| 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.
|
|
| 11. |
- Carmont, Michael R, 1972, et al.
(författare)
-
No difference in achilles tendon resting angle, patient-reported outcome or heel-rise height index between non-and early-weightbearing the first year after an achilles tendon rupture
- 2020
-
Ingår i: Muscles, Ligaments and Tendons Journal. - : Edra SpA. - 2240-4554. ; 10, s. 651-658
-
Tidskriftsartikel (refereegranskat)abstract
- © 2020, CIC Edizioni Internazionali s.r.l.. All rights reserved. Background. Patient-reported outcome scores and comparable re-rupture rates in randomized controlled trials have not shown a definitive benefit for operative treatment after acute Achilles tendon rupture. This, together with the increasing rupture rates in the older age group has led to non-operative treatment being increasingly used. Objective. This study aimed to determine the variation in Achilles Tendon Resting Angle (ATRA) together with patient reported and functional outcome, with non-operative management of the ruptured Achilles tendon using two different regimes, which have been shown to offer low re-rupture rates. Methods. This is a non-randomised cohort comparison of Achilles tendon rupture patients managed with Non-Weight-Bearing (NWB) for 6 weeks vs. Early Weight-Bearing (EWB). The NWB-group received a cast in plantar flexion for 2 weeks followed by 6 weeks in a controlled ankle motion boot with incremental diminishing plantar flexion. The EWB-group received an initial anterior protective plaster slab in plantar flexion followed by 6 weeks of weight-bearing on the meta-tarsal heads, with an anterior shell restricting dorsiflexion. Results. At 12 months after the injury there were no differences in any of the variables between the two treatment groups. The NWB-group compared to the EWB-group reported at mean (SD) for ATRA-9.8˚ (4.6˚) versus-11.4˚ (5˚), p=0.32, for Achilles tendon Total Rupture Score (ATRS) 87 (10) versus 79 (19), p=0.43 and for Heel-Rise Height Index (HRHI) 71% (19%) versus 59% (13%), p=0.13. Conclusions. The two methods of non-operative treatment studied lead to increased relative ATRA following injury, however, patients report only minor limitation in terms of outcome. Patients had almost a third less heel-rise height compared with the non-injured ankle.
|
|
| 12. |
- Carmont, Michael R, 1972, et al.
(författare)
-
No difference in strength and clinical outcome between early and late repair after Achilles tendon rupture.
- 2020
-
Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 28, s. 1587-1594
-
Tidskriftsartikel (refereegranskat)abstract
- This retrospective study aimed to determine the patient-reported and functional outcome of patients with delayed presentation, who had received no treatment until 14days following injury of Achilles tendon rupture repaired with minimally invasive surgery and were compared with a group of sex- and age-matched patients presenting acutely. Based on the outcomes following delayed presentation reported in the literature, it was hypothesized that outcomes would be inferior for self-reported outcome, tendon elongation, heel-rise performance, ability to return to play, and complication rates than for acutely managed patients.Repair was performed through an incision large enough to permit mobilisation of the tendon ends, core suture repair consisting of a modified Bunnell suture proximally and a Kessler suture distally and circumferential running suture augmentation.Nine patients presented 21.8 (14.9)days (range 14-42days) after rupture. The rate of delayed presentation was estimated to be 1 in 10. At 12months following repair, patients with delayed treatment had median (range) ATRS score of 90 (69-99) compared with 94 (75-100) in patients treated acutely presenting 0.66 (1.7) (0-5)days. There were no significant differences between groups: ATRA [mean (SD) delayed: -6.9° (5.5), acute: -6° (4.7)], heel-rise height index [delayed: 79% (20), acute: 74% (14)], or heel-rise repetition index [delayed: 77% (20), acute: 71% (20)]. In the delayed presentation group, two patients had wound infection and one iatrogenic sural nerve injury.Patients presenting more than 2weeks after Achilles tendon rupture may be successfully treated with minimally invasive repair.III.
|
|
| 13. |
- Carmont, Michael R, 1972, et al.
