The hotel Enzian's secret to success is their welcoming and friendly attitude to their guests, particularly children. It is in an ideal situation, set back from the main street and right at the foot of the piste with two of the nursery lifts close by.
There is a welcoming lounge with bar and open fireplace, and an Austrian-styled restaurant that serves a combination of traditional and international cuisine.
The bedrooms and suites vary in size, configuration and style. All are pleasantly furnished with complementary fabrics.
The charming panelled Zirbenstube is a cosy place for après-ski.
On a sunny day the large slopeside terrace is a great place to stop and enjoy some refreshments whilst taking in the amazing view.
Why not visit the grotto style spa and sport centre that offers a multitude of facilities for all the family.


Throughout history, the knife plays a significant role in some cultures, especially as the knife was an essential tool for that helped the early man is his survival. In those times, In Egypt, it was not only a practical tool and weapon but also a magical tool for ritual and protection. Knife symbols can be found in various cultures to symbolize defense, to keep away nightmares and for protection during childbirth.
The knife was also a part of lunar symbology. The crescent moon was imagined to be a knife wielded by the God of the Moon, Thoth. Thoth was said to be the destroyer of evil-doers, with the crescent moon as his weapon.


There is a new version of the classic Robin Hood story heading to theaters in 2018, and audiences are getting their first official look at Taron Egerton as he takes on the role of the title character. While it is clear that Egerton is Robin Hood in the images shared on the movie's official Twitter page, there is definitely a lack of green in the character's outfit.
While there have been plenty of takes on the character and his story, with this new adaptation, it seems that director Otto Bathurst is offering a brand new interpretation of the classic tale, which will be grittier and much more dark than previous versions. Even in the first look images that have been released, it is clear that Taron Egerton is an entirely different Robin Hood than audiences have seen in the past.
With three images having been shared on the Robin Hood Twitter page, audiences are getting three different looks at Egerton in action. One of the tweeted image shows Taron Egerton alongside Eve Hewson, who plays Maid Marion, in a scene that appears to be Robin Hood showing his leading lady how to shoot a bow and arrow. Then there is a second image which looks to be part of an action sequence with Egerton, while the third photo shows Robin Hood alongside Little John, played by Jamie Foxx.
As Cinema Blend reported, the aesthetic of all these images is one that seems to fall in line with the new darker and more gritty tone of the movie. In these first look pictures, Taron Egerton's Robin Hood has yet to take up the rather iconic green that he is known for in past incarnations of the character. However, while Robin Hood is often seen in a rather bright and vibrant green costume, it is unlikely that the aesthetic of the film will see him in that same shade of green. Instead, if the character does end up in a green costume, it will likely be more of a dark camouflage green to fall in line with the apparent backstory that will see the character having fought in the crusades.
While it is clear that Robin Hood is a grittier character this time around, he is not the only one getting a makeover, as Jamie Foxx's Little John also looks to be a much more serious and gritty individual as well. Although there is no footage to go along with these images at this time, just based on these three pictures, it looks like audiences can expect to see a bit of a change when it comes to the classic story of the hero who takes from the rich in order to give back to the poor.


