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Sökning: WFRF:(Dahlgren Gunilla)

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1.
  • Aboagye, Emmanuel, et al. (författare)
  • Individual preferences for physical exercise as secondary prevention for non-specific low back pain : a discrete choice experiment
  • 2017
  • Ingår i: PLOS ONE. - : Public library science. - 1932-6203. ; 12:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Exercise is effective in improving non-specific low back pain (LBP). Certain components of physical exercise, such as the type, intensity and frequency of exercise, are likely to influence participation among working adults with non-specific LBP, but the value and relative importance of these components remain unknown. The study's aim was to examine such specific components and their influence on individual preferences for exercise for secondary prevention of non-specific LBP among working adults. Methods: In a discrete choice experiment, working individuals with non-specific LBP answered a webbased questionnaire. Each respondent was given ten pairs of hypothetical exercise programs and asked to choose one option from each pair. The choices comprised six attributes of exercise (i.e., type of training, design, intensity, frequency, proximity and incentives), each with either three or four levels. A conditional logit regression that reflected the random utility model was used to analyze the responses. Results: The final study population consisted of 112 participants. The participants' preferred exercise option was aerobic (i.e., cardiovascular) rather than strength training, group exercise with trainer supervision, rather than individual or unsupervised exercise. They also preferred high intensity exercise performed at least once or twice per week. The most popular types of incentive were exercise during working hours and a wellness allowance rather than coupons for sports goods. The results show that the relative value of some attribute levels differed between young adults (age <= 44 years) and older adults (age <= 45 years) in terms of the level of trainer supervision required, exercise intensity, travel time to exercise location and financial incentives. For active study participants, exercise frequency (i.e., twice per week, 1.15; CI: 0.25; 2.06) influenced choice of exercise. For individuals with more than one child, travel time (i.e., 20 minutes, - 0.55; CI: 0.65; 3.26) was also an influential attribute for choice of exercise, showing that people with children at home preferred to exercise close to home. Conclusions: This study adds to our knowledge about what types of exercise working adults with back pain are most likely to participate in. The exercise should be a cardiovascular type of training carried out in a group with trainer supervision. It should also be of high intensity and preferably performed twice per week during working hours. Coupons for sports goods do not appear to motivate physical activity among workers with LBP. The findings of the study could have a substantial impact on the planning and development of exercise provision and promotion strategies to improve non-specific LBP. Providers and employers may be able to improve participation in exercise programs for adults with non-specific LBP by focusing on the exercise components which are the most attractive. This in turn would improve satisfaction and adherence to exercise interventions aimed at preventing recurrent non-specific LBP.
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2.
  • Abrandt Dahlgren, Madeleine, 1956-, et al. (författare)
  • Questioning to learn and learning to question : Structure and function of PBL scenarios in environmental science education.
  • 2000
  • Ingår i: Second International Conference on Problem-Based Learning in Higher Education,2000.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • In problem-based learning, scenarios relating to real life are used as a point of departure for the learning process. Even though the importance of suitable cases or scenarios to bring about a fruitful learning process is emphasised in the literature, few studies focus on how they actually function in the learning process. This study focuses on how the scenarios used in a ten-week introductory course of a new four-year, undergraduate programme in environmental science functioned in terms of the structure and content of the questions they evoked. Data were gathered through diary notes from nine groups of students, comprising 5-8 students per group. The data were subjected to a qualitative analysis aimed at describing the structure and content of the questions generated by the groups. Five different kinds of questions were identified and labelled; A. Encyclopaedic, B. Meaning-oriented, C. Relational, D. Value-oriented and E. Solution-oriented.  All scenarios generated questions pertaining to all five categories in all groups, but the emphasis varied. The results are discussed in relation to the design of scenarios, and in relation to students’ approaches to learning.
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3.
  • Abrandt Dahlgren, Madeleine, 1956-, et al. (författare)
  • Questioning to learn and learning to question : Structure and function of problem-based learning scenarios in environmental science education
  • 2001
  • Ingår i: Higher Education. - 0018-1560 .- 1573-174X. ; 41:3, s. 263-282
  • Tidskriftsartikel (refereegranskat)abstract
    • In problem-based learning, scenarios relating to real life are used as a point of departure for the learning process. Even though the importance of suitable cases or scenarios in bringing about a fruitful learning process is emphasised in the literature, few studies focus on how they actually function in the learning process. This study focuses on how the scenarios used in a ten-week introductory course of a new four-year undergraduate programme in environmental science functioned in terms of the structure and content of the questions they evoked. Data were gathered through diary notes from nine groups of students, comprising 5-8 students per group. The data were subjected to a qualitative analysis aimed at describing the structure and content of the questions generated by the groups. Five different kinds of questions were identified and labelled, encyclopaedic, meaning-oriented, relational, value-oriented and solution-oriented. All scenarios generated questions pertaining to all five categories in all groups, but the emphasis varied. The results are discussed in relation to the design of scenarios, and in relation to students' approaches to learning.
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6.
  • Avby, Gunilla, 1965-, et al. (författare)
  • Ways of understanding evidence-based practice in social work : A qualitative study
  • 2014
  • Ingår i: British Journal of Social Work. - Oxford : Oxford University Press (OUP). - 0045-3102 .- 1468-263X. ; 44:6, s. 1366-1383
  • Tidskriftsartikel (refereegranskat)abstract
    • This qualitative, empirical study explores and describes the variation in how evidence-based practice (EBP) is understood in social work. A phenomenographic approach to design and analysis was applied. Fourteen semi-structured interviews were conducted with politicians, managers and executive staff in three social welfare offices in Sweden. The main findings suggest that there are qualitatively different ways in which EBP is understood, described in five categories: (i) fragmented; (ii) discursive; (iii) instrumental; (iv) multifaceted; and (v) critical. The outcome space is hierarchically structured with a logical relationship between the categories. However, the informants found it difficult to account for EBP, depending on what was expressed as deficient knowledge of EBP in the organisation, as well as ability to provide a seemly context for EBP. The results highlight the importance of acknowledging these differences in the organisation to compose a supportive atmosphere for EBP to thrive rather than merely assume the case of evidence-based social work. The categories can be utilised as stimuli for reflection in social work practice, and thereby provide the possibility to promote knowledge use and learning in the evolving evidence-based social work.
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7.
  • Axelsson, Susanna, et al. (författare)
  • Effect of combined caries-preventive methods: a systematic review of controlled clinical trials.
  • 2004
  • Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 163-9
  • Forskningsöversikt (refereegranskat)abstract
    • The aim of this systematic review was to evaluate the caries-preventive effect of combined caries-preventive methods, defined as two or more different interventions in combination, each expected to prevent dental caries. The Medline database was searched for articles published in the period January 1966 to June 2003. Twenty-four controlled studies met the inclusion criteria, and their value as evidence was assessed according to predetermined criteria. The level of evidence for the overall conclusion regarding each method was graded according to the protocol of the Swedish Council on Technology Assessment in Health Care. The scientific evidence for the combination of treatments involving fluoride that had a preventive effect on caries in children and adolescents was graded as moderate. However, for elderly patients the scientific evidence for the caries-preventive effect of different combinations of treatments was found to be incomplete. No conclusion could be drawn regarding the evidence for combinations of treatments being effective for groups at high caries risk, as the results from the identified clinical studies were conflicting.
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8.
