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1.
  • Gatzinsky, Kliment, et al. (författare)
  • Repetitive transcranial magnetic stimulation of the primary motor cortex in management of chronic neuropathic pain: a systematic review.
  • 2021
  • Ingår i: Scandinavian journal of pain. - 1877-8879. ; 21:1, s. 8-21
  • Forskningsöversikt (refereegranskat)abstract
    • Repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex (M1) with frequencies 5-20 Hz is an expanding non-invasive treatment for chronic neuropathic pain (NP). Outcome data, however, show considerable inhomogeneity with concern to the levels of effect due to the great diversity of treated conditions. The aim of this review was to survey the literature regarding the efficacy and safety of M1 rTMS, and the accuracy to predict a positive response to epidural motor cortex stimulation (MCS) which is supposed to give a more longstanding pain relief.A systematic literature search was conducted up to June 2019 in accordance with the PRISMA guidelines. We used the PICO Model to define two specific clinical questions: (1) Does rTMS of M1 relieve NP better than sham treatment? (2) Can the response to rTMS be used to predict the effect of epidural MCS? After article selection, data extraction, and study quality assessment, the certainty of evidence of treatment effect was defined using the GRADE system.Data on 5-20 Hz (high-frequency) rTMS vs. sham was extracted from 24 blinded randomised controlled trials which were of varying quality, investigated highly heterogeneous pain conditions, and used excessively variable stimulation parameters. The difference in pain relief between active and sham stimulation was statistically significant in 9 of 11 studies using single-session rTMS, and in 9 of 13 studies using multiple sessions. Baseline data could be extracted from 6 single and 12 multiple session trials with a weighted mean pain reduction induced by active rTMS, compared to baseline, of -19% for single sessions, -32% for multiple sessions with follow-up <30 days, and -24% for multiple sessions with follow-up ≥30 days after the last stimulation session. For single sessions the weighted mean difference in pain reduction between active rTMS and sham was 15 percentage points, for multiple sessions the difference was 22 percentage points for follow-ups <30 days, and 15 percentage points for follow-ups ≥30 days. Four studies reported data that could be used to evaluate the accuracy of rTMS to predict response to MCS, showing a specificity of 60-100%, and a positive predictive value of 75-100%. No serious adverse events were reported.rTMS targeting M1 can result in significant reduction of chronic NP which, however, is transient and shows a great heterogeneity between studies; very low certainty of evidence for single sessions and low for multiple sessions. Multiple sessions of rTMS can maintain a more longstanding effect. rTMS seems to be a fairly good predictor of a positive response to epidural MCS and may be used to select patients for implantation of permanent epidural electrodes. More studies are needed to manifest the use of rTMS for this purpose. Pain relief outcomes in a longer perspective, and outcome variables other than pain reduction need to be addressed more consistently in future studies to consolidate the applicability of rTMS in routine clinical practice.
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2.
  • Johansson, Inga-Lena, 1967- (författare)
  • Parkinson’s Disease and Communication : Intelligibility, Interaction and Participation
  • 2024
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Parkinson’s disease is a neurodegenerative disorder affecting dopamine production in the basal ganglia. It is a common cause of disability among elderly people. The main symptoms are tremor, rigidity, and bradykinesia, but there is a substantial individual variation of how the disease manifests itself. Communicative changes occur frequently and motor speech impairment in the form of dysarthria is common. Other communicative abilities, such as language functions and the use of body gestures, may also be affected.  Traditionally, the focus for research and clinical assessments and interventions in the context of communicative changes in Parkinson’s disease has mainly been on speech and voice impairment. However, the impact on communication is multi-faceted, and different factors may affect the ability to make oneself understood and participate in conversations. Conversation is also a collaborative activity, where all participants’ contributions would need to be considered. Although there is a growing body of research on communicative impact in Parkinson’s disease, these aspects have, so far, been less studied.   In the present thesis, communicative changes in Parkinson’s disease were explored with a focus on speech intelligibility, interaction in conversations, and communicative participation.In study I, qualitative interviews with dyads consisting of a person with Parkinson’s disease and a close communication partner revealed individual variation in experiences of communicative changes. The results indicated multi-factorial disease-related impact on everyday communication and communicative participation. A change noted in almost all dyads was that the partner with Parkinson’s disease participated less in conversations. In study II, listener ratings of connected speech intelligibility showed both inter- and intra-speaker variability between different types of assessment tasks, indicating that di-verse factors may influence intelligibility for individual speakers. Listener knowledge of context significantly increased intelligibility scores. Acoustic analyses of consonant articulation in study III indicated that some measures may be more sensitive for detecting impact on speech and intelligibility for speakers with Parkinson’s disease, while other aspects of articulation may be demanding in terms of acoustic realisation also for healthy elderly speakers. Visual examination of spectrograms may provide qualitative information about speech production in relation to intelligibility. Paper IV reports a pilot trial of dyadic intervention from a self-management perspective. Qualitative exploratory interviews and video recordings of the dyads’ joint conversations formed the basis for the intervention. At follow-up, the participating dyads reported increased communicative awareness and changes in mind-set but minor changes of communicative behaviours.  The results from the included studies contribute to the understanding of the complexity and individual variability of possible communicative impact in Parkinson’s disease and support a holistic perspective on communication. The thesis demonstrates that it is necessary to apply multiple methods in assessment for achieving in-depth knowledge of how Parkinson’s disease impacts on speech intelligibility and everyday communication, to optimally tailor communication interventions to the individuals’ needs. This should also include insights in the communicative habits and experiences of persons with Parkinson’s disease and their close communication partners. 
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3.
  • Samuelsson, Christina, et al. (författare)
  • Production and perception of metrical patterns in Swedish children with language impairment
  • 2011
  • Ingår i: LOGOPEDICS PHONIATRICS VOCOLOGY. - : Informa Healthcare. - 1401-5439 .- 1651-2022. ; 36:1, s. 1-11
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of the present study was to investigate the relationship between perception and production of metrical patterns in Swedish children with language impairment (LI), in order to add to the knowledge on underlying explanations of LI. A further aim was to explore whether omissions are mainly related to prosodic aspects or to linguistic function. Children with LI omitted significantly more unstressed syllables than did children with typical language development. Exploration of the relationship between perception and production of phrasal stress patterns demonstrated that children with LI might be divided into three subgroups: Group a: children who perform better on perception than production; Group b: children who perform better on production than perception; and Group c: children with rather poor results on both perception and production.
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4.
  • Aided Communication in Everyday Interaction
  • 2013
  • Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
    • This book argues for the importance of the participants' perspective within both theory and practice on the function of augmentative and alternative communication (AAC) aids in everyday talk-in-interaction. Interactional approaches such as Conversation Analysis (CA) and Topical episode analysis are used to analyze and demonstrate the way participants make sense and display their understanding of AAC-mediated action. The book documents various practices and methods of the everyday use of AAC which can be applied clinically when establishing evidence-based assessment and intervention procedures. The book aims to bridge the gap between research and clinical practice, analyzes and explains the use of AAC aids, uses video recordings and transcriptions of naturally occurring, everyday talk-in-interacton, and demonstrates how the communicative context of the user's home is a powerful environment for learning and developing AAC use.
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6.
