| 1. |
- Anåker, Anna, et al.
(författare)
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The physical environment and multi-professional teamwork in three newly built stroke units
- 2020
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; , s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore multi-professional teamwork in relation to the physical environment in three newly built or renovated stroke units. Materials and methods: An observational study was undertaken. The participants were all staff members of a multi-professional team working in the reviewed stroke units. The data were collected using behavioural mapping and semi-structured observations, and they were analysed by content analysis and descriptive statistics. Results: Out of all the observations in the behavioural mapping, very few were of two or more members from the team together with a patient. None of the included stroke units had a co-location for all the members of the multi-professional team. Three main categories emerged from the analysis of the interviews: (i) the hub of the unit; (ii) the division of places; and (iii) power imbalance. All the categories reflected the teamwork in relation to parts of the physical environment. Conclusion: The design of the physical environment is important for multi-professional teamwork. Emphasis must be placed on better understanding the impact of the physical environment and on incorporating the evidence related to multi-professional teamwork during the design of stroke units.IMPLICATIONS FOR REHABILITATION Understanding the link between the physical environment and effective teamwork can lead to more tailored and supportive design solutions. The design of the physical environment should be considered as a vital part of effective teamwork in stroke units. The physical environment should include shared workstations, allowing team members to meet and communicate face to face.
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| 2. |
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| 3. |
- Dury, Jack, 1993-
(författare)
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Dealing With Reservoir Effects in Human and Faunal Skeletal Remains : Understanding the radiocarbon dating of aquatic samples
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Archaeology relies on the ordering of past events to study cultural developments. This has traditionally been achieved by looking at the stratigraphic depths of materials relative to one another. In this way, chronologies of past technological progressions and stylistic changes can be built. The introduction of radiocarbon dating in the 1950s revolutionised archaeology, allowing for direct, numerical estimates of a sample’s age. This allowed for more detailed past chronologies than was previously possible. Radiocarbon dating utilises the radioactive decay of carbon-14 (radiocarbon, 14C) to estimate a sample’s age with older samples having less 14C. Shortly after the introduction of radiocarbon dating, however, it was demonstrated that 14C is not evenly distributed globally. Typically, there is less 14C in marine (and sometimes freshwater) systems compared to the atmosphere. This results in aquatic samples appearing older than they are, a phenomenon known as a ‘reservoir effect’. When radiocarbon dating material from archaeological sites with marine activity, this is an important consideration. With aquatic resources being vital for human populations across the globe and for millennia, the ability to interpret aquatic radiocarbon dates is incredibly important. Making use of radiocarbon dates without properly handling any reservoir effects have proved problematic, sometimes resulting in archaeologically incorrect chronologies being constructed. Reservoir effects can, however, be managed. This thesis demonstrates how archaeologists should interpret radiocarbon dates from aquatic samples, avoiding erroneously-old age estimates. Through careful sample selection, considering complicated carbon source mixing, measuring the scale and variability of reservoir effects within a single ecosystem and using prior knowledge about a sample’s age, the dating of aquatic material can be greatly improved. This thesis also details a novel method of dating teeth, reducing uncertainty, and concomitantly estimating the extent of the reservoir effect. This was achieved by dating dental increments, combined with complex modelling. It is clear that there is no single method of handling reservoir effects, and methods for dealing with reservoir effects will differ depending on the archaeological site and specific research question. In this thesis, novel and existing methods of dealing with reservoir effects are demonstrated by considering five case studies from four archaeological sites:At the site of Hamanaka 2 (Rebun Island, Japan), it is demonstrated that by carefully selecting samples without reservoir effects, the dating of the stratigraphy of the site can be accurately modelled. Concerning the cemetery site of Rounala (northern Sweden), it is demonstrated that by carefully reconstructing complex human diets, the dating of humans can be modelled to a high resolution. This has implications for the understanding of the Church’s relationship with the cemetery. At the site of Ekven (Chukotka, Bering Strait) reservoir effect variability between species is carefully described. A more detailed understanding of regional reservoir effects allows for more accurate dating of human remains from the marine hunting Old Bering Sea culture. More accurate dating of human remains allows for the refining of existing Old Bering Sea culture chronologies. Finally, concerning the material from Resmo (Ӧland, Sweden), a novel dental wiggle matching model is presented as a possible method for reducing dating uncertainty in individuals with a marine dietary component.
