Stefan Sörensen

Quality of light and quality of life--the effect of lighting adaptation among people with low vision.

Purpose:  The study has investigated the effect of lighting on the daily activities (ADL) of the visually impaired in their homes by comparison before and after light adjustments were made in the kitchen, hall and bathroom. It has also investigated the additional effects on the quality of life after providing task lighting in the living room.

Assessments of oral health care in dependent older persons in nursing facilities

The number of dependent elderly with natural teeth is increasing dramatically. If these elderly persons do not receive proper oral health care, severe oral problems are likely to result. In conjunction with an oral health care education program for the staff of nursing facilities, oral health status was assessed and semi-structured interviews performed with residents and their relatives about oral health care. The assessments were made at baseline and at an 18-month follow-up. The project was conducted as a longitudinal, controlled study with an intervention and a control group. The aim of the study was to evaluate differences between the intervention and control group after oral health care intervention. At follow-up, it was shown that the intervention group had established more dental contacts. However, the results also indicated that the residents were not concerned about their oral health. Nursing staff therefore have to be responsible for oral health care if improved care for residents is to be realized.

Quality of light and quality of life: An intervention study among older people:

The aim of this study was to gain a better understanding concerning the relationship between lighting and quality of life in relation to older people. In the first phase, an evaluation was made of the standard of lighting in elderly peoples dwellings. A total of 185 people aged 65 or more was randomly selected, with 160 agreeing to participate in an interview investigation. The results from this phase of the study demonstrated a close relationship between lighting and quality of life. The causal relation was studied in a second stage. Using results from the initial interviews as a bases, 48 people were chosen whose living rooms reading area was poorly lit. All 48 agreed to further participation in the study. They were randomly divided into an experimental and a control group and the lighting in the reading area was improved for those included in the experimental group. In the follow-up interviews three months later, an increase was observed in the quality of life in the experimental group as compared with the control group. A second and a third follow-up interview performed after a further one year and three years respectively, demonstrated that this improvement in life quality persisted. Results from the present study indicate that once improvements of lighting standard have been achieved, the subjects do not want to return to previous inferior lighting conditions. Future efforts should focus on studies that stimulate and encourage older people to improve their lighting standard.

Conversion from laparoscopic to open appendicectomy : A possible drawback of the laparoscopic technique?

OBJECTIVE To analyse the reasons for, and outcome of, conversion from laparoscopic to open appendicectomy and to identify factors that may predict the need for conversion. DESIGN Subgroup analysis from a randomised multicentre study. SETTING One university hospital and four county hospitals, Sweden. SUBJECTS A total of 500 patients were randomised to laparoscopic (n = 244) or open (n = 256) appendicectomy. Thirty operations (12%) were converted to open appendicectomy. MAIN OUTCOME MEASURES Reasons for conversion, outcome, and preoperative predictive variables. RESULTS Difficult anatomy or the presence of an abscess were the main reasons for conversion (25/30). The incidence of perforated appendicitis was higher among patients who required conversion compared with both the open and laparoscopic group. Operating time, anaesthetic time, and duration of hospital stay were longer after conversion. Time to full recovery and length of sick leave were also longer, except for patients with perforated appendicitis. There was no difference in the complication rate. No predictive factors were identified. CONCLUSION The main reasons for conversion were difficult anatomy and the presence of an abscess. After conversion patients recovered more slowly than those operated on laparoscopically or by primary open operation.

Dental auscultation for nursing personnel as a model of oral health care education: development, baseline, and 6-month follow-up assessments

Oral health care has been shown to have low priority in nursing and has been only partly successful. To create more positive effects than those achieved through traditional oral health care education, this project tested an educational model for nursing staff personnel. In addition to traditional oral health care education, some of the nursing staff members passed an additional dental auscultation period and served as oral care aides. The aides were responsible for the oral health care of the residents at their nursing facilities (intervention group). The intervention nursing facilities were compared with facilities where nursing personnel only received a traditional oral health care education program. Assessments were made at baseline and at a 6-month follow-up. At follow-up it was shown that the nursing staff in the intervention group gave higher priority to the oral health care work than the nursing staff in the control group.

Effect of menopause on left ventricular filling in 50-year-old women

Abstract In conclusion, our study shows menopause-related changes in Doppler indexes of LV filling, suggesting impaired LV filling in postmenopausal women.

