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- Rosen, Raymond C., et al.
(author)
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Quality of Life and Sexual Function Benefits of Long-Term Testosterone Treatment : Longitudinal Results From the Registry of Hypogonadism in Men (RHYME)
- 2017
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In: Journal of Sexual Medicine. - : WILEY. - 1743-6095 .- 1743-6109. ; 14:9, s. 1104-1115
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Journal article (peer-reviewed)abstract
- Background: The benefits and risks of long-term testosterone administration have been a topic of much scientific and regulatory interest in recent years. Aim: To assess long-term quality of life (QOL) and sexual function benefits of testosterone replacement therapy (TRT) prospectively in a diverse, multinational cohort of men with hypogonadism. Methods: A multinational patient registry was used to assess long-term changes associated with TRT in middle-age and older men with hypogonadism. Comprehensive evaluations were conducted at 6, 12, 24, and 36 months after enrollment into the registry. Outcomes: QOL and sexual function were evaluated by validated measures, including the Aging Males' Symptom (AMS) Scale and the International Index of Erectile Function (IIEF). Results: A total of 999 previously untreated men with hypogonadism were enrolled at 25 European centers, 750 of whom received TRT at at least one visit during the period of observation. Patients on TRT reported rapid and sustained improvements in QOL, with fewer sexual, psychological, and somatic symptoms. Modest improvements in QOL and sexual function, including erectile function, also were noted in RHYME patients not on TRT, although treated patients showed consistently greater benefit over time in all symptom domains compared with untreated patients. AMS total scores for patients on TRT were 32.8 (95% confidence interval = 31.3-34.4) compared with 36.6 (95% confidence interval = 34.8-38.5) for untreated patients (P < .001). Small but significant improvements in IIEF scores over time also were noted with TRT. Approximately 25% of treated and untreated men also used phosphodiesterase type 5 inhibitors, with notable differences in the frequency of phosphodiesterase type 5 inhibitor prescription use according to physician specialty and geographic site location. Clinical Implications: TRT-related benefits in QOL and sexual function are well maintained for up to 36 months after initiation of treatment. Strengths and Limitations: The major strengths are the large, diverse patient population being treated in multidisciplinary clinical settings. The major limitation is the frequency of switching from one formulation to another. Conclusion: Overall, we confirmed the broad and sustained benefits of TRT across major QOL dimensions, including sexual, somatic, and psychological health, which were sustained over 36 months in our treatment cohort. Copyright (C) 2017, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.
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- Ekman, Inger, 1952, et al.
(author)
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Person-centered care -ready for prime time.
- 2011
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 10:4, s. 248-251
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Journal article (peer-reviewed)abstract
- Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the focus and mainstay of care in long-term illness.
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- Rosén, Helena I., et al.
(author)
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Patients' experiences and perceived causes of persisting discomfort following day surgery
- 2010
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In: BMC Nursing. - : BioMed Central. - 1472-6955. ; 9, s. artikelnummer 16-
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Journal article (peer-reviewed)abstract
- Background: The aim of this study was to describe patients’ experiences and perceived causes of persisting discomfort following day surgery. Earlier research has mainly covered symptoms and signs during a recovery period of up to one month, and not dealt with patients’ perceptions of what causes persisting, longer-term discomfort. Methods: This study is a part from a study carried out during the period May 2006 to May 2007 with a total of 298 day surgery patients. Answers were completed by 118 patients at 48 hours, 110 at seven days and 46 at three months to one open-ended question related to discomfort after day surgery constructed as follows: If you are stillexperiencing discomfort related to the surgery, what is the reason, in your opinion? Data was processed, quantitatively and qualitatively. Descriptive, inferential, correlation and content analyses were performed. Results: The results suggest that patients suffer from remaining discomfort e.g. pain and wound problem, with effects on daily life following day surgery up to three months. Among patients’ perceptions of factors leading to discomfort may be wrongful or suboptimal treatment, type of surgery or insufficient access to provider/information. Conclusions: The results have important implications for preventing and managing discomfort at home followingday surgery, and for nursing interventions to help patients handle the recovery period better.
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- Rosén, P, et al.
