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  • 51.
    Azios, Jamie H.
    et al.
    Lamar Univ, TX 77710 USA.
    Bellon-Harn, Monica
    Lamar Univ, TX 77710 USA.
    Dockens, Ashley L.
    Lamar Univ, TX 77710 USA.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar Univ, TX 77710 USA; Audiol India, India.
    Quality and readability of English-language internet information for aphasia2019In: International Journal of Speech-Language Pathology, ISSN 1754-9507, E-ISSN 1754-9515, Vol. 21, no 1Article in journal (Refereed)
    Abstract [en]

    Purpose: Little is known about the quality and readability of treatment information in specific neurogenic disorders, such as aphasia. The purpose of this study was to assess quality and readability of English-language Internet information available for aphasia treatment. Method: Forty-three aphasia treatment websites were aggregated using five different country-specific search engines. Websites were then analysed using quality and readability assessments. Statistical calculations were employed to examine website ratings, differences between website origin and quality and readability scores, and correlations between readability instruments. Result: Websites exhibited low quality with few websites obtaining Health On the Net (HON) certification or clear, thorough information as measured by the DISCERN. Regardless of website origin, readability scores were also poor. Approximate educational levels required to comprehend information on aphasia treatment websites ranged from 13 to 16 years of education. Significant differences were found between website origin and readability measures with higher levels of education required to understand information on websites of non-profit organisations. Conclusion: Current aphasia treatment websites were found to exhibit low levels of quality and readability, creating potential accessibility problems for people with aphasia and significant others. Websites including treatment information for aphasia must be improved in order to increase greater information accessibility.

  • 52.
    Baek Larsen, Louise
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Tranberg, Roy
    Ortopeden, Sahlgrenska Universitetssjukhuset, Gothenburg University, Göteborg.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Jämförande studie av Svensk polis rörelseförmåga vid användandet av bål och/eller bäcken fixerad utrustning2014Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under det senaste decenniet har det blivit allt vanligare med arbetsrelaterade besvär hos uniformerad polis i yttre tjänst, främst är det besvär från nedre delen av ryggen som uppgetts. Hälsohögskolan i Jönköping har fått i uppdrag av Rikspolisstyrelsen att belysa och utreda den uppkomna problematiken. Två tidigare rapporter, Polisens fysiska arbetsmiljö och Polisens psykosociala miljö, har presenterats. I rapporten om polisens fysiska arbetsmiljö framkom en hög förekomst av besvär från muskler och leder, främst nedre delen av ryggen under förhållande med bärande av utrustningsbältet i kombination med mycket stillasittande i tjänstebilar. I den andra rapporten framkom att en stor del av poliserna arbetar treskift och i många fall långa arbetspass, vilket yttrar sig i att de har svårt att psykiskt återhämta sig, inte har tid för familj och vänner samt att de ofta upplever sig trötta. I den tredje och sammanfattande rapporten presenteras vilka bakomliggande variabler som påverkar den fysiska och psykosociala arbetsmiljön.

    Syftet med studien var att analysera vilka variabler och vilka kombinationer av variabler som påverkar den fysiska och psykosociala arbetsmiljön för uniformerad polis i yttre tjänst i Sverige. Rapporten baseras på 4244 enkätsvar från poliser i yttre uniformerad tjänst.

    Resultatet från föreliggande studie har visat att det finns skillnaden i besvärsfrekvens mellan myndigheterna när det gäller otillräcklig fysisk och psykisk återhämtning samt besvär ifrån nedre delen av ryggen. Orsakerna till skillnaden mellan myndigheterna är inte utredda. Studien har visat att besvärsfrekvensen ökar då det föreligger krav att arbeta på ett rullande treskiftsschema. Utifrån detta föreslår vi att man:

    • utför benchmarking av polismyndigheter för att öka förståelsen för de stora skillnader som förekommer

    • utvärderar olika modeller av schemaläggning avseende treskift

    • fortsätter arbetet med att utreda hur polisens uniform och kroppsburna utrustning, i kombination med bilsätets utformning, påverkar besvär från nedre delen av ryggen.

  • 53.
    Ball, Martin J
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Granese, Angela
    University of Louisiana at Lafayette.
    Towards an evidence-base for /r/ therapy in English.2013In: Journal of Clinical Speech and Language Studies, ISSN 0791-5985, Vol. 20, p. 1-23Article in journal (Refereed)
  • 54.
    Ball, Martin J
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Müller, NicoleLinköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.Nelson, Ryan L.University of Louisiana at Lafayette, LA, USA.
    Handbook of qualitative research in communication disorders2014Collection (editor) (Other academic)
    Abstract [en]

    This volume provides a comprehensive and in-depth handbook of qualitative research in the field of communication disorders. It introduces and illustrates the wide range of qualitative paradigms that have been used in recent years to investigate various aspects of communication disorders.

    The first part of the Handbook introduces in some detail the concept of qualitative research and its application to communication disorders, and describes the main qualitative research approaches. The contributions are forward-looking rather than merely giving an overview of their topic. The second part illustrates these approaches through a series of case studies of different communication disorders using qualitative methods of research.

    This Handbook is an essential resource for senior undergraduate and graduate students, researchers and practitioners, in communication disorders and related fields.

  • 55.
    Ball, Martin J
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences.
    Rutter, Ben
    University of Sheffield, UK.
    Kroll, Tobias
    Texas Tech University, USA.
    Interactional phonetics: background and examples.2014In: Handbook of qualitative research in communication disorders / [ed] Martin J. Ball, Nicole Müller, and Ryan L. Nelson, New York: Psychology Press, 2014, p. 311-328Chapter in book (Refereed)
  • 56.
    Barbabella, Francesco
    National Institute of Health and Science on Ageing (INRCA), Italy.
    [ Review of ] Blanche Le Bihan, Claude Martin and Trudie Knijn (eds.): Work and Care Under Pressure. Care Arrangements Across Europe. Amsterdam 2013: Amsterdam University Press, 197 pp2014In: Czech Sociological Review, ISSN 1210-3861, Vol. 6, p. 999-1001Article, book review (Other academic)
  • 57.
    Baunsgaard, Carsten Bach
    et al.
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Nissen, Ulla Vig
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Brust, Anne Katrin
    SPC, Nottwil, Switzerland.
    Frotzler, Angela
    SPC, Nottwil, Switzerland.
    Ribeill, Cornelia
    Ulm Univ, SCI Ctr Orthopaed Dept, Ulm, Germany.
    Kalke, Yorck-Bernhard
    Ulm Univ, SCI Ctr Orthopaed Dept, Ulm, Germany.
    Leon, Natacha
    FLM, Madrid, Spain.
    Gomez, Belen
    FLM, Madrid, Spain.
    Samuelsson, Kersti
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Antepohl, Wolfram
    Linkoping Univ, Dept Rehabil Med, Linkoping, Sweden;Linkoping Univ, Dept Med & Hlth Sci, Linkoping, Sweden.
    Holmstrom, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery. Uppsala Univ Hosp, Spinal Cord Rehabil Unit, Uppsala, Sweden.
    Marklund, Niklas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery. Uppsala Univ Hosp, Spinal Cord Rehabil Unit, Uppsala, Sweden.
    Glott, Thomas
    Sunnaas Rehabil Hosp, Nesoddtangen, Norway.
    Opheim, Arve
    Sunnaas Rehabil Hosp, Nesoddtangen, Norway;Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Rehabil Med, Gothenburg, Sweden;Reg Vastra Gotaland, Habilitat & Hlth, Gothenburg, Sweden.
    Benito Penalva, Jesus
    Neurorehabil Hosp, Inst Guttmann, Barcelona, Spain.
    Murillo, Narda
    Neurorehabil Hosp, Inst Guttmann, Barcelona, Spain.
    Nachtegaal, Janneke
    Heliomare Rehabil Ctr, Wijk Aan Zee, Netherlands.
    Faber, Willemijn
    Heliomare Rehabil Ctr, Wijk Aan Zee, Netherlands.
    Biering-Sorensen, Fin
    Univ Copenhagen, Rigshosp, Clin Spinal Cord Injuries, Havnevej 25, DK-3100 Hornbaek, Denmark.
    Exoskeleton Gait Training After Spinal Cord Injury: An Exploratory Study on Secondary Health Conditions2018In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, no 9, p. 806-813Article in journal (Refereed)
    Abstract [en]

    Objective: To explore changes in pain, spasticity, range of motion, activities of daily living, bowel and lower urinary tract function and quality of life of individuals with spinal cord injury following robotic exoskeleton gait training.

    Design: Prospective, observational, open-label multicentre study. Methods: Three training sessions per week for 8 weeks using an Ekso GT robotic exoskeleton (Ekso Bionics). Included were individuals with recent (<1 year) or chronic (>1 year) injury, paraplegia and tetraplegia, complete and incomplete injury, men and women.

    Results: Fifty-two participants completed the training protocol. Pain was reported by 52% of participants during the week prior to training and 17% during training, but no change occurred longitudinally. Spasticity decreased after a training session compared with before the training session (p< 0.001), but not longitudinally. Chronically injured participants increased Spinal Cord Independence Measure (SCIM III) from 73 to 74 (p= 0.008) and improved life satisfaction (p= 0.036) over 8 weeks of training. Recently injured participants increased SCIM III from 62 to 70 (p<0.001), but no significant change occurred in life satisfaction. Range of motion, bowel and lower urinary function did not change over time.

