| 1. |
- Vinogradova, Olena, et al.
(författare)
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3000 Years of past regional and local land-use and land-cover change in the southeastern Swedish coastal area : Early human-induced increases in landscape openness as a potential nutrient source to the Baltic Sea coastal waters
- 2024
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Ingår i: The Holocene. - : Sage Publications. - 0959-6836 .- 1477-0911. ; 34:1, s. 56-73
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Tidskriftsartikel (refereegranskat)abstract
- Reconstructions of past land use and related land-cover changes at local and regional scales are needed to evaluate the potential long-term impacts of land use on the coastal waters of the Baltic Sea. In this purpose, we selected the Gamleby area at the Swedish Baltic Sea coast for a case study. We use a new, high resolution pollen record from a small lake (Lillsjön) located 3.6 km NNW of the bay Gamlebyviken and detailed analysis of the available archeological data to reconstruct local land-use changes over the last 3000 years. To estimate land-cover change at local (2–3 km radius area) and regional (50 km radius area) scales we use four additional, published pollen records from two small and two large lakes (25–70 km S of Lillsjön) and the Landscape Reconstruction Algorithm, a pollen-vegetation modeling scheme. Results show that regional and local (small lakes Lillsjön and Hyttegöl) land-cover changes are comparable over the last 1500 years (Late Iron Age to present), and that landscape openness was much larger locally than regionally (difference of 20–40% cover over the last 500 years). The periods of largest potential impacts on the Gamlebyviken Bay from regional and local land use are 200–950 CE (Late Iron Age) and 1450 CE to present, and of lowest potential impacts 950–1450 CE. The question on whether the large landscape openness 1150–50 BCE and significant afforestation 50 BCE–200 CE reconstructed for Lillsjön’s area are characteristic of the Gamlebyviken region will require additional pollen records in the catchment area.
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| 2. |
- Hellstrand Tang, Ulla, 1956, et al.
(författare)
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Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial
- 2014
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Ingår i: Journal of Clinical and Translational Endocrinology. - : Elsevier BV. - 2214-6237. ; 1:4, s. 121-132
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Tidskriftsartikel (refereegranskat)abstract
- Background: Special insoles and shoes designed to prevent foot ulcers caused by repetitive high pressures are recommended for patients with diabetes who have any of the following risk factors: neuropathy; peripheral vascular disease; foot deformities; previous ulcers; amputation; and skin pathologies. However, there is a need for increased knowledge regarding: a) differences in the peak pressure (PP) and pressure time integral (PTI) for different types of insoles; and b) the properties of the pressure distribution for insoles used over a period of several months. We present the results of a randomized trial to compare the plantar pressures of three commonly used insoles. Objectives: The primary objective was to compare the PP and PTI between three types of insoles. The secondary objective was to explore the long-term pattern of peak plantar pressure distribution and variations in specific regions of interest (ROI). The tertiary objective was to investigate the impacts of insole adjustments, how much the insoles were used, and the levels of patient satisfaction. Methods In a 2-year trial, 114 patients with type 1 (N = 31) or type 2 (N = 83) diabetes (62 men and 52 women; mean age, 57.7 ± 15.4 years; duration of diabetes, 12.3 ± 11.2 years; neuropathy, 38%), were randomized to be supplied with one of three different insoles. The ethylene vinyl acetate (EVA) insoles were used in outdoor walking shoes. The 35 EVA group (N = 39) received soft custom-made insoles composed of EVA of 35 shore A hardness, the 55 EVA group (N = 37) received custom-made insoles composed of EVA of 55 shore hardness, and the control group (N = 38) received prefabricated insoles composed of a hard core with a top layer of soft 12 shore hardness microfiber. Using F-Scan®, the in-shoe plantar pressures were measured at seven ROI (hallux, metatarsal head 1, metatarsal head 2, metatarsal head 4, metatarsal head 5, lateral aspect of the mid-foot, heel) on five occasions during the study period. The plantar-pressure variables used were PP (main outcome) and PTI. The plantar patterns of load were explored, satisfaction and usage of the insoles were rated by the participants, and insole adjustments were recorded. Results:A mixed model analysis estimated lower PP values in the heel regions for the 35 EVA and 55 EVA insoles (171 ± 13 and 161 ± 13 kPa, respectively) than for the prefabricated insoles (234 ± 10 kPa) (p
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| 3. |
- Hellstrand Tang, Ulla, 1956, et al.
