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Continuity of Care during Care Transition: nurses’ Experiences and Challenges

Open Journal of nursing 2017年第2期7卷 277-293页

作者： Else cathrine Rustad Berit Seiger Cronfalk Bodil Furnes Elin Dysvik Department of Clinical Medicine Helse Fonna Local Health Authority Haugesund Norway Department of Health Studies Faculty of Social Sciences University of Stavanger Stavanger Norway Faculty of Health and Caring Sciences Stord/Haugesund University College Haugesund Norway Palliative Research Center Ersta Sk&#246ndal Br&#228cke University College Stockholm Sweden Department nVS Karolinska Institute Stockholm Sweden

The aim of this study was to gain increased knowledge about nurses’ experiences of care transition of older patients from hospital to municipal health care, based on two research questions: How is nurses’ experience continuity during care transition of older patients from hospital to municipal health care? How would nurses describe an optimal care transition? nurses have a pivotal role during care transitions of older patients. More knowledge about their experiences is necessary to develop favorable improvements for this important period in the older patient’s treatment and care. The study has a qualitative explorative design with follow-up focus group interviews. nurses (n = 30) working in hospital (n = 16) and municipal (n = 14) health care were organized in five mixed focus groups during the period October-January 2014/2015. The focus groups met twice, answering the research questions following a previously circulated semi-structured interview guide. The interview analysis was inspired by content analysis. The analysis resulted in the themes “Administrative demands challenge terms for collaboration” and “Essentials for nursing determine optimal care transitions for older patients”. Administrative demands may prevent nurses’ professional dialogue and collaboration across health care levels. Older patients’ best interests should be ensured through a collaborative relationship between hospital and municipal nurses, to form continuous care across health care levels. Clinical practice should be aware of essentials for nursing, which could influence and facilitate a more individualized and continuous transition for older patients.

关键词： Care Transition Municipal Health Care Hospital Care Continuity of Care Focus Groups

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The effect of sustained, long-term changes in alcohol intake on cardiovascular risk

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Open Journal of Preventive Medicine 2012年第4期2卷 444-451页

作者： Ulla Toft Charlotta Pisinger Mette Aadahl Allan Linneberg cathrine Lau Torben Jorgensen Research Centre for Prevention and Health GlostrupDenmark Steno Diabetes Center GentofteDenmark

Objective: To investigate whether sustained long-term changes in alcohol intake are predictive of cardiovascular risk. Methods: The study population was a subpopulation of the five-year intervention study, Inter99 study, (1999-2006), Copenhagen, Denmark (n = 2117;30 - 60 years). Alcohol intake was assessed by questionnaires at baseline, one-, three- and five-year follow-up. The associations between sustained long-term changes in alcohol intake and cardiovascular risk factors (HDL and non-HDL cholesterol, systolic and diastolic blood pressure (BP);the absolute risk of ischemic heart disease (CRS)) at five-year follow-up were explored by linear regression models. The alcohol variables were tested for linear association with the response variable. Results: Sustained increased alcohol intake was significantly associated with increased CRS (β = 0.0028;P = 0.006) and a decreased HDL cholesterol (β = -0.0028;P = 0.005). Among participants with a moderate overall alcohol in-take at baseline increased alcohol intake was significantly associated with an increased plasma triglyceride (β = 0.0069;P = 0.04). no association with triglyceride was found for participants with a high alcohol intake. Change in wine intake was significantly negatively associated with changes in diastolic BP (β = 0.0015;P = 0.02). Conclusions: Sustained increase in the long-term intake of alcohol was a significant risk factor for an increased CRS, increased triglyceride level and decreased HDL cholesterol. Increased wine intake was associated with decreased diastolic BP.

