Biomedical subjects

L Jakobsson

Publications and source records attributed to L Jakobsson.

9 recordsLinked to original sources

PubMed2006

A population-based binational register for monitoring long-term outcome and possible disease concordance among blood donors and recipients.

BACKGROUND AND OBJECTIVES: Even with appropriate donor deferrals and advanced screening tests, the risk of disease transmission through blood transfusion cannot be completely disregarded. Efficient monitoring of possible disease transmission between blood donors and recipients should be an important component of a comprehensive haemovigilance system. MATERIALS AND METHODS: We assembled the Scandinavian Donations and Transfusions (SCANDAT) database, with data on virtually all blood donors and recipients who have been registered at least once in any of the computerized local blood bank databases in Sweden and Denmark since the start of computerized registration in 1966. The records of these individuals, with their entire computerized donation and/or transfusion histories and all donor-component-recipient connections, were linked to nationwide population and health registers to attain essentially complete follow-up for up to 36 years regarding reproduction, hospital morbidity, cancer, and death. RESULTS: After data cleaning, the database contained 1,134,290 blood donors who contributed 15,091,280 records of donations and 1,311,079 recipients who received 11,693,844 transfusions. The data quality in the existing data sources was satisfactory. From the data obtained from local blood banks, 4.6%, 1.6%, and 6.4% of the person, donation, and transfusion records, respectively, had to be discarded after review of the legitimacy of recorded values, and comparisons with independent, external databases. CONCLUSION: It is possible to use existing computerized data, collected in routine health care, in haemovigilance systems for monitoring long-term outcome and disease concordance in blood donors and transfusion recipients.

Blood Donors↗

PubMed2001

Sexual problems in men with prostate cancer in comparison with men with benign prostatic hyperplasia and men from the general population.

In a questionnaire study, men with prostate cancer (n = 155) or benign prostatic hyperplasia (n = 131) identified more sexual problems than did men from the general population (n = 129). Sexual dysfunction was acknowledged regarding sexual pleasure and attraction, erectile function and sexual satisfaction and sexual performance. Lowered rates of sexual desire, pleasure and attraction were found when comparing their situation in recollection of pre-treatment situation to the current situation. Lower intercourse frequency and sexual satisfaction were also found. Medication, masturbation and artificial aids to achieve erection were not used as substitutes for shortcomings of erectile function either by men with prostate cancer and benign prostatic hyperplasia nor by their partners. There seemed to be a lack of information about the illness and treatment consequences for sexual life, including what physical dysfunction to expect after surgery and also what possible help to expect to compensate for the shortcomings.

Aged↗

PubMed2000

Comparison of car seats in low speed rear-end impacts using the BioRID dummy and the new neck injury criterion (NIC).

Long-term whiplash associated disorders (WAD) 1-3 sustained in low velocity rear-end impacts is the most common disability injury in Sweden. Therefore, to determine neck injury mechanisms and develop methods to measure neck-injury related parameters are of importance for current crash-safety research. A new neck injury criterion (NIC) has previously been proposed and evaluated by means of dummy, human and mathematical rear-impact simulations. So far, the criterion appears to be sensitive to the major car and collision related risk factors for injuries with long-term consequences. To further evaluate the applicability of NIC, four seats were tested according to a recently proposed sled-test procedure. 'Good' as well as 'bad' seats were chosen on the basis of a recently presented disability risk ranking list. The dummy used in the current tests was the Biofidelic Rear Impact Dummy (BioRID). The results of this study showed that NICmax values were generally related to the real-world risk of long-term WAD 1-3. Furthermore, these results suggested that NICmax calculated from sled tests using the BioRID dummy can be used for evaluating the neck injury risk of different car seats.

Acceleration↗

PubMed2000

WHIPS--Volvo's Whiplash Protection Study.

