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Swedish Hospitals (swedish + hospital)
Selected AbstractsBody mass index, alcohol, tobacco and symptomatic gallstone disease: a Swedish twin studyJOURNAL OF INTERNAL MEDICINE, Issue 5 2007D. Katsika Abstract. Background/Aims., Both genetic and environmental factors are involved in the pathogenesis of gallstone disease (GD). We aimed to examine the association between symptomatic GD and overweight (body mass index, BMI, 25,30 kg m,2), obesity (BMI > 30 kg m,2), alcohol, smoking and smoke-free tobacco by analysing a large twin population. Methods., The Swedish Twin Registry (STR) was linked to the Swedish Hospital Discharge and Causes of Death Registries for GD and GD-surgery related diagnoses. Weight, height, use of alcohol, smoking and smoke-free tobacco were provided by STR and analysed for possible associations by conditional logistic regression. Results., Overweight and obesity were associated with a significantly higher risk for symptomatic GD in the whole study population (OR 1.86 and OR 3.38; CI: 1.52,2.28 and 2.28,5.02 respectively). High alcohol consumption was associated with a lower risk for GD in the whole population (OR 0.62; CI: 0.51,0.74) with no difference between discordant monozygotic and dizygotic twins (OR 1.08 and OR 0.96; CI: 0.82,1.42 and 0.79,1.16). Smoking or smoke-free tobacco was not correlated with GD. Conclusion., Consistent with epidemiological studies, we found positive associations between BMI and the development of symptomatic GD. High alcohol consumption was associated with a decreased risk against GD. Tobacco use has no impact on GD. [source] Hospitalization in adolescence affects the likelihood of giving birth: a Swedish population-based register studyACTA PAEDIATRICA, Issue 3 2009K Ekholm Selling ABSTRACT Aim: To examine the effect of hospitalization during adolescence on the likelihood of giving birth. Methods: 142 998 women born in 1973,75 were followed with the help of the Swedish Medical Birth Register (MBR) and the Swedish Total Population Register (TPR) up until the end of 2000 with respect to their likelihood of giving birth. All analyses were adjusted for parental socio-economic characteristics and factors related to the studied women's own birth. Results: The likelihood of giving birth between 20 and 27 years of age was positively affected by hospitalization at least once during adolescence according to the Swedish Hospital Discharge Register (HDR); adjusted hazard ratio (HR) = 1.32, 95% confidence interval: 1.29,1.35. Women hospitalized due to genitourinary diseases, respiratory diseases, abdominal problems and abuse of alcohol and drugs were more likely to have given birth during the study period, while hospitalizations according to cerebral palsy and congenital malformations tended to decrease childbearing. Women hospitalized due to psychiatric diseases had an increase likelihood of given birth at 20,24 years but a reduced thereafter. Conclusion: A majority of the causes of hospitalization during adolescence increased the likelihood of giving birth between ages 20 to 27. [source] Effects of nursing interventions within an integrated care pathway for patients with hip fractureJOURNAL OF ADVANCED NURSING, Issue 2 2007Lars-Eric Olsson Abstract Title. Effects of nursing interventions within an integrated care pathway for patients with hip fracture Aim., This paper reports a study to evaluate the contribution of nursing care within an integrated care pathway for patients with hip fracture. Background., There is growing interest in quality assurance in health care. Integrated care pathways are a method to achieve this goal, and are a multi-professional team approach where the requirement for nurses to work effectively within the team is important. However, the nurses' role and contribution within the team have not been well described. Method., A quasi-experimental, prospective study comparing an intervention group with a comparison group was carried out. One hundred and twelve independently living patients, aged 65 years or older and admitted to a Swedish hospital with a hip fracture, were consecutively selected. Pathological fracture and severe intellectual impairment (Pfeiffer's test <3 points) served as exclusion criteria. The intervention was designed to focus on patients' motivation and their prerequisites for rehabilitation and was based on the concept of transition. The main outcome measure was the number of patients restored to preoperative activities of daily living levels in 2003,2004. Findings., In the intervention group 21% were restored to activities of daily living to level A (independent) at discharge, whereas only 5% in the comparison group were restored to this level. No patients in the intervention group, admitted as independent, remained at activities of daily living level F (dependent), whereas 16% remained at level F in the comparison group (P = 0·003). Conclusion., When admitting older patients with a hip fracture, it is important to acquire good knowledge about each patient and their prerequisites and to offer them accelerated rehabilitation in accordance with their individual ability. By monitoring process indicators during the transition, serious deviations from the care plan can be avoided. [source] Downsizing and reorganization: demands, challenges and ambiguity for registered nursesJOURNAL OF ADVANCED NURSING, Issue 2 2004Anna Hertting MD Background., The 1990s were characterized by substantial financial cuts, and related staff redundancies and reorganizations in the