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  • 201.
    Grankvist, Sara
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Jämförelse mellan en manuell keratometer (Topcon OM-4) och en corneal topograf (Topcon CA-100)2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 202.
    Granström, Joakim
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Den simulerade fluoresceinbilden: Hur väl överensstämmer den med verkligheten?2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att undersöka hur väl den fluoresceinbild som linstillpassningsprogrammeti topografen Top Con CA-100 simulerar överensstämmde med den verkliga fluoresceinbilden.

    Metod: Mätning med topograf utfördes på båda ögonen hos 12 patienter. Av dessafullföljde 10 patienter deltagandet i studien. Topografens linstillpassningsprogram fick sedan välja ut de bäst passande parametrarna för en A90AS och Conflex Air stabilkontaktlins för vardera ögat (denna funktion kallas ”auto fit”), och simulera fluoresceinbilden för dessa linser. Linser av samma design och parametrar som simuleratstillpassades sedan på patientens ögon. Efter att linserna fått sätta sig i 25-30 min. droppadesfluorescein i ögonen och bilder på fluoresceinmönstret togs med digitalkamera. De olika fluoresceinbilderna jämfördes sedan med hjälp av en mall, vilken gav ett mått på hur stordel av linsens area som de olika bilderna överensstämmde.

    Resultat: 21 av de 39 fluoresceinmönstrena bedömdes överensstämma helt (100%), 6 mönster stämde för 81,25% respektive 62,50%. 2 mönster stämde till 75% och ett mönsterstämde till vardera 56,25%; 43,75%; 25% och 18,75%. P <0,05 (Wilcoxons teckenrangtest)och visar att det finns en skillnad mellan simulering och verklig fluoresceinbild.

    Slutsats: Simulering av fluoresceinbild är ett användbart redskap men det är inte 100% tillförlitligt och det har inte ersatt behovet av en skicklig kliniker.

  • 203.
    Green, Jason J. A.
    et al.
    Indiana University, USA.
    Elsner, Ann E.
    Indiana University, USA;Aeon Imaging, USA.
    Baskaran, Karthikeyan
    Indiana University, USA.
    Haggerty, Bryan P.
    Indiana University, USA.
    Clendenon, Jeff
    Aeon Imaging, USA.
    Muller, Matthew S.
    Aeon Imaging, USA.
    Retina Artery to Vein Intensity Ratio as a Function of Wavelength and Dark-Field Offset With Low Cost Ophthalmoscope2014Conference paper (Refereed)
    Abstract [en]

     PurposeTo quantify light return from retinal vessels for oxygenation status. To use a low-cost Digital Light Ophthalmoscope (DLO) based on a novel structured light pattern Digital Light Projector for quantitative retinal imaging.  MethodsFive normal subjects of ages 27-63 and various eye colors were imaged without mydriasis. The DLO produced a progressively scanning 6 pixel wide stripe, 96 stripe illumination pattern (85 μm stripe width at retina) with LEDs at 635 +/- 25nm (Red) and 535 +/- 70nm (Green) with a constant fixation target location across tests. The illumination was synchronized to a 13.2 Hz rolling shutter CMOS sensor (11 μm resolution at retina). To collect the light return from the retina at varying light multiply scattered levels, aperture offset was varied in position with respect to the illumination centerline: dark-field mode was obtained with large offsets and confocal mode had small offsets, where offset was varied from -517 μm (row start 30) to 1353 μm (row start 200). Multiple images of 12 bit dynamic range were captured in sequence, aligned with translational cross correlation, then time averaged to reduce noise. The artery and vein gray scale intensity level was measured at vessel centers for: 1) both vessels over background retina and 2) artery over the optic disc and vein over background. Mean-to-mean intensity ratios were then compared.  ResultsWith an aperture width of 704 μm, intensity varied by 2.60 bits (a factor of 4.5) for each subject per condition: red, green, artery, and vein, 3.39 bits if same subject and condition (2.3% Red A/V ratio CoV σ/μ), and by 5.07 bits over all tests. Yet, the ratio (Red/Green Artery)/(Red/Green Vein) was close to unity across offsets and linear fits had an R^2 regression of, for case 1: 0.72, 0.06, 0.25, 0.18, and 0.49, and case 2: 0.0005, 0.89, 0.75, 0.50, and 0.18. The Artery/Vein ratio trend slopes, intercept points, and inversions varied between subjects, i.e. contrast reversals were observed.  ConclusionsThe DLO can be utilized electronically to effectively perform quantitative fundus imaging at both Red and Green wavelengths, which is a step towards performing oximetry. 77 is zero offset

  • 204.
    Gren, Cim
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Köhnke, Emma
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    COPINGSTRATEGIER HOS PATIENTER MED AVANCERAD CANCER: En litteraturstudie utifrån ett patientperspektiv2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Cancerfallen i Sverige har fördubblats sedan 1970-talet och om cirka 20 år uppskattas 100 000 nya personer insjukna i cancer per år. Att drabbas av cancer anses vara en av de mest stressfyllda situationer en person kan uppleva och sjukdomen påverkar patienten både fysiskt, psykiskt och existentiellt. För att lättare hantera sin nya vardag kan patienten behöva tillämpa olika copingstrategier som används för att hantera svåra påfrestningar. 

    Syfte: Syftet med studien var att utifrån ett patientperspektiv beskriva copingstrategier som kan hjälpa patienter med avancerad cancer. 

    Metod: En litteraturstudie med 14 kvalitativa vetenskapliga artiklar genomfördes. Artiklarna analyserades utifrån Lundman och Hällgren-Graneheims (2017) manifesta innehållsanalys. 

    Resultat: Resultatet delades in i fyra kategorier och tretton underkategorier. Kategorierna som framkom var; Viljan att styra över sitt liv, uppmuntrande känslor, socialt stöd samt andligt stöd.

    Slutsats: Sjuksköterskan behöver agera på ett sådant sätt att patientens hälsa ökar och lidandet minskar. Sjuksköterskan behöver också utgå ifrån patientens unika och subjektiva livsvärld eftersom det är först då som patientens copingstrategier kan identifieras och stärkas. Tillgodosedda copingstrategier leder till att patientens vardag och liv kan genomsyras av en känsla av hanterbarhet, begriplighet och meningsfullhet.

  • 205.
    Gunnarsson, Anna
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nylander, Linnea
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    FÖRÄLDER TILL EN ÄNGEL: Upplevelser av välbefinnande och lidande efter att barn avlidit i cancer2011Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING

    Bakgrund: Årligen dör ett av fyra cancerdiagnostiserade barn i Sverige. Föräldrarnas liv efter förlusten förändras för alltid och reaktionerna kan variera. Efter förlusten är föräldrarna i stort behov av stöd från sina nätverk. De måste lära sig att leva med förlusten och de får kämpa för att komma tillbaka till vardagen. Syfte: Syftet med studien var att beskriva hur föräldrarna upplevde välbefinnande respektive lidande upp till två år efter att deras barn avlidit i cancer. Metod: Studien utgår från fem självbiografier som analyserades med kvalitativ innehållsanalys. Resultat: Att förlora sitt barn skapar många blandade känslor hos föräldrarna, allt från sorg till lättnad. Föräldrarna är i behov av stöd efter den livsomvälvande upplevelsen. Barnen är en del av familjerna då minnena alltid lever kvar. Syskonen är en avgörande faktor för föräldrarnas kamp att fortsätta den nya vardagen. Föräldrarna lär sig att leva med saknaden och sorgen. Slutsats: Att förlora ett barn är en traumatisk händelse som skapar många olika känslor. Att få bra stöd är viktigt för föräldrarna som bearbetar händelsen på olika sätt. Minnena av barnen finns alltid hos föräldrarna så länge de lever och de genomgår förändringar efter att barnen har avlidit.

  • 206.
    Gunnarsson, Helena E. M.
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Hälsoringen, Neron HSU AB, Osby.
    Grahn, Birgitta
    Lund University ; Region Skåne ; Region Kronoberg.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. jens.agerstrom@lnu.se.
    Increased deep pain sensitivity in persistent musculoskeletal pain but not in other musculoskeletal pain states2016In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 13, p. 1-5Article in journal (Refereed)
    Abstract [en]

    BackgroundPressure pain thresholds (PPTs) in a non-painful body area are known to be affected in some chronic pain states. The aim of this study is to investigate PPTs in a pain-free body part in relation to pain persistence and intensity in patients with musculoskeletal pain. MethodsPatients with musculoskeletal pain were divided into three different pain groups: acute pain (pain duration < 3 months, n = 38), regularly recurrent pain (regularly recurrent pain duration > 3 months, n = 56), persistent pain (persistent pain duration > 3 months, n = 52) and a healthy control group (n = 51). PPT measures were conducted over the tibialis anterior muscle on the right leg in all groups. ResultsThe persistent pain group showed significantly lower PPTs over the tibialis anterior muscle compared to controls. No significant differences were found between the acute and regularly recurrent pain groups compared to healthy controls. Significant correlations, albeit small, were found between pain intensity and PPTs. ConclusionsIncreased deep pain sensitivity was found in patients with persistent musculoskeletal pain, but not in regularly recurrent pain or in acute pain. Yet, a limitation of the study is that it did not have sufficient power to detect small levels of increased deep pain sensitivity among the latter groups when compared to healthy controls. Implications: Knowledge about increased general hypersensitivity in persistent musculoskeletal pain could be important in clinical treatment.

