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  • 2751.
    Thorsson, Maria
    Halmstad University, School of Social and Health Sciences (HOS).
    Operationsteamets erfarenheter av att arbeta med WHO:s checklista för säker kirurgi2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    WHO's checklist has significantly reduced complications and mortality and increased patient safety in surgical patients by being a standardized tool for communication and co-operation of the surgical team. At the end of 2011 most Swedish hospitals used WHO´s checklist, but there are only a few studies from Sweden after the introduction. The purpose of this pilot study was to investigate the surgical team´s experiences working with WHO´s checklist for safe surgery. A focus group interview was conducted with a surgical team. Data analysis was done by qualitative manifest content analysis. The result shows both benefits and difficulties when WHO´s checklist is used. The checklist is important for the team´s communication and planning and is a routine security and control to avoid mistakes. It´s a meeting point, it´s clarifying the facts, providing safer care and it takes less time if the team synchronizes itself, waits for each other, focuses and concentrates on the checklist. There is a need of shared responsibility to remember it and the commitment and support from the management for good implementation. Everyone must be involved, agree to use it and take it seriously. The checklist is less relevant for small procedures where the desire is to be able to modify it. Further studies of multidisciplinary team training for the development of the checklist would be interesting. In order to compare various professional categories with each other and gain deeper knowledge, it is necessary to do several focus group interviews. 

  • 2752.
    Thorstensson, Carina
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Lund University, Lund, Sweden.
    Exercise and Functional Performance in Middle-aged Patients with Knee Osteoarthritis2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall purpose of this thesis was to explore the impact of exercise and functional performance on development and treatment of knee osteoarthritis in the middle aged.

    In this thesis, I have studied a population based cohort of middle-aged subjects (35-54 years, 42 % women) with chronic knee pain at baseline, to evaluate the longitudinal effect of muscle weakness on knee osteoarthritis development, the relationship between muscle function and joint load and the effects of exercise on joint load. I have also studied the effect of exercise on pain and function in another middle-aged cohort (36-65 years, 51 % women) with moderate to severe knee osteoarthritis, and explored their conceptions of exercise as treatment. In the first study, 148 subjects with chronic knee pain underwent radiographic examination and tests of functional performance at baseline. 94 of them had no radiographic signs of knee osteoarthritis. Five years later they had new radiographs taken and 41/94 (44 %) had developed incident knee osteoarthritis. I found that reduced functional performance, assessed by maximum number of one-leg rises from a stool, predicted knee osteoarthritis development. The result was controlled for the previously known risk factors of age, BMI and pain.

    In the second study, I used 3-dimensional motion analysis to explore the possibility of altering joint load by exercise. The medial compartment joint load (peak adduction moment) during maximum number of one-leg rises was assessed in 13 subjects with early radiographic signs of knee osteoarthritis from the cohort in study one, before and after 8 weeks of exercise. Two subjects were lost to follow up for reasons not related to the knee. The peak adduction moment could be reduced by exercise, and a high maximum number of one-leg rises was associated with lower levels of peak adduction moment.

    The third study included 61 subjects with moderate to severe radiographic knee osteoarthritis. They were randomized to 6 weeks of intensive exercise or to a control group. The effects of exercise were assessed using questionnaires. No effects were seen on pain or self estimated function, however, the quality of life improved. The individual response to exercise ranged from clinically significant improvement to clinically significant worsening.

    As an attempt to understand this large inter individual response to exercise, I designed the fourth study, where I interviewed 16 of the 30 patients in the exercise group about their conceptions of exercise as treatment. The interviews were analysed using qualitative methodology, and it was revealed that all patients were aware of the general health benefits of exercise, but had doubts about exercise as treatment of osteoarthritis even if they had perceived pain relief and improvement in physical function from the exercise intervention. The pain experienced during exercise caused the patients to believe that exercise was harmful to their knees, and some of them would prefer not to exercise at all. They thought that exercise should be introduced early during the course of the disease, and all of them expressed the need of continuous encouragement and support to adhere to exercise.

    From this thesis I conclude that reduced muscle function is a risk factor of knee osteoarthritis development among middle aged subjects with knee pain. Reduced muscle function is associated with increased joint load, which seem to be modifiable by exercise. Initial pain when starting exercise, or occasional pain from exercise, should be treated by combining exercise with pain relief such as analgesics or acupuncture. Pain contributes to the difficulty patients have determining the degree of benefit or damage related to exercise, and thus causes feelings of anxiety and helplessness (paper IV). Pain also seems to interfere with the possibility of achieving increased functional performance (paper II, III, IV).

  • 2753.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Lund University, Lund, Sweden.
    Henriksson, M.
    Karolinska Institutet, Stockholm, Sweden.
    von Porat, A.
    Lund University, Lund, Sweden.
    Roos, E. M.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Lund University, Lund, Sweden.
    Eight weeks of exercise reduced knee adduction moment during one-leg rise in patients with early knee osteoarthritisManuscript (preprint) (Other academic)
    Abstract [en]

    Background

    Reduced functional performance is a risk factor for development of knee osteoarthritis, and peak knee adduction moment is associated with radiographic progression. Knee adduction moment can be reduced by high tibial osteotomy. The effect of dynamic stabilization through increased muscle performance is not known.

    Aims

    To study the effect from exercise on external peak knee adduction moment during one-leg rise, and the relationship between peak knee adduction moment during one-leg rise and maximum number of one-leg rise.

    Methods

    13 patients, aged 48–63, with mild to moderate knee osteoarthritis underwent 8 weeks of supervised exercise, aiming at increasing neuromuscular control and lower extremity strength. The maximum number of one-leg rise from a stool (48 cm), 3-dimensional gait analysis and self-estimated knee symptoms were assessed before and after exercise intervention. Peak external knee adduction moment during one-leg rise and gait was calculated using a Vicon system. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as assessment of knee symptoms. Patients defined their most symptomatic knee as index knee.

    Results

    Peak knee adduction moment during one-leg rise was reduced for the index knee from 0.57 Nm/kg at baseline to 0.51 after 8 weeks of exercise (p=0.04). The change for the opposite knee was not significant (from 0.58 to 0.56 Nm/kg, p=0.23). No significant changes were seen for index or opposite knees in peak adduction moment during gait (p>0.40). A higher maximum number of one-leg rise was correlated to a lower peak adduction moment for the index knee at baseline (rs =-0.35, p=0.24) and follow up (rs = -0.65, p=0.03). For the opposite knee the correlation was similar at baseline (rs= -0.47, p=0.10), and no correlation was seen at follow up (rs = 0.13, p=0.70). Correlations for change over time were poor (-0.43 to -0.03) and not significant (p>0.20). Patients with symptomatic knee osteoarthritis had higher peak adduction moment in their opposite knee, than patients without symptoms at baseline (0.72 (0.09) vs. 0.50 (0.11), p=0.01) and follow-up (0.66 (0.14) vs. 0.51 (0.07), p=0.04). The differences for the index knee pointed in the same direction, however not significant (p>0.28).

    Conclusion

    Peak knee adduction moment in the most symptomatic knee of middle-aged patients with early signs of knee osteoarthritis can be reduced by exercise. Improved muscular performance might reduce the risk of radiographic progression of knee osteoarthritis. It seem of importance to reduce pain prior to starting exercising. A lower maximum number of one-leg rise is associated with higher peak knee adduction moment and has the potential to serve as a surrogate in studies where 3-dimensional analysis is not feasible.

  • 2754.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Petersson, I. F.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Jacobsson, L. T. H.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Rheumatology, Malmö University Hospital, Malmö, Sweden.
    Boegård, T. L.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Radiology, County Hospital, Helsingborg, Sweden.
    Roos, E. M.
    Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Department of Orthopaedics, Lund University Hospital, Lund, Sweden.
    Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later2004In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 63, no 4, p. 402-407Article in journal (Refereed)
    Abstract [en]

    Background: Reduced quadriceps strength is an early finding in subjects with knee osteoarthritis, but it is not clear whether it is a cause or a consequence of knee osteoarthritis.

    Objective: To determine whether reduced functional performance in the lower extremity predicts the incidence or progression of radiographic knee osteoarthritis.

    Design: Prospective, epidemiological, population based cohort study.

    Patients: 148 subjects (62 women), aged 35–54 (mean 44.8), with chronic knee pain from a population based cohort.

    Measurements: Predictors analysed were age, sex, body mass index, baseline knee pain, and three tests of lower extremity functional performance: maximum number of one-leg rises from sitting, time spent walking 300 m, and timed standing on one leg. Weightbearing tibiofemoral knee radiographs were obtained at baseline and after 5 years (median 5.1, range 4.2–6.1), and classified according to Kellgren and Lawrence as no osteoarthritis (Kellgren and Lawrence = 0, n = 94) or prevalent osteoarthritis (Kellgren and Lawrence ⩾1, n = 54).

    Results: Fewer one-leg rises (median 17 v 25) predicted incident radiographic osteoarthritis five years later (OR 2.6, 95% CI 1.1 to 6.0). The association remained significant after controlling for age, sex, body mass index, and pain. No significant predictor of radiographic progression in the group with prevalent osteoarthritis was found.

    Conclusion: Reduced functional performance in the lower extremity predicted development of radiographic knee osteoarthritis 5 years later among people aged 35–55 with chronic knee pain and normal radiographs at baseline. These findings suggest that a test of one-leg rises may be useful, and interventions aimed at improving functional performance may be protective against development of knee osteoarthritis.

  • 2755.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Roos, Ewa M.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Petersson, Ingemar F.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden.
    Arvidsson, Barbro
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    How do middle-aged patients conceive exercise as a form of treatment for knee osteoarthritis?2006In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 28, no 1, p. 51-59Article in journal (Refereed)
    Abstract [en]

    Purpose. To describe conceptions, as registered by a semi-structured interview, of exercise as treatment among sixteen middle-aged patients with moderate to severe knee osteoarthritis.

    Method. Sixteen patients (aged 39 – 64) with symptomatic, radiographic knee osteoarthritis and previous participants in an exercise intervention, were interviewed. The qualitative data obtained were analysed using phenomenographic approach.

    Results. Four descriptive categories containing 13 conceptions emerged: Category 1) To gain health included five conceptions; to experience coherence, to experience well-being, to be in control, to experience improved physical functioning, to experience symptom relief; 2) To become motivated included three conceptions; to experience inspiration, to be prepared to persevere, to experience the need to exercise; 3) To experience the need for support included three conceptions; to have structure, to receive guidance, to devote time; 4) To experience resistance included two conceptions; to hesitate, to deprecate.

    Conclusion. Patients with knee osteoarthritis and knee pain, previously participating in exercise intervention, are aware of the health benefits of exercise, but have many doubts and concerns about exercise as treatment. These aspects should be considered when designing patient information and treatment programmes. Furthermore, a hesitative and resistive perception of exercise as a concept could have major influences on the implementation of health programmes. © 2006 Taylor & Francis.

