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  • 601.
    Vellone, Ercole
    et al.
    Tor Vergata University, Rome, Italy.
    Jaarsma, Tiny
    University of Linköping.
    Strömberg, Anna
    University of Linköping.
    Fida, Roberta
    Sapienza University, Italy.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Linköping.
    Rocco, Gennaro
    Center of Excellence for Nursing Scholarship, Italy.
    Cocchieri, Antonello
    Tor Vergata University, Italy.
    Alvaro, Rosaria
    Tor Vergata University, Italy.
    The European Heart Failure Self-care Behaviour Scale: new insights into factorial structure, reliability, precision and scoring procedure.2014In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 94, no 1, p. 97-102, article id S0738-3991(13)00367-4Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate a new factorial structure of the European Heart Failure Self-care Behaviour Scale 9-item version (EHFScBS-9), and to test its reliability, floor and ceiling effect, and precision. To propose a new 0-100 score with a higher score meaning better self-care.

    METHODS: A sample of 1192 Heart Failure (HF) patients (mean age 72 years, 58% male) was enrolled. Psychometric properties of the EHFScBS-9 were tested with confirmative factor analysis, factor score determinacy, determining the floor and ceiling effect, and evaluating the precision with the standard error of measurement (SEM) and the smallest real difference (SRD).

    RESULTS: We identified three well-fitting factors: consulting behaviour, autonomy-based adherence, and provider-based adherence (comparative fit index=0.96). Reliability ranged from 0.77 to 0.95. The EHFScBS-9 showed no floor and ceiling effect except for the provider-based adherence which had an expected ceiling effect. The SEM and the SRD indicated good precision of the EHFScBS-9.

    CONCLUSION: The new factorial structure of the EHFScBS-9 showed supportive psychometric properties.

    PRACTICE IMPLICATIONS: The EHFScBS-9 can be used to compute a total and specific scores for each identified factor. This may allow more detailed assessment and tailored interventions to improve self-care. The new score makes interpretation of the EHFScBS-9 easier.

  • 602.
    Venkataraman, Abinaya Priya
    et al.
    Royal Institute of Technology.
    Lewis, Peter
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Lundström, Linda
    Royal Institute of Technology.
    Optical Correction and Stimulus Motion to Improve Vision in Eccentric Preferred Retinal Locus2016In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 57, no 12, article id Meeting Abstract: 5175Article in journal (Refereed)
  • 603.
    Vilhelmsson, Maria
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Mortensen, Moa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Operationssjuksköterskans upplevelse av oväntade händelser på operationssalen: En kvalitativ intervjustudie.2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: The operating room is a high-tech and risky environment, where the patient is often in a vulnerable position. The operation nurse’s profession includes providing safe care to the patient which means, among other things, doing risk analyzes and working actively to prevent patient injuries. Although there are tools to ensure patient safety, such as the WHO Safe Surgery Checklist, unexpected events can occur. Unexpected events can involve arised errors and complications which can jeopardize the patient's safety.

    Aim: To investigate the operation theater nurse's experience of unexpected events in the operating room.

    Method: The study was a qualitative interview study conducted with semi-structured questions. A total of eight operating theater nurse’s were interviewed at two hospitals in southern Sweden. The interviews were analyzed with qualitative content analysis

    Result: Following the analysis three themes emerged that described how operating theatre nurses’ experienced unexpected events in the operating room; Feeling confident in oneself and others. The experience of preserving and losing control and Emotional aspects of unexpected events. How well-functioning the team is and the degree of professional experience are perceived to be key factors the influence how to handle an unexpected event. Mixed feelings such as inadequacy and stimulation in the profession emerged. 

    Conclusion: Operating theatre nurses generally feel secure when unexpected events occur. The study shows both positive and negative experiences in connection with an unexpected event. 

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  • 604.
    Von Wangenheim, Burkard
    et al.
    Kalmar county hospital, Sweden.
    Israelsson, Johan
    Kalmar county hospital, Sweden.
    Lindstaedt, Michael
    Kalmar county hospital, Sweden.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.
    Halvautomatiska hjärtstartare tolkar inte alltid rätt: fem patienter defibrillerades trots icke-defibrillerbar rytm2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 32-33, p. 1-4Article in journal (Refereed)
    Abstract [sv]

    Halvautomatiska defibrillatorer är en viktig del i kampen mot plötslig hjärtdöd. 

    Höga krav på sensitivitet och specificitet vid rytmtolkning ska säkerställa effektivt och säkert bruk. 

    Vi rapporterar fem fall där brister i specificitet hos defibrillatorn ledde till defibrillering av icke-defibrillerbara rytmer.

    Systematisk undersökning av halvautomatiska defibrillatorers prestationsförmåga vid rytmtolkning är nödvändig och skulle kunna bidra till utveckling av förbättrade analysalgoritmer och utbildningsprogram.

  • 605.
    Vumma, Ravi
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Johansson, Jessica
    Örebro University.
    Venizelos, Nikolaos
    Örebro University.
    Proinflammatory cytokines and oxidative stress decrease the transport of dopamine precursor tyrosine in human fibroblasts2017In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 75, no 4, p. 178-184Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Proinflammatory cytokines and oxidative stress responses have been extensively implicated in the pathophysiology of neuropsychiatric disorders over the past 2 decades. Moreover, disturbed transport of the dopamine precursor (i.e., the amino acid tyrosine) has been demonstrated, in different studies, across fibroblast cell membranes obtained from neuropsychiatric patients. However, the role and influences of proinflammatory cytokines and oxidative stress, and the reasons for disturbed tyrosine transport in neuropsychiatric disorders, are still not evaluated.

    AIMS: The present study aimed to assess the role of proinflammatory cytokines and oxidative stress, indicated in many neuropsychiatric disorders, in tyrosine transportation, by using human skin-derived fibroblasts.

    METHODS: Fibroblasts obtained from a healthy control were used in this study. Fibroblasts were treated with proinflammatory cytokines (IL-1β, IFN-γ, IL-6, TNF-α), their combinations, and oxidative stress, optimized for concentrations and incubation time, to analyze the uptake of 14C-tyrosine compared to untreated controls.

    RESULTS AND CONCLUSION: This study demonstrates that proinflammatory cytokines and oxidative stress decrease the transport of tyrosine (47% and 33%, respectively), which can alter dopamine synthesis. The functionality of the tyrosine transporter could be a new potential biomarker to target for discovering new drugs to counteract the effects of proinflammatory cytokines and oxidative stress in the pathophysiology of neuropsychiatric disorders.

  • 606.
    Vågenäs, Olivia
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Trepca, Ibadete
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Unga vuxnas upplevelser av att leva med diabetes typ 1.: En litteraturstudie.2014Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes typ 1 är en av de vanligaste folksjukdomarna i Sverige och drabbar många unga vuxna. Diabetes typ 1 innebär att kroppen har brist på insulin och behandlingen av sjukdomen är alltid insulin. För den drabbade krävs ansvar för att kunna hantera sjukdomen så optimalt som möjligt. Unga vuxna upplever ofta att egenvården vid diabetes typ 1 ger begränsningar i det vardagligalivet. Därför är det viktigt att som vårdpersonal ge stöd till dessa unga vuxna.                                                                                                               

    Syfte: Belysa unga vuxnas upplevelser av att leva med diabetes typ 1.                                                                                                         

    Metod: En litteraturstudie av tio kvalitativa artiklar som analyserats i enlighet med en kvalitativ innehållsanalys.                                                                                              

    Resultat: I studiens resultat framkommer det tydligt att unga vuxna som lever med diabetes typ 1 upplever diabetessjukdomen som en begränsning i livet. Diabetes typ 1 kan även leda till känslor av oro och osäkerhet. Resultatet belyser även att stödet från vården är betydelsefullt för unga vuxna med diabetes typ 1. Unga vuxna önskar mer emotionellt och individuellt stöd, både från vården och utanför vården. Personer med diabetes typ 1 kan genom kunskap, ansvar och stöd från andra hantera sjukdomen så optimalt som möjligt.                                                                                                                 

    Slutsatser: Resultatet i studien visar på att diabetes typ 1 ger begränsningar i livet för den unga vuxna.  Det framkom också att vården har en central roll i att stödja den unga vuxna individen som lever med diabetes typ 1. Genom kunskap, eget ansvar och professionellt stöd kan den unga vuxna individen hantera diabetessjukdomen på bästa sätt. Även från andra som lever med sjukdomen kan betydelsefullt stöd fås.

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    Diabetes typ 1
  • 607.
    Wahlgren, Ida
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rökningens betydelse för uppkomst och utveckling av åldersrelaterad makuladegeneration2010Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Åldersrelaterad makuladegeneration (AMD) är den vanligaste orsaken till allvarlig synnedsättning hos den äldre delen av befolkningen i Europa, och övriga högutvecklade delar av världen. Sjukdomen finns i två olika former, en torr och en våt. De främsta riskfaktorerna för sjukdomen är åldern och hereditet, och dessa faktorer kan man inte påverka själv. Påverkbara riskfaktorer som diskuterats är bl.a. rökning, högt blodtryck, övervikt, kostsammansättning och exponering av UV-ljus. Av dessa faktorer är rökning den riskfaktor som är starkast sammankopplad med sjukdomen.