  • Backman, Linda, et al. (författare)
  • Monthlong Intubated Patient with Life-Threatening COVID-19 and Cerebral Microbleeds Suffers Only Mild Cognitive Sequelae at 8-Month Follow-up : A Case Report
  • 2022
  • Ingår i: Archives of clinical neuropsychology. - : Oxford University Press (OUP). - 0887-6177 .- 1873-5843. ; 37:2, s. 531-543
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To elaborate on possible cognitive sequelae related to COVID-19, associated cerebrovascular injuries as well as the general consequences from intensive care. COVID-19 is known to have several, serious CNS-related consequences, but neuropsychological studies of severe COVID-19 are still rare.Methods: M., a 45-year-old man, who survived a severe COVID-19 disease course including Acute Respiratory Distress Syndrome (ARDS), cerebral microbleeds, and 35 days of mechanical ventilation, is described. We elaborate on M’s recovery and rehabilitation process from onset to the 8-month follow-up. The cognitive functions were evaluated with a comprehensive screening battery at 4 weeks after extubation and at the 8-month follow-up.Results: Following extubation, M. was delirious, reported visual hallucinations, and had severe sleeping difficulties. At about 3 months after COVID-19 onset, M. showed mild to moderate deficits on tests measuring processing speed, working memory, and attention. At assessments at 8 months, M. performed better, with results above average on tests measuring learning, memory, word fluency, and visuospatial functions. Minor deficits were still found regarding logical reasoning, attention, executive functioning, and processing speed. There were no lingering psychiatric symptoms. While M. had returned to a part-time job, he was not able to resume previous work-tasks.Conclusion: This case-study demonstrates possible cognitive deficits after severe COVID-19 and emphasizes the need of a neuropsychological follow-up, with tests sensitive to minor deficits. The main findings of this report provide some support that the long-term prognosis for cognition in severe COVID-19 may be hopeful.
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9.
  • Bjerneld, Magdalena (författare)
  • Images, Motives, and Challenges for Western Health Workers in Humanitarian Aid
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis presents how humanitarian aid workers were attracted, motivated, recruited, and prepared for fieldwork, and how they reported their work experience directly from the field and when they returned home. Data were derived from interviews with experienced aid workers, focus group discussions with presumptive aid workers, analysis of letters from aid workers in the field on MSFs homepages in Europe, and from interviews with recruitment officers at some of the main humanitarian organisations. Health professionals were attracted by the positive images of humanitarian action. They wished to work in teams with like-minded people, and to make a difference in the world. However, this image was not supported by the recruitment officers, or experienced aid workers, who described a complex reality in humanitarian action. The experienced aid workers instead had realised they learned more than they contributed. The recruitment system for relief workers would benefit from a more holistic approach, where personalities of the aid workers are more in focus. More time must be spent with the applicants, both recruited and returning aid workers, in order to improve the system. A socialisation approach could help identify the right personnel and to motivate current personnel to continue.
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10.
  • Björklund, Martin, 1961-, et al. (författare)
  • Office-cycling while working : An innovative concept to prevent and reduce musculoskeletal pain in office workers - a controlled feasibility study
  • 2015
  • Konferensbidrag (refereegranskat)abstract
    • Background: According to the World Health Organization, WHO, a sedentary lifestyle is the single largest health risk for a number of diseases including musculoskeletal disorders and metabolic diseases. The negative health effects of excessive sitting are not compensated for by shorter bouts of increased physical activity. However, evidence shows that increased physical activity reduces musculoskeletal pain, which is very prevalent in those who are inactive. About 50-70 % of those who work at a computer report musculoskeletal pain and spend on average about 5 hours/day with very low energy metabolism. Work places are therefore an important arena for prevention and intervention by means of reducing sedentary time and increasing physical activity both for general health benefits and effects on the musculoskeletal pain.Purpose: To test the feasibility of office-cycling in an office work place and explore its potential effects on musculoskeletal pain in office workers.Methods: Twenty office workers (ages 27-61, 5 males) with musculoskeletal pain participated in this three-week controlled pilot field study. The intervention group (n=10), had access to an innovative customized cycle ergometer (OfficeBiking®) at their regular office workstation whilst performing their usual work tasks. Offie-cycling was an alternative to sitting/standing by their height adjustable office desk; they were instructed to bike as often as comfortable. The control group (n=10) was instructed to continue to work as usual. The experiences of office-cycling and how it influenced work performance was studied with a questionnaire. Musculoskeletal pain was evaluated using pain drawings and pain ratings and participants' total pain was calculated by adding each individuals' self-reported pain from their three most painful areas (NRS 0-10).Results: Importantly, office-cycling did not reduce self-reported work performance; the majority (9/10) would like daily access; and made suggestions to improve the user-friendliness of the bike. Office-cycling was used regularly (median, 11/15 workdays; median active time 59 min/day IQR 39;91). There was no observed difference regarding either number of self-reported areas of pain (NSAP) or general musculoskeletal pain (GMP) between the intervention group and the control group at baseline. Self-reported GMP decreased in 8 persons in the intervention group which was one more than in the control group (n=7). NSAP decreased in the intervention group (n=7; md -1,0 IQR -2,3;0,0); and the control group (n=5; md -0,5 IQR -1,3;0,3). The difference in total pain (intervention end-baseline) revealed a clinically important change in the intervention group (NRS -2,5, IQR -8,8;4,0) but not in the control group (NRS 0,0 IQR -6,2;2,5).Conclusions: The results suggest that office-cycling is a feasible method for use in work place interventions with some promising results. Future research suggestions are: underlying mechanisms regarding effects of physical activity on pain in parallel with controlled studies in laboratory environments to investigate dose-effects for metabolic expenditure and optimal pain reduction whilst office-cycling.Implications: The results in this feasibility study indicate a promising potential of the innovative office-cycling concept to prevent and reduce musculoskeletal pain in sedentary office workers.
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11.
  • Dahlgren, Christina, et al. (författare)
  • Perception of quality of care in patients with pituitary disorders
  • 2012
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: In order to support patients with lifelong chronic illness, such as pituitary disorders, it is a challenge to continuously offer high quality of care.Aim: The aim of this study was to examine how patients with pituitary disorders of different causes perceive quality of care in contact with a specialized endocrinology reception.Methods and materials: Randomly selected, patients with chronic pituitary disorders (n=100) were asked to participate. Seventy-seven patients (females, n=44), 22–82 years of age responded and participated in the study. The questionnaire Quality from the Patient’s Perspective (QPP; modified short version) was used to measure patient’s perception of quality of care (considered from four dimensions: physical- technical, medical-technical, identity- orientation and socio-cultural atmosphere). Each question was calculated using an action index of each investigated area. Impaired quality of care in specific dimensions above 15% indicates need of improvement. In addition two open-ended questions were asked.Results: Most of the respondents, 97%, expressed that necessary physical-technical equipment was available while in the medical-technical dimension 26% reported impaired quality of care. In the identity-orientation dimension, impaired quality of care was reported by 25% mainly due to non-participation in care- and treatment decisions as well as concerning information about results of treatments and self-care activities. In the socio-cultural dimension impaired quality of care was reported in 25%. In addition, the patients asked for extended telephone receptions at the clinic and improved information about pituitary disorders.Conclusion: The patients were satisfied with the technical part of the medical care, but less satisfied with participation in care decisions and information about self-care. In our setting improvements are needed regarding patient information and access to care.
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12.
  • Dahlgren, Gunilla, et al. (författare)
  • Correlations between Ratings and Technical Measurements in Hand-Intensive Work
  • 2023
  • Ingår i: Bioengineering. - : MDPI AG. - 2306-5354. ; 10:7
  • Tidskriftsartikel (refereegranskat)abstract
    • An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value(& REG;) were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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13.
  • Dahlgren, Gunilla, et al. (författare)
  • Local oxygen saturation during computer work in patients with computer related disorders from the upper extremity : a pilot study
  • 2003
  • Ingår i: Conference proceeding at the 49th NAM conference (Nordiska Arbetsmiljömötet).