Whiplash associated disorders (WAD) resulting from rear end car impacts are an increasing problem. WAD are usually not life threatening, but are one of the most important injury categories with regard to long-term consequences. This paper is a review of Volvo's Whiplash Protection Study (WHIPS), which is the result of more than ten years of concentrated research efforts in the area of neck injuries in car collisions, with the focus on rear end car impacts. The study follows the whole chain from accident research to the development of a seat for increased protection against WAD. Results from Volvo's accident research are summarized. Existing biomechanical knowledge regarding possible injury mechanisms are presented and discussed. Based on the interpretation of accident research and biomechanical knowledge, guidelines for improved protection against WAD in rear end impacts are presented. Requirements and test methods based on the guidelines are explained. An important part of the study is a new rear end impact dummy, BioRID. Test results using the new dummy are presented. Finally, the paper explains the design of a new seat for increased WAD protection, the WHIPS-seat. Results from the accident research and biomechanical research emphasize the importance of considering the whole spine of the occupant and, accordingly, the whole seat when addressing WAD in rear end impacts, with a particular focus on low and moderate impact severity. Low and moderate impact severity crashes should be focused. Also important to consider are the individual differences between occupants, the seating position and the variety of seating postures. All results, including sub-system testing, mathematical modeling, sled testing, as well as geometrical parameters show that the WHIPS-seat will have considerable potential for offering increased protection against WAD in rear end impacts.

Accidents, Traffic↗

PubMed2000

Experiences of micturition problems, indwelling catheter treatment and sexual life consequences in men with prostate cancer.

Men with prostate cancer (n=25) were interviewed, focusing on experiences of micturition problems, indwelling catheter treatment and sexual life consequences. Narrations were found to be practical and technical descriptions rather than emotional, and experiences were described with reduction and negligence regarding personal well-being and the impact of problems. Phenomenological-hermeneutic analysis was used and findings ordered in subthemes and themes of meaning. Micturition problems, catheter treatment and sexual life problems were all phenomena that radically affected the clients' autonomy and life quality and changed the life continuum. Impact from the disease was either accepted or not and related to what had already been borne in life. Experiences were linked together, each of them giving rise to feelings of physical deterioration and fear of ridicule, and hidden from others. Maintaining self-image and social role was important and connected with the degree of perceived deprivation of life content. Responsibility for medical decisions was left to professionals while everyday problems with micturition, catheters and sexual life were regarded as the men's sole responsibility. Findings were interpreted to mean that comparing the personal situation with that of others worse off made the life situation look better. The clinical implication of this study was that because the men came forward with their problems when given time to talk in their own way these areas should be given time and interest in the nursing care. Interpretation did not provide a unified picture of problems. Thus, nurses will have to seek men's individual experience actively and give legitimacy to patients' problems by opening up opportunities to speak about otherwise concealed problems. Then it may be possible to provide solutions that may ease the men's burdens.

Aged↗

PubMed1997

Experiences of daily life and life quality in men with prostate cancer. An explorative study. Part I.

Eleven men with prostate cancer were randomly chosen and interviewed during an in-patient period at a southern Swedish hospital. The interview focused on functional health status in relation to daily life and life quality. In addition the sense of coherence scale was used, as well as the European Organization or Research and Treatment of Cancer (EORTC) QLQ C-30 questionnaire. The interview findings were analysed from a phenomenological-hermeneutic perspective and interpreted within the concept of transition. The entry to transition was marked by the men when experiencing an altered life continuum in terms of physical and existential fatigue, pain, micturition problems and an altered sex life. The passage phase was marked by descriptions of a new lifestyle where hope was a central internal resource, creating a positive illusion of life in order to endure. Their external resources were wives and family who supported physically (household matters, gardening) and psycho-logically (comfort, encouragement). The exit phase meant continuously adapting to a new life style, living with a slowly deteriorating functional health status, a new sense of dependency on others, daily life routine broken by in-patient hospital periods and contacts with primary health care. Thus the findings pointed more at continuously facing new passages than a stable exit, i.e. an ongoing transition. The areas of life imbalance described may serve as a basis for care assessment and intervention as well as supplying support of the transitional process.

