| 1. |
- Ålander, Johan, et al.
(författare)
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Tidstrender av tungmetalleroch organiska klorerademiljöföroreningar i baslivsmede
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Ett av Riksdagens 16 miljömål är ”giftfri miljö”. Mået innebä bland annat att kemiskaämnen i miljön inte hotar eller påverkar människors hälsa och ekosystemen. Konsumenternautsätts dock fortfarande för vissa föroreningar på en nivå som kan misstänkasleda till hälsoproblem. Livsmedel är ofta en viktig exponeringsväg för många av dessamiljöföroreningar.Livsmedelsverket har nu undersökt hur halterna av vissa miljöföroreningar har förändratsöver tiden i baslivsmedel (vete- och rågmjöl, vetekli) och livsmedelsproducerandedjur (nötkreatur, svin, lamm, odlad fisk, mjölk och ägg). Undersökningen har använtdata från Livsmedelsverkets livsmedelskontroll mellan 1976 och 2010. De ämnen somanalyserades var tungmetallerna kadmium, bly och kvicksilver och de svårnedbrytbaraklorerade organiska föreningarna α-hexaklorcyklohexan (α-HCH), polykloreradebifenyler (PCB), hexaklorbensen (HCB) och DDT-föreningen p,p'-DDE, även kalladePOP (persistent organic pollutants).Sammantaget visar resultaten att de riskreducerande åtgärder som hittills har vidtagitsmot kadmium- och kvicksilverförorening inte har haft någon markant effekt på halternai svenska livsmedel. För bly, HCH, PCB, HCB och DDT har dock åtgärderna i de flestafall haft positiv effekt på halterna.Kadmium.Halterna har mycket långsamt sjunkit i vete- och rågmjöl (halveringstid 80-120 år). I njure från nötkreatur, lamm och ren har halterna inte ändrats under denstuderade tidsperioden. I vetekli och svinnjure tycks kadmiumhalterna långsamt öka (fördubblingstid84 respektive 26 år). Resultaten för vetekli är dock osäkra på grund av relativtfå prover i undersökningen. Generellt sett är halterna högre i Skåne och Blekinge än iövriga delar av landet. Halterna i ren är klart högre i Västerbotten än i Jämtland och Norrbotten.De mycket långsamma förändringarna kan till viss del bero på ändrade produktionsmetoderi jordbruket, nya bearbetningsmetoder, samt ändrad foderproduktion.Bly.De riskreducerande åtgärderna har haft positiv effekt på halterna i de undersöktaproverna, med undantag för ren– där syns ingen trend. I mjölprodukterna halveradeshalterna vart 13-16 år, medan halterna i njure från nötkreatur och lamm minskadesnabbare (halveringstid 7-9 år).Kvicksilver.I odlad regnbåge var halterna oförändrade under åren 2001-2010.POP.Halterna av ämnena sjunker över tiden (halveras på 3,5-16 år). HCB i ren ochnötkreatur är dock ett undantag. I ren ökade halterna 2000 2010 med en fördubblingstidpå 10 år och i nötkreatur med en fördubblingstid på 17 år. Nötkreatur och mjölk frånSkåne och Blekinge har, generellt sett, högre halter av PCB och p,p´-DDE än i övrigalandet.
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| 2. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment.
- 2011
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Ingår i: Midwifery. - : Elsevier BV. - 1532-3099 .- 0266-6138. ; 27:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher((R)) (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment. DESIGN: randomised controlled trial. SETTING: labour ward with approximately 2500 childbirths per year in western Sweden. PARTICIPANTS: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180minutes after treatment. MEASUREMENTS AND FINDINGS: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements. CONCLUSIONS: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain. IMPLICATIONS FOR PRACTICE: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.
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| 3. |
- Bergh, Ingrid H. E., et al.
(författare)
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Midwifery students attribute different quantitative meanings to "hurt", "ache" and "pain" : A cross-sectional survey
- 2013
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 26:2, s. 143-146
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. Results: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. Conclusions: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain. © 2012.
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| 4. |
- Bergh, Ingrid, et al.
(författare)
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Reliability and validity of the Acceptance Symptom Assessment Scale in assessing labour pain
- 2012
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 28:5, s. e684-e688
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to investigate the reliability and validity of the Acceptance Symptom Assessment Scale (ASAS) in assessing labour pain.Design: a test-retest approach was used to assess reliability and validity.Setting: labour ward with approximately 2,400 deliveries annually in western part of Sweden.Participants: forty-seven pregnant women in the latent or active phase of labour.Methods: a total of five pain assessments with both the ASAS and the VAS were conducted in three sessions.Main outcome measures: correlation between ASAS and VAS.Findings: both scales demonstrated high and significant test–retest correlations (r=0.83–0.92; p<0.001). High and significant alternative-form reliability correlations (r=0.76–0.93, p<0.001) were found between ASAS and VAS ratings at all five assessments. Construct validity was established when both the ASAS and the VAS identified a pain reduction(p<0.001) 2 hrs after birth, compared to the previous assessment. Over two-thirds of the women preferred the ASAS to the VAS ,mainly(n=30) because the ASAS provided more choices relating to the pain experience, making it possible to label pain acceptable/unacceptable.Conclusions: the ASAS is interchangeable with the VAS for assessing labour pain. Over two-thirds of the women preferred it to the VAS.
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| 5. |
- Bergh, Ingrid, et al.
