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  • 2801.
    Åkesson, Per
    Halmstad University, School of Social and Health Sciences (HOS).
    Att vara eller inte vara fysiskt aktiv bland medelålders män: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Iakttagelser har dock visat en minskad grad av fysisk aktivitet hos befolkningen. Könsskillnader har visats vara en faktor, män och kvinnor har ibland olika motivationskällor till fysisk aktivitet. Syfte : Syftet med den här studien var att beskriva vad som motiverar medelålders män till fysisk aktivitet. Metod : Genom att ha en litteraturstudie som metod var målet att få en fördjupning av det nuvarande kunskapsområdet som berör syftet. Studien har inkluderat 15 stycken artiklar från databaserna: Cinahl, Pubmed, Sciverse och Academic search elite. Artiklarna lästes och genomgick en temaanalys. Resultat : Resultatet delades in i fem teman. Socioekonomi och psykosociala faktorer menar att socioekonomisk tillhörighet och till exempel socialt stöd är betydande faktorer. Närmiljön och dess tillgångar är styrande med tillgängliga parker, cykelbanor etcetera som visats stimulera mäns motionsvanor. Förhållandet till det manliga idealet menar bland annat att det finns förutfattade meningar om hur män ska bete sig och hur detta påverkar deras motivation till fysisk aktivitet. Möjligheter till fysisk aktivitet på arbetet och fritiden visade att ett tungt jobb minskar chansen till motion på fritiden. Vardagsmotion eller bekvämlighet är till stor del styrande av ekonomiska resurser samt om utvecklade cykel och promenadvägar som finns tillgängligt. Implikation: För att främja fysisk aktivitet hos medelålders män bör både yttre och inre faktorer tillgodoses. Mer företag bör överväga att införa hälsovård. Kanske viktigast att ge arbetare i låga socioekonomiska grupper exempelvis förmånliga priser på gymkort. Det rekommenderas upprätthållande av platser såsom cykelbanor och motionsspår, där fysisk aktivitet kan utövas. Åtgärder som riktar sig till att stärka mäns självförtroende och andra inre egenskaper som är viktiga för att främja motivation till fysisk aktivitet hos medelålders män.

  • 2802.
    Ålenius, Piamari
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Schagerlöv, Caroline
    Halmstad University, School of Social and Health Sciences (HOS).
    Det är det lilla som gör det stora: -hälsofrämjande åtgärder vid hypertoni2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hypertension is common in today's society and is therefore considered to have become a national disease. An estimated 1.8 million of Sweden's adult population have hypertension. Hypertension accounts for about 13 percent of the total mortality in the world, and is seen as a risk factor for numerous cardiovascular diseases. Today there are international guidelines for the treatment of hypertension in, England and USA. However, there are no specific Swedish guidelines for treatment of hypertension. The purpose of this study was to elucidate how health interventions can influence blood pressure in people with hypertension. The results of this literature study are based on a review of 16 scientific articles which was based on literature review and order problem. The health-promoting interventions that can affect blood pressure in people with hypertension are highlighted in the results. Such interventions are weight loss, physical activity, diet, alcohol, smoking, stress and support. The effect of health promotion interventions has shown that lowering blood pressure can occur if lifestyle changes are implemented and carried out. A braking in the development of hypertension can lead to health-economic benefits to the community. National guidelines and care programs for the treatment of hypertension should be developed to a braking of hypertension to happen.

