the study period, 18.9% of FAs received long-term SL/DP compared with 6% of NAs. Chronic disease was a predictive factor for long-term SL/DP among FAs [odds ratio (OR) 7.0] and NAs (OR 3.4). Among FAs, a life event was also a predictive factor (OR 2.1). Each additional life event increased the ratio of FAs with long-term SL/DP by 110%. Conflicts and losses had the greatest negative effects on FAs. CONCLUSIONS: FAs are a high-risk group for long-term SL/DP. Besides chronic disease, a life event was the only predictive factor for long-term SL/DP among FAs. These findings indicate that FAs are a vulnerable group for stressful events. Consequently, healthcare personnel should take more notice of life events among FAs.
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| 6. |
- Helgesson, Östen, 1957, et al.
(författare)
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Quality of life in cancer survivors as observed in a population study of Swedish women
- 2007
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Ingår i: Scandinavian Journal of Primary HealthCare. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 25:4, s. 220-5
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To investigate quality of life, measured by the SF-36 scales, in a population-based sample of women who have survived cancer at any site and, specifically, breast cancer. Design. A representative cohort of women was observed over 24 years with regard to cancer prevalence, incidence, and quality of life. Setting. Gothenburg, Sweden. Subjects. A total of 1462 women aged 38-60 years at baseline. Main outcome measures. Differences in quality of life between cancer survivors and cancer-free controls measured by the SF-36 Short Form Health Survey, with adjustment for age and additionally for social status, and history of major disease (diabetes, stroke, and myocardial infarction) at follow-up in 1992-93. Results. In women who had survived cancer, a lower feeling of general health was the only score found to be significantly associated with having had cancer. Similar analysis was conducted separately for breast cancer cases. Survivors of breast cancer reported lower vitality and when controlled for major disease also lower general health compared with women who had not had cancer. All other results were independent when adjusted for social status, and also for history of major disease. Conclusions. Women who have survived cancer report lowered general health, and breast cancer cases lowered vitality, but considering the non-significant results for the other scores and summary scales it can be concluded that the well-being of women who have survived a cancer on the whole did not differ profoundly from that of other women.
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| 7. |
- Lydell, Marie C, 1961, et al.
(författare)
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Predictive factors for work capacity in patients with musculoskeletal disorders.
- 2005
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - Oslo, Norway : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 37:5, s. 281-5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To identify predictive factors for work capacity in patients with musculoskeletal disorders. DESIGN: A descriptive, evaluative, quantitative study. SUBJECTS/PATIENTS: The study was based on 385 patients who participated in a rehabilitation programme. METHODS: Patients were divided into 2 groups depending on their ability to work. The groups were compared with each other with regard to sociodemographic factors, diagnoses, disability pension and number of sick days. The patient's level of exercise habits, ability to undertake activities, physical capacity, pain and quality of life were compared further using logistic regression analysis. RESULTS: Predictive factors for work capacity, such as ability to undertake activities, quality of life and fitness on exercise, were identified as important independent factors. Other well-known factors, i.e. gender, age, education, pain and earlier sickness certification periods, were also identified. Factors that were not significantly different between the groups were employment status, profession, diagnosis and levels of exercise habits. CONCLUSION: Identifying predictors for ability to return to work is an essential task for deciding on suitable individual rehabilitation. This study identified new predictive factors, such as ability to undertake activities, quality of life and fitness on exercise.
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| 8. |
- Lydell, Marie C, 1961, et al.
(författare)
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Predictive factors of sustained return to work for persons with musculoskeletal disorders who participated in rehabilitation.
- 2009
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Ingår i: Work (Reading, Mass.). - Amsterdam : IOS Press. - 1051-9815 .- 1875-9270. ; 33:3, s. 317-328
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Tidskriftsartikel (refereegranskat)abstract
- Musculoskeletal disorders (MSD) account for the majority of total morbidity cases in the working-age Swedish population. These disorders are thought to be the reason given for one-third of total certified sick leave requests. In addition to the high cost to society, MSD involve both physical and emotional suffering, pain and financial and social problems for the injured persons. The aim of this study was to identify predictive multidimensional factors for sustainable return to work (RTW) in a long-term follow-up persons with MSD. During the period 1992-1999, 385 persons participated in a rehabilitation program. Ten years later, 354 of these took part in a prospective follow-up study. The average post-rehabilitation time was ten years (range=7-13 years) and 243 persons (69%) completed a questionnaire. The "working full-time" group (n=110) and the "sick-listed" group (n=73) were included in the study. The two groups were compared in terms of predictors for RTW. Multiple stepwise logistic regression and bivariate analysis, as well as parametric and non-parametric tests, were used to identify predictive factors. The number of sick-listed days before rehabilitation, age, self-rated pain, life events, gender, physical capacity, self-rated functional capacity, educational level and light physical labor were predictors of long-term RTW. Return to work an be facilitated by planning at an early stage of the certified sick leave period using instrument that take these predictors into account.
