| 1. |
- Kassa, Ann-Marie, et al.
(författare)
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Attention difficulties and physical dysfunction common in children with complex congenital malformations : a study of preschool children with VACTERL association
- 2020
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 109:4, s. 783-789
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Knowledge on the neurodevelopmental and physical function in children with vertebral defects, anorectal malformations, cardiac defects, tracheo-oesophageal fistula, renal and limb malformations (VACTERL) is scarce. We evaluated Swedish preschool children with VACTERL and identified whether they would need extra support in school.METHODS: From 2015 to 2017, we recruited children aged 5-7 with VACTERL association from the paediatric surgical centre at the University Children's Hospital at Uppsala. Neurodevelopmental function was assessed by age-appropriate intelligence and visual and auditory attention tests, and the children's behaviour and attention were observed by an experienced psychologist. Physical function was evaluated through parental interviews and examinations. Data on patient characteristics, including any surgery and anaesthesia, were extracted from medical records.RESULTS: Of the 13 eligible families, 10 agreed to participate. Intelligence was within the normal range for all children, but attention difficulties were found in eight of the children, requiring adjustments at school, and two of these were later diagnosed with attention deficit hyperactivity disorder. All children had physical dysfunctions that affected their daily nutrition, bowel or bladder functions.CONCLUSION: Attention difficulties and physical dysfunction were common in Swedish preschool children aged 5-7 with VACTERL and they would need support and adjustments when they started school.
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| 2. |
- Bergin, Michelle, et al.
(författare)
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Exploring with children, play in Irish primary schoolyards
- 2024
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Ingår i: International Journal of Play. - : Taylor & Francis. - 2159-4937. ; 13:2, s. 157-172
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Tidskriftsartikel (refereegranskat)abstract
- Children’s play in Irish schoolyards remains neglected in educational policies and practices despite government commitments to inclusive schools and children’s rights. There is a dearth of research on children’s perspectives of play, criticisms of ‘at risk’ discourses underpinning concerns for certain children’s play rights, and studies identifying exclusion within Irish schoolyards, particularly for children with minoritized identities. This inquiry informed by the theory of practice architectures used walking interviews to explore with twenty-three children their play practices in two Irish primary schools identified as disadvantaged. Analysis of the interviews generated three themes: (1) the state of play – cracks with(in) the routines of the schoolyard, (2) playing along and with(in) this shared space and (3) the hard yard. This inquiry contributes to understandings of children’s play with(in) Irish schoolyards, as socially situated practices with contrasting representations of play as habitual and emerging. Play was central to children’s social lives, identities, and friendships and interrelated with diverse constraints, exclusionary practices, and the (re)production of the ‘hard yard’. While mattering most children’s experiences of significant constraints and inequities, this inquiry also highlighted the transformative possibilities generated within play to create shared possibilities for individual and collective flourishing.
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| 3. |
- Bergin, Michelle, et al.
(författare)
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‘Finding the play’- exploring with occupational therapists practice possibilities in the context of Irish schoolyards
- 2024
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 31:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundResearch has identified diverse constraints to the adoption of school-based occupational therapy approaches and a lack of attention to addressing the barriers to children’s play opportunities. Critical contextualised research is advocated to inform practice possibilities.Aims/ObjectivesThis inquiry aimed to explore with occupational therapists their existing practices in Irish schoolyards to generate practice possibilities concerned with play, as an issue of occupational justice.Materials and MethodsUsing the theory of practice architectures, six occupational therapists from diverse sites of practice participated in the first phase of a critical action research process using dialogical focus group and occupational mapping methods.ResultsThree themes were generated (1) Existing practices as situated (2) (Re)mattering play and practices as occupations and (3) Practice possibilities – ‘Finding the play’ between responsiveness and responsibilities. A further interrelated dimension was how the research methods provided mechanisms of raising consciousness.Conclusions, and SignificanceAlongside constructing knowledges on existing practices in an Irish context, this inquiry contributes to understandings of practices as socially embedded generative processes of ‘finding the play’, highlighting ethical responsibilities to make visible inequities reproduced in habitual practices and engage in relationships of solidarity to (re)construct alternative shared practices.
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| 4. |
- Bergin, Michelle, et al.
(författare)
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Irish Schoolyards: Teacher’s Experiences of Their Practices and Children’s Play-“It’s Not as Straight Forward as We Think”
- 2024
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Ingår i: Journal of Occupational Therapy, Schools, & Early Intervention. - : Taylor & Francis. - 1941-1243 .- 1941-1251. ; 17:2, s. 259-278
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Tidskriftsartikel (refereegranskat)abstract
- With the inclusion of play as a right, schools are urged to consider whether all children can access play opportunities in schoolyards. Refocusing on play as occupation is identified as an important way in which occupational therapists can contribute within schools. Greater knowledges of children’s play and teachers’ practices, in schoolyards in an Irish context, is required however to guide practices. This inquiry used interviews to explore with 10 primary school teachers, their practices, and experiences of children’s play in Irish schoolyards. Reflexive thematic analysis was used to generate three interrelated themes. These were a) Break(in)time: Play in schoolyards as different from other ways of doing within schools, b) play as producing inclusion and exclusion, c) and certainties and uncertainties produced in teachers’ everyday practices. This inquiry generated knowledges on the social nature of children’s play and teachers” practices in Irish schoolyards as negotiated processes, interacting with diverse intentions, and the particularities of each schoolyard. The consequences of individualizing choice were highlighted as central to the production of inclusion and exclusion in schoolyards. Greater consideration of how children’s play and teachers” practices occur as collective occupations, is proposed to advance inclusive schoolyards.
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| 5. |
- Bergin, Michelle, et al.
(författare)
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Irish Traveller Children's Play: A Scoping Review
- 2023
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Ingår i: Journal of Child and Family Studies. - : Springer. - 1062-1024 .- 1573-2843. ; 32, s. 3860-3875
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Forskningsöversikt (refereegranskat)abstract
- Irish Traveller children, an ethnic indigenous minoritized community in Ireland are identified in Ireland’s play policy as at higher risk of exclusion from realising their right to play, alongside a reported absence of research on indigenous children’s play. This scoping review aimed to identify the breadth and scope of available research on representations of Irish Traveller children’s play and the factors influencing play opportunities. Applying the updated Joanna Briggs Institute methodological guidance, a systematic search was completed of nine databases. Thirty-five peer reviewed studies met the inclusion criteria, descriptive study information was charted and summarised and enabling and restricting factors influencing Irish Traveller children’s play were identified using an existing conceptual model. The scoping review findings revealed a limited focus within research on Irish Traveller children’s play. Included studies however, provided evidence of; the importance of feeling a sense of belonging and safety to enable Irish Traveller children’s access to preferred play opportunities, involving real life activities, physical play outdoors and play with others; Irish Traveller parents value and facilitation of play; and the significant restricting influence of racism on Irish Traveller children’s play .Limited knowledge on Irish Traveller children’s own perspectives on play and the need to address racism as a restricting influence on play in school and community environments are considered in relation to practice and further research. Discourses representing Irish Traveller children as marginalised, were problematized as reflective of culturist assumptions, and a shift towards understanding the situated nature of Irish Traveller children’s play, as a capability is proposed.
