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  • 1.
    Adlers, Ann-Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Att främja normal förlossning: Barnmorskans främsta uppgift2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    En graviditet och förlossning är i de allra flesta fall en normal livshändelse. De senaste decennierna har andelen instrumentella- och kejsarsnittsförlossningar ökat på bekostnad av den normala förlossningen. Trots fler interventioner ses ingen skillnad i den maternella och perinatala morbiditeten och mortaliteten. I barnmorskans arbetsområde ingår att handlägga den normala graviditeten och förlossningen. Syftet med studien var att beskriva hur barnmorskan kan främja en normal förlossning. Studien genomfördes som en litteraturstudie där 13 vetenskapliga artiklar, med både kvantitativ och kvalitativ ansats, analyserades. I resultatet framkom tre kategorier som beskriver hur barnmorskan främjar normal förlossning. Barnmorskan skapar genom närhet en god relation till kvinnan och ger vägledning. Genom att använda sig själv som kunskapskälla bidrar barnmorskans sinnen, erfarenheter av tidigare förlossningar och formell kunskap till att fatta korrekta beslut. Barnmorskan stödjer och bekräftar det normala individuellt efter kvinnans behov, vilket skapar en säker miljö runt kvinnan och förhindrar onödiga interventioner. Då det råder en medicinsk kultur inom förlossningsvården, behöver barnmorskans arbete kring normal förlossning stärkas. Forskning behövs på organisationsnivå, eftersom omgivande system inverkar på barnmorskans arbete med att främja den normala förlossningen.

  • 2.
    Adlers, Ann-Cathrine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Att verka som lots - Ett sätt för barnmorskan att främja normal förlossning2012Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Trots att majoriteten av alla graviditeter bedöms normala, ses en ökad frekvens av interventioner under förlossningsförloppet, där kejsarsnitt utan medicinsk indikation utgör en del. En orsak kan vara att vården av kvinnor med okomplicerad graviditet, bedrivs på samma nivå som en komplicerad graviditet. För både kvinnan och barnet kan ett kejsarsnitt leda till ökad risk för hälsoproblem. I barnmorskans ansvarsområde ingår att självständigt handlägga vården vid normal, okomplicerad graviditet och förlossning. Barnmorskan har i sitt arbete även möjlighet att verka för att främja kvinnors hälsa. Syftet med studien var att öka förståelsen för hur förlossningsbarnmorskor främjar den normala förlossningsprocessen. En icke deltagande observationsstudie, av sammanlagt fyra barnmorskor i verksamhet på förlossningsavdelning, genomfördes vid två sjukhus. Grounded Theory användes som metod för datainsamling och analys. Som resultat framkom kärnkategorin att verka som lots samt fyra underkategorier. Primärt skapar och förankrar barnmorskan en relation med kvinnan. Genom förlossningens olika faser bedömer, underlättar och bekräftar barnmorskan förlossningsförloppet individuellt efter kvinnans behov. Kategorierna formar tillsammans en modell som beskriver vad barnmorskan utför; i verbal och i tyst kommunikation och i att agera eller att avstå från att agera, för att främja en normal förlossning. Behov finns av fortsatt forskning kring vad i barnmorskans handläggning av förlossningsprocessen som gynnar den normala förlossningen. Det är även väsentligt med forskning på organisationsnivå då det inverkar på hur barnmorskan främjar den normala förlossningen.

  • 3.
    Afifi, Mustafa
    et al.
    Department of Non-Communicable Diseases Control, Ministry of Health (HQ), Muscat, Oman.
    von Bothmer, Margareta
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Egyptian women's attitudes and beliefs about female genital cutting and its association with childhood maltreatment2007Ingår i: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 9, nr 4, s. 270-276Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to establish Egyptian women's attitudes and beliefs about female genital cutting (FGC) or mutilation by applying a questionnaire module about violence to a subsample of 5249 married women from a total of 19 474 women who participated in the 2005 Egypt Demographic Health Survey. Women were interviewed to determine if they had been exposed to marital violence in the year prior to the survey, their attitudes and beliefs about FGC, and if they physically abused their children. The association of beliefs about FGC with maternal physical abuse was examined, adjusting for exposure to marital violence and other socio-demographic variables. Of the women surveyed 16.4% and 3.4% had been exposed to physical and sexual violence, respectively, during the year prior to the survey. Around 76% of the women surveyed intended to continue the FGC practice, and 69.8% had slapped or hit their children during the year prior to the survey. Holding positive beliefs about the practice of FGC or intending to continue it was associated with maternal physical abuse and this has significant implications for health and welfare workers in Egypt and for society in general.

  • 4.
    Albinsson, John
    et al.
    Lund Univ, Dept Biomed Engn, S-22100 Lund, Sweden..
    Brorsson, Sofia
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS).
    Rydén Ahlgren, Åsa
    Lund Univ, Dept Clin Sci, Clin Physiol & Nucl Med Unit, Malmo, Sweden..
    Cinthio, Magnus
    Lund Univ, Dept Biomed Engn, S-22100 Lund, Sweden..
    Improved tracking performance of lagrangian block-matching methodologies using block expansion in the time domain: In silico, phantom and invivo evaluations2014Ingår i: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 40, nr 10, s. 2508-2520Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate tracking performance when an extra reference block is added to a basic block-matching method, where the two reference blocks originate from two consecutive ultrasound frames. The use of an extra reference block was evaluated for two putative benefits: (i) an increase in tracking performance while maintaining the size of the reference blocks, evaluated using in silico and phantom cine loops; (ii) a reduction in the size of the reference blocks while maintaining the tracking performance, evaluated using in vivo cine loops of the common carotid artery where the longitudinal movement of the wall was estimated. The results indicated that tracking accuracy improved (mean - 48%, p<0.005 [in silico]; mean - 43%, p<0.01 [phantom]), and there was a reduction in size of the reference blocks while maintaining tracking performance (mean - 19%, p<0.01 [in vivo]). This novel method will facilitate further exploration of the longitudinal movement of the arterial wall. (C) 2014 World Federation for Ultrasound in Medicine & Biology.

  • 5.
    Allisson, Anna
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    När återhämtar patienten sig snabbast?: Jämförlse mellan inhalationsanestesi och total intravenös anestesi.2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Generell anestesi kan ges som inhalationsanestesi eller total intravenös anestesi (TIVA). En förutsägbar anestesi med snabbt uppvaknande och bibehållen vakenhet är en högt önskvärd egenskap oavsett anestesiform. Det råder en klinisk och vetenskaplig diskussion om vilken anestesiform som ger snabbast tidig postoperativ återhämtning. syftet med studien var att jämföra patienters tidiga postoperativa återhämtning efter inhalationsanestesi respektive efter total intravenös anestesi (TIVA). Metoden var en litteraturstudie baserad på 15 vetenskapliga artiklar. Dessa analyserades utifrån frågeställningen: Vilken anestesiform som ger den snabbaste tidiga postoperativa återhämtningen. Det framkom en indelning av resultatet i tre kategorier: snabbare tidig postoperativ återhämtning efter inhalationsanestesi, lika lång tid till återhämtning efter inhalationsanestesi som efter TIVA samt snabbare tidig postoperativ återhämtning efter TIVA. Resultatet visade att inhalationsanestesi gav snabbast tdiig postoperativ återhämtning. Anestesisjuksköterskans handhavande, planering och erfarenhet påverkar patientens uppvakande. därför skulle vidare forskning istället jämföra dessa båda anestesiformer på ett annat sätt. Tiden kunde istället mätas från det att anestesisjukskäterskan extuberat patienten och till payienten verkar adekvat orienterad för att erhålla ett mer jämförbart resultat.

  • 6.
    Almqvist-Tangen, Gerd
    et al.
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Dahlgren, Jovanna
    Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Roswall, Josefine
    Department of Paediatrics, County Hospital, Halmstad, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Alm, Bernt
    Child Health Care Team, County Council Halland, Sweden & Department of Paediatrics, University of Gothenburg, Gothenburg, Sweden.
    Factors associated with discontinuation of breastfeeding before 1 month of age2012Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, nr 1, s. 55-60Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Breastfeeding is associated with many benefits for both mother and child. Initiation rates are high in Sweden. Recently a slight decline is seen.

    AIM: The aim of this study was to assess factors associated with discontinuation of breastfeeding during the first 4 weeks.

    METHOD: A population-based longitudinal birth cohort study recruiting from 2007 to 2008 in south-western Sweden. At the first visit to the child health centre, parents were asked to complete a questionnaire. Also, the infants' height, weight, head and waist circumference were collected. Response rate was 69.2%.

    RESULTS: Twenty-seven per cent of mothers had breastfeeding problems. In a multivariate analysis, there was a negative correlation between breastfeeding and use of pacifier (OR 3.72; CI 2.09-6.63), maternal smoking (OR 2.09; CI 1.08-4.05) and breastfeeding problems (OR 2.54; CI 1.73-3.71). Breastfeeding problems were correlated with poor sucking technique (OR 2.96; CI 2.14-4.07), support from maternity ward (OR 2.56; CI 2.05-3.19) and perceived poor weight gain (OR 1.37; CI 1.00-1.86).

    CONCLUSION: Many mothers reported breastfeeding problems that are associated with an early cessation. This is preventable with support, but the timing is crucial. To promote breastfeeding, the support from the child health centres must be tailored with the maternal perspective in mind.

    © 2011 Foundation Acta Pædiatrica

  • 7.
    Andersen, Sara
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Johannesson, Caroline
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Det finns inget kvar att erövra: Upplevelse av att leva med myelom2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Myleom är en cancersjukdom som uppkommer i benmärgen. I Sverige insjuknar ungefär 500-600 personer i myelom per år. Syftet med litteraturstudien var att med hjälp av de sex dimensionerna av smärta belysa upplevelsen av att leva med sjukdomen myelom. Studien genomfördes utifrån en teoretisk referensram. För att få en helhetsbild av individernas upplevelser av sjukdomen redovisas resultatet utifrån sex dimensioner av smärta. Resultatet visar att individer med myelom får ett inskränkt socialt liv, förändrade vanor och både fysisk och psykisk ohälsa. Individerna påverkas av smärta, trötthet och upprepade infektioner som orsakas av ett nedsatt immunförsvar. Då kunskap om sjukdomen i samhället är begränsad får individer med myelom minskad förståelse när det gäller sjukdomsbilden. För att sjuksköterskan skall få förståelse för individerna och deras livskvalitet krävs en adekvat smärtbedömning, som bör beröra hur individen påverkas av sin sjukdom i det vardagliga livet. Mer forskning kring sjukdomen, behandlingar och mediciner behövs och det vore önskvärt om målet vore att sjukdomen skall kunna botas.

