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  • Giné-Garriga, Maria, et al. (författare)
  • A co-created intervention with care home residents and university students following a service-learning methodology to reduce sedentary behaviour The GET READY project protocol
  • 2018
  • Ingår i: Journal of Frailty, Sarcopenia and Falls. - Hylonome Publications. - 2459-4148. ; 3:3, s. 132-137
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Background:</strong> There is a growing demand for long-term care settings. Care-home residents are a vulnerable group with high levels of physical dependency and cognitive impairment. Long-term care facilities need to adapt and offer more effective and sustainable interventions to address older residents’ complex physical and mental health needs. Despite the increasing emphasis on patient and public involvement, marginalised groups such as care-home residents, can be overlooked when including people in the research process. The GET READY project aims to integrate servicelearning methodology into Physical Therapy and Sport Sciences University degrees by offering students individual service opportunities with residential care homes, in order to co-create the best suited intervention with researchers, older adults of both genders (end-users) in care homes, health professionals, caregivers, relatives and policy makers. <strong>Methods:</strong> Stage 1 will integrate a service-learning methodology within a Physical Therapy module in Glasgow and Sport Sciences module in Barcelona, design two workshops for care home residents and one workshop for staff members, relatives and policy makers and conduct a co-creation procedure. Stage 2 will assess the feasibility, safety and preliminary effects of the co-created intervention in a group of 60 care home residents, within a two-armed pragmatic randomized clinical trial. <strong>ClinicalTrials.gov Identifier:</strong> NCT03505385.</p>
  • Giné-Garriga, Maria, et al. (författare)
  • A Novel Approach to Reduce Sedentary Behaviour in Care Home Residents : The GET READY Study Utilising Service-Learning and Co-Creation
  • 2019
  • Ingår i: International Journal of Environmental Research and Public Health. - MDPI. - 1661-7827 .- 1660-4601. ; 16:3
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The GET READY study aimed to integrate service-learning methodology into University degrees by offering students individual service opportunities with residential care homes, to co-create the best suited intervention to reduce the sedentary behaviour (SB) of residents throughout the day, with researchers, end-users, care staff, family members and policymakers. Eight workshops with care home residents and four workshops with care staff, relatives and policymakers, led by undergraduate students, were audiotaped, transcribed verbatim and analysed with inductive thematic analysis to understand views and preferences for sustainable strategies to reduce SB and increase movement of residents. Perspectives about SB and movement in care homes highlighted four subthemes. Assets for decreasing SB included three subthemes, and suggestions and strategies encapsulated four subthemes. There is a need to include end-users in decision making, and involve care staff and relatives in enhancing strategies to reduce SB among residents if we want sustainable changes in behaviour. A change in the culture at a policymaker and care staff's level could provide opportunities to open care homes to the community with regular activities outside the care home premises, and offer household chores and opportunities to give residents a role in maintaining their home environment.</p>
  • Giné-Garriga, Maria, et al. (författare)
  • A Pilot Randomised Clinical Trial of a Novel Approach to Reduce Sedentary Behaviour in Care Home Residents : Feasibility and Preliminary Effects of the GET READY Study
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - MDPI. - 1661-7827 .- 1660-4601. ; 17:8
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Care-home residents are among the most sedentary and least active of the population. We aimed to assess the feasibility, acceptability, safety, and preliminary effects of an intervention to reduce sedentary behaviour (SB) co-created with care home residents, staff, family members, and policymakers within a pilot two-armed pragmatic cluster randomized clinical trial (RCT). Four care homes from two European countries participated, and were randomly assigned to control (usual care, CG) or the Get Ready intervention (GR), delivered by a staff champion one-to-one with the care home resident and a family member. A total of thirty-one residents participated (51.6% female, 82.9 (13.6) years old). GR involves six face to face sessions over a 12-week period with goal-oriented prompts for movement throughout. The feasibility and acceptability of the intervention were assessed and adverse events (AEs) were collected. The preliminary effects of the GR on SB, quality of life, fear of falling, and physical function were assessed. Means and standard deviations are presented, with the mean change from baseline to post-intervention calculated along with 95% confidence intervals. The CG smoked more, sat more, and had more functional movement difficulties than the GR at baseline. The GR intervention was feasible and acceptable to residents and staff. No AEs occurred during the intervention. GR participants showed a decrease in daily hours spent sitting/lying (Cohen's d = 0.36) and an increase in daily hours stepping, and improvements in health-related quality of life, fear of falling, and habitual gait speed compared to usual care, but these effects need confirmation in a definitive RCT. The co-created GR was shown to be feasible and acceptable, with no AEs.</p>