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| 6. |
- Bergin, Michelle
(författare)
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Playing along (with)in the hard yard? Play, practices, and occupational justice in Irish schoolyards
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis aims to generate knowledges on practice possibilities concerned with children’s play and occupational justice in Irish schoolyards. Navigating the intersections between theory and practice required an ongoing examination of the tensions and points of resonance between ideas, ideals, and practices. Drawing on critical occupational perspectives, four distinct yet interrelated studies contribute to the thesis aim, exploring play, particularly the play of children with minoritized identities, as an issue of occupational justice from diverse perspectives. Minoritized draws attention to the active social processes that create inequitable opportunities for children because of their identities relative to gender, race, ethnicity, socioeconomic status, religion, sexuality, and disability.In Study I, a scoping review using the Joanna Briggs institute methodology, showed a paucity of existing research on the play of Irish Traveller children, an ethnic minoritized community. Using an existing conceptual model to categorise reported influencing factors emphasized the distinct restricting factor of racism on Irish Traveller children’s play. To address the problematization of at-risk representations of Irish Traveller children, as reflective of culturist assumptions, greater attention to children’s own diverse constructions of play as a capability is proposed.Study II completed virtual and walking interviews with ten primary school teachers to explore their practices and experiences of particularly children with minoritized identities play in Irish schoolyards. The reflexive thematic analysis highlighted how prevailing norms interrelated with the locus of risks of exclusion to children’s individual choices and how teachers’ while valuing play, prioritised safety and an absence of conflict. Knowledges constructed on teachers and children negotiating individual and collective interests within diverse occupations in relationships (with)in the schoolyard, resonated with conceptualisations of collective occupations as constitutive with the production of the social space.Study III used individual and group walking interview methods to explore with 23 children their play in two Irish primary schools, identified as disadvantaged. Using the lens of the theory of practice architectures, the analysis highlighted children’s contrasting representations of play as habitual and emerging situated relational processes. Children’s acceptance of social hierarchies, individualistic and exclusionary social practices within schoolyards generated insights into the consequences of significant constraints and normative ideas on children’s play. Play was thus interrelated with the reproduction of what was termed the “hard yard”. However, the transformative potential of play was also suggested in how shared play created possibilities for fun, solidarity, and friendship.Study IV drawing on earlier studies, engaged six occupational therapists from diverse sites of practice in a critical action research inquiry to interrogate existing practices and generate practice possibilities focused on play and occupational justice in Irish schoolyards. Putting the theory of practice architectures to use again, the analysis drew attention to how habitual practices interrelated with constraints including circumscribed professional identities, service expectations and cultural norms to (re)produce practice possibilities, in tension with occupational justice ideals. Furthermore, the research process using dialogical focus group and occupational mapping methods provided a mechanism for raising consciousness that (re)mattered occupations and occupational justice.In conclusion, this thesis contributes nuanced understandings of play as socially situated practices interrelated with significant constraints and diverse social practices (with)in the particularities of Irish schoolyards. The ways in which inequities were (re)produced in habitual, individualistic, and exclusionary practices within schoolyards, and relationships of solidarity and fun were created within shared play supports understandings of the centrality of occupations to (in)justice. The insights generated problematized inclusive practices drawing attention to normative discourses, the individualising of choices, the neglect of substantive issues, such as racism and the significance of vulnerabilities and friendships. This thesis suggests practice possibilities that extend beyond play as an individual concern to consider ethical responsibilities to raise consciousness on the relational nature of collective practices with(in) shared spaces. Furthermore, in connecting (with) theorizing on occupation as collective, the theory of practice architectures and mechanisms of raising consciousness this thesis contributes to understandings of praxis.
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| 7. |
- Björklund, Cecilia, et al.
(författare)
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Temporal Patterns of Daily Occupations among Older Adults in Northern Sweden
- 2014
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Ingår i: Journal of Occupational Science. - : Informa UK Limited. - 1442-7591 .- 2158-1576. ; 21:2, s. 143-160
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Tidskriftsartikel (refereegranskat)abstract
- This study sought to expand knowledge regarding patterns of daily occupations and, specifically, to explore and describe the daily occupations of Swedish people aged over 70 years by investigating sequences, contexts and time-use. A cross-sectional design with a time-geographic approach was used. Open time diaries from 151 participants were collected and analysed using the software VISUAL-TimePAcTS. The results were illustrated as a routine of six pooled intervals during 24-hour sequences. The intervals comprised different lengths of time and each interval was dominated by different occupations. Night was dominated by ‘care for oneself’; morning by ‘house-keeping’ and ‘reflection and recreation’; lunch-time by care for oneself; afternoon by ‘reflection and recreation’; dinner/tea-time by ‘care for oneself’, and evening by ‘reflection and recreation’. The results were also illustrated as characteristic profiles of occupations visualised by the number of participants in each occupation during 24-hour sequences. Occupations were mainly supported by the home environment. Summed time-use showed the highest proportions in ‘care for oneself’ and ‘reflection and recreation’ occupations. To what extent health and well-being experiences of patterns of daily occupations might be related to challenges and fulfilment of basic occupational needs requires further investigation
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| 8. |
- Björklund, Cecilia, et al.
(författare)
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Temporal Patterns of Daily Occupations Related to Older Adults' Health in Northern Sweden
- 2015
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Ingår i: Journal of Occupational Science. - Melbourne : Informa UK Limited. - 1442-7591 .- 2158-1576. ; 22:2, s. 127-145
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify characteristics of temporal patterns of daily occupations that could be related to high and low subjective health among older adults in Northern Sweden. A cross-sectional design imprinted by time-geographic methodology was used and participants 70 years and older were purposively selected and divided into groups of high and low health using the SoC-29 and SF-36 questionnaires. Daily occupations data were registered and analysed using VISUAL Time-PAcTS and related to health conditions using SPSS. The results showed that the participants in the high- and low-health groups showed similar patterns of participation in occupations during the 24-hour sequences describing their daily routines. Some differences in patterns of frequency and duration of occupations were shown between health groups during the 24-hour sequences as well as within six intervals. The low-health group showed higher frequencies and longer durations for “care for oneself” and “reflection and recreation” occupations and lower for “house-keeping” and “procure and prepare food” occupations compared to the high-health groups. There were few significant differences between the high- and low-health groups' mean durations for occupations. The results of this study could contribute to the support and assistance of occupations of older adults in society.