(författare)
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Foot deformities, function in the lower extremities, and plantar pressure in patients with diabetes at high risk to develop foot ulcers
- 2015
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Ingår i: Diabetic Foot & Ankle. - : Informa UK Limited. - 2000-625X. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Objective : Foot deformities, neuropathy, and dysfunction in the lower extremities are known risk factors that increase plantar peak pressure (PP) and, as a result, the risk of developing foot ulcers in patients with diabetes. However, knowledge about the prevalence of these factors is still limited. The aim of the present study was to describe the prevalence of risk factors observed in patients with diabetes without foot ulcers and to explore possible connections between the risk factors and high plantar pressure. Patients and methods : Patients diagnosed with type 1 ( n= 27) or type 2 ( n= 47) diabetes (mean age 60.0±15.0 years) were included in this cross-sectional study. Assessments included the registration of foot deformities; test of gross function at the hip, knee, and ankle joints; a stratification of the risk of developing foot ulcers according to the Swedish National Diabetes Register; a walking test; and self-reported questionnaires including the SF-36 health survey. In-shoe PP was measured in seven regions of interests on the sole of the foot using F-Scan ® . An exploratory analysis of the association of risk factors with PP was performed. Results : Neuropathy was present in 28 (38%), and 39 (53%) had callosities in the heel region. Low forefoot arch was present in 57 (77%). Gait-related parameters, such as the ability to walk on the forefoot or heel, were normal in all patients. Eighty percent had normal function at the hip and ankle joints. Gait velocity was 1.2±0.2 m/s. All patients were stratified to risk group 3. Hallux valgus and hallux rigidus were associated with an increase in the PP in the medial forefoot. A higher body mass index (BMI) was found to increase the PP at metatarsal heads 4 and 5. Pes planus was associated with a decrease in PP at metatarsal head 1. Neuropathy did not have a high association with PP. Conclusions: This study identified several potential risk factors for the onset of diabetic foot ulcers (DFU). Hallux valgus and hallux rigidus appeared to increase the PP under the medial forefoot and a high BMI appeared to increase the PP under the lateral forefoot. There is a need to construct a simple, valid, and reliable assessment routine to detect potential risk factors for the onset of DFU.
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| 4. |
- Hellstrand Tang, Ulla, 1956, et al.
(författare)
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The D-Foot, for prosthetists and orthotists, a new eHealth tool useful in useful in risk classification and foot assessment in diabetes
- 2017
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Ingår i: Foot and Ankle Online Journal. - : International Foot & Ankle Foundation. - 1941-6806. ; 10:2
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prevention and care of foot problems in diabetes begins with a risk classification. Today, the prosthetists and orthotists (CPO) and other health care professionals assess the risk of developing foot ulcers more or less subjectively. The objective of the study was to describe the construction of an eHealth tool, the D-Foot, which generates a risk classification. The reliability of the D-Foot was tested. Methods: The D-Foot includes 22 clinical assessments and four self-reported questions. The content validity was assured by expert group consensus and the reliability was assessed through an empirical test-retest study. Inter- and intra-rater reliability was calculated using patients referred to four departments of prosthetics and orthotics (DPO). Results: The agreement for the risk classification generated using the D-Foot was 0.82 (pooled kappa 0.31, varying from 0.16 to 1.00 at single DPOs). The inter-rater agreement was > 0.80 regarding the assessments of amputation, Charcot deformity, foot ulcer, gait deviation, hallux valgus/hallux varus and risk grade. The inter- and intra-rater agreements for the discrete measurements were > 0.59 and > 0.72 respectively. For continuous measurements, the inter- and intra-rater correlation varied (0.33-0.98 and 0.25-0.99 respectively). Conclusion: The D-Foot gave a reliable risk foot classification. However, there was a variation in the inter- and intra-rater reliability of the assessments included and refinements are needed for variables with low agreement. Based on the results, the D-Foot will be revised before it is implemented in clinical practice.
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| 5. |
- Ivarsson, Andreas, 1984-, et al.
