Dignified care is a central issue in the nursing care of older adults. Nurses are expected to treat older adults with dignity, and older adults wish to be treated in a dignified manner. Researchers ...have recommended investigating the concept of dignity based on specific contexts and population groups. This meta-synthesis study aims to explore the understandings of dignity from the perspective of older adults in the Nordic countries. Synthesising findings from qualitative studies on older adults’ experiences of dignity has provided important insight into what can be essential for dignified care in a Nordic context. The importance of visibility and recognition for the experience of dignity is an overarching theme in all the studies. The participants’ descriptions mostly implicated an existence dominated by a lack of recognition. The older adults do not feel valued as people or for their contribution to society and strive to tone down their illnesses in an attempt to become more visible and acknowledged as people. Toning down their illnesses and masking their needs can protect their independence. At the same time, becoming less visible can leave them without a voice. The metaphorical phrase protected and exposed by a cloak of invisibility is used to express the authors’ overall interpretation of the findings. Lack of recognition and being socially invisible is a genuine threat to older adults’ dignity.
•PTH, vitamin D, calcium, and phosphate measured in 2211 children and adolescents.•Biomarkers of bone metabolism vary with sex and age in a population-based cohort.•The concentration of vitamin D was ...lowest in February/March and highest in August.•Vitamin D insufficiency is common in high-latitude countries.•Almost half of the participants exhibited vitamin D insufficiency during winter.
Parathyroid hormone (PTH) and vitamin D are essential hormones in bone metabolism, especially during pediatric growth. Vitamin D insufficiency is often asymptomatic and is prevalent in high-latitude countries.
In a Danish population-based cohort of 2211 6–18-year-olds, sex- and age-specific pediatric reference values for fasting concentrations of intact serum PTH, vitamin D (25-hydroxycholecalciferol, 25-OH-D), total calcium, and phosphate were generated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. The effect of season on these biomarkers of bone metabolism was evaluated.
In boys, PTH concentrations increased with age, while the vitamin D and phosphate concentrations decreased (all p < .001). In girls, a peak in PTH concentrations and a nadir in vitamin D concentrations were observed in the 10–14-year-olds (both p < .001). Calcium and phosphate decreased with age for both sexes (girls: both p < .001; boys calcium: p < .05, boys phosphate: p < .001). Vitamin D was 20% lower in winter than summer for both sexes (both p < .001). Individuals with vitamin D sufficiency (25-OH-D > 50 nmol/L) exhibited a 5% lower level of PTH compared to the whole sample population (p < .001).
The concentrations of PTH, vitamin D, calcium, and phosphate vary during childhood and adolescence, and is dependent on sex and season. These factors should be considered when screening for and treating imbalances in bone metabolism.
Nordic Health Promotion Perspectives on Older Adults Participation and Sense og Security
Demographic changes and the growing elderly population in Scandinavia provide an incentive to study Health ...Ageing in the Nordic Countries. The chosen Nordic perspective takes into account commonalities and differences in socio-economic status, welfare systems, gender, history and culture. It also involves focusing on the health of individuals and populations. The Nordic perspective and the authors’ understanding of health and health promotion provide a backdrop for the essay. The authors are part of the Nordic Health Promotion Network (NHPRN), which is grounded in an ethics of health and well-being. This understanding highlights key values such as participation, justice and equality (freedom from discrimination), autonomy (independence). The authors focus mainly on the importance of participation and on the older person’s sense of security in this paper. We seek answers to what prevents and in which way Healthy Ageing can be promoted in the Northern countries. Concepts such as discrimination, retirement, dementia, nursing home residents’ access to nature and the elements, and the importance of relationships are illuminated.
Sufficient serum concentrations of vitamin D are required to maintain bone health during growth. The aims of this study were to determine whether vitamin D deficiency is more prevalent among children ...and adolescents with obesity compared to their normal weight peers and to identify clinical and biochemical variables associated with vitamin D deficiency.
One thousand four hundred and eighty-four children and adolescents with overweight/obesity and 2143 population-based controls were recruited from the Danish Childhood Obesity Biobank. Anthropometric variables and fasting concentrations of serum 25-hydroxy vitamin D (25-OH-D), plasma parathyroid hormone (PTH), calcium and phosphate were assessed at baseline. Vitamin D deficiency was defined as serum 25-OH-D concentrations <30 nmol/L. Linear and logistic regressions were used to identify variables associated with vitamin D deficiency.
A total of 16.5% of the children and adolescents with obesity (body mass index BMI standard deviation score SDS>2.33) exhibited vitamin D deficiency, with an odds ratio (OR) 3.41 (confidence interval CI: 2.27-5.71; p<0.0001) for being vitamin D deficient compared to their normal weight peers. BMI-SDS was independently and inversely associated with serum 25-OH-D concentrations. Other independent risk factors for vitamin D deficiency were being older than 14 years (OR: 2.39; CI: 1.28-4.48; p=0.006), more than 4 daily hours of screen time (OR: 4.56; CI: 2.59-8.05; p<0.0001) and blood sample assessment during winter-spring (OR: 6.44; CI: 4.47-9.26; p<0.0001).
Vitamin D deficiency was common among Danish children and adolescents with obesity. The degree of obesity was independently associated with lower serum 25-OH-D concentrations.
