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- Ek, Ulla, 1948-
(författare)
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Children with visual disorders : cognitive development, developmental disorders and consequences for treatment and counselling
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The causes of visual impairment and blindness has changed over the years, in Sweden and in other industrialised countries, giving rise to a new population of visually impaired children. Damages to the posterior visual pathway and the brain are now common causes of visual impairment. In contrast, purely ocular diseases or conditions are increasingly rare. In this thesis this changed panorama was explored and cognitive and behavioural outcome in children with ocular vs. cerebral visual impairment was examined in various studies. More cognitive deficits and developmental disorders, such as autism, attention deficit hyperactivity disorders and complex visual perceptual and visual cognitive disorders were found in children with cerebral visual impairment or combinations of ocular and cerebral causes of visual impairment. Children born preterm, now form a considerable part of the population of visually impaired children and are at risk for such disorders. In contrast, children born at term with visual impairment due to causes in the anterior parts of the visual system have an entirely different developmental outcome. Psychological assessment methods, early intervention, counselling of parents and teachers and the education of visually impaired children in mainstream classes should be adapted to correspond with this changing population of visually impaired children.
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| 2. |
- Wissing, Ulla, 1945-, et al.
(författare)
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A follow-up study of ulcer healing, nutrition, and life-situation in elderly patients with leg ulcer
- 2001
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Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 5:1, s. 37-42
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Tidskriftsartikel (refereegranskat)abstract
- This study was undertaken in order to follow up ulcer healing, ulcer recurrence, nutritional status and life-situation in elderly patients with leg ulcers. Of 70 patients assessed previously in 1996, 43 (61%) were still alive in 2000 and, of these, 38 (88%) participated in the follow-up. Rate of healing, recurrence and amputation were obtained from medical records and interviews with the patients. The Mini Nutritional Assessment (MNA) was used to assess their nutritional status and the Philadelphia Geriatric Center Multilevel Assessment Instrument was used for assessment of their life-situation. Nineteen patients (50%), mean age 82+/-4.6 years, had healed ulcers. Two (5%) patients, mean age 86+/-2.8, had required amputation and had no ulceration after surgery. Seventeen patients (45%), mean age 80.3+/-6 years, had open ulcers, six had their original ulcers still unhealed, and 11 had open recurrent ulcers. Decreased mean MNA scores, as well as decreased mean scores in ADL and mobility, were seen over time in patients with open ulcers but not in those who were healed. Patients with healed ulcers had significantly higher mean scores in social interaction than those with open ulcers and significantly increased mean scores in environmental quality over time. The results indicate that nutrition and the life-situation might be related to leg ulcer healing. The nutritional situation and the whole life-situation should be observed and taken into consideration when care is planned. Additional research is needed to increase the understanding of the relationship between nutrition, life-situation and ulcer healing.
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| 3. |
- Wissing, Ulla, 1945-, et al.
(författare)
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Can individualised nutritional support improve healing in therapy-resistant leg ulcers?
- 2002
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Ingår i: Journal of wound care. - : Mark Allen Group. - 0969-0700 .- 2052-2916. ; 11:1, s. 15-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study investigated whether an individually designed programme of nutritional support can improve healing in otherwise therapy-resistant venous leg ulcers. METHOD: Six primary health-care patients, aged between 79 and 93 years, with venous ulcers that had been open for one year or more (range: 1.5-8 years) were recruited into the study. The patients were asked to follow an individualised diet plan which included the use of liquid dietary supplements. Ulcer area, anthropometric and biochemical variables, and energy and nutrient intake were assessed before intervention and then regularly for nine months.RESULTS: At nine months ulcer healing had occurred in two patients, of whom one had had ulcers on both legs. In a third patient the ulceration on one leg had healed and that on the other leg had almost healed. In a fourth patient, the ulcer area reduced by approximately 90%.CONCLUSION: The use of nutritional support might have assisted the wound healing in these patients. Although the relationship between nutritional supplementation and wound healing is not well defined, an appropriate nutritional plan is recommended if undernourishment is suspected and leg ulcers are not healing.
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| 4. |
- Wissing, Ulla, 1945-, et al.
(författare)
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Life situation and function in elderly people with and without leg ulcers
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 16:1, s. 59-65
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Tidskriftsartikel (refereegranskat)abstract
- The majority of elderly patients with leg ulcers live at home and receive treatment for their ulcers within the primary health care system. Little is known about the patients' ability or behaviour in the life situation and how well they manage their daily life at home. The Philadelphia Geriatric Center Multilevel Assessment Instrument (PGC MAI) was used to assess and compare the life situation in 70 patients (mean age 79 +/- 6.5 years) with leg ulcers and in 74 elderly persons (mean age 80 +/- 5.7 years) without leg ulcers. The patients with leg ulcers had significantly lower mean values in the domains of physical health, activity of daily living (ADL), cognition, time use and social behaviour, personal adjustment and environmental quality than those without ulcers. Sixty-three percent of the patients reported ulcer-related pain, and all of them were dependent on health care personnel for dressing changes. This may indicate that the life situation among elderly persons with leg ulcers is not so good as compared with that of elderly persons without ulcers and that patients with leg ulcers are more vulnerable than elderly people of the same age.
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| 5. |
- Wissing, Ulla, 1945-, et al.
(författare)
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Meal patterns and meal quality in patients with leg ulcers
- 2000
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Ingår i: Journal of human nutrition and dietetics (Print). - 0952-3871 .- 1365-277X. ; 13:1, s. 3-12
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Tidskriftsartikel (refereegranskat)abstract
- Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers.Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients.Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.
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