  • 2803.
    Årestedt, K.
    et al.
    Linnéuniversitetet, Sweden.
    Ågren, S. A. Susanna
    Linköping University, Dept Med & Hlth Sci, Linköping, Sweden .
    Flemme, Inger
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Moser, D. M. Bedbra
    Univ Kentucky, Coll Nursing, Lexington, KY 40506, USA.
    Strömberg, A. S. Anna
    Linköping Univ, Dept Med & Hlth Sci, Linköping, Sweden .
    Psychometric properties of the Swedish version of the Control Attitudes Scale (CAS) for patients with cardiac disease and their partners2010In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 31, no Supplement 1, p. 230-230Article in journal (Other academic)
  • 2804.
    Årneby, Henrik
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS).
    The acute effect of a foam rolling and a dynamic stretch warm-up routine on jumping performance2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Self-myofascial release is widely used by athletes but the scientific evidence of its supposedly positive effects is limited. This study was conducted to investigate the effects of foam rolling as a warm-up routine in comparison with a dynamic stretching routine and how it may affect the jumping performance among subjects familiar with weight training. Aim: The aim of this study was to investigate the acute effect of foam rolling vs. a standardized dynamic stretch warm-up routine on jumping performance. Method: Twelve subjects, mean (SD) age 25.1 (± 3.0) years, participated in a randomized, controlled, crossover study. All subjects completed a standardized foam rolling (FR) and a dynamic stretch (DS) warm-up routine on separate days of testing. Squat jump (SJ), counter movement jump (CMJ) and loaded counter movement jump (L-CMJ) all performed bilaterally and unilaterally were conducted to investigate the acute effect of the two warm-up routines. A dependent T-test was used to investigate differences between the warm-up routines. Results: A statistical significant difference in favor of the DS was found for SJ performed bilaterally among males (p = 0.009). The mean (SD) jumping height for SJ FR was 35.6 (± 4.7) cm and for SJ DS 37.9 (± 5.2) cm. The male group also improved more in L-CMJ performed on the right leg with an external load of 54kg after DS compared to FR. No other statistical significant differences were found between the two interventions. A near statistical significant difference was found for SJ performed bilaterally for the total sample (p = 0.057) also in favor of the DS. The mean (SD) jumping height for SJ FR was 29.3 (± 8.7) cm and for SJ DS 30.5 (± 9.9) cm. Conclusion: Findings from this study supports a dynamic stretch warm-up routine prior to performing high intensity bilateral plyometrics instead of a foam rolling warm-up routine. However the data was inconsistent and more research with larger sample sizes is needed to further investigate the possible effects of foam rolling as a warm-up routine on jumping performance performed both bilaterally and unilaterally.

  • 2805.
    Åsa, Augustsson
    Halmstad University, School of Social and Health Sciences (HOS).
    Kära Dagbok...: Dagbokens betydelse för patienten2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vid sjuksköterskans omvårdnadsarbete ska fokus ligga i den enskilda patientens behov och önskningar och omvårdnaden skall vara individanpassad. Patienten skall vara delaktig och uppleva trygghet och respekt. Vid god omvårdnad måste sjuksköterskan utgå från den unika patientens behov, erfarenheter och upplevelser varpå kunskap om personen i fråga krävs. Dagboksanteckningar kan identifiera tillstånd och känslor hos patienten, vilket kan fångas upp av sjuksköterskan som i sin tur får ökad förståelse för den individuella patientens behov. Syftet med studien var att beskriva dagbokens betydelse ur patientens perspektiv. En litteraturstudie där resultatet baserades på tolv artiklar genomfördes. Resultatet belyser att dagböcker som företeelse kan identifiera känslor och tillstånd hos patienterna vilket kan hjälpa sjuksköterskan till ökad förståelse för den individuella patientens behov. Dagböckerna ökade patienternas medvetenhet om sin sjukdom eller tillstånd, vilket ledde till bättre följsamhet vid egenvård, symtomlindring och ökad delaktighet i vården. Detta kan ses som ett verktyg utifrån vilket sjuksköterskan planerar olika omvårdnadsåtgärder vilket bör uppmärksammas och utvecklas i omvårdnadsutbildningar. Dagbokens användningsområde bör expanderas och kommande forskning bör genomföras i syfte att utveckla dagbokens betydelse som ett effektivt omvårdnadsverktyg i dagliga rutiner.

