| 1. |
- Eriksson, Gunilla, et al.
(author)
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Handling fatigue in everyday activities at five years after stroke : A long and demanding process
- 2023
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In: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Group. - 1103-8128 .- 1651-2014. ; 30:2, s. 228-238
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Journal article (peer-reviewed)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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| 2. |
- Lantz, Ann‐Christin Hultman, et al.
(author)
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Evaluation of patient participation in relation to the implementation of a person-centered nursing shift handover
- 2023
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In: Worldviews on Evidence-Based Nursing. - : WILEY. - 1545-102X .- 1741-6787. ; 20:4, s. 330-338
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Journal article (peer-reviewed)abstract
- BackgroundIt has been suggested that nursing shift-to-shift handover should be a more team-based dialogue with and for the patient rather than about a patient. AimThe aim of this study was to evaluate patient participation in relation to the implementation of the person-centered handover (PCH). MethodA pretest-posttest design was used without a comparison group, including patients from nine units in a university hospital at pretest (n = 228) and after implementing PCH (posttest, n = 253) per the framework integrated-Promoting Action on Research Implementation in Health Services. The PCH is inspired by an Australian bedside handover model. The Patient Preferences for the Patient Participation tool was used to rate the preference for and experience of participation on 12 items, combined into three levels of preference-based participation (insufficient-fair-sufficient). ResultsThere were no differences regarding experience or preference-based participation between patients at pretest-posttest; however, posttest patients experienced participation in the item Reciprocal communication to a lesser extent than the pretest patients. Only 49% of the posttest group received PCH; of those not receiving PCH, some would have wanted PCH (27%), while some would have declined (24%). Patients receiving PCH had sufficient participation (82%), to a greater extent, regarding the item Sharing ones symptoms with staff than patients at pretest (72%). Patients receiving PCH also had sufficient participation, to a greater extent, than patients at posttest who did not receive, but would have wanted PCH, regarding four items: (1) sharing ones symptoms with staff, (2) reciprocal communication, (3) being told what was done, and (4) taking part in planning. Linking evidence to actionMost patients want to be present at PCH. Therefore, nurses should ask for the patients preferences regarding PCH and act accordingly. Not inviting patients who want PCH could contribute to insufficient patient participation. Further studies are needed to capture what assistance nurses would want in identifying and acting in alignment with patient preferences.
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| 3. |
- Tõrv, Mari, et al.
(author)
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Buried at home? Stable isotope analysis of the late hunter-gatherer cemetery population at Tamula, SE Estonia
- 2023
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In: Estonian Journal of Archaeology. - 1406-2933 .- 1736-7484. ; 27:2, s. 98-128
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Journal article (peer-reviewed)abstract
- The function of European Stone Age forager sites with several burials has been debated for decades. One little-known site of this kind is the 4th–3rd millennium cal BC Tamula I (hereinafter Tamula) in south-eastern Estonia. Bringing together the results of archaeological and archaeothanatological analyses and departing from stable isotope based dietary reconstructions together with the idea of ‘you are what you eat’ as a basis for forming a group identity, we discuss the function of Stone Age forager sites with more than one interment. Should these be considered cemeteries, meeting places or ordinary settlements? Bulk stable carbon (δ13C) and nitrogen isotope (δ15N) analysis of human skeletal remains from Tamula and a spatio-temporally close multiple burial at Veibri (5th millennium cal BC) demonstrate a significant consumption of freshwater resources. However, the stable isotope values from these two sites differ significantly, allowing a clear distinction between the two populations. Regarding these values not merely as a reflection of peoples’ dietary preferences, but also as a reflection of their primary identities and an indication of local ecologies, we argue that the stable isotope data together with the fact that the late foragers were sedentary provides additional insights into the discussion on the structure of buried populations. These new isotope data together with archaeological records from Tamula, Veibri and the Stone Age complex Zvejnieki in Latvia suggest that at least three different types of burial places existed among the hunter-gatherer communities in the eastern Baltic region during the Stone Age. In the future, these preliminary results about the people forming a burial community could be further consolidated by the establishment of local baseline information and the application of stable isotope analysis of single amino acids.
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| 4. |
- Dury, Jack, et al.
(author)
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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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In: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 32:11, s. 1209-1221
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Journal article (peer-reviewed)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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| 5. |
- Eriksson, Gunilla, et al.
(author)
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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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In: BMJ Open. - : NLM (Medline). - 2044-6055. ; 12:8
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Journal article (peer-reviewed)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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| 6. |
- Fallahpour, Mandana, et al.