    Conclusion: Training seemed not to provoke new pain. Spasticity decreased after a single training session. SCIM III and quality of life increased longitudinally for subsets of participants.

  • 58.
    Beckman, Elsa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Jönsson, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Gesters påverkan på talflytet2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Oflyt i tal är något som förekommer hos alla talande människor och likadant är det med gester. Det är dock inte självklart hur de är relaterar till varandra. Det finns få studier inom området och ännu färre med svensktalande försökspersoner. Denna studies syfte är att se hur gester påverkar talflytet hos personer med svenska som modersmål och om det finns någon skillnad rörande detta mellan olika kontexter.

    Studien genomfördes med åtta försökspersoner i åldrarna 20–30 år som har svenska som modersmål. Alla försökspersoner fick individuellt svara på fyra frågor varav två med spatialt innehåll och två med abstrakt innehåll. Under första halvan av testningen fick försökspersonerna använda gester och resterande tid fick de sitta på sina händer för att inte kunna använda gester.

    Resultatet visade att ikoniska gester användes oftare vid spatialt innehåll och metaforiska gester användes mer frekvent vid abstrakt innehåll, vilket var en signifikant skillnad. Ytterligare en signifikant skillnad noterades mellan spatialt och abstrakt innehåll vid mätning av tallängd. Detta oberoende av fri respektive begränsad användning av gester.

    De få studier som gjorts på området ger ingen tydlig bild av hur tal och gester är relaterade till varandra. Denna studie understryker komplexiteten inom området tal och gester.

  • 59.
    Bedro, Edward
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Användningen av β-blockerare vid långt QT-syndrom: - Litteraturstudie med fokus på skillnader i effekt av olika β-blockerare2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 60.
    Beernaert, Kim
    et al.
    Belgien.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Fürst, Carl Johan
    Lunds universitet.
    Nyberg, Tommy
    Karolinska institutet; University of Cambridge, United Kingdom.
    Steineck, Gunnar
    Karolinska institutet; Sahlgrenska akademin, Göteborgs universitet.
    Bylund-Grenklo, Tove
    Karolinska institutet; Linnéuniversitetet.
    Distrust in the End-of-Life Care Provided to a Parent and Long-Term Negative Outcomes Among Bereaved Adolescents: A Population-Based Survey Study2017In: Journal of Clinical Oncology, ISSN 0732-183X, E-ISSN 1527-7755, Vol. 35, no 27, p. 3136-3144Article in journal (Refereed)
    Abstract [en]

    Purpose: Previous research shows that the death of a parent places children at risk for a number of negative outcomes. The role of trust in health care at the end of life has been acknowledged as crucial for patients and adult family members. However, the consequences of children’s distrust in the care provided to their parents remain unknown. Therefore, we investigated the negative long-term outcomes of cancer-bereaved sons’ and daughters’ distrust in the care that was provided to a dying parent.

    Methods: We used a population-based nationwide survey to investigate self-reported distrust in the care provided and possible negative outcomes in 622 (73%) participants who had lost a parent as a result of cancer 6 to 9 years earlier, at ages 13 to 16 years. All participants were 18 years or older at the time of the survey.

    Results: In those who reported no or little trust (ie, distrust) in the health care provided to their dying parents, we found statistically significantly higher risks of various negative outcomes at the time of survey: bitterness toward health care professionals for not having done everything that was possible (crude risk ratio [RR], 3.5; 95% CI, 2.3 to 5.1) and for having stopped treatment (RR, 3.4; 95% CI, 2.1 to 6.0), self-destructiveness (eg, self-injury [RR, 1.7; 95% CI, 1.2 to 2.4]), and psychological problems (eg, moderate to severe depression according to the Patient Health Questionnaire–9 [RR, 2.3; 95% CI, 1.5 to 3.5]).

    Conclusion: In cancer-bereaved former adolescents, distrust in the health care provided to the dying parent is associated with a higher risk of negative long-term outcomes. The health care professionals involved in this care might play an important role in safeguarding the trust of adolescents.

  • 61.
    Begum, Alexandra
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    ”Nobody puts (the) Baby in a Corner”: Späd- och småbarnens plats i det familjeterapeutiska samtalsrummet2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Familjeproblem anses i de flesta familjeterapeutiska teorier uppstå i samspelet, kommunikationen och interaktionen mellan individerna i familjen. Samtal med små barn upplevs som komplicerat av många familjeterapeuter. I de flesta familjeteorier förväntas dock hela familjesystemet delta i den terapeutiska processen. Men de allra minsta barnen, de mellan 0 – 3 år, har inte den verbala förmågan eller abstraktionsförmågan som krävs för den ”traditionella” familjeterapin. Syftet med den här studien har varit att undersöka familjeterapeuters erfarenheter av att bedriva familjeterapi med späd- och småbarnsfamiljer. Hur arbetar familjeterapeuter med de minsta barnen och vilka möjligheter och hinder finns det med att arbeta familjeterapeutiskt med dessa familjer? Studien är kvalitativ och bygger på semistrukturerade intervjuer med åtta legitimerade familjeterapeuter som arbetar med späd- och småbarnsfamiljer. Resultatet visar att det bedrivs familjeterapi med dessa familjer. Terapeuterna väver in metoder i terapin som används vid samspelsbehandling, exempelvis videofeedback. Flera av terapeuterna uttrycker dock oro över att den familjeterapeutiska kunskapen alltmer försvinner från de mottagningar dit småbarnsfamiljer kommer för att få hjälp. Ett sätt att lyfta fram familjeterapin skulle kanske kunna vara att tydligare stå för och visa att det är familjeterapi som är den behandlande insatsen.

  • 62.
    Benedek, Hunor
    et al.
    Skåne University Hospital, Lund, Sweden.
    Isacsson, Ulf
    Uppsala University Hospital, Uppsala, Sweden .
    Olevik-Dunder, Maria
    Karolinska University Hospital, Stockholm, Sweden.
    Westermark, Mathias
    Karolinska University Hospital, Stockholm, Sweden.
    Hållström, Per
    Gävle Hospital, Gavle, Swe.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Gustafsson, Magnus
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Strategies for quality assurance of intensity modulated radiation therapy2015In: 8TH INTERNATIONAL CONFERENCE ON 3D RADIATION DOSIMETRY (IC3DDOSE), Institute of Physics (IOP), 2015, Vol. 573, p. 012015-, article id 012015Conference paper (Refereed)
    Abstract [en]

    In late 2011 The Swedish Society of Radiation Physics formed a working group to concentrate on the Quality Assurance of modern radiation therapy techniques. The given task was to identify and summarise the different QA strategies in Sweden and also the international recommendations. This was used to formulate recommendations for practical guidelines within Sweden. In this paper a brief summery of the group's work is presented. All the Swedish radiation therapy centres do a pre treatment verification measurement as QA for every new IMRT and VMAT plan. Physicists do it and they believe it to be time consuming. A general standpoint from all the centres was that new guidelines and legislation is needed to allow QA that does not require a measurement. Based on various international publications and recommendations the working group has presented two strategies, one where all new plans are checked through measurement and one where no measurement is needed. The measurement-based strategy is basically the same as the one used today with an extended machine QA part. The other presented strategy is process oriented where all the different parts of the treatment chain are checked separately. The final report can be found in Swedish on http://www.radiofysik.org.

  • 63.
    Benson, Eva
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    “Find out what is expected of you” The interdependence between the senior consultant on call and the junior doctor – from the senior consultans perspective2017Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 64.
    Berg, Johan
    et al.
    Lund Univ, Sweden.
    Lundh, Lars-Gunnar
    Lund Univ, Sweden.
    Falkenström, Fredrik
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Countertransference in Swedish psychotherapists: testing the factor structure of the Therapist Response Questionnaire2019In: RESEARCH IN PSYCHOTHERAPY-PSYCHOPATHOLOGY PROCESS AND OUTCOME, ISSN 2239-8031, Vol. 22, no 1, p. 99-112Article in journal (Refereed)
    Abstract [en]

    Questionnaires need testing of reliability and factor structure before clinical use or research in new languages or cultures. The aim of this study was to evaluate the Therapist Response Questionnaire (TRQ) in Sweden compared to corresponding factor analyses in USA and Italy. A national sample of psychotherapists (N=242) registered their countertransference with a single client using TRQ. The data were analyzed with confirmatory factor analysis (CFA) to test factor structures from previous studies, and exploratory factor analysis (EFA). The CFA did not verify the factor structure from the previous studies. The EFA extracted seven factors as the best solution: Helpless/Inadequate, Overwhelmed/Disorganized, Hostile/Angry, Parental/Protective, Disengaged, Special/Overinvolved, Sex-ualized. Analysis of convergent validity indicated that five of these could be considered equivalent to factors in the previous studies, and the remaining two were conceptually related to corresponding factors. Even though the factor structure was not confirmed by the CFA, the concordance was large, indicating a reliable self-report instrument with promising validity for measurement of complex aspects of countertransference. Common countertransference themes can inform psychotherapy supervision and education, give feedback to the therapist, and lay ground for a taxonomy for therapist reactions and feelings.