  • 8.
    Andersson, Frida
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Bodén, Anna
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Käll, Elin
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    En förändrad framtid – Kvinnors upplevelser av att behandlats för cervixcancer2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Sedan 1960 talet har screening för och vaccinering mot cervixcancer blivit allt mer utbrett, trots detta drabbas fortfarande 450 kvinnor varje år av cervixcancer i Sverige. Då incidensen minskar finns risken för att kunskapen om sjukdomen minskar. Syftet var därför att belysa kvinnors upplevelser av att behandlats för cervixcancer för att öka kunskap och förståelse i mötet med kvinnorna. Studien utfördes som en litteraturstudie där 20 artiklar låg till grund för resultatet. Resultatet belyser kvinnors upplevelser av att behandlats för cervixcancer och hur det påverkade vardagen, reproduktiv och sexuell hälsa, deras syn på framtiden samt hur de upplevde sjukvården. Att ha behandlats för cervixcancer var något som drabbade hela människan, såväl fysiskt, psykiskt som sexuellt och inte bara genitalierna där sjukdomen hade sitt ursprung. Det framkom att kvinnorna ville samtala om tabubelagda ämnena men inte alltid vågade ta upp dem själva. Därför är det betydelsefullt att sjuksköterskorna ställer frågor angående de här ämnena. Omvårdnad bör grundas på evidens och därför är det viktigt att forskningen fortskrider för att optimera vården för kvinnor med cervixcancer.

  • 9.
    Andersson, S.
    et al.
    Länssjukhuset, Halmstad.
    Fridlund, Bengt
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    The aphasic person's views of the encounter with other people: a grounded theory analysis2002Ingår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 9, nr 3, s. 285-292Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Notes that being affected by aphasia influences the total life experience. The aim of this study was to generate a theoretical model, from a nursing perspective, of what 12 aphasic persons (aged 28-92 yrs old) experience in encounters with other people. Data were collected through interviews which adopted a biophysical, socio-cultural and psychological approach and then analyzed using grounded theory method. Two main categories emerged, namely: interaction and support. Encountered experiences led to (1) a feeling of having ability, (2) a feeling of being an outsider, and (3) a feeling of dejection or uncertainty. The feeling state was dependent on whether the interaction was obstructed or secure and on whether the support resulted in strengthened or impaired self-esteem. Therefore, nurses need to give support that enhances patients self-esteem and which results in them gaining a positive and realistic view of their aphasia, as well as involving those around them in this perspective. This then will give the possibility for the patient to turn the interaction process from an obstructed into a secure one.

  • 10.
    Andersson, Ulrika
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Helin, Ann-Sofi
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Ögonsjuksköterskors upplevelser av att använda sin specifika omvårdnadskunskap vid telefonrådgivning2013Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Telefonrådgivning är en vanlig vårdform. I en alltmer medicinskt och tekniskt utvecklad ögonsjukvård efterfrågas ögonsjuksköterskornas omvårdnadskompetens av både patienter, anhöriga och kollegor inom andra delar av sjukvården. Syftet med studien var att undersöka ögonsjuksköterskors upplevelser av att använda sin specifika omvårdnadskunskap vid telefonrådgivning inom ögonsjukvård. Studien genomfördes med en kvalitativ metod och data samlades in genom semistrukturerade intervjuer. Materialet analyserades med kvalitativ innehållsanalys. Resultatet visade att ögonsjuksköterskorna upplevde arbetet som utvecklande och utmanande. De såg sig själva som en lots i vården med en stor rådgivande funktion relaterat till sin specifika kunskap. De beskrev också en del svårigheter med att triagera via telefon. De önskade bättre bedömningsunderlag men var dock trygga med sina bedömningar och någon rädsla för anmälningar till tillsynsmyndighet framkom inte. De uttryckte även ett behov av utbildning inom samtalsmetodik. Ögonsköterskorna saknade tid för kollegiala reflektioner för att utveckla sin professionella hållning i arbetet med telefonrådgivningen

  • 11.
    Andreasson, Maria
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Ekstav Lilja, Lena
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Förebyggande av anestesirelaterad atelektasbildning.2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Atelektaser uppstår inom tio minuter hos 90 % av alla patienter som sövs och leder till försämrad syresättning men kan även leda till postoperativa lungkomplikationer. Syftet med studien var att beskriva hur anestesisjuksköterskan med olika ventilationsstrategier kan förebygga atelektasbildning under generell anestesi. Studien genomfördes som en litteraturstudie där 19 vetenskapliga artiklar granskades och analyserades. Resultatet visar att när 100 % syrgas ges under induktionen av anestesi ökar uppkomsten av atelektaser. Om positive end-expiratory pressure (PEEP) 6-10 cmH2O används tillsammans med 100 % syrgas motverkas detta. Det är mer oklart vilken effekt PEEP har efter induktionen av anestesi. PEEP bör kombineras med rekryteringsmanöver för att effektivt motverka atelektasbildning. Olika metoder för att genomföra rekryteringsmanöver finns beskrivna men gemensamt är att topptrycket ska nå upp till cirka 40 cmH2O. Efter induktionen kan anestesisjuksköterskan även förebygga uppkomst av atelektaser genom använda 40 % syrgas. I den kliniska verksamheten saknas ofta riktlinjer för vilken ventilationsstrategi som ska användas. För att kunna arbeta preventivt med att förebygga atelektasbildning måste anestesisjuksköterskan diskutera ventilationsstrategi med anestesiläkaren innan problem med syresättningen uppstår. För framtida forskning skulle det kunna vara av intresse att undersöka hur olika ventilationsinställningar påverkar patientens upplevelse under preoxygenering.

  • 12.
    Archer, Trevor
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Josefsson, Torbjörn
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Lindwall, Magnus
    University of Gothenburg, Gothenburg, Sweden.
    Effects of physical exercise on depressive symptoms and biomarkers in depression2014Ingår i: CNS & Neurological Disorders: Drug Targets, ISSN 1871-5273, E-ISSN 1996-3181, Vol. 13, nr 10, s. 1640-1653Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Regular physical exercise/activity has been shown repeatedly to promote positive benefits in cognitive, emotional and motor domains concomitant with reductions in distress and negative affect. It exerts a preventative role in anxiety and depressive states and facilitates psychological well-being in both adolescents and adults. Not least, several meta-analyses attest to improvements brought about by exercise. In the present treatise, the beneficial effects of exercise upon cognitive, executive function and working memory, emotional, self-esteem and depressed mood, motivational, anhedonia and psychomotor retardation, and somatic/physical, sleep disturbances and chronic aches and pains, categories of depression are discussed. Concurrently, the amelioration of several biomarkers associated with depressive states: hypothalamic-pituitary-adrenal (HPA) axis homeostasis, anti-neurodegenerative effects, monoamine metabolism regulation and neuroimmune functioning. The notion that physical exercise may function as "scaffolding" that buttresses available network circuits, anti-inflammatory defences and neuroreparative processes, e.g. brain-derived neurotrophic factor (BDNF), holds a certain appeal. © 2014 Bentham Science Publishers.

  • 13.
    Arvidsson, Barbro
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Skärsäter, IngelaHögskolan Väst, Institutionen för omvårdnad, hälsa och kultur, Avd för sjuksköterskeutbildning.
    Psykiatrisk omvårdnad: att stödja hälsofrämjande processer2006Samlingsverk (redaktörskap) (Övrig (populärvetenskap, debatt, mm))
    Abstract [sv]

    oken, den första i sitt slag, har ett hälsofrämjande förhållningssätt både vad gäller att förhindra att psykisk ohälsa uppstår och att förhålla sig till personer som i någon mening drabbats av psykisk ohälsa. Syftet är att locka fram hälsofrämjande processer, att hitta hälsan i det sjuka. Författarna beskriver den vårdande insatsen, mötet och relationen mellan vårdare och patient/vårdtagare. Boken belyser också betydelsen av att övriga sociala relationer fungerar, såväl inom familjen som i övriga samhällslivet.

    (Beskrivning från förlaget)

  • 14.
    Arvidsson, Jenny
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Theodorsson, Linda
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Den fysiska aktivitetens betydelse för depression2011Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Depression är en sjukdom där forskarna inte är överens om dess uppkomst. Forskning tyder på att depression år 2020 kommer att vara den näst vanligaste sjukdomen i världen. Fysisk aktivitet är viktigt för folkhälsan och påverkar individen såväl fysiskt som psykiskt. Syftet med denna litteraturstudie var att belysa sambandet mellan depression och fysisk aktivitet. Resultatet baseras på 14 artiklar som relaterar till syftet. Resultatet visade att de personer som är fysiskt aktiva har minskad risk att uppleva psykiska besvär som depression. Det finns även ett samband mellan hur mycket fysisk aktivitet som utförs och graden av depression. Sjuksköterskan har en viktig roll både vad det gäller förebyggande och lindrande av depression. Genom dialog med patienten kan fysisk aktivitet föreslås som ett komplement till den medicinska behandlingen. Det kan räcka med ett par promenader i veckan för att risken för uppkomst av depression samt depressionssymtomen hos dem som lider av depression skall minska. Om fler människor motionerar regelbundet skulle med största sannolikhet depressionsfrekvensen minska. Vidare forskning inom området samt implementering av den kunskap som finns bör göras. Det är viktigt att den positiva effekten av fysisk aktivitet vid depression når fram till alla professioner inom hälso- och sjukvården och att den implementeras i verksamheterna. Detta kan på sikt tillsammans med ytterligare forskning leda till att viss del av den medicinska behandlingen kan ersättas med fysisk aktivitet.

  • 15.
    Asker-Arnason, Lena
    et al.
    Section of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University.
    Wengelin, Åsa
    Centre for Languages and Literature, Department of Linguistics, Lund University.
    Sahlén, Birgitta
    Section of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University.
    Process and product in writing: A methodological contribution to the assessment of written narratives in 8-12 year old Swedish children using ScriptLog2008Ingår i: Logopedics Phoniatrics Vocology, ISSN 1401-5439, Vol. 33, nr 3, s. 143-152Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Twenty-seven children, with typical language development (TLD), 8-10 years old and 10-12 years old, were assessed with keystroke-logging in order to investigate their narrative writing. Measures of the writing process and the written product were used. One purpose was to explore how children produce written narratives in on-line production, and to relate the writing process to the written product. The results showed that those children who produced the final text faster, also wrote stories that comprised of more words. In the group of older children, children with better narrative ability used less pause time than those with worse ability, and the girls were faster writers than the boys. We believe that keystroke-logging gives valuable information for the assessment of young children's writing and that it is a potentially valid assessment tool for children from about 10 years of age.

  • 16.
    Asker-Árnason, Lena
    et al.
    Lund University.
    Ibertsson, Tina
    Lund University.
    Wass, Malin
    Linköping University.
    Wengelin, Åsa
    Lund University.
    Sahlén, Birgitta
    Lund University.
    Picture-elicited written narratives, process and product, in 18 children with cochlear implants2010Ingår i: Communication Disorders Quarterly, ISSN 1525-7401, E-ISSN 1538-4837, Vol. 31, nr 4, s. 195-212Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the study was to explore the narrative writing of 18 children, ages 11 to 19, with severe and profound hearing impairment who had cochlear implants (CI), compared with the performance of hearing children. Nine of the 18 children had prelingual deafness and 9 children had postlingual deafness. The hearing impairment was progressive in 11 children. The participants thus formed a heterogeneous group, which was split in two ways: according to age at testing and age at implantation. The narratives were collected by means of keystroke logging. The difference between the children with CI and the hearing children was most prominent for two measures: the percentage of pause time (in the group of children older than 13 years) and lexical density. Furthermore, the children implanted after 5 years of age performed more like the hearing children. This group consisted of children with postlingual deafness and also of children who were deafened progressively. Our interpretation is that these children benefited from the early linguistic input. Taking the whole group of participants into consideration, the results reflect linguistic and cognitive processing limitations in complex linguistic tasks like narration for the children with CI in comparison with their hearing peers.

