| 1. |
- Alt Murphy, Margit, 1970, et al.
(författare)
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Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There is an evidence-practice gap in assessment of the upper extremities during acute and subacute stroke rehabilitation. The aim of this study was to target this gap by describing and evaluating the implementation of, and adherence to, an evidence-based clinical practice guideline for occupational therapists and physiotherapists. Methods: The upper extremity assessment implementation process at Sahlgrenska University Hospital comprised 5 stages: mapping clinical practice, identifying evidence-based outcome measures, development of a guideline, implementation, and evaluation. A systematic theoretical framework was used to guide and facilitate the implementation process. A survey, answered by 44 clinicians (23 physiotherapists and 21 occupational therapists), was used for evaluation. Results: The guideline includes 6 primary standardized assessments (Shoulder Abduction, Finger Extension (SAFE), 2 items of the Actions Research Arm Test (ARAT-2), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), 9-Hole Peg Test (9HPT), and grip strength (Jamar hand dynamometer)) performed at specified time-points post-stroke. More than 80% (35 to 42) clinicians reported reported being content with the guideline and the implementation process. Approximately 60-90% of the clinicians reported good adherence to specific assessments, and approximately 50% reported good adherence to the agreed time-points. Comprehensive scales were more difficult to implement compared with the shorter screening scales. High levels of work rotation among staff, and the need to prioritize other assessments during the first week after stroke, hindered to implementation. Conclusion: The robustness of evidence, adequate support and receptive context facilitated the implementation process. The guideline enables a more structured, knowledge-based and consistent assessment, and thereby supports clinical decision-making and patient involvement.
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| 2. |
- Heikkilä, Kristiina, 1958-, et al.
(författare)
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Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model : An integrative review
- 2022
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 47, s. 171-182
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Tidskriftsartikel (refereegranskat)abstract
- Mealtimes are important events in care homes for physical and social well-being. However, residents usually have little input concerning meal timings, what food is offered, and how it is served. This integrative review explored mealtime interventions and their outcomes in care homes related to the Five Aspects Meal Model (FAMM). Research articles published 2010–2021 were searched for in ASSIA, CINAHL, PsycINFO, PubMed, and SveMed+ and resulted in 13 articles focusing on interventions. The analysis was based on the aspects of FAMM: room, meeting, product, management control system, and atmosphere. The result shows that even though interventions specifically focused on one aspect, they often evaluated outcomes related to several aspects. Different aspects can work together to foster effective mealtimes. FAMM eased to visualise the usefulness of mealtime interventions from a broad perspective and can be a useful tool for assessing and improving mealtime situations in clinical practice.
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| 3. |
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| 4. |
- Hussain, Netha, et al.
(författare)
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Prevalence of symptoms of anxiety and depression one year after intensive care unit admission for COVID-19
- 2024
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Ingår i: BMC PSYCHIATRY. - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTo the best of our knowledge, the long term prevalence of symptoms of anxiety and depression in ICU admitted individuals after COVID-19 in Sweden during the first wave of the pandemic has not been investigated. Furthermore, no studies have exclusively investigated the risk factors for experiencing symptoms of anxiety and depression in this population.AimThe aim of this study was to determine the prevalence of symptoms of anxiety and depression at one year after ICU admission for COVID-19. An additional aim was to identify any early predictors that are associated with symptoms of anxiety and depression, at one year following ICU admission for COVID-19.MethodsThis multicenter cohort study had a cross-sectional and a longitudinal design. The primary outcomes and dependent variables, symptoms of anxiety and depression, were assessed using the Hospital Anxiety and Depression Scale (HADS). The independent variables were related to demographic factors, comorbidities, and complications during COVID-19-related ICU admission. Logistic regression analyses were performed to identify any predictors of symptoms of anxiety and depression.ResultsOut of 182 eligible individuals, 105 participated in the study. Symptoms of anxiety was found in 40 (38.1%) and depression in 37 (35.2%) of the participants. Using univariable logistic regression analyses, female sex was identified as a predictor of depression as defined by HADS at one year following ICU admission for COVID-19 (odds ratio 2.53, 95% confidence intervals 1.01-6.34, p-value 0.048).ConclusionsThe high prevalence of symptoms of anxiety and depression in ICU admitted individuals one year after COVID-19 is a public health issue of concern. Our findings imply that individuals who recovered after an ICU stay for COVID-19 may benefit from long-term follow-ups and continuous mental health support for more than a year following the ICU admission. For women specifically, this is true.
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| 5. |
- Larsson, Jenny, 1974-, et al.
(författare)
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Anti-inflammatory effects of a titanium-peroxy gel: role of oxygen metabolites and apoptosis.
