| 1. |
- Adman, Per, et al.
(författare)
-
171 forskare: ”Vi vuxna bör också klimatprotestera”
- 2019
-
Ingår i: Dagens nyheter (DN debatt). - Stockholm. - 1101-2447.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- DN DEBATT 26/9. Vuxna bör följa uppmaningen från ungdomarna i Fridays for future-rörelsen och protestera eftersom det politiska ledarskapet är otillräckligt. Omfattande och långvariga påtryckningar från hela samhället behövs för att få de politiskt ansvariga att utöva det ledarskap som klimatkrisen kräver, skriver 171 forskare i samhällsvetenskap och humaniora.
|
|
| 2. |
- Andersson, Lisbet, et al.
(författare)
-
I'm afraid! Children's experiences of being anesthetized
- 2020
-
Ingår i: Pediatric Anaesthesia. - : John Wiley & Sons. - 1155-5645 .- 1460-9592. ; 30:9, s. 998-1005
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction Children experience anesthetization as stressful, and many preoperative measures have been tested for reducing their anxiety. There is, however, little research about children's own experiences and thoughts about being anesthetized. Aims The aim of the present study was thus to explain and understand the meaning of being anesthetized as experienced by children. Methods A qualitative lifeworld hermeneutic approach was used. Data were collected through nonparticipant video observations, field notes, and interviews. The participants were children (n = 28) aged 4-13 years who required general elective minor surgery performed in four Swedish hospitals. Results The four interpreted themes describe the children's experiences of being anesthetized: Being powerless, Striving for control, Experiencing an ambiguous comprehensibility, and Seeking security. The children struggled with anxiety as a result of their inability to protect themselves from perceived external threats while being anesthetized. In order to meet their needs, it would be beneficial for them to receive appropriate information in a calm, supportive, and protective environment. Conclusion The reasons for children experiencing anxiety when being anesthetized are multifaceted, and this study highlights the importance of listening to each child's own voice and striving to create an individually adapted caring and safe environment with as much protection as possible.
|
|
| 3. |
- Bray, Lucy, et al.
(författare)
-
Developing rights-based standards for children having tests, treatments, examinations and interventions : using a collaborative, multi-phased, multi-method and multi-stakeholder approach to build consensus
- 2023
-
Ingår i: European Journal of Pediatrics. - : Springer Nature. - 0340-6199 .- 1432-1076.
-
Tidskriftsartikel (refereegranskat)abstract
- Children continue to experience harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care. The international ISupport collaboration aimed to develop standards to outline and explain good procedural practice and the rights of children within the context of a clinical procedure. The rights-based standards for children undergoing tests, treatments, investigations, examinations and interventions were developed using an iterative, multi-phased, multi-method and multi-stakeholder consensus building approach. This consensus approach used a range of online and face to face methods across three phases to ensure ongoing engagement with multiple stakeholders. The views and perspectives of 203 children and young people, 78 parents and 418 multi-disciplinary professionals gathered over a two year period (2020–2022) informed the development of international rights-based standards for the care of children having tests, treatments, examinations and interventions. The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.Conclusion: This is the first study of its kind which outlines international rights-based procedural care standards from multi-stakeholder perspectives. The standards offer health professionals and educators clear evidence-based tools to support discussions and practice changes to challenge prevailing assumptions about holding or restraining children and instead encourage a focus on the interests and rights of the child.What is Known:• Children continue to experience short and long-term harm when undergoing clinical procedures despite increased evidence of the need to improve the provision of child-centred care.• Professionals report uncertainty and tensions in applying evidence-based practice to children’s procedural care. What is New:• This is the first study of its kind which has developed international rights-based procedural care standards from multi-stakeholder perspectives.• The standards are the first to reach international multi-stakeholder consensus on definitions of supportive and restraining holds.
|
|
| 4. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Development and evaluation of a new seated heel-rise test in the early stages of rehabilitation after an acute Achilles tendon rupture.