  • 2806.
    Åsenlöf, Pernilla
    et al.
    Uppsala University, Uppsala, Sweden.
    Demmelmaier, Ingrid
    Uppsala University, Uppsala, Sweden.
    Emilson, Christina
    Uppsala University, Uppsala, Sweden.
    Pettersson, Susanne
    Uppsala University, Uppsala, Sweden.
    Bergman, Stefan
    Spenshult Centre for Rheumatic Disease, Oskarström, Sweden.
    Step-Up: An Innovative Stepped-Care Protocol for Tailored Behavioral Medicine Treatment in the Management of Musculoskeletal Pain in Primary Care2013In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 72, no Suppl. 3, p. A120-A120Article in journal (Refereed)
    Abstract [en]

    Background: Multimodal rehabilitation and tailored behavioral medicine treatments should be provided to patients suffering from persistent and activity limiting pain according to current state-of-science. There is also evidence that a minimal intervention including 'stay-active advice' can produce effects comparable to effects of comprehensive treatment packages. Nevertheless, there is a gap of knowledge regarding which individuals who benefit the most from which modalities of pain treatment, at what time point, and with the highest cost-effectiveness. Accordingly, we have set up an innovative stepped-care protocol for the management of musculoskeletal pain in primary care, which is evaluated in a randomized controlled trial.

    Objectives: The aim is to compare effects and cost-effectiveness of a stepped care model including advice and tailored behavioral medicine pain treatment (experimental condition) with a stepped care model including advice and physical exercises (comparison condition) for patients with low back and neck pain and/or widespread pain including fibromyalgia in primary care. A further aim is to characterize patients who benefit/do not benefit from the respective steps i.e. treatments varying in dose and content.

    Methods: A stratified randomized stepped care design is applied. Stratification is based on primary care center and psychological risk profile. A consecutive selection is performed at primary care centers in southern, central and northern Sweden. After having received a minimal intervention (step 1) comprising 'stay-active advice', participants scoring high on the Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) according to preset criteria are randomly allocated to an eight-week treatment in step 2. The experimental condition includes supervised physical exercises integrated with either (a) graded activity, or (b) hierarchical graded exposure depending on psychological risk profile. The comparison condition includes supervised physical exercises irrespective of risk profile. Primary outcome is pain-related disability complemented with a comprehensive set of secondary outcomes adhering to the IMMPACT recommendations.

    Results: The stepped-care design will be presented including illustrations of conclusions possible to draw with this kind of innovative design.

    Conclusions: There is a call for stepped-care interventions within pain intervention research, particularly in the primary care setting. However, published studies are still lacking. This study will contribute to an important progression of behavioral medicine pain treatments by the way treatments are tailored in accordance with psychological risk profile. This will be discussed to stimulate research activities and collaboration within this area of research and clinical implementation.

  • 2807.
    Ödegård, Synnöve
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Hallberg, Lillemor
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Perceived potential risk factors in child care2004In: Journal of Health Organisation & Management, ISSN 1477-7266, E-ISSN 1758-7247, Vol. 18, no 1, p. 38-52Article in journal (Refereed)
    Abstract [en]

    This study is based on semi-structured interviews focusing on staff members’ opinions about potential risk factors that could threaten patient safety. The aim was to acquire more in-depth knowledge about the causes of patient injuries. The study, which was conducted at a children's hospital, has a qualitative approach that is influenced by the critical incident technique. A total of 28 persons were interviewed. Analysis of the data resulted in five qualitatively differentiated categories of potential risk factors: a large influx of patients, a lack of professional experience, a lack of inter-professional communication and cooperation, and deficiencies related to work hours and to the physical environment. The results reflect a complex picture where the risks, as described by the informants, can either alone or in concert directly or indirectly affect the individual in the practice of his or her profession or contribute to a mistake.

