Transitions in the communication experiences of tracheostomised patients in intensive care: a qualitative descriptive study.

Aims And Objectives: To describe how tracheostomised patients in intensive care experience acts of communication and to better understand their experiences in the context of the transitions theory.

Background: Waking up in an intensive care unit unable to speak because of mechanical ventilation can be challenging. Communication aids are available, but patients still report difficulties communicating.

Disclosing discourses: biomedical and hospitality discourses in patient education materials.

Patient education materials have the potential to strengthen the health literacy of patients. Previous studies indicate that readability and suitability may be improved. The aim of this study was to explore and analyze discourses inherent in patient education materials since analysis of discourses could illuminate values and norms inherent in them.

Preoperative oral carbohydrate therapy.

Purpose Of Review: Management of the postoperative response to surgical stress is an important issue in major surgery. Avoiding preoperative fasting using preoperative oral carbohydrates (POC) has been suggested as a measure to prevent and reduce the extent to which such derangements occur. This review summarizes the current evidence and rationale for this treatment.

Free dissociable IGF-I: Association with changes in IGFBP-3 proteolysis and insulin sensitivity after surgery.

Background: Patients receiving a carbohydrate drink (CHO) before major abdominal surgery display improved insulin sensitivity postoperatively and increased proteolysis of IGFBP-3 (IGFBP-3-PA) compared to patients undergoing similar surgery after overnight fasting.

Aims: We hypothesized that serum IGFBP-3-PA increases bioavailability of circulating IGF-I and preserves insulin sensitivity in patients given CHO.

Design: Matched control study.

Maintaining everyday life in a family with a dying parent: Teenagers' experiences of adapting to responsibility.

Objective: Teenagers are living through a turbulent period in their development, when they are breaking away from the family to form their own identities, and so they are particularly vulnerable to the stressful situation of having a parent affected by a progressive and incurable illness. The current study sought to gain more knowledge about the ways that teenagers themselves describe living in a family with a seriously ill and dying parent. More specifically, the aims were to describe how teenagers are emotionally affected by everyday life in a family with a dying parent and to determine how they attempt to adapt to this situation.

The fat cell epigenetic signature in post-obese women is characterized by global hypomethylation and differential DNA methylation of adipogenesis genes.

Background/objectives: Obese subjects have increased number of enlarged fat cells that are reduced in size but not in number in post-obesity. We performed DNA methylation profiling in fat cells with the aim of identifying differentially methylated DNA sites (DMS) linked to adipose hyperplasia (many small fat cells) in post-obesity.

Subjects/methods: Genome-wide DNA methylation was analyzed in abdominal subcutaneous fat cells from 16 women examined 2 years after gastric bypass surgery at a post-obese state (body mass index (BMI) 26±2 kg m(-2), mean±s.

Lived Observations: Linking the Researcher's Personal Experiences to Knowledge Development.

As researchers in palliative care, we recognize how involvement with seriously ill and dying persons has an impact on us. Using one's own senses, emotional and bodily responses in observations might open intersubjective dimensions of the research topic. The aim of the article is to highlight how phenomenological theories on intersubjectivity can be useful to develop rich and transparent data generation and analysis.

Adipose tissue morphology predicts improved insulin sensitivity following moderate or pronounced weight loss.

Background: Cross-sectional studies show that white adipose tissue hypertrophy (few, large adipocytes), in contrast to hyperplasia (many, small adipocytes), associates with insulin resistance and increased risk of developing type 2 diabetes. We investigated if baseline adipose cellularity could predict improvements in insulin sensitivity following weight loss.

Methods: Plasma samples and subcutaneous abdominal adipose biopsies were examined in 100 overweight or obese individuals before and 10 weeks after a hypocaloric diet (7±3% weight loss) and in 61 obese subjects before and 2 years after gastric by-pass surgery (33±9% weight loss).

First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality.

Ursodeoxycholic acid exerts farnesoid X receptor-antagonistic effects on bile acid and lipid metabolism in morbid obesity.

Background & Aims: Bile acids (BAs) are major regulators of hepatic BA and lipid metabolism but their mechanisms of action in non-alcoholic fatty liver disease (NAFLD) are still poorly understood. Here we aimed to explore the molecular and biochemical mechanisms of ursodeoxycholic acid (UDCA) in modulating the cross-talk between liver and visceral white adipose tissue (vWAT) regarding BA and cholesterol metabolism and fatty acid/lipid partitioning in morbidly obese NAFLD patients.

Methods: In this randomized controlled pharmacodynamic study, we analyzed serum, liver and vWAT samples from 40 well-matched morbidly obese patients receiving UDCA (20 mg/kg/day) or no treatment three weeks prior to bariatric surgery.

Social support: an important factor for quality of life in women with hirsutism.

Background: Women with hirsutism have reported imparied health and health-related quality of life (HRQoL). Social support is a factor that might increase HRQoL in chronic diseases, but little is known about this association among women with hirsutism.

Aim: The aim of the study was to describe social support and explore its association with HRQoL among women with hirsutism.

Patient participation in patients with heart failure receiving structured home care--a prospective longitudinal study.

Background: Patient participation is important for improving outcomes, respect for self-determination and legal aspects in care. However, how patients with heart failure view participation and which factors may be associated with participation is not known. The aim of this study was therefore to describe the influence of structured home care on patient participation over time in patients diagnosed with heart failure, and to explore factors associated with participation in care.