    Syfte: Studiens syfte är att med hjälp av litteratur ta reda på hur sambandet mellan rökning och AMD ser ut. Det som undersökts i de vetenskapliga studierna och som tas upp i det här arbetet är hur mycket risken att drabbas av AMD ökar för en rökare jämfört med en icke-rökare, samt om det hjälper att sluta röka för att minska denna risk.

    Metod: Arbetet har gjorts i form av en litteraturstudie. Vetenskapliga artiklar har sökts via sökmotorerna PubMed, Web of science och Google Scholar.

    Resultat: 9 artiklar som presenterar resultatet från studier som gjorts på relationen mellan rökning och AMD har valts ut och presenteras i detta arbete.

    Slutsats: Flertalet av studierna pekar på att det finns ett samband mellan rökning och AMD.  Risken ökar med antalet cigaretter som rökts under livstiden. Den ökade risken för AMD verkar finnas kvar upp till 20 år efter att en rökare slutat röka. Detta är en anledning för en person som röker att sluta röka redan vid tidig ålder.

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    FULLTEXT01
  • 608.
    Wai, Hay Mar
    et al.
    Karolinska Institutet, Sweden.
    Middelveld, Roelinde
    Karolinska Institutet, Sweden.
    Thörnqvist, Victoria
    Karolinska Institutet, Sweden.
    Ballardini, Natalia
    Karolinska Institutet, Sweden;Södersjukhuset, Sweden.
    Nilsson, Evalill
    Linköping University, Sweden.
    Strömquist, Jennie
    Linköping University, Sweden.
    Nilsson, Lennart
    Linköping University, Sweden.
    Ahlstedt, Staffan
    Karolinska Institutet, Sweden.
    Protjuder, Jennifer
    Karolinska Institutet, Sweden;University of Manitoba, Canada;George and Fay Yee Centre for Healthcare Innovation, Canada;The Children's Hospital Research Institute of Manitoba, Canada.
    Pediatric food allergy-related household costs are influenced by age, but not disease severity2019In: World Allergy Organization Journal, ISSN 1731-3317, E-ISSN 1939-4551, Vol. 12, no 9, p. 1-7, article id 100061Article in journal (Refereed)
    Abstract [en]

    Objective

    The economic burden of food allergy on households is poorly understood. We evaluated the household costs associated with specialist-diagnosed pediatric food allergy, with focus on age and disease severity.

    Study design

    A cross-sectional study of 70 Swedish case-control pairs (59% boys) was conducted using Food Allergy Economic questionnaire. Household costs were analyzed between age- and gender-matched cases (children aged 0–17 years, with specialist-diagnosed food allergy) and controls (non-food allergic households).

    Results

    Parents were predominantly university-educated and employed full-time. Most cases had parent-reported previous anaphylaxis. Mean total annual household costs were comparable between cases and controls. However, compared to controls, cases had significantly higher direct medical-, and non-medical related costs; higher indirect medical-related costs, and higher intangible costs (all p < 0.05). In a sensitivity analyses of only cases aged 0–12 years, direct household costs, including lost earnings due to child's hospitalization, were significantly higher than controls. Results from only children with severe disease paralleled those of all cases vs. controls.

    Conclusions

    Although pediatric food allergy is not associated with higher total annual household costs, these households have significantly higher direct medical-related, indirect and intangible costs vs. non-food allergic households. Higher household costs were identified amongst younger children, but not disease severity.

  • 609.
    Waldréus, Nana
    et al.
    Karolinska Institutet, Sweden.
    Jaarsma, Tiny
    Linköping University, Sweden;Australian Catholic University, Sweden.
    Ivarsson, Bodil
    Lund University, Sweden;Skåne University Hospital, Sweden;Region Skåne, Sweden.
    Strömberg, Anna
    Linköping University, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Kjellström, Barbro
    Karolinska Institutet, Sweden;Karolinska University Hospital, Sweden.
    Development and validation of a questionnaire to measure patient's experiences of health care in pulmonary arterial hypertension outpatient clinics2019In: Heart, Lung and Circulation, ISSN 1443-9506, E-ISSN 1444-2892, Vol. 28, no 7, p. 1074-1081Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Measuring the patients' experience of care at an outpatient clinic can provide feedback about the quality of health care and if needed, can be support for quality improvements. To date, there is no patient reported experience measurement (PREM) developed targeting patients at the pulmonary arterial hypertension (PAH) outpatient clinics. Therefore, the aim was to develop and evaluate the psychometric properties of a PREM scale to be used for patients at PAH-outpatient clinics.

    METHODS: The development and psychometric evaluation of the PREM for patients at PAH outpatient clinics followed two stages: (I) development of the PAH Clinic PREM (PAHC-PREM) scale based on interviews with patients; and (II) psychometric evaluation of the PAHC-PREM scale including data quality, factor structure (construct validity), criterion validity and internal consistency.

    RESULTS: A sample of 156 patients at PAH outpatient clinics completed the PAHC-PREM scale (median age 69 years, 57% women). Unidimensionality of the PAHC-PREM scale was supported by parallel analysis. A single factor explained 67% of the variance. Inter-item and item-total correlations were satisfactory (0.46-0.88 and 0.64-0.91, respectively). Internal consistency reliability with ordinal coefficient alpha was good (0.93).

    CONCLUSIONS: The PAHC-PREM scale was demonstrated to have good psychometric properties and is now ready to be used to measure quality of health care experience from patients at PAH-outpatient clinics.

  • 610. Walfridsson, Ulla
    et al.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Linköpings universitet.
    Strömberg, Anna
    Development and validation of a new Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) with focus on symptom burden.2012In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 10, p. Article ID: 44-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Arrhythmias can appear with a variety of symptoms, all from vague to pronounced and handicapping symptoms. Therefore, patient-reported outcomes (PROs) concerning symptom burden are important to assess and take into consideration in the care and treatment of patients with arrhythmias. The main purpose was to develop and validate a disease-specific questionnaire evaluating symptom burden in patients with different forms of arrhythmias.

    METHODS: A literature review was conducted and arrhythmia patients were interviewed. Identified symptoms were evaluated by an expert panel consisting of cardiologists and nurses working daily with arrhythmia patients. SF-36 and Symptoms Checklist (SCL) were used in the validation of the new questionnaire Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA). Homogeneity was evaluated with Spearman's correlations and Cronbach's alpha coefficient (α) was used to evaluate internal consistency. Construct validity was evaluated using item-total correlations and convergent and discriminant validity. For this, Spearman's correlations were calculated between the ASTA symptom scale, SCL and SF-36. Concurrent validity was validated by Spearman's correlations between the ASTA symptom scale and SCL.

    RESULTS: The correlations between the different items in the ASTA symptom scale showed generally sufficient homogeneity. Cronbach's coefficient was found to be satisfactory (α = 0.80; lower bound 95% CI for α = 0.76). Construct validity was supported by item-total correlations where all items in the symptom scale were sufficiently correlated (≥0.3). Convergent and discriminant validity was supported by the higher correlations to the arrhythmia-specific SCL compared to the generic SF-36. Concurrent validity was evaluated and there were sufficiently, but not extremely strong correlations found between the ASTA symptom scale and SCL.

    CONCLUSIONS: The nine items of the ASTA symptom scale were found to have good psychometric properties in patients with different forms of arrhythmias. Arrhythmia patients suffer from both frequent and disabling symptoms. The validated ASTA questionnaire can be an important contribution to PROs regarding symptom burden in arrhythmia patients.

  • 611.
    Wall, R.
    et al.
    Örebro University.
    Marques, T.
    Örebro University.
    Edebol-Carlman, H.
    Örebro University.
    Sundin, J.
    University of Gothenburg.
    Vumma, Ravi
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Rangel, I.
    Örebro University.
    Brummer, R.
    Örebro University.
    Altered expression of membrane transporters in colonic mucosa of patients with Irritable Bowel Syndrome (IBS) and Post-infectious (PI)-IBS compared to healthy subjects2017In: Neurogastroenterology and Motility, ISSN 1350-1925, E-ISSN 1365-2982, Vol. 29, no Supplement 2, p. 107-108, article id 219Article in journal (Other academic)
  • 612.
    Wanby, Pär
    Kalmar County Hospital, Sweden.
    On certain genetic and metabolic risk factors for carotid stenosis and stroke2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The present study evaluated genetic and metabolic factors influencing the risk of acute cerebrovascular disease (CVD) and internal carotid artery stenosis (ICA stenosis) in a Swedish community. The threonine (T) containing protein of the FABP2 A54T gene polymorphism has a greater affinity for long chain fatty acids (FFAs) than the alanine (A) containing protein. This altered affinity for FFAs has been shown to affect the intestinal absorption of fatty acids and consequently the fatty acid composition of serum lipids, in particularly postprandially. Endothelium derived NO is a potent vasodilator and antiatherogenic agent. Asymmetric dimethyl arginine (ADMA) is an endogenous competitive inhibitor of endothelial nitric oxide synthase (eNOS). ADMA has been shown to be involved in the pathogenesis of atherosclerotic disease, and ADMA inhibits eNOS by displacement of L-arginine from the enzyme, which in turn is believed to affect the amount of NO available within the endothelium.