  • 17.
    Attema, Joanne L.
    et al.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Pronk, Cornelis J. H.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Norddahl, Gudmundur L.
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Nygren, Jens Martin
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Bryder, David
    Immunology Unit, Institution for Experimental Medical Research, Lund University, Lund, Sweden.
    Hematopoietic stem cell ageing is uncoupled from p16 INK4A-mediated senescence2009Ingår i: Oncogene, ISSN 0950-9232, E-ISSN 1476-5594, Vol. 28, nr 22, s. 2238-2243Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Somatic stem cells are ultimately responsible for mediating appropriate organ homeostasis and have therefore been proposed to represent a cellular origin of the ageing process-a state often characterized by inappropriate homeostasis. Specifically, it has been suggested that ageing stem cells might succumb to replicative senescence by a mechanism involving the cyclin-dependent kinase inhibitor p16(INK4A). Here, we tested multiple functional and molecular parameters indicative of p16(INK4A) activity in primary aged murine hematopoietic stem cells (HSCs). We found no evidence that replicative senescence accompanies stem cell ageing in vivo, and in line with p16(INK4A) being a critical determinant of such processes, most aged HSCs (>99%) failed to express p16(INK4A) at the mRNA level. Moreover, whereas loss of epigenetically guided repression of the INK4A/ARF locus accompanied replicative senescent murine embryonic fibroblasts, such repression was maintained in aged stem cells. Taken together, these studies indicate that increased senescence as mediated by the p16(INK4A) tumor suppressor has only a minor function as an intrinsic regulator of steady-state HSC ageing in vivo.

  • 18.
    Backman, Ellen
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Region Halland, Halmstad, Sweden.
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Sjögreen, Lotta
    Mun-H-Center Orofacial Resource Center for Rare diseases, Gothenburg, Sweden.
    The use of gastrostomy in Swedish children – indications, and trends between 2005 and 20152017Konferensbidrag (Refereegranskat)
    Abstract [en]

    Children with complex medical needs requiring nutritional support are growing in number. This presentation will add new knowledge regarding gastrostomy in children by reporting primary diagnosis, and indications for the use of gastrostomy. Furthermore, the presentation will discuss and analyse data evolution trends from 2005 to 2015 in Sweden.

    Methods: The first part of the study used national statistics to provide a broad picture of gastrostomy use in Swedish children. The second part applied a retrospective observational study design, reviewing medical charts in order to obtain an in-depth picture of the children in need for gastrostomy, and its use in a five-year perspective.

    Results: The number of gastrostomy cases recorded in the national database was 3 946, 53% male, and 47% female. The distribution of age groups was: 0-4 years: 61% , 5-9 years: 17%, 10-14 years: 12%, and 15-19: years 10%.  When observing trends on a national level, the number of children receiving gastrostomy increased in average by 13% per year. Changes in the separate age groups were analysed. An increase was noted for children aged 0-4 years and for children aged 5-9 years. In the age groups 10-14 years and 15-19 years, there was no progressive increase. The results from the national statistics database will be discussed in relation to the medical chart-analyses of 75 children receiving gastrostomy in one Swedish administrative region between 2005 and 2015. 

    Conclusions: As in many parts of Europe, the number of children in need for gastrostomy is also growing in Sweden, with the youngest children seeming to be the group increasing most.

    Clinical implications: Nutritional support in Sweden is publicly financed, therefore these findings may be useful when planning both monetary and human resources in meeting the future challenges of paediatric health care.

  • 19.
    Benoni, Anna Clara
    et al.
    Research and Development Department, Halmstad Central Hospital, Halmstad, Sweden.
    Bremander, Ann
    Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Nilsdotter, Anna
    Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Patient-reported outcome after rheumatoid arthritis-related surgery in the lower extremities: A report from the Swedish National Register of Rheuma Surgery (RAKIR)2012Ingår i: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 83, nr 2, s. 179-84Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE: Although decreasing with the development of effective pharmacological regimes, joint surgery has improved the function and quality of life of patients with rheumatoid arthritis (RA). Few studies have assessed patient-reported outcomes after RA surgery to the lower extremities. Here we report patient-relevant outcome after RA-related surgery based on the first data from the Swedish National Register of Rheuma Surgery (RAKIR).

    PATIENTS AND METHODS: 258 RA patients (212 women) who had joint surgery performed at the Department of Orthopaedics, Spenshult Hospital between September 2007 and June 2009 were included. Mean age at surgery was 64 (20-86) years. The patients completed the SF-36 and HAQ questionnaires preoperatively and 6 months postoperatively, and 165 patients completed them after 12 months.

    RESULTS: Improvement was seen as early as at 6 months. At 12 months, 165 patients (141 women)-including hip (n = 15), knee (n = 27), foot (n = 102), and ankle (n = 21) patients-reported statistically significant improvements from preoperatively to 12 months postoperatively in HAQ (mean change: -0.11) and SF-36 subscales physical function (11), role physical (12), bodily pain (13), social functioning (6.4), and role emotional (9.4). Hip and knee patients reported the greatest improvements.

    INTERPRETATION: Orthopedic RA-related surgery of the lower extremities has a strong effect on pain and physical function. Improvement is evident as early as 6 months postoperatively and remains after 12 months. Copyright © 2011 Nordic Orthopaedic Federation.

  • 20.
    Berg, Marie
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Erlandsson, Lena-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Sparud-Lundin, Carina
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Breastfeeding and its impact on daily life in women with type 1 diabetes during the first six months after childbirth: a prospective cohort study2012Ingår i: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 7, artikel-id 20Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: For mothers with diabetes, breastfeeding is a great challenge due to their struggle with potentially unstable blood glucose levels. This paper explores breastfeeding attitudes and impact of breastfeeding on the daily life of mothers with type 1 diabetes compared with non-diabetic mothers.Methods: We performed a prospective cohort study of 108 mothers with type 1 diabetes and a reference group of 104 mothers in the west of Sweden. Data were collected through medical records and structured telephone interviews at 2 and 6 months after childbirth.Results: Women in both the diabetes group and the reference group had high levels of confidence (84% and 93% respectively) in their breastfeeding capacity before childbirth, and 90% assessed breastfeeding as a positive and an important experience during the six months of follow-up. About 80% assessed breastfeeding as influencing daily life 'very much' or 'quite a lot' at 2 months as did 60% at 6 months, with no difference between the groups. In mothers with diabetes, the impact of breastfeeding on the priority of other duties decreased over time, as did feelings of time pressure and negative effects on patterns of sleep. Compared to the reference group, mothers with diabetes at 6 months remained more affected by disruptions in daily life and they felt more worried about their health both at 2 and 6 months after childbirth. For the reference group mothers' sensitivity to unexpected disruptions in daily routines decreased between 2 and 6 months after childbirth, and they expressed a greater need to organize their time than mothers with diabetes.Conclusion: Mothers with diabetes type 1 express more worry for own health and are more sensitive to distruptions. To balance their everyday life and to reduce the risk of stress and illhealth they are therefor, compared to other mothers, likely to need additional professional and peer support. © 2012 Berg et al.; licensee BioMed Central Ltd.

  • 21.
    Berggren, Anette
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Jansson, Eliana
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Sjöstrand, Charlotta
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    En komplex vardag: Att leva med tvångssyndrom2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Tvångssyndrom är en psykisk sjukdom som ca 2 % av världens befolkning lever med och som visar sig som tvångstankar eller tvångstankar och tvångshandlingar. Den ångest som ligger bakom tvångssyndromet lindras med hjälp av tvångshandlingar. Då sjuksköterskan i sitt yrke kommer att träffa personer med tvångssyndrom är det viktigt med förståelse om hur vardagen ser ut för personer med tvångssyndrom och hur de upplever sitt syndrom.

    I denna litteraturstudie, vars syfte var att öka sjuksköterskans kunskaper kring de komplexa situationer som kan uppstå vid omvårdnaden av personer med tvångssyndrom genom att belysa erfarenheter av den levda vardagen hos personer med tvångssyndrom, har 12 artiklar varav 4 kvalitativa och 8 kvantitativa systematiskt granskats och analyserats.

    Resultatet visar att personer med tvångssyndrom lever med en låg livskvalitet i förhållande till personer utan tvångssyndrom. En försämrad livskvalitet påverkar personens vardagliga liv genom att negativt påverka relationer, arbete och utbildning.

    För att ytterligare öka förståelsen för personer med tvångssyndrom rekommenderas ytterligare kvalitativ forskning om personers upplevelser. Att nå ut till sjuksköterskestudenter och verksamma sjuksköterskor med resultatet av ny forskning är av stor vikt. Temadagar om psykisk ohälsa under utbildningen samt på arbetsplatser kan öka förståelsen inom ämnet.

  • 22. Berggren, Ulf
    et al.
    Hägglin, Catharina
    Hallberg, Ulrika
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Psychological and Quality of Life Aspects of Edentulousness and Treatment with Dental Implants2005Ingår i: The osseointegration book: from calvarium to calcaneus, Berlin: Quintessence Publishing , 2005, s. 157-172Kapitel i bok, del av antologi (Refereegranskat)
  • 23.
    Bergman, Cilie
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Lorentsson, Kajsa
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Gåvan till liv: upplevelser av att donera en njure2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Att ge bort en del av sig själv för att förbättra livet för en annan människa, är att ge gåvan till liv. Levande njurdonatorers upplevelser kommer ofta i skymundan eftersom studier ofta fokuserat på mottagarens upple-velse av njurtransplantationen. Donationen beskrivs med både positiva och negativa upplevelser. De negati-va upplevelserna förknippas med fysiska och psykiska komplikationer efter donationen. De positiva upplevel-serna beskrivs som ökad livskvalitet och glädje inför att hjälpa en människa till ett bättre liv. Syftet med denna litteraturstudie var att beskriva levande donatorers upp-levelser av att donera en njure från beslutsfattandet till tiden efter donationen. Studien genomfördes som en lit-teraturstudie, där 13 artiklar granskades och analysera-des. Resultatet visar att det finns flera faktorer, såsom oro inför mottagarens situation och oro inför sin egen framtid som påverkar donatorernas beslutsfattande. Det framkom även att både fysiska och psykiska upplevelser förekommer efter donationen. De fysiska upplevelserna var framförallt smärta, illamående samt ömhet och obe-hag runt operationssåret. Donatorns psykiska upplevel-ser efter donationen var vanligen oro inför mottagarens tillfrisknande, stress, depression samt nedstämdhet. Överlag upplevde donatorerna donationen positivt och var nöjda med sitt beslut. Mer forskning kring levande njurdonatorers upplevelser kan bidra till att sjuksköters-kor lättare kan stödja donatorer i donationsprocessen samt att blivande donatorer kan få en inblick i hur dona-tionen upplevs.