  • Guerrero, Esteban, et al. (författare)
  • Activity qualifiers in an argumentation framework as instruments for agents when evaluating human activity
  • 2016
  • Ingår i: Advances in Practical Applications of Scalable Multi-agent Systems. The PAAMS Collection : 14th International Conference, PAAMS 2016, Sevilla, Spain, June 1-3, 2016, Proceedings. - Springer. - 978-3-319-39323-0 - 978-3-319-39324-7 ; s. 133-144
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • <p>Theoretical frameworks have been developed for enabling software agents to evaluate simple activities such as walking and sitting. However, such frameworks typically do not include methods for how practically dealing with uncertain sensor information. We developed an argument-based method for evaluating complex goal-based activities by adapting two qualifiers: Performance and Capacity defined in the health domain. The first one evaluates what a person does, and the second one how "well" or "bad" an activity is executed. Our aim is to deal with uncertainty and inconsistent information; generate consistent hypotheses about the activity execution; and resemble an expert therapist judgment, where an initial hypothesis assessment can be retracted under new evidence. We conducted a pilot test in order to evaluate our approach using a Physiotherapy assessment test as a goal-based activity. Results show that skeptic argumentation semantics are may be useful for discriminating individuals without physical issues by considering Performance and Capacity; conversely, credulous semantics may be suitable for obtaining information in the evaluation of activity, which an intelligent agent may use for providing personalized assistance in an ambient assisted living environment.</p>
  • Guerrero, Esteban, et al. (författare)
  • Activity qualifiers using an argument-based construction
  • 2018
  • Ingår i: Knowledge and Information Systems. - Springer. - 0219-1377 .- 0219-3116. ; 54:3, s. 633-658
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>Based on an argumentation theory approach, we present a novel method for evaluating complex goal-based activities by generalizing a notion of <em>qualifier</em> defined in the health domain. Three instances of the general qualifier are proposed: Performance, Actuation and Capacity; the first one evaluates what a person does, the second how an individual follows an action plan, and the third one how "well" or "bad" an activity is executed. Qualifiers are intended to be used by autonomous systems for evaluating human activity. We exemplify our approach using a health domain assessment protocol. Main results of this test show a partial correlation between ambiguities assessed by experts and our argument-based approach; and a multi-dimensional perspective how an activity is executed when a combined evaluation of qualifiers is used. This last outcome was interesting for some therapists consulted. Results also show differences between values of qualifiers using different argumentation semantics; two scenarios were proposed by therapist for using different semantics: preliminary activity screening and time-span follow-up evaluation.</p>
  • Hansson, L, et al. (författare)
  • The relationship of needs and quality of life in persons with schizophrenia living in the community. A Nordic multi-center study
  • 2003
  • Ingår i: Nordic Journal of Psychiatry. - Informa Healthcare. - 1502-4725. ; 57:1, s. 5-11
  • Tidskriftsartikel (refereegranskat)abstract
    • The relationship between needs for care and support and subjective quality of life was investigated in a cross-sectional multi-center study including 418 individuals with schizophrenia from 10 centers in Nordic countries. Needs in 22 domains were investigated by interviews with key workers and their patients using the Camberwell Assessment of Need scale, and quality of life by the Lancashire Quality of Life Profile. The results showed that key workers rated slightly more needs than patients. To have more unmet needs, as rated by both key workers and patients, were correlated to a worse overall subjective quality of life, while met needs showed no such association. A regression analysis, controlling for clinical and social characteristics of the patients, showed more unmet needs to be associated with a worse quality of life, accounting for 6% out of a total of 41% explained variance in subjective quality of life. Regression analyses of the relationship of unmet needs in specific life domains and overall quality of life showed that unmet needs in five domains as perceived by patients accounted for 17% of the explained variance in overall quality of life. More than half of this variance was related to an unmet need in the domain of social relationships. It is concluded that unmet needs are of specific importance in needs assessment and that attention must be paid to separate met needs for care and services from unmet needs, since the latter seem more important to consider in order to improve outcome of interventions with regard to quality of life. Specific attention should in this context also be paid to unmet needs concerning social relationships and problems with accommodation.