  • 207.
    Gustafsson, Jörgen
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Inde, Krister
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Mohn Jenssen, Gaute
    Tömta, Arne
    Kobberö, Kirsten
    Mejlvang, Jytte
    Baggesen, Kirsten
    Synrehabiliteringen i Skandinavien2010In: Optikeren, ISSN 0333-1598, E-ISSN 1891-0874, no 1, p. 42-45Article in journal (Other academic)
  • 208.
    Gustafsson, Maria
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Läshastighet på datorskärm med färgade overlays2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To investigate reading speed on a computer screen and if it can be improved by using coloured overlays, and also if there is any difference in reading speed on printed paper and computer screen.

    Methods: The participants (n=30) read a Wilkins rate of reading test translated into Swedish, where the number of words read out loud in one minute was compared when reading on a paper without overlay and on a computer screen with and without an overlay. This study was performed on students aged 18-31 years.

    Results: This study shows that there is no significant difference in reading speed between reading on a printed paper and on a computer screen (p=0.508). The participants read 1.6 ± 13.3 words/min more on the computer screen than on the paper. A significant difference however was found in reading on a computer screen with and without coloured overlay (p=0.008). The reading speed increased with 4.7 ± 9.1 words/min with a coloured overlay.

    Conclusions: The reading speed on paper is similar to the reading speed on computer screen. The reading speed on the computer screen can be increased by placing a coloured overlay in front of the text.

  • 209.
    Gustafsson, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Jonsborg, Helena
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Vårdpersonalens upplevelser i mötet med patienter som skadar sig själva: en systematisk litteraturstudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: It appears to be central aspects regarding the care of patients who self-harm and these aspects set requirements on psychiatric health care personnel's ability to relate to the meeting with the patients. Aim: To illustrate psychiatric health care personnel's experiences of meeting with patients who self-harm. Method: A systematic literature review based on a method described by Evans with a result based on 22 articles of qualitative design. Result: To meet patients who self-harm can be seen out of the six themes described in the result of the present study; To be challenged by negative emotions, To disconnect from your empathic ability, To be unsure of what´s to come, A difficult balancing act, A favorably meeting and Professional development.

    Conclusion: The result of the present study shows that the negative emotions were prominent. Continuous further training and tutorial appears necessary conditions to enable favorable meetings with the patient group.

  • 210.
    Guthrie, Philip
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Är det någon skillnad mellan Sirius & Wave Analyzer Medica 700 vid pakymetri och topografiska mätningar?2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att jämföra korneala mätningar tagna med två olika topografiska mätinstrument (Sirius & Wave Analyzer Medica 700) och att utvärdera om dessa två instrument kan användas utbytbart.

    Metod: Det var 23 stycken deltagare i denna studie som var indelade i två grupper. Det var 17 stycken deltagare i grupp A som hade en normal kornea och i grupp B var det 6 stycken deltagare som hade en onormal kornea. Tre upprepade mätningar utfördes på det högra ögat för alla deltagare med båda instrumenten. Förutom på en deltagare som hade keratokonus i hens vänstra öga. De simulerade K (Sim-K) parametrarna som innehåller ”Flattest” (Kf), ”Steepest” (Ks) och ”Average” K (Km) analyserades. Dessutom togs den centrala korneas tjocklek också med båda mätinstrumenten och utvärderades.

    Resultat: En skillnad mellan de uppmätta värdena för de två mätinstrumenten hittades. Mellan dessa två mätinstrument var medelvärdet av skillnaden i grupp A för parametrarna Kf, Ks och Km ungefär 0,1mm. I grupp B var medelvärdet av skillnaden för parametrarna Kf, Ks och Km ungefär 0,15mm. För pachymetri var medelvärdet av skillnaden för de två mätinstrumenten 23µm för grupp A och 31µm för grupp B.

    Slutsats: De två topografiska mätinstrumenten visade en statistiskt signifikant skillnad i mätning utav korneala parametrarna. Trots att det var en statistiskt signifikant skillnad när man jämförde Sim-K för båda mätinstrumenten var skillnaden kliniskt obetydlig för de deltagare som hade en frisk kornea. Därför kan båda utav dessa mätinstrument användas utbytbart för att mäta keratometri i friska ögon.

  • 211.
    Halcox, Julian P.
    et al.
    Swansea Univ, UK.
    Banegas, Jose R.
    Univ Autonoma Madrid, Spain ; CIBER Epidemiol & Publ Hlth CIBERESP, Spain.
    Roy, Carine
    Hop Bichat Claude Bernard, France.
    Dallongeville, Jean
    Univ Lille Nord France, France.
    De Backer, Guy
    Univ Ghent, Belgium.
    Guallar, Eliseo
    Johns Hopkins Bloomberg Sch Publ Hlth, USA.
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hajage, David
    Hop Bichat Claude Bernard, France.
    Henriksson, Karin M.
    Uppsala University.
    Borghi, Claudio
    Univ Bologna, Italy.
    Prevalence and treatment of atherogenic dyslipidemia in the primary prevention of cardiovascular disease in Europe: EURIKA, a cross-sectional observational study2017In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 17, article id 160Article in journal (Refereed)
    Abstract [en]

    Background: Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. Here, we address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of high-density lipoprotein cholesterol. Methods: This cross-sectional observational study assessed the prevalence of two atherogenic dyslipidemia markers, high triglyceride levels and low high-density lipoprotein cholesterol levels, in the study population from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; N = 7641; of whom 51.6% were female and 95.6% were White/Caucasian). The EURIKA population included European patients, aged at least 50 years with at least one cardiovascular risk factor but no history of cardiovascular disease. Results: Over 20% of patients from the EURIKA population have either triglyceride or high-density lipoprotein cholesterol levels characteristic of atherogenic dyslipidemia. Furthermore, the proportions of patients with one of these markers were higher in subpopulations with type 2 diabetes mellitus or those already calculated to be at high risk of cardiovascular disease. Approximately 55% of the EURIKA population who have markers of atherogenic dyslipidemia are not receiving lipid-lowering therapy. Conclusions: A considerable proportion of patients with at least one major cardiovascular risk factor in the primary cardiovascular disease prevention setting have markers of atherogenic dyslipidemia. The majority of these patients are not receiving optimal treatment, as specified in international guidelines, and thus their risk of developing cardiovascular disease is possibly underestimated.

  • 212.
    Halcox, Julian P.
    et al.
    Swansea University College of Medicine, UK.
    Tubach, Florence
    INSERM, France ; Paris Diderot University, France.
    Lopez-Garcia, Esther
    Universidad Autónoma de Madrid, Spain ; CIBERESP, Spain.
    De Backer, Guy
    University of Ghent, Belgium.
    Borghi, Claudio
    University of Bologna, Italy.
    Dallongeville, Jean
    Université Lille-Nord de France, France.
    Guallar, Eliseo
    Johns Hopkins Bloomberg School of Public Health, USA ; National Center for Cardiovascular Research, Spain.
    Medina, Jesús
    AstraZeneca Farmacéutica Spain, Spain.
    Perk, Joep
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sazova, Oguen
    AstraZeneca Global Medical Affairs, UK.
    Sweet, Stephen
    Oxford PharmaGenesis Ltd, UK.
    Roy, Carine
    INSERM, France ; Hôpital Bichat-Claude Bernard, France.
    Banegas, José R.
    Universidad Autónoma de Madrid, Spain ; CIBERESP, Spain.
    Rodriguez-Artalejo, Fernando
    Universidad Autónoma de Madrid, Spain ; CIBERESP, Spain.
    Low Rates of Both Lipid-Lowering Therapy Use and Achievement of Low-Density Lipoprotein Cholesterol Targets in Individuals at High-Risk for Cardiovascular Disease across Europe2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 2, article id e0115270Article in journal (Refereed)
    Abstract [en]

    Aims To analyse the treatment and control of dyslipidaemia in patients at high and very high cardiovascular risk being treated for the primary prevention of cardiovascular disease (CVD) in Europe. Methods and Results Data were assessed from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336), which included a randomly sampled population of primary CVD prevention patients from 12 European countries (n = 7641). Patients' 10-year risk of CVD-related mortality was calculated using the Systematic Coronary Risk Evaluation (SCORE) algorithm, identifying 5019 patients at high cardiovascular risk (SCORE >= 5% and/or receiving lipid-lowering therapy), and 2970 patients at very high cardiovascular risk (SCORE >= 10% or with diabetes mellitus). Among high-risk individuals, 65.3% were receiving lipid-lowering therapy, and 61.3% of treated patients had uncontrolled low-density lipoprotein cholesterol (LDL-C) levels (>= 2.5 mmol/L). For very-high-risk patients (uncontrolled LDL-C levels defined as >= 1.8 mmol/L) these figures were 49.5% and 82.9%, respectively. Excess 10-year risk of CVD-related mortality (according to SCORE) attributable to lack of control of dyslipidaemia was estimated to be 0.72% and 1.61% among high-risk and very-high-risk patients, respectively. Among high-risk individuals with uncontrolled LDL-C levels, only 8.7% were receiving a high-intensity statin (atorvastatin >= 40 mg/day or rosuvastatin >= 20 mg/day). Among very-high-risk patients, this figure was 8.4%. Conclusions There is a considerable opportunity for improvement in rates of lipid-lowering therapy use and achievement of lipid-level targets in high-risk and very-high-risk patients being treated for primary CVD prevention in Europe.

