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  • 1. Aguiar, A.
    et al.
    Ahring, K.
    Almeida, M. F.
    Assoun, M.
    Belanger Quintana, A.
    Bigot, S.
    Bihet, G.
    Malmberg, Karin Blom
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Burlina, A.
    Bushueva, T.
    Caris, A.
    Chan, H.
    Clark, A.
    Clark, S.
    Cochrane, B.
    Corthouts, K.
    Dalmau, J.
    Dassy, M.
    De Meyer, A.
    Didycz, B.
    Diels, M.
    Dokupil, K.
    Dubois, S.
    Eftring, K.
    Ekengren, J.
    Ellerton, C.
    Evans, S.
    Faria, A.
    Fischer, A.
    Ford, S.
    Freisinger, P.
    Gizewska, M.
    Gokmen-Ozel, H.
    Gribben, J.
    Gunden, F.
    Heddrich-Ellerbrok, M.
    Heiber, S.
    Heidenborg, C.
    Jankowski, C.
    Janssen-Regelink, R.
    Jones, I.
    Jonkers, C.
    Joerg-Streller, M.
    Kaalund-Hansen, K.
    Kiss, E.
    Lammardo, A. M.
    Lang, K.
    Lier, D.
    Lilje, R.
    Lowry, S.
    Luyten, K.
    MacDonald, A.
    Meyer, U.
    Moor, D.
    Pal, A.
    Robert, M.
    Robertson, L.
    Rocha, J. C.
    Rohde, C.
    Ross, K.
    Saruhan, S.
    Sjoqvist, E.
    Skeath, R.
    Stoelen, L.
    Ter Horst, N. M.
    Terry, A.
    Timmer, C.
    Tuncer, N.
    Vande Kerckhove, K.
    van der Ploeg, L.
    van Rijn, M.
    van Spronsen, F. J.
    van Teeffelen-Heithoff, A.
    van Wegberg, A.
    van Wyk, K.
    Vasconcelos, C.
    Vitoria, I.
    Wildgoose, J.
    Webster, D.
    White, F. J.
    Zweers, H.
    Practices in prescribing protein substitutes for PKU in Europe: No uniformity of approach2015In: Molecular Genetics and Metabolism, ISSN 1096-7192, E-ISSN 1096-7206, Vol. 115, no 1, p. 17-22Article in journal (Refereed)
    Abstract [en]

    Background: There appears little consensus concerning protein requirements in phenylketonuria (PKU). Methods: A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein substitute [PS]) by age, administration frequency and method, monitoring, and type of protein substitute. Data were analysed by European region using descriptive statistics. Results: The amount of total protein (from PS and natural/intact protein) varied according to the European region. Higher median amounts of total protein were prescribed in infants and children in Northern Europe (n = 24 centres) (infants <1 year, >2-3 g/kg/day; 1-3 years of age, >2-3 g/kg/day; 4-10 years of age, >1.5-2.5 g/kg/day) and Southern Europe (n = 10 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, 2 g/kg/day; 4-10 years of age, 1.5-2 g/kg/day), than by Eastern Europe (n = 4 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, >2-2.5 g/kg/day; 4-10 years of age, >1.5-2 g/kg/day) and with Western Europe (n = 25 centres) giving the least (infants <1 year, >2-2.5 g/kg/day, 1-3 years of age, 1.5-2 g/kg/day; 4-10 years of age, 1-1.5 g/kg/day). Total protein prescription was similar in patients aged >10 years (1-1.5 g/kg/day) and maternal patients (1-1.5 g/kg/day). Conclusions: The amounts of total protein prescribed varied between European countries and appeared to be influenced by geographical region. In PKU, all gave higher than the recommended 2007 WHO/FAO/UNU safe levels of protein intake for the general population.

  • 2.
    Ahlstedt, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Eriksson Lindvall, Carin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; School of Nursing, University of Adelaide, Australia.
    What makes registered nurses remain in work? An ethnographic study2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89, p. 32-38Article in journal (Refereed)
    Abstract [en]

    Background: Registered nurses' work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses' workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses' work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses' development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.

  • 3.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Hamblin, Lydia
    Ager, Joel
    Aranyos, Deanna
    Upfal, Mark J.
    Luborsky, Mark
    Russell, Jim
    Essenmacher, Lynnette
    Application and Implementation of the Hazard Risk Matrix to Identify Hospital Workplaces at Risk for Violence2014In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 57, no 11, p. 1276-1284Article in journal (Refereed)
    Abstract [en]

    BackgroundA key barrier to preventing workplace violence injury is the lack of methodology for prioritizing the allocation of limited prevention resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to enable prioritization of units for safety intervention. MethodsProbability of violence was based on violence incidence rates; severity was based on lost time management claims for violence-related injuries. Cells of the hazard risk matrix were populated with hospital units categorized as low, medium, or high probability and severity. Hospital stakeholders reviewed the matrix after categorization to address the possible confounding of underreporting. ResultsForty-one hospital units were categorized as medium or high on both severity and probability and were prioritized for forthcoming interventions. Probability and severity were highest in psychiatric care units. ConclusionsThis risk analysis tool may be useful for hospital administrators in prioritizing units for violence injury prevention efforts.  

  • 4.
    Arnoldsson, Sara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Aronsson, Bente
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Femåringar berättar på svenska och engelska: Referensdata och jämförelse med 6- och 7-åringar2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Since 2009, the EU research network COST Action IS0804 has been working towards gaining more knowledge about bilingual language acquisition in typically and atypically developing children, and towards creating assessment tools which are specifically adapted to bilingual children. Within COST Action, one working group, Narrative and discourse, focuses on narratives as a way to assess children’s language. Narratives provide more naturalistic language samples than item-based tests and are less biased against bilingual children compared to other language assessments. The Narrative and discourse group developed the assessment tool MAIN (Multilingual Assessment Instrument for Narratives). MAIN examines children’s production and comprehension of narratives on a macrostructural level (i.e. overall story structure) within the framework of story grammar (SG). One current hypothesis is that macrostructure is language independent and can therefore be compared across languages. In the current study, 16 simultaneous bilingual children (ages 4:11- 5:8, mean 5:4 years) with the language combination Swedish-English were assessed with MAIN. Their results were compared with the results of bilingual 6-7 year olds with the same language combination (Härdelin & Naylor, 2012). Results showed no significant difference regarding macrostructure between the children’s two languages, neither in production(p= 0,084) nor in comprehension (p= 0,21). However, there was a significant difference between the younger and the older children, both in production (p= 0,00099) and comprehension (p= 0,0072). Non-targetlike structures due to cross-linguistic influence,e.g. transfer and code-mixing, were noticed for both age groups. Cross-linguistic influence should thus not be mistaken for language impairment, but rather be treated as a natural part of bilingual language acquisition. In conclusion, differences in macrostructure seemed to be related to age rather than to language. The results of the current study provide insight into the performance of five-year-olds on MAIN, which has not previously been studied in a Swedish context. By comparing the results with older children, the study documents the narrative development of Swedish-English bilinguals from age 5 to 7.

  • 5.
    Arousell, Jonna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sacred Ideals: Diversity and Equality in Swedish Reproductive Healthcare2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    To promote diversity (mångfald) and equality (jämlikhet) is a key task for a wide range of welfare institutions in Sweden. The two terms appeal to several aspects simultaneously: inclusiveness, moral goodness, awareness and willingness to facilitate a positive social change. Diversity and equality have become, as I suggest in this thesis, two sacred ideals in Swedish society today. In the context of reproductive healthcare, various forms of diversity and equality measures are thought of as solutions to, for instance, inequalities between immigrant groups and others, structural discrimination of minority groups, and difficulties faced by the Swedish healthcare system in caring for patients’ diverse needs and preferences in clinical encounters. In this thesis, diversity and equality are analysed as two important governing mechanisms in the organisation of healthcare in multicultural Sweden. The aim was to explore how these ideals contribute to shape the provision of reproductive healthcare, and its consequences.

    Paper I shows that targeted interventions towards immigrant women in contraceptive counselling risk singling out some women from standard routes of care because they are categorised as “immigrants” or “Muslims”. Paper II shows that demands upon healthcare providers to accommodate Muslim patients’ presumed needs have the potential of also creating needs that were not there from the start. Paper III shows that many religious counsellors who are affiliated with Swedish healthcare as spiritual advisers present ideas on abortion that are less progressive than what is stipulated in Swedish abortion law. Paper IV shows that imperatives to promote gender equality in contraceptive counselling were taken seriously by providers in their encounters with non-Western women, at the possible expense of respect for relationship structures that do not conform to the ideals of gender equality.

    The findings presented in this thesis show that the interventions and initiatives that sought to presumably help disadvantaged groups of people (i.e. Muslims, immigrant women) could, in fact, be obstacles to solving the problems they were meant to address. I argue that the governance of Swedish reproductive healthcare through diversity and equality ideals must be problematised and balanced with regard to their plausible consequences.

    List of papers
    1. Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception? A qualitative exploration and critique of a common argument in reproductive health research
    Open this publication in new window or tab >>Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception? A qualitative exploration and critique of a common argument in reproductive health research
    2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 75, p. 59-65Article in journal (Refereed) Published
    Abstract [en]

    Objective: 'Low socioeconomic status' and 'religiousness' appear to have gained status as nearly universal explanatory models for why women in minority groups are less likely to use contraception than other women in the Scandinavian countries. Through interviews with pious Muslim women with immigrant background, living in Denmark and Sweden, we wanted to gain empirical insights that could inform a discussion about what 'low socioeconomic status' and 'religiousness' might mean with regard to women's reproductive decisions.

    Design: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016.