  • Konferensbidrag (refereegranskat)abstract
    • IntroductionAlong with increasing number of computer users in work organizations, upper extremity complaints become more and more common. Research has shown that increased exposure to repetitive keyboard and mouse use increases the risk of musculoskeletal disorders. However, the physiological mechanisms remain unclear. Pathological processes as the rate of the metabolism (energy crisis) can be conceivable as a cause of the symptoms and disability related to intensive computer work 1 . To date, there are no studies made upon local tissue oxygen (O2) saturation during computer work in patients suffering from computer related disorders in the upper extremity. In the present study, we examined local tissue oxygen (O2) saturation in m. trapezius and m. extensor carpi radialis brevis before and during mouse operated computer work in patients suffering from computer related disorders, and looked at relations between oxygen saturation, subjective ratings of pain, symptoms and disability.Material and methodFour right dominant female patient subjects (PS) aged 27 to 46 recruited through the company health care participated in the study. Their mean height was 166 cm and weight of three PS 55.8 kg (130 kg for the fourth PS). They had one or several diagnoses each, comprising of neck myalgia, diffuse forearm pain and lateral epicondylitis. All of them worked full-time and used computer with keyboard and mouse or mousetrapper device. Three PS used the computer for 7-8 hours per workday. The PS related their disorder to intensive computer work for long hours and high precision demands.Skin fold thickness was measured with a caliper at m. trapezius (TRAP) and m. extensor carpi radialis (ECRB) on the right side, and ranged from 2-6 mm. The mean skin temperature was 32.2° during rest and 32.7° following work on the ECRB (there was one missing post-value due to technical problems). The local tissue oxygen saturation was measured non-invasively with near-infrared spectroscopy, NIRS (Inspectra, Hutchinson Technology). One NIRS-electrode was placed at TRAP and the other on ECRB, both on the right side. After five minutes of rest, the PS performed a mouse operated computer task for 45 minutes with their right hand. The task consisted of painting squares presented on the screen, by using the mouse. Measurements of oxygen saturation were made throughout the computer work. Furthermore, subjective ratings of tiredness and strain were recorded on a 10 cm long VAS-scale. Symptoms and disability of the hand, arm and shoulder was rated with the DASH questionnaire, which contains the areas activities of daily living (ADL) and work 3. Descriptive statistics of the oxygen saturation comprised average and standard deviation of StO2 values in %. Comparison of the local tissue oxygen was made with the subjective ratings.Results and discussionTable 1. Local tissue oxygen (during 5 minutes rest and 45 minutes of computer work) and subjective ratings in PS.The mean saturation value for ECRB during rest was 52.6 (SD 20.2), work 46.7 (SD 14.7), and for TRAP during rest 58.8 (SD 21.2) and work 61.2 (SD 21.7). Skin fold thickness and skin temperature did not show any obvious interaction with the tissue oxygen values. Neither did comparisons of PS´s subjective ratings of tiredness and strain, symptoms, disability and the oxygen saturation, or severity of ratings and oxygen saturation. This might be due to the small amount of subjects and/or that the subjective ratings were not sensitive enough or do not fully reflect the state of art of computer related disorders from the upper extremity. One of the PS in our study reported intense delayed onset of pain 24 hours after the computer work. It is important to be aware that this can occur. The group of PS in this study had lower mean tissue oxygen saturation than healthy female subjects in another study that used the same device and performed an identical mouse operated computer task2. More research is needed for a better understanding of the mechanisms behind upper extremity disorders and the extent to which local tissue oxygen saturation reflects their symptoms and disability.References1. Boushel, R.; H., L.; Olesen, J.; Gonzales-Alonzo, J.; Bulow, J.; and Kjaer, M.: Monitoring tissue oxygen availability with near infrared spectroscopy (NIRS) in health and disease. Scand J Med Sci Sports, 11: 213-22, 2001.2. Heiden, M.; Dahlgren, G.; Lyskov, E.; Crenshaw, A.; and Johansson, H.: Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense. In Nordiska arbetsmiljömötet. Edited, Nyslott, Finland, 2003.3. http://iwh.on.ca/dash.html.
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14.
  • Dahlgren, Gunilla, et al. (författare)
  • Ratings of Hand Activity and Force Levels among Women and Men Who Perform Identical Hand-Intensive Work Tasks
  • 2022
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:24, s. 16706-
  • Tidskriftsartikel (refereegranskat)abstract
    • We compared hand activity and force ratings in women and men doing identical hand-intensive work tasks. Musculoskeletal disorders are more common in women and hand-intensive work leads to an increased risk of these disorders. Knowledge of the gender influence in the rating of work exposure is lacking. The aim of this study was to investigate whether women and men performing identical hand-intensive work tasks were equally rated using hand activity and normalized peak force levels with the Hand Activity Threshold Limit Value((R)). Fifty-six workers participated, comprising 28 women-men pairs. Four observers-two woman-man pairs-were also involved. Self-ratings and observers' ratings of hand activity and force level were collected. The results of these ratings showed no significant gender differences in self-rated hand activity and force, as well as observer-rated hand activity. However, there was a significant gender difference in the observer-rated force, where the women were rated higher (mean (SD): women 3.9 (2.7), men 3.1 (1.8) (p = 0.01)). This difference remained significant in the adjusted model (p = 0.04) with grip strength and forearm-finger anthropometrics. The results provide new insights that observers' estimates of force can be higher in women compared with men in the same work tasks. Force should be further investigated and preferably compared to objective measurements.
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15.
  • Dahlgren, Gunilla, et al. (författare)
  • Reliabilitetstestning av den svenska versionen av Shoulder Rating Questionnaire, SRQ-S
  • 2002
  • Ingår i: Nordisk fysioterapi. - 1402-3024. ; 6, s. 134-143
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to evaluatethe test-retest reliability of theSwedish version of the ShoulderRating Questionnaire - SRQ-S.This self-rating scale comprises21 questions, divided into sevenweighted domains concerninghealth, pain, daily activities, recreationaland athletic activities, work,satisfaction and areas for improvement.The Shoulder Rating Questionnairewas fi rst translated intoSwedish and slightly adapted. Itwas then sent twice to 38 patientswith clinically stable shoulder disordersat an Orthopaedic Clinicin Sweden. The majority of theanswers were identical or almostidentical on both occasions. Theagreement of the total score wasexcellent (both rs and ICC=0.97).All domains, except ‘recreationaland athletic activities’, also showedan excellent agreement (rs 0.90-0.97, ICC 0.88-0.97). Individualquestions resulted in a very highweighted Kappa value for sevenof the questions (0.81-1.0), elevenquestions with a substantial value(0.61-0.80) and three moderatevalues (0.41-0.60). We concludethat the questions posed wereeasily understood and answeredand that the SRQ–S is test-retestreliable. These qualities wouldmake it a useful instrument for theassessment of the outcome of treatmentof shoulder disorders.
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17.
  • Dahlgren, Gunilla, et al. (författare)
  • Test-retest reliability of step counts with the ActivPAL™ device in common daily activities.
