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  • 1.
    Breivik, Mia
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Midwives’ perceptions of HIV-positive women’s sexual and reproductive health and rights in urban Namibia: An interview study with ten midwives2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Namibia has challenges in the area of sexual and reproductive health and rights. Working with sexual and reproductive health care, midwives are an important facilitating factor for a better sexual and reproductive health in Namibia.

    Aim:

    To explore midwives’ perceptions of HIV-positive women's sexual and reproductive health and rights in urban Namibia.

    Method:

    A qualitative study with ten midwives at a hospital in Windhoek. Individual interviews were done using an interview guide. The method used for analysis was phenomenography. The phenomenon being studied was the sexual and reproductive health and rights of HIV-positive women and the phenomenon was studied through the perceptions of midwives.

    Findings:

    The midwives perceived that improvements of HIV-positive women’s reproductive health were obstructed. The midwives perceived that the HIV-positive women’s reproductive possibilities and decisions were related to HIV. According to the midwives’ perceptions, sexual relations could be complicated by HIV and it was difficult for HIV-positive women to use condoms.

    Conclusion:

    The findings of this study can be used to reflect on the current situation for HIV-positive women in Namibia. The midwives' perceptions highlight the need to reduce the remaining stigma related to HIV and to work towards the empowerment of HIV-positive women.

  • 2. Conradsson, D.
    et al.
    Friden, C.
    Nilsson-Wikmar, L.
    Äng, Björn
    Ankle-joint mobility and standing squat posture in elite junior cross-country skiers. A pilot study2010In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 50, no 2, p. 132-8Article in journal (Refereed)
  • 3. de Alwis, M. P.
    et al.
    Lo Martire, R.
    Äng, Björn
    Garme, K.
    Development and validation of a web-based questionnaire for surveying the health and working conditions of high-performance marine craft populations2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, p. e011681-Article in journal (Refereed)
  • 4.
    Dragsten, Mirjam
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Salmonsson, Ingela
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Vårdpersonalens kunskapsläge i hjärtlungräddning samt följsamhet till det svenska hjärtlungräddningsregistret på ett länssjukhus i Mellansverige: En kvantitativ tvärsnittsstudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To identify the healthcare professional´s knowledge and training frequency of cardiopulmony resuscitation in a county hospital in central Sweden, and compliance of the Swedish Register of cardiopulmony resuscitation.

    Method: Survey with quantitative approach consisting of 177 respondents, as well as a retrospective observational study.

    Main results: Individuals answered correctly to all knowledge questions, but as a group, there were deficiencies in the knowledge of cardiopulmonary resuscitation. When comparing healthcare professional´s knowledge it was demonstrated that in four of the seven knowledge questions it was a significant difference in knowledge between the health professionals who have more regular training than those with fewer. Those who had more regular education had more right answers. A significant difference was also detected depending on when they had their latest CPR training, where those who have had their education more recently also had more right answers. Compliance of healthcare professional´s to register patients treated for cardiac arrest in hospital at the Swedish CPR registry, can be summarized by the deficiencies in reporting. Conclusion: It is important to create conditions for frequent training to health professionals to increase the knowledge and preparedness in CPR, which can also be seen as a quality assurance work. An improvement is necessary in order to improve compliance to registration.

  • 5. Farrohknia, Nasim
    et al.
    Castrén, Maaret
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lind, Lars
    Oredsson, Sven
    Jonsson, Håkan
    Asplund, Kjell
    Göransson, Katarina
    Emergency department triage scales and their components: a systematic review of the scientific evidence2011In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 19, no 42Article in journal (Refereed)
    Abstract [en]

    Emergency department (ED) triage is used to identify patients' level of urgency and treat them based on their triage level. The global advancement of triage scales in the past two decades has generated considerable research on the validity and reliability of these scales. This systematic review aims to investigate the scientific evidence for published ED triage scales. The following questions are addressed:

    1. Does assessment of individual vital signs or chief complaints affect mortality during the hospital stay or within 30 days after arrival at the ED?

    2. What is the level of agreement between clinicians' triage decisions compared to each other or to a gold standard for each scale (reliability)?

    3. How valid is each triage scale in predicting hospitalization and hospital mortality?

    A systematic search of the international literature published from 1966 through March 31, 2009 explored the British Nursing Index, Business Source Premier, CINAHL, Cochrane Library, EMBASE, and PubMed. Inclusion was limited to controlled studies of adult patients (≥15 years) visiting EDs for somatic reasons. Outcome variables were death in ED or hospital and need for hospitalization (validity). Methodological quality and clinical relevance of each study were rated as high, medium, or low. The results from the studies that met the inclusion criteria and quality standards were synthesized applying the internationally developed GRADE system. Each conclusion was then assessed as having strong, moderately strong, limited, or insufficient scientific evidence. If studies were not available, this was also noted.