(författare)
-
The release of adhesions improves outcome following minimally invasive repair of Achilles tendon rupture
- 2022
-
Ingår i: Knee Surgery Sports Traumatology Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 30, s. 1109-1117
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose Operative repair of Achilles tendon rupture may lead to complications, which influence outcome adversely. The aim of this study was to determine the incidence, impact and response to treatment of post-operative adhesions. Methods From February 2009 to 2021, 248 patients operated on with percutaneous or minimally invasive surgical repair have been prospectively evaluated using the Achilles tendon Total Rupture Score (ATRS) and Heel-Rise Height Index (HRHI), following acute Achilles tendon rupture. Results Fourteen (5.6%) patients were identified as having adhesions. Four patients reported superficial adhesions and ten patients reported a deeper tightness of the tendon. At a mean (SD) of 10.5 (2.3) months following repair, the overall ATRS was at a median (IQR) 65 (44.5-78) points and (HRHI) was mean (SD) 81.5 (13.5)%. Of those deemed to have deep adhesions the antero-posterior diameter of the tendon was at mean (SD) 15.6 (4.6) mm. Open release of superficial adhesions resulted in improved ATRS in all patients. Endoscopic debridement anterior to the Achilles tendon led to alleviation of symptoms of tightness and discomfort from deep adhesions and improved outcome in terms of the ATRS score. At a mean (SD) of 15.9 (3.3)-month follow-up from initial rupture and repair, the patients reported at median (IQR) ATRS scores of 85 (64.8-92.8) points, Tegner level 5 (3-9) and mean (SD) HRHI 86.2 (9.5)%. Patients significantly improved both ATRS and HRHI following release at median (IQR) of 16.5 (- 1.8-29.3) points (p = 0.041) and mean (SD) 5.6 (8.3)% (p = 0.043). Conclusions The incidence of patient-reported adhesions following minimally invasive repair of Achilles tendon rupture was estimated to be 5.6%. The occurrence of superficial adhesions was associated with a lower outcome scores as well as symptoms of anterior tendon tightness and stiffness were associated with a lower score in most patients. Surgical release of adhesions led to a significant improvement in outcome.
|
|
| 14. |
- Carmont, Michael R, 1972, et al.
(författare)
-
The reliability, reproducibility and utilization of the radiographic Achilles Tendon Loading Angle in the management of Achilles Tendon rupture.
- 2021
-
Ingår i: Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons. - : Elsevier BV. - 1460-9584. ; 27:7, s. 760-766
-
Tidskriftsartikel (refereegranskat)abstract
- During management of Achilles tendon rupture, determination of tendon-end approximation, either clinically or by ultrasound is difficult, following brace application of during loading. The Radiographic Achilles Tendon Loading Angle (RadATLA) is proposed as a method of measuring ankle position whilst loading in a brace during the management of Achilles tendon rupture. This study aims to determine the reliability and reproducibility of the RadATLA.A loaded true lateral ankle radiograph including the fifth metatarsal head was taken when wearing a brace at the 6-week time point in 18 patients (19 ankles). following Achilles tendon repair or reconstruction. The RadATLA was compared with the Tibio-talar angle, other radiographic and clinical measures used to quantify foot and ankle position during the first 6 weeks of early rehabilitation in a resting position and during loading.The intra-rater reliability of both angles was found to be good (>0.8). The RadATLA was found to have an excellent intra-rater reliability with Intra-class correlation of (ICC) 0.992-0.996 (95%CI 0.889-0.999), standard error of the measurement (SEM) 1.03-3.65 and Minimal Detectable Change (MDC) 2.86-10.12. The inter-rater reliability was good with ICC of 0.798-0.969 (95%CI-0.03 to 0.964), SEM 2.9-7.6, and MDC 8.1-20.9. The RadATLA loaded at 6 weeks in all patients was at mean (SD) (range) 41.9˚ (16.5), (18.5-75.9). There was a significant difference between the patients in the Repair group compared with patients in the Reconstruction group both in RadATLA loaded at 6 weeks: 35.6˚ (11.2), (18.5-56.5) versus 55.5˚ (19), (20-75.9), (p = 0.01). The amount loaded in all patients was at mean (SD) (range) 29.2Kg (17.7), (2-56) and the percentage Body Weight was 30.7% (19), (2.1-63.2). There were no differences between the groups neither in amount loaded nor in percentage Body weight (p = 0.614-0.651).The RadATLA is a reliable and reproducible angle and can be used to determine the position of the ankle, when loaded in a brace during rehabilitation following Achilles tendon rupture.