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| 9. |
- Borell, Lena, et al.
(författare)
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Community-based Occupational Therapy : A Study of Elderly People with Home Help in a Social-Welfare District in Stockholm
- 1995
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 2:3-4, s. 138-144
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Tidskriftsartikel (refereegranskat)abstract
- Since 1992 the local authorities in Sweden have been responsible for the rehabilitation of elderly people living at home. Few studies of this relatively new form of rehabilitation have been reported. The aim of this study was to describe the type of occupational- therapy interventions received by elderly people over the age of 65 living in an urban area. Another aim was to describe the patterns in the performances of 648 elderly people. The study demonstrated that most of the elderly people who received occupational therapy also received home help several times a day. indicating that these elderly people had severe problems in the activities of daily living (ADL) in the area of self-care. Home-making activities and activities outside the home were the most problematic activities. The elderly also wanted to engage in more activities than they were judged to have the capacity for and or the environmental support to do. The implications of the results for community-base, occupational-therapy programs are discussed
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| 10. |
- Borell, Lena, et al.
(författare)
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Occupations and Signs of Reduced Hope : An Explorative Study of Older Adults with Functional Impairments
- 2001
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Ingår i: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 55:3, s. 311-316
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Tidskriftsartikel (refereegranskat)abstract
- Objective. The purpose of this explorative study was to uncover and interpret the experiences, values, and meaning of being in daily occupations of older adults with functional impairments. Method. Interviews were conducted with 21 older adults with disabilities who were between 70 and 92 years of age. The interviews occurred in their home environments; 18 of the 21 participants lived alone. The interviews were analyzed using a constant comparative approach. Findings. Occupational themes related to participation against the odds, retreat from occupation, the need for an invitation from others, and personal meanings related to capacities for occupation were uncovered. Conclusions. The findings suggest that the loss of positive belief in enjoyable occupations can be a sign of reduced hope in late life. For occupational therapists, whether an older adult has made a conscious choice to withdraw from occupational life or has too few occupational choices is important to distinguish.
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| 11. |
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| 12. |
- Carlsson.Alm, Siv, et al.
(författare)
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Etiska konflikter vid rehabilitering
- 1995
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Ingår i: Medicinsk etik. - Stockholm : Bonnier utbildning. - 9162208373 ; , s. 48-58
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Bokkapitel (populärvet., debatt m.m.)
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| 13. |
- Clauss, Adam, et al.
(författare)
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Three genes expressing Kunitz domains in the epididymis are related to genes of WFDC-type protease inhibitors and semen coagulum proteins in spite of lacking similarity between their protein products
- 2011
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Ingår i: BMC Biochemistry. - : Springer Science and Business Media LLC. - 1471-2091. ; 12:55
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Tidskriftsartikel (refereegranskat)abstract
- Background: We have previously identified a locus on human chromosome 20q13.1, encompassing related genes of postulated WFDC-type protease inhibitors and semen coagulum proteins. Three of the genes with WFDC motif also coded for the Kunitz-type protease inhibitor motif. In this report, we have reinvestigated the locus for homologous genes encoding Kunitz motif only. The identified genes have been analyzed with respect to structure, expression and function. Results: We identified three novel genes; SPINT3, SPINT4 and SPINT5, and the structure of their transcripts were determined by sequencing of DNA generated by rapid amplification of cDNA ends. Each gene encodes a Kunitz domain preceded by a typical signal peptide sequence, which indicates that the proteins of 7.6, 8.7, and 9.7 kDa are secreted. Analysis of transcripts in 26 tissues showed that the genes predominantly are expressed in the epididymis. The recombinantly produced proteins could not inhibit the amidolytic activity of trypsin, chymotrypsin, plasmin, thrombin, coagulation factor Xa, elastase, urokinase and prostate specific antigen, whereas similarly made bovine pancreatic trypsin inhibitor (BPTI) had the same bioactivity as the protein isolated from bovine pancreas. Conclusions: The similar organization, chromosomal location and site of expression, suggests that the novel genes are homologous with the genes of WFDC-type protease inhibitors and semen coagulum proteins, despite the lack of similarity in primary structure of their protein products. Their restricted expression to the epididymis suggests that they could be important for male reproduction. The recombinantly produced proteins are presumably bioactive, as demonstrated with similarly made BPTI, but may have a narrower spectrum of inhibition, as indicated by the lacking activity against eight proteases with differing specificity. Another possibility is that they have lost the protease inhibiting properties, which is typical of Kunitz domains, in favor of hitherto unknown functions.
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| 14. |
- Dolva, Anne-Stine, et al.
(författare)
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Functional performance characteristics associated with postponing elementary school entry among children with Down syndrom
- 2007
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Ingår i: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 61:4, s. 414-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: This study investigated the relation between functional performance skills of children with Down syndrome and the age of entry into mainstream elementary education. METHOD: In a cross-sectional study of 70% of the 7-year-old children with Down syndrome in Norway (N = 43), we measured functional performance using the Pediatric Evaluation of Disability Inventory (PEDI). The study was a follow-up of a previous study of the same children at age 5 assessed using the same instrument. Data from both studies were used in the analysis. RESULTS: Forty percent of the sample of children with Down syndrome in Norway had entered elementary school after a 1-year postponement (i.e., at age 7). The functional performance skills of the children, as measured using the PEDI, were significantly lower at both age 5 and age 7 in self-care and social function compared with children with Down syndrome who entered elementary school at the usual time (i.e., at age 6). The main characteristics associated with postponed elementary school entry were found in communication skills and bladder and bowel management. CONCLUSION: A certain level of development and independence seems to be required for a child with Down syndrome to be viewed as ready to enter elementary school, and perceptions of readiness for school may be culturally dependent. In addition to the well-described challenges in language and communication skills, being viewed as ready for school includes having stopped using diapers, a topic not previously mentioned as a factor in postponing elementary school entry for children with Down syndrome. Awareness of culturally influenced performance skills may give direction to parents and professionals in targeting areas in the preschool years that might help promote these children's readiness for school.
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| 15. |
- Dolva, Anne Stine, et al.