  • Astell, A. J., et al. (författare)
  • Developing a pragmatic evaluation of ICTs for older adults with cognitive impairment at scale : the IN LIFE experience
  • 2022
  • Ingår i: Universal Access in the Information Society. - Heidelberg, Germany : Springer. - 1615-5289 .- 1615-5297. ; 21:1, s. 1-19
  • Tidskriftsartikel (refereegranskat)abstract
    • Implementing information and communications technology (ICT) at scale requires evaluation processes to capture the impacton users as well as the infrastructure into which it is being introduced. For older adults living with cognitive impairment, thisrequires evaluation that can accommodate diferent levels of cognitive impairment, alongside input from family and formalcaregivers, plus stakeholder organisations. The European Horizon 2020 project INdependent LIving support Functions forthe Elderly (IN LIFE) set out to integrate 17 technologies into a single digital platform for older people living with cognitive impairment plus their families, care providers and stakeholders. The IN LIFE evaluation took place across six nationalpilot sites to examine a number of variables including impact on the users, user acceptance of the individual services andthe overall platform, plus the economic case for the IN LIFE platform. The results confrmed the interest and need amongolder adults, family caregivers, formal caregivers and stakeholders, for information and communications technology (ICT).Relative to the baseline, quality of life improved and cognition stabilised; however, there was an overall reluctance to payfor the platform. The fndings provide insights into existing barriers and challenges for adoption of ICT for older peopleliving with cognitive impairment.
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7.
  • Bergh, Christina, 1953, et al. (författare)
  • Regionalt HTA-arbete kan ge bra genomslag i vården. Goda exempel från Västra Götaland : [Regional HTA work can have a good impact on health care. Good examples form Vastra Gotaland].
  • 2010
  • Ingår i: Läkartidningen. - 0023-7205. ; 107:29-31, s. 1780-1783
  • Tidskriftsartikel (refereegranskat)abstract
    • HTA (health technology assessment) innebär en systematisk granskning av det vetenskapliga underlaget för en viss teknik. Ett väl definierat PICO (patients, intervention, comparison, outcome) är en grundförutsättning för att få fram den dokumentation som ska granskas. En fokuserad fråga är central i HTA-processen. En teknik granskas med avseende på effektivitet och risker, etiska och organisatoriska aspekter samt kostnader. I en systematisk litteraturöversikt granskas vetenskapliga artiklar med avseende på kvalitet och relevans. Slutsatserna evidensgraderas enligt GRADE. I Västra Götalandsregionen har inrättats ett HTA-centrum som arbetar med regional medicinsk utvärdering. Regionalt HTA-arbete har flera fördelar; en är att den praktiska omsättningen av de nyvunna kunskaperna troligen kan ske snabbare.
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9.
  • Blomgren, Charlotte, et al. (författare)
  • Long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors-Impact of cognitive dysfunction, emotional problems and fatigue.
  • 2019
  • Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 14:5
  • Tidskriftsartikel (refereegranskat)abstract
    • With an upward trend in the number of people who return home to independent living after stroke, the ability to perform more complex activities is becoming an increasingly important long-term outcome after stroke. Although associations between Instrumental Activities of Daily Living (IADL) and cognitive dysfunction, emotional problems, and fatigue have been reported, less is known about the long-term impact of these stroke consequences on the performance of everyday activities in young and middle-aged stroke survivors.To explore the impact of cognitive dysfunction, emotional problems, and fatigue on long-term performance of instrumental activities of daily living in young and middle-aged stroke survivors.Data on stroke survivors, aged 18-69 at index stroke, were collected from the Sahlgrenska Academy Study on Ischaemic Stroke. IADL outcome was assessed using the Frenchay Activities Index (FAI), and the impact of chosen variables was assessed using Spearman´s rank-order correlation and logistic regression.Seven years after index stroke, 296 stroke survivors (median age of 64) were included in this study. Cognitive dysfunction showed the strongest correlations with FAI outcome and independently explained worse outcome on FAI summary score and the domain of work/leisure activities. Fatigue was independently explanatory of worse outcome on FAI summary score and domestic chores, while depressive symptoms independently explained worse outcome on work/leisure activities. In a subgroup with only those participants who had no or minimal residual neurological deficits at follow-up (NIHSS score 0), cognitive dysfunction independently explained worse outcome on FAI summary score and work/leisure activities. Depressive symptoms independently explained worse outcome on FAI summary score and domestic chores.Our results show that in young and middle-aged stroke survivors, cognitive dysfunction, depressive symptoms, and fatigue negatively impact performance of IADL even at seven years post stroke onset. Further, we have shown that an impact of both cognitive dysfunction and depressive symptoms can be found also among stroke survivors with mild or no remaining neurological deficits.
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10.
  • Brännmark, Cecilia, et al. (författare)
  • FIND Stroke Recovery Study (FIND): rationale and protocol for a longitudinal observational cohort study of trajectories of recovery and biomarkers poststroke
  • 2023
  • Ingår i: Bmj Open. - 2044-6055. ; 13:5
  • Tidskriftsartikel (refereegranskat)abstract
    • ntroduction Comprehensive studies mapping domain-specific trajectories of recovery after stroke and biomarkers reflecting these processes are scarce. We, therefore, initiated an exploratory prospective observational study of stroke cases with repeated evaluation, the FIND Stroke Recovery Study. We aim to capture trajectories of recovery from different impairments, including cognition, in combination with broad profiling of blood and imaging biomarkers of the recovery. Methods and analysis We recruit individuals with first-ever stroke at the stroke unit at the Sahlgrenska University Hospital, Sweden, to FIND. The inclusion started early 2018 and we aim to enrol minimum 500 patients. Neurological and cognitive impairments across multiple domains are assessed using validated clinical assessment methods, advanced neuroimaging is performed and blood samples for biomarker measuring (protein, RNA and DNA) at inclusion and follow-up visits at 3 months, 6 months, 1 year, 2 years and 5 years poststroke. At baseline and at each follow-up visit, we also register clinical variables known to influence outcomes such as prestroke functioning, stroke severity, acute interventions, rehabilitation, other treatments, socioeconomic status, infections (including COVID-19) and other comorbidities. Recurrent stroke and other major vascular events are identified continuously in national registers. Ethics and dissemination FIND composes a unique stroke cohort with detailed phenotyping, repetitive assessments of outcomes across multiple neurological and cognitive domains and patient-reported outcomes as well as blood and imaging biomarker profiling. Ethical approval for the FIND study has been obtained from the Regional Ethics Review Board in Gothenburg and the Swedish Ethics Review Board. The results of this exploratory study will provide novel data on the time course of recovery and biomarkers after stroke. The description of this protocol will inform the stroke research community of our ongoing study and facilitate comparisons with other data sets.
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11.