    The FABP2 A54T gene polymorphism was analyzed in 407 patients with acute CVD and also in a subset of these patients whose carotids had been evaluated with ultrasound. Both the FABP2 polymorphism and a common polymorphism of the eNOS gene, Glu298Asp, were analyzed in a different population consisting of 54 matched pairs of patients with ICA stenosis and controls. ADMA levels were measured in both study populations.

    We found that the T54 allele was more frequent in patients with transient ischaemic attacks (TIA), and that the TT genotype was more prevalent in young, non-smoking patients with CVD than in controls.

    Increased concentrations of ADMA were observed in cardio-embolic infarction and TIA, but not significantly in non-cardio-embolic infarction nor in haemorrhagic stroke. In multivariate logistic regression models, CVD increased across quartiles of ADMA in all subgroups, but this association was only significant in the TIA group. A decreased arginine/ADMA ratio, a measure of NO availability was associated with CVD in the entire study population. Patients with severe carotid stenosis had significantly higher ADMA levels than the controls. Allele and genotype frequencies of the FABP2 and eNOS polymorphisms did not differ between patients with ICA stenosis and controls.

    Our results indicate that ADMA is a strong marker for TIA and severe ICA stenosis, and that relative defiency of arginine, measured as L-arginine/ADMA, is present in acute CVD.

    We also conclude that a common polymorphism of the FABP2 gene increases susceptibility to ischaemic stroke and TIA.

  • 613.
    Wanby, Pär
    et al.
    Kalmar County Hospital, Sweden.
    Berglund, J.
    University Hospital of Linköping, Sweden.
    Brudin, L.
    Kalmar County Hospital, Sweden.
    Hedberg, D.
    Kalmar County Hospital, Sweden.
    Carlsson, Martin
    Kalmar County Hospital, Sweden.
    Increased ferritin levels in patients with anorexia nervosa: impact of weight gain.2016In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 21, no 3, p. 411-417Article in journal (Refereed)
    Abstract [en]

    PURPOSE: A few recent studies have found elevated ferritin levels in patients with anorexia nervosa (AN), indicating ferritin as a potential biomarker of disease severity. The purpose of this study was to study how body mass index (BMI) and changes in BMI affect plasma ferritin concentrations in Swedish patients with eating disorders.

    MATERIALS AND METHODS: In a retrospective computer search from 2009 to 2014, 662 patients with an eating disorder were identified from more than 200,000 individuals with electronic medical records. Three hundred and eighty-nine patients (374 females and 15 males) were found to have at least one p-ferritin value with a corresponding BMI value. Patients with AN were compared to a combined group consisting of patients with bulimia nervosa (BN) and patients with an eating disorder not otherwise specified (EDNOS).

    RESULTS: Patients with AN had lower BMI compared to the combined group of patients with other eating disorders (BMI = 16.5 ± 1.5, n = 77 vs. 21.0 ± 4.7, n = 312, p < 0.001). Patients with AN also had higher plasma ferritin levels (median 42 μg/L (range 3.3-310) vs. 31 μg/L (range 2.8-280); p < 0.001). As BMI increased in patients with AN, ferritin levels decreased (from a median of 40 μg/L (7-400) to 26 (4-170), n = 47; p < 0.001).

    DISCUSSION: Measuring ferritin in patients with AN could be valuable in monitoring improvements of nutritional status, but the full clinical value of following ferritin in individual patients has yet to be determined. The study also shows how research can benefit from electronically captured clinical data using electronic health records.

  • 614.
    Wanby, Pär
    et al.
    Kalmar County Hospital, Sweden.
    Nobin, R
    Kalmar County Hospital, Sweden.
    Von, S-P
    Kalmar County Hospital, Sweden.
    Brudin, L
    Kalmar County Hospital, Sweden.
    Carlsson, Martin
    Kalmar County Hospital, Sweden.
    Serum levels of the bone turnover markers dickkopf-1, sclerostin, osteoprotegerin, osteopontin, osteocalcin and 25-hydroxyvitamin D in Swedish geriatric patients aged 75 years or older with a fresh hip fracture and in healthy controls.2016In: Journal of Endocrinological Investigation, ISSN 0391-4097, E-ISSN 1720-8386, Vol. 39, no 8, p. 855-863Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Bone turnover markers have a potential clinical use in describing bone remodeling and in predicting fractures.

    AIMS: In an elderly population ≥75 years with a fresh hip fracture, and in healthy controls, investigate bone turnover markers and their relation to each other, to vitamin D status and to bone mineral density (BMD).

    METHODS: In a cross-sectional study serum levels of dickkopf-1 (DKK-1), sclerostin (SOST), osteoprotegerin (OPG), osteopontin (OPN), osteocalcin, 25-hydroxyvitamin D (25(OH)D) were analyzed in 89 Swedish patients with a fresh hip fracture and in 82 healthy volunteers. Serum levels of bone markers were determined by Luminex technique.

    RESULTS: S-25-hydroxyvitamin D (S-25(OH)D) was decreased in patients compared to controls (48 ± 21 vs. 76 ± 25 nmol/L, p < 0.001). SOST, but none of the other bone turnover markers correlated with BMD (r = 0.50, p < 0.001). Compared with controls, higher levels of OPG (488 ± 1.4 vs. 191 ± 1.4 ng/L, p < 0.001), OPN (69 ± 1.7 vs. 19 ± 1.4 µg/L, p < 0.001), DKK-1 (273 ± 1.7 vs. 168 ± 1.7 ng/L, p < 0.001), and lower levels of osteocalcin (5.8 ± 3.5 vs. 9.5 ± 3.6 µg/L, p < 0.001), were found in the fracture group. Levels of OPG, DKK-1 and SOST in both groups were positively associated. S-25(OH)D concentration was not found to be strongly associated with any of the bone markers.

    CONCLUSIONS: In contrast to findings in other studies, we found no strong correlation between 25(OH)D and the investigated bone markers. Both in patients with a fresh hip fracture and in healthy elderly, DKK-1, SOST and OPG appear to be associated. This suggests a relevance in these relationships meriting further investigation.

  • 615.
    Wanby, Pär
    et al.
    Kalmar County Hospital, Sweden.
    Olsen, Björn
    Kalmar County Hospital, Sweden.
    Myocarditis in a patient with salmonella and campylobacter enteritis.2001In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 33, no 11, p. 860-862Article in journal (Refereed)
    Abstract [en]

    Myocarditis associated with bacterial enteritis has only rarely been described and the pathogenesis is unclear. Herein we report a case where a young adult developed myocarditis during the acute stage of an infection with Salmonella heidelberg and Campylobacter jejunii/coli. The patient's troponin I value was elevated. We suggest that use of cardiac-sensitive troponins may be a useful tool for diagnosis of acute myocarditis in the context of bacterial enteritis. We also suggest the need for further investigation of the pathogenesis of myocarditis associated with enteric pathogens.

  • 616.
    Wells, M.
    et al.
    Univ Stirling, UK.
    Campbell, P.
    Glasgow Caledonian Univ, UK.
    Torrens, C.
    Glasgow Caledonian Univ, UK.
    Charalambous, A.
    Cyprus Univ Technol, Cyprus.
    Sharp, L.
    Regionalt CancerCentrum - Stockholm Gotland.
    Wiseman, T.
    Royal Marsden NHS Fdn Trust, UK;Univ Southampton, UK.
    Östlund, Ulrika
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Patiraki, E.
    Univ Athens, Greece.
    Nohavova, I.
    Charles Univ Prague, Czech Republic.
    Domenech-Climent, N.
    Alicante Univ, Spain.
    Oldenmenger, W.
    Erasmus MC Canc Inst, Netherlands.
    Kelly, D.
    Univ Cardiff, UK.
    Recognising European Cancer Nursing (RECaN): A systematic review of trial evidence that helps to identify the roles and interventions of nurses caring for patients with cancer2017In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 72, p. S4-S4Article in journal (Other academic)
  • 617. Wenner, Jörgen
    et al.
    Nilsson, Gunilla
    Lunds universitet, medicinska fakulteten.
    Öberg, Sven
    Melin, Tor
    Larsson, Sylvia
    Johnsson, Folke
    Short-term outcome after laparoscopic and open 360 degrees fundoplication. A prospective randomized trial.2001In: Surgical Endoscopy, ISSN 0930-2794, E-ISSN 1432-2218, Vol. 15, no 10, p. 1124-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite the lack of randomized trials supporting the laparoscopic approach, laparoscopic antireflux surgery has gained widespread acceptance during the last decade. The aim of this study was to compare the short-term symptomatic and objective outcome after laparoscopic and open 360 degrees fundoplication in a prospective randomized clinical trial. METHODS: Sixty patients with GERD were randomized to undergo either laparoscopic (LF) or open 360 degrees fundoplication (OF). Endoscopy, esophageal manometry, 24-h pH monitoring, clinical symptom evaluation, and symptom scoring according to a validated questionnaire (the Gastrointestinal Symptom Rating Scale [GSRS]) was performed preoperatively and 6 months after surgery. RESULTS: Five patients randomized to the laparoscopic group were converted to open surgery. Esophageal acid exposure was restored to normal in all patients. Lower esophageal sphincter length and resting pressure were significantly increased after both laparoscopic and open fundoplication (p < 0.001); there were no differences between the groups. No significant differences were seen in symptomatic outcome, although there was a trend toward a higher rate of mild dysphagia (p = 0.051) after laparoscopic surgery. GSRS revealed a decrease in reflux score (p < 0.001) and abdominal pain score (p < 0.001) postoperatively. There were no significant differences in GSRS scores between the two groups. CONCLUSION: Laparoscopic 360 degrees fundoplication is as effective in treating reflux disease as open fundoplication. Six months postoperatively, no significant differences were seen in symptomatic or objective outcome. Long-term evaluation is needed.

