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  • 301.
    Grape Viding, Christina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    Osika, Walter
    Bojner Horwitz, Eva
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Allmänmedicin och preventivmedicin.
    "You Can´t Feel Healthier than Your Caregiver": The Ripple Effect of Trust and Empathy for Patients and Health Care Staff, Cultivated through Cultural Activities2017Ingår i: Journal of Nursing & Care, ISSN 2167-1168, Vol. 6, nr 5, artikel-id 1000422Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Stress-related problems, including burnout, cause personal suffering, disability and result in costly sick leave. The use of different cultural activities within a health care system may help to prevent burnout, but very few studies have focused on what happens after such activities.

    Methods: Interventions with different cultural activities were conducted for burn out patients in four primary health care settings during three months. Focus group interviews were conducted with patients, cultural producers and health care nurses. The aim was to provide a description of the participant’s experiences after the activities.

    Results: The cultural activities were found to affect both participants' emotions and behaviour and created a sense of belonging and equality among them. Positive 'spill-over' effects were also seen on nurses of health care management.

    Conclusion: We find that the cultural activities help to create a trustful and empathic health care environment where the wellbeing of staff and that of patients have an impact on each other. We suggest the incorporation of arts into health care as a possible contributor to the development of a sustainable health care system.

  • 302.
    Grenklo, Tove Bylund
    et al.
    Karolinska Institutet, Stockholm Sjukhem Foundation.
    Kreicbergs, Ulrika C
    Karolinska Institutet, Sophiahemmet.
    Valdimarsdóttir, Unnur A
    Karolinska Institutet, University of Iceland, Reykjavík, Iceland, Harvard School of Public Health, Boston, USA.
    Nyberg, Tommy
    Karolinska Institutet.
    Steineck, Gunnar
    Karolinska Institutet, Göteborgs universitet.
    Fürst, Carl Johan
    Karolinska Institutet, Stockholm Sjukhem Foundation, Lunds universitet.
    Communication and trust in the care provided to a dying parent: A nationwide study of cancer-bereaved youths.2013Ingår i: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 31, nr 23, s. 2886-2894Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To assess children's trust in the care provided to a dying parent during the final week of life in relation to end-of-life medical information about disease, treatment, and death.

    METHODS: This nationwide population-based survey included 622 (73%) of 851 youths who, 6 to 9 years earlier, at age 13 to 16 years, lost a parent to cancer. We asked about the children's reception of end-of-life professional information and trust in the care provided. We also asked about depression and several potential risk factors of distrust in the care provided.

    RESULTS: A majority (82%) reported moderate/very much trust in the care provided. Compared with children who received end-of-life medical information before their loss, the risk of distrust in the care provided was higher in those who received no information (risk ratio [RR], 2.5; 95% CI, 1.5 to 4.1), in those who only received information afterward (RR, 3.2; 95% CI, 1.7 to 5.9), and in those who did not know or remember if end-of-life medical information was provided (RR, 1.7; 95% CI, 1.1 to 2.5). Those reporting distrust in the care provided had an RR of 2.3 (95% CI, 1.5 to 3.5) for depression. Furthermore, the risk of distrust in the care provided was higher among children reporting poor efforts to cure (RR, 5.1; 95% CI, 3.6 to 7.3), and/or a poor relationship with the surviving parent (RR, 2.9; 95% CI, 2.0 to 4.1).

    CONCLUSION: Our study suggests that children's trust in the care provided to a dying parent was highest when they received end-of-life medical information before their loss.

  • 303.
    Grill, Lisa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Jönsson, Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Hur skapar terapeuten ett samtalsklimat där patienten kan förmedla sitt dilemma med öppenhet och tillit?2015Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Som kliniker värderar vi energin i det terapeutiska samtalet. Studien syftar till att undersöka vad

    som möjliggör för patienter att sätta ord på livets mångfald, tillkortakommanden och existentiella

    dilemman i ett psykoterapeutiskt sammanhang. Kvalitativ metod tillämpades. En initierad

    kollega intervjuade en av författarna i hens roll som terapeut tillsammans med tre patienter och

    deras anhöriga vid olika tillfällen. Patienterna hade diagnoserna psykos, GAD (=generaliserad

    ångest) och depression och är knutna till öppenpsykiatrin. Intervjun genomfördes enligt

    samforskningsmetoden och filmades. Författarna har tittat spontant på de filmade intervjuerna

    och skrivit ned direkta reflektioner. Därefter särskådades materialet metodiskt för att identifiera

    samband och upprepningar. Analys av inspelningarna bekräftar vikten av terapeutens personliga

    egenskaper: Att kunna inge trygghet, och inspiration, att ha förmåga till inkännande, samt tilltro

    till patientens kapacitet under och utanför samtalen. Våra slutsatser stämmer väl med tidigare

    publicerade forskningsresultat.

  • 304.
    Grim, Katarina
    et al.
    Karlstads universitet, Fakulteten för humaniora och samhällsvetenskap (from 2013), Institutionen för sociala och psykologiska studier (from 2013).
    Rosenberg, David
    Umeå universitet.
    Svedberg, Petra
    Högskolan Halmstad.
    Schon, Ulla-Karin
    Högskolan Dalarna.
    Development and Usability Testing of a Web-Based Decision Support for Users and Health Professionals in Psychiatric Services2017Ingår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, nr 3, s. 293-302Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users' experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.

  • 305. Grim, Katarina
    et al.
    Rosenberg, David
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Svedberg, Petra
    Schön, Ulla-Karin
    Development- and usability testing of a web-based decision support for users and health professionals in psychiatric services2017Ingår i: Psychiatric rehabilitation journal, ISSN 1095-158X, E-ISSN 1559-3126, Vol. 40, nr 3, s. 293-302Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Shared decision making (SMD) related to treatment and rehabilitation is considered a central component in recovery-oriented practice. Although decision aids are regarded as an essential component for successfully implementing SDM, these aids are often lacking within psychiatric services. The aim of this study was to use a participatory design to facilitate the development of a user-generated, web-based decision aid for individuals receiving psychiatric services. The results of this effort as well as the lessons learned during the development and usability processes are reported. Method: The participatory design included 4 iterative cycles of development. Various qualitative methods for data collection were used with potential end users participating as informants in focus group and individual interviews and as usability and pilot testers. Results: Interviewing and testing identified usability problems that then led to refinements and making the subsequent prototypes increasingly user-friendly and relevant. In each phase of the process, feedback from potential end-users provided guidance in developing the formation of the web-based decision aid that strengthens the position of users by integrating access to information regarding alternative supports, interactivity between staff and users, and user preferences as a continual focus in the tool. Conclusions and Implications for Practice: This web-based decision aid has the potential to strengthen service users’ experience of self-efficacy and control as well as provide staff access to user knowledge and preferences. Studies employing participatory models focusing on usability have potential to significantly contribute to the development and implementation of tools that reflect user perspectives.

  • 306. Grooten, W. J.
    et al.
    Conradsson, D.
    Äng, Björn
    Franzen, E.
    Is active sitting as active as we think?2013Ingår i: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, nr 8, s. 1304-14Artikel i tidskrift (Refereegranskat)
  • 307. Grooten, W. J.
    et al.
    Äng, Björn
    Reliability of measurements of wrist extension force obtained with a Nicholas Manual Muscle Tester (NMMT)2010Ingår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, nr 4, s. 281-7Artikel i tidskrift (Refereegranskat)
  • 308. Grooten, Wilhelmus Johannes Andreas
    et al.
    Tseli, Elena
    Äng, Björn
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Karolinska institutet; Uppsala universitet.
    Boersma, Katja
    Stålnacke, Britt-Marie
    Gerdle, Björn
    Enthoven, Paul
    Elaborating on the assessment of the risk of bias in prognostic studies in pain rehabilitation using QUIPS-aspects of interrater agreement2019Ingår i: Diagnostic and Prognostic Research, ISSN 2397-7523, Vol. 3, artikel-id 5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Many studies have been performed to identify important prognostic factors for outcomes after rehabilitation of patients with chronic pain, and there is a need to synthesize them through systematic review. In this process, it is important to assess the study quality and risk of bias. The "Quality In Prognosis Studies" (QUIPS) tool has been developed for this purpose and consists of several prompting items categorized into six domains, and each domain is judged on a three-grade scale (low, moderate or high risk of bias). The aim of the present study was to determine the interrater agreement of the risk of bias assessment in prognostic studies of patients with chronic pain using QUIPS and to elaborate on the use of this instrument.

    Methods: We performed a systematic review and a meta-analysis of prognostic factors for long-term outcomes after multidisciplinary rehabilitation in patients with chronic pain. Two researchers rated the risk of bias in 43 published papers in two rounds (15 and 28 papers, respectively). The interrater agreement and Cohen's quadratic weighted kappa coefficient (κ) and 95% confidence interval (95%CI) were calculated in all domains and separately for the first and second rounds.