  • 24.
    Bergman, Stefan
    Spenshult Hospital, Oskarström, Sweden.
    Management of musculoskeletal pain2007Ingår i: Baillière's Best Practice & Research: Clinical Rheumatology, ISSN 1521-6942, E-ISSN 1532-1770, Vol. 21, nr 1, s. 153-166Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic musculoskeletal pain is a major public health problem affecting about one third of the adult population. Pain is often present without any specific findings in the musculoskeletal system and a strictly biomedical approach could be inadequate. A biopsychosocial model could give a better understanding of symptoms and new targets for management. Identification of risk factors for chronicity is important for prevention and early intervention. The cornerstones in management of chronic non-specific, and often widespread, musculoskeletal pain are non-pharmacological. Physical exercise and cognitive behavioral therapy, ideally in combination, are first line treatments in e.g. chronic low back pain and fibromyalgia. Analgesics are useful when there is a specific nociceptive component, but are often of limited usefulness in non-specific or chronic widespread pain (including fibromyalgia). Antidepressants and anticonvulsants could be of value in some patients but there is a need for more knowledge in order to give general recommendations.

  • 25.
    Bergman, Stefan
    Spenshult Hospital, Oskarström, Sweden.
    Public health perspective - how to improve the musculoskeletal health of the population2007Ingår i: Baillière's Best Practice & Research: Clinical Rheumatology, ISSN 1521-6942, E-ISSN 1532-1770, Vol. 21, nr 1, s. 191-204Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Musculoskeletal disorders are the most common cause of long-term sick leave in several western countries and individuals with chronic musculoskeletal pain score very low on health status measurements. Musculoskeletal health is multidimensional and is best understood from a biopsychosocial perspective. Body structure and function interacts with personal and environmental factors, affecting the ability to perform activities and participate in society. Interventions aimed at the whole population must attend to the underlying causes of musculoskeletal disorders and promote a healthy lifestyle. Safe environments and activities could reduce the risk of traumatic events and also make participation possible for those with a disability. Public beliefs about musculoskeletal symptoms and consequences need to be changed in order to minimise fear and avoidance, which, together with other psychosocial factors, could lead to chronicity. Public awareness and identification of those at risk for the development of musculoskeletal problems could lead to early and properly timed management.

  • 26.
    Bergman, Stefan
    et al.
    Primary Care Centre Hertig Knut, Halmstad, Sweden.
    Herrström, Per
    Jacobsson, Lennart T
    Petersson, Ingemar F
    Chronic widespread pain: a three year followup of pain distribution and risk factors2002Ingår i: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 29, nr 4, s. 818-825Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the change of pain reports over time in 3 cohorts derived from the general population: (1) no chronic pain (NCP; n = 1156); (2) chronic regional pain (CRP; n = 502); and (3) chronic widespread pain (CWP; n = 242). To identify risk factors that predict the development or persistence of chronic widespread pain.

    METHODS: A 3-year followup from 1995 to 1998 with postal questionnaire to 2425 subjects of both sexes aged 20-74 years on the west coast of Sweden.

    RESULTS: At followup, a larger proportion of subjects with initial CRP compared to initial NCP reported CWP (16.4 and 2.2%, respectively; p < 0.001). The majority of subjects (56.9%) who primarily reported CWP remained in that group at followup, but 26.8% had changed status to CRP and 16.3% to NCP. The number of painful regions (7-12 vs 0 regions) reported at baseline was the strongest predictor for the development of CWP with an odds ratio (OR) of 12.13 (95% CI 4.47-32.88). The development of CWP was also predicted by higher age (OR = 3.13, 95% CI 1.47-6.69, age-group 59-74 years vs age-group 20-34 years), and a family history of chronic pain (OR = 1.87, 95% CI 1.14-3.07). A habit of drinking alcohol weekly (OR = 0.42, 95% CI 0.21-0.85) compared to the habit of never or seldom drinking alcohol was protective, as well as having personal social support (OR = 0.49, 95% CI 0.28-0.85). The persistence of CWP was predicted by the number of painful regions (13-18 vs 1-6 regions) at baseline (OR = 7.56, 95% CI 2.17-26.30), and being an immigrant (OR = 3.22, 95% CI 1.33-7.77).

    CONCLUSION: Although the overall prevalence of CWP was stable over a 3-year period there was a considerable variation on an individual basis. This variability in expressing CWP was moderately predicted by a combination of risk factors, the most important being the number of painful regions at baseline. Future research will need to show how useful the identified factors are in clinical practice and whether intervention aimed at changing these factors will improve pain outcome. 

  • 27.
    Bergsten, Ulrika
    et al.
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Bergman, Stefan
    Spenshult Hosp, Ctr Res & Dev, Oskarstrom.
    Fridlund, Bengt
    Jonkoping Univ, Sch Hlth Sci, Jonkoping.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Berglund, Anita
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm.
    Arvidsson, Barbro
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Petersson, Ingemar
    Univ Lund Hosp, Dept Rheumatol, S-22185 Lund.
    Patterns of background factors related to early RA patients conceptions of the cause of their disease2011Ingår i: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 30, nr 3, s. 347-352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the present study was to identify patterns of background factors related to the early RA patients' conceptions of the cause of the disease. Conceptions from a qualitative study formed the basis for the stratification of 785 patients from the Swedish EIRA study answering a question about their own thoughts about the cause to RA. Logistic regression analyses were used to explore the associations between patients' conceptions and relevant background factors: sex, age, civil status, educational level, anti-cyclic citrullinated peptide antibody (anti-CCP) and smoking habits. The results were presented as odds ratios (OR) with 95% confidence intervals (CI). A conception of family-related strain was strongly associated with being young (OR 0.50; 95% CI 0.33-0.78 for age 58-70 vs. 17-46), female (OR 0.38; 95% CI 0.25-0.60 for male vs. female) and having a high level of education (OR 2.15; 95% CI 1.54-3.01 for university degree vs. no degree). A conception of being exposed to climate changes was associated with being male (OR 1.99; 95% CI 1.24-3.22 for male vs. female), having a low level of education (OR 0.33; 95% CI 0.18-0.58 for university degree vs. no degree) and positive Anti-CCP (OR 1.72; 95% CI 1.03-2.87 for positive vs. negative Anti-CCP). Linking patients' conceptions of the cause of their RA to background factors potentially could create new opportunities for understanding the complexity of the aetiology in RA. Furthermore, this information is important and relevant in the care of patients with early RA.

  • 28.
    Bergström, Emelie
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Sager, Simet
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Hög intensitet av preoperativ stress och oro - en fara vid kirurgiska ingrepp2010Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Preoperativ stress och oro är vanligt förekommande i dagens sjukvård. Patienter med hög intensitet av preoperativ stress och oro får ofta postoperativa komplikationer såsom längre återhämtningsfas och svårare sårläkning. Syftet med litteraturstudien var att belysa omvårdnadsåtgärder som kan påverka preoperativ stress och oro. Litteraturstudiens resultat bygger på en analys av 16 vetenskapliga artiklar som söktes utifrån litteraturstudiens syfte. Tre omvårdnadsåtgärder som är en del av sjuksköterskeprofessionen eller som finns tillgängliga på vårdavdelningar är information, sjuksköterskans förhållningssätt samt musik. Med hjälp av dessa omvårdnadsåtgärder kan sjuksköterskan hjälpa patienten att reducera preoperativ stress och oro i god tid. Detta resulterar i att patienten upplever trygghet i sin omgivning, slappnar av och blir mottaglig för information. Om intensiteten av stress och oro reduceras preoperativt leder det till kortare sjukhusvistelse och därigenom lägre sjukhuskostnader. För att underlätta sjuksköterskans planering av omvårdnadsåtgärder kan patientdagbok vara till hjälp. Det behövs forskning kring sjuksköterskans upplevelse att arbeta utifrån dessa tre omvårdnadsåtgärder.

  • 29.
    Bernson, Jenny M.
    et al.
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Elfstrom, Magnus L.
    Department of Psychology, School of Sustainable Development of Society and Technology, Mälardalen University, Eskilstuna, Sweden.
    Hakeberg, Magnus
    Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
    'Making dental care possible - a mutual affair'. A grounded theory relating to adult patients with dental fear and regular dental treatment2011Ingår i: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 119, nr 5, s. 373-380Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Dental fear is a common and widespread problem, which can cause severe stress. Even so, most patients with dental fear undergo regular dental treatment in spite of their fear and many enjoy good oral health. The aim of this study was to obtain a deeper understanding of how patients with dental fear manage to undergo dental treatment. Fourteen patients with dental fear, who undergo regular dental care, were interviewed. Qualitative analysis of the transcribed interviews was performed according to the principles of grounded theory. A conceptual framework was generated, and the main concern was identified as 'making dental care possible - a mutual affair'. Four additional categories explained how patients handled their dental fear and how dental care became possible. The strategies were labelled 'taking part in a mental wrestling match', 'trust-filled interaction with dental staff', 'striving for control' and 'seeking and/or receiving social support'. The results showed that making dental care possible for patients with dental fear is a mutual challenge that requires interplay between dental staff and patients, involving verbal and non-verbal communication reflecting respect, attention, and empathy. Moreover, a balance between nearness and distance and between professional and personal treatment is required.

  • 30.
    Björk, Maria
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Göransson, Christine
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Sjuksköterskans upplevelser av att vårda patienter med HIV/Aids2009Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Idag lever cirka 33 miljoner människor med HIV/Aids. Totalt har omkring 30 miljoner människor avlidit sedan första Aids- fallet diagnostiserades år 1981. I västvärlden har HIV-smittade en tät kontakt med sjukvården eftersom de går på regelbundna kontroller, därmed är sjuksköterskor en yrkeskategori som träffar dessa patienter ofta. I utvecklingsländerna ser det ofta tyvärr annorlunda ut, HIV-smittade har ingen eller gles kontakt med sjukvården. Syftet med studien var att belysa sjuksköterskans upplevelser i omvårdnaden av HIV/Aids patienter. Uppsatsen genomfördes som en litteraturstudie där 14 vetenskapliga artiklar granskades, bearbetades och analyserades. Resultatet visade att sjuksköterskornas upplevelser av att vårda HIV/Aids patienter varierade. Positiva upplevelser kunde bland annat vara att arbetet var utvecklande och sjuksköterskorna kände sig viktiga för patienterna. Negativa upplevelser var bland annat rädsla och brist på resurser. Att vårda patienter med HIV/Aids kräver god kunskap om både sjukdomen och adekvata omvårdnadsåtgärder. Mer utbildning inom området efterlyses i sjuksköterskans grundutbildning. Förslag till vidare forskning är att undersöka vad sjuksköterskorna anser att man kunde göra för att ta bort de felaktiga negativa bilderna av sjukdomen och komma till rätta med de brister som finns idag.

  • 31.
    Bolse, Kärstin
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI). Linköpings Universitet, Linköping, Sweden.
    Living with an implantable cardioverter defibrillator: Swedish and US patients' experiences of their life situation2004Licentiatavhandling, sammanläggning (Övrigt vetenskapligt)
  • 32.
    Bramsved, Rebecka
    et al.
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Novak, Daniel
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mehlig, Kirsten
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Lissner, Lauren
    Institute of Medicine, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Mårild, Staffan
    The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Parental education and family income affect birthweight, early longitudinal growth and body mass index development differently2018Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, nr 11, s. 1946-1952Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study investigated the effects of two parental socio-economic characteristics, education and income, on growth and risk of obesity in children from birth to 8 years of age.

    METHODS: Longitudinal growth data and national register-based information on socio-economic characteristics were available for 3,030 Swedish children. The development of body mass index (BMI) and height was compared in groups dichotomised by parental education and income.

