| 1. |
- Karlsson, Christina, 1961-, et al.
(författare)
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Registered Nurses´ View of Performing Pain Assessment among Persons with Dementia as Consultant Advisors
- 2012
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Ingår i: Open Nursing Journal. - : Bentham Open. - 1874-4346. ; 6, s. 62-70
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Pain assessment in persons with dementia is well known as a challenging issue to professional caregivers, because of these patients´ difficulties in verbalising pain problems. Within municipal dementia care in Sweden, pain assessment has become problematic for registered nurses, as they have entered a new role in their nursing profession, from being clinical practitioners to becoming consultant advisers to other health care staff.AIM: To present municipal registered nurses´ view of pain assessment in persons with dementia in relation to their nursing profession as consultant advisers.METHODS: Purposive sampling was undertaken with 11 nurses invited to participate. Data were collected by focus groups. Qualitative content analysis was used to analyse the data.FINDINGS: Four categories were identified to describe registered nurses´ view of pain assessment: estrangement from practical nursing care, time consuming and unsafe pain documentation, unfulfilled needs of reflection possibilities, and collaboration and coordination.CONCLUSIONS: The performance of pain assessment through a consultant advising function is experienced as frustrating and as an uncomfortable nursing situation. The nurses feel resistance to providing nursing in this way. They view nursing as a clinical task demanding daily presence among patients to enable them to make accurate and safe assessments. However, due to the consultative model, setting aside enough time for the presence seems difficult to accomplish. It is necessary to promote the quality of systematic routines in pain assessment and reflection, as well as developing professional knowledge of how pain can be expressed by dementia patients, especially those with communication difficulties.
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| 2. |
- Högström, Gabriel, et al.
(författare)
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Body composition and performance : influence of sport and gender among adolescents
- 2012
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Ingår i: Journal of Strength and Conditioning Research. - : Lippincott Williams & Wilkins. - 1064-8011 .- 1533-4287. ; 26:7, s. 1799-1804
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Tidskriftsartikel (refereegranskat)abstract
- Body composition is well known to be associated with endurance performance amongst adult skiers, however the association among adolescent cross-country and alpine skiers is inadequately explored. The study sample was comprised of 145 male and female adolescent subjects (aged 15-17 years), including 48 cross-country skiers, 33 alpine skiers, and 68 control subjects. Body composition [%body fat, %lean mass, bone mineral density (g/cm2)] was measured with a dual-emission X-ray absorptiometer, and pulse and oxygen uptake were measured at three break points during incremental performance tests to determine physical fitness levels. Female cross-country and alpine skiers were found to have significantly higher %lean mass (mean difference = 7.7%, p < 0.001) and lower %body fat (mean difference = (8.1%, p < 0.001) than female control subjects. Male cross-country skiers were found to have lower %body fat (mean difference = 3.2%, p < 0.05) and higher %lean mass (mean difference = 3.3%, p < 0.01) than male alpine skiers and higher % lean mass (mean difference = 3.7%, p < 0.05) and % body fat (mean difference = 3.2%, p < 0.05) than controls. The present study found strong associations between %lean mass and the OBLA and VO2 max weight adjusted thresholds among both genders of the cross-country skiing cohort (r = 0.47-0.67, p < 0.05) and the female alpine skiing cohort (r = 0.77-0.79, p < 0.001 for all). The present study suggests that body composition is associated with physical performance already in adolescent athletes.
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| 3. |
- Wallin, Karin, et al.
(författare)
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Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later : a population based study
- 2012
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 31:3, s. 669-676
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Tidskriftsartikel (refereegranskat)abstract
- Inflammation has been associated with Alzheimer's disease (AD) and dementia. The association between rheumatoid arthritis (RA) or arthritis and dementia/AD has been investigated in several case-control or hospital- and register-based studies with mixed results. This long-term population-based study investigates the association between presence of joint disorders (RA and other joint disorders) in midlife and cognitive status later in life. 1,449 participants were first evaluated in 1972, 1977, 1982, and 1987 and follow-up was performed after 21 years. A self-administered questionnaire including questions on joint disorders was used at both evaluations. Cognitive status (control, mild cognitive impairment, dementia/AD) was assessed at follow-up. The presence of any joint disorder in midlife was significantly associated with a worse cognitive status later in life: OR (95% CI) in an ordinal logistic regression analysis adjusted for age, gender, follow-up time, education, APOE epsilon 4, body mass index, smoking, drug treatment, and diabetes was 1.96 (1.17-3.28). For RA only, OR (95% CI) was 2.77 (1.26-6.10). The correlation remained significant for RA when AD was considered instead of dementia OR (95% CI) 2.49 (1.09-5.67). The presence of joint disorders, especially RA, at midlife seems to be associated with a worse cognitive status later in life. Given the chronic inflammatory component of RA, this study suggests that inflammatory mechanisms may have an important role in increasing the risk of cognitive impairment and dementia/AD.
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| 4. |
- Kalpouzos, Gregoria, et al.
(författare)
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Local brain atrophy accounts for functional activity differences in normal aging
- 2012
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Ingår i: Neurobiology of Aging. - : Elsevier BV. - 0197-4580 .- 1558-1497. ; 33:3, s. 623.e1-
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Tidskriftsartikel (refereegranskat)abstract
- Functional brain imaging studies of normal aging typically show age-related under-and overactivations during episodic memory tasks. Older individuals also undergo nonuniform gray matter volume (GMv) loss. Thus, age differences in functional brain activity could at least in part result from local atrophy. We conducted a series of voxel-based blood oxygen level-dependent (BOLD)-GMv analyses to highlight whether age-related under-and overrecruitment was accounted for by GMv changes. Occipital GMv loss accounted for underrecruitment at encoding. Efficiency reduction of sensory-perceptual mechanisms underpinned by these areas may partly be due to local atrophy. At retrieval, local GMv loss accounted for age-related overactivation of left dorsolateral prefrontal cortex, but not of left dorsomedial prefrontal cortex. Local atrophy also accounted for age-related overactivation in left lateral parietal cortex. Activity in these frontoparietal regions correlated with performance in the older group. Atrophy in the overrecruited regions was modest in comparison with other regions as shown by a between-group voxel-based morphometry comparison. Collectively, these findings link age-related structural differences to age-related functional under-as well as overrecruitment.