    Results: The raters agreed in 61% of the domains (157 out of 258), with similar interrater agreement in the first (59%, 53/90) and second rounds (62%, 104/168). The overall weighted kappa coefficient (kappa for all domains and all papers) was weak: κ = 0.475 (95%CI = 0.358-0.601). A "minimal agreement" between the raters was found in the first round, κ = 0.323 (95%CI = 0.129-0.517), but increased to "weak agreement" in the second round, κ = 0.536 (95%CI = 0.390-0.682).

    Conclusion: Despite a relatively low interrater agreement, QUIPS proved to be a useful tool in assessing the risk of bias when performing a meta-analysis of prognostic studies in pain rehabilitation, since it demands of raters to discuss and investigate important aspects of study quality. Some items were particularly hard to differentiate in-between, and a learning phase was required to increase the interrater agreement. This paper highlights several aspects of the tool that should be kept in mind when rating the risk of bias in prognostic studies, and provides some suggestions on common pitfalls to avoid during this process.

    Trial registration: PROSPERO CRD42016025339; registered 05 February 2016.

  • 309.
    Grossi, Giorgio
    et al.
    National Institute for Psychosocial Factors and Health, Stockholm.
    Perski, Aleksander
    National Institute for Psychosocial Factors and Health, Stockholm.
    Ekstedt, Mirjam
    National Institute for Psychosocial Factors and Health, Stockholm.
    Johansson, Thorbjörn
    National Institute for Psychosocial Factors and Health, Stockholm.
    Lindström, Morie
    Uppsala University.
    Holm, Karin
    Uppsala University.
    The morning salivary cortisol response in burnout.2005Ingår i: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 59, nr 2, s. 103-111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The results of the present study indicate a dysregulation in hypothalamic-pituitary-adrenocortical axis (HPA axis) activity, characterised by elevated morning salivary cortisol levels, among female burnout patients. Among males, increased cortisol levels were observed among participants with moderate levels of burnout, but not among patients or healthy controls.

  • 310.
    Grunér, Sofia
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi.
    Östberg, Per
    Institutionen för Klinisk vetenskap, Intervention och Teknik (CLINTEC), Karolinska Institutet.
    Hedenius, Martina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Logopedi. Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    The Compensatory Effect of Text-to-Speech Technology on Reading Comprehension and Reading Rate in Swedish Schoolchildren With Reading Disability: The Moderating Effect of Inattention and Hyperactivity Symptoms Differs by Grade Groups2018Ingår i: Journal of Special Education Technology, ISSN 0162-6434, Vol. 33, nr 2, s. 98-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this study was (i) to investigate if the compensatory effect of text-to-speech (TTS) technology on reading comprehension and reading rate in schoolchildren with reading disability is influenced by problems with inattention and hyperactivity and (ii) to examine whether a potentially moderating effect of such symptoms differ between grade groups. Participants (N = 49) were randomized into one of the two experimental conditions: Group A listened to a text with TTS, and Group B read the text themselves. The conditions were then switched. Inattention and hyperactivity symptoms were assessed with the Strengths and Difficulties Questionnaire (SDQ). Statistical analyses were performed both on the whole group and within-grade groups (Grades 3–5 and 6–9). Using TTS technology had a positive effect on reading rate for both grade groups, and this effect was not influenced by attention-deficit/hyperactivity disorder (ADHD) symptoms. As for reading comprehension, the two groups differed both with respect to the amount of improvement seen in the TTS condition and with respect to the moderating effect of ADHD symptoms. Reading with TTS improved reading comprehension significantly in the younger group, whereas no effect on reading comprehension was found in the older group. A higher score on the SDQ ADHD Scale was associated with less improvement in reading comprehension in the younger group and with greater improvement in reading comprehension in the older group. The results indicate that symptoms of inattention and hyperactivity, as well as the child’s grade level, are factors that should be taken into account when planning and introducing TTS technology.

  • 311.
    Gryth, Dan
    et al.
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm Prehospital Centre, Stockholm, Sweden.
    Rådestad, Monica
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm Prehospital Centre, Stockholm, Sweden.
    Nilsson, Heléne
    Östergötlands Läns Landsting, Katastrofmedicinskt centrum. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Kirurgi. Linköpings universitet, Hälsouniversitetet.
    Nerf, Ola
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm Prehospital Centre, Stockholm, Sweden.
    Svensson, Leif
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm Prehospital Centre, Stockholm, Sweden.
    Castrén, Maaret
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm Prehospital Centre, Stockholm, Sweden.
    Rüter, Anders
    Östergötlands Läns Landsting, Katastrofmedicinskt centrum.
    Evaluation of medical command and control using performance indicators in a full-scale, major aircraft accident exercise.2010Ingår i: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 25, nr 2, s. 118-123Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Large, functional, disaster exercises are expensive to plan and execute, and often are difficult to evaluate objectively. Command and control in disaster medicine organizations can benefit from objective results from disaster exercises to identify areas that must be improved.

    OBJECTIVE: The objective of this pilot study was to examine if it is possible to use performance indicators for documentation and evaluation of medical command and control in a full-scale major incident exercise at two levels: (1) local level (scene of the incident and hospital); and (2) strategic level of command and control. Staff procedure skills also were evaluated.

    METHODS: Trained observers were placed in each of the three command and control locations. These observers recorded and scored the performance of command and control using templates of performance indicators. The observers scored the level of performance by awarding 2, 1, or 0 points according to the template and evaluated content and timing of decisions. Results from 11 performance indicators were recorded at each template and scores greater than 11 were considered as acceptable.

    RESULTS: Prehospital command and control had the lowest score. This also was expressed by problems at the scene of the incident. The scores in management and staff skills were at the strategic level 15 and 17, respectively; and at the hospital level, 17 and 21, respectively.

    CONCLUSIONS: It is possible to use performance indicators in a full-scale, major incident exercise for evaluation of medical command and control. The results could be used to compare similar exercises and evaluate real incidents in the future.

  • 312.
    Gröndal, Hedvig
    Uppsala universitet, Humanistisk-samhällsvetenskapliga vetenskapsområdet, Samhällsvetenskapliga fakulteten, Sociologiska institutionen.
    Signs of bacteria: Enacting Sore Throat2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    In this paper I analyse the diagnostic process in relation to bacterial sore throat and how this disease comes into being, or how it is enacted, at two Swedish health centres. The empirical data analysed consist of interviews with nurses and general practioners as well as observations at the health centres. The concept of enactment implies that disease is relationally constituted in and through relations between human and non-human actors. In the paper the relations between health care personnel, bodies, symptoms, instruments, bacteria and other actors are investigated, and I discuss how different enactments of bacterial sore throat come to being depending on how these relations are organized. When doing this the clinical gaze - the diagnosing gaze that interpret signs of an underlying pathology on the patients body – is explored and in relation to the empirical material this gaze is investigated, that is, how it is employed and how it is established in relation to a number of human and non-human actors. 

  • 313.
    Gudmundsson, Cecilia
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    "Anknytningsteori har ju funnits sen Hedenhös": Anknytning som psykoterapeutiskt fenomen2012Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Detta är en kvalitativ studie vars syfte är att undersöka anknytingsfenomenet. Frågorna berör hur terapeuter ser på anknytningsfenomenet, vilken betydelse de tillskriver fenomenet och hur det tar sig uttryck i det konkreta terapiarbetet med barn och ungdomar. För att få svar på frågorna genomfördes en intervjustudie. Fem yrkesverksamma barn- och ungdomsterapeuter, tre kvinnor och två män, alla med mångårig erfarenhet av att arbeta med terapier med barn och ungdomar intervjuades. Intervjuerna spelades in, transkriberades, lästes noggrant och analyserades därefter i två steg. I första steget markerades de för studien relevanta citaten och sammanställdes i huvudteman utifrån frågeordning och respondent. Detta följdes av en sammanfattande kommentar. I andra steget togs nyckelbegrepp ut och grupperades.  Resultaten visar bland annat hur mångfacetterat fenomenet blir genom terapeutens subjektiva upplevelse och därigenom deras olika sätt att beskriva fenomenet. Resultaten visar vidare att terapeuter tillskriver fenomenet stor betydelse och beaktar detta medvetet i sitt praktiska arbete.

  • 314.
    Gunnarsson, Ingemar
    Linnéuniversitetet, Fakulteten för konst och humaniora (FKH), Institutionen för kulturvetenskaper (KV). Linnaeus University Centre for Concurrences in Colonial and Postcolonial Stuides.
    Biografin som historisk genre och metod2015Ingår i: Livsberättelser, kultur & hälsa / [ed] Motzi Eklöf, Margareta Petersson, Växjö: Linnaeus University Press, 2015, 1, s. 75-79Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 315.
    Gunnarsson, Ingemar
    Linnéuniversitetet, Fakulteten för konst och humaniora (FKH), Institutionen för kulturvetenskaper (KV). Linnéuniversitetet, Universitetsbiblioteket.
    Referenshantering med EndNote2017Ingår i: Vetenskaplig teori och metod: Från idé till examination inom omvårdnad / [ed] Maria Henricson, Lund: Studentlitteratur AB, 2017, 2, s. 439-458Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 316.
    Gunnarsson, Lars-Gunnar
    et al.
    Örebro universitet, Institutionen för medicinska vetenskaper.
    Bodin, Lennart
    Örebro universitet, Handelshögskolan vid Örebro Universitet.
    Epidemiologiskt undersökta samband mellan Alzheimers sjukdom och faktorer i arbetsmiljön2015Rapport (Refereegranskat)
    Abstract [en]

    Epidemiological evidence on associations between work environment and Alzheimers disease

    Lars-Gunnar Gunnarsson, assistant professor at School of Medicine, Örebro University, Sweden and

    Lennart Bodin, professor emeritus, Department of Statistics, Örebro University, Sweden and senior researcher at Institute of Environmental Medicine, Karolinska Institute, Sweden.