(författare)
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Functional performance in children with Down syndrome
- 2004
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Ingår i: American Journal of Occupational Therapy. - : AOTA Press. - 0272-9490 .- 1943-7676. ; 58:6, s. 621-629
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe home and community functional performance in 5-year-old children with Down syndrome. METHOD. In a cross-sectional study of 5-year-old children with Down syndrome in Norway (N = 43), functional performance was measured with the Norwegian translation of the Pediatric Evaluation of Disability Inventory (PEDI). Additional descriptive information related to health, disabilities, and function was also gathered. RESULTS. The children showed a wide range of functional performance. Performance of self-care activities appeared most delayed on activities that required fine motor skills. Children appeared less affected in basic functional mobility skills. Parents' identified their main concerns as language functioning and, for the children not yet toilet trained, the management of bladder and bowel control in relation to starting school. CONCLUSION. The results provide baseline information regarding typical levels of functional performance in children with Down syndrome at 5 years of age. However, the broad range of functional performance across children indicates a need for caution in generalizing the results to an individual child.
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| 16. |
- Eriksson, Gunilla, et al.
(författare)
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Occupation of Elderhood
- 2015. - 4
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Ingår i: Occupational therapy. - Thorofare, NJ, USA : SLACK Incorporated. - 9781617110504 ; , s. 169-183
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Bokkapitel (refereegranskat)
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| 17. |
- Eriksson, Gunilla, et al.
(författare)
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Occupations of Elderhood
- 2024. - 4
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Ingår i: Occupational Therapy. - : Taylor and Francis. - 9781617110504 - 9781003522997 ; , s. 169-183
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 18. |
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| 19. |
- Johansson, Karin Mauri, et al.
(författare)
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Balancing the good : a critical discourse analysis of home modification services
- 2010
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Ingår i: Sociology of Health and Illness. - : Wiley. - 0141-9889 .- 1467-9566. ; 32:4, s. 563-582
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Tidskriftsartikel (refereegranskat)abstract
- Today an increasing number of people with functional limitations are ageing in their homes. Although the home has become an arena for assessment and implementation of services, little is known about how the interrelationships between ideological and practical circumstances influence the allocation of such welfare services. This explorative study applied a combination of critical discourse analysis and a narrative approach to closely examine such relationships in home modification services to older persons in Sweden. Data consisted of focus group discussions with street-level bureaucrats from two institutional contexts in the organisational field of home modification services and official documents related to such services. Findings showed that the attempts of street-level bureaucrats to allocate resources in accordance with the good were complicated by competing local definitions of 'the good'. The process of forming local perceptions of the good included complex balancing acts between hegemonic discourses within the organisational field which influenced and shaped how 'the good' was practised. Understanding the moral dimensions that enter into the complexity of allocation of home modification services across institutional settings has implications for the policies of and practices for the allocation of welfare resources.
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| 20. |
- Johansson, Karin Mauri, et al.
(författare)
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Creating possibilities for action in the presence of environmental barriers in the process of 'ageing in place'
- 2009
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779. ; 29:1, s. 49-70
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Tidskriftsartikel (refereegranskat)abstract
- The need for an understanding of 'ageing in place' as a progressive process has emerged among researchers in the field of environmental gerontology. The aim of this study was to explore this process, in relation to home modification services. Four older adults who had applied for home modification services in one Swedish municipality were included. Data were collected by open interviews with the participants in their homes on subsequent occasions, from before the modification had been installed until recognised stability in the situation relating to the home modification. In the analysis, the concept of place integration was used as a tool to explore the active relations that connect people and context over time. The main findings show that the participants used creativity and initiative to direct future situations towards increased possibilities for action. This indicates that services aiming to support people 'ageing in place' should be directed towards increasing possibilities for action rather than only facilitating activity performance. Furthermore, it can be concluded that if the service-users' creativity and efforts are recognised as resources in design and provision of services, services that aim to support individuals who are ageing in place have the potential to be empowering
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| 21. |
- Johansson, Karin Mauri, et al.
(författare)
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Older persons' navigation through the service system towards home modification resources
- 2009
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 16:4, s. 227-237
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Tidskriftsartikel (refereegranskat)abstract
- Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a "geographical map". Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system. ©
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| 22. |
- Johansson, Karin Mauri, et al.
(författare)
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Performance of activities of daily living in a sample of applicants for home modification services
- 2007
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 44-53
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Tidskriftsartikel (refereegranskat)abstract
- Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupational therapy interventions.
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| 23. |
- Johansson, Margareta, et al.
(författare)
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Freebirth, the only option for women who do not fit into common practice : A Swedish national interview study.
- 2023
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To explore women's experience of freebirth, as giving birth without the presence of a skilled healthcare professional such as a midwife.METHODS: Online semi-structured interviews with nine multiparous women in Sweden. A qualitative experiential approach, as described by Burnard, was followed for data analysis.RESULTS: The five main categories explored were: (i) previous negative experiences of hospital care as a reason for freebirth; (ii) receiving support for the decision of freebirth was crucial; (iii) longing for individual midwifery-assisted home-birthing support; (iv) to give birth in peace and in self-control, in the safe home environment; and (v) helpful support during labor and birth was appreciated.CONCLUSIONS: The women in the study had a powerful and positive experience of freebirth, but individual midwifery birthing support was also requested. Easily available and respectful midwifery support should be offered to all childbearing women.
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| 24. |
- Köpsén, Sofia, et al.
(författare)
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Midwives' and diabetes nurses' experience of screening and care of women with gestational diabetes mellitus : a qualitative interview study
- 2023
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Ingår i: Nursing Research and Practice. - : Hindawi Publishing Corporation. - 2090-1429 .- 2090-1437. ; 2023
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Tidskriftsartikel (refereegranskat)abstract
- Background: Gestational diabetes mellitus (GDM) is increasing and is associated with adverse outcomes for both mother and child. The metabolic demands of pregnancy can reveal a predisposition for type 2 diabetes mellitus (T2DM), and women with a history of GDM are more likely to develop T2DM than women with normoglycemic pregnancies.Aim: The aim of this study was to explore midwives' and diabetes nurses' experience of their role in screening, care, and follow-up of women with gestational diabetes mellitus and, further, to explore their opinions and thoughts about existing routines and guidelines.Method: Individual interviews were performed with ten diabetes nurses and eight midwives working in primary and special care. Qualitative content analysis was done according to Graneheim and Lundman.Results: The analysis of the interviews resulted in the overall theme "An act of balance between normalcy and illness, working for motivation with dilemmas throughout the chain of health care."Difficulties in carrying out the important task of handling GDM while at the same time keeping the pregnancy in focus were central. Women were described as highly motivated to maintain a healthy lifestyle during pregnancy with the baby in mind, but it seemed difficult to maintain this after delivery, and compliance with long-term follow-up with the aim of reducing the risk of T2DM was low. The women came to the first follow-up but did not continue with later contact. This was at a time when the women felt healthy and were focusing on the baby and not themselves. A lack of cooperation and easy access to a dietician and physiotherapist were pointed out as well as a wish for resources such as group activities and multiprofessional teams.
