Biomedical subjects

A Norberg

Publications and source records attributed to A Norberg.

At least 19 recordsLinked to original sources

PubMed2005

Elimination kinetics of L-alanyl-L-glutamine in ICU patients.

A randomised, double blind, placebo-controlled study was performed giving 0.5 g x kg(-1) x day(-1) of undiluted alanyl-glutamine (20%) or saline in a peripheral vein during 4 hours in ICU patients (n = 20). During the infusion period a steady state in plasma concentration was reached for alanyl-glutamine, but not for alanine, glutamine or glutamate. On the other hand there was no accumulation of any of the amino acids, as the pre-infusion concentrations were reached within 8 hours after the end of infusion. The half-life of the dipeptide was 0.26 hours (range, 0.15-0.63 h). The distribution volume of alanyl-glutamine was larger than the extracellular water volume, indicating a rapid hydrolysis of the dipeptide. There was no detectable alanyl-glutamine in the urine of any of the patients. All patients had excretion of small amounts of amino acids in urine, but the renal clearance of alanine, glutamine and glutamate were not different between the two groups.

Adult↗

PubMed2005

Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old.

Different concepts have been presented which denote driving forces and strengths that contribute to a person's ability to meet and handle adversities, and keep or regain health. The aim of this study, which is a part of The Umeå 85+ study, was to describe resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health in a sample of the oldest old. The study sample consisted of 125 participants 85 years of age or older, who ranked themselves on the Resilience Scale, Sense of Coherence Scale, Purpose in Life Scale and Self-Transcendence Scale and answered the SF-36 Health Survey questionnaire. The findings showed significant correlations between scores on the Resilience Scale, the Sense of Coherence Scale, the Purpose in Life Test, and the Self-Transcendence Scale. Significant correlations were also found between these scales and the SF-36 Mental Health Summary among women but not among men. There was no significant correlation between perceived physical and mental health. The mean values of the different scales showed that the oldest old have the same or higher scores than younger age groups. Regression analyses also revealed sex differences regarding mental health. The conclusions are that, the correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults. Another conclusion is that the dimensions that constitute mental health differ between women and men.

Adaptation, Psychological↗

PubMed2005

Psychiatric nurses' response to suicidal psychiatric inpatients: struggling with self and sufferer.

Research on nurses' responses to suicidal patients is sparse. The purpose of this secondary analysis of qualitative data from interviews with 19 nurses employed in Norway was to describe nurses' responses to suicidal psychiatric inpatients. Thematic analyses revealed four themes: 'struggling with discernment of self and sufferer'; 'reconciling inner dialogue'; 'opening up while envisioning self from sufferer'; and 'revisioning the meaning of life revealed over time'. The main theme was 'struggling with self and sufferer'. While these findings reveal existential issues and self reflections of psychiatric nurses' struggle with the suffering of suicidal patients, they also contribute to a methodological debate. Further research is needed to examine nurses' responses to suicidal patients in various settings and to develop secondary analysis of qualitative data.

Attitude of Health Personnel↗

PubMed2003

Identification of the bioactive peptide PEC-60 in brain.

PEC-60 is a 60-residue peptide originally isolated from pig intestine. It inhibits glucose-induced insulin secretion from perfused pancreas in a hormonal manner and also has biological activity in the immune system. PEC-60-like immunoreactive material has been reported in catecholamine neurons of the central and peripheral nervous systems, but the peptide has not been identified from that material. We have now isolated PEC-60 from pig and rat brains with a method that combines column purification procedures with the specificity of a radioimmunoassay and the sensitivity of mass spectrometry to directly identify the peptide. The results show that PEC-60, like many other peptides, is expressed in the gastrointestinal tract and the central nervous system. The specific regional brain distribution and interaction with classical neurotransmitters raise the possibility that PEC-60 may play a role in the central nervous system disorders involving dopamine dysregulation.

Animals↗

PubMed2003

Dientamoeba fragilis--a protozoal infection which may cause severe bowel distress.

