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  • Kallin, Kristina, et al. (författare)
  • Why the elderly fall in residential care facilities, and suggested remedies.
  • 2004
  • Ingår i: The Journal of family practice. - 0094-3509. ; 53:1, s. 41-52
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study precipitating factors for falls among older people living in residential care facilities. DESIGN: Prospective cohort study. SETTING: Five residential care facilities. PARTICIPANTS: 140 women and 59 men, mean age +/- SD 82.4 +/- 6.8 (range, 65-97). MEASUREMENTS: After baseline assessments, falls in the population were tracked for 1 year. A physician, a nurse, and a physiotherapist investigated each event, and reached a consensus concerning the most probable precipitating factors for the fall. RESULTS: Previous falls and treatment with antidepressants were found to be the most important predisposing factors for falls. Probable precipitating factors could be determined in 331 (68.7%) of the 482 registered falls. Acute disease or symptoms of disease were judged to be precipitating, alone or in combination in 186 (38.6%) of all falls; delirium was a factor in 48 falls (10.0%), and infection, most often urinary tract infection, was a factor in 38 falls (7.9%). Benzodiazepines or neuroleptics were involved in the majority of the 37 falls (7.7%) precipitated by drugs. External factors, such as material defects and obstacles, precipitated 38 (7.9%) of the falls. Other conditions both related to the individual and the environment, such as misinterpretation (eg, overestimation of capacity or forgetfulness), misuse of a roller walker, or mistakes made by the staff were precipitating factors in 83 (17.2%) of falls. CONCLUSION: Among older people in residential care facilities, acute diseases and side effects of drugs are important precipitating factors for falls. Falls should therefore be regarded as a possible symptom of disease or a drug side effect until proven otherwise. Timely correction of precipitating and predisposing factors will help prevent further falls.
  • Pohl, Petra, et al. (författare)
  • Fall risk awareness and safety precautions taken by older community-dwelling women and men A qualitative study using focus group discussions
  • 2015
  • Ingår i: PLoS ONE. - 1932-6203. ; 10:3
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Daily life requires frequent estimations of the risk of falling and the ability to avoid a fall. The objective of this study was to explore older women's and men's understanding of fall risk and their experiences with safety precautions taken to prevent falls.METHODS: A qualitative study with focus group discussions was conducted. Eighteen community-dwelling people [10 women and 8 men] with and without a history of falls were purposively recruited. Participants were divided into two groups, and each group met four times. A participatory and appreciative action and reflection approach was used to guide the discussions. All discussions were audio recorded and transcribed verbatim. Data were analysed by qualitative content analysis, and categories were determined inductively.FINDINGS: Three categories describing the process of becoming aware of fall risks in everyday life were identified: 1] Facing various feelings, 2] Recognizing one's fall risk, and 3] Taking precautions. Each category comprised several subcategories. The comprehensive theme derived from the categories was "Safety precautions through fall risk awareness". Three strategies of ignoring [continuing a risky activity], gaining insight [realizing the danger in a certain situation], and anticipating [thinking ahead and acting in advance] were related to all choices of actions and could fluctuate in the same person in different contexts.CONCLUSIONS: The fall risk awareness process might be initiated for various reasons and can involve different feelings and precautions as well as different strategies. This finding highlights that there are many possible channels to reach older people with information about fall risk and fall prevention, including the media and their peers. The findings offer a deeper understanding of older peoples' conceptualizations about fall risk awareness and make an important contribution to the development and implementation of fall prevention programmes.
  • Sandlund, Marlene, et al. (författare)
  • Older women and men as co-creators in design of a mobile application for fall prevention
  • 2013
  • Konferensbidrag (refereegranskat)abstract
    • IntroductionThere is a plethora of fall prevention programs for older community-dwelling people. The evidence for exercise-based programs is strong. There is a problem however with implementation and adherence. Motivational factors and barriers have been identified to some extent. Previous studies have shown that what works best is when exercise programs are tailor made, home based, and when people have access to personal feedback on a regular basis. Mobile applications for Smartphones with exercises have these advantages, and have been available for a long time, but these are most commonly directed to young and middle-aged people. There are no applications for fall prevention developed based on senior’s own wishes. The aim was to investigate how healthy older community-dwelling women and men reason and what exercises they prefer when participating in development and design of a fall prevention program in shape of a mobile application for Smartphones.Method Participatory and appreciative action research design with focus group interviews and workshops. Qualitative data analysis.Results The preliminary results show that when older community-dwelling men and women participate in developing a fall prevention program for Smartphones, they have many ideas, thoughts and experiences that may serve as a motivational factor for following a fall prevention program regularly.ConclusionThe implementation and adherence for evidence based fall preventative exercise programs is insufficient. This study will gain knowledge to design tailor made, home based fall prevention exercise programs among community-dwelling healthy seniors.
