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Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics) srt2:(1995-1999)"

Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics) > (1995-1999)

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  • Sidenvall, Birgitta, et al. (författare)
  • Elderly patients' meal patterns : A retrospective study
  • 1996
  • Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 9:4, s. 263-272
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to examine possible causes of malnutrition in geriatric patients on admission to hospital by evaluation and comparison of their meal pattern between periods of working, retirement and hospitalization, respectively. Forty-five consecutive patients aged 60 years or older participated. By use of modified dietary history interviews, a retrospective assessment of food intake was carried out. A qualitative system for meal classification was then applied. In the retirement period there was a strong reduction in daily eating frequency when compared to working and hospital periods. Thus, the daily intake and also distribution of energy and nutrients seem to be reduced during retirement, which might lead to nutritional deficiency.
  • Holst, Göran, et al. (författare)
  • The relationship of vocally disruptive behavior and previous personality in severely demented institutionalized patients.
  • 1997
  • Ingår i: Archives of Psychiatric Nursing. - : Elsevier. - 1532-8228. ; 11:3, s. 147-154
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to explore the previous personalities of patients, their behavior during the course of the disease, and the relationship between the previous personality and vocally disruptive behavior of severely demented patients. Twenty-one severely demented patients identified as vocally disruptive and 19 severely demented control subjects who were matched for gender and ward were studied. A family member or close relative who knew the patient very well described the patient's personal characteristics from what they judged to be the “best” period in the patient's life and responded, on behalf of the patient, to the 57 items in a modified version of the Eysenck Personality Inventory. The results of this study can be interpreted to indicate that a previous personality described as introverted, rigid, and with a tendency to control emotions, as remembered retrospectively by a close family member, may correlate to current disruptive behavior. Despite the limitations of this study, the findings indicated that a patient's previous personality characteristics need to be taken into consideration because they may partially explain vocal activity and are therefore important for the provision of nursing care. Further research has to be performed to highlight the impact of previous personality characteristics on various kinds of behavior during the course of the disease.
  • Edberg, Anna-Karin, et al. (författare)
  • Effects of clinical supervision on nurse-patient cooperation quality - A controlled study in dementia care.
  • 1996
  • Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738. ; 5:2, s. 127-146
  • Tidskriftsartikel (refereegranskat)abstract
    • An intervention consisting of individualized planned care for patients and regular clinical systematic supervision for nurses was carried out on a ward for dementia care (the experimental ward, EW). On a similar control ward (CW), no changes were made. Observations of nurse-patient cooperation during morning care were collected at both wards, before and during the intervention. The observations (N = 107) were analyzed blindly and sorted into already-developed categories. The distribution of the cooperation-style categories was then analyzed statistically. The patients who survived throughout the study period (N = 18) were also compared over time. Nurse-patient cooperation at the EW improved significantly during the intervention period, whereas, at the CW, it deteriorated (p = .02). Status of surviving patients followed the same pattern (p = .001). The findings indicate that such interventions can improve the quality of nurse-patient cooperation in dementia care.
  • Gustafson, Lars, et al. (författare)
  • Apolipoprotein E genotyping in Alzheimer’s disease and frontotemporal dementia
  • 1997
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : Karger. - 1420-8008. ; 8:4, s. 240-243
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease (AD) and frontotemporal dementia (FTD) are characterized by progressive neuronal loss and microvacuolization, although with different distributions of cortical involvement. In contrast to AD there is no amyloid, senile plaques or tangles in FTD. The involvement of chromosome 19 in AD has been associated with apoliprotein E (ApoE) and the epsi4 gene frequency has been related to increased risk and early onset of AD. Our analysis of frequency of the ApoE alleles in 38 patients with AD, 21 patients with FTD and 29 normal controls indicates an association of both AD and FTD with an increased frequency of the epsi4 allele and in AD also with homozygosity for epsi4. Our results might indicate that ApoE epsi4 is an important aggravating and pathoplastic factor in the presence of genetic and other determinants for the development of AD or FTD. A significantly higher epsi2 frequency in our FTD material compared to AD and normals might also indicate a connection with the distribution of cortical degeneration.
  • Elmståhl, Sölve, et al. (författare)
  • How should a group living unit for demented elderly be designed to decrease psychiatric symptoms?