    In this systematic literature review we identified 50 original publications on associations between work and Alzheimer’s disease. GRADE guidelines were used to secure high scientific quality and reliable guidelines were applied to classify the papers. Thirty-one papers fulfilled high quality standards while 19 were methodologically deficient and thus were excluded from our meta-analyses.

    Twenty-seven studies concerned exposure to electromagnetic fields and two published meta-analyses indicated a weighted relative risk (RR) reaching 2.0. Our meta-analysis was only based on twelve high quality publications and the weighted relative risk included statistically over chemicals was evaluated in seven studies and the weighted RR was 1.55 (95% confidence interval 1.19-2.02). Only some few publications concerned pesticides and other chemicals and the weighted RR indicated increased risk.

    Higher education and work complexity were evaluated in eleven publications and our meta-analysis show a reduced the risk for Alzheimer’s disease. The weighted RR was 0.47 (95% confidence interval 0.35-0.63). Both factors were independently and additively protective.

    There are indications of an association between ALS and exposure to heavy muscle work especially in combination with muscle trauma, i.e. professional football players are reported to have an elevated risk. More studies are needed with more precise measures on these exposures.

  • 317.
    Gunnarsson Payne, Jenny
    Södertörns högskola, Institutionen för historia och samtidsstudier, Etnologi. Södertörns högskola, Centrum för Östersjö- och Östeuropaforskning (CBEES).
    Mattering Kinship: Inheritance, biology and egg donation, between genetics and epigenetics2016Ingår i: Critical Kinship Studies / [ed] Charlotte Krolokke, Lene Myong, Stine W. Adrian, Tine Tjornhoj-Thomsen, London: Rowman & Littlefield Publishers, 2016, 1, s. 33-47Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 318.
    Gunnarsson, Stina
    et al.
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Alehagen, Siw
    Linkoping Univ, Dept Med & Hlth Sci, Div Nursing Sci, Linkoping, Sweden.
    Lemming, Dag
    Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Ertzgaard, Per
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Berntsson, Shala Ghaderi
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för neurovetenskap, Neurologi.
    Samuelsson, Kersti
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Experiences from intrathecal baclofen treatment based on medical records and patient- and proxy-reported outcome: a multicentre study2019Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 9, s. 1037-1043Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose:

    To investigate patient satisfaction with intrathecal baclofen treatment, complications from the treatment, and the impact of general expectations on treatment outcome in relation to satisfaction.

    Methods:

    A multicentre study with cross-sectional design. Data were collected through questionnaires and patient records. Patients were recruited from six outpatient intrathecal baclofen clinics in Sweden. Eighty-three patients who had been treated with intrathecal baclofen for 1-4 years were included. For patients unable to communicate, data were collected through a proxy. The Patient Global Impression of Change was used to measure patients' general satisfaction with change from intrathecal baclofen treatment. The Life Orientation Test - revised, was used to measure general expectations/optimism.

    Results:

    General satisfaction with intrathecal baclofen treatment was high; 51/77 patients reported "much improved" or "very much improved." There was no relationship between the two main outcomes (general satisfaction and general expectations/optimism) (r(s) = 0.12, p = 0.382). The two groups; those who could and those who could not communicate, did differ regarding personal characteristics and should be evaluated as such.

    Conclusions:

    Most patients/proxies reported a high level of satisfaction with intrathecal baclofen treatment. The reported satisfaction with intrathecal baclofen treatment was not dependent on general expectations.

  • 319.
    Gustafsson, Berit M.
    et al.
    Linköpings universitet, Centrum för social och affektiv neurovetenskap (CSAN). Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Högland Hospital, Sweden; Jönköping University, Sweden.
    Gustafsson, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Barn- och ungdomspsykiatriska kliniken.
    Proczkowska, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Hospital Jönköping, Sweden.
    The Strengths and Difficulties Questionnaire (SDQ) for preschool childrena Swedish validation2016Ingår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 70, nr 8, s. 567-574Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In Sweden, 80-90% of children aged 1-5 years attend preschool, and that environment is well suited to identify behaviours that may be signs of mental health problems. The Strengths and Difficulties Questionnaire (SDQ) is a well-known short and structured instrument measuring child behaviours that indicate mental health problems well suited for preschool use.Aim: To investigate whether SDQ is a reliable and valid instrument for identifying behavioural problems in children aged 1-3 years and 4-5 years in a Swedish population, as rated by preschool teachers.Methods: Preschools situated in different sized municipalities in Sweden participated. The preschool teacher rated each individual child. Concurrent validity was tested using the Child-Teacher Report Form (C-TRF) and Child Engagement Questionnaire (CEQ). Exploratory factor analysis was conducted for age groups, 1-3 years and 4-5 years.Results: The preschool teachers considered most of the SDQ items relevant and possible to rate. For the children aged 1-3 years, the subscales Hyperactivity (Cronbach alpha=0.84, split half=0.73) and Conduct (Cronbach alpha=0.76, split half=0.80) were considered to be valid. For the age group 4-5 years, the whole original SDQ scale, 4-factor solution was used and showed reasonable validity (Cronbach alpha=0.83, split half=0.87).Conclusion: SDQ can be used in a preschool setting by preschool teachers as a valid instrument for identifying externalizing behavioural problems (hyperactivity and conduct problems) in young children.Clinical implications: SDQ could be used to identify preschool children at high-risk for mental health problems later in life.

  • 320.
    Gustafsson, E.
    et al.
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Litström, Emma
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Drott, Jenny
    Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Reliability testing of oxaliplatin-associated neurotoxicity questionnaire (OANQ), a pilot study2016Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, nr 2, s. 747-754Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE:

    The purpose of this study was to test the reliability of the Swedish version of the Oxaliplatin-Associated Neurotoxicity Questionnaire (OANQ) administrated throughout a self-reported mobile phone-based system, a pilot study.

    METHODS:

    Twenty-three patients from two university hospitals and two regional hospitals who had been treated with oxaliplatin were included through purposive sampling between autumn 2013 to autumn 2014. A test-retest was performed through a mobile phone-based system, with a recall period of 1 h to determine the reliability of the questionnaire.

    RESULTS:

    Internal consistency was strong for the three domains of the scale (α > 0.840). The statistical analyses for the test-retest indicated that the OANQ was stable. Intraclass correlation (ICC) for symptom items and effect on daily activities items showed an overall excellent reproducibility at 69 and 83 %, respectively. The weighted kappa for symptom items and daily activities items showed an overall almost perfect agreement at 59 and 52 %, respectively. A paired samples t test did not reveal any significant differences between the two measures.

    CONCLUSIONS:

    The OANQ was tested and considered a reliable assessment for capturing the oxaliplatin-induced peripheral neurotoxicity (OIPN) in patients receiving oxaliplatin. However, further reliability testing of the OANQ is needed.

  • 321.
    Gustafsson, Gabriel
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik. Uppsala University.
    Alpha-Synuclein Oligomers: Cellular Mechanisms and Aspects of Antibody Treatment2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    In Parkinson’s disease (PD) and dementia with Lewy bodies (DLB), aggregated α-synuclein deposit inside cells within the brain. Smaller soluble α-synuclein aggregates, oligomers, are present both intra- and extracellularly. The α-synuclein oligomers are known to be particularly harmful, although the underlying neurotoxic mechanisms are not fully understood. The aim of this thesis was to investigate the pathogenic roles of α-synuclein oligomers and the possibility to target such species with antibody treatment.

    Passive immunotherapy with α-synuclein antibodies can lead to reduced pathology and ameliorated symptoms in transgenic mice. However, it remains unknown whether the antibodies are taken up by cells or whether they act extracellularly. In Paper I, we assessed cellular internalization of various α-synuclein monoclonal antibodies. The oligomer selective mAb47 displayed the highest uptake, which was promoted by the extracellular presence of α-synuclein.

    Alpha-synuclein aggregates can be found in both neurons and glial cells, but the pathogenic role of glial deposits has only been sparsely investigated. In Paper II, co-cultures of neurons and glia were exposed to α-synuclein oligomers. The astrocytes in the cultures rapidly accumulated oligomers, which were only partially degraded by lysosomes. The sustained intracellular α-synuclein deposits were associated with mitochondrial stress reactions in the astrocytes. 