关键词： Alcohol Consumption Cardiovascular Disease Intervention Studies

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Single semen analysis as a predictor of semen quality： clinical and epidemiological implications

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Asian Journal of Andrology 2009年第6期11卷 723-730页

作者： Lars Rylander Boel Wetterstrand Trine B Haugen Gunilla Malm Johan Malm cathrine Bjorsvik Trine Henrichsen Thomas Saether Aleksander Giwercman Reproductive Medicine Centre Maltao University Hospital Lund University Maltao SE-20502 Sweden Division of Occupational and Environmental Medicine Lund University Lund SE-22185 Sweden Faculty of Health Sciences Oslo University College Oslo NO-O130 Norway Andrology Laboratory Dept of Gynecology and Obstetrics Rikshospitalet University Hospital Oslo N0-0027 Norway Department of Clinical Chemistry Malmo University Hospital Malmo SE-20502 Sweden Department of Molecular Biosciences University of Oslo Oslo N0-0316 Norway

It is generally thought that a single ejaculate is a bad predictor of semen quality of a subject, because of significant intra-individual variation. Therefore, we investigated the degree to which the results of a first semen analysis differ from that of a second analysis among men from a how the two different semen results mirrored the overall general population in norway. In addition, we analysed semen quality assessment. A total of 199 volunteers participated in the study and delivered two semen samples with an interval of 6 months. The semen parameters were determined according to the World Health Organization （WHO） 1999 guidelines, which were also used to determine whether semen quality was normal or abnormal. In addition, the DnA fragmentation index （DFI） was determined using the Sperm Chromatin Structure Assay. The two samples from each individual were very similar with regard to standard semen parameters and DFI （rs： 0.67-0.72）, and there were no significant systematic differences between the two samples. The result of the first sample （normal/abnormal） was highly predictive of the overall conclusion based on the two samples （sperm concentration： in 93% of the cases （95% confidence interval [CI]： 89%-96%）; sperm motility： in 85% of the cases （95% CI： 79%-89%）; overall semen quality： in 85% of the cases （95% CI： 80%-90%）. In epidemiological studies, one ejaculate is a sufficient indicator of semen quality in a group of subjects. In a clinical situation, when the question is whether the semen quality is normal or not, the first ejaculate will, in at least 85% of cases, give a correct overall conclusion.

关键词： DnA fragmentation intra-individual semen quality semen volume sperm concentration sperm motility

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Sampling strategy for estimating human exposure pathways to consumer chemicals

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Emerging Contaminants 2016年第1期2卷 26-36页

作者： Eleni Papadopoulou Juan A.Padilla-Sanchez Chris D.Collins Ian T.Cousins Adrian Covaci Cynthia A.de Wit Pim E.G.Leonards Stefan Voorspoels cathrine thoms.n Stuart Harrad Line S.Haug Division of Environmental Medicine Norwegian Institute of Public HealthLovisenberggata 80456 OsloNorway Soil Research Centre Department of Geography and Environmental ScienceUniversity of ReadingWhiteknightsReading RG66DWUK Department of Environmental Science and Analytical Chemistry(ACES) Stockholm UniversitySE 10691 StockholmSweden Toxicological Center University of AntwerpUniversiteitsplein 12610 WilrijkBelgium Institute for Environmental Studies VU UniversityDe Boelelaan 10871081 HV AmsterdamThe Netherlands Flemish Institute for Technological Research(VITO) Boeretang 2002400 MolBelgium School of Geography Earth and Environmental SciencesUniversity of BirminghamEdgbaston B152TTUK

Human exposure to consumer chemicals has become a worldwide *** this work,a comprehensive sampling strategy is presented,to our knowledge being the first to study all relevant exposure pathways in a single cohort using multiple methods for assessment of exposure from each exposure *** selected groups of chemicals to be studied are consumer chemicals whose production and use are currently in a state of transition and are;per-and polyfluorinated alkyl substances(PFASs),traditional and“emerging”brominated flame retardants(BFRs and EBFRs),organophosphate esters(OPEs)and phthalate esters(PEs).Information about human exposure to these contaminants is needed due to existing data gaps on human exposure intakes from multiple exposure pathways and relationships between internal and external *** environment,food and biological samples were collected from 61 participants and their households in the Oslo area(norway)on two consecutive days,during winter ***,dust,hand wipes,and duplicate diet(food and drink)samples were collected as indicators of external exposure,and blood,urine,blood spots,hair,nails and saliva as indicators of internal exposure.A food diary,food frequency questionnaire(FFQ)and indoor environment questionnaire were also *** 2000 samples were collected in total and participant views on their experiences of this campaign were collected via *** 91%of our participants were positive about future participation in a similar project,some tasks were viewed as *** the food diary and collection of duplicate food/drink portions were the tasksmost frequent reported as“hard”/“very hard”.nevertheless,a strong positive correlation between the reported total mass of food/drinks in the food record and the total weight of the food/drinks in the collection bottles was observed,being an indication of accurate performance of the participants despite the challenges of the sampling campaign.