- 2014
-
Ingår i: 16th ESSKA (European Society of Sports Traumatology, Knee Surgery and Arthroscopy) Congress, 14-17 May 2014, Amsterdam, Netherlands.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The early stages of rehabilitation appear to be of great importance for outcome after an Achilles tendon rupture. It is a challenge to evaluate the patients’ calf muscle endurance at this stage in a safe and adequate way. The aim of our study was to develop a seated heel-rise test suitable for evaluating calf muscle endurance three months after an Achilles tendon rupture. Furthermore we wanted to evaluate how the seated heel-rise test correlated to the ability to perform one-legged standing heel-rise and patient-reported symptoms. Method: Ninety-three patients, 79 men and 14 women, mean age of 40 (20-63) years, were included from a cohort of 100 patients participating in a prospective, randomized controlled trial comparing non-surgical and surgical treatment after Achilles tendon rupture. Forty-seven were treated with surgery and 46 with non-surgery. They were evaluated after 3, 6 and 12 months. Patient reported outcome was evaluated with Achilles Tendon Rupture Score (ATRS) and functional outcome with seated and standing heel-rise test. The seated heel-rise test was performed with the patient sitting with hip and knee in 90°. A leg extension weight-training machine was used to provide load onto the patient’s thigh at 50% body weight. The limb symmetry index (LSI=injured/healthy x 100) was calculated in order to compare the results from the seated and standing heel-rise test. Results: Ninety-one patients out of 93 (98%) could perform the seated heel-rise test. At the 3-month follow-up there was a significant difference (p<0.01) in the seated heel-rise test between the injured and the healthy side. There were no significant differences between the surgical and non-surgical treatment groups. There were significant differences in the seated heel-rise test and in ATRS (p<0.01) when comparing the group who could perform a standing heel-rise test at the 3-months follow-up, with the group who could not. There were significant correlations between the LSI-values in the seated heel-rise height at the 3-month follow-up and the standing heel-rise height at the 6-month (r=0.36, p<0.001, n= 91) and the 12-month follow-up (r=0.35, p=0.001, n=85). There were also significant correlations (r=0.22-0.37, p=<0.04) between the seated heel-rise test and ATRS. Conclusions: The seated heel-rise-test has the capacity to identify differences between the injured and the healthy side three months after injury. This test also correlates with patient reported outcomes and the heel-rise ability at 6 and 12 months. This test appears to be a safe and suitable test for evaluating calf muscle endurance and function in the early stages of rehabilitation after an Achilles tendon rupture.
|
|
| 5. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Long-term follow up after acute Achilles tendon rupture.
- 2015
-
Ingår i: Danish Sports Medicine Congress, Copenhagen, January 22-24, 2015. - : Danish Association of Sports Medicine.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- It is still unknown why many patients never fully recover after an Achilles tendon rupture (ATR). The aim of this study was to perform a long-term follow-up (5-9 years) of patients treated either surgically or non-surgically after an ATR. Furthermore, we wanted to examine if the patients had a tendon elongation on the injured side and evaluate if this correlated to function, symptoms and foot structure. Material and Method Sixty-seven patients (13 women) mean age of 50 years were evaluated 5-9 years after injury. Thirty-five patients were treated with surgery and 32 with non-surgery. Patient reported outcome and activity level, lower leg function, tendon length, and foot-structure were evaluated. Both the healthy and the injured side were examined and the limb symmetry index (LSI=injured/healthy x 100) was calculated. Results There were significant differences between the healthy and injured side in all function tests (p<0.001-0.015) and the tendon was significantly longer on the injured side (p<0.001) independent of treatment. There were no significant correlations between tendon length and patient reported outcome, function or foot structure. The heel-rise height increased significantly (p<0.000) from the 1 year- to the 5-9-years-follow up. The mean Achilles tendon Total Rupture Score (ATRS) was 91/100, indicating minor symptoms. Conclusion: Patients with an Achilles tendon rupture continues to have significant deficits in tendon structure and function 5-9 years after injury. There is, however continued improvement between the 1 and 5-9 year follow-up.
|
|
| 6. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Recovery of calf muscle endurance 3 months after an Achilles tendon rupture.
- 2016
-
Ingår i: Scandinavian journal of medicine & science in sports. - : Wiley. - 1600-0838 .- 0905-7188. ; 26:7, s. 844-853
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to evaluate calf muscle endurance in a seated position 3 months after an Achilles tendon rupture and to evaluate how the ability to perform standardized seated heel-rises correlated to the single-leg standing heel-rise test and to patient-reported symptoms evaluated with the Achilles tendon Total Rupture Score (ATRS) 3 and 6 months after the injury. Ninety-three patients were included from a cohort of 101 patients participating in a prospective, randomized controlled trial comparing surgical and nonsurgical treatment after Achilles tendon rupture. Forty-seven patients were treated surgically and 46 nonsurgically. Ninety-one patients out of 93 (98%) could perform the standardized seated heel-rises. At the 3-month follow-up, there was a significant difference (P<0.001) between the injured and the healthy side performing standardized seated heel-rises. There were also significant correlations (r=0.29-0.37, P=<0.05) between the standardized seated heel-rises and ATRS 3 and 6 months after injury in the group who could not perform single-leg standing heel-rises. There were no significant differences between the surgical and nonsurgical treatment groups. The evaluation of standardized seated heel-rises appears to be a useful tool to quantify progress and predict future functional performance and patient-reported symptoms.
|
|
| 7. |
- Brorsson, Annelie, 1963, et al.