  • 65.
    Berg, Linda
    et al.
    Sahlgrenska akademin, Göteborgs universitet.
    Nolbris, Margaretha Jenholt
    Sahlgrenska akademin, Göteborgs universitet.
    Koinberg, Ingalill
    Sahlgrenska akademin, Göteborgs universitet.
    Melin-Johansson, Christina
    Sahlgrenska akademin, Göteborgs universitet.
    Möller, Anders
    Ersta Sköndal University College, Department of Social Sciences. Sahlgrenska akademin, Göteborgs universitet.
    Öhlen, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Sahlgrenska akademin, Göteborgs universitet.
    Characterisation of cancer support and rehabilitation programmes: a Swedish multiple case study.2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, article id TONURSJ-8-1Article in journal (Refereed)
    Abstract [en]

    Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.

  • 66.
    Berg von Linde, Maria Berg
    et al.
    Department of Cardiology, Faculty of Health, Örebro University, Orebro, Sweden.
    Arevström, Lilith
    Department of Cardiology, Faculty of Health, Örebro University, Orebro, Sweden.
    Fröbert, Ole
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
    Insights from the Den: How Hibernating Bears May Help Us Understand and Treat Human Disease2015In: Clinical and Translational Science, ISSN 1752-8054, E-ISSN 1752-8062, Vol. 8, no 5, p. 601-605Article, review/survey (Refereed)
    Abstract [en]

    Hibernating brown bears (Ursus arctos) and black bears (Ursus americanus) spend half of the year in a physically inactive state inside their winter dens without food intake and defecating and no or little urination. Under similar extreme conditions, humans would suffer from loss of lean body mass, heart failure, thrombosis, azotemia, osteoporosis, and more. However, bears exit the den in the spring strong without organ injuries. Translational animal models are used in human medicine but traditional experimental animals have several shortcomings; thus, we believe that it is time to systematically explore new models. In this review paper, we describe physiological adaptations of hibernating bears and how similar adaptations in humans could theoretically alleviate medical conditions. The bear has solved most of the health challenges faced by humans, including heart and kidney disease, atherosclerosis and thrombosis, and muscle wasting and osteoporosis. Understanding and applying this library of information could lead to a number of major discoveries that could have implications for the understanding and treatment of human disease.

  • 67.
    Berginström, Nils
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Fatigue after traumatic brain injury: exploring novel methods for diagnosis and treatment2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Traumatic brain injury (TBI) is one of the most common causes of disability and mortality. While some patients recover quickly, especially at the mild side of the injury severity continuum, many will experience symptoms for years to come. In this chronic phase, patients report a wide array of symptoms, where fatigue is one the most common. This fatigue makes huge impact in several areas of these patients’ lives. Despite the prevalence of fatigue after TBI, the underlying mechanisms are unclear. Further, there are no standardized way for assessment and diagnosis, and there are no treatments with satisfying empirical support. The aim of this thesis was to examine the effects of the novel compound OSU6162 on fatigue in patients with TBI, and to explore functional and structural brain imaging correlates of fatigue after TBI.

    Methods: Studies I and III were based on a placebo-controlled, double-blinded clinical trial examining the effects of the monoaminergic stabilizer OSU6162 on fatigue in patients in the chronic phase of traumatic brain injury. In study I, self-assessment scales of fatigue and neuropsychological tests were used as outcomes, while functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) signal was the primary outcome in study III. Studies II and IV used cross-sectional designs, comparing patients with TBI with age- and gender matched healthy controls. Study II examined whether fMRI BOLD signal could be used to detect and diagnose fatigue in patients with TBI, and study IV whether white matter hyperintensities (WMH) contribute to lower cognitive functioning and presence of fatigue after TBI.

    Results: Study I revealed no effects of OSU6162 during 28 days of treatment at maximum doses of 15 mg twice daily on measures of fatigue or any other outcome. The results from study II indicated that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and suggested that fMRI could be a promising technique to use in the diagnosis of fatigue after TBI. In study III the results revealed effects of treatment in the right occipitotemporal and orbitofrontal cortex. In these areas, the BOLD response was normalized in the OSU6162 group as compared to healthy controls, while the placebo group showed a steady low activity in these areas. The regional effects were located outside the network shown to be linked to fatigue in study II, which might explain why there were no effects on fatigue after treatment with OSU6162 in study I. Study IV showed that WMH lesions increased with increased TBI severity, but the presence and extent of lesions did not explain lower neuropsychological functioning or fatigue in subjects with previous TBI.

    Conclusions: In summary, although no effects on fatigue after treatment with OSU6162 were seen, the results provide support to the theory that fatigue after TBI is linked to alterations in striato-thalamic-cortical loops, and on how fatigue after TBI could be assessed or diagnosed using fMRI. Structural damage within white matter was however not related to fatigue.

  • 68.
    Bergius, Anki
    et al.
    Drottning Silvias barn- och ungdomssjukhus, Göteborg.
    Palmqvist, Gunilla
    Sahlgrenska universitetssjukhuset, Göteborg.
    Holm, Ann-Kristin
    Göteborgs universitet, Sahlgrenska universitetssjukhuset.
    Öhlén, Joakim
    Göteborgs universitet, Karolinska institutet.
    Stödverksamhet för barn som förlorat en förälder: En litteraturstudie2004In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 24, no 4, p. 41-44Article, review/survey (Other academic)
    Abstract [en]

    The aim with this literature review was to describe content, objectives, design, and outcomes of support groups for parentally bereaved children three to twelve years of age. In a support group with children in similar situation the children's thoughts, experiences and feelings will be normalised through different activities. Pedagogical methods include creative activities of different kinds, e.g. painting, writing letters and poems, reading stories, play and games. The purposes of the methods are to accept and understand the reality of the loss, to understand and work through the grieving, to enhance family communication, and to keep the memory of the death and go on living. Organisation and structure are described in relation to development levels and ages of children and youths. Outcomes of groups are characterized by clinical observations and a dearth of evaluative studies. All bereaved children should have the opportunity to participate in a support group when a parent, sibling or other relative dies. Well developed services for bereaved children should be a matter of health care policy and quality.

  • 69.
    Bergknut, Mirjam
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Petra, Jacobsen
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    KBT vid samtidig somatisk sjukdom: KBT-terapeuters erfarenheter av att i psykiatrin möta patienter som lever med allvarlig och/eller kronisk somatisk sjukdom.2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Studiens syfte var att undersöka erfarenheter hos psykoterapeuter inom psykiatrin av att bedriva KBT med patienter som samtidigt lever med kronisk och/eller allvarlig somatisk sjukdom. Detta utifrån frågeställningar om hur KBT-terapeuter beskriver hur samtidig allvarlig och/eller kronisk somatisk sjukdom påverkar det terapeutiska arbetet och hur terapeuterna förhåller sig till denna påverkan i relation till att genomföra terapin? Semistrukturerade intervjuer genomfördes med sex psykoterapeuter som alla hade KBT-inriktning och arbetade inom psykiatrin. En tematisk analys gjordes sedan av intervjuerna och där framkom huvudteman som följsamhet, helhetssyn och organisatorisk påverkan. Följsamhet till patienternas behov av anpassning gällde allt från längden på sessionerna till möjligheten att pausa terapin under vissa perioder. Att ha en helhetssyn kunde innebära att psykoterapeuten klev utanför sitt expertområde för att samarbeta med den somatiska vården kring en patient, eller att patienten kunde ta rollen som expert kring den somatiska sjukdomen. Det kom även fram att yttre förutsättningar som den organisatoriska tillhörigheten påverkade hur terapeuten kan förhålla sig till patienter med samtidig psykisk och somatisk ohälsa. De informanter som tidigare arbetat inom somatisk vård beskrev att de använde denna erfarenhet som stöd medan de informanter som inte hade samma erfarenhet beskrev att detta var något de kunde sakna i dessa ärenden. Då många människor lever med allvarlig och/eller kronisk somatisk sjukdom samtidigt som de har behov av psykoterapi, är detta en aspekt av vården som är viktig att ha vetskap om. Vi kan konstatera att det finns en kunskapslucka att fylla om hur man i psykoterapi kan hantera och arbeta med samtidig psykiatrisk och somatisk problematik som vi är övertygade om skulle komma psykoterapeuter generellt till nytta, inte enbart de som arbetar inom psykiatrisk vård.