    We found ED triage scales to be supported, at best, by limited and often insufficient evidence.

    The ability of the individual vital signs included in the different scales to predict outcome is seldom, if at all, studied in the ED setting. The scientific evidence to assess interrater agreement (reliability) was limited for one triage scale and insufficient or lacking for all other scales. Two of the scales yielded limited scientific evidence, and one scale yielded insufficient evidence, on which to assess the risk of early death or hospitalization in patients assigned to the two lowest triage levels on a 5-level scale (validity).

  • 6. Gladh, K.
    et al.
    Lo Martire, R.
    Äng, Björn
    Lindholm, P.
    Nilsson, J.
    Westman, A.
    Decelerations of parachute opening shock in skydivers2017In: Aerospace Medicine and Human Performance, ISSN 2375-6314, Vol. 88, no 2, p. 121-127Article in journal (Refereed)
  • 7. Gladh, K.
    et al.
    Äng, Björn
    Lindholm, P.
    Nilsson, J.
    Westman, A.
    Decelerations and muscle responses during parachute opening shock2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 11, p. 1205-10Article in journal (Refereed)
  • 8.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Olsen, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mentoring model in municipal health care in Dalarna, Sweden: A model for supporting new employeed nurses' professional role in municipal health care2012In: Ageing connects: book of abstracts, International Federation on Ageing. Global Conference on Ageing , 2012Conference paper (Refereed)
    Abstract [en]

    Background

    The society and health care units are increasing the demands on nurses.  Newly employed nurses   are expected to be able to work from the first day of employment independently.

    Aim

    That the newly employed nurses in communities within the County of Dalarna, receive support enabling them to feel safe in their professional role and ensure patient safety.

    The scope of the project

    The Mentor Model (MM) is based on the fact that the municipalities in Dalarna County (n = 15) appoints a Headmentor (HM).  The HM is responsible for appointing a mentor (M) for all newly employed nurses and has a supportive function for all mentors. The mentors (M) should have professional experience and are responsible for the newly employed nurses under a period of one year. In order for the M to provide support i.e. time for reflection with the HM and newly employed nurse sufficient, time must be allocated, i.e. two weeks.

    The (M) should be available to answer necessary, and networking with other mentors in Dalarna.

    Interviews with HM, M and newly employed in the municipalities showed positive gains with appointing an MM. The positive effects were: patient safety, the nurses felt more confident and the HM and M had opportunity to develop professionally.

  • 9. Grooten, W. J.
    et al.
    Conradsson, D.
    Äng, Björn
    Franzen, E.
    Is active sitting as active as we think?2013In: Ergonomics, ISSN 0014-0139, E-ISSN 1366-5847, Vol. 56, no 8, p. 1304-14Article in journal (Refereed)
  • 10. Grooten, W. J.
    et al.
    Äng, Björn
    Reliability of measurements of wrist extension force obtained with a Nicholas Manual Muscle Tester (NMMT)2010In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 26, no 4, p. 281-7Article in journal (Refereed)
  • 11. Grooten, W.J.A.
    et al.
    Äng, Björn
    Hagstromer, M.
    Conradsson, D.
    Nero, H.
    Franzen, E.
    Does a dynamic chair increase office workers' movements? – Results from a combined laboratory and field study2017In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 60, p. 1-11Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Dynamic chairs have the potential to facilitate movements that could counteract health problems associated with sedentary office work. This study aimed to evaluate whether a dynamic chair can increase movements during desk-based office work.

    METHODS:

    Fifteen healthy subjects performed desk-based office work using a dynamic office chair and compared to three other conditions in a movement laboratory. In a field study, the dynamic office chair was studied during three working days using accelerometry.

    RESULTS:

    Equivocal results showed that the dynamic chair increased upper body and chair movements as compared to the conventional chair, but lesser movements were found compared to standing. No differences were found between the conditions in the field study.

    CONCLUSIONS:

    A dynamic chair may facilitate movements in static desk-based office tasks, but the results were not consistent for all outcome measures. Validation of measuring protocols for assessing movements during desk-based office work is warranted.