  • Bäck, Marcus, et al. (författare)
  • Novel potent macrocyclic inhibitors of the hepatitis C virus NS3 protease : use of cyclopentane and cyclopentene P2-motifs
  • 2007
  • Ingår i: Bioorganic & Medicinal Chemistry. - : Elsevier BV. - 0968-0896 .- 1464-3391. ; 15:22, s. 7184-7202
  • Tidskriftsartikel (refereegranskat)abstract
    • Several highly potent novel HCV NS3 protease inhibitors have been developed from two inhibitor series containing either a P2 trisubstituted macrocyclic cyclopentane- or a P2 cyclopentene dicarboxylic acid moiety as surrogates for the widely used N-acyl-(4R)-hydroxyproline in the P2 position. These inhibitors were optimized for anti HCV activities through examination of different ring sizes in the macrocyclic systems and further by exploring the effect of P4 substituent removal on potency. The target molecules were synthesized from readily available starting materials, furnishing the inhibitor compounds in good overall yields. It was found that the 14-membered ring system was the most potent in these two series and that the corresponding 13-, 15-, and 16-membered macrocyclic rings delivered less potent inhibitors. Moreover, the corresponding P1 acylsulfonamides had superior potencies over the corresponding P1 carboxylic acids. It is noteworthy that it has been possible to develop highly potent HCV protease inhibitors that altogether lack the P4 substituent. Thus the most potent inhibitor described in this work, inhibitor 20, displays a Ki value of 0.41 nM and an EC50 value of 9 nM in the subgenomic HCV replicon cell model on genotype 1b. To the best of our knowledge this is the first example described in the literature of a HCV protease inhibitor displaying high potency in the replicon assay and lacking the P4 substituent, a finding which should facilitate the development of orally active small molecule inhibitors against the HCV protease.
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13.
  • Carboni, Andrea, et al. (författare)
  • Success and Hindrance Factors of AHA-Oriented Open Service Platforms
  • 2021
  • Ingår i: ADVANCES IN COMPUTATIONAL COLLECTIVE INTELLIGENCE (ICCCI 2021). - Cham : SPRINGER INTERNATIONAL PUBLISHING AG. - 9783030881139 - 9783030881122 ; , s. 656-668
  • Konferensbidrag (refereegranskat)abstract
    • In the past years, there has been a flourishing of platforms dedicated to Active Assisted Living (AAL) and Active and Healthy Ageing (AHA). Most of them feature as their core elements intelligent systems for the analysis of multisource and multimodal data coming from sensors of various nature inserted in suitable IoT ecosystems. While progress in signal processing and artificial intelligence has shown how these platforms may have a great potential in improving the daylife of seniors or frail subjects, there are still several technological and non-technological barriers that should be torn down before full uptake of the existing solutions. In this paper, we address specifically this issue describing the outcome and creation process of a methodology aimed at evaluating the successful uptake of existing platforms in the field of AHA. We propose a pathway (as part of an overarching methodology) to define and select for Key Performance Indicators (KPIs), taking into account an extensive amount of parameters related to success, uptake and evolution of platforms. For this, we contribute a detailed analysis structured along with the 4 main actions of mapping, observing, understanding, and defining. Our analysis focuses on Platforms, defined as operating environments, under which various applications, agents and intelligent services are designed, implemented, tested, released and maintained. By following the proposed pathway, we were able to define a practical and effective methodology for monitoring and evaluating the uptake and other success indicators of AHA platforms. Besides, by the same token, we were able to provide guidelines and best practices for the development of the next-generation platforms in the AHA domain.
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15.
  • Dahle, Charlotte, et al. (författare)
  • Elevated number of cells secreting transforming growth factor β in Guillain-Barré syndrome
  • 2003
  • Ingår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS). - : Wiley. - 0903-4641 .- 1600-0463. ; 111:12, s. 1095-1104
  • Tidskriftsartikel (refereegranskat)abstract
    • We used ELISPOT and cell ELISA to study secretion of IL-4, IFN-γ, TGF-β, IL-6, and TNF-α by circulating mononuclear cells during the course of Guillain-Barré syndrome (GBS). Compared to healthy controls, patients with GBS had higher numbers of TGF-β-secreting cells and the number of individuals with myelin-peptide-induced IL-4 and TGF-β secretion was higher in the GBS group. No significant differences were seen concerning the predominantly pro-inflammatory cytokines IFN-γ, IL-6 or TNF-α. Our findings indicate a down-regulatory role for TGF-β and IL-4 in GBS.
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16.
  • Dahle, Charlotte, et al. (författare)
  • T helper type 2 like cytokine responses to peptides from P0 and P2 myelin proteins during the recovery phase of Guillain-Barré syndrome
  • 1997
  • Ingår i: Journal of the Neurological Sciences. - 0022-510X .- 1878-5883. ; 153:1, s. 54-60
  • Tidskriftsartikel (refereegranskat)abstract
    • T-lymphocytes are probably involved in the pathogenesis of Guillain-Barré syndrome (GBS). T-helper-1 (Th1) cytokines activate macrophages and induce a delayed type hypersensitivity (DTH) inflammatory response, consistent with the morphology of the demyelination in GBS. Th2 cytokines encourage antibody production and downregulate Th1 responses. To study the Th1/Th2 cytokines in relation to the clinical course of GBS an ELISPOT method for determination of single cells secreting interferon-γ, IFN-γ (Th1) or interleukin-4, IL-4 (Th2) was used. We serially investigated antigen-induced cytokine secretion from circulating T-cells stimulated with human peptides from the P0 and P2 proteins in seven patients and compared to results from seven serially investigated healthy controls. Most patients (five of seven) showed IL-4 responses during the plateau- or recovery-phase as compared to controls. One patient with a prolonged disease course, on the other hand, had an IFN-γ dominated reactivity. We suggest that the IL-4 responses are beneficial in GBS, and may have a role in terminating the disease process in this self-limiting inflammatory disease.
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18.
  • Derbring, Sandra, et al. (författare)
  • Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives
  • 2023
  • Ingår i: Ageing & Society. - Cambridge, United Kingdom : Cambridge University Press. - 0144-686X .- 1469-1779. ; 43:9, s. 1983-2000
  • Tidskriftsartikel (refereegranskat)abstract
    • Dementia is a source of growing concern globally, and often impacts on social and commu-nicative functioning. INdependent LIving Support Functions for the Elderly (IN LIFE) was aproject carried out within the European Commission Research and Innovation programmeHorizon 2020 that resulted in the development of two digital communication aids for rem-iniscence intervention for elderly people with dementia and their communication partners.The purpose of this intervention study was to investigate the effects on quality of life forpeople with dementia when using these aids. People with dementia (N = 118) and their for-mal care-givers (N = 187) and relatives (N = 9) were given the communication aids for a per-iod of 4–12 weeks. To assess a range of outcomes, questionnaires developed within theproject were used along with the EQ-5D (European Quality of Life – 5 Dimensions) andQoL-AD (Quality of Life in Alzheimer’s Disease) questionnaires. Quality of life improvedamong people with dementia when measured using EQ-5D ( p < 0.05). There was also a cor-relation between the impact on the participants’ health and wellbeing, the carers’ rating ofthe usefulness of the digital communication aids and the care-givers’ satisfaction with usingtechnology ( p < 0.05). These results indicate that digital communication aids may be usefulin social interaction where one partner has dementia.
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19.