Diagnostic testing of positive blood cultures is among the most critical tasks performed by clinical microbiology laboratories, and the total analysis time from sampling to results should be kept as ...short as possible. By providing identification of pelleted bacteria directly from positive blood‐cultures, MALDI‐TOF MS opens for relatively low‐complex species‐adjusted genetic susceptibility testing from the same bacterial pellet. In our lab routine, we prospectively evaluated a rapid in‐house real‐time PCR targeting the most common aminoglycoside and cephalosporin resistance genes in Escherichia coli and Klebsiella pneumoniae and measured time to preliminary susceptibility reporting for 138 samples. The results were compared to direct phenotypic susceptibility testing with interpretation after 6 h and overnight incubation respectively. Results from the genetic susceptibility testing were available for 69.5% (96/138) of the positive blood cultures within 24 h after sample collection. No phenotypic susceptibility results were available at this time. Compared to overnight direct susceptibility testing, the average time from sample collection to preliminary susceptibility reporting was reduced with 43%, from 45 h and 5 min to 25 h and 44 min, providing an earlier adjustment of antimicrobial therapy for 12 patients. Minor logistic adjustments have the potential to save yet another 4 h.
The CopenHeartRFA trial was designed and conducted to explore the effects of rehabilitation on patients treated with ablation for atrial fibrillation (AF). It included a cardiac rehabilitation ...program consisting of physical exercise and psychoeducational consultations over 6 months. As part of the evaluation of the CopenHeartRFA trial, both quantitative and qualitative data were collected. The intervention was delivered by a multidisciplinary team.
This study aimed to understand the experience of patients treated for AF with ablation who participated in the CopenHeartRFA cardiac rehabilitation program.
A qualitative descriptive design was used. A purposive sample of 10 patients who had completed the intervention consented to participate. The interviews were conducted face-to-face and were audio-recorded and transcribed. Qualitative content analyses were used to analyze the data. The interviews were analyzed individually by two researchers and themes were constructed and discussed.
The sample included 10 participants, mean age 54.6 years. Four categories were identified and labeled: 1) strengthening belief in one's own physical capacity and survival; 2) still struggling with fear of AF symptoms; 3) a need for support to move on; and 4) regaining confidence in one's own mental strength with support from professionals.
The four themes describe a positive experience from participating in the rehabilitation program. The rehabilitation program promoted self-efficacy for engaging in physical activity and the benefit of a safe environment for processing the emotional responses and the value of the therapeutic relationship between the patient and the rehabilitation provider.
Demographic changes and the growing elderly population in Scandinavia provide an incentive to study Health Ageing in the Nordic Countries. The chosen Nordic perspective takes into account ...commonalities and differences in socio-economic status, welfare systems, gender, history and culture. It also involves focusing on the health of individuals and populations. The Nordic perspective and the authors’ understanding of health and health promotion provide a backdrop for the essay. The authors are part of the Nordic Health Promotion Network (NHPRN), which is grounded in an ethics of health and well-being. This understanding highlights key values such as participation, justice and equality (freedom from discrimination), autonomy (independence). The authors focus mainly on the importance of participation and on the older person’s sense of security in this paper. We seek answers to what prevents and in which way Healthy Ageing can be promoted in the Northern countries. Concepts such as discrimination, retirement, dementia, nursing home residents’ access to nature and the elements, and the importance of relationships are illuminated.
Scand J Caring Sci; 2010; 24; 108–115
Being involved in an everlasting fight – a life with postnatal faecal incontinence. A qualitative study
The prevalence of women suffering from faecal ...incontinence as a complication to childbirth has been estimated to 0.6–6%. The aim of this study was to elucidate the life situation and the psychosocial processes of women suffering from this injury and to find out how they cope with being in that situation. Nine women were strategically and consecutively selected from a surgery outpatient department at a hospital, to be the participants of this study. Data collection and analysis were made according to the grounded theory approach. In the analysis a core category Being involved in an everlasting fight was identified. Three main categories Fighting to be like others, Fighting against attitudes and Striving for confirmation with six sub categories depict the constant struggle to not only keep up an appearance of a normal, healthy person, but also to feel like one. The women described feelings of shame and marginalization and expressed a strong need of support and confirmation from husbands and private network in order to cope better with their lives. Conclusions and clinical implications: Health care professionals must inform women at risk about the effects of the injury and inform them about treatment in case of future problems in order to prevent physical, psychological and social suffering. They should also, as a routine, question the patients with regard to problems with incontinence of urine, faeces and flatulence.
Nurses play a key role in ensuring that nutritional needs of cancer patients are met and is enabling patients to manage rehabilitation. Most patients with colorectal cancer are malnourished.
The ...objective was to examine how patients' experiences of information, support, and involvement concerning nutrition during hospitalization are associated with rehabilitation. Furthermore, to investigate how patients' experiences of admission- and discharge consultations, as well as having a primary contact person are associated with rehabilitation.
Patients who had undergone surgery according to the ICD-10 codes (International Classification of Diseases) with the diagnostic criteria C18-C21 in Denmark were included.
Two self-administered questionnaires were sent to the patients' home address.
Outcome measures were constructed as reduction in physical, mental and social conditions in order to reveal potentials of improvement in nursing.
The experiences of guidance and practical help, as well as the experiences of having a primary contact person (nurse/physician) and admission — and discharge consultations were related to physical, mental and social rehabilitation. Patients' experiences of care were associated with rehabilitation following colorectal surgery.
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