  • 70.
    Berglund, Charlotte
    Linnaeus University, Faculty of Social Sciences, Department of pedagogy.
    Samverkan - en gemensam angelägenhet: En kvalitativ studie kring socialsekreterares organisatoriska och professionella villkor i samarbetet med sjukvården kring personer med missbruksproblem2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka olika aspekter av samverkan såsom de uppfattades av en grupp socialsekreterare, för att beskriva organisatoriska och professionella villkor som påverkar samverkan och styr det dagliga arbetet. Metod: Studien utgick från ett fenomenologiskt vetenskapsteoretiskt perspektiv med fokus på människans uppfattning av ett fenomen. Kvalitativa intervjuer gjordes med åtta socialsekreterare med hjälp av vinjettmetoden. Analysen genomfördes enligt fenomenologisk modell utan tolkningar och med fenomenologisk objektivitet. Resultat: Analysen av socialsekreterarnas berättelser visade att klienterna är en gemensam angelägenhet för socialtjänsten och sjukvården. Brister i samverkan påverkar relationen mellan socialtjänsten och sjukvården negativt och kan få allvarliga konsekvenser för klienterna. God och väl fungerande samverkan verkar enande och belönande för såväl socialtjänsten och sjukvården som för klienten. Särskilt poängterades en tydlig och öppen kommunikation, personliga möten och personlig kännedom om varandra och varandras verksamheter. Slutsatser: Olika organisatoriska och professionella villkor för samverkan påverkar varandra ömsesidigt. Viktigt är att skapa hållbara strukturer för en god samverkan. Fortsatta studier krävs för att utveckla en fungerande samverkan i praktiken.

     

  • 71.
    Berglund, Johan
    et al.
    University of Kalmar, School of Human Sciences.
    Åkerman Sturup, Erik
    University of Kalmar, School of Human Sciences.
    Sjuksköterskors erfarenheter av att vårda barn i livets slutskede och deras föräldrar: Döden såväl som födelsen hör sammman med livet2010Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    : Vård av barn i livets slutskede och deras föräldrar innefattar att försöka se både barnet och föräldrarnas behov och som sjuksköterska bemöta dessa. Syfte: Syftet är att utifrån aktuell forskning beskriva sjuksköterskors erfarenheter av att vårda till barn i livets slutskede och till deras föräldrar. Metod: Studien är utförd som en systematisk litteraturstudie på kvalitativa studier. Sökningarna utfördes i PubMed, Cinahl och PsychINFO. Sex artiklar inkluderades efter kvalitetsgranskning och analyserades med innehållsanalys. Resultat: Sjuksköterskorna upplever att det är emotionellt påfrestande men också givande och bekräftande att vårda till barn i livets slutskede. Sjuksköterskornas erfarenhet är att barnens existentiella frågor är svåra att bemöta. Samtidigt anser de att organisatoriska faktorer försvårar och upptar tid och resurser från patientarbetet. Copinstrategier var något sjuksköterskorna använde sig av eller som saknades för att klara av arbetet. Slutsats: Sjuksköterskor erfar svårighet att svara på barns frågor om döden och inte engagera sig för mycket emotionellt. Det professionella förhållningssättet var något som var problematiskt att upprätthålla vid vård av barn i livets slutskede. Brist på resurser och tid genererade att de kände en oförmåga att lindra barnens psykiska och fysiska lidande och föräldrarnas sorg. Sjuksköterska har behov informella och formella strategier för att klara av att vårda barn i livets slutskede och deras föräldrar.

  • 72.
    Berglund, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Andersson, Martina
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Gunnarsson, Erika
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Botulinum toxin, dess fysiologiska effekter och användningsområden.2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Fördjupning om botulinum toxins och dess fysiologiska effekter samt grundläggande information om ämnet.

    Informationen är hämtad från vetenskapliga artiklar och böcker som bearbetas, sammanställs och hänvisas till i arbetet. Databaser som vi använt oss av är bland annat PubMed, SveMed och AMED.

    Av artiklarna som lästs så har det visat sig att injektion av botulinum toxin har ökat genom åren och främst inom det kosmetiska. Botulinum toxin är ett farligt nervgift som hindrar signalerna till musklerna.

    Ytterligare fysiologiska effekter är att rynkor slätas ut, svettningar försvinner, muskelskador repareras, men för höga doser kan leda till bieffekter så som hängande ögonlock, dregling och/eller svårigheter vid intag av föda.

    Slutsatsen är att botulinum toxin är populärt men med tanke på de fysiologiska effekterna så borde man avstå från medlet eller åtminstone utsätta kroppen för det med stor försiktighet.

    1.1 Nyckelord:

    Botulinum Toxin, Botulinum Toxin typ A, Botox, Fysiologisk effekt, Användningsområden, Cosmetic, Injection, Primary care

  • 73. Bergman, David
    et al.
    Liljefors, Ingrid
    Palm, Kristina
    Medical Management Centre, Department of Learning,Informatics,Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    The effects of dialogue groups on physicians' work environment: A matter of gender?2015In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 52, no 2, p. 407-417Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Over the past decades, the work environment of physicians has been deteriorating, particularly for female physicians. OBJECTIVE: In this study, we evaluated the effects of dialogue groups on the work environment of physicians in relation to gender. METHODS: Sixty physicians (38 women) at Sachs' Children's Hospital in Stockholm, Sweden, participated in dialogue groups once a month during a period of one year. Assessments of their psychosocial work environment were performed before and after the intervention. RESULTS: At baseline, female physicians experienced their work environment as less satisfactory compared to male physicians. After the intervention, the female physicians perceived improvements in more areas than their male colleagues. CONCLUSIONS: Our study shows that female physicians at this clinic were disadvantaged in relation to the work environment, but, more importantly, the findings suggest that several of the disadvantages can be reduced. Dialogue groups appear to improve the physicians' work environment and promote gender equality.

  • 74.
    Bergqvist, Elisabeth
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Anorexia Nervosa och självbild efter individual respektive familjeterapi2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I Sverige används både individuell – och familjeterapeutisk behandling för unga nyinsjuknade

    anorexia nervosa patienter. Familjeterapeutisk behandling rekommenderas. Det finns dock

    kritik mot familjeterapeutisk behandling som säger att man inte tillräckligt påverkar

    patienternas kognitiva/affektiva svårigheter. Å andra sidan kan familjesamspelet vara en

    viktig faktor för förändring av kognitiva/affektiva variabler, då våra självbilder och affekter

    formas i relation till andra. Negativ självbild och stark självkontroll vid anorexia kan kvarstå

    efter behandling och kan öka risken för återfall.

    Studiens syfte är dels att beskriva självbilden på gruppnivå innan och efter behandling av

    unga anorexia nervosa patienter som behandlats på Stockholm Centrum för Ätstörningar.

    Vidare är syftet att se om självbilden förändras olika mycket, efter familjebaserad respektive

    individual terapi.

    Studien är en registerstudie och använder sig av data från kvalitetssäkringsbasen Stepwise.

    Totalt ingår 44 patienter. I studien mäts självbild med hjälp av Structural Analys of Social

    Behavior som är ett självskattningsformulär där självbilden beskrivs i åtta kluster.

    Anorexia Nervosa patienter har en negativ självbild som kännetecknas av självkontroll,

    självkritik och självhat. Trots detta upplever de att de tar hand om sig själva i högre

    utsträckning än normalgruppen. Vid ett årsuppföljning har självbilden normaliserats oavsett

    individual eller familjebehandling, vilket talar för att psykoterapi är verksamt för unga

    anorexia nervosa patienter.

  • 75. Bergqvist, L.
    et al.
    Eriksson, Mats
    Örebro University, School of Health and Medical Sciences.
    Kronsberg, S.S.
    Schollin, Jens
    Örebro University, School of Health and Medical Sciences.
    Barton, B.
    Anand, K.J.S.
    Seeing through the blind!: ability of hospital staff to differentiate morphine from placebo, in neonates at a placebo controlled trial2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 7, p. 1004-1007Article in journal (Refereed)
    Abstract [en]

    AIM: To investigate whether professional training and/or clinical experience affect the ability of caregiver to assess clinical signs of pre-emptive morphine analgesia. METHODS: In the Neurological Outcomes & Pre-emptive Analgesia In Neonates trial preterm infants undergoing mechanical ventilation were randomized to receive continuous infusion, either of morphine or placebo blinded. Staff from centres in Sweden (Stockholm and Orebro) completed an assessment form. RESULTS: A total of 360 assessment forms were collected from 52 neonates. In 59% of the cases, caregivers correctly identified patients group. Comparable proportion of answers were correct between physicians, nurses and assistant nurses (63, 60 and 54%, respectively, p = 0.60). Staff with Neonatal intensive care unit experience <1 year identified 63%, as compared to 65% for working 1-5 year, and 55% that has been working >5 years (p = 0.28). Staff's ability to correctly identify group assignment was reduced by amount of additional morphine (p < 0.01) and severity of illness (p = 0.01). CONCLUSIONS: Clinical medical staffs, including neonatologists, have great difficulties in assessing the presence and severity of pain. Further studies should focus on the methods for assessment of prolonged pain in preterm neonates, define the effects of adequate analgesia, and investigate the clinical factors that may alter neonatal responses to acute and prolonged pain.