  • Larsson, Gunilla, 1944-, et al. (författare)
  • Normal reactions to orthostatic stress in Rett syndrome
  • 2013
  • Ingår i: Research in Developmental Disabilities. - Oxford : Pergamon Press. - 0891-4222 .- 1873-3379. ; 34:6, s. 1897-1905
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>The aim of this study was to investigate orthostatic reactions in females with Rett syndrome (RTT), and also whether the severity of the syndrome had an impact on autonomic reactions. Based on signs of impaired function of the central autonomic system found in RTT, it could be suspected that orthostatic reactions were affected. The orthostatic reactions in 21 females with RTT and 14 normally developed femalesmatched by age were investigated when they rose from a sitting position, and during standing for 3 min. Reactions of the heart, the blood pressure and the time for recovery of systolic blood pressure, were studied in real time, heartbeat by heartbeat, simultaneously. There was no difference between participants with RTT and the normally developed controls regarding general orthostatic reactions (heart rate, systolic and diastolic blood pressure, and mean arterial pressure) when getting up from a sitting position, and when standing erect for 3min. In the specific immediate response by the heart to standing up, the 30:15 ratio, significantly lower values were found for females with RTT. In the RTT group, the maximum fall of systolic blood pressure showed a tendency to a larger decrease, and the initial decrease in systolic blood pressure was significantly faster. The time for recovery of systolic blood pressure from standing erect did not differ between groups. At baseline the females with RTT had significantly lower systolic blood pressure and a tendency to a higher heart rate. The results do not indicate any autonomic limitations for people with RTT in getting up from a sitting position and standing. The participants with RTT had normal orthostatic reactions indicated by the heart and blood pressure responses when standing erect for 3 min. A faster initial drop in systolic blood pressure in people with RTT was notable.</p>
  • Larsson, Gunilla, 1944-, et al. (författare)
  • Walking on treadmill with Rett syndrome : effects on the autonomic nervous system
  • 2018
  • Ingår i: Research in Developmental Disabilities. - Elsevier. - 0891-4222 .- 1873-3379. ; 83, s. 99-107
  • Tidskriftsartikel (refereegranskat)abstract
    • <p>People with Rett syndrome have deficient central autonomic control, which may interfere with walking. We have limited knowledge regarding the effects of exertion during physical activity in Rett syndrome. The aim was to investigate the autonomic responses during walking on a treadmill in Rett syndrome. Twenty-six females, 12 with Rett syndrome and 14 healthy females were included. All individuals started on the treadmill by standing still, followed by walking slowly with progressive speed until reaching maximum individual speed, which they kept for 6 min. Heart rate (HR), systolic (SBP), diastolic (DBP), mean arterial blood pressures (MAP), cardiac vagal tone (CVT), cardiac sensitivity to baroreflex (CSB), transcutaneous partial pressures of oxygen (pO2), carbon dioxide (pCO2), and breathing movements were recorded simultaneously and continuously. Autonomic responses were assessed by MAP, CSB and CVT during walking at 3 and 6 min. The changes in CSB and CVT in people with Rett syndrome compared to controls indicated more arousal, but only when the treadmill was started; as they continued walking, the arousal dropped to control level. People with Rett syndrome exhibited little changes in pCO2 whereas the controls showed increased values during walking. This suggests poor aerobic respiration in people with Rett syndrome during walking. Five people with Rett syndrome had Valsalva type of breathing at rest, three of those had normal breathing while walking on the treadmill while the remaining two started but soon stopped the Valsalva breathing during the walk. Our results show that individuals with Rett syndrome can walk for up to 6 min at their own maximum sustainable speed on a treadmill. Energy production may be low during walking in Rett syndrome, which could cause early tiredness. A treadmill can be used in people with Rett syndrome, but must be introduced slowly and should be individually tailored. We propose that walking promotes regular breathing in Rett syndrome.</p>
  • Leask, Calum F., et al. (författare)
  • Co-creating a tailored public health intervention to reduce older adults' sedentary behaviour
  • 2017
  • Ingår i: Health Education Journal. - 0017-8969 .- 1748-8176. ; 76:5, s. 595-608
  • Tidskriftsartikel (refereegranskat)abstract
    • <p><strong>Objective</strong>: The increasing health care costs associated with an ageing population and chronic disease burden are largely attributable to modifiable lifestyle factors that are complex and vary between individuals and settings. Traditional approaches to promoting healthy lifestyles have so far had limited success. Recently, co-creating public health interventions with end-users has been advocated to provide more effective and sustainable solutions. The aim of this study was to document and evaluate the co-creation of a public health intervention to reduce sedentary behaviour in older adults.</p><p><strong>Design</strong>: Community-dwelling older adults (<em>N</em> = 11, mean age = 74 years) and academic researchers attended 10 interactive co-creation workshops together.</p><p><strong>Setting</strong>: Workshops took place on university campus and the co-creators completed fieldwork tasks outside the workshops.</p><p><strong>Method</strong>: Workshops were informed by the Participatory and Appreciative Action and Reflection methodology. Data were collected using field notes, video recording and worksheet tasks. Analysis was conducted using a qualitative content analysis approach.</p><p><strong>Results</strong>: The co-creators developed a tailored intervention delivered through a mode congruent with older adults’ lives. Key elements of the intervention included (1) education on sedentary behaviour, (2) resources to interrupt sedentary behaviour, (3) self-monitoring, (4) action planning and (5) evaluating the benefits of interrupting sedentary behaviour.</p><p><strong>Conclusion</strong>: Co-creation is a feasible approach to develop public health interventions; however, it is limited by the lack of a systematic framework to guide the process. Future work should aim to develop principles and recommendations to ensure co-creation can be conducted in a more scientific and reproducible way. The effectiveness and scalability of the intervention should be assessed.</p>
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