  • 2756.
    Thorstensson, Carina A.
    et al.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Dept. of Rheumatology, Lund University, Lund, Sweden.
    Roos, Ewa M.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Dept. of Orthopedics, Lund University, Lund, Sweden.
    Petersson, Ingemar F.
    Spenshult Hospital for Rheumatic Diseases, Halmstad, Sweden & Dept. of Orthopedics, Lund University, Lund, Sweden.
    Ekdahl, Charlotte
    Dept. of Physical Therapy, Lund University, Lund, Sweden.
    Six-week high-intensity exercise program for middle-aged patients with knee osteoarthritis: a randomized controlled trial [ISRCTN20244858]2005In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 6, article id 27Article in journal (Refereed)
    Abstract [en]

    Background: Studies on exercise in knee osteoarthritis (OA) have focused on elderly subjects. Subjects in this study were middle-aged with symptomatic and definite radiographic knee osteoarthritis. The aim was to test the effects of a short-term, high-intensity exercise program on self-reported pain, function and quality of life. Methods: Patients aged 36-65, with OA grade III (Kellgren & Lawrence) were recruited. They had been referred for radiographic examination due to knee pain and had no history of major knee injury. They were randomized to a twice weekly supervised one hour exercise intervention for six weeks, or to a non-intervention control group. Exercise was performed at ≥ 60% of maximum heart rate (HR max). The primary outcome measure was the Knee injury and Osteoarthritis Outcome Score (KOOS). Follow-up occurred at 6 weeks and 6 months. Results: Sixty-one subjects (mean age 56 (SD 6), 51 % women, mean BMI 29.5 (SD 4.8)) were randomly assigned to intervention (n = 30) or control group (n = 31). No significant differences in the KOOS subscales assessing pain, other symptoms, or function in daily life or in sport and recreation were seen at any time point between exercisers and controls. In the exercise group, an improvement was seen at 6 weeks in the KOOS subscale quality of life compared to the control group (mean change 4.0 vs. -0.7, p = 0.05). The difference between groups was still persistent at 6 months (p = 0.02). Conclusion: A six-week high-intensive exercise program had no effect on pain or function in middle-aged patients with moderate to severe radiographic knee OA. Some effect was seen on quality of life in the exercise group compared to the control group. © 2005 Thorstensson et al; licensee BioMed Central Ltd.

  • 2757.
    Thorvaldsson, Valgeir
    et al.
    University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Peter
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). University of Gothenburg, Gothenburg, Sweden.
    Skoog, Johan
    University of Gothenburg, Gothenburg, Sweden.
    Skoog, Ingmar
    Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Johansson, Boo
    University of Gothenburg, Gothenburg, Sweden.
    Better Cognition in New Birth Cohorts of 70 Year Olds, But Greater Decline Thereafter2017In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 72, no 1, p. 16-24Article in journal (Refereed)
    Abstract [en]

    Objectives

    To evaluate birth cohort differences in level of cognition and rate of change in old age.

    Methods

    Data were drawn from three population-based Swedish samples including age-homogenous cohorts born 1901/02, 1906/07, and 1930, and measured on the same cognitive tests at ages 70, 75, and 79 as part of the Gerontological and Geriatric Populations Studies in Gothenburg (H70). We fitted growth curve models to the data using a Bayesian framework and derived estimates and inferences from the marginal posterior distributions.

    Results

    We found moderate to large birth cohort effects in level of performance on all cognitive outcomes. Later born cohorts, however, showed steeper linear rate of decline on reasoning, spatial ability, and perceptual- and motor-speed, but not on picture recognition memory and verbal ability.

    Discussion

    These findings provide strong evidence for substantial birth cohort effects in cognition in older ages and emphasize the importance of life long environmental factors in shaping cognitive aging trajectories. Inferences from cognitive testing, and standardization of test scores, in elderly populations must take into account the substantial birth cohort differences. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.

  • 2758.
    Thorén, Ann Britt
    et al.
    Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Axelsson, Åsa B.
    Halmstad University, School of Health and Welfare. Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Holmberg, Stig
    Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Herlitz, Johan D.
    Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
    Measurement of skills in cardiopulmonary resuscitation-do professionals follow given guidelines?2001In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 8, no 3, p. 169-176Article in journal (Refereed)
    Abstract [en]

    Since it is suggested that only effective cardiopulmonary resuscitation (CPR) improves survival rates, quality control of training outcomes is important and comparisons between different training methods are desirable. The aim of this study was to test a model of quality assurance, consisting of a computer program combined with the Brennan et al. checklist, for evaluation of CPR performance. A small group of trained medical professionals (cardiac care unit nurses) (n = 10) was used in this pilot study. The result points out several points of concern: half of the participants did not open the airway prior to breathing control. Over 90% of all inflations were ‘too fast’ and 71% were ‘too much’. Only 6.5% of the inflations were correct. On average, the participants made 5.4 inflations per minute. Concerning chest compressions, 40% were ‘too deep’ while only 4% were ‘too shallow’. In spite of the fact that the participants had an average rate at 95 compressions per minute the number of compressions varied between 32 and 51 during 1 minute. When new guidelines are discussed, it would be beneficial if they were tested by a number of people to investigate if following the guidelines is at all possible. © 2001 Lippincott Williams & Wilkins, Inc.

  • 2759.
    Thorén, Lina A.
    et al.
    Lunds Universitet, Lund, Sverige.
    Liuba, Karina
    Lunds Universitet, Lund, Sverige.
    Bryder, David
    Lunds Universitet, Lund, Sverige.
    Nygren, Jens Martin
    Lunds universitet, Lund, Sverige.
    Jensen, Christina T
    Lunds Universitet, Lund, Sverige.
    Qian, Hong
    Lunds Universitet, Lund, Sverige.
    Antonchuk, Jennifer
    Lunds Universitet, Lund, Sverige.
    Jacobsen, Sten-Eirik W
    Lunds Universitet, Lund, Sverige.
    Kit regulates maintenance of quiescent hematopoietic stem cells2008In: Journal of Immunology, ISSN 0022-1767, E-ISSN 1550-6606, Vol. 180, no 4, p. 2045-2053Article in journal (Refereed)
    Abstract [en]

    Hematopoietic stem cell (HSC) numbers are tightly regulated and maintained in postnatal hematopoiesis. Extensive studies have supported a role of the cytokine tyrosine kinase receptor Kit in sustaining cycling HSCs when competing with wild-type HSCs posttransplantation, but not in maintenance of quiescent HSCs in steady state adult bone marrow. In this study, we investigated HSC regulation in White Spotting 41 (Kit(W41/W41)) mice, with a partial loss of function of Kit. Although the extensive fetal HSC expansion was Kit-independent, adult Kit(W41/W41) mice had an almost 2-fold reduction in long-term HSCs, reflecting a loss of roughly 10,000 Lin(-)Sca-1(+)Kit(high) (LSK)CD34(-)Flt3(-) long-term HSCs by 12 wk of age, whereas LSKCD34(+)Flt3(-) short-term HSCs and LSKCD34(+)Flt3(+) multipotent progenitors were less affected. Whereas homing and initial reconstitution of Kit(W41/W41) bone marrow cells in myeloablated recipients were close to normal, self-renewing Kit(W41/W41) HSCs were progressively depleted in not only competitive but also noncompetitive transplantation assays. Overexpression of the anti-apoptotic regulator BCL-2 partially rescued the posttransplantation Kit(W41/W41) HSC deficiency, suggesting that Kit might at least in the posttransplantation setting in part sustain HSC numbers by promoting HSC survival. Most notably, accelerated in vivo BrdU incorporation and cell cycle kinetics implicated a previously unrecognized role of Kit in maintaining quiescent HSCs in steady state adult hematopoiesis.

  • 2760.
    Thulin, Erika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Årzén, Melina
    Halmstad University, School of Social and Health Sciences (HOS).
    Att leva i skuggan av döden: upplevelser hos patienter med cancer i den palliativa fasen2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Problem: Every year a large number of people with a cancer diagnosis die. In the palliative care of patients with cancer the goal is to achieve the best possible quality of life. Experiences such as fear and anxiety are common problems and have a special meaning for each individual. It is therefore important to highlight the experiences of being at the end of lifeto increase understanding and knowledge to nurses.

    The aim: was to illuminate the experience of being in the end of life for patients with cancer inthe palliative phase.

    Method: A literature review which consist of 12 scientific papers with a qualitative and quantitative approach.

    Results and conclusion: The results show that existential experiences, a sense of worry and anxiety, loss, hope and acceptance were the most common experiences for patients who were facing death.

    Implication: Patients' experiences at the end of life are varied and are relevant for nurses to understand to meet patient the patient’s needs. Therefore education and further research from a patient perspective is necessary to optimize palliative care for patients with terminal cancer

  • 2761.
    Thylen, Ingela
    et al.
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Wenemark, Marika
    Division of Community Medicine, Linköping University, Linköping, Sweden.
    Fluur, Christina
    Department of Cardiology, County Council of Östergötland, Linköping, Sweden.
    Strömberg, Anna
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Bolse, Kärstin
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Årestedt, Kristofer
    Division of Nursing Sciences, Linköping University, Linköping, Sweden.
    Development and evaluation of the EOL-ICDQ as a measure of experiences, attitudes and knowledge in end-of-life in patients living with an implantable cardioverter defibrillator2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, no 2, p. 142-151Article in journal (Refereed)
    Abstract [en]

    Background: Due to extended indications and resynchronization therapy, many implantable cardioverter defibrillator (ICD) recipients will experience progressive co-morbid conditions and will be more likely to die of causes other than cardiac death. It is therefore important to elucidate the ICD patients' preferences when nearing end-of-life. Instead of avoiding the subject of end-of-life, a validated questionnaire may be helpful to explore patients' experiences and attitudes about end-of-life concerns and to assess knowledge of the function of the ICD in end-of-life. Validated instruments assessing patients' perspective concerning end-of-life issues are scarce.

    Aim: The purpose of this study was to develop and evaluate respondent satisfaction and measurement properties of the 'Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients' Questionnaire' (EOL-ICDQ).

    Methods: The instrument was tested for validity, respondent satisfaction, and for homogeneity and stability in the Swedish language. An English version of the EOL-ICDQ was validated, but has not yet been pilot tested.

    Results: The final instrument contained three domains, which were clustered into 39 items measuring: experiences (10 items), attitudes (18 items), and knowledge (11 items) of end-of-life concerns in ICD patients. In addition, the questionnaire also contained items on socio-demographic background (six items) and ICD-specific background (eight items). The validity and reliability properties were considered sufficient.

    Conclusions: The EOL-ICDQ has the potential to be used in clinical practice and future research. Further studies are needed using this instrument in an Anglo-Saxon context with a sample of English-speaking ICD recipients. © The European Society of Cardiology 2013.

