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  • 1.
    Aasa, Agneta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hovbäck, Malin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Det preoperativa informationssamtalets betydelse för patientens delaktighet i sin vård inom kolorektalkirurgi2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: ERAS (Enhanced Recovery After Surgery) är ett standardiserat multimodalt vårdprogram vid elektiv kolorektalkirurgi, som syftar till snabbare återhämtning och kortare vårdtider genom ett tvärprofessionellt samarbete.  En vecka innan planerad operation träffar sjuksköterskan patienten för ett samtal om vårdförloppet.

     

    Syfte: Att identifiera och beskriva patientens upplevelse av sjuksköterskans ERAS- samtal och dess betydelse för patientens delaktighet i sin vård. 

     

    Metod: Datainsamlingen skedde genom kvalitativa intervjuer. Tolv patienter, nio män och tre kvinnor har intervjuats. De ljudinspelade samtalen har transkriberats ordagrant och analyserats med hjälp av tolkande fenomenologisk analys (Interpretative Phenomenological Analysis).

     

    Resultat: Analysarbetet resulterade i fem olika teman; bli sedd, trygghet, tillit, ansvar samt delaktighet. Alla teman relaterar till varandra och illustrerar en positiv och en negativ sida av den upplevda erfarenheten. Tillsammans bildar en helhet av upplevelsen; ERAS- samtalet och dess betydelse för patientens delaktighet.

     

    Konklusion: Resultatet visar att patienterna känner sig sedda under informationssamtalet. Det är viktigt att bekräfta patienten och knyta an mer till informationssamtalet under vårdtiden för att patienterna ska vara delaktiga och ta eget ansvar. Tilliten till vårdpersonalen har betydelse för att patienterna ska känna trygghet. Studien visar att ERAS- samtalet upplevs strukturerat och individuellt men informationen måste följa patienterna under hela vårdtillfället.

  • 2.
    Abbey, Susan E.
    et al.
    University of Toronto, Canada.
    De Luca, Enza
    University Health Network, University of Toronto, Canada.
    Mauthner, Oliver E.
    University Health Network, University of Toronto, Canada.
    McKeever, Patricia
    Bloorview Research Institute, Bloorview Kids Rehab, Canada.
    Shildrick, Margrit
    Queen's University, Belfast, Northern Ireland.
    Poole, Jennifer M.
    Ryerson University, Canada.
    Gewarges, Mena
    University Health Network, University of Toronto, Canada.
    Ross, Heather J.
    University Health Network, University of Toronto, Canada.
    Qualitative interviews versus standardised self-report questionnaires in assessing qualityb of life in heart transplant recipients2011In: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, E-ISSN 1557-3117, Vol. 30, no 8, p. 963-966Article in journal (Refereed)
    Abstract [en]

    Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.06 ± 2.42 years). Self-report questionnaire data reported poor QoL and more distress compared with previous studies and normative population samples; in contrast, 52% of HTRs displayed pervasive distress according to visual methodology. Using qualitative methods to assess QoL yields information that would otherwise remain unobserved by the exclusive use of quantitative QOL questionnaires.

  • 3.
    Abbott, Allan
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia.
    Evidence base and future research directions in the management of low back pain2016In: World Journal of Orthopedics, ISSN 2218-5836, E-ISSN 2218-5836, Vol. 7, no 3, p. 156-161Article in journal (Other academic)
    Abstract [en]

    Low back pain (LBP) is a prevalent and costly condition. Awareness of valid and reliable patient history taking, physical examination and clinical testing is important for diagnostic accuracy. Stratified care which targets treatment to patient subgroups based on key characteristics is reliant upon accurate diagnostics. Models of stratified care that can potentially improve treatment effects include prognostic risk profiling for persistent LBP, likely response to specific treatment based on clinical prediction models or suspected underlying causal mechanisms. The focus of this editorial is to highlight current research status and future directions for LBP diagnostics and stratified care.

  • 4.
    Abbott, Allan
    et al.
    Department of Physical Therapy, Neuro R1:07, Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden; Institute of Health and Sport, Bond University, Queensland, Australia.
    Ghasemi-Kafash, Elaheh
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden.
    Dedering, Åsa
    Department of Physical Therapy, Neuro R1:07, Karolinska University Hospital, Stockholm, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Huddinge, Sweden.
    The validity of using an electrocutaneous device for pain assessment in patients with cervical radiculopathy2014In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 30, no 7, p. 500-506Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the validity and preference for assessing pain magnitude with electrocutaneous testing (ECT) compared to the visual analogue scale (VAS) and Borg CR10 scale in men and women with cervical radiculopathy of varying sensory phenotypes. An additional purpose was to investigate ECT sensory and pain thresholds in men and women with cervical radiculopathy of varying sensory phenotypes. This is a cross-sectional study of 34 patients with cervical radiculopathy. Scatterplots and linear regression were used to investigate bivariate relationships between ECT, VAS and Borg CR10 methods of pain magnitude measurement as well as ECT sensory and pain thresholds. The use of the ECT pain magnitude matching paradigm for patients with cervical radiculopathy with normal sensory phenotype shows good linear association with arm pain VAS (R(2) = 0.39), neck pain VAS (R(2) = 0.38), arm pain Borg CR10 scale (R(2) = 0.50) and neck pain Borg CR10 scale (R(2) = 0.49) suggesting acceptable validity of the procedure. For patients with hypoesthesia and hyperesthesia sensory phenotypes, the ECT pain magnitude matching paradigm does not show adequate linear association with rating scale methods rendering the validity of the procedure as doubtful. ECT for sensory and pain threshold investigation, however, provides a method to objectively assess global sensory function in conjunction with sensory receptor specific bedside examination measures.

  • 5.
    Abbott, Allan
    et al.
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Halvorsen, Marie
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Dedering, Åsa
    Physiotherapist, Department for Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
    Is there a need for cervical collar usage post anterior cervical decompression and fusion?: A randomized control pilot trial2013In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 29, no 4, p. 290-300Article in journal (Refereed)
    Abstract [en]

    Anterior cervical discectomy and fusion (ACDF) is a common surgical intervention for radiculopathy resulting from degenerative cervical spine conditions. Post-surgical cervical collar use is believed to reduce post-operative pain, provide the patient with a sense of security during activities of daily living and even reduce rates of non-fusion. This prospective randomized controlled pilot trial investigates trial design feasibility in relation to prospective physical, functional, and quality of life-related outcomes of patients undergoing ACDF with interbody cage, with (n = 17) and without (n = 16) post-operative cervical collar usage. Results show that the sample provides sufficient statistical power to show that the use of a rigid cervical collar during 6 post-operative weeks is associated with significantly lower levels of neck disability index after 6 weeks and significantly lower levels of prospective neck pain. To investigate causal quality of life or fusion rate outcomes, sample size needs to be increased at least fourfold and optimally sixfold when accounting for data loss in prospective follow-up. The study suggests that post-surgical cervical collar usage may help certain patients cope with initial post-operative pain and disability.

  • 6.
    Abbott, Allan
    et al.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden; Bond University, Australia.
    Kjellman, Görel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Multidimensional assessment of pain related disability after surgery for cervical disc disease2013In: APA Conference 2013: New moves, Australian Physiotherapy Association , 2013, p. 2-2Conference paper (Other academic)
    Abstract [en]

    Questions: Given only 25% of patients, 10 year post-surgery for cervical disc disease report clinically meaningful improvements in functional disability, what are the biopsychosocial factors associated with continued long-term disability? What are the implications for physiotherapy practice?

    Design: Cross-sectional observational study.

    Participants: Ninety patients who had undergone anterior discectomy and fusion (ACDF) surgery 10-13 years prior.

    Outcome Measures: The Neck Disability Index (NDI), ACDF surgery type, surgical fusion status, patient age and Part 1 of the West Haven-Yale multidimensional pain inventory Swedish version (MPI-S) were entered into a statistical model. Part 1 of the MPI-S contains 5 subscales: pain severity, interference, life control, affective distress and support.

    Results: Seventy-three patients answered the questionnaires. Non-linear categorical regression modeling (CATREG) of the selected predictive variables explained 76.1% of the variance in NDI outcomes 10-13 years post ACDF. Of these predictors, MPI-S affective distress subscale (β = 0.635, p = <0.001) and pain severity subscale (β = 0.354, p = <0.001) were significant individual predictors of NDI ratings.

    Conclusion: This is the first study to investigate potential factors associated with prolonged functional disability greater than 10 years post-surgery for cervical disc disease. The results suggest the importance of not only pain severity but also screening affective distress as a potential barrier to physical functioning in patients previously operated for cervical disc disease. Future research on the utility of affect-focused body awareness therapy and pain coping strategies for post-surgical patients with continuing pain and physical disability is indicated.

    Key Practice Points:

    •  The screening of pain severity and affective distress is of importance for patients presenting with continuing physical disability after previous surgery for cervical disc disorders

    •  Affect-focused body awareness therapies and pain coping strategies may be a potential treatment alternative for patients with continuing pain and physical disability.

  • 7.
    Abbott, Allan
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Schröder, Karin
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Enthoven, Paul
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Öberg, Birgitta
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences.
    Effectiveness of implementing a best practice primary healthcare model for low back pain (BetterBack) compared with current routine care in the Swedish context: an internal pilot study informed protocol for an effectiveness-implementation hybrid type 2 trial2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 8, no 4, article id e019906Article in journal (Refereed)
    Abstract [en]

    Introduction Low back pain (LBP) is a major health problem commonly requiring healthcare. In Sweden, there is a call from healthcare practitioners (HCPs) for the development, implementation and evaluation of a best practice primary healthcare model for LBP.

    Aims (1) To improve and understand the mechanisms underlying changes in HCP confidence, attitudes and beliefs for providing best practice coherent primary healthcare for patients with LBP; (2) to improve and understand the mechanisms underlying illness beliefs, self-care enablement, pain, disability and quality of life in patients with LBP; and (3) to evaluate a multifaceted and sustained implementation strategy and the cost-effectiveness of the BetterBack☺ model of care (MOC) for LBP from the perspective of the Swedish primary healthcare context.

    Methods This study is an effectiveness-implementation hybrid type 2 trial testing the hypothesised superiority of the BetterBack☺ MOC compared with current routine care. The trial involves simultaneous testing of MOC effects at the HCP, patient and implementation process levels. This involves a prospective cohort study investigating implementation at the HCP level and a patient-blinded, pragmatic, cluster, randomised controlled trial with longitudinal follow-up at 3, 6 and 12 months post baseline for effectiveness at the patient level. A parallel process and economic analysis from a healthcare sector perspective will also be performed. Patients will be allocated to routine care (control group) or the BetterBack☺ MOC (intervention group) according to a stepped cluster dogleg structure with two assessments in routine care. Experimental conditions will be compared and causal mediation analysis investigated. Qualitative HCP and patient experiences of the BetterBack☺ MOC will also be investigated.

    Dissemination The findings will be published in peer-reviewed journals and presented at national and international conferences. Further national dissemination and implementation in Sweden and associated national quality register data collection are potential future developments of the project.