  • 213.
    Hallberg, Julia
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Håkansson, Linnéa
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    TREDJE GRADENS BRÄNNSKADOR I SJÄLEN: En litteraturstudie om kvinnors upplevelser av att leva med Borderline Personlighetsstörning.2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Personer med Borderline Personlighetsstörning (BPS) ses ofta inom sjukvården och är starkt förknippade med hög dödlighet. Återkommande egenskaper i denna patientgrupps liv är instabilitet, impulsivitet, en växlande självbild samt bristande relationer. Tidigare forskning visar att allmänsjuksköterskor besitter bristfälliga kunskaper om borderlinepatienter och deras upplevelser av att leva med BPS.

    Syfte: Studiens syfte är att belysa hur kvinnor med Borderline Personlighetsstörning (BPS) upplever sin livsvärld, för att genom livsvärlden delge allmänsjuksköterskor bättre verktyg för att möta och vårda denna patientgrupp på bästa sätt.

    Metod: Studien genomförs utifrån en kvalitativ ansats, med utgångspunkt från hermeneutiken. Fyra självbiografier analyseras med hjälp av Lundman och Hällgren-Graneheims (2008) kvalitativa innehållsanalys.

    Resultat: Upplevelsen av Borderline Personlighetsstörning beskrivs i studiens resultat genom fyra huvudkategorier: uppväxtens betydelse, behovet av relationer, ett svårthanterligt känsloliv samt synen på sig själv.

    Slutsatser: Ett livsvärldsperspektiv är nödvändigt att ha med sig som allmänsjuksköterska, för att förstå, vårda och möta borderlinepatienter på bästa möjliga sätt. Utifrån livsvärlden kan patientens sanna upplevelse av vad som bidrar till lidande respektive välbefinnande nås. Genom att kartlägga ett mönster av vad som bidrar till lidande respektive välbefinnande kan vårdpersonal vägleda patienterna till ett tillfrisknande samt till en mer hanterbar vardag.

  • 214.
    Hambraeus, Kristina
    et al.
    Uppsala Univ / Falun Cent Hosp.
    Held, Claes
    Uppsala Univ.
    Johansson, Per
    Sahlgrens Univ Hosp.
    Svennberg, Lars
    Gävle Cent Hosp.
    Cider, Åsa
    Gothenburg Univ, Sahlgrenska Acad.
    James, Stefan
    Uppsala Univ.
    Lagerqvist, Bo
    Uppsala Univ.
    Friberg, Örjan
    Univ Örebro.
    Nilsson, Johan
    Lund Univ / Skåne Univ Hosp / Umeå Univ.
    From Attebring, Mona
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Harnek, Jan
    Lund Univ.
    Jernberg, Tomas
    Karolinska Inst.
    SWEDEHEART Annual Report 20122014In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 48, p. 1-129Article in journal (Refereed)
    Abstract [en]

    The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) supports continuous monitoring and improvement of care for coronary artery disease, catheter-based and surgical coronary interventions, secondary prevention as well as catheter based and surgical valve intervention, by providing extensive data on base-line, diagnostic, procedural and outcome variables. Design. This national quality registry collects information from all Swedish hospitals treating patients with acute coronary artery disease and all patients undergoing coronary angiography, catheter-based interventions or heart surgery. Combination with other national mandatory official registries enables complete follow-up of all individuals regarding myocardial infarction, new interventional procedures, death and all-cause hospitalizations. The registry is governed by an independent steering committee and funded by the Swedish National Health care provider. The software is developed by Uppsala Clinical Research Center. Results. The SWEDEHEART Quality Index reflects overall quality of care for coronary artery disease including secondary prevention. In comparison with 2011, an improvement of the index occurred in 2012 overall. There was however, still a wide range in performance between individual centers, emphasizing the need for continuous monitoring of quality of care at a national as well as on a center level.

  • 215.
    Hansson, Jennie
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Påverkar polariserande solglasögon avståndsbedömningen?2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Denna undersökning utreder om polariserande Suncovers skulle kunna påverka djupseendet.

    Metod: Mätningarna genomfördes på tre meters avstånd med en modifierad variant av Frisby Davis Distance Stereotest och med jämförande mätningar mellan bruna Suncovers från Polaroid, gråa Suncovers från Polaroid och utan solskydd. Undersökningarna gjordes på 36 frivilliga försökspersoner som alla hade samsyn och inte mer visusskillnad mellan ögonen än 0,1 med en synskärpa över 0,9 Snellen-visus.

    Resultat: Utan solglasögon var medelvärdet på stereoseendet för försökspersonerna 16,0´´ ± 10,7´´. Med polariserande Suncovers blev det en försämring, denna försämring var 2,8´´ med gråa Suncovers (p = 0,08) och 5,4´´ med bruna Suncovers (p = 0,02).

    Slutsats: Med de bruna Suncovers fanns en signifikant försämring i jämförelse med utan Suncovers även om skillnaden var liten. Att det är en större påverkan med bruna Suncovers än med gråa kan möjligtvis bero på att de bruna till skillnad mot de gråa absorberar våglängderna ojämnt över det synliga spektrumet.

  • 216.
    Hansson, Sofie
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Kontrastseende i samband med åldrande2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att mäta en patients synskärpa ses idag som standard. Men att även mäta en persons kontrastseende och därmed kvaliteten på dennes syn är däremot inte lika vanligt.

    Syfte: Syftet med denna studie var att undersöka om kontrastseendet hos människor med friska ögon förändras med stigande ålder.

    Metod: Två åldersgrupper jämfördes, en från 10 till 30 år med en mellan 50 och 70 år. I resultatet ingick totalt 49 personer. Kontrastseendet mättes i 100, 10 samt 5 % kontrast med ETDRS-tavlor och kontrastkänsligheten mättes upp med The Mars Letter Contrast Sensitivity Test.

    Resultat: Mätningar med ETDRS-testet visade skillnad grupperna emellan endast då tavla i 5 % kontrast användes. Med ett medelvärde på 0.05 logMAR enheter blev skillnaden drygt två bokstäver sämre för den äldre gruppen. Med ”Mars testet” blev skillnaden 0.08 logCS enheter, vilket på denna motsvarar två bokstäver. Standardavvikelserna för testerna var höga och överlappande.

    Slutsats: Kontrastseendet för människor med friska ögon visar ett klart sämre resultat för en äldre grupp i jämförelse med en yngre. Detta lägre resultat erhölls vid användande av tavla med 5 % kontrast samt i kontrastkänslighet med ”Mars testet”. Standardavvikelserna var höga, vilket tyder på hur viktigt det är att se varje patient som unik och inte dra slutsatser om dennes syn innan mätningar av kontrastseendet gjorts.

  • 217.
    Harris, Michael
    et al.
    University of Bath, UK.
    Frey, Peter
    Universität Bern, Switzerland.
    Esteva, Magdalena
    Majorca Primary Health Care Department, Spain;Instituto de Investigación sanitaria Illes Balears (idISBA), Spain.
    Gašparović Babić, Svjetlana
    University of Rijeka, Croatia.
    Marzo-Castillejo, Mercè
    Institut Català de la Salut, Spain.
    Petek, Davorina
    University of Ljubljana, Slovenia.
    Petek Ster, Marija
    University of Ljubljana, Slovenia.
    Thulesius, Hans
    Lund University, Sweden.
    How the probability of presentation to a primary care clinician correlates with cancer survival rates: a European survey using vignettes.2017In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: European cancer survival rates vary widely. System factors, including whether or not primary care physicians (PCPs) are gatekeepers, may account for some of these differences. This study explores where patients who may have cancer are likely to present for medical care in different European countries, and how probability of presentation to a primary care clinician correlates with cancer survival rates.

    DESIGN: Seventy-eight PCPs in a range of European countries assessed four vignettes representing patients who might have cancer, and consensus groups agreed how likely those patients were to present to different clinicians in their own countries. These data were compared with national cancer survival rates.

    SETTING: A total of 14 countries.

    SUBJECTS: Consensus groups of PCPs.

    MAIN OUTCOME MEASURES: Probability of initial presentation to a PCP for four clinical vignettes.

    RESULTS: There was no significant correlation between overall national 1-year relative cancer survival rates and the probability of initial presentation to a PCP (r  = -0.16, 95% CI -0.39 to 0.08). Within that there was large variation depending on the type of cancer, with a significantly poorer lung cancer survival in countries where patients were more likely to initially consult a PCP (lung r = -0.57, 95% CI -0.83 to -0.12; ovary: r = -0.13, 95% CI -0.57 to 0.38; breast r = 0.14, 95% CI -0.36 to 0.58; bowel: r = 0.20, 95% CI -0.31 to 0.62).

    CONCLUSIONS: There were wide variations in the degree of gatekeeping between countries, with no simple binary model as to whether or not a country has a "PCP-as-gatekeeper" system. While there was case-by-case variation, there was no overall evidence of a link between a higher probability of initial consultation with a PCP and poorer cancer survival. KEY POINTS European cancer survival rates vary widely, and health system factors may account for some of these differences. The data from 14 European countries show a wide variation in the probability of initial presentation to a PCP. The degree to which PCPs act as gatekeepers varies considerably from country to country. There is no overall evidence of a link between a higher probability of initial presentation to a PCP and poorer cancer survival.