    Findings: We found that a low level of education and a low income were not necessarily obstacles for women's use of contraception; rather, these were strong imperatives for women to wait to have children until their life circumstances become more stable. Arguments grounded in Islamic dictates on contraception became powerful tools for women to substantiate how it is religiously appropriate to postpone having children, particularly when their financial and emotional resources were not yet established.

    Conclusion: We have shown that the dominant theory that 'low socioeconomic status' and 'religiousness' are paramount barriers to women's use of contraception must be problematized. When formulating suggestions for how to provide contraceptive counseling to women in ethnic and religious minority groups in Denmark and Sweden, one must also take into account that factors such as low financial security as well as religious convictions can be strong imperatives for women to use contraception.

    Implications for practice: This study can help inform a critical discussion about the difficulties of using broad group-categorizations for understanding individuals' health-related behavior, as well as the validity of targeted interventions towards large heterogeneous minority groups in Scandinavian contraceptive counseling.

    Keywords
    Muslim women, Immigrant women, Contraceptive use, Reproductive health, Denmark, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
    Identifiers
    urn:nbn:se:uu:diva-388751 (URN)10.1016/j.midw.2019.03.017 (DOI)000470962400011 ()31005014 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4576
    Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-09-05Bibliographically approved
    2. Modes of Governing: A Foucaultian Perspective on Encounters between Healthcare Providers and Muslim Women in Swedish Reproductive Healthcare
    Open this publication in new window or tab >>Modes of Governing: A Foucaultian Perspective on Encounters between Healthcare Providers and Muslim Women in Swedish Reproductive Healthcare
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    There are probably few groups of patients in Sweden today that arouse as much associations and thoughts as do Muslims from the Middle East. The core dilemma in much of these discussions is whether healthcare providers should adjust the provision of care to Muslims’ divergent religious preferences, or if they would be better off to treat Muslims in the same way as other patients. These debates are often entangled with both a concern about politics of equality (i.e. ambitions to treat everyone the same) and politics of diversity (i.e. to treatpeople from ethnic and religious minority groups differently). Inspired by Foucault’s concept of governmentality, we in this study intended to explore the principles of ‘equality’ and 'diversity’ as governing tools for the shaping of healthcare providers and patients’ conduct. We found that although these governing tools are presented as non-conflicting in health policies, there seems to be an often-present trade-off between diversity and equality ideals in their practical implementation. When these policies are assigned meaning and implemented inpractice, they appear to generate unforeseeable consequences, both for healthcare providers and for the patients. It thus appears that the policies that were introduced with the intention of improving the structure of multicultural care encounters, in some cases, had an opposite effect.

    Keywords
    Muslim, reproductive healthcare, diversity, equality, politics of recognition, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-392207 (URN)
    Available from: 2019-08-31 Created: 2019-08-31 Last updated: 2019-09-05Bibliographically approved
    3. Does Religious Counselling on Abortion Comply with Sweden’s ‘Women‑Friendly’ Abortion Policies?: A Qualitative Exploration Among Religious Counsellors
    Open this publication in new window or tab >>Does Religious Counselling on Abortion Comply with Sweden’s ‘Women‑Friendly’ Abortion Policies?: A Qualitative Exploration Among Religious Counsellors
    2019 (English)In: Sexuality & Culture, ISSN 1095-5143, E-ISSN 1936-4822, Vol. 23, no 4, p. 1230-1249Article in journal (Refereed) Published
    Abstract [en]

    The abortion discourse in Sweden is marked by historically liberal ideals about women’s inviolable right to make autonomous reproductive decisions. However, to respond to the increase in cultural and religious pluralism building up over several decades, religious organizations have been given opportunities to provide so-called spiritual care in affiliation with Swedish hospitals since the 1980s. In this study we asked: in what ways do religious counsellors, affiliated with Swedish hospitals, construct their ideas on abortion, and how well do their ideas comply with Sweden’s ‘women-friendly’ abortion policies? Through interviews with Protestant, Catho-lic, Muslim, and Buddhist religious counsellors, we wanted to empirically test the presumption underlying the decisions to grant space to religious actors in Swedish healthcare, i.e., that religious counselling serves to complement existing services. We found that it cannot be expected that religious advice on abortion will always comply with Swedish abortion law and with the women-friendly abortion policy that the Swedish state seeks to impose. When policy-makers open up possibilities for diverse norms on abortion to manifest in close affiliation with healthcare institutions, they must be aware that some religious counsellors argue that only God—and not the woman herself—can decide whether a woman can terminate a pregnancy. We argue that the findings in this study speaks to what researchers have referred to as the “diversity-equality paradox”, which highlights the tension between the promotion of religious ideas on abortion on the one hand and the promotion of liberal ideas about women’s reproductive freedom on the other.

    Keywords
    Abortion, Women’s rights, Religious counselling, Diversity promotion, The diversity–equality paradox, Healthcare, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Social Sciences Interdisciplinary
    Identifiers
    urn:nbn:se:uu:diva-389908 (URN)10.1007/s12119-019-09614-6 (DOI)000490290000011 ()
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2019-07-31 Created: 2019-07-31 Last updated: 2019-11-08Bibliographically approved
    4. Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling: A Discourse Analysis.
    Open this publication in new window or tab >>Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling: A Discourse Analysis.
    Show others...
    2017 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, no 10, p. 1518-1528Article in journal (Refereed) Published
    Abstract [en]

    In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers' ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women's possibilities to obtain adequate support. At the end of the article, we suggest how health care providers' reflexivity might be used as a working tool for increased awareness about the taken-for-granted cultural norms that exist in their clinical milieu.

    Keywords
    Sweden, contraceptive counseling, cultural diversity, discourse analysis, gender equality, qualitative method, reproductive health, women
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-327196 (URN)10.1177/1049732317697099 (DOI)000406057500007 ()28728532 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2017-08-07 Created: 2017-08-07 Last updated: 2019-08-31Bibliographically approved
  • 6.
    Bergman, Karolin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Eli, Karin
    Institute of Social and Cultural Anthropology, School of Anthropology and Museum Ethnography, 51/53 Banbury Road, Oxford, OX2 6PE.
    Persson Osowski, Christine
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Lövestam, Elin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Nowicka, Paulina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Public expressions of trust and distrust in governmental dietary advice in Sweden2019In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 29, no 8, p. 1161-1173Article in journal (Refereed)
    Abstract [en]

    We examine public trust and distrust in governmental food and nutrition authorities, through analyzing 727 letters sent electronically to the Swedish National Food Agency by lay people. Using thematic analysis, four themes were developed, defining public expressions of trust and distrust in official dietary advice. Trust was expressed as (a) seeking to confirm and clarify dietary advice, or (b) seeking official arbitration between competing dietary advice. Distrust was expressed as (c) questioning and scrutinizing dietary advice, or (d) protesting and resisting dietary advice. Notably, expressions of distrust employed discursive practices that both mirrored authoritative discourses and subverted official advice, by appealing to scientific language and 'alternative' evidence. All letters positioned the agency as the ultimate authority on healthy eating; notwithstanding whether the agency’s advice was to be followed or resisted. Thus, the letters revealed how the same authoritative discourses can simultaneously be a site of public trust and distrust.

  • 7.
    Bergström, Christel A.S.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
    Avdeef, Alex
    In ADME Res, 1732 First Ave,102, New York, NY 10128 USA.
    Perspectives in solubility measurement and interpretation2019In: ADMET AND DMPK, ISSN 1848-7718, Vol. 7, no 2, p. 88-105Article, review/survey (Refereed)
    Abstract [en]

    Several key topics in solubility measurement and interpretation are briefly summarized and illustrated with case studies drawing on published solubility determinations as a function of pH. Featured are examples of ionizable molecules that exhibit solubility-pH curve distortion from that predicted by the traditionally used Henderson-Hasselbalch equation and possible interpretations for these distortions are provided. The scope is not exhaustive; rather it is focused on detailed descriptions of a few cases. Topics discussed are limitations of kinetic solubility, 'brick-dust and grease-balls,' applications of simulated and human intestinal fluids, supersaturation and the relevance of pre-nucleation clusters and sub-micellar aggregates in the formation of solids, drug-buffer/excipient complexation, hydrotropic solubilization, acid-base 'supersolubilization,' cocrystal route to supersaturation, as well as data quality assessment and solubility prediction. The goal is to highlight principles of solution equilibria - graphically more than mathematically - that could invite better assay design, to result in improved quality of measurements, and to impart a deeper understanding of the underlying solution chemistry in suspensions of drug solids. The value of solid state characterizations is stressed but not covered explicitly in this mini-review.

  • 8.
    Christiansen, Mats
    Karolinska Institutet.
    Varför har vi fetischer?2017In: Medicinsk Vetenskap, ISSN 1104-3822, Vol. 24, no 2, p. 49-49Article in journal (Other (popular science, discussion, etc.))
  • 9.
    Clausson, Amalia
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
    Jansson, Patrik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
    Att vara eller att inte vara med i en idrottsföreing: - Faktorer som påverkar beslutet2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att ta reda på om ungdomar som valt ett liv inom föreningsidrotten på grund av inre eller yttre motivation och faktorer. Finns det skillnader mellan könen?  

    Vi kom fram till att det väldigt ofta var den inre motivationen som låg bakom påbörjandet eller upprätthållandet av medlemskapet i en idrottsförening. Av de personer som svarat att de valt att inte vara aktiva utövare i en idrottsförening visar det sig att drygt hälften inte är det på grund av yttre faktorer och många anser att aktiviteten är ”tråkig”. Ungdomar som är aktiva väljer att vara det för att det ”är kul” och de flesta påbörjade idrotten för att de ”ville prova på”.