  • 8.
    Abbott, Allan
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Tynni-Lenne, Raija
    Karolinska Institute, Stockholm, Sweden.
    Hedlund, Rune
    Karolinska Institute, Stockholm, Sweden.
    Early physiotherapeutic rehabilitation following lumbar spinal fusion surgery2009In: Oral Presentations: Cervical Spine: The Surgical Treatment of Painful Disorders, Springer, 2009, Vol. 18, Supplement 4, p. S409-S410Conference paper (Other academic)
    Abstract [en]

    Background: Physiotherapy after lumbar spinal fusion surgery is traditionally focused on physical exercise. Too few studies have investigatedthe efficacy of modern lumbar stabilization exercise regimes. Benefits have been shown for combining traditional physical exercise with a psychosocial intervention. No randomised controlled study has evaluated thecombined biopsychosocial effect of modern lumbar stabilization exercisesand cognitive behavioural intervention compared to traditional physical exercise starting immediately after lumbar spinal fusion.

    Purpose: To investigate the effectiveness of modern physiotherapy(MPT) compared to a traditional physiotherapy (TPT) starting immediately after lumber spinal fusion.

    Study design/setting: Randomized controlled clinical trial.

    Patient sample, inclusion period and follow-up: Patients between 18 and 65 years, selected for lumbar spinal fusion due to at least 12 months of CLBP symptoms caused by spinal stenosis, spondylosis, spondylolisthesis or degenerative disc disease were included in the study between 2005 and 2007. A total of 107 patients were randomly allocated to the MPT group (n = 53) and TPT group (n = 54). The TPT group was prescribed daily home based pain contingent training of traditional physical exercises for back, abdominal and leg muscles. The MPT group was prescribed daily home based training of lumbar stabilization exercises combined with 90 min of cognitive behavioural intervention at 3, 6 and 9 weeks after the operation. The patients outcomes were followed up at 3, 6, 12 months and 2–3 years

    Outcome measures: Oswestry disability index (ODI), pain intensity, HRQOL, kinesiophobia, anxiety/depression, self-efficacy, outcome expectancy, use of coping strategies, work status, sickness leave and health care use.

    Methods: Analysis of mean differences between groups.

    Results: 2–3 year follow-up showed that the MPT group had significantly lower percentage scores in ODI = 18.2 (P = 0.008), kinesiophobia= 30.0 (P = 0.001), catastrophizing = 21.8 (P = 0.006) and higher self-efficacy = 64.6 (P = 0.019) compared to TPT group’s ODI = 28.1, kinesiophobia = 41.9, catastrophizing = 31.3 and self-efficacy = 55.5. The MPT group had significantly more employment, less health care use (P = 0.035) and less long-term sickness leave (P = 0.040).

    Conclusions: This study provides evidence for the benefits of combining lumbar stabilization exercise and cognitive behavioural intervention starting immediately after lumbar fusion.

  • 9.
    Abbott, Allan
    et al.
    Karolinska University Hospital, Stockholm, Sweden.
    Tynni-Lenné, R
    Karolinska University Hospital, Stockholm, Sweden; Karolinska Institute, Stockholm, Sweden.
    Hedlund, R
    Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    The effectiveness of physiotherapeutic rehabilitation and issues of outcome prediction after lumber fusion surgery.2011In: Proceedings of the WCPT Congress, Amsterdam Netherlands. / [ed] Physiotherapy, World Confederation of Physical Therapy , 2011, Vol. 97 (Suppl 1), p. 20-Conference paper (Other academic)
    Abstract [en]

    Purpose: The primary purpose was to analyse the short and long term effectiveness of physiotherapeutic rehabilitation programs performed during the first 3 month after lumbar fusion surgery. A secondary purpose was to analyse factors predicting long-term disability, back pain and health related quality of life (HRQOL) outcomes after lumbar fusion.

    Relevance: The study provides evidence for the effectiveness of early physiotherapy after lumbar fusion. Furthermore improved knowledge of predictive factors can help physiotherapist in the screening of lumbar fusion candidates and the individualised implementation of pre-surgical and post-surgical interventions.

    Participants: A total of 107 patients were recruited from the Karolinska University Hospital's Orthopaedic Clinic, Stockholm, Sweden. The inclusion criteria were: men and women aged between 18 and 65 years with a >12 month history of back pain and/or sciatica; a primary diagnosis of spinal stenosis, degenerative or isthmic spondylolisthesis or degenerative disc disease; selected for lumbar fusion with or without decompression; competence in the Swedish language. The criteria for exclusion were: previous lumbar fusion, rheumatoid arthritis and ankylosing spondylitis.

    Methods: An open book randomised controlled trial with pre-surgical and post-surgical measures at 3, 6, 12 and 24-36 months was performed to investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy focusing on strength and conditioning, applied during the first 3 months after lumbar fusion. Randomisation allocated 53 patients to psychomotor therapy and 54 patients to exercise therapy. The Oswestry disability index (ODI) was the primary outcome measure. Secondary measures included the Visual analogue scale for back pain (VAS), European quality of life questionnaire (EQ5D), as well as other clinical, psychological and work related variables.

    Analysis: A total of 78 patients were needed assuming a power = 80%. Patient compliance was analysed and an intention to treat principle applied to data analysis. For statistical comparison between the 2 independent groups, analysis of covariance was used. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate pre-surgical predictor variables and address predictive model validity.

    Results: Follow-up rates were 93% at 12 months and 81% at 24-36 months after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical lasegue test significantly predicted back pain. The implementation of post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL.

    Conclusions: The study shows that post-operative rehabilitation can be safely implemented during the first 3 months after lumbar fusion and should include measures to modify psychological as well as motor functions. The study also demonstrates the importance of pre-surgical psychological factors, leg pain intensity, the lasegue test and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL related outcomes.

    Implications: Physiotherapist should screen patients pain, psychological factors and neuromusculoskeletal system pre-surgically and rehabilitate patients with early psychomotor therapy after lumbar fusion.

  • 10.
    Abbott, Allan
    et al.
    Karolinska Institute, Stockholm, Sweden.
    Tynni-Lenné, Raija
    Karolinska Institute, Stockholm, Sweden.
    Hedlund, Rune
    Gothenburg University, Gothenburg, Sweden.
    Early rehabilitation targeting cognition, behaviour and motor function after lumbar fusion: A randomised controlled trial2010In: Abstracts: Oral Presentations, 2010, p. 186-186Conference paper (Other academic)
    Abstract [en]

    Study Design: Open label randomised controlled trial with 3, 6, 12 month and 2-3 year follow-up.

    Objective. To investigate the effectiveness of a psychomotor therapy focusing on cognition, behaviour and motor relearning compared to exercise therapy applied during the first 3 months after lumbar fusion.

    Methods: The study recruited 107 patients, aged 18 to 65 years, selected for lumbar fusion due to 12 months of symptomatic spinal stenosis, degenerative/isthmic spondylolisthesis or degenerative disc disease. The exercise therapy group received a home program focusing on pain contingent training of back, abdominal and leg muscle functional strength and endurance, stretching and cardiovascular fitness. The psychomotor therapy group received a home program and 3 outpatient sessions focusing on modifying maladaptive pain cognitions, behaviours and motor control. Patient-rated questionnaires investigating functional disability, pain, health related quality of life, functional self-efficacy, outcome expectancy, fear of movement/(re)injury and copingwere assessed at baseline, 3, 6, 12 months and 2-3 years after surgery.

    Results: Follow-up rates were 93% at 12 months and 81% at 2-3 years after surgery. Psychomotor therapy improved functional disability, self-efficacy, outcome expectancy and fear of movement/(re)injury significantly more than exercise therapy at respective follow-up occasions. Similar results occurred for pain coping but group differences were non-significant at 2-3 year follow-up.

    Conclusions: The study shows that post-operative rehabilitation can be effectively implemented during the first 3 months after lumbar fusion and should include measures to modify psychological aswell as motor functions.

  • 11.
    Abdelrahman, Islam
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt.
    Elmasry, Moustafa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Plastic Surgery Unit, Surgery Department, Suez Canal University, Ismailia, Egypt.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Steinvall, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Validation of the burn intervention score in a National Burn Centre2018In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, no 5, p. 1159-1166Article in journal (Refereed)
    Abstract [en]

    The Linköping burn score has been used for two decades to calculate the cost to the hospital of each burned patient. Our aim was to validate the Burn Score in a dedicated Burn Centre by analysing the associations with burn-specific factors: percentage of total body surface area burned (TBSA%), cause of injury, patients referred from other (non-specialist) centres, and survival, to find out which of these factors resulted in higher scores. Our second aim was to analyse the variation in scores of each category of care (surveillance, respiration, circulation, wound care, mobilisation, laboratory tests, infusions, and operation).

    We made a retrospective analysis of all burned patients admitted during the period 2000–15. Multivariable regression models were used to analyse predictive factors for an increased daily burn score, the cumulative burn score (the sum of the daily burn scores for each patient) and the total burn score (total sum of burn scores for the whole group throughout the study period) in addition to sub-analysis of the different categories of care that make up the burn score.

    We retrieved 22 301 daily recordings for inpatients. Mobilisation and care of the wound accounted for more than half of the total burn score during the study. Increased TBSA% and age over 45 years were associated with increased cumulative (model R2 0.43, p < 0.001) and daily (model R2 0.61, p < 0.001) burn scores. Patients who died had higher daily burn scores, while the cumulative burn score decreased with shorter duration of hospital stay (p < 0.001).

    To our knowledge this is the first long term analysis and validation of a system for scoring burn interventions in patients with burns that explores its association with the factors important for outcome. Calculations of costs are based on the score, and it provides an indicator of the nurses’ workload. It also gives important information about the different dimensions of the care provided from thorough investigation of the scores for each category.