  • 12. Heijne, A.
    et al.
    Äng, Björn
    Werner, S.
    Predictive factors for 12-month outcome after anterior cruciate ligament reconstruction2009In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 6, p. 842-9Article in journal (Refereed)
  • 13. Lo Martire, R.
    et al.
    Gladh, K.
    Westman, A.
    Lindholm, P.
    Nilsson, J.
    Äng, Björn
    Neck muscle activity in skydivers during parachute opening shock2016In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 26, no 3, p. 307-16Article in journal (Refereed)
  • 14. Lo Martire, Riccardo
    et al.
    Gladh, Kristofer
    Westman, Anton
    Äng, Björn
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science. Karolinska Institutet.
    Neck muscle EMG-force relationship and its reliability during isometric contractions2017In: Sports medicine - open, ISSN 2199-1170, Vol. 3, no 1, article id 16Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Susceptible to injury, the neck is subject to scientific investigations, frequently aiming to elucidate possible injury mechanisms via surface electromyography (EMG) by indirectly estimating cervical loads. Accurate estimation requires that the EMG-force relationship is known and that its measurement error is quantified. Hence, this study examined the relationship between EMG and isometric force amplitude of the anterior neck (AN), the upper posterior neck (UPN), and the lower posterior neck (LPN) and then assessed the relationships' test-retest reliability across force-percentiles within and between days.

    METHODS: EMG and force data were sampled from 18 participants conducting randomly ordered muscle contractions at 5-90% of maximal voluntary force during three trials over 2 days. EMG-force relationships were modeled with general linear mixed-effects regression. Overall fitted lines' between-trial discrepancies were evaluated. Finally, the reliability of participants' fitted regression lines was quantified by an intraclass correlation coefficient (ICC) and the standard error of measurement (SEM).

    RESULTS: A rectilinear model had the best fit for AN while positively oriented quadratic models had the best fit for UPN and LPN, with mean adjusted conditional coefficients of determination and root mean square errors of 0.97-0.98 and 4-5%, respectively. Overall EMG-force relationships displayed a maximum 6% between-trial discrepancy and over 20% of maximal force, and mean ICC was above 0.79 within day and 0.27-0.61 between days across areas. Corresponding SEM was below 12% both within and between days across areas, excluding UPN between days, for which SEM was higher.

    CONCLUSIONS: EMG-force relationships were elucidated for three neck areas, and provided models allow inferences to be drawn from EMG to force on a group level. Reliability of EMG-force relationship models was higher within than between days, but typically acceptable for all but the lowest contraction intensities, and enables adjustment for measurement imprecision in future studies.

  • 15.
    Marmstål Hammar, Lena
    et al.
    Mälardalens högskola.
    Williamn, Christine
    Florida Atlantic University.
    Swall, Anna
    Sophiahemmet Högskola.
    Engström, Gabriella
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Humming as a mean of communicating during meal time situations: A Single Case study involving a women with severe dementia and her caregiver2012In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 2, no 3, p. 93-102Article in journal (Refereed)
    Abstract [en]

    Objective:

    ‘Music Therapeutic Caregiving’, when caregivers sing for or together with persons with dementia during morning care situations, has been shown to increase verbal and nonverbal communication between persons with dementia and their caregivers, as well as enhance positive and decrease negative emotions in persons with dementia. No studies about singing during mealtimes have been conducted, and this pilot project was designed to elucidate this. However, since previous studies have shown that there is a risk that persons with dementia will start to sing along with the caregiver, the caregiver in this study hummed such that the person with dementia did not sing instead of eat. The aim of this pilot project was threefold: to describe expressed emotions in a woman with severe dementia, and describe communication between her and her caregivers without and with the caregiver humming. The aim was also to measure food and liquid intake without and with humming.

    Method: The study was constructed as a Single Case ABA design in which the ordinary mealtime constituted a baseline which comprised a woman with severe dementia being fed by her caregivers in the usual way. The intervention included the same woman being fed by the same caregiver who hummed while feeding her. Data comprised video observations that were collected once per week over 5 consecutive weeks. The Verbal and Nonverbal Interaction Scale and Observed Emotion Rating Scale were used to analyze the recorded interactions.

    Results:

    A slightly positive influence of communication was shown for the woman with dementia, as well as for the caregiver. Further, the women with dementia showed a slight increase in expressions of positive emotions, and she ate more during the intervention.