    Vid en jämförelse av pojkar och flickor och upprätthållande i en föreningsidrott visade sig en skillnad där flickorna i något större andel drevs av inre motivation. När det gäller avslutande eller att inte påbörjat medlemskap visade sig yttre faktorer ha haft störst påverkan bland ungdomarna. 

  • 10.
    Danielsson, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sakarya, Aysegül
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Jansson-Fröjmark, Markus
    Department of Clinical Neuroscience, Karolinska Institute.
    The reduced Morningness–Eveningness Questionnaire: Psychometric properties and related factors in a young Swedish population2019In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 36, no 4, p. 530-540Article in journal (Refereed)
    Abstract [en]

    During puberty, there is a delay in sleep patterns and the circadian clock, and the prevalence of sleep difficulties is high among young adults. Thus, it is important to be able to measure chronotype (CT) in this group, both in the clinic and for broader epidemiological studies, to better understand the sleep difficulties observed. The reduced version of one of the most widely used questionnaire to measure CT, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), has been developed and validated in many languages. The aim of the present study was to investigate the reliability and validity of the Swedish reduced MEQ (rMEQ) and to investigate factors correlated with rMEQ scores in a random sample of young Swedish participants. We sent the rMEQ, sleep questions, demographic questions, the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, and the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) to 1000 randomly selected individuals aged 16–26 years in Uppsala, Sweden (response rate = 68%). A parallel analysis of the rMEQ revealed a single factor solution. Inter-item correlations within the questionnaire were between 0.08 and 0.46. One of the rMEQ items displayed weak correlations with the other questions. Cronbach’s alpha of the rMEQ was 0.68. Low rMEQ scores (eveningness) were correlated with more frequent late bedtimes and difficulties getting up in the morning. Lower rMEQ scores were significantly related to male sex, no educational activity or work, nicotine use, younger age, and higher ISI and HADS-D scores. Even though the inter-item correlations of the rMEQ were very low to moderate, the rMEQ had a Cronbach’s alpha not far off from acceptable levels, and the strong correlations of the rMEQ scores with responses to the sleep questions indicated that the rMEQ had an adequate validity. To conclude, the rMEQ can be used to effectively estimate CT when a short questionnaire is required; however, caution should be taken when interpreting the results considering the reliability of the questionnaire.

  • 11.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 12.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 13.
    Ekstrand-Hammarström, Barbro
    et al.
    FOI, Umeå.
    Akfur, Christine
    FOI, Umeå.
    Andersson, Per Ola
    FOI, UMEÅ.
    Lejon, Christian
    FOI, Umeå.
    Österlund, Lars
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Solid State Physics.
    Buch, Anders
    FOI, Umeå.
    Human Primary Bronchial Epithelial Cells are more Responsive to Titanium Dioxide Nanoparticles than the Lung Epithelial Cell Lines A549 and BEAS-2B2012In: Nanotoxicology, ISSN 1743-5390, E-ISSN 1743-5404, Vol. 6, no 6, p. 623-634Article in journal (Refereed)
    Abstract [en]

    We have compared the cellular uptake and responses of fivepreparations of nanocrystalline titanium dioxide (TiO2) betweennormal human bronchial epithelial (NHBE) cells and epithelialcell lines (A549 and BEAS-2B). The P25 nanoparticles, containingboth anatase and rutile modifications, induced reactive oxygenspecies (ROS) and secretion of the neutrophil chemoattractantIL-8 in all three cell types used. Pure anatase and rutile particlesprovoked differential IL-8 response in A549 and no response inBEAS-2B cells despite similar formation of ROS. The pure TiO2modifications also provoked release of the inflammatorymediators: IL-6, G-CSF and VEGF, in NHBE cells but not in the twocell lines. We conclude that the responsiveness of lung epithelialcells is strongly dependent on both the physicochemicalproperties of TiO2 nanoparticles and the type of responder cells.The differential pro-inflammatory responsiveness of primarylung epithelial cells compared with immortalized cell linesshould be considered in the assessment of adverse reactions toinhaled nanoparticles.

  • 14.
    Eldh, Ann Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Education, Health, and Social Studies, Dalarna University, SE.
    Fredriksson, Mio
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Halford, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Wallin, Lars
    School of Education, Health, and Social Studies, Dalarna University, SE.
    Dahlström, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Vengberg, Sofie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Facilitators and barriers to applying a national quality registry for quality improvement in stroke care2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 354-Article in journal (Refereed)
    Abstract [en]

    Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. Results: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. Conclusion: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

  • 15. Faggiano, Fabrizio
    et al.
    Allara, Elias
    Giannotta, Fabrizia
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Molinar, Roberta
    Sumnall, Harry
    Wiers, Reinout
    Michie, Susan
    Collins, Linda
    Conrod, Patricia
    Europe Needs a Central, Transparent, and Evidence-Based Approval Process for Behavioural Prevention Interventions2014In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 11, no 10, p. e1001740-Article in journal (Refereed)
  • 16.
    Fletcher, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    van Maren, Wendy
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Cordfunke, Robert
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Dinkelaar, Jasper
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Codee, Jeroen
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Marel, Gijs
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Melief, Cornelis
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Ossendorp, Ferry
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Drijfhout, Jan Wouter
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Mangsbo, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Formation ofimmune-complexes by a defined linear tetanus toxin-derived B cell epitope boosts human T cell responses to long peptides: ICs boost specific-T cellsManuscript (preprint) (Other academic)
    Abstract [en]

    Enhancing T cell responses against both viral and tumor antigens requires efficient co-stimulation and directed delivery of peptide antigens into APCs. As short peptides can lead to T cell tolerance and can only be used in a specific set of patients, long peptides are considered favourable vaccine moieties from a clinical perspective as they can harbor more than one immunogenic epitope enabling a broader target population. In addition, longer peptides are not bound unselectively to MHC class I on any cell, but rather require processing and will thereby be presented to T cells in secondary lymphoid organs. However, as peptides are not actively targeted to and taken up by APCs, and the standard non-conjugated adjuvant-peptide mixtures do not ensure co-targeting of the two to the same APC. We have identified a linear tetanus-toxin derived B cell epitope that can mediate the formation of immune-complexes by the presence of circulating antibodies. Herein, we show that these complexes, improve both antigen uptake by APCs (blood monocytes and CD1c+ DCs) and thereby CD8+ T cell recall responses in a human ex-vivo blood loop system. The uptake of the peptide conjugate by blood monocytes is dependent on antibodies and the complement component C1q.  The defined linear peptide steers the immune-complex formation to a monoclonal-like complex and as a consequence we show that the number of linear tetanus sequences per T cell epitope determines the outcome of the response. We envision that this strategy can be used to facilitate active uptake of antigens into antigen-presenting cells to improve T cell responses against pathogens or cancer.

  • 17.
    Forinder, Ulla
    et al.
    Socialhögskolan, Stockholms universitet.
    Lindahl Norberg, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care. Karolinska Institutet.
    Posttraumatic growth and support among parents whose children have survived stem cell transplantation2014In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 18, no 4, p. 326-335Article in journal (Refereed)
    Abstract [en]

    In the current study, we investigated the occurrence of posttraumatic growth (PTG) among parents whose children had had stem cell transplantation (SCT) and survived. Although SCT is well established, it remains stressful and dangerous, and SCT is only performed if there is no other choice of treatment to be considered. A questionnaire batteries including the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian version and the Post-Traumatic Growth Inventory were sent out to a cross-sectional national sample of parents of children who had had SCT six months or more before the study. The response rate was 66% (n = 281). The data were analyzed in relation to parents' appraisal of the event, gender, and perceived social support. The results confirm that SCT in childhood is an event of extreme adversity for the parents. Indications of PTSD were found among an important minority of the parents. Nevertheless, a large proportion of the parents had experienced growth as a consequence of the child's illness. Appreciation of life and personal strength were the domains with the highest scores. Moreover, a higher level of PTG was correlated with a higher level of posttraumatic stress and with an experience of the trauma as more severe. In summary, the study indicates that PTG is a relevant concept for this group of parents.

  • 18.
    Fransson, Emma
    et al.
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hjern, Anders
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden.;Karolinska Inst, Karolinska Univ Hosp, Dept Med, Clin Epidemiol, S-17176 Stockholm, Sweden..
    Bergstrom, Malin
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Why should they live more with one of us when they are children to us both?: Parents' motives for practicing equal joint physical custody for children aged 0-42016In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 66, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Joint physical custody, i.e., children spending an equal amount of time in both parents' home after a separation or divorce, is increasing in many countries. In line with the national policy to promote paternal involvement in parenting, two-thirds of Swedish preschoolers with non-cohabiting parents live in two homes. Internationally, there has been a debate regarding the benefits or risks with joint physical custody for infants and toddlers. The aim of this qualitative study was to explore the reasons given by divorced parents for sharing joint physical custody of children 0-4 years of age. Interviews were conducted with 46 parents (18 fathers and 28 mothers) and analyzed using systematic text condensation. Two themes emerged in response to the research question. In the theme Same rights and responsibilities, parents described that joint physical custody was 'a given' as both parents were seen to have equal rights to and responsibility for the children. Both men and women described involved fatherhood as an ideal goal. In the theme For the sake of the child, parents emphasized that joint physical custody was in the best interest of the child. Some parents had conflicts with their ex-spouses, but were still convinced of the benefits of joint physical custody and strove to make it work.