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| 25. |
- Lang, Margareta, et al.
(författare)
-
Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest: a prospective multicentre study
- 2024
-
Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238.
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Application of standardised and automated assessments of head computed tomography (CT) for neuroprognostication after out-of-hospital cardiac arrest. Methods: Prospective, international, multicentre, observational study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial. Routine CTs from adult unconscious patients obtained > 48 h <= 7 days post-arrest were assessed qualitatively and quantitatively by seven international raters blinded to clinical information using a pre-published protocol. Grey-white-matter ratio (GWR) was calculated from four (GWR-4) and eight (GWR-8) regions of interest manually placed at the basal ganglia level. Additionally, GWR was obtained using an automated atlas-based approach. Prognostic accuracies for prediction of poor functional outcome (modified Rankin Scale 4-6) for the qualitative assessment and for the pre-defined GWR cutoff < 1.10 were calculated. Results: 140 unconscious patients were included; median age was 68 years (interquartile range [IQR] 59-76), 76% were male, and 75% had poor outcome. Standardised qualitative assessment and all GWR models predicted poor outcome with 100% specificity (95% confidence interval [CI] 90-100). Sensitivity in median was 37% for the standardised qualitative assessment, 39% for GWR-8, 30% for GWR-4 and 41% for automated GWR. GWR-8 was superior to GWR-4 regarding prognostic accuracies, intra- and interrater agreement. Overall prognostic accuracy for automated GWR (area under the curve [AUC] 0.84, 95% CI 0.77-0.91) did not significantly differ from manually obtained GWR. Conclusion: Standardised qualitative and quantitative assessments of CT are reliable and feasible methods to predict poor functional outcome after cardiac arrest. Automated GWR has the potential to make CT quantification for neuroprognostication accessible to all centres treating cardiac arrest patients.
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| 26. |
- Lang, Margareta, et al.
(författare)
-
Standardised and automated assessment of head computed tomography reliably predicts poor functional outcome after cardiac arrest : a prospective multicentre study
- 2024
-
Ingår i: Intensive Care Medicine. - : SPRINGER. - 0342-4642 .- 1432-1238. ; 50:7, s. 1096-1107
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Application of standardised and automated assessments of head computed tomography (CT) for neuroprognostication after out-of-hospital cardiac arrest. Methods: Prospective, international, multicentre, observational study within the Targeted Hypothermia versus Targeted Normothermia after out-of-hospital cardiac arrest (TTM2) trial. Routine CTs from adult unconscious patients obtained > 48 h ≤ 7 days post-arrest were assessed qualitatively and quantitatively by seven international raters blinded to clinical information using a pre-published protocol. Grey–white-matter ratio (GWR) was calculated from four (GWR-4) and eight (GWR-8) regions of interest manually placed at the basal ganglia level. Additionally, GWR was obtained using an automated atlas-based approach. Prognostic accuracies for prediction of poor functional outcome (modified Rankin Scale 4–6) for the qualitative assessment and for the pre-defined GWR cutoff < 1.10 were calculated. Results: 140 unconscious patients were included; median age was 68 years (interquartile range [IQR] 59–76), 76% were male, and 75% had poor outcome. Standardised qualitative assessment and all GWR models predicted poor outcome with 100% specificity (95% confidence interval [CI] 90–100). Sensitivity in median was 37% for the standardised qualitative assessment, 39% for GWR-8, 30% for GWR-4 and 41% for automated GWR. GWR-8 was superior to GWR-4 regarding prognostic accuracies, intra- and interrater agreement. Overall prognostic accuracy for automated GWR (area under the curve [AUC] 0.84, 95% CI 0.77–0.91) did not significantly differ from manually obtained GWR. Conclusion: Standardised qualitative and quantitative assessments of CT are reliable and feasible methods to predict poor functional outcome after cardiac arrest. Automated GWR has the potential to make CT quantification for neuroprognostication accessible to all centres treating cardiac arrest patients.
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| 27. |
- Lidström Holmqvist, Kajsa, 1965-
(författare)
-
Occupational therapy practice for clients with cognitive impairments following aquired brain injury : occupational therapists' perspective
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to describe occupational therapy practice for clients with cognitive impairment following acquired brain injury (CIABI) from the perspective of practicing occupational therapists (OTs).To fulfill this aim, qualitative and quantitative approaches were used including interviews (Study I) and questionnaires (Studies II -IV). Based on the qualitative descriptions generated in Study I, a questionnaire was developed and evaluated for content validity and test-rest validity (Study II). The questionnaire was then used in a survey (Study III). The reactive Delphi technique was used to empirically define the aspects that OTs found to be consistent with the concept of therapeutic use of self (Study IV).The results showed that a predominant practice pattern was the use of ADL activities for intervention regardless of whether limitations in occupational performance or cognitive function were assessed, or whether the approach to therapy was remedial or compensatory. General ADL-instruments were used more than instruments focused on impairment level. Therapies covering a wide range of cognitive impairments, and abilities important to organizing and executing occupational performance were commonly targeted. Therapies targeting clients’ activity limitations were prioritized before remediating impairment. Therapeutic use of self was regarded as being important and the results identified clientspecific aims not earlier described in relation to therapeutic use of self. Another prominent practice pattern was the collaborative approach toward clients, relatives, and other staff. Theories used to support practice were primarily general. Occupational therapy practice for clients with CIABI was found to be complex, and the practice patterns were affected by circumstances such as the ‘hidden’ nature of the cognitive impairments, perceived lack of knowledge, and organizational issues. The results of this thesis can be used as a foundation for further research on practice patterns or the specific therapies used. It can facilitate discussions on strengths and weaknesses witcurrent practice, the need for development, and research utilization.
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| 28. |
- Lilja, Margareta, et al.
(författare)
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Attitudes towards rehabilitation needs and support from assistive technology and the social environment among elderly people with disability
- 2003
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Ingår i: Occupational Therapy International. - : Wiley. - 0966-7903 .- 1557-0703. ; 10:1, s. 75-93
-
Tidskriftsartikel (refereegranskat)abstract
- This study aimed to survey the attitudes of elderly people with disabilities who were living at home regarding their support from assistive technology and the social environment. These attitudes were compared with their identified needs by an occupational therapist and in relation to perception of social engagement, loneliness and overall contentment with life. From a sample of 102 participants who were interviewed using a standardized procedure, 53 persons were included in the study. The results indicated that attitudes among elderly people towards social and occupational engagement and change have a greater influence on their rehabilitation status than their disability as indicated by their health condition and limitations in activities of daily living and instrumental activities of daily living. The elderly people who accepted rehabilitation were more able, and were better equipped and better supported with assistive technology, than those who declined rehabilitation. Rehabilitation needs that the occupational therapists recognized were not always shared by the disabled elderly people, for several reasons; one reason of particular importance was the elderly person's attitude towards change and social engagement. However, the small sample size limits the generalization of the findings to the population of elderly people with disabilities. An ethnographic research design that allows for repeated interviews and observations of elderly people with disabilities for a prolonged period of time in their ordinary everyday lives may present an avenue for future research and lead to a deeper understanding of the issues
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| 29. |
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| 30. |
- Lilja, Mikael, et al.