    Conclusion:

    Based on this pilot study no general conclusions can be drawn. It can be concluded, however, that humming while feeding persons with dementia might slightly enhance communication, and positive expressed emotions in persons with dementia. To confirm this, more studies on group levels are needed. Because previous studies have found that caregiver singing during caring situations influences persons with dementia positively it might be desirable to test the same during mealtime.

  • 16.
    Nerpin, Elisabet
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    The kidney in different stages of the cardiovascular continuum2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. The complex, interaction between the kidney and the cardiovascular system is incompletely understood, particularly at the early stages of the cardiovascular continuum.

    The overall aim of this thesis was to clarify novel aspects of the interplay between the kidney and the cardiovascular system at different stages of the cardiovascular continuum; from risk factors such as insulin resistance, inflammation and oxidative stress, via sub-clinical cardiovascular damage such as endothelial dysfunction and left ventricular dysfunction, to overt cardiovascular death.

    This thesis is based on two community-based cohorts of elderly, Uppsala Longitudinal Study of Adult Men (ULSAM) and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS).

    The first study, show that higher insulin sensitivity, measured with euglycemic-hyperinsulinemic clamp technique was associated to improve estimated glomerular filtration rate (eGFR) in participants with normal fasting plasma glucose, normal glucose tolerance and normal eGFR. In longitudinal analyses, higher insulin sensitivity at baseline was associated with lower risk of impaired renal function during follow-up. In the second study, eGFR was inversely associated with different inflammatory markers (C-reactive protein, interleukin-6, serum amyloid A) and positively associated with a marker of oxidative stress (urinary F2-isoprostanes). In line with this, the urinary albumin/creatinine ratio was positively associated with these inflammatory markers, and negatively associated with oxidative stress.

    In study three, higher eGFR was associated with better endothelial function as assessed by the invasive forearm model. Further, in study four, higher eGFR was significantly associated with higher left ventricular systolic function (ejection fraction). The 5th study of the thesis shows that higher urinary albumin excretion rate (UAER) and lower eGFR was independently associated with an increased risk for cardiovascular mortality. Analyses of global model fit, discrimination, calibration, and reclassification suggest that UAER and eGFR add relevant prognostic information beyond established cardiovascular risk factors in participants without prevalent cardiovascular disease.

    Conclusion: this thesis show that the interaction between the kidney and the cardiovascular system plays an important role in the development of cardiovascular disease and that this interplay begins at an early asymptomatic stage of the disease process.

  • 17. Nilsson, J.
    et al.
    Friden, C.
    Buren, V.
    Westman, A.
    Lindholm, P.
    Äng, Björn
    Musculoskeletal pain and related risks in skydivers: a population-based survey2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 10, p. 1034-40Article in journal (Refereed)
  • 18. Nilsson, J.
    et al.
    Friden, C.
    Buren, V.
    Äng, Björn
    Development and validation of a web-based questionnaire for surveying skydivers2011In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 82, no 6, p. 610-4Article in journal (Refereed)
  • 19.
    Nilsson, Johnny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science. The Swedish School of Sport and Health Sciences, Stockholm.
    Cardinale, Daniele
    Running economy and blood lactate accumulation in elite football players with high and low maximal aerobic power2015In: LASE Journal of Sport Science, ISSN 1691-7669, E-ISSN 1691-9912, Vol. 6, no 2, p. 44-51Article in journal (Refereed)
    Abstract [en]

    The purpose was to determine running economy and lactate threshold among a selection of male elite football players with high and low aerobic power. Forty male elite football players from the highest Swedish division (“Allsvenskan”) participated in the study. In a test of running economy (RE) and blood lactate accumulation the participants ran four minutes each at 10, 12, 14, and 16 km•h-1 at horizontal level with one minute rest in between each four minutes interval. After the last sub-maximal speed level the participants got two minutes of rest before test of maximal oxygen uptake (VO2max). Players that had a maximal oxygen uptake lower than the average for the total population of 57.0 mL O2•kg-1•minute-1 were assigned to the low aerobic power group (LAP) (n=17). The players that had a VO2max equal to or higher than 57.0 mL O2•kg-1•minute-1 were selected for the high aerobic power group (HAP) (n=23). The VO2max was significantly different between the HAP and LAP group. The average RE, measured as oxygen uptake at 12, 14 and 16km•h-1 was significantly lower but the blood lactate concentration was significantly higher at 14 and 16 km•h-1 for theLAP group compared with the HAP group.