  • 12.
    Abioye, Ajibola I.
    et al.
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Park, Sangshin
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Ripp, Kelsey
    Brown Univ, RI 02912 USA.
    McDonald, Emily A.
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Kurtis, Jonathan D.
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Wu, Hannah
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Pond-Tor, Sunthorn
    Rhode Isl Hosp, RI USA.
    Sharma, Surendra
    Brown Univ, RI 02912 USA; Women and Infants Hosp Rhode Isl, RI 02908 USA.
    Ernerudh, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
    Baltazar, Palmera
    Res Inst Trop Med, Philippines; Remedios Trinidad Romualdez Hosp, Philippines.
    Acosta, Luz P.
    Res Inst Trop Med, Philippines.
    Olveda, Remigio M.
    Res Inst Trop Med, Philippines.
    Tallo, Veronica
    Res Inst Trop Med, Philippines.
    Friedman, Jennifer F.
    Brown Univ, RI 02912 USA; Rhode Isl Hosp, RI USA; Rhode Isl Hosp, RI USA.
    Anemia of Inflammation during Human Pregnancy Does Not Affect Newborn Iron Endowment2018In: Journal of Nutrition, ISSN 0022-3166, E-ISSN 1541-6100, Vol. 148, no 3, p. 427-436Article in journal (Refereed)
    Abstract [en]

    Background: To our knowledge, no studies have addressed whether maternal anemia of inflammation (AI) affects newborn iron status, and few have addressed risk factors for specific etiologies of maternal anemia. Objectives: The study aims were to evaluate 1) the contribution of AI and iron deficiency anemia (IDA) to newborn iron endowment, 2) hepcidin as a biomarker to distinguish AI from IDA among pregnant women, and 3) risk factors for specific etiologies of maternal anemia. Methods: We measured hematologic biomarkers in maternal blood at 12 and 32 wk of gestation and in cord blood from a randomized trial of praziquantel in 358 pregnant women with Schistosoma japonicum in The Philippines. IDA was defined as anemia with serum ferritin amp;lt; 30 ng/mL and non-IDA (NIDA), largely due to AI, as anemia with ferritin amp;gt;= 30 ng/mL. We identified cutoffs for biomarkers to distinguish IDA from NIDA by using area under the curve (AUC) analyses and examined the impact of different causes of anemia on newborn iron status (primary outcome) by using multivariate regression modeling. Results: Of the 358 mothers, 38% (n = 136) had IDA and 9% (n = 32) had NIDA at 32 wk of gestation. At 32 wk of gestation, serum hepcidin performed better than soluble transferrin receptor (sTfR) in identifying women with NIDA compared with the rest of the cohort (AUCs: 0.75 and 0.70, respectively) and in identifying women with NIDA among women with anemia (0.73 and 0.72, respectively). The cutoff that optimally distinguished women with NIDA from women with IDA in our cohort was 6.1 mu g/L. Maternal IDA, but not NIDA, was associated with significantly lower newborn ferritin (114.4 ng/mL compared with 148.4 mu g/L; P = 0.042). Conclusions: Hepcidin performed better than sTfR in identifying pregnant women with NIDA, but its cost may limit its use. Maternal IDA, but not NIDA, is associated with decreased newborn iron stores, emphasizing the need to identify this cause and provide iron therapy.

  • 13.
    Abong'o, Deborah
    et al.
    University of Nairobi, Kenya.
    Wandiga, Shem
    University of Nairobi, Kenya.
    Jumba, Isaac
    University of Nairobi, Kenya.
    Madadi, Vincent
    University of Nairobi, Kenya.
    Kylin, Henrik
    Linköping University, The Tema Institute, Department of Water and Environmental Studies. Linköping University, Faculty of Arts and Sciences.
    Impacts of pesticides on human health and environment in the River Nyando catchment, Kenya2014In: International Journal of Humanities, Arts, Medicine and Sciences, ISSN 2348-0521, Vol. 2, no 3, p. 1-14Article in journal (Other academic)
    Abstract [en]

    The population of the River Nyando catchment largely relies on rain fed agriculture for their subsistence.

    Important crops grown include cereals, cash crops fruits and vegetables. Farming is one of the contributors of pollution to Lake Victoria. Organophosphates and other banned organochlorine pesticides such as lindane, aldrin and dieldrin were used by farmers. The pesticides transport was by storm water run-off and air drift into the lake. Environmental risk assessment background information was collected through questionnaire and interviews of farmers to determine knowledge and safe use of pesticides. Fourteen pesticides were identified as commonly used of which four are toxic to bees and five to birds. The farmers identified declines in the number of pollinating insects, the disappearance of Red-billed Oxpecker (Buphagus erythrorthynchus) and wild bird’s fatalities. The general knowledge among farmers about chemicals risks, safety, and chronic illnesses was low. Activities that increases environmental awareness and safety of pesticides should be initiated by the agrochemical firms and government.

  • 14.
    Adini, B.
    et al.
    Tel Aviv University, Israel.
    Bodas, M.
    Tel Aviv University, Israel.
    Nilsson, Heléne
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Disaster Medicine and Traumatology.
    Peleg, K.
    Tel Aviv University, Israel; Gertner Institute Health Policy and Epidemiol, Israel.
    Policies for managing emergency medical services in mass casualty incidents2017In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 48, no 9, p. 1878-1883Article in journal (Refereed)
    Abstract [en]

    Introduction: Diverse decision-making is needed in managing mass casualty incidents (MCIs), by emergency medical services (EMS). The aim of the study was to review consensus among international experts concerning policies of EMS management during MCIs. Methods: Applicability of 21 EMS policies was tested through a 2-cycle modified e-Delphi process, in which 38 multi-disciplinary experts from 10 countries participated. Threshold for approving proposed solutions was defined as consensus of amp;gt;80%. Policies that did not achieve the targeted consensus were reviewed to detect variability according to respondents origin country. Results: 16 policies were endorsed in the first cycle including collaboration between ambulance service providers; implementing a unified mode of operation; preparing criteria for ground versus aerial evacuation; and, developing support systems for caregivers exposed to violence. An additional policy which proposed that senior EMS officers should not necessarily act as on-site MCI commanders was endorsed in the second cycle. Demographic breakdown of views concerning non-consensual policies revealed differences according to countries of origin. Assigning ambulances to off-duty team members was highly endorsed by experts from Israel and South Africa and strongly rejected by European respondents. Avoiding entry to risk areas until declared safe was endorsed by European, Asian and Oceanic experts, but rejected by Israeli, South African and North American experts. Conclusions: Despite uniqueness of countries and EMS agencies, solutions to most dilemmas were applicable to all organizations, regardless of location or affiliation. Cultural diversity was found concerning readiness to implement military-civilian collaboration in MCIs and a rigid separation between work-leisure responsibilities. (C) 2017 Elsevier Ltd. All rights reserved.

  • 15.
    Aerts, Marc
    et al.
    Interuniversity Institute for Biostatistics and Statistical Bioinformatics.
    Minalu, Girma
    Interuniversity Institute for Biostatistics and Statistical Bioinformatics.
    Bösner, Stefan
    Department of General Practice and Family Medicine, Philipps University Marburg, Germany..
    Buntinx, Frank
    Department of Public Health and Primary Care, KU Leuven, Belgium; Department of General Practice, Maastricht University, The Netherlands..
    Burnand, Bernard
    Institute of Social and Preventive Medicine, Lausanne University Hospital, Switzerland..
    Haasenritter, Jörg
    Department of General Practice and Family Medicine, Philipps University Marburg, Germany..
    Herzig, Lilli
    Institute of Family Medicine, University of Lausanne, Switzerland..
    Knottnerus, J André
    Department of General Practice, Maastricht University, The Netherlands..
    Nilsson, Staffan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Vikbolandet.
    Renier, Walter
    Department of Public Health and Primary Care, KU Leuven, Belgium.
    Sox, Carol
    Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, USA..
    Sox, Harold
    Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH , USA; Patient-Centered Outcomes Research Institute, Washington, USA..
    Donner-Banzhoff, Norbert
    Department of General Practice and Family Medicine, Philipps University Marburg, Germany..
    Pooled individual patient data from five countries were used to derive a clinical prediction rule for coronary artery disease in primary care.2017In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 81, p. 120-128Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To construct a clinical prediction rule for coronary artery disease (CAD) presenting with chest pain in primary care.

    STUDY DESIGN AND SETTING: Meta-Analysis using 3,099 patients from five studies. To identify candidate predictors, we used random forest trees, multiple imputation of missing values, and logistic regression within individual studies. To generate a prediction rule on the pooled data, we applied a regression model that took account of the differing standard data sets collected by the five studies.

    RESULTS: The most parsimonious rule included six equally weighted predictors: age ≥55 (males) or ≥65 (females) (+1); attending physician suspected a serious diagnosis (+1); history of CAD (+1); pain brought on by exertion (+1); pain feels like "pressure" (+1); pain reproducible by palpation (-1). CAD was considered absent if the prediction score is <2. The area under the ROC curve was 0.84. We applied this rule to a study setting with a CAD prevalence of 13.2% using a prediction score cutoff of <2 (i.e., -1, 0, or +1). When the score was <2, the probability of CAD was 2.1% (95% CI: 1.1-3.9%); when the score was ≥ 2, it was 43.0% (95% CI: 35.8-50.4%).

    CONCLUSIONS: Clinical prediction rules are a key strategy for individualizing care. Large data sets based on electronic health records from diverse sites create opportunities for improving their internal and external validity. Our patient-level meta-analysis from five primary care sites should improve external validity. Our strategy for addressing site-to-site systematic variation in missing data should improve internal validity. Using principles derived from decision theory, we also discuss the problem of setting the cutoff prediction score for taking action.

  • 16.
    Af Sandeberg, Margareta
    et al.
    Department of Women's and Children's Health, Karolinska Institutet, Children's and Women's Health, Karolinska University Hospital.
    Wenemark, Marika
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Bartholdson, Cecilia
    Department of Women's and Children's Health, Karolinska Institutet, Children's and Women's Health, Karolinska University Hospital.
    Lützén, Kim
    Department of Women's and Children's Health, Karolinska Institutet.
    Pergert, Pernilla
    Department of Women's and Children's Health, Karolinska Institutet, Children's and Women's Health, Karolinska University Hospital.
    To change or not to change - translating and culturally adapting the paediatric version of the Moral Distress Scale-Revised (MDS-R)2017In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 18, no 14, p. 1-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised (MDS-R) is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were to translate and culturally adapt the questionnaire to the context of Swedish paediatric cancer care. In doing so we endeavoured to keep the content in the Swedish version as equivalent to the original as possible but to introduce modifications that improve the functional level and increase respondent satisfaction.

    METHODS: The procedure included linguistic translation and cultural adaptation of MDS-R's paediatric versions for Physicians, Nurses and Other Healthcare Providers to the context of Swedish paediatric cancer care. The process of adjustment included: preparation, translation procedure and respondent validation. The latter included focus group and cognitive interviews with healthcare professionals in paediatric cancer care.

    RESULTS: To achieve a Swedish version with a good functional level and high trustworthiness, some adjustments were made concerning design, language, cultural matters and content. Cognitive interviews revealed problems with stating the level of disturbance hypothetically and items with negations caused even more problems, after having stated that the situation never happens.

    CONCLUSIONS: Translation and cultural adaptation require the involvement of various types of specialist. It is difficult to combine the intention to keep the content as equivalent to the original as possible with the need for modifications that improve the functional level and increase respondent satisfaction. The translated and culturally adapted Swedish MDS-R seems to have equivalent content as well as improved functional level and respondent satisfaction. The adjustments were made to fit paediatric cancer care but it could be argued that the changes are relevant for most areas of paediatric care of seriously ill patients.

  • 17.
    Agnew, Louise
    et al.
    University of Queensland, Australia.
    Johnston, Venerina
    University of Queensland, Australia.
    Landén Ludvigsson, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Rehabilitation in Motala.
    Peterson, Gunnel
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Uppsala University, Sweden.
    Overmeer, Thomas
    Malardalen University, Sweden; University of Örebro, Sweden.
    Johansson, Gun
    Karolinska Institute, Sweden.
    Peolsson, Anneli
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. University of Queensland, Australia.
    FACTORS ASSOCIATED WITH WORK ABILITY IN PATIENTS WITH CHRONIC WHIPLASH-ASSOCIATED DISORDER GRADE II-III: A CROSS-SECTIONAL ANALYSIS2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 6, p. 546-551Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Design: Cross-sectional analysis. Patients: A total of 166 working age patients with chronic whiplash-associated disorder. Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R-2 = 0.65, p less than 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress. Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder.