  • 2808.
    Öijervall, Jörgen
    Halmstad University, School of Social and Health Sciences (HOS).
    Sjuksköterskors erfarenheter av verksamma faktorer i processorienterad omvårdnadshandledning i grupp, ett år efter avslutad sjuksköterskeutbildning: Nurses' experiences of the active factors in process-oriented clinical group supervision, one year after degree2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Processorienterad omvårdnadshandledning i grupp är ett stöd för studenter att utveckla sin förmåga att hantera komplexa vårdsituationer. Reflektionen har en central roll samt handledarens förhållningsätt. Den omvårdnadsteoretiska förankringen beskrivs som betydelsefull, men det finns beskrivningar att alla handledare inte använder omvårdnad som teoretisk grund. Studiens syfte var att beskriva sjuksköterskors erfarenheter av verksamma faktorer i processorienterad omvårdnadshandledning i grupp, ett år efter avslutad sjuksköterskeutbildning. Analysen har gjort med hjälp av kvalitativ innehållsanalys utifrån intervjuer med 18 sjuksköterskor presenteras i fyra kategorier: Handledarens karaktär, Handledningssessionens struktur, Pedagogiska metoder och Reflekterande kommunikation. Resultatet visar att handledarens personliga egenskaper har stor betydelse likaså vikten av att ha ett uppmuntrande förhållningssätt gentemot deltagarna. handledarens engagemang för att skapa trygghet, detta kan medföra att hanledaren kan bli en god rollmodell. En annan viktig faktor är att handledningssessionerna har en tydlig struktur, detta visar sig betydelsefullt för att skapa trygghet och att bibehålla fokus på problemställningarna. Resultatet beskriver olika pedagogiska strategier, såsom rollspel och att använda gruppen för att stödja lärprocesser.  Ytterligare en viktig faktor är att handledningen utgår från ett omvårdnadsteoretiskt perspektiv, då detta fungerar som en kompass i omvårdnadshandledningen. Vikten av ett omvårdnadsteoretiskt perspektiv beskrivs mer implicit i resultatet. Däremot beskrivs vikten av reflekterad kommunikation mer tydligt i materialet.  Reflekterad kommunikation bidrar till studenternas fördjupade kunskaper kring omvårdnadens praktiska genomförande. Ytterligare forskning bör fokuseras på hur det omvårdnadsteoretiska perspektivet kan belysas som en verksam faktor i omvårdnadshandledning

  • 2809.
    Öijervall, Jörgen
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Främjande faktorer för professionell utveckling i processorienterad omvårdnadshandledning i grupp: Sjuksköterskors erfarenheter ett år efter avslutad sjuksköterskeutbildning2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 1, p. 9-13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe nurses' experiences of factors enhancing professional development trough process-oriented group super- vision, one year after completed nursing education. The objective of process-oriented group supervision in nursing care is to support students’ development of their ability to manage complex care situations. The attitude of the supervisor and the students’ willingness to reflect on them- selves have been described as playing key roles in process-oriented group supervision during nursing education. The link to nursing science has also been described as significant by several researchers, but some supervisors are not using nursing science as a foundation in group supervision for nurses. The analysis was completed using a qualitative content analysis method based on interviews with 18 nurses resulting in the general theme “Process oriented pedagogy” which is presented in three categories: Supervisor’s character, Pedagogical strategy and Reflective communication. The findings suggest that the supervisor's personal qualities in combination with an inspiring structure are impor- tant to promote the participants’ reflective communication during the group supervision sessions. Reflective communication supports the students’ development towards a deeper professional knowledge. Further research should focus on the use of nursing science as a foundation in clinical process-oriented group supervision.

  • 2810.
    Öijervall, Jörgen
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Jormfeldt, Henrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Promoting factors for professional development in process oriented group supervision. Nurses experiences one year after completed nursing degree2013In: Breaking Barriers 2013, 2013, p. 43-44Conference paper (Refereed)
    Abstract [en]

    The aim of this study was to describe nurses' experiences of factors enhancing professional development trough process-oriented group supervision, one year after completed nursing education. The objective of process-oriented group supervision in nursing care is to support students’ development of their ability to manage complex care situations. The attitude of the supervisor and the students’willingness to reflect on themselves have been described as playing key roles in process-oriented group supervision during nursing education. The link to nursing science has also been described as significant by several researchers, but some supervisors are not using nursing science as a foundation in group supervision for nurses. The analysis was completed using a qualitative content analysis method based on interviews with 18 nurses resulting in the general theme “Process oriented pedagogy” which is presented in three categories: Supervisor’s character, Pedagogical strategy and Reflective communication. The findings suggest that the supervisor's personal qualities in combination with an inspiring structure are important to promote the participants’ reflective ommunication during the group supervision sessions. Reflective communication supports the students’ development towards a deeper professional knowledge. Further research should focus on the use of nursing science as a foundation in clinical process-oriented group supervision.