A retrospective study of 87 patients diagnosed with the protozoan Dientamoeba fragilis was performed due to a recent increase in the number of patients diagnosed with this organism at the Unit of Clinical Parasitology, Huddinge University Hospital, Stockholm, Sweden. Medical records were reviewed. The highest incidence was found in pre-school boys, who also had the longest duration of symptoms, with a range of 1-630 weeks. A majority of the patients had symptoms of diarrhea, abdominal pain and flatus. The diarrhea varied from watery to loose, blood being reported only sporadically. Most patients had traveled outside Europe and had no other parasites in their stools. This study indicates potential pathologic properties in D. fragilis, and prospective studies are recommended.

Adolescent↗

PubMed2002

Promoting a good life among people with Alzheimer's disease.

AIM: To illuminate the meaning of offering care and a place to live to people with Alzheimer's disease in a special care unit. RATIONALE: There is a need to gain a deeper understanding about so called 'homelike' care settings, and about how to promote experiences of being at home in residents with Alzheimer's disease. The study is part of a long-term study in a special care unit. METHODS: The study comprises phenomenological hermeneutic interpretation of interviews with 10 care providers. RESULTS: The analyses revealed a number of caring aspects such as, for example, 'viewing dignity and striving to preserve a sense of self in the resident', 'encouraging a sense of belonging', 'offering relief' and 'promoting a sense of power and control in the resident', although integrated and reflected in each other. The caring aspects constituted the themes confirmation, familiarity, communion and agency considered as dimensions of the good life. CONCLUSION: To avoid simplification in which, for example, the furniture from a certain decade become the standard for good care, it seems important to focus upon the meaning of the good life. Care that promotes a good life of people with Alzheimer's disease seemed relationship centred.

Activities of Daily Living↗

PubMed2001

Ser(13)-phosphorylated PYY from porcine intestine with a potent biological activity.

We have isolated a posttranslationally modified form of peptide YY (PYY) from porcine intestine and shown by MALDI-TOF and electrospray tandem mass spectrometry that it is phosphorylated at Ser(13). Phospho-PYY exhibits high affinity for binding to neuropeptide Y (NPY) receptors Y1, Y2 and Y5. The IC(50) values with the Y1, Y2, and Y5 receptor subtypes were for NPY 2.4, 3.1, and 3.3 nM, for PYY 2.3, 0.94, and 3.2 nM, and for phospho-PYY 4.6, 2.2, and 5.5 nM, respectively. Phospho-PYY potently inhibits forskolin-stimulated cAMP accumulation in SK-N-MC cells with an IC(50) value of 0.5 nM compared to 0.15 nM for non-phosphorylated PYY. The finding of phosphorylation of PYY is unusual among hormonal peptides, and emphasizes the importance of direct protein analysis of gene products.

Amino Acid Sequence↗

PubMed2001

Male physicians' narratives about being in ethically difficult care situations in paediatrics.

This study is a part of a comprehensive investigation into the narratives of male and female physicians and nurses concerning their experience of being in ethically difficult care situations in paediatrics. Seventeen male physicians with a range of levels of expertise, working on various wards in paediatric clinics at two university hospitals in Norway, narrated 78 stories. The transcribed interview texts were subjected to hermeneutic analysis. All the interviewees related problems in both an action and a relation ethics perspective. The main focus was on ethical problems concerning life and death decisions. The central theme was overtreatment, which they felt they could easily slip into because of a lack of exact knowledge about the outcome of life-saving treatment. The less experienced physicians required criteria and ethical guidelines that could tell them when to stop treatment, and they expected the more experienced physicians to be able to teach them about such things. The more experienced physicians, however, told a different story about life-saving practices in paediatrics. They spoke of a very demanding life situation. In such a situation communication seems decisive, not only to clarify treatment questions, but primarily to cope with life. The physicians' main concern seemed to be the parents rather than the children. Both groups underlined the importance of professional distance to patients and to ethical problems.