Swedish health care sector. A large hospital in Sweden was selected for the study, in which downsizing had occurred between 1995 and 1997. The number of staff in the hospital was reduced by an average of 20%, and 10% were relocated to other departments. Objective., The aims of this study were to explore registered nurses' experiences of psychosocial ,stressors' and ,motivators', and how they handled their work situations, following a period of personnel reductions and ongoing reorganization. Method., Interviews were undertaken with 14 nurses working in one Swedish hospital. Nurses were interviewed in 1997 about the recent and last round of redundancies, and were followed up 1 year later in 1998 and again in 2001. Interviews were audiotaped, transcribed and analysed for thematic content. Results., Five themes emerged in relation to nurses' perceived stressors, motivators, and coping options: ,distrust towards the employer', ,concurrent demands and challenges', ,professional ambiguity, ,a wish for collaboration', and ,efforts to gain control'. A common feature was duality and ambiguity in nurses' descriptions of the phenomena studied, meaning that identified themes had underlying sub-themes with both negative and positive dimensions. Conclusions., The concurrence of ,ever-growing job demands' and ,work going unrewarded' contributed to a feeling of being taken advantage of by the employer. The ,waste of human resources' and ,competence drain' that followed redundancies provoked anger. Unfulfilled collaboration with doctors was a major stress producer, which related to both the downsized work organization, and the complex ,deference-dominance' doctor,nurse relationship. The well-being of nurses depends on being an equal/parallel health professional in a comprehensive team that shares knowledge and improves collaborative care of patients. A consciously formulated nursing philosophy emerged as a health-promoting resource. This study demonstrates the importance of analysing feelings relating to professional ambiguity and gaining influence in a gender-related, hierarchical environment, and the need to support professional assertiveness in relation to superiors and doctors. It is also important to stress considerations that relate to differences in the age, care philosophy, and psychosocial health conditions of nurses. [source] Scandinavian test of artificial neural network for classification of myocardial perfusion imagesCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2000Lindahl Artificial neural networks are systems of elementary computing units capable of learning from examples. They have been applied to automated interpretation of myocardial perfusion images and have been shown to perform even better than experienced physicians. It has been shown that physicians interpreting myocardial perfusion images benefit from the advice of such networks. These networks have been developed and validated in the same hospital. However, widespread use of neural networks will only take place if the networks can maintain a high accuracy in other hospitals, i.e. hospitals using different gamma cameras, different acquisition techniques, different study protocols, etc. The purpose of this study was to develop a neural network in one hospital and test it in another. An artificial neural network was trained to detect coronary artery disease using myocardial perfusion scintigrams from 135 patients at a Swedish hospital. Thereafter, this network was tested using scintigrams from 68 patients at a Danish hospital and compared to six criteria based on expert physician analysis and quantitative analysis by the CEqual program. The sensitivity of the network was significantly higher than that of one of the physician criteria (0·92 versus 0·71) and two of the CEqual-based criteria (0·94 versus 0·63 and 0·96 versus 0·65) compared at equal specificities. It was concluded that an artificial neural network can maintain high accuracy in a hospital other than the one where it was developed. [source] Plantar pressures in diabetic patients with foot ulcers which have remained healedDIABETIC MEDICINE, Issue 11 2009T. M. Owings Abstract Aims, The recurrence of foot ulcers is a significant problem in people with diabetic neuropathy. The purpose of this study was to measure in-shoe plantar pressures and other characteristics in a group of neuropathic patients with diabetes who had prior foot ulcers which had remained healed. Methods, This was an epidemiological cohort study of patients from diabetes clinics of two Swedish hospitals. From a database of 2625 eligible patients, 190 surviving patients with prior plantar ulcers of the forefoot (hallux or metatarsal heads) caused by repetitive stress were identified and 49 patients agreed to participate. Barefoot and in-shoe plantar pressures were measured during walking. Data on foot deformity, activity profiles and self-reported behaviour were also collected. Results, Mean barefoot plantar peak pressure at the prior ulcer site (556 kPa) was lower than in other published series, although the range was large (107,1192 kPa). Mean in-shoe peak pressure at this location averaged 207 kPa when measured with an insole sensor. Barefoot peak pressure only predicted ,35% of the variance of in-shoe peak pressure, indicating variation in the efficacy of the individual footwear prescriptions (primarily extra-depth shoes with custom insoles). Conclusions, We propose that the mean value for in-shoe pressures reported in these patients be used as a target in footwear prescription for patients with