(författare)
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Sense of coherence over time for parents with a child diagnosed with cancer
- 2012
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Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: When a child is diagnosed with childhood cancer this creates severe stress in the parents. The aim of the study was to describe the sense of coherence and its change over time in a sample of parents of children diagnosed with cancer.Methods: The Swedish version of SOC (29 items) was used to measure the parents’ (n = 29) sense of coherence. Data were collected at four time-points: Time-point 1 at the time of diagnosis; time-point 2 during the treatment; time-point 3 after the child had completed their treatment and time-point 4 when the child had been off treatment for some years or had died.Results: The results showed that SOC in the investigated population is not stable over time. The parents decreased in total SOC between time-points 1, 2 and 3. Mothers had significantlyweaker total SOC score including the components Manageability and Meaningfulness at time-points 1 as well time-point 2 compared to the fathers. However, for the component Comprehensibility no significant differences were shown between mothers and fathers. This study indicates that mothers’ and fathers’ SOC scores change over time during the child’s cancer trajectory. However, the pattern in these changes varies between mothers and fathers.Conclusions: This study indicates that mothers and fathers may have different support needs during their child’s cancer trajectory.
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| 6. |
- Ek, Kristina, et al.
(författare)
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Death and caring for dying patients : exploring first-year students´descriptive experiences
- 2014
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Ingår i: International Journal of Palliative Nursing. - : Mark Allen Group. - 1357-6321 .- 2052-286X. ; 20:10, s. 509-515
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe first-year nursing students' experiences of witnessing death and providing end-of-life care.Methods: This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, ‘a search for meaning’ (Van Manen, 1997) was applied.Results: The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual experience, (2) Daring to approach the dying patient and offering something of oneself, (3) The experience of not sufficing in the face of death and (4) Being confronted with one's own feelings.Conclusion: Nursing students require continuous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical supervisors need to give support using reflective practice to help students to develop confidence in their capacity for caring for dying patients.
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| 7. |
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| 8. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Patients' experiences of acquiring a deep surgical site infection : An interview study
- 2010
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Ingår i: American Journal of Infection Control. - : Mosby, Inc.. - 0196-6553 .- 1527-3296. ; 38:9, s. 711-717
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Tidskriftsartikel (refereegranskat)abstract
- Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients’ experiences of SSI, the aim of the present study was to describe patients’ experiences of acquiring a deep SSI. Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.
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| 9. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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The application of evidence-based measures to reduce surgical site infections during orthopedic surgery - report of a single-center experience in Sweden.
- 2012
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Ingår i: Patient safety in surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 6:11
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Current knowledge suggests that, by applying evidence-based measures relating to the correct use of prophylactic antibiotics, perioperative normothermia, urinary tract catheterization and hand hygiene, important contributions can be made to reducing the risk of postoperative infections and device-related infections. The aim of this study was to explore and describe the application of intraoperative evidence-based measures, designed to reduce the risk of infection. In addition, we aimed to investigate whether the type of surgery, i.e. total joint arthroplasty compared with tibia and femur/hip fracture surgery, affected the use of protective measures. METHOD: Data on the clinical application of evidence-based measures were collected structurally on site during 69 consecutively included operations involving fracture surgery (n = 35) and total joint arthroplasties (n = 34) using a pre-tested observation form. For observations in relation to hand disinfection, a modified version of the World Health Organization hand hygiene observation method was used. RESULTS: In all, only 29 patients (49%) of 59 received prophylaxis within the recommended time span. The differences in the timing of prophylactic antibiotics between total joint arthroplasty and fracture surgery were significant, i.e. a more accurate timing was implemented in patients undergoing total joint arthroplasty (p = 0.02). Eighteen (53%) of the patients undergoing total joint arthroplasty were actively treated with a forced-air warming system. The corresponding number for fracture surgery was 12 (34%) (p = 0.04).Observations of 254 opportunities for hand hygiene revealed an overall adherence rate of 10.3% to hand disinfection guidelines. CONCLUSIONS: The results showed that the utilization of evidence-based measures to reduce infections in clinical practice is not sufficient and there are unjustifiable differences in care depending on the type of surgery. The poor adherence to hand hygiene precautions in the operating room is a serious problem for patient safety and further studies should focus on resolving this problem. The WHO Safe Surgery checklist "time out" worked as an important reminder, but is not per se a guarantee of safety; it is the way we act in response to mistakes or lapses that finally matters.
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| 10. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Traffic flow in the operating room : An explorative and descriptive study on air quality during orthopedic trauma implant surgery
- 2012
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 40:8, s. 750-755
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Tidskriftsartikel (refereegranskat)abstract
- Background:Understanding the protective potential of operating room (OR) ventilation under different conditions is crucial to optimizing the surgical environment. This study investigated the air quality, expressed as colony-forming units (CFU)/m³, during orthopedic trauma surgery in a displacementventilated OR; explored how traffic flow and the number of persons present in the OR affects the air contamination rate in the vicinity of surgical wounds; and identified reasons for door openings in the OR.Methods:Data collection, consisting of active air sampling and observations, was performed during 30 orthopedic procedures.Results:In 52 of the 91 air samples collected (57%), the CFU/m³ values exceeded the recommended level of <10 CFU/m³. In addition, the data showed a strongly positive correlation between the total CFU/m³ per operation and total traffic flow per operation (r=0.74;P=.001; n=24), after controlling for duration of surgery. A weaker, yet still positive correlation between CFU/m³ and the number of persons present in the OR (r=0.22;P=.04; n=82) was also found. Traffic flow, number of persons present, and duration of surgery explained 68% of the variance in total CFU/m³ (P=.001).Conclusions:Traffic flow has a strong negative impact on the OR environment. The results of this study support interventions aimed at preventing surgical site infections by reducing traffic flow in the OR.
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