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hkr.sePublikationer
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Khalaf, Atika
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
Ekblom, Örjan
Berggren, Vanja
Westergren, Albert
Al-Hazzaa, H.
Determinants of physical activity (PA), sedentary behaviors, and BMI among female university students in South Western Saudia Arabia (KSA)2012Ingår i: Clinical Nutrition Supplements, 2012, 7(1), page 263, 2012, s. 263-Konferensbidrag (Refereegranskat)
Rationale: The aim of this study was to examine the prevalence and determinants of PA, sedentary behaviors, and BMI among female university students in south western KSA.
Methods: This cross-sectional study included 663 female students who were randomly selected from a female university centre. Logistic regressions were used to identify determinants for moderate and vigorous PA, sedentary behaviors, and overweight/obesity and underweight.
Results: The females reported moderate PA in 49% and vigorous PA in 21% of cases, as defined by the American College of Sports Medicine recommendations. Total energy expenditure in METs-min/week increased with increased BMI (1216 among underweight, 1474 among normal weight, and 1810 among overweight). Sedentary behaviors were found among 15% of participants. The prevalence of overweight and obesity was 24%, and underweight 19%. Significant predictors for moderate PA were found to be present of one obese parent (negative relation), proximity to parks, and BMI (positive relation) while vigorous PA was predicted by age, fathers' level of education, waist-height ratio (negative relation), mothers' level of education, proximity to molls and parks, and BMI (positive relation). Sedentary behaviours were only predicted by proximity to parks. Overweight and obesity were found to correlate to the number of sisters (negative relation), presence of one obese parent, obese siblings, and proximity to molls (positive relation). On the other hand, both age and presence of obese parents were found to be negatively and significantly correlated to underweight.
Conclusion: A minority of the subjects met with current recommendations for PA. Intervention studies and implementation of national nutritional and PA guidelines are needed and should be integrated in the education of the adolescents and young adults.
Gymnasik- och indrottshögskolan, Stockholm.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap.
Saudiarabien.
Prevalence and determinants of obesity and physical inactivity among female university students in South Western Saudi Arabia2011Ingår i: Clinical Nutrition Supplements: abstracts of the 33rd ESPEN congress, 2011, Vol. 6(1), s. 100-Konferensbidrag (Refereegranskat)
Rationale: The prevalence of obesity in Saudi Arabia (KSA) is a growing challenge to public health, it may affect and be related to the levels of physical activity. The aim of this study was to examine the prevalence of overweight and obesity, physical activity, and unhealthy food intake among female university students in Saudi Arabia. In addition, determinants for levels of physical activity and unhealthy food intake were examined.
Methods: This cross-sectional study included 663 female students in a university centre in KSA. Measures included anthropometric, socioeconomic, environmental, cultural, and life style factors such as physical activities, sedentary activities and eating habits. Logistic regressions were used to identify predictors of physical activity and unhealthy food intake respectively.
Results: The prevalence of overweight was 19% and obesity 6%. Physically active females were 41%, as defined by the American College of Sports Medicine (ACSM) recommendations for moderate physical activity (Haskell et al. 2007). Concerning vigorous physical activity, only 17%, of the subjects met the current recommendations. According to WHO's recommendations for physical activity levels 55% were minimally active and 12% active. Significant predictors for moderate/vigorous physical activity were found to be proximity to parks, mothers' education (positive relation), lack of knowledge, and number of brothers (negative relation). It also emerged that 88% of the participants had unhealthy food intake with the fathers' level of education as the only significant predictor.
Conclusion: A minority of the subjects met with current recommendations for physical activity. Intervention studies and implementation of national nutritional guidelines are needed and should be integrated in the education of the adolescents and young adults.
Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm.
Kowalski, Jan
National Childhood Obesity Center, Departments of Pediatrics and of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Karolinska Institute.
Department of Public Health Sciences, Karolinska Institute.
Al-Hazzaa, Hazzaa
Pediatric Exercise Physiology Research Laboratory, College of Education and Obesity Research Chair, King Saud University, Riyadh.
Female university students' physical activity levels and associated factors: a cross-sectional study in southwestern Saudi Arabia2013Ingår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 10, nr 8, s. 3502-3517 Artikel i tidskrift (Refereegranskat)
Background: The high prevalence of physical inactivity in Saudi Arabia is a growing challenge to public health. This study aimed to examine the prevalence of physical activity (PA) and associated factors among female university students. Methods: This cross-sectional study involved 663 randomly selected female university students who completed the Arab Teens Life Style questionnaire. Data included measurements of anthropometric, socioeconomic and environmental factors, as well as self-reported PA. Ordinal regression was used to identify associated factors with low, moderate and high PA levels. Results: The mean age of participants was 20.4 years (SD 1.5). Mean BMI of the students in relation to PA were 23.0, 22.9, 22.1 for high, moderate and low levels of activity, respectively. The analysis revealed significantly higher PA levels among married students, those with high educated mothers, and those who lived far from parks, and lower activity levels among underweight students. Conclusions: This study raises four important determinants for female university students' PA levels. These factors could be of great importance in the endeavor to prevent the health-threatening increase in physical inactivity patterns and thus non-communicable diseases and obesity where the focus should be on the specific situation and needs of women in Saudi Arabia.
Nurses' views and experiences of caring for malnourished patients in surgical settings in South Western Saudi Arabia (KSA)2012Ingår i: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 7, nr Suppl. 1, s. 264-265Artikel i tidskrift (Refereegranskat)
Associated factors to female university students' dietary habits and body weight in Saudi ArabiaArtikel i tidskrift (Refereegranskat)
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Lund University.
The Swedish School of Sport and Health Sciences, Stockholm.
Al-Hazzaa, Hazzaa M.
King Saud University, Riyadh.
Prevalence and association of female weight status and dietary habits with sociodemographic factors: a cross-sectional study in Saudi Arabia2015Ingår i: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 18, nr 5, s. 784-796Artikel i tidskrift (Refereegranskat)
OBJECTIVE: Research about the prevalence of underweight and overweight/obesity in the Saudi Arabian female population is limited. The aim of the present study was to examine the dietary habits and the prevalence of underweight and overweight/obesity and associated factors among female university students.
DESIGN: A cross-sectional study.
SETTING: A university centre for female students in south-western Saudi Arabia.
SUBJECTS: The study involved 663 randomly selected female university students who self-reported their physical activities, nutritional habits and socio-economic factors. Multiple linear and logistic regression analyses were used to identify factors associated with the students' BMI, dietary variables, underweight and overweight/obesity.
RESULTS: The majority of the university females were normal weight (56·9 %), but a high prevalence of underweight (19·2 %) and overweight/obesity (23·8 %) occurred. Social factors significantly associated with BMI were the presence of obese parents and siblings as well as physical activity levels, marital status, number of sisters, father's level of education and more frequent intake of French fries/potato chips (>3 times/week). Several variables were found to correlate with dietary habits, underweight and overweight/obesity. Of special interest is the association between the number of siblings and the participants' BMI and dietary intake in both negative and positive ways.
CONCLUSIONS: The findings of this research have implications for health promotion and prevention of malnutrition among college-aged females. Health-care providers and policy makers need to involve the whole family when promoting females' physical activity. The study serves as an evidence-based background for planning and implementation of interventions targeting improvement of highly educated populations' nutritional habits.
Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Karolinska Institute.
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
The Swedish School of Sport and Health Sciences.
Hazzaa, A-H
Saudi Arabia.
Perceived and ideal body image in young women in South Western Saudi Arabia2015Ingår i: Journal of Obesity, Vol. 2015, s. 1-7-, artikel-id 697163Artikel i tidskrift (Refereegranskat)
Objectives. The aim of this study was to investigate perceived and ideal body image (BI) and associated factors among female university students in Saudi Arabia. Methods. This cross-sectional study included 663 university female students. Anthropometric measurements including weight, height, BMI, and BI perception (the 9-figure silhouette) were obtained. Descriptive and logistic regression analysis were conducted. Results. An agreement between actual, perceived, and ideal BI was found in 23% of the participants. Behavioral (activity levels), social (presence of obese parents and fathers' level of education), and economic factors (households' monthly income, number of cars in the household, and kind of residence) were positively and significantly associated with the desire to be thinner. Similarly, socioeconomic associations (number of sisters and number of cars in the household) correlated positively and significantly with the desire to be heavier. Conclusions. The whole family should rather be considered in interventions related to appearance concerns and BI discrepancies. Furthermore, campaigns targeting improvement of adolescents' physical self-image should be a major priority of the public health sector.
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsmiljön Mat, måltid, hälsa i 24-timmarsperspektivet. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna.
Association of weight status and dietary habits with socio-demographic factors among university female students in Saudi Arabia2014Konferensbidrag (Övrigt vetenskapligt)