  • 2811.
    Önnerfält, Jenny
    et al.
    Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Paediatrics, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    Erlandsson, Lena-Karin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Orban, Kristina
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Broberg Olsson, Malin
    Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Thorngren-Jerneck, Kristina
    Department of Paediatrics, Clinical Sciences, Lund University, Lund, Sweden & Vårdalinstitutet, Swedish Institute for Health Sciences, Lund University, Lund, Sweden & Skåne University Hospital, Lund, Sweden.
    A family-based intervention targeting parents of preschool children with overweight and obesity: Conceptual framework and study design of LOOPS- Lund Overweight and Obesity Preschool Study2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 1, article id 879Article in journal (Refereed)
    Abstract [en]

    Background: As the rate of overweight among children is rising there is a need for evidence-based research that will clarify what the best interventional strategies to normalize weight development are. The overall aim of the Lund Overweight and Obesity Preschool Study (LOOPS) is to evaluate if a family-based intervention, targeting parents of preschool children with overweight and obesity, has a long-term positive effect on weight development of the children. The hypothesis is that preschool children with overweight and obesity, whose parents participate in a one-year intervention, both at completion of the one-year intervention and at long term follow up (2-, 3- and 5-years) will have reduced their BMI-for-age z-score.

    Methods/Design: The study is a randomized controlled trial, including overweight (n=160) and obese (n=80) children 4-6-years-old. The intervention is targeting the parents, who get general information about nutrition and exercise recommendations through a website and are invited to participate in a group intervention with the purpose of supporting them to accomplish preferred lifestyle changes, both in the short and long term. To evaluate the effect of various supports, the parents are randomized to different interventions with the main focus of: 1) supporting the parents in limit setting by emphasizing the importance of positive interactions between parents and children and 2) influencing the patterns of daily activities to induce alterations of everyday life that will lead to healthier lifestyle. The primary outcome variable, child BMI-for-age z-score will be measured at referral, inclusion, after 6 months, at the end of intervention and at 2-, 3- and 5-years post intervention. Secondary outcome variables, measured at inclusion and at the end of intervention, are child activity pattern, eating habits and biochemical markers as well as parent BMI, exercise habits, perception of health, experience of parenthood and level of parental stress.

    Discussion: The LOOPS project will provide valuable information on how to build effective interventions to influence an unhealthy weight development to prevent the negative long-term effects of childhood obesity.

    Trial registration: ClinicalTrials.gov NCT00916318

    © 2012 Önnerfält et al.; licensee BioMed Central Ltd.

  • 2812.
    Östberg, Anna-Lena
    et al.
    Karlstad University, Karlstad, Sweden.
    Nyholm, Maria
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
    Gullberg, Bo
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Råstam, Lennart
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Lindblad, Ulf
    Lund University, Department of Clinical Sciences, Malmö, Sweden.
    Tooth loss and obesity in a defined Swedish population2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 427-433Article in journal (Refereed)
    Abstract [en]

    Aims: To explore the association between tooth loss and obesity in an adult Swedish population, and to investigate the influence of socioeconomy, life-style, and co-morbidity.

    Methods: A cross-sectional population health survey conducted in 2001-2005 in 2816 randomly selected Swedish men and women (age: 30-74 years; participation rate 76%). Main measures were; tooth loss: < 20 remaining teeth (self-reported), general obesity: BMI[≥]30 kg m-2, abdominal obesity: waist circumference > 88 in women and > 102 cm in men. Adjustments were made for socioeconomy, life-style, and co-morbidity.