  • 618. Westerholm, Barbro
    et al.
    Akner, Gunnar
    Örebro University.
    Fastbom, Johan
    Karolinska Institutet.
    Det behövs en nollvision också för säker läkemedelsbehandling2006In: Dagens Medicin, ISSN 1104-7488, p. 21-21Article in journal (Other (popular science, discussion, etc.))
  • 619.
    Wijkman, Magnus
    et al.
    Linköping University, Sweden.
    Carlsson, Martin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Accumbo AB, Sweden.
    Darwiche, Gassan
    Accumbo AB, Sweden;Lund University, Sweden.
    Nyström, Fredrik H.
    Linköping University, Sweden.
    A pilot study of hypertension management using a telemedicine treatment approach2020In: Blood Pressure Monitoring, ISSN 1359-5237, E-ISSN 1473-5725, Vol. 25, no 1, p. 18-21Article in journal (Refereed)
    Abstract [en]

    We recruited 78 men and 94 women to investigate if the proportion of subjects with well-controlled home blood pressure levels could be increased when treatment was guided by smartphone-based telemonitoring. All patients were prescribed one to three antihypertensive drugs. The Accumbo smartphone telemonitoring application was downloaded to the Iphones of the participants and home blood pressure information was gathered from semi-automatic oscillometric blood pressure-recorders by Bluetooth. The study physician adjusted the medications based on home blood pressure for 3 months. home blood pressure was controlled (<135/<85 mmHg) in 55 participants at baseline and in 56 subjects after 3 months (Chi-square P = 0.91). The 117 patients with initially uncontrolled home blood pressure had a drop in home blood pressure (from 138.0 +/- 9.0/91.3 +/- 6.5 mmHg to 133.4 +/- 8.0/88.6 +/- 6.1 mmHg, P < 0.001) and prescribed antihypertensive drugs increased from 1.71 +/- 0.94/day to 2.00 +/- 0.92/day, P < 0.0001. Thus, while the proportion of participants with controlled home blood pressure remained unchanged, the home blood pressure levels were lowered in participants who had uncontrolled home blood pressure at study start.

  • 620. Wijma, Barbro
    et al.
    Thapar-Björkert, Suruchi
    Swahnberg, Katarina
    Linköpings universitet.
    What is an error?2005In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 26, no 4, p. 233-235Article in journal (Other academic)
  • 621.
    Wiklund Gustin, Lena
    et al.
    Nationellt nätverk för specialistsjuksköterskeutbildning i psykiatrisk vård.
    Gabrielsson, Sebastian
    Nationellt nätverk för specialistsjuksköterskeutbildning i psykiatrisk vård.
    Jormfeldt, Henrika
    Psykiatriska riksföreningen för sjuksköterskor, PRF.
    Tuvesson, Hanna
    Psykiatriska riksföreningen för sjuksköterskor, PRF.
    "Psykiatrin behöver mer kompetens - inte bara fler händer"2018In: Dagens Medicin, ISSN 1104-7488, no 2018-03-07Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    För att få en långsiktigt hållbar psykiatrisk vård krävs satsningar som underlättar för sjuksköterskor att specialistutbilda sig, skriver fyra debattörer.

  • 622. Wiklund, S
    et al.
    Norelius, M
    Perk, Joep
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Check-up your hearthealth at the pharmacy2012In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 19, no 1, p. S82-Article in journal (Refereed)
  • 623. Wilde Björling, Camilla
    et al.
    Lagerlund, Magnus
    Östlund, Martin
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Johansson, Pauline
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Axelsson, Clara
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Johnsson, Stefan
    Can patients be better prepared and more satisfied during the course of radiation therapy by using iPad's?2012In: Radiotherapy and Oncology: Vol. 103 Supplement 1, 2012, p. S30-Conference paper (Refereed)
  • 624.
    Wileryd, Sara
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Utvärdering av Lucentisbehandling vid ögonkliniken i Kalmar2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med arbetet var att utvärdera effekten av ett års behandling med Lucentis hos patienter med exsudativ åldersrelaterad makuladegeneration (AMD) på ögonkliniken i Kalmar.

    Metod: Ett brev skickades till de 41 patienter som någon gång under 2008 eller januari 2009 hade fått minst en behandling med Lucentis på ögonkliniken i Kalmar. I brevet tillfrågades patienterna om uppgifter fick hämtas ur deras journaler. Följande data inhämtades från de 33 patienter som godkände detta: kön, ålder, visus (avstånd och nära) före behandlingens början, visus (avstånd och nära) omkring ett år efter första behandlingen samt antal erhållna injektioner. Dessutom efterfrågades den subjektiva upplevelsen av visus via telefonsamtal med patienterna.

    Resultat: Den genomsnittliga synskärpan före behandlingens början och ett år senare var i princip oförändrad både på avstånd och nära håll. Denna utvärdering visar därmed inte någon signifikant förändring av visus efter ett års behandling med Lucentis. Det noterades dock hög standardavvikelse, vilket pekar på stora individuella skillnader mellan patienterna. 65,6% (avstånd) och 59,4% (nära) av patienterna upplever att synskärpan är förbättrad eller den samma efter behandlingen med Lucentis.

    Slutsats: Utvärderingen visar inte någon signifikant förändring av visus efter ett års behandling med Lucentis på ögonkliniken i Kalmar. Eftersom visus hos patienter med AMD sjunker utan behandling, tyder detta på att Lucentisbehandlingen på ögonkliniken i Kalmar har effekt och fördröjer synnedsättningen. Behandlingen på ögonkliniken i Kalmar är dock inte lika effektiv som den har varit i studier med månatliga injektioner eller månatliga återbesök med OCT och visuskontroll inför beslut om ytterligare Lucentisinjektion ska ges.

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  • 625.
    Wilkens, Jens
    et al.
    The National Board of Health and Welfare, Sweden;Lund University, Sweden.
    Thulesius, Hans
    Lund University, Sweden.
    Schmidt, Ingrid
    The National Board of Health and Welfare, Sweden.
    Carlsson, Christina
    The National Board of Health and Welfare, Sweden;Lund university, Sweden.
    The 2015 National Cancer Program in Sweden: Introducing standardized care pathways in a decentralized system.2016In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 120, no 12, p. 1378-1382Article in journal (Refereed)
    Abstract [en]

    Starting in 2015, the Swedish government has initiated a national reform to standardize cancer patient pathways and thereby eventually speed up treatment of cancer. Cancer care in Sweden is characterized by high survival rates and a generally high quality albeit long waiting times. The objective with the new national program to standardize cancer care pathways is to reduce these waiting times, increase patient satisfaction with cancer care and reduce regional inequalities. A new time-point for measuring the start of a care process is introduced called well-founded suspicion, which is individually designed for each cancer diagnosis. While medical guidelines are well established earlier, the standardisation is achieved by defining time boundaries for each step in the process. The cancer reform program is a collaborative effort initiated and incentivized by the central government while multi-professional groups develop the time-bound standardized care pathways, which the regional authorities are responsible for implementing. The broad stakeholder engagement and time-bound guidelines are interesting approaches to study for other countries that need to streamline care processes.

  • 626.
    Wimo, Anders
    et al.
    Karolinska Institutet;Uppsala University;County Council of Gävleborg;HC Bergsjö.
    Elmstål, S.
    Lund University.
    Fratiglioni, L.
    Karolinska Institutet;Stockholm Gerontology Research Center.
    Sjölund, B.-M.
    Karolinska Institutet.
    Sköldunger, A.
    Karolinska Institutet.
    Fagerström, Cecilia
    Blekinge Institute of Technology.
    Berglund, Johan
    Blekinge Institute of Technology.
    Lagergren, M.
    Stockholm Gerontology Research Center.
    Formal and informal care of community-living older people: a population-based study from the Swedish National study on Aging and Care2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 1, p. 17-24Article in journal (Refereed)
    Abstract [en]

    Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC).

    Design: Cross-sectional, population based cohort.

    Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County.

    Participants: 3,338 persons ≥72 years.

    Measurements: Patterns and amounts of informal and formal care by cognition and area of residence.

    Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole.

    Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.