  • Derbring, Sandra, et al. (författare)
  • Effects of a digital reminiscing intervention on people with dementia and their care-givers and relatives
  • 2023
  • Ingår i: Ageing & Society. - 0144-686X .- 1469-1779. ; 43:9, s. 1983-2000
  • Tidskriftsartikel (refereegranskat)abstract
    • Dementia is a source of growing concern globally, and often impacts on social and communicative functioning. INdependent LIving Support Functions for the Elderly (IN LIFE) was a project carried out within the European Commission Research and Innovation programme Horizon 2020 that resulted in the development of two digital communication aids for reminiscence intervention for elderly people with dementia and their communication partners. The purpose of this intervention study was to investigate the effects on quality of life for people with dementia when using these aids. People with dementia (N = 118) and their formal care-givers (N = 187) and relatives (N = 9) were given the communication aids for a period of 4–12 weeks. To assess a range of outcomes, questionnaires developed within the project were used along with the EQ-5D (European Quality of Life – 5 Dimensions) and QoL-AD (Quality of Life in Alzheimer's Disease) questionnaires. Quality of life improved among people with dementia when measured using EQ-5D (p < 0.05). There was also a correlation between the impact on the participants’ health and wellbeing, the carers’ rating of the usefulness of the digital communication aids and the care-givers’ satisfaction with using technology (p < 0.05). These results indicate that digital communication aids may be useful in social interaction where one partner has dementia.
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20.
  • Ekström, Anna, 1979-, et al. (författare)
  • Communication and collaboration in dementia
  • 2017
  • Ingår i: Living with dementia. - : Palgrave Macmillan. - 9781137593740 - 9781137593757 ; , s. 93-115
  • Bokkapitel (refereegranskat)
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21.
  • Ekström, Anna, et al. (författare)
  • Digital communication support and Alzheimer’s disease
  • 2017
  • Ingår i: Dementia. - : Sage Publications. - 1471-3012 .- 1741-2684. ; 16:6, s. 711-731
  • Tidskriftsartikel (refereegranskat)abstract
    • Communication is one of the areas where people with dementia and their caregivers experience most challenges. The purpose of this study is to contribute to the understanding of possibilities and pitfalls of using personalized communication applications installed on tablet computers to support communication for people with dementia and their conversational partners. The study is based on video recordings of a woman, 52 years old, with Alzheimer’s disease interacting with her husband in their home. The couple was recorded interacting with and without a tablet computer including a personalized communication application. The results from the present study reveal both significant possibilities and potential difficulties in introducing a digital communication device to people with dementia and their conversational partners. For the woman in the present study, the amount of interactive actions and the number of communicative actions seem to increase with the use of the communication application. The results also indicate that problems associated with dementia are foregrounded in interaction where the tablet computer is used.
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22.
  • Ekström, Anna, 1979-, et al. (författare)
  • It depends on who Im with: How young people with developmental language disorder describe their experiences of language and communication in school
  • 2023
  • Ingår i: International journal of language and communication disorders. - : WILEY. - 1368-2822 .- 1460-6984. ; 58:4, s. 1168-1181
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundThe risks of developmental language disorder (DLD) for both educational progress and socio-emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. AimsTo understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? Methods & ProceduresThe study is based on data generated from qualitative semi-structured interviews with 23 participants diagnosed with DLD (age 13-19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID-19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. Outcomes & ResultsFour main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. Conclusions & ImplicationsThe results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered. WHAT THIS PAPER ADDSWhat is already known on this subjectChildren and young people have unique knowledge about their language and communication which is instrumental for designing interventions and support strategies. Qualitative analyses of interview data have been able to identify both risk factors and protective strategies in relation to the well-being of individuals with DLD. Despite this, children and young people with DLD are rarely heard in research or clinical discussions. What this paper adds to existing knowledgeIn this study we listen to the voices of young people with DLD as they describe their experiences of language and communication in school. The participants describe a condition that makes them struggle to keep up with peers and puts them at risk of being misjudged by teachers, but also give examples of situations where negative consequences are hardly felt. What are the potential or actual clinical implications of this work?DLD is a complex and dynamic disorder where contextual and social factors interact with individual abilities in creating the end result. The results of the study indicate that DLD can cause persisting problems related to language and communication in school, with impact on educational, social and emotional dimensions. To counteract these effects, SLT services may be needed throughout the school years, and support that goes beyond language abilities must be considered.
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23.
  • Ekström, Anna, 1979-, et al. (författare)
  • Likvärdig utbildning för barn med språkstörning : en studie av måluppfyllelse, erfarenheter och deltagande
  • 2023
  • Ingår i: Resultatdialog 2023. - Stockholm : Vetenskapsrådet. ; , s. 32-37
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
    • Språkstörning är en funktionsnedsättning som förekommer hos cirka sju procent av alla barn. Eftersom skolans undervisning förutsätter en god språklig förmåga, är risken stor att dessa elever inte når skolans mål. I detta pågående projekt undersöks situationen för elever med språkstörning i den svenska skolan med både kvantitativa och kvalitativa undersökningar.
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25.
  • Elm, Lovisa, et al. (författare)
  • Clinical practices in Swedish speech-language pathology for children with (developmental) language disorder
  • 2024
  • Ingår i: Clinical Linguistics & Phonetics. - : TAYLOR & FRANCIS INC. - 0269-9206 .- 1464-5076.
  • Tidskriftsartikel (refereegranskat)abstract
    • In Sweden, treatment for children with (developmental) language disorder ((D)LD) is traditionally carried out at a speech-language pathology (SLP) clinic, and based on formal language tests, which may not entirely represent the child's everyday language and communication skills. SLP services that include video recordings have shown positive outcomes in terms of providing information about children's linguistic and communicative abilities in everyday life, but little is known about the use of video in clinical practice. The aim of this study is therefore to investigate how Swedish SLPs link their clinical practices (assessment, treatment, and evaluation of treatment outcome) to the everyday language and communication abilities of children with (D)LD. A further aim is to explore SLPs' utilisation of video recordings as a part of their clinical practices with the target group. A web-based questionnaire was distributed to SLPs in Sweden, who work with children with (D)LD. Results demonstrate that Swedish SLPs perceive that their intervention is in alignment with children's everyday language and communication needs to a fairly high degree. However, an exception is assessment, which is considered to have a weaker alignment with children's everyday communication abilities. The use of video recordings for clinical purposes is very limited. It is suggested here that incorporating video recordings from children's everyday life would be an easy and time-efficient way to strengthen the ecological validity of SLP practices for children with (D)LD.
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26.
  • Elm, Lovisa, et al. (författare)
  • Swedish speech and language pathologists reflect on how their clinical practises align to everyday language and communication skills of children with developmental language disorder
  • 2024
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022.
  • Tidskriftsartikel (refereegranskat)abstract
    • This study aims to extend current knowledge about the possibilities and challenges encountered by Swedish speech and language pathologists (SLPs) in targeting everyday language and communication in children with developmental language disorder (DLD). To explore this matter, unstructured focus groups were conducted where 15 SLPs, working with children with DLD, shared their views on the alignment between their clinical practices and children's everyday lives. Thematic analysis was used to analyse the data, which resulted in five themes: It's everyday life that matters; As an SLP, you're not a part of the child's everyday life; How do we merge the different worlds?; Resources at home vary, and The employer sets the framework for clinical practices. The SLPs stressed the importance of targeting everyday skills and needs, but they experienced themselves as being detached from the children's daily context. Collaboration with caregivers and (pre)school staff was emphasised; however, the resources and capacity of the caregivers and staff varied, and this was experienced as a challenge for providing the most appropriate care. Some children and their families were situated in a multifaceted context and needed more extensive care, and this group was described as increasing. However, the services that the SLPs were able to offer varied and were largely regulated by organisational constraints. Individualised services are crucial for ensuring a positive development for children with DLD and for empowering caregivers to be effective collaborative partners in intervention. Therefore, it is essential for SLPs to have the time and resources to ensure high-quality care.