  • 218.
    Harris, Michael
    et al.
    University of Bath, UK;University of Bern, Switzerland.
    Vedsted, Peter
    Aarhus University, Denmark.
    Esteva, Magdalena
    Balearic Islands Health Research Institute (IdISBa), Spain.
    Murchie, Peter
    University of Aberdeen, UK.
    Aubin-Auger, Isabelle
    Université Paris Diderot, France.
    Azuri, Joseph
    Tel Aviv University, Israel.
    Brekke, Mette
    University of Oslo, Norway.
    Buczkowski, Krzysztof
    Nicolaus Copernicus University, Poland.
    Buono, Nicola
    National Society of Medical Education in General Practice (SNaMID), Italy.
    Costiug, Emiliana
    Iuliu Hatieganu University of Medicine and Pharmacy, Romania.
    Dinant, Geert-Jan
    Maastricht University, Netherlands.
    Foreva, Gergana
    Medical Center BROD, Plovdiv, Bulgaria.
    Gašparović Babić, Svjetlana
    The Teaching Institute of Public Health of Primorsko-goranska County, Croatia.
    Hoffman, Robert
    Tel Aviv University, Israel.
    Jakob, Eva
    Centro de Saúde Sarria, Spain.
    Koskela, Tuomas H
    University of Tampere, Finland.
    Marzo-Castillejo, Mercè
    Institut Catala De La Salut, Spain.
    Neves, Ana Luísa
    Imperial College London, UK;University of Porto, Porto, Portugal.
    Petek, Davorina
    University of Ljubljana, Slovenia.
    Petek Ster, Marija
    University of Ljubljana, Slovenia.
    Sawicka-Powierza, Jolanta
    Medical University of Bialystok, Poland.
    Schneider, Antonius
    Technische Universität München, Germany.
    Smyrnakis, Emmanouil
    Aristotle University of Thessaloniki, Greece.
    Streit, Sven
    University of Bern, Switzerland.
    Thulesius, Hans
    Lund University, Sweden.
    Weltermann, Birgitta
    University of Bonn, Germany.
    Taylor, Gordon
    University of Bath, UK.
    Identifying important health system factors that influence primary care practitioners' referrals for cancer suspicion: a European cross-sectional survey.2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 9, p. 1-13, article id e022904Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Cancer survival and stage of disease at diagnosis and treatment vary widely across Europe. These differences may be partly due to variations in access to investigations and specialists. However, evidence to explain how different national health systems influence primary care practitioners' (PCPs') referral decisions is lacking.This study analyses health system factors potentially influencing PCPs' referral decision-making when consulting with patients who may have cancer, and how these vary between European countries.

    DESIGN: Based on a content-validity consensus, a list of 45 items relating to a PCP's decisions to refer patients with potential cancer symptoms for further investigation was reduced to 20 items. An online questionnaire with the 20 items was answered by PCPs on a five-point Likert scale, indicating how much each item affected their own decision-making in patients that could have cancer. An exploratory factor analysis identified the factors underlying PCPs' referral decision-making.

    SETTING: A primary care study; 25 participating centres in 20 European countries.

    PARTICIPANTS: 1830 PCPs completed the survey. The median response rate for participating centres was 20.7%.

    OUTCOME MEASURES: The factors derived from items related to PCPs' referral decision-making. Mean factor scores were produced for each country, allowing comparisons.

    RESULTS: Factor analysis identified five underlying factors: PCPs' ability to refer; degree of direct patient access to secondary care; PCPs' perceptions of being under pressure; expectations of PCPs' role; and extent to which PCPs believe that quality comes before cost in their health systems. These accounted for 47.4% of the observed variance between individual responses.

    CONCLUSIONS: Five healthcare system factors influencing PCPs' referral decision-making in 20 European countries were identified. The factors varied considerably between European countries. Knowledge of these factors could assist development of health service policies to produce better cancer outcomes, and inform future research to compare national cancer diagnostic pathways and outcomes.

  • 219.
    Hasan, Badrul
    et al.
    Uppsala Univ.
    Melhus, Åsa
    Uppsala Univ.
    Sandegren, Linus
    Uppsala Univ.
    Alam, Munirul
    Int Ctr Diarrhoeal Dis Res, Bangladesh.
    Olsen, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Biology and Environmental Science. Uppsala Univ.
    The Gull (Chroicocephalus brunnicephalus) as an Environmental Bioindicator and Reservoir for Antibiotic Resistance on the Coastlines of the Bay of Bengal2014In: Microbial Drug Resistance, ISSN 1076-6294, E-ISSN 1931-8448, Vol. 20, no 5, p. 466-471Article in journal (Refereed)
    Abstract [en]

    The presence and frequency of multiresistant bacteria in wild birds act as indicators of the environmental contamination of antibiotic resistance. To explore the rate of contamination mediated by Escherichia coli, 150 fecal samples from the brown-headed gull (Chroicocephalus brunnicephalus) and 8 water samples from the Bay of Bengal area were collected, cultured, and tested for antibiotic susceptibility. Special attention was paid to extended-spectrum beta-lactamase (ESBL)-producing isolates, which were further characterized genetically. Antibiotic resistance was found in 42.3% (36/85) of the E. coli isolates and multidrug resistance in 11.8%. Isolates from the area with a higher human activity were more resistant than those from an area with a lower level of activity. Most frequent was resistance to ampicillin (29.4%), followed by trimethoprim-sulfamethoxazole (24.7%) and quinolones (22.4%). Carriage of ESBL-producing E. coli was relatively high (17.3%) in the gulls, whereas no ESBL producers were found in the water. All ESBL-producing E. coli isolates, but one, carried bla(CTX-M-15) or bla(CTX-M-15)-like genes. A bla(CTX-M-14)-like enzyme was found as an exception. Gulls from two different colonies shared E. coli clones and harbored the clinically relevant sequence types ST10, ST48, and ST131. The high frequency of antibiotic resistance and ESBL production among E. coli isolates from gulls indicates that the environmental contamination of antibiotic resistance has already gone far on the coastlines of the Bay of Bengal. Considering the limited control over the antibiotic consumption and waste from human activities in Bangladesh, there is no easy solution in sight.

  • 220.
    Hattini, Ahmed
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    En litteraturstudie om de senaste behandlingsalternativen för keratoconus.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att hitta de senaste behandlingsmodaliteterna som finns tillgängliga för behandling av keratoconus genom att genomföra en litteraturstudie.

    Metod: En enkel sökfråga för keratoconusbehandling gjordes i databasen av National Library of Medicine Website (pubmed.gov). Olika filter användes för att få resultat inom de senaste 5 åren. De var uppdelade enligt ämnet för varje artikel i tre kategorier: Icke-kirurgisk hantering, kirurgisk hantering och strategier för hantering och protokoll av keratoconus.

    Resultat: Totalt 459 artiklar erhölls. Av alla dessa valdes 18 ut för den nuvarande studie. Fyra artiklar var i den icke kirurgisk kategori, 12 artiklar i kirurgisk kategori, medan två var i kategorin om strategier för hantering och protokoll av keratoconus. Icke-kirurgiska modaliteter för behandling av mild till måttlig keratoconus har fortfarande stor inverkan, särskillt med tillkomsten av nya hybridlinser. Kirurgisk behandling av avancerade fall av keratoconus ger fortfarande bra resultat. Utvecklingen av hanteringsprotokollet och hanteringsstrategier har nått nya fronter baserade på de olika behandlingsalternativen som finns tillgänliga idag.

    Slutsats: En genomgripande förbättring kan ses vid behandling av keratoconus de senaste åren, tack vare nya tekniker och utveckling av gamla. Optiker tillsammans med ögonläkare har sin roll i att förbättra livskvaliteten hos keratoconus patienter.

  • 221.
    Haug Johansson, Trude
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    "Två decennier med amningsvänliga sjukhus - upplever mammorna stöd vid amningen på BB?"2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

     

    Sometimes breastfeeding initiating can be hard. Some mothers get a good start others need more support. Baby Friendly Hospital Initiative (BFHI) and “ten steps to successful breastfeeding” were meant to encourage breastfeeding at maternity hospital through measures like education of midwifes in supporting the mothers. The aim of this study was to describe mother’s feelings for breastfeeding and their experience of support from nursing staff and fathers during the stay on BB and to compare with a group of mothers from 1993. The method was a quantitative cross-sectional study. A survey study was accomplished among mothers in a birth-Clinique in Sweden. Participating mothers was 91 in 1993 and 16 in 2010. Statistical Package for the Social Science (SPSS) was used to processing data. The result showed that mothers experienced a greater feeling of uncertainty and anxiety in 2010 compared with 1993. The majority of mothers 2010 also felt that breastfeeding was something they “had to learn”. Mothers experienced that fathers were more supportive in 2010 than 1993. Initiative to the first breastfeeding was in most of the cases in 2010 taken by a midwife and a higher share of the mothers 2010 got help from the nursing staff at breastfeeding time. The conclusion is that breastfeeding might be a sensitive period to the mothers and that support was needed. BFHI has had a positive effect on the work in supporting mother’s breastfeed in the maternity hospital, but there are still needs of following-up and controls of the activity. The fathers took in 2010 more responsibility and are more supporting to the mothers compared with 1993.

  • 222.
    Haziri, Donjeta
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Holmin, Elisabet
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Doulastöd - kvinnor berättar varför: En kvalitativ intervjustudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 223.
    Hedberg, Berith
    et al.
    Jönköping University;Region Jönköpings län.
    Malm, Dan
    Jönköping University;Ryhov County Hospital.
    Karlsson, Jan-Erik
    Jönköping University;Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Broström, Anders
    Jönköping University;Linköping University.
    Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 5, p. 446-455Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making.