  • 2010
  • Ingår i: Gait & Posture. - : Elsevier. - 0966-6362 .- 1879-2219. ; 32:3, s. 386-90
  • Tidskriftsartikel (refereegranskat)abstract
    • The ActivPAL device is a well-established physical activity monitor for assessment of physical activity. AIM: To investigate test-retest reliability of step counts and establish minimal detectable changes (MDC) in step count to account for intra device error over time in various physical activities. METHODS: Healthy participants (n=24, age range, 19-28 years) performed activities on two occasions, 1 week apart, in a laboratory setting; self-paced floor walking, treadmill walking at three different speeds (3.2 km/h, 4.5 km/h and 4.5 km/h with incline), treadmill jogging (8.0 km/h), stair walking and cycling on an exercise bike at three speeds (45 rpm, 60 rpm and 75 rpm). Relative reliability was calculated using intraclass correlation coefficient (ICC) and Spearman correlation. Absolute reliability was assessed using standard error of measurement (SEM) and coefficient of repeatability (CR). RESULTS: The ActivPAL showed high to very high relative reliability for treadmill walking at all speeds and stair walking, while self-paced normal floor walking showed moderate reliability. The absolute reliability was the best for treadmill walking activities, slightly increased for self-paced walking, followed by stair walking and jogging. The use of activity monitors during cycling has been questioned and our results confirm a low absolute and relative reliability. MDC values varied according to the type of activity e.g. treadmill walking 4.5 km/h (10 steps), walking on the floor (45 steps). Data loss in this study (10-13%) was higher than previously reported. CONCLUSIONS: The ActivPAL is reliable for treadmill walking, jogging and self-paced walking. MCD varies according to the activity and should be considered when establishing true change over time.
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18.
  • Eliasson, Kristina, et al. (författare)
  • Company representatives’ experiences of occupational health surveillance for workers exposed to hand-intensive work : A qualitative study
  • 2021
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Exposure assessment seldom precedes the medical health checks in occupational health surveillance. In order to emphasize the interconnection between exposure assessment and medical health checks, a process model was developed. The process model aimed to guide employers and Occupational Health Service providers through the execution of occupational health surveillance. The objective of this qualitative study is to explore company representatives’ experiences of the process model, in terms of feasibility and values, and to identify factors that facilitate or impede the process. Thirty-three company representatives from ten companies were interviewed. Interviews were analyzed using content analysis. The company representatives experienced that the model contributed to increased risk awareness and understanding of the exposure effects on workers’ health. They valued the exposure assessments performed by an ergonomics expert, which led to the discovery of previously unidentified risks. The feasibility was facilitated by: a joint start-up meeting in which the process was planned, clear communication between the involved parties, and clarity regarding the process ownership. The findings reveal that a guiding process model is valuable for the execution of occupational health surveillance. However, the model should not only define the components included; a practical guide concerning how the process can be executed is also needed.
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19.
  • Eliasson, Kristina, et al. (författare)
  • Does occupational health surveillance lead to risk reduction for workers exposed to hand-intensive work?
  • 2023
  • Ingår i: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 112
  • Tidskriftsartikel (refereegranskat)abstract
    • This mixed method study aimed to describe what risk-reducing actions were proposed by ergonomists after the execution of a guided process for occupational health surveillance for workers exposed to hand-intensive work in ten companies. Another aim was to describe the exposed workers' proposals for risk-reducing actions, including their perceptions of potential changes in the self-assessed exposure levels and work-related pain. Several actions, targeting organizational, technical, and/or individual measures were proposed. Proposals from the ergonomists more often targeted the personal measures, whereas the workers' proposals targeted technology or organizational changes. Six companies implemented at least one of the action proposals. These action proposals were not related to evaluation metrics, nor were they evaluated. This study indicates that both ergonomists and companies need guidance on how to improve to work in a participatory process for the implementation and evaluation of risk-reducing actions, e.g., by how to better include workers’ experiences.
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20.
  • Eliasson, Kristina, et al. (författare)
  • Ergonomists’ experiences of executing occupational health surveillance for workers exposed to hand-intensive work : a qualitative exploration
  • 2022
  • Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: In order to reduce work-related upper limb disorders, the Swedish Work Environment Authority introduced an occupational health surveillance targeting hand-intensive work. A process model, aimed at supporting the employers as well as the occupational health service provider (i.e., ergonomist) in the work process with the occupational health surveillance, was developed. The objective of this qualitative study was to explore ergonomists’ experiences of the execution of occupational health surveillance for hand-intensive work when following the novel process model as well as factors influencing the execution.Methods: Semi-structured individual interviews were conducted with ten ergonomists on one occasion regarding their experience of following the work process. Qualitative content analysis with an inductive approach was used for analyzing the data.Results: The ergonomists’ experiences were summarized in one theme “A joint roadmap supporting a participatory process” and two categories “Clear structure provided by the components” and “The process influenced by collaboration and context”. The ergonomists valued being guided by the systematics of the model, which provided structure and clarity in their work. Factors affecting the execution were related to communication deficiencies and uncertainties regarding expectations between different roles and functions (e.g., ergonomists and contact person, lack of information to workers). Additional factors, for instance, companies’ routines and the ergonomist’s intra-organizational support, such as access to IT-resources, could also affect the process.Conclusions: The findings reveal that this process model facilitates the ergonomists’ work and cooperation with a client company. However, the process model needs to be developed and accompanied by a guideline with information related to the process, including e.g., description of a start-up meeting and of the roles/functions of the involved parties.
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21.
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22.
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23.
  • Eliasson, Kristina, et al. (författare)
  • Study protocol for a qualitative research project exploring an occupational health surveillance model for workers exposed to hand-intensive work
  • 2020
  • Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:17
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study protocol is to describe the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (the HIW-model), and to describe the studies that will explore the model. The studies are designed to: (1) explore stakeholders' experiences of the model, and (2) explore if, and how, the model affects actions for reduction of exposure to hand-intensive work. The study protocol presents a research project that is described as two studies. The first study will explore company representatives' and ergonomists' experiences of the execution of the HIW-model and its various components concerning feasibility and values. Semi-structured interviews will constitute the data source. The second study will explore whether the execution of the HIW-model leads to work environmental changes, such as actions for reduction of exposure to hand-intensive work, and whether these potential actions are based on the ergonomist's feedback of the exposure assessment and the medical health checks. A mixed method approach will be applied, in which the data sources will be comprised of semi-structured interviews, questionnaires, and documents. The project is expected to generate knowledge regarding the values of the HIW-model. The project is anticipated to shed light on factors that facilitate or impede execution of the model from the different stakeholders' perspectives; the employer's as having the legal responsibility for the work environment, and the occupational health service consultants', being the work environment experts supporting the employers.
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24.
  • Eriksson, Elisabet (författare)
  • Christian Communities and Prevention of HIV among Youth in KwaZulu-Natal, South Africa
  • 2011
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Young people in South Africa, particularly females, are at great risk of acquiring HIV, and heterosexual sex is the predominant mode of HIV transmission. In order to curb the epidemic the Department of Health encourages all sectors in the society, including religious institutions, to respond effectively. The present thesis seeks to increase the understanding of the role of Christian communities in prevention of HIV for young people. Three denominations in KwaZulu-Natal were selected to reflect the diversity of Christian churches in South Africa: the Roman Catholic Church, the Evangelical Lutheran Church in Southern Africa, and the Assemblies of God. Using qualitative interviews the first paper explores how religious leaders (n=16) deal with the conflict between the values of the church and young people’s sexuality. Study II reports on attitudes to HIV prevention for young people among religious leaders (n=215) using questionnaire survey data. Study III investigates how young people (n=62) reflect on messages received from their churches regarding premarital sex by analysing nine focus group discussions. In the fourth paper, based on questionnaire survey data, we report on young people’s (n=811) experiences of relationships with the opposite sex and their perceived risk of HIV infection. The view that young people in churches are sexually active before marriage was common among religious leadership. The majority of religious leaders also reported that they are responsible for educating young people about HIV prevention. Religious leaders who had received training on HIV were more likely to run a life skills programme for young people, however they were ambivalent about prevention messages. Young people reported premarital sexual abstinence as the main HIV prevention message from their churches. The majority responded that they had received information about HIV in church. To be in a relationship was common, more so for males for whom multiple relationships also were viewed more acceptable. To perceive themselves at risk of HIV infection was common. Further training for religious leaders is needed to enable them to manage the conflict between the doctrine of the church and their willingness to assist young people in the transition into adulthood.
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25.
