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Sökning: LAR1:hj > Medicin och hälsovetenskap

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1.
  • Ahlgren, Jennie, et al. (författare)
  • Ethical considerations in relation to personalised nutrition : An overview of Work Package 5, with respect to ethics
  • 2015
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.
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3.
  • Vuorinen, Miika, et al. (författare)
  • Changes in vascular factors 28 years from midlife and late-life cortical thickness
  • 2013
  • Ingår i: Neurobiology of Aging. - : Elsevier BV. - 0197-4580 .- 1558-1497. ; 34:1, s. 100-109
  • Tidskriftsartikel (refereegranskat)abstract
    • We assessed midlife blood pressure (BP), body mass index, total cholesterol, and their changes over time in relation to cortical thickness on magnetic resonance imaging 28 years later in 63 elderly at risk of dementia. Participants in the population-based Cardiovascular Risk Factors, Aging, and Dementia study were first examined at midlife. A first follow-up was conducted after 21 years, and a second follow-up after an additional 7 years. Magnetic resonance images from the second follow-up were analyzed using algorithms developed at McGill University, Montreal, Canada. Midlife hypertension was related to thinner cortex in several brain areas, including insular, frontal, and temporal cortices. In elderly with thinner insular cortex, there was a continuous decline in systolic BP and an increase in pulse pressure after midlife, while in elderly with thicker insular cortex the decline in systolic BP started at older ages, paralleled by a decline in pulse pressure. No associations were found between body mass index, cholesterol, or apolipoprotein E ε4 allele and cortical thickness in this group of elderly at risk individuals.
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4.
  • Östlund, Gunnel, 1956-, et al. (författare)
  • Emotions related to participation restrictions as experienced by patients with early rheumatoid arthritis : A qualitative interview study (The Swedish TIRA project)
  • 2014
  • Ingår i: Clinical Rheumatology. - : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 33:10, s. 1403-1413
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Psychological distress is a well-known complication in rheumatoid arthritis (RA), but knowledge regarding emotions, and their relationship to participation restrictions, is scarce.Objectives: To explore emotions related to participation restrictions by patients with early RA. Method: In this study, 48 patients with early RA, aged 20-63 years, were interviewed about participation restrictions using Critical Incident Technique. Information from transcribed interviews was converted into dilemmas and linked to ICF participation codes. The emotions described were condensed and categorized.Results: Hopelessness and sadness were described when trying to perform daily activities such as getting up in the mornings, getting dressed, or not being able to perform duties at work. Sadness was experienced in relation to not being able to continue leisure activities or care for children. Examples of fear descriptions were found in relation to deteriorating health and fumble fear, which made the individual withdraw from activities as a result of mistrusting the body. Anger and irritation were described in relation to domestic and employed work, but also in social relations where the individual felt unable to continue valued activities. Shame or embarrassment was described when participation restrictions became visible in public.Conclusions: Feelings of grief, aggressiveness, fear and shame are emotions closely related to participation restrictions in everyday life in early RA. Emotions related to disability need to be addressed both in clinical settings in order to optimize rehabilitative multi-professional interventions and in research to achieve further knowledge.  
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5.
  • Grynne, A., et al. (författare)
  • Women's experience of the health information process involving a digital information tool before commencing radiation therapy for breast cancer : a deductive interview study
  • 2023
  • Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Individuals undergoing radiation therapy for breast cancer frequently request information before, throughout and after the treatment as a means to reduce distress. Nevertheless, the provision of information to meet individuals needs from their level of health literacy is often overlooked. Thus, individuals information needs are often unmet, leading to reports of discontent. Internet and digital information technology has significantly augmented the available information and changed the way in which persons accesses and comprehends information. As health information is no longer explicitly obtained from healthcare professionals, it is essential to examine the sequences of the health information process in general, and in relation to health literacy. This paper reports on qualitative interviews, targeting women diagnosed with breast cancer who were given access to a health information technology tool, Digi-Do, before commencing radiation therapy, during, and after treatment. METHODS: A qualitative research design, inspired by the integrated health literacy model, was chosen to enable critical reflection by the participating women. Semi-structured interviews were conducted with 15 women with access to a digital information tool, named Digi-Do, in addition to receiving standard information (oral and written) before commencing radiation therapy, during, and after treatment. A deductive thematic analysis process was conducted. RESULTS: The results demonstrate how knowledge, competence, and motivation influence women's experience of the health information process. Three main themes were found: Meeting interactive and personal needs by engaging with health information; Critical recognition of sources of information; and Capability to communicate comprehended health information. The findings reflect the women's experience of the four competencies: to access, understand, appraise, and apply, essential elements of the health information process. CONCLUSIONS: We can conclude that there is a need for tailored digital information tools, such as the Digi-Do, to enable iterative access and use of reliable health information before, during and after the radiation therapy process. The Digi-Do can be seen as a valuable complement to the interpersonal communication with health care professionals, facilitating a better understanding, and enabling iterative access and use of reliable health information before, during and after the radiotherapy treatment. This enhances a sense of preparedness before treatment starts.