Adult↗

PubMed2001

Experiences of coercion in psychiatric care as narrated by patients, nurses and physicians.

AIM: The aim of the study was to increase understanding of psychiatric patients', nurses' and physicians' experience of coercion, in relation to their own and the other parties' experiences. METHODS: Seven triads of patient, nurse and physician narrated their experiences of the same coercive event. The 21 interviews were analysed focusing on narrative elements. RESULTS: The nurse and physician narratives revealed that they felt unable to connect with the patients, while the patients told us that they wanted more human contact with nurses and physicians. All three parties expressed the belief that interpersonal relationships and the human contact were important. The nurses and physicians stated that knowing the patient made them feel easier about using coercion and that their actions were less violating for the patient. The patients stated that human contact alleviated their feeling of discomfort and made them feel more secure when subjected to coercion. CONCLUSION: The salient aspect described by all three parts was the importance of human contact and having a mutual relationship. These findings indicate a need for more dialogue between patients and staff. The dialogue should aim at making staff understand patients' feelings better regarding coercion and at informing the patients about the coercive measures.

Adult↗

PubMed2001

Women's narratives during the acute phase of their myocardial infarction.

AIM: The purpose of this study was to illuminate the meaning of lived experiences during the acute phase of an acute myocardial infarction (AMI). METHOD: Ten women (< 60 years old) afflicted with AMI narrated their experiences during their stay in the coronary care unit (CCU). The interview texts were interpreted using a method with a phenomenological hermeneutic approach, inspired by the philosophy of Ricoeur. The text was divided into meaning units that were condensed and abstracted. Three themes were then extracted from the text. FINDINGS: One theme was 'oneself as vulnerable' with the subthemes: 'the feeling of being dependent upon others', 'the feeling of being insulted' and 'the feeling of being a troublesome person'. Another theme was 'oneself as distanced', with the subthemes: 'not facing the reality', 'captive in an unreal situation', and 'inhibition out of concern for others'. The last theme was: 'oneself as making sense' with the subthemes: 'acquirement of some insight' and 'discovery of a new meaning with life'. CONCLUSION: The reported comprehensive understanding revealed the phenomena guilt and shame. These, in combination with the experience of being in an unreal situation and the withholding of feelings may have led to a deterioration of communication. It seems that relatives and the staff at CCU were not allowed to share the burden of being afflicted with an AMI.

Adaptation, Psychological↗

PubMed2001

Being overwhelmed by the feeling of having a home and family. One aspect of the meaning of being dependent on care: a study of one patient and two of his nurses.

RATIONALE: This article is part of an ongoing study which aims at disclosing the meaning of being dependent on care. From a larger body of data, interviews with one patient and two of his nurses were selected to study. AIM: The aim was to deepen understanding of the meaning of being dependent on care when this appears desirable for the patient. METHODS: A phenomenological-hermeneutic approach was used to interpret the material. Interviews were recorded and transcribed verbatim. FINDINGS/DISCUSSION: The interpretation discloses the meaning of being dependent on care as an overwhelming, unfamiliar feeling of having a home and family. The patient is beguiled into believing he is the ruler in an established relationship and his dependency on care gives him an opportunity to be surrounded by loving, altruistic, helpful people. Being dependent on care is overwhelming and irresistible, i.e. coveted, but simultaneously it is like walking on thin ice, i.e. treacherous. The irresistible desire concerns being unconditionally cared about. The danger is that this 'family membership' will not last. It is brought to the patient because of his dependency on care and it is based on his terms. There is reflection about the patient being unprepared for dealing with his own world of loneliness.

Activities of Daily Living↗

PubMed2001

Interaction relating to privacy, identity, autonomy and security. An observational study focusing on a woman with dementia and "behavioural disturbances", and on her care providers.

