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Biomedical subjects

E Danielson

Publications and source records attributed to E Danielson.

17 recordsLinked to original sources
PubMed2001

Effect of statin therapy on C-reactive protein levels: the pravastatin inflammation/CRP evaluation (PRINCE): a randomized trial and cohort study.

CONTEXT: Plasma levels of the inflammatory biomarker C-reactive protein (CRP) predict cardiovascular risk, and retrospective studies suggest that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) may lower CRP in a manner largely independent of low-density lipoprotein cholesterol (LDL-C). However, prospective trial data directly evaluating this anti-inflammatory effect of statins are not available. OBJECTIVE: To test the hypothesis that pravastatin has anti-inflammatory effects as evidenced by CRP reduction. DESIGN, SETTING, AND PARTICIPANTS: Community-based, prospective, randomized, double-blind trial including 1702 men and women with no prior history of cardiovascular disease (primary prevention cohort) and open-label study including 1182 patients with known cardiovascular disease (secondary prevention cohort) who provided at least baseline and 12-week blood samples. The study was conducted in US office-based practices from February to December 2000. INTERVENTIONS: Participants in the double-blind primary prevention trial were randomly assigned to receive 40 mg/d of pravastatin (n = 865) or placebo (n = 837) for 24 weeks. Participants in the secondary prevention cohort received 40 mg/d of open-label pravastatin for 24 weeks. MAIN OUTCOME MEASURE: Change in CRP levels from baseline to 24 weeks. RESULTS: In the primary prevention trial, compared with placebo, pravastatin reduced median CRP levels by 16.9% (P<.001) at 24 weeks, reflecting a decrease of 0.02 mg/dL in the pravastatin group while no change in CRP levels was observed in the placebo group. This effect was seen as early as 12 weeks (median reduction in CRP with pravastatin, 14.7%; P<.001) and was present among all prespecified subgroups according to sex, age, smoking status, body mass index, baseline lipid levels, presence of diabetes, and use of aspirin or hormone replacement therapy. No significant association was observed between baseline CRP and baseline LDL-C levels, end-of-study CRP and end-of-study LDL-C levels, or change in CRP and change in LDL-C levels over time. In linear regression analyses, the only significant predictors of change in CRP on a log scale were randomized pravastatin allocation and baseline CRP levels (P<.001 for both). Similar reductions in CRP levels were observed at 12 weeks (-14.3%) and 24 weeks (-13.1%) in the secondary prevention cohort treated with pravastatin (P<.005 for both). CONCLUSIONS: In this prospective trial, pravastatin reduced CRP levels at both 12 and 24 weeks in a largely LDL-C-independent manner. These data provide evidence that statins may have anti-inflammatory effects in addition to lipid-lowering effects.

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

Caregivers' descriptions of patients with advanced breast cancer in connection with supervision sessions in a surgical ward.

The purpose of this study was to describe the content of caregivers' (health care professionals') presentation of care situations as told at supervision sessions. For 1 year, 21 caregivers in a surgical ward of a county hospital in the middle of Sweden participated in a clinical supervision session 2 hours every third week. The participants in the supervision sessions were divided so as to form three mixed groups composed of registered nurses, practical nurses, physiotherapists, and physicians. The purpose of the supervision sessions was to give caregivers the opportunity to reflect on different care situations in a way that contributed to the development of patient care. The 38 supervision sessions were tape-recorded and transcribed verbatim. The transcripts were analyzed using a qualitative content analysis. The caregivers described difficult care situations focusing on the feelings of patients, relatives, and caregivers, with an emphasis on the caregivers' being dominant. Difficult care situations were described as giving caregivers feelings of discomfort, powerlessness, and reduced self-esteem. These feelings were described as arising in connection with caring for women with advanced breast cancer and other seriously ill patients in an organization lacking clear goals and rules. This study found that supervision sessions offering an opportunity to reflect on the difficult care situations are important for caregivers. These sessions seem therefore to be of vital importance for the future development of cancer care on the surgical ward.

Adult↗
PubMed1999

Nurses' narrations about caring for inpatients with acute myocardial infarction.

The purpose of this study was to examine the meaning of lived experiences of caring for people affected by acute myocardial infarction. Thirty-four registered nurses at a Coronary Care Unit in the north of Sweden narrated their experiences of this specialized care of inpatients. The interview texts were transcribed and then interpreted using a phenomenological-hermeneutic method, inspired by the philosophy of Ricoeur. Two groups of texts were identified. One comprised 'narratives about the patient' within which were the themes: 'distancing oneself from what is happening' and 'showing oneself as vulnerable'. The other was 'narratives about caring', with the themes: 'reading of', 'adapting', 'coming close' and 'helping'. Various views on caring were disclosed and interpreted with reference to Martin Buber's philosophy. A comprehensive understanding of caring as oscillations between the poles distance and relation was formulated.