(author)
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Changes in perceived impact of stroke on everyday life over five years in a rehabilitation sample that received an activity of daily living intervention : A follow-up study
- 2022
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In: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 54
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Journal article (peer-reviewed)abstract
- Objective: To compare changes in the perceived impact of stroke on everyday life over time in a rehabilitation sample that received a client-centred activities of daily living (CADL) intervention or usual ADL (UADL) intervention.Design: Longitudinal follow-up of a randomized controlled trial.Methods: A total of 145 persons with stroke were assigned into CADL or UADL. Groups were assessed using the Stroke Impact Scale (SIS) at 3 months, 12 months and 5 years post-intervention. Changes in SIS domain scores over time were compared within and between groups.Results: Changes in the impact of stroke over time were not related to which intervention the groups received. There were no significant differences in the SIS domains or stroke recovery between groups at the 3-month, 12-month and 5-year follow-ups. Despite an increased impact of stroke over time in some domains in both groups, both groups perceived a decreased impact of stroke in the Participation domain at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups.Conclusion: These findings stress the importance of access to follow-up rehabilitation interventions 1-year post-stroke to enable participation in daily activities. Such follow-up and enablement would support the use of self-management strategies in the performance of persons’ valued activities, which might be difficult to perform, due to, for example, impact on hand function or mobility. The results of this study emphasize the importance of prioritizing participation in activities that are meaningful from a personal perspective.Lay abstractIn this study, perceived impact of stroke on everyday life over time was compared among 145 persons with stroke who received the client-centred or usual activities of daily living intervention. They were followed up at 3, 12 months and 5-years post-stroke. No differences were found in the impact of stroke over time between groups. Despite increased impact of stroke (indicating more problems) over time in some areas, the groups perceived decreased impact of stroke (less problems) in their participation at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups. Findings stress the importance of access to follow-up rehabilitation interventions one-year post-stroke to enable participation in daily activities, and to support the use of self-management strategies to facilitate participation in valued and meaningful activities that might be difficult due to person’s functional limitations.
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| 7. |
- Fjellström, Markus, 1987-, et al.
(author)
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Fishing at Vivallen : stable isotope analysis of individuals from a South Saami burial ground
- 2022
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In: Fornvännen. - Stockholm : Kungl. Vitterhets Historie och Antikvitets Akademien. - 0015-7813 .- 1404-9430. ; 117:1, s. 37-57
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Journal article (peer-reviewed)abstract
- Vivallen is a Late Iron Age/Early Middle Ages South Saami site with a burialground as well as a large dwelling site in Härjedalen, Sweden, located in the borderland between Saami and Norse groups. As food can be used as an indicator of cultural affiliation, we investigated the relative importance of various foodstuffs at this site, performing δ13C and δ15N analysis of human and faunal skeletal remains. The site was located along the St Olaf pilgrimage route, implying that some of the buried individuals may not have been local to the site, and therefore we performed δ34S analysis to study mobility. We set out to investigate if there were any changes in diet and mobility over the lifespan of the people buried at Vivallen. The results showed that freshwater fish were an important part of the diet, whereas reindeer and big game do not seem to have been major proteinsources. We could not identify any substantial changes in diet in the individuals over time. Our results further demonstrated low mobility among the individuals,with one exception, a female who evidently grew up somewhere else.
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| 8. |
- Fjellström, Markus, 1987-, et al.
(author)
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Fishing at Vivallen – stable isotope analysis of a south Sámi burial ground
- 2022
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In: Fornvännen. - 0015-7813 .- 1404-9430. ; 117:1, s. 37-57
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Journal article (other academic/artistic)abstract
- Vivallen is a Late Iron Age/Early Middle Ages South Saami site with a burial ground as well as a large dwelling site in Härjedalen, Sweden, located in the borderland between Saami and Norse groups. As food can be used as an indicator of cultural affiliation, we investigated the relative importance of various foodstuffs at this site, performing δ13C and δ15N analysis of human and faunal skeletal remains. The site was located along the St Olaf pilgrimage route, implying that some of the buried individuals may not have been local to the site, and therefore we performed δ34S analysis to study mobility. We set out to investigate if there were any changes in diet and mobility over the lifespan of the people buried at Vivallen. The results showed that freshwater fish were an important part of the diet, whereas reindeer and big game do not seem to have been major protein sources. We could not identify any substantial changes in diet in the individuals over time. Our results further demonstrated low mobility among the individuals, with one exception, a female who evidently grew up somewhere else.
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| 9. |
- Gharibi, Hassan, et al.
(author)
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Abnormal (Hydroxy)proline Deuterium Content Redefines Hydrogen Chemical Mass
- 2022
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In: Journal of the American Chemical Society. - : American Chemical Society (ACS). - 0002-7863 .- 1520-5126. ; 144:6, s. 2484-2487
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Journal article (peer-reviewed)abstract
- Analyzing the δ2H values in individual amino acids of proteins extracted from vertebrates, we unexpectedly found insome samples, notably bone collagen from seals, more than twice as much deuterium in proline and hydroxyproline residues than inseawater. This corresponds to at least 4 times higher δ2H than in any previously reported biogenic sample. We ruled out diet as aplausible mechanism for such anomalous enrichment. This finding puts into question the old adage that “you are what you eat”.
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| 10. |
- Guidetti, Susanne, et al.
(author)
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Activities in Daily Living : The development of a new client-centred ADL intervention for persons with stroke
- 2022
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In: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 29:2, s. 104-115
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Journal article (peer-reviewed)abstract
- BackgroundAn intervention that contains several interacting components can be defined as a complex intervention. This intervention was developed in accordance with the Medical Research Council (MRC) guidance for complex interventions.AimTo describe the development, theoretical framework, and content of a client-centred activities in daily living intervention (CADL) for people with stroke.Material and methodsDifferent steps were used; identifying the evidence base, identifying/developing theory and the modelling process and outcomes in the development of the CADL. The remodelling of the process and content of the intervention that emerged are defined.ResultsFindings from a series of qualitative studies of people with stroke demonstrated the need to develop an ADL intervention based on the clients’ lived experiences. The theoretical framework is based on empirical research, theories about human occupation and client-centredness. The CADL is applying an occupational and phenomenological perspective in order to enable agency in daily activities and participation in everyday life among persons with stroke.Conclusions and significanceThe article can be used as an example of how to present the development and theoretical framework of a new complex intervention in occupational therapy.
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