    AIM: The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms.

    METHODS: A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale-Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data.

    RESULTS: Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication.

    CONCLUSION: Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.

  • 224.
    Hedberg, Karin
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ejdhall, Charlotte
    Intensivvårdspatienters upplevelse av den tid de vårdats i ventilator2012Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
  • 225.
    Hedenstierna, Isabella
    University of Kalmar, School of Pure and Applied Natural Sciences.
    En undersökning av myopiförekomst i fyra städer i Nicaragua och jämförelse med studier från andra delar av världen2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka myopiförekomsten i fyra städer i Nicaragua för att sedan jämföra resultatet med studier om myopiförekomst från andra delar av världen. Om resultatet skiljer mellan de olika studierna så skall dessa skillnader försöka förklaras.

    Metod & material: Undersökningarna utfördes i fyra olika städer i Nicaragua av tre optikerstudenter och en legitimerad optiker. Försökspersonerna, som var mellan 6 och 95 år, fick själva uppsöka undersökningsplatserna efter det att olika organisationer spridit information om var och när undersökningarna skulle ske. En testtavla med Snellen E sattes upp på 5 meters avstånd och försökspersonerna refraktionerades binokulärt med provbåge och provglas. Sedan jämfördes resultatet med andra studier om myopiförekomst.

    Resultat: Av de 1178 personerna som undersöktes så hade 73 stycken en myopi på minst -0,50 D vilket motsvarar en myopiförekomst på 6,20% hos försökspersonerna. Av de myopa försökspersonerna var 48 stycken kvinnor och 25 stycken var män. Högst myopiförekomst var det i åldersgruppen 65 år och äldre där närmare 21% var myopa. Då man jämförde myopiförekomsten i Nicaragua med andra studier fann man att den var lägre i Nicaragua jämfört med alla studier förutom två. De två studierna med lägre myopiförekomst undersökte barn mellan 5-15 år och var utförda i Nepal och Sydafrika. Störst skillnad var det mellan Nicaragua och en studie med studenter mellan 15 och 19 år från Singapore medan det var minst skillnad mellan resultatet från Nicaragua och det från en studie utförd i Ecuador med försökspersoner mellan 18 och 45 år.

    Slutsats: Myopiförekomsten i den undersökta gruppen i Nicaragua var betydligt lägre än de flesta studier resultatet jämfördes med. Orsaken till detta kan vara skillnader i hur mycket närarbete försökspersonerna utför samt genetiska faktorer då myopi kan ärvas vilket ökar myopiförekomsten i vissa delar av världen.

  • 226.
    Hedström, Annelie
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Prevalensen av presbyopi i Nicaragua2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte - Syftet med denna studie var att ta reda på hur prevalensen av presbyopi ser ut i Nicaragua under en resa med den ideella organisationen Vision For All.

    Metod och material - För att få svar på frågeställningen utfördes en studie i Nicaragua där additionsbehovet och ackommodationsvidden undersöktes. Behovet av addition undersöktes hos alla som hade besvär på nära håll med hjälp av provbåge och provglaslåda. För att ta reda på ackommodationsvidden användes en linjal med en bild innehållande små detaljer och fina linjer. Linjalen fördes närmare patienten tills denne upplevde att bilden ej längre var tydlig.

    Resultat - De flesta som undersöktes var inom åldersgruppen 41-60 år. Den addition som ordinerades mest frekvent var +2,50 till +2,75 dioptrier. Det var även många under 40 år som fick läsglasögon på grund av problem med synen på nära håll.

    Diskussion - Jämfört med andra länder, som till exempel USA och Sverige, blir invånarna i Nicaragua presbyopa vid en lägre ålder. Den troligaste anledningen till detta är klimatet. Det har upptäckts att i länder närmare ekvatorn som har ett varmare klimat förändras strukturen av linsens proteiner snabbare. Detta leder till minskad ackommodationsvidd och en tidigare presbyopidebut.

  • 227.
    Heikkilä, Kristiina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Sarvimäki, Anneli
    Ekman, Sirkka-Liisa
    Culturally congruent care for older people: Finnish care in Sweden2007In: Scandinavian Journal of Caring Science, Vol. 21, p. 354-361Article in journal (Refereed)
    Abstract [en]

    An increasing number of older people belong to minority and immigrant groups. This calls for new models on the subject of how to provide culturally adjusted care for these populations. The aim of this study is to describe how culturally congruency is used in care for older Finnish immigrants in order to promote their well-being. The study was conducted with an ethnographic design, based on participant observations and interviews among residents, staff and visitors in the Finnish Home in Sweden. In the core of the cultural congruency is the use of the Finnish language, and the fact that both residents and staff have Finnish backgrounds. In addition to this, Finnish customs and celebrations, popular culture and topics of discussion, are actively used in order to create a common ground for communication and shared understanding of the individual person. Cultural congruency, based on the residents' mother language, shared athnic background with staff, and shared customs creates a common ground for communication and an understanding. This enables caring relationships, which, in turn, increases the residents' well-being.

  • 228. Hellström, M
    et al.
    Hellström, L
    Perk, Joep
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Resting heart rate: a cardiovascular risk predictor for healthy middle aged men.2012In: EuroPrevent, Dublin 2012, 2012Conference paper (Refereed)
  • 229.
    Henrysson, Ida
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus Univ, Dept Med & Optometry, Bergen, Norway..
    Theagarayan, Baskar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Binocular Vision, Reading Ability and Associated Symptoms in School Children2015In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 56, no 7, p. 530-Article in journal (Other academic)
    Abstract [en]

    Purpose: The purpose of this study was to investigate relationship between binocular vision, reading ability and any associated symptoms in School Children.

    Methods: The study was conducted in a School in western Sweden. A sample of 54 Children aged between 10 and 12 years were invited to participate in this study. A consent form and a letter with information was sent to their parents. Children with at least 20/25 and N6 visual acuity and good Stereopsis were included. After receiving consent forms, 27 Children participated in all the measurements. Amplitude of accommodation was measured using push-up method both monocularly and binocularly. Accommodative facility was measured using ± 2.00 D flippers at 40 cm both monocularly and binocularly. Near point of convergence was measured using a Royal Air Force (RAF) ruler and both break and recovery points were documented. All the Children performed a group of reading ability tests to detect whether they have any reading difficulties. A questionnaire called "The College of Optometrists in Vision Development Quality of Life (COVD-QOL)" was filled by their parents together with their Children. A score of 20 or more is considered as symptomatic.

    Results: Mean amplitude of accommodation was OD 10.8 ± 4.0 D, OS 11.8 ± 4.1 D and OU 14.2 ± 3.7 D. Amplitude of accommodation was low in terms of Hofstetter's formula. Based on age, 59% of the Children were below expected value. The accommodative facility was lower than expected, with mean values of OD 5.5 ± 4.0 cpm, OS 5.5 ± 4.0 cpm and OU 5.0 ± 3.5 cpm. Mean near point of convergence was 6.0 ± 5.4 cm for break and 6.6 ± 5.9 cm for recovery. In the reading ability tests all the Children had normal values. Three Children received ≥ 20 points on the symptom questionnaire COVD-QOL, which is considered to be high. All of these three Children had values below normal limits for the amplitude of accommodation and/or the accommodative facility. Regression analysis showed no significant correlation between binocular vision tests, reading ability and symptom score (r < 0.6; p > 0.05).

    Conclusions: Amplitude of accommodation and accommodative facility was lower than expected values for their age. Near point of convergence values reached the expected normal level. There was no significant correlation between binocular vision tests, reading ability and associated symptoms in this sample of Swedish Children.

  • 230.
    Herlitz, Johan
    et al.
    University of Borås, Sweden;Sahlgrenska University Hospital, Sweden.
    Bång, Angela
    University of Borås, Sweden.
    Wireklint-Sundström, Birgitta
    University of Borås, Sweden.
    Axelsson, Christer
    University of Borås, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Hagiwara, Magnus
    University of Borås, Sweden.
    Jonsson, Anders
    University of Borås, Sweden.
    Lundberg, Lars
    University of Borås, Sweden.
    Suserud, Björn-Ove
    University of Borås, Sweden.
    Ljungström, Lars
    Skövde Central Hospital, Sweden.
    Suspicion and treatment of severe sepsis: An overview of the prehospital chain of care2012In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 20, no 42Article in journal (Refereed)
    Abstract [en]

    Background

    Sepsis is a life-threatening condition where the risk of death has been reported to be even higher than that associated with the major complications of atherosclerosis, i.e. myocardial infarction and stroke. In all three conditions, early treatment could limit organ dysfunction and thereby improve the prognosis.

    Aim

    To describe what has been published in the literature a/ with regard to the association between delay until start of treatment and outcome in sepsis with the emphasis on the pre-hospital phase and b/ to present published data and the opportunity to improve various links in the pre-hospital chain of care in sepsis.

    Methods

    A literature search was performed on the PubMed, Embase (Ovid SP) and Cochrane Library databases.

    Results

    In overall terms, we found a small number of articles (n=12 of 1,162 unique hits) which addressed the prehospital phase. For each hour of delay until the start of antibiotics, the prognosis appeared to become worse. However, there was no evidence that prehospital treatment improved the prognosis.Studies indicated that about half of the patients with severe sepsis used the emergency medical service (EMS) for transport to hospital. Patients who used the EMS experienced a shorter delay to treatment with antibiotics and the start of early goal-directed therapy (EGDT). Among EMS-transported patients, those in whom the EMS staff already suspected sepsis at the scene had a shorter delay to treatment with antibiotics and the start of EGDT.There are insufficient data on other links in the prehospital chain of care, i.e. patients, bystanders and dispatchers.