  • 18.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, SE-55185, Jönköping, Sweden..
    Engvall, Jan
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Maret, Eva
    Department of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, SE-14186, Stockholm, Sweden..
    Ericsson, Elisabeth
    Faculty of Medicine and Health, School of Health Science, Örebro University, SE-701 82, Örebro, Sweden..
    Positive effect on patient experience of video-information given prior to cardiovascular magnetic resonance imaging, a clinical trial.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1250-1261Article in journal (Refereed)
    Abstract [en]

    Aims: To evaluate the effect of video information given before cardiovascular magnetic resonance imaging on patient anxiety and to compare patient experiences of cardiovascular magnetic resonance imaging versus myocardial perfusion scintigraphy. To evaluate if additional information has an impact on motion artefacts.less thanbr /greater thanBackground: Cardiovascular magnetic resonance imaging and myocardial perfusion scintigraphy are technically advanced methods for the evaluation of heart diseases. Although cardiovascular magnetic resonance imaging is considered to be painless, patients may experience anxiety due to the closed environment.less thanbr /greater thanDesign: A prospective randomized intervention study, not registered.less thanbr /greater thanMethods: The sample (n=148) consisted of 97 patients referred for cardiovascular magnetic resonance imaging, randomized to receive either video information in addition to standard text-information (CMR-video/n=49) or standard text-information alone (CMR-standard/n=48). A third group undergoing myocardial perfusion scintigraphy (n=51) was compared with the cardiovascular magnetic resonance imaging-standard group. Anxiety was evaluated before, immediately after the procedure and one week later. Five questionnaires were used: Cardiac Anxiety Questionnaire, State-Trait-Anxiety Inventory, Hospital-Anxiety and Depression-scale, MRI-Fear-Survey-Schedule and the MRI-Anxiety-Questionnaire. Motion artefacts were evaluated by three observers, blinded to the information given. Data were collected between April 2015 and April 2016. The study followed the CONSORT guidelines RESULT: The CMR-video group scored lower (better) than the cardiovascular magnetic resonance imaging-standard group in the factor Relaxation (p=0.039) but not in the factor Anxiety. Anxiety levels were lower during scintigraphic examinations compared to the CMR-standard group (pless than0.001). No difference was found regarding motion artefacts between CMR-video and CMR-standard.less thanbr /greater thanConclusion: Patient ability to relax during cardiovascular magnetic resonance imaging increased by adding video information prior the exam, which is important in relation to perceived quality in nursing. No effect was seen on motion artefacts.less thanbr /greater thanRelevance To Clinical Practice: Video information prior to examinations can be an easy and time effective method to help patients cooperate in imaging procedures.

    The full text will be freely available from 2018-11-17 10:44
  • 19.
    Ahlberg, Mona
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Bäckman, Carl
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Jones, Christina
    Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
    Walther, Sten
    Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center.
    Moving on in life after intensive care - partners' experience of group communication2015In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 5, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background:Partners have a burdensome time during and after their partners’ intensive care period. They may appear to be coping welloutwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited.

    Aim:The aim of this study was to describe the experience of participating in group communication with other partners of former intensivecare patients.

    Design:The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive careunit (ICU) patients was evaluated.

    Methods:A strategic selection was made of adult partners to former adult intensive care patients (n=15), 5 men and 10 women, aged37–89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote,in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six ofthe partners were interviewed. Content analysis was used to analyse the notebooks and the interviews.

    Findings:Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2)Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participatein group communication.

    Conclusion:Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategiesto ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is oneway for partners to be able to move forward in life.

    Relevance to clinical practice:Group communication with other patients’ partners eases the process of going through the burden ofbeing a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus andevidence for the best practice.

  • 20.
    Ahldén, Ingegerd
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Dahlgren, Lars Owe
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Parents' Expectations About Participating in Antenatal Parenthood Education Classes2012In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    Our objective was to assess parents' expectations about participating in antenatal parenthood education classes and to determine whether their expectations might be related to gender, age, and educational level. Data from 1,117 women and 1,019 partners residing in three cities in Sweden were collected with a questionnaire in a cross-sectional study. Participants believed that antenatal education classes would help them to feel more secure as parents and to be better oriented toward childbirth. Men had more positive expectations about the childbirth than the women. The participants mostly wanted help in preparing for parenthood and in learning infant care skills, followed by help in preparing for childbirth. The participants' expectations were affected by gender, age, and educational level. The expectant parents appeared to want more focus on preparation for parenthood than on childbirth.

  • 21.
    Ahldén, Maria KC
    et al.
    Oslo University, Norway.
    Helén, Rönning
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Jönköping University.
    Agren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure2014In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 2, no 2, p. 74-83Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.

    Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.

    Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.

    Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.

    Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.

  • 22.
    Ahlgren, Thorbjörn
    et al.
    Luppen kunskapscentrum.
    Näslund, Johan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Kartläggning av barn i behov av stöd år 2002: Eksjö kommun2003Report (Other academic)
    Abstract [sv]

    Följande rapport bygger på enkätsvar från olika myndigheter i Eksjö kommun som har rapporterat de barn/ungdomar i åldern 0-18 år som man i sin verksamhet kommer i kontakt med och som man känner oro för, p.g.a. en ogynnsam utveckling. Tjugo förutbestämda kriterier användes för att beskriva orsaken till myndighetens oro. Myndigheterna har också rapporterat om de insatser som görs redan idag samt om man bedömer att det kan bli aktuellt med ytterligare insatser nu eller i framtiden.

    Totalt inrapporterades 842 barn och ungdomar. Socialförvaltningen rapporterade 78 barn och ungdomar, Barnavårdscentralen 30 barn och skolan 689 barn och ungdomar. Av 45 enkätsvar framgår det inte vem som är rapportör. Vid bearbetningen av insamlat material har 10 enkätsvar uteslutits eftersom de inte var tillräckligt ifyllda. 103 enkätsvar uteslöt för att de flerrapporterade barn och/eller ungdomar och 17 enkätsvar uteslöts eftersom de rapporterade ungdomar som inte är skrivna i Eksjö kommun. Slutligen kom 712 barn och ungdomar att ingå i kartläggningen. Detta är drygt 18,8 % av alla aktuella barn och ungdomar. Av dessa är en klar majoritet pojkar (446 dvs. 62,6 %). För hela målgruppen främst tre huvudorsaker som ger anledning till oro hos berörda myndigheter. Det är;

    1. Föräldrarna brister i omsorgen, i stödet till den unge eller möjligheten att ge stimulans pågrund av sociala, mentala, fysiska eller psykiska handikapp och/eller missbruksproblem. För130 (av 712) barn och ungdomar anser man att det är huvudorsaken till oro.
    2. Barn/ungdomar som är introverta (tysta, blyga, nedstämda, mutister). För 69 av (712) barnoch ungdomar är det huvudorsaken till att man känner oro.
    3. Föräldrars separation eller ständiga konflikter påverkar den unge negativt. För 66 av (712)barn och ungdomar är det huvudorsaken till att man känner oro.

    Resultatredovisningen visar att skolan är den myndighet vars insatser dominerande är det också så att olika insatser inom skolan dominerar. Vanligast är undervisning i liten grupp och olika typer av specialundervisning. Olika typer av anpassad studiegång är också en vanlig insats att möta barn och ungdomar med olika svårigheter. Även olika psykosociala åtgärder förekommer också t.ex. stödsamtal med skolsköterska eller kurator. Vanligast av socialförvaltningens insatser är kontaktperson/familj.

    Berörda myndigheter uppmanas också att föreslå olika typer av nya insatser för de rapporterade barnen och ungdomarna. Även här dominerar olika typer av skolinriktade insatser. Vanliga förslag är undervisning i liten grupp och/eller olika typer av specialundervisning. När socialförvaltningen anses vara ansvarig myndigheter för önskade insatser föreslår rapporterande myndigheter allt från olika typer av familjestöd till direkta förslag till omhändertagande och placering på behandlingshem.

  • 23.
    Ahlstrand, Inger
    et al.
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Björk, Mathilda
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Thyberg, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences.
    Börsbo, Björn
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Falkmer, Torbjörn
    Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering.
    Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv2011Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.

  • 24.
    Ahlstrom, Gerd
    et al.
    Lund Univ, Sweden.
    Nilsen, Per
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Benzein, Eva
    Linnaeus Univ, Sweden.
    Behm, Lina
    Lund Univ, Sweden.
    Wallerstedt, Birgitta
    Linnaeus Univ, Sweden.
    Persson, Magnus
    Lund Univ, Sweden.
    Sandgren, Anna
    Linnaeus Univ, Sweden.
    Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design: a study protocol2018In: BMC Palliative Care, ISSN 1472-684X, E-ISSN 1472-684X, Vol. 17, article id 52Article in journal (Refereed)
    Abstract [en]

    Background: The demography of the world is changing as the population is ageing. Because of this change to a higher proportion of older people, the WHO has called for improved palliative care for older persons. A large number of all deaths in the industrialised world occur while older people are living in nursing homes and therefore a key question becomes how the principles of palliative care can be implemented in that context. The aims of this study are: a) to describe a model of an educational intervention with the goal of implementing knowledge-based palliative care in nursing homes, and b) to describe the design of the evaluation of the effectiveness regarding the implementation of knowledge-based palliative care. Methods/design: A complex intervention is evaluated by means of a cross-over design. An educational intervention concerning palliative care consisting of five seminars during 6 months for staff and managers has been developed and conducted in 20 nursing homes in two counties. Before the intervention started, the feasibility was tested in a pilot study conducted in nursing homes not included in the main study. The intervention is evaluated through a non-randomized experimental design with intervention and control groups and pre- and post-assessments. The evaluation includes older persons living in nursing homes, next-of-kin, staff and managers. Data collection consists of quantitative methods such as questionnaires and register data and qualitative methods in the form of individual interviews, focus-group interviews and participant observations. Discussion: The research will contribute to new knowledge about how to implement knowledge-based palliative care in a nursing home setting. A strength of this project is that the Medical Research Council framework of complex intervention is applied. The four recommended stages, Development, Feasibility and piloting, Evaluation and Implementation, are combined for the educational intervention, which functions as a strategy to achieve knowledge-based palliative care in the nursing homes. Implementation is always a question of change and a good theoretical understanding is needed for drawing valid conclusions about the causal mechanisms of change. The topic is highly relevant considering the worlds ageing population. The data collection is completed and the analysis is ongoing.