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Karolinska Institute.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Karolinska Institute.
Discrepancies between actual, perceived and ideal body image among young female university students in southwestern Saudi Arabia2014Konferensbidrag (Övrigt vetenskapligt)
Rationale: Body-shape preference is an important determinant of obesity and underweight, but studies on body image among females in the Arab region are, at most, scanty. The aim of this study was to describe the prevalence of underweight and overweight/obesity among Saudi Arabian female university students, and to investigate discrepancies between their actual, perceived and ideal body shape.
Methods: This cross sectional study included 663 female students in a university centre in Saudi Arabia. Anthropometric measurements including weight, height, BMI and body image scale (9-figures silhouette) were used. A cross-tabulation was made between "warped self-image" against "subjective goal image". Regression analysis was used to predict variables related to body image perception.
Results: The participants had a mean age of 20.4 years (SD 1.5), 16% were underweight and 25% were over- weight/obese.Discrepancy in subjective goal image: 44% wished they were slimmer and 20% that they were heavier than what they perceived themselves. Thus, 36% were happy with their current body shape.Warped self-image: It was 16% that thought they were slimmer and 18% that they were heavier than what they actually were. Thus, in 61% of cases the perceived body image was in agreement with their actual body shape. Cross-tabulation showed that only 23% had an agreemen tbetween their actual, perceived and ideal body shape. Of all variables entered into the regression analysis, only BMI was able to predict how the subject perceives herself in the body image scale (R square = 0.676; p < 0.000). None of the variables entered was significant enough to predict how the subject wishes to look like.
Conclusion: Discrepancies between actual, perceived and ideal body image is common among the Saudi Arabian female students and can possibly lead to eating disorders and increased prevalence of underweight oroverweight/obesity.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
Nurses bridging malnutrition and physical inactivity: nurses' views and experiences of caring for malnourished patients in surgical settings in Saudi Arabia – A qualitative study2014Ingår i: BMC Nursing, Vol. 13, nr 29Artikel i tidskrift (Refereegranskat)
Although the occurrence of malnutrition in hospitals is a growing concern, little is known about how hospital staff understand the care that nurses provide to patients with malnutrition. The purpose of this study was to explore nurses' views and experiences of caring for malnourished patients in Saudi Arabia (KSA).
Using a qualitative explorative design, fifteen nurses were interviewed as part of a purposive sample hospital staff. The transcripts were analyzed using latent content analysis.
The nurses spontaneously and consistently linked malnutrition with physical inactivity. The two main categories, which emerged, were: 'Potentials for nurses to provide good nutrition and physical activity', and 'Having the ability but not the power to promote proper nutrition and physical activity'. These arose from the subcategories: Good nursing implies providing appropriate health education; Acknowledging the Mourafiq (sitter) as a potential resource for the nursing, but also as a burden; Inadequate control and lack of influence; Cultural diversity and lack of dialog; and Views of women's weight gain in KSA society.
The nurses felt they have the capacity and passion to further improve the nutrition and activity of their patients, but obstacles in the health care system are impeding these ambitions. The implications for nursing practice could be acknowledgement of the nurses' views in the clinical practice; culturally adjusted care, improved communication and enhanced language skills.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
Nurses' views and experiences of caring for malnourished patients in surgical settings in Saudi Arabia: a qualitative study2014Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, s. 29- Artikel i tidskrift (Refereegranskat)
BACKGROUND: Although the occurrence of malnutrition in hospitals is a growing concern, little is known about how hospital staff understand the care that nurses provide to patients with malnutrition. The purpose of this study was to explore nurses' views and experiences of caring for malnourished patients in Saudi Arabia (KSA).
METHODS: Using a qualitative explorative design, fifteen nurses were interviewed as part of a purposive sample hospital staff. The transcripts were analyzed using latent content analysis.
RESULTS: The nurses spontaneously and consistently linked malnutrition with physical inactivity. The two main categories, which emerged, were: 'Potentials for nurses to provide good nutrition and physical activity', and 'Having the ability but not the power to promote proper nutrition and physical activity'. These arose from the subcategories: Good nursing implies providing appropriate health education; Acknowledging the Mourafiq (sitter) as a potential resource for the nursing, but also as a burden; Inadequate control and lack of influence; Cultural diversity and lack of dialog; and Views of women's weight gain in KSA society.
CONCLUSIONS: The nurses felt they have the capacity and passion to further improve the nutrition and activity of their patients, but obstacles in the health care system are impeding these ambitions. The implications for nursing practice could be acknowledgement of the nurses' views in the clinical practice; culturally adjusted care, improved communication and enhanced language skills.
Lindskov, Susanne
Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan. Censtralsjukhuset, Kristianstad.
Hagell, Peter
Lunds universitet.
Viktförändring - ett problem vid Parkinsons sjukdom2010Ingår i: I vården, ISSN 2000-4141, Vol. 1, nr 4, s. 24-26Artikel i tidskrift (Övrigt vetenskapligt)
Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Sjoberg, Klas
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap I. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Sjuksköterskeutbildningarna. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Weight stability in Parkinson's disease2016Ingår i: Nutritional neuroscience, ISSN 1028-415X, E-ISSN 1476-8305, Vol. 19, nr 1, s. 11-20Artikel i tidskrift (Refereegranskat)
Objectives: Parkinson's disease (PD) has traditionally been associated with weight loss. However, recent studies have not found any evidence of underweight in PD. Nevertheless, few studies have addressed nutritional status changes over time in relation to other clinical PD features. Here, we explore changes in nutritional status and motor and non-motor PD features (including dopaminergic drug therapy) in PD patients after 1 year. Methods: Motor and non-motor PD features, dopaminergic drug therapy, under-nutrition and malnutrition risk, and anthropometric measures (BMI, handgrip strength, triceps skin-fold, mid-arm circumference, and mid-upper arm muscle circumference) were assessed at baseline and 1 year later among 65 people with PD. Results: Disability, PD motor symptoms, dysautonomia, and dopaminergic drug therapy increased. Underweight was uncommon both at baseline (n= 3) and follow-up (n = 2); malnutrition risk was common but stable (88 and 92%), whereas triceps skin-fold increased (P = 0.030); mid-upper arm muscle circumference decreased (P = 0.002); and the proportion of people with low handgrip strength (P = 0.012) increased. Correlations between nutritional variables and motor and non-motor PD features were absent to modest. Multiple linear regression analysis showed that baseline pupillomotor functioning was associated with decreased weight and BMI, and sleep with increased weight and BMI. In addition, increases in anxiety were associated with decreased weight, BMI, and triceps skin-fold. Discussion: During the PD course, there seems to be redistribution in body composition from muscle to fat. Studies are needed to identify possible explanations for the findings. This implies that malnutrition should be regularly screened to identify those at risk of developing reduced muscle mass and increased morbidity.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap II. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Sjöberg, K.
Malnutrition risk in Parkinson's disease2014Ingår i: Journal of Aging Research & Clinical Practice, ISSN 2258-8094, Vol. 3, nr 2, s. 93-99Artikel i tidskrift (Refereegranskat)
Background: Unintentional weight loss and undernutrition have been found common in Parkinson's disease but its relation to other disease aspects is unclear.
Objectives: To explore nutritional status in relation to disease duration in Parkinson's disease, as well as associations between nutritional status and motor and autonomic features.
Design: Cross-sectional.
Setting: South-Swedish outpatient Parkinson-clinic.
Participants: Home-dwelling people with Parkinson's disease (n=71), without significant cognitive impairment (mean age, 67.3 years; 56% men; mean disease duration, 6.3 years).
Measurements: Parkinsonian motor symptoms, mobility, activity level, disability, dyskinesias, dysautonomia, under- and malnutrition risk screening (using MEONF II and MUST for undernutrition and SCREEN II for malnutrition) and anthropometric measures (BMI, handgrip strength, triceps skin-fold, mid-arm circumference and mid-upper arm muscle circumference) were recorded. The sample was divided into those with longer (n=34) and shorter disease duration (n=37) according to the median (5 years).
Results: Longer disease duration was associated with more, disability, dyskinesias and dysautonomia than shorter duration (P ≤0.04). Mean (SD) body weight and BMI were 80.3 (16.3) kg and 28.1 (4.8) kg/m 2, respectively, and did not differ between duration groups (body weight, 80.9 vs. 79.6 kg; BMI, 28.0 vs. 28.3 kg/m 2; P≥0.738). There were no differences in other anthropometric measures between duration groups (P ≥0.300). BMI identified 4% and 62% as under- and overweight, respectively, and 4% exhibited undernutrition risk, whereas 87% were at risk for malnutrition. Nutritional and motor/dysautonomic variables showed relatively weak correlations (r s, ≤ 0.33), but people with orthostatic hypotension had lower BMI (26.7 vs 29.2 kg/m 2; P=0.026) and lower handgrip strength (33.2 vs 41.6 kg; P=0.025) than those without orthostatic hypotension.
Conclusion: Motor and autonomic features showed expected relationships with disease duration. In contrast to these observations, and to most previous reports on nutrition in PD, frequencies of underweight and undernutrition were low. However, malnutrition risk was high, emphasizing the need for regular clinical monitoring of nutritional status. The reasons for the preserved nutritional status have to be explored prospectively.
Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Sjöberg, Klas
Weight loss in Parkinson´s disease?2013Konferensbidrag (Refereegranskat)