关键词： Biomonitoring Indoor environment Consumer products Diet Dust non-invasive samples

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人类生命早期暴露组(HELIX)：项目理念与设计(待续)

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环境与职业医学 2015年第1期32卷 90-95页

作者： Martine Vrijheid Rémy Slama Oliver Robinson Leda Chatzi Muireann Coen Peter van den Hazel cathrine thoms.n John Wright Toby J.Athersuch narcis Avellana Xavier Basagana Celine Brochot Luca Bucchini Mariona Bustamante Angel Carracedo Maribel Casas Xavier Estivill Lesley Fairley Diana van Gent Juan R.Gonzalez Berit Granum Regina Grazuleviiene Kristine B.Gutzkow Jordi Julvez Hector C.Keun Manolis Kogevinas Rosemary R.C.McEachan Helle Margrete Meltzer Eduard Sabidó PerE.Schwarze Valérie Siroux Jordi Sunyer Elizabeth J.Want Florence Zeman Mark J.nieuwenhuijsen 何蓉操仪汪源金泰廙 Centre for Research in Environmental Epidemiology(CREAL) Universitat Pompeu Fabra(UPF) CIBER Epidemiología y Salud Pública(CIBERESP) Institut national de la Santé et de la Recherche Médicale(InSERM) Institut Albert Bonniot(U823) University of Crete(UOC) Imperial College London(ICL) Veiligheids-en Gezondheidsregio Gelderland Midden(VGGM) norwegian Institute of Public Health(nIPH) Bradford Institute for Health Research Bradford Teaching Hospitals NHS Foundation Trust(BTHFT) Sensing & Control Systems S.L(.S&C) Institut national de l’Environnement Industriel et des Risques(InERIS) Unit of Models for Ecotoxicology and Toxicology Hylobates Consulting S.R.L(.HYLO) Centre for Genomic Regulation(CRG) IMIM Hospital del Mar Research Insititute Grupo de Medicina Xenomica Fundación Pública Galega de Medicina Xeómica(SERGAS)CIBERERCEGENUniversidade de Santiago de Compostela Center of Excellence in Genomic Medicine Research King Abdulaziz University Vytauto Didziojo Universitetas(VDU)

[背景]人类在生命早期的发育期间可能特别容易受到环境暴露的影响。有关这一主题的人体研究一般集中在单一暴露与健康效应之间的关系。而"暴露组"的概念涵盖了从受孕开始的的全部暴露,完善了基因组。[目的]人类生命早期暴露组(HELIX)项... 详细信息

[背景]人类在生命早期的发育期间可能特别容易受到环境暴露的影响。有关这一主题的人体研究一般集中在单一暴露与健康效应之间的关系。而"暴露组"的概念涵盖了从受孕开始的的全部暴露,完善了基因组。[目的]人类生命早期暴露组(HELIX)项目是一个新的合作研究项目,目的是为了采用新的暴露评估和生物标志分析方法来描述生命早期多种环境因素的暴露,并将这些与生物标志组学和儿童健康结局相关联,从而刻画"生命早期暴露组"。本文描述了该项目的总体设计。[方法]HELIX将利用欧洲现有的6个出生队列研究来估计产前、产后暴露的一系列化学和物理暴露。建立全部队列中总共32 000对母亲和儿童的暴露模型,并在一个包含1 200对母亲和儿童的子队列中测量生物标志。嵌套重复采样的定组研究(n=150)将收集生物标志的变化数据,利用智能手机来评估流动性和体力活动,并监测个体暴露。采用组学技术确定与暴露相关的分子学特征(代谢组、蛋白质组、转录组和表观基因组)。对于多次暴露,采用统计方法估计胎儿和儿童的成长、肥胖、神经发育和呼吸系统结局中的暴露-效应关系。项目还将进行一项健康效应评估测试,以评价组合暴露的风险和收益。[结论]HELIX是描述欧洲人群生命早期暴露组并解开它与组学标志物和儿童健康之间关联的首次尝试之一。作为对暴露组学这一概念的验证,该项目向生命过程中暴露组迈出了重要的第一步。