  • 2762.
    Tisell, Tobias
    et al.
    Halmstad University, School of Health and Welfare.
    Hellberg, Johan
    Halmstad University, School of Health and Welfare.
    Det sociala stödets betydelse för skadade idrottares psykologiska välbefinnande under rehabilitering2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to examine if injured athletes perceived autonomy support during rehabilitation had an indirect effect on: (a) positive affects via need-satisfaction and self-determined motivation, and (b) negative affects via need-thwarting and controlled motivation. Based on the purpose, two hypothetical models were designed and tested through mediation analysis. The study used a quantitative cross-sectional design where the data collection was performed through a strategic convenience sample. There was a total of 71 competitive athletes between the age of 15 and 51 (M=21 SD=5.1) who participated in the study, all of them had been affected by an acute or serious injury. As it   showed that autonomy support did not have an indirect effect on any of the affects via (a) need-satisfaction and self-determined motivation, or (b) need-thwarting and controlled motivation together the aspects from the models could not be considered confirmed. However, the result showed that autonomy support had an indirect effect on the affects when the relation only mediated through need-satisfaction or need thwarting which means that certain segments from the models are in line with the result. The present study highlights that injured athletes increase their psycho logical well-being when the social support from physiotherapists fulfills the basic psychological needs. Using the results from recent study, physiotherapist can get a broaderunderstanding in how their support can affect an athlete’s well-being during their rehabilitation.

  • 2763.
    Toft Ingfeldt, Camilla
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Holmén, Gunilla
    Halmstad University, School of Social and Health Sciences (HOS).
    Probiotika i små barns kost2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Probiotics, beneficial and useful bacterias for the human body, occur more often in different products targeted to small children – in everything from drops and capsules to formula and porridge. Within the child health care, the pediatric- and the district nurse lacks guidance and guidelines concerning probiotics in small children's diet. The aim with the literature review was to examine evidence concerning probiotics health effects in prevention, in small children. The method was a literature review based on 20 scientific articles. The analysis resulted in that probiotics were safe to give to healthy small children. All studies gave uniformly results and showed no disadvantages with giving small children probiotics. No negative health effects were detected in this literature review. Positive health effects of great importance have shown be beneficial within treatment of colic with probiotics given to infants since relief occurred within a week. A predominately positive result was seen in use of probiotics to small children in order to prevent eczemas came to light. Probiotics also decreased absence from day care centers since infection diseases were reduced among the children. Antibiotic prescriptions also decreased when probiotics were used to pre-school children. The positive health effects of probiotics can be used for health recommendations to small children within the child health care by the pediatric- and the district nurse. Extended research is desirable since increased or and combinations of several probiotic bacterium stutters can give increased health effects.

  • 2764.
    Torell, A.
    et al.
    Ängelholms sjukhus, Ängelholm, Sweden.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Lund University, Lund, Sweden & Spenshult R&D center, Halmstad, Sweden.
    Bergman, Stefan
    Lund University, Lund, Sweden; Spenshult R&D center, Halmstad, Sweden & The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Haglund, Emma
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Spenshult R&D center, Halmstad, Sweden.
    Symptoms of pain, fatigue and self-efficacy in young patients with spondyloarthritis: – a comparison between women and men2017In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, no Suppl. 2, p. 1515-1515Article in journal (Refereed)
    Abstract [en]

    Background; The disease spondyloarthritis (SpA) have often an early onset, and can debuts already in teenagers or young adults.  Knowledge of how these patients reporting pain, fatigue and self-efficacy can help to better understand the characteristics of women and men with SpA.

    Objectives: To study the differences between young women and men with SpA with regards to self-reported questionnaires on pain, fatigue and self-efficacy.

    A cross sectional population based cohort were used to create a young patients with SpA.

    Methods: The study is created on a cross-sectional population based cohort of patients with SpA.  They were identified through a health care register by searching for ICD-10 codes for SpA between the years 2003-2007, responding to a questionnaire survey in 2009. 201 patients, 18-36, 29% with the diagnosis of ankylosing spondylitis, 39% with psoriatic arthritis, and 32% with undifferentiated spondyloarhtritis form a subgroup of young patients eligible for analysis.  The surveys including questions concerning self-reported pain (NRS 0-10 and pain mannequin), fatigue (NRS 0-10), self-efficacy (ASES 10-100, low-high). The pain mannequin was used to categorize patients into groups; non chronic pain, chronic regional pain or chronic generalized pain. Self-reported disease activity (BASDAI 0-10) and health related quality of life (EQ5D, 0-1) were used to describe the group. Characteristic symptoms are reported as mean, standard deviation (SD) and frequencies. Mann- Whitney U test and Chi2 test were used to study gender differences.

    Results: The mean age (SD) was, 30 (5) years, 60 % were women. The group reported disease activity (BASDAI) of 3.8 (2.3), quality of life 0.75 (0.16), and that they had their diagnosis for 7 (5) years. One third were smokers or former smokers, and 69 % reached WHO’s recommended level of health enhancing physical activity. Women reported higher pain 3.9 (2.4) compared to men 2.9 (2.1), p=0.001. In the group of both women and men 21 % reported regional chronic pain, 41 % generalized chronic pain and the remaining 38 % reported non chronic pain. More women reported regional and generalized chronic pain than men, p=0.026. Women reported more fatigue 5.0 (2.6) compared to men 3.9 (2.7), p=0.003, less self-efficacy for pain 53 (20), compared to men 59 (21), p=0.041 and for symptoms 59 (19) compared to men 65 (20), p=0.045.

    Conclusion: A significant proportion of both women and men reported symptoms consistent with chronic generalized pain. Women reported generally impaired health compared to men, with a greater percentage with chronic pain, higher rates of pain and fatigue and reduced self-efficacy to manage pain and symptoms. This information could be valuable for clinicians in the care of young patients with SpA. 

  • 2765.
    Torsheim, Torbjørn
    et al.
    Department of Psychosocial Science, University of Bergen, Bergen, Norway.
    Nygren, Jens M.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Rasmussen, Mette
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Arnarsson, Arsæll M.
    School of Humanities and Social Sciences, University of Akureyri, Akureyri, Iceland.
    Bendtsen, Pernille
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Schnohr, Christina W.
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Nielsen, Line
    National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
    Nyholm, Maria
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Social inequalities in self-rated health: A comparative cross-national study among 32,560 Nordic adolescents2018In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, no 1, p. 150-156Article in journal (Refereed)
    Abstract [en]

    AIMS: We aimed to estimate the magnitude of socioeconomic inequality in self-rated health among Nordic adolescents (aged 11, 13 and 15 years) using the Family Affluence Scale (a composite measure of material assets) and perceived family wealth as indicators of socioeconomic status.

    METHODS: Data were collected from the Health Behaviour in School-aged Children (HBSC) survey in 2013-2014. A sample of 32,560 adolescents from Denmark, Norway, Finland, Iceland, Greenland and Sweden was included in the study. Age-adjusted regression analyses were used to estimate associations between fair or poor self-rated health and the ridit scores for family affluence and perceived wealth.

    RESULTS: The pooled relative index of inequality of 2.10 indicates that the risk of fair or poor health was about twice as high for young people with the lowest family affluence relative to those with the highest family affluence. The relative index of inequality for observed family affluence was highest in Denmark and lowest in Norway. For perceived family wealth, the pooled relative index of inequality of 3.99 indicates that the risk of fair or poor health was about four times as high for young people with the lowest perceived family wealth relative to those with the highest perceived family wealth. The relative index of inequality for perceived family wealth was highest in Iceland and lowest in Greenland.

    CONCLUSIONS: Social inequality in self-rated health among adolescents was found to be robust across subjective and objective indicators of family affluence in the Nordic welfare states. © Author(s) 2017

  • 2766.
    Torstensson, Mia
    Halmstad University, School of Social and Health Sciences (HOS).
    Äldres erfarenhet av att genomföra fysisk aktivitet regelbundet och dess påverkan på deras livskvalitet: – en intervjustudie2011Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Physical inactivity is a risk factor for the most common public diseases like cardiovascular diseases, high blood pressure, osteoporosis and depression. Studies show a relationship between regular physical activity and increased quality of life among elderly. The purpose of this study was to describe the experience of physical activity regularly and the effect on quality of life among elderly. Qualitative method was chosen and ten interviews were conducted with elderly over 70 years. Data were analyzed with content analysis. The result that were produced found tree categories; increases well-being, have a function in everyday life and effects everyday life. The latent content was shown in the team: creates possibilities for increased meaningfulness in everyday life. The conclusion was that regular physical activity contributes to better well-being and meaningfulness in everyday life; this show that regular physical activity may improve quality of life among elderly. With an aging population there is a need for increased health promotion activities towards elderly for example group exercise for elderly with an instructor present. The suggestion for continues studies is to investigate physical inactivity among elderly and there experience of barriers and motivation factors towards physical activity.

  • 2767.
    Torstensson, Mia
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Borgman, Anni
    Halmstad University, School of Social and Health Sciences (HOS).
    Livskvalitet och främjande insatser ur långtidsarbetslösas perspektiv: - en kvalitativ intervjustudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The long-term unemployed people in Sweden are feeling unsatisfied than any other population groups and they are in a more vulnerable situation in society in comparison to others. Lowered health status and sense of coherence are often the situation for unemployed people. The purpose of this study was to describe how long-term unemployed people with economic support experience their quality of life and their experience and thoughts of supportive interventions. Data was collected through semi-structured interviews with eight long-term unemployed people who were listed in a project in south-west Sweden. The results showed social support, freedom and creativity in everyday life appears to increase quality of life. Obstacles for quality of life were the unemployment, discrimination, language problems and economic difficulties. Encouraging activities like practical experience, study tours, Swedish language courses and health activities were experienced as positive and an increased selection of some selection was wished for. This could be reached through interventions and local authorities increased cooperation and networking with other parts in society such as companies, universities and non-profit organizations. An evaluation of political implementations and goals for the unemployed, an increased language support in Swedish and a qualitative study with people who work with the long-term unemployed, to get their point of view of supportive interventions, are recommendations for further studies within this health science field.

  • 2768.
    Torén, Sara
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Westerlund, Sofi
    Halmstad University, School of Social and Health Sciences (HOS).
    Motiverande Samtal: - En metod till tobaksrökstopp?2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Several earlier studies on MI as a method to smoking cessation shows positive and negative results to help smokers quit. MI is used by nurse’s today inpatients and in primary care to create behavior changes for instance smoking cessation. The aim of this study was to examine why it´s obscure if motivational interviewing (MI) is a method that can result to smoking cessation. The study was made as a literature review. Searches were made in Cinahl, Oxford Journals, PsycINFO, PubMed and SveMed+ and resulted in 15 selected articles. Several studies showed significant results that MI as a method for smoking cessation had effect but there were studies where MI showed negative effect. In the studies there are significant results that MI can help patients reduce smoking. The results of a few articles showed that participants with lower motivation didn´t succeed in smoking cessation. The conclusion is that more research on MI must be conducted on the connection between MI and motivation in smoking cessation. Caution must be taken if MI should be applied in care as a method for smoking cessation.