  • 19.
    Frigell, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Förlossningsrädsla under graviditet: Betydande bakgrundsfaktorer- Förekomst- Önskemål om förlossningssätt- Kvinnors kontakt med klinik för förlossningsrädda2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka förekomst av gravida kvinnors upplevelse av förlossningsrädsla i relation till deras sociodemografiska, psykiatriska och obstetriska bakgrund samt önskat förlossningssätt. Metod. Förstföderskor och omföderskor som skrevs in på barnmorskemottagning tillfrågades om deltagande i studien och fick besvara två frågeformulär under graviditeten. Resultat. Totalt 776 kvinnor svarade på båda frågeformulären och svarsfrekvensen för de flesta frågor som användes till studien var över 92 %. I tidig graviditet upplevdes förlossningsrädsla av 12 % av kvinnorna i studien och av 15,5 % i sen graviditet. Nästan hälften av de med tidig upplevelse av förlossningsrädsla upplevde i slutet på graviditeten ingen eller liten rädsla. Upplevd förlossningsrädsla var vanligare bland kvinnor som tidigare varit gravida, omföderskor med erfarenhet av kejsarsnitt, kvinnor födda utanför Sverige och kvinnor som tidigare haft kontakt med psykiater och kurator. Kvinnor med upplevd förlossningsrädsla var mer benägna att önska kejsarsnitt än de som upplevde ingen eller liten rädsla. Av kvinnor med upplevd förlossningsrädsla hade omkring en fjärdedel under graviditeten varit i kontakt med Klaramottagningen, en mottagning med specialisering på förlossningsrädsla och en femtedel av dessa kvinnor rapporterade mot slutet av graviditeten ingen eller liten rädsla. Kontakt med Klaramottagningen hade även kvinnor som i tidig graviditet rapporterade ingen eller liten rädsla. Av dessa kvinnor rapporterade 45,8 % att de upplevde förlossningsrädsla i slutet på graviditeten. Konklusion. Former för hur identifiering, fördelning av vårdens resurser och utformning av stödet till gravida kvinnor och framförallt till de med upplevd förlossningsrädsla bäst sker kan utvecklas ytterligare.

  • 20.
    Grunér, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Effekten av talsyntesstöd på textförståelse och läshastighet hos personer med lässvårigheter2016Independent thesis Advanced level (degree of Master (Two Years)), 30 credits / 45 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka om ett modernt talsyntesprogram (TorTalk) hade en kompensatorisk effekt på textförståelse och läshastighet hos 63 svensktalande skolbarn och vuxna (i åldrarna 8 till 26 år) med lässvårigheter. I denna randomiserade studie användes en cross-over design i två faser för att jämföra två typer av textpresentation (datorstödd kontra högläsning). I Fas 1 lyssnade deltagarna antingen på en text med talsyntes samtidigt som de följde med i texten via en markering på datorskärmen (datorstödd textpresentation), eller läste texten högt för sig själva (högläsning). I Fas 2 byttes betingelserna så att även en inomgruppsanalys kunde göras. De statistiska analyserna visade att användning av talsyntesprogrammet hade en signifikant effekt på både textförståelse och läshastighet. Den största effekten sågs gällande läshastigheten där deltagarna som använde programmet höjde sin läshastighet betydligt. I inomgruppsanalysen delades deltagarna in i grupper om yngre deltagare (skolår 3 till 5) och äldre deltagare (skolår 6 till vuxen ålder). Analysen avseende de yngre deltagarna visade på en signifikant effekt av talsyntesprogrammet på både textförståelse och läshastighet medan analysen avseende de äldre deltagarna endast visade på en signifikant effekt gällande läshastighet. En explorativ analys genomfördes även avseende de individuella prestationerna. Denna visade att alla deltagare antingen höjde sin prestation avseende läshastighet eller textförståelse med hjälp talsyntesprogrammet, eller båda delarna. Vissa deltagare höjde dock sin läshastighet mot att textförståelsen sänktes, vilket inte var önskvärt. Potentiella orsaker till detta diskuteras. Dessa resultat kan ha en stor betydelse för personer med lässvårigheter då resultaten starkt indikerar att man med hjälp av ett talsyntesprogram ofta kan minska hindret som lässvårigheter medför i skolgång, vardag eller arbetsliv.

  • 21.
    Guo, Cheng
    et al.
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden..
    Tomson, Goran
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden.;Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Guo, Jizhi
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Li, Xiangyun
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Keller, Christina
    Jonkoping Univ, Int Business Sch, Jonkoping, Sweden..
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Psychometric evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Chinese adolescents - a methodological study2015In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 13, article id 198Article in journal (Refereed)
    Abstract [en]

    Background: In epidemiological surveillance of mental health there is good reason to also include scales that measure the presence of well-being rather than merely symptoms of ill health. The Mental Health Continuum-Short Form (MHC-SF) is a self-reported scale to measure emotional, psychological and social well-being and conduct categorical diagnosis of positive mental health. This particular instrument includes the three core components of the World Health Organization's definition of mental health and had previously not been psychometrically evaluated on adolescents in China. Methods: In total 5,399 students (51.1 % female) from schools in the urban areas of Weifang in China were included in the study (mean age = 15.13, SD = 1.56). Participants completed a comprehensive questionnaire with several scales, among them the MHC-SF. Statistical analyses to evaluate reliability, structural validity, measurement invariance, presence of floor and ceiling effects and to some extent external validity of the MHC-SF were carried out. Results: The Cronbach's a coefficients for sub-scales as well as the total scale were all above 0.80 indicating good reliability. Confirmative factor analysis confirmed the three-dimensional structure of the Chinese version of MHC-SF and supported the configural and metric invariance across gender and age. Noteworthy ceiling effects were observed for single items and sub-scales although not for the total scale. More importantly, observed floor effects were negligible. The stronger correlation found between MHC-SF and Minneapolis-Manchester Quality of Life Instrument (as measure of positive mental health) than between MHC-SF and Hospital Anxiety Depression Scale (as measure of mental illness and distress) yielded support for external validity. Conclusion: In conclusion, the main findings of this study are in line with studies from other countries that evaluated the psychometric properties of the MHC-SF and show that this instrument, that includes the three core components of the WHO definition of mental health, is useful in assessing positive adolescent mental health also in China.

  • 22. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Department of Oncology, University Hospital, Örebro, Sweden.
    Hansson Mild, Kjell
    Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone use2013In: International Journal of Oncology, ISSN 1019-6439, Vol. 43, no 6, p. 1833-1845Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown a consistent association between long-term use of mobile and cordless phones and glioma and acoustic neuroma, but not for meningioma. When used these phones emit radiofrequency electromagnetic fields (RF-EMFs) and the brain is the main target organ for the handheld phone. The International Agency for Research on Cancer (IARC) classified in May, 2011 RF-EMF as a group 2B, i.e. a 'possible' human carcinogen. The aim of this study was to further explore the relationship between especially long-term (>10 years) use of wireless phones and the development of malignant brain tumours. We conducted a new case-control study of brain tumour cases of both genders aged 18-75 years and diagnosed during 2007-2009. One population-based control matched on gender and age (within 5 years) was used to each case. Here, we report on malignant cases including all available controls. Exposures on e.g. use of mobile phones and cordless phones were assessed by a self-administered questionnaire. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index using the whole control sample. Of the cases with a malignant brain tumour, 87% (n=593) participated, and 85% (n=1,368) of controls in the whole study answered the questionnaire. The odds ratio (OR) for mobile phone use of the analogue type was 1.8, 95% confidence interval (CI)=1.04‑3.3, increasing with >25 years of latency (time since first exposure) to an OR=3.3, 95% CI=1.6-6.9. Digital 2G mobile phone use rendered an OR=1.6, 95% CI=0.996-2.7, increasing with latency >15-20 years to an OR=2.1, 95% CI=1.2-3.6. The results for cordless phone use were OR=1.7, 95% CI=1.1-2.9, and, for latency of 15-20 years, the OR=2.1, 95% CI=1.2-3.8. Few participants had used a cordless phone for >20-25 years. Digital type of wireless phones (2G and 3G mobile phones, cordless phones) gave increased risk with latency >1-5 years, then a lower risk in the following latency groups, but again increasing risk with latency >15-20 years. Ipsilateral use resulted in a higher risk than contralateral mobile and cordless phone use. Higher ORs were calculated for tumours in the temporal and overlapping lobes. Using the meningioma cases in the same study as reference entity gave somewhat higher ORs indicating that the results were unlikely to be explained by recall or observational bias. This study confirmed previous results of an association between mobile and cordless phone use and malignant brain tumours. These findings provide support for the hypothesis that RF-EMFs play a role both in the initiation and promotion stages of carcinogenesis.

  • 23. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Department of Oncology, University Hospital, Örebro.
    Hansson Mild, Kjell
    Pooled analysis of case-control studies on acoustic neuroma diagnosed 1997-2003 and 2007-2009 and use of mobile and cordless phones2013In: International Journal of Oncology, ISSN 1019-6439, Vol. 43, no 4, p. 1036-1044Article in journal (Refereed)
    Abstract [en]

    We previously conducted a case-control study of acoustic neuroma. Subjects of both genders aged 20-80 years, diagnosed during 1997-2003 in parts of Sweden, were included, and the results were published. We have since made a further study for the time period 2007-2009 including both men and women aged 18-75 years selected from throughout the country. These new results for acoustic neuroma have not been published to date. Similar methods were used for both study periods. In each, one population-based control, matched on gender and age (within five years), was identified from the Swedish Population Registry. Exposures were assessed by a self-administered questionnaire supplemented by a phone interview. Since the number of acoustic neuroma cases in the new study was low we now present pooled results from both study periods based on 316 participating cases and 3,530 controls. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index (SEI). Use of mobile phones of the analogue type gave odds ratio (OR) = 2.9, 95% confidence interval (CI) = 2.0-4.3, increasing with >20 years latency (time since first exposure) to OR = 7.7, 95% CI = 2.8-21. Digital 2G mobile phone use gave OR = 1.5, 95% CI = 1.1-2.1, increasing with latency >15 years to an OR = 1.8, 95% CI = 0.8-4.2. The results for cordless phone use were OR = 1.5, 95% CI = 1.1-2.1, and, for latency of >20 years, OR = 6.5, 95% CI = 1.7-26. Digital type wireless phones (2G and 3G mobile phones and cordless phones) gave OR = 1.5, 95% CI = 1.1-2.0 increasing to OR = 8.1, 95% CI = 2.0-32 with latency >20 years. For total wireless phone use, the highest risk was calculated for the longest latency time >20 years: OR = 4.4, 95% CI = 2.2-9.0. Several of the calculations in the long latency category were based on low numbers of exposed cases. Ipsilateral use resulted in a higher risk than contralateral for both mobile and cordless phones. OR increased per 100 h cumulative use and per year of latency for mobile phones and cordless phones, though the increase was not statistically significant for cordless phones. The percentage tumour volume increased per year of latency and per 100 h of cumulative use, statistically significant for analogue phones. This study confirmed previous results demonstrating an association between mobile and cordless phone use and acoustic neuroma.

