| 1. |
- Cirovic, Stefan
(författare)
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Non-invasive biomedical analysis : recent advances, challenges, and future perspectives
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Non-invasive healthcare technologies are increasingly pivotal in research anddevelopment due to their affordability and the convenience they offer to bothhealthcare recipients and providers. Alongside traditional non-invasive methodssuch as ultrasound imaging, a variety of innovative non-invasive devices havebeen developed. These include cardiovascular diagnostic systems, bioimpedancebasedscales, and various types of analyzers. These analyzers, which can be fluidlessor fluid-based, are capable of measuring not just physical parameters of thebody but also key biomarkers like glucose and lactate. This comprehensive andtransdisciplinary thesis encompasses three distinct yet interconnected segments:1) Advanced ultrasound imaging (Papers I and II): The first explored vortexformation time in female athletes and the second detailed investigations of thesuperficial venous systems of apparently healthy volunteers.2) Validation and application of commercially available fluid-less bloodanalyzers (Papers IV-VI). These papers focus on non-invasive blood glucosemonitoring (Paper IV) and the general use of non-invasive healthcaretechnologies among female participants from socioeconomicallydisadvantaged areas (Papers V and VI).3) Design and testing of novel, fluid-based sensors, and biosensors (Papers II andIII): Paper II delves into biosensing of viruses, and paper III deals withcontinuous ex vivo glucose sensing in human blood using an enzymatic sensorin a vein replica.Each of these segments contribute to the broader understanding and advancementof non-invasive healthcare technologies, highlighting the significant role suchtechnologies play in modern healthcare research. The thesis's transdisciplinaryapproach, spanning from advanced imaging techniques to the development ofnovel biosensors, exemplifies the dynamic and evolving nature of medicaltechnology research.
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| 2. |
- Granholm Valmari, Elin, 1983-
(författare)
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Beyond the badge : police officers’ lifestyles and health
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Being a frontline police officer is regarded to be one of the most high-strain professions in the world, encompassing physical, emotional and cognitive stressors. These stressors may cause ill health, physically, mentally and socially, impacting both professional and private life roles and everyday activities. Despite this, there has been limited consideration of the broader complexities of police officers’ lifestyles. Thus, the primary aim of this thesis was to identify health promoters and health challenges within the lifestyles of frontline police officers using a transactional perspective. The secondary aim was to translate these findings into the initial developmental stages of an instrument targeting critical areas of police officers’ lifestyles to foster health sustainability.Method: The thesis includes four studies. In Study I, a method for scoping reviews was used when gathering data from previously conducted studies within Europe. Studies II and III were qualitative studies using in-depth interviews. In Study II a reflexive thematic analysis was used, whereas in Study III qualitative content analysis was utilized. Study IV builds on data from the other studies. During the early development process of the instrument focus groups, cognitive interviewing methods and a content validity approach were undertaken.Findings: Altogether, the findings offer insights into how police officers’ lifecontexts, roles and everyday activities transact to become their unique lifestyles. In Study I the life contexts affecting police officers’ lives and health were mapped. It was concluded that research on police officers’ private lives is limited in Europe, despite contextual and environmental influences on their lives and health. In Studies II and III it was found that balancing work with private-life activities and roles included health challenges and resources. The findings relate to balancing risk and violence with vigilance in private life, societal attitudes with the police identity, work with healthy routines and habits, and unpredictability with stability. Study IV took initial steps towards crafting a self-reflection instrument targeting the essential conditions for living a sustainable and healthy lifestyle asa police officer.Conclusion: This thesis illuminates the complex interplay of factors that definethe unique lifestyles of police officers, influenced by their life contexts, roles, and everyday activities. It highlights the importance of both organizational strategies and police officers utilizing health-promoting strategies in maintaining asustainable lifestyle essential for fostering health sustainability. In the context of societal challenges and the need for a strong police force, maintaining police officers’ health sustainability is crucial for the benefit of both the Police Authority and society.