  • 76.
    Bergsten, Gunilla
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Waernulf, Lena
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    KBT-inriktade psykoterapeuters erfarenheter att tala om sex: -underlättande och försvårande omständigheter2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Studiens syfte var att undersöka om det finns ett samband mellan KBT-inriktade psykoterapeuters kunskapsnivå i sexologi och deras erfarenhet och förhållningssätt till frågor om sexualitet i det psykoterapeutiska arbetet. Studien genomfördes med en webbenkät som bestod av en kvantitativ och kvalitativ del. Undersökningsgruppen bestod av 118 legitimerade psykoterapeuter med inriktning kognitiv beteendeterapi som var registrerade på www.kbt.nu och www.sfkbt.se. Studiens resultat visar att de flesta av respondenterna inte har haft något utbildningsmoment i ämnet sexologi under sin psykoterapeututbildning. Majoriteten anser att det är ganska viktigt eller mycket viktig att ha teoretisk kunskap i ämnet. Vidare visar studien på ett signifikant samband mellan mängden utbildningsdagar i sexologi och att anse sig ha tillräcklig kunskap för att arbeta med det i terapier. Undersökningen har tydliggjort att andra faktorer än utbildning har betydelse för hur psykoterapeuter förhåller sig till ämnet som exempelvis trygghet, självkännedom samt medvetna och omedvetna hinder. Med stöd av vår studie ser vi att de psykoterapeuter som känner sig bekväma i ämnet också i högre utsträckning talar med sina klienter om sexuella spörsmål i terapin. Mot bakgrund av detta behöver det skapas förutsättningar för psykoterapeuter att ha mod att våga fråga och integrera sexualitet som en naturlig del i psykoterapi.

     

    Nyckelord: Kognitiv beteendeterapi, KBT-inriktade psykoterapeuter, sexologi, sexualitet

  • 77.
    Bergström, Eva
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Känslor och ord arbetar tillsammans i en gemensam resa: En studie om samtal mellan patient och terapeut utifrån en språksystemisk inriktning2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att belysa patientens och terapeutens erfarenheter av att samtala utifrån språksystemisk inriktning. Studiens frågeställningar var; vad kännetecknar ett språksystemiskt samtal och vilka erfarenheter har patienten och terapeuten av det språksystemiska samtalet? Studien har en kvalitativ ansats och data utgjordes av 4 videofilmer; en med ett samtal mellan patient och terapeut, en med ett samtal där patient och terapeut reflekterar över den första filmen, en med reflektioner omkring andra filmen från terapeutens handledningsgrupp i utbildningen samt en där en kollega till terapeuten intervjuar patienten och terapeuten.  Data analyserades med hjälp av kvalitativ innehållsanalys. I resultatet framkom ett tema för patienten; känslor och ord arbetar tillsammans – man blir berörd, lyssnad till men kanske inte alltid förstådd. Temat för terapeuten var; att göra en resa tillsammans – terapeuten är inte expert på patientens liv, visar lugn och respekt, lyssnar på patientens språk. Slutsatserna var att samtal med en språksystemisk inriktning visar att det är viktigt att lyssna på patienten och dennes språk i samtalet, att terapeuten inte är expert på patientens liv och att genom samtalet görs en gemensam resa.

  • 78. Bergström, Margareta
    et al.
    Ejelöv, Marina
    Mattsson, Monika
    Stålnacke, Britt-Marie
    One-year follow-up of body awareness and perceived health after participating in a multimodal pain rehabilitation programme –A pilot study2014In: European Journal of Physiotherapy, Vol. 16, no 246, article id 254Article in journal (Refereed)
  • 79.
    Bergvall, Ingegerd
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Haraldsson, Ludvig
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Co-terapi  ­–  när ett plus ett blir mer än två: Om hur terapeuter upplever samarbetet med en kollega, och om hur familjer i behandling upplever mötet med två terapeuter.2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Co-terapi, vilket skulle kunna definieras som en särskild arbetsform där två terapeuter samarbetar i terapirummet, är ett förvånansvärt outforskat koncept, särskilt med tanke på hur ofta co-terapi används i kliniska sammanhang. Syftet med denna studie har varit att undersöka vilka åsikter och upplevelser legitimerade psykoterapeuter och familjer har kring co-terapi. Tonvikten har legat vid co-terapiteamets samverkan och samspel i och utanför terapirummet. Huvudfrågeställningarna har bl.a. varit vilken inställning terapeuter och familjer har till co-terapi, vad som kännetecknar ett välfungerande samarbete mellan två terapeuter och vad som är viktigt att tänka på när en terapeut skall välja ut en kollega att samarbeta med. Utifrån en kvalitativ metod har semistrukturerade intervjuer genomförts med fyra legitimerade familjeterapeuter och fyra familjer som deltagit i familjeterapeutisk behandling vid de barnpsykiatriska klinikerna i Östersund och Umeå. Resultatet gör gällande att co-terapi är en omtyckt arbetsform som förmodligen ger en högre vårdkvalitet; familjerna känner en stor trygghet i mötet med två terapeuter, och terapeuterna beskriver en förbättrad arbetsmiljö.   Co-terapi framstår också som något kvalitativt sett mer än bara samarbete mellan två terapeuter.

  • 80.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies.
    Teamarbete: ett livsviktigt samspel2013In: Sjuksköterskans kärnkompetenser / [ed] Leksell, Janeth, Lepp, Margret, Stockholm: Liber, 2013, 1, p. 159-177Chapter in book (Refereed)
  • 81.
    Bertholdsson, Liz
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Hur roligt får det vara?: En undersökning om humorns betydelse för familjeterapimedlemmar i terapi2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna uppsats har varit att undersöka vad familjemedlemmar tycker om att terapeuten använder humor i familjeterapi. Familjer i terapi, vuxna och barn från 12 år, ombads via sina terapeuter besvara en kort anonym enkät om humor kunde vara viktigt, till hjälp eller störande i samtalet. Totalt besvarade 117 personer enkäten, 80 vuxna och 37 barn. Resultatet visar att familjerna uppskattar humor och ser det som en hjälp i behandlingen. Få ser humor som ett störande inslag. Studien ifrågasätter den många gånger förhärskande inställningen att humor skapar ett undvikande av svåra saker i familjeterapier.

  • 82.
    Bester, CJ
    University of Stellenbosch, South Africa.
    Comparing road fatilities on three continents2001In: Proceedings of the conference Road Safety on Three Continents: International conference in Pretoria, South Africa, 20-22 September 2000 / [ed] Asp, Kenneth, Linköping: Statens väg- och transportforskningsinstitut, 2001, Vol. 15A, p. 263-271Conference paper (Other academic)
    Abstract [en]

    It has been shown in the past that the road fatality rates of differentcountries are dependent on the total vehicle ownership of such counties.Recent research has revealed that the passenger car ownership is a betterpredictor of the fatality rate of a country. This is also the case for thedifferent continents. When comparing the fatality rates of three continents,it was found that there are other socio-economic factors, such as income,illiteracy and life expectancy that also contribute to the large differencesbetween the developed countries of the Northern Hemisphere and the developingcountries of Africa. Accident and fatality rates can be expressed in terms ofthe population, or the vehicle or passenger car population or the roadnetwork of a country. In the paper the comparisons are made for all four ofthese rates and the differences are discussed. The relationships between roadsafety and the different socio-economic variables as applicable to thecountries of the three continents are also shown. Conclusions are maderegarding the reasons for the differences in fatality rates.

  • 83.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin University, England.
    Allen, Peter M.
    Anglia Ruskin University, England; Anglia Ruskin University, England.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar University, TX 77710 USA; Audiol India, India.
    Baguley, David M.
    Anglia Ruskin University, England; University of Nottingham, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Internet-Based Intervention for Tinnitus: Outcome of a Single-Group Open Trial2017In: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 28, no 4, p. 340-351Article in journal (Refereed)
    Abstract [en]

    Background: Managing chronic tinnitus is challenging, and innovative ways to address the resulting health-care burden are required. Internet-based cognitive behavioral therapy (iCBT) for tinnitus shows promise as a cost-effective treatment option. The feasibility and effectiveness of iCBT in the United Kingdom are yet to be explored. Furthermore, it is not known if iCBT can be supported by an audiologist rather than a psychologist. Purpose: This study aimed to determine the feasibility of guided iCBT using audiological support on tinnitus distress and tinnitus-related comorbidities. Furthermore, it aimed to establish the feasibility of iCBT for tinnitus distress in the United Kingdom, by determining recruitment, attrition, and compliance rates. Finally, it aimed to identify which aspects of the protocol require refinement for subsequent clinical trials. Research Design: A single-group open trial design was implemented. This study would serve as a prerequisite study, to identify barriers, before undertaking effectiveness trials. Study Sample: Participants consisted of 37 adults (18 males, 19 females), with an age range of between 50 and 59 yr. The mean preintervention tinnitus severity rating was 56.15 (standard deviation = 18.35), which is categorized as "severe tinnitus" as measured by the Tinnitus Functional Index (TFI). Five participants withdrew during the study, and 29 of the remaining participants completed the postintervention questionnaire. Intervention: The guided iCBT intervention ran over an eight-week period and consisted of 16 obligatory modules and five optional modules. The intervention was designed to be interactive, interesting, and stimulating. A key element was the provision of support from an audiologist throughout the program. Data Collection and Analysis: Online questionnaires were used throughout the study. These were administered at baseline and postintervention to determine attrition and compliance rates and to facilitate sample size estimates for further clinical trials. Outcome measures for tinnitus severity, hearing handicap, insomnia, cognitive functioning, hyperacusis, anxiety, depression, and life satisfaction were used to investigate the effects of iCBT with audiological support. In addition, a weekly questionnaire was incorporated to monitor change in tinnitus distress while undertaking the intervention. Results: Feasibility was established using an audiologist to support this guided iCBT intervention, as a significant change postintervention was found for tinnitus severity, as measured by the TFI and the Tinnitus Handicap Inventory, Screening version. The attrition rate was 22% and compliance was variable. Although these results were based on a small sample, they provide encouraging evidence for the feasibility of delivering iCBT treatment for tinnitus symptoms with audiology support in the United Kingdom. Conclusions: An Internet-based intervention of tinnitus appears to be feasible in the United Kingdom when using audiological support. Randomized controlled trials to further investigate the effectiveness of iCBT for tinnitus in the United Kingdom are required.