    Results: 420 individuals (21.2%) had < 20 remaining teeth: 30-59 years 6.0%, 60-74 years 53.5%. Mean BMI was similar in men and women (26.9 kg m-2), however, both general and abdominal obesity was still more frequent among women (both p < 0.001). There was a significant interaction between age and tooth loss in the association with both general (p = 0.004) and abdominal obesity (p < 0.011) in men. In participants below 60 years of age, the association between tooth loss and general obesity (OR 2.17 [95% CI 1.51 - 3.12]) and abdominal obesity (2.23 [1.58 - 3.15]), respectively, was statistically significant independent of age and gender, and remained so also when accounting for differences in socioeconomy, life-style, and co-morbidity. There was no similar association in those 60 years or older. The findings in men and women were robust and concordant.

    Conclusions: Common mechanisms for oral health and obesity should be explored more also including longitudinal designs. The findings are important for targeting comprehensive interventions against obesity and tooth loss, especially among younger adults.

  • 2813.
    Ørstavik, Kristin
    et al.
    Faculty of Medicine, University of Oslo.
    Namer, Barbara
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Schmidt, Roland
    Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Schmelz, Martin
    Department of Anesthesiology Mannheim, University Heidelberg, Mannheim, Germany,.
    Hilliges, Marita
    Halmstad University, School of Business and Engineering (SET), Biological and Environmental Systems (BLESS).
    Weidner, Christian
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Carr, Richard W.
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Handwerker, Hermann
    Department of Physiology and Experimental Pathophysiology, University of Erlangen/Nürnberg.
    Jørum, Ellen
    Laboratory of Clinical Neurophysiology, Department of Neurology, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway.
    Torebjörk, H. Erik
    Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Abnormal Function of C-Fibers in Patients with Diabetic Neuropathy2006In: Journal of Neuroscience, ISSN 0270-6474, E-ISSN 1529-2401, Vol. 26, no 44, p. 11287-11294Article in journal (Refereed)
    Abstract [en]

    The mechanisms underlying the development of painful and nonpainful neuropathy associated with diabetes mellitus are unclear. We have obtained microneurographic recordings from unmyelinated fibers in eight patients with diabetes mellitus, five with painful neuropathy, and three with neuropathy without pain. All eight patients had large-fiber neuropathy, and seven patients had pathological thermal thresholds in their feet, indicating the involvement of small-caliber nerve fibers. A total of 163 C-fibers were recorded at knee level from the common peroneal nerve in the patients (36–67 years old), and these were compared with 77 C-fibers from healthy controls (41–64 years old). The ratio of mechano-responsive to mechano-insensitive nociceptors was ~2:1 in the healthy controls, whereas in the patients, it was 1:2. In patients, a fairly large percentage of characterized fibers (12.5% in nonpainful and 18.9% in painful neuropathy) resembled mechano-responsive nociceptors that had lost their mechanical and heat responsiveness. Such fibers were rarely encountered in age-matched controls (3.2%). Afferent fibers with spontaneous activity or mechanical sensitization were found in both patient groups. We conclude that small-fiber neuropathy in diabetes affects receptive properties of nociceptors that leads to an impairment of mechano-responsive nociceptors. Copyright © 2006 Society for Neuroscience

  • 2814.
    Ørstavik, Kristin
    et al.
    Department of Neurology, Rikshospitalet University Hospital, Oslo, Norway.
    Weidner, Christian
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany; Universitat Erlangen/Nurnberg, Inst. Physiol./Exp. Pathophysiol., Erlangen, Germany.
    Schmidt, Roland
    Dept. of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Schmelz, Martin
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany.
    Hilliges, Marita
    Department of Basic Oral Sciences, Karolinska Institute, Huddinge, Sweden.
    Jørum, Ellen
    Department of Neurology, Rikshospitalet University Hospital, Oslo, Norway.
    Handwerker, Herman
    Department of Physiology, University of Erlangen/Nürnberg, Erlangen, Germany.
    Torebjörk, Erik
    Dept. of Clinical Neurophysiology, University Hospital, Uppsala, Sweden.
    Pathological C-fibres in patients with a chronic painful condition2003In: Brain, ISSN 0006-8950, E-ISSN 1460-2156, Vol. 126, no 3, p. 567-578Article in journal (Refereed)
    Abstract [en]