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| 9. |
- Marklund, Bertil, 1945, et al.
(författare)
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Computer-supported telephone nurse triage: an evaluation of medical quality and costs.
- 2007
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Ingår i: Journal of nursing management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 15:2, s. 180-7
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To evaluate a telephone nurse triage model in terms of appropriateness of referrals to the appropriate level of care, patient's compliance with given advice and costs. BACKGROUND: A key concern in each telephonic consultation is to evaluate if appropriate. METHOD: An evaluative design in primary health care with consecutive patients (N = 362) calling telephone nurse triage between November 2002 and February 2003. RESULTS: The advice was considered adequate in 325 (97.6%) cases. The patients' compliance with self-care was 81.3%, to primary health care 91.1% and to Accident and Emergency department 100%. The nurses referred self-care cases (64.7%) and Accident and Emergency cases (29.6%) from a less adequate to an appropriate level of care. The cost saving per call leading to a recommendation of self-care was euro 70.3, to primary health care euro 24.3 and to Accident and Emergency department euro 22.2. CONCLUSIONS: The telephone nurse triage model showed adequate guidance for the patients concerning level of care and released resources for the benefit of both patients and the health care system.
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| 10. |
- Månsson, Jörgen, 1958, et al.
(författare)
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Costs in primary care of investigating symptoms suspicious of cancer in a defined population.
- 2006
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 24:4, s. 243-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To calculate total cost of investigating symptoms related to one of the four most common cancers: prostate, breast, colorectal, and pulmonary. Special attention was given to two non-specific and common symptoms: vertigo/dizziness and tiredness/fatigue. DESIGN: Retrospective examination of patient records in a defined population. SETTING: Primary health care (PHC) and hospital care. MAIN OUTCOME MEASURES: Investigation costs of selected ICD codes. RESULTS: In total 6812 patients with 14,541 ICD codes were investigated to a total cost per registered ICD code, with one of the selected diagnostic measures, of SEK 800. Some 50% of the costs were due to X-ray examinations of which colonic X-ray was the most expensive single procedure. Symptoms related to colorectal cancer were the most expensive to investigate with vertigo/dizziness and tiredness/fatigue examined separately. Tiredness/fatigue symptoms cost SEK 395 and vertigo/dizziness SEK 197 per registered code to investigate and none of them yielded a detected malignancy. The incidence of cancer was 0.7%. The average cost of diagnosing one malignancy was SEK 236,700, if all diagnostic activities could be justified only for detection of malignancies. CONCLUSION: A high cost of diagnosing malignancy can be expected and justified, but many symptoms presented in PHC, such as tiredness/fatigue and vertigo/dizziness, have a relatively high investigation cost but detected no case of cancer in this study.
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| 11. |
- Månsson, Jörgen, 1958, et al.
(författare)
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Symptom panorama in upper secondary school students and symptoms related to iron deficiency. Screening with laboratory tests, questionnaire and interventional treatment with iron.
- 2005
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 23:1, s. 28-33
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study symptom panorama in students, to identify undiagnosed iron deficiency, and to evaluate any changes in symptoms and laboratory test results after treatment with iron supplementation. DESIGN: Descriptive and prospective, interventional study. SETTING: Healthcare in upper secondary school. INTERVENTION: Treatment with iron supplementation for a period of 3 months. SUBJECTS: Students in the first grade of one upper secondary school. MAIN OUTCOME MEASURES: Frequency of iron deficiency related to symptoms measured by a questionnaire (30 questions) on symptoms related to quality of life and 9 questions about diet and exercise. RESULTS: Iron deficiency was diagnosed in 12% of the students (two or more abnormal laboratory tests) and in 61% of the students one or more laboratory tests were abnormal. Symptoms of vertigo/ dizziness were significantly more common in students with iron deficiency. After iron supplementation there was a significant increase in s-ferritin levels and a decrease in s-transferrin levels, with an accompanying significant reduction of the symptom scores of vertigo/dizziness, irritability, depressive symptoms, and indisposition. CONCLUSIONS: Symptoms of vertigo/dizziness were significantly more common in students with iron deficiency. Iron supplementation reduced the symptoms of vertigo/dizziness, irritability, depressive symptoms, and indisposition.
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| 12. |
- Månsson, Lena, et al.