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27.
  • Ferm, Ulrika, et al. (författare)
  • Tablet computer-supported conversation between people with dementia and their carers: technology as interactional focus
  • 2021
  • Ingår i: Universal Access in the Information Society. - : Springer. - 1615-5289 .- 1615-5297. ; 20, s. 753-765
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of the study is to explore when and how technology becomes a topic in interactions involving people with dementia and their carers. Three dyads of older women with dementia and their carers participated in the study. The dyads interacted in the home environments of the persons with dementia using tablet computers and two web-based applications with generic pictures, videos, and music files (CIRCA) and personalized pictures and films (CIRCUS). The data included twenty-one video-recorded interactions. Topical episode analysis and transcripts of interaction were used to analyze and exemplify when and how technology was talked about in the dyads. The dyads were engaged in exploring the tablets, and six common ways of making technology a topic of conversation were identified: talk about tech problems, commenting actions, expressing uncertainty in navigation, instructing and explaining, expressing surprise, and talk about technical development. The dyads explored the tablets in ways that were reflected in the content of their conversations. If people with dementia and their carers should benefit from todays technology, such as there is evidence for the interactions examined in this study, their homes and daily environments must be equipped with sufficient internet access and technical support.
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28.
  • Forsberg, Camilla, 1983- (författare)
  • Students’ Perspectives on Bullying
  • 2016
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim of the present thesis was to listen to, examine and conceptualise students’ perspectives on bullying. Students’ perspectives have not been commonly heard in research and less qualitative research has been conducted. This study contributes with students’ perspectives on bullying using semi-structured interviews with students from fourth-to eighth grade.This thesis includes four studies. The aim with paper I was to investigate how bystander actions in bullying situations and reasons behind these actions were articulated. Paper II was a comparison study between Sweden and US, focused on how students articulate and discuss what factors influence students’ decisions to defend or not defend victims when witnessing bullying. The aim in Paper III was to study how students themselves discuss, reason and make sense of how and why bullying processes emerges in their social worlds. In paper IV the aim was to study how junior high school girls discuss and understand bullying. Findings reveal that students’ reactions as bystanders to bullying depend on how they define the situation. Explanations to the emergence of bullying were understood through a complex social ordering of belonging process. Students position themselves and others in striving to belong, and when defining victims as responsible for bullying. Social norms and negotiation of identities were also discussed among the students. Students discussed how gender and a normative peer structure, where a pressure to fit in, interlinked with how they understood bullying.
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29.
  • From, Asa, et al. (författare)
  • Differences in phonologic and prosodic abilities in children with phonological language impairment and phonological-grammatical language impairment assessed with non-word repetition
  • 2016
  • Ingår i: Logopedics, Phoniatrics, Vocology. - : TAYLOR & FRANCIS LTD. - 1401-5439 .- 1651-2022. ; 41:2, s. 66-76
  • Tidskriftsartikel (refereegranskat)abstract
    • Prosody can be described as the rhythmic, dynamic, and melodic aspects of language. Swedish has a relatively complex prosodic system compared to, for example, English. A large percentage of Swedish children with language impairment show prosodic problems to some extent. In the present study, non-word repetition was used to assess the phonological and prosodic abilities in children with phonological language impairment and children with phonological-grammatical language impairment. In the study, 10 children with phonological language impairment and 14 children with phonological-grammatical language impairment from 4;3 to 6;2 years of age participated. All children heard the same recorded non-words and words. The group with phonological language impairment received higher scores in all variables, compared to the group with phonological-grammatical language impairment. The results showed significant differences between the groups regarding production of vowels correct in words and production of phonemes correct in non-words as well as production of unstressed syllables in non-words and production of correct stress in non-words. Percent correctly produced vowels in words, but not in non-words, correlated significantly with grammatical ability.
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30.
  • Geneid, A., et al. (författare)
  • Union of the European Phoniatricians position statement on the exit strategy of phoniatric and laryngological services: staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020)
  • 2020
  • Ingår i: Journal of Laryngology and Otology. - : CAMBRIDGE UNIV PRESS. - 0022-2151 .- 1748-5460. ; 134:8, s. 661-664
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
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31.
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32.
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33.
  • Gerafi, Joel, et al. (författare)
  • Neglect and aphasia in the acute phase as predictors of functional outcome 7 years after ischemic stroke
  • 2017
  • Ingår i: European Journal of Neurology. - : Wiley. - 1351-5101 .- 1468-1331. ; 24:11, s. 1407-1415
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2017 EAN Background and purpose: Visuospatial inattention (VSI) and language impairment (LI) are often present early after stroke and associations with an unfavorable short-term functional outcome have been reported. The purpose of this study was to investigate whether a screening of VSI and LI as indicators of cortical symptoms early after stroke could predict long-term functional outcomes. Methods: A consecutive cohort of 375 patients with ischemic stroke was assessed for the occurrence of VSI at a median of 7 days after admission (interquartile range, 1–5 days) using the Star Cancellation Test and for LI (within the first 7 days) with the language item in the Scandinavian Stroke Scale. Seven years later, functional outcomes were assessed by the modified Rankin scale and Frenchay Activities Index in 235 survivors without recurrent stroke. Relationships between baseline predictors and functional outcome at 7 years were analyzed with bivariate correlations and multiple categorical regressions with optimal scaling. Results: The regression model significantly explained variance in the modified Rankin scale (R 2 = 0.435, P < 0.001) and identified VSI (P = 0.001) and neurological deficits (P < 0.001; Scandinavian Stroke Scale score without the language item) as the significant independent predictors. The model for Frenchay Activities Index was also significant (R 2 = 0.269, P < 0.001) with VSI (P = 0.035) and neurological deficits (P < 0.001) as significant independent predictors. Conclusions: Visuospatial inattention at acute stroke has an independent impact on long-term functional outcomes. Early recognition may enable targeted rehabilitative interventions.
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34.
  • Gerafi, Joel, et al. (författare)
  • The presence and prediction of lateralized inattention 7 years post-stroke
  • 2020
  • Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 141:5, s. 423-430
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective Lateralized inattention is a typical sign of neglect and related to poor functional outcome. Knowledge of the long-term course of this phenomenon is limited. The purpose of this study was to investigate presence and predictors for signs of lateralized inattention 7 years after stroke. Methods From a cohort of acute ischemic stroke patients, aged 18-69 years (n = 297), a consecutive series of 188 survivors without recurrent stroke at follow-up 7 years later were included. Within the first week after stroke onset, stroke severity was assessed according to the Scandinavian Stroke Scale. Target omissions, asymmetry of omissions, and perceptual speed according to Star- and Letter Cancellation Tests were also assessed. Presence of lateralized inattention at the 7-year follow-up was investigated with the Star- and Letter Cancellation Tests and with the neglect item in the National Institutes of Health Stroke Scale. Results At the follow-up, 22 (11.7%) participants had lateralized inattention and the multivariable regression showed that independent significant baseline predictors were total omissions in target cancellations (P < .001) and inferior baseline performance on visual processing speed (P = .008). Conclusion About one of ten individuals exhibited signs of lateralized inattention 7 years after stroke. Baseline performance in perceptual processing speed and target omissions independently predicted presence of late signs of lateralized inattention. This is the first time processing speed is recognized as a significant predictor of lateralized inattention several years after the stroke incidence, indicating that the longitudinal course of processing speed following stroke is a critical subject for future research.