The Fenyö-Lindberg scoring system for appendicitis increases positive predictive value in fertile women—A prospective study in 455 patients randomized to either laparoscopic or open appendectomy

BackgroundSuspected appendicitis is one of the most common indications for acute laparotomy or laparoscopy. The negative laparotomy and laparoscopy rates are high, often in the range of 15–30%, and especially high in some groups of patients such as women of child-bearing age and young patients. Different scoring systems have been introduced in order to improve diagnostic accuracy. The aim of the present study was to analyse the outcome of the Fenyö-Lindberg scoring system in a prospectively randomized multicenter trial and to analyze how well the score performed in stratified subgroups.MethodsThe variables of the Fenyö-Lindberg scoring system were collected in a prospective study comparing laparoscopic and open surgery in suspected appendicitis and with four participating centers. None of the hospitals had used the scoring system previously. Since surgeons were unfamiliar with the score, they could not use it as a diagnostic aid. When comparing the score with the clinical outcome, retrospectively, the investigators interpreting the score were blinded regarding the surgical outcome.ResultsPositive predictive value (PPV) of the Fenyö-Lindberg score was higher than that of the surgeon’s clinical diagnosis in the patient cohort [0.90 vs 0.79 (p < 0.001)]. The score demonstrated an improvement of PPV in women [0.83 vs 0.70 (p < 0.01)]. PPV was increased in women between 15 and 50 years of age. In women aged 15–30 years and 31–50 years PPV increased from 0.69 to 0.82 and 0.68 to 0.86, respectively (p < 0.01). Both the sensitivity (0.77) and the specificity (0.69) of the score were, however, low.ConclusionThe Fenyö-Lindberg score is an inexpensive clinical tool that may improve the diagnostic accuracy for acute appendicitis in women of childbearing age, which is a group of patients where the diagnostic accuracy usually is low and where the arsenal of diagnostic tools such as computed tomography is limited because of radiation. The low specificity of the score in women of childbearing age must, however, be kept in mind.

Hyposalivation and iron stores among individuals with and without active dental caries

The aims of the study were to investigate frequencies of low unstimulated whole saliva (UWS) levels and low serum ferritin (S-f) levels among individuals with active dental caries (ADC) and dental caries inactive (DCI) individuals and to compare the relationship between UWS and S-f levels. In this descriptive study, 48 ADC patients and 48 DCI individuals were compared. The two groups were matched regarding age and sex (30 females and 18 males in each group, age range 15–40 years). In the ADC group, 32 individuals (67%) had low (≤0.20 ml/min) UWS levels compared with 13 individuals (27%) in the DCI group. This difference was statistically significant (P< 0.001). The mean values of UWS were significantly lower in the ADC group compared to the DCI group (mean ml/min ± SD) 0.20 ± 0.13 and 0.33 ± 0.24, respectively (P = 0.002). There were significant differences for females but not for males when comparing frequencies of low UWS levels (P < 0.001) and mean UWS levels (P = 0.002). There was no difference in S-f levels between the two groups. Neither was any correlation between UWS and S-f found. In conclusion, the significant negative relationship found between UWS and ADC indicates that a suppressed defense for dental caries activity could play a more important role in ADC than previously presumed, especially among females. The absence of a correlation between UWS and S-f might indicate that saliva secretion will not be stimulated by iron supplementation.

No increase in walking distance on repeated tests in COPD patients with exercise-induced hypoxaemia

The aim of the study was to investigate the effect of retesting on the 12-min walking distance (12MWD) in patients with moderate or severe chronic obstructive pulmonary disease (COPD), with and without exercise-induced hypoxaemia (EIH) and to evaluate whether baseline characteristics derived before walking influence on variation of repeated tests. Fifty-seven COPD patients, mean age 66 (range 47 84) years, performed three 12-min walk tests within 1 week. Before and after each test, oxygen saturation (pulse oximetry, SpO2), heart rate, breathing frequency, peak expiratory flow, and subjective ratings of exertion and dyspnoea were measured. EIH was defined as a fall in SpO2 below 90% at the first walk test. The 12MWD did not increase on repeated testing in the EIH group. In the non-EIH group, the 12MWD increased by 12% (p<0.001) from test 1 to test 2 and by 4% (p<0.001) from test 2 to test 3. No day-to-day variation was observed in pre-walking characteristics. At least one training test is needed in non-EIH patients with COPD, as their effort and performance on the 12-min walk test increases on retesting (learning effects). In patients with EIH, the term “training test” is not relevant, as their walking distance did not homogeneously increase on repeated testing.