  • Heiden, Marina, 1974-, et al. (författare)
  • Effects of time pressure and precision demands during computer mouse work on muscle oxygenation and position sense
  • 2003
  • Ingår i: Conference proceeding at the 49th NAM conference (Nordiska Arbetsmiljömötet).
  • Konferensbidrag (refereegranskat)abstract
    • IntroductionAs the number of employees involved in computer work increases, neck and upper extremity complaints grow more common. Tight deadlines lead to high time pressure, which, in combination with precision demands, may increase the risk of musculoskeletal disorders. The physiological manifestation of such demands, however, is not entirely clear. In the present study, we examined local tissue oxygen saturation in the upper extremity as well as subjective stress responses during computer mouse work with and without time pressure and precision demands, and investigated whether these working situations have different effects on wrist position sense.Material and methodsTwenty-four healthy, right-handed subjects (12 females, 12 males; age 19-28 years) participated in the study. Except for one subject who reported using a computer for 480 minutes per day, their average daily computer use was 84 minutes (SD 65 minutes). Subjects performed a 45-min mouse operated computer task on two occasions, separated by 3-5 days. The task consisted of painting squares that were presented on the screen. On one occasion, time pressure and precision demands were imposed on the task by limiting the time available for painting a square and introducing a scoring system based on precision of painting. On the other occasion, no such restraints were added. The order of the two task versions was randomized. During the task, tissue oxygen saturation in trapezius and extensor carpi radialis on the right arm was measured non-invasively by near-infrared spectroscopy, NIRS (Inspectra, Hutchinson Technology). In addition, subjective ratings of tenseness and strain, painting performance measures, and skin temperature were recorded. The position matching ability of the wrist was measured before and after the computer task. In the position matching tests, subjects attempted to actively reproduce target positions of horizontal movements about the right wrist joint. From a starting position of 30° of extension, target positions were randomized between 0° and 30° of flexion. The absolute value of the difference between presented target and reproduced position (AE) was used as outcome measure. Skin fold thickness at the locations of the NIRS electrodes was measured with a caliper at the beginning of the experiment.Repeated measures analyses of variance were used to test for differences in oxygen saturation throughout the task, and for testing differences in position sense, as estimated by position matching ability, before and after the task. Subjective ratings during the task were analyzed by Wilcoxon’s non-parametric tests. Remaining parameters were tested for differences by t-tests or Wilcoxon’s non-parametric tests, depending on distribution of data. In all tests, p<0.05 was considered significant.ResultsA significant decline in oxygen saturation during mouse work under time pressure and precision demands was seen for extensor carpi radialis (F=4.68, p=0.036). This pattern was not present when mouse work was performed under more relaxed conditions. For trapezius, no difference in oxygen saturation between task versions was seen (F=0.01, p=0.932), although a general increase in saturation during work was found (F=10.35, p=0.002). Gender differences were apparent for extensor carpi radialis as well as for trapezius. Females showed an overall lower oxygen saturation in extensor carpi radialis than men (F=4.81, p=0.034). Furthermore, they showed a significantly different trend in trapezius oxygen saturation during work than men (F=6.27, p=0.016). Somewhat surprisingly, these gender differences could not be explained by differences in skin fold thickness at electrode positions (extensor carpi radialis: t=0.77, p=0.449; trapezius: t= 1.34, p=0.193). Subjects’ mean skin temperature changes during work was +0.41°C (SD 0.83°C).AE measured before the computer task did not significantly differ between occasions (paired t-test: t=0.08, p=0.940), indicating that the time period between occasions was long enough for effects of work to wash out. A significant increase in AE was seen following the task (F=15.59, p<0.001), irrespective of task version (F<0.01, p=0.968). No gender differences in AE were found (F=0.08, p=0.774). Subjects’ ratings of tenseness and strain were significantly higher during work under time pressure and precision demands (Wilcoxon’s signed-ranks test: Z>3.41, p<0.001), compared to work without such demands. This is in agreement with the fact that subjects increased their work pace (squares painted in work with demands: 119, without demands: 84, paired t-test: t=8.38, p<0.001), and made an effort to paint as accurate and precise as possible (no. of times outside the square in work with demands: 2, without demands: 4, paired t-test: t=3.68, p=0.001) during the more demanding task version. No gender differences in subjective ratings (Mann-Whitney U-test: Z<2.14, ns) or performance variables (t-test: t<1.71, ns) were found.DiscussionSubjects’ showed diminished oxygen saturation in extensor carpi radialis when working under time pressure and precision demands. This could be attributed to an increased mental load and/or a higher work intensity associated with this working situation. In support of this, subjective ratings of tenseness and strain scored higher during the more demanding task. It was also shown that subjects painted squares at a higher rate during the task. The fact that no differences in trapezius oxygen saturation between task versions was found might suggest that the physical strain associated with the work, being more prominent in extensor carpi radialis, could be a major contributor to oxygen saturation changes. Subjects’ tenseness ratings, however, would argue against it. Position sense, although poorer following work, was not affected by work type. One may speculate that physiological mechanisms involved in our measurement of position sense are not affected by local tissue oxygen saturation in extensor carpi radialis. The present data show considerable gender differences in oxygen saturation during rest as well as computer mouse work, that does not seem to be caused by skin fold thickness or painting performance.
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26.
  • Jansson, Markus, 1982-, et al. (författare)
  • Risk factors for perineal and vaginal tears in primiparous women : the prospective POPRACT-cohort study
  • 2020
  • Ingår i: BMC Pregnancy and Childbirth. - : BioMed Central. - 1471-2393 .- 1471-2393. ; 20:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The aim of this study was to estimate the incidence of second-degree perineal tears, obstetric anal sphincter injuries (OASI), and high vaginal tears in primiparous women, and to examine how sociodemographic and pregnancy characteristics, hereditary factors, obstetric management and the delivery process are associated with the incidence of these tears.Methods: All nulliparous women registering at the maternity health care in Region Örebro County, Sweden, in early pregnancy between 1 October 2014 and 1 October 2017 were invited to participate in a prospective cohort study. Data on maternal and obstetric characteristics were extracted from questionnaires completed in early and late pregnancy, from a study-specific delivery protocol, and from the obstetric record system. These data were analyzed using unadjusted and adjusted multinomial and logistic regression models.Results:  A total of 644 women were included in the study sample. Fetal weight exceeding 4000 g and vacuum extraction were found to be independent risk factors for both second-degree perineal tears (aOR 2.22 (95% CI: 1.17, 4.22) and 2.41 (95% CI: 1.24, 4.68) respectively) and OASI (aOR 6.02 (95% CI: 2.32, 15.6) and 3.91 (95% CI: 1.32, 11.6) respectively). Post-term delivery significantly increased the risk for second-degree perineal tear (aOR 2.44 (95% CI: 1.03, 5.77), whereas, maternal birth positions with reduced sacrum flexibility significantly decreased the risk of second-degree perineal tear (aOR 0.53 (95% CI 0.32, 0.90)). Heredity of pelvic floor dysfunction and/or connective tissue deficiency, induced labor, vacuum extraction and fetal head circumference exceeding 35 cm were independent risk factors for high vaginal tears (aOR 2.32 (95% CI 1.09, 4.97), 3.16 (95% CI 1.31, 7.62), 2.53 (95% CI: 1.07, 5.98) and 3.07 (95% CI 1.5, 6.3) respectively).Conclusion: The present study corroborates previous findings of vacuum extraction and fetal weight exceeding 4000 g as risk factors of OASI. We found that vacuum extraction is a risk factor for second-degree tear, and vacuum extraction, fetal head circumference exceeding 35 cm and heredity of pelvic floor dysfunction and/or connective tissue deficiency were associated with increased risk of high vaginal tears. These findings have not been documented previously and should be confirmed by additional studies.
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27.