    Conclusion

    Severe sepsis is a life-threatening condition. Previous studies suggest that, with every hour of delay until the start of antibiotics, the prognosis deteriorates. About half of the patients use the EMS. We need to know more about the present situation with regard to the different links in the prehospital chain of care in sepsis.

  • 231.
    Herlitz, Johan
    et al.
    University of Borås, Sweden;Västra Götalandsregionen, Sweden.
    Ravn-Fischer, Annica
    Sahlgrenska universitetssjukhuset, Sweden.
    Svensson, Leif
    Karolinska institutetet, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Bång, Angela
    University of Borås, Sweden.
    Circulation: Bröstsmärtor2016In: Prehospital Akutsjukvård, Liber, 2016, 2, p. 308-321Chapter in book (Other academic)
  • 232.
    Hermansson, Stina
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Synskärpa för personbilsförare2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka om personbilsförare uppfyller de visuskrav som finns för att inneha körkort i Sverige.

    Bakgrund: I Sverige måste alla som ansöker om körkortstillstånd genomgå en visus- och synfältskontroll. Denna kontroll görs vanligen i 16 årsålder, då det är tillåtet att börja övningsköra. Efter denna undersökning finns ingen obligatorisk kontroll av vare sig visus eller synfält om man har behörighet AM, A1, A, B, BE och traktorkort. Detta är något anmärkningsvärt eftersom andelen äldre i Sverige ökar och med stigande ålder blir ögonåkommor och ögonsjukdomar mer frekventa. Även refraktionsstatusen förändras under årens lopp.

    Metod: Genom en visus-screening undersöktes 100 personer med minst behörighet B. Innan visuskontroll fick samtliga deltagare fylla i en enkät om 6 stycken frågor om sig själva, sin syn och sitt körkort.

    Resultat: Samtliga deltagare klarade visusgränsen för B-behörighet. Även de med högre behörighet klarade sin gräns.

    Slutsats: Samtliga deltagare i studien klarade överraskande men positivt kravet vad det gäller visus för körkort i Sverige. Dock krävs en större och mer omfattande studie för att kunna fastställa detta resultat.

  • 233.
    Hernandez-Moreno, Laura
    et al.
    University of Minho Braga, Portugal.
    Moreno Perdomo, Natacha
    Hospital Santa Maria Maior E.P.E-Barcelos, Portugal.
    Aleman, Tomas S.
    University of Pennsylvania, USA.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. University of Minho Braga, Portugal.
    Absent Foveal Pit, Also Known as Fovea Plana, in a Child without Associated Ocular or Systemic Findings2018In: Case Reports in Ophthalmological Medicine, ISSN 2090-6722, E-ISSN 2090-6730, p. 1-5, article id 2146826Article in journal (Refereed)
    Abstract [en]

    The purpose of this report is to describe a case of bilateral foveal hypoplasia in the absence of other ophthalmological or systemic manifestations. We characterize the case of a 9-year-old Caucasian male who underwent full ophthalmologic examination, including functional measures of vision and structural measurements of the eye. Best corrected visual acuity was 0.50 logMAR in the right eye and 0.40 logMAR in the left eye. Ophthalmoscopy revealed a lack of foveal reflex that was further investigated. Optical coherence tomography (OCT) confirmed the absence of foveal depression (pit). OCT images demonstrated the abnormal structure of retina in a region in which we expected a fovea; these findings were decisive to determine the cause of reduced acuity in the child.

  • 234.
    Hernández-Moreno, Laura
    et al.
    University of Minho, Portugal.
    Massof, Robert W.
    Johns Hopkins Wilmer Eye Institute, USA.
    Sousa, Sofia
    University of Minho, Portugal.
    Cima, Joana
    Nova University of Lisbon, Portugal.
    Costa, J.P.M.
    University of Minho, Portugal.
    Monteiro, Joel
    Centro Hospitalar do Alto Ave, Portugal.
    Baptista, Antonio M. G.
    University of Minho, Portugal.
    Moreno, Natacha
    Hospital Santa Maria Maior de Barcelos, Portugal.
    Santana, Rui
    Nova University of Lisbon, Portugal.
    Macedo, António Filipe
    University of Minho, Portugal.
    The Portuguese version of the activity inventory2015In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 56, no 7, article id 1368Article in journal (Refereed)
    Abstract [en]

    Purpose: To characterize interventions needed by the population with visual impairment or to assess interventions in vision rehabilitation validated and standardized instruments used in different cultural contexts are necessary. The aim of this work was to characterize the functional status of a sample of people with visual impairment with the Portuguese version of the activity inventory (AI)

    Methods: A group of participants in the study Prevalence and Costs of Visual Impairment in Portugal (PC-VIP) was recruit to face-to-face interviews and the activity inventory was administered. The AI examines 50 goals split between three objectives: social functioning, recreation and daily living. Goals rated ‘not important’ were skipped, but for all other goals the participant was asked to rate its difficulty on a five point scale ranging from ‘not difficult’ to ‘impossible without help’. The difficulty responses were Rasch analysed (Winsteps v3.81.0) to produce a continuous measure of visual ability (AI score). Additional information about distance and near visual acuity (ETDRS scale), contrast sensitivity (MARS test) and critical print size (MNREAD test) was collected.

    Results: A total of 94 persons participated in this study. Some participants were not able to read or recognize letters due to their poor vision or poor literacy and were excluded from further analysis. Data reported here are from 62 participants, median age 63y (range=12-85) and the most common cause of visual impairment were retinal diseases. Mean presenting acuity in the better eye was 0.93logMAR (SD=0.5). The mean difficulty (item measure) in the AI was -0.33 logits (SD=0.96). The most difficult items were "sew or do needlework", "read the newspaper", "drive" and the easiest items were "provide care for a pet", "eat your meals", "use the restroom in a public place". The mean ability score (person measures) was 1.11 logits (SD=2.04). The ability measures in the AI were correlated with distance visual acuity (r=-0.57, p<.001), near visual acuity (r=-0.66, p<0.001), contrast sensitivity (r=0.62, p<.001) and critical print size (r=-0.60, p<.001).

    Conclusions: Our results indicate that the AI scores in a sample of people Portuguese people with visual impairment were in line with what has been found in other cultural contexts. The visual ability measured by the AI was correlated with visual function assessed by different visual tests, which shows that this instrument can be used with confidence.

  • 235.
    Higginbottom, Gina
    et al.
    University of Alberta, Canada.
    Safipour, Jalal
    University of Alberta, Canada.
    Mumtaz, Zubia
    University of Alberta, Canada.
    Chiu, Yvonne
    Multicultural Health Brokers Co-operative, Canada.
    Paton, Patricia
    Alberta Health Services, Canada.
    Pillay, Jennifer
    University of Alberta, Canada.
    “I have to do what I believe”: Sudanese women’s beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada2013In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 13, no 51Article in journal (Refereed)
    Abstract [en]

    Background: Evidence suggests that immigrant women having different ethnocultural backgrounds than thosedominant in the host country have difficulty during their access to and reception of maternity care services, butlittle knowledge exists on how factors such as ethnic group and cultural beliefs intersect and influence health careaccess and outcomes. Amongst immigrant populations in Canada, refugee women are one of the most vulnerablegroups and pregnant women with immediate needs for health care services may be at higher risk of healthproblems. This paper describes findings from the qualitative dimension of a mixed-methodological study.

    Methods: A focused ethnographic approach was conducted in 2010 with Sudanese women living in an urban Canadian city. Focus group interviews were conducted to map out the experiences of these women in maternitycare, particularly with respect to the challenges faced when attempting to use health care services.

    Results: Twelve women (mean age 36.6 yrs) having experience using maternity services in Canada within the past two years participated. The findings revealed that there are many beliefs that impact upon behaviours andperceptions during the perinatal period. Traditionally, the women mostly avoid anything that they believe couldharm themselves or their babies. Pregnancy and delivery were strongly believed to be natural events without needfor special attention or intervention. Furthermore, the sub-Saharan culture supports the dominance of the family bymales and the ideology of patriarchy. Pregnancy and birth are events reflecting a certain empowerment forwomen, and the women tend to exert control in ways that may or may not be respected by their husbands.Individual choices are often made to foster self and outward-perceptions of managing one’s affairs with strength.

    Conclusion: In today’s multicultural society there is a strong need to avert misunderstandings, and perhaps harm,through facilitating cultural awareness and competency of care rather than misinterpretations of resistance to care.

  • 236.
    Hiltunen, Linda
    Linnaeus University, Faculty of Social Sciences, Department of Social Studies.
    Psykisk ohälsa i skolan2015In: När livet känns fel: Ungas upplevelser kring psykisk ohälsa / [ed] Tiina Ekman, Stockholm: Myndigheten för ungdoms- och civilsamhällesfrågor , 2015, , p. 263p. 218-239Chapter in book (Other academic)
  • 237.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Berntorp, Kerstin
    Department of Endocrinology, Malmö University hospital, Lund University.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University hospital, Lund university.
    Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 9-10, p. 1374-1386Article in journal (Refereed)
    Abstract [en]

    Aims.  Exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. Further , to study the influence of beliefs on self-care and care seeking. Design: Exploratory descriptive study. Methods.  Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied. Results.  Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting. Conclusions.  Health/illness beliefs differed and affected self-care and care seeking. Relevance to clinical practice.  Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.