  • 1997
  • Ingår i: Alzheimer Disease and Associated Disorders. - : Lippincott Williams & Wilkins. - 0893-0341. ; 11:1, s. 47-52
  • Tidskriftsartikel (refereegranskat)abstract
    • The main objectives were to study relationships between the design of group living (GL) units and psychiatric symptoms in demented patients before, 6 months after, and 1 year after admission to GL units. The study population comprised 105 demented elderly (83 ± 6 years), 37% with dementia of Alzheimer's type and 58% with vascular dementia. The patients were relocated by the municipal care planning team after clinical examination. An observational scale (the Organic Brain Syndrome scale) was used to assess confusional symptoms and disorientation. The physical environment was assessed by an architect using the Therapeutic Environment Screening Scale, which evaluates general design, space, lighting, noise, communication area, floor plan, and related factors. Less than 15% of the patients had no signs of dyspraxia, hallucinosis, dysphasia, or depression at admission, whereas 66% or more reported lack of vitality, aggressiveness, or restlessness. Fourteen out of 18 units had a corridor-like design (group A), one unit an L-shaped design (group B), and the others a square or H-shaped design (group C). Patients living in the B unit had less disorientation than the others at the 6-month follow-up. After 1 year, the patients in the A units had more dyspraxia, lack of vitality, and disorientation of identity. The communication areas in the units were negatively associated with 'disorientation for recent memory' and 'lack of vitality,' adjusted for type of dementia (r = -0.13 to -0.16). The size of the activity area, indoor public rooms in square meters, was not correlated to confusional reactions and disorientation. In conclusion, a GL unit design that facilitates perception without reducing the communication area is to be preferred.
  • Fäldt, Roger, et al. (författare)
  • Prevalence of thyroid hormone abnormalities in elderly patients with symptoms of organic brain disease.
  • 1996
  • Ingår i: Aging (Milan, Italy). - : Kurtis. - 0394-9532. ; 8:5, s. 347-357
  • Tidskriftsartikel (refereegranskat)abstract
    • Analysis of the serum concentrations of free thyroid hormones (fT3, fT4) and thyrotropin (TSH) in 173 psychogeriatric patients (94 females and 79 males, mean age 79 +/- 8 years) disclosed that the hormone levels were related to sex, psychiatric diagnosis, medication and the presence of nonthyroid illness (NTI). Subnormal concentrations of thyroid hormones and/or TSH were found in 25% of the patients. In addition, fT3 and fT4 concentrations were significantly lower (p < 0.05 and p < 0.001, respectively) in demented males compared with demented females although the levels were within the reference limits. Strongly negative correlations between fT3 and age (p < 0.001), and between fT3 and the sedimentation rate (SR) (p < 0.01) were found in demented but not in non-demented patients. These correlations were most pronounced in (age) or restricted to (SR) demented males. In addition, the correlation between fT3 and Hb was strongly positive (p < 0.001) in demented as well as in nondemented patients, particularly in males. The concentration of fT4 was positively correlated to Hb in demented males (p < 0.001), whereas TSH concentration was positively correlated to Hb in demented females (p < 0.05). The results show that TSH is not sufficient as the sole screening assay for evaluation of possible thyroid dysfunction in psychogeriatric patients. In addition, central (hypothalamic?) hypothyroidism may be present in a substantial amount of psychogeriatric patients, as we found an adequate TSH response to exogenous thyrotropin-releasing hormone (TRH) also in patients with decreased fT3/fT4 and no signs of non thyroid diseases. Furthermore, there was an apparent lack of correlation between thyroid hormone levels and dementia (or subgroups of dementia), even though thyroid hormone abnormalities seemed to be rather common in frontotemporal dementia (38%) and non specified dementia (36%).