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35.
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36.
  • Gustafson, Stefan, et al. (författare)
  • How Simple is the Simple View of Reading?
  • 2013
  • Ingår i: Scandinavian Journal of Educational Research. - : Routledge. - 0031-3831 .- 1470-1170. ; 57:3, s. 292-308
  • Tidskriftsartikel (refereegranskat)abstract
    • According to the Simple View of Reading, reading ability can be divided into decoding and language comprehension. In the present study, decoding and comprehension's contribution to reading ability was studied both in children with reading difficulties and in children with typical reading ability. Decoding and comprehension was further divided into sub-components, and the contribution from non-verbal ability and general processing speed was also studied. The results demonstrated that decoding made the largest contribution to reading ability for children with reading difficulties, while language comprehension contributed the most for children with typical reading ability. The contribution of non-verbal ability was not significant, and general processing speed only made a significant contribution to decoding for typical children. The two factors in the Simple View of Reading, decoding and comprehension, together explained less of the variance in reading ability for children with reading difficulties than for children with typical reading ability.
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37.
  • Hjalmarsson Österholm, Johannes, et al. (författare)
  • Orally positioning persons with dementia in assessment meetings
  • 2015
  • Ingår i: Ageing & Society. - Cambridge : Cambridge University Press. - 0144-686X .- 1469-1779. ; 35:2, s. 367-388
  • Tidskriftsartikel (refereegranskat)abstract
    • In this paper the authors study if and how persons with dementia are orally positioned by others, and how they position themselves while participating in assessment meetings held in order to discuss access to supportive services. We analysed five assessment meetings where two older persons (one diagnosed with dementia and one without a dementia diagnosis) participated to investigate whether the person with dementia is positioned differently than the other old person. Interactional phenomena used to position the person with dementia were identified by interactional analysis.The paperidentifies six phenomena that positioned the person with dementia as an individual with less interactional competence than the other participants: ignoring the person with dementia; voicing the feelings, capacity or opinion of the person with dementia; posing questions implying lack of competence; others' use of diagnosis; self-(re)positioning; and elderspeak. Persons with dementia are often orally positioned as less competent, indicating that they suffer further from discrimination than other older persons. We suggest that this has an impact on the participation of people with dementia in negotiations regarding their future care. The results indicate that social workers should be made aware that negative positioning exists and how it may affect the ability of people with dementia to contribute to discussions about their everyday life. Social workers should be encouraged to find strategies to reduce negative positioning in interaction.
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38.
  • Hofgren, Caisa, 1952, et al. (författare)
  • Cognitive screen and employment long-term after infratentorial stroke
  • 2022
  • Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 145:5, s. 610-618
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Motor problems are well-described neurological deficits that occur commonly after an infratentorial ischemic stroke. However, the brain stem and cerebellum are also part of the neural interconnections responsible for cognition, emotions, and behavioral responses. We lack studies on long-term cognitive outcomes and patient employment after an infratentorial stroke. In the present study, we described and compared long-term poststroke cognitive outcomes and employment between patients that experienced infratentorial and supratentorial ischemic strokes. Materials and Methods: We included consecutive patients that experienced an acute ischemic stroke at <= 58 years of age. Patients were classified according to the stroke location. At seven years poststroke, surviving participants were assessed for neurological deficits (National Institutes of Health Stroke Scale [NIHSS]), functional outcome (modified Rankin Scale [mRS]), cognitive function Barrow Neurological Institute Screen (BNIS), and employment. Results: Among 141 participants, 25 (18%) had infratentorial and 116 (82%) had supratentorial strokes. At the 7-year poststroke follow-up, there was no significant difference in BNIS total scores; with a median of 43 (IQR 40.5-46) and 41 (IQR 38-46) in the infratentorial and supratentorial groups, respectively. This result indicated that cognitive dysfunction occurred frequently in both groups. Similar employment rates were observed in the infratentorial (48%) and supratentorial (55%) groups. Both groups had a median NIHSS score of 0 and a median mRS score of 2 at the 7-year follow-up. Conclusion: Patients who survived an infratentorial or supratentorial ischemic stroke had similar rates of long-term cognitive dysfunction and difficulties in returning and/or remaining at work.
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39.
  • Holst, Rose-Marie, 1946, et al. (författare)
  • Expression of cytokines and chemokines in cervical and amniotic fluid: Relationship to histological chorioamnionitis
  • 2007
  • Ingår i: J Matern Fetal Neonatal Med. - : Informa UK Limited. ; 20:12, s. 885-893
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To correlate cervical and amniotic fluid cytokines and macrophage-related chemokines to the development of histological chorioamnionitis (HCA) in patients with preterm labor (PTL) and preterm prelabor rupture of the membranes (PPROM). Study design. Cervical and amniotic fluid interleukin (IL)-6, IL-8, IL-18, monocyte chemotactic protein (MCP)-1, MCP-2, and MCP-3 from pregnant women (at
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40.
  • Hydén, Lars-Christer, et al. (författare)
  • Feedback and common ground in conversational storytelling involvning people with Alzheimer's disease
  • 2012
  • Ingår i: Journal of Interactional Research in Communication Disorders/Equinox. - : Equinox Publishing. - 2040-5111 .- 2040-512X. ; 4:2, s. 211-247
  • Tidskriftsartikel (refereegranskat)abstract
    • The present article focuses on feedback in storytelling involving people with Alzheimer’s disease (AD), and how feedback is related to the ways participants establish a common ground (Clark 1996) in interaction. The establishment of common ground is important in all kinds of interaction and becomes an especially intricate process if participants have AD, since the achievement of common ground requires the ability to draw from knowledge and experiences relating to past as well as present events; an ability that is often hampered by the disease. Analyses show that other aspects than the actual content of the conversation are important for the participants – for instance being together, supporting the positive identities both presented in the story and embodied in the socially rewarding activity that they manage to engage in, implying that the participants create and sustain a common ground not so much about the story-layer as of the storytelling activity.
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41.
  • Hydén, Lars-Christer, et al. (författare)
  • So they are not alive?
  • 2019
  • Ingår i: Dementia. - : SAGE PUBLICATIONS LTD. - 1471-3012 .- 1741-2684. ; 18:7-8, s. 2662-2678
  • Tidskriftsartikel (refereegranskat)abstract
    • In some conversations involving persons with Alzheimers disease, the participants may have to deal with the difficulty that they do not share a common ground in terms of not only who is alive or dead, but even more, who could possibly be alive. It is as if the participants face a reality disjunction. There are very few empirical studies of this difficulty in conversations involving persons with Alzheimers disease or other kinds of dementia diagnoses. Often studies of confabulation have a focus on the behavior and experience of the healthy participants, but rarely on the interaction and the collaborative contributions made by the person with dementia. In the present article, we discuss various strategies used by all participants in an everyday conversation. The material consists of an hour long everyday conversation between a woman with Alzheimers disease and two healthy participants (relatives). This conversation is analyzed by looking at the organization of the interaction with an emphasis on how the participants deal with instances of reality disjunctions. The result from the analysis demonstrates that both the healthy participants as well as the person with dementia together skillfully avoid the face threats posed by reality disjunctive contributions by not pursuing argumentative lines that in the end might jeopardize both the collaborative and the personal relations.
