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- Edberg, Anna-Karin, et al.
(author)
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Akut konfusion
- 2024
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In: Omvårdnad & äldre. - Lund : Studentlitteratur. ; :2, s. 295-306
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Book chapter (other academic/artistic)
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2. |
- Edberg, Anna-Karin, et al.
(author)
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Sexuell hälsa : Hälsa och ohälsa
- 2019
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In: Omvårdnadens grunder. - Lund : Studentlitteratur AB. ; :3 upplaga, s. 93-118
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Book chapter (other academic/artistic)
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3. |
- Claesson Lingehall, Helena, 1965-
(author)
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Delirium in older people after cardiac surgery : risk factors, dementia, patients’ experiences and assessments
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Background:Delirium is common in older people undergoing cardiac surgery. Delirium is an acute or subacute neuro-psychiatric syndrome, characterized by a change in cognition, disturbances in consciousness; it fluctuates, develops over a short period of time and always has an underlying cause. It is associated with a disturbance in psychomotor activity, and is classified according to different clinical profiles such as hypoactive, hyperactive and mixed delirium. Delirium after cardiac surgery is not harmless, it increases the risk of complications such as prolonged stay in hospital, falls, reduced quality of life, reduced cognitive function and increased mortality.Aim:The overall aim of this thesis was to investigate postoperative delirium in older people undergoing cardiac surgery with Cardiopulmonary Bypass (CPB), focusing on risk factors, dementia and patients’ experiences; and to evaluate an assessment for screening delirium.Methods:This thesis compromises four studies. All participants (n=142) were scheduled for cardiac surgery with use of CPB at the Cardiothoracic Surgery Department, Heart Centre, Umeå University Hospital, Sweden, between February and October 2009. Six structured interviews were conducted preoperatively, day one and day four postoperatively, and in home visits, one, three and five years after surgery (2010, 2012 and 2014). The assessment scales used in Studies I, II and IV were: the Mini-Mental State Examination (MMSE) for cognition, the Organic Brain Syndrome Scale (OBS) for delirium, Geriatric Depression Scale 15 (GDS-15) for depression, Katz staircase with Activities of Daily Living (ADL) for participants’ functional status and the Numerical Rating Scale (NRS) for pain. During the hospital stay, nursing staff used the Swedish version of the Nursing Delirium Screening Scale (Nu-DESC) to assess delirium. Semi-structured interviews were also carried out (III) in the one-year follow up. Delirium, dementia and depression were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR).Results: Out of 142 participants 54.9% (78/142) developed delirium after cardiac surgery (I). Independent risk factors, predisposing and precipitating, associated with delirium were: age, diabetes, gastritis/peptic ulcer, volume load during operation, longer time on ventilator in intensive care, increased temperature and plasma sodium concentration in the intensive care unit. Out of 114 participants thirty (26.3%) developed dementia within the five years of follow-up. It was shown that a lower preoperative MMSE score and postoperative delirium were factors independently associated with development of dementia (II). One year after cardiac surgery, participants diagnosed with postoperative delirium described in detail feelings of extreme vulnerability and frailty. Despite this, the participants were grateful for the care they had received (III). Hypoactive was the most common symptom profile for delirium. The Swedish version of Nu-DESC showed high sensitivity in detecting hyperactive delirium, but low sensitivity in detecting hypoactive delirium (IV).Conclusion:Delirium was common among older patients undergoing cardiac surgery. Both predisposing and precipitating factors contributed to postoperative delirium. Preventive strategies should be considered in future randomized studies. It might also be suggested that cognitive function should be screened for preoperatively and patients who develop delirium should be followed up to enable early detection of symptoms of dementia. Whether prevention of postoperative delirium can reduce the risk of future dementia remains to be studied. To minimise unnecessary suffering, patients and next of kin should be informed about and prepared for the risk of delirium developing during hospitalization. The Swedish version of Nu-DESC should be combined with cognitive testing to improve detection of hypoactive delirium, but further research is needed. Healthcare professionals need knowledge concerning postoperative delirium in order to prevent, detect and treat delirium so as to avoid and relieve the suffering it might cause.
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5. |
- Edberg, Frida, et al.
(author)
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Mobilization of metals from uranium mine waste : the role of pyoverdines produced by Pseudomonas fluorescens
- 2010
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In: Geobiology. - : Wiley. - 1472-4677 .- 1472-4669. ; 8:4, s. 278-292
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Journal article (peer-reviewed)abstract
- Microorganisms produce chelating agents, such as siderophores and other ligands, which allow them to mobilize and scavenge essential elements from the environment when bioavailability is low. To better understand the effects of biologically mediated leaching of metals from mine waste, Pseudomonas fluorescens was cultivated in the presence of processed ore from the former uranium mine in Ranstad, southern Sweden. Light conditions, the concentration of the mineral source and oxygen availability were varied. The presence of ore in the culture flasks enhanced bacterial growth and raised the pH of the culture medium. Increasing the amount of ore or enhancing aeration of the medium further encouraged cell growth and pH rise. Bacteria mobilized Fe, Ni and Co from the ore. Fe-siderophore complexes were detected and estimated to be present at approximately 9 μm. In the presence of bacteria and light, dissolved Fe and U concentrations were higher compared to dark conditions. Increasing the amount of ore resulted in higher dissolved Ni concentrations but lower dissolved Fe, most likely due to precipitate formation. Data from this study support siderophore production by bacteria that allowed mobilization of essential nutrients from the processed ore. However, the availability of potentially toxic metals like Ni and U may also be enhanced. Microbial-promoted mobilization could contribute to leaching of toxic metals in current and historic mining areas. This process should be considered during design and implementation of remediation projects where trace metals are of environmental concern.
