| 1. |
- Callaghan, Terry, et al.
(författare)
-
Multi-Decadal Changes in Tundra Environments and Ecosystems : Synthesis of the International Polar Year-Back to the Future Project (IPY-BTF)
- 2011
-
Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 40:6, s. 705-716
-
Tidskriftsartikel (refereegranskat)abstract
- Understanding the responses of tundra systemsto global change has global implications. Most tundraregions lack sustained environmental monitoring and oneof the only ways to document multi-decadal change is toresample historic research sites. The International PolarYear (IPY) provided a unique opportunity for such researchthrough the Back to the Future (BTF) project (IPY project#512). This article synthesizes the results from 13 paperswithin this Ambio Special Issue. Abiotic changes includeglacial recession in the Altai Mountains, Russia; increasedsnow depth and hardness, permafrost warming, andincreased growing season length in sub-arctic Sweden;drying of ponds in Greenland; increased nutrient availabilityin Alaskan tundra ponds, and warming at mostlocations studied. Biotic changes ranged from relativelyminor plant community change at two sites in Greenland tomoderate change in the Yukon, and to dramatic increasesin shrub and tree density on Herschel Island, and in subarcticSweden. The population of geese tripled at one sitein northeast Greenland where biomass in non-grazed plotsdoubled. A model parameterized using results from a BTFstudy forecasts substantial declines in all snowbeds andincreases in shrub tundra on Niwot Ridge, Colorado overthe next century. In general, results support and provideimproved capacities for validating experimental manipulation,remote sensing, and modeling studies.
|
|
| 2. |
- Athlin, Elsy, 1945-, et al.
(författare)
-
Factors of importance to the development of pressure ulcers in the care trajectory : perceptions of hospital and community care nurses
- 2010
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 19:15-16, s. 2252-2258
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. The study aimed at describing contributing factors for the progression or regression of pressure ulcers in the care trajectory as they were understood by nurses working in hospitals or community care. Background. The development of pressure ulcers is considered to be connected with early prevention and awareness among nurses and some studies have indicated that the care trajectory may be a weak point. Design. The study was carried out with a qualitative design. Method. Fifteen nurses from two Swedish hospitals and 15 nurses from community care were interviewed during 2005. Qualitative content analysis was used to make an understanding of patterns possible. Findings. Three main categories arose, showing that pressure ulcers were considered to be affected in the care trajectory by factors related to the individual patient, to the healthcare personnel and to the healthcare structure. Hospital and community care nurses mostly had corresponding perceptions of these factors. Conclusion. The study both confirmed previous findings and added new knowledge about factors that may affect pressure ulcer in the trajectory of care. The informants' views of nurses' responsibilities and their attitudes towards the care of pressure ulcers could, along with their views on the organisation of care, increase the understanding of the occurrence of pressure ulcers. The need for development and clarification of the organisation and responsibility of pressure ulcer care in the care trajectory was stressed. Relevance to clinical practice. The study highlighted attitudes and values among registered nurses, as well as to how to preserve their commitment and increase their knowledge concerning prevention of pressure ulcers.
|
|
| 3. |
- Austeng, Dordi, et al.
(författare)
-
Incidence of and risk factors for neonatal morbidity after active perinatal care : extremely preterm infants study in Sweden (EXPRESS)
- 2010
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 99:7, s. 978-992
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.
|
|
| 4. |
- Bachrach-Lindström, Margareta, et al.
(författare)
-
Nutritional status and functional capacity after femoral neck fractures : a prospective randomized one-year follow-up study
- 2000
-
Ingår i: Aging. - 1945-4589. ; 12:5, s. 366-374
-
Tidskriftsartikel (refereegranskat)abstract
- The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.
|
|
| 5. |
- Bachrach-Lindström, Margareta, et al.
(författare)
-
Patients on the waiting list for total hip replacement : a 1-year follow-up study
- 2008
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:4, s. 536-542
-
Tidskriftsartikel (refereegranskat)abstract
- Patients on the waiting list for total hip replacement: a 1-year follow-up study Untreated osteoarthritis (OA) in the hip causes pain and reduced physical and social functioning. The aim of this study was to evaluate the effect of waiting time on health-related quality of life (HRQOL), functional condition and dependence on help at the time of surgery and during follow-up 1 year after surgery. A further aim was to elucidate possible differences between men and women. Two hundred and twenty-nine consecutively included patients with OA in the hip were interviewed when assigned to the waiting list, again 1 week prior to surgery with unilateral total hip replacement (THR), and 1 year after surgery. Health-related quality of life and function were measured using the Nottingham Health Profile, EuroQoL and the Western Ontario and McMaster Universities Osteoarthritis Index. The result showed that the average waiting time was 239 days, that 15% of the patients were operated on within 3 months, and that 21% had to wait more than 6 months. At the time of surgery, HRQOL had deteriorated significantly (p < 0.05) and the number of patients receiving support from relatives had increased from 31% to 58% during the wait. At the 1-year follow-up, both HRQOL and functional condition had improved significantly despite the wait, and the need for support from relatives had decreased to 11% (p < 0.001). In conclusion, long waiting time for THR is detrimental to patients HRQOL causing reduced functional condition, pain and increased need for support from relatives, which limit the independence in daily life.
|
|
| 6. |
- Bernhardsson, Susanne, 1958, et al.