关键词：人类生命早期暴露设计出生队列研究儿童健康生物标志效应评估生命早期

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人类生命早期暴露组(HELIX)：项目理念与设计(续完)

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环境与职业医学 2015年第2期32卷 186-190页

作者： Martine Vrijheid Rémy Slama Oliver Robinson Leda Chatzi Muireann Coen Peter van den Hazel cathrine thoms.n John Wright Toby J.Athersuch narcis Avellana Xavier Basagana Celine Brochot Luca Bucchini Mariona Bustamante Angel Carracedo Maribel Casas Xavier Estivill Lesley Fairley Diana van Gent Juan R.Gonzalez Berit Granum Regina Grazuleviiene Kristine B.Gutzkow Jordi Julvez Hector C.Keun Manolis Kogevinas Rosemary R.C.McEachan Helle Margrete Meltzer Eduard Sabidó Per E.Schwarze Valérie Siroux Jordi Sunyer Elizabeth J.Want Florence Zeman Mark J.nieuwenhuijsen 何蓉操仪汪源金泰廙 Centre for Research in Environmental Epidemiology(CREAL) Universitat Pompeu Fabra(UPF) CIBER Epidemiologíay Salud Pública(CIBERESP) Institut national de la Santé et de la Recherche Médicale(InSERM) Institut Albert Bonniot(U823) University of Crete(UOC) HeraklionCreteGreece Imperial College London(ICL) Veiligheids-en Gezondheidsregio Gelderland Midden(VGGM) norwegian Institute of Public Health(nIPH) Bradford Institute for Health Research Sensing & Control Systems S.L.(S&C) Institut national de l’Environnement Industriel et des Risques(InERIS) Unit of Models for Ecotoxicology and Toxicology Hylobates Consulting S.R.L.(HYLO) RomeItaly Centre for Genomic Regulation(CRG) IMIM Hospital del Mar Research Insititute Grupo de Medicina Xenomica Fundación Pública Galega de Medicina Xeómica(SERGAS)CIBERERCEGENUniversidade de Santiago de CompostelaSantiago de CompostelaSpain Center of Excellence in Genomic Medicine Research King Abdulaziz UniversityJeddahKingdom of Saudi Arabia Vytauto Didziojo Universitetas(VDU) KaunusLithuania Bradford Institute for Health Research Bradford Teaching Hospitals NHS Foundation Trust(BTHFT)

3．2研究2：室外暴露传统h基于居住区评估的暴露，如室外空气污染、噪声、建筑环境，可以通过收集时间一空间活动以及（就空气污染而言）个人吸入空气量的信息，改善暴露评估和减小测量误差。例如，可替代吸入率（Kawahara等，2011）的... 详细信息

3．2研究2：室外暴露传统h基于居住区评估的暴露，如室外空气污染、噪声、建筑环境，可以通过收集时间一空间活动以及（就空气污染而言）个人吸入空气量的信息，改善暴露评估和减小测量误差。例如，可替代吸入率（Kawahara等，2011）的体力活动方面的信息与个人空气污染测量结合来评估吸入剂量。基于暴露评估的新一代地理信息系统（GIS）（Beelen等，2013;Eeflens等，2012）、遥感（Dadvand等，2012）和智能手机技术（denazelle等，2013）使评估室外暴露和整合个人活动范围及体力活动数据变得更容易。

关键词：早期暴露人类生命地理信息系统设计空气污染测量误差体力活动建筑环境

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