  • 25.
    Ahlvin, Anna
    et al.
    Linköping University. Region Östergötland, Public Dental Health Care.
    Warnberg Gerdin, Elisabeth
    Regional Örebro County, Sweden.
    Bågesund, Mats
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Public Dental Health Care.
    Ordell, Sven
    Region Östergötland, Public Dental Health Care.
    Self-perceived oral health among 19-year-olds in a Swedish County - A comparative study between 2004 and 20112016In: Swedish Dental Journal, ISSN 0347-9994, Vol. 40, no 1, p. 53-65Article in journal (Refereed)
    Abstract [en]

    For decades, Swedish dental professionals have collected clinical epidemiological data from the dental records. To supplement the epidemiology, Ostergotland County Council decided to examine patient perceptions of oral health: self-rated knowledge, self-perceived oral health, and opinions about oral health. The aim was to compare self-perceived oral health among 19-year-olds to determine differences between genders, various municipalities and between 2004 and 2011. This study analysed the responses from two cross-sectional surveys of the entire population of 19-year-olds in Ostergotland County, Sweden, performed in 2004 and 2011. Of the 2,413 (53 %) (50 % men, 50 % women) 19-year-olds who responded to the questionnaire in 2004 and the 3,803 (67 %) (50 % men, 50 % women) in 2011, most 19-year-olds (88.1 % [2004] and 87.5 % [am]) reported satisfaction with their oral health. Around half of the respondents rated their knowledge on periodontitis as low. Boys rated their knowledge about avoiding periodontitis higher than girls (p&lt;0.05 in 2004 and p&lt;0.001 in 2011). In 2004, 84.7 % reported shooting pain. In 2011 that figure was 83.7 %. The respondents expressed some uncertainty about the benefits of fluoride toothpaste (7.5 % in 2004 and 9.3 % in 2011), especially the boys (10.3 % in 2004 and 10.5 % in 2011). Girls reported both a higher social impact and greater concern about aesthetics related to their oral health. They also reported headache (27.5 %) nearly twice as often as boys (14.2 %) (p&gt;0.001). Responses between the municipalities did not differ, with the exception of items regarding periodontitis. Thus, this study found indications that perceptions of oral health and knowledge in Ostergotland County complied with Swedish Dental Act. The study also found patient perceptions of oral health among 19-year-olds to be good.

  • 26.
    Aho, Anna Carin
    et al.
    Linnaeus University, Sweden.
    Hultsjö, Sally
    Psychiat Clin, Sweden; Jönköping University, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Experiences of being parents of young adults living with recessive limb-girdle muscular dystrophy from a salutogenic perspective2017In: Neuromuscular Disorders, ISSN 0960-8966, E-ISSN 1873-2364, Vol. 27, no 6, p. 585-595Article in journal (Refereed)
    Abstract [en]

    Recessive limb-girdle muscular dystrophies (LGMD2) involve progressive muscle weakness. Parental support is important for young adults living with LGMD2, but no study has been identified focusing on the parents experiences. The salutogenic perspective concentrates on how daily life is comprehended, managed and found meaningful, i.e. the persons sense of coherence. The aim of this study was to describe, from a salutogenic perspective, experiences of being parents of young adults living with LGMD2. Nineteen participants were included. Data were collected by semi-structured interviews and the self-administrated 13-item sense of coherence questionnaire. Interview data were analysed with content analysis and related to self-rated sense of coherence. The result shows experiences of being influenced, not only by thoughts and emotions connected to the disease but also by caregiving duties and the young adults well-being. Simultaneously, difficulty in fully grasping the disease was expressed and uncertainty about progression created worries about future management. Trying their best to support their young adults to experience well-being and to live fulfilled lives, the importance of having a social network, support from concerned professionals and eventually access to personal assistance was emphasized. The need to have meaningful pursuits of ones own was also described. The median sense of coherence score was 68 (range 53-86). Those who scored high (amp;gt;= 68) described satisfaction with social network, external support provided, work and leisure activities to a greater extent than those who scored low (amp;lt;68). The result shows that the young adults disease has a major impact on the parents lives. Assessment of how the parents comprehend, manage and find meaning in everyday life may highlight support needed to promote their health. (C) 2017 Elsevier B.V. All rights reserved.

  • 27.
    Aho, Anna Carin
    et al.
    Linnaeus Univ, Dept Hlth & Caring Sci, Vaxjo, Sweden.
    Hultsjö, Sally
    Cty Hosp, Psychiat Clin, Jonkoping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 22, p. 2083-2091Article in journal (Refereed)
    Abstract [en]

    To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. Methods: A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Result: Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. Conclusion: In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Implications for Rehabilitation Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

  • 28.
    Aho, Anna-Carin
    et al.
    Linnéuniversitetet, Växjö, Sweden.
    Hultsjö, Sally
    Ryhovs sjukhus, Landstinget i Jönköping, Sweden.
    Hjelm, Katarina
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Health perceptions of young adults living with recessive limb-girdle muscular dystrophy2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1915-1925Article in journal (Refereed)
    Abstract [en]

    AIM:

    The aim of this study was to describe health perceptions related to sense of coherence among young adults living with recessive limb-girdle muscular dystrophy.

    BACKGROUND:

    Limb-girdle muscular dystrophy refers to a group of progressive muscular disorders that may manifest in physical disability. The focus in health care is to optimize health, which requires knowledge about the content of health as described by the individual.

    DESIGN:

    A descriptive study design with qualitative and quantitative data were used.

    METHOD:

    Interviews were conducted between June 2012-November 2013 with 14 participants aged 20-30 years. The participants also answered the 13-item sense of coherence questionnaire. Qualitative data were analysed with content analysis and related to self-rated sense of coherence.

    FINDINGS:

    Health was viewed as intertwined physical and mental well-being. As the disease progressed, well-being was perceived to be influenced not only by physical impairment and mental strain caused by the disease but also by external factors, such as accessibility to support and attitudes in society. Factors perceived to promote health were having a balanced lifestyle, social relations and meaningful daily activities. Self-rated sense of coherence varied. The median score was 56 (range 37-77). Those who scored ≥56 described to a greater extent satisfaction regarding support received, daily pursuits and social life compared with those who scored <56.

    CONCLUSION:

    Care should be person-centred. Caregivers, with their knowledge, should strive to assess how the person comprehends, manages and finds meaning in daily life. Through dialogue, not only physical, psychological and social needs but also health-promoting solutions can be highlighted.

  • 29.
    Aho, Nikolas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Victimization, Prevalence, Health and Peritraumatic Reactions in Swedish Adolescents2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to expand the knowledge of victimization in children and youth in Sweden. Victimization, prevalence, health and peritraumatic reactions were explored in a cross sectional, representative sample of 5,960 second grade high school students in Sweden. A computerized survey was developed and administered in class room setting.

    Lifetime victimization was found in 84.1% of the sample (m=83.0%, f=85.2%), and, in relation to the five domains, 66.4% had experienced conventional crime, 24% child maltreatment, 54.4% peer and sibling victimization, 21.8% sexual victimization, and 54% had experienced witness victimization. Females experienced significantly more child maltreatment, peer and sibling victimization, sexual victimization, and witnessed victimization, males more conventional crime (p<0.001). Using logistic regression risk factors for victimization were confirmed by a significant increase OR regarding gender, environment and lack of both parents.

    Symptoms (TSCC), were clearly associated with both victimizations per se and the number of victimizations. The results indicated a relatively linear increase in symptoms with an increase in number of events experienced. Mental health of the polyvictimized group was significantly worse than that of the non-polyvictimized group, with significantly elevated TSCC scores (t<0.001). Hierarchical regression analysis resulted in beta value reduction when polyvictimization was introduced supporting the independent effect on symptoms. Social anxiety was found in 10.2 % (n = 605) of the total group (n = 5,960). A significant gender difference emerged, with more females than males reporting social anxiety. Elevated PTSS was found in 14.8 % (n=883). Binary logistic regression revealed the highest OR for having had contact with child and adolescent psychiatry was found for the combined group with social anxiety and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73, p<001). Significant associations were also found between use of child and adolescent psychiatry and female gender (OR = 2.05, 95 % CI = 1.70–2.45), Swedish birth origin (OR = 1.68, 95 % CI = 1.16–2.42) and living in a small municipality (OR = 1.33, 95 % CI = 1.02–1.73).

    Mediation models used peritraumatic reactions (PT): total, physiological arousal (PA), peritraumatic dissociation (PD), and intervention thoughts (IT) and JVQ and TSCC. Of the n=5,332 cases, a total of n=4,483 (84.1%) reported at least one victimizing event (m = 83.0%, f = 85.2%). Of these, 74.9% (n=3,360) also experienced a PT reaction of some kind. The effect mediated by PT tot was b= 0.479, BCa CI [0.342 – 0.640], representing a relatively small effect of 7.6%, κ2=0.076, 95% BCa CI [0.054- 0.101]. The mediating effect of JVQ on TSCC was mediated by PD more for males (b=0.394 BCa CI [0.170-0.636]) than for females (b=0.247, BCa CI [0.021-0.469]). The indirect effect of the JVQ on the TSCC tot mediated by the different PT reactions was significant for PD (b=0.355, BCa CI [0.199- 0.523]. In males a mediating effect of PD could be seen in the different models, while females had a more mixed result. IT did not show any indirect effect in males, but had a mixed effect for females.

    The empirical findings in this thesis lead to the conclusion that victimization is highly prevalent in children and youth and is related to health issues. The association of victimization on symptoms was mediated by peritraumatic reactions. Using a comprehensive instrument such as the JVQ provides the researcher or clinician the opportunity to acquire more complete measurement and also makes it possible to identify polyvictimization, a high-level category of events with severe impact on health.  

    List of papers
    1. The Prevalence of Potentially Victimizing Events, Poly-Victimization, and Its Association to Sociodemographic Factors: A Swedish Youth Survey
    Open this publication in new window or tab >>The Prevalence of Potentially Victimizing Events, Poly-Victimization, and Its Association to Sociodemographic Factors: A Swedish Youth Survey
    2016 (English)In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 31, no 4, p. 620-651Article in journal (Refereed) Published
    Abstract [en]

    Studying the extent to which children are exposed to victimizing events is important to fully understand the effect of such exposure in shaping them as adults. The aim of this study was to use self-report by adolescents to measure the prevalence of victimizing events and of poly-victimization. A representative sample of 5,960 students (aged 17) from high schools in Sweden was given the self-administrated version of the Juvenile Victimization Questionnaire (JVQ) along with questions concerning gender, birthplace, parents birthplace and employment, residence, educational program, and municipality size. The results show that 84.1% (83.0% young men and 85.2% young women) of the students had experienced victimization during their lifetime, and 10.3% were categorized as poly-victims (8.1% young men and 12.5% young women; OR = 1.62, 95% confidence interval [CI] = [1.35, 1.94]). Adolescents living with both parents were at lower risk of any form of victimization for both genders, while females were at higher risk of maltreatment, peer victimization, and, most significantly, sexual victimization. In conclusion, the vast majority of young people have been victimized during their lifetime. A greater awareness of the impact of these victimizing events on children and adolescents is important as a basis for providing a safer milieu and establishing better interventions, especially for those that have been victimized on multiple occasions. The high-exposure group was determined by using 10 events as a cutoff. Findings on this group corresponded with findings in other international studies regarding distribution, elevated risk for females, and the possibility of limiting the effects of victimization by modifying living conditions.

    Place, publisher, year, edition, pages
    SAGE PUBLICATIONS INC, 2016
    Keywords
    JVQ; victim; youth; poly-victimization; sociodemographics
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:liu:diva-124456 (URN)10.1177/0886260514556105 (DOI)000367838200004 ()25392393 (PubMedID)
    Note

    Funding Agencies|Crime Victim Compensation and Support Authority in Sweden; Medical Research Council of Southeast Sweden

    Available from: 2016-02-02 Created: 2016-02-01 Last updated: 2018-02-21
    2. Victimization, polyvictimization , and health in Swedish adolescents
    Open this publication in new window or tab >>Victimization, polyvictimization , and health in Swedish adolescents
    2016 (English)In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 7, p. 89-99Article in journal (Refereed) Published
    Abstract [en]

    The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization) and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652), of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV]) proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization.