    RESULTS: Low parental education was associated with a higher BMI from 4 years of age, independent of income, immigrant background, maternal BMI and smoking during pregnancy. Low family income was associated with a lower birthweight, but did not independently predict BMI development. At 8 years of age, children from less educated families had a three times higher risk of obesity, independent of parental income. Children whose parents had fewer years of education but high income had significantly higher height than all other children.

    CONCLUSION: Parental education protected against childhood obesity, even after adjusting for income and other important parental characteristics. Income-related differences in height, despite similar BMIs, raise questions about body composition and metabolic risk profiles. The dominant role of education underscores the value of health literacy initiatives for the parents of young children. ©2018 Foundation Acta Pædiatrica.

  • 33.
    Brantmark, Anna
    et al.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Karlsson, Rebecca
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS).
    Föräldrars påverkan i utvecklingen av övervikt och fetma hos barn2011Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Övervikt och fetma hos barn är ett allvarligt och växande problem. Det är ett tillstånd som för med sig många olika sjukdomar och i och med att antalet överviktiga barn ökar hastigt kommer det att vara en stor belastning för den framtida hälso- och sjukvården. Prevalensen är särskilt stor i vissa delar av världen och inom vissa grupper i samhället. Föräldrar spelar en väsentlig roll i huruvida barnen lever hälsosamma liv eftersom de bär ansvaret för barnen. Syftet med denna litteraturstudie var att undersöka föräldrars påverkan i utvecklingen av övervikt och fetma hos barn och genom en systematisk bearbetning av litteraturen granskades och bearbetades slutligen 19 vetenskapliga artiklar till resultatdelen i studien. Socioekonomiska faktorer, faktorer inom familjen och föräldrars roll var tre teman som utmärkte sig där det under varje rubrik beskrivs hur föräldrar påverkar med att bidra till eller motverka riskfaktorer till en ohälsosam viktstatus hos barn. Föräldrar har ett behov av stöd i form av information och kunskap och hälso- och sjukvården bär ett stort ansvar i att stödja föräldrar, förebygga sjukdom och främja hälsa.

     

  • 34.
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS). FoU Spenshult & Lunds universitet, Lund, Sverige.
    Reumatoid artrit2015Ingår i: Fysisk aktivitet vid reumatisk sjukdom / [ed] Christina H. Opava, Lund: Studentlitteratur AB, 2015, 1:1, s. 129-139Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [sv]

    Reumatoid artiri (RA) medför ofta konsekvenser för en persons funktionstillstånd, upplevda hälsa och livskvalitet. Att främja förmågan till fysisk aktivitet är en viktig uppgift för hälso- och sjukvården och ger stora vinster för den enskildes hälsa. Rekommendationer för om fysisk aktivitet och träning har gått från vila och passiv rörelseträning till att idag kunna jämställas med aktiv träning på samma nivå som finns i rekommendationer till befolkningen i allmänhet. Naturligtvis måste träningen anpassas till individens behov, förutsättningar och önskemål.

  • 35.
    Bremander, Ann B
    et al.
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Hubertsson, Jenny
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Petersson, Ingemar F
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences, Lund University, Lund, Sweden.
    Grahn, Birgitta
    Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
    Education and benchmarking among physicians may facilitate sick-listing practice2012Ingår i: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 22, nr 1, s. 78-87Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Assessing work ability and sickness certification are considered problematic by many physicians and education and implementation of guidelines to improve knowledge and skills has been requested. Our aim was to study the association between such interventions and physicians' sick-listing practices.

    METHODS: A web-based questionnaire was sent to all physicians working in primary care, psychiatry, orthopedics/rheumatology in the southern region of Sweden before (in 2007 to 1,063 physicians) and after (in 2009 to 1,164 physicians) educational interventions in insurance medicine were offered.

    RESULTS: With a response rate of 58%, half of the physicians (51%) reported to work at a clinic with a sick-listing policy in 2009 compared with 31% in 2007. Primary care physicians (OR 12.4) and physicians who had participated in educational interventions in insurance medicine (OR 2.4) more often had a sick-listing policy at the clinic. Physicians with a longer medical experience (OR 0.7) and those with support at the clinic (OR 0.3) and the possibility to extend time if needed (OR 0.4) were less likely to report of problematic cases while primary care physicians were (OR 2.9). On the contrary, physicians who reported to rarely have the possibility to extend time when handling problematic cases were more likely to issue a higher number of sickness certificates.

    CONCLUSIONS: The sick-listing process is often viewed as problematic and more often by primary care physicians. Benchmarking and education in insurance medicine together with the possibility to allocate extra time if encountering problematic cases may facilitate sick-listing practice.

  • 36.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS). Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Forslind, K.
    Lund University, Lund and Helsingborg, Sweden & Helsingborg's hospital, Helsingborg, Sweden.
    Eberhardt, K.
    Lund University, Lund, Sweden.
    Andersson, M.
    Lund University, Lund, Sweden & Spenshult Research and Devlopment Centre, Halmstad, Sweden.
    Functional Impairment in Patients with RA in an Eight Year Perspective2017Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, nr Suppl. 2, s. 1513-1514Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In people with Rheumatoid arthritis (RA) impaired physical functioning is an acute as well as long term effect of the disease. Observational performance tests reflecting range of motion in upper as well as in lower extremities should be easy to perform in the clinic as well as in research as a complement to self-reported measures of physical functioning. The Signal Of Functional Impairment (SOFI)1 is a performance test which so far has been applied only in Sweden but commonly used in the clinic and in long term follow-up clinical studies.

    Objectives: The aim was to study performance-based function assessed with SOFI over 8 years and, secondly, to study which items included in SOFI that were associated with change in functioning over time.

    Methods: An inception cohort of 1 052 patients with early RA, from the BARFOT-study, recruited 1992–2006 was investigated, mean (SD) age was 54 years (14), 70% were women. The patients were followed by a structured protocol at baseline, 3 and 6 months and at 1, 2, 5, and 8 years. SOFI consists of 3 parts measuring hand, arm (upper), and leg (lower) function (1). Hand function is tested by 4 movements; cylinder grip (H1), pen grip (H2), pincer grip (H3) and opposition of the thumb (H4). Arm function is assessed by 3 movements; hand behind the head and the ability to touch the cervical spine processes with fingers (A1), elbow supination (A2) and elbow extension (A3). Leg function is tested by 4 movements; the ability to touch the opposite knee with the heel while sitting (L1), knee extension in supine position (L2), dorsiflexion of the foot standing on a balance board (L3), and the ability to stand on tip toes without shoes (L4). An assessor scores the patient's ability to perform the different tests on an ordinal scale (0=normal, 1= partly impaired and 2= unable to perform). The range of SOFI scores is 0–44 (best to worst).

    Results: At baseline the mean (SD) SOFI was 7.2 (5.8), and at 1 year follow-up the improvement was 2.75 (5.65), p<0.001. From 1 year to 8 year follow-up the deterioration was 1.5 (4.6), p<0.001. When studying hand, upper and lower function separately, the pen grip and the ability to stand on tip toes improves most during the first year. From 1 to 8 year the pincer grip and the ability to stand on tip toes are the items that deteriorate most (Figure). Assessment of the pen grip, the pincer grip and the ability to stand on tip toes explain 58% to 70% of the SOFI score over time, with the highest rate at 5 (65%) and 8 years follow-up (70%).

    Conclusions: Functioning as assessed by SOFI improved during the first year in patients with early RA and then deteriorated slowly. Over a longer period, pincer grip and the ability to stand on tip toes seemed to be the two most important items to measure when assessing functional impairment over time. © 2017, BMJ Publishing Group Limited

  • 37.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS). Department of Clinical Sciences, Section of Rheumatology, Lund, Sweden & R&D centre, Spenshult, Halmstad, Sweden.
    Haglund, Emma
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS). R&D centre, Spenshult, Halmstad, Sweden.
    Bergman, Stefan
    Department of Clinical Sciences, Section of Rheumatology, Lund, Sweden & R&D centre, Spenshult, Halmstad, Sweden & Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Measures of Physical Activity and Fear Avoidance in People with Chronic Pain2018Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, nr Suppl. 2, s. 1829-1830, artikel-id SAT0737-HPRArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Lifestyle factors such as physical activity (PA) has the possibility to contribute to improved health and quality of life in the population as well as in chronic diseases. Most often PA is self-reported while measures of the aerobic capacity are more seldom measured in subjects with chronic pain.

    Objectives To describe physical activity levels (self-reported and aerobic capacity) in people with chronic pain classified as regional or widespread and to compare the findings with a group that report no pain.

    Methods From the 2016 follow-up of the Swedish population based Epipain cohort (n 1321), 146 subjects were invited to a clinical assessment where the aerobic capacity was assessed by using a submaximal bicycle test, the Ekblom-Bak test, together with assessment of the Borg scale for perceived exertion (RPE). Aerobic capacity was also classified as low, average or high according to data from the general population. Self-reported physical activity was coded as MVPArec if recommended levels of PA was reported (physically active on a moderate level ≥150 min/week (MPA) or on an vigorous level ≥75 min/week (VPA) or not). The Fear Avoidance Beliefs Questionnaire for PA (FABQ-PA, 0–24 best to worst) and for work (FABQ-W, 0–48 best to worst) were also assessed. The participants were classified as having chronic widespread pain (CWP), chronic regional pain (CRP) or no chronic pain (NCP) based on a pain mannequin presenting 0–18 pain regions and if pain had lasted for 3 months or more. Chi2 and Kruskal-Wallis tests were performed to study differences between the three pain groups.

    Results 141/146 (97%) subjects (mean (SD) age 59.4 (8.2) years) whereof 61% were women, could be classified into pain groups; 43 as CWP (84% women), 43 as CRP (42% women) and 55 as NCP (58% women). The group with CWP was slightly older than those with CRP (mean (SD) age 57.0 (7.6) years vs. 61.9 (6.9) years, p 0.02). The CWP group also had lower aerobic capacity (mean (SD) 2.2 (0.5) l/min vs. 2.6 (0.6) l/min, p 0.03), and a larger proportion was classified as having low aerobic capacity (CWP 21%, CRP 7% and NCP 10%, p 0.04). The proportion of MVPArec did not differ between the groups; CWP 70%, CRP 81% and NCP 74% (p 0.5). There was neither a difference between the groups in BMI, RPE or in sitting hours/week (p>0.6). However, differences were found in the FABQ where in the PA scale those with CRP had worse scores compared with NCP (mean (SD) 11.2 (7.3) vs. 6.0 (6.0), p<0.001), the difference between CWP (mean (SD) 8.9 (6.7)) and NCP was p 0.06. In the work subscale of FABQ, CWP had worse scores compared with CRP (mean (SD) 18.9 (15.7) vs. 10.0 (12.5), p 0.002) and CRP had worse scores compared to those with NCP (mean (SD) 10.0 (12.5) vs. 6.5 (9.1), p<0.001).

    Conclusions In this sample of subjects with chronic pain or no pain, having widespread pain tended to affect the aerobic capacity negatively while self-reports of reaching recommended levels of physical activity did not differ between groups. Fear avoidance in relation to physical activity and especially in relation to work was more noticeable in subjects with chronic pain compared to those with no pain. Measures of aerobic capacity and information of fear avoidance beliefs might help health professionals to better tailor the non-pharmacological treatment for subjects with chronic pain.