Low-dose budesonide for maintenance of clinical remission in collagenous colitis: a randomised, placebo-controlled, 12-month trial.

Objective: This 1-year study aimed to assess low-dose budesonide therapy for maintenance of clinical remission in patients with collagenous colitis.

Design: A prospective, randomised, placebo-controlled study beginning with an 8-week open-label induction phase in which patients with histologically confirmed active collagenous colitis received budesonide (Budenofalk, 9 mg/day initially, tapered to 4.5 mg/day), after which 92 patients in clinical remission were randomised to budesonide (mean dose 4.

Exome sequencing followed by genotyping suggests SYPL2 as a susceptibility gene for morbid obesity.

Recently developed high-throughput sequencing technology shows power to detect low-frequency disease-causing variants by deep sequencing of all known exons. We used exome sequencing to identify variants associated with morbid obesity. DNA from 100 morbidly obese adult subjects and 100 controls were pooled (n=10/pool), subjected to exome capture, and subsequent sequencing.

Health-related quality of life and long-term morbidity and mortality in patients hospitalised with systolic heart failure.

Background: Health-related quality of life has been shown to impact prognosis in chronic heart failure, however with limited long-term follow-up. We analysed data spanning 8-12 years to assess the impact of health-related quality of life using the Nottingham Health Profile on first hospitalisation and mortality, for cardiovascular and all causes.

Methods: We included 208 patients aged ≥60 years with New York Heart Association class II-IV and left ventricular systolic dysfunction hospitalised in Stockholm during 1996-99.

Weight loss prior to bariatric surgery: an updated review of the literature.

Background And Aims: Prior to bariatric surgery, a preoperative weight-reducing regimen is usually adhered to in most centers. The clinical effects of such a regimen are yet to be determined.

Material And Methods: We reviewed the current literature by searching in PubMed for publications reporting clinical effects resulting from a preoperative weight loss regimen prior to bariatric surgery published from January 1, 1995 to April 30, 2014.

[New method of treating achalasia is now being tested. Minimally Invasive POEM has produced promising results so far].

Achalasia of the cardia is a motor disorder of the esophagus and lower esophageal sphincter with dysphagia as the dominating symptom. The diagnosis is based on esophageal manometry and barium swallow. During work-up dysphagia of other origin should be excluded by endoscopy.

Preparing for palliative caregiving as a transition in the awareness of death: family carer experiences.

Aim: The aim of this study was to explore family caregivers´ experiences from partners' stories about preparing for caregiving.

Methods: The study had a descriptive and interpretive design using qualitative interviews and qualitative content analysis.

Results: Preparing for caregiving was described in the two sub-themes: living in uncertainty, focusing on the present and preparing for the future; and preparing for caregiving while transitioning to new roles.

Meanings of eating deficiencies for people admitted to palliative home care.

Objective: Food and eating are embedded in people's everyday social lives: at home with family members and as part of social interactions. For people with progressive life-limiting conditions, however, eating is often obstructed. The objective of the present study was to explore the meanings of living with eating deficiencies at the end of life among people admitted to specialist palliative home care.

Connectedness at the End of Life Among People Admitted to Inpatient Palliative Care.

The significance of connectedness for well-being is well known. At the end of life however, illness and body decline may challenge a person's ability of staying and feeling connected. The aim of this phenomenological study was to interpret meanings of connectedness, through narrative interviews with persons admitted to inpatient palliative care in Sweden.

Academic learning for specialist nurses: a grounded theory study.

The aim was to explore the major concerns of specialist nurses pertaining to academic learning during their education and initial professional career. Specialist nursing education changed in tandem with the European educational reform in 2007. At the same time, greater demands were made on the healthcare services to provide evidence-based and safe patient-care.

Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg).

Background: A preoperative weight-reducing regimen is usually adhered to in most centers performing bariatric surgery for obesity. The potential to reduce postoperative complications by such a routine is yet to be defined.

Methods: Data on 22,327 patients undergoing primary gastric bypass from January 1, 2008, to June 30, 2012, were analyzed.

Natural course vs interventions to clear common bile duct stones: data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks).

Importance: The optimal strategy for common bile duct stones (CBDSs) encountered during cholecystectomy is yet to be determined.

Objective: To evaluate the outcomes after various interventional techniques to clear the bile ducts and the natural course of CBDSs found during intraoperative cholangiography.

Design, Setting, And Participants: In a large retrospective cohort analysis, we analyzed data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks).

Is there a difference in survival between men and women suffering in-hospital cardiac arrest?

Objectives: To describe in-hospital cardiac arrest (CA) events with regard to sex and to investigate if sex is associated with survival.

Background: Previous studies exploring differences between sexes are incongruent with regard to clinical outcomes. In order to provide equality and improve care, further investigations into these aspects are warranted.

Regional variations in the relationship between arterial stiffness and adipocyte volume or number in obese subjects.

Background: Cardiovascular disease is associated with multiple risk factors including stiff arteries and large adipocytes. Whether the latter two are interrelated is unknown. We aimed to determine whether arterial stiffness is associated with fat cell size and number in subcutaneous or visceral white adipose tissue (WAT).