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| 4. |
- Dury, Jack, et al.
(författare)
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Dental wiggle matching : Radiocarbon modelling of micro-sampled archaeological human dentine
- 2021
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Ingår i: Quaternary International. - : Elsevier BV. - 1040-6182 .- 1873-4553. ; 595, s. 118-127
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Tidskriftsartikel (refereegranskat)abstract
- Marine reservoir effects (MRE) have the potential to increase the dating uncertainty of humans incorporating marine resources into their diets. Here we attempt a novel dental wiggle-match model to reduce dating uncertainty of seven individuals from the Resmo megalithic tomb (Öland, Sweden) and to test whether this model can be used to calculate MRE from a single tooth. Previous stable isotope ratio studies of these individuals demonstrated that their diets changed, between more or less marine protein, during the early years of their lives. Several incremental samples of dentine from each individual were subjected to radiocarbon dating and stable isotope ratio analysis. An OxCal model was designed that makes use of the known formation sequence of human teeth to reduce overall dating uncertainty. The new dental wiggle-match model is able to reduce overall dating uncertainty in all of the sampled individuals compared to more conventional 14C calibration methods. A utility of the dental wiggle model to estimate marine reservoir effects without associated faunal material is also demonstrated, with promising results.
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| 5. |
- Dury, Jack, et al.
(författare)
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Species-specific reservoir effect estimates : A case study of archaeological marine samples from the Bering Strait
- 2022
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Ingår i: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 32:11, s. 1209-1221
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Tidskriftsartikel (refereegranskat)abstract
- Due to the marine reservoir effect, radiocarbon dates of marine samples require a correction. Marine reservoir effects, however, may vary among different marine species within a given body of water. Factors such as diet, feeding depth and migratory behaviour all affect the 14C date of a marine organism. Moreover, there is often significant variation within single marine species. Whilst the careful consideration of the ΔR values of a single marine species in a given location is important, so too is the full range of ΔR values within an ecosystem. This paper illustrates this point, using a sample pairing method to estimate the reservoir effects in 17 marine samples, of eight different species, from the archaeological site of Ekven (Eastern Chukotka, Siberia). An OxCal model is used to assess the strength of these estimates. The marine reservoir effects of samples passing the model range from ΔR (Marine20) = 136 ± 41–ΔR = 460 ± 40. Marine reservoir effect estimates of these samples and other published samples are used to explore variability in the wider Bering Strait region. The archaeological implications of this variability are also discussed. The calibrating of 14C dates from human bone collagen, for example, could be improved by applying a dietary relevant marine reservoir effect correction. For humans from the site of Ekven, a ΔR (Marine20) correction of 289 ± 124 years or reservoir age correction of 842 ± 123 years is suggested.
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| 6. |
- Elmberg Sjoholm, M., et al.