    In Paper III, we sought to explore whether the astrocytic pathology induced by α-synuclein oligomers could be ameliorated by antibody treatment. Pre-incubation of oligomers with mAb47 promoted α-synuclein clearance, reduced astrocytic accumulation and rescued cells from mitochondrial stress. We could demonstrate that binding of the antibody to its antigen in the extracellular space was crucial for these effects to occur.

    The progressive pathology in PD is believed to be driven by cell-to-cell spreading of α-synuclein aggregates, potentially via exosomes and other extracellular vesicles (EVs). In Paper IV, we found that either fusing α-synuclein to a non-physiological protein tag or introducing the PD-causing A53T mutation directed α-synuclein towards EV secretion. Also, EV-associated α-synuclein was particularly prone to induce toxicity in recipient cells.

    In conclusion, this thesis sheds new light on the cellular dysfunction related to α-synuclein pathology and on how the underlying pathogenic processes may be targeted by antibody treatment.  

  • 322.
    Gustafsson, Ingrid
    et al.
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för hälso- och vårdvetenskap (HV).
    Olandersson, Carin
    Centralsjukhuset Kristianstad.
    Kliniska examinationer på KTC2015Ingår i: Kliniska examinationer: Handbok för sjuksköterskestudenter på grund- och avancerad nivå / [ed] Sofia Almerud Österberg och Carina Elmqvist, Lund: Studentlitteratur AB, 2015, s. 77-108Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 323.
    Gustafsson, Sofia
    et al.
    Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin.
    Jeanette, Backholm
    Högskolan i Halmstad, Sektionen för ekonomi och teknik (SET), Bio- och miljösystemforskning (BLESS), Biomekanik och biomedicin.
    PÅVERKAR ÅLDER, KÖN OCH TRÄNINGSMÄNGD FMS?: En tvärsnittsstudie mellan Functional movement screen samt sf-36v2 Health survey2012Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Regelbunden fysisk aktivitet motverkar en rad fysiska och mentala sjukdomar. Hälsovinster av fysisk aktivitet är bland annat en högre funktionell muskulär- och kardiovaskulär kapacitet samt en högre livskvalitet. Stillasittande och inaktivitet kan leda till övervikt, kardiovaskulära sjukdomar, cancer, psykosociala problem och metaboliska sjukdomar.

    Mellan män och kvinnor finns fysiologiska skillnader som visar sig i kroppsstorlek och muskelmassa. Detta ger generellt sett kvinnor mer flexibel fysik medan män är fysiskt starkare.

    WHOs rekommendationer om daglig fysisk aktivitet är 150 min/vecka av moderat aerobisk träning eller 75 min mer ansträngande aerobisk träning. Styrketräning som involverar större muskelgrupper rekommenderas i åldrarna 18-64.  

    Till hjälp att undersöka hypotesen har två oberoende test används. En skriftlig enkät, SF-36v2 Health Survey, samt ett fysiskt test, Functional Movement Screen.

    I denna studie undersöks huruvida det finns ett samband mellan en ökad träningsmängd och ett högre FMS-resultat samt om en högre ålder ger lägre FMS-resultat, oavsett kön. Vi tror oss även se ett samband mellan högre FMS-poäng och ett högre uppskattat mentalt och fysiskt mående.

    Testpersonerna (N:30) som deltog i studien var arbetande eller studerande män (N:15) och kvinnor (N:15) i åldrarna 20-65år.

    FMS-resultaten visade ingen signifikant skillnad mellan kön eller stigande ålder. Däremot ser vi signifikanta skillnader mellan könen vid specifika styrke- eller rörlighetstester i FMS. Kvinnorna visar tydligt via resultaten att de generellt har en mer flexibel fysik medan männen är starkare.

    Som slutsats av denna studie kan vi konstatera att FMS som testmetod är könsneutralt och kan användas på blandade populationer. Detta ger testmetoden en bred användbarhet på just en blandad population.

    Fler studier krävs för att få fram normerande poängsättning om FMS skall användas på medelmotionären. 

  • 324.
    Gustafsson, Åsa
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för kemi och biomedicin (KOB).
    Kadmium och preeklampsi - finns det något samband? En litteraturstudie2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Kadmium (Cd) är ett metalliskt grundämne med välkända negativa hälsoeffekter som vi exponeras för i vår miljö, till stor del genom kosten. Preeklampsi drabbar årligen 3-7 % av alla gravida kvinnor och är en av de vanligaste orsakerna till sjuklighet och dödlighet för modern och en stor orsak till prematuritet och hämmad fostertillväxt.

    Syfte: Syftet med studien var att undersöka om det finns något samband mellan Cd och preeklampsi och i så fall vad sambandet/sambanden kan vara.

    Metod: Arbetet är en litteraturstudie baserad på vetenskapliga artiklar som sammanfattats.

    Resultat: Samtliga sju artiklar visar ett samband mellan Cd och preeklampsi. I experimentella modeller på dräktiga råttor som exponeras för Cd så utvecklar råttorna karakteristika för preeklampsi inklusive högt blodtryck. Hos människor observeras signifikanta samband mellan preeklampsi och högre Cd-halter i blod, serum samt fostervatten.

    Slutsats: Artiklarna visar att det finns ett samband mellan Cd och preeklampsi även om det inte går att fastställa att det rör sig om direkta orsakssamband utan fortsatt forskning.

  • 325.
    Haake, Kim
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Dahlgren, Emelie
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Föda utan rädsla: En utvärdering av förlossningsförberedelse i grupp2015Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: En förlossningsupplevelse har beskrivits som en central upplevelse i en kvinnas liv och något som hon och hennes partner bar med sig.

    Syftet: var att undersöka blivande föräldrars oro, rädsla, trygghet, tillit till sin egen förmåga och kroppsförståelse inför en förlossning, innan och efter genomgången Föda utan rädsla kurs samt om det fanns skillnader relaterat till sociodemografiska variabler. Metod: Studiens design var experimentell och utformades som en före- och eftermätning med huvudsakligen kvantitativ ansats. Ett semistrukturerat frågeformulär användes och 42 blivande föräldrar deltog i studien.

    Huvudresultat: Deltagarna kände större trygghet, mer tillit till den egna förmågan, större förståelse för vad som hände i kroppen samt mindre oro inför en förlossning, efter kursen. Den största oron inför förlossningen var kontrollförlust, oro för komplikationer, bristande vård och stöd samt distraktion. Deltagare med barn upplevde en lägre trygghet, mer oro och ökad rädsla inför förlossningen än de deltagare som inte hade barn. Efter kursen planerade deltagarna i större utsträckning, att använda sig av massage, andning och avslappning samt Föda utan rädsla metoden under förlossningen. Fler deltagare beskrev att samarbete och Föda utan rädsla metoden var de främsta verktygen som de tänkt använda. Fler deltagare ansåg att intimitet, humor, tystnad, lugn och avslappning samt musik tillhörde en förlossning, efter kursen. Deltagarna beskrev även en ökad känsla av förberedelse efter genomgången kurs.

    Slutsats: Föda utan rädsla kursen kan medföra ett bättre samarbete mellan paret och barnmorskan. Det kan även ge föräldrarna större möjligheter till olika val då de har mer kunskap om de alternativ som finns. Materialet i studien var dock relativt litet vilket innebär att inga säkra slutsatser gentemot populationen kunde dras. 

  • 326.
    Hagel, Sofia
    et al.
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Lindqvist, Elisabet
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Petersson, Ingemar F
    Department of Clinical Sciences in Lund, Section of Rheumatology & Orthopaedics, Lund University & Skane University Hospital, Lund, Sweden.
    Meesters, Jorit J L
    Department of Rheumatology, Department of Physical Therapy, Leiden University Medical Center, Leiden, Netherlands & National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Klokkerud, Mari
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Aanerud, Gerd J
    National Resource Center for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway .
    Stovgaard, Inger H
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Hørslev-Petersen, Kim
    King Christian Xth Hospital for Rheumatic Diseases, University of Southern Denmark, Gråsten, Denmark.
    Strömbeck, Britta
    Department of Clinical Sciences in Lund, Orthopaedics, Lund University, Lund, Sweden.
    Vliet Vlieland, Thea P M
    Department of Orthopaedics, Leiden University Medical Center, Leiden, Netherlands .
    Bremander, Ann
    Högskolan i Halmstad, Akademin för ekonomi, teknik och naturvetenskap, Bio- och miljösystemforskning (BLESS). Department of Clinical Sciences Lund, Section of Rheumatology, Lund University, Lund, Sweden & School of Business and Engineering, Department of Exercise Physiology, Biomechanics and Health, Spenshult, Halmstad, Sweden.
    Which patients improve the most after arthritis rehabilitation? A study of predictors in patients with inflamatory arthritis in northern Europe, the STAR-ETIC collaboration2014Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 46, nr 3, s. 250-257Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investigated.

    DESIGN: Multicentre prospective observational study in 4 European countries.

    METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and the Short Form 36 Health Survey (SF-36) in 731 patients who underwent multidisciplinary rehabilitation. Potential predictors were physical functioning (Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)), pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity, education, clinical setting and change of medication during rehabilitation. Analysis of covariance (ANCOVA) was used to assess for potential predictors and interactions. The minimal important differences for HRQoL were analysed.