prior ulcers. Although plantar pressure is only one factor in a multifaceted strategy to prevent ulcer recurrence, the quantitative focus on pressure reduction in footwear is likely to have beneficial effects. [source] Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudesACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 2 2010L. NILSSON Background: The operating room is a complex work environment with a high potential for adverse events. Protocols for perioperative verification processes have increasingly been recommended by professional organizations during the last few years. We assessed personnel attitudes to a pre-operative checklist (,time out') immediately before start of the operative procedure. Methods: ,Time out' was implemented in December 2007 as an additional safety barrier in two Swedish hospitals. One year later, in order to assess how the checklist was perceived, a questionnaire was sent by e-mail to 704 persons in the operating departments, including surgeons, anesthesiologists, operation and anesthetic nurses and nurse assistants. In order to identify differences in response between professions, each alternative in the questionnaire was assigned a numerical value. Results: The questionnaire was answered by 331 (47%) persons and 93% responded that ,time out' contributes to increased patient safety. Eighty-six percent thought that ,time out' gave an opportunity to identify and solve problems. Confirmation of patient identity, correct procedure, correct side and checking of allergies or contagious diseases were considered ,very important' by 78,84% of the responders. Attitudes to checking of patient positioning, allergies and review of potential critical moments were positive but differed significantly between the professions. Attitudes to a similar checklist at the end of surgery were positive and 72,99% agreed to the different elements. Conclusion: Staff attitudes toward a surgical checklist were mostly positive 1 year after their introduction in two large hospitals in central Sweden. [source] Leadership styles among nurse managers in changing organizationsJOURNAL OF NURSING MANAGEMENT, Issue 6 2000M. Lindholm RNT Aim, The intention in this study was to explore the meaning, exposition and application of nurse managers' leadership styles within the organizational culture of a changing healthcare system. Background, Nurse managers are expected to act, under the pressure of a changed and restructured healthcare system, as skilled and competent future managers of people, operations, budgets and information. Knowledge concerning nurse managers' thoughts and ideas is important if their leadership development is to be supported and their management strengthened. Method, Open-ended, tape-recorded interviews were conducted with 15 nurse managers from three Swedish hospitals. The analysis was inductive, and made use of two deductive perspectives. Findings, Four leadership styles were identified: the formation of hierarchical authority; the formation of hierarchical adjustment; the formation of a career approach; and the formation of a devotional approach. Conclusion, Nurse managers who had a clear leadership style related mainly to a transformational or transactional leadership model, experienced fewer management problems than nurse managers with a composite leadership style. There was a connection between nurse managers' attitudes to the existing organizational culture and the leadership model adopted, the strategy towards the top level and their management idea. [source] Increased death risk and altered cancer incidence pattern in patients with isolated or combined autoimmune primary adrenocortical insufficiencyCLINICAL ENDOCRINOLOGY, Issue 5 2008Sophie Bensing Summary Objectives, Primary adrenocortical insufficiency is mostly caused by an autoimmune destruction of the adrenal cortex. The disease may appear isolated or as a part of an autoimmune polyendocrine syndrome (APS). APS1 is a rare hereditary disorder with a broad spectrum of clinical manifestations. In APS2, primary adrenocortical insufficiency is often combined with autoimmune thyroid disease and/or type 1 diabetes. We analysed mortality and cancer incidence in primary adrenocortical insufficiency patients during 40 years. Data were compared with the general Swedish population. Design and patients, A population based cohort study including all patients with autoimmune primary adrenocortical insufficiency (3299) admitted to Swedish hospitals 1964,2004. Measurements, Mortality risk was calculated as the standardized mortality ratio (SMR) and cancer incidence as the standardized incidence ratio (SIR). Results, A more than 2-fold increased mortality risk was observed in both women (SMR 2·9, 95% CI 2·7,3·0) and men (SMR 2·5, 95% CI 2·3,2·7). Highest risks were observed in patients diagnosed in childhood. SMR was higher in APS1 patients (SMR 4·6, 95% CI 3·5,6·0) compared with patients with APS2 (SMR 2·1, 95% CI 1·9,2·4). Cancer incidence was increased (SIR 1·3, 95% CI 1·2,1·5). When tumours observed during the first year of follow-up were excluded, only the cancer risk among APS1 patients remained increased. Cause-specific cancer incidence analysis revealed significantly higher incidences of oral cancer, nonmelanoma skin cancer, and male genital system cancer among patients. Breast cancer incidence was lower than in the general population. Conclusions, Our study shows a reduced life expectancy and altered cancer incidence pattern in patients with autoimmune primary adrenocortical insufficiency. [source] | ||||||||||