(författare)
-
Evaluation of a tailored, multi-component intervention for implementation of evidence-based clinical practice guidelines in primary care physical therapy: a non-randomized controlled trial
- 2014
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Clinical practice guidelines are important for transmitting research findings into practice and facilitating the application of evidence-based practice (EBP). There is a paucity of knowledge about the impact of guideline implementation strategies in primary care physical therapy. The aim of this study was to evaluate the effect of a guideline implementation intervention in primary care physical therapy in western Sweden. Methods An implementation strategy based on theory and current evidence was developed. A tailored, multi-component implementation intervention, addressing earlier identified determinants, was carried out in three areas comprising 28 physical therapy practices including 277 physical therapists (PTs) (intervention group). In two adjacent areas, 171 PTs at 32 practices received no intervention (control group). The core component of the intervention was an implementation seminar with group discussions. Among other components were a website and email reminders. Data were collected at baseline and follow-up with a web-based questionnaire. Primary outcomes were the self-reported awareness of, knowledge of, access to, and use of guidelines. Secondary outcomes were self-reported attitudes toward EBP and guidelines. Analyses were performed using Pearson’s χ2 test and approximative z-test. Results 168 PTs (60.6%) in the intervention group and 88 PTs (51.5%) in the control group responded to the follow-up questionnaire. 186/277 PTs (67.1%) participated in the implementation seminars, of which 97 (52.2%) responded. The proportions of PTs reporting awareness of (absolute difference in change 20.6%, p = 0.023), knowledge where to find (20.4%, p = 0.007), access to (21.7%, p < 0.001), and frequent use of (9.5%, NS) guidelines increased more in the intervention group than in the control group. The proportion of PTs reporting frequent guideline use after participation in the implementation seminar was 15.2% (p = 0.043) higher than the proportion in the control group. A higher proportion considered EBP helpful in decision making (p = 0.018). There were no other significant differences in secondary outcomes. Conclusions A tailored, theory- and evidence-informed, multi-component intervention for the implementation of clinical practice guidelines had a modest, positive effect on awareness of, knowledge of, access to, and use of guidelines, among PTs in primary care in western Sweden. In general, attitudes to EBP and guidelines were not affected.
|
|
| 7. |
|
|
| 8. |
|
|
| 9. |
- Johansson, Glenn, 1967-
(författare)
-
Environmental performance requirements in product development : an exploratory study of two development projects
- 2001
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In recent years, Ecodesign has attracted increased attention from researchers. In this thesis, the term Ecodesign refers to the actions taken and activities carried out originating from the incorporation of environmental performance requirements in a product development project. Earlier Ecodesign research has primarily focused on the development of various tools for supporting practitioners. Only a few studies have focused on how the incorporation of environmental performance requirements affects development projects and the changes that a development organisation undergoes to become more environmentally conscious. The objective of this thesis is therefore to explore characteristics of product development projects originating from the incorporation of environmental performance requirements.The empirical material has been collected from two in-depth case studies of product development projects in which new and complex business-to-business products were developed. The first case study addressed a project in which a telecommunications product was developed. The study occupied approximately 1 ½ years and was performed as a real-time, longitudinal study. The second case study was performed as an ex-post study and addressed a product development project in which a new power generating gas turbine was developed.The analysis, which takes as its starting point a number of essential product development elements derived from the literature, revealed a number of differences between the projects. These differences seem largely tobe due to different levels of Ecodesign experience in the development organisations carrying out each project. When relating the development organisations' level of Ecodesign experience to a three-phase model of theEcodesign integration process presented in earlier research, it was found that one of the organisations fitted into the model, whereas the other did not. On the basis of this finding, a fourth Ecodesign integration phase was detected and denoted the Innovative Ecodesign phase. Complementing the existing model with this new phase, the so-called Extended Ecodesign Integration model was developed. The model shows that the focus in development projects carried out within development organisations in the first three phases of Ecodesign seems to be set on the environment and integration of Ecodesign in the development process. Development organisations that have reached the Innovative Ecodesign phase tend to direct efforts in the projects mainlytowards the application of new technology and technical problem solving in order to fulfil the environmentalperformance requirements.
|
|
| 10. |
- Johansson, Inger, 1943-, et al.
(författare)
-
Balancing integrity vs. risk of falling - Nurses experiences of caring for elderly people with dementia in nursing homes
- 2009
-
Ingår i: Journal of Research in Nursing. - : SAGE Publications. - 1744-9871 .- 1744-988X. ; 14:1, s. 61-73
-
Tidskriftsartikel (refereegranskat)abstract
- Dementia is recognized as being a major risk for falls that cause suffering and increase dependency for the individual. The purpose of this study was to explore registered nurses and nurse assistants experiences of caring for elderly people with dementia who are at risk of falling, and factors that contribute or reduce falls in this group. A phenomenographic design was chosen. Ten nurses and 18 nurse assistants with experience of fall events were strategically selected for a recorded interview. The informants were chosen from 10 nursing homes in Sweden and Norway. They were asked to describe a fall situation they had been involved in when caring for elderly people with dementia. The findings shed light on an ethical dilemma in the main category Balancing integrity and autonomy versus risk of falling � which was comprehensively related to two descriptive categories. The first one was Adjusting to the older person�s condition� with the concepts of forgetfulness, anxiety and confusion, ability to express oneself and understand, bodily build and function. The second category was Adjusting the care environment�, comprising these conceptions: the physical environment, the psychosocial environment, organization and human resources. Based on the staff�s perceived difficulties in preventing falls in elderly people with dementia, there is a need for additional support or professional supervision in their work to enhance possibilities for successful fall prevention.
|
|