    RESULTS: Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b 0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b 0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication during rehabilitation (b 0.08, p = 0.013) was associated with greater improvement in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal important differences were noted in 46% (EQ-5D) and 23-47% (SF-36 subscales) of the patients.

    CONCLUSION: Patients with more severe symptoms experienced the largest gain in HRQoL post-intervention. The results of this study are of value for selecting the right patients for rheumatological team rehabilitation. © 2014 The Authors

  • 327.
    Hagell, Peter
    et al.
    Kristianstad University.
    Broman, Jan-Erik
    Uppsala University.
    Hellström, Amanda
    Blekinge Institute of Technology.
    Fagerström, Cecilia
    Blekinge Institute of Technology.
    Willman, Ania
    Malmö University.
    Westergren, Albert
    Kristianstad University.
    Measurement properties of the Minimal Insomnia Symptom Scale (MISS) as an insomnia screening tool among adults and the elderly2015Ingår i: The 6th International Conference on Probabilistic Models for Measurement in Education: Psychology, Social Science and Health, 12 - 14 January 2015, University of Cape Town, 2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: The Minimal Insomnia Symptom Scale (MISS) has been suggested as a brief 3-item screening tool for detecting insomnia. Each item has an ordered 5-category (0-4) response scale and the instrument yields a total score between 0-12 (higher scores = more insomnia). Available MISS evaluations have been based on classical test theory (CTT) approaches. Different cut-offs for identifying insomnia have been suggested for adults (aged 20-64) and elderly (aged 65+). For adults, a cut-off of ≥6 has been suggested, while a cut-off of ≥7 has been suggested for the elderly, as determined from applications of the Youden index.

    Aim: To test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on Differential Item Functioning (DIF) by age, and to explore implications for the two suggested cut-off scores.

    Design: Cross-sectional MISS data from adult (n=1075) and elderly (n=548) populations were analysed by the unrestricted polytomous Rasch measurement model using the RUMM2030 software program. To avoid an inflated type I error rate, sample size was algebraically adjusted to 500 in the calculation of P-values while leaving all other aspects of data (e.g., locations, fit residuals) unaltered.

    Results: Mean person location was -1.095 (SD, 1.28), i.e. items tend to represent more severe levels of insomnia than that experienced by the sample. However, for the purpose of screening this may be considered acceptable. There were no statistically significant deviations from model expectations, with a non-significant overall item-trait interaction (χ2 = 26.94, P=0.173). Reliability (PSI) was 0.59 suggesting that the MISS can separate approximately two statistically distinct groups of people (1.92 strata). The highest Information Function (IF) was found at -0.2 logits. There were no disordered response category thresholds. There was uniform DIF by age for all three items, which disappeared following adjustment (split by age group) for the most pronounced DIF, suggesting that DIF was artificial for two items. Examination of raw scores-to-location estimates between the two age groups revealed differences at the lower and higher ends of the scale. The raw score cut-off of ≥6 was associated with a smaller logit difference between age groups than the ≥7 cut-off (0.09 vs. 0.23). That is, at a raw score of 6 the two age groups were comparable regarding their logit location estimates. This raw score (representing a logit value of -0.03 for the pooled sample) was also the one closest to the location of the highest IF (i.e., -0.2 logits).

    Summary and implications: This study provides general support for the measurement properties of the MISS. However, caution should be exercised in comparing MISS scores between age groups, but applying a ≥6 raw score cut-off appears to allow for valid comparisons between adults and elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia. 

  • 328.
    Hagerman, Heidi
    et al.
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Skytt, Bernice
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Wadensten, Barbro
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Högberg, Hans
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Engström, Maria
    Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    A longitudinal study of working life among first-line managers in the care of older adults2016Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, s. 7-13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To study whether the number of subordinates plays a role in first-line managers’ and subordinates’ ratings of empowerment, stress symptoms, and leadership–management performance. The aim was also to study relationships between managers’ empowerment and stress symptoms and leadership–management performance.

    Methods

    A longitudinal and correlational design was used. All first-line managers (n = 98) and their subordinates (n = 2085) working in the care of older adults in five municipalities were approached.

    Results

    With fewer (≤ 30) subordinates per manager, there were higher ratings of structural empowerment among managers and subordinates and lower stress symptoms among subordinates, than with ≥ 31 subordinates. Furthermore, structural empowerment was related to the managers’ stress symptoms and leadership–management performance, mediated through psychological empowerment. Moreover, structural empowerment can control/adjust for large numbers of subordinates in relation to stress symptoms.

    Conclusion

    The higher FLMs rated their access to empowerment, the lower stress symptoms and higher leadership–management performance they rated over time.

  • 329.
    Hagman, Karl
    et al.
    Section for Infectious Diseases, Department of Medical Science, Uppsala University.
    Barboutis, Christos
    Natural History Museum of Crete, University of Crete, Iraklion, Greece.
    Ehrenborg, Christian
    Section for Infectious Diseases, Department of Medical Science, Uppsala University.
    Fransson, Thord
    Naturhistoriska riksmuseet, Enheten för miljöforskning och övervakning.
    Jaenson, Thomas G. T.
    Department of Systematic Biology, Medical Entomology Unit, Uppsala University.
    Lindgren, Per-Eric
    Department of Clinical and Experimental Medicine, Microbiology, Linköping University.
    Lundkvist, Åke
    Department of Medical Microbiology and Biochemistry, Uppsala University and Swedish Institute for Communicable Diseases and Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet.
    Nyström, Fredrik
    Department of Clinical and Experimental Medicine, Microbiology, Linköping University.
    Waldenström, Jonas
    Center for Ecology and Evolution, Microbial Model Systems, Linneaus University.
    Salaneck, Erik
    Section for Infectious Diseases, Department of Medical Science, Uppsala University.
    On the potential roles of ticks and migrating birds in the ecology of West Nile virus.2014Ingår i: Infection Ecology and Epidemiology, ISSN 2000-8686, Vol. 4Artikel i tidskrift (Refereegranskat)
  • 330.
    Hagström, Anneli Silvén
    et al.
    Univ Gavle, Fac Hlth & Occupat Studies, Dept Social Work & Psychol, Gavle, Sweden;Stockholm Univ, Dept Social Work, Stockholm, Sweden.
    Toft, Teolinda
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Forskargrupper (Inst. för kvinnor och barns hälsa), Klinisk psykologi i hälso- och sjukvård.
    "TOGETHER WE ARE UNBEATABLE": young sisters' narration of a sibling's cancer in personal blogs on the internet2019Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 14, nr 1, artikel-id 1586625Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Siblings of children and young people diagnosed with cancer are commonly reluctant to talk about their experiences due to the circumstances of the illness situation. This article aims to bring voice to experience and inform practice by investigating what and how three young sisters narrate about their illness experiences in personal blogs on the Internet.

    Methods: A narrative methodology for the analysis of life storytelling was applied primarily to investigate the sister's coping strategies and support needs.

    Results: The results show how the sisters constructed their own space for narration, with the main aims of expressing their feelings about the illness and seeking social support. The telling of their experiences along with encouraging comments from a supportive audience enabled a change in position from feeling neglected and silenced to being a recognized agent and caring sister. In addition, through their narrative coping the sisters went from powerless to powerful in their position in relation to cancer.

    Conclusion: The results highlight the need for siblings to be able to narrate experience in a supportive context, where the processing of their relationship with the ill sister/brother should be understood as an important element of their coping with cancer and death.

  • 331.
    Hagström, Katja
    et al.
    Department of Environmental Science, Örebro University, Örebro,Sweden.
    Axelsson, Sara
    Örebro University Hospital, Department of Occupational and Environmental Medicine, Örebro, Sweden.
    Arvidsson, Helena
    Örebro University Hospital, Department of Occupational and Environmental Medicine, Örebro, Sweden.
    Bryngelsson, Ing-Liss
    Örebro University Hospital, Department of Occupational and Environmental Medicine, Örebro, Sweden.
    Lundholm, Cecilia
    Örebro University Hospital, Department of Occupational and Environmental Medicine, Örebro, Sweden.
    Eriksson, Kåre
    University Hospital of Umeå, Department of Occupational and Environmental Medicine, Umeå, Sweden.
    Exposure to Wood Dust, Resin Acids, and Volatile Organic Compounds During Production of Wood Pellets2008Ingår i: Journal of Occupational and Environmental Hygiene, ISSN 1545-9624, E-ISSN 1545-9632, Vol. 5, s. 296-304Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The main aim of this study was to investigate exposure to airborne substances that are potentially harmful to health during the production of wood pellets, including wood dust, monoterpenes, and resin acids, and as an indicator of diesel exhaust nitrogen dioxide. In addition, area measurements were taken to assess background exposure levels of these substances, volatile organic compounds (VOCs), and carbon monoxide. Measurements were taken at four wood pellet production plants from May 2004 to April 2005. Forty-four workers participated in the study, and a total of 68 personal measurements were taken to determine personal exposure to wood dust (inhalable and total dust), resin acids, monoterpenes, and nitrogen dioxide. In addition, 42 measurements of nitrogen dioxide and 71 measurements of total dust, resin acids, monoterpenes, VOCs, and carbon monoxide were taken to quantify their indoor area concentrations. Personal exposure levels to wood dust were high, and a third of the measured levels of inhalable dust exceeded the Swedish occupational exposure limit (OEL) of 2 mg/m 3 . Parallel measurements of inhalable and total dust indicated that the former were, on average, 3.2 times higher than the latter. The data indicate that workers at the plants are exposed to significant amounts of the resin acid 7-oxodehydroabietic acid in the air, an observation that has not been recorded previously at wood processing and handling plants. The study also found evidence of exposure to dehydroabietic acid, and exposure levels for resin acids approached 74% of the British OEL for colophony, set at 50 μg/m 3 . Personal exposure levels to monoterpenes and nitrogen dioxide were low. Area sampling measurements indicated that aldehydes and terpenes were the most abundant VOCs, suggesting that measuring personal exposure to aldehydes might be of interest. Carbon monoxide levels were under the detection limit in all area measurements. High wood dust exposure levels are likely to have implications for worker health; therefore, it is important to reduce exposure to wood dust in this industry.