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| 5. |
- Rosengren, Björn, et al.
(författare)
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Inferior physical performance test results of 10,998 men in the MrOS Study is associated with high fracture risk.
- 2012
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Ingår i: Age and ageing. - : Oxford University Press (OUP). - 1468-2834 .- 0002-0729. ; 41:3, s. 339-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: most fractures are preceded by falls. Objective: the aim of this study was to determine whether tests of physical performance are associated with fractures. Subjects: a total of 10,998 men aged 65 years or above were recruited. Methods: questionnaires evaluated falls sustained 12 months before administration of the grip strength test, the timed stand test, the six-metre walk test and the twenty-centimetre narrow walk test. Means with 95% confidence interval (95% CI) are reported. P < 0.05 is a statistically significant difference. Results: fallers with a fracture performed worse than non-fallers on all tests (all P < 0.001). Fallers with a fracture performed worse than fallers with no fractures both on the right-hand-grip strength test and on the six-metre walk test (P < 0.001). A score below –2 standard deviations in the right-hand-grip strength test was associated with an odds ratio of 3.9 (95% CI: 2.1–7.4) for having had a fall with a fracture compared with having had no fall and with an odds ratio of 2.6 (95% CI: 1.3–5.2) for having had a fall with a fracture compared with having had a fall with no fracture. Conclusion: the right-hand-grip strength test and the six-metre walk test performed by old men help discriminate fallers with a fracture from both fallers with no fracture and non-fallers.
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| 6. |
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| 7. |
- Kramberger, Milica Gregoric, et al.
(författare)
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Cerebrospinal fluid alzheimer markers in depressed elderly dubjects with and without alzheimer's disease
- 2012
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Ingår i: Dementia and Geriatric Cognitive Disorders Extra. - : S. Karger AG. - 1664-5464. ; 2:1, s. 48-56
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to explore the relationship between cerebrospinal fluid Alzheimer's disease (AD) markers and depression in elderly people.Method: We included subjects with AD as well as persons with subjective cognitive impairment and normal cognition. Depression was assessed with the Cornell Scale for Depression in Dementia, and a cut-off score of >6 was used to define depression. Cerebrospinal fluid was analyzed using commercially available assays for β-amyloid 1-42, total tau, and phosphorylated tau 181.Result: A total of 183 participants (66.7% female) were included (92 with AD and 91 with subjective cognitive impairment), with a mean age (±SD) of 67.6 ± 7.4 years, a Mini-Mental State Examination score of 26.0 ± 4.0, and a median Cornell Scale for Depression in Dementia score of 5 (range 0-19). Depression scores were not associated with higher phosphorylated tau 181 and total tau or reduced β-amyloid 1-42 in AD or non-demented subjects.Conclusions: These results suggest that AD pathology does not contribute to depression, indicating that other factors may be more important. Further studies of the aetiology of depression in elderly people with and without AD are warranted.
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| 8. |
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| 9. |
- Mei, Wang Shu, et al.
(författare)
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Elderly injury prevention perspectives : a qualitative study of elderly people in different socioeconomic strata within a Safe Community in Shanghai
- 2012
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Ingår i: HealthMed. - Sarajevo, Bosnia & Herzegovina : DRUNNP. - 1840-2291 .- 1986-8103. ; 6:12, s. 4170-4178
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Tidskriftsartikel (refereegranskat)abstract
- Injuries represent an important cause of health problems among elderly people. The study has explored the perspectives and ideas of elderly people from different socioeconomic groups in terms of their injury-related issues. This paper examines a Safe Community accredited by the WHO Community Safety program. The community has three different residential sections labeled as Section-A, Section-B and Section-C, representing high, medium and low socioeconomic status of the residents respectively. Three focus group discussions (FGDs) were organized from three residential sections separately with 8 to 12 elderly people (>60years) in each group. Elderly people from Section-A were more concerned about emotional abuse whilst those from Sections B and C thought that fall and traffic injuries were most common injures. In Section-A, the most frequent risk factors were age, mental status and other people's unsafe behavior. In Section-B risk factors were age, environment and safety procedures. In Section-C, risk factors were environments, age and disease. For injury prevention, the elderly in A and B Sections thought that education should be improved while in C Section they emphasized environmental improvements. The perspectives and needs in terms of injury prevention among elderly people from different socioeconomic levels were not the same. When local governments develop their injury prevention plans and strategies, those differences should be considered.
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| 10. |
- van De Glind, Esther, et al.
(författare)
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Evidence-based medicine in geriatrics
- 2012
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Ingår i: European Geriatric Medicine. - Oxford, United Kingdom : Elsevier. - 1878-7649 .- 1878-7657. ; 3:Suppl. 1, s. S14-S15
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Tidskriftsartikel (refereegranskat)abstract
- Session Description/Moderator Details.– Evidence-based medicine in geriatrics Geriatric patients often have multiple chronic conditions, use many medications and may suffer from cognitive and functional impairments. A study about prevalence of morbidities in the elderly showed, that 82% of patients aged 65 and over had at least one chronic condition; 24% had even four or more conditions [1]. Due to deteriorating organ functions they are prone to medication-related side effects [2]. Considering these complex problems, arriving at the best treatment for individual older people is complicated.
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