  • Sandlund, Marlene, et al. (författare)
  • Towards a mobile exercise application to prevent falls : a participatory design process
  • 2015
  • Ingår i: Technology, Rehabilitation and Empowerment of People with Special Needs. - New York : Nova Science Publishers, Incorporated. - 978-1-63482-713-3 - 978-1-63482-737-9 ; s. 157-168
  • Bokkapitel (övrigt vetenskapligt)abstract
    • The digitalization of society is spreading around the world and technology has become part of many people’s daily lives. It acts as a means of communication, work, education and leisure. For populations with special needs (people with some kind of disability or disorder) technology can play an essential role in their rehabilitation and treatment. It also empowers the individuals themselves. The aim of this multi-disciplinary research for decades has been to explore, develop and evaluate innovative technology to aid people with disabilities through virtual reality and associated machinery. The field engages researchers from health sectors, areas of engineering and schools of education to collaborate in order to take on a holistic approach to meet these challenges.
  • Otten, Julia, 1973-, et al. (författare)
  • Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control a randomized controlled trial in individuals with type 2 diabetes
  • 2017
  • Ingår i: Diabetes/Metabolism Research Reviews. - 1520-7552. ; 33:1
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundMeans to reduce future risk for cardiovascular disease in subjects with type 2 diabetes are urgently needed.MethodsThirty-two patients with type 2 diabetes (age 59 ± 8 years) followed a Paleolithic diet for 12 weeks. Participants were randomized to either standard care exercise recommendations (PD) or 1-h supervised exercise sessions (aerobic exercise and resistance training) three times per week (PD-EX).ResultsFor the within group analyses, fat mass decreased by 5.7 kg (IQR: −6.6, −4.1; p < 0.001) in the PD group and by 6.7 kg (−8.2, −5.3; p < 0.001) in the PD-EX group. Insulin sensitivity (HOMA-IR) improved by 45% in the PD (p < 0.001) and PD-EX (p < 0.001) groups. HbA1c decreased by 0.9% (−1.2, −0.6; p < 0.001) in the PD group and 1.1% (−1.7, −0.7; p < 0.01) in the PD-EX group. Leptin decreased by 62% (p < 0.001) in the PD group and 42% (p < 0.001) in the PD-EX group. Maximum oxygen uptake increased by 0.2 L/min (0.0, 0.3) in the PD-EX group, and remained unchanged in the PD group (p < 0.01 for the difference between intervention groups). Male participants decreased lean mass by 2.6 kg (−3.6, −1.3) in the PD group and by 1.2 kg (−1.3, 1.0) in the PD-EX group (p < 0.05 for the difference between intervention groups).ConclusionsA Paleolithic diet improves fat mass and metabolic balance including insulin sensitivity, glycemic control, and leptin in subjects with type 2 diabetes. Supervised exercise training may not enhance the effects on these outcomes, but preserves lean mass in men and increases cardiovascular fitness.