  • 84.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England; Lamar Univ, TX 77710 USA.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Allen, Peter M.
    Anglia Ruskin Univ, England.
    Manchaiah, Vinaya
    Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Baguley, David M.
    Nottingham Biomed Res Ctr, England; Univ Nottingham, England; Nottingham Univ Hosp, England.
    Effectiveness of Guided Internet-Based Cognitive Behavioral Therapy vs Face-to-Face Clinical Care for Treatment of Tinnitus A Randomized Clinical Trial2018In: JAMA Otolaryngology - Head and Neck Surgery, ISSN 2168-6181, E-ISSN 2168-619X, Vol. 144, no 12, p. 1126-1133Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE Accessible clinical care is not always available to individuals with distressing tinnitus. Internet-based cognitive behavioral therapy has the potential to increase access to evidence-based services that manage tinnitus. Research comparing the effectiveness of this internet-based intervention with face-to-face care is required. OBJECTIVE To evaluate whether an internet-based cognitive behavioral therapy intervention is at least as effective as established individualized face-to-face clinical care in reducing tinnitus distress and tinnitus-related difficulties. DESIGN, SETTING. AND PARTICIPANTS A randomized, multicenter, 2-arm parallel group, non-inferiority trial with 2-month follow-up was performed between October 4, 2016, and July 14, 2017. Invited to participate were 374 adults based in the United Kingdom who had been referred to their local tinnitus clinics because of bothersome tinnitus. The experimental group received the internet-based intervention online, and the active control group underwent the usual face-to-face tinnitus care at 1 of 3 UK-based National Health Service hospitals. Participants were randomly assigned (1:1) to either intervention using variable permuted block sizes of 4 and 6. Of 92 participants who were randomized (46 each in the experimental and control groups), 88 participants completed the assessment immediately after intervention and 74 participants completed the follow-up assessment. INTERVENTIONS Participants were randomized to receive either 8 weeks of guided internet-based cognitive behavioral therapy or a mean of 2 to 3 individualized face-to-face appointments in a tinnitus clinic. MAIN OUTCOMES AND MEASURES The primary outcome was a change in tinnitus distress (assessed by the Tinnitus Functional Index). Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. RESULTS Of 92 patients overall, 55 (60%) were men with a mean (SD) age of 52.96 (12.07) years and mean (SD) tinnitus duration of 6.54 (9.25) years. The between-group difference in the Tinnitus Functional Index scores after intervention were 5.18 (95% CI, -4.17 to 14.53) at the initial assessment and 5.52 (95% CI, -4.60 to 15.61) at follow-up; both differences were within the non-inferiority margin of 13 points for the lower 95% CI. For the secondary outcomes, only outcomes for insomnia fell outside the non-inferiority margin, both after intervention and at follow-up, favoring internet-based cognitive behavioral therapy. CONCLUSIONS AND RELEVANCE This is the first trial, to our knowledge, to compare an internet-based intervention with standard individualized face-to-face care for tinnitus. It revealed that both interventions are equally effective for reducing tinnitus distress and most tinnitus-related difficulties.

  • 85.
    Bhandage, Amol K.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiology.
    Jin, Zhe
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiology.
    Korol, Sergiy V.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiology. Uppsala University.
    Shen, Qiujin
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular tools.
    Pei, Yu
    Karolinska Institute, Stockholm, Sweden.
    Deng, Qiaolin
    Karolinska Institute, Stockholm, Sweden.
    Espes, Daniel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Transplantation and regenerative medicine.
    Carlsson, Per-Ola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Transplantation and regenerative medicine.
    Kamali-Moghaddam, Masood
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Molecular tools. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Birnir, Bryndis
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiology.
    GABA Regulates Release of Inflammatory Cytokines From Peripheral Blood Mononuclear Cells and CD4+ T Cells and Is Immunosuppressive in Type 1 Diabetes2018In: EBioMedicine, ISSN 0360-0637, E-ISSN 2352-3964, Vol. 30, p. 283-294Article in journal (Refereed)
    Abstract [en]

    The neurotransmitter γ-aminobutyric acid (GABA) is an extracellular signaling molecule in the brain and in pancreatic islets. Here, we demonstrate that GABA regulates cytokine secretion from human peripheral blood mononuclear cells (PBMCs) and CD4+ T cells. In anti-CD3 stimulated PBMCs, GABA (100nM) inhibited release of 47 cytokines in cells from patients with type 1 diabetes (T1D), but only 16 cytokines in cells from nondiabetic (ND) individuals. CD4+ T cells from ND individuals were grouped into responder or non-responder T cells according to effects of GABA (100nM, 500nM) on the cell proliferation. In the responder T cells, GABA decreased proliferation, and inhibited secretion of 37 cytokines in a concentration-dependent manner. In the non-responder T cells, GABA modulated release of 8 cytokines. GABA concentrations in plasma from T1D patients and ND individuals were correlated with 10 cytokines where 7 were increased in plasma of T1D patients. GABA inhibited secretion of 5 of these cytokines from both T1D PBMCs and ND responder T cells. The results identify GABA as a potent regulator of both Th1- and Th2-type cytokine secretion from human PBMCs and CD4+ T cells where GABA generally decreases the secretion.

  • 86.
    Bjornsdottir, Sigrun Vala
    et al.
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland;HNLFI Rehabil Clin, Hverageroi, Iceland.
    Triebel, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. HNLFI Rehabil Clin, Hverageroi, Iceland.
    Arnljotsdottir, Margret
    HNLFI Rehabil Clin, Hverageroi, Iceland.
    Tomasson, Gunnar
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland.
    Valdimarsdottir, Unnur Anna
    Univ Iceland, Fac Med, Ctr Publ Hlth Sci, Reykjavik, Iceland;Harvard Sch Publ Hlth, Dept Epidemiol, Boston, MA USA.
    Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 15, p. 1764-1772Article in journal (Refereed)
    Abstract [en]

    Purpose:

    To determine whether observed health-related quality-of-life improvements after four-week traditional multidisciplinary pain management program and additional neuroscience education and mindfulness-based cognitive therapy for chronic pain are sustained at six-month follow-up.

    Method:

    This observational longitudinal follow-up study, with complete follow-up of 75 women, 61.5% of initial traditional approach group (treated 2001-2005) and 56 (62.2%) receiving the new approach (treated 2006-2009). Pain intensity and quality of life were measured at baseline and six months after interventions. Analysis of variance (ANOVA) and paired samples t-tests were used for statistical analysis.

    Results:

    Both groups showed sustained improvements in pain intensity (traditional approach = -10.6 [p < 0.001]; new approach = -14.5 [p < 0.001]) and quality of life (traditional approach = 6.4 [p < 0.001]; new approach = 6.9 [p < 0.001]). Sleep was not sustained among traditional approach group (change = 2.4 [p = 0.066]), whereas all other domains among both groups were sustained. Significant decline was observed from discharge to six month among both groups with the exception of the sleep domain among the traditional approach group, pain intensity among the new approach and financial status among both groups. No baseline differences were revealed between responders and nonresponders.

    Conclusions:

    Multidisciplinary interventions for women with chronic pain conditions improved quality of life and pain intensity with lasting improvements observed half a year after treatment completion.

  • 87.
    Björkdahl, Ann
    et al.
    Ersta Sköndal University College, Department of Social Sciences. Göteborgs universitet.
    Esbjörnsson, Eva
    Göteborgs Universitet.
    Ljungqvist, Johan
    Göteborgs Universitet.
    Skoglund, Thomas
    Göteborgs Universitet.
    Stibrant Sunnerhagen, Katharina
    Göteborgs Universitet.
    Decline in cognitive function due to diffuse axonal injury does not necessarily imply a corresponding decline in ability to perform activities2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 10, p. 1006-1015Article in journal (Refereed)
    Abstract [en]

    Purpose: The study explored the direction of change (decline vs. improvement) after diffuse axonal injury (DAI) in the domains of the ICF: body structure, body function, and activity.

    Methods: Thirteen patients with DAI were assessed by using diffusion tensor imaging (DTI) to measure body structure, the Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) to measure body function, and the Assessment of Motor and Process Skills (AMPS) to measure activity. The DTI, BNIS, and AMPS were applied at the acute phase (A1), and at 6 and 12 months post-injury (A2 and A3). Visual and statistical analyses were conducted to explore time-dependent changes in the ICF domains.

    Results: Improvements were observed for most patients in all ICF domains from injury until six months. Thereafter, the results diverged, with half of the subjects showing a decline in DTI and BNIS scores between A2–A3, and all but one of the patients exhibiting identical or better A2–A3 AMPS process skill scores.