(författare)
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Time series modelling and trophic interactions: rainfall, vegetation and un gulate dynamics
- 2007
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Ingår i: Population Ecology. - : Wiley. - 1438-390X .- 1438-3896. ; 49:4, s. 287-296
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Time series analysis is a tool that is now commonly used when analysing the states of natural populations. This is a particularly complicated task for ungulates, since the data involved usually contain large observation errors and span short periods of time relative to the species’ life expectancies. Here we develop a method that expands on previous analyses, combining statistical state space modelling with biological mechanistic modelling. This enables biological interpretability of the statistical parameters. We used this method to analyse African ungulate census data, and it revealed some clarifying patterns. The dynamics of one group of species were generally independent of density and strongly affected by rainfall, while the other species were governed by a delayed density dependence and were relatively unaffected by rainfall variability. Dry season rainfall was more influential than wet season rainfall, which can be interpreted as indicating that adult survival is more important than recruitment in governing ungulate dynamics.
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| 13. |
- Månsson, Robert, et al.
(författare)
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Molecular evidence for hierarchical transcriptional lineage priming in fetal and adult stem cells and multipotent progenitors
- 2007
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Ingår i: Immunity. - : Elsevier BV. - 1074-7613 .- 1097-4180. ; 26:4, s. 407-419
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies implicated the existence of adult lymphoid-primed multipotent progenitors (LMPPs) with little or no megakaryocyte-erythroid potential, questioning common myeloid and lymphoid progenitors as obligate intermediates in hematopoietic stem cell (HSC) lineage commitment. However, the existence of LMPPs remains contentious. Herein, global and single-cell analyses revealed a hierarchical organization of transcriptional lineage programs, with downregulation of megakaryocyte-erythroid genes from HSCs to LMPPs, sustained granulocyte-monocyte priming, and upregulation of common lymphoid (but not B and T cell-specific) genes. These biological and molecular relationships, implicating almost mutual exclusion of megakaryocyte-erythroid and lymphoid pathways, are established already in fetal hematopoiesis, as evidenced by existence of LMPPs in fetal liver. The identification of LMPPs and hierarchically ordered transcriptional activation and downregulation of distinct lineage programs is compatible with a model for HSC lineage commitment in which the probability for undergoing different lineage commitment fates changes gradually when progressing from HSCs to LMPPs.
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| 14. |
- Nilsson, Gunnar H., et al.
(författare)
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Patients, general practitioners, diseases and health problems in urban general practice : a cross-sectional study on electronic patient records
- 2008
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 9:2, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Background Statistics from primary health care in Sweden, as well as from other Nordic countries, have been sparse. The electronic patient records (EPR) will be an increasingly important source of clinical information. The aim of this study was to investigate types of encounters, managed diseases and health problems, and characteristics of patients and general practitioners (GPs) in everyday general practice using EPR.Methods A multi-centre, cross-sectional database study of EPR in primary health care in Stockholm, Sweden. Twenty-six randomly selected GPs with 20 randomly selected encounters each. Main outcome measures were the number and distribution of diseases and health problems, age and gender of patients and GPs, and type of encounter.Results The mean age of the patients was 51.2 years, 30.2% were aged 75 years or older, and 57.5% were women. The mean number of managed problems per encounter was 1.4. The most common specific diagnoses were essential hypertension (9.3% of the encounters) and acute upper respiratory infections (8.8%). Older patients had more health problems in each encounter (P = 0.000001). GPs differed regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter. The patients of different GPs differed regarding sex, age and number of health problems managed. Female and male patients had different diagnostic panoramas and they had a tendency to encounter a GP of the same sex (odds ratio 1.5, P = 0.053).Conclusions We found that two diagnoses (essential hypertension and acute upper respiratory infections), four diagnostic groups, women and the elderly are predominant. Female and male patients have different diagnostic panoramas and they have a tendency to encounter a GP of the same sex. GPs differ regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter.
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| 15. |
- Nilsson, Gunnar H., et al.