  • Kronstrand, Robert, et al. (författare)
  • A Cluster of Deaths Involving 5-(2-Aminopropyl)Indole(5-IT)
  • 2013
  • Ingår i: Journal of Analytical Toxicology. - : Oxford University Press (OUP): Policy F. - 0146-4760 .- 1945-2403. ; 37:8, s. 542-546
  • Tidskriftsartikel (refereegranskat)abstract
    • During 2012, the designer drug 5-(2-aminopropyl)indole emerged in Sweden, and became available at different web sites under the name 5-IT or 5-API. This compound is an indole derivative and a positional isomer of alpha-methyltryptamine. In this paper, we report the pathology and toxicology from 15 deaths involving 5-IT. Routine postmortem toxicology was performed in femoral blood, using a targeted screening for pharmaceuticals and drugs of abuse with liquid chromatography time-of-flight technology, and positive results were quantified using chromatographic techniques. For 5-IT, a new method was developed using ultra-high-performance liquid chromatography and tandem mass spectrometry. In 11 cases, intoxication was the cause of death. Two cases were signed out as causa ignota, and they were considered to be natural deaths. All determinations of 5-IT were performed in femoral blood and the concentrations ranged from 0.7 to 18.6 mg/g. Two cases had 5-IT as the only drug identified, while the others presented with other psychotropic drugs or medications in the blood as well. Shortly after this series of deaths, 5-IT was scheduled as a hazardous substance according to the regulation Certain Goods Dangerous to Health on 18 September 2012 prohibiting the handling and selling of the drug. Since then, no positive cases have been found.
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28.
  • Källestål, Carina, et al. (författare)
  • Economic evaluation of dental caries prevention : a systematic review
  • 2003
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:6, s. 341-346
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of the present study was to perform a systematic review of economic evaluations of caries prevention. A search in Medline from 1966 until May 2003 and a manual search in a number of journals identified 154 references, 74 of which were included. There were 17 original studies including an economic evaluation, and these form the basis of the present article. The rest were reviews, model studies and reports concerning economic practice in dentistry. The results show that the reviewed original studies on economic evaluation of caries prevention do not provide support for the economic value of caries prevention. The scarcity of well-conducted studies, as well as contra-dictory evidence in the reviewed articles, makes it difficult to judge the health-economic effect of the studied caries-prevention methods.
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29.
  • Langhamer, Olivia, 1977, et al. (författare)
  • Effect of an offshore wind farm on the viviparous eelpout: Biometrics, brood development and population studies in Lillgrund, Sweden
  • 2018
  • Ingår i: Ecological Indicators. - : Elsevier BV. - 1470-160X .- 1872-7034. ; 84, s. 1-6
  • Tidskriftsartikel (refereegranskat)abstract
    • Sufficient, clean and secure energy is the main driver for a worldwide growing welfare and economic development of a society. Environmental concerns on the expansion of offshore renewable energy and its impact on marine organisms need to be scientifically assessed for risks and consequences. In order to observe the effects of an operating wind farm on fish, we studied the rather stationary and benthic-living fish species viviparous eelpout (Zoarces viviparous) as model indicator organisms. We compared local populations of viviparous eelpout in the Lillgrund Offshore Wind Farm (OWF) with natural sites in the Öresund strait in Sweden. Eelpout studies on population dynamics, biometrics, reproductive success and fry development were conducted in 2011 and 2012. Condition index, histosomatic index, gonadosomatic index were measured additionally. Our findings showed that Lillgrund OWF neither had an impact on the condition index (CI), nor on brood development of female viviparous eelpout. Furthermore, populations size estimates in Lillgrund indicated that eelpout neither specifically aggregated in nor avoided the offshore wind farm, and no clear reef effect attracting eelpout to the foundations and scour protections of the OWF was observed. Our conclusion is that the operating wind farm did not have any potentially negative effects, since we did not observe any negative effects neither on the individual health of eelpout nor of the reproductive performance. We suggest that eelpout which may also be used as an indicator species for the environmental status of Lillgrund, as well as for other offshore wind farms and marine renewable energy installations, both in the Baltic and coastal waters in northern Europe. © 2017 Elsevier Ltd
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30.
  • Larson, Mia, et al. (författare)
  • Putting ’fika’ at the top of the agenda – Research and industrial opportunities
  • 2023
  • Ingår i: Presented at Stockholm Gastronomy Conference, Tore Wretman Symposium, Stockholm, Sweden, November 23-25, 2023. - Stockholm.
  • Konferensbidrag (refereegranskat)abstract
    • ‘Fika’, the Swedish definition of a causal break, the coffee or tea with pastries and the inclusive meeting point for friends, relatives, colleagues, or business partners signify a central part of everyday life in Sweden. Fika takes many different forms – most of us have fika multiple times a day. The practice of doing fika reaches well beyond the food and beverage consumption that may be what comes first to mind. Relationships are formed, personal and business decisions are made, all in the context of a relaxed atmosphere – the basic intention with fika.The idea of fika has reached beyond the Swedish borders. It has become an increasingly known cultural concept in other countries. Therefore, fika is often used by Swedish companies not only to consider the positive work atmosphere but also in their branding efforts. Fika is also used in destination marketing to attract tourists. We can therefore talk about fika from a social, tourism, and business point of view, and the culinary aspects seem almost endless. Yet there is surprisingly little about fika from a research point of view. We believe that fika has a vast potential to create more positive values and industrial opportunities than it currently does but to achieve that we need more knowledge about fika.How can research facilitate industrial opportunities? This question sets the agenda for what we want to explore. How does interdisciplinary research enhance knowledge of fika in such a way that it can lead to positive spin-offs for the industry? A consortium of researchers from different fields, together with representatives from the industry,  are currently aiming to explore these questions.
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31.
  • Lingström, Peter, et al. (författare)
  • Dietary factors in the prevention of dental caries : a systematic review
  • 2003
  • Ingår i: Acta Odontologica Scandinavica. - : Informa Healthcare. - 0001-6357 .- 1502-3850. ; 61:6, s. 331-340
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of this study was, systematically, to evaluate the effect of die-tary changes in the prevention of dental caries. A search and analysis strategy was followed, as suggested by the Swedish Council on Tech-nology Assessment in Health Care (SBU). The search strategy for arti-cles published in 1966-2003 was performed using electronic databases and reference lists of articles and selected textbooks. Out of 714 arti-cles originally identified, 18 met the inclusion criteria for a random-ized or controlled clinical trial--at least 2 years’ follow-up and caries increment as a primary endpoint. This included the total or partial substitution of sucrose with sugar substitutes or the addition of pro-tective foods to chewing gum. No study was found evaluating the ef-fect of information designed to reduce sugar intake/frequency as a sin-gle preventive measure. It is suggested that the evidence for the use of sorbitol or xylitol in chewing gum, or for the use of invert sugar, is in-conclusive. No caries-preventive effect was found from adding calcium phosphate or dicalcium phosphate dihydrate to chewing gums. The review clearly demonstrates the need for well-designed randomized clinical studies with adequate control groups and high compliance.
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32.
  • Lönnbring, Gunilla, et al. (författare)
  • Två räta och en avig : Samhällsentreprenörskap och lokal utveckling
  • 2013
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • Samhällsentreprenörskapet kännetecknas av samhälleligt engagemang och entreprenöriellt handlande i förening. I rapporten ges samhällsentreprenörskapet sammanhang och perspektiv genom resonemang om vad som ligger i tidsandan och i platsens betydelse som bra eller dålig jordmån för företagsamhet och lokal utveckling. I dess karaktärsdrag ligger att det ofta sker underifrån och möjligen på tvären mot tingens ordning i form av spelregler och dominerande trender. Det handlar om förnyelse och förändring med samhälleliga och hållbara förtecken.Rapporten bygger på möten, samtal och intervjuer samt enkäter. Empirin handlar om Värmland och Torsby kommun. Utgångspunkten är två frågeställningar om samhällsentreprenörskapets samspel med vad som kan kallas systemet å ena sidan och den lokala omgivningen å den andra. Begreppen systemet och den lokala omgivningen spelar roll och sätter spelregler för samhällsentreprenörskapet och bör kunna användas för en slags självreflektion från olika aktörers sida som går bortom enskildheter och exempel var för sig. Samhällsentreprenörskapet skulle säkerligen vinna på att ges legitimitet i övergripande programdokument på regional och lokal nivå.