  • 332.
    Halilovic, Amra
    et al.
    Landstinget i Dalarna.
    Terner, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Forskning om funktionshinder och habilitering.
    Standardized headings as a foundation for semantic interoperability in EHR2016Ingår i: MATEC Web of Conferences / [ed] N. Mastorakis, V. Mladenov and A. Bulucea, 2016, Vol. 76, artikel-id 04001Konferensbidrag (Refereegranskat)
    Abstract [en]

    The new Swedish Patient Act, which allows patients to choose health care in county councils other than their own, creates the need to be able to share health-related information contained in electronic health records [EHRs) across county councils. This demands interoperability in terms of structured and standardized data. Headings in EHR could also be a part of structured and standardized data. The aim was to study to what extent terminology is shared and standardized across county councils in Sweden. Headings from three county councils were analyzed to see to what extent they were shared and to what extent they corresponded to concepts in SNOMED CT and the National Board of Health and Welfare’s term dictionary [NBHW’s TD). In total 41% of the headings were shared across two or three county councils. A third of the shared headings corresponded to concepts in SNOMED CT. Further, an eighth of the shared headings corresponded to concepts in NBHW’s TD. The results showed that the extent of shared and standardized terminology in terms of headings across the studied three county councils were negligible.

  • 333.
    Halilovic, Amra
    et al.
    Landstinget Dalarna.
    Terner, Annika
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap.
    The Extent of Shared Headings in Electronic Health Records in Swedish County Councils and Regions2018Ingår i: Journal of Medical Imaging and Health Informatics, ISSN 2156-7018, E-ISSN 2156-7026, Vol. 8, nr 3, s. 532-536Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The need to exchange health-related information contained in electronic health records across county councils and regions in Sweden has become necessary due to the new Swedish Patient Act. This act allows patients to choose health care both in their own county council or region as well as in county councils or regions other than their own. Exchange of health-related information demands interoperability and especially semantic interoperability. In Sweden headings are traditionally employed for structure the data in the health records. If the headings are shared and standardised they can enable the sharing of health-related information across county councils and regions. However, each county council and region has their own terminology of headings. The aim is to study to what extent headings are shared and to what extent the shared headings are standardised across county councils and regions in Sweden. The spelling of 32,228 headings from three county councils and regions was analysed to see to what extent they were spelled exactly the same and to what extent those headings spelled exactly the same corresponded to concepts in the Swedish Common Information Structure. In total 130 headings were spelled exactly the same across three county councils and regions. More than half of the headings spelled exactly the same corresponded to concepts in the Swedish Common Information Structure. The results showed that the three county councils and regions in total shared 2% of the studied headings. Of the shared headings more than half were standardised. Professional groups have long experience of employing headings and therefore we recommend headings as a tool for implementing a National Language for Specific Purposes as Swedish National Board of Health and Welfare's standard. This will enable health-related information to be available wherever the patient is located across county councils and regions.

  • 334.
    Hallberg, Anneli
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    SOS 112– vad har inträffat?: En studie av framgångs- och riskfaktorer i nöd-samtalet utifrån ett förbättringsarbete för att öka säkerställandet av vitala parametrar genom reflektion.2018Självständigt arbete på avancerad nivå (masterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Den akuta prehospitala vården börjar ofta med ett nödsamtal. Detta, mycket komplexa samtal, är vård som ska vara av god kvalitet, ges på lika villkor och den som har störst behov ska ges företräde. Syftet med förbättringsarbetet var att genom regelbunden återkommande, strukturerad återkoppling och reflektion öka säkerställandet av vitala parametrar och korrekt prioritering i nödsamtalen. Syftet med studien var identifiera framgångs- och riskfaktorer ur SOS-operatörens perspektiv på nödsamtalet med fokus på säkerställande av vitala parametrar, korrekt prioritering samt sammanhanget runt ett nödsamtal.

     

    Genom att, under fyra månader, tillsammans med initialt 12 operatörer, individuellt reflektera över innehållet samtalet samt skriva ned reflektionerna medvetandegjordes operatören på innehållet i samtalet. Detta ledde till en ökning gällande säkerställande av vitala parametrar och korrekt prioritering. En innehållsanalys av reflektionerna visade att det var en framgångsfaktor att vara professionell och att brister i samtalsmetodiken var en stor riskfaktor. När fastställd process för samtalet följdes var det en framgångsfaktor likväl som det var en riskfaktor när den inte följdes.

     

    Slutsatsen blev att regelbunden avlyssning och reflektion ökar säkerställandet av vitala parametrar och korrekt prioritering i nödsamtalen samt att det är en framgångsfaktor att följa fastställd process för samtalet men att tekniskt stöd för ändamålet saknas.

  • 335.
    Hallvig, David
    et al.
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT. Chalmers Tekniska Högskola.
    Anund, Anna
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Fors, Carina
    Statens väg- och transportforskningsinstitut, Trafik och trafikant,TRAF, Samspel människa, fordon, transportsystem, MFT.
    Kecklund, Göran
    Stockholms Universitet.
    Karlsson, Johan G.
    Autoliv Development AB.
    Wande, Mattias
    Chalmers Tekniska Högskola.
    Åkerstedt, Torbjörn
    Stockholms Univeristet, Karolinska institutet.
    Sleepy driving on the real road and in the simulator: A comparison2013Ingår i: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 50, s. 44-50Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study compared real driving with driving in a high fidelity, moving base, driving simulator with respect to driving performance, sleep related physiology (using electroencephalography and electrooculography) and subjective sleepiness during night and day driving for 10 participants.

    Sleepiness has been identified as one of the most important factors contributing to road crashes. However, almost all work on the detailed changes in behavior and physiology leading up to sleep related crashes has been carried out in driving simulators. It is not clear, however, to what extent simulator results can be generalized to real driving.

    The real road was emulated in the simulator. The results show that the simulator was associated with higher levels of subjective and physiological sleepiness than real driving. However, both for real and simulated driving, the response to night driving appears to be rather similar for subjective sleepiness and sleep physiology. Lateral variability was more responsive to night driving in the simulator, while real driving at night involved a movement to the left in the lane and a reduction of speed, both of which effects were absent in the simulator. It was concluded that the relative validity of simulators is acceptable for many variables, but that in absolute terms simulators cause higher sleepiness levels than real driving. Thus, generalizations from simulators to real driving must be made with great caution.

  • 336.
    Halvorsen, Peter
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Sharma, Hari Shanker
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Basu, Samar
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Oxidativ stress och inflammation.
    Wiklund, Lars
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Neural injury after use of vasopressin and adrenaline during porcine cardiopulmonary resuscitation2015Ingår i: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 120, nr 1, s. 11-19Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Our aim was to investigate cerebral and cardiac tissue injury subsequent to use of vasopressin and adrenaline in combination compared with vasopressin alone during cardiopulmonary resuscitation (CPR). Methods. In a randomized, prospective, laboratory animal study 28 anesthetized piglets were subject to a 12-min untreated cardiac arrest and subsequent CPR. After 1 min of CPR, 10 of the piglets received 0.4 U/kg of arg(8)-vasopressin (V group), and 10 piglets received 0.4 U/kg of arg(8)-vasopressin, 1 min later followed by 20 mu g/kg body weight of adrenaline, and another 1 min later continuous administration (10 mu g/kg/min) of adrenaline (VA group). After 8 min of CPR, the piglets were defibrillated and monitored for another 3 h. Then they were killed and the brain immediately removed pending histological analysis. Results. During CPR, the VA group had higher mean blood pressure and cerebral cortical blood flow (CCBF) but similar coronary perfusion pressure. After restoration of spontaneous circulation there was no difference in the pressure variables, but CCBF tended to be (36% +/- 16%) higher in the V group. Neuronal injury and signs of a disrupted blood-brain barrier (BBB) were greater, 20% +/- 4% and 21% +/- 4%, respectively, in the VA group. In a background study of repeated single doses of adrenaline every third minute after 5 min arrest but otherwise the same protocol, histological measurements showed even worse neural injury and disruption of the BBB. Conclusion. Combined use of vasopressin and adrenaline caused greater signs of cerebral and cardiac injury than use of vasopressin alone during experimental cardiopulmonary resuscitation.