    Place, publisher, year, edition, pages
    Dovepress, 2016
    Keywords
    victimization, childhood trauma, psychological symptoms, JVQ, TSCC
    National Category
    Clinical Medicine Public Health, Global Health, Social Medicine and Epidemiology Psychiatry Neurosciences
    Identifiers
    urn:nbn:se:liu:diva-132626 (URN)10.2147/AHMT.S109587 (DOI)27616895 (PubMedID)
    Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2018-02-21Bibliographically approved
    3. Posttraumatic stress symptoms and mental health services utilization in adolescents with social anxiety disorder and experiences of victimization
    Open this publication in new window or tab >>Posttraumatic stress symptoms and mental health services utilization in adolescents with social anxiety disorder and experiences of victimization
    Show others...
    2013 (English)In: European Child and Adolescent Psychiatry, ISSN 1018-8827, E-ISSN 1435-165X, Vol. 22, no 3, p. 177-184Article in journal (Refereed) Published
    Abstract [en]

    Recent findings from studies on adults show similarities between social anxiety disorder (SAD) and posttraumatic stress in the form of recurrent memories and intrusive and distressing images of earlier aversive events. Further, treatment models for SAD in adults have been successfully developed by using transdiagnostic knowledge on posttraumatic stress symptoms (PTSS). Studies on adolescents are though missing. The present study aimed at exploring the association between PTSS and SAD in Swedish adolescents. A second aim was to study mental health services utilization in relation to these conditions. A total of 5,960 high-school students participated and reported on SAD, life time victimization, PTSS and mental health service utilization. Socially anxious adolescents reported significantly higher levels of PTSS than adolescents not reporting SAD and this difference was seen in victimized as well as non-victimized subjects. Contact with a school counselor was the most common mental health service utilization in subjects with SAD and those with elevated PTSS. In the prediction of contact with a CAP-clinic, significant odds ratios were found for a condition of SAD and elevated PTSS (OR = 4.88, 95 % CI = 3.53–6.73) but not for SAD only. Screening of PTSS in adolescents with SAD is recommended. The service of school counselors is important in detecting and helping young people with SAD and elevated PTSS. Clinical studies on SAD and PTSS in adolescents could aid in modifying treatment models for SAD.

    Place, publisher, year, edition, pages
    Springer, 2013
    Keywords
    Social anxiety disorder, victimization, mental health service utilization, adolescents
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-89939 (URN)10.1007/s00787-012-0336-z (DOI)000315736200005 ()
    Available from: 2013-03-11 Created: 2013-03-11 Last updated: 2018-02-21
  • 30.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Gren Landell, Malin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Linköping University, Center for Social and Affective Neuroscience (CSAN).
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    The Prevalence of Potentially Victimizing Events, Poly-Victimization, and Its Association to Sociodemographic Factors: A Swedish Youth Survey2016In: Journal of Interpersonal Violence, ISSN 0886-2605, E-ISSN 1552-6518, Vol. 31, no 4, p. 620-651Article in journal (Refereed)
    Abstract [en]

    Studying the extent to which children are exposed to victimizing events is important to fully understand the effect of such exposure in shaping them as adults. The aim of this study was to use self-report by adolescents to measure the prevalence of victimizing events and of poly-victimization. A representative sample of 5,960 students (aged 17) from high schools in Sweden was given the self-administrated version of the Juvenile Victimization Questionnaire (JVQ) along with questions concerning gender, birthplace, parents birthplace and employment, residence, educational program, and municipality size. The results show that 84.1% (83.0% young men and 85.2% young women) of the students had experienced victimization during their lifetime, and 10.3% were categorized as poly-victims (8.1% young men and 12.5% young women; OR = 1.62, 95% confidence interval [CI] = [1.35, 1.94]). Adolescents living with both parents were at lower risk of any form of victimization for both genders, while females were at higher risk of maltreatment, peer victimization, and, most significantly, sexual victimization. In conclusion, the vast majority of young people have been victimized during their lifetime. A greater awareness of the impact of these victimizing events on children and adolescents is important as a basis for providing a safer milieu and establishing better interventions, especially for those that have been victimized on multiple occasions. The high-exposure group was determined by using 10 events as a cutoff. Findings on this group corresponded with findings in other international studies regarding distribution, elevated risk for females, and the possibility of limiting the effects of victimization by modifying living conditions.

  • 31.
    Aho, Nikolas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Proczkowska-Björklund, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Svedin, Carl Göran
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Victimization, polyvictimization , and health in Swedish adolescents2016In: Adolescent Health, Medicine and Therapeutics, ISSN 1179-318X, Vol. 7, p. 89-99Article in journal (Refereed)
    Abstract [en]

    The main objective of this article was to study the relationship between the different areas of victimization (eg, sexual victimization) and psychological symptoms, taking into account the full range of victimization domains. The final aim was to contribute further evidence regarding the bias that studies that focus on just one area of victimization may be introduced into our psychological knowledge. The sample included 5,960 second-year high school students in Sweden with a mean age of 17.3 years (range =16–20 years, standard deviation =0.652), of which 49.6% were females and 50.4% males. The Juvenile Victimization Questionnaire and the Trauma Symptom Checklist for Children were used to assess victimization and psychological problems separately. The results show that a majority of adolescents have been victimized, females reported more total events and more sexual victimization and childhood maltreatment, and males were more often victims of conventional crime. The majority of victimization domains as well as the sheer number of events (polyvictimization [PV]) proved to be harmful to adolescent health, affecting females more than males. PV explained part of the health effect and had an impact on its own and in relation to each domain. This suggests the possibility that PV to a large degree explains trauma symptoms. In order to understand the psychological effects of trauma, clinicians and researchers should take into account the whole range of possible types of victimization.

  • 32.
    Ahsani Ghahreman, Sarang
    Linköping University, Department of Social and Welfare Studies.
    En del av spelet: En studie av fotbollsdomarnas tillvaro i Gästrikland2008Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    There is a clear difference between the way football players and leaders regard the role of the referee, compared to the way the refereeing body looks at it. The refereeing body regard themselves as fundamental for the existence of the sport, while the other mentioned parties merely see them as functional justice makers. This view places the referees outside the field of football. This establishes a football culture, which is conflicted when it comes to the role of the referees on the field. The conflict comes to its edge in youth football, where the referees are under severe pressure. The only way for the referees to handle this pressure is through experience and respect, which is essential for creation of a well working referring role. Thus, a change in the football culture is necessary in order to include the referees in the football family and change the general conception of the referees’ role and function.

  • 33.
    Ainsbury, Elizabeth A.
    et al.
    Publ Hlth England, England.
    Samaga, Daniel
    Bundesamt Strahlenschutz, Germany.
    Della Monaca, Sara
    Ist Super Sanita, Italy.
    Marrale, Maurizio
    Univ Palermo, Italy; Univ Palermo, Italy.
    Bassinet, Celine
    Inst Radioprotect and Surete Nucl, France.
    Burbidge, Christopher I.
    Environm Protect Agcy, Ireland.
    Correcher, Virgilio
    Ctr Moncloa, Spain.
    Discher, Michael
    Univ Salzburg, Austria.
    Eakins, Jon
    Publ Hlth England, England.
    Fattibene, Paola
    Ist Super Sanita, Italy.
    Guclu, Inci
    Turkish Atom Energy Commiss, Turkey.
    Higueras, Manuel
    Basque Ctr Appl Math, Spain.
    Lund, Eva
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Maltar-Strmecki, Nadica
    Rudjer Boskovic Inst, Croatia.
    McKeever, Stephen
    Oklahoma State Univ, OK 74078 USA.
    Raaf, Christopher L.
    Lund Univ, Sweden.
    Sholom, Sergey
    Oklahoma State Univ, OK 74078 USA.
    Veronese, Ivan
    Univ Milan, Italy; Natl Inst Nucl Phys, Italy.
    Wieser, Albrecht
    Helmholtz Zentrum Munchen, Germany.
    Woda, Clemens
    Helmholtz Zentrum Munchen, Germany.
    Trompier, Francois
    Inst Radioprotect and Surete Nucl, France.
    UNCERTAINTY ON RADIATION DOSES ESTIMATED BY BIOLOGICAL AND RETROSPECTIVE PHYSICAL METHODS2018In: Radiation Protection Dosimetry, ISSN 0144-8420, E-ISSN 1742-3406, Vol. 178, no 4, p. 382-404Article in journal (Refereed)
    Abstract [en]

    Biological and physical retrospective dosimetry are recognised as key techniques to provide individual estimates of dose following unplanned exposures to ionising radiation. Whilst there has been a relatively large amount of recent development in the biological and physical procedures, development of statistical analysis techniques has failed to keep pace. The aim of this paper is to review the current state of the art in uncertainty analysis techniques across the EURADOS Working Group 10-Retrospective dosimetry members, to give concrete examples of implementation of the techniques recommended in the international standards, and to further promote the use of Monte Carlo techniques to support characterisation of uncertainties. It is concluded that sufficient techniques are available and in use by most laboratories for acute, whole body exposures to highly penetrating radiation, but further work will be required to ensure that statistical analysis is always wholly sufficient for the more complex exposure scenarios.

  • 34.
    Albin, Björn
    et al.
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden; Lund University, Malmö, Sweden.
    Elmståhl, Sölve
    Lund University, Universitetssjukhuset MAS, Malmö, Sweden.
    Comparison of Stroke Mortality in Finnish-Born Migrants Living in Sweden 1970-1999 and in Swedish-Born Individuals2014In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 1, p. 18-23Article in journal (Refereed)
    Abstract [en]

    A limited number of studies have been found on stroke mortality in migrants showing higher mortality for some groups. Influence of time of residence has been studied by a previous  research group. A previous study showed a significantly higher number of deaths in Diseases of the circulatory system in Finnish migrants compared to native Swedes. The aim was to test the hypothesis of a higher mortality in and a decrease in mortality over time in stroke among Finnish migrants in Sweden. The study was based on National Population registry data. The study population included 321,407 Swedish and 307,174 foreign born persons living in Sweden 1987-1999. Mean age was lower at time for death for Finnish migrants than native Swedes, men 5.1 years difference and women 2.3 years. The dissimilarity decreased over time. The risk of death by stroke was higher for migrants with short time of residence in Sweden than with long time (≤10 years, OR 1.61-1.36 vs ≥11 year, OR 1.18). Migrants with short time of residence in Sweden died 9.8-5.3 years earlier than native Swedes. The hypothesis was confirmed and an indication of adjustment to life in the new host country was found. International studies show similar results for other migrant groups but further studies are needed to verify if a similar pattern can be found in other migrant groups living in Sweden and to be able to generalise the findings.