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33.
  • Malmgren Fänge, Agneta, et al. (författare)
  • The TECH@HOME study, a technological intervention to reduce caregiver burden for informal caregivers of people with dementia: study protocol for a randomized controlled trial
  • 2017
  • Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 18:63
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision. Methods/design: This randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual's behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia. Discussion: This is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden.
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34.
  • Mejàre, Ingegerd, et al. (författare)
  • Caries-preventive effect of fissure sealants : a systematic review
  • 2003
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:6, s. 321-330
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • The objectives of this study were to evaluate systematically the evi-dence of the caries-preventive effect of fissure sealing of occlusal tooth surfaces and to examine factors potentially modifying the effect. The search strategies included electronic databases, reference lists of arti-cles, and selected textbooks. Inclusion criteria were randomized or quasi-randomized clinical trials or controlled clinical trials comparing fissure sealing with no treatment or another preventive treatment in children up to 14 years of age at the start; the outcome measure was caries increment; the diagnostic criteria had been described; and the follow-up time was at least 2 years. Inclusion decisions were taken and grading of the studies was done independently by two of the authors. The main measure of effect was relative risk reduction. Thirteen stud-ies using resin-based or glass ionomer sealant materials were included in the final analysis. The results showed that most studies were per-formed during the 1970s and a single application had been utilized. The relative caries risk reduction pooled estimate of resin-based seal-ants on permanent 1st molars was 33% (relative risk = 0.67; CI = 0.55-0.83). The effect depended on retention of the sealant. In conclu-sion, the review suggests limited evidence that fissure sealing of 1st permanent molars with resin-based materials has a caries-preventive effect. The evidence is incomplete for permanent 2nd molars, premo-lars and primary molars and for glass ionomer cements. Overall, there remains a need for further trials of high quality, particularly in child populations with a low and a high caries risk, respectively.
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35.
  • Petersson, Lars G, et al. (författare)
  • Professional fluoride varnish treatment for caries control: a systematic review of clinical trials.
  • 2004
  • Ingår i: Acta odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:3, s. 170-6
  • Forskningsöversikt (refereegranskat)abstract
    • The aim of this paper was systematically to evaluate the caries-preventive effect of professional fluoride varnish treatments. A search of the literature for articles published between 1966 and August 2003 was carried out in electronic databases, reference lists of articles, and selected textbooks in accordance with the strategy of the Swedish Council on Technology Assessment in Health Care. Out of 302 identified papers, 24 randomized and controlled clinical trials comparing fluoride varnish with placebo, no active treatment or other fluoride preventive regimens of at least 2 years' study duration were included. The trials that met the inclusion criteria were assessed independently and systematically by at least two reviewers and scored from A to C according to predetermined criteria for methodology and performance. The main outcome measure was the preventive fraction expressed as a percentage. The results displayed limited evidence (evidence level 3) for the caries preventive effect of topical applications of fluoride varnishes in permanent teeth. The average prevented fraction was 30% (0-69%) when compared with untreated controls. Inconclusive evidence (evidence level 4) was found for fluoride varnish treatment in the primary dentition and in adults. This systematic review reinforces the need for future dinical research of high quality, incorporating modern concepts of dinical performance and evaluation to assess dental caries control using professional fluoride varnish.
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36.
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37.
  • Thunberg, Gunilla, 1960, et al. (författare)
  • Autism, communication and use of a speech-generating device in different environments – a case study
  • 2011
  • Ingår i: Journal of Assistive Technologies. - : Emerald. - 1754-9450. ; 5:4, s. 181-198
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – This paper aims to examine interaction patterns in two activities at home and one activity at school when a seven-year-old boy with autism and learning disabilities was supplied with a speech-generating device (SGD). Design/methodology/approach – Activity-based communication analysis (ACA) was used as the basis for analysing and discussing of communicative behaviours in video recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn-taking and communicative form, function and effectiveness. Conversational topics were also analysed. Findings – Activity characteristics seemed important for the outcome. In the two more structured activities (story reading at home and morning circle at school), the child could use the SGD to communicate more effectively within the given frames. During mealtime at home, topic length increased and the instruction to the parents to also use the SGD resulted in positive changes in this activity. ACA highlighted some important issues related to SGD intervention, such as use for expression of communicative needs and access to suitable vocabulary. There also seems to be a need for more guidance to communication partners with respect to the use of communicative strategies to support communication and machine-mediated interaction. Originality/value – Research of the effects of augmentative and alternative communication techniques used in natural interaction is almost non-existent. This case study, therefore, is an important contribution to the field and provides some insights into the challenge of using an electronic device in natural interaction.
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38.
  • Thunberg, Gunilla, 1960, et al. (författare)
  • Children with autistic spectrum disorders and speech‐generating devices: Communication in different activities at home
  • 2007
  • Ingår i: Clinical Linguistics and Phonetics. - : Informa UK Limited. - 1464-5076 .- 0269-9206. ; 21:6, s. 457-479
  • Tidskriftsartikel (refereegranskat)abstract
    • The communication of four children with autistic spectrum disorder was investigated when they were supplied with a speech‐generating device (SGD) in three different activities in their home environment: mealtime, story reading and “sharing experiences of the preschool day”. An activity based communication analysis, in which collective and individual background factors for the activities were outlined, was used as a basis for the discussion of linguistic coding data derived from video‐recordings made before and during SGD intervention. The coded communicative behaviours were engagement in activity, role in turn‐taking, communicative form, function and effectiveness. An increase in communicative effectiveness was more noticeable when the SGDs could be used to fulfil goals and roles within the activity. The instruction to the parents to use the SGDs in their communication with the child had an important influence on the activities.
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39.
  • Thunberg, Gunilla, 1960, et al. (författare)
  • Interaction and Use of Speech-Generating Devices in the Homes of Children with Autism Spectrum Disorders–An Analysis of Conversational Topics
  • 2009
  • Ingår i: Journal of Special Education Technology. - : Council for Exceptional Children. - 0162-6434. ; 24:2, s. 1-16
  • Tidskriftsartikel (refereegranskat)abstract
    • This project investigated the communication of four children with autism spectrum disorders, who used a speech-generating device (SGD) in one or two selected activities in their home environment. The children were between five and seven years of age. The conversational topics introduced by the children and their parents were analyzed. The introduction of the SGD increased conversational interaction, as measured by topic length, for all children in five of the six activities studied. The analysis of topics showed that conversation within the “ongoing activity” increased and that the irrelevant speech used by the two more verbal children was reduced with access to the SGD.
  •  
40.
  • Thunberg, Gunilla, 1960, et al. (författare)
  • Speech-Generating Devices Used at Home by Children With Autism Spectrum Disorders : A Preliminary Assessment
  • 2009
  • Ingår i: Focus on Autism and other developmental disabilities. - : Sage Publications, Inc.. - 1088-3576 .- 1538-4829. ; 24:2, s. 104-114
  • Tidskriftsartikel (refereegranskat)abstract
    • Three children diagnosed within the autism spectrum between the ages of 5 and 7 years at different stages of communication development were supplied with speech-generating devices (SGDs) in their homes. The parents were taught to introduce the SGDs into home routines and the effects were evaluated naturalistically. Videotapes recorded by the parents before and during SGD use were coded with respect to communication effectiveness, mode, role in turn taking, and engagement in activity. Findings varied among the children and activities, but an increased level of communication effectiveness was seen during SGD use for all children. Variations of outcome among the three children and factors of importance for effective SGD use in the homes of children with autism spectrum disorders are discussed.