(författare)
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Elite female footballers’ stories of sociocultural factors, emotions, and behaviours prior to anterior cruciate ligament injury
- 2019
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Ingår i: International Journal of Sport and Exercise Psychology. - New York, NY : Taylor & Francis. - 1612-197X .- 1557-251X. ; 17:6, s. 630-646
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine how players’ perceptions of sociocultural factors and intra- and interpersonal aspects of sporting experiences may have influenced the emotions, cognitions, and behaviours of elite female soccer players prior to the occurrence of ACL injuries. The research questions guiding the study were: (a) how did female elite soccer players perceive that their psychosocial experiences were related to their cognitive, physiological, and emotional states prior to their ACL injuries, and (b) how did the players feel their perceived states influenced their behaviours prior to injury occurrence. The participants consisted of the total population of female players (N = 18) competing in the Swedish women’s elite league, who incurred a total ACL tear during the 2012 season. Using a semi-structured interview guide, all players were interviewed post-season. We represented the data using a storytelling approach of aggregated creative nonfiction. The aggregated stories showed sociocultural rules and expectations of overtraining and placing pressure on athletes to play even if they were not physically or psychologically fit. Responding to pressures with potentially risk-increasing behaviours might raise the probability of becoming injured through a number of pathways. Team managers, coaches, and members of the medical team are recommended to develop environments that stimulate the players to engage in adaptive stress-recovery and risk-decreasing behaviours. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 6. |
- Johansson, Jonas, 1984-
(författare)
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The Healthy Ageing Initiative : Prevention of falls and fractures
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The world is currently experiencing a dramatic increase in the number of older individuals, an amount that is expected to double between 2015 and 2050. This increase will likely affect the prevalence of age-related functional impairments, such as those caused by fractures. Fractures are often immobilizing events leading to increased individual suffering and vast healthcare costs. Prevention of these events and detection of underlying risk factors are hence of utmost importance. Fracture prevention strategies have traditionally focused on strengthening the skeleton by improving bone mineral density, partly through the mechanical load of increased physical activity. However, research has shown that nine out of ten hip fractures are attributed to falls. While several risk factors behind falls have been identified, there is less knowledge about how aspects such as gait patterns and postural stability predict future falls. The aim of this thesis was to expand upon the current knowledge by investigating objective measures of physical activity in relation to bone parameters, and measures of gait patterns and postural stability in relation to incident falls, in a large population-based sample of 70-year-olds.The samples investigated in the four included studies were drawn from the Healthy Ageing Initiative (HAI) cohort. Study I examined associations between physical activity, objectively measured using accelerometers, and bone parameters, measured by Dual-energy X-ray Absorptiometry and Peripheral Quantitative Computed Tomography. Study II examined how gait variability, measured using the GAITRite electronic walkway system, predicted incident falls in men and women. Studies III and IV examined how center of pressure (COP) sway and limits of stability (LOS), measured using a force platform, predicted incident falls. Independent prediction of bone parameters and incident falls were investigated using multiple linear and logistic regression models.Study I revealed that moderate-to-vigorous physical activity and vertical peak acceleration independently predicted parameters of bone in the weight-bearing skeleton. Study II showed that women’s increased risk of falling could be explained by increased gait variability during dual-task assignments. Study III revealed that the risk of falling was increased by 75-90% for individuals in the highest quintile of COP sway. Study IV integrated COP and LOS data, showing that fall risk was increased by 9-16% per 1-unit increase in COP-LOS ratio. In conclusion, this thesis highlighted several objective predictors of incident falls among older adults. Future studies and recommendations should emphasize strategies to improve balance, muscle strength and physical activity in order to prevent falls and fractures.
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| 7. |
- Johnson, Urban, 1961-, et al.
(författare)
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Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors
- 2016
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Ingår i: Bmc Sports Science Medicine and Rehabilitation. - London : Springer Science and Business Media LLC. - 2052-1847. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction. Methods: A qualitative method was used based on individual in-person interviews and video communication of players who incurred a first-time ACL tear during the 2012 season of the Swedish Women's Elite Football League. In total, 13 players had a first-time ACL and were interviewed post-season. The interviews were followed by a thematic content analysis. Based on this, eight players were identified as showing resilient behaviors during their rehabilitation and were included in the final analysis. Results: Three core themes representing psychosocial factors that help players cope successfully with rehabilitation were identified: (I) constructive communication and rich interaction with significant others; (II) strong belief in the importance and efficacy of one's own actions; and (III) the ability to set reasonable goals. Conclusions: The findings suggest three core themes of psychosocial factors that characterize first-time ACL-injured elite female football players showing resilience during rehabilitation after ACL reconstruction. Suggestions for medical teams about ways to support communication, self-efficacy, and goal-setting during the rehabilitation process, are provided.
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| 8. |
- Karlsson, Jon, 1984-, et al.
(författare)
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Tracing modern environmental conditions to their roots in early mining, metallurgy, and settlement in Gladhammar, southeast Sweden : Vegetation and pollution history outside the traditional Bergslagen mining region
- 2015
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Ingår i: The Holocene. - : Sage Publications. - 0959-6836 .- 1477-0911. ; 25:6, s. 944-955
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Tidskriftsartikel (refereegranskat)abstract
- We present results from a multidisciplinary project using lake sediment as a natural archive in combination with archaeology to investigate the earliest history of the Gladhammar mining area, southeastern Sweden. The aim was to identify and trace human impacts on the landscape, specifically in connection with settlement and metal production. Sediment records from two lakes linked to different processes in metal production were analyzed; Tjursbosjon down-slope of the mining area and Hyttegol situated downstream of an excavated blast furnace, 1.8km from the mines. The sediment analyses included multi-element geochemistry (WD-XRF), stable lead isotopes, pollen, and charcoal. Although historical documents record activities beginning in AD 1526, the archaeological study found indications that mining and metal production likely predated this period. The known historical period is well reflected in the sediment records, such as a 500-fold increase in copper, stream erosion, loss of forest cover and an expansion in agriculture. More importantly, already in the 12th-13th centuries, there was a 2- to 10-fold increase in lead, copper, and charcoal particles and evidence of erosion linked to the establishment of a blast furnace. Lead isotopes reveal a change from natural conditions to an input of lead from regional ores as early as the 9th-10th centuries. Settlement in the form of agriculture can be seen from 2000 BP. This sediment evidence of early mining or metallurgy during the 9th-15th centuries is supported by a few radiocarbon dates from the excavated mining fields, which on their own were considered as vague or improbable outliers by archaeologists.