  • 35.
    Alehagen, Siw
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hägg, Monica
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Kalén-Enterlöv, Maria
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, AnnaKarin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Experiences of community health nurses regarding father participation in child health care2011In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 15, no 3, p. 153-162Article in journal (Refereed)
    Abstract [en]

    Traditionally child health care (CHC) has been an arena where mothers and nurses meet, but in recent years fathers are entering CHC with increasing frequency. The aim of this study was to describe nurses’ experiences of fathers’ participation in CHC. Nine Swedish nurses working in CHC were interviewed and asked to give a description of their experiences from meetings with fathers in CHC. Phenomenology according to Giorgi was used for the analysis and the essence of the findings was that father participation was seen from the perspective of mother participation and was constantly compared to mother participation in CHC. The essence is explicated in the following themes: participation through activities; equal participation although diverse; influence of structures in society; and strengthening participation. Clinical implications include the need for creating a separate identity in CHC for fathers and more communication directed at fathers.

  • 36.
    Alehagen, Urban
    et al.
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine.
    Johansson, Peter
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Björnstedt, Mikael
    Division of Pathology F42, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
    Rosén, Anders
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Post, Claes
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Aaseth, Jan
    Research Department, Innlandet Hospital Trust and Hedmark University College, Norway.
    Relatively high mortality risk in elderly Swedish subjects with low selenium status2016In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 70, no 1, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Background/Objectives: 

    The daily dietary intake of selenium (Se), an essential trace element, is still low in Sweden in spite of decades of nutritional information campaigns and the effect of this on the public health is presently not well known. The objective of this study was to determine the serum Se levels in an elderly Swedish population and to analyze whether a low Se status had any influence on mortality.

    Subjects/Methods: 

    Six-hundred sixty-eight (n=668) elderly participants were invited from a municipality and evaluated in an observational study. Individuals were followed for 6.8 years and Se levels were re-evaluated in 98 individuals after 48 months. Clinical examination of all individuals included functional classification, echocardiography, electrocardiogram and serum Se measurement. All mortality was registered and endpoints of mortality were assessed by Kaplan–Meier plots, and Cox proportional hazard ratios adjusted for potential confounding factors were calculated.

    Results: 

    The mean serum Se level of the study population (n=668) was 67.1 μg/l, corresponding to relatively low Se intake. After adjustment for male gender, smoking, ischemic heart disease, diabetes, chronic obstructive pulmonary disease and impaired heart function, persons with serum Se in the lowest quartile had 43% (95% confidence interval (CI): 1.02–2.00) and 56% (95% CI: 1.03–2.36) increased risk for all-cause and cardiovascular mortality, respectively. The result was not driven by inflammatory effects on Se concentration in serum.

    Conclusion: 

    The mean serum Se concentration in an elderly Swedish population was 67.1 μg/l, which is below the physiological saturation level for several selenoprotein enzymes. This result may suggest the value of modest Se supplementation in order to improve the health of the Swedish population.

  • 37.
    Alehagen, Urban
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Slind Olsen, Renate
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. County Hospital Ryhov, Sweden.
    Länne, Toste
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Matussek, Andreas
    County Hospital Ryhov, Sweden.
    Wågsäter, Dick
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences.
    PDGF-D gene polymorphism is associated with increased cardiovascular mortality in elderly men2016In: BMC Medical Genetics, ISSN 1471-2350, E-ISSN 1471-2350, Vol. 17, no 62Article in journal (Refereed)
    Abstract [en]

    Background: Platelet-derived growth factor (PDGF) D has been reported to be active in fibroblasts, and in areas of myocardial infarction. In this longitudinal study we evaluated the association between PDGF-D polymorphism and cardiovascular mortality, and attempted to discover whether specific genotype differences regarding risk could be observed, and if gender differences could be seen. Methods: Four hundred seventy-six elderly community participants were included in this study. All participants underwent a clinical examination, echocardiography, and blood sampling including PDGF-D single nucleotide polymorphism (SNP) analyses of the rs974819 A/A, G/A and G/G SNP. The follow-up time was 6.7 years. Results: No specific genotype of rs974819 demonstrated increased cardiovascular mortality in the total population, however, the male group with genotypes A/A and G/A demonstrated an increased risk that persisted in a multivariate evaluation where adjustments were made for well-known cardiovascular risk factors (2.7 fold compared with the G/G genotype). No corresponding finding was observed in the female group. Conclusion: We report here for the first time that the genotypes G/A or A/A of the SNP rs974819 near PDGF-D exhibited a 2.7 fold increased cardiovascular mortality risk in males. Corresponding increased risk could not be observed in either the total population and thus not in the female group. However, the sample size is was small and the results should be regarded as hypothesis-generating, and thus more research in the field is recommended.

  • 38.
    Alexanderson, Kristina
    et al.
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Leijon, Margareta
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Åkerlind, Ingemar
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Rydh, Hillevi
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Bjurulf, Per
    Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Epidemiology of sickness absence in a Swedish county in 1985, 1986 and 1987: A three year longitudinal study with focus on gender, age and occupation1994In: Scandinavian Journal of Social Medicine, ISSN 0300-8037, Vol. 22, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    In order to get a better epidemiological base for preventive intervention in the county of Östergötland, Sweden, a comprehensive study of sickness absence was done. During the years 1985, 1986 and 1987, all new periods of sick-leave exceeding seven days were registered with demographic variables. This information was related to data about the total population of Östergötland. Each year approx. 45,000 persons had approx. 61,000 sickness spells. These figures were stable over the years while the number of sick-leave days increased. Blue-collar occupations had the highest sick-leave rates and the female sick-leave rate was higher in general and much higher in most male-dominated occupations. The male rate was lower within female-dominated areas, except among secretaries and textile workers. Females in extremely male-dominated groups had the highest rates, while both male and female sick-leave rates were lower in more gender-integrated occupations.

  • 39.
    Alfredsson, Joakim
    et al.
    Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Duke Clin Research Institute, NC 27705 USA.
    Stebbins, Amanda
    Duke Clin Research Institute, NC 27705 USA.
    Brennan, J. Matthew
    Duke University, NC USA.
    Matsouaka, Roland
    Duke University, NC USA.
    Afilalo, Jonathan
    McGill University, Canada.
    Peterson, Eric D.
    Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA.
    Vemulapalli, Sreekanth
    Duke University, NC USA.
    Rumsfeld, John S.
    University of Colorado, CO USA.
    Shahian, David
    Massachusetts Gen Hospital, MA 02114 USA.
    Mack, Michael J.
    Baylor Scott and White Heatlh, TX USA.
    Alexander, Karen P.
    Duke Clin Research Institute, NC 27705 USA; Duke University, NC USA.
    Gait Speed Predicts 30-Day Mortality After Transcatheter Aortic Valve Replacement Results From the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry2016In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 133, no 14, p. 1351-1359Article in journal (Refereed)
    Abstract [en]

    Background Surgical risk scores do not include frailty assessments (eg, gait speed), which are of particular importance for patients with severe aortic stenosis considering transcatheter aortic valve replacement. Methods and Results We assessed the association of 5-m gait speed with outcomes in a cohort of 8039 patients who underwent transcatheter aortic valve replacement (November 2011-June 2014) and were included in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. We evaluated the association between continuous and categorical gait speed and 30-day all-cause mortality before and after adjustment for Society of Thoracic Surgeons-predicted risk of mortality score and key variables. Secondary outcomes included in-hospital mortality, bleeding, acute kidney injury, and stroke. The overall median gait speed was 0.63 m/s (25th-75th percentile, 0.47-0.79 m/s), with the slowest walkers (&lt;0.5 m/s) constituting 28%, slow walkers (0.5-0.83 m/s) making up 48%, and normal walkers (&gt;0.83 m/s) constituting 24% of the population. Thirty-day all-cause mortality rates were 8.4%, 6.6%, and 5.4% for the slowest, slow, and normal walkers, respectively (P&lt;0.001). Each 0.2-m/s decrease in gait speed corresponded to an 11% increase in 30-day mortality (adjusted odds ratio, 1.11; 95% confidence interval, 1.01-1.22). The slowest walkers had 35% higher 30-day mortality than normal walkers (adjusted odds ratio, 1.35; 95% confidence interval, 1.01-1.80), significantly longer hospital stays, and a lower probability of being discharged to home. Conclusions Gait speed is independently associated with 30-day mortality after transcatheter aortic valve replacement. Identification of frail patients with the slowest gait speeds facilitates preprocedural evaluation and anticipation of a higher level of postprocedural care. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01737528.

  • 40.
    Alfredsson Ågren, Kristin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Internet use among adolescents with intellectual disabilities at home and school2016In: Abstract book: International Conference on Cerebral Palsy and other Childhood-onset Disabilities Stockholm 1–4 June 2016, 2016Conference paper (Other academic)
    Abstract [en]

    Background: Today everyday life depends on having access to, understand and use internet inorder to participate and take part in societal resources. This understanding can be complex forpersons with intellectual disabilities (ID) due to their cognitive impairments. It is even statedthat internet-use can be yet another part of daily life activities they are excluded from. Internet-use is claimed to involve risks, but also benefits for persons with ID, but there is a shortage inempirical studies with the target group ́s own opinion regarding this. Broader knowledge isacquired of internet-use in everyday life for adolescents with ID, as a precondition toparticipation. 

    Aim: This study aims to explore and describe internet-use and doing internet activities at homeand at school among adolescents with mild and moderate intellectual disabilities. Method: The study has a qualitative inductive design using observations and interviews in thetwo settings; at home and at school. Participants are six adolescents with mild and moderate ID,from special schools in the middle-region of Sweden, between the ages 13-20, that use internetto some extent. Data was collected at 2 occasions/participant for about 2hours/participant/setting. The analysis was done using a qualitative content analysis.

    Result: Preliminary results show that adolescents with mild and moderate ID use internet both athome and in school, to a greater extent than was expected, but the doings of internet-activitiesvaries in the different settings. Both facilitating and hindering aspects are described by theparticipants. Pictures on the internet seem to be of support when using and navigating theinternet.

    Conclusion: Deeper knowledge regarding internet-use from the target groups own perspectivehas been gained. The results can be used in the different occupational settings and in furtherresearch to survey internet use and participation in internet-activities

  • 41.
    Alfredsson Ågren, Kristin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Holstein, Jane
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    How can an entrepreneurial mind-set be encouraged among occupational therapy students? An example from Linköping University, Sweden.2014Conference paper (Other academic)
    Abstract [en]

    Introduction

    The structures of social and health care are changing, and public health related problems in Western Europe are increasing, such as an increased elderly population, obesity and mental health problems in young people. In order to meet the need of the clients in occupational therapy practice we have to look into new ways to approach the changing times. A way to support the students’ preparedness for action in the field is to encourage the use of an entrepreneurial mindset through different learning methods. An entrepreneurial mindset is defined as “a way to see the possibilities and make something out of them”.

    Objectives

    To describe learning methods to raise awareness and promote an entrepreneurialmind-set among OT students and teachers.Description/ReportThe learning methods for the students varies from working with a specific design problem in groups, discussing literature about entrepreneurship in seminars and get supervision from Innovation office. To enhance the teachers awareness about entrepreneurial mind-set workshops about how to find new non-traditional fieldwork placements in a creative way was conducted.

