Aspiring for competence in a multifaceted everyday life:A qualitative study of adult students'experiences of a blended learning master programme in Norway

Aim:To gain knowledge of how adult students experienced the first year of a blended learning master programme to better understand their learning process.Method...     

The emerging role of lipoproteins in atherogenesis: beyond LDL cholesterol

Low-density lipoprotein cholesterol has a well-established role in atherogenesis and the development of coronary heart disease. However, despite effective lowering of low-density lipoprotein cholesterol, many patients continue to have cardiovascular events. It has subsequently emerged that several additional dyslipidemic states promote atherogenesis. In particular, the atherogenic lipoprotein phenotype comprising an elevation of triglycerides and triglyceride-rich lipoproteins; decreased concentrations of high-density lipoprotein cholesterol; and increased small, dense low-density lipoprotein cholesterol, in addition to impaired postprandial lipemia, have been demonstrated to have profound effects on the arterial wall. As such, these factors have become important targets in the development of effective strategies to prevent atherosclerotic cardiovascular disease.     

Experiences of physical and sexual abuse and their implications for current health

OBJECTIVE: To estimate the prevalence of a history of physical and sexual abuse in adulthood among gynecological patients and the association with general and reproductive health. METHODS: A cross-sectional questionnaire study on abusive experiences of gynecologic outpatients in a tertiary hospital. The total sample size was 691. RESULTS: Of all women, 42.4% had experienced moderate or severe physical or sexual abuse as an adult. One hundred forty-seven (21.6%) women reported physical abuse, 84 (12.3%) sexual abuse, and 58 (8.5%) both. The abused and nonabused women did not differ in mean age, education, or parity. Sexually abused women and those who were both sexually and physically abused reported poor general health significantly more often (P=.005 and P=.001, respectively) than the nonabused. They also rated their sex life as significantly worse than the nonabused women (P=.002 and P=.012, respectively). Over half of abused women had experienced common physical complaints during the previous 12 months compared with one third of the nonabused (P<.001). Two thirds of both the abused and the nonabused women preferred that their gynecologist not ask directly about abuse. CONCLUSION: Abusive experiences were common in gynecologic outpatients. Women with abusive experiences had ill health and poor sexual life more often than the controls. In contrast to the results of previous studies, most of the women did not want to be asked about abuse by their gynecologist.     

Apomorphine formulation may influence subcutaneous complications from continuous subcutaneous apomorphine infusion in Parkinson’s disease

Journal of Neurology - Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson’s disease (PD), but a limitation is the formation of troublesome s.c. nodules....     

Relation between renal function,presentation, use of therapies and in‐hospital complications in acute coronary syndrome: data from the SWEDEHEART register

Abstract. Szummer K, Lundman P, Jacobson SH, Schön S, Lindbäck J, Stenestrand U, Wallentin L, Jernberg T, for SWEDEHEART. (Karolinska Institute, Karolinska University Hospital, Stockholm; Karolinska Institute, Danderyd Hospital, Danderyd; Ryhov County Hospital, Jönköping; University Hospital, Uppsala and University Hospital, Linköping; Sweden) Relation between renal function, presentation, use of therapies and in‐hospital complications in acute coronary syndrome: data from the SWEDEHEART register. J Intern Med 2010; 268 :40–49. Objective. To examine clinical characteristics, presenting symptoms, use of therapy and in‐hospital complications in relation to renal function in patients with myocardial infarction (MI). Design. Observational study. Setting. Nationwide coronary care unit registry between 2003–2006 in Sweden. Subjects. Consecutive MI patients with available creatinine (n = 57 477). Results. Glomerular filtration rate was estimated with the Modification of Diet in Renal Disease Study formula. With declining renal function patients were older, had more co‐morbidities and more often used cardio‐protective medication on admission. Compared to patients with normal renal function, fewer with renal failure presented with chest pain (90% vs. 67%, P < 0.001), Killip I (89% vs. 58%, P < 0.001) and ST‐elevation myocardial infarction (STEMI) (41% vs. 22%, P < 0.001). In a logistic regression model lower renal function was independently associated with a less frequent use of anticoagulant and revascularization in non‐ST‐elevation MI. The likelihood of receiving reperfusion therapy for STEMI was similar in patients with normal‐to‐moderate renal dysfunction, but decreased in severe renal dysfunction or renal failure. Reperfusion therapy shifted from primary percutaneous coronary intervention in 71% of patients with normal renal function to fibrinolysis in 58% of those with renal failure. Renal function was associated with a higher rate of complications and an exponential increase in in‐hospital mortality from 2.5% to 24.2% across the renal function groups. Conclusion. Renal insufficiency influences the presentation and reduces the likelihood of receiving treatment according to current guidelines. Short‐term prognosis remains poor.     

Antenatal maternal depressive mood and parental–fetal attachment at the end of pregnancy

The present study investigates if mothers and fathers have similar ways of thinking and feeling about their babies during late pregnancy and how aspects of parental–fetal attachment are related to maternal depressive mood. Two hundred and ninety-eight Swedish-speaking women at 30–32 weeks of gestation and partners (n = 274) participated in the study. Socio-demographic background data were collected. Prenatal attachment was assessed with the maternal/paternal–fetal attachment scale (MFA/PFA), and depressive symptoms were assessed by the Edinburgh postnatal depression scale (EPDS). MFA and PFA scores mirrored each other. After factor analysis, five different factors loaded somewhat differently for men were revealed as significant. These factors were (I) concerns about the fetus and health behavior, (II) mental preparation to take care of the unborn child, (III) experiences of pregnancy, (IV) experiences of fetal movements, and (V) naming of the baby. Factors III and IV were related to depressive symptoms. Mothers with slight depressive symptoms were somewhat less positive about the pregnancy but showed more attention to the fetal movements. Midwives should conduct interviews on the women’s psychosocial history and use validated instruments, which may help them to identify problems with the psychosocial health of the mother and her partner as they journey through pregnancy and transition to parenthood.     

Changes in sense of coherence in old age – a 5‐year follow‐up of the Umeå 85+ study

Scand J Caring Sci; 2013; 27; 13–19 Changes in sense of coherence in old age – a 5‐year follow‐up of the Umeå 85+ study Objective: This study aims to describe the changes in sense of coherence (SOC) over time and relate these changes to negative life events among very old people. Design: Prospective and longitudinal study. Subjects: 190 old women and men participated, of whom 56 could be included in the 5‐year follow‐up. Methods: The mean SOC score from the first and second data collection were compared using a paired sample t‐test. The relationship between the index of negative life events and the changes on SOC score between the two data collections was investigate using linear regression. Main outcome measures: Antonovsky’s SOC scale and an index of negative life events including severe physical and mental diseases, various losses as losses of spouses, cognitive and functional ability. Result: For the whole group of subjects (n = 56), the SOC scores was higher (70.1 vs. 73.7, p = 0.029) at the second point measure. The most common negative life events at follow‐up were loss of independence in activities in daily living and decrease in cognitive function. A significant correlation between the index of negative life events and changes in SOC over 5 years was found (p = 0.025). The more negative life events, the more decrease in SOC. Conclusion: We concluded that there is a risk of decreased SOC and thereby quality of life when negative life events accumulate among very old people. Nursing interventions might play an important role for maintaining and perhaps strengthening SOC among old people exposed to negative life events.