(författare)
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Living with consequences of stroke and risk factors for unhealthy diet- experiences among stroke survivors and caregivers in Nairobi, Kenya
- 2021
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStroke prevalence is increasing in sub-Saharan Africa and has been partly attributed to the rapid economic and population growth that have contributed to changes in lifestyle and increased the prevalence of modifiable risk factors for stroke. Healthy diet is important in stroke management and secondary stroke prevention. The aim was to explore the clinical characteristics and functioning after stroke and the experiences of nutritional aspects among stroke survivors and caregivers in Nairobi, Kenya.MethodsA cross-sectional study with qualitative and quantitative methods involving two rounds of data collection was utilised. In the first round, data on demographics and clinical characteristics were collected for 30 people poststroke during a seminar organized by the Kenya Stroke Association. In the second round, nine participants then agreed to be interviewed together with their caregivers and asked to describe their own experiences and their household eating patterns after suffering a stroke. The food frequency questionnaire and anthropometric measurements of weight, height and waist measurements were used. The self-reported data were analyzed using descriptive statistics and the transcribed interview texts used a constructivist-based theory.ResultsThe results give an insight in the life situation for people living with consequences after stroke and their caregivers in Nairobi. The participants were aware that they were overweight and that this indicated an increased risk for the development of cardiovascular diseases. A core category emerged: The caregiver as the main definer of health and enabler of healthy diet among persons who have had a stroke. Healthy diets and provided information on eating healthy were lacking from the healthcare professionals, whereupon the responsibility for managing a healthy diet had shifted to the caregivers.ConclusionsSupport needs to be given to people with stroke and their caregivers to achieve a healthy diet. The importance of healthy eating as a way of reducing the risk of suffering a stroke needs to be communicated by health care. The Kenyan food-based dietary guidelines need to be more implemented and accessible as well as an overall secondary stroke prevention program.
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| 7. |
- Eriksson, Christina, et al.
(författare)
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Occupational therapists' perceptions of implementing a client-centered intervention in close collaboration with researchers : A mixed methods study
- 2020
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 27:2, s. 142-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: Integration of research-based knowledge in health care is challenging. Occupational therapists (OTs) need to implement new research-based interventions in clinical practice. Therefore it is crucial to recognize and understand the factors of specific barriers and facilitators affecting the implementation process. Aim: To identify the key factors important for OTs during the implementation process of a complex intervention.Materials and methods: A cross-sectional study with a combination of qualitative and quantitative data in a mixed method design. Forty-one OTs and 23 managers from three county councils in Sweden, responded to a questionnaire one year after the OTs participation in a workshop to prepare for implementation of a client-centered activity of daily living intervention for persons with stroke.Results: Over 70% of the OTs benefitted from reading and discussing articles in the workshop; 60% had faith in the intervention; 69% reported usability of the intervention. High level of support from managers was reported, but less from team members. The therapists' interaction, perceptions of own efforts and contextual influence affected the implementation process.Conclusion: The workshop context with facilitation and access to evidence, supportive organizations and teams, sufficient interaction with researchers and satisfying self-image were successful key factors when involved in research.
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| 8. |
- Eriksson, Gunilla, et al.
(författare)
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Handling fatigue in everyday activities at five years after stroke : A long and demanding process
- 2023
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 30:2, s. 228-238
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Tidskriftsartikel (refereegranskat)abstract
- Background Fatigue is common and can be challenging after stroke. Aim To explore how post-stroke fatigue (PSF) was experienced and handled among people with stroke in their performance of everyday activities and in participation in social activities five years after stroke. Methods Nine persons who perceived PSF one year after stroke onset were interviewed five years later. The interviews were analysed using qualitative content analysis. Results Most participants experienced PSF even five years after stroke and reported longstanding difficulties in everyday activities. Handling fatigue-a long slow process with invisible adjustments in everyday life emerged as the theme. By implementing new strategies in everyday life their PSF lessened over time. Understanding among significant others as to how PSF appears and providing information about PSF early after stroke was perceived important. Conclusion This study adds new knowledge regarding experiences of PSF and long-term support needs. Even if PSF still was reported the participants experienced improvements in everyday life through the application of new strategies. Information about PSF and strategies for managing everyday life should be provided during rehabilitation. Significance This study is one out of only a few focussing on long-term PSF and adjustment to its consequences in everyday life.
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| 9. |
- Eriksson, Gunilla, et al.