    Results/Discussion

    Our experiences of how the entrepreneurial mind-set can be encouraged are that entrepreneurship can be looked upon in different ways and should be seen close to the reality that one work in. Follow-up from workshops with teachersas well evaluations from the students about the entrepreneurial mind set will be presented. Primary results show that students feel more prepared for a new and creative way of thinking and that teachers have more entrepreneurial mind-set than they think in the beginning.

    Conclusion

    An increased entrepreneurial mindset can be learned/trained and used as a way of dealing with the future challengesin the health care sector for occupational therapists.

  • 42.
    Alfredsson Ågren, Kristin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Holstein, Jane
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hur kan ett entreprenöriellt förhållningssätt främjas hos studenter på arbetsterapeutprogrammet?2015Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Strukturerna för den offentliga sektorn och hälso- och sjukvården förändras ständigt, och folkhälsorelaterade problem ökar. Exempel på detta är en ökad andel äldre i befolkningen, eller fetma och psykisk ohälsa hos unga människor. För att möta dessa förändringar och behoven hos klienter i arbetsterapeutisk verksamhet måste nya förhållningssätt användas. Ett sätt att under utbildningen utveckla studenters handlingsberedskap inför framtida insatser kan vara att medvetandegöra och främja ett entreprenöriellt förhållningssättgenom olika lärmoment. Entreprenöriellt förhållningssätt definieras som"ett sätt att se möjligheterna och göra något av dem".

    Syfte: Syftet är att beskriva och utvärdera lärmoment för att främja entreprenöriellt förhållningssätt hos studenter på Arbetsterapeutprogrammet.

    Metod: Två huvudsakliga lärmoment användes för studenterna, och uppföljande utvärderingar genomfördes via enkät med öppna och slutna frågor. Utöver detta anordnades workshop för lärare, som följdes av utvärdering.

    Resultat/preliminärt resultat: Lärmomenten för studenter innebar att arbeta i projektform i gruppmed ett aktivitetsproblem för en specifik målgrupp utifrån Design för alla under handledning. Uppföljande seminarium utifrån specifik litteratur genomfördes. Studenternas utvärdering visar vikten av att ha lärmoment om design och entreprenörskap i utbildningen. Många studenteruppgav att de kunde använda denna kunskap i arbetsterapeutisk verksamhet. Workshop genomfördes med lärare där begrepp inom entreprenörskap diskuterades och kreativa sätt att utveckla lärmoment för studenter inom detta lyftes. I utvärderingen uppgav merparten av lärarna entreprenöriellt förhållningssätt som viktigt inom utbildningen.

    Slutsats: Vikten av lärares förståelse för entreprenöriellt förhållningssätt identifierades. Entreprenöriellt förhållningssätt kan främjas genom att kombinera fler lärmoment för studenter. Genom detta kan studenter utveckla handlingsberedskap gällande utmaningar i ett föränderligt samhälle.

  • 43.
    Alfredsson Ågren, Kristin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Medvetna relationer skapar bra interventioner2012In: Arbetsterapeuten, ISSN 0345-0988, no 3, p. 32-33Article in journal (Other academic)
    Abstract [sv]

    IRM är utvecklad av professor Renée Taylor, som är doktor i klinisk psykologi och professor i arbetsterapi vid University of Illinois i Chicago. Modellen beskrivs i hennes bok från 2008 The Intentional Relationship – Occupational Therapy and Use of Self. Syftet med modellen är att erbjuda en specifik begreppsapparat för ett medvetet användande av sig själv som arbetsterapeut och den behandlar händelser som förekommer i relationer mellan personer i en interventionsprocess. Dessa händelser påverkar såväl aktivitetsengagemang som utfall av intervention.

  • 44.
    Alfredsson Ågren, Kristin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Internet use among adolescents with intellectual disabilities in Sweden2018In: 18th International WFOT18 Congress on Occupational Therapy Connected in Diversity, Positioned for Impact, Cape Town, South Africa, 21-25 May 2018, 2018Conference paper (Refereed)
  • 45.
    Alföldi, Peter
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Wiklund, Tobias
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    SPREADING OF PAIN AND INSOMNIA IN PATIENTS WITH CHRONIC PAIN: RESULTS FROM A NATIONAL QUALITY REGISTRY (SQRP)2017In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 1, p. 63-70Article in journal (Refereed)
    Abstract [en]

    Objective: To explore how demographics, pain, psychosocial factors and insomnia relate to the spread of chronic pain. Methods: The study included 708 patients (68% women; median age 46 years; interquartile range 3557 years) with chronic pain who were referred to a multidisciplinary pain centre. Spreading of pain was assessed using a questionnaire covering 36 anatomically predefined pain regions. Data were collected on demographics, pain symptoms, psychological distress, and insomnia (Insomnia Severity Index). Four sub-categories of chronic pain were established: chronic local pain, chronic regional pain medium, chronic regional pain heavy, and chronic widespread pain. Results: The median number of pain regions was 10 (interquartile range 6-18). Prevalence of chronic pain was as follows: chronic local pain 9%, chronic regional pain medium 21%, chronic regional pain heavy 39%, and chronic widespread pain 31%. In the regression models, being a woman and persistent pain duration had the strongest associations with spreading of pain, but anxiety, pain interference, and insomnia were also important factors. Conclusion: Spreading of chronic pain can only partly be explained by the simultaneous levels of insomnia. Female sex, pain duration, pain interference and anxiety appear to have more significant relationships with the spread of pain. Targeting these factors may lead to improvements in treatment and prevention strategies.

  • 46.
    Alkner, Björn A.
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine. Reg Jonkoping Cty, Linkoping, Sweden.
    Norrbrand, Lena
    KTH Royal Institute Technology, Sweden.
    Tesch, Per A.
    Karolinska Institute, Sweden.
    Neuromuscular Adaptations Following 90 Days Bed Rest With or Without Resistance Exercise2016In: AEROSPACE MEDICINE AND HUMAN PERFORMANCE, ISSN 2375-6314, Vol. 87, no 7, p. 610-617Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: This study examined the effects of long-term bed rest with or without a concurrent resistance exercise protocol on different muscle function indices of the knee extensors and their influence on previously shown atrophy, neural impairment, and slow-to-fast phenotype shift. METHODS: Nine men underwent 90 d of bed rest only (BR), while eight men in addition performed maximal supine squats every third day (BRE). Before and at day 1 and 5 following bed rest, surface quadriceps electromyographic (EMG) activity was measured during a sustained (60-s) submaximal isometric action and rate of force development (RFD) was assessed during a maximal isometric action, both in the supine squat position. Maximal torque was measured during isokinetic knee extensions at different angular velocities before and after (day 2 and 11) bed rest. RESULTS: EMG amplitude at a fixed submaximal load increased in BR, but not in BRE. The increase in amplitude during the sustained action was elevated in BR but not in BRE. RFD decreased in BR; this effect was attenuated day 1 and normalized day 5 in BRE. RFD expressed relative to maximal force was maintained in both groups. Angle-specific torque decreased equally for all velocities in BR. The decrease in isokinetic strength was attenuated day 2 in BRE. DISCUSSION: Phenotype changes were not reflected in muscle function measurements, probably because they were overridden by the effects of atrophy and neural adaptation. The protective effect of resistance exercise was more pronounced in tasks similar to the training action, inferring great impact of neural mechanisms.

  • 47.
    Allemann, Hanna
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Sund-Levander, Märta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Nurses' actions in response to nursing assistants' observations of signs and symptoms of infections among nursing home residents2015In: Nursing Open, ISSN 2054-1058, Vol. 2, no 3, p. 97-104Article in journal (Refereed)
    Abstract [en]

    Aims

    To describe what nurses do during episodes of suspected infection in elderly nursing home residents and if these actions are linked to who is initiating an episode and whether the episode is considered an infection or not.

    Design

    Prospective descriptive study. Data were collected in 2008–2010.

    Methods

    Summarized and categorized documentation by nursing assistants and nurses was used for summative content analysis.

    Results

    Nurses' actions seem to be related to who initiated the episode and if the episodes are categorized as ‘non-infection’, ‘possible infection’ or ‘infection’. Actions could be ‘observation’, ‘screenings’, ‘engaged in waiting’, ‘follow-ups’, ‘nurse-prescribed actions’, ‘diagnosing’, ‘contacting the physician’, ‘carrying out an action prescribed by the physician’, ‘contacting an ambulance or arranging an emergency visit to the hospital’ and ‘prescribing screening’. As NAs often initiate episodes of suspected infection by observing changed conditions, it seems important to include the NA in the decision-making process as these observations could detect possible early signs and symptoms of infections.

  • 48.
    Alm, Tina
    et al.
    Linköping University, Department of Neuroscience and Locomotion.
    Franzén, Daniel
    Linköping University, Department of Neuroscience and Locomotion.
    Arbetssökandes upplevelser av utredningsperioden på Arbetsförmedlingen Rehabilitering2005Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Work has a great influence on most of individuals in society. It influences both identity as well as the structure of the day. Unemployed people are often affected in a negative way through economic and psychological problems. In order to help people with reduced work capacity back to the labour market and decrease unemployment, the Labour Market Board works with vocational rehabilitation. The aim of this study is to investigate experiences of vocational rehabilitation within the Labour Market Board among unemployed people. A qualitative method was used by which interviews were made with 11 unemployed persons who participated in an investigation as a part of vocational rehabilitation within the Labour Market Board. The result shows both positive and negative experiences of the investigation period. The identified experiences were sorted into code groups: Support, Insight, Confidence in the investigation and result, Belief in the future, Motivation, and Participation. Both the actions of the personnel and the presence of the group members influenced the experiences. The support given by the personnel and how it is experienced is of great importance for the future of the unemployed. When the investigation was pursued during a short period of time, there was a lack of confidence in the investigation and result. A suggestions for future studies is to design a questionnaire that can be used in a larger study including a large number of individuals who are participating in vocational rehabilitation within the Labour Market Board.

  • 49.
    Almberg, Maria
    et al.
    Mobil Centre Gothenburg, Sweden.
    Selander, Helena
    Mobil Centre Gothenburg, Sweden; University of Gothenburg, Sweden.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Vaz, Sharmila
    Curtin University, Australia.
    Ciccarelli, Marina
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 2, p. 59-67Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education. Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learners permit, from the perspective of the learner drivers and their driving instructors. Methods: Datawere collected from33 participants with ASD or ADHD, and nine of their driving instructors. Results: Participants with ASD required twice asmany driving lessons andmore on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to "unfamiliar driving situations to be the greatest challenges. Conclusion: Obtaining a driving license was associated with stressful training experience.

  • 50.
    Almborg, Ann-Helene
    et al.
    Socialstyrelsen.
    Bolic, Vedrana
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    ICF/ICF-CY utbildningsmaterial. Del 1- Introduktion av modell, struktur och innehåll.2011Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Utbildningsmaterialet om de internationella klassifikationerna ICF och ICF-CY ger information om deras struktur och innehåll samt hur koderna kan användas för att beskriva funktionstillstånd, funktionshinder och hälsa. Utbildningsmaterialet är gjort för personal i olika verksamheter inom vård och omsorg och kan användas både enskilt och i grupp. Den första delen av materialet beskriver klassifikationens struktur och innehåll samt modellen den bygger på. Den andra delen handlar om hur man kan använda koderna i sitt arbete.

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