Department of Geriatrics and Neurology, Central Hospital Kristianstad.
Research and Development Unit, Central Hospital Kristianstad.
Department of Health Sciences, Lund University.
A controlled trial of an educational programme for people with Parkinson's disease2007Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 11C, s. 368-376Artikel i tidskrift (Refereegranskat)
AIMS AND OBJECTIVE: To evaluate patient-reported health outcomes of a multidisciplinary group educational programme for people with Parkinson's disease (PD), delivered as part of routine clinical practice. BACKGROUND: Studies suggest that educational programmes for people with PD have potential to improve patients' perceived health and well-being. However, controlled trials of multidisciplinary group educational programmes are lacking. DESIGN: Naturalistic non-randomized controlled trial. METHODS: Following ethical approval and informed consent, 48 people with PD (58% men; mean age, 69.3) received the intervention and 48 (52% men; mean age, 72) were allocated to a delayed intervention control group. The intervention was a six-week (two hours per week) multidisciplinary group educational programme. Patient-reported health outcomes were assessed by the 12-item short-form health survey (SF-12) at baseline and one month postintervention. RESULTS: Changes in SF-12 scores at follow-up did not differ between the groups and there were no within-group differences over time. Daily dopaminergic medication increased in the control group but not in the intervention group. CONCLUSIONS: Slightly, but significantly, increased drug requirement in the control group may in part have masked deterioration in perceived health. However, failure to demonstrate improved patient-reported health may relate to the intervention design, response shift (i.e. change in how people perceive their health), and/or quality and choice of outcome measures. Further studies that take these aspects into consideration are needed to determine the potential for patient education interventions in PD. RELEVANCE TO CLINICAL PRACTICE: Nurses and other healthcare professionals need to document the effects of patient educational programmes and to be aware of the importance of intervention design and challenges associated with evaluating programme outcomes. Otherwise, there is a risk that benefits cannot be demonstrated and that decision makers will not invest resources in interventions that actually are beneficial for chronically ill people.
Centralsjukhuset, Kristianstad.
Patientundervisning vid Parkinsons sjukdom2010Ingår i: I vården, ISSN 2000-4141, Vol. 1, nr 4, s. 28-30Artikel i tidskrift (Övrigt vetenskapligt)
69. Marktorp, Caroline
Norberg, Erika
Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
Tenghagen Moberg, Carina
Mat, medicin och sväljsvårigheter vid Parkinsons sjukdom2017Övrigt (Övrigt vetenskapligt)
Martinsson, Anna
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
Haak, Maria
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
Petersson, Pia
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
Health related resources among older persons that receive preventive home visits – implications for further recommendations on health promotion2019Konferensbidrag (Refereegranskat)
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Lunds universitet.
Peterson, Pia
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
Health related resources among older persons that receive preventive home visits: implications for further recommendations on health promotion2019Konferensbidrag (Övrigt vetenskapligt)
In the sustainable development goals for 2030 the emphasis is on health promotion to enable healthy lives and wellbeing for all. Health promotion from an individual perspective focus on enabling the person to take control and improve health, by focusing on positive health related resources. Health promotion can be applied to older persons during a preventive home visit (PHV). Most of the studies made on PHVs to older persons have focused on risk factors. Suggestions for improvement of the PHV would be to add recommendations that promote health related resources, not only look at risk factors. In order to develop health promotion for older persons there is a need for research about positive health related resources. Therefore this study aim for exploring health related resources that could be found among older persons that have received a PHV.
Methods: A cross-sectional study design was used including older persons age ≥75 years old, living in their own homes, and that had received PHV. Data were collected during a period of nine months, in two municipalities in the south of Sweden. Questions covered wellbeing, nutrition, physical health, functional ability, housing and economy. Binary logistic regression was used to analyse data.
Results: In total 625 older persons were included in the study, 55.4 % were women, mean age was 80.6 (standard deviation 2.2 years). Preliminary results indicate that following factors are significantly associated with good general health (adjusting for age and gender): being able to do things that make one feel valuable, satisfied with existence, physically active several times per week, having no physical problems to participate in social activities, not feeling sad, not having reduced energy and not having reduced endurance.
Conclusion: This results indicate that it can be of importance to pay attention to some specific health related resources when giving health promotion advices during the PHV.
Nielsen, M
Maribo, T
Melgaard, D
Associations between eating difficulties, nutritional status and activity of daily living in acute geriatric patients2018Konferensbidrag (Övrigt vetenskapligt)
73. Nielsen, M
Associations between eating difficulties, nutritional status and activity of daily living in acute geriatric patients2018Konferensbidrag (Refereegranskat)
Nielsen, Mie Marie
Maribo, Thomas
Melgaard, Dorte
Associations between eating difficulties, nutritional status and activity of daily living in acute geriatric patients2018Ingår i: Clinical Nutrition ESPEN, ISSN 2405-4577, Vol. 25, s. 95-99Artikel i tidskrift (Refereegranskat)
Background & aims
Eating difficulties, having a poor nutritional status, and low activity of daily living are all prevalent issues in the geriatric population. The aim of this study was to explore associations between patients' eating difficulties, their nutritional status and their activity of daily living in patients aged 60 years or older who were admitted to an acute geriatric unit.
A cross-sectional study was conducted between March and September 2016 at the geriatric department of North Denmark Regional Hospital, Hjørring. The inclusion criteria were: ≥ 60years old and hospitalized for a minimum of 24 h. The patients' eating difficulties were assessed using the Minimal Eating Observational Form (MEOF-II), including observations related to ingestion, deglutition and energy/appetite. Eating difficulties were determined on the basis of one or more components of the MEOF-II. Poor nutritional status was defined as an age-specific low body mass index (BMI), <20 kg/m2 if < 70 years, or <22 kg/m2 if ≥ 70 years. Activity of daily living was assessed using the Barthel-100 Index and defined as low (<50) or high (≥50).
A total of 297 geriatric patients were included; the mean age was 83.0 (7.7) years and 56.2% of the patients were female. The prevalence of eating difficulties was 55%. Geriatric patients with eating difficulties had a risk increase of 155% of having poor nutritional status (p = 0.003). Geriatric patients with eating difficulties had a risk increase of 60% of having low activity of daily living (p < 0.001).
Eating difficulties were highly prevalent in geriatric patients and were associated with poor nutritional status and reduced activity of daily living. The identification of eating difficulties may be important for nutritional interventions and maintenance or improvement of activities of daily living in the geriatric population
Nilsson, Maria H.
Carlsson, Gunilla
Department of Neurology, University Hospital, Lund.
Uncovering indications of the international classification of functioning, disability, and health from the 39-item Parkinson's Disease Questionnaire2010Ingår i: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, s. 984673- Artikel i tidskrift (Refereegranskat)
The 39-item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient-reported rating scale in Parkinson's disease (PD). However, recent studies have questioned its validity and it is unclear what scores represent. This study explored the possibility of regrouping PDQ-39 items into scales representing the International Classification of Functioning, Disability, and Health (ICF) components of Body Functions and Structures (BF), Activities and Participation (AP), and Environmental (E) factors. An iterative process using Rasch analysis produced five new items sets, two each for the BF and AP components and one representing E. Four of these were found to represent clinically meaningful variables: Emotional Impairment (BF), Gross Motor Disability (AP), Fine Motor Disability (AP), and Socioattitudinal Environment (E) with acceptable reliability (0.73–0.96) and fit to the Rasch model (total item-trait chi-square, 8.28–33.2; P>.05). These new ICF-based scales offer a means to reanalyze PDQ-39 data from an ICF perspective and to study its health components using a widely available health status questionnaire for people with PD.
Nyberg, Maria
Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Praktisk-estetiska ämnen. Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL).
Olsson, Viktoria
Pajalic, Zada
Linnaeus University.
Örtman, Gerd
Andersson, Håkan S.
Blücher, Anna
Wendin, Karin
Eating difficulties, nutrition, meal preferences and experiences among elderly: a literature overview from a Scandinavian context2015Ingår i: Journal of Food Research, ISSN 1927-0887, E-ISSN 1927-0895, Vol. 4, nr 1, s. 22-37Artikel, forskningsöversikt (Refereegranskat)
The risk of malnutrition increases with ageing, resulting in poorer health and higher risk of disease. Eating difficulties are important risk factors for malnutrition. Moreover, independence in relation to food and meals is highly rated by the elderly and has been associated with health and well-being. The purpose of this literature overview was to provide insights into nutritional status, food choice and preferences as well as the meal situations of home-living elderly (65+) people with motoric eating difficulties focusing on Scandinavia. The overall aim is to support independence and to prevent malnutrition. Nutritional status in the elderly was found to be negatively influenced by motoric eating difficulties including problems with manipulating food on the plate and transporting food to the mouth. Motoric eating difficulties may result in practical simplifications such as use of pre-prepared meals, less advanced cooking, and omission of certain meal constituents in order to avoid e.g. mismanagement and spillage. Eating difficulties are often accompanied by feelings of guilt and shame. Choosing smaller portions, reducing the number of eating episodes and not cooking independently have been associated with a higher risk of malnutrition. The nutritional effects of eating difficulties may be exacerbated by diminished chemosensory functions. Furthermore, both past and present food preferences should be considered in order to meet nutritional needs and meal satisfaction. Development of refined and socially accepted eating aids, in combination with tasty and nutritious products, is important in order to promote healthy and independent living among home-living elderly with motoric eating difficulties.