  • Minthon, Lennart, et al. (författare)
  • Somatostatin and neuropeptide Y in cerebrospinal fluid: correlations with severity of disease and clinical signs in Alzheimer's disease and frontotemporal dementia
  • 1997
  • Ingår i: Dementia and Geriatric Cognitive Disorders. - : Karger. ; 8:4, s. 232-239
  • Tidskriftsartikel (refereegranskat)abstract
    • Alzheimer's disease (AD) and frontotemporal dementia (FTD) are the most common types of progressive neurodegenerative disorder in our catchment area. The distribution of cortical degeneration in FTD is mainly the reverse of that in AD, while there are both differences and similarities in the clinical characteristics. Somatostatin and neuropeptide Y (NPY) are neuropeptides with a widespread distribution in the human cerebral cortex. Somatostatin is involved in the regulation of hormone release from the anterior pituitary and may act as a neurotransmitter-modulator. NPY is a potent anxiolytic neuropeptide. Somatostatin and NPY coexist in the cerebral cortex, basal ganglia and in amygdaloid complexes. The present study of AD (n = 34) and FTD (n = 22) analyses the cerebrospinal-fluid (CSF) levels of somatostatin-like immunoreactivity and NPY-like immunoreactivity and correlates their levels to 54 different clinical items, such as restlessness, anxiety, irritability and depression. The CSF levels of the two neuropeptides somatostatin and NPY were significantly correlated in FTD (p < 0.02), but not in AD. Several significant correlations to the clinical signs were found: in AD disorientation and dyspraxia, and in FTD agitation, irritability and restlessness. Somatostatin showed a significant negative correlation with severity of dementia in AD (p < 0.013).
  • Elmståhl, S., et al. (författare)
  • The prevalence of anaemia and mineral supplement use in a Swedish middle-aged population. Results from the Malmo Diet and Cancer Study
  • 1996
  • Ingår i: European Journal of Clinical Nutrition. - : Nature Publishing Group. - 0954-3007. ; 50:7, s. 450-455
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To describe dietary habits and use of mineral supplements in relation to nutrient recommendations and anaemia. Design: a population-based cohort study. Subjects: 2665 men and 3878 women, born between 1926 and 1945, randomly invited and participating in the prospective 'Malmo Diet and Cancer study' during 1991-1992. Methods: The diet was assessed using a combined 7-day menu book for hot meals, beverages and supplements and a quantitative food frequency questionnaire for other foods. Anaemia was defined as haemoglobin ≤131 g/l for men and ≤115 g/l for women. Results: Intake of mineral supplements were reported by 19% of the men and 31% of the women. Less than 0.2% had intakes of iron and selenium above highest recommended Swedish long-term intakes. The percentage of women with intake below nutrient recommendations were: zinc and selenium (60%); magnesium (35%); calcium (21%) and iron (70%, premenopausal). The corresponding values for men were: zinc, selenium and magnesium (33-47%); calcium and iron (5%). The median contribution of calcium from supplements was less than 110 mg. Supplement users had higher intakes of fish, fruits, vegetables and tea and lower intakes of coffee and meat. The iron intake was correlated to haemoglobin levels, and iron supplementation constituted about 45% of the intake. Three per cent of premenopausal women had anaemia as did less than 2% of postmenopausal women. Conclusion: A substantial number had mineral intake below present recommendations despite supplement use. The nutrient content of some supplements could be improved, especially calcium. Iron supplementation among postmenopausal women and men are questionable.
  • Elmståhl, Sölve, et al. (författare)
  • Malnutrition in geriatric patients : A neglected problem?
  • 1997
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402. ; 26:5, s. 851-855
  • Tidskriftsartikel (refereegranskat)abstract
    • The nutrient intake in geriatric long-stay patients and the mortality risk associated with low energy intake were studied in 61 patients, 43 women and 18 men, with a mean age of 87 years, at a geriatric long-stay care hospital during a 6-month follow-up. Dietary intake was assessed with a 9-day dietary record. Energy expenditure was calculated assuming a physical activity level of 1.33 × basal metabolic rate (BMR), predicted from equations given by FAO/WHO. Mean energy intakes were 1557 kcal in men and 1280 kcal in women; 84% of the patients had an intake below estimated energy expenditure and 30% were below estimated BMR. Only 5% received dietary supplement. Eleven out of the 61 patients died during the follow-up and the deceased had lower energy intake than the others (1185 kcal vs 1401 kcal, P<0.05). An energy intake below median (1378 kcal) was associated with an age adjusted increased 6-month mortality risk, odds ratio 12.5. A high proportion of geriatric long-stay patients report dietary intake far below present recommendations and are thereby at risk for having/developing malnutrition. Improved surveillance of geriatric long-stay patients' dietary habits seems justified.
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