  • 627.
    Winger, Anette
    et al.
    Oslo and Akershus University College of Applied Sciences, Norway.
    Kvarstein, Gunnvald
    UIT The Arctic University of Norway, Norway.
    Wyller, Vegard Bruun
    University of Oslo, Norway;Oslo University Hospital, Norway;Akershus University Hospital, Norway.
    Ekstedt, Mirjam
    KTH Royal Institute of Technology;Oslo University Hospital, Norway.
    Sulheim, Dag
    Oslo University Hospital, Norway;Innlandet Hospital Trust, Norway.
    Fagermoen, Even
    University of Oslo, Norway.
    Smastuen, Milada Cvancarova
    Oslo and Akershus University College of Applied Sciences, Norway.
    Helseth, Solvi
    Oslo and Akershus University College of Applied Sciences, Norway.
    Health related quality of life in adolescents with chronic fatigue syndrome: a cross-sectional study2015In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 13, article id 96Article in journal (Refereed)
    Abstract [en]

    Aim: To study health related quality of life (HRQOL) and depressive symptoms in adolescents with chronic fatigue syndrome (CFS) and to investigate in which domains their HRQOL and depressive symptoms differ from those of healthy adolescents.

    Background and objective: Several symptoms such as disabling fatigue, pain and depressive symptoms affect different life domains of adolescents with CFS. Compared to adolescents with other chronic diseases, young people with CFS are reported to be severely impaired, both physiologically and mentally. Despite this, few have investigated the HRQOL in this group.

    Method: This is a cross-sectional study on HRQOL including 120 adolescents with CFS and 39 healthy controls (HC), between 12 and 18 years. The Pediatric Quality of Life Inventory (TM), 4.0 (PedsQL) was used to assess HRQOL. The Mood and Feelings Questionnaire assessed depressive symptoms. Data were collected between March 2010 and October 2012 as part of the NorCAPITAL project (Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial). Linear and logistic regression models were used in analysis, and all tests were two-sided.

    Results: Adolescents with CFS reported significantly lower overall HRQOL compared to HCs. When controlling for gender differences, CFS patients scored 44 points lower overall HRQOL on a scale from 0-100 compared to HCs. The domains with the largest differences were interference with physical health (B = -59, 95 % CI -54 to -65) and school functioning (B = -52, 95 % CI -45 to -58). Both depressive symptoms and being a patient were independently associated with lower levels of HRQOL

    Conclusion: The difference in HRQOL between CFS patients and healthy adolescents was even larger than we expected. The large sample of adolescents with CFS in our study confirms previous findings from smaller studies, and emphasizes that CFS is a seriously disabling condition that has a strong impact on their HRQOL. Even though depressive symptoms were found in the group of patients, they could not statistically explain the poor HRQOL.

  • 628.
    Wixe, Stina
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Placebo effect on accommodative functions2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 629.
    Wogatai, Ulrika
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Förekomst av hyperopi bland hjälpsökande på en VFA-resa i Bolivia2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka förekomst av hyperopi i förhållande till läskunnighet hos hjälpsökande hos VFA i Bolivia, samt jämföra med studier från andra delar av världen.

    Metod: Studien utfördes i april 2010 på tre olika orter i centrala Bolivia. Patienterna sökte själva upp platsen för att få en undersökning. Subjektiv refraktion utfördes binokulärt, utan dimning, med hjälp av provbåge, provlåda och syntavla med Snellen E, uppsatt på 5 meters avstånd. Hyperopi räknades som sfärisk ekvivalent ≥ +1,00 D, myopi som ≤ –0,25 DS.

    Resultat: 1 313 personer undersöktes, varav 1 271, mellan 6 och 92 år gamla, ingick i studien. Förekomsten av hyperopi var totalt 23,8% (som mest 39,8% hos kvinnor 66-92 år gamla, och som minst 10,7% hos kvinnor 6-19 år gamla), läskunnighet totalt var 81,7% (kvinnor 74,7%, män 90,7%). Det var något lägre läskunnighet bland hyperoper (78,1%) än bland myoper (83,2%) och emmetroper (82,7%).

    Slutsats: Bolivia verkar ha större förekomst av hyperopi än Asien och Europa. Hyperopi ökar med åldern, främst efter 50-årsåldern. Miljöfaktorn ser ut att ha viss betydelse.

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  • 630.
    Wolke, Daniel
    et al.
    University of Kalmar, School of Human Sciences.
    Tunås, Hannes
    University of Kalmar, School of Human Sciences.
    Depression hos män – att upptäcka och stödja2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Depression är en av de stora folksjukdomarna i Sverige och av män i västvärlden riskerar 20 % någon gång att drabbas av en depression som kräver professionell hjälp. Män med depression har ofta dolda symtom därför är det svårt att upptäcka manlig depression ute i samhället.  Syftet med denna litteraturstudie är att belysa hur depression kan ta sig uttryck hos män och hur vårdpersonal kan vara till stöd. Litteratursökningen har gjorts i Cinahl, PubMed och Psykinfo och resultatet grundas på åtta vetenskapliga artiklar, varv av fem är kvantitativa och tre är kvalitativa. Resultatet presenterades i två huvudkategorier, ”uttryck för depression hos män” och ”hjälp och stöd”. Resultatet tyder på att en manlig depression ger sig uttryck i form av flyktbeteende, missbruk, affektivt beteende och i värsta fall suicid. Vårdpersonalens viktigaste roll är att sätta sig in i mäns livsvärld för att kunna tyda symtom. Det är viktigt att arbeta med de deprimerade männens egna resurser och tidigare erfarenheter för att stärka deras självkänsla och självförtroende för framtiden. Kvalitativa studier för att ytterligare fastställa begreppet manlig depression. En förändring i DSM-IV kriterierna behövs för att i framtiden lättare kunna diagnostisera män med depression.

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  • 631.
    Wolmhag, Anna
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Hansson, Johanna
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Att vara förälder till ett barn med ätstörningar.: En litteraturstudie.2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med litteraturstudien är att belysa föräldrars erfarenheter av hur det är att ha ett barn med ätstörningar samt föräldrarnas erfarenheter av vården. Nio stycken vetenskapliga artiklar användes i litteraturstudien och samtliga artiklar har blivit granskade av etiska kommittéer. Åtta av artiklarna som användes var kvalitativa och en var kvantitativ. Efter syftet valdes sökorden som sedan användes i databaserna. Databaserna som användes var Pubmed, Swemed+ och Cinahl. Författarna använde sig av en kvalitativ innehållsanalys med manifest ansats. Studien visar att föräldrar vill ha mer stöd och information om vad ätstörningar är samt hur de ska förhålla sig till sjukdomen. Det framkommer även att föräldrarna vill vara mer delaktiga i vården av deras barn. För att sjukvårdspersonalen ska kunna ge föräldrarna ett så bra stöd som möjligt är det viktigt att de vet hur föräldrarna upplever sin situation. Genom att sjukvårdspersonalen stöttar föräldrarna kan de i sin tur vara ett stöd åt sitt barn.

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  • 632.
    Wörner, Tobias
    et al.
    Lund University, Sweden.
    Nilsson, Johanna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Thorborg, Kristian
    Copenhagen University Hospital, Denmark.
    Granlund, Viktor
    Capio Artro Clinic, Sweden.
    Stålman, Anders
    Capio Artro Clinic, Sweden;Karolinska Institutet, Sweden.
    Eek, Frida
    Lund University, Sweden.
    Hip function 6 to 10 months after arthroscopic surgery: a cross-sectional comparison of subjective and objective hip function, including performance-based measures, in patients versus controls2019In: Orthopaedic Journal of Sports Medicine (OJSM), E-ISSN 2325-9671, Vol. 7, no 6, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Background:

    Little is known about hip-related function, mobility, and performance in patients after hip arthroscopic surgery (HA) during the time that return to sports can be expected.

    Purpose:

    To evaluate measures of subjective and objective hip function 6 to 10 months after HA in patients compared with healthy controls and to compare objective function in the HA group between the operated and nonoperated hips.

    Study Design:

    Cross-sectional study; Level of evidence, 3.

    Methods:

    A total of 33 patients who had undergone HA (mean, 8.1 ± 2.6 months postoperatively) and 33 healthy participants matched on sex, age, and activity level were compared regarding subjective hip function (Copenhagen Hip and Groin Outcome Score [HAGOS]) and objective function including hip range of motion (ROM; flexion, internal rotation, and external rotation), isometric hip muscle strength (adduction, abduction, flexion, internal rotation, and external rotation), and performance-based measures: the Y Balance Test (YBT), medial and lateral triple-hop test, and Illinois agility test. Group differences were analyzed using independent-samples t tests. Paired-samples t tests were used for a comparison of the operated and nonoperated hips. Standard effect sizes (Cohen d) were provided for all outcomes.

    Results:

    The HA group reported worse subjective hip function than the control group (HAGOS subscores: d = –0.7 to –2.1; P ≤ .004). Objective measures of hip ROM (d = –0.5 to –1.1; P ≤ .048), hip flexion strength (d = –0.5; P = .043), and posteromedial reach of the YBT (d = –0.5; P = .043) were also reduced in the HA group, although there were no significant differences between groups regarding the remaining objective measures (d = –0.1 to –0.4; P ≥ .102 to .534). The only significant difference between the operated and nonoperated hips in the HA group was reduced passive hip flexion (d = –0.4; P = .045).

    Conclusion:

    Patients who had undergone HA demonstrated reduced subjective hip function compared with controls 6 to 10 months after surgery, when return to sports can be expected. While most objective strength and performance test results were comparable between the HA and control groups at 6 to 10 months after surgery, the HA group presented with impairments related to hip mobility and hip flexion strength. No consistent pattern of impairments was found in operated hips compared with nonoperated hips.