(författare)
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Diagnos och behandlingsmål vid diabetes typ 2
- 2018
-
Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 115
-
Tidskriftsartikel (refereegranskat)abstract
- The article presents diagnostic criteria for diabetes and treatment goals for diabetes type 2.
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| 31. |
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| 32. |
- Lilja, Margareta, et al.
(författare)
-
Disability policy in Sweden : policies concerning assistive technology and home modification services.: An article from: Journal of Disability Policy Studies
- 2003
-
Ingår i: Journal of Disability Policy Studies. - : SAGE Publications. - 1044-2073 .- 1538-4802. ; 14:3, s. 130-135
-
Tidskriftsartikel (refereegranskat)abstract
- This article describes policy concerning provision of services to persons with disabilities in Sweden. The Swedish welfare system provides general support for society as a whole, which is supplemented by specific support for persons with special needs. This philosophy has guided the way Sweden has built public service systems. The authors describe the range of accessible services for persons with disabilities, including the system of delivery for assistive technology and housing modifications. Strengths and weaknesses in Swedish policy related to decentralization, responsibility, equality, and cost are also discussed.
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| 33. |
- Lilja, Margareta
(författare)
-
Elderly disabled persons in the home setting : aspects of activities in daily life
- 2000
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to explore and describe elderly disabled persons' activities in daily life in the home environment from an occupational perspective and, secondly to describe occupational therapy interventions provided to elderly disabled persons in their home setting. Study I explored and described elderly persons' performance in ADL, and occupational therapy interventions provided. Most of the participants wanted to engage in more activities than they were judged to have the capacity and/or environmental support for. Hobby activities outside/inside the home, taking a bath or shower, washing clothes, and cooking were activities presenting significant problems. Participants who received occupational therapy experienced problems regarding self-care. Assessment and assistive devices were the most common occupational therapy interventions provided in the study. Study II focused on participants from study I that had an elevator in their housing and their need for mobility support in the environment. Social contacts in the home and weekly shopping were activities where no major difference could be seen between those elderly persons who needed assistance using the elevator and those who managed the elevator alone. Mobility was not only related to a person's bodily function but also to social support from the environment. Study III explored and described occupational therapy intervention patterns over two periods. Treatment/training, prevention in everyday activities and information/consultation increased from period I to period 2, while interventions concerning assistive devices decreased. Treatment/training during both periods concerning leisure/recreation activities, whilst interventions concerned consultation seemed to be changing over time from focusing on clients to relatives and home help staff. Study IV aimed at uncovering and interpreting elderly disabled persons' experiences, values and meanings of being engaged in daily occupations. Themes related to participation against the odds, retreat from occupation, the need for an invitation from others, and personal meanings related to capacities for occupations were uncovered. The findings suggest that for occupational therapy it is important to distinguish between when a person has made a conscious choice to withdraw from occupational life and when a person, for example, has too few occupational choices. Study V described and evaluated a clinical attempt to change occupational therapy practice when reporting clients between occupational therapists in the chain of care. The ADL taxonomy was used as an instrument for transferring the information. It was seen as useful for this purpose but there was still a need for reporting clients orally. Aspects of temporality, structure, professionalism and the instrument's usefulness overall influenced the transfer of information. Systematic discharge planning schemes, written and formally structured information, feedback loop for communication, and collaboration with the clients and their families in the discharge process are suggested as guidelines for the transfer of information. Implications of the studies for occupational therapy for elderly disabled persons in the home setting are proposed in the discussion section.
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| 34. |
- Lilja, Margareta, et al.
(författare)
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Elderly people's daily activities and need for mobility support
- 1997
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 11:2, s. 73-80
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study is to describe elderly people's performance of some daily activities in relation to their need for mobility support in their living environment. Two groups of individuals, over the age of 65 and living in an old urban area with access to elevators in their housing, were compared, as regards mobility, shopping, hobbies and social contacts. The first group (n = 284) comprised persons who needed assistance from another person in using the elevator. The subjects in the second group (n = 325) were able to manage the elevator independently. The subjects in the first group experienced more problems in carrying out the activities than those in the second group. Weekly shopping was the only action in which the findings demonstrated no main differences between the groups. Throughout all the activities of daily living (ADL), and in both groups, there were persons who were rated as having the capacity to perform the activities, but did not do so and did not want to do so. The elderly, especially in the first group, wanted to engage in more activities than they were judged to have the capacity for and/or the environmental support to do. The implications of the result for the assessment of the homes of the elderly in relation to their environment are discussed.
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| 35. |
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| 36. |
- Lilja, Margareta, et al.
(författare)
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Occupational therapy practice patterns with older Swedish persons at home
- 2001
-
Ingår i: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie. - : SAGE Publications. - 0008-4174. ; 68:1, s. 51-59
-
Tidskriftsartikel (refereegranskat)abstract
- This paper explores and describes occupational therapy practice patterns during two periods for 89 elderly persons living at home. Occupational therapists working in one social welfare district in Stockholm, Sweden documented and reported every occupational therapy intervention provided. The results revealed that the elderly persons who received occupational therapy services during an extended period had an age span of 30 years, with a mean age over 80 years. They had several medical problems and were living in different types of settings. Occupational therapists provided a wide range of interventions, most frequently categorised as treatment, especially related to leisure activities. Irrespective of level of care, the median of interventions per person increased or was the same over time, and 72% of the elderly persons remained at the same level of care. Enabling occupation for elderly disabled person living in their home involves constantly adjusting to the current situation since the clients' capacities, goals and environment change over time. Therefore, occupational therapists need to have a client-centred approach working in home health community services
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| 37. |
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| 38. |
- Lilja, Mikael, et al.