  • 337.
    Hanson, Anton
    et al.
    Linnéuniversitetet, Fakulteten för teknik (FTK), Sjöfartshögskolan (SJÖ).
    Horck, Emma
    Linnéuniversitetet, Fakulteten för teknik (FTK), Sjöfartshögskolan (SJÖ).
    Arbetsskador som drabbar marin maskinpersonal: En kartläggning av skaderiskerna för marin maskinpersonal ombord på svenska fartyg, samt en jämförelse av skaderisken med liknande arbeten iland2013Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med undersökningen är att kartlägga skaderiskerna med att arbeta som marin maskinpersonal och jämföra skaderisken med anställda som har liknande arbeten iland. Undersökningen inbegriper även att kartlägga vilka typer av arbetsskador, som ger de mest allvarliga konsekvenserna för den anställde i förhållande till hur vanlig olyckan är.

    Undersökningen är en litteraturstudie där Arbetsmiljöverkets arbetsskadeanmälningar utgör grundmaterialet, där totalt 198 arbetsskador behandlades och kategoriserades. Transportstyrelsens statistik för ombordanställda jämfördes med Arbetsmiljöverket och Statistiska centralbyrån statistik över anställda iland. Detta för att se vilken yrkeskategori som hade högst skaderisk.

    Resultatet av undersökningen visar att arbetsolyckor under kategorierna ”Bära” och ”Halka/Snubbla/Trilla” och arbetssjukdomar under kategorin ”Tunga lyft/Arbetsställningar” är de arbetsskador, som ger de mest allvarliga konsekvenserna i förhållande till hur vanlig arbetsskadan är. Vid jämförelsen av skaderisken med liknande yrkeskategorier iland ligger maskinanställda till sjöss näst sämst till. Den yrkeskategori som är mest lik marin maskinpersonal har fyra gånger mindre skaderisk.

  • 338.
    Hanson, Claudia
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Waiswa, Peter
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Marchant, Tanya
    Department of Disease Control, London School of Hygiene and Tropical Medicine, United Kingdom.
    Marx, Michael
    Evaplan GmbH the University of Heidelberg, Germany.
    Manzi, Fatuma
    Ifakara Health Institute, Dar-es-Salaam, Tanzania.
    Mbaruku, Godfrey
    Ifakara Health Institute, Dar-es-Salaam, Tanzania.
    Rowe, Alex
    Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA.
    Tomson, Göran
    Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
    Schellenberg, Joanna
    Department of Disease Control, London School of Hygiene and Tropical Medicine, United Kingdom.
    Peterson, Stefan
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa.
    Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda.2014Ingår i: Implementation science : IS, ISSN 1748-5908, Vol. 9, artikel-id 41Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda.

    METHODS: In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys.

    DISCUSSION: EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings.

    TRIAL REGISTRATION: PACTR201311000681314.

  • 339.
    Hartleb, Hanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Törnqvist, Patrik
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
      Gör terapeuten det hon tror hon gör och spelar det någon roll?: En explorativ validitetsstudie om sambanden mellan självrapporterad och observatörsskattad följsamhet till IPT som metod och dess betydelse för terapins utfall.  2012Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

     

    Denna studie har syftat till att mäta följsamhet till terapimetoden Interpersonell psykoterapi, undersöka sambanden mellan självrapporterad och observatörsskattad följsamhet samt utforska om terapeutens följsamhet påverkar behandlingsresultatet. Inga signifikanta samband mellan den självrapporterade och observatörsskattade följsamheten hos terapeuterna kunde konstateras. På de observatörsskattade variablerna fanns det en signifikant skillnad mellan terapeuterna, där en terapeut var mer följsam än de övriga två. Detta visade sig dock inte ha någon signifikant betydelse för behandlingsresultatet. Patienterna uppnådde en betydande symtomreduktion efter behandlingen utifrån deras självskattningar på MADRS-S och PHQ-9, men några samband med terapeuternas nivå av följsamhet kunde inte statistiskt beläggas. Författarna menar att det låga undersökningsmaterialet och bristen på ett enhetligt skattningsinstrument för den subjektiva och objektiva mätningen ger anledning att inte övertolka resultaten. En utvidgning av följsamhet som begrepp förespråkas, där följsamhet inte bara definieras av terapeutens beteende utan även av patientens beteende och samspelet mellan terapeut och patient. Vikten av fortsatta studier med denna definition som utgångspunkt poängteras.

  • 340. Hastbacka, Johanna
    et al.
    Fredén, Filip
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Anestesiologi och intensivvård.
    Hult, Maarit
    Bergquist, Maria
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för medicinska vetenskaper, Klinisk fysiologi.
    Wilkman, Erika
    Vuola, Jyrki
    Sorsa, Timo
    Tervahartiala, Taina
    Huss, Fredrik
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kirurgiska vetenskaper, Plastikkirurgi.
    Matrix Metalloproteinases-8 and-9 and Tissue Inhibitor of Metalloproteinase-1 in Burn Patients. A Prospective Observational Study2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, artikel-id e0125918Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction Matrix metalloproteinases (MMPs) -8 and -9 are released from neutrophils in acute inflammation and may contribute to permeability changes in burn injury. In retrospective studies on sepsis, levels of MMP-8, MMP-9, and tissue inhibitor of metalloproteinase-1 (TIMP-1) differed from those of healthy controls, and TIMP-1 showed an association with outcome. Our objective was to investigate the relationship between these proteins and disease severity and outcome in burn patients. Methods In this prospective, observational, two-center study, we collected plasma samples from admission to day 21 post-burn, and burn blister fluid samples on admission. We compared MMP-8, -9, and TIMP-1 levels between TBSA<20% (N = 19) and TBSA>20% (N = 30) injured patients and healthy controls, and between 90-day survivors and non-survivors. MMP-8, -9, and TIMP-1 levels at 24-48 hours from injury, their maximal levels, and their time-adjusted means were compared between groups. Correlations with clinical parameters and the extent of burn were analyzed. MMP-8, -9, and TIMP-1 levels in burn blister fluids were also studied. Results Plasma MMP-8 and -9 were higher in patients than in healthy controls (P<0.001 and P = 0.016), but only MMP-8 differed between the TBSA<20% and TBSA>20% groups. MMP-8 and -9 were not associated with clinical severity or outcome measures. TIMP-1 differed significantly between patients and controls (P<0.001) and between TBSA<20% and TBSA>20% groups (P<0.002). TIMP-1 was associated with 90-day mortality and correlated with the extent of injury and clinical measures of disease severity. TIMP-1 may serve as a new biomarker in outcome prognostication of burn patients.

  • 341.
    Haynes, John E.
    et al.
    School of Education, University of New England, Armidale NSW, Australia.
    Miller, Judith A.
    School of Education, University of New England, Armidale NSW, Australia.
    Varea, Valeria
    School of Education, University of New England, Armidale NSW, Australia.
    Preservice generalist teachers enlightened approach to teaching Physical Education through Teacher Biography2016Ingår i: Australian Journal of Teacher Education, ISSN 1835-517X, Vol. 41, nr 3, s. 21-38Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This paper describes a new learning experience, which was introduced following an examination of the literature regarding preservice primary school teachers' (PPST) notions of their past experience in Physical Education (PE) (Elliott 2013). PPSTs were given the opportunity to recognise, reflect, interrogate and reframe a critical incident from their schooling in PE or Sport. This exercise was designed to enlighten students about their own schooling and the potential impact this event may have on pre-conceived ideas and opinions about teaching PE. Students (N=214) enrolled in off and on campus mode, of a preservice teacher education program in a university located in regional NSW, were asked to provide information about, and to analyse, an incident, either positive or negative that occurred in PE or Sport during their primary or secondary school years. In addition, students were encouraged to reframe the incident and to seek out alternative actions that could have influenced the outcome. The aim was to encourage reflection about how preconceived notions pertaining to PE might be dealt within their present position as a preservice teacher. The PPSTs scripts were analysed using the Leximancer text mining software (Smith, 2000). Findings from the analysis provided themes and concepts, which suggest a similarity for both, off and on campus, males and females. However, there are some subtle differences between the cohorts that may be due to age or experience.