  • 633.
    Xiu, Lijuan
    et al.
    Karolinska Institutet, Sweden.
    Ekstedt, Mirjam
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.
    Hagströmer, Maria
    Karolinska Institutet, Sweden;Sophiahemmet University, Sweden;Karolinska University Hospital, Sweden.
    Bruni, Oliviero
    Sapienza University, Italy.
    Bergqvist-Norén, Linnea
    Karolinska Institutet, Sweden.
    Marcus, Claude
    Karolinska Institutet, Sweden.
    Sleep and adiposity in children from 2 to 6 years of age2020In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 145, no 3, p. 1-11, article id e20191420Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare sleep in young children at different obesity risks, which were based on parental weight, as well as to explore the longitudinal associations of sleep characteristics with adiposity.

    METHODS: In total, 107 children from an obesity prevention project were included, of which 43 had normal-weight parents (low obesity risk) and 64 had overweight and/or obese parents (high obesity risk). Sleep was measured yearly from ages 2 to 6 years by using actigraphy. Five sleep characteristics, that of late sleep, long sleep latency, short sleep duration, low sleep efficiency, and irregular sleep onset, were defined and scored across ages, with a higher score indicating more frequent exposure. The outcome variables, also measured yearly, were BMI z score and waist circumference.

    RESULTS: There was no difference in sleep patterns among children at different risks. Higher short sleep duration score was associated with a greater increase in BMI z score (0.12; 95% confidence interval [CI] 0.01 to 0.25) across ages. Independently of sleep duration, higher late sleep score was associated with greater increases in BMI z score (0.16; 95% CI 0.05 to 0.27) and waist circumference (0.60 cm; 95% CI 0.23 to 0.98). Moreover, compared with children at low risk and without habitual late sleep, children at high risk and with habitual late sleep had greater increases in BMI z score (0.93; 95% CI 0.40 to 1.45) and waist circumference (3.45 cm; 95% CI 1.78 to 5.12).

    CONCLUSIONS: More frequent exposures to late sleep were associated with greater increases in adiposity measures from ages 2 to 6 years, particularly in children with obese parents.

  • 634.
    Xiu, Lijuan
    et al.
    Karolinska Institutet, Sweden.
    Hagströmer, Maria
    Karolinska Institutet, Sweden.
    Bergqvist-Norén, Linnea
    Karolinska Institutet, Sweden.
    Johansson, Elin
    Karolinska Institutet, Sweden.
    Ekbom, Kerstin
    Karolinska Institutet, Sweden.
    Svensson, Viktoria
    Karolinska Institutet, Sweden.
    Marcus, Claude
    Karolinska Institutet, Sweden.
    Ekstedt, Mirjam
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.
    Development of sleep patterns in children with obese and normal-weight parents2019In: Journal of Paediatrics and Child Health, ISSN 1034-4810, E-ISSN 1440-1754, Vol. 55, no 7, p. 809-818Article in journal (Refereed)
    Abstract [en]

    Aim

    To study the sleep development and sleep characteristics in children at different obesity risks, based on parental weight, and also to explore their weekday–weekend sleep variations and associated family factors.

    Methods

    A total of 145 children participating in a longitudinal obesity prevention project were included, of which 37 had normal‐weight parents (low obesity risk), and 108 had overweight/obese parents (high obesity risk). Sleep diaries at ages 1 and 2 years were used to study sleep development in children at different obesity risks. Objectively assessed sleep using an accelerometer at 2 years of age was used to analyse weekday–weekend sleep variations.

    Results

    There was no difference in sleep development from age 1 to age 2 among children at different obesity risks, but more children in the high‐risk group had prolonged sleep onset latency and low sleep efficiency. At 2 years of age, children in the high‐risk group had more weekday–weekend variation in sleep offset (mean difference 18 min, 95% confidence interval (CI) 4–33 min), midpoint of sleep (mean difference 14 min, 95% CI 3–25 min) and nap onset (mean difference 42 min, 95% CI 10–74 min) than children in the low‐risk group, after adjusting for other family factors. However, no difference could be detected between groups in weekday–weekend variation in sleep duration.

    Conclusions

    Unfavourable sleep characteristics, as well as more variation in sleep schedules, have been observed in children at high obesity risk. While the differences were relatively small, they may reflect the unfavourable sleep hygiene in families at high obesity risk.

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  • 635.
    Y Banaem, Hossein
    et al.
    Tehran University of Medical Science, Iran.
    Ahmadian, Alireza
    Tehran University of Medical Science, Iran.
    Saberi, Hooshangh
    Tehran University of Medical Science, Iran.
    Daneshmehr, Alireza
    University of Tehran, Iran.
    Khodadad, Davood
    Tehran University of Medical Science, Iran.
    Brain tumor modeling: glioma growth and interaction with chemotherapy2011In: International Conference on Graphic and Image Processing (ICGIP 2011) / [ed] Yi Xie, Yanjun Zheng, 2011, article id 82851MConference paper (Refereed)
    Abstract [en]

    In last decade increasingly mathematical models of tumor growths have been studied, particularly on solid tumors which growth mainly caused by cellular proliferation. In this paper we propose a modified model to simulate the growth of gliomas in different stages. Glioma growth is modeled by a reaction-advection-diffusion. We begin with a model of untreated gliomas and continue with models of polyclonal glioma following chemotherapy. From relatively simple assumptions involving homogeneous brain tissue bounded by a few gross anatomical landmarks (ventricles and skull) the models have been expanded to include heterogeneous brain tissue with different motilities of glioma cells in grey and white matter. Tumor growth is characterized by a dangerous change in the control mechanisms, which normally maintain a balance between the rate of proliferation and the rate of apoptosis (controlled cell death). Result shows that this model closes to clinical finding and can simulate brain tumor behavior properly.

  • 636.
    Young, Stuart B.
    et al.
    Indiana University, USA.
    Baskaran, Karthikeyan
    Indiana University, USA.
    Elsner, Ann E.
    Indiana University, USA;Aeon Imaging, USA.
    Muller, Matthew S.
    Aeon Imaging, USA.
    Gast, Thomas J.
    Indiana University, USA.
    Malinovsky, Victor E.
    Indiana University, USA.
    Clark, Christopher A.
    Indiana University, USA.
    Brahm, Shane
    Indiana University, USA.
    Litvin, Taras V.
    University of California Berkeley, USA.
    Ozawa, Glen Y.
    University of California Berkeley, USA.
    Cuadros, Jorge
    University of California Berkeley, USA.
    Central Macular Thickness in Diabetic Patients: A Gender Based Analysis2014Conference paper (Refereed)
    Abstract [en]

    PURPOSE: To investigate gender differences in central macular thickness (CMT) in underserved diabetic patients who were judged to have clinically significant macular edema (CSME), using the criterion of hard exudates within 1500 microns of the fovea. METHODS: Using EyePACS certified graders, 142 of 2080 diabetic patients from Alameda County, CA, clinics, had CSME as judged from color fundus images (Canon CR6-45NM). Of the 2080 patients, 1784 were imaged with SD-OCT (iVUE). Graders then analyzed the SD-OCT images for hard exudates and macular edema, excluding subjects with poor fixation or other ocular conditions. From these data, 142 patients with CSME, 11 males had CMT >300 microns. The 11 females from the group with the greatest values of CMT were then compared for CMT, and mean age. A control group, diabetic patients without CSME, showed a 12-micron larger CMT for males, as compared with females. Thus, a one-tailed t-test was used to determine if the CMT for males with CSME also was greater than for females by 12 microns. We compared mean age, self-report of duration of diabetes, and HbA1c values between genders. RESULTS: Males with CSME had an average CMT of 377 microns, statistically greater than the 12 micron difference expected between genders, with females averaging 321 microns (p<0.05). There was no statistical significance in the mean age between genders 59.3 vs. 59.2 yr. (p>0.05) or the population HbA1c levels 9.5 vs. 9.3% for males and females (p>0.05), respectively. While females had slightly longer durations of diabetes, Chi square analysis also showed no significance between genders (p>0.05). In the OCT images, males had cysts that were larger and more numerous. CONCLUSIONS: In patients with CSME, males had greater CMT than females. This difference is not explained by differences in thickness with gender when CSME is not found, nor by age or duration of diabetes. Instead, the cystic changes in the retinas of males were more striking.

  • 637.
    Yousefi-Banaem, Hossein
    et al.
    Isfahan University of Med. Sci., Iran.
    Kermani, Saeed
    Isfahan University of Med. Sci., Iran.
    Sarrafzadeh, Omid
    Isfahan University of Med. Sci., Iran.
    Khodadad, Davood
    Luleå University of Technology.
    An improved spatial FCM algorithm for cardiac image segmentation2013In: 13th Iranian Conference on Fuzzy Systems (IFSC), 2013, IEEE Press, 2013Conference paper (Refereed)
    Abstract [en]

    Image segmentation is one of challenging field in medical image processing. Segmentation of cardiac wall is one of challenging work and it is very important step in evaluation of heart functionality by existing methods. For cardiac image analysis, Fuzzy C- Means (FCM) algorithm proved to be superior over the other clustering approaches in segmentation field. However, the nave FCM algorithm is sensitive to noise because of not considering the spatial information in the image. In this paper an improved FCM algorithm is formulated by incorporating the spatial domain neighborhood information into the membership function for clustering (ISFCM). In this paper we applied improved Fuzzy c-Means with spatial information for left ventricular wall segmentation. Obtained results showed that the proposed method can segment cardiac wall automatically with acceptable accuracy. The comparison of proposed method with nave FCM proved that ISFCM can segment with more accuracy than nave FCM.