(författare)
-
The iImpact of Leptin and Adiponectin on incident type 2 Diabetes is modified by sex and insulin resistance
- 2012
-
Ingår i: Metabolic Syndrome and Related Disorders. - : Mary Ann Liebert Inc. - 1540-4196 .- 1557-8518. ; 10:2, s. 143-151
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Adiponectin and leptin and their ratio have been associated with incident type 2 diabetes (T2DM), although the data presented are conflicting and the populations studied have been small. In this large, prospective, nested, case referent study, we hypothesized that these associations are sex specific and may be modified by insulin resistance. Methods: Men and women aged 30-60 years with incident T2DM (n = 640) and a prior health survey within the Vasterbotten Intervention Programme (VIP) and matched referents (n = 1564) were identified. Using conditional logistic regression analyses, we tested whether baseline plasma adiponectin and leptin levels and their ratio independently predicted incident T2DM, stratified for gender and insulin resistance. Results: Adjusted for traditional risk factors, fourth-quartile levels of adiponectin were associated with a reduced risk of T2DM in men [odds ratio (OR) 0.55 (0.36-0.86)] and women [OR 0.47 (0.27-0.83)]. Quartile four of the leptin/adiponectin ratio predicted T2DM in both men [OR 3.08 (1.68-5.67)] and women [OR 3.31 (1.56-7.03)], whereas quartile-four levels of leptin predicted T2DM only in men [OR 2.30 (1.32-4.02)]. When stratified for insulin sensitivity and adjusted for body mass index (BMI), loge-transformed leptin predicted T2DM in insulin-sensitive men [OR 1.56 (1.13-2.17)] but not in insulin-resistant men [OR 1.03 (0.76-1.39)]. The effect of adiponectin and the leptin/adiponectin ratio was not influenced by the insulin sensitivity status. Conclusions: Leptin in men and adiponectin in both sexes were independent predictors of T2DM. The association was modified by the degree of insulin sensitivity. The leptin/adiponectin ratio may add predictive information beyond the separate hormones.
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| 39. |
- Lilja, Mikael, et al.
(författare)
-
The impact of leptin and adiponectin on incident type 2 diabetes is modified by sex and insulin resistance
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background Adiponectin and leptin and their ratio have been associated with incident type 2 diabetes (T2DM), although presented data are conflicting and populations studied have been small. In this large prospective nested case referent study, we hypothesised that these associations are sex-specific and may be modified by insulin resistance. Methods Men and women aged 30–60 years with incident T2DM (n=640) and a prior health survey within the Västerbotten Intervention Programme (VIP), and matched referents (n=1564) were identified. Using conditional logistic regression analyses, we tested whether baseline plasma adiponectin and leptin levels and their ratio independently predicted incident T2DM, stratified for gender and insulin resistance. Results Adjusted for traditional risk factors, fourth-quartile levels of adiponectin were associated with a reduced risk of T2DM in men (OR 0.55 [0.36–0.86]) and women (OR 0.47 [0.27–0.83]). Quartile four of the leptin/adiponectin ratio predicted T2DM in both men (OR 3.08 [1.68–5.67]) and women (OR 3.31 [1.56–7.03]), while quartile-four levels of leptin predicted T2DM only in men (OR 2.30 [1.32–4.02]). When stratified for insulin sensitivity and adjusted for BMI, loge-transformed leptin predicted T2DM in insulin-sensitive men (OR 1.56 [1.13–2.17]) but not in insulin-resistant men (OR 1.03 [0.76–1.39]). The effect of adiponectin and the leptin/adiponectin ratio was not influenced by the insulin sensitivity status. Conclusions Leptin in men and adiponectin in both sexes were independent predictors of T2DM. The association was modified by the degree of insulin sensitivity. The leptin/adiponectin ratio may add predictive information beyond the separate hormones
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| 40. |
- Lilja, Margareta, et al.
(författare)
-
The transfer of information about geriatric clients in the occupational therapy chain of care : An intervention study
- 2000
-
Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 7:2, s. 51-59
-
Tidskriftsartikel (refereegranskat)abstract
- Continuity of interventions for elderly persons after discharge from hospital is affected by the communication between professionals involved in the rehabilitation process. This study describes an intervention project that was implemented to improve ways of transferring information relating to geriatric clients between occupational therapists working on different organizational levels. An assessment of activities of daily living (the ADL taxonomy) was used as a uniform instrument of communication. The results revealed that aspects of temporality, structure, professionalism and the instrument's usefulness influenced the transfer of information. Systematic discharge planning schemes, written and formally structured information, a feedback loop for communication, and collaboration with the clients and their families in the discharge process are all suggested as ways of transferring information.
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| 41. |
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| 42. |
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| 43. |
- Lundström, Ulrica, et al.
(författare)
-
Experiences of participation in everyday occupations among persons aging with a tetraplegia
- 2015
-
Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 37:11, s. 951-957
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to gain understanding of participation in everyday occupations through life stories of persons aging with a traumatic spinal cord injury (SCI). Method: A narrative method was used for data collection and a paradigmatic analysis was used to analyze data. Results: The analysis resulted in three themes that illustrate how the participants acted to participate in everyday occupations, how that changed over time, and some concerns about their future. The first theme illustrates how participants following SCI acted to become agents of their lives and participate in everyday occupations. The second theme illustrates how participants had to prioritize participation in meaningful occupations due to personal and environmental factors. The third theme shows how they had to try new strategies to continue participation in occupations, due to secondary health complications related to aging. Conclusions: This study captures how persons aging with tetraplegia acted to participate in everyday occupations from soon after the injury until several decades later. In addition, their ability to act and participate changed over time. Our findings provide knowledge that can guide clinicians in their work within this complex area of rehabilitation. Besides, it can also guide the work with policy recommendations for healthcare and social service systems.Implications for Rehabilitation
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| 44. |
- Lundström, Ulrica, et al.
(författare)
-
Leisure repertoire among persons with a spinal cord injury: Interests, performance, and well-being
- 2014
-
Ingår i: Journal of Spinal Cord Medicine. - 2045-7723 .- 1079-0268. ; 37:2, s. 186-192
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore and describe the leisure repertoire of persons with traumatic spinal cord injury (SCI) and how the repertoire is related to interest, performance, and well-being. Design: Cross-sectional study. Setting: A total of 97 persons with traumatic SCI were recruited from the non-profit national organization, RG Active Rehabilitation in Sweden. Outcome measure: Data were collected through a two-part postal survey. The first comprised of questions investigating socio-demographic variables and injury characteristics; the second part included an interest checklist with 20 areas of leisure activities. Results: The participants were mostly interested in, performed, and experienced well-being from social and culture activities and TV/DVD/movies. The areas of leisure activities in which they had most likely experienced changes after the SCI were outdoor activities, exercise, and gardening. Sex, age, and to some extent, time since injury were related to interest, performance, well-being, and changed performance. Conclusions: The results provided an explanation and limited description of a changed leisure repertoire among persons after a traumatic SCI. The study showed that sex, age, and time since injury were more closely related to the choice of leisure activities to include in the leisure repertoire than the level of injury. This knowledge can be of importance when professionals in the field of rehabilitation are planning and implementing interventions concerning leisure activities for persons with SCI.