  • 20.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Att översätta och anpassa ett engelskt instrument för bedömning av fysisk miljö på särskilt boende till svenska förhållanden: utmaningar och erfarenheter2012Conference paper (Refereed)
  • 21.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    A review of existing tools for assessing the design quality of healthcare environments2011Conference paper (Other academic)
  • 22.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Assessment of the physical environment - a way to high quality care2012Conference paper (Refereed)
  • 23.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Support to elderly care nurses: developing a knowledge centre2012Conference paper (Refereed)
    Abstract [en]

    Objectives: Nurses working in elderly health care in the municipalities needs a wide competence. They have to deal with a broad range of health problems, multi-morbidity, medical and nursing treatment, supervision of patients, relatives and staff. The nurses also have to handle with national guidelines (NG) and evidenced based methods (EBM) as well as documenting the care process in data records. The aim of the knowledge centre is to support and coordinate work and care development in elderly health care, based on research and evidence based practice.

    Methods: All 15 local authorities in the county of Dalarna and the Dalarna University have developed a Knowledge Centre (KC) for elderly health care. A Senior Lecturer (SL) supervise and develop the work in near collaboration with the nursing staff. The first step was identifying the nurses needs, i.e. support and education, and the identifying process is still going on. The second step was work in small groups under supervision from the (SL). Documents, local care programmes, and working routines from all authorities, together with NG’s and EBM’s, were compiled and developed to updated regional care programmes, in consensus.

    Results: So far, the work has contributed to a brief production of documents in nursing care related areas such as patient security, implementing national guidelines, routines for delegating health care duties to unqualified staff, i.e., care assistants, mentor-program for newly employed registered nurses, networks for nurses with responsibilities in dementia, diabetic care etc. The production of documents produced by the knowledge centre is available on a Swedish web-site www.du.se/kommunalvardutveckling with free access. The work has generated a number of ideas for diploma work for nursing students and some ideas for research have also been formulated. The KC has contributed to cooperation between nurses in different authorities.

    Conclusions: The KC contributes support regarding processes and structures for knowledge dispersion and practical issues with a special focus on elderly care nurses, and has been successfully implemented.

  • 24.
    Olsson, Helén
    Mittuniversitetet, Avdelningen för omvårdnad.
    Att minska risken för våld och att främja återhämtning i den rättspsykiatriska vården: Patienters och personalens erfarenheter av vägen mot återhämtning2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Detta avhandlingsarbete är utfört inom en rättspsykiatrisk vårdkontext och återspeglar patienters[1] och personals[2] erfarenheter och upplevelser av vändpunkter i samband med minskad risk för våld och återhämtning. Med utgångspunkt från ett holistiskt och salutogent hälsovetenskapligt perspektiv har avhandlingen ett tvärvetenskapligt förhållningssätt.   Teoretiska ämnesdiscipliner såsom psykiatrisk omvårdnad, kriminologi och sociologi har influerat arbetet.

    Avhandlingens övergripande syfte var att utifrån de salutogena aspekterna i det rättspsykiatriska omvårdnadsarbetet undersöka vad som är relaterat till vändpunkter i samband med minskad risk för våld och vad som bidrar till återhämtning. Avhandlingen baseras på fyra olika studier. Syftet med den inledande kvantitativa delstudien (I) var att identifiera och jämföra rättspsykiatriska patienter som sänkt sin bedömda risk för våld med 30 % eller mer enligt riskbedömningsinstrument HCR-20. Resultatet visade att den bedömda risken för våld minskade över tid. En demografisk analys genomfördes för att studera skillnader mellan de patienter som sänkt sin bedömda risk för våld och de som inte sänkt sin risk. Det framgick att rättspsykiatriska patienter som bedömts med hjälp av riskbedömningsinstrumentet HCR-20, minskade den bedömda risken för våld, både på kort och på lång sikt. Den rättspsykiatriska vården fungerade bäst när det gällde att förbättra de kliniska riskfaktorerna (C-skalan).

    Riskhanteringen (R-skalan) gällande eventuell utskrivning och framtida friförmåner visade inte samma goda progress. Demografiska karaktäristika såsom ålder, alkohol och drogmissbruk och psykiatriska diagnoser var inte relaterade till minskad risk för våld, dock var kvinnliga patienter och patienter utan psykopatidiagnos mer benägna att sänka sin risk för våld. Ett urval av de patienter som minskade sin risk för våld med 30 % eller mer utgjorde basen för delstudie II och III.