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| 3. |
- Ramji, Rathi
(författare)
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Health promotional interventions informed by community-based participatory research in a socially disadvantaged neighbourhood : development, exploration and evaluation
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to understand the impact of community-based participatory research-informed health promotional initiatives on the health of communities living in socially disadvantaged neighbourhoods in Southern Sweden. The thesis was part of a larger program, Health promotion, Innovation in Collaboration which was a community-based participatory research program aiming to create novel ways to improve health through participatory and collaborative strategies. The thesis embraces one mixed-method study, a quantitative study, a qualitative study and finally a participatory action research study with a qualitative approach. A total of 49 citizens and 10 families with children aged 7-14 years from a disadvantaged neighbourhood in Southern Sweden participated in the different studies. The mixed-method study (Study I) described the development of initial evaluation of a Community-based participatory research(CBPR) informed physical activity intervention, which showed the need for the intervention to be offered cost-free and exclusively for women. In line with the results of the first study, the CBPR physical activity intervention was offered to 35 women in the neighbourhood and the effect of the intervention was assessed over time both quantitatively (Study II) and qualitatively (Study III), including a perspective on the pandemic. The last study (Study IV) focused on diet and oral health among families, particularly mothers and children. In this study, the children were initially engaged in a photovoice interview which was followed by a focus group with parents. The pre-study revealed that children disliked school lunch and did not eat breakfast regularly owing to time constraints and family situations. Furthermore, children also consumed a high amount of sugar. To this, the parents expressed that they were not able to guide their children appropriately and needed help with aspects such as diet focusing on breakfast, lunch and dinner, as well as knowledge on oral hygiene habits. The quantitative part of Study I and Study II were repeated measures data at different time points before and after the intervention. The qualitative data in studies I and III were collected in form of focus group interviews in parallel to the quantitative data. The mode of data collection in Study IV was Multi-staged focus groups where the same families met at different time points and engaged in dialogue and reflection on different topics at each meeting. The results of the first three studies show that a CBPR informed physical activity intervention when offered in groups improved health-related quality of life, physical health, induced behavioural change and potentially builds resilience to withstand the psychosocial and physical effects of the pandemic. The last study shows that a CBPR informed oral health promotion through reflection and dialogue among families together with other stakeholders, influences behavioural change and perceived changes in health among parents and children living in a disadvantaged neighbourhood. In conclusion, this thesis highlights that social support is key to improved perceived health, empowerment, and sustainable behavioural change among citizens in the neighbourhood. Although women are most in need of support, they are also gateways to the families and thereby their communities. And finally, health promoters have had a vital role in engaging communities in health promotional efforts and bringing them closer to other societal actors, strengthening their social bonds and helping build community resilience in the face of adversity.
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| 4. |
- Gaber, Sophie Nadia
(författare)
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The participation of older people with and without dementia in public space, through the lens of everyday technology use
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Participation in activities and places within public space has been linked to numerous health benefits and yet, little is known about participation among older people with and without dementia. Insights about participation in activities and places within public space can contribute to the somewhat ambiguous definition of participation, as “involvement in a life situation”, by acknowledging the complexity and interrelatedness of subjective, social, contextual, temporal, and technological aspects of participation. Thus, the overarching aim of the four studies was to explore participation in activities and places within public space, among older people with and without dementia in two European countries (Sweden and UK), and to evaluate how different aspects, such as the relevance and perceived ability to use Everyday Technologies (ETs), interact with and influence participation, over time.Across all studies, interviews used the Participation in Activities and Places Outside Home Questionnaire (ACT-OUT) and the Everyday Technology Use Questionnaire (ETUQ), in order to focus on the perspectives of older people with and without dementia themselves. Study one explored stability and changes in participation in places visited within public space in relation to the relevance of ETs used in public space, among a baseline Swedish sample. Study two utilised ordinal regression to investigate the ways in which perceived risks and ET use were associated with out-of-home participation, among a UK sample of older people. Using a mixed methods design and data visualisations, study three delved into aspects of social participation in more depth, including ET use and social deprivation of the living environment, among two UK sub-samples of older people with and without dementia. Study four’s longitudinal design and multilevel modelling deepened the knowledge about how use of ET outside home, relates to participation in places visited within public space among a Swedish sample of older people with dementia over time.Study one’s findings demonstrated a statistically significant positive association between a higher person measure of ability to use ETs and higher participation in places visited within public space, among the Swedish sub-sample of older people with dementia but not those without dementia. According to the ordinal regression model in study two, a higher probability of ET use was associated with a higher level of out-of-home participation, among the UK sample of older people. By elucidating motivators, considerations that require extra attention, and management strategies among UK sub-samples of older people with and without dementia, study three provided insights into the nuances of social participation. Finally, study four’s findings revealed that decreasing use of ET outside home was associated with decreasing participation in places visited within public space, in a statistically significant way when accounting for age.In summary, this thesis contributes empirical insights about the participation of older people with and without dementia in activities and places within public space, through the lens of ET use. Such knowledge can be used to develop targeted health and social care planning and the design of more inclusive places, technologies, and services.