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| 45. |
- Lundström, Ulrica, et al.
(författare)
-
Participation in activities and secondary health complications among persons aging with traumatic spinal cord injury
- 2017
-
Ingår i: Spinal Cord. - : Nature Publishing Group. - 1362-4393 .- 1476-5624. ; 55:4, s. 367-372
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN:Cross-sectional study.OBJECTIVES:To describe participation in activities and explore the relationship with secondary complications among persons aging with a traumatic spinal cord injury (SCI).SETTING:A regional SCI outpatient center in Sweden.METHODS:Data were collected through a phone survey, which included 10 activities from the instrument PARTS/M-v3 (PARTicipation Survey/Mobility version-3) together with data from the participants' medical records. Cross-tabulation and χ2 were used for data analysis.RESULTS:In this study, 121 persons matched the inclusion criteria and the final study sample comprised 73 participants (60% response rate): 55 men and 18 women. Mean age was 63.7±9.4 years, and mean time since injury was 36.3±9.2 years. Regardless of duration of SCI, all 73 participated in dressing, bathing and leisure activities. Women reported better health than men. Particularly for those who lived 36-55 years after injury; increasing pain, fatigue, spasticity and decreased muscle strength were negatively affecting participation in activities, especially exercise and active recreation. Additionally, a need to save strength/energy was also a reason for not participating in the activities. Perceived future support and concerns in relation to personal assistance, assistive devices and rehabilitation was also reported.CONCLUSION:Increasing secondary health complications and a need to save strength/energy influenced participation in activities. Laws and/or governmental policies regarding personal assistance and assistive devices did not always support participation in activities. Interventions should aim to create a balance among activities in everyday life
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| 46. |
- Lundström, Ulrica, et al.
(författare)
-
"To Work Just Like Anyone Else" : a narrative from a man aging with spinal cord injury
- 2017
-
Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years. The narrative analysis generated an overall plot, named "To Work Just Like Anyone Else," and gives a picture of his experiences, thoughts, and reflections about meaning in occupations, from when he became injured to the present, and in relation to his future. His life story is characterized by secondary health complications, and his experiences of negotiating with the aging body and making choices to continue working. Further, how occupational risk factors, e.g., imbalance, alienation, and deprivation, occur as a result of lack of rehabilitation and support from social systems is addressed. Future research should explore how rehabilitation and social systems can support people aging with SCI to experience meaning in everyday occupations and to have balance in everyday life.
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| 47. |
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| 48. |
- Mollberg, Margareta, 1953, et al.
(författare)
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High birthweight and shoulder dystocia: the strongest risk factors for obstetrical brachial plexus palsy in a Swedish population-based study
- 2005
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Ingår i: Acta Obstet Gynecol Scand. ; 84:7, s. 654-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obstetrical brachial plexus palsy (OBPP) is a serious form of neonatal morbidity. OBJECTIVE: The aim of this work was to study the incidence of OBPP and to analyze its risk factors. METHODS: This is a population-based retrospective case-control study. All deliveries recorded in the Swedish Medical Birth Registry between 1987 and 1997 (n = 1 213 987) were investigated. Cases (n = 2399) with OBPP were compared to all other cases. RESULTS: The incidence of OBPP increased from 0.17 in 1987 to 0.27% in 1997 (p = 0.002). During the same time period, the mean birthweight increased from 3483 to 3525 g. Birthweight increasing from 4000 g was associated with a progressive rise in OBPP risk. Other significant risk factors associated with the injury were shoulder dystocia, breech presentation in vaginal delivery, operative vaginal delivery, diabetes mellitus, induction of labor, protracted active phase, secondary arrest of dilatation, and epidural anesthesia. Cesarean section was associated with a decreased risk of OBPP. If 5000 g is chosen as cut-off for cesarean section, 85% of the infants in this weight class are underestimated using ultrasonography. Approximately, 331 abdominal deliveries have to be performed to avoid one case of OBPP. CONCLUSIONS: Shoulder dystocia and infant birthweight of 4500 g and more are the strongest risk factors for OBPP in a Swedish population.
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| 49. |
- Mollberg, Margareta, 1953, et al.
(författare)
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Risk factors for obstetric brachial plexus palsy among neonates delivered by vacuum extraction
- 2005
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Ingår i: Obstet Gynecol. ; 106:5 Pt 1, s. 913-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The risk of obstetric brachial plexus palsy (OBPP) is increased in infants delivered instrumentally. The aim of this study was to identify risk factors for OBPP and to evaluate the association between possible risk factors linked to the duration of the vacuum extraction procedure and the subsequent risk. METHODS: A population-based retrospective design was adopted. Using a national registry of operative vaginal deliveries linked to the Medical Birth Registry in Sweden, we evaluated by univariate and multiple logistic regression analyses the risk factors for OBPP in 13,716 women delivered by vacuum extraction. The variables assessed in the multiple logistic regression analysis were shoulder dystocia, fetal birth weight of 3,999 g or greater, fundal pressure, number of tractions, vacuum application time, parity, vacuum silicone cup, epidural anesthesia, and fetal head at the level of the ischial spines at vacuum application time. RESULTS: Obstetric brachial plexus palsy was recorded in 153 (1.1%) infants. The following variables increased significantly the risk of OBPP in the newborn: shoulder dystocia (odds ratio 16.0; 95% confidence interval 8.9-28.7), fetal birth weight of 3,999 g or greater (7.1; 4.8-10.5), and administration of fundal pressure (1.6; 1.1-2.3). The probability of the risk of OBPP in vacuum-assisted deliveries increased in relation to vacuum extraction time (minutes). CONCLUSION: Shoulder dystocia in the setting of vacuum extraction is a prominent risk factor for OBPP in the newborn. The risk of OBPP increases with the time required for vacuum extraction. LEVEL OF EVIDENCE: II-3.
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| 50. |
- Nilsson, Ines, et al.
(författare)
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Continuing to work after the onset of rheumatoid arthritis
- 2007
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Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 28:4, s. 335-342
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this qualitative study was to explore and describe what have made it possible for a group of people with rheumatoid arthritis to remain in work. There were ten participants, six women and four men, aged from 32 to 59. They were working either full time or part-time, at the time the study was conducted. Data was gathered using focus group interviews. The transcribed interviews were analysed in accordance with the constant comparative method. The result showed that the assets the individuals possessed and the character of the environment in which they worked were important reasons why they were able to remain in employment. Four main categories were identified: the constructive value of work, the characteristics of work, physical health and well-being and the understanding and support of colleagues. The findings support a client-centred occupational therapy and rehabilitation, where the experiences of the person provide the reason for the intervention.
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