    Disclosure of Interest None declared

    © 2018, Published by the BMJ Publishing Group Limited.

  • 38.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS). Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden.
    Haglund, Emma
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Rydberglaboratoriet för tillämpad naturvetenskap (RLAS). Spenshult Research and Development Center, Halmstad, Sweden.
    Bergman, Stefan
    Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Spenshult Research and Development Center, Halmstad, Sweden & Primary Health Care Unit, Department ofPublic Health and Community Medicine,Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Ndosi, Mwidimi E.
    Department of Nursing and Midwifery, University of the West of England, Bristol, United Kingdom.
    The educational needs of patients with undifferentiated spondyloarthritis: Validation of the ENAT questionnaire and needs assessment2018Ingår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, nr 2, s. 313-317Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA.

    METHODS: This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI]). Rasch analysis was utilized to evaluate the construct validity, internal consistency and unidimensionality of the SwENAT before studying differences in educational needs between patient subgroups (gender, age and disease severity).

    RESULTS: = 11.488; p = 0.119), including strict unidimensionality. Overall, the mean (SD) SwENAT score was 86 (32). Women reported higher needs than men in the domains of pain (mean [SD] 13.1 [6.8] versus 10.1 [6.0]; p = 0.05); movement (mean [SD] 13.0 [5.5] versus 9.9 [5.7]; p = 0.02) and self-help (mean [SD] 17.0 [5.8] versus 14.1 [5.0]; p = 0.03). Higher disease activity (BASDAI >4) was associated with higher educational needs (mean [SD] 92.6 [31.9] versus 73.7 [29.4]; p = 0.02).

    CONCLUSIONS: These data suggest that the SwENAT is valid in USpA. Women and patients with higher disease activity are more likely to have high levels of educational needs, so special attention and strategies to target patient education are warranted. © 2018 John Wiley & Sons, Ltd.

  • 39.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS).
    Jacobsson, Lennart T. H.
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bergman, Stefan
    Research and Development Centre Spenshult, Halmstad, Sweden.
    Haglund, Emma
    Research and Development Centre Spenshult, Halmstad, Sweden.
    Petersson, Ingemar
    Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Smoking is Associated with Worse and More Widespread Pain, Worse Fatigue, General Health and Quality of Life in a Swedish population Based Cohort of Patients with Psoriatic Arthritis2012Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, nr S10, s. S777-S778, artikel-id 1828Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/Purpose: Smoking has been found to be associated with an increased risk of developing psoriatic arthritis (PsA)1. The purpose of this study was analyse possible associations of smoking habits with self-reported clinical features in a large population based cohort of patients with a diagnosis of PsA.

    Methods: All health care seeking subjects with a diagnose of PsA according to ICD 10 codes (given at least once by a rheumatologist/internist or twice by any other physician) were identified by a regional health care register during 2003-20072. In 2009 all identified subjects aged 18 years or older (n=2003) were invited to participate in a cross sectional questionnaire survey. The questionnaire included self-reported data on smoking (never smokers or ever smokers), age at disease onset, physical function (HAQ, 0-3 best to worst), pain, fatigue and global health (numerical rating scales 0-10 best to worst) health related quality of life (EQ-5D, 0-1 worst to best), and number of painful regions noted on a pain mannequin (0-16, best to worst). Linear regression analysis was performed and all data were controlled for sex and age.

    Results: Response rate was 77% whereof 369 patients (18%) declined participation and 1185 (59%) returned the questionnaire,  mean age 57.5 (SD 13.5) years and 58% were women. 1173 subjects responded to the smoking question whereof 448 (38%) were never smokers and 725 (62%) were ever smokers.

    Mean age at disease onset was 42.3 (SD 13.4) years in never smokers vs. 46.0 (SD 13.2) in ever smokers. Never smokers vs. ever smokers had mean HAQ 0.59 (SD 0.6) vs. 0.71 (SD 0.6),  mean pain 3.9 (SD 2.4) vs.4.4 (SD 2.5),  mean fatigue 4.4 (SD 2.8) vs. 5.0 (SD 2.7),  mean global health 3.9 (SD 2.4) vs. 4.4 (SD 2.3), mean EQ-5D 0.68 (SD 0.23) vs. 0.63 (SD 0.26) and mean no of painful regions were 7.2 (SD 4.0) vs. 7.9 (SD 4.3).

    The regression analysis showed that ever smokers had worse pain with age-sex adjusted parameter estimates (B) = 0.38 (95% CI 0.09 ; 0.67), worse fatigue B = 0.34 (95% CI 0.02 ; 0.66), worse global health B = 0.36 (95% CI 0.09 ; 0.64), worse EQ-5D B = -0.04 (95% CI -0.07 ; -0.01) and an increased no of painful regions B = 0.54 (95% CI 0.02 ; 1.07) compared with never smokers.

    Conclusion: In this population based PsA cohort, patients who were ever smokers reported worse clinical features compared with never smokers. Further longitudinal studies are needed to better understand cause and effect. However, smoking cessation should be recommended due to general health perspectives and also due to disease specific issues.

  • 40.
    Bremander, Ann
    et al.
    Department of Clinical Sciences, Lund, Section of Rheumatology, Lund, Sweden & R&D Centre, Spenshult, Halmstad, Sweden.
    Malm, K.
    R&D Centre, Spenshult, Halmstad, Sweden.
    Andersson, M. L.
    Department of Clinical Sciences, Lund, Section of Rheumatology, Lund, Sweden & R&D Centre, Spenshult, Halmstad, Sweden.
    Physical Activity in Established RA and Variables Associated with Physical Activity Maintenance Over a Seven Year Period2018Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, nr Suppl. 2, s. 188-188, artikel-id OP0280-HPRArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Interventions to promote a healthy lifestyle also in patients with rheumatoid arthritis (RA) have been in focus over the last years. Physical activity (PA) defined as moderate-to-vigorous physical activity (MVPA) has the possibility to reduce disease burden in RA and may contribute to improved quality of life (QoL). It is well known that a large number of patients with RA have a sedentary life style and are less active than their healthy peers. However, less information is known about the long term change of MVPA and possible associated variables.

    Objectives: To study self-reported change of MVPA over seven years in a well-defined RA cohort.

    Methods: A lifestyle questionnaire was sent twice to patients in the BARFOT cohort, in 2010 (n 1525) and in 2017 (n 1046) with a response rate of 73% and 68% respectively and 950 patients responded to both questionnaires. All patients fulfilled the ACR criteria for classification of RA and had a disease duration at inclusion (1992 to 2006) of ≤12 months. Patients were dichotomized as being active on recommended levels of MVPA (MVPArec ;physically active on a moderate level ≥150 min/week (MPA) or on an intense level ≥75 min/week (VPA)) or not (sedentary). The patients reported body mass index, smoking habits, tender (TJC) and swollen joint count (SJC, 28-joints), patient global assessment (PatGA), pain intensity (NRS) and distribution (pain mannequin), fatigue (NRS), physical function (HAQ), health related QoL (EQ5D), comorbidities and medical treatment. Possible associated variables with meeting MVPArec at both time points or not (dependent variable) was studied by using a logistic regression analysis. All variables were adjusted for age, gender and smoking habits.

    Results: Forty-one percent (n 389) of the patients met MVPArec at both occasions, and they reported better EQ5D scores compared with the sedentary group (mean 0.77 (SD 0.18) vs 0.68 (0.27). The patients who met MVPArec were younger, (mean age (SD) 5913 years vs 6213 years, p<0.001) and were to higher extent never smokers 46% vs 38%, p=0.021. There was a negative association with meeting MVPArec and being overweight (OR 0.58, 95% CI: 0.43 to 0.96) or obese (OR 0.38, 95% CI: 0.25 to 0.59), the presence of cardiovascular (OR 0.56, 95% CI: 0.41 to 0.75) and pulmonary diseases (OR 0.51, 95% CI: 0.31 to 0.85), TJC (OR 0.98, 95% CI: 0.95 to 0.995), high pain intensity (OR 0.99, 95% CI: 0.987 to 0.998), and pain distribution (OR 0.93, 95% CI: 0.90 to 0.96), worse fatigue (OR 0.99, 95% CI: 0.998 to 0.997) and a worse physical function (HAQ, OR 0.58, 95% CI: 0.45 to 0.76). Patients with higher values in QoL (EQ5D, OR 3.1, 95% CI: 1.52 to 6.2) were positively associated with meeting MVPArec. In 2010 there were no differences in medical treatment between the groups, p=0.377. In 2017 the group meeting MVPArec included a lower number of untreated patients compared to 2010 (25% vs 34%, p=0.017).

    Conclusions: Only four out of ten patients with established RA reported to maintain recommended levels of PA over a seven year period. Experiencing high quality of life seems to be important for PA maintenance together with lower levels of pain, fatigue and better physical function. Health care professionals need to take the patient perspective into account andsupport maintenance of physical activities accordingly.

    Disclosure of Interest: None declared

  • 41.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin. Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Petersson, Ingemar F.
    Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Haglund, Emma
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Jacobsson, Lennart T.H.
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
    Smoking Is Associated with Worse and More Widespread Pain, Worse Disease Activity, Function, Fatigue and Health Related Quality of Life in Patients with Axial Spondyloarthritis: Results From a Population Based Cohort2012Ingår i: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, nr S10, s. S43-S43, artikel-id 95Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In subjects with early axial Spondyloarthritis (SpA) smoking has recently been associated with earlier onset of disease, worse lesions of the sacroiliac joints and in later stages syndesmophyte progression. The aim was to study associations of smoking habits with self-reported information in a large population based cohort of patients with axial SpA.

    Methods: A cross-sectional questionnaire survey performed in 2009 included all health care seeking subjects aged >18 years with a diagnosis of SpA according to ICD 10 codes identified by a regional health care register (n=3711). Smoking habits were studied in patients with ankylosing spondylitis (AS, ICD M45) and in patients who fulfilled criteria for “non AS axial SpA” (without having one of AS). Criteria for non AS axial SpA were based on data from the questionnaire: pain for 3 months or more during the last 12 months together with 2 or more features out of 5 (inflammatory back pain, history of psoriasis, uveitis/tendinitis, inflammatory bowel disease or heredity). The questionnaire included data on smoking (never smokers vs. ever smokers), disease activity (BASDAI) physical function (BASFI), general health (BAS-G) all measured with numerical rating scales 0-10 (best to worst), health related quality of life (EQ-5D, 0-1 worst to best), pain, fatigue (numerical rating scales 0-10 best to worst) and number of painful regions noted on a pain mannequin (0-16 best to worst). Linear regression analysis was performed and all data were controlled for sex and age.

    Results:

    Response rate was 76% whereof 2167 (58%) returned the questionnaire and 18% declined participation in the study. 598 subjects had an AS diagnose and 572 fulfilled the criteria for non AS axial SpA.

    The AS group had a mean age of 54 (SD14) years and 35% were women. Never smokers constituted 48% of the AS group. Ever smokers had worse scores in all studied variables compared with never smokers.

