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- Dahlgren, Christina, et al.
(author)
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Perception of quality of care in patients with pituitary disorders
- 2012
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Conference paper (other academic/artistic)abstract
- Background: In order to support patients with lifelong chronic illness, such as pituitary disorders, it is a challenge to continuously offer high quality of care.Aim: The aim of this study was to examine how patients with pituitary disorders of different causes perceive quality of care in contact with a specialized endocrinology reception.Methods and materials: Randomly selected, patients with chronic pituitary disorders (n=100) were asked to participate. Seventy-seven patients (females, n=44), 22–82 years of age responded and participated in the study. The questionnaire Quality from the Patient’s Perspective (QPP; modified short version) was used to measure patient’s perception of quality of care (considered from four dimensions: physical- technical, medical-technical, identity- orientation and socio-cultural atmosphere). Each question was calculated using an action index of each investigated area. Impaired quality of care in specific dimensions above 15% indicates need of improvement. In addition two open-ended questions were asked.Results: Most of the respondents, 97%, expressed that necessary physical-technical equipment was available while in the medical-technical dimension 26% reported impaired quality of care. In the identity-orientation dimension, impaired quality of care was reported by 25% mainly due to non-participation in care- and treatment decisions as well as concerning information about results of treatments and self-care activities. In the socio-cultural dimension impaired quality of care was reported in 25%. In addition, the patients asked for extended telephone receptions at the clinic and improved information about pituitary disorders.Conclusion: The patients were satisfied with the technical part of the medical care, but less satisfied with participation in care decisions and information about self-care. In our setting improvements are needed regarding patient information and access to care.
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| 3. |
- Dahlgren, Eva, et al.
(author)
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Long-term outcome of porcine skin graft in surgical treatment of recurrent pelvic organ prolapse. An open randomized controlled multicenter study
- 2011
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In: Acta Obstetricia et Gynecologica Scandinavica. - : Informa Healthcare / Wiley-Blackwell. - 0001-6349 .- 1600-0412. ; 90:12, s. 1393-1401
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Journal article (peer-reviewed)abstract
- Objective. To determine the long-term objective and subjective outcomes of use of a porcine skin graft (Pelvicol(TM)) compared with conventional colporrhaphy in recurrent pelvic organ prolapse surgery and to analyze risk factors and safety. Design. Open randomized controlled multicenter study. Setting. Eight Swedish hospitals. Population. 135 consecutive women with recurrent cystocele and/or rectocele admitted for vaginal prolapse surgery; 132 completed the study, 64 were randomly allocated to receive conventional colporrhaphy and 68 to Pelvicol. Methods. Conventional anterior and posterior colporrhaphy and colporrhaphy with use of Pelvicol(TM) mesh reinforcement. Clinical evaluation by means of pelvic organ prolapse quantification (POP-Q) and symptom questionnaire preoperatively, three months and three years postoperatively. Main outcome measures. Anatomical and subjective outcome.? Recurrence was defined as POP-Q=stage 2. Results. At three-month follow-up, early recurrence/surgical failures occurred significantly more often in the Pelvicol(TM) group, but at the three-year follow-up the recurrence rates were similar. The recurrence rates in the anterior compartment were 5762% and 4423% in the posterior compartment for the colporrhaphy and Pelvicol(TM) groups, respectively. Symptoms were substantially and equally reduced in the two groups after surgery. Sexual activity and function did not seem to be affected adversely in any group. The complication rate was low. Risk factors for anatomical recurrence were age, body mass index and preoperative stage of the prolapse. Conclusions. With the surgical technique used in this study, Pelvicol(TM) did not provide advantages over conventional colporrhaphy in recurrent pelvic organ prolapse concerning anatomical and subjective outcomes.
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| 5. |
- Dangardt, Frida, 1977, et al.
(author)
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High physiological omega-3 Fatty Acid supplementation affects muscle Fatty Acid composition and glucose and insulin homeostasis in obese adolescents.
- 2012
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In: Journal of nutrition and metabolism. - : Hindawi Limited. - 2090-0732 .- 2090-0724. ; 2012
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Journal article (peer-reviewed)abstract
- Obese adolescents have high concentrations of saturated fatty acids and low omega-3 long-chain polyunsaturated fatty acids (LCUFAs) in plasma phospholipids. We aimed to investigate effects of omega-3 LCPUFA supplementation to obese adolescents on skeletal muscle lipids and glucose and insulin homeostasis. Twenty-five obese adolescents (14-17 years old, 14 females) completed a randomized double-blind crossover study supplying capsules containing either 1.2g omega-3 LCPUFAs or placebo, for 3 months each with a six-week washout period. Fasting blood glucose, insulin, leptin, adiponectin, and lipids were measured. Intravenous glucose tolerance test (IVGTT) and euglycemic-hyperinsulinemic clamp were performed, and skeletal muscle biopsies were obtained at the end of each period. The concentrations of EPA, DHA, and total omega-3 PUFA in muscle phospholipids increased in both sexes. In the females, omega-3 LCPUFA supplementation improved glucose tolerance by 39% (P = 0.04) and restored insulin concentration by 34% (P = 0.02) during IVGTT. Insulin sensitivity improved 17% (P = 0.07). In males, none of these parameters was influenced by omega-3 supplementation. Thus, three months of supplementation of omega-3 LCPUFA improved glucose and insulin homeostasis in obese girls without influencing body weight.