    I delstudie II intervjuades tretton rättspsykiatriska patienter om upplevelser och erfarenheter kring vad som bidrar till minskad respektive ökad risk för våld inne på en rättspsykiatrisk avdelning. Data analyserades med hjälp av en tolkande beskrivning (Interpretive Description). Studien visade att orsakerna till ökad respektive minskad risk för våld var processrelaterad, där interaktioner mellan personal och patienter bidrog till en utveckling som antingen präglades av välbefinnande eller disharmoni. Delstudie II utgjorde en viktig kunskapskälla som präglade ansatsen i delstudie III och IV. Detta med hänvisning till att flertalet patienter i delstudie II lämnade intressanta beskrivningar av vändpunkter i samband med minskad risk för våld och återhämtning.

    Sålunda intervjuades i delstudie III, tio rättspsykiatriska patienter om deras upplevelser av förändringsprocesser i samband med vändpunkter och återhämtning. Dataanalysen skedde med hjälp av en kvalitativ innehållsanalys. Processen beskrevs utifrån tre faser där man i högriskfasen upplevde kaotiska och överväldigande känslor. Vändpunkten upplevdes som ett känsligt skede som präglades av att tvingas hitta en ny, konstruktiv väg i livet. Återhämtningsfasen präglades av ett accepterande och en mognad. Stöd och erkännande från omgivningen ansåg främja dessa processer.

    Delstudie IV bestod av intervjuer med tretton personal. Syftet var att belysa upplevelser och erfarenheter kring rättspsykiatriska patienters vändpunkter och återhämtning. Kvalitativ innehållsanalys användes för att analysera data. Beskrivningar kring hur en vändpunkt kunde bevaras och främjas baserades på vikten av att vara uppmärksam, lyhörd och att inte skynda på processen. En vändpunkt upplevdes genom att patienten uppvisade synbara positiva förändringar. Sammansättningen på personalen och patienterna ansågs påverka atmosfären på avdelningen, och bidrog till huruvida processen mot vändpunkter och återhämtning underlättades eller försvårades.

    Avhandlingen visar hur ett ständigt växelspel mellan patienter och mellan personal bidrog till huruvida vårdatmosfären upplevdes såsom hälsofrämjande eller ej. Vidare framgår att processer kring vändpunkter i samband med minskad risk för våld och återhämtning präglades av känslor av sårbarhet och utsatthet. Processen beskrevs som ett känsligt förlopp som behövde understödjas av förtroendefulla relationer med andra, samt möjligheter att få vistas i en trygg miljö.

    [1] Den vetenskapliga litteraturen använder sig av begrepp såsom client, consumer, service user eller forensic patient för att beteckna människor som är inskrivna inom den rättspsykiatriska vården. Inom det psykiatriska svenska fältet kan begreppen brukare, vårdtagare eller patient förekomma. I denna avhandling kommer begreppet patient och vårdtagare omväxlande att användas för att beteckna de människor som är föremål för den rättspsykiatriska vården. De patienter som deltagit i avhandlingens två delstudier kommer omväxlande att benämnas såsom deltagare eller patienter, för att åstadkomma en varierande och läsvänlig text.

    [2] I denna avhandling anser begreppet personal den personalkategori som arbetar med omvårdnad inom en rättspsykiatrisk kontext. Det är främst sjuksköterskor och skötare som inkluderas i begreppet omvårdnadspersonal inom den vetenskapliga litteraturen. Sjuksköterskor benämns såsom registered mental health nurses eller registered nurses. Övrig omvårdnadspersonal tituleras till exempel som nurse manager eller assistant nurses. När begreppen personal, vårdare eller omvårdnadspersonal används i denna avhandling avses då den personalkategori som arbetar närmast patienten med omvårdnad och ingen åtskillnad kommer att göras mellan de båda yrkesgrupperna. Personalen som deltar i delstudie IV har omväxlande kallats för personal eller vårdare.

  • 25.
    Orrell, Alison
    et al.
    University of Sheffield.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Gilhooly, Mary
    Brunel University.
    Parker, Stuart
    University of Sheffield.
    Improving continence services for older people from the service-providers’ perspective: a qualitative interview study2013In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, no 7Article in journal (Refereed)
    Abstract [en]

    Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI).

    Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services.

    Setting: 3 acute and 13 primary care National Health Service Trusts in England.

    Participants: 16 continence service leads in England actively treating and managing older people with UI.

    Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work.

    Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

  • 26. Peterson, Kerstin
    et al.
    Persson, Margareta
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Nilses, Carin
    Haglund, Ingrid
    Skoglund, Yvonne
    Lindkvist, Marie
    Mogren, Ingrid
    Mödrahälsovårdsregistret: studier av intern validitet och registeranvändarnas erfarenheter, uppfattningar samt nyttjande av registret2012Report (Other academic)
  • 27. Pousette, M. W.
    et al.
    Lo Martire, R.
    Linder, J.
    Kristoffersson, M.
    Äng, Björn
    Neck Muscle Strain in Air Force Pilots Wearing Night Vision Goggles2016In: Aerospace Medicine and Human Performance, ISSN 2375-6322, Vol. 87, no 11, p. 928-932Article in journal (Refereed)
  • 28. Rasmussen-Barr, E.
    et al.
    Campello, M.
    Arvidsson, I.
    Nilsson-Wikmar, L.
    Äng, Björn
    Factors predicting clinical outcome 12 and 36 months after an exercise intervention for recurrent low-back pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 2, p. 136-44Article in journal (Refereed)
  • 29. Rasmussen-Barr, E.
    et al.
    Granstrom, H.
    Äng, Björn
    Inter- and intra-observer reliability of three movement control tests for the lumbo-pelvic complex2015In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 101, no suppl. 1, p. e1259-e1260Article in journal (Refereed)
  • 30. Rasmussen-Barr, E.
    et al.
    Äng, Björn
    Arvidsson, I.
    Nilsson-Wikmar, L.
    Graded exercise for recurrent low-back pain: a randomized, controlled trial with 6-, 12-, and 36-month follow-ups2009In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 34, no 3, p. 221-8Article in journal (Refereed)
  • 31. Soderberg, J.
    et al.
    Grooten, W. J.
    Äng, Björn
    Effects of eccentric training on hand strength in subjects with lateral epicondylalgia: a randomized-controlled trial2012In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 22, no 6, p. 797-803Article in journal (Refereed)
  • 32.
    Talman, Lena
    et al.
    Mälardalens högskola.
    Gustafsson, Christine
    Mälardalens högskola.
    Stier, Jonas
    Dalarna University, School of Humanities and Media Studies.
    Wilder, Jenny
    Mälardalens högskola.
    Staffs’ documentation of participation for adults with profound intellectual disability or profound intellectual and multiple disabilities2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 1, p. 2527-2537Article in journal (Refereed)
    Abstract [en]

    Purpose: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation.

    Methods: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool.

    Results: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented.

    Conclusions: A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group.

    • Implications for rehabilitation
    • There is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities.

    • For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan.

    • The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual’s functioning in their environment is not omitted in documentation.

  • 33.
    Thomas, Ilias
    et al.
    Dalarna University, School of Technology and Business Studies, Microdata Analysis.
    Alam, Moudud
    Dalarna University, School of Technology and Business Studies, Statistics.
    Bergquist, Filip
    Johansson, Dongni
    Memedi, Mevludin
    Nyholm, Dag
    Westin, Jerker
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Sensor-based algorithmic dosing suggestions for oral administration of levodopa/carbidopa microtablets for Parkinson's disease: a first experience2019In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 266, no 3, p. 651-658Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Dosing schedules for oral levodopa in advanced stages of Parkinson's disease (PD) require careful tailoring to fit the needs of each patient. This study proposes a dosing algorithm for oral administration of levodopa and evaluates its integration into a sensor-based dosing system (SBDS).

    MATERIALS AND METHODS: In collaboration with two movement disorder experts a knowledge-driven, simulation based algorithm was designed and integrated into a SBDS. The SBDS uses data from wearable sensors to fit individual patient models, which are then used as input to the dosing algorithm. To access the feasibility of using the SBDS in clinical practice its performance was evaluated during a clinical experiment where dosing optimization of oral levodopa was explored. The supervising neurologist made dosing adjustments based on data from the Parkinson's KinetiGraph™ (PKG) that the patients wore for a week in a free living setting. The dosing suggestions of the SBDS were compared with the PKG-guided adjustments.

    RESULTS: The SBDS maintenance and morning dosing suggestions had a Pearson's correlation of 0.80 and 0.95 (with mean relative errors of 21% and 12.5%), to the PKG-guided dosing adjustments. Paired t test indicated no statistical differences between the algorithmic suggestions and the clinician's adjustments.

    CONCLUSION: This study shows that it is possible to use algorithmic sensor-based dosing adjustments to optimize treatment with oral medication for PD patients.