    The linear regression analysis showed that ever smokers in the AS group had worse self-reported scores in BASDAI with age-sex adjusted parameter estimate (B) = 0.60 (95% CI 0.21 ; 1.00), BASFI B = 0.51 (95% CI 0.11 ; 0.91) and fatigue B = 0.51 (95% CI  0.06 ; 1.00) . There was a tendency to worse scores for ever smokers also in EQ-5D B = -0.04 (95% CI -0.09 ; 0.001)

    Mean age in the non AS axial SpA group was 55 (SD 14) years and 68% were women. Never smokers constituted 38% of this group. Also in the non AS axial SpA group the linear regression analysis showed that ever smokers had worse self-reported scores in BASDAI with age-sex adjusted parameter estimate (B) = 0.59 (95% CI 0.23 ; 0.94), BASFI B = 0.59 (95% CI 0.17 ; 1.00), pain B = 0.45 (95% CI 0.08 ; 0.82) and fatigue B = 0.43 (95% CI  0.03 ; 0.83), no of painful areas B = 0.73 (95% CI  0.06 ; 1.46) and also in EQ-5D B = -0.06 (95% CI -0.11 ; -0.002).                                                                                                                                                

    Conclusion: In a large population based axial SpA cohort, both patients with AS and non AS axial SpA who were ever smokers reported worse clinical features compared with never smokers. Further longitudinal studies are needed to better understand cause and effect. However, smoking cessation should be recommended not only due to general health perspectives but also due to disease specific issues.

    References

    1Smokers in early axial spondyloarthritis have earlier disease onset, more disease activity, inflammation and damage, and poorer function and health-related quality of life: results from the DESIR cohort. Chung HY, Machado P, van der Heijde D, D'Agostino MA, Dougados M. Ann Rheum Dis. 2012 Jun;71(6):809-16.

  • 42.
    Bremander, Ann
    et al.
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS). Research and Development Center, Spenshult Hospital, Oskarström, Sweden.
    Wikström, Ingegerd
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Larsson, Ingrid
    Research and Development Center, Spenshult Hospital, Oskarström, Sweden.
    Bengtsson, Maria
    Department of Rheumatology, Clinical Sciences Lund and Malmö, Lund University, Lund, Sweden.
    Hagel, Sofia
    Department of Rheumatology, Clinical Sciences Lund and Malmö, Lund University, Lund, Sweden.
    Strömbeck, Britta
    Musculoskeletal Sciences, Department of Orthopedics, Clinical Sciences Lund, Lund University, Lund, Sweden.
    Cultural adaptation, validity, reliability and responsiveness of the Swedish version of the effective musculoskeletal consumer scale (EC-17)2012Ingår i: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 10, nr 1, s. 43-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Endorsed by the Outcome MEasures in Rheumatoid Arthritis in Clinical Trials (OMERACT) group, The Effective Consumer Scale (EC-17) was developed in English for patients with musculoskeletal diseases to assess the skills and perceptions important for participating in and managing health care. The objective of this study was culturally to adapt the questionnaire into Swedish and to study its psychometric properties.

    METHODS: After translation of the questionnaire into Swedish, two different groups of outpatients from two specialist rheumatology departments participated in the study. Face validity was assessed, together with internal consistency, test-retest and responsiveness of the questionnaire. Construct validity was assessed using the Arthritis Self-Efficacy Scale (ASES), and responsiveness to a five day educational intervention was analysed using the standardized response mean (SRM).

    RESULTS: Analyses were based on 124 patients with inflammatory rheumatic diseases, of whom 50 attended the intervention. Data quality met the requirements, with missing values <5%, and floor and ceiling effects <15%. Item total correlations were all >0.4, ranging from 0.49 to 0.88. Cronbach's alpha was 0.93 and 0.95 for the two groups. The test-retest correlation (ICC₂.₁) was 0.94, and there was a significant improvement as a result of the intervention, with an SRM of 0.43. However, the questionnaire had a higher construct validity with the ASES subscale 'other symptoms' than hypothesized a priori (r(s) 0.75).

    CONCLUSION: The Swedish version of the EC-17 met the required recommendations for face validity, internal consistency, test-retest reliability and responsiveness. Its construct validity needs to be further established, and the questionnaire needs further testing in different groups of patients and in different interventions. © 2012 John Wiley & Sons, Ltd.

  • 43.
    Brink, Eva
    et al.
    Dept. of Nursing, Health and Culture, Univ. of Trollhättan/Uddevalla.
    Grankvist, Gunne
    Dept. Studs. Individual and Soc., Univ. of Trollhättan/Uddevalla.
    Karlsson, Björn
    Division of Cardiology, Sahlgrenska University Hospital, Göteborg.
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Sektionen för hälsa och samhälle (HOS), Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Health-related quality of life in women and men one year after acute myocardial infarction2005Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, nr 3, s. 749-757Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of the present study was, first, to detect possible changes in health-related quality of life (HRQL) over time and, second, to predict HRQL at 1year based on measures made 1 week and 5 months after a first-time acute myocardial infarction. There was an improvement in HRQL at 1year, as measured by the questionnaire 36-item Medical Outcomes Study Short-Form (SF-36), for both men and women as compared with the assessment 5 months after the acute myocardial infarction. However, the pattern was somewhat different for women and men. Women mainly reported increased scores on scales reflecting better mental health, whereas men, on the whole, demonstrated higher scores in the physical health domain. Depression (HAD) and fatigue were identified as early predictors of lower HRQL at the 1-year follow-up. Our conclusion is that early assessment of fatigue and depression is worthwhile, as they may indicate decreased HRQL in men and women 1year after first-time myocardial infarction.

  • 44.
    Brorsson, Sofia
    et al.
    Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin.
    Pedersen, Eja
    Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), Bio- och miljösystemforskning (BLESS).
    12-weeks of hand exercise provides better hand function, muscle balance and muscle strength in the rheumatoid arthritis hand2010Ingår i: Abstract Archive Sessions Index 2010, EULAR , 2010Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background:

    Impaired grip ability in RA is due to reduced strength in the flexor muscles as well as by dysfunctional extensor muscles leading to inability to open the hand. Furthermore the extensor muscles are important for stabilization during flexion force production and active for developing a controlled grip force. There is today scientific evidence showing that various forms of hand exercise are beneficial for improving hand function and strength in RA patients (Ronningen and Kjeken 2008; Brorsson, Hilliges et al. 2009). However, comparatively little research has evaluated and specific designed hand exercise program for the extensor muscles controlling the hand and fingers (Weiss, Moore et al. 2004; O'Brien, Jones et al. 2006).

    Objectives:

    The objectives for this study were to evaluate the effect of an exercise program on hand strength, hand function and perceived function of daily life activities among RA patients and to explore the possibility to improve the balance between the extensor and flexor muscle forces in the hand.

    Methods:

    The study group comprised of 20 patients with RA (median disease duration 20 years) that performed a hand exercise program for twelve weeks. The finger extension force was measured with a newly developed device (EX-it), finger flexion force was measured with the Grippit. Hand function was evaluated with the Grip Ability Test (GAT) and self reported questionnaire Disability Arm Shoulder and Hand (DASH).

    Results:

    Hand strength (both extension and flexion force) and hand function improved significantly after twelve weeks. The RA group showed improvement in the results of the DASH questionnaire (p < 0.05), but on individual level, the result was partly significant. The relation between extension and flexion force in the hand was not correlated, however, after the exercise there was a strong association between flexion and extension force (p < 0.001). The result on individual level is related to age and duration time.

    Conclusion:

    Twelve weeks of hand exercise significantly improved hand strength, hand function and perceived function for RA patients. Furthermore, exercise improved the relation between the finger extension and flexion force. Hand exercise is thus an effective intervention for RA patients, providing better strength and function.

    References:

    1. Brorsson, S., M. Hilliges, et al. (2009). A six-week hand exercise programme improves strength and hand function in patients with rheumatoid arthritis. J Rehabil Med 41(5): 338-42.
    2. O'Brien, A.V., P. Jones, et al. (2006). Conservative hand therapy treatments in rheumatoid arthritis–a randomized controlled trial. Rheumatology (Oxford) 45(5): 577-83.
    3. Ronningen, A. and I. Kjeken (2008). ffect of an intensive hand exercise programme in patients with rheumatoid arthritis. Scand J Occup Ther: 1-11.
    4. Weiss, A. P., D. C. Moore, et al. (2004). Metacarpophalangeal joint mechanics after 3 different silicone arthroplasties. J Hand Surg [Am] 29(5): 796-803.
  • 45.
    Broström, Anders
    et al.
    Linköping University, Department of Cardiology.
    Strömberg, Anna
    Linköping University, Department of Cardiology.
    Dahlström, Ulf
    Linköping University, Department of Cardiology.
    Fridlund, Bengt
    Linköping University, Department of Cardiology.
    Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure2004Ingår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 19, nr 4, s. 234-242Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Normal sleep changes with age in duration, fragmentation, and depth. The prevalence of insomnia is high in the elderly general population. In patients with chronic heart failure (HF) objective sleep assessments have shown disturbances such as a shorter total duration of sleep, frequent arousals, and sleep stage changes. Objective: To describe self- assessed sleep difficulties, daytime sleepiness, and their relation to health-related quality of life (HRQOL) in men and women with HF, as well as to make a comparison to data from a norm population. Methods: Cross-sectional design including 223 patients with HF, New York Heart Association classification II-IV, assessed using the Uppsala Sleep Inventory-Chronic Heart Failure, the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short Form Health Survey, and Minnesota Living With Heart Failure Questionnaire. Results: The most commonly reported sleep difficulties were initiating and maintaining sleep. The ratio of habitual sleep to the amount of estimated need for sleep was significantly shorter for women (P < .05), and the number of awakenings per night was significantly increased for men (P < .001). A total of 21% suffered from daytime sleepiness. Patients suffering from difficulties maintaining sleep, initiating sleep, and early morning awakenings reported significantly lower HRQOL in almost all dimensions of the SF-36 (P < .05-P < .001) compared to patients without sleeping difficulties, as well as to the normal population. The disease-specific Minnesota living With Heart Failure Questionnaire showed significantly reduced (P < .05-P < 001) HRQOL as measured by the total and subscale scores for patients suffering from sleeping difficulties compared to patients without sleeping difficulties. Conclusion: Patients with, HF have a reduced HRQOL especially if difficulties maintaining sleep, initiating sleep, and early morning awakenings are involved.