Eating Difficulties, Nutrition, Meal Preferences and ExperiencesAmong Elderly
Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Mat- och måltidsvetenskap.
Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL). Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Humaniora.
Linnaeus University, Kalmar, Sweden.
Norge.
Linnaeus University, Kalmar.
Lindborg, Ann-Louise
Mälardalen University, Västerås.
The meal as a performance: food and meal practices beyond health and nutrition2018Ingår i: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 38, nr 1, s. 83-107Artikel i tidskrift (Refereegranskat)
The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to investigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman's concept of performance as a theoretical framework together with Bourdieu's thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi-structured interviews were conducted with 14 elderly people (aged between 67 and 87 years) and meal observations were carried out with 11 of these people. Participants were found to manage food and meal practices by continuously adjusting and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the façade and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as 'fuel' where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance.
Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Humanvetenskap. Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL).
Agerhem, Halina
Ipsos, Sweden.
Svensson, Therése
Improved everyday food for home living elderly – perception of protein and energy enrichment2015Konferensbidrag (Övrigt vetenskapligt)
Protein-energy malnutrition can be a problem among elderly. A way to increase protein intake may be to enrich home-cooked foods. In this, special attention should be given to that the food is conveniently prepared and well accepted by the target group.
Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Mat- och måltidsvetenskap. Högskolan Kristianstad, Forskningsmiljön Food and Meals in Everyday Life (MEAL).
Linnéuniversitetet.
Blucher, Anna
Andersson, Håkan
Designing meals for elderly with eating difficulties: a cooperative approach2014Konferensbidrag (Övrigt vetenskapligt)
Approximately 15 % of the Scandinavian population aged 60 and above suffer from eating difficulties with malnutrition as a risk factor. In an effort to improve their possibilities of a healthy and independent living, we have chosen the strategy to develop nutritious and tasty food in combination with functional eating aids to be integrated in the everyday lives of elderly.
This new, multi-disciplinary project concerns the design of meals for those who experience difficulties in transporting food from the plate to the mouth. The present paper, as part of the project, aims at presenting today's knowledge of what home-living Scandinavian elderly with pre-oral eating difficulties experience as important factors concerning the meal. The review of peer-reviewed research publications will be complemented with in-depth interviews, surveys and observation studies. Data will be used in a co-designing process, where elderly are involved in developing meals and eating aids that support independence and integrity.
For elderly in general it is well known that food and drink preferences are affected by past experiences. However, impaired appetite, taste and smell as well as eating difficulties require special adaptations of food and beverages. Serving popular dishes and using distinct flavours and presentations improves meal satisfaction. Elderly suffering from e.g. hand tremor or difficulties in gripping often develop strategies to remain independent, of which one may be to omit meal constituents affecting the sensory and nutritional quality of the meal. Furthermore, the eating situation among people with eating difficulties is often associated with guilt and shame, and social withdrawal is therefore a common scenario.
Remaining independent in respect to eating is highly valued among elderly. By integrating various dimensions of the meal, including nutritional and sensory aspects, in the development of functional eating aids, the possibility of a healthy and independent living among elderly increases.
Högskolan Kristianstad, Sektionen för lärande och miljö, Avdelningen för Praktisk-estetiska ämnen.
Linneaus University.
Designing meals for elderly with eating difficulties: a cooperative approach2014Konferensbidrag (Refereegranskat)
Högskolan Kristianstad, Institutionen för hälsovetenskaper.
Karlsson, Siv
Department of Rehabilitation Medicine, Central Hospital Kristianstad.
Functioning and subjective health among stroke survivors after discharge from hospital2006Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 54, nr 4, s. 457-466Artikel i tidskrift (Refereegranskat)
Existing Activities of Daily Living scales were expanded and found to relate to a participation scale and a subjective health scale. Using these scales in nursing care has the potential to correct current bias towards functions and activities by broadening the focus to include the social as well as the physical.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Persson, Lena
Skovdahl, Kirsti
The School of Medical and Health Sciences, Örebro University.
Facilitating change, the decision-maker's views of municipality organized food distribution to elderly people living at home and suggestions for development: a participatory action research study2012Ingår i: Public Administration Research, ISSN 1927-517X, Vol. 1, nr 1, s. 14-23Artikel i tidskrift (Refereegranskat)
This study is the final part of a larger project with an action research approach focusing on food distribution (FD) within municipal service and care for elderly persons, living at home (≥65 years), from various perspectives. The aim was to describe the decision-makers' the politicians and top level administrative manager's views on the FD service, and to give feedback from the results of earlier studies based on information given by FD receivers, the perspectives of involved professionals, and the results of an intervention study and further to report the decision-makers suggestions for which areas should be taken into consideration as starting points to improve the FD process and practice. Data was gathered in two steps: step 1, through individual interviews (n=12) with the decision-makers during the spring of 2009, step 2a through feedback from previous studies, received during the autumn of 2011 and step 2b from discussions based on the feedback. The interview data was analysed using qualitative content analysis. The findings indicated a discrepancy between the reality and the political visions. It was shown that decision-maker's needed to make decisions despite their uncertain knowledge of the complexity of the FD programme. They considered what has been, what is, and will be, when setting goals. Their goal was that elderly person's rights and needs should be fulfilled. This included freedom of choice and individual consideration. In addition, it meant, meeting elderly people's medical and social needs. Three areas were found to require facilitation for change related to FD: 1) the monitoring of the elderly's health and wellbeing while providing FD, 2) the increasing of professional competence, and 3) the creation of a forum for inter-professional communication. The findings in this study have implications for nursing, gerontology and public administration.
Facilitating Change, the Decision-maker's Views of Municipality
School of Medical and Health Sciences, Örebro University.
The experiences of elderly people living at home related to their receiving meals distributed by a municipality in Sweden2012Ingår i: Journal of Food Research, ISSN 1927-0887, Vol. 1, nr 1, s. 68-78Artikel i tidskrift (Refereegranskat)
The purpose of the study was to describe the experiences of elderly people, living at home who receive hot meals that are distributed by their municipality. Qualitative content analysis was used to analyse the (n=13) interviews. The results showed that feelings of dependency, loneliness and gratitude were expressed by the participants in the study related to their meals being delivered home. Dependency was expressed as not having influence over the food products the meals were made from. Loneliness was expressed as being isolated and being confined at home alone due to difficulties getting out of the house, which was associated with the costs of taxis transportation. Gratitude was expressed by the sincere thanks for the possibility of receiving traditional meals delivered daily.
The major conclusion of the study was the indication that greater attention should be paid to meet both the practical and psychological needs of elderly people.
Hälsoakademin Örebro Universitet.
Evaluation for change, the decision maker's involvement in the development of food distribution to home living elderly people2012Konferensbidrag (Refereegranskat)
Findings from international research as well as from Sweden show that food distribution as a single intervention involves various professional groups on the various levels in organisation.
The present research is one of several Action Research projects initiated as a result of a resolution on the highest political level aiming at achieving improvements within the care and service through collaboration between different levels in the organisations.
The overall aim of this specific study is to describe the "top-down" perspective i.e. decision-makers involvement in identifying areas for the development of the food distribution chain.
Data was collected in two steps, firstly by individual interviews with decision makers (politicians n=21, one administrative manager and one medical responsible nurse) and secondly by evaluation dialogue in group (n=23) discussion. The group discussions were based on findings from individual interviews and results from two previous studies focused on interviews with various professionals and food distribution recipients.
The findings were that food distribution was seen as a multifaceted system that included three interrelated issues: the administration of work, the professional's competence in nutrition and the relationship between various professional groups. To achieve a change, the central component of complexity needs to be clarified. When the issues are multifaceted the solutions need to regard the whole picture rather than its parts.
Evaluation for change, the decision maker's involvement in the development of food distribution to home living elderly people2012Ingår i: International Conference Interprofessional Partnership: Improvement for Global Health Outcomes Thailand, 2012Konferensbidrag (Refereegranskat)