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| 5. |
- Johansson, Anette
(författare)
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Hemrehabilitering ur ett personcentrerat perspektiv
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med avhandlingen var att studera hemrehabilitering ur ett personcentrerat perspektiv där de tre första delstudierna utgår ifrån ett kommunalt hemrehabiliteringsprojekt som pågick mellan 2015-2022 i södra Sverige. Kvalitativa och kvantitativa data som samlades in i utvecklingssyfte inom hemrehabiliterings-projektet gjordes tillgängliga för vetenskapliga analyser inom doktorandprojektet. Första delstudien är en kvalitativ studie som utforskade vilka aspekter äldre personer upplevde var av värde för dem i hemrehabilitering. Andra delstudien är en kvantitativ analys av förändringar i funktion och aktivitetsförmåga och hälsa samt faktorer som kan ha påverkat dessa förändringar. Tredje delstudien undersökte relationer mellan standardiserade tester och ett självrapporterat frågeformulär som används vid hemrehabilitering och om det fanns könsskillnader inom och mellan bedömningarna. Avhandlingens fjärde och sista delstudie är en scoping review för att undersöka det internationella kunskapsläget av äldre personers upplevelser av hemrehabilitering. Det sammanlagda resultatet beskrivs och reflekteras utifrån McCormack & McCance’s ramverk för personcentrerad praktik.Resultatet visade att förutsättningar för personcentring fanns i hemrehabiliteringen då deltagarna upplevde personalen som professionellt, socialt och känslomässigt kompetenta. Hemmet som rehabiliteringens sammanhang var uppskattat av de äldre personerna och upplevdes som naturligt att träna i. Det fysiska hemmet innebar både möjligheter och hinder för vardagliga aktiviteter och delaktighet i samhället. För personcentrerade processer var teamsamverkan med internt lärande i hemmet viktigt. När deltagarna involverades som en naturlig del i teamet i hemmet främjades en jämlik relation mellan personal och deltagare. Dock upplevde vissa deltagare en bristande respekt från personalen kring deras integritet och att deras autonomi begränsades när hemmet blev en arbetsplats. En kombination av standardiserade tester och ett självskattningsinstrument bidrog till en kompletterade bedömning av funktion och aktivitetsförmåga. Det framkom dock könsskillnader inom och mellan bedömningsinstrumenten. Hemrehabiliteringen baserades på vad deltagarna själv ansågs vara viktigt för dem. Dock fanns upplevelser av motsatsen där insatsen inte överensstämde med önskemål eller behov. Intensiv rehabilitering med träning av arbetsterapeut och, med statistisk tendens, fysioterapeut var associerat med en förbättrad mobilitet. För deltagare som inte kunde påverka antalet besök och tidpunkt upplevdes ibland besöken som olägliga eller som alltför frekventa. Personcentrerade resultat av hemrehabiliteringen var upplevd förbättrad funktion och aktivitetsförmåga, ökad självständighet, insikt i och ökad tillit till egna förmågor och en känsla av kontroll i vardagen. Mätbara förbättringar framkom inom funktion och aktivitetsförmåga samt självskattad hälsa. De flesta deltagare upplevde att de fått vara delaktiga i beslut och var nöjda med insatsen, vilket dock inte gällde för alla. Avhandlingens slutsats är att hemmet som sammanhang för rehabilitering verkar ha förutsättningar att kunna bidra till skapandet av en personcentrerad praktik. Vissa komponenter och mekanismer kan dock påverka hemrehabiliteringsprocessen negativt. Därför är personalens kompetens och färdighet i att kunna förstå, bedöma och hantera den äldre personens sociala, fysiska och känslomässiga hem som sammanhang för rehabilitering en förutsättning för att en personcentrerad process med personcentrerade resultat kan kunna ske. Avhandlingens implikationer för praktiken presenteras i form av en standardiserad strukturerad hemrehabiliteringsmodell för att guida en personcentrerad praktik.