  • 24.
    Jalmsell, Li
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Kontio, Taru
    Stein, Maria
    Henter, Jan-Inge
    Kreicbergs, Ulrika
    On the child's own initiative: parents communicate with their dying child about death2015In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683, Vol. 39, no 2, p. 111-117Article in journal (Refereed)
    Abstract [en]

    Open and honest communication has been identified as an important factor in providing good palliative care. However, there is no easy solution to if, when, and how parents and a dying child should communicate about death. This article reports how bereaved parents communicated about deathwith their child, dying from a malignancy. Communication was often initiated by the child and included communication through narratives such as fairy tales and movies and talking more directly about death itself. Parents also reported that their child prepared for death by giving instructions about his or her grave or funeral and giving away toys.

  • 25.
    Johansson, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
    Cancerpatienten i primärvården2013In: Rehabilitering vid cancersjukdom: Att möta framtiden / [ed] Maria Hellbom & Bibbi Thomé, Stockholm: Natur och kultur, 2013, 1, p. 57-66Chapter in book (Other (popular science, discussion, etc.))
  • 26.
    Johansson, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
    Thalén-Lindström, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Oncology.
    Bedömning av rehabiliteringsbehov2013In: Rehabilitering vid cancersjukdom: att möta framtiden / [ed] Maria Hellbom & Bibbi Thomé, Stockholm: Natur och kultur, 2013, 1, p. 38-56Chapter in book (Other (popular science, discussion, etc.))
  • 27.
    Jonsson, Jessica
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Carlsson, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Arbetsrelaterad stress hos röntgensjuksköterskor: En intervjustudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Healthcare professionals are often the subject to occupational stress, the professional radiographer is no exception. Occupational stress has been seen as a predictor to burn outs amongst radiographer and may jeopardise the patients’ safety during radiologic examinations.  Purpose: The purpose of this study is to find out more about how radiographers in Uppsala County perceive stress in their workplace, the study aims to find out which factors affect occupational stress and how it expresses itself physically and mentally to the radiographer.  Method: The study was done through a qualitative method in the form of interviews with staff at x-ray departments at different hospitals.  Results: All of the informants felt some kind of occupational stress from time to time, some very rarely and others more frequent. The most common factors for stress that emerged from this study were staff shortage, and a high workflow, as well as high patient flow for radiological examinations. There were varied symptoms that appeared; mild symptoms such as sweating and more serious symptoms such as fatigue, anxiety and trouble sleeping.  Conclusion: The occupational stress of radiographers affects the radiographer both physically and mentally, and also patient safety and the quality of the examinations. One can clearly see that the amount of patients in relation to the sparse staff density creates an excessively high workload that leads to stress. This means that the radiographer finds it difficult to maintain the care they would like, in terms of time and quality.

  • 28.
    Kallström, A.P.
    et al.
    Swedish Institute for Infectious Disease Control, Sweden..
    Björkman, Ingeborg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Stålsby Lundborg, Cecilia
    Division of Global Health, IHCAR Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden..
    The 'sterile' doctor: doctors' perceptions of infection control in hospitals in Sweden2011In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 79, no 2, p. 187-188Article in journal (Refereed)
  • 29.
    Kerstis, Birgitta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Berglund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Engström, Gabriella
    5Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA.
    Edlund, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Sylven, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Aarts, Clara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Depressive symptoms postpartum among parents are associated with marital separation: A Swedish cohort study2014In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 42, no 7, p. 660-668Article in journal (Refereed)
    Abstract [en]

    Aims: To study whether there is an association between dyadic consensus, depressive symptoms, and parental stress during early parenthood and marital separation 6–8 years after childbirth, among couples in Sweden.

    Methods: At baseline, 393 couples were included. The couples answered three questionnaires, including: Dyadic consensus at 1 week post-partum, depressive symptoms at 3 months post-partum and parental stress at 18 months post-partum. The parents’ addresses were followed up after 6–8 years, to study the marital separation rate.

    Results: We found, 6–8 years after childbirth, that 20% of study couples were separated. Separation was associated with less dyadic consensus (mothers p < 0.001; fathers p < 0.001), depressive symptoms (mothers p = 0.022; fathers p = 0.041) and parental stress (mothers p = 0.002; fathers p = 0.040). The hazard ratio (HR) for marital separation was related to dyadic consensus for fathers (HR 0.51; 95% CI 0.28–0.92), depressive symptoms for mothers (HR 1.69; 95% CI 1.01–2.84) and fathers (HR 1.92; 95% CI 1.12–3.28), and the mother’s parental stress (HR 2.16; 95% CI 1.14–4.07).

    Conclusions: Understanding how dyadic consensus, depressive symptoms and parental stress are associated with marital separation is important for health professionals. It could be useful in developing interventions to provide parents with adequate support during pregnancy and early parenthood. This knowledge is also important for the public. Parents should get support in pregnancy and while bringing up children, which may help prevent marital separation and optimize conditions for the children.

  • 30.
    Khan, Arshad
    et al.
    Southeast Univ, Natl Demonstrat Ctr Expt Biomed Engn Educ, State Key Lab Bioelect, Nanjing, Jiangsu, Peoples R China.
    Liu, Mei
    Southeast Univ, Natl Demonstrat Ctr Expt Biomed Engn Educ, State Key Lab Bioelect, Nanjing, Jiangsu, Peoples R China.
    Usman, Rabia
    Southeast Univ, Natl Demonstrat Ctr Expt Biomed Engn Educ, State Key Lab Bioelect, Nanjing, Jiangsu, Peoples R China.
    He, Nongyue
    Southeast Univ, Natl Demonstrat Ctr Expt Biomed Engn Educ, State Key Lab Bioelect, Nanjing, Jiangsu, Peoples R China; Hunan Univ Technol, Hunan Key Lab Biomed Nanomat & Devices, Econ Forest Cultivat & Utilizat Collaborat Innova, Zhuzhou, Peoples R China.
    Li, Rongrong
    Taizhou Univ, Sch Pharmaceut Chem & Mat Engn, Taizhou, Zhejiang, Peoples R China.
    Sayed, Sayed Mir
    Southeast Univ, Natl Demonstrat Ctr Expt Biomed Engn Educ, State Key Lab Bioelect, Nanjing, Jiangsu, Peoples R China.
    Li, Shaohan
    Southeast Univ, Sch Mat Sci & Engn, Jiangsu Key Lab Adv Metall Mat, Nanjing, Jiangsu, Peoples R China.
    Sun, Weiwei
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy, Materials Theory. KTH Royal Inst Technol, Dept Mat Sci & Engn, Stockholm, Sweden.
    Chen, Hui
    Hunan Univ Technol, Hunan Key Lab Biomed Nanomat & Devices, Econ Forest Cultivat & Utilizat Collaborat Innova, Zhuzhou, Peoples R China.
    Zhang, Lubing
    Taizhou Univ, Sch Pharmaceut Chem & Mat Engn, Taizhou, Zhejiang, Peoples R China.
    Qiu, Leyi
    Taizhou Univ, Sch Pharmaceut Chem & Mat Engn, Taizhou, Zhejiang, Peoples R China.
    Tang, Tian
    Taizhou Univ, Sch Pharmaceut Chem & Mat Engn, Taizhou, Zhejiang, Peoples R China.
    Solid emission color tuning of organic charge transfer cocrystals based on planar π-conjugated donors and TCNB2019In: Journal of Solid State Chemistry, ISSN 0022-4596, E-ISSN 1095-726X, Vol. 272, p. 96-101Article in journal (Refereed)
    Abstract [en]

    Two luminescent Charge Transfer (CT) cocrystals involving planar phenanthrene derivatives namely, formyl phenanthrene (FP) and acetyl phenanthrene (AP) as donors (D) and 1,2,4,5-tetracyanobenzene (TCNB) as an acceptor (A) building block, are formed by molecular self-assembly. Detailed structural and spectroscopic measurements elucidated the mixed stack sequence DADAD in the CT cocrystals. The solid supramolecular architecture for both the cocrystals forms 2D sheet, supported by the extended network of C-H center dot center dot center dot O, and C-H center dot center dot center dot N hydrogen bonds as evidenced by the crystallographic observation. Interestingly, the two cocrystals display tunable emissions compared to the blue emissions of donor compounds, which correlate with the formation of excited CT state between the donor and acceptor motifs as a result of mixed stack orientation. The nature of the CT interactions in the two cocrystals was further explored by applying density functional theoretical (DFT) studies. Such a supramolecular cocrystal approach provides a facile platform towards the design of new luminescent two component CT complexes with desired functionalities.