(author)
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Diatom transfer-functions for quantifying past air temperature, pH and total organic carbon concentration from lakes in northern Sweden
- 2000
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In: Journal of Paleolimnology. - 0921-2728 .- 1573-0417. ; 24:2, s. 109-123
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Journal article (peer-reviewed)abstract
- The relationships between diatoms (Bacillariophyceae) in surface sediments of lakes and summer air temperature, pH and total organic carbon concentration (TOC) were explored along a steep climatic gradient in northern Sweden to provide a tool to infer past climate conditions from sediment cores. The study sites are in an area with low human impact and range from boreal forest to alpine tundra. Canonical correspondence analysis (CCA) constrained to mean July air temperature and pH clearly showed that diatom community composition was different between lakes situated in conifer-, mountain birch- and alpine-vegetation zones. As a consequence, diatoms and multivariate ordination methods can be used to infer past changes in treeline position and dominant forest type. Quantitative inference models were developed to estimate mean July air temperature, pH and TOC from sedimentary diatom assemblages using weighted averaging (WA) and weighted averaging partial least squares (WA-PLS) regression. Relationships between diatoms and mean July air temperature were independent of lake-water pH, TOC, alkalinity and maximum depth. The results demonstrated that diatoms in lake sediments can provide useful and independent quantitative information for estimating past changes in mean July air temperature (R-jack(2) = 0.62, RMSEP = 0.86 degrees C; R-2 and root mean squared error of prediction (RMSEP) based on jack-knifing), pH (R(j)(2)ack = 0.61, RMSEP = 0.30) and TOC (R-jack(2) = 0.49, RMSEP = 1.33 mg l(-1)). The paper focuses mainly on the relationship between diatom community composition and mean July air temperature, but the relationships to pH and TOC are also discussed.
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- Rosén, P, et al.
(author)
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Holocene climatic change reconstructed from diatoms, chironomids, pollen and near-infrared spectroscopy at an alpine lake (Sjuodjljaure) in northern Sweden
- 2001
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In: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 11:5, s. 551-562
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Journal article (peer-reviewed)abstract
- The results of a multiproxy study reconstructing the climate history of the last 9300 years in northern Sweden are presented. It is based on diatom, chironomid and pollen analyses, as well as near-infrared spectroscopy (NIRS), of a radiocarbon dated sediment core from Sjuodjijaure (67 degrees 22'N, 18 degrees 04'E), situated 100 m above tree-line in the Scandes mountains. Mean July air temperature was reconstructed using transfer functions established for the region. The biological proxies show significant changes in composition during the Holocene and the inferred temperatures all follow the same general trend. For the period between about 9300 to 7300 cal. BP the reconstructions should be interpreted with caution due to the lack of convincing modem analogues in the training set. However the reconstruction suggest that July temperature was on average about the same as today, with several rapid short-term cold and warm periods. Cold periods were dated to about 8500, 8200 and 7600 cal. years BP and a warm period to about 7700 cal. BP. About 7300 cal. BP, a major shift to a warmer climate occurred. Pine migrated into the area, which was previously covered with birch forest. From the mid-Holocene until today the sediment record suggests a descending tree-limit and a gradual lowering of July temperature.
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- Sunesson, A-L, et al.
(author)
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Multivariate evaluation of VOCs in buildings where people with non-specific building-related symptoms perceive health problems and in buildings where they do not.
- 2006
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In: Indoor Air. - : Hindawi Limited. - 0905-6947 .- 1600-0668. ; 16:5, s. 383-391
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Journal article (peer-reviewed)abstract
- Volatile organic compounds (VOCs) were sampled in buildings where people with non-specific building-related symptoms perceive health problems and in buildings where they do not. In total, nine persons and 34 buildings were included in the study. The obtained VOC data was evaluated using multivariate methods, to investigate possible systematic differences in air quality of 'problem' and 'non-problem' buildings. All individual compounds were included as variables in a multivariate partial least squares (PLS) data analysis. 'Problem' and 'non-problem' buildings separated into two distinct groups, showing that air samples of the two groups of building were chemically different. PRACTICAL IMPLICATIONS: The study showed that there was an identifiable systematic difference in the collected VOC data between buildings causing and not causing problems for people with non-specific building-related symptoms (also called sick building syndrome, SBS). This is an important indication that even such volatile organic compounds that can be sampled by commonly used adsorbents are of importance for the presence of such symptoms. By coordination of procedures for sampling and analysis of VOCs in buildings between laboratories, to get large datasets and more general models, the method can become a useful diagnostic measure in evaluating indoor air and to identify chemical compounds and sources that contribute to SBS problems.
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