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| 6. |
- Kottorp, Anders, 1965-
(författare)
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Occupation-based evaluation and intervention : validity of the assessment of motor and process skills when used with persons with mental retardation
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The ability to perform everyday life occupations is a critical component in both evaluation and intervention for persons with mental retardation (MR). While the ability to perform personal and instrumental activities of daily living (ADL) has always been important for occupational therapy (OT) practice, there is an absence in OT literature and research with a focus on ADL and persons with MR. The overall aim of this thesis was to evaluate the validity of the Assessment of Motor and Process Skills (AMPS) for evaluation and intervention of ADL ability for persons with MR.In order to evaluate the evidence of validity of the AMPS ability measures based on relation to level of MR, two groups of participants with MR were evaluated with the AMPS (,#=22; #= 39). The results indicated expected moderate relationships between ADL motor and ADL process ability measures and level of MR, despite different methods used for evaluating level of MR. The results also indicated that the results of the AMPS evaluation could be used to directly describe and measure the consequences in performance of ADL tasks for persons with different levels of MR.The evidence of validity of the AMPS was further examined in a study including participants with different types of developmental disabilities (e.g., MR, cerebral palsy, spina bifida) (#=1724). An application of many-faceted Rasch analysis was used to examine goodness-of-fit of the responses for the tasks, skill items, and participants included in the study. All tasks and all items except one demonstrated acceptable goodness-of-fit to the model on the ADL motor and ADL process scales. An expected proportion of participants demonstrated acceptable goodness-of-fit on the ADL motor scale. On the ADL process scale, a slightly lower proportion of participants than expected demonstrated acceptable goodness-of-fit. The results indicated further that persons with more severe levels of MR and persons with more limited ADL process abilities demonstrated different response patterns across tasks and possibly items.The evidence of validity of the internal structure of the AMPS scales was also evaluated between persons with mild and moderate MR (#=178; #=170). Group specific ADL motor and ADL process skill item hierarchies were generated using many-faceted Rasch analyses and compared. The hierarchies of ADL motor and ADL process skill items remained stable across groups, indicating evidence of validity of the AMPS scales when used to evaluate persons with MR. The results also indicated that although participants with moderate MR demonstrated overall lower mean ADL motor and ADL process ability, they did perform some specific ADL motor and ADL process skills at a similar level as persons with mild MR.Finally, the utility of the AMPS ability measures for detecting change were examined in an intervention study including three female participants with moderate MR. The study was based on a single case design and evaluated the effectiveness of a structured occupational therapy intervention program. Improvements were found for the participants in relation to the implementation of the program, but the pattern of changes were different between the participants and across the dependent variables. ADL process ability was the only variable that improved across all participants. The results supported the ADL process abilities as sensitive measures for detecting changes in ADL ability of persons with MR.In conclusion, the results of these studies contribute to the evidence of validity of the AMPS ability measures and scales, specifically in relation to the evaluation of persons with MR. The finding that an OT program resulted in improved ADL process ability also suggest that the results of the AMPS can be used to plan as well as evaluate outcomes of OT practice. Further research is also suggested in order to improve validity evidence and utility of the AMPS when used with persons with MR.
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| 7. |
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