(författare)
-
Återhämtning av vadmuskelfunktion tre månader efter hälseneruptur -utvärdering av standardiserade sittande tåhävningar
- 2015
-
Ingår i: Vägen till Framgång. Idrottsmedicinskt Vårmöte. Linköping 7-9 maj 2015. - Linköping : Svensk Förening För Fysisk Aktivitet och Idrottsmedicin.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund/syfte: Hälseneruptur drabbar ofta medelålders, fysiskt aktiva kvinnor och män och har ökat de senaste decennierna. Skador i senor läker oftast långsamt och det är inte klarlagt hur rehabiliteringen efter denna skada kan optimeras. Syftet med denna studie var att undersöka vadmuskelns uthållighet i en sittande position och att utvärdera hur förmågan att utföra standardiserade sittande tåhävningar korrelerade med förmågan att utföra stående enbenta tåhävningar tre månader efter skadan samt med patientrapporterade symtom tre och sex månader efter skadan. Metod: Nittiotre patienter inkluderades från en kohort av 101 patienter som deltog i en prospektiv, randomiserad kontrollerad studie där behandling med kirurgi jämfördes med behandling med icke kirurgi efter akut hälseneruptur. Fyrtiosju patienter behandlades med kirurgi och 46 med icke-kirurgi. Vadmuskelfunktion utvärderades med standardiserade sittande tåhävningar samt enbenta stående tåhävningar tre månader efter hälsenerupturen. Patientrapporterade symptom utvärderades med Achilles tendon Total Rupture Score (ATRS) tre och sex månader efter hälsenerupturen. Resultat: Nittioen patienter av 93 (98 %) kunde utföra standardiserade sittande tåhävningar och 46 av 93 patienter (49 %) kunde utför enbenta stående tåhävningar tre månader efter hälsenerupturen. Det var signifikant skillnad mellan den skadade och den friska sidan i tåhävningshöjd (6,1 cm respektive 8,9 cm, p<0.000) och i antal repetitioner (58 st respektive 90 st, p<0.000) vid utförandet av de sittande tåhävningarna tre månader efter skadan. Det var också signifikant skillnad i tåhävningshöjd samt antal repetitioner (p<0.001 resp. p=0.011) i de standardiserade sittande tåhävningarna på den skadade sidan vid jämförelse mellan de som kunde utföra enbenta stående tåhävningar tre månader efter skadan och de som inte klarade det. Det förelåg signifikanta korrelationer (r=0.29-0.37, p=<0.05) mellan standardiserade sittande tåhävningar och ATRS tre och sex månader efter skadan i gruppen som inte klarade att utföra enbenta stående tåhävningar tre månader efter hälsenerupturen. Det fanns inga signifikanta skillnader mellan de två behandlingsgrupperna som behandlades med kirurgi respektive icke kirurgi. Konklusion: Standardiserade sittande tåhävningar verkar vara ett kliniskt användbart verktyg i det tidiga skedet efter hälseneruptur för att kunna utvärdera vadmuskelfunktionen och förutsäga framtida funktion och patientrapporterade symptom.
|
|
| 8. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Achilles Tendon Ruptures in Basketball
- 2020
-
Ingår i: Basketball Sports Medicine and Science. Laver L., Kocaoglu B., Cole B., Arundale A.J.H., Bytomski J., Amendola A. (eds). - Berlin, Heidelberg : Springer. - 9783662610701 ; , s. 481-489
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Basketball is a springing, jumping, and sprinting sport with players repetitively jumping to play shots and to make and receive passes or work sudden sprints together with the start–stop nature of the game. In the United States, sporting activity was responsible for 68% tendon ruptures, of which basketball was the most commonly involved sport, accounting for 48% of sports-related ruptures. There has been considerable debate as to whether operative or nonoperative treatment leads to the best outcome. Operative treatment may reduce the resultant calf muscle weakness, tendon elongation, predictability of outcome, and re-rupture rate compared with nonoperative treatment. Patients undergoing minimally invasive surgery are significantly more likely to report a satisfactory subjective outcome compared with open surgery. The overall rate of return to play (RTP) in all sports following Achilles tendon rupture has been estimated to 80%. However, for players in the National Basketball Association (NBA) who sustained an Achilles tendon rupture, more than a third (36.8%) either did not return to play or started in fewer than 10 games for the remainder of their career. Twenty-one percent of ruptures led to retirement. The mean time to return to play was 10.5 months, and the rate of return to play was lower in the NBA, 61–71%, compared with that of the National Football League players, 64–71%. Achilles tendon rupture in elite basketball players continues to be a serious, potentially career ending, injury.
|
|
| 9. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Age and Tightness of Repair Are Predictors of Heel-Rise Height After Achilles Tendon Rupture.