Findings from international research as well as fromSwedenshow that food distribution as a single intervention involves various professional groups on the various levels in organisation.
Data was collected in two steps, firstly by individual interviews with decision makers and secondly by group discussions. The group discussions were based on findings from individual interviews and results from two previous studies focused on interviews with various professionals and food distribution recipients.
Keywords: action research, decision-makers, food distribution in Swedish context, "top-down" perspective
The short paper and presentation would fit in the key theme Health Care Management of the congress.
Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Högskolan Kristianstad, Sektionen för hälsa och samhälle. Högskolan Kristianstad, Forskningsmiljön PRO-CARE.
School of Health and Medical Sciences, Örebro University.
Food distribution within a municipality from different perspectives – older people, decision makers and professionals: an action research study2011Konferensbidrag (Refereegranskat)
The present research project is one of Action Research (AR) projects in a region in southern part of Sweden, Scania. All the AR projects originate as result of a decision on the highest political level. The decision was to do changes within the care service where collaboration between different care organisations should be advocated in aim to support and help care consumers. The care should be provided in more care consumer centred ways in which care consumers should be in the centre. These changes should emphasise public and care users' involvement and participation in decisions around the treatment, service development and evaluation. The participatory service should be performed through a constructive dialogue between care users, health care professionals as a catalyst to common practice change. The overall aim of the project was to explore FD to older people living alone in their own homes from different perspectives: elderly as consumers, decision-makers and various professionals. The specific aims were: 1)to explore various professionals' experiences in relation to their involvement in food distribution in order to get a comprehensive understanding of the organisation, responsibilities and roles in the specific context ("bottom-up" perspective);
2) to explore older people's experiences of food distribution and their suggestions what they whish to change ("bottom-up" perspective); 3) to identify, suggest, implement and evaluate chosen actions issues together with various professionals and elderly people ("bottom-up" perspective); 4) the results from the studies 1-3 will be given as feedback to the decision-makers level and it will be start point for reflective reasoning by using Story Dialogue Method in aim to identify conditions for development of food distribution chain ("top-down" perspective).
The short paper and presentation, on how to identify the practical issues involved and what can be done to create a receptive context for change, would fit in the fourth key theme of the congress.
Public home care professionals' experiences of being involved in food distribution to home-living elderly people in Sweden: a qualitative study with an action research approach2012Ingår i: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 2, nr 2, s. 41-51Artikel i tidskrift (Refereegranskat)
Background: Research focusing on Food Distribution (FD) from various professionals' and organisational perspectivesare lacking. The aim of this study was therefore to explore various professionals' experiences of involvement in FD inorder to get comprehensive understanding of the organisation, responsibilities and roles.
Methods: This qualitative study is a part of a larger project with an action research approach focusing on FD in themunicipal home service and care for home-living elderly persons in a municipality in southern Sweden. The data wascollected through participatory observations (n=90 occasions and in total 480 hours), repeated focus group interviews (n =4) with different professionals (n =10) involved in the FD process and one individual interview. The material was analysedby qualitative manifest and latent content analysis.
Results: The study indicates that Food Distribution is a fragmentary intervention where a comprehensive perspective andclear roles of responsibility are lacking. The FD organisation seemed to be strictly divided and limited by constraintsregarding time and money. The fragmented organisation led partly to staff only taking responsibility for their part of thechain and no one having the full picture of and responsibility for the FD process, but also to some professionals takingmore responsibility than they were supposed to.
Conclusions: The aim of the study was met by using an action research approach. The study was however limited by thatno home help officers were represented. The FD appeared as an extremely complex chain of different but connectedactivities. It is not merely the distribution of a product, i.e. the meal box. The fragmentation of FD means that staff onlytakes responsibility for their part of the chain, and that no one has the full picture of or responsibility for the FD process.Consequently, there is a need for an outline of responsibilities. The findings have implications for nursing, gerontology,and in the care for the elderly.
How the professionals can identify needs for improvement and improve food distribution service for the home-living elderly people in Sweden - an action research project2013Ingår i: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, nr 8, s. 29-40Artikel i tidskrift (Refereegranskat)
Background: Making changes to municipal social care and service has been found to be challenging to realise and highly multifaceted. The aim of this study was to describe how the professionals can identify needs for improvement and improve Food Distribution (FD) service for the home-living elderly people in Sweden.
Methods: This study is part of a larger project with an action research approach focusing on to municipal FD to older people living in their own home in Sweden. The professionals involved in FD invited the first author to assist them in this process. The study participants were comprised of the following groups: "The Identification focus group" that identified need for improvement of FD (n= 5); "The Action focus group" that planned and choose suitable 'action' for improvement (n=5); "The First Evaluation group" (n=4) that evaluated the content of planned improvement and finally "The Second Evaluation group" (n=29) that evaluated the changes following improvement. The data was gathered and analysed by Story Dialogue Method.
Results: The need to update and increase the FD recipient's knowledge in nutrition by sending them informative letters was found to be an important area to focus on. The information letters (n=1700) were distributed to the all FD recipients in six municipalities in southern Sweden during April 2011. The results were evaluated during May 2011. The overall general estimation was that the content of the letters indicated that this was a suitable method for gaining information to make a nutrition competence update. Following this, "The Action focus group" decided: firstly, to continue preparing and distributing information letters to all FD recipients to be sent out twice a year, and secondly: to make the information letters accessible on the websites of the six municipalities and county councils involved.
Conclusions: This study showed that systematic work inspired by an action research approach with motivated and involved participants can be beneficial and a starting point for the process of change in municipal service and care practice. The major conclusion of the study was that systematic reflection over everyday practice can be the vehicle for the future change of practice. The research process and the findings have implications for nursing, care of the elderly and gerontology.
A Network for Eating and Nutrition as a platform for cooperation over the organisational borders between healthcare sectors in Sweden2014Ingår i: Journal of Health Sciences, ISSN 2232-7576, Vol. 4, nr 3, s. 1-7Artikel i tidskrift (Refereegranskat)
Introduction: Requirements to implement scientific knowledge in practice within the Swedish health and social care sectors have increased during the last decades. One of these networks was the Network for Eating and Nutrition that began in 2003. The aim of this study was to retrospectively evaluate how the Network for Eating and Nutrition has functioned during a period of ten years and in what way it has affected work practice.
Methods: This is a descriptive qualitative study. Data sources for this study were meeting records collected over 10 years and two evaluation surveys (at five and 10 years). Participants were members of the Network for Eating and Nutrition (n=12 at five years and n=10 at 10 years). The manifest qualitative content analysis was used.
Results: The Network for Eating and Nutrition was seen as offering support for personal and organisational knowledge development. Further aspects of support from the workplaces of the members and the significance for the work places were described. Further the Network for Eating and Nutrition reached out to care receivers by using specifically tailored education programmes and material. The Network for Eating and Nutrition results and recommendations were described as important references for the development of nutrition routines.
Conclusion: Networks between organisations with different professional backgrounds can form a basis for knowledge exchange both for focus on the specific topic but also on how to work with quality improvement, i.e. evidence based practice.
Aktionsforskningens grunder2013Ingår i: Aktionsforskning i vård och omsorg: tillämpning och teori / [ed] Liselotte Jakobsson, Malmö: Gleerups Utbildning AB, 2013, s. 85-94Kapitel i bok, del av antologi (Övrigt vetenskapligt)
Improvement of food distribution to home living elderly people by using action research approach2012Ingår i: Book of abstracts 2012: Nobel Day festivities Örebro University, 2012, s. 33-Konferensbidrag (Refereegranskat)
The study was performed in accordance with action research approach and included four phases: look, think, act and evaluate.
Look phase was performed in the three steps:
To gain insight into and describe the experiences of elderly home-living people who receive meals from municipality
To explore various professional's experiences of involvement in the food distribution process in order to get a comprehensive understanding of the organization and responsibilities and roles
To describe decision makers views on the food distribution service
Think phase was performed in the three steps:
To reflect on what was important for the elderly people relating to their receiving meals distributed by the municipality
To reflect on what the various involved professionals identify as most important to develop in the food distribution chain
To reflect over suggested developmental areas and choose one of them and reflect over how to perform action and evaluation