  • 2769.
    Tranaeus, U.
    et al.
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Heintz, E.
    Swedish Council on Health Technology Assessment, Stockholm, Sweden & Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Forssblad, M.
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Werner, S.
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Injuries in Swedish floorball: a cost analysis2017In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, no 5, p. 508-513Article in journal (Refereed)
    Abstract [en]

    The epidemiology of sport injuries is well documented. However, the costs are rarely discussed. Previous studies have presented such costs in specific sports or localization. No study has investigated the costs related to injuries in elite floorball. Thus, the aim of this study was to estimate cost of injuries in Swedish elite floorball players. During 1year, 346 floorball players were prospectively followed. All time-loss injures were recorded. The injured players were asked to complete a questionnaire regarding their costs tied to the injury. Mean costs were calculated by multiplying the total resource use with the collected unit costs and dividing these total costs with the number of injuries as well as players. The results showed that the average cost per injury increased with the level of severity and ranged from 332 to 2358 Euros. The mild and moderate overuse injuries were costlier than the corresponding traumatic injuries. However, the severe traumatic injuries were associated with higher costs than overuse injuries. Knee injuries were the costliest. Our results indicate that there are costs to be saved, if floorball injuries can be avoided. They should be of interest to decision makers deciding whether to invest in preventive interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

  • 2770.
    Tranaeus, Ulrika
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Karolinska Institutet, Stockholm, Sverige.
    Ger mindre stress färre skador?2013In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 22, no 4, p. 20-24Article in journal (Other academic)
  • 2771.
    Tranaeus, Ulrika
    Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Stockholm, Sweden.
    Psychological prevention intervention, a cluster RCT study among elite floorball players2014Conference paper (Refereed)
  • 2772. Tranaeus, Ulrika
    The importance of mental readiness before considering return to sport after injury2014In: Physio therapy programme: PT Symposium: Return to sport, 2014Conference paper (Refereed)
  • 2773.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Götesson, Eva
    Rehab Öppenvård, TioHundra, Norrtälje, Sweden.
    Werner, Suzanne
    Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Injury Profile in Swedish Elite Floorball: A Prospective Cohort Study of 12 Teams2016In: Sports Health: a multidisciplinary approach, ISSN 1941-7381, Vol. 8, no 3, p. 224-229Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Floorball is an indoor team sport with growing popularity worldwide characterized by rapid accelerations, decelerations, and cutting and pivoting movements. While injuries are common, there are few high-quality epidemiological investigations of floorball injuries. Therefore, the aim of this study was to determine the incidence and severity of injuries in male and female elite-level floorball players in Sweden.

    HYPOTHESIS: The incidence of injuries has not decreased; female players are more vulnerable to injury than male players.

    STUDY DESIGN: Prospective cohort study.

    LEVEL OF EVIDENCE: Level 3.

    METHODS: Twelve floorball teams (6 male, 6 female) in the Swedish premiere leagues were followed for 1 year (preseason, game season, and the entire year). The team medical staff reported injury incidence, location, type (traumatic or overuse), and severity. Differences between male and female players were analyzed using the Mann-Whitney U test.

    RESULTS: The injury incidence was greater in female players during preseason (22.9 vs 7.4, P = 0.01), game season (39.5 vs 28.3, P = 0.002), as well as the whole year combined (33.9 vs 20.8, P = 0.02). The thigh was the most common injury location in male players and the ankle in female players. Overuse injuries were more common among men and were primarily back problems. Traumatic injuries were more common in women-mainly knee and ankle injuries. Most injuries were of mild severity. A greater number of anterior cruciate ligament injuries occurred in women (n = 11) than in men (n = 2).

    CONCLUSION: The injury incidence was significantly greater in female floorball players throughout the entire floorball year. Male players sustained mostly overuse injuries while female players suffered traumatic injuries. The majority of injuries in floorball were mild, irrespective of player sex.

    CLINICAL RELEVANCE: Knowledge of the incidence and severity of floorball injuries is an essential step in the sequence of injury prevention. Future research should focus on identifying injury mechanisms and risk factors for these injuries to develop injury prevention strategies.

     © 2016, 2016 The Author(s).

  • 2774.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Johnson, Urban
    Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Reduction of sport injuries in male elite icehockey in Sweden: A psychological intervention study2008Conference paper (Other academic)
    Abstract [en]

    Background: According to current statistics ice hockey is ranked as a high-risk injury sport. However, recent research shows the possibility of preventing the occurrence of sport-related injury in high-risk sport through psychological intervention.Objective: The objective was to study the potential of reducing injuries among male elite ice hockey players through brief psychological interventions during a season. Design: An experimental prospective intervention study, using a matched pair, experimental control group design was used followed by a pretest–posttest and a qualitative analysis.Setting: One Swedish elite ice hockey team was contacted for psychometric testing. Moreover, brief intervention was performed outside the training facilities of the team. Main Outcome Measurement: Athletic coping skills inventory— 28 and the sports anxiety scale was used to measure coping and anxiety before and after the intervention. A sport injury frequency form was used to record all injuries before and during the study. In addition, a critical incidence diary was used (experimental group) to record situations that were experienced as positive and negative within as well as outside ice hockey.Participants: Altogether 10 players in the experimental group and 14 players in the control group constituted the group of participants in the study. Interventions: Five individual sessions using somatic and cognitive intervention as well as self-confidence and goal-setting training were conducted within the experimental group.Results: The study showed that the experimental group faced fewer injuries compared with the control group (p,0.05). Although no statistical differences emerge using the psychometrics, the qualitative analysis, using citation techniques of the critical incidence diary, showed that the experimental group had moredifficulty finding negative stressful moments at the end of the study compared with the beginning. Conclusion: It seems possible to decrease sport-related injuries through psychological interventions such as stress management in a brief intervention programme for ice hockey players.

  • 2775.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Engström, Björn
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Skillgate, Eva
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
    Werner, Suzanne
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    A psychological injury prevention group intervention in Swedish floorball2015In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, no 11, p. 3414-3420Article in journal (Refereed)
    Abstract [en]

    Purpose

    The main purpose of the study was to evaluate a psychological skills training intervention at group level aiming to prevent injuries, separated in traumatic and overuse, in male and female elite floorball players.

    Methods

    Twenty-three teams in the premiere leagues for males and females were volunteered, and the teams were allocated to an intervention group (n = 11, males n = 94, females n = 99) and a control group (n = 12, males n = 109, females n = 99). The teams in the intervention group participated in a psychological skills training programme consisting of six meetings with each team. The control group received no substitute. All injuries were registered and documented according to the time-loss definition and classified into either traumatic or overuse.

    Results

    In total, 142 players (35 %) out of the 401 players sustained 197 injuries, 0.49 injury/player: in the intervention group 0.45 injury/player and in the control group 0.53 injury/player. The analyses revealed no significant differences in injuries between intervention groups and control groups. The effect size of the influence of the psychological skills training in overuse injuries was considered to be small, Cohen’s d 0.2.

    Conclusions

    This study comprised the whole team for a group intervention and did not screen for at-risk athletes, e.g. scoring high in anxiety or low in coping skills, which might have influenced the result. A psychological injury prevention intervention forward to a whole team might not influence the injury occurrence significantly. Thus, this psychological intervention decreased the injury incidence which is of clinical interest.

    Level of incidence

    Level II.

    © Springer-Verlag Berlin Heidelberg 2014

  • 2776.
    Tranaeus, Ulrika
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Johnson, Urban
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Ivarsson, Andreas
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Sport Health and Physical activity.
    Engström, Björn
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Skillgate, Eva
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden & Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden.
    Werner, Suzanne
    Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden & Capio Artro Clinic, Sophiahemmet, Stockholm, Sweden.
    Sports injury prevention in Swedish elite floorball players: evaluation of two consecutive floorball seasons2015In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 23, no 3, p. 899-905Article in journal (Refereed)
    Abstract [en]

    Purpose

    The objective was to evaluate the effect of a psychological group-based injury prevention, which was implemented throughout the first season, after the second season, in Swedish elite floorball teams (males and females). The secondary objective was to evaluate the effect of the intervention over the two consecutive floorball seasons as a whole.

    Methods

    Twenty-three teams in the premier leagues for males and females volunteered and were allocated to an intervention group, n = 175 players, and a control group n = 171 players. The intervention group participated in psychological skills training during the first season. The control group did not receive any alternative treatment. Neither of the groups received any intervention during the second season. All injuries were registered and documented according to time-loss definition and classified into either traumatic or overuse injuries.

    Results

    Ninety-three players (27 %) sustained 119 injuries during the second season. The intervention group 0.31 (95 % CI 0.22–0.39) and the control group 0.41 (95 % CI 0.29–0.53) injuries/player. The injury incidence decreased in the intervention group and was lower than the control group. The analysis showed no statistical differences when comparing the intervention group and the control group neither after the second season nor after the two seasons together, Cohen’s d 0.2.

    Conclusion

    This group-based training showed a small effect size after the second year resulting in fewer injuries, especially severe injuries, in the intervention group compared to the control group. It is, therefore, important not to overlook the potential of a group-based psychological injury prevention programme.

    Level of incidence: II.

    © 2014, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

  • 2777.
    Treschow, Ann
    Halmstad University, School of Social and Health Sciences (HOS).
    Women’s experiences of severe nausea and vomiting during pregnancy: Analysis of diaries and blogs from the internet2014Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To describe women's experiences of severe nausea and vomiting during pregnancy and its influence on everyday life, using diaries and blogs from the internet.

    Design: A descriptive study using narratives from the internet, analyzed with qualitative content analysis.

    Participants: 16 diaries and blogs from the internet written by women during the last five years, with experienced severe nausea and vomiting during pregnancy.

    Findings: The data resulted in four categories which showed the women´s experiences of severe nausea and vomiting during pregnancy. They were all strongly linked to everyday life such as the household, family, work and social life. Three of the categories, Inanition, Frustration and Aversion can be perceived as very negative with a great impact on daily life. The fourth, Empowerment, is small and weak but still highlights the whole meaning with the pregnancy. The categories stands on its own but are nevertheless connected with each other and results in an overall theme: Bright spots in the dark.

    Conclusion and implication for practice: In analyzing narratives from the internet, a new perspective on severe nausea and vomiting during pregnancy is delineated. Hence, for caregivers to take part of ailing women's net published experiences is an excellent opportunity to increase knowledge and understanding of the subject. Consequently, future treatment and care will result in a higher quality of life for these women. In addition, an increased understanding of the high impact the state has on the daily life, future studies need to address the experienced negative consequences during the first pregnancy on the subsequent pregnancies. One method of doing this is through analysis of net published narratives.

  • 2778.
    Trevik, Birgitta
    Halmstad University, School of Health and Welfare.
    Patienters upplevelse av öronakupunktur som behandlingsmetod vid psykisk ohälsa: - från maktlöshet och lidande till livskvalitet och en känsla av sammanhang2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Psykisk ohälsa som oro, ångest, depressioner och sömnsvårigheter är så omfattande i Sverige att det idag är ett folkhälsoproblem. Personer med psykisk ohälsa efterfrågar alltmer komplementära behandlingsmetoder, därför är det av intresse att belysa upplevelsen av en komplementär metod som används vid psykisk ohälsa. Syftet med studien var att belysa patienters upplevelse av öronakupunktur som behandlingsmetod vid psykisk ohälsa. Metod: En kvalitativ innehållsanalys med induktiv ansats valdes som metod. Tio patienter som får öronakupunktur mot oro, ångest, depression och/eller sömnsvårigheter intervjuades. En intervjuguide med semistrukturerade frågor användes. Resultat: Ett tema framkom i analysen: Öronakupunktur-en livlina när inget annat hjälper och fem subteman: Att vara maktlös i sitt lidande, Läkemedel är inte alltid hela lösningen, Att en så enkel åtgärd kan leda till att effekten i slutändan blir så stor, Öronakupunktur löser inte problemen men akupunktur hjälper en att lösa problemen samt Att bli sedd och bekräftad i ett engagerat möte. Slutsats: Patienterna i denna studie var mycket nöjda med öronakupunktur. Öronakupunkturen kan ses som en verkningsfull omvårdnadsåtgärd för att lindra lidande vid psykisk ohälsa. Fler studier om öronakupunkturens effekter bör göras för att få evidens och kunskap om vad i behandlingsprocessen med öronakupunktur som leder till en förbättrad psykisk hälsa.