|
|
| 15. |
- Darcy, Laura, 1967-, et al.
(författare)
-
Humanising Care for Sick Children in Hospital : – are we ready to meet the demands of The Convention on Human Rights of the Child (CHRC)?
- 2018
-
Konferensbidrag (refereegranskat)abstract
- BackgroundNursing Care of children is complex and nurses need specific knowledge in meeting children to ensure high quality care. Caring for children based on their age, developmental stage and maturity can be a challenge for nurses and sets demands on care. When the CRC becomes law in Sweden 2020 children’s rights will be strengthened and we can expect repercussions in the quality of care delivered to children in need AimThe aim of this study was to investigate the degree to which nurses in paediatric hospital services work in compliance with the CRC. Method Nurses in paediatric services in Western Sweden answered a survey on if their work situation allowed them to give care to children in accordance with the CRC. Survey responses (n=69) were analysed with descriptive analysis. Personal interviews were performed with paediatric nurses (n=9) and analysed with a qualitative content analysis. ResultsNurses working in paediatric services are well aware of children’s rights in health care and strive to meet children’s needs. However, a stressed working situation with lack of time and/or an environment that is not child friendly means that their caring is not always optimal. Children are not participatory to the degree nurses would wish then to be and the CRC stipulates they should. ConclusionsNurses working with children show competence in and knowledge of children’s needs. However thay are limited by their working environments. Clear guidelines and working tools such as time for reflection are suggestions of measures that need to be taken to ensure compliance with the upcoming demands of the CRC.
|
|
| 16. |
- darcy, laura, 1967-, et al.
(författare)
-
Humanising children's suffering during medical procedures
- 2017
-
Ingår i: European Conference in Nursing and Nursing Research 2017. - : Springer Science and Business Media LLC. ; , s. 32-
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Humanising children’s suffering during medical procedures Laura Darcy, Katarina Karlsson, Kate GalvinBackground: The views of children have historically been seen as unimportant – they have been viewed as unintelligent and unable to tell of their experiences or participate in care, resulting in dehumanisation. Recent research has given young vulnerable children a voice and highlighted the importance of caring humanly for sick children (Darcy, 2015 & Karlsson, 2015). A conceptual framework consisting of eight dimensions of humanisation has been proposed by Todres, Galvin and Holloway (2009)which can highlight the need for young children to be cared for as human beings: Insiderness, Agency, Uniqueness, Togetherness, Meaning – making, Personal journey, Sense of Place and Embodiment. The aim of this study is to demonstrate the value of a humanising theoretical framework in paediatric care illustrated by examples of young children’s suffering when undergoing medical procedures.Materials and Methods: In two separate Swedish studies 20 children (3-7 years of age) with a variety of diagnosis were interviewed about their experiences of everyday life with cancer or their experiences of undergoing painful medical procedures. Parents and nurses views were welcomed as complimentary to child data. Interviews had been analysed qualitatively by either content analyses or by phenomenological and life world hermeneutic approaches. In the present study, a secondary inductive qualitative content analysis of the results has been made based on the proposed dimensions of humanisation/dehumanistion.Results: The eight dimensional framework Illustrated several forms of dehumanisation: Objectification –children’s opinions and experiences are seldom requested; Passivity – the use of restraint still happens and negatively affects the child; Homogenisation – children are viewed as their diagnosis; Isolation – children sense separation from parents, siblings and friends; Loss of meaning –appropriate information and preparation for the child is lacking; Loss of personal journey - everyday life functioning is affected making it difficult to see meaning; Dislocation – a sense of homelessness is experienced at home, at the hospital and at