    Little is known about the contribution of C-afferent fibres to chronic painful conditions in humans. We sought to investigate the role of C-fibres in the pathophysiology of pain and hyperalgesia in erythromelalgia as a model disease for chronic pain. Erythromelalgia is a condition characterized by painful, red and hot extremities, and patients often report tenderness on walking. We made microneurographic recordings from single C-fibres in cutaneous fascicles of the peroneal nerve in patients suffering from this disease. All patients had had a pain attack recently and psychophysical signs of allodynia and punctate hyperalgesia were found. We obtained recordings from a total of 103 C-fibres and found significantly lower conduction velocities and increased activity-dependent slowing of the conduction velocity of afferent C-fibres in the patients compared with healthy controls. Furthermore, several units with biophysical properties of mechano-insensitive fibres were pathological, being spontaneously active or sensitized to mechanical stimuli. Since these fibres also mediate the axon reflex flare, their hyperexcitability might account not only for ongoing pain and tenderness but also for redness and warming in this pain syndrome. The changes in conductive properties found in the C-fibres of these patients could be the first signs of a small-fibre neuropathy. This is the first systematic study of single C-fibres in patients and it shows an active contribution of mechano-insensitive fibres to chronic pain.

  • 2815.
    Überbacher, Ewa
    Halmstad University, School of Social and Health Sciences (HOS).
    VÄGAR TILL REFLEKTION: Avdelningschefers uppfattningar inom somatisk omvårdnad2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Continuous feedback through reflection can be used as a tool by the department head for leading the development, learning and innovation in nursing work. The aim of the study was to describe the department heads´perceptions of reflection in nursing care by a phenomenographical approach. The analysis of 15 interviews resulted in five description categories of reflection. Knowledge integral reflection captures students´training that can be used in nursing work. Processing creates a continuous thought process in nursing work. Reflection development was reinforced among employees when talking to each orther. Managerial reflection was described as a separate forum in the process manager role. Patient-oriented reflection highlighted the patient´s participation. The conclusion was that department heads used reflection on different levels and in different contexts. Reflection proved important in nursing care. Study findings may help to increase knowledge in order to develop leadership whick leads to beter quality of care and patient safety. Continued research should focus on intervention studies with an emphasis on reflection.

  • 2816.
    Berglund, Maria (Editor)
    Växjö universitet, Växjö, Sverige.
    Johansson Sundler, Annelie (Editor)
    Växjö universitet, Växjö, Sverige.
    Roxberg, Åsa (Editor)
    Växjö universitet, Växjö, Sverige.
    Vårdvetenskapliga vägskäl2008Report (Other academic)
    Abstract [en]

    Denna vårdvetenskapliga jubileumsskrift tar läsaren med på en resa genom den utveckling som skett av ämnet vid forskarutbildning i vårdvetenskap vid Växjö universitet. Många bäckar små… ett talesätt som kan illustrera det gemensamma arbete och den samlade kunskap som ligger bakom denna skrift. I skriften får vi stifta bekantskap med vårdvetenskapen i varierande kontexter alltifrån rättpsykiatri till akut- och hemsjukvård. Sammanställningen av den vårdvetenskapliga forskning som under denna femårsperiod har gjorts på IVOSA visar att vårdvetenskapen är en autonom vetenskap med en tydlig substans eller kärna. I kärnan finns patienten, och ämnet tar sin utgångspunkt i människors existens. Med fokus på människan som är i behov av vård framträder lidande, hälsa och välbefinnande som väsentliga begrepp. I bokens delar fördjupas och kontextualiseras vårdvetenskapen i skiftande vårdande liksom lärande miljöer. En vårdvetenskap med grund i ett patientperspektiv behövs såväl akademiskt som i vården för att anta både dagens och morgondagens utmaningar.

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