  • 31.
    Khoddam, Homeira
    et al.
    Iran University of Medical Sciences, Iran.
    Mehrdad, Neda
    Tehran University of Medical Sciences, Iran.
    Peyrovi, Hamid
    Iran University of Medical Sciences, Iran.
    Kitson, Alison
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Schultz, Timothy
    School of Nursing, Faculty of Health Sciences, the University of Adelaide, Australia.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    Knowledge translation in health care: a concept analysis2014In: Medical Journal of the Islamic Republic of Iran, ISSN 1016-1430, E-ISSN 2251-6840, Vol. 28, article id 98Article in journal (Refereed)
    Abstract [en]

    Background:

    Although knowledge translation is one of the most widely used concepts in health and medicalliterature, there is a sense of ambiguity and confusion over its definition. The aim of this paper is to clarify thecharacteristics of KT. This will assist the theoretical development of it and shape its implementation into thehealth care system

    Methods:

    Walker and Avant’s framework was used to analyze the concept and the related literature publishedbetween 2000 and 2010 was reviewed. A total of 112 papers were analyzed.

    Results:

    Review of the literature showed that "KT is a process" and "implementing refined knowledge into aparticipatory context through a set of challenging activities" are the characteristics of KT. Moreover, to occursuccessfully, KT needssome necessary antecedents like an integrated source of knowledge, a receptive context,and preparedness. The main consequence of successful process is a change in four fields of healthcare, i.e. quali-ty of patient care, professional practice, health system, and community. In addition, this study revealed someempirical referents which are helpful to evaluate the process.

    Conclusion:

    By aiming to portray a clear picture of KT, we highlighted its attributes, antecedents, conse-quences and empiricalreferents. Identifying the characteristics of this concept may resolve the existing ambigui-ties in its definition and boundaries thereby facilitate distinction from similar concepts. In addition, these find-ings can be used as a knowledge infrastructure fordeveloping the KT-related models, theories, or tools.

  • 32.
    Lagerberg, Dagmar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
    Barnets bästa – absolut och relativt: Funderingar kring ett aktuellt exempel (assisterad befruktning)2014In: Barnrätt: En antologi / [ed] Cederborg Ann-Christin & Warnling-Nerep Wiweka, Stockholm: Norstedts Juridik AB, 2014, 1, p. 238-256Chapter in book (Other (popular science, discussion, etc.))
  • 33. Landén Ludvigsson, Maria
    et al.
    Peterson, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Jull, Gwendolen
    Trygg, Johan
    Peolsson, Anneli
    Mechanical properties of the trapezius during scapular elevation in people with chronic whiplash associated disorders: A case-control ultrasound speckle tracking analysis2016In: Manual Therapy, ISSN 1356-689X, E-ISSN 1532-2769, Vol. 21, p. 177-182Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Approximately 50% of people with Whiplash Associated Disorders (WAD) report longstanding symptoms. The upper trapezius is commonly painful yet its mechanical properties are not fully understood.

    OBJECTIVES:

    This study examined the deformation of different depths of the upper trapezius muscle during a scapular elevation task (shoulder shrugging) before and following loaded arm abduction.

    DESIGN AND METHODS:

    A cross-sectional case-control study of 36 people (26 female and 10 male, mean age 38 (SD 11)) with chronic WAD and 36 controls, matched for age and gender. Real-time ultrasound recordings of upper trapezius were taken during both scapular elevation tasks. Post-process speckle tracking analysis was undertaken of three different sections of the upper trapezius muscle (superficial, middle, deep).

    RESULTS:

    The WAD group had lower deformation of the superficial section of the upper trapezius compared to the control group in both concentric and eccentric phases of scapular elevation (p < 0.05) especially before the loaded arm abduction. After arm abduction, the deformation of the trapezius was reduced in both groups but only significantly in the WAD-group (p = 0.03). Within-group analysis revealed that the control group least engaged the deep section of upper trapezius during the task (p < 0.01).

    CONCLUSION:

    This study, measuring mechanical deformation of the upper trapezius during a scapular elevation task indicates that persons with WAD may display different patterns in engagement of the muscle sections than those in the control group. Further research is needed to replicate and understand the reasons for and implications of this possible change in motor strategy within upper trapezius. Clinical Trials.gov, Number: NCT01547624.

  • 34.
    Langesten, Karin
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Dyskalkyli: Resultat på Dyscalculia Screener för svenska barn utredda för läs- och skrivsvårigheter2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Children who are assessed for reading and writing difficulties (dyslexia, diagnosis F81.0 according to The National Social Welfare Board classification ICD. 10) sometimes even have problems with counting which are characteristic of the diagnosis dyscalculia (F81.2). When both types of difficulties exist, the diagnosis mixed disorder of scholastic skills (F81.3) should be given. The need for methods to screen mathematical ability is large. Aim: To study how children with dyslexia compared to children with mixed disorder of scholastic skills perform on the Dyscalculia Screening Test (DS) ( Butterworth 2003), to compare the result using both Swedish and English norms and using teachers´ evaluations of how the children reach the schools' goals in mathematics. Method: Children (N=45) who are assessed for reading and writing difficulties by the speech and language therapy department. The DS-test and a formula filled in by the teacher showing how well the children attained the goals in mathematics prior to the assessment. Result: Children with dyslexia attained normal results on the subtests of the DS testing quantity and number sense which is considered sensitive to dyscalculia and low results on the subtests for counting ability (addition, multiplication). They attained significantly lower results than the Swedish norms (Sahlberg and Taavola 2011) on the same subtests in the DS. Children with mixed disorder of scholastic skills (F811.3) attained generally lower results in all the subtests of the DS. According to the teachers´ evaluation, the participants with dyslexia (F81.3) had most difficulty with worded problem-solving and multiplication whilst the participants with mixed disorder of scholastic skills had difficulty in all the given goals in mathematics. Conclusion: The Dyscalculia Screening Test can be a useful component in the assessment of reading and writing difficulties in order to differentiate the diagnosis dyslexia (F81.0) from mixed disorder of scholastic skills.

  • 35.
    Lejonklou, Fredrik
    et al.
    Hälsa och habilitering, Landstinget Uppsala län.
    Pless, Mia
    Hälsa och habilitering, Landstinget Uppsala län.
    Vardagsförmågor hos barn med måttlig synnedsättning: Funktionella färdigheter, hjälpbehov och föräldrars uppfattning om barnens motorik2011Report (Other academic)
  • 36.
    Lindahl Norberg, Annika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care. Karolinska Institutet.
    Mellgren, Karin
    Winiarski, Jacek
    Forinder, Ulla
    Relationship between problems related to child late effects and parent burnout after pediatric hematopoietic stem cell transplantation2014In: Pediatric Transplantation, ISSN 1397-3142, E-ISSN 1399-3046, Vol. 18, no 3, p. 302-309Article in journal (Refereed)
    Abstract [en]

    A few studies have indicated that parents' reactions to a child's serious disease may entail long-term stress for the parents. However, further knowledge of its consequences is valuable. The aim of the study was to investigate the occurrence of burnout in a Swedish national sample of parents of children who had undergone HSCT and survived. Burnout (Shirom-Melamed Burnout Questionnaire) and estimations of the child's health status (Lansky/Karnofsky estimations and study-specific questions) were self-reported by 159 mothers and 123 fathers. In addition, physicians made estimations of the child's health status (Lansky/Karnofsky estimations). Nonparametric tests revealed that burnout symptoms occurred more often among fathers of children who had undergone transplantation within the last five yr compared to fathers of children with no history of serious disease (34.4% vs. 19.9%). Burnout among mothers and fathers was associated with the child's number and severity of health impairments up to five yr after the child underwent HSCT (Spearman's rho for mothers 0.26-0.36 and for fathers 0.36-0.61). In conclusion, chronic stress in parents after a child's HSCT seems to abate eventually. However, parents should be monitored and offered adequate support when needed. Moreover, the situation of fathers in the often mother-dominated pediatric setting should receive more attention in research as well as in the clinic.

  • 37. Lindbäck, Camilla
    et al.
    Nordgren, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD). Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Mälardalens högskola.
    To be on sick-leave due to heart failure: a qualitative perspective2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 18-19, p. 1732-1738Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of the present study was to explore and describe meanings of being on sick leave due to heart failure.

    Methods: The study was conducted in Sweden during 2011-2012. Five men and one woman, aged 46 to 62, were interviewed. A reflective life-world research approach based on phenomenological philosophy was used. The result of the analysis is presented in three themes.

    Results: To be on sick leave due to heart failure implies a life situation characterized by anxiety, insecurity and uncertainty. When rehabilitation professionals do not take on their professional responsibility, sick listed people with heart failure perceive they are dismissed and abandoned. If rehabilitation professionals take on their professional responsibility it can be experienced as supportive.

    Conclusions: People who are on sick leave due to heart failure are abandoned by rehabilitation professionals and they lack opportunities to participate in their own sick leave/rehabilitation processes. Rehabilitation professionals need to take more responsibility and allow the patients to participate by connecting and recognizing patients as equal human beings. The present results can be used by rehabilitation professionals to reflect on and discuss the needs of people on sick leave due to heart failure. Implications for Rehabilitation Heart failure is a chronic condition implying a complicated life-situation. People with heart failure experience abandonment by rehabilitation professionals and lack participation in their own rehabilitation process. In order to support people on sick leave due to heart failure collaboration and coordination between rehabilitation professionals are needed.