preschool/school; Reductionist view – medical procedures becomes the professional focus of care, not the child.Conclusion: Dehumanisation occurs when humanising dimensions are obscured to a significant degree. Children’s own voices in care and research are required to correct the present power imbalance. Children require assistance in making sense of healthcare situations through play and preparation. Access to family and friends, being treated with dignity and encouragement to participate in care, will encourage humanising the dehumanisation illustrated in this study.References: Darcy, L. (2015). The everyday life of young children through their cancer trajectory. Jönköping: School of Health Sciences.Karlsson, K. (2015). ”I´m afraid, I want my mommy”: Younger children´s, parents’ and nurses´ lived experiences of needle procedures in health care. Jönköping: Jönköping University, School of Health and WelfareTodres, L., Galvin, K. T., & Holloway, I. (2009). The humanization of healthcare: A value framework for qualitative research. International Journal of Qualitative Studies on Health and Well-being, 4(2), 68-77.
|
|
| 17. |
|
|
| 18. |
- Darcy, Laura, 1967-, et al.
(författare)
-
The use of restraint with young children during painful medical procedures
- 2016
-
Ingår i: Nordic Conference in Nursing Research 2016.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Children’s need for support is tied to their experiences of fear during times of trauma and uncertainty. Two recent studies gave insight to the experiences of young children (3-7 years of age) undergoing painful medical procedures. Children and parents described trauma related to the suddenly changed caring role parents’ play: from caring parent to health care assistant. Parents helped restrain children and took part in painful and unpleasant procedures and treatments. Nurses described the use of restraint as sometimes necessary due to logistical constraints but also as supportive to the child. Lack of access to parents as protectors was experienced as traumatic by the child. The child felt ashamed, humiliated and powerless, having lost the right to control his/her own body.The aim of this paper is to review the use of restraint with young children during painful medical proceduresFrom the young child’s perspective, restraint is never supportive. Children require a sense of security to overcome fear. When the child seeks security in an adult, the adult’s response becomes extremely important. Children need to guide and be guided by adults, until they think: “I can manage this”. Adequate support enables a caring situation characterised by mutual trust. Parents ought to be involved to help alleviate fear, but strategies for collaboration and role definition for parents and health care professionals need to be reassessed.
|
|
| 19. |
- Glise Sandblad, Katarina, 1982, et al.
(författare)
-
Prevalence of Cancer in Patients with Venous Thromboembolism: A Retrospective Nationwide Case-Control Study in Sweden.
- 2023
-
Ingår i: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. - : SAGE Publications. - 1938-2723. ; 29
-
Tidskriftsartikel (refereegranskat)abstract
- Cancer is a risk factor for venous thromboembolism (VTE). We aimed to define sex-specific risk of preceding cancer in patients with a first-time VTE by conducting a nationwide Swedish registry-based study including 298172 patients with VTE and 1185079 matched controls. This included 44685 patients with a diagnosis of cancer at/or within 1 year before a VTE diagnosis. Female patients with VTE had a higher multivariable adjusted odds ratios of preceding cancer than male patients with VTE (5.5 [99% confidence interval 5.4-5.7] vs 3.9 [3.8-4.0]). The highest risk of cancer in patients with VTE were found for pancreatic cancer (women: 19.6 [15.8-24.4]; men: 17.2 [13.7-21.6]) and brain cancer (women: 17.4 [12.9-23.4]; men: 17.5 [13.8-22.2]). Weak associations were seen between VTE and bladder/urothelial cancer (women: 1.31 [1.12-1.53]; men: 1.34 [1.23-1.47]), prostate cancer (men: 2.17 [2.07-2.27]), malignant melanoma (women: 2.51 [2.07-3.05]; men: 2.67 [2.23-3.18]), and kidney cancer (women: 3.20 [2.49-4.11]; men: 3.33 [2.79-4.07]). In conclusion, associations with VTE were weak for bladder/urothelial cancer and kidney cancer, and strong for pancreatic, brain, and biliary cancers.
|
|
| 20. |
- Grävare Silbernagel, Karin, 1965, et al.