Activities of Daily Living↗

PubMed1997

Met and unmet nursing care needs in men with prostate cancer. An explorative study. Part II.

Men with prostate cancer (n = 11) were interviewed during an in-patient period at a urological clinic, about their experiences of met and unmet needs from health professionals. Their perception of quality of life and sense of coherence were also assessed. The findings were analysed from a phenemenological-hermeneutic perspective and interpreted within the concept of transition. It was interpreted that objective functional health needs were mostly met by health professionals and subjective existential needs were mostly not met. The analysis revealed patients as passive or active receivers of care. Passive receivers were explicitly and implicitly stating unmet needs, or explicitly stating satisfaction with nursing care at the same time as implicitly contradicting, referring to their needs as bagatelles, unimportant, whereas active receivers talked about their needs explicitly with the staff and did not state implicit unmet needs. This suggests that nurses need to be aware of and have sensitive ears to undertones in statements and actively seek for patients' needs. The most important nursing care areas seemed to be to provide solutions to physical problems together with staff support including information, and acting to increase confidence in staff and staff availability. This encourages patient, wives and families, in cooperation, towards a healthy exit of transition.

Aged↗

PubMed1995

A solid-phase test using antiglobulin and enzyme-enhanced techniques for erythrocyte antibody screening during pregnancy.

We have modified previously described solid-phase tests for erythrocyte antibody screening to develop a method, suitable for antiglobulin- and enzyme-enhanced techniques (SPH-IAT and SPH-ENZ). In this study we compared the SPH tests with an autoanalyzer (AA) technique. The results were more specific with the SPH tests than with the AA. Of 4,234 unselected samples from pregnant women, screen-positive samples were reduced from 96 (2.27%) by the AA, to 56 (1.32%) by the SPH tests. This difference was due to the reduced number of false-positive reactions with the SPH tests, 0.47% compared to 1.44% with the AA. Antibodies detected by the AA and the SPH-IAT and -ENZ were: 9 Rh prophylaxis, 2 anti-c, 1 anti-K and anti-M, and 1 anti-Jka. Antibodies detected only by the SPH tests were 1 anti-K, 1 anti-Le(a) (SPH-IAT and -ENZ), 1 anti-M (SPH-IAT) and 4 anti-Jka (SPH-ENZ). One anti-C, 2 anti-D, 3 Rh prophylaxis and 1 anti-E were detected by the AA and the SPH-ENZ but failed to react by the SPH-IAT. One anti-Le(a) and 8 Rh prophylaxis antibodies were detected by AA only. All clinically important antibodies were detected by the SPH tests. We conclude that the SPH-IAT and SPH-ENZ are screening methods with high specificity that are readily adaptable to larger series of samples from pregnant women and suitable for automated handling throughout the screening and identification process.

Antibodies, Anti-Idiotypic↗

PubMed1994

Patient satisfaction with nursing care, evaluation before and after cutback in expenditure and intervention at a surgical clinic.

After a major cutback in the budget and staffing of a surgical clinic in southern Sweden there was intervention to improve the quality of nursing care and to evaluate the outcome. The intervention consisted of the implementation of: (1) nursing care organized in such a way that it would secure continuity of the nurse-patient relationship, (2) individually planned care by means of diagnostic reasoning, and (3) quality assurance for aspects believed to be connected with quality of care. Patient satisfaction before and after the intervention was assessed by means of a patient questionnaire survey (May 1991; n = 105 and May 1992; n = 137). Patient satisfaction improved significantly in variables related to nursing care viz. overall satisfaction and satisfaction with information and decision making; satisfaction with contact and staff-patient relationship; ward facilities and physical treatment or examinations; and satisfaction with physical nursing care. The results were interpreted to mean that the intervention may have counteracted any negative impact the reduced budget might have had such as the higher patient turn-over and the shorter in-patient periods, and thus seemed to have improved the quality of the nursing care in terms of patient satisfaction.

Continuity of Patient Care↗