  • 2779.
    Troilius, Christin
    Halmstad University, School of Social and Health Sciences (HOS).
    Ohälsa hos barn med dyslexi: - en angelägenhet för skolsköterskor2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Dyslexia implicates problems with reading and writing. The problem is common and approximately five to ten percent of all schoolchildren are estimated to have dyslexia. Dyslexia is a disability that often leads to ill-health among schoolchildren. Ill-health is difficult to interpret and the school nurse has an important role to prevent, detect and to reduce the impact of the disability. The purpose of this study was to identify signs for ill-health seen in children with dyslexia and what factors that affect the ill-health. This study was conducted as a literature review in which 11 scientific articles were reviewed. The results showed that children with dyslexia had significantly more emotional, psychosocial and behavioural problems. The children's self-esteem was low, they were often bullied and the school situation was perceived as annoying. In order to feel good have the children developed more or less successful strategies. Positive for the children was to have friends, parents and teachers who understand them, have a positive attitude and be good at something that not had to do with reading. In order to prevent ill-health should the children early get help of special teaching methods for dyslexics and the school nurse would develop procedures for a rapid and early detection of ill-health.

  • 2780.
    Trojefors, Gustav
    et al.
    Halmstad University, School of Health and Welfare.
    Jegust, Morris
    Halmstad University, School of Health and Welfare.
    Sjuksköterskans omvårdnadsåtgärder för patienter med osteoporos2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Osteoporosis is a very common disease which causes suffering for the patient with reduced quality of life and increased mortality as a result. With an increasing lifespan of the global population, the incidence of osteoporosis also increases. The costs for society are huge, and are estimated to rise further if the care for patients remain unchanged. The knowledge among nurses about nursing interventions when it comes to osteoporosis is limited, and this gap needs to be filled to improve the nursing care. In order to contribute to this, the purpose of this study was to describe nurse’s interventions for patients with osteoporosis. The study was conducted as a literature study and the analysis inspired by content analysis. The literature study’s result highlights and describes nursing interventions the nurse can use in the care of patients with osteoporosis. Factors limiting the nurse’s implementation also emerges. By using education, counselling, assessment and physical activity osteoporosis can be prevented and counteracted. Further research surrounding nurse’s interventions for patients with osteoporosis is considered necessary.

  • 2781.
    Tucker, Sue
    et al.
    Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom.
    Brand, Christian
    Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom.
    Challis, David
    Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Tartu, Estonia.
    Verbeek, Hilde
    Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
    Cabrera, Esther
    School of Health Sciences TecnoCampus, University Pompeu Fabra, Barcelona, Spain & Fundació Privada Clínic per la Recerca Biomédica, Hospital Clínic of Barcelona, Spain.
    Karlsson, Staffan
    Department of Health Sciences, Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland.
    Stephan, Astrid
    Faculty of Health, School of Nursing Science, University of Witten/Herdecke, Witten, Germany.
    Soto, Maria
    Geriatrics Department, Gerontôpole, Toulouse University Hospital, Toulouse, France.
    What makes institutional long-term care the most appropriate setting for people with dementia? Exploring the influence of client characteristics, decision-maker attributes, and country in 8 European nations2016In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 17, no 5, p. 465.e9-465.e15Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the extent to which client characteristics, decision-maker attributes, and country influence judgments of institutional long-term care (ILTC) appropriateness for people with dementia.

    Design, setting, and participants: A total of 161 experts in dementia care from 8 European countries reviewed a series of 14 vignettes representing people with dementia on the cusp of ILTC admission and indicated the most appropriate setting in which to support each case in a simple discrete choice exercise: own home, very sheltered housing, residential home, or nursing home. At least 16 experts participated in each country (Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the United Kingdom).

    Measurements: Descriptive statistics were used to characterize the experts and their placement preferences. Logistic regression modeling was used to explore the extent to which the sociodemographic and clinical characteristics of people with dementia, and the profession, workplace, and country of decision-makers were associated with ILTC recommendation.

    Results: Client characteristics, decision-maker attributes, and country all seemed to play a part in influencing professionals' perceptions of the appropriateness of ILTC for people with dementia. Expert decision-makers were more likely to recommend ILTC for individuals who required help with mobility or had multiple care needs, and appeared to give more weight to carers' than clients’ wishes. Community-based social workers were less likely than other professional groups to favor ILTC placement. Experts in Finland, Germany, and the United Kingdom were less likely to recommend ILTC than experts in France, the Netherlands, and Estonia; experts in Sweden and Spain took an intermediate position.

    Conclusion: This study provides new understanding of the factors that shape professionals' perceptions of ILTC appropriateness and highlights the need to construct multifaceted models of institutionalization when planning services for people with dementia. It also has several important clinical implications (including flagging interventions that could decrease the need for ILTC), and provides a basis for enhancing professionals’ decision-making capabilities (including the greater involvement of clients themselves).

    © 2016 AMDA - The Society for Post-Acute and Long-Term CareMedicine

  • 2782.
    Tucker, Sue
    et al.
    University of Manchester, Manchester, United Kingdom.
    Sutcliffe, Caroline
    University of Manchester, Manchester, United Kingdom.
    Bowns, Ian
    University of Manchester, Manchester, United Kingdom.
    Challis, David
    University of Manchester, Manchester, United Kingdom.
    Saks, Kai
    University of Tartu, Tartu, Estonia.
    Verbeek, Hilde
    Maastricht University, Maastricht, The Netherlands.
    Cabrera, Esther
    University Pompeu Fabra, Barcelona, Spain.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland & Turku University Hospital, Turku, Finland.
    Meyer, Gabriele
    University of Witten/Herdecke, Witten, Germany & Martin Luther University Halle-Wittenberg, Halle-Wittenberg, Germany.
    Soto, Maria
    Toulouse University Hospital, Toulouse, France.
    Improving the mix of institutional and community care for older people with dementia: an application of the balance of care approach in eight European countries2016In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 20, no 12, p. 1327-1338Article in journal (Refereed)
    Abstract [en]

    Objectives: To examine whether the mix of community and institutional long-term care (ILTC) for people with dementia (PwD) in Europe could be improved; assess the economic consequences of providing alternative services for particular groups of ILTC entrants and explore the transnational application of the ‘Balance of Care’ (BoC) approach.

    Method: A BoC study was undertaken in Estonia, Finland, France, Germany, the Netherlands, Spain, Sweden, and the UK as part of the RightTimePlaceCare project. Drawing on information about 2014 PwD on the margins of ILTC admission, this strategic planning framework identified people whose needs could be met in more than one setting, and compared the relative costs of the possible alternatives.

    Results: The findings suggest a noteworthy minority of ILTC entrants could be more appropriately supported in the community if enhanced services were available. This would not necessarily require innovative services, but more standard care (including personal and day care), assuming quality was ensured. Potential cost savings were identified in all countries, but community care was not always cheaper than ILTC and the ability to release resources varied between nations.

    Conclusions: This is believed to be the first transnational application of the BoC approach, and demonstrates its potential to provide a consistent approach to planning across different health and social care systems. Better comparative information is needed on the number of ILTC entrants with dementia, unit costs and outcomes. Nevertheless, the findings offer important evidence on the appropriateness of current provision, and the opportunity to learn from different countries' experience. © 2015 Taylor & Francis

  • 2783.
    Turner, Cecilia
    et al.
    Halmstad University, School of Health and Welfare.
    Sund, Magdalena
    Halmstad University, School of Health and Welfare.
    Lundberg, Jenny
    Halmstad University, School of Health and Welfare.
    Sjuksköterskans upplevelse av att triagera patienter med ögonsymptom vid en akutmottagning2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2784.
    Turnstedt, Max
    Halmstad University, School of Business, Engineering and Science.
    A comparison between activation of pectoralis major and triceps brachii using different grip widths in the bench press2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Turnstedt, M. – Background. Resistance training has many positive effects on the human body and can be beneficial for people all ages. The bench press exercise is a commonly used exercise that targets many upper body muscles such as pectotralis major, triceps brachii, deltoideus, serratus anterior and the abdominal muscles. Variations of the bench press exercise are common where grip width variations are supposed to largely impact the muscles targeted. Some research has been done to accurately decide whether these theories are true, however more research is needed to definitely decide the effect on muscle activity of grip width in bench press. Aim. The aim of this study was to compare the muscle activity with surface electromyography (EMG) in pectoralis major and triceps brachii between wide, regular and narrow grip width in the bench press exercise. Method. 21 healthy males (23.19 ±2.5 years) volunteered to participate in this study. The raw EMG data from the bench presses were converted to root mean square and then average root mean square. The mean average muscle activation (in µV) was divided by a maximum voluntary isometric contraction (MVIC) and expressed as percent MVIC (%MVIC). Result. The results of the present study showed a statistically significantly higher muscle activation in the wide grip width compared to the narrow grip width in pectoralis major (p<0.005) and a statistically significantly higher muscle activation could be found in the narrow grip width compared to the wide grip width in triceps brachii (p<0.033). Conclusion. Practical use of this study is to use the narrow grip width in bench press when increased tricep brachii strength and size is desired and if increased pectoralis major strength and size is desired the wide grip bench press exercise is preferable.

  • 2785.
    Törnblom, Margareta
    et al.
    Helsingborg Hospital, Department of Occupational Therapy and Physiotherapy, Helsingborg, Sweden & RandD Spenshult, Halmstad, Sweden.
    Andersson, Maria
    RandD Spenshult, Halmstad, Sweden & Lund University, Department of Clinical Sciences, Department of Rheumatology, Lund, Sweden.
    Trulsson Schouenborg, Anna
    Skåne University Hospital, Department of Pain Rehabilitation, Lund, Sweden & Lund University, Department of Health Sciences, Physiotherapy, Lund, Sweden.
    Haglund, Emma
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). RandD Spenshult, Halmstad, Sweden.
    Validation of the Test for Substitution Patterns - in individuals with symptomatic knee osteoarthritis2019In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, no Suppl 2, p. 0712-0712Article in journal (Refereed)
    Abstract [en]

    Background: Few tools evaluates quality of movements in individuals with knee osteoarthritis (OA). The Test for Substitution Patterns (TSP) is developed to measure the ability to perform five functional movements regarding postural control and altered movement patterns (1). TSP is validated and reliable in individuals with anterior cruciate ligament injury, but has not yet been evaluated in individuals with knee OA.

    Objectives: To study the relationships between the OA modified TSP (OA-TSP) and self-reported knee function as measured with the Knee Injury and osteoarthritis Outcome Score (KOOS) and the 30-s chair stand test (30-s CST) in individuals with symptomatic knee OA. A second aim was to study the discriminative ability of the OA-TSP for unilateral knee pain.