- 2020
-
Ingår i: Orthopaedic journal of sports medicine. - : SAGE Publications. - 2325-9671. ; 8:3
-
Tidskriftsartikel (refereegranskat)abstract
- Achilles tendon rupture leads to weakness of ankle plantarflexion. Treatment of Achilles tendon rupture should aim to restore function while minimizing weakness and complications of management.To determine the influence of factors (age, sex, body mass index [BMI], weight, time from injury to operative repair, and tightness of repair) in the initial surgical management of patients after an acute Achilles tendon rupture on 12-month functional outcome assessment after percutaneous and minimally invasive repair.Cohort study; Level of evidence, 3.From May 2012 to January 2018, patients sustaining an Achilles tendon rupture receiving operative repair were prospectively evaluated. Tightness of repair was quantified using the intraoperative Achilles tendon resting angle (ATRA). Heel-rise height index (HRHI) was used as the primary 12-month outcome variable. Secondary outcome measures included Achilles tendon total rupture score (ATRS) and Tegner score. Stepwise multiple regression was used to create a model to predict 12-month HRHI.A total of 122 patients met the inclusion criteria for data analysis (mean ± SD age, 44.1 ± 10.8 years; 78% male; mean ± SD BMI, 28.1 ± 4.3 kg/m2). The elapsed time to surgery was 6.5 ± 4.0 days. At 12-month follow-up, patients had an HRHI of 82% ± 16% and performed 82% ± 17% of repetitions compared with the noninjured side. Participants had a mean ATRS of 87 ± 15 and a median Tegner score of 5 (range, 1-9), with a reduction in Tegner score of 2 from preinjury levels. The relative ATRA at 12 months was -4.8° ± 3.9°. Multiple regression identified younger age (B = ±0.006; P < .001) and greater intraoperative ATRA (B = 0.005; P = .053) as predictors of more symmetrical 12-month HRHI (R2 = 0.19; P < .001; n = 120).Age was found to be the strongest predictor of outcome after Achilles tendon rupture. The most important modifiable risk factor was the tightness of repair. It is recommended that repair be performed as tight as possible to optimize heel-rise height 1 year after Achilles tendon rupture and possibly to reduce tendon elongation.
|
|
| 10. |
- Carmont, Michael R, 1972, et al.
(författare)
-
Functional Outcomes of Achilles Tendon Minimally Invasive Repair Using 4- and 6-Strand Nonabsorbable Suture: A Cohort Comparison Study
- 2017
-
Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 5:8
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of management of Achilles tendon rupture is to reduce tendon lengthening and maximize function while reducing the rerupture rate and minimizing other complications. Purpose: To determine changes in Achilles tendon resting angle (ATRA), heel-rise height, patient-reported outcomes, return to play, and occurrence of complications after minimally invasive repair of Achilles tendon ruptures using nonabsorbable sutures. Methods: Between March 2013 and August 2015, a total of 70 patients (58 males, 12 females) with a mean age of 42 8 years were included and evaluated at 6 weeks and 3, 6, 9, and 12 months after repair of an Achilles tendon rupture. Surgical repair was performed using either 4-strand or 6-strand nonabsorbable sutures. After surgery, patients were mobilized, fully weightbearing using a functional brace. Early active movement was permitted starting at 2 weeks. Results: There were no significant differences in the ATRA, Achilles Tendon Total Rupture Score (ATRS), and Heel-Rise Height Index (HRHI) between the 4- and 6-strand repairs. The mean (SD) relative ATRA was -13.1 degrees (6.6 degrees) (dorsiflexion) following injury; this was reduced to 7.6 degrees (4.8 degrees) (plantar flexion) directly after surgery. During initial rehabilitation at 6 weeks, the relative ATRA was 0.6 degrees (7.4 degrees) (neutral) and -7.0 degrees (5.3 degrees) (dorsiflexion) at 3 months, after which ATRA improved significantly with time to 12 months (P = .005). At 12 months, the median ATRS was 93 (range, 35-100), and the mean (SD) HRHI and Heel-Rise Repetition Index were 81% (0.22%) and 82.9% (0.17%), respectively. The relative ATRA at 3 and 12 months correlated with HRHI (r = 0.617, P < .001 and r = 0.535, P < .001, respectively). Conclusion: Increasing the number of suture strands from 4 to 6 does not alter the ATRA or HRHI after minimally invasive Achilles tendon repair. The use of a nonabsorbable suture during minimally invasive repair when used together with accelerated rehabilitation did not prevent the development of an increased relative ATRA. The ATRA at 3 months after surgery correlated with heel-rise height at 12 months.
|
|