  • 638.
    Zabriskie, Matthew S.
    et al.
    University of Utah, USA.
    Eide, Christopher A.
    Oregon Health & Science University, USA;Howard Hughes Medical Institute, USA.
    Tantravahi, Srinivas K.
    University of Utah, USA.
    Vellore, Nadeem A.
    University of Utah, USA.
    Estrada, Johanna
    University of Utah, USA.
    Nicolini, Franck E.
    Centre Hospitalier Lyon Sud, France.
    Khoury, Hanna J.
    Emory University, USA.
    Larson, Richard A.
    University of Chicago, USA.
    Konopleva, Marina
    University of Texas, USA.
    Cortes, Jorge E.
    University of Texas, USA.
    Kantarjian, Hagop
    University of Texas, USA.
    Jabbour, Elias J.
    University of Texas, USA.
    Kornblau, Steven M.
    University of Texas, USA.
    Lipton, Jeffrey H.
    University of Toronto, Canada.
    Rea, Delphine
    Hospital Saint-Louis, France.
    Stenke, Leif
    Karolinska Institutet.
    Barbany, Gisela
    Karolinska Institutet.
    Lange, Thoralf
    University of Leipzig, Germany.
    Hernandez-Boluda, Juan-Carlos
    Hospital Clı´nico Universitario, Spain.
    Ossenkoppele, Gert J.
    VU University Medical Center, Netherlands.
    Press, Richard D.
    Oregon Health & Science University, USA.
    Chuah, Charles
    Singapore General Hospital, Singapore.
    Goldberg, Stuart L.
    John Theurer Cancer Center at Hackensack University Medical Center, USA.
    Wetzler, Meir
    Roswell Park Cancer Institute, USA.
    Mahon, Francois-Xavier
    Centre Hospitalier Universitaire de Bordeaux, France.
    Etienne, Gabriel
    Institut Bergonie, France.
    Baccarani, Michele
    University of Bologna, Italy.
    Soverini, Simona
    University of Bologna, Italy.
    Rosti, Gianantonio
    University of Bologna, Italy.
    Rousselot, Philippe
    Université de Versailles, France.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Deininger, Marie
    University of Utah, USA.
    Reynolds, Kimberly R.
    University of Utah, USA.
    Heaton, William L.
    University of Utah, USA.
    Eiring, Anna M.
    University of Utah, USA.
    Pomicter, Anthony D.
    University of Utah, USA.
    Khorashad, Jamshid S.
    University of Utah, USA.
    Kelley, Todd W.
    University of Utah, USA.
    Baron, Riccardo
    University of Utah, USA.
    Druker, Brian J.
    Oregon Health & Science University Knight Cancer Institute, USA;Howard Hughes Medical Institute, USA.
    Deininger, Michael W.
    University of Utah, USA.
    O'Hare, Thomas
    University of Utah, USA.
    BCR-ABL1 Compound Mutations Combining Key Kinase Domain Positions Confer Clinical Resistance to Ponatinib in Ph Chromosome-Positive Leukemia2014In: Cancer Cell, ISSN 1535-6108, E-ISSN 1878-3686, Vol. 26, no 3, p. 428-442Article in journal (Refereed)
    Abstract [en]

    Ponatinib is the only currently approved tyrosine kinase inhibitor (TKI) that suppresses all BCR-ABL1 single mutants in Philadelphia chromosome-positive (Ph+) leukemia, including the recalcitrant BCR-ABL1(T315I) mutant. However, emergence of compound mutations in a BCR-ABL1 allele may confer ponatinib resistance. We found that clinically reported BCR-ABL1 compound mutants center on 12 key positions and confer varying resistance to imatinib, nilotinib, dasatinib, ponatinib, rebastinib, and bosutinib. T315I-inclusive compound mutants confer high-level resistance to TKIs, including ponatinib. In vitro resistance profiling was predictive of treatment outcomes in Ph+ leukemia patients. Structural explanations for compound mutation-based resistance were obtained through molecular dynamics simulations. Our findings demonstrate that BCR-ABL1 compound mutants confer different levels of TKI resistance, necessitating rational treatment selection to optimize clinical outcome.

  • 639.
    Zarazaga, Jose
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Utvärdering av föräldragrupper på mödrahälsovårdsmottagningar i Norra Kalmar Län2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    SAMMANFATTNING: Blivande föräldrar står inför stora utmaningar. Föräldragrupperna utformas på mödrahälsovårdsmottagningarna så att föräldrarna får stöd i föräldraskapet och skapar ett nätverk som kan främja en positiv utveckling. Norra Kalmar län vill utveckla sitt arbetssätt i syfte att säkerställa kvalitet inom föräldrastödet för att svara mot föräldrars behov. Syfte: Utvärdering av föräldragrupperna bland förstagångsföräldrar. Metod: Retrospektiv tvärsnittstudie med kvantitativt ansats. Data samlades in genom ett frågeformulär med strukturerade frågor som har utarbetats av författaren. Analys: Beskrivande statistik. Resultatet sammanställdes med hjälp av programmet Excel. Resultat: 252 (n=656) föräldrar deltog i studien. 202 föräldrar (123 mammor och 79 partner) hade deltagit i grupperna. 145 föräldrar hade deltagit i alla träffar. Resultatet visar på att föräldrarna tyckte att grupperna var meningsfulla (84,5 %) och uppfyllde deras behov (85,9 %). Föräldragrupperna anses som en bra förlossningsförberedelse (85,1 %) och kan stärka föräldrarna i föräldraskapet (75,5 %). Hälften av föräldrarna (50, 4 %) har tack vare grupperna skapat kontakter och gemenskap med andra föräldrar. Slutsats: Nästan alla föräldrar känner sig nöjda med sitt deltagande (97,8 %) och kan rekommendera andra (93,3 %) att delta i grupperna.

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  • 640.
    Zbikowski, Ancke
    et al.
    Linköpings universitet.
    Brüggemann, Adrianus Jelmer
    Linköpings universitet.
    Wijma, Barbro
    Linköpings universitet.
    Zeiler, Kristin
    Linköpings universitet.
    Swahnberg, Katarina
    Linköpings universitet.
    Ethical guidelines and the prevention of abuse in healthcare2012In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, E-ISSN 1872-7654, Vol. 165, no 1, p. 18-28Article in journal (Refereed)
    Abstract [en]

    Objective

    In obstetrical and gynaecological healthcare, patients often find themselves in a vulnerable position. Sensitive issues such as sexual and reproductive health are addressed and certain procedures can be experienced as abusive. According to research a lifetime prevalence of abuse in healthcare (AHC) can be assumed for 13–28% of female patients in the Nordic countries. In the present study we analyse the content of ethical documents for healthcare professionals within obstetrics and gynaecology in Sweden, in order to find out to what extent ethical guidelines consider issues that have shown to be related to the occurrence of AHC.

    Study design

    We searched the literature to find empirical data on AHC. Guidelines for nurses, midwives and physicians were selected. After developing an analytical framework based on the empirical data the content of the ethical guidelines was analysed.

    Results

    The various ethical guidelines for staff working within obstetrics and gynaecology differ distinctively from each other regarding their content of issues that are related to AHC. Issues that were mostly disregarded were: considering the patient's perspective and the patients’ possible experience of violence, considering power imbalances within healthcare, sexual misconduct, how to deal with other professional's ethical misconduct and how professionals relate to each other. We found the ethical guidelines of the International Federation of Gynecology and Obstetrics (FIGO) and of the International Confederation of Midwives to be those which contained most of the issues that have empirically shown to be important in regard to AHC.

    Conclusion

    While staff members from different professions may share responsibility for the same patient, their ethical guidelines vary considerably. To become a possible resource for prevention of AHC, we suggest that ethical guidelines in healthcare should be revised following empirical research on ethical conduct. As ethical guidelines cannot be effective by their existence only, we would like to initiate a discussion on the function and use of ethical guidelines in general and regarding AHC in particular. Being aware that ethical guidelines are only a part of ethics in healthcare, however, we envision a broader approach to the aim of preventing AHC, where research is encouraged on how a virtue ethics approach could be applied.

  • 641.
    Zineldin, Mosad
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Cognitive and Brain Reserve (CBR): Tools to Reduce the Risk of Dementia and Alzheimer2018In: Advances in Alzheimer's Diseases, ISSN 2210-5727, Vol. 7, no 4, p. 93-102, article id 88472Article in journal (Refereed)
    Abstract [sv]

    The study was performed to examine and assess the impact of the education, occupation and leisure time on building brain and cognitive reserves (CBR). A cross sectional study of 132 persons at age between 40 to 70 years old has been conducted. A structuredquestionnaire covering multiple constructs was used to collect the data. Multivariate regression results show that the three independent variables (LE, OC and ED) were statistically significant in the models with CBR as dependent variable. Leisure time and activities (LE) makethe strongest unique contribution (0.683) followed by occupation (0.261) and the weak contribution of the education (0.198) to explainthe dependent variable cognitive and brain reserve (CBR).The Brain and Cognitive Reserve hypothesesassumes that a rich intellectual measures and abilities a person have during her/his life enable this person to copewith difficult cognitive tasks and social events in life.