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42.
  • Ingebrand, Elias, 1991- (författare)
  • Dementia and learning : The use of tablet computers in joint activities
  • 2023
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Living with dementia is generally associated with terms such as loss, confusion, and dependency; not development, agency and collaboration. Contributing to a growing body of research that acknowledges the remaining abilities of people living with dementia, and how they cope with challenges in their everyday lives, this thesis concerns a topic habitually framed by negative presumptions, namely learning. The risk of developing dementia increases with advancing age, and with an aging population the number of people living with dementia is expected to rise. Dementia is a complex condition that can have various underlying causes; it includes numerous diagnoses and is commonly characterized by a decline in cognitive and communicative functions. Due to its clinical connotations, people living with dementia often face negative assumptions about how they are, and what they can or cannot do. Alongside prevailing metaphors such as a return to childhood or empty shells, people living with dementia have been depicted as passive and disengaged communicators, incapable of initiating social action and asserting agency, who struggle to maintain attention in interactions. The aim of this thesis is to study novel learning in everyday activities for people living with dementia, taking the use of tablet computers as a case in point. Learning is approached from an interactionist perspective, where it is understood as a social and situated process, and conceptualized as changing participation in joint activities. The data used in this thesis comprises a collection of 50 video recordings where a person living with dementia, who has no previous experience of using touchscreen technologies, is using a tablet computer together with either a caregiver or another person living with dementia. The participants were asked to use the tablet computers according to their own interests, and did not receive any information regarding learning as an objective of their activities. Through four empirical studies, all using the methodological framework of multimodal conversation analysis, this thesis challenges the stereotypical belief that people living with dementia are incapable of novel learning. Study I shows how a woman living with dementia, over the course of six weeks, learns to perform the basic navigational steps needed to use an augmentative and alternative communication application. The analysis demonstrates how the participant's reliance on detailed information from her interlocutors gradually declined both during and across recordings. Study II highlights how people living with dementia position themselves as learners in unfamiliar joint activities. The results emphasize that the participants living with dementia publicly display their current understanding of the ongoing joint activities, introduce learning as a conversational topic, and are actively engaged in soliciting the information needed to partake. Study III shows how professional and family carers support the participants living with dementia in managing the tablet computers. The analysis reveals that the caregivers orient towards the doing of the participants with dementia, are attentive to their displayed understanding of the unfolding activities, and adapt any instructions with detailed multimodal cues if required. Study IV moves away from the dyadic constellations consisting of a person living with dementia together with a caregiver, and instead focuses on how people living with dementia manage the joint activities together with a peer. The results show that the participants treat the activities as collaborative endeavors, and orient towards the displayed competences of each other by offering or soliciting information when needed. Taken together, the findings from this thesis demonstrate that novel learning is possible for people living with dementia even without the use of structured interventions. The learning process is highly collaborative, and the participants actively support each other's conduct throughout the unfolding activities. Apart from possibilities for repeated participation in joint activities, procedural and agentive aspects of learning for people living with dementia are emphasized. 
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43.
  • Ingebrand, Elias, 1991-, et al. (författare)
  • People living with dementia collaborating in a joint activity
  • 2022
  • Ingår i: Learning, Culture and Social Interaction. - : Elsevier. - 2210-6561 .- 2210-657X. ; 34
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent research has stressed the collaborative competences of people living with dementia, showing how they are capable of participating in a multitude of everyday activities when supported by cognitively healthy individuals. However, little is known about the collaborative work between different people living with dementia. Accordingly, this study aims to explore how people living with dementia, without the support of a cognitively healthy interlocutor, collaborate with other people living with dementia in an unfamiliar activity. The study is based on video recordings of three dyads, each comprising two individuals living with dementia, as they are using tablet computers with reminiscence and communication aiding applications. Drawing on multimodal interaction analysis, we show how the participants living with dementia treat the activities as joint endeavors and, when needed, engage in problem-solving sequences where they make their knowledge about how to progress within the activities publicly visible to their interlocutor. Our findings suggest that people living with dementia do collaborate with each other, and that the interactional labor between different people living with dementia is more symmetrical than what has been described in joint activities involving people living with dementia and cognitively healthy individuals.Previous article in issue
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44.
  • Ingebrand, Elias, et al. (författare)
  • People with dementia positioning themselves as learners
  • 2021
  • Ingår i: Educational gerontology. - : TAYLOR & FRANCIS INC. - 0360-1277 .- 1521-0472. ; 47:2, s. 47-62
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent studies have demonstrated that people living with dementia, contrary to common believes, are capable of novel learning without structured interventions. Opportunities for learning throughout an individuals lifespan have been acknowledged as important factors in facilitating social participation and promoting wellbeing. However, little is still known about the situated practices used in the learning process for people living with dementia. This study aims to explore how people living with dementia in Swedish residential care facilities position, perceive, and assert, themselves as learners in a novel activity. The study is based on video recordings of eight people living with dementia, who for the first time use tablet computers as a social activity on a one-to-one basis with their formal caregivers. Through interaction analysis, we show how the participants living with dementia use the engagement displays of requests, accounts, formulations and metacomments to make their active undertaking in the ongoing activity public to their communication partner. Our findings suggest that people living with dementia might still perceive themselves as individuals capable of novel learning and that they are active and engaged agents in this process.
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45.
  • Ingebrand, Elias, 1991-, et al. (författare)
  • Supporting people living with dementia in novel joint activities: Managing tablet computers
  • 2023
  • Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 65
  • Tidskriftsartikel (refereegranskat)abstract
    • A bourgeoning number of studies have demonstrated that people living with dementia are capable of participating in a wide range of everyday activities when supported by care professionals or family carers. However, little remains known about the situated practices used by carers to support people living with dementia as active co-participants in novel joint activities. Taking the use of tablet computers as an example, this study focuses on the interactional organization of instructions in joint activities involving people living with dementia, who have no previous experiences of touchscreen technologies, and their carers. The study is based on forty-one video recordings of ten dyads, each comprising a person living with dementia and a carer, as they are using tablet computers with applications suited to individual interests. Drawing on multimodal interaction analysis, we show how the carers continually foster the accomplishment of their interlocutors, and rarely take over responsibility for closing an ongoing joint project themselves. Our findings suggest that the carers' instructions, realized as verbal and embodied directives, function as a form of scaffolding practice that facilitates the coordination of visual perception and embodied conduct for the participants living with dementia.
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46.