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| 9. |
- Lundberg Zachrisson, Andreas, 1987, et al.
(författare)
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Athlete availability and incidence of overuse injuries over an athletics season in a cohort of elite Swedish athletics athletes - A prospective study
- 2020
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Ingår i: Injury Epidemiology. - London : Springer Science and Business Media LLC. - 2197-1714. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Athletics is a sport with a high incidence of injury, where most injuries are caused by overuse. Research on injury incidence and the occurrence of overuse injuries during a season in athletics is scarce. An athlete availability (unrestricted ability to participate in training or competition) of less than 80% has been linked with athletes being less likely to reach their performance goals. The purpose of this study was to estimate the monthly injury incidence rates, athlete availability, and the overuse injury incidence rate per 1000 athletics-hours of training in a cohort of Swedish elite athletics athletes. Methods: The cohort consisted of 59 male and female elite athletes competing in either middle or long-distance running, sprint, or jumping events. Injury and training data were collected during one athletics season, from October to the end of August. All injury data were collected by medical professionals. Training data were collected monthly, and consisted of event-specific training diaries covering training sessions, training days, and non-training or non-competition days. Monthly injury incidence rates were based on the number of new injuries per month in relation to the number of exposed (injury-free) athletes. Results: The overall injury incidence rate for all athletes was highest in October (22.0%). Monthly injury incidence rate for middle and long-distance runners was highest in October (26.1%), for sprinters in April (19.0%), and for jumpers in October (21.4%). The overall athlete availability was 78.0% for the cohort. Sprinters had the lowest athlete availability (71.4%), followed by jumpers (77.3%), and middle-distance and long-distance runners (82.7%). Female athletes (76.5%) had a lower athlete availability than male athletes (79.7%). The injury incidence rate was 1.81 injuries per 1000 athletics hours of training. Middle and long-distance runners had the highest injury incidence rate (2.38), followed by jumpers (1.62), and sprinters (1.34). Conclusion: Monthly injury incidence rates during a season appears to correspond to periods of high training volume (conditioning phases and training camps). The low overall athlete availability (> 80%) indicates that many Swedish elite athletes are less likely to reach their full potential. © 2020 The Author(s).
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| 10. |
- Lundberg Zachrisson, Andreas, 1987, et al.
(författare)
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Risk factors for overuse injuries in a cohort of elite Swedish track and field athletes
- 2021
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Ingår i: Bmc Sports Science Medicine and Rehabilitation. - London : Springer Science and Business Media LLC. - 2052-1847. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Most injuries in track and field are caused by overuse with conflicting reports concerning the underlying mechanisms. The purpose of this study was to evaluate how biomechanical and clinical factors relate to the risk of overuse injuries, and to investigate whether the relationships between potential risk factors and injury become stronger if injuries are grouped by location. Methods The study is a prospective cohort study conducted during a Swedish track and field season over eleven months, from October to August. The cohort consisted of elite male and female track and field athletes competing in either middle- and long-distance running, sprinting, jumping, or throwing events (n = 96). Athletes performed a baseline screening at enrollment consisting of a clinical examination, running, and strength tests. Injury data was collected during the season by medical professionals and divided according to their anatomical location into upper-body, thigh/hip, knee, or foot/shank injuries. Results Thirty-four (54.8%) injuries where located at the foot/shank, followed by sixteen injuries at the thigh/hip (25.8%). Only eight knee (12.9%) and four upper-body (6.5%) injuries were registered during the season and therefore not analysed. Effect sizes were calculated for all test variables. Small effect sizes (r(pb) = .10-.23) were found for eleven risk factors between the overall injured (all injuries combined) and non-injured athletes. By further sub-grouping the injured group into thigh/hip injuries, effect size increased in hip adduction range of motion knee flexion velocity and the muscle flexibility of the iliopsoas. For foot/shank injuries, only the hamstring:quadriceps strength ratios increased for the right side to a small effect size. Conclusions Injury grouping appears to increase effect size for certain risk factors. Athletes with a slower knee flexion velocity during stance phase were more likely to become injured (p-value <.03, r(pb) = .37). An increased cohort size to further sub-divide injuries into specific diagnoses is needed.
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