    Methods: Sixty-two individuals with symptomatic knee osteoarthritis were included using consecutive sampling. Health status was assessed with the EuroQol five dimension scale (EQ5D, 0-1 worst-best), and knee function in five subscales for KOOS (pain, symptoms, ADL, quality of life and sport/recreation, 0-100 worst-best). The 30-s CST-test measured the number of rises in 30 seconds. In the OA-TSP, substitution patterns are observed and scored from 0-3 (no substitution pattern-poorly performed) during five standardized functional movements. The maximum score is 54 points/side with score of 108 points. Median and min-max were used for all descriptive data. Spearman´s correlation and Wilcoxon signed rank test were used for analyzes. A correlation coefficient rs ≥±0.50 is considered large, ±0.30 to < 0.50 moderate and ±0.10 < 0.30 small.

    Results: The median age was 54 years (30-61), 76% were women. The median Body Mass Index was 25 (18-48) and EQ5D 0.8 (0.29-1.00). There were no significant differences between the gender regarding BMI and EQ5D. Median OA-TSP total score was 29 (10-70). Median KOOS pain was 75 (36-100), symptoms 71 (21-96), ADL 87 (30-100), and sport/rec 50 (0-100). In the 30-s CST the median was 16 raises (5-32). Moderate, significant correlations were observed between TSP total score and KOOS pain and KOOS ADL (rs=-0.30; p=0.03, rs=-0.35; p=0.01 respectively) and small correlations between TSP and KOOS sport/recreation and KOOS symptoms (rs=-0.13; p=0.36, rs=-0.22; p=0.11 respectively). There was a moderate, significant correlation between TSP total score and 30-s CST (rs=-0.34; p<0.01). Discriminative ability for the TSP for unilateral knee pain was found to be significant worse in the painful side, with median 18 (2-36) vs. 14 (7-37) in the not painful side, p=0.001.

    Conclusion: The OA-TSP could be used as a functional test to detect altered knee alignment interpreted as an early sign of knee OA and assist the physiotherapist in functional testing during the rehabilitation of individuals with symptomatic knee OA.

  • 2786.
    Törnqvist, Jeanette
    Halmstad University, School of Social and Health Sciences (HOS).
    Dubbeldokumentation i patientjournaler2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att dokumentera är en nödvändighet för att säkra att patienterna får god och säker vård. I dag dokumenterar flera hälso- och sjukvårdsprofessioner i befintligt journalsystem var för sig angående samma patient under hela vårdtillfället, vilket kan leda till dubbeldokumentation. Syftet med studien var att beskriva dubbeldokumentation i journaler för patienter som vårdats inneliggande med diagnosen höftfraktur. En retrospektiv deskriptiv journalgranskning av 30 journaler genomfördes. Innehållsanalys enligt Krippendorff användes för att bearbeta data. Journalhandlingar som skrivits av läkare, sjuksköterska, sjukgymnast och arbetsterapeut granskades. Resultatet visade att dubbeldokumentation förkom vid alla granskade tillfällen under vårdförloppet och inom eller mellan samtliga granskade professioner. Totalt hittades 886 tillfällen av dubbeldokumentation. Flest tillfällen av dubbeldokumentation förekom sjuksköterskor emellan och mellan sjuksköterskor och sjukgymnast. Dokumentationen skulle kunna utvecklas genom införande av en standardiserad tvärprofessionell vårdplan. Mer forskning behövs framför allt gällande dokumentationen vid utskrivningstillfället av patienten

  • 2787.
    Uhrberg, Susanne
    et al.
    Halmstad University, School of Health and Welfare.
    Waad, Katharina
    Halmstad University, School of Health and Welfare.
    Sjuksköterskans omvårdnadsroll i samband med hypertoni och blodtrycksmätning inom primärvården2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I Sverige har 1,8 miljoner människor diagnosen hypertoni. Hypertoni kräver livsstilsförändringar tillsammans med eventuell farmakologisk behandling. Riktlinjer för hur vårdpersonal skall mäta blodtryck finns i vårdhandböcker, men där nämns ingenting om själva omvårdnaden. Syftet var att belysa sjuksköterskans omvårdnadsroll i samband med hypertoni och blodtrycksmätning inom primärvården. Litteratursökningen resulterade i tolv resultatartiklar. Analysen av artiklarna utmynnade i tre kategorier: sjuksköterskans omvårdnadsroll i samband med; Att ge information, Att ge praktiskt och emotionellt stöd och Att följa upp. Slutsatsen i studien var att när sjuksköterskan gav adekvat information angående patientens hypertoni, medicinering och livsstilsfaktorer, samt följde upp patienten för att regelbundet ge praktiskt och emotionellt stöd gav det en signifikant minskning av blodtrycksvärdet. Patienten fick möjlighet att påverka sin situation och livsstil och det stämde väl överens med personcentrerad vård. För patienter som mätte sitt blodtryck med en hemblodtrycksmätare var det viktigt att sjuksköterskan förvissade sig om att patienten hade kunskap om hur och när den skulle användas samt att blodtrycksmätaren var validerad. Det vore värdefullt att implementera en handlingsplan vid hypertoni, där alla omvårdnadsaspekter tas med tillsammans med riktlinjer runt blodtrycksmätning. På detta sätt skulle sjuksköterskan fått verktyg för att ge en säker vård till patienter med hypertoni.

  • 2788.
    Uloza, Virgilijus
    et al.
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Padervinskis, Evaldas
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Vegiene, Aurelija
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Pribuisiene, Ruta
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Saferis, Viktoras
    Lithuanian University of Health Sciences, Kaunas, Lithuania.
    Vaiciukynas, Evaldas
    Kaunas University of Technology, Kaunas, Lithuania.
    Gelzinis, Adas
    Kaunas University of Technology, Kaunas, Lithuania.
    Verikas, Antanas
    Halmstad University, School of Information Technology, Halmstad Embedded and Intelligent Systems Research (EIS), CAISR - Center for Applied Intelligent Systems Research.
    Exploring the feasibility of smart phone microphone for measurement of acoustic voice parameters and voice pathology screening2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 11, p. 3391-3399Article in journal (Refereed)
    Abstract [en]

    The objective of this study is to evaluate the reliability of acoustic voice parameters obtained using smart phone (SP) microphones and investigate the utility of use of SP voice recordings for voice screening. Voice samples of sustained vowel/a/obtained from 118 subjects (34 normal and 84 pathological voices) were recorded simultaneously through two microphones: oral AKG Perception 220 microphone and SP Samsung Galaxy Note3 microphone. Acoustic voice signal data were measured for fundamental frequency, jitter and shimmer, normalized noise energy (NNE), signal to noise ratio and harmonic to noise ratio using Dr. Speech software. Discriminant analysis-based Correct Classification Rate (CCR) and Random Forest Classifier (RFC) based Equal Error Rate (EER) were used to evaluate the feasibility of acoustic voice parameters classifying normal and pathological voice classes. Lithuanian version of Glottal Function Index (LT_GFI) questionnaire was utilized for self-assessment of the severity of voice disorder. The correlations of acoustic voice parameters obtained with two types of microphones were statistically significant and strong (r = 0.73–1.0) for the entire measurements. When classifying into normal/pathological voice classes, the Oral-NNE revealed the CCR of 73.7 % and the pair of SP-NNE and SP-shimmer parameters revealed CCR of 79.5 %. However, fusion of the results obtained from SP voice recordings and GFI data provided the CCR of 84.60 % and RFC revealed the EER of 7.9 %, respectively. In conclusion, measurements of acoustic voice parameters using SP microphone were shown to be reliable in clinical settings demonstrating high CCR and low EER when distinguishing normal and pathological voice classes, and validated the suitability of the SP microphone signal for the task of automatic voice analysis and screening.

  • 2789.
    Uloza, Virgilijus
    et al.
    Department of Otolaryngology, Kaunas University of Medicine, Eiveniu 2, LT-50009 Kaunas, Lithuania.
    Verikas, Antanas
    Halmstad University, School of Information Science, Computer and Electrical Engineering (IDE), Halmstad Embedded and Intelligent Systems Research (EIS), Intelligent systems (IS-lab).
    Bacauskiene, Marija
    Department of Electrical and Control Instrumentation, Kaunas University of Technology, Kaunas, Lithuania.
    Gelzinis, Adas
    Department of Electrical and Control Instrumentation, Kaunas University of Technology, Kaunas, Lithuania.
    Pribuisiene, Ruta
    Department of Otolaryngology, Kaunas University of Medicine, Eiveniu 2, LT-50009 Kaunas, Lithuania.
    Kaseta, Marius
    Department of Otolaryngology, Kaunas University of Medicine, Eiveniu 2, LT-50009 Kaunas, Lithuania.
    Saferis, Viktoras
    Department of Physics, Mathematics and Biophysics, Kaunas University of Medicine, Kaunas, Lithuania.
    Categorizing Normal and Pathological Voices: Automated and Perceptual Categorization2011In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 25, no 6, p. 700-708Article in journal (Refereed)
    Abstract [en]

    Objectives: The aims of the present study were to evaluate the accuracy of an elaborated automated voice categorization system that classified voice signal samples into healthy and pathological classes and to compare it with classification accuracy that was attained by human experts. Material and Methods: We investigated the effectiveness of 10 different feature sets in the classification of voice recordings of the sustained phonation of the vowel sound /a/ into the healthy and two pathological voice classes, and proposed a new approach to building a sequential committee of support vector machines (SVMs) for the classification. By applying “genetic search” (a search technique used to find solutions to optimization problems), we determined the optimal values of hyper-parameters of the committee and the feature sets that provided the best performance. Four experienced clinical voice specialists who evaluated the same voice recordings served as experts. The “gold standard” for classification was clinically and histologically proven diagnosis. Results: A considerable improvement in the classification accuracy was obtained from the committee when compared with the single feature type-based classifiers. In the experimental investigations that were performed using 444 voice recordings coming from 148 subjects, three recordings from each subject, we obtained the correct classification rate (CCR) of over 92% when classifying into the healthy-pathological voice classes, and over 90% when classifying into three classes (healthy voice and two nodular or diffuse lesion voice classes). The CCR obtained from human experts was about 74% and 60%, respectively. Conclusion: When operating under the same experimental conditions, the automated voice discrimination technique based on sequential committee of SVM was considerably more effective than the human experts.