  • Jaén-Luchoro, Daniel, 1987, et al. (författare)
  • Comparative Genomic Analysis of ST131 Subclade C2 of ESBL-Producing E. coli Isolates from Patients with Recurrent and Sporadic Urinary Tract Infections
  • 2023
  • Ingår i: Microorganisms. - 2076-2607. ; 11:7
  • Tidskriftsartikel (refereegranskat)abstract
    • The global emergence of extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-E. coli), mainly causing urinary tract infections (UTI), is a major threat to human health. ESBL-E. coli sequence type (ST) 131 is the dominating clone worldwide, especially its subclade C2. Patients developing recurrent UTI (RUTI) due to ST131 subclade C2 appear to have an increased risk of recurrent infections. We have thus compared the whole genome of ST131 subclade C2 isolates from 14 patients with RUTI to those from 14 patients with sporadic UTI (SUTI). We aimed to elucidate if isolates causing RUTI can be associated with specific genomic features. Paired isolates from patients with RUTI were identical, presenting 2-18 single nucleotide polymorphism (SNP) differences for all six patients investigated. Comparative genomic analyses, including virulence factors, antibiotic resistance, pangenome and SNP analyses did not find any pattern associated with isolates causing RUTI. Despite extensive whole genome analyses, an increased risk of recurrences seen in patients with UTI due to ST131 subclade C2 isolates could not be explained by bacterial genetic differences in the two groups of isolates. Hence, additional factors that could aid in identifying bacterial properties contributing to the increased risk of RUTI due to ESBL-E. coli ST131 subclade C2 remains to be explored.
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47.
  • Johansson, Inga-Lena, 1967-, et al. (författare)
  • Consonant articulation acoustics and intelligibility in Swedish speakers with Parkinson’s disease : a pilot study
  • 2023
  • Ingår i: Clinical Linguistics & Phonetics. - : Taylor & Francis Group. - 0269-9206 .- 1464-5076. ; 37:9, s. 845-865
  • Tidskriftsartikel (refereegranskat)abstract
    • Imprecise consonant articulation is common in speakers with Parkinson’s disease and can affect intelligibility. The research on the relationship between acoustic speech measures and intelligibility in Parkinson’s disease is limited, and most of the research has been conducted on English. This pilot study investigated aspects of consonant articulation acoustics in eleven Swedish speakers with Parkinson’s disease and six neurologically healthy persons. The focus of the study was on consonant cluster production, articulatory motion rate and variation, and voice onset time, and how these acoustic features correlate with speech intelligibility. Among the measures in the present study, typicality ratings of heterorganic consonant clusters /spr/ and /skr/ had the strongest correlations with intelligibility. Measures based on syllable repetition, such as repetition rate and voice onset time, showed varying results with weak to moderate correlations with intelligibility. One conclusion is that some acoustic measures may be more sensitive than others to the impact of the underlying sensory-motor impairment and dysarthria on speech production and intelligibility in speakers with Parkinson’s disease. Some aspects of articulation appear to be equally demanding in terms of acoustic realization for elderly healthy speakers and for speakers with Parkinson’s disease, such as sequential motion rate measures. Clinically, this would imply that for the purpose of detecting signs of disordered speech motor control, choosing measures with less variation among older speakers without articulation impairment would lead to more robust results. 
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48.
  • Johansson, Inga-Lena, 1967-, et al. (författare)
  • Patients’ and communication partners’ experiences of communicative changes in Parkinson’s disease
  • 2020
  • Ingår i: Disability and Rehabilitation. - : Taylor & Francis. - 0963-8288 .- 1464-5165. ; 42:13, s. 1835-1843
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim of the present study was to investigate the experiences of people with Parkinson’s disease and their close communication partners regarding disease-related communicative changes and participation in everyday conversations.Materials and methods: Semi-structured qualitative interviews were conducted with six dyads consisting of a person with Parkinson’s disease and a close communication partner. The interview material was analysed through thematic analysis.Results: The main theme was the experiences of barriers and facilitators for participation in conversations. Subthemes were experiences related to changes in voice and articulation, language and cognition, body language and facial expressions, fatigue, self-image, communicative initiative, and familiarity with conversation partner. The results show individual variation. A change observed in almost all dyads was the person with Parkinson’s disease participating less in conversations.Conclusions: Assessment and interventions should be based on a broad perspective on communication, and individuals’ priorities should be foregrounded in intervention planning. Both the person with Parkinson’s disease and communication partners need to make adjustments for communication to work. Therefore, close communication partners should be included in assessment and intervention of communicationin Parkinson’s disease from an early stage.
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49.
  • Johansson, Inga-Lena, 1967-, et al. (författare)
  • Picture description in the assessment of connected speech intelligibility in Parkinson's disease : A pilot study
  • 2022
  • Ingår i: Folia Phoniatrica et Logopaedica. - Basel, Switzerland : S. Karger. - 1021-7762 .- 1421-9972. ; 74:5, s. 320-334
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: Assessment of intelligibility in dysarthria tends to rely on oral reading of sentences or words. However, self-generated utterances are closer to a clients’ natural speech. This study investigated how transcription of utterances elicited by picture description can be used in the assessment of intelligibility in speakers with Parkinson’s disease.Methods: Speech samples from eleven speakers with Parkinson’s disease and six neurologically healthy persons were audio-recorded. Forty-two naive listeners completed transcriptions of self-generated sentences from a picture description task and orally read sentences from the Swedish Test of Intelligibility, as well as scaled ratings of narrative speech samples.Results:  Intelligibility was higher in orally read than self-generated sentences and higher for content words than for the whole sentence in self-generated sentences for most of the speakers, although these within-group differences were not statistically significant at group level. Adding contextual leads for the listeners increased intelligibility in self-generated utterances significantly, but with individual variation. Although correlations between the intelligibility measures were at least moderate or strong, there was a considerable inter- and intra-speaker variability in intelligibility scores between tasks for the speakers with Parkinson’s disease, indicating individual variation of factors that impact intelligibility. Intelligibility scores from neurologically healthy speakers were generally high across tasks with no significant differences between the conditions.Conclusion: Within-speaker variability supports literature recommendations to use multiple methods and tasks when assessing intelligibility. The inclusion of transcription of self-generated utterances elicited by picture description to the intelligibility assessment has the potential to provide additional information to assessment methods based on oral reading of pre-scripted sentences and to inform the planning of interventions.
  •  
50.
  • Larsson, Elias, 1991-, et al. (författare)
  • Recycling narratives as a joint accomplishment in interaction with people with dementia
  • 2018
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • This presentation focuses on recycling of stories in conversations involving people with dementia. In dementia, communicative ability gradually deteriorates as the disease progresses typically leading to profound decline of communicative skills in the late stage. Of all of the domains affected by dementia diseases, communication is one of the areas where people with dementia and their caregivers experience most challenges. A significant characteristic for persons with dementia is a tendency to tell the same stories over and over (e.g. Hydén et al., 2013). While the significance conversational partners have on the organization of stories told by people with dementia are highly recognized (e.g. Hydén, et al., 2013; Hydén, 2011), how conversational partners to people with dementia orient toward recycling of stories are still in need of further investigation. In previous research, the phenomenon of recycling stories is mainly credited to the person with dementia. In our present study, we would like to propose another parallel point of view in which caregivers also tend to recycle stories repetitively in conversation with persons with dementia. We argue that recycling of stories in interaction involving people with dementia is a highly collaborative activity, and sometimes even initiated by conversational partners to people with dementia. In this presentation, we focus on how recycling of stories are sequentially organized is ordinary interaction between people with dementia and professional caregivers. The data consist of video recordings of 4 dyads (one person diagnosed with dementia and a professional caregiver in each dyad) totaling approximately 2,5 hours of recordings. In the analyses, we have focused specifically on how the telling of recycled stories is initiated in conversation, and what kind of feedback such stories receive. Our analyses show that recycled stories told by persons with dementia receive strong interactional support from conversational