- 2004
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Ingår i: Journal of biomedical materials research. Part A. - : Wiley. - 1549-3296 .- 0021-9304 .- 1097-4636. ; 68:3, s. 448-57
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Tidskriftsartikel (refereegranskat)abstract
- Polymorphonuclear neutrophils (PMN) are among the first inflammatory cells to arrive at an implant interface, where they encounter with the foreign material and may produce reactive oxygen species (ROS). During the interaction between titanium and ROS, titanium-peroxy (Ti-peroxy) compounds may be formed. We used a Ti-peroxy gel, made from titanium and hydrogen peroxide, to study the effects of Ti-peroxy compounds on PMN. In the absence of serum, the Ti-peroxy gel decreased the oxidative response of PMN to yeast and PMA and reduced PMN apoptosis without inducing necrosis. These effects could not be ascribed to the release of hydrogen peroxide from the Ti-peroxy gel, because a steady-state hydrogen peroxide producing system failed to mimic the effects of the gel. The effects were similarly unaffected when PMN were preincubated with beta(2)-integrin antibodies, questioning the involvement of adhesion molecules. Nevertheless, when a filter was used to separate the Ti-peroxy gel from the cells, the gel effect on PMN life span was abolished, pointing to a contact-dependent mechanism. In the presence of serum, the Ti-peroxy gel had no effect on the PMN oxidative response and life span, but appeared rather inert. In summary, this study demonstrates that the Ti-peroxy gel has potentially anti-inflammatory properties through a combined peroxide and physical contact effect, supporting the notion that interactions between titanium and inflammatory cells are responsible for the good performance of titanium in vivo.
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| 6. |
- Nielsen, Magdalena, et al.
(författare)
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The five aspects mealtime environment observationinstrument for assessing mealtime environments in nursing homes : Development and validation
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712.
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Tidskriftsartikel (refereegranskat)abstract
- Aims and ObjectivesTo further develop and validate the Mealtime instrument, an observational instrument for assessing mealtime environments in nursing homes originating from the theoretical framework: Five Aspects Meal Model (FAMM).Methodological Design and JustificationA mealtime experience is significant for a sense of well-being. In nursing homes, residents' personal preferences, combined with their diagnoses and different stages of illness, influence their mealtime experience and provide a complexity that has been found difficult to assess. Using FAMM, a theoretical framework as its base, this study, attempts to look at different parts of the mealtime environment. FAMM structures the mealtime environment in to five aspects: room, meeting, product, management control system and atmosphere.This study's design includes instrument development and validation.Ethical Issues and ApprovalThis study has been approved by the Swedish Ethical Review Authority (dnr 2019–05477).DesignMethodological study.Research MethodAn existing instrument, the Mealtime instrument with FAMM as a theoretical framework, was used as a foundation for the development of the Five Aspects Mealtime Environment Observation Instrument (FAME-OI). Content validity index (CVI) was used to validate FAME-OI.ResultsFAME-OI's item-CVI, scale-CVI and modified Kappa displayed high validity. Changes were made in its structure and phrasing. These developments resulted in having a distinct structure in FAME-OI, in reference to FAMM.ConclusionFAME-OI is applicable for clinical use in nursing homes and in research; however, adjustments may be needed before its use in other health care facilities.
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| 7. |
- Persson, Carina Ulla, 1970, et al.
(författare)
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Secular trends in cardiovascular risk factors among women aged 45-54years in Gothenburg, Sweden, from 1980 to 2014
- 2020
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34years.MethodsSix population-based, cross-sectional samples of women (n=2294) mean age: 49.8years (range: 45-54), living in Gothenburg, Sweden, were investigated between 1980 and 2014.ResultsBody mass index (BMI) increased over time, with a mean BMI of 24.7kg/m(2) in 1980 to 25.7kg/m(2) in 2013-2014, corresponding to a weight gain of 4.5kg, together with an increase in the proportion of obese individuals (BMI >= 30kg/m(2)) from 10.4 to 16.6% (p=0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p=0.0006) and from 37.7 to 24.5% (p<0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013-2014 (p<0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013-2014 (p<0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38-2.41), compared with women born in 1925-1934.ConclusionThe trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated.
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| 8. |
- Samuelsson, Carina M, et al.
(författare)
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Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT).