  • 34. Thuresson, M.
    et al.
    Äng, Björn
    Linder, J.
    Harms-Ringdahl, K.
    Intra-rater reliability of electromyographic recordings and subjective evaluation of neck muscle fatigue among helicopter pilots2005In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 15, no 3, p. 323-31Article in journal (Refereed)
  • 35. Thuresson, M.
    et al.
    Äng, Björn
    Linder, J.
    Harms-Ringdahl, K.
    Mechanical load and EMG activity in the neck induced by different head-worn equipment and neck postures2005In: Journal of Industrial Economics, ISSN 0022-1821, E-ISSN 1467-6451, Vol. 35, no 1, p. 13-18Article in journal (Refereed)
  • 36. Thuresson, M.
    et al.
    Äng, Björn
    Linder, J.
    Harms-Ringdahl, K.
    Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment2003In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 74, no 5, p. 527-32Article in journal (Refereed)
  • 37.
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Styrkt av träning2015In: Äldre i Centrum, ISSN 1653-3585, Vol. 29, no 4, p. 21-23Article in journal (Other academic)
  • 38. van den Heuvel, Eleanor
    et al.
    Gilhooly, Mary
    Sutherland, Ian
    Jowitt, Felicity
    McKee, Kevin
    Dalarna University, School of Health and Social Studies, Social Work.
    Dahlberg, Lena
    Dalarna University, School of Health and Social Studies, Social Work.
    Parker, Stuart
    Gaydecki, Patrick
    Ratcliffe, Norman
    Bichard, Jo-Anne
    Long, Adele
    Cotterill, Nikki
    Orme, Susie
    Tackling ageing continence through theory, tools and technology (TACT3)2013Report (Other academic)
  • 39.
    Vixner, Linda
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet.
    Manual and electroacupuncture for labour pain. Study design of a longitudinal randomized controlled trial2013Conference paper (Other academic)
    Abstract [en]

    Introduction: Results from previous acupuncture studies for labour pain are contradictory and lack important information on methodology. The sample sizes are in general small, information about the intervention such as needle placement, number of acupuncture points, type of stimulation, and duration of treatment, is often sparse or lacking However, studies indicate that acupuncture has a positive effect on women’s experiences of labour pain.

     

    Aim: The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain. Our hypothesis is that acupuncture with manual or electrical stimulation is more effective than standard care in the relief of labor pain, and that acupuncture with electrical stimulation is the most effective.

    Outcome measures: Primary outcome: Labour pain measured with visual analogue scale (VAS). Secondary outcomes are use of epidural analgesia, experience of relaxation, labour outcomes and infant outcomes. Biochemical markers of proinflammatory cytokines, memory of labour pain and overall childbirth experience.

    Methods: The study was designed as a randomized controlled trial based on Western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. VAS was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment.

    At the conference, information on the design of the study will be presented and the considerations of whether to use placebo controls or not will be discussed.

    ClinicalTrials.gov: NCT01197950

  • 40.
    Wåhlin-Larsson, Britta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Kadi, Fawzi
    Ulfberg, Jan
    Piehl Aulin, Karin
    Skeletal muscle function and morphology in persons with restless legs syndrome (RLS)2005In: 19th Annual Meeting of the Associated Professional Sleep Societies, 2005Conference paper (Other academic)
  • 41. Äng, Björn
    Impaired neck motor function and pronounced pain-related fear in helicopter pilots with neck pain - a clinical approach2008In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 18, no 4, p. 538-49Article in journal (Refereed)
  • 42. Äng, Björn
    et al.
    Harms-Ringdahl, K.
    Neck pain and related disability in helicopter pilots: A survey of prevalence and risk factors2006In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 77, no 7, p. 713-9Article in journal (Refereed)
  • 43. Äng, Björn
    et al.
    Kristoffersson, M.
    Neck muscle activity in fighter pilots wearing night-vision equipment during simulated flight2013In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 84, no 2, p. 125-33Article in journal (Refereed)
  • 44. Äng, Björn
    et al.
    Linder, J.
    Harms-Ringdahl, K.
    Neck strength and myoelectric fatigue in fighter and helicopter pilots with a history of neck pain2005In: Aviation, Space and Environmental Medicine, ISSN 0095-6562, E-ISSN 1943-4448, Vol. 76, no 4, p. 375-80Article in journal (Refereed)
  • 45. Äng, Björn
    et al.
    Monnier, A.
    Harms-Ringdahl, K.
    Neck/shoulder exercise for neck pain in air force helicopter pilots: a randomized controlled trial2009In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 34, no 16, p. E544-51Article in journal (Refereed)
1 - 45 of 45
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