  • 238.
    Hofflander, Beatrice
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    En litteraturstudie om hur kvinnor med diabetes typ 1 upplevde sin sjukdom under graviditet2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes Mellitus typ 1 är en autoimmun sjukdom som innebär att kroppens eget immunförsvar förstör insulinproduktionen. Graviditet är en stressituation för kroppen, vilket leder till ökad förbränning och därmed ökat energibehov.

    Syfte: Syftet med studien var att belysa diabetes typ 1 sjuka kvinnors upplevelser av sin sjukdom i samband med graviditet.

    Metod: En kvalitativ litteraturstudie baserad på sju vetenskapliga originalartiklar gjordes. Artiklarna kvalitetsgranskades och de artiklar som inkluderades var av hög och medelhög kvalitet. Därefter gjordes analys av materialet med innehållsanalys.

    Resultat: I resultatet framkom två huvudkategorier; Påverkan av sammanhang och Mötet med vårdpersonal.

    Slutsats: Det är viktigt att kvinnor med Diabetes Mellitus typ 1 får den kunskap som krävs för att kunna hantera sin graviditet. Kvinnorna upplever dock en kunskapsbrist hos vårdgivarna, både när det rör sig om sjukdomen, men även när det gäller hur graviditeten kan påverka sjukdomen.

  • 239.
    Hollenberg, Jacob
    et al.
    Södersjukhuset ; Karolinska institutet.
    Engdahl, Johan
    Hallands sjukhus.
    Axelsson, Åsa B.
    University of Gothenburg.
    Bremer, Anders
    University of Borås.
    Hjärtstopp2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Leif Svensson, Liber, 2009, 1, p. 295-304Chapter in book (Other academic)
  • 240.
    Holm, Maja
    et al.
    Karolinska Institutet ; Ersta Sköndal Bräcke University College.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Carlander, Ida
    Ersta Sköndal Bräcke University College ; Karolinska Institutet.
    Wengström, Yvonne
    Karolinska Institutet ; Örebro University.
    Ohlen, Joakim
    Ersta Sköndal Bräcke University College ; University of Gothenburg.
    Alvariza, Anette
    Karolinska Institutet ; Ersta Sköndal Bräcke University College ; Dalen Hosp, Stockholm.
    Characteristics of the Family Caregivers Who Did Not Benefit From a Successful Psychoeducational Group Intervention During Palliative Cancer Care A Prospective Correlational Study2017In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 40, no 1, p. 76-83Article in journal (Refereed)
    Abstract [en]

    Background: Although there has been a steady increase in intervention studies aimed toward supporting family caregivers in palliative cancer care, they often report modest effect sizes and there is a lack of knowledge about possible barriers to intervention effectiveness. Objective: The aim of this study is to explore the characteristics of family caregivers who did not benefit from a successful psychoeducational group intervention compared with the characteristics of those who did. Intervention/Methods: A psychoeducational intervention for family caregivers was delivered at 10 palliative settings in Sweden. Questionnaires were used to collect data at baseline and following the intervention. The Preparedness for Caregiving Scale was the main outcome for the study and was used to decide whether or not the family caregiver had benefited from the intervention (Preparedness for Caregiving Scale difference score <= 0 vs >= 1). Results: A total of 82 family caregivers completed the intervention and follow-up. Caregivers who did not benefit from the intervention had significantly higher ratings of their preparedness and competence for caregiving and their health at baseline compared with the group who benefited. They also experienced lower levels of environmental burden and a trend toward fewer symptoms of depression. Conclusions: Family caregivers who did not benefit from the intervention tended to be less vulnerable at baseline. Hence, the potential to improve their ratings was smaller than for the group who did benefit. Implications for Practice: Determining family caregivers in cancer and palliative care who are more likely to benefit from an intervention needs to be explored further in research.

  • 241.
    Holmberg, Mats
    et al.
    Sörmland County Council, Sweden;Mälardalen University, Sweden;University of Borås, Sweden.
    Andersson, Henrik
    University of Borås, Sweden.
    Winge, Karin
    South Älvsborgs Hospital, Sweden.
    Lundberg, Camilla
    South Älvsborgs Hospital, Sweden.
    Karlsson, Thomas
    University of Gothenburg, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Wireklint Sundström, Birgitta
    University of Borås, Sweden.
    Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome2018In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 18, p. 1-10, article id 216Article in journal (Refereed)
    Abstract [en]

    Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development of potentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) are important. The aim of this study has therefore been to explore the possible association between patients' estimated intensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcome before and after arrival in hospital. 

    Methods: Data was collected both prospectively and retrospectively. The inclusion criteria were chest pain raising suspicion of ACS and a reported intensity of pain 4 on the visual analogue scale. 

    Results: All in all, 1603 patients were included in the study. Increased intensity of chest pain was related to: 1) more heart-related complications before hospital admission; 2) a higher proportion of heart failure, anxiety and chest pain after hospital admission; 3) a higher proportion of acute myocardial infarction and 4) a prolonged hospitalisation. However, there was no significant association with mortality neither in 30 days nor in three years. Adjustment for possible confounders including age, a history of smoking and heart failure showed similar results. 

    Conclusion: The estimated intensity of chest pain reported by the patients on admission by the ambulance team was associated with the risk of complications prior to hospital admission, heart failure, anxiety and chest pain after hospital admission, the final diagnosis and the number of days in hospital.

  • 242.
    Holmgren, Christina M.
    et al.
    University of Gothenburg, Sweden;County Hospital Ryhov, Sweden.
    Abdon, Nils J.
    Hudiksvall Hospital, Sweden.
    Bergfeldt, Lennart B.
    University of Gothenburg, Sweden.
    Edvardsson, Nils G.
    University of Gothenburg, Sweden.
    Herlitz, Johan D.
    University of Borås, Sweden;Sahlgrenska University Hospital, Sweden.
    Karlsson, Thomas
    University of Gothenburg, Sweden.
    Svensson, Leif G.
    Karolinska Institutet, Sweden.
    Åstrand, Bengt
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Changes in Medication Preceding Out-of-hospital Cardiac Arrest Where Resuscitation Was Attempted2014In: Journal of Cardiovascular Pharmacology, ISSN 0160-2446, E-ISSN 1533-4023, Vol. 63, no 6, p. 497-503Article in journal (Refereed)
    Abstract [en]

    Objective: To describe recent changes in medication preceding out-of-hospital cardiac arrest (OHCA) where resuscitation was attempted. Methods: OHCA victims were identified by the Swedish Cardiac Arrest Register and linked by means of their unique 10-digit personal identification numbers to the Prescribed Drug Register. We identified new claimed prescriptions during a 6-month period before the OHCA compared with those claimed in the period 12 to 18 months before. The 7-digit Anatomical Therapeutical Chemical codes of individual drugs were used. The study period was November 2007-January 2011. Results: OHCA victims with drugs were (1) older than those who did not claim any drugs in any period (70 +/- 16 years vs. 54 +/- 22 years, P < 0.001), (2) more often women (34% vs. 20%, P < 0.001), and (3) had more often a presumed cardiac etiology (67% vs. 54%, P < 0.001). The OHCA victims were less likely to have ventricular tachycardia/ventricular fibrillation as the first recorded ;rhythm (26% vs. 33%, P < 0.001) or to survive 1 month (9% vs. 17%, P < 0.0001). New prescriptions were claimed by 5122 (71%) of 7243 OHCA victims. The most frequently claimed new drugs were paracetamol (acetaminophen) 10.3%, furosemide 7.8%, and omeprazole 7.6%. Of drugs known or supposed to cause QT prolongation, ciprofloxacin was the most frequent (3.4%) altogether; 16% had a new claimed prescription of a drug included in the "qtdrugs.org" lists. Conclusions: Most OHCA victims had new drugs prescribed within 6 months before the event but most often intended for diseases other than cardiac. No claims can be made as to the causality.

  • 243.
    Hovstadius, Bo
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hellström, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Trends in Inappropriate Drug Therapy Prescription in the Elderly in Sweden from 2006 to 2013: Assessment Using National Indicators2014In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 31, no 5, p. 379-386Article in journal (Refereed)
    Abstract [en]

    Background Medication for elderly patients is often complex and problematic. Several criteria for classifying inappropriate prescribing exist. In 2010, the Swedish National Board of Health and Welfare published the document "Indicators of appropriate drug therapy in the elderly" as a guideline for improving prescribing for the elderly. Objective The aim of this study was to assess trends in the prescription of inappropriate drug therapy in the elderly in Sweden from 2006 to 2013 using national quality indicators for drug treatment. Methods Individual-based data on dispensed prescription drugs for the entire Swedish population aged >= 65 years during eight 3-month periods from 2006 to 2013 were accumulated. The data were extracted from the Swedish Prescribed Drug Register. Eight drug-specific quality indicators were monitored. Results For the entire population studied (n = 1,828,283 in 2013), six of the eight indicators showed an improvement according to the guidelines; the remaining two indicators (drugs with anticholinergic effects and excessive polypharmacy) remained relatively unchanged. For the subgroup aged 65-74 years, three indicators showed an improvement, four indicators remained relatively unchanged (e.g. propiomazine, and oxazepam) and one showed an undesirable trend (anticholinergic drugs) according to guidelines. For the older group (aged >= 75 years), all indicators except excessive polypharmacy showed improvement. Conclusion According to the quality indicators used, the extent of inappropriate drug therapy in the elderly decreased from 2006 to 2013 in Sweden. Thus, prescribers appear to be more likely to change their prescribing patterns for the elderly than previously assumed.