    Conclusions: From 6 to 12 months post-injury, some patients underwent an ongoing degenerative process, causing a decline in cognitive function. The same decline was not observed in the activity measure, which might be explained by the use of compensatory strategies.

    • Implications for rehabilitation
    • In rehabilitation it is essential to be aware that in some cases with TBI, an ongoing degenerative process in the white matter can be expected, causing an adverse late effect on cognitive function.

    • The cognitive decline, caused by DAI, does not necessarily mean a concurrent decrease in activity performance, possibly explained by the use of compensatory strategies. This suggests that, after the post-acute phase, rehabilitation offering strategy training may be beneficial to enhance every-day functioning.

    • Strategy use requires awareness, which imply the need to assess level of awareness in order to guide rehabilitation.

  • 88.
    Björnstig, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    [Children up to the age of 12 at risk in the traffic. Analysis of traffic accidents at the Norrland University Hospital in Umea]2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 26-28, p. 1361-1364Article in journal (Refereed)
  • 89.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Snowmobile, motorcycle and moose-car accidents: aspects on injury control1985Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Injuries related to snowmobiles, motorcycles and moose-car collisions have increased. The aim of the present thesis was to analyse mechanisms and consequences in fatal and non-fatal accidents of these types, and to penetrate possible preventive measures.

    Snowmobiles

    The median age of the injured was 30 and of the killed 32, males pre­dominating. A majority of the accidents occurred during weekends, and especially the fatal accidents occurred after dark. The extremities were the most commonly injured parts of the body, however, drowning, crushed chest and cranial injuries caused most of the fatalities. Among the fatalities, four out of five were under the influence of alcohol. The present Swedish laws regarding snowmobiles seem well motivated. "Built-in" safety measures in the construction of the snowmobiles, pro­perly designed snowmobile tracks and functional search and rescue sys­tems could reduce the injuries.

    Motorcycles

    The median age was 19 years for both the traffic injured and the kil­led. Half of the traffic accidents were collisions with other motor ve­hicles. In the fatally injured group, also collisions with fixed road­side objects were common. Of the fatally injured, more than every fifth person died in an accident where alcohol was an influential factor. In the injured group, lower extremity injuries (especially in off-road riding) were common and among the fatalities most riders died from injuries to the head or chest. Out of one thousand motorcycle riders interviewed, 45% reported wobbling experiences (8% reported severe wobbling). Possible injury reducing measures include increasing the licensing age, more discriminating driving test, "built-in" restriction of the motorcycle's top speed, elimination of motorcycles prone to wobbling, and a more intensive traffic supervision (speeding, alco­hol).

    Moose-car collisitions

    The median age of the drivers was 38 years. Most collisions happened at dusk or when dark (3/4). The median collision speed was 70 km/h. The damage to the car was typical, the roof and the windshield pillars were deformed downwards and backwards. The broken windshield was often pressed into the passenger compartment. Most of the injured car occu­pants suffered cuts predominantly to the head and upper extremities. Nearly all the fatally injured died of head and neck injuries. The injuries may be reduced by strengthening the roof and the windshield pillars, and by introducing anti 1 acerati ve windshields.

  • 90.
    Björs, Madeleine
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Yzden, Tami
    Luleå University of Technology, Department of Health Sciences.
    Tyreoideapåverkan av intraarteriellt jodkontrastmedel efter koronarangiografi: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: I Sverige utförs cirka 40 000 koronarangiografier årligen. I samband med koronarangiografi används intraarteriellt jodkontrastmedel. Tyreoidea (sköldkörteln) är avgörande för metabolismen och hormonproduktionen kan påverkas av jod-injicering. Skador och biverkningar på tyreoidea efter jodkontrast tillförsel är inte lika omdiskuterat som inducerade njurskador. Syfte: Syftet var att sammanställa hur tyreoidea påverkas av intraarteriellt jodkontrastmedel efter koronarangiografi.Metod:Denna studie genomfördessom en allmän litteraturstudie. Databaserna PubMed och Cinahl användes och totalt inkluderades och analyserades 10 vetenskapliga artiklar i resultatet. Resultat:Studiens resultat sammanfattades i två kategorier; Patienter med “eutyroid (frisk) tyreoidea” och patienter med “avvikande tyreoidea” före studiernas start. Resultatet för varje kategori visade hur tyreoidea påverkades efter en koronarangiografi med jodkontrastmedel. Båda kategorierna visade att det förekom patienter som utvecklade olika former av tyreoideadysfunktion. Slutsats: Rapportens resultat samstämmer med de nationella rekommendationerna för jodkontrastmedel att hänsyn ska tas till patientens tyreoideastatus före en koronarangiografi. Detta för att eventuellt kunna premedicinera riskpatienter och uppmana remittenten om uppföljning av fritt T3, fritt T4 och TSH.

  • 91.
    Blidal, Tünde
    et al.
    Kristianstad University, Faculty of Health Science.
    Schüler, Elise
    Kristianstad University, Faculty of Health Science.
    Livet efter Sepsis: En litteraturöversikt2019Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Globalt drabbas 30 miljoner människor varje år av sepsis varav ca 5 miljoner människor dör. Forskning har fokuserat på överlevnad och den kunskapen har gjort att fler överlever. En tredjedel av de personer som överlevt sepsis drabbas av restsymtom och en sjättedel får kvarstående men för livet. Livskvalitet är en subjektiv upplevelse av välbefinnande och är beroende av flera faktorer. Hälso- och sjukvården ska bedriva personcentrerad omvårdnad och se patienten i sin helhet. Syfte: Syftet var att beskriva livskvalitet hos patienter som överlevt sepsis. Metod: Studien har genomförts som en litteraturöversikt och rymmer 18 artiklar. Datainsamling har skett i databaserna Cinahl Complete, PubMed samt PsycINFO. Resultat: Totalt 17 kvantitativa artiklar och en kvalitativ artikel inkluderades i litteraturöversikten. Resultatet visar att personer som överlevt sepsis blir påverkade inom fyra domäner; fysisk-, kognitiv-, psykisk- och social livskvalitet. Diskussion: Personer som överlever sepsis har ökad risk för fysisk, kognitiv, psykisk och social påverkan på livskvaliteten och söker i stor utsträckning vård. Det är viktigt att sjuksköterskan har kunskap kring de restsymtom som personerna kan drabbas av, en förståelse för det den gått igenom och en uppfattning om hur detta kan påverka deras livskvalitet.

  • 92.
    Blom Johansson, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Aphasia: as experienced by significant others2017Conference paper (Refereed)
  • 93.
    Blomqvist, Sven
    et al.
    Swedish Development Center for Disability Sport, Bollnäs, Sweden.
    Olsson, Josefin
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden.
    Wallin, Louise
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden.
    Wester, Anita
    Department of Research and Evaluation, Swedish National Agency for Education, Stockholm, Sweden.
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden.
    Adolescents with intellectual disability have reduced postural balance and muscle performance in trunk and lower limbs compared to peers without intellectual disability2013In: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 34, no 1, p. 198-206Article in journal (Refereed)
    Abstract [en]

    For adolescent people with ID, falls are more common compared to peers without ID. However, postural balance among this group is not thoroughly investigated. The aim of this study was to compare balance and muscle performance among adolescents aged between 16 and 20 years with a mild to moderate intellectual disability (ID) to age-matched adolescents without ID. A secondary purpose was to investigate the influence of vision, strength, height and Body Mass Index (BMI) on balance. A group of 100 adolescents with ID and a control group of 155 adolescents without ID were investigated with five balance tests and three strength tests: timed up and go test, one leg stance, dynamic one leg stance, modified functional reach test, force platform test, counter movement jump, sit-ups, and Biering-Sørensen trunk extensor endurance test. The results showed that adolescents with an ID in general had significantly lower scores in the balance and muscle performance tests. The group with ID did not have a more visually dominated postural control compared to the group without ID. Height, BMI or muscle performance had no strong correlations with balance performance. It appears as if measures to improve balance and strength are required already at a young age for people with an ID.

  • 94.
    Blomqvist, Sven
    et al.
    Swedish Development Centre for Disability Sport, Bollnäs, Sweden.
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.
    Validity and reliability of the Dynamic One Leg Stance (DOLS) in people with vision loss2007In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 9, no 3, p. 129-135Article in journal (Refereed)
    Abstract [en]

    This study tests the concurrent validity and test–retest reliability of a new functional balance test – the Dynamic One Leg Stance (DOLS) in blind subjects and sighted, blindfolded subjects. Twelve blind and 12 sighted men and women between 19 and 61 years volunteered to participate. The correlation between DOLS and the commonly used One Leg Stance balance test (OLS) and the force platform test (FPT) was tested for both the right and left leg. The test–retest reliability of DOLS was analysed using three measurements at least 2 h apart. The correlation between DOLS and FPT and between DOLS and OLS for blind subjects was −0.13 (n.s.) and 0.77 for the left leg and −0.78 and 0.89 for the right leg. For blindfolded subjects, the correlations were −0.56 (n.s.) and 0.93 for the left leg and −0.61 and 0.71 for the right leg. The weighted Kappa values for DOLS were between 0.47 and 0.88 for blind subjects and between 0.47 and 0.72 for blindfolded subjects. Based on these findings, DOLS appears to be a fairly valid and reliable balance test for subjects with vision loss, acquired and experimental. However, further tests of DOLS are necessary.