(författare)
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Patients, general practitioners, diseases and health problems in urban general practice: a cross-sectional study on electronic patient records
- 2008
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Ingår i: Primary Health Care Research & Development. - : Cambridge University Press (CUP). - 1463-4236 .- 1477-1128. ; 9:02, s. 119-125
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Tidskriftsartikel (refereegranskat)abstract
- Background: Statistics from primary health care in Sweden, as well as from other Nordic countries, have been sparse. The electronic patient records (EPR) will be an increasingly important source of clinical information. The aim of this study was to investigate types of encounters, managed diseases and health problems, and characteristics of patients and general practitioners (GPs) in everyday general practice using EPR. Methods: A multi-centre, cross-sectional database study of EPR in primary health care in Stockholm, Sweden. Twenty-six randomly selected GPs with 20 randomly selected encounters each. Main outcome measures were the number and distribution of diseases and health problems, age and gender of patients and GPs, and type of encounter. Results: The mean age of the patients was 51.2 years, 30.2% were aged 75 years or older, and 57.5% were women. The mean number of managed problems per encounter was 1.4. The most common specific diagnoses were essential hypertension (9.3% of the encounters) and acute upper respiratory infections (8.8%). Older patients had more health problems in each encounter (P = 0.000001). GPs differed regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter. The patients of different GPs differed regarding sex, age and number of health problems managed. Female and male patients had different diagnostic panoramas and they had a tendency to encounter a GP of the same sex (odds ratio 1.5, P = 0.053). Conclusions: We found that two diagnoses (essential hypertension and acute upper respiratory infections), four diagnostic groups, women and the elderly are predominant. Female and male patients have different diagnostic panoramas and they have a tendency to encounter a GP of the same sex. GPs differ regarding the characteristics of their patients, including sex, age and number of health problems managed at each encounter.
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| 16. |
- Nilsson, Pia, 1959, et al.
(författare)
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A prospective pilot study of a multidisciplinary home training programme for lateral epicondylitis.
- 2007
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Ingår i: Musculoskeletal care. - : Wiley. - 1478-2189 .- 1557-0681. ; 5:1, s. 36-50
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate a new multidisciplinary structured home training programme for patients with lateral epicondylitis compared to conventional attendance. DESIGN: This study utilized a prospective non-randomized design to compare the effect of a home exercise programme against a pragmatic approach to managing patients with lateral epicondylitis in a primary care setting in Sweden. SUBJECTS: A total of 78 patients, presenting to their general practitioner with lateral epicondylitis were recruited from two separate geographical areas. The patients were divided into two group, 51 entered the intervention group and 27 entered the control group. METHODS: The intervention group was treated with a specific home training programme, ergonomic advice and when necessary wrist and/or night bandages. The control group was treated with conventional treatment, e.g. corticosteroid injections, stretching or no intervention. Pain and function were evaluated by the PRFEQ. An electronic hand-power gauge measured strength and stamina. Sick-leave absence was collected via the regional Social Insurance Office. RESULTS: After four weeks the intervention group experienced less sick-leave, less pain, better function and returned to work earlier than the control group. After 16 weeks the intervention group still had significantly better function than the control group and were taking less sick-leave. Pain decreased more in the intervention group but this was not significant. There was no difference in grip strength between the two groups. CONCLUSION: A structured home training programme can improve function and reduce sick leave in patients with lateral epicondylitis.
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| 17. |
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| 18. |
- Yang, Liping, et al.
(författare)
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Identification of Lin(-)Sca1(+)kit(+)CD34(+)Flt3- short-term hematopoietic stem cells capable of rapidly reconstituting and rescuing myeloablated transplant recipients
- 2005
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Ingår i: Blood. - Washington : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 105:7, s. 2717-2723
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Tidskriftsartikel (refereegranskat)abstract
- In clinical bone marrow transplantation, the severe cytopenias induced by bone marrow ablation translate into high risks of developing fatal infections and bleedings, until transplanted hematopoietic stem and progenitor cells have replaced sufficient myeloerythroid offspring. Although adult long-term hematopoietic stem cells (LT-HSCs) are absolutely required and at the single-cell level sufficient for sustained reconstitution of all blood cell lineages, they have been suggested to be less efficient at rapidly reconstituting the hematopoietic system and rescuing myeloablated recipients. Such a function has been proposed to rather be mediated by less well-defined short-term hematopoietic stem cells (ST-HSCs). Herein, we demonstrate that Lin(-)Sca1(+)kit(hi)CD34+ short-term reconstituting cells contain 2 phenotypically and functionally distinct subpopulations: Lin(-)Sca1(+)kit(hi)CD34(+)flt3- cells fulfilling all criteria of ST-HSCs, capable of rapidly reconstituting myelopoiesis, rescuing myeloablated mice, and generating Lin(-)Sca1(+)kit(hi)CD34(+)flt3+ cells, responsible primarily for rapid lymphoid reconstitution. Representing the first commitment steps from Lin(-)Sca1(+)kit(hi) CD34(-)flt3- LT-HSCs, their identification will greatly facilitate delineation of regulatory pathways controlling HSC fate decisions and identification of human ST-HSCs responsible for rapid reconstitution following HSC transplantations.
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