AIM: The study aims to illuminate how one woman with severe dementia and so-called behavioural disturbances acts in relation to her care providers and how the care providers act in relation to her. METHODS: Fourteen participant observations, including one woman with dementia and six care providers, were performed. A reflective dialogue focusing on the interaction between the woman and her care providers followed each observation. The tape-recorded observational notes and reflective dialogues were fixed as a text, which was subjected to a thematic content analysis. FINDINGS: The main findings are that the interaction between a woman with severe dementia and "behavioural disturbances" and her care providers relates to privacy, identity, autonomy and security. The phenomena are intertwined and also in conflict with each other. Interaction is a complex dialectic process in which those who are engaged meet problems that can be solved and are involved in dilemmas that cannot be solved, only related to.

Activities of Daily Living↗

PubMed2001

The meaning of suicidal psychiatric inpatients' experiences of being treated by physicians.

Twenty-one psychiatric inpatients who had thought about, expressed a wish to, or even attempted to commit suicide narrated their experiences of receiving treatment from physicians. The interview texts were transcribed and interpreted using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. Two main themes and eight themes were found. Participating Approach: being with the patients, listening to patients without prejudice, trusting each other, respecting patients' integrity; and Observing Approach: leaving patients to themselves, listening to patients with prejudice, mistrusting each other, not respecting patients' integrity. These findings were interpreted in the light of the writings of Hegel, Buber and Cissna and Sieburg. The suicidal patients expressed their need for confirmation in their interaction with physicians, that is they needed to meet with respect and interest when staying in the hospital with suicidal thoughts or after suicidal attempts.

Attitude to Health↗

PubMed2001

Evaluation of the QALY model for analysis of cost-effectiveness of eating training after stroke.

New methods developed and insights gained in research are of increasing significance in health care and the question is which services and methods are to be implemented. If eating training after stroke is to be implemented it must be given priority in relation to other measures. Otherwise there is a risk that patients with eating difficulties after stroke will be fed by personnel or permanently receive nourishment via tube. This may lead to expensive measures or costs for the tube feeding as well as costs for the personnel needed for feeding, and patients' well-being will be reduced if they do not have the opportunity to eat as independently as possible. Economic analyses should not guide the priorities to be made, but can be one of several bases for resource allocation. The estimation of cost-effectiveness must, however, be made by means of a method which in its ethical foundation is in line with nursing and the Swedish Government Bill for guiding priorities in health care. The aim of this paper is to discuss the ethical foundation of nursing care and the ethical principles proposed by the Swedish Government Bill for guiding priorities in health care and the model of Quality Adjusted Life Years (QALYs) related to eating training after stroke. The findings showed that there was a considerable difference in the ways health and health maximization were discussed in the QALY model and in specific nursing care. There are two aspects underpinning the QALY model that are not in line with either the ethical foundations of nursing or the principles proposed by the Swedish Government Bill for guiding priorities in health care. However, a new method called Equity Adjusted Life Years (EQALYs) can be a tool for evaluation in specific nursing care. Cost per EQALY is based on a compromise between initial severity of disease and treatment effect that is very close to the distribution rule applied in specific nursing care. In conclusion it is obvious that cost per EQALY, a balance between health maximization and severity of disease and treatment effects, can be a tool for the evaluation of eating training after stroke.

Cost-Benefit Analysis↗

PubMed2001

Individualized music played for agitated patients with dementia: analysis of video-recorded sessions.

Many nursing home patients with dementia suffer from symptoms of agitation (e.g. anxiety, shouting, irritability). This study investigated whether individualized music could be used as a nursing intervention to reduce such symptoms in four patients with severe dementia. The patients were video-recorded during four sessions in four periods, including a control period without music, two periods where individualized music was played, and one period where classical music was played. The recordings were analysed by systematic observations and the Facial Action Coding System. Two patients became calmer during some of the individualized music sessions; one patient remained sitting in her armchair longer, and the other patient stopped shouting. For the two patients who were most affected by dementia, the noticeable effect of music was minimal. If the nursing staff succeed in discovering the music preferences of an individual, individualized music may be an effective nursing intervention to mitigate anxiety and agitation for some patients.