Adult↗
PubMed1999

Nurses' and physicians' narratives about long-term non-malignant pain among men.

The aim of this study was to illuminate the meaning of skilled nurses' and physicians' lived experiences in their encounters with men suffering from long-term, non-malignant pain of at least 6 months duration. Seventeen nurses and four physicians participated in the study. A phenomenological-hermeneutic method was used. In the analysis three themes, 'needing to be manly', 'struggling for relief from pain' and 'needing human support' emerged. The phenomenon 'confirmation' was especially important in all three themes. This study indicates that confirmation of the theme 'needing to be manly' means that nurses' and physicians' must have such a relationship with these men that they really feel respected. Confirmation of the theme 'struggling for relief from pain' means that the care givers must convince these men that they really believe each unique individual's narratives. Confirmation of the theme 'needing human support' means that nurses and physicians have to behave in such a way that these men are convinced that the caregivers really care about them. When the men felt confirmation they dared to disclose their pain experiences more honestly. This is a preliminary prerequisite for nurses' and physicians' potential to help these men.

Adult↗
PubMed1998

A rare-earth phosphor containing one-dimensional chains identified through combinatorial methods

An unusual luminescent inorganic oxide, Sr2CeO4, was identified by parallel screening techniques from within a combinatorial library of more than 25,000 members prepared by automated thin-film synthesis. A bulk sample of single-phase Sr2CeO4 was prepared, and its structure, determined from powder x-ray diffraction data, reveals one-dimensional chains of edge-sharing CeO6 octahedra, with two terminal oxygen atoms per cerium center, that are isolated from one another by Sr2+ cations. The emission maximum at 485 nanometers appears blue-white and has a quantum yield of 0.48 +/- 0.02. The excited-state lifetime, electron spin resonance, magnetic susceptibility, and structural data all suggest that luminescence originates from a ligand-to-metal Ce4+ charge transfer.

Journal Article↗
PubMed1998

Living with breast cancer: care givers' perceptions in a surgical ward.

Caring for women with breast cancer has potential for increasing care giver distress and anxiety. Knowledge of the threats implicit in the disease and treatment as well as overidentification with the patient form the basis for this outcome. In order to describe perceptions of breast cancer as an illness, semistructured interviews were carried out with 37 care givers at a surgical department. The interviews were tape-recorded and transcribed verbatim. An analysis was then carried out of the stories told by the care givers about breast cancer as an illness. The results indicated that breast cancer as an illness gave rise to predominantly negative and dark associations among the care givers. Their experiences of caring for women in critical stages of the illness over many years appear to have had a negative influence on them. Death itself, and even more so the process leading to the end, were very tangible in their stories. The article concludes that care givers on a surgical ward have a fragmented picture of the patients and need to be given opportunities to follow the total care process. Those care givers who were able to follow the women's stages of illness throughout more often had a positive picture.

Adult↗
PubMed1997

Patients' experiences of long-term oxygen therapy.

The aim of this study, which was undertaken in patients' homes in Sweden, was to describe patients' experiences in the self-management of continuous oxygen therapy and their view of managing their chronic disease. A phenomenological approach was used. Data were collected in interviews and analysis produced four categories. The findings show that the patients need help with relief for different physiological and psychological difficulties and from social isolation. The patients had insufficient resources for daily life. They were restricted to their homes, had mobility problems and were dependent upon a continuous life rhythm. Dependence upon another family member is therefore an important factor. But even with the presence of a significant other, social isolation is prevalent.

Activities of Daily Living↗
PubMed1996

Photochemical energy conversion in a helical oligoproline assembly.

A general method is described for constructing a helical oligoproline assembly having a spatially ordered array of functional sites protruding from a proline-II helix. Three different redox-active carboxylic acids were coupled to the side chain of cis-4-amino-L-proline. These redox modules were incorporated through solid-phase peptide synthesis into a 13-residue helical oligoproline assembly bearing in linear array a phenothiazine electron donor, a tris(bipyridine)ruthenium(II) chromophore, and an anthraquinone electron acceptor. Upon transient 460-nm irradiation in acetonitrile, this peptide triad formed with 53% efficiency an excited state containing a phenothiazine radical cation and an anthraquinone radical anion. This light-induced redox-separated state had a lifetime of 175 ns and stored 1.65 eV of energy.