Act phase was performed in two steps:
The knowledge in nutrition as developmental area was chosen to focus action on
The way how to develop nutrition knowledge, the information letters, was chosen
The information letters were developed I collaboration with professionals and elderly people
The 1700 information letters were distributed
The evaluation phase was performed in three phases:
The preliminary outcomes were given as feedback to involved representatives from various professionals
The finally outcomes were given as feedback to decision makers
Final feedback resulted in three future actions
Outcomes from look and think phase are:
The food distribution receivers expressed feelings of: to not have influence over food products the meals were made from, to feel isolated and confined at home due to difficulties getting out of the house and expressed sincere gratitude for the meal service from the municipality.
The various professionals expressed that: food distribution is a fragmentary intervention where comprehensive perspective and roles of responsibility are lacking, the fragmented organization seemed strictly divided and limited by constrains regarding time and money, the necessary observations and structured following up of nutrition status for food distribution receivers is missing, and that knowledge in nutrition need to be continuously developed.
The decision makers found areas to require facilitation for change related to food distribution: the monitoring of the food distribution receiver's health and wellbeing, to focus on involved professional's competence in nutrition and to create a forum for inter-professional communication.
Matdistribution till äldre2013Ingår i: Aktionsforskning i vård och omsorg: tillämpning och teori / [ed] Liselotte Jakobsson, Malmö: Gleerups Utbildning AB , 2013, s. 13-32Kapitel i bok, del av antologi (Övrigt vetenskapligt)
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsmiljön PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
Högskolan Kristianstad, Sektionen för hälsa och samhälle, Avdelningen för Hälsovetenskap. Högskolan Kristianstad, Forskningsplattformen Hälsa i samverkan.
Matdistribution från olika perspektiv - professioner, beslutsfattare och från äldre personer - en aktionsforskningsstudie2011Konferensbidrag (Övrig (populärvetenskap, debatt, mm))
Edberg, Anna-Karin
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan.
Developing a model that support preventive home visit for seniors – a collaborative development and research project2019Konferensbidrag (Refereegranskat)
Rolandsson, Sara
Andersson Sjöland, Annika
Brune, Jan C.
Li, Hongzhe
Kassem, Moustapha
University of Southern Denmark.
Mertens, Fredrik
Eriksson, Leif
Hansson, Lennart
Skog, Ingrid
Bjermer, Leif
Scheding, Stefan
Westergren-Thorsson, Gunilla
Primary mesenchymal stem cells in human transplanted lungs are CD90/CD105 perivascularly located tissue-resident cells2014Ingår i: BMJ Open Respiratory Research, ISSN 2052-4439, Vol. 1, nr 1, s. e000027-Artikel i tidskrift (Refereegranskat)
BACKGROUND: Mesenchymal stem cells (MSC) have not only been implicated in the development of lung diseases, but they have also been proposed as a future cell-based therapy for lung diseases. However, the cellular identity of the primary MSC in human lung tissues has not yet been reported. This study therefore aimed to identify and characterise the 'bona fide' MSC in human lungs and to investigate if the MSC numbers correlate with the development of bronchiolitis obliterans syndrome in lung-transplanted patients. METHODS: Primary lung MSC were directly isolated or culture-derived from central and peripheral transbronchial biopsies of lung-transplanted patients and evaluated using a comprehensive panel of in vitro and in vivo assays. RESULTS: Primary MSC were enriched in the CD90/CD105 mononuclear cell fraction with mesenchymal progenitor frequencies of up to four colony-forming units, fibroblast/100 cells. In situ staining of lung tissues revealed that CD90/CD105 MSCs were located perivascularly. MSC were tissue-resident and exclusively donor lung-derived even in biopsies obtained from patients as long as 16 years after transplantation. Culture-derived mesenchymal stromal cells showed typical in vitro MSC properties; however, xenotransplantation into non-obese diabetic/severe combined immunodeficient (NOD/SCID) mice showed that lung MSC readily differentiated into adipocytes and stromal tissues, but lacked significant in vivo bone formation. CONCLUSIONS: These data clearly demonstrate that primary MSC in human lung tissues are not only tissue resident but also tissue-specific. The identification and phenotypic characterisation of primary lung MSC is an important first step in identifying the role of MSC in normal lung physiology and pulmonary diseases.
Sjödahl Hammarlund, Catharina
Högskolan Kristianstad, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
Fall risk and its associated factors among older adults without home help services in a Swedish municipality2016Ingår i: Journal of Community Health Nursing, ISSN 0737-0016, E-ISSN 1532-7655, Vol. 33, nr 4, s. 181-189Artikel i tidskrift (Refereegranskat)
During preventive home visits, the purpose of this study was, to identify the prevalence of fall risk and any associated factors. Participants (n=1471) were cognitively sound community-dwelling older adults (≥ 70 years) without home-help service, living in a Swedish municipality. The Downton Fall Risk Index and nine single items were used. Tiredness/fatigue, age ≥ 80, inability to walk one hour, inability to climb stairs and worrying were significantly associated with fall risk. Preventive home visits incorporating fall risk screening proved valuable, providing information for interventions aimed at preventing falls, maintaining independence and facilitating health among community dwelling participants.
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Lund University.
Åström, Ingrid
Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
The Impact of Living with Parkinson's Disease: Balancing within a Web of Needs and Demands2018Ingår i: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, Vol. 2018, artikel-id 4598651 Artikel i tidskrift (Refereegranskat)
This study explores the impact of living with Parkinson's disease (PD). Nineteen persons (11 women) aged 55–84 diagnosed with PD 3–27 years ago participated. Data were collected through semistructured interviews, which were recorded, transcribed verbatim, and analysed by qualitative content analysis. Four categories represented the impact of living with PD: "Changed prerequisites for managing day-to-day demands," "Loss of identity and dignity," "Compromised social participation," and "The use of practical and psychological strategies." There was a shift from an internal to an external locus of control in managing, control, competence, relatedness, and autonomy. According to self-determination theory, a shift towards extrinsically motivated behaviours may occur when these basic needs are thwarted, leading to compensatory strategies or needs substitutes with negative consequences on health and well-being. We suggest a needs-based approach as an important starting point to better understand the consequences of living with PD and to explore the means for people with PD to acquire an improved quality of life on their own terms. In conclusion, our findings suggest for a shift in focus, from a biomedical to a needs-based approach to understand the impact of living with PD and facilitate more person-centred care and person-centred outcome measurement.
Smith, Steve
Storbritannien.
Saunders, Julia
Nutritional screening: a user-friendly tool adapted from Sweden2016Ingår i: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 25, nr 4, s. 208-211Artikel i tidskrift (Refereegranskat)
Screening for undernutrition is highly important and may reduce morbidity and mortality. The Minimal Eating Observation and Nutrition Form Version II (MEONF-II) is a nutritional screening tool specifically developed for use by nurses. The authors describe the translation, performance and appropriateness of MEONF-II for the UK. Following translation from Swedish to British English, the user-friendliness and appropriateness of the British MEONF-II was tested by 29 registered nurses and final-year student nurses on 266 hospital inpatients. The new British MEONF-II was perceived as highly user-friendly and appropriate. Assessors found MEONF-II to compare favourably with other similar tools in terms of preference, usefulness and helpfulness in providing good nutritional care. Dependency in activities and poorer subjective health were associated with a higher risk of undernutrition. These findings support the appropriateness of the British MEONF-II version and suggest it may act as a user-friendly facilitator for good nutritional nursing care.
Stenzelius, Karin
Hallberg, Ingalill Rahm
The Swedish Institute for Health Sciences, Lund University.
Bowel function among people 75+ reporting faecal incontinence in relation to help seeking, dependency and quality of life2007Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 3, s. 458-468Artikel i tidskrift (Refereegranskat)
AIMS AND OBJECTIVES: The aim was to compare faecal incontinence and related bowel symptoms among men and women and being dependent or not (aged >or=75 years) and furthermore to identify which bowel symptoms predicted help seeking, dependency and low quality of life (QoL). BACKGROUND: Faecal incontinence (FI) in old age is a common condition and influences daily life to a great extent, although few actually seek medical help. METHODS: A total of 248 people with reported difficulties controlling faeces answered a postal questionnaire or were interviewed with questions about FI-related bowel symptoms. A factor analysis resulted in four areas of bowel symptoms and was used in logistic regression with help seeking, dependency and low QoL as dependent variables. RESULTS: Of all the subjects, 56.4% had leakage, 54.7% did not reach the toilet in time, 55.6% had incomplete emptying, 27.9% had hard stool, 36.8% bother from moisture from the anus, 32.2% could not withstand urgency for five minutes and 17% had red skin or wounds in the genital region. Women and those dependent were most affected. Totally 40.8% had sought help and 30.1% used protective aids. Leakage, discomfort, consistency and contractibility symptoms were the categories of bowel symptoms related to FI. Discomfort predicted help seeking (OR 3.0), dependency (OR 1.5) and physical QoL (OR 1.7). Leakage predicted help seeking (OR 1.9) but not dependency and QoL. CONCLUSIONS: Overall bowel function was disturbed among those with FI and unmet needs seem problematic especially for women and those needing help in Activities of Daily Living (ADL). Encouragement to seek and get medical help and to use protective aids may improve the very low quality of life in this group. RELEVANCE TO CLINICAL PRACTICE: Older people with FI should be asked about, assessed for and examined for overall bowel function to get adequate treatment and be encouraged to use protection.
Högskolan Kristianstad, LärandeResursCentrum
Instruktioner för författare