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  • 642.
    Åhlander Elvér, Mimmi
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Östlund, Jon
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    ATT LEVA MED MULTIPEL SKLEROS: En kvalitativ litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Multipel skleros är en neurologisk sjukdom som drabbar det centrala nervsystemet. Sjukdomen har störst prevalens i västerländsk kultur men etiologin är ännu inte klarlagd. Symtomen är individuella med funktionsnedsättningar i den fysiska likväl som den kognitiva förmågan.

    Syfte: Syftet var att beskriva vuxnas upplevelse av att leva med multipel skleros.

    Metod: En kvalitativ litteraturstudie med induktiv ansats genomfördes och analyserades enligt Granheim och Lundmans (2004) modell.

    Resultat: Analysen resulterade i fyra huvudkategorier som beskriver upplevelsen av att leva med multipel skleros: en förändrad kropp, farhåga för sjukdomens exponering och utveckling, behov av stöd och viljan att leva. Resultatet påvisade att de MS-drabbade personerna upplevde både fysiska och kognitiva begränsningar och anpassade därför livet efter sjukdomen för att hantera sitt tillstånd.

    Slutsats: Multipel skleros varierar i symtombild och förändrar hur kroppen upplevs. Begränsningarna som MS medförde innebar anpassningar i arbete, vardag och fritid. Det framkom också att MS-drabbade personer upplevde rädsla att tillståndet missuppfattas och en oro inför framtiden. De MS-drabbade strävade efter att uppnå hälsa trots sjukdom genom att omprioritera mål i livet och visa hänsyn till kroppens begränsningar. Resultatet kan bidra till vara stöd för hälso- och sjukvårdspersonal att få en insikt i MS-drabbade personers upplevelser, för att på så vis förbättra omvårdnaden för dessa.

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  • 643.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Alvariza, A.
    Ersta Sköndal Bräcke University College, Sweden.
    Håkansson, C.
    Ersta Sköndal Bräcke University College, Sweden.
    Öhlén, J.
    University of Gothenburg, Sweden.
    Boman, K.
    Umeå University, Sweden.
    Goliath, I.
    Karolinska Institutet, Sweden.
    Fürst, C-J
    Lund University, Sweden.
    Brännstrom, M.
    Umeå University, Sweden.
    Symptom relief and palliative care during the last week of life among patients with heart failure2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S58-S59, article id 155Article in journal (Other academic)
    Abstract [en]

    Background: Heart failure is a disease with high morbidity, mortality and physical and psychological burden. Patients with heart failure have symptoms as severe and distressing as those of cancer patients. Likewise, the knowledge about care oriented towards palliation provided close to death is sparse.

    Purpose: To describe symptom prevalence and key aspects of palliative care the last week of life for patients with heart failure, from the perspective of health care professionals.Methods: Data was taken from the Swedish Register of Palliative Care, 2011 and 2012 (n=3981). Inclusion criteria were; heart failure as underlying cause of death (ICD-10; I50.0, I50.1 & I50.9), expected death and 18 years or older. During this period, the register covered 58% of all deaths in Sweden. Variables were described using univariate statistics.

    Results: The sample consisted of 3981 patients (63% women) with a mean age of 88.1 (SD=7.1) years. The most common reported symptom was pain (62%), followed by rattles (51%), anxiety (39%), shortness of breath (29%), confusion (25%), and nausea (11%). Symptom relief was most prominent for pain and anxiety. Still, 25% and 38% respectively were partly or not relieved. Poorer relief was found for patients suffering shortness of breath, nausea and rattles. More than half of patients were partly or not reviled, 61%, 58% and 55% respectively. Poorest symptom relief was showed for patients with confusion, 85 % were partly or not reviled. Validated self-rating scales were seldom used to assess symptoms. Pain was more often assessed (12%) than other symptoms (8%). Two third of the patients (72%) and almost half of family members (39%) did not have an end of life discussions with a physician. One fifth (17%) died alone without family members or health care professionals present.

    Conclusions: Our findings indicate that the palliative care is inadequate for patients with heart failure during their last week of life. Symptom management needs to be improved, for example by structured use of validated symptom rating scales. End of life discussions needs to be improved, both for patients and family members.

  • 644.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sawatzky, R.
    Trinity Western Univ, Canada.
    Israelsson, Johan
    Kalmar County Hospital, Sweden.
    Herlitz, J.
    University of Borås, Sweden.
    Lilja, G.
    Lund University, Sweden.
    Cronberg, T.
    Lund University, Sweden.
    Bremer, Anders
    University of Borås, Sweden.
    Psychometric properties of the Hospital Anxiety and Depression scale in cardiac arrest survivors2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S2-S3Article in journal (Other academic)
  • 645.
    Åsenlöf, Pernilla
    et al.
    Uppsala Universitet.
    Bergman, Patrick
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Demmelmeier, Ingrid
    Karolinska Institutet.
    Nordgren, Birgitta
    Karolinska Institutet.
    Opava H, Christina
    Karolinska Institutet.
    Sedentary time among adults with rheumatoid arthritis. The PARA 2010 study2013In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, no Suppl 3, p. 766-Article in journal (Other academic)
  • 646.
    Öhman, Eleonor
    et al.
    University of Kalmar, School of Human Sciences.
    Anna-Lena, Lindstedt
    University of Kalmar, School of Human Sciences.
    Mannens och kvinnans copingstrategier vid infertilitet: En systematisk litteraturstudie2009Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
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  • 647.
    Öhrberg, Pi
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Kan +1-metoden upptäcka förekomsten av dold hyperopi?2008Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpStudent thesis
    Abstract [sv]

    Introduktion: Vid synkontrollen hos skolsköterskan upptäcks ofta de barn som har nedsatt synskärpa, som de närsynta. Men de barnen som är översynta slinker lätt genom detta kontrollnät i och med att de kan kompensera sitt synfel genom ackommodation.

    Syfte: Syftet med denna undersökning var att se hur mycket dold översynthet det finns hos barn i lågstadiet samt för att se om +1-metoden är lämplig för detta ändamål.

    Metod: +1-metoden går ut på att det ena ögat täcks för så att det inte kan se något alls medan det andra ögat får titta genom ett glas som mäter +1 dioptrier. Den förväntade synskärpeförändringen i förhållande till barnets fria synskärpa är en minskning på 5 rader, eller en visusförsämring på 0,5 med en tavla som är indelad i decimaler. Om förändringen är mindre är inte patienten rätt korrigerad och en dold översynthet kan vara den bakomliggande orsaken.

    Resultat: Totalt deltog 27 barn i studien i årskurs 2 och 3. Vid undersökningarna visade det sig att 25,9% av skolbarnen fick en försämrad synskärpa med 0,5 eller mer med +1-metoden, alltså de var inte översynta.

    Diskussion och slutsats: Denna studie visar att +1-metoden är ett bra sätt att upptäcka dold översynthet bland barn i skolan. Metoden borde inkluderas i skolsköterskornas synscreening för att kunna fånga upp de översynta barnen som ackommoderar hela dagarna.

    2008:O26

  • 648.
    Ölje, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Metodjämförelse mellan DiffMaster Octavia och CellaVision DM1200 avseende differentialräkning av leukocyter: en viktig analys inom vården2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Leukocytes, white blood cells, are cells of the immune system. They are produced and derived from hematopoietic stem cells in the bone marrow. Leukocytes can be divided into neutrophils, lymphocytes, monocytes, eosinophils and basophils. To determine the numbers of leukocytes in blood the leukocyte particle concentration (B-LPK) can be analyzed by cell counters. When B-LPK is elevated or lowered a differential count of leukocytes (B-Diff) is performed to see in which cell systems the change exists. The manual analysis involves peripheral blood smears stained with a cytochemical color, May-Grünwald Giemsa. The smear examined in an automatic microscopically system that counts, photographs and pre-classify leukocytes by its appearance. DiffMaster Octavia and CellaVision DM1200 are two variants of such instruments from the same manufacturer (CellaVision AB, Lund, Sweden). The aim of the study was to do a comparison between these instruments by analyzing 60 samples consisting venous blood in EDTA-tubes. The samples were collected randomly from patients (32 men and 28 women) between 19-95 years old. The results from two-sided paired t-test showed no significant difference between the differential count of neutrophils, lymphocytes and monocytes. The correlation was 0,95, 0,91 and 0,68. However, there was a significant difference between the instruments differential count of eosinophils and basophils, the correlation was 0,91 and 0,20. When counting only 200 cells a profit of 2 % distinguish up to 1-5 %. Abnormalities in leukocytes which represents only a few percent in blood can therefore be very large. Method comparison showed that both instruments give the same results and are considered equivalent in analysis of manual B-Diff.

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