- 2019
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 33:4, s. 773-783
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Tidskriftsartikel (refereegranskat)abstract
- To identify the incidence of falls and factors present shortly after stroke, which are associated with the occurrence of falls over the first 12months after stroke onset, following discharge from inpatient rehabilitation.Prospective follow-up study.Stroke unit and outpatient department.A total of 490 individuals with acute stroke.Postural control was assessed using the Swedish modified version of the Postural Assessment Scale for Stroke Patients. Data on self-reported falls were collected using a standardized questionnaire at threemonths after discharge and six and 12months after stroke onset. Associations between characteristics during the acute phase after a stroke and falls after six and 12months were investigated using univariable and multivariable regression analyses.The endpoint was a self-reported fall.Within threemonths after discharge, 38 of 165 respondents (23%) had experienced at least one fall. Within six and 12months after stroke onset, respectively, 108 of 376 (29%) and 140 of 348 (40%) of the respondents had experienced at least one fall. Poor postural control (odds ratio 3.92, 95% confidence interval 2.07-7.45, P<0.0001) and using a walking aid (odds ratio 2.84, 95% confidence interval 1.71-4.72, P<0.0001) were predictors of falls after discharge within 12months after stroke onset. The same variables were independent predictors of falls within sixmonths.Poor postural control and using a walking aid in the acute phase after a stroke are associated with falls after discharge from a stroke unit within 12months after stroke onset.
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| 9. |
- Schnitzer, Lior, et al.
(författare)
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Fatigue in stroke survivors: a 5-year follow-up of the Fall study of Gothenburg
- 2023
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Ingår i: Journal of Neurology. - 0340-5354 .- 1432-1459. ; 270:10, s. 4812-4819
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Tidskriftsartikel (refereegranskat)abstract
- Longer term knowledge of post-stroke fatigue (PSF) is limited. Our aim was to describe the prevalence of, and to identify baseline predictors associated with, PSF 5years after stroke. We undertook a follow-up of stroke survivors from the 504 consecutively recruited participants in the observational “The Fall Study of Gothenburg”, conducted between 2014 and 2016. The dependent variable, PSF, was assessed using the Swedish version of the Fatigue Assessment Scale (S-FAS) and defined as having a S-FAS score ≥ 24. The S-FAS questionnaire was mailed to potential participants in August 2020. The independent variables, previously obtained from medical records, included age; sex; comorbidities; stroke severity; hospital length of stay; body mass index (BMI); number of medications and lifestyle factors at index stroke. To identify predictors of PSF, univariable and multivariable logistic regression analyses were performed. Of the 305 eligible participants, 119 (39%) responded with complete S-FAS. Mean age at index stroke was 71 (SD 10.4) years and 41% were female. After a mean of 4.9years after stroke, the prevalence of PSF was 52%. Among those with PSF, almost two thirds were classified as having both physical and mental PSF. In the multivariable analysis, only high BMI predicted PSF with an odds ratio of 1.25 (95% CI 1.11–1.41, p < 0.01). In conclusion, half of the participants reported PSF 5years after index stroke and higher body mass index was identified as a predictor. The findings from this study are important for healthcare professionals, for planning health-related efforts and rehabilitation of stroke survivors. ClinicalTrials.gov, Identifier NCT02264470.
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| 10. |
- Segerdahl, Mårten, et al.
(författare)
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Health-related quality of life in stroke survivors: a 5-year follow-up of The Fall Study of Gothenburg (FallsGOT)
- 2023
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Ingår i: BMC Geriatrics. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are limited data on long-term prevalence and predictors of health-related quality of life (HRQoL) in stroke survivors. Therefore, the aim was to describe the prevalence of impaired HRQoL, and to identify factors in acute stroke that are associated with impaired HRQoL, 5years after stroke. Methods: The 305 (60.5%) stroke survivors of the original 504 participants from The Fall Study of Gothenburg were invited to participate in a 5-year follow-up including assessment of HRQoL using the EuroQol 5 Dimensions 3 Levels questionnaire (EQ-5D-3L). To identify baseline predictors of impaired HRQoL, based on the EQ-5D-3L’s five dimensions, univariate and multivariate logistic regression analyses were performed. Results: A total of 129 participants (42.3% of the survivors) completed the questionnaire at a median follow-up time of 58months. At baseline, their mean age was 70.6years, and they had a median NIHSS score of 1. The median (interquartile range [IQR]) EQ-5D-3L index score was 0.87 (0.71–0.93) and the median (IQR) EQ-visual analogue scale was 70 (49.8–88). In total, 102 (79%) participants were classified as having impaired HRQoL, stated primarily (among 68.5%) related to Pain/Discomfort. Higher age was identified as a predictor of impaired HRQoL related to Mobility (Odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01–1.10) and Self-Care (OR 1.09, 95% CI 1.02–1.17), and longer hospital stay at baseline was identified as a predictor related to Mobility (OR 1.09, 95% CI 1.01–1.18), Self-Care (OR 1.10, 95% CI 1.02–1.18)) and Usual Activities. (OR 1.10, 95% CI 1.03–1.18). Conclusion: At 5years after stroke, four out of five participants (79%) reported impaired HRQoL related to any of the five dimensions assessed by using the EQ-5D-3L. Most reported, impaired HRQoL was related to Pain/Discomfort. Higher age and longer hospital care period at index stroke were associated with impaired HRQoL. The findings could assist to identify individuals at high risk of low HRQoL, who might benefit from special attention and psychological support.
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