redpajama_set_name: RedPajamaCommonCrawl


 Plan, coordinate, prioritize, assign, supervise, review, and participate in the work of staff responsible for facility maintenance.
 Establish schedules and methods for providing facility maintenance services; identify resource needs; review needs with appropriate management staff; allocate resources accordingly.
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Please, send your CV/Resume to hr@azerbaijansupermarket.com with "Facility Engineer" subject.


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Q: Is there any limitation of number of connection between Cloud Run and Cloud SQL? We are bouncing into "Connection refused" errors in our application despite having limit in Cloud SQL high enough.
I found this error in Cloud-run error log:
"Exceeded maximum of 100 connections per instance for CLOUD_SQL_INSTANCE_NAME."
logName: "projects/PROJECT_ID/logs/run.googleapis.com%2Fvarlog%2Fsystem"

Our Cloud SQL (MySQL 8) is being run with this VM: db-n1-standard-1 and it has max_connections variable set 4030 (this is the default) so I guess the restriction is not coming from the database itself.
In documentation there is no mention of any limitation of Cloud SQL connections from Cloud Run side, just the general one enforced by database itself.
Am I missing anything? Is it a bug or undocumented feature?
Thanks for any answer!

A: So I got a response from Cloud SQL Documentation team:

I've learned that Cloud Run uses the same mechanism as App Engine to control connections to Cloud SQL. This mechanism has a max connections limit that is independent of the database setting.
This limit is 100 per instance. That means each instance of the application can have 100 connections, and as it scales the total number of connections per deployment can grow.
The user doesn't have any ability to change this limit.

A: Cloud SQL MySQL instances are reaching connection limit 4000 default. Potential workarounds I've found so far include:

*

*Pooling connections - Implementing a connection pooling, as mentioned here could help you to reuse connections, which would not only reduce the overall amount of connections being established, but also improve the overall performance.

*Checking if your application is leaking connections - Properly closing the connections made to your Cloud SQL MySQL instance will help you to detect 'leaked' connections that should not be reused

*Use exponential backoff - implementing an exponential backoff to retry connections would also help your team improve the overall quality of connections being established against your Cloud SQL MySQL instance.

redpajama_set_name: RedPajamaStackExchange


THE ANNUAL MEETING of regional central bank governors gathers governors, bank and financial sector representatives. The meeting aims at improving the cooperation between regional financial institutions and exchanging experiences in suppressing and mitigating the consequences of financial crises and in the overall economy.
THE MEETING IS ORGANIZER by LIDER business weekly.


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./gradlew build bundleInstall -Psling_host=$SLING_HOST -Psling_port=$SLING_PORT

redpajama_set_name: RedPajamaGithub


text:
forensic toxicology jobs
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