  • 244.
    Huang, Shan
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Sandholm, Kerstin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Jonsson, Nina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Nilsson, Anders
    Gambro Lundia AB.
    Wieslander, Anders
    Gambro Lundia AB.
    Grundström, Gunilla
    Gambro Lundia AB.
    Hancock, Viktoria
    Gambro Lundia AB.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Low concentrations of citrate reduce complement and granulocyte activation in vitro in human blood2015In: Clinical Kidney Journal, ISSN 2048-8505, E-ISSN 2048-8513, Vol. 8, no 1, p. 31-37Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:The use of acetate in haemodialysis fluids may induce negative effects in patients including nausea and increased inflammation. Therefore, haemodialysis fluids where acetate is substituted with citrate have recently been developed. In this study, we investigated the biocompatibility of citrate employing concentrations used in haemodialysis.

    METHODS:The effects of citrate and acetate were investigated in human whole blood in vitro under conditions promoting biomaterial-induced activation. Complement activation was measured as generation of C3a, C5a and the sC5b-9 complex, and granulocyte activation as up-regulation of CD11b expression. For the experimental set-up, a mathematical model was created to calculate the concentrations of acetate and citrate attained during haemodialysis.

    RESULTS:Citrate reduced granulocyte activation and did not induce higher complement activation compared with acetate at concentrations attained during haemodialysis. Investigating different citrate concentrations clearly showed that citrate is a potent complement inhibitor already at low concentrations, i.e. 0.25 mM, which is comparable with concentrations detected in the blood of patients during dialysis with citrate-containing fluids. Increased citrate concentration up to 6 mM further reduced the activation of C3a, C5a and sC5b-9, as well as the expression of CD11b.

    CONCLUSIONS:Our results suggest that citrate is a promising substitute for acetate for a more biocompatible dialysis, most likely resulting in less adverse effects for the patients.

  • 245.
    Huang, Yanyan
    et al.
    Memorial University of Newfoundland, Canada.
    Wille, Michelle
    Memorial University of Newfoundland, Canada.
    Benkaroun, Jessica
    Memorial University of Newfoundland, Canada.
    Munro, Hannah
    Memorial University of Newfoundland, Canada.
    Bond, Alexander L.
    Memorial University of Newfoundland, Canada.
    Fifield, David A.
    Newfoundland and Labrador Department of Natural Resources, Canada.
    Robertson, Gregory J.
    Environment Canada, Canada.
    Ojkic, Davor
    University of Guelph, Canada.
    Whitney, Hugh
    Newfoundland and Labrador Department of Natural Resources, Canada.
    Lang, Andrew S.
    Memorial University of Newfoundland, Canada.
    Perpetuation and reassortment of gull influenza A viruses in Atlantic North America2014In: Virology, ISSN 0042-6822, E-ISSN 1096-0341, Vol. 456-457, p. 353-363Article in journal (Refereed)
    Abstract [en]

    Gulls are important hosts of avian influenza A viruses (AIVs) and gull AIVs often contain gene segments of mixed geographic and host lineage origins. In this study, the prevalence of AIV in gulls of Newfoundland, Canada from 2008 to 2011 was analyzed. Overall prevalence was low (30/1645, 1.8%) but there was a distinct peak of infection in the fall. AIV seroprevalence was high in Newfoundland gulls, with 50% of sampled gulls showing evidence of previous infection. Sequences of 16 gull AIVs were determined and analyzed to shed light on the transmission, reassortment and persistence dynamics of gull AIVs in Atlantic North America. Intercontinental and waterfowl lineage reassortment was prevalent. Of particular note were a wholly Eurasian AIV and another with an intercontinental reassortant waterfowl lineage virus. These patterns of geographic and inter-host group transmission highlight the importance of characterization of gull AIVs as part of attempts to understand global AIV dynamics.

  • 246.
    Hultqvist, Emelie
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Förändringen av lipidskiktets tjocklek i tårfilmen mellan förmiddag och eftermiddag2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Symptom vid torra ögon kan vara en känsla av torrhet, irritation, okomfort, främmande kropps känsla och ökad produktion av tårar. Torrhetskänslan varierar under dagen men är mest påtaglig framåt kvällen. 3 av 4 som upplever symptom för torra ögon har ett tunnare lipidskikt. Diagnostisering av normala, måttligt torra och torra ögon kan dels göras med hjälp av en symtomenkät t.ex. TERTC-DEQ.

    Syfte: Att undersöka om lipidskiktet förändras i tjocklek från förmiddag jämfört med eftermiddag under samma dag.

    Metod: I studien deltog 6 män och 21 kvinnor med en medelålder på 23.3 ± 2.1 år. Mätning av lipidskiktet utfördes en gång på förmiddagen och en gång på eftermiddagen under samma dag. Gradering av lipidskiktet utfördes med hjälp av instrumentet Tearscope-plus. Försökspersonerna fick även svara på enkäten TERTC-DEQ.

    Resultat: På förmiddagen hade 55% av försökspersonerna lipidskikt wave pattern typ (3). Medelvärdet av typ på förmiddagen, var 2.7. På eftermiddagen låg lipidskiktet jämnt fördelat över wave pattern typ (3) med 40.7% och closed meshwork typ (2) med 40.7%. Medelvärdet av typ på eftermiddagen, var 2.4. Medelvärdet hade förändrats 0.3 mellan förmiddag och eftermiddag, från ett tjockare till ett tunnare skikt. Vid sammanställning TERTC-DEQ upplevde 74.1% normala ögon och 25.9% måttligt torra ögon.

    Slutsats: Resultatet av studien visar att det sker en förändring av lipidskikts tjockleken från förmiddag jämfört med eftermiddag. Lipidskiktet är tjockare på förmiddagen jämfört med eftermiddagen. Att lipidskiktet förändras kan ha resulterat i att torrhetskänslan i ögonen kan blir mer påtaglig framåt kvällen.

  • 247.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: An interview study with health staff.2012In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, no 5, p. 480-489Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.

  • 248.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 10, p. 891-902Article in journal (Refereed)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes.

    Methods: qualitative and quantitative studies in the area were identified and reviewed. 

    Results: It were indicated that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.

  • 249.
    Håkansson, Krister
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Helkala, E.L.
    University of Eastern Finland, Kuopio.
    Soininen, H.
    University of Eastern Finland, Kuopio.
    Nissinen, A.
    National Institute for Health and Welfare, Helsinki.
    Winblad, B.
    Karolinska Institutet.
    Mohammed, Abdul K. H.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Education, Psychology and Sport Science.
    Kivipelto, M.
    Karolinska Institutet.
    Depressive signs in midlife: A risk factor for cognitive impairment in later life?2010In: International Conference on Alzheimer's Disease (ICAD) 2010, Chicago, USA: Alzheimer's Association , 2010Conference paper (Refereed)
    Abstract [en]

    Background: Although depression has been associated with dementia, the nature of this relation is still unclear. Establishing causality from previous studies has been complicated by the typical use of a short follow-up and participants aged over 70 already at baseline. The main purpose of this study was to evaluate if depressive signs already in midlife are related to cognitive impairment in later life. Methods: Participants were derived from random, population-based samples previously investigated in 1972, 1977, 1982, or 1987. Their mean age at baseline was 50.4 years (SD 6.0). After an average follow-up of 21 years, 1449 individuals (73%) aged 65 to 79 years were re-examined in 1998. At the re-examination some form of cognitive impairment was diagnosed in 139 of the participants: 82 with mild cognitive impairment and 57 with dementia (48 of these with Alzheimer’s disease). Signs of depression were estimated through responses to three questions concerning the perception of a hopeless future, impossible life goals and loneliness. The relation between depressive signs in midlife and cognitive impairment in later life was analyzed with logistic regression with adjustments for age, gender, apolipoprotein e4 status and a number of midlife health and lifestyle indicators, including blood pressure, cholesterol and marital status. Results: Depressive signs in midlife, as measured in this study, were significantly related to general cognitive impairment in later life, but also separately to both mild cognitive impairment and Alzheimer’s disease. When dichotomized into high versus low levels of depressive signs the odds ratios were 2.19 (1.1 to 4.3) for mild cognitive impairment and 3.81 (1.3 to 11.5) for Alzheimer’s disease. Significant associations were also found between the separate measures of hopelessness and loneliness on the one hand and the separate outcomes of mild cognitive impairment and Alzheimer’s disease on the other. Conclusions: The results support a causal relation between depressive signs relatively early in life and cognitive function in later life. Clinical relevance includes the long-term health implications of depressive signs in midlife also for the risk of dementia.

  • 250.
    Håkansson, Krister
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Karolinska institutet.
    Ngandu, Tiia
    National Institute for Health and Welfare, Finland.
    Kivipelto, Miia
    Karolinska Institutet;University of Eastern Finland, Finland.
    The Patient with Cognitive Impairment2018In: Treatable and Potentially Preventable Dementias / [ed] Hachinsky, Vladimir, New York: Cambridge University Press, 2018, p. 52-80Chapter in book (Refereed)
2345678 201 - 250 of 606
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