  • 342. Hedman, Leif
    et al.
    Fahlstedt, Madelen
    KTH, Skolan för teknik och hälsa (STH), Medicinsk teknik, Neuronik.
    Schlickum, Marcus
    Möller, Hans
    von Holst, Hans
    KTH, Skolan för teknik och hälsa (STH), Medicinsk teknik, Neuronik.
    Felländer-Tsai, Li
    A pilot evaluation of an educational program that offers visualizations of cervical spine injuries: medical students' self-efficacy increases by training2014Ingår i: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 39, nr 1, s. 33-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this pilot study, a new method for visualization through imaging and simulation (VIS-Ed) for teaching diagnosis and treatment of cervical spine trauma was formatively evaluated. The aims were to examine if medical students' self-efficacy would change by training using VIS-Ed, and if so these changes were related to how they evaluated the session, and the user interface (UI) of this program. Using a one-group, pre-post course test design 43 Swedish medical students (4th year, 17 males, 26 females) practiced in groups of three participants. Overall the practice and the UI were considered as positive experiences. They judged VIS-Ed as a good interactive scenario-based educational tool. All students' self-efficacy increased significantly by training (p<0.001). Spearman's rank correlation tests revealed that increased self-efficacy was only associated with: how the session was compared to as expected (p<0.007). Students' self-efficacy increased significantly by training, but replication studies should determine if this training effect is gender-related.

  • 343. Heijne, A.
    et al.
    Äng, Björn
    Werner, S.
    Predictive factors for 12-month outcome after anterior cruciate ligament reconstruction2009Ingår i: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, nr 6, s. 842-9Artikel i tidskrift (Refereegranskat)
  • 344. Heldal, Ilona
    et al.
    Backlund, Per
    Johannesson, Mikael
    Lebram, Mikael
    Lundberg, Lars
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Connecting the links: Narratives, simulations and serious games in prehospital training.2017Ingår i: Studies in Health Technology and Informatics, ISSN 0926-9630, E-ISSN 1879-8365, Vol. 235, s. 343-347Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Due to rapid and substantial changes in the health sector, collaboration and supporting technologies get more into focus. Changes in education and training are also required. Simulations and serious games (SSG) are often advocated as promising technologies supporting training of many and in the same manner, or increasing the skills necessary to deal with new, dangerous, complex or unexpected situations. The aim of this paper is to illustrate and discuss resources needed for planning and performing collaborative contextual training scenarios. Based on a practical study involving prehospital nurses and different simulator technologies the often-recurring activity chains in prehospital training were trained. This paper exemplifies the benefit of using narratives and SSGs for contextual training contributing to higher user experiences. The benefits of using simulation technologies aligned by processes can be easier defined by narratives from practitioners. While processes help to define more efficient and effective training, narratives and SSGs are beneficial to design scenarios with clues for higher user experiences. By discussing illustrative examples, the paper contributes to better understanding of how to plan simulation-technology rich training scenarios.

  • 345.
    Helgesson, Gert
    et al.
    Karolinska Institutet, Sweden.
    Lindblad, Anna
    Karolinska Institutet, Sweden.
    Thulesius, Hans
    Lund university, Sweden;Region Kronoberg, Sweden.
    Lynöe, Niels
    Karolinska Institutet, Sweden.
    Reasoning about physician-assisted suicide: analysis of comments by physicians and the Swedish general public2009Ingår i: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 4, nr 1, s. 19-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Two questionnaires directed to Swedish physicians and a sample of the Swedish population investigated attitudes towards physician-assisted suicide (PAS). The aim of the present work was to analyse qualitative data from these questionnaires in order to explore how respondents reason about PAS. Data were analysed in two steps. First, we categorized different kinds of responses and identified pro and con arguments. Second, we identified general conclusions from the responses. The data reflect the differences in attitudes towards PAS among the public and physicians, with the former mainly in favour of PAS and the latter mainly against. There was, however, considerable agreement about what requirements must be met before PAS could be considered ethical. Many arguments against PAS concerned the professional role of physicians, which indicates that it may not be assisted suicide as such that many PAS opponents disagree with, but rather that it is handled by physicians in the regular health-care system.

  • 346.
    Helldahl, Karin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Mattsson, Carola
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykoterapi.
    Negativa effekter av psykoterapi2016Självständigt arbete på avancerad nivå (yrkesexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Syftet med studien var att undersöka blivande psykoterapeuters uppfattning av negativa effekter av den egenterapi som de genomgått inom ramen för utbildningen till legitimerade psykoterapeuter. Vilka negativa effekter av egenterapi rapporterar psykoterapeutstudenter och skiljer sig dessa från vad patienter som genomgått psykoterapi rapporterar? En frågeställning var också hur blivande psykoterapeuter ser på egenterapins funktion (terapeutisk funktion, modellfunktion, empatisk funktion eller övertygelsefunktion),

    En enkätundersökning genomfördes bland studenter på två olika psykoterapeutprogram under den avslutande terminen. Totalt kom 33 studenter att delta. Instrumentet som använts, “Negativa händelser och effekter av psykologisk behandling”, består av 60 påståenden som skattas utifrån upplevda biverkningar av psykoterapi (och vad som specifikt orsakats av egenterapin). Jämförelse gjordes med redan publicerade data kring patienters rapportering (Norström, 2015). I tillägg fick studenterna skatta egenterapins funktion på en fyrgradig skala. Resultatet visar att en relativt stor andel av psykoterapeutstudenterna rapporterade någon form av negativ effekt av egenterapin. Vanligast var att man upplevde att gamla obehagliga minnen väcktes till liv (36%), att man inte förstod sin terapeut (27%) och att man kände sig mer sorgsen (24%). Resultatet visar också att rapporterade negativa effekter av egenterapi var relativt likartad mellan gruppen studenter och patienter. Egenterapins terapeutiska funktion angavs ha mycket stor betydelse bland drygt hälften av studenterna. Störst andel av studenterna, drygt hälften, angav att den terapeutiska funktionen hade en mycket stor betydelse.

    Sammantaget pekar studien på behovet av att uppmärksamma de negativa effekterna av psykoterapi, samtidigt som fortsatt forskning inom detta komplexa område är nödvändig.

  • 347.
    Hellgren, Susanne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Vikten av det sociala stödet vid viktminskningskirurgi2014Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Antalet vuxna som lever med fetma har enligt WHO fördubblats sedan 1980. Kirurgiskt ingrepp såsom gastric bypass är den metod som leder till hållbar viktminskning. Syftet med studien var att undersöka hur patienter som genomgått viktminskningskirurgi kan uppleva stödet före, under och efter operation. Studien har en narrativ fenomenologisk ansats, berättelserna har analyserats genom meningskoncentrering, strukturering och tolkning. Studien innefattar berättelser från fem informanter som valdes genom handplockat urval. Resultatet visar att de flesta informanter upplever ett fint stöd från omgivningen under processen. Missnöjet riktar sig mot sjukvården och det först efter operationen. Informanterna upplever sig som ensamma och saknar sjukvårdens förståelse. Den bristfälliga uppföljningen genererar i svårigheter för patienterna att med tiden följa de kostrekommendationer som angavs. En samtalskontakt som stöd för hållbar viktminskning och för undvikande av bristsjukdomar är att rekommendera.

  • 348.
    Hellström Muhli, Ulla
    et al.
    Högskolan i Skövde, Institutionen för vård och natur.
    Delbene, Roxana
    The ethical dimension of presence in elderly care talk-encounter2012Ingår i: Discursive, ethical, and psychological dimensions of Presence in Health Care Communication – implications for professional education / [ed] J.C. Gonçalves, Niteroi: Editora da Universidade Federal Fluminense , 2012Kapitel i bok, del av antologi (Refereegranskat)
  • 349.
    Helmfrid, Ingela
    et al.
    Linköping University, Sweden.
    Ljunggren, Stefan
    Linköping University, Sweden.
    Nosratabadi, Reza
    Linköping University, Sweden.
    Augustsson, Anna
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för biologi och miljö (BOM).
    Filipsson, Monika
    Linnéuniversitetet, Fakulteten för Hälso- och livsvetenskap (FHL), Institutionen för biologi och miljö (BOM).
    Fredriksson, Mats
    Linköping University, Sweden.
    Karlsson, Helen
    Linköping University, Sweden.
    Berglund, Marika
    Karolinska Institutet, Sweden.
    Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glassworks area2019Ingår i: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 131, s. 1-10, artikel-id 104985Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Production of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer.

    Objective

    The aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors.

    Methods

    The study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979–2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer.

    Results

    Despite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms.

    Conclusions

    The associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.

  • 350.
    Hemmingsson, Helena
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Björk Olafsdottir, Linda
    University of Iceland, Iceland.
    Thora Egilson, Snaefridur
    University of Iceland, Iceland.
    Agreements and disagreements between children and their parents in health-related assessments2017Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 39, nr 11, s. 1059-1072Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Purpose: To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. Method: The Uni-Search and five additional databases were searched. Childrens health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. Results: Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their childrens difficulties in emotional functioning and pain. There were no consistencies in differences between childrens and parents ratings on levels of agreement with respect to the childrens health issue, age or gender. Conclusions: Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. IMPLICATIONS FOR REHABILITATION In general, parents consider their children to have more difficulties - or more extensive difficulties than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the childs health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the childrens emotional functioning and pain. Clinicians should prioritize obtaining childrens views on subjective aspects such as emotional issues as well as on pain.

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