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| 7. |
- Grönlund, Marita Andersson, 1959, et al.
(author)
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Ophthalmological findings in children and adolescents with Silver-Russell syndrome.
- 2011
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In: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 95:5, s. 637-41
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Journal article (peer-reviewed)abstract
- Aim To evaluate ophthalmological findings in children with Silver-Russell syndrome (SRS). Methods An ophthalmological evaluation including visual acuity (VA), refraction, strabismus, near point of convergence (NPC), slit-lamp examination, ophthalmoscopy, axial length measurements and full-field electroretinogram was performed on 18 children with SRS (8 girls, 10 boys; mean age 11.6 years). Fundus photographs were taken for digital image analysis. Data were compared with data on an age- and gender-matched reference group (ref) of school children (n=99). Results Seventeen out of 18 children with SRS had ophthalmological abnormalities. Best corrected VA of the best eye was <0.1 log of the minimal angle of resolution in 11 children (ref n=98) (p<0.0001), and 11 children had refractive errors (ref n=33) (p=0.05). Anisometropia (>/=1 dioptre) was noted in three of the children (ref n=3) (p=0.046). Subnormal stereo acuity and NPC were found in 2/16 (ref=0) (p=0.02). The total axial length in both eyes was shorter compared with that in controls (p<0.006 and p<0.001). Small optic discs were found in 3/16, large cup in 3/16 and increased tortuosity of retinal vessels in 4/13 children with SRS. Conclusion Children with SRS, who are severely intrauterine growth retarded, show significant ophthalmological abnormalities. Based on the present findings, ophthalmological examination is recommended in children with SRS.
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| 9. |
- Göthberg, Gunnar, et al.
(author)
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Laparoscopic Roux-en-Y gastric bypass in adolescents with morbid obesity-Surgical aspects and clinical outcome.
- 2014
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In: Seminars in pediatric surgery. - : Elsevier BV. - 1532-9453 .- 1055-8586. ; 23:1, s. 11-16
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Journal article (peer-reviewed)abstract
- In this paper, we address surgical aspects on bariatric surgery in adolescents from a nationwide Swedish study. Laparoscopic gastric bypass surgery was performed for 81 adolescents with morbid obesity (13-18 years), while 81 adolescents with obesity-matched by age, sex, and BMI received conventional care. Another comparison group was adults undergoing gastric bypass at the same institution during the same time period. This report addresses the 2-year clinical outcome and five-year surgical adverse event rate. Body weight decreased from 133kg (SD = 22) at inclusion to 92kg (SD = 17) after 1 year and was 89 (SD = 18) after 2 years (p < 0·001) representing a 32% (-35 to -30) weight loss after 2 years, corresponding to 76% (-81 to -71) excess weight loss. Weight loss was similar in the adult gastric bypass patients (-31%) while weight gain (+3%) was seen in the conventionally treated obese adolescents. Significant improvement in cardiovascular and metabolic risk factors and inflammation was seen after surgery. The treatment was generally well tolerated and quality of life improved significantly. The surgical adverse events included cholecystectomies (10%) and operations for internal hernia (9%) but no postoperative mortality. Adolescents undergoing laparoscopic gastric bypass surgery achieve similar weight loss to adults. Improvements in risk factors and quality of life were substantial. There were surgical complications similar to the adult group, which may be preventable.
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| 10. |
- Johannesson, Eva, et al.
(author)
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Simulating the real - manual clinical skills training : Conditions and practices of learning through simulation
- 2013
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In: Realising exemplary practice-based education. - Rotterdam, Nederländerna : Sense Publishers. ; , s. 187-194
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Book chapter (other academic/artistic)abstract
- For educators, scholars, practitioners and researchers this book offers an opportunity to explore and engage with practice-based education theories and concepts in real life teaching spaces. It is a place to see theory embodied and situated within PBE practices. It is also an opportunity to see how educators and scholars from other disciplines are applying theory to understand teaching and learning in their particular area. This volume provides an opportunity for readers to deepen their understanding of practice-based education and broaden and critically appraise their strategies for engaging
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