  • 38.
    Lutz, Peter A.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of Cultural Anthropology and Ethnology.
    CareMoves [Final Report]: Conceptual approach for new routes in eHealth: Movement practices of elderly care2012Report (Other academic)
    Abstract [en]

    CareMoves confirms the importance of mobility and other forms of movement for proper care but also seniors’ own sense of independence. It has also investigated the frictions of movement and ways that care workers and elderly try to overcome these challenges. The conceptual framework developed in the project is based on these findings. The framework situates the concept of care as networked movement practices that enroll humans, domestic environments and their technologies. This conceptual framework of care as a networked or distributed phenomenon is an alternative to the conventional distinction of formal and informal care. This approach is expected to have potential impact for the design and development of new healthcare IT as well as future ethnographic studies of elderly care. 

  • 39.
    Matar, Amal
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Hansson, Mats G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    Höglund, Anna T.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    "A perfect society": Swedish policymakers' ethical and social views on preconception expanded carrier screening2019In: Journal of Community Genetics, ISSN 1868-310X, E-ISSN 1868-6001, Vol. 10, no 2, p. 267-280Article in journal (Refereed)
    Abstract [en]

    To improve healthcare policymaking, commentators have recommended the use of evidence, health technology assessment, priority setting, and public engagement in the process of policymaking. Preconception expanded carrier screening, according to the World Health Organization’s definition, is a novel health technology and therefore warrants assessment, part of which involves evaluating ethical and social implications. We examined ten Swedish policymakers’ perspectives on ethical and social aspects of preconception expanded screening through in-depth expert interviewing, using a semi-structured questionnaire. Respondents were affiliated to governmental and non-governmental institutions that directly influence healthcare policymaking in Sweden. The interviews were recorded, transcribed verbatim, and analyzed via inductive thematic analysis method, which generated seven themes and several subthemes. Policymakers harbored concerns regarding the economics, Swedish and international political respects, implementation procedures, and societal effects, which included long-term ones. Moreover, participants detailed the role of public engagement, research, and responsibility in regard to preconception expanded carrier screening implementation. Since this is a qualitative study, with a small non-random sample, the results may not be generalizable to all policymakers in Sweden. However, the results give a profound insight into the process and interpretative knowledge of experts, in the Swedish milieu and the extent of readiness of Sweden to implement a preconception expanded carrier screening program.

  • 40.
    Mohammadi, Soheila
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Carlbom, Aje
    Taheripanah, Robabeh
    Essén, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    ‘Who cares for Afghanis?’ Care Experiences of Migrant Mothers Surviving Near-Miss Morbidity in IranManuscript (preprint) (Other academic)
  • 41.
    Nakeva von Mentzer, Cecilia
    Linköpings universitet, Handikappvetenskap.
    Rethinking Sound: Computer-assisted reading intervention with a phonics approach for deaf and hard of hearing children using cochlear implants or hearing aids2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the present thesis, computer-assisted reading intervention with a phonics approach was examined in deaf and hard of hearing children (DHH) aged 5, 6 or 7 years old using cochlear implants, hearing aids or a combination of both. Children with normal hearing (NH), matched for non-verbal intelligence and age, served as a reference group. Deaf and hard of hearing children constitute a heterogenetic population regarding cognitive and academic achievement. Many of them do not reach age appropriate levels in language and reading ability during their school years, with negative consequences for later training facilities and job opportunities. Finding relevant intervention methods to promote early language learning and literacy development that are easy to implement is therefore of great importance. In this thesis three aspects of cognitive ability (phonological processing skills, lexical access and working memory capacity), and reading ability was examined at three points in time; baseline 1, pre intervention and post intervention. Additionally, computer-assisted training delivered by  means of the Internet in the children’s homes was explored in order to determine whether it would be a useful and efficient method for the DHH population. Overall, the results from the present thesis support the notion that offering a computer-assisted intervention program delivered at home, is an alternative way to support not only NH children with reading difficulties but also to support DHH children’s phonological development and decoding proficiency.

  • 42.
    Nakeva von Mentzer, Cecilia
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lyxell, Björn
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Sahlén, Birgitta
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Dahlström, Örjan
    Linköpings universitet, Handikappvetenskap.
    Lindgren, Magnus
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Ors, Marianne
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Kallioinen, Petter
    Department of Linguistics, Stockholm University.
    Engström, Elisabet
    Karolinska Institutet (CLINTEC), Dept of Audiology and Neurootology, Karolinska University Hospital.
    Uhlén, Inger
    Karolinska University Hospital and Karolinska Institutet, Rosenlunds sjukhus, Stockholm, Sweden.
    Segmental and suprasegmental properties in nonword repetition: An explorative study of the associations with nonword decoding in children with normal hearing and children with bilateral cochlear implants2015In: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 29, no 3, p. 216-235Article in journal (Refereed)
    Abstract [en]

    The present study explored nonword repetition (NWR) and nonword decoding in normalhearing (NH) children and in children with cochlear implants (CIs). Participants were 11 children with bilateral CIs, 5:0-7:11 years (M = 6.5 yrs.), and 11 NH children, individually age-matched to the children with CIs. The purpose was twofold; to thoroughly describe aspects of repetition and decoding of novel words and to study possible associations between them. All children were assessed after having practiced with a computer-assisted reading intervention with a phonics approach during four weeks. Results showed that NH children outperformed children with CIs on the majority of aspects of NWR. The analysis of syllable length in NWR revealed that children with CIs made more syllable omissions than did the NH children, and predominantly in prestressed positions. Additionally, the consonant cluster analysis showed significantly more consonant omissions and substitutions in children with CIs suggesting that reaching fine- grained levels of phonological processing was particularly difficult for these children. No significant difference was found for decoding accuracy between the groups, as measured by percent nonwords and percent phonemes correctly decoded, but differences were observed regarding error patterns. Further, phoneme deletions and lexicalizing of nonwords occurred more often in children with CIs than in those with NH. The correlation analysis revealed that the ability to repeat consonant clusters in NWR had the strongest associations to nonword decoding in both groups.

  • 43.
    Nakeva von Mentzer, Cecilia
    et al.
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lyxell, Björn
    Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Sahlén, Birgitta
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Dahlström, Örjan
    Linköpings universitet, Handikappvetenskap.
    Lindgren, Magnus
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Ors, Marianne
    Humanities laboratory, Cognition, Communication & Learning, Lund University.
    Kallioinen, Petter
    Department of Linguistics, Stockholm University.
    Uhlén, Inger
    Karolinska University Hospital and Karolinska Institutet, Rosenlunds sjukhus, Stockholm, Sweden.
    Computer-assisted reading intervention with a phonics approach for children using cochlear implants or hearing aids2014In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 55, no 5, p. 448-455Article in journal (Refereed)
    Abstract [en]

    The present study examines computer-assisted reading intervention with a phonics approach for deaf and hard of hearing (DHH) children in Sweden using cochlear implants or hearing aids, or a combination of both. The study included forty-eight children, 5, 6 and 7 years of age. Sixteen children with normal hearing (NH) served as a reference group. The first purpose of the study was to compare NH and DHH children’s reading ability at pre and post intervention. The second purpose was to investigate effects of the intervention. Cognitive and demographic factors were analyzed in relation to reading improvement. Results showed no statistically significant difference for reading ability at the group level, although NH children showed overall higher reading scores at both test points. Age comparisons revealed a statistically significant higher reading ability in the NH 7-year olds compared to the DHH 7-year olds. The intervention proved successful for word decoding accuracy, passage comprehension and as a reduction of nonword decoding errors in both NH and DHH children. Reading improvement was associated with complex working memory and phonological processing skills in NH children. Correspondent associations were observed with visual working memory and letter knowledge in the DHH children. Age was the only demographic factor that was significantly correlated with reading improvement. The results suggest that DHH children’s beginning reading may be influenced by visual strategies that might explain the reading delay in the older children.

  • 44.
    Neuman, Nicklas
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Eli, Karin
    Institute of Social and Cultural Anthropology, Oxford University.
    Nowicka, Paulina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Feeding the extended family: Gender, generation, and socioeconomic disadvantage in food provision to children2019In: Food, Culture, and Society: an international journal of multidisciplinary research, ISSN 1552-8014, E-ISSN 1751-7443, Vol. 22, no 1, p. 45-62Article in journal (Refereed)
    Abstract [en]

    This paper examines how US parents and grandparents describe their provision of food to preschool-age children. Drawing on 49 interviews with 16 families, most of which were socio-economically disadvantaged, we argue that gender and generation intersect in everyday efforts to care for children’s eating. The analysis explores gendered divisions of foodwork, highlights the struggles of single mothers, and examines fathers’ redefinitions of the paternal role to include feeding and caring for children. At the core of the analysis, however, is the participants’ emphasis on grandmothers as sources of knowledge and support, with both fathers and mothers citing grandmothers and other women of earlier generations as culinary influences and as role models for good parenting. We thus discuss “feeding the extended family,” and conclude with a discussion about moving beyond the couple-focused paradigm of parenting in research on food and the gendered division of foodwork.