  • Arnadottir, Solveig A, 1968-, et al. (författare)
  • Application of rasch analysis to examine psychometric aspects of the activities-specific balance confidence scale when used in a new cultural context
  • 2010
  • Ingår i: Archives of Physical Medicine and Rehabilitation. - 0003-9993. ; 91:1, s. 156-163
  • Tidskriftsartikel (refereegranskat)abstract
    • Arnadottir SA, Lundin-Olsson L, Gunnarsdottir ED, Fisher AG. Application of Rasch analysis to examine psychometric aspects of the Activities-Specific Balance Confidence Scale when used in a new cultural context. OBJECTIVE: To investigate by using Rasch analysis the psychometric properties of the Activities-Specific Balance Confidence (ABC) Scale when applied in a new Icelandic context. DESIGN: Cross-sectional, population-based, random selection from the Icelandic National Registry. SETTING: Community-based. PARTICIPANTS: Icelanders (N=183), 65 to 88 years old, and 48% women. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ABC, an instrument used to evaluate how confident older people are in maintaining balance and remaining steady when moving through the environment. An Icelandic translation of the ABC (ABC-ICE) scale was evaluated by implementing Rasch rating scale analysis to transform ordinal ABC-ICE scores into interval measures and evaluating aspects of validity and reliability of the scale. RESULTS: Participants were not able to differentiate reliably between the 11 rating scale categories of the ABC-ICE. Additionally, 3 items failed to show acceptable goodness of fit to the ABC-ICE rating scale model. By collapsing categories and creating a new 5-category scale, only 1 item misfit. Removing that item resulted in a modified version of ABC-ICE with 5 categories and 15 items. Both item goodness-of-fit statistics and principal components analysis supported unidimensionality of the modified ABC-ICE. The ABC-ICE measures reliably separated the sample into at least 4 statistically distinct strata of balance confidence. Finally, the hierarchical order of item difficulties was consistent with theoretic expectations, and the items were reasonably well targeted to the balance confidence of the persons tested. CONCLUSIONS: Rasch analysis indicated a need to modify the ABC-ICE to improve its psychometric properties. Further studies are needed to determine if similar analyses of other versions of the ABC, including the original one, will yield similar results.
  • Arnadottir, Solveig A, 1968-, et al. (författare)
  • Are rural older Icelanders less physically active than those living in urban areas? : a population-based study
  • 2009
  • Ingår i: Scandinavian Journal of Public Health. - 1403-4948. ; 37:4, s. 409-417
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life. AIMS: We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities. METHODS: Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work. RESULTS: The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores. CONCLUSIONS: Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.
  • Arnadottir, Solveig A, et al. (författare)
  • Determinants of self-rated health in old age a population-based, cross-sectional study using the international classification of functioning
  • 2011
  • Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 11, s. 670
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.Methods: The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.Results: Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p < 0.001), upper extremity capacity (adjOR = 1.13, p = 0.040), household physical activity (adjOR = 1.01, p = 0.016), and older age (adjOR = 1.09, p = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, p < 0.001).Conclusions: The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.
  • Arnadottir, Solveig A, 1968-, et al. (författare)
  • Participation frequency and perceived participation restrictions at older age : applying the International Classification of Functioning, Disability and Health (ICF) framework
  • 2011
  • Ingår i: Disability and Rehabilitation. - Informa Healthcare. - 0963-8288. ; 33:23-24, s. 2208-2216
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To identify variables from different components of International Classification of Functioning, Disability and Health (ICF) associated with older people's participation frequency and perceived participation restrictions. Method: Participants (N = 186) were community-living, 65-88 years old and 52% men. The dependent variables, participation frequency (linear regression) and perceived participation restrictions (logistic regression), were measured using The Late-Life Function and Disability Instrument. Independent variables were selected from various ICF components. Results: Higher participation frequency was associated with living in urban rather than rural community (beta = 2.8, p < 0.001), physically active lifestyle (beta = 4.6, p < 0.001) and higher cognitive function (beta = 0.3, p = 0.009). Lower participation frequency was associated with being older (beta = -0.2, p = 0.002) and depressive symptoms (beta = -0.2, p = 0.029). Older adults living in urban areas, having more advanced lower extremities capacity, or that were employed had higher odds of less perceived participation restrictions (adjusted odds ratio [OR] = 5.5, p = 0.001; OR = 1.09, p < 0.001; OR = 3.7, p = 0.011; respectively). In contrast, the odds of less perceived participation restriction decreased as depressive symptoms increased (OR = 0.8, p = 0.011). Conclusions: Our results highlight the importance of capturing and understanding both frequency and restriction aspects of older persons' participation. ICF may be a helpful reference to map factors associated with participation and to study further potentially modifiable influencing factors such as depressive symptoms and advanced lower extremity capacity.
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