  • 2790.
    Upphoff, Anna Lena
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Wallin, Anna
    Halmstad University, School of Social and Health Sciences (HOS).
    Distriktssköterskans erfarenhet av vården av patienter med långvarig smärta2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Långvarig smärta är ett folkhälsoproblem. I vården av patienter med långvarig smärta har det visat sig att distriktssköterskor kan känna sig maktlösa och uppleva bristande kunskap och handlingsplan. Patienter anser att vården är tillfredställande om relationen mellan distriktssköterska och patient fungerar. Syftet med studien var att beskriva distriktssköterskans erfarenhet av vården av patienter med långvarig smärta. Designen var kvalitativ metod med en induktiv ansats, där kvalitativ innehållsanalys användes vid bearbetning av data. Fyra distriktssköterskor med varierande yrkeserfarenhet och ålder i Halmstad och Hylte kommun deltog i studien. Datainsamling utfördes i form av intervjuer. I resultatet framkom att vården bygger på förtroende mellan distriktssköterska och patient. Förtroendet skapas genom distriktssköterskors möte med patienten, tillämpande av kunskap och arbete i team. Distriktssköterskor har erfarenhet och kunskap genom yrkeserfarenhet och utbildning inom området smärta och smärtbehandling, vilket inte används optimalt i praktiken. Olika kunskapsnivåer bidrar till att vården av patienter blir varierad. Samarbete mellan olika yrkeskategorier är av betydelse, där patienten är i centrum och ses som en unik individ. Vården kan förbättras genom ytterligare forskning  som styrker resultatet av distriktssköterskors erfarenhet i genomförd pilotstudie, belyser patienternas erfarenhet av vården av långvarig smärta och utvärderar samhällsekonomisk betydelse.

  • 2791.
    Urrutia-Cordero, Pablo
    et al.
    Halmstad University, School of Business, Engineering and Science. Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Agha, Ramsy
    Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Cires, Samuel
    Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Angeles Lezcano, Maria
    Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Sanchez-Contreras, Maria
    Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Waara, Karl-Otto
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS).
    Utkilen, Hans
    Norwegian Inst Publ Hlth, Dept Water Hyg, N-0403 Oslo, Norway..
    Quesada, Antonio
    Univ Autonoma Madrid, Dept Biol, Madrid 28049, Spain..
    Effects of harmful cyanobacteria on the freshwater pathogenic free-living amoeba Acanthamoeba castellanii2013In: Aquatic Toxicology, ISSN 0166-445X, E-ISSN 1879-1514, Vol. 130, p. 9-17Article in journal (Refereed)
    Abstract [en]

    Grazing is a major regulating factor in cyanobacterial population dynamics and, subsequently, considerable effort has been spent on investigating the effects of cyanotoxins on major metazoan grazers. However, protozoan grazers such as free-living amoebae can also feed efficiently on cyanobacteria, while simultaneously posing a major threat for public health as parasites of humans and potential reservoirs of opportunistic pathogens. In this study, we conducted several experiments in which the freshwater amoeba Acanthamoeba castellanii was exposed to pure microcystin-LR (MC-LR) and six cyanobacterial strains, three MC-producing strains (MC-LR, MC-RR, MC-YR, MC-WR, [Dha7] MC-RR) and three strains containing other oligopeptides such as anabaenopeptins and cyanopeptolins. Although the exposure to high concentrations of pure MC-LR yielded no effects on amoeba, all MC-producing strains inflicted high mortality rates on amoeba populations, suggesting that toxic effects must be mediated through the ingestion of toxic cells. Interestingly, an anabaenopeptin-producing strain caused the greatest inhibition of amoeba growth, indicating that toxic bioactive compounds other than MCs are of great importance for amoebae grazers. Confocal scanning microscopy revealed different alterations in amoeba cytoskeleton integrity and as such, the observed declines in amoeba densities could have indeed been caused via a cascade of cellular events primarily triggered by oligopeptides with protein-phosphatase inhibition capabilities such as MCs or anabaenopeptins. Moreover, inducible-defense mechanisms such as the egestion of toxic, MC-producing cyanobacterial cells and the increase of resting stages (encystation) in amoebae co-cultivated with all cyanobacterial strains were observed in our experiments. Consequently, cyanobacterial strains showed different susceptibilities to amoeba grazing which were possibly influenced by the potentiality of their toxic secondary metabolites. Hence, this study shows the importance of cyanobacterial toxicity against amoeba grazing and, that cyanobacteria may contain a wide range of chemical compounds capable of negatively affect free-living, herbivorous amoebae. Moreover, this is of high importance for understanding the interactions and population dynamics of such organisms in aquatic ecosystems. (c) 2012 Elsevier B.V. All rights reserved.

  • 2792.
    Vallmark Jansson, Jasper
    Halmstad University, School of Social and Health Sciences (HOS).
    ”Winning isn’t everything.” A Mixed-method study of a Swedish female handball team throughout a competitive season2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the present study was to (1) examine throughout the season dynamics of the handball team's performance and related factors (i.e. emphasizing leadership, emotions and concentration) as perceived by the coach and the captain. The analysis was used to motivate the emotions being studied in objective two (2) examine the handball team during successful and less successful games in terms of the dynamics of the players’ emotions, concentration and performance between two halves of the game and after time-outs. Informants for objective 1, was the team coach and the team captain. Objective 2 of the study consisted of 15 women all playing in the same team. The study includes longitudinal data over a ten game period containing five successful and five less successful games. Data was collected after games using the ECPP(H) developed by Olausson and Vallmark-Jansson (2013). In-depth narrative interviews were used. Three analyses were made: (1) sjuzet- fabula, (2) holistic- content and (3) categorical-content analysis. Poetic representation was used to present parts of the results. The results showed shifts in the dynamics of performance, possible explanation to the shift of dynamics of emotions, concentration and performance and different types of leadership styles demonstrated throughout the season. Furthermore, similarities and diversities were found between the coach and captain’s perceptions of the season in focus. Finally, practical team-specific applications are suggested, such as working with emotional control in order to help the team enhance their performance.

  • 2793.
    van den Hout, Wilbert B
    et al.
    Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
    Bremander, Ann
    Spenshult Hospital for Rheumatic Diseases, Research and Development Centre, Oskarström, Sweden.
    Vliet Vlieland, Thea P M
    Departments of Rheumatology and Orthopedics, Leiden University Medical Center, Leiden, The Netherlands.
    Recommendations for economic evaluations of non-pharmacological arthritis care: results from the CARE VI meeting 2010.2011In: Musculoskeletal care, ISSN 1557-0681, Vol. 9, no 2, p. 120-3Article in journal (Refereed)
  • 2794.
    Van der Elst, Kristien
    et al.
    Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium & Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven–University of Leuven, Leuven, Belgium.
    Bremander, Ann
    Halmstad University, School of Business, Engineering and Science, The Rydberg Laboratory for Applied Sciences (RLAS). Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden & Research and Development Centre, Spenshult, Halmstad, Sweden.
    De Groef, An
    Department of Rehabilitation Sciences, KU Leuven – University of Leuven, Leuven, Belgium.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Mathijssen, Elke G.E.
    Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
    Vriezekolk, Johanna E.
    Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.
    Westhovens, Rene
    Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium & Skeletal Biology and Engineering Research Centre, Department of Development and Regeneration, KU Leuven–University of Leuven, Leuven, Belgium.
    van Eijk-Hustings, Yvonne J.L.
    Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands & Department of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands.
    European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA): rationale, design and methods of a multinational, multicentre, multilingual, longitudinal qualitative study2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 3, article id e023606Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Including the patient perspective is important to achieve optimal outcomes in the treatment of rheumatoid arthritis (RA). Ample qualitative studies exist on patient outcomes in RA. A Belgian study recently unravelled what matters most to patients throughout the overwhelming and rapidly evolving early stage of RA. The present study, European Qualitative research project on Patient-preferred outcomes in Early Rheumatoid Arthritis (EQPERA) was created to contribute to a more universal understanding of patient-preferred health and treatment outcomes by integrating the perspectives of patients with early RA from three European countries.

    METHODS AND ANALYSIS: In EQPERA, a qualitative, explorative, longitudinal study will be implemented in The Netherlands and Sweden, parallel to the methods applied in the previously conducted Belgian study. In each country, a purposive sample of patients with early RA will be individually interviewed 3-6 months after start of the initial RA treatment and subsequently, the same participants will be invited to take part in a focus group 12-18 months after RA treatment initiation. Data collection and analysis will be independently conducted by the local research teams in their native language. A meta-analysis of the local findings will be performed to explore and describe similarities, differences and patterns across countries.

    ETHICS AND DISSEMINATION: Ethics approval was granted by the responsible local ethics committees. EQPERA follows the recommendations of the Declaration of Helsinki. Two main papers are foreseen (apart from the data reporting on the local findings) for peer-reviewed publication.

    © Author(s) (or their employer(s)) 2019.

  • 2795.
    Van der Elst, Kristien
    et al.
    University Hospitals Leuven, Leuven, Belgium.
    Bremander, Ann
    Lund University, Lund, Sweden.
    De Groef, Ann
    University Hospitals Leuven, Leuven, Belgium.
    Grønning, Kjerstin
    Norwegian University of Science and Technology, Trondheim, Norway.
    Larsson, Ingrid
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Spenshult Research and Development Center, Halmstad, Sweden.
    Mathijssen, Elke
    Sint Maartenskliniek, Nijmegen, Netherlands.
    Vriezekolk, Joke
    Sint Maartenskliniek, Nijmegen, Netherlands.
    Westhovens, René
    University Hospitals Leuven, Leuven, Belgium.
    van Eijk-Hustings, Yvonne
    Maastricht University Medical Center, Maastricht, Netherlands.
    European Qualitative Research Project on Patient-preferred Outcomes in Early Rheumatoid Arthritis (EQPERA): Rationale, Design and Methods of a Multi-country, Multi-center, Multi-language, Longitudinal Qualitative Study2017In: European Congress of Qualitative Inquiry: Abstracts, 2017, p. 117-117Conference paper (Refereed)
    Abstract [en]

    Background: A successful medical outcome is no guarantee for patient perception of treatment success. Unraveling the patient’s perspective on outcome preferences is therefore crucial to deliver patient-centered, high-quality chronic illness care. Furthermore, the earliest stage of a chronic disease, such as in Rheumatoid Arthritis (RA), can be considered as a critical phase in the patient pathway for achieving optimal long-term outcomes. A Belgian qualitative study provided a first glimpse on what matters most to patients with recently diagnosed RA (1). However, there was a need for an international data set to better understand this complex phenomenon being studied, and to investigate whether the Belgian findings could be transferred to contexts with different national healthcare systems, practices and values. To this end, EQPERA –European Qualitative research collaboration on Patient-preferred outcomes in Early Rheumatoid Arthritis– was founded.

    Objectives: The overall research objective of EQPERA is to unravel longitudinally preferences for treatment and health outcomes among patients with early RA across Belgium, the Netherlands, Sweden and Norway, placing findings in a context broader than Belgium. Furthermore, EQPERA aims to add to qualitative methodology research.

    Methods: EQPERA applies a qualitative, explorative, longitudinal research design, which was developed in collaboration with patient research partners and the patient perspective in mind. In each country, a purposive sample of patients with early RA will be individually interviewed between 3-6 months after start of the initial RA treatment and subsequently, the same participants will be invited to take part in a focus group about 1 year after RA treatment initiation. Interviews will be analyzed using the constant comparison method as described in Qualitative Analysis Guide of Leuven. The longitudinal analysis will be guided by Saldaña’s steps for analyzing change through time in longitudinal qualitative research. To study the multinational findings, we will carry out a meta-synthesis of all locally gathered and interpreted data. The local research teams will independently employ a qualitative study, while the project leader will monitor the research as it unfolds and evolves. Moreover, to support consistency in data collection and the inter-coder reliability across countries, we will implement a detailed research protocol, a structured cultural translation and validation process of the interview guides, data collection templates, a quality assurance reporting tool and specific training sessions.