Aged↗

PubMed2001

Well-being, sense of coherence, and burnout in stroke victims and spouses during the first few months after stroke.

Ten stroke victims, who had recently suffered their first manifest stroke with lasting neurological symptoms, participated, together with their spouses, in a study aimed at elucidating the well-being, sense of coherence (SOC), and burnout during the first few months after discharge. The stroke victims had no substantial speech disturbances, and showed no evidence of significant cognitive impairment, signifying they were mildly to moderately impaired by their stroke. All subjects were investigated at 1 and 3 months after homecoming. The methods used in this study were open-ended interviews with all research participants, performed at two different appointments, and three self-reporting questionnaires: the well-being measure (WM), the SOC scale, and the burnout measure (BM). The instruments suit each other well, broaden the picture of living with stroke and give an attuned comprehensive understanding. The most striking finding was the substantial differences in the results, both regarding the stroke victims and their spouses, clearly indicating the limited value current generalizations have. The results also pointed to considerable distress both in stroke victims and spouses, although individuals with a weak SOC clearly displayed more difficulties in coping with the situation and risk of burnout, than did those with a strong SOC.

Adaptation, Psychological↗

PubMed2001

Being met--a passageway to hope for relatives of patients at risk of committing suicide: a phenomenological hermeneutic study.

Fifteen Norwegian relatives narrated their experiences of "being met" by mental health care personnel regarding the care of their adult family member who had seriously thought about or attempted suicide. The narrative interviews were audiotaped, transcribed into text, and then interpreted using a phenomenological hermeneutic method. The results of the interpretation revealed that the context of being met was characterized by "being helpless and powerless." The six themes that were constructed describing being met were: Being-seen as a human being; participating in an I-Thou relationship; trusting personnel, treatment, and care; feeling trusted by personnel; being consoled; and entering into hope. The experience of being met in the midst of the care of a relative in crisis created possibilities for hope. Being met, in this context, is a passageway to hope.

Adaptation, Psychological↗

PubMed2001

Do ethanol and deuterium oxide distribute into the same water space in healthy volunteers?

BACKGROUND: The volume of distribution at steady state for ethanol (Vss) is thought to be identical to the total body water (TBW). We compared a two-compartment pharmacokinetic model with parallel Michaelis-Menten and first-order renal elimination with the classical one-compartment zero-order elimination model. Ethanol concentration-time profiles were established for breath, venous blood, and urine. The values of Vss obtained for ethanol were compared with TBW determined by deuterium oxide dilution. METHODS: Sixteen healthy volunteers each received a 30-min intravenous infusion of ethanol on two occasions. Ethanol was measured in breath by a quantitative infrared analyzer and in blood and urine by headspace gas chromatography. Deuterium oxide was given as an intravenous injection and measured in serum by isotope-ratio mass spectrometry. Components of variation were calculated by ANOVA to determine the precision of the estimates of Vss and TBW. RESULTS: Mean TBW, determined by deuterium oxide dilution, was 44.1 +/- 3.9 liters (+/-SD) for men, corresponding to 0.61 liters/kg, and 37.4 +/- 3.2 liters for women, or 0.54 liters/kg. Estimates of Vss from blood-ethanol pharmacokinetics were 87.6% of TBW according to isotope dilution and 84.4% for breath analysis with the two-compartment model. This compares with 95.1% and 95.4% for blood and breath alcohol, respectively, when the classical zero-order kinetic analysis is used. The precision of the estimates of Vss and TBW was between +/-1.56 and +/-2.19 liters (95% confidence interval). CONCLUSIONS: Ethanol does not distribute uniformly into the TBW. The precision of measuring Vss by ethanol dilution was comparable to estimates of TBW by isotope dilution. Results of noninvasive breath ethanol analysis compared well with use of venous blood for estimating Vss. The sophisticated two-compartment model was much superior to the classical one-compartment model in explaining the total concentration-time course of intravenously given ethanol.

Adult↗