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6.
  • Heikkilä, Katriina, et al. (författare)
  • Job strain and COPD exacerbations: an individual-participant meta-analysis
  • 2014
  • Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 44:1, s. 247-251
  • Tidskriftsartikel (refereegranskat)abstract
    • To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
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7.
  • Almborg, Ann-Helene, et al. (författare)
  • Discharged after stroke - important factors for health-related quality of life
  • 2010
  • Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 19:15-16, s. 2196-2206
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims. This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke. Background. HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge. Design. Cross-sectional study. Methods. The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL. Results. Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL. Conclusions. Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests. Relevance to clinical practice. These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.
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8.
  • Bai, Ge, et al. (författare)
  • Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
  • 2021
  • Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
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9.
  • Emsfors, Åsa, et al. (författare)
  • Nursing actions that create a sense of good nursing care in patients with wet age-related macular degeneration
  • 2017
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 26:17-18, s. 2680-2688
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: To identify and describe nursing actions performed by nurses that create a sense of good nursing care in patients with wet age-related macular degeneration.BACKGROUND: People who suffer from wet age-related macular degeneration risk central vision loss. Treatment with antivascular endothelial growth factor is the only available option at present that preserves vision and no definitive cure currently exists. Patients feel that they are compelled to accept this treatment because they might otherwise become blind.DESIGN: An explorative and descriptive design based on the critical incident technique was used.METHOD: Interviews with 16 Swedish patients who all had received intravitreal treatment for wet age-related macular degeneration.RESULTS: Two main areas of good nursing care were identified: 'Being perceived as an individual' and 'Being empowered'. The first area was divided into two categories: being respectful and being engaged. Being respectful was observed when nurses had a benevolent attitude towards their patients and answered questions kindly and politely. Patients saw themselves as individuals when nurses were available for conversation and focused on them. The second area was divided into two categories: encouraging participation and creating confidence. Encouraging participation refers to when nurses provided information continuously. Nurses instilled confidence and trust in their patients by keeping promises and by being honest.CONCLUSIONS: A respectful interaction between patients and caregivers is necessary for patients to obtain beneficial health care.RELEVANCE TO CLINICAL PRACTICE: Patient interviews revealed important information about nursing actions that created a sense of good nursing care in patients with wet age-related macular degeneration. Nurses acknowledged people as individuals and created trust by building partnerships and sharing decision-making. To address each patient's concerns, nurses need to prioritise each patient's narrative and participation by documenting agreements in their medical record.
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10.
  • Pihl, Emma, et al. (författare)
  • Exercise in elderly patients with chronic heart failure in primary care : Effects on physical capacity and health-related quality of life
  • 2011
  • Ingår i: European Journal of Cardiovascular Nursing. - London : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:3, s. 150-158
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Chronic heart failure (CHF) limits exercise capacity which influences physical fitness and health-related quality of life (HRQoL). AIM: The aim was to determine the effects on physical capacity and HRQoL of an exercise programme in elderly patients with CHF in primary care.METHODS: An exercise intervention was conducted as a prospective, longitudinal and controlled clinical study in primary care in elderly patients with CHF. Endurance exercise and resistance training were conducted as group-training at the primary care centre and as home training. Follow-up on physical capacity and HRQoL was done at 3, 6 and 12 months.RESULTS: Exercise significantly improved muscle endurance in the intervention group (n=29, mean age 76.2years) compared to the control group (n=31, mean age 74.4years) at all follow-ups except for shoulder flexion right at 12months (shoulder abduction p=0.006, p=0.048, p=0.029; shoulder flexion right p=0.002, p=0.032, p=0.585; shoulder flexion left p=0.000, p=0.046, p=0.004). Six minute walk test improved in the intervention group at 3months (p=0.013) compared to the control group. HRQoL measured by EQ5D-VAS significantly improved in the intervention group at 3 and 12months (p=0.016 and p=0.034) and SF-36, general health (p=0.048) and physical component scale (p=0.026) significantly improved at 3months compared to the control group. CONCLUSION: This study shows that exercise conducted in groups in primary care and in the patients' homes could be used in elderly patients with CHF. The combination of endurance exercise and resistance training has positive effects on physical capacity. However, the minor effects in HRQoL need further verification in a study with a larger study population. ©Sage Publications
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