  • 46.
    Bäckhed, Fredrik
    et al.
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden & Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology and Enteroendocrinology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
    Roswall, Josefine
    Department of Pediatrics, Hallands Hospital Halmstad, Halmstad, Sweden & Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg, Sweden.
    Peng, Yangqing
    BGI-Shenzhen, Shenzhen, China.
    Feng, Qiang
    BGI-Shenzhen, Shenzhen, China &Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Jia, Huijue
    BGI-Shenzhen, Shenzhen, China.
    Kovatcheva-Datchary, Petia
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Li, Yin
    BGI-Shenzhen, Shenzhen, China.
    Xia, Yan
    BGI-Shenzhen, Shenzhen, China.
    Xie, Hailiang
    BGI-Shenzhen, Shenzhen, China.
    Zhong, Huanzi
    BGI-Shenzhen, Shenzhen, China.
    Khan, Muhammad Tanweer
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Zhang, Jianfeng
    BGI-Shenzhen, Shenzhen, China.
    Li, Junhua
    BGI-Shenzhen, Shenzhen, China.
    Xiao, Liang
    BGI-Shenzhen, Shenzhen, China.
    Al-Aama, Jumana
    BGI-Shenzhen, Shenzhen, China & Princess Al Jawhara Albrahim Center of Excellence in the Research of Hereditary Disorders, King Abdulaziz University, Saudi Arabia.
    Zhang, Dongya
    BGI-Shenzhen, Shenzhen, China.
    Lee, Ying Shiuan
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Kotowska, Dorota
    Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Colding, Camilla
    Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Tremaroli, Valentina
    The Wallenberg Laboratory, Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.
    Yin, Ye
    BGI-Shenzhen, Shenzhen, China.
    Bergman, Stefan
    Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg & Research and Development Center Spenshult, Oskarström, Sweden.
    Xu, Xun
    BGI-Shenzhen, Shenzhen, China.
    Madsen, Lise
    Department of Biology, University of Copenhagen, Copenhagen, Denmark & National Institute of Nutrition and Seafood Research, Bergen, Norway.
    Kristiansen, Karsten
    BGI-Shenzhen, Shenzhen, China & Department of Biology, University of Copenhagen, Copenhagen, Denmark.
    Dahlgren, Jovanna
    Göteborg Paediatric Growth Research Center, Department of Paediatrics, the University of Gothenburg, Queen Silvia Children’s Hospital, Gothenburg & .
    Wang, Jun
    BGI-Shenzhen, Shenzhen, China, Department of Biology, University of Copenhagen, Copenhagen, Denmark, Princess Al Jawhara Albrahim Center of Excellence in the Research of Hereditary Disorders, King Abdulaziz University, Saudi Arabia, Macau University of Science and Technology, Avenida Wai long, Taipa, China & Department of Medicine and State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong.
    Dynamics and Stabilization of the Human Gut Microbiome during the First Year of Life2015Ingår i: Cell Host and Microbe, ISSN 1931-3128, E-ISSN 1934-6069, Vol. 17, nr 5, s. 690-703Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The gut microbiota is central to human health, but its establishment in early life has not been quantitatively and functionally examined. Applying metagenomic analysis on fecal samples from a large cohort of Swedish infants and their mothers, we characterized the gut microbiome during the first year of life and assessed the impact of mode of delivery and feeding on its establishment. In contrast to vaginally delivered infants, the gut microbiota of infants delivered by C-section showed significantly less resemblance to their mothers. Nutrition had a major impact on early microbiota composition and function, with cessation of breast-feeding, rather than introduction of solid food, being required for maturation into an adult-like microbiota. Microbiota composition and ecological network had distinctive features at each sampled stage, in accordance with functional maturation of the microbiome. Our findings establish a framework for understanding the interplay between the gut microbiome and the human body in early life. © 2015 Elsevier Inc.

  • 47.
    Börnhorst, Claudia
    et al.
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Siani, Alfonso
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Russo, Paola
    Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
    Kourides, Yannis
    Research and Education Institute of Child Health, Strovolos, Cyprus.
    Sion, Isabelle
    Department of Public Health, Ghent University, Ghent, Belgium.
    Molnár, Denés
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    Moreno, Luis A.
    Rodríguez, Gerardo
    GENUD (Growth, Exercise, Nutrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
    Ben-Shlomo, Yoav
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Howe, Laura
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom, MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Mehlig, Kirsten
    Section for Epidemiology and Social Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Bammann, Karin
    Institute for Public Health and Nursing Research (IPP), Faculty for Human and Health Sciences, University Bremen, Bremen, Germany.
    Foraita, Ronja
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany.
    Ahrens, Wolfgang
    Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany, Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
    Tilling, Kate
    School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
    Early Life Factors and Inter-Country Heterogeneity in BMI Growth Trajectories of European Children: The IDEFICS Study2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 2, artikel-id e0149268Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Starting from birth, this explorative study aimed to investigate between-country differences in body mass index (BMI) trajectories and whether early life factors explain these differences.

    Methods

    The sample included 7,644 children from seven European countries (Belgium, Cyprus, Germany, Hungary, Italy, Spain, Sweden) participating in the multi-centre IDEFICS study. Information on early life factors and in total 53,409 repeated measurements of height and weight from 0 to <12 years of age were collected during the baseline (2007/2008) and follow-up examination (2009/2010) supplemented by records of routine child health visits. Country-specific BMI growth curves were estimated using fractional polynomial mixed effects models. Several covariates focussing on early life factors were added to the models to investigate their role in the between-countries differences.

    Results

    Large between-country differences were observed with Italian children showing significantly higher mean BMI values at all ages ≥ 3 years compared to the other countries. For instance, at age 11 years mean BMI values in Italian boys and girls were 22.3 [21.9;22.8; 99% confidence interval] and 22.0 [21.5;22.4], respectively, compared to a range of 18.4 [18.1;18.8] to 20.3 [19.8;20.7] in boys and 18.2 [17.8;18.6] to 20.3 [19.8;20.7] in girls in the other countries. After adjustment for early life factors, differences between country-specific BMI curves became smaller. Maternal BMI was the factor being most strongly associated with BMI growth (p<0.01 in all countries) with associations increasing during childhood. Gestational weight gain (GWG) was weakly associated with BMI at birth in all countries. In some countries, positive associations between BMI growth and children not being breastfed, mothers’ smoking during pregnancy and low educational level of parents were found.

    Conclusion

    Early life factors seem to explain only some of the inter-country variation in growth. Maternal BMI showed the strongest association with children’s BMI growth.

  • 48.
    Börnhorst, Claudia
    et al.
    a Biometry and Data Management, Leibniz Institute for Epidemiology and Prevention Research, BIPS, Bremen, Germany.
    Siani, Alfonso
    Institute of Food Sciences, National Research Council, Avellino, Italy.
    Tornaritis, M.
    c Research and Education Institute of Child Health, Research and Education Institute of Child Health, Strovolos, Cyprus.
    Molnár, D.
    Department of Pediatrics, University of Pécs, Pécs, Hungary.
    Lissner, Lauren
    Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Regber, Susann
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Potential selection effects when estimating associations between the infancy peak or adiposity rebound and later body mass index in children2018Ingår i: Revue d'épidémiologie et de santé publique, ISSN 0398-7620, E-ISSN 1773-0627, Vol. 66, nr Suppl. 5, s. S422-S423Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: Lots of research has been conducted to identify early life factors or growth characteristics in infancy and childhood related to an unfavorable weight development. For instance, a late age at infancy peak (IP), an early age at adiposity rebound (AR) as well as body mass index (BMI) at IP and AR were shown to be positively associated with later adiposity status. The present study aims to investigate the usefulness of the IP and AR in comparison to other measures of BMI growth as indicators of later weight status. For the first time, the selection effect possibly occurring when excluding children with non-identifiable IP or AR will be explored.

    Methods: Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants (IDEFICS)/I. Family is an ongoing cohort study conducted in eight European countries with 16,229 children participating in the baseline survey in 2006/2007 [1]. In a subset of 4744 children with at least four repeated measurements of height and weight in the age interval from 0 to 8 years (37,998 measurements in total; survey data supplemented with records of routine child visits), fractional polynomial mixed-effects models were used to derive individual BMI trajectories. Based on these trajectories, age and BMI at IP and AR, BMI values and growth velocities at selected ages as well as the area under the BMI curve were estimated. The BMI growth measures were standardized and related to later BMI z-scores (mean age at outcome assessment: 9.2 years).

    Results: Age and BMI at IP and AR were not identifiable in 5.4% and 7.8% of the children, respectively. These groups of children showed a significantly higher BMI growth during infancy and childhood. In the remaining sample, BMI at IP correlated almost perfectly (r ≥ 0.99) with BMI at ages 0.5, 1 and 1.5 years, whereas BMI at AR correlated perfectly with BMI at ages 4–6 years (r ≥ 0.98). In the total study group, BMI values in infancy and childhood were positively associated with later BMI z-scores where associations increased with age. Associations between BMI velocities and later BMI z-scores were largest at ages 5 and 6 years. Results markedly differed for children with non-identifiable IP and AR, demonstrating a selection effect.

    Conclusions: IP and AR may not be estimable in children with higher-than-average BMI growth. Excluding these children from analyses may result in a selection bias that distorts effect estimates. BMI values at ages 1 and 5 years might be more appropriate to use as predictors for later weight status instead.

    © 2018 Published by Elsevier Masson SAS

  • 49.
    Carlsson, Ing-Marie
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Being in a safe and thus secure place, the core of the early labour: A secondary analysis in a Swedish context2016Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikel-id 30230Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Early labour is the very first phase of the labour process and is considered to be a period of time when no professional attendance is needed. However there is a high frequency of women who seek care at the delivery wards during this phase. When a woman is admitted to the delivery ward, one role for midwives is to determine whether the woman is in established labour or not. If the woman is assessed as being in early labour she will probably then be advised to return home. This recommendation is made due to past research that found that the longer a woman is in hospital the higher the risk for complications for her and her child. Women have described how this situation leaves them in a vulnerable situation where their preferences are not always met and where they are not always included in the decision-making process.

    Aim: The aim of this study was to generate a theory based on where a woman chooses to be during the early labour process and to increase our understanding about how experiences can differ from place to place.

    Methods: The method was a secondary analysis with grounded theory. The data used in the analysis was from two qualitative interview studies and 37 transcripts.

    Conclusion: The findings revealed a substantive theory that women needed to be in a safe and thus secure place during early labour. This theory also describes the interplay between how women ascribed their meaning of childbirth as either a natural live event or a medical one, how this influenced where they wanted to be during early labour, and how that chosen place influenced their experiences of labour and birth.

  • 50.
    Carlsson, Ing-Marie
    et al.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Hälsofrämjande processer.
    Hallberg, Lillemor R.-M.
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI), Gruppen för forskning om hälsofrämjande och Livsstilsförändrande arbete.
    Odberg Pettersson, Karen
    Högskolan i Halmstad, Akademin för hälsa och välfärd, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Swedish women's experiences of seeking care and being admitted during the latent phase of labour: A grounded theory study2007Ingår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, nr 2, s. 172-180Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: to gain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour.

    Design: a qualitative interview study using the grounded theory approach.

    Setting: the study was conducted at a hospital in the southwestern part of Sweden with a range of 1600-1700 deliveries per year. The interviews took place in the women's homes two to six weeks after birth.

    Participant: eighteen Swedish women, aged 22-36, who were admitted to the tabour ward while they were stilt in the latent phase of tabour.

    Findings: 'Handing over responsibility' to professional caregivers emerged as the core category or the central theme in the data. The core category and five additional categories formed a conceptual model explaining what it meant to women being admitted in the early stage of tabour and their experiences of the Latent phase of tabour. The categories, which all related to the core category, were labelled: (1) 'longing to complete the pregnancy,' (2) 'having difficulty managing the uncertainty,' (3) 'having difficulty enduring the stow progress,' (4) 'suffering from pain to no avail' and (5) 'oscillating between powerfulness and powerlessness.'

    Conclusions and implications for practice: findings indicate that women being admitted to the tabour ward in the latent phase of tabour experienced a need for handing over responsibility for the tabour, the welt-being of the unborn baby, and for themselves. Midwives have an important role in assisting women with coping during the latent phase of tabour, and in giving the women opportunity to hand over responsibility. This care should include validation of experienced pain and confirmation of the normality of the slow process, information and support. © 2007 Elsevier Ltd. All rights reserved.

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