(författare)
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Study protocol of a non-randomised controlled trial evaluating the effectiveness of the F@ce 2.0 programme : a person-centred, ICT-supported and interdisciplinary rehabilitation intervention after stroke
- 2022
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Ingår i: BMJ Open. - : NLM (Medline). - 2044-6055. ; 12:8
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Knowledge is missing on use of information and communication technology (ICT), for example, mobile phones/tablets in rehabilitation after stroke. F@ce 2.0 is a person-centred, interdisciplinary intervention supported by ICT. The components of F@ce 2.0 intend to increase performance in daily activities and participation in everyday life for patients with stroke and their significant others. Based on previous feasibility studies, a full-scale evaluation is planned in Sweden. The aim is to implement and evaluate F@ce 2.0, regarding performance of daily activities and participation in everyday life, in comparison with ordinary rehabilitation among persons who have had stroke and significant others. Second, to increase knowledge about how the programme leads to a potential change by studying the implementation process and mechanisms of impact. METHODS AND ANALYSIS: Twelve rehabilitation teams (intervention n=7; control n=5) will recruit patients (n=160) who receive rehabilitation at home after stroke and their significant others. F@ce 2.0 is an 8-week intervention where patients, together with the team, formulate three activity goals regarding what they need and want to do in daily lives. The patients will receive short messages service (SMS) each morning reminding about goals, and in the evening to rate their performance during the day. Primary outcomes for patients: self-efficacy measured by the Self-Efficacy Scale; perceived performance in daily activities measured by the Canadian Occupational Performance Measure. Significant others: perceived caregiver burden measured by Caregiver Burden Scale. Qualitative interviews with team members delivering, patients receiving intervention and significant others will explore experiences of F@ce 2.0. A process evaluation applying a case-study design using mixed methods will be conducted. ETHICS AND DISSEMINATION: Approved by the Swedish Ethical Review Authority, Stockholm. Knowledge will be created for using ICT for rehabilitation of people after stroke in self-selected activities. Dissemination will include peer-reviewed publications, presentations at conferences, and information to stakeholders. TRIAL REGISTRATION NUMBER DETAILS: NCT04351178 . © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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| 10. |
- Eriksson, Gunilla, et al.
(författare)
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The everyday life situation of caregivers to family members who have had a stroke and received the rehabilitation intervention F@ce in Uganda
- 2021
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Ingår i: Archives of Public Health. - : BioMed Central (BMC). - 0778-7367 .- 2049-3258. ; 79
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stroke is increasing in Africa and consequences such as limitations in the performance of activities in everyday life persist a long time. A family member might need to care for and assist the person who has had a stroke. The life situation of these caregivers thereby changes, which could lead to increased workload and new responsibilities in caring for which they lack but request knowledge. During the F@ce rehabilitation program, the caregivers received counseling, which is uncommon in the African context. The aim of the study was twofold; (1) to investigate the perceived caregiver burden and life satisfaction and, (2) to explore and describe the life situation for caregivers to persons that have had a stroke and received the mobile phone supported rehabilitation F@ce in urban areas in Uganda.Method: A mixed method design was used. Twelve caregivers took part in a semi-structured interview regarding their everyday life situation and responded to questionnaires on caregiver burden and life satisfaction. Latent qualitative content analysis was used to analyse the interviews.Results: Five categories were identified in the caregivers' experiences of their life situation: Feels obligated but is just a natural commitment; a tightly scheduled everyday life; being the supporting relative; the caregivers approach as rehabilitators; and being supported by the rehabilitation intervention. The caregivers rated relatively high on the Caregiver Burden Scale and two thirds of the sample rated their satisfaction with life as a whole as dissatisfying. Further ratings on the Life Satisfaction checklist revealed that the financial, vocational, leisure and family situations were dissatisfying.Conclusions: Even if it was viewed as a natural commitment to be a caregiver when a family member had had a stroke, the life situation changed substantially for those who took on the caregiving role. Caregiving responsibilities were challenging as well as a heavy workload and a strained financial situation as many were giving up on jobs. The participants felt burdened and rated a low life satisfaction. The F@ce intervention was, however, expressed as valued and involved support and advice in their caregiving situation as well as information on stroke which relieved stress among them.
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