(författare)
-
Sex Differences in Outcome After an Acute Achilles Tendon Rupture.
- 2015
-
Ingår i: Orthopaedic journal of sports medicine. - : SAGE Publications. - 2325-9671. ; 3:6
-
Tidskriftsartikel (refereegranskat)abstract
- Tendon healing differs between the sexes. Comparisons in outcome between the sexes after an Achilles tendon rupture are often not possible because of the small cohort (<20%) of women.
|
|
| 21. |
- Gustafsson, Ida, et al.
(författare)
-
Breastfeeding and experienced exposedness in partner relationshiop
- 2023
-
Ingår i: Abstract Book The Nordic Breastfeeding Conference 2023.
-
Konferensbidrag (refereegranskat)abstract
- BREASTFEEDING AND EXPERIENCED EXPOSEDNESS IN PARTNER RELATIONSHIPIda Gustafsson RN, RM, Lecturer, PhD-studentFaculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SwedenGunilla Carlsson RN, PhD, ProfessorFaculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SwedenKatarina Karlsson RN, PhDFaculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SwedenAleksandra Jarling RN, PhD, LecturerFaculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SwedenLina Palmér RN, RM, PhD, Associate Professor, DocentFaculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden Background: About 110 000 children are born in Sweden annually. The vast majority of their mothers wish to breastfeed, and also initiate breastfeeding. An important factor for continued breastfeeding is support, especially from the partner. It is likely that lack of support can lead to perceived vulnerability in the partner relationship. Intimate partner violence (IPV) during pregnancy is in Sweden nearly as common as gestational diabetes and the frequency seems to rise postpartum. IPV is multifaceted and encompasses many types and degrees of violence. In a caring science perspective the experience of vulnerability and/or exposedness in partner relationship during breastfeeding (or breastfeeding desire) risks negatively affecting womens health and well-being, regardless of the reason or degree of exposedness. For care to be caring - that is, support health and well-being - knowledge is needed from the perspective of the exposed women. Previous lifeworld theoretical research has shown that breastfeeding may be experienced as an existential challenge and that exposedness to violence during the childbearing period means a long-lasting embodied experience. In this project, these two phenomena are intertwined into a common phenomenon - Breastfeeding in case of experienced exposedness in a partner relationship. Aim: The purpose of the PhD-project is to develop in-depth knowledge of existential meanings of breastfeeding in case of experienced exposedness in a partner relationship (Study 1-2), and what it means to be cared for (Study 3), as well as to give care and support in this context (Study 4). Methods: The project has a reflective lifeworld approach. Data has been collected through lifeworld interviews and written lifeworld stories and will be analyzed using a phenomenological or hermeneutical approach. Results & Conclusion: The results and conclusions of the first study are expected to be completed in the summer of 2023 and will be presented at the conference.
|
|
| 22. |
- Hallberg, Pär, et al.