  •  
41.
  • Twetman, Svante, et al. (författare)
  • Caries-preventive effect of fluoride toothpaste : a systematic review
  • 2003
  • Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 61:6, s. 347-355
  • Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
    • With a questionnaire addressed to general dental practitioners in Sweden, the Swedish Council on Technology Assessment in Health Care launched a project group in 1999 to systematically review and evaluate the existing literature on various caries preventive methods. The aim of this article was to report findings concerning the caries preventive effect of fluoride toothpastes in various age groups, with special emphasis on fluoride concentration and supervised versus non-supervised brushing. A systematic search in electronic databases for articles published between 1966 and April 2003 was conducted with the inclusion criteria of a randomized or controlled clinical trial, at least 2 years follow-up and caries increment in the permanent (DMFS/T) or primary (dmfs/t) dentition as endpoint. Out of 905 articles originally identified, 54 met the inclusion criteria. These studies were assessed independently by at least two reviewers and scored A-C according to predetermined criteria for methodology and performance. The measure of effect was the prevented fraction (PF), expressed as percent. The results revealed strong evidence (level 1) (i) for the caries preventive effect of daily use of fluoride toothpaste compared to placebo in the young permanent dentition (PF 24.9%), (ii) that toothpastes with 1,500 ppm of fluoride had a superior preventive effect compared with standard dentifrices with 1,000 ppm F in the young permanent dentition (PF 9.7%), and (iii) that higher caries reductions were recorded in studies with supervised toothbrushing compared with non-supervised (PF 23.3%). However, incomplete evidence (level 4) was found regarding the effect of fluoride toothpaste in the primary dentition. In conclusion, this review reinforced the importance of daily toothbrushing with fluoridated toothpastes for preventing dental caries, although long-term studies in age groups other than children and adolescents are still lacking.
  •  
42.
  • Twetman, Svante, et al. (författare)
  • Caries-preventive effect of sodium fluoride mouthrinses: a systematic review of controlled clinical trials.
  • 2004
  • Ingår i: Acta odontologica Scandinavica. - Oslo : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 62:4, s. 223-30
  • Forskningsöversikt (refereegranskat)abstract
    • The Swedish Council on Technology Assessment in Health Care launched a project group in 1999 to systematically review and evaluate the existing literature on different caries-preventive methods. The aim of this article was to report the findings concerning the caries-preventive effect of fluoride mouthrinses (FMRs) in various age groups, with special reference to background fluorides. A systematic search in electronic databases for literature published between 1966 and August 2003 was conducted with the inclusion criteria of a randomized or controlled clinical trial, at least 2 years' follow-up, and caries increment in the permanent dentition (DeltaDMFS/T) as endpoint. Out of 174 articles originally identified, 62 met the inclusion criteria. These studies were assessed independently by at least two reviewers and scored A-C according to predetermined criteria for methodology and performance. The measure of effect was the prevented fraction (PF) expressed as percent. The level of evidence was based on 25 articles. The results revealed limited evidence (evidence level 3) for the caries-preventive effect (PF 29%) of daily or weekly sodium fluoride rinses compared with placebo in permanent teeth of schoolchildren and adolescents with no additional fluoride exposure and for a caries-preventive effect on root caries in older adults. Inconclusive evidence (evidence level 4) was found regarding the effect of FMRs in schoolchildren and adolescents exposed to additional fluoride sources such as daily use of fluoride toothpaste. No firm support for the use of FMRs was disclosed in a small number of studies designed for patients at caries risk. Furthermore, no association between the frequency of the rinses and prevented fraction or saved surfaces per year was found. In conclusion, this systematic review suggests that sodium fluoride mouthrinses may have an anti-caries effect in children with limited background of fluoride exposure, while its additional effect in children with daily use of fluoride toothpaste could be questioned. The need for further clinical trials to elucidate the effect of FMRs in risk patients and older adults is emphasized.
  •  
43.
  • Wibeck, Victoria, 1974-, et al. (författare)
  • Learning in focus groups : An analytical dimension for enhancing focus group research
  • 2007
  • Ingår i: Qualitative Research. - : SAGE Publications. - 1468-7941 .- 1741-3109. ; 7:2, s. 249-267
  • Tidskriftsartikel (refereegranskat)abstract
    • The focus group is a research methodology in which a small group of participants gathers to discuss a specified issue under the guidance of a moderator. The discussions are tape-recorded, transcribed and analysed. Notably, the interaction between focus group participants has seldom been evaluated, analysed or discussed in empirical research. We argue that considering the focus group in light of current research into interaction in problem-based learning (PBL) tutorial groups would facilitate the deliberate exploitation of group processes in designing focus groups, staging data collection and analysing and interpreting data. When the analytical focus shifts from mere content analysis to an analysis of what the participants themselves are trying to learn, one can explore not only what the participants are talking about, but also how they are trying to understand and conceptualise the issue under discussion. © 2007 Sage Publications.
  •  
44.
  • Wibeck, Victoria, 1974-, et al. (författare)
  • Learning in focus groups : an analytical dimension for enhancing focus group research
  • 2010. - 1
  • Ingår i: Data Collection. - London : Sage. - 9781847879301
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Insufficient attention to collecting data is often to blame when a research project founders. So how can we avoid, at best, redoing the research and at worst, scrapping the project due to a lack of sufficient data? Data collection is the foundation of high quality research, but it is often given less attention than later steps in a research project, such as coding and analyzing data. The first step in implementing a research design is collecting the data. You first have to take care to gather appropriate types of and amount of data, because making adjustments later in the project can be prohibitive. This major work focuses on this neglected aspect of the research process. It is divided into five main sections that correspond to the broad types of research design and their associated sampling methods. The five categories of research design used to organize the selection are:SurveysInterviewsExperimentsObservations, including ethnographicArchival and public sources of dataIn each of the five sections, quantitative, and qualitative data collection is discussed because each of these design types can be used to collect either or both types of data.
  •  
45.
  • Wikström, Maria, et al. (författare)
  • An Accidental Fatal Intoxication with Methoxetamine
  • 2013
  • Ingår i: Journal of Analytical Toxicology. - : Oxford University Press. - 0146-4760 .- 1945-2403. ; 37:1, s. 43-46
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper reports an unintentional death involving the administration of methoxetamine [2-(3-methoxyphenyl)-2-(ethylamino)-cyclohexanone] and offers some reference values from living drug abusers. Methoxetamine is a new recreational drug with a similar structure to ketamine. The deceased was a 26-year-old male with a history of drug abuse; he was found lying on the floor in his apartment. Several red-line plastic bags were found, one of which was labeled 2-(3-methoxyphenyl)-2-(ethylamino)-cyclohexanone and another labeled Haze. In four cases from living subjects with unknown doses, concentrations of methoxetamine were found from 0.13 to 0.49 g/g. In three of the cases, the blood samples also contained natural or synthetic cannabinoids. In the autopsy case, a considerably higher concentration of methoxetamine, 8.6 g/g, was found in femoral blood. In addition, tetrahydrocannabinol and the three different synthetic cannabinoids AM-694, AM-2201, and JWH-018, were present in femoral blood. The circumstances and the high femoral blood concentration of methoxetamine point toward an unintentional, acute fatal intoxication with methoxetamine, although the presence of the three synthetic cannabinoids may have contributed to the death.
  •  
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