    Added value: Our innovative, qualitative, longitudinal research design goes beyond the abilities of the frequently used cross-sectional designs in qualitative research. A European research context allows to uncover subtle cultural differences in patient-preferred outcomes across more or less similar organized countries. This project is thus a first step in gathering widely applicable findings in a research area where evidence-based knowledge is lacking, yet, highly needed to tailor care processes and optimize patient outcomes. Various data management strategies are applied to ensure quality and trustworthiness of our findings, and to promote a smooth European collaboration.

  • 2796.
    Van der Elst, Kristien
    et al.
    University Hospitals Leuven, Leuven, Belgium.
    Bremander, Ann
    Spenshult Research and Development Center, Spenshult Hospital, Halmstad, Sweden.
    De Groef, Ann
    University Hospitals Leuven, Leuven, Belgium.
    Larsson, Ingrid
    Spenshult Research and Development Center, Spenshult Hospital, Halmstad, Sweden.
    Mathijssen, Elke
    Sint-Maartenskliniek, Nijmegen, Netherlands.
    Vriezekolk, Joke
    Sint-Maartenskliniek, Nijmegen, Netherlands.
    Westhovens, Renee
    University Hospitals Leuven, Leuven, Belgium.
    van Eijk-Hustings, Yvonne
    Maastricht University Medical Center, Maastricht, Netherlands.
    European Qualitative Research Project on Patient-preferred Outcomes in Early Rheumatoid Arthritis (EQPERA): Rationale, Design and Methods of a Multi-country, Multi-center, Multi-language, Longitudinal Qualitative Study2017In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, no Suppl. 2, p. 1488-1489Article in journal (Refereed)
    Abstract [en]

    Background: Ample studies exist on outcome assessment from the patient perspective in Rheumatoid Arthritis (RA), but little is known about health and treatment preferences of recently diagnosed patients, and how these evolve over time. A Belgian qualitative study has set the scene (1), but knowledge on cross-cultural nuances in patient-preferred outcomes is lacking. To this end, EQPERA – European Qualitative research collaboration on Patient-preferred outcomes in Early Rheumatoid Arthritis– was founded.

    Objectives: EQPERA aims to unravel longitudinally preferences for treatment and health outcomes among patients with early RA across Belgium, the Netherlands and Sweden. To yield sound results, specific preparations for this cross-country qualitative study are reported here.

    Methods: Several steps have been undertaken to ensure trustworthiness of findings and consistency across countries in sampling, interviewing, analysis and project management: a detailed research protocol has been written; the interview guides have been translated following a structured forward-backward linguistic validation process; templates for data collection and a quality assurance reporting tool have been developed; and local staff has been trained and supervised by the project leader in implementing the study protocol. Each country will document changes with sufficient detail in their research logbook.

    Results: EQPERA will be a qualitative, explorative, longitudinal study with active involvement of patient researchers. In each country, a purposive sample of patients with early RA will be individually interviewed 3–6 months after start of the initial RA treatment and subsequently, the same participants will be invited back to take part in a focus group 12–18 months after RA treatment initiation. Data collection and analysis will be independently conducted by the local research teams in their native language. The local teams will analyze their interview data using the constant comparison method as detailed in Qualitative analysis guide of Leuven, after which Saldana's guiding questions will be adopted for analyzing change over time. Afterwards, a meta-synthesis of all locally gathered and interpreted data will be conducted to explore and describe patterns, similarities and differences across countries.

    Conclusions: This European project is a first step in gathering contextual findings on patient-preferred outcomes in early RA. Such knowledge is of crucial importance for tailoring therapeutic approaches in a timely and meaningful way. Our innovative, qualitative, longitudinal research design goes beyond the abilities of the frequently used cross-sectional designs in qualitative research. Large, multi-national qualitative projects are scarce in rheumatology research, thus applied data management and quality assurance strategies could be of interest to other researchers. © 2017, BMJ Publishing Group Limited

  • 2797.
    van der Mark, Marianne
    et al.
    Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
    Jonasson, Josefine
    Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden.
    Svensson, Madeleine
    Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden & Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden.
    Linné, Yvonne
    Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden.
    Rössner, Stephan
    Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden.
    Lagerros, Ylva Trolle
    Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden & Obesity Unit, Karolinska Hospital, Huddinge, Stockholm, Sweden.
    Older Members Perform Better in an Internet-Based Behavioral Weight Loss Program Compared to Younger Members2009In: Obesity Facts, ISSN 1662-4025, E-ISSN 1662-4033, Vol. 2, no 2, p. 74-79Article in journal (Refereed)
    Abstract [en]

    Background: New technology offers increased opportunities for weight control. However, it is not clear whether older people with less computer training can make use of this tool. Our objective was to examine how members above the age of 65 years performed in an internet-based behavioral weight loss program, compared to younger members. Methods: Data from members (n = 23,233) of an internet-based behavioral weight loss program were analyzed. We restricted our study to active participants accessing the weight club, during a 6-month period (n = 4,440). The number of logins, food intake, and weight records were examined. Participants were divided into age tertiles separately for men and women. The oldest tertile was further subdivided into two groups: above and below the age of 65 years. Results: Participants aged 65 or older were more likely to remain active in the weight club for at least 6 months compared to younger age groups. They had the highest frequency of recordings of food intake and current weight. Among women, those older than 65 years had on average the highest percentage of weight loss (5.6 kg, 6.8%). Men above 65 years of age had the highest number of logins, on average 161 times during the 6-month period. Conclusion: Older participants are performing equally well or even better in an internet-based behavioral weight loss program than younger participants. Internet-based programs could be a promising and attractive option for older adults requiring assistance in losing weight. © 2009 S. Karger AG, Basel.

  • 2798.
    Vancura, Jeanette
    et al.
    Halmstad University, School of Social and Health Sciences (HOS).
    Sandström, Malin
    Halmstad University, School of Social and Health Sciences (HOS).
    Preventivt omvårdnadsarbete inom riskområdet trycksår: En registerstudie utifrån kvalitetsregistret Senior Alert2014Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Pressure ulcers are common and cause both suffering for patients and high costs for the health care services. To prevent the occurrence of pressure ulcers, it is important to find patients at risk and do the preventive care. This can be done based on The National Registry Senior Alert which focus is on preventive care of elderly over 65 years. The registry includes measurements of the risk of pressure ulcers, planned actions and evaluation of the inserted measures. The purpose of this study was to examine the coverage and what preventive actions that was planned and registered in Senior Alert. A data collection was performed during 2013 and included all patients 75 years or older, at a medical clinic, in western Sweden, recorded with increased risk of developing pressure ulcers. The material was analyzed quantitatively. The results showed that the coverage of registration was 61.8% and that 22.7 % had increased risk for developing pressure ulcers. On average 5.84 (± 2.72 ) actions were planned per patient. Most frequent actions were in nutrition. There was a weak correlation between the number of planned actions and Modified Norton-score (MNS-score). The results of this study showed that further work to increase the coverage is required and that more individualized measures are needed.         

  • 2799.
    Verbeek, Hilde
    et al.
    Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands.
    Meyer, Gabriele
    School of Nursing Science, Faculty of Health, Witten/Herdecke University, Germany & Institut für Gesundheits- und Pflegewissenschaft, Medizinische Fakultät, Martin-Luther-University Halle-Wittenberg, Germany.
    Challis, David
    Personal Social Services Research Unit, Faculty of Medical and Human Sciences, University of Manchester, UK.
    Zabalegui, Adelaida
    Fundacíó Privada Clinic per la Recerca Biomedica, Hospital Clinic of Barcelona, Spain.
    Soto, Maria
    Geriatrics Department, INSERM U 1027, Toulouse University Hospital, France.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Leino-Kilpi, Helena
    Department of Nursing Science, Faculty of Medicine, University of Turku, University Hospital Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Hamers, Jan
    Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands.
    Inter-country exploration of factors associated with admission to long-term institutional dementia care: evidence from the RightTimePlaceCare study2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 6, p. 1338-1350Article in journal (Refereed)
    Abstract [en]

    Aim: To explore inter-country variation of factors associated with institutionalization of people with dementia.

    Background: There is an urgent need for evidence on whether factors associated with admission to institutional dementia care are applicable across healthcare systems, as increasing evidence suggests that these factors could be country-specific.

    Design: A prospective cohort study.

    Method: Primary data were collected in eight European countries, at baseline and after 3 months follow-up (November 2010–April 2012). The sample included 2014 dyads of people with dementia and their informal caregivers; 791 patients were recently institutionalized, 1223 patients lived at home and were at risk of institutionalization. Associations between care setting (institution vs. home) and factors shown to influence institutionalization (e.g. cognition, independence in activities of daily life, behaviour) were studied.

    Results: Considerable differences were found between the eight countries in characteristics of people with dementia who had been recently admitted to ILTC. However, caregiver burden appeared the most consistent factor associated with institutionalization in all analyses. Indications for the importance of independence in activities of daily life were found as well, although country differences may be more prominent for this factor.

    Conclusion: Evidence was found for two common factors, crucial in the process of institutionalization across countries: caregiver burden and independency in activities of daily life. However, this study also suggests that admission to institutional dementia care is context-specific, as wide variation exists in factors associated with institutionalization across countries. Tailored best-practice strategies are needed to reflect variations in response to these needs. 

    © 2015 John Wiley & Sons Ltd.

  • 2800.
    Verdin, Linn
    et al.
    Halmstad University.
    Johansson, Frida
    Halmstad University.
    Medias påverkan på unga flickors kroppsuppfattning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Den psykiska ohälsan hos unga flickor har ökat drastiskt och förändringar i miljöer där ungdomar befinner sig kan vara en anledning till denna ökning. Media har stor inverkan på människor då vi dagligen exponeras i form av internet, sociala medier, TV och press. I dagens samhälle ligger stort fokus på hälsa och kroppsförändring vilket måga ungdomar vill sträva efter. Syfte: Att undersöka medias beskrivning av rådande kroppsideal och dess påverkan på unga flickor i åldern 13-25 år. Metod:  Detta var en litteraturstudie med tematisk metod och databaserna som användes för att hitta artiklar var PubMed och Psycinfo. Utefter de resultaten som hittades framkom tre teman. Resultat: Medias tunna kroppsideal kan bidra till att unga flickor får sämre självkänsla och ångest och kan leda till depression och ätstörningar. Kroppsuppfattningen visade sig vara sämst under tonåren och att jämföra sig med andra och känna press från omgivningen var ett vanligt förekommande. Att förändra sitt utseende för att uppå de ideal som media skapar genom plastikkirurgi, diet eller träning är idag många ungdomars lösning för att få passa in. Fyra teman framkom i resultatet: Felaktig kroppsuppfattning, Press att förändra, Påverkar självkänslan och Försämrat välbefinnande. Implikation: Att informera om hälsa i skolorna hade kunnat vara   en åtgärd men även fortsatt forskning inom området behövs för att i framtiden hitta lösningar på problemet.

53545556575859 2751 - 2800 of 2954
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