(författare)
-
Transforming growth factor beta1 genotype and change in left ventricular mass during antihypertensive treatment : results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation versus Atenolol (SILVHIA)
- 2004
-
Ingår i: Clinical Cardiology. - : Wiley. - 0160-9289 .- 1932-8737. ; 27:3, s. 169-73
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Angiotensin II, via the angiotensin II type 1 (AT1) receptor, may mediate myocardial fibrosis and myocyte hypertrophy seen in hypertensive left ventricular (LV) hypertrophy through production of transforming growth factor beta1 (TGF-beta1); AT1-receptor antagonists reverse these changes. The TGF-beta1 G + 915C polymorphism is associated with interindividual variation in TGF-beta1 production. No study has yet determined the impact of this polymorphism on the response to antihypertensive treatment. HYPOTHESIS: We aimed to determine whether the TGF-beta1 G + 915C polymorphism was related to change in LV mass during antihypertensive treatment with either an AT1-receptor antagonists or a beta1-adrenoceptor blocker. The polymorphism was hypothesized to have an impact mainly on the irbesartan group. METHODS: We determined the association between the TGF-beta1 genotype and regression of LV mass in 90 patients with essential hypertension and echocardiographically diagnosed LV hypertrophy, randomized in a double-blind study to receive treatment for 48 weeks with either the AT1-receptor antagonist irbesartan or the beta1-adrenoceptor blocker atenolol. RESULTS: Irbesartan-treated patients who were carriers of the C-allele, which is associated with low expression of TGF-beta1, responded with a markedly greater decrease in LV mass index (LVMI) than subjects with the G/G genotype (adjusted mean change in LVMI -44.7 g/m2 vs. -22.2 g/m2, p = 0.007), independent of blood pressure reduction. No association between genotype and change in LVMI was observed in the atenolol group. CONCLUSIONS: The TGF-beta1 G + 915C polymorphism is related to the change in LVMI in response to antihypertensive treatment with the AT1-receptor antagonist irbesartan.
|
|
| 23. |
- Karlsson, Katarina, 1963-, et al.
(författare)
-
Creativity During Data Collection When Researching Existential Phenomena in Caring Science
- 2022
-
Ingår i: International journal for human caring. - 1091-5710. ; :1, s. 1-8
-
Tidskriftsartikel (refereegranskat)abstract
- In this study, we highlight the importance of methodological creativity when researching existential phenomena in caring science. Our intention is to provide epistemological and methodological support that would encourage researchers to be creative when collecting data. One fruitful way to approach creativity involves basing one’s research on the epistemological and methodological ideas of lifeworld research. We will illustrate the usefulness of lifeworld research via examples from empirical caring science research and show how creativity may contribute to a profound understanding of patients’ experiences. Hopefully, this article will help other researchers be creative without losing epistemological foundations and scientific validity.
|
|
| 24. |
- Karlsson, Katarina, 1963-, et al.
(författare)
-
Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7 Years)
- 2016
-
Ingår i: Journal of Pediatric Nursing. - : Elsevier BV. - 0882-5963 .- 1532-8449. ; 31:6, s. 667-677
-
Tidskriftsartikel (refereegranskat)abstract
- Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.AIM:This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.METHOD:The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs.RESULTS:The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.CONCLUSIONS:The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.
|
|
| 25. |
- Karlsson, Katarina, 1963-, et al.
(författare)
-
Medical procedures in children using a conceptual framework that keeps a focus on human dimensions of care–a discussion paper.
- 2019
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Taylor & Frances : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 14:1
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Children's perspectives in the context of health service delivery have historically been seen as unimportant. They have been viewed as unintelligent, unable to effectively share or tell of their experiences or fully participate in their care, potentially resulting in a sense of dehumanisation. Method: The present paper illustrates children's experiences when undergoing medical procedures, using application of the eight dimensions of humanised care theoretical framework. Results: Findings from six published papers were reflectively interrogated to identify implicit findings related to the dimensions of humanised care. These implicit findings show ways of caring for childrenwhichcan lead to enhanced human sensitivity in care or conversely where the dimensions of being human are obscured to greater or lesser degrees and can result in forms of dehumanisation. Conclusions: Inadvertent dehumanising features of practice can be mediated by encouraging the inclusion of children's own lifeworld perspective and make room for their voices in both care and research. In this way the present well documented power imbalance could be addressed. Adding the value of the theoretical framework highlights areas of need for young children to be cared for as human beings.
|
|