  • 95.
    Blomqvist, Sven
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Sports science. Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Wester, Anita
    Department of Research and Evaluation, Swedish National Agency for Education, Stockholm, Sweden.
    Persson, Elin
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Sundkvist, Hillevi
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Sundelin, Gunnevi
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Postural stability, physical activity, aerobic capacity and their associations for young people with and without intellectual disabilities2014In: European Journal of Adapted Physical Activity, ISSN 1803-3857, E-ISSN 1803-3857, Vol. 7, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Previous studies show that people with intellectual disability (ID) appear to have impaired postural stability, a lower level of physical activity, and lower aerobic capacity compared to persons without ID, limitations that could affect their health. This study investigates these physical functions and their associations in a group of young people with ID compared to an age-matched group without ID. In total, this cross-sectional study included 106 high school students (16-20 years): 57 students with mild to moderate ID and 49 age-matched students without ID (control group). Tests were performed for postural stability, level of physical activity, and aerobic capacity. Both females and males with ID had significantly lower estimated maximum oxygen uptake (l O2/min) (p< 0.001 for females and p=0.004 for males) and a lower aerobic capacity expressed relative to body weight (ml O2/ kg*min) (p< 0.001 for females and p=0.012 for males) compared to age-matched peers. Analyses of associations were made using the Pearson’s correlation coefficient and multivariate linear regression analysis. No significant associations could be found. Physical status appears impaired for young people with ID and functions, such as postural stability, should be evaluated separately.

  • 96.
    Blomqvist, Sven
    et al.
    Swedish Development Centre for Disability Sport, Bollnäs, Sweden; Umeå universitet.
    Wester, Anita
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Rehn, Börje
    Department of Research and Evaluation, Swedish National Agency for Education, Stockholm, Sweden.
    Postural muscle responses and adaptations to backward platform perturbations in young people with and without intellectual disability2014In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 39, no 3, p. 904-908Article in journal (Refereed)
    Abstract [en]

    This study examines postural muscle responses to backward perturbations in young people (16-20 years) with and without intellectual disability (ID). The study included 56 young people with ID and 43 age-matched without ID volunteers. The subjects stood on a platform that was moved backwards in a surface translation. Lower and upper leg muscles and lower back spine muscles were recorded with surface electromyography (EMG). Muscle onset latency, time to peak amplitude (EMG), adaptation of muscle responses to repeated perturbations (using integrated EMG (IEMG) for epochs), and synergies and strategies were assessed. The result showed no differences between the two groups in muscle onset latency, synergies, and strategies. Young people with ID reduced their time to peak amplitude in investigated muscles, a response that was different from the group without ID. Also, young people with ID tended to adapt their IEMG less compared to the controls. These findings suggest that young people with ID have limited ability to use somatosensory information and adapt their postural muscle responses to repeated external perturbations.

  • 97.
    Blomqvist, Sven
    et al.
    Swedish Development Centre for Disability Sport, Bollnäs, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Wester, Anita
    Department of Research and Evaluation, Swedish National Agency for Education, Stockholm, Sweden .
    Sundelin, Gunnevi
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden .
    Rehn, Börje
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umea University, Umea, Sweden .
    Test-retest reliability, smallest real difference and concurrent validity of six different balance tests on young people with mild to moderate intellectual disability2012In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 98, no 4, p. 313-319Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Some studies have reported that people with intellectual disability may have reduced balance ability compared with the population in general. However, none of these studies involved adolescents, and the reliability and validity of balance tests in this population are not known. The purpose of this study was to examine the reliability of six different balance tests and to investigate their concurrent validity.

    DESIGN:

    Test-retest reliability assessment.

    SETTINGS:

    All subjects were recruited from a special school for people with intellectual disability in Bollnäs, Sweden.

    PARTICIPANTS:

    Eighty-nine adolescents (35 females and 54 males) with mild to moderate intellectual disability with a mean age of 18 years (range 16 to 20 years).

    INTERVENTIONS:

    All subjects followed the same test protocol on two occasions within an 11-day period.

    MAIN OUTCOMES:

    Balance test performances.

    RESULTS:

    Intraclass correlation coefficients greater than 0.80 were achieved for four of the balance tests: Extended Timed Up and Go Test, Modified Functional Reach Test, One-leg Stance Test and Force Platform Test. The smallest real differences ranged from 12% to 40%; less than 20% is considered to be low. Concurrent validity among these balance tests varied between no and low correlation.

    CONCLUSION:

    The results indicate that these tests could be used to evaluate changes in balance ability over time in people with mild to moderate intellectual disability. The low concurrent validity illustrates the importance of knowing more about the influence of various sensory subsystems that are significant for balance among adolescents with intellectual disability.

  • 98.
    Bohman, Marie-Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Freudenthal, Yvonne
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Bryta isen- göra det svåra pratbart: En kvalitativ studie av föräldrars upplevelser av Beardslees familjeintervention för dem själva och deras barn2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Barn till föräldrar med psykisk ohälsa kallas ibland för de osynliga barnen. Beardslee familjeintervention (BFI) är en hälsofrämjande preventiv metod för barn till föräldrar med psykisk ohälsa. Den har en viss evidens för positiva långtidseffekter för barn och familjer när föräldern har depression. Barnen har nu uppmärksammats ännu mer p.g.a. att lagstiftningen har skärpts från och med 1 januari 2010. Det gäller skyldighet för personal inom hälso- och sjukvård att ge information, råd och stöd utifrån barns behov. Mot bakgrund av detta var syftet med denna studie att undersöka föräldrars upplevelser och erfarenheter av BFI samt få med barnperspektiv genom att  till samma föräldrar ställa frågor som berörde deras barn. En kvalitativ metod med öppna breda frågeställningar har använts. Materialet analyserades med en kvalitativ innehållsanalys. Sex föräldrar, som under 2010 hade genomgått BFI, intervjuades. De viktigaste resultaten från intervjuerna var att kommunikationen i familjen hade påverkats positivt med öppnare dialog. Tidpunkten av BFI var mycket viktig, att personalen, enligt föräldrarna, kunde prata med barnen på rätt nivå och att metodens flexibilitet och möjlighet till uppföljning uppskattades av föräldrarna.

     

  • 99. Bohman, Tony
    et al.
    Tegern, Matthias
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden.
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Reliability and agreement of the IsoKai isokinetic lift test - A test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0209419Article in journal (Refereed)
    Abstract [en]

    This study was performed to evaluate the reliability and agreement of the IsoKai isokinetic lift test as it is currently administered in admission to the Swedish Armed Forces. The study included an intrarater (n = 534) and interrater reliability sample (n = 137), of Swedish male conscripts who performed the test on two test occasions about two hours apart. Two-to-four lifts were performed at each occasion, and the highest mean (IsoKai(MF)) and peak force (IsoKai(PF)) produced (N) were used for evaluation. All intraclass coefficients showed excellent reliability. The interrater analyses resulted in intraclass coefficients of 0.942 (95% CI; 0.920-0.959) and 0.858 (95% CI; 0.806-0.896) for the IsoKai(MF) and IsoKai(PF), respectively, while the corresponding coefficients for the intrarater analyses were 0.935 (95% CI; 0.923-0.946) and 0.865 (95% CI; 0.842-0.886). Agreement, the capability of a test to detect changes, was assessed by the standard error of measurement (SEM/SEM%) and the smallest real difference (SRD/SRD%). These estimate indicated that it is possible to achieve measurements relevant to use in real practice with the IsoKai isokinetic lift test. Bland and Altman analyses revealed no systematic errors in either sample. Based on these findings, the IsoKai isokinetic lift test is suggested to be a highly reliable test for maximal dynamic muscular strength. The test could be of use in selection procedures in order to accurately evaluate maximal dynamic muscular strength, and for evaluating longitudinal changes in strength.

  • 100.
    Bojcic, Irma
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Tiderman, Pernilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Implementering av evidensbaserad omvårdnad – en intervjustudie med specialistsjuksköterskor inom medicinsk vård2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When healthcare's clinical work is based on evidence patient safety increases, healthcare becomes more cost-effective, treatment outcomes and patients' quality of life improves. Today's healthcare is characterized by high work rate and high workload, which complicates the implementation of evidence. Nurse specialists are considered to be those who can take responsibility for developing evidence-based nursing. Aim: The purpose was to describe nurse specialists’ experiences of implementing evidence based nursing in medical care. Design: Qualitative interview study with inductive and descriptive approach was performed. Method: Semi-structured interviews were conducted with eight Medical nurse specialists. The result was analyzed according to Krippendorffs´ content analysis. Results: Medical nurse specialists’ experiences of implementation of evidence based nursing in medical care is described by four categories: Expectations, Attitude and engagement, Implementation, a process and Safe and secure nursing. Conclusion: Medical nurse specialists are expected to have a higher competence for implementing evidence based nursing, they can take responsibility for actuating an implementation forward, but support from employees and organization is needed. When evidence based nursing is implemented, patient safety and safety for nurses in their profession increases, provided that the implementation process is given time and resources and is relevant to the healthcare context.

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