Models, Molecular↗
PubMed1995

Trials of Hypertension Prevention, phase II. Structure and content of the weight loss and dietary sodium reduction interventions. Trials of Hypertension Prevention (TOHP) Collaborative Research Group.

Identifying effective, nonpharmacologic means of preventing or significantly delaying the onset of hypertension would be a major advance in the primary prevention of cardiovascular disease. In the first phase of the Trials of Hypertension Prevention (TOHP I), adults with high-normal diastolic blood pressure were randomly assigned to one of seven nonpharmacologic interventions. Only weight loss and reduction of dietary sodium proved to be effective strategies for reducing blood pressure. The second phase of TOHP (TOHP II) will test the effectiveness of weight loss, reduction of dietary sodium, and their combination of lowering blood pressure and preventing the onset of hypertension over a 3- to 4-year follow-up period. This article describes the three interventions used in TOHP II, methods used to maintain continued participation in this long-term trial, and protocol enhancements designed to maximize intervention effectiveness.

Adult↗
PubMed1995

An integrated cooperation model for long-term mentally ill in the community.

1. This article describes a Swedish model of community support for patients with a long-term mental illness. 2. The result confirms that the staff-psychiatric practical nurses and aids are important in the care with support and coping as essential elements. 3. The staff members do require supervision from a nurse with knowledge about society and psychiatric care.

Community Health Nursing↗
PubMed1990

The nurses transmissions of the professional role to students in nursing education.

In the reformed nursing education, introduced in Sweden in 1982, the emphasis is placed on nursing as the nurse's distinguishing characteristic. The profession comprises many coexisting functions, one of which is to transmit the professional role to the student of nursing. With the aim of acquiring knowledge concerning this transmission we analysed one topic of a questionnaire which was sent to the nurses at surgery clinics. This material was processed qualitatively. The answers crystallised into two categories discerning how the role is transmitted: (A) Conscious Approach, (B) Unconscious Approach. The results show that most of the nurses acted in a conscious manner, i.e. in a form of active influence on the students, in their transmission of the professional role. The unconscious approach, with a vague perception of, and therefore vague transmission of, the professional role is frequent.

Adult↗
PubMed1984

Sodium lactate infusion, panic attacks, and ionized calcium.

The ability of sodium lactate to precipitate panic attacks in vulnerable individuals has been repeatedly demonstrated, although its mechanism of action is unknown. Pitts and McClure hypothesized that the panicogenic effect of sodium lactate was due to its induction of a peripheral hypocalcemia via the complexing of infused lactate ions with extracellular ionized calcium. In the current study, serial ionized calcium measurements during lactate infusion are assessed for 22 panic patients who panicked during infusion, 11 panic patients who did not panic during the procedure, and 6 normal controls. Intravenous sodium lactate infusion was found to be associated with a significant decrease in ionized calcium in all groups. No specific association was found between the rate or magnitude of decrease in ionized calcium and the occurrence of a panic attack during the infusion.

Agoraphobia↗
PubMed1976

Catechol-O-methyltransferase activity in psychotic children.

Catechol-O-Methyltransferase (COMT) activity was studied in three groups of institutionalized children: (1) a group of schizophrenic children; (2) a heterogeneous group of chronic psychotic children characterized by severe symptomatology and onset before 5 years of age; (3) a group of acting-out but nonpsychotic children. Erythrocyte COMT activity was found to be significantly lower among the schizophrenic subjects in contrast to the greater activity in both the other groups--the nonpsychotic and chronic psychotic children. The difference in COMT activity between psychotic groups appeared to be related to diagnosis and age of onset of disorder. Generality of findings is limited by the small sample size (N = 42) and by the difficulties inherent in the diagnosis of severe mental disorder in children. However, this preliminary study suggests that enzymatic activity may be associated with the development of schizophrenia in children.

Adolescent↗
PubMedDate not supplied

Men's experiences during the acute phase of their partners' myocardial infarction.

The men's narratives about the women reveal a disturbance in the balance of their daily life, showing how they, the men, perceive powerlessness, and also how they passively adapted themselves to what happened. The narratives reveal that the women are 'ignoring and withholding' their feelings and that they want to be as 'responsible and independent' as they used to be. The women are disclosed as 'not wanting to face reality': there is an enervating lack of communication.

Adaptation, Psychological↗