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7. |
- Henriksson (Alvariza), Anette
(author)
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A support group programme for family members : an intervention during ongoing palliative care
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Family members are central in providing care for patients with lifethreatening illness, but they often experience a lack of necessary preparation and knowledge, with a need for information and psychosocial support. The overall aim of this thesis was to investigate participant’s experiences as well as effects of a support group programme for family members of patients with life-threatening illness during ongoing palliative care.Methods: A mixed method design was used. Study I was retrospective descriptive and used a phenomenological method to analyse 10 face-to-face interviews about experiences of participating in the programme. Study II was retrospective descriptive and used qualitative content analysis to analyse 29 telephone interviews about experiences of the programme design. Study III was correlational and used a confirmatory factor analysis to psychometrically evaluate the preparedness for caregiving scale(PCS), caregiver competence scale(CCS) and rewards of caregiving scale(RCS) in 124 family members. Study IV was prospective quasi-experimental and used interferential statistics to investigate effects of the programme, assessing preparedness, competence, rewards, anxiety, depression, hope and health in 125 family members.Results: The main experiences of participation in the programme were; a sense of safety and belonging, confirmation, insight into the gravity of the illness, and a moment of rest. The programme was experienced as covering topics of interest, structured to make participants feel invited by the caring team and using an open approach that fostered a warm atmosphere. The Swedish versions of PCS, CCS and RCS were shown to be valid and reliable. Family members who participated in the programme significantly increased in preparedness, competence and rewards in relation to caregiving. No significant changes were shown for anxiety, depression, hope and health.Clinical implications: The results should provide encouragement in the challenging work to develop and deliverer interventions, with the explicit purpose of supporting family members in palliative care.
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8. |
- Hidemark, Ove, et al.
(author)
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Nygotiska kyrkor i Skåne : utveckling i form, material och konstruktion 1840-1910
- 1991
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Book (pop. science, debate, etc.)abstract
- Denna bok har sin utgångspunkt i 1981/82 års studier i skånskt 1800-talsbyggande där Arkitekturskolans restaureringslinje valde att ägna sitt intresse åt det relativt obeaktade bestånd av nygotiska kyrkor som Skåne erbjuder. Studiernas syfte har varit attförsöka fånga kyrkornas specifika såväl estetiska som tekniska karaktäristiska och beskriva den utveckling som de representerar.
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9. |
- Johansson, Linda
(author)
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Foodwork and meals in everyday life among persons with dementia and their partners
- 2013
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Doctoral thesis (other academic/artistic)abstract
- The aim of this thesis was to explore and describe foodwork and meals for older persons with dementia and their partners in ordinary homes.Descriptive and explorative designs were used in the four papers this thesis is based on. Longitudinal data, including older home-living unlike-sex twins, were analysed using descriptive and analytical statistics. An ethnographic approach was used to describe everyday life for persons with dementia. Interviews with partners and staff were analysed using thematic analysis and qualitative content analysis, respectively.The results revealed that, among home-living older persons, there is an association between a person’s cognitive ability and nutritional status; i.e. low cognitive ability leads to increased risk of malnutrition. For home-living persons with dementia and their partners, foodwork and meals sometimes changed, meaning that shopping, preparing food and eating as well as social interaction become complicated, which seemed to lead to transitions in roles, routines and relations. There was foodwork that the persons with dementia could perform, and participants expressed a desire that abilities and independence be preserved. However, support was sometimes needed, and it was emphasized that this was based on the person’s needs, wishes and problems.In conclusion, there is an association between decreased cognitive ability and increased risk of malnutrition. Furthermore, foodwork and meals affected both persons with dementia and their partners. Therefore, early intervention whereby both partners in a couple get individually adjusted support is of importance. Consequently, a person-centred care approach can be useful in arranging the support.
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10. |
- Kalinowski, Birgitta E., et al.
(author)
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Microbial mobilization of uranium from shale mine waste
- 2006
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In: Geomicrobiology Journal. - : Informa UK Limited. - 0149-0451 .- 1521-0529. ; 23:3-4, s. 157-164
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Journal article (peer-reviewed)abstract
- The alum shale in the Billingen area in southern Sweden was mined in Ranstad for 5 years during the 1960s. The crushed tailings (processed and unprocessed) were left behind when the Ranstad mine was closed that has caused leaching of metals to the surroundings. The siderophore producing bacterium Pseudomonas fluorescens (sp, SE Sweden) was grown in batch cultures for 5 to 8 days with naturally weathered (unprocessed) uranium ore (0.0029% U by weight), kolm (0.52% U by weight) and acid-leached ore (0.0099% U by weight) in chemically defined media (unbuffered and buffered). Pseudomonas fluorescens grown with ore and unbuffered medium changed the pH from 4.7 to 9.3 and leached out 0.016 to 0.9% (normalized to surface area) of the total amount of U from the different ores. Incubation of the acid-leached ore with bacteria in buffered medium leached out 0.04% of the total U. Uranium was leached out selectively at all conditions, but this could be a pH effect, as pH increased at the same time as the U concentrations did. The observed release of Fe was most likely attributed to the production of microbial siderophores (Fe3+ specific chelators) since Fe3+ has a low solubility at pH > 4. As siderophores contain a number of chelating groups they may still function as complexators even in partly degraded form also for other metals than Fe. Thus, the production of microbial chelators could contribute to the elevated metal concentrations in the drainage water from the closed Ranstad mine, as abiotic processes cannot fully explain these high metal concentrations. In the extension: ligand promoted leaching of toxic elements could also be the key to bioremediation as there is a need for nontoxic cleanup methods for metal contaminated sites.
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