  • 45.
    Nilsson, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Univ Hosp, Ctr Res & Dev, Gavle, Sweden.;Gavle Univ Hosp, Dept Radiol, Gavle, Sweden.;Umea Univ Hosp, Dept Radiat Sci & Oncol, Umea, Sweden..
    Kallman, Mikael
    Gavle Univ Hosp, Dept Oncol, Gavle, Sweden..
    Ostlund, Ulrika
    Gavle Univ Hosp, Ctr Res & Dev, Gavle, Sweden..
    Holgersson, Georg
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology. Gavle Univ Hosp, Ctr Res & Dev, Gavle, Sweden.;Gavle Univ Hosp, Dept Oncol, Gavle, Sweden..
    Bergqvist, Michael
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Univ Hosp, Ctr Res & Dev, Gavle, Sweden.;Gavle Univ Hosp, Dept Oncol, Gavle, Sweden.;Umea Univ Hosp, Dept Radiat Sci & Oncol, Umea, Sweden..
    Bergström, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Gavle Univ Hosp, Ctr Res & Dev, Gavle, Sweden.;Gavle Univ Hosp, Dept Oncol, Gavle, Sweden..
    The Use of Complementary and Alternative Medicine in Scandinavia2016In: Anticancer Research, ISSN 0250-7005, E-ISSN 1791-7530, Vol. 36, no 7, p. 3243-3251Article, review/survey (Refereed)
    Abstract [en]

    Background: Complementary alternative medicine (CAM) is widely used among patients with cancer. This usage may have potentially harmful effects, especially when combined with anticancer drugs. However, some complementary methods may benefit patients. This review investigated the prevalence of CAM use among patients with cancer in Scandinavia and secondly studied the educational levels of CAM users compared to non-users. Materials and Methods: A systematic search of the PubMed library was carried out to locate articles published between January 2000 and October 2015 that investigated prevalence of CAM use among Scandinavian patients with cancer. Results: Twenty-two articles were found, of which nine were included in the review. The prevalence of CAM use was 7.9% to 53%, with an average of 36.0% across all studies. Conclusion: Use of CAM is widespread among patients with cancer. Knowledge about CAM should be disseminated to both patients and staff in order to optimise discussions about CAM in clinical practice.

  • 46.
    Olsson, Camilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Blom Johansson: Speech-Language Pathology.
    Arvidsson, Patrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Blom Johansson, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Blom Johansson: Speech-Language Pathology.
    Relations between executive function, language and functional communication in severe aphasia2019Conference paper (Refereed)
    Abstract [en]

    People who, due to aphasia, have severely limited ability to make themselves understood through speech, are forced to find other means of communication. However, the ability to flexibly and efficiently use gesture, drawing, writing, communication aids and so on differs widely in people with severe aphasia. Studies of interventions focusing on use of augmentative and alternative communication (AAC) in aphasia typically show that the participants have ability to learn to use the communication aid in the clinical context, but frequently fails to generalise the use to real-life functional communication (Jacobs, Drew, Ogletree, & Pierce, 2004). The same problem is often seen for other kinds of alternative communication, such as gesture and drawing. Intervention in severe aphasia aims for access to meaningful social interaction in spite of great linguistic barriers (Darrigrand et al., 2011; Koleck et al., 2017),  and a profound understanding of the different factors affecting the functional communication in this population is therefore crucial.

    One factor that is thought to play an important role is executive function. It has been shown that people with aphasia often have impaired executive function, and there also seems to be a link to functional communication (Fridriksson, Nettles, Davis, Morrow, & Montgomery, 2006; Murray, 2012; Purdy & Koch, 2006; Ramsberger, 2005). However, the studies are few and conducted on small samples often including participants with a wide variation in aphasia severity. The aim of the present study was to expand the understanding of the relations between executive functions, linguistic ability and functional communication in severe aphasia.

    Executive functions, linguistic ability and functional communication were assessed in 47 participants with severe aphasia. Functional communication was assessed using the Scenario Test (van der Meulen, van de Sandt-Koenderman, Duivenvoorden, & Ribbers, 2010). The results were analysed for the total sample as well as separated into a verbal and a non-verbal subgroup.

    Impairment of executive function was found in 79% of the participants. Moderate to strong correlations were found between linguistic ability and executive functions. In the total sample, partial correlation analysis showed that functional communication was mainly related to verbal output. In the verbal subgroup, no relations were found between functional communication and the other two variables. In the non-verbal subgroup however, the partial correlation analysis showed a strong relation between executive function and functional communication. Generally, there was large variation of executive functions and functional communication among the participants, especially in the nonverbal subgroup.

    The study led to several conclusions. Impairments of executive functions are, as expected, common in people with severe aphasia, and executive function is closely related to linguistic ability. The ability to produce verbal output is, also as expected, strongly related to functional communication and on the group level a small increase in verbal output results in a relatively large increase in functional communication, as measured by the Scenario Test. However, in people with extreme limitation or total absence of verbal output, where use of other modes of communication are ineluctable, executive functions seem to be an important factor. This suggests that executive functions need to be considered when planning intervention. In both design and training to use AAC and other forms of communication support, it is important to understand the demands the task puts on executive functions and, if possible, to minimise them. This also raises the importance of making sure people with severe aphasia are given a proper assessment of their cognitive abilities including executive functions, even though this is often challenging.

     

     

    Darrigrand, B., Dutheil, S., Michelet, V., Rereau, S., Rousseaux, M., & Mazaux, J.-M. (2011). Communication impairment and activity limitation in stroke patients with severe aphasia. Disabil Rehabil, 33(13-14), 1169-1178. doi:10.3109/09638288.2010.524271

    Fridriksson, J., Nettles, C., Davis, M., Morrow, L., & Montgomery, A. (2006). Functional communication and executive function in aphasia. Clinical Linguistics & Phonetics, 20(6), 401-410. doi:10.1080/02699200500075781

    Jacobs, B., Drew, R., Ogletree, B. T., & Pierce, K. (2004). Augmentative and Alternative Communication (AAC) for adults with severe aphasia: where we stand and how we can go further. Disabil Rehabil, 26(21-22), 1231-1240. doi:10.1080/09638280412331280244

    Koleck, M., Gana, K., Lucot, C., Darrigrand, B., Mazaux, J. M., & Glize, B. (2017). Quality of life in aphasic patients 1 year after a first stroke. Quality of Life Research, 26(1), 45-54. doi:10.1007/s11136-016-1361-z

    Murray, L. L. (2012). Attention and other cognitive deficits in aphasia: Presence and relation to language and communication measures. Am J Speech Lang Pathol, 21(2), s51-s64. doi:10.1044/1058-0360(2012/11-0067)

    Purdy, M., & Koch, A. (2006). Prediction of strategy usage by adults with aphasia. Aphasiology, 20(2-4), 337-348. doi:10.1080/02687030500475085

    Ramsberger, G. (2005). Achieving conversational success in aphasia by focusing on non-linguistic cognitive skills: A potentially promising new approach. Aphasiology, 19(10-11), 1066-1073. doi:10.1080/02687030544000254

    van der Meulen, I., van de Sandt-Koenderman, W. M., Duivenvoorden, H. J., & Ribbers, G. M. (2010). Measuring verbal and non-verbal communication in aphasia: reliability, validity, and sensitivity to change of the Scenario Test. Int J Lang Commun Disord, 45(4), 424-435. doi:10.3109/13682820903111952

     

  • 47. Peolsson, Anneli
    et al.
    Ludvigsson, Maria Landen
    Wibault, Johanna
    Dedering, Asa
    Peterson, Gunnel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centrum för klinisk forskning i Sörmland (CKFD).
    Function in Patients With Cervical Radiculopathy or Chronic Whiplash-Associated Disorders Compared With Healthy Volunteers2014In: Journal of Manipulative and Physiological Therapeutics, ISSN 0161-4754, E-ISSN 1532-6586, Vol. 37, no 4, p. 211-218Article in journal (Refereed)
    Abstract [en]

    Objective: The purposes of this study were to examine whether any differences in function and health exist between patients with cervical radiculopathy (CR) due to disk disease scheduled for surgery and patients with chronic whiplash-associated disorders (WADs) and to compare measures of patients' physical function with those obtained from healthy volunteers. Methods: This is a cross-sectional study of patients with CR (n = 198) and patients with chronic WAD (n = 215). Patient data were compared with raw data previously obtained from healthy people. Physical measures included cervical active range of motion, neck muscle endurance, and hand grip strength. Self-rated measures included pain intensity (visual analog scale), neck disability (Neck Disability Index), self-efficacy (Self-Efficacy Scale), and health-related quality of life (EuroQol 5-dimensional self-classifier). Results: Patient groups exhibited significantly lower performance than the healthy group in all physical measures (P < .0005) except for neck muscle endurance in flexion for women (P > .09). There was a general trend toward worse results in the CR group than the WAD group, with significant differences in neck active range of motion, left hand strength for women, pain intensity, Neck Disability Index, EuroQol 5-dimensional self-classifier, and Self-Efficacy Scale (P < .0001). Conclusions: Patients had worse values than healthy individuals in almost all physical measures. There was a trend toward worse results for CR than WAD patients.

  • 48.
    Pettersson, Nina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Prehospital vätskebehandling av hypovolema traumapatienter2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 49.
    Pettersson, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    BB vård i hemmet efter hemgång direkt från förlossningsenhet2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 50.
    Pless, Mia
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Granlund, Mats
    Hälsohögskolan, Högskolan i Jönköping.
    Implementation of the International Classification of Functioning, Disability and Health (ICF) and the ICF Children and Youth Version (ICF-CY) Within the Context of Augmentative and Alternative Communication2012In: Augmentative and Alternative Communication: AAC, ISSN 0743-4618, E-ISSN 1477-3848, Vol. 28, no 1, p. 11-20Article in journal (Refereed)
    Abstract [en]

    The purpose of this article is to discuss the implementation of the International Classification of Functioning, Disability and Health (ICF), and the ICF version for Children and Youth (ICF-CY), within the context of augmentative and alternative communication (AAC). First, the use of the ICF and the ICF-CY in AAC research is analyzed. Second, examples of training and implementation of ICF from other contexts besides AAC are provided. Finally, we synthesize data to provide directions for future implementation of the ICF and ICF-CY in the field of AAC. We conclude that, within AAC, organizational routines and intervention documents need to be adapted to the universal language and classification framework of the ICF and ICF-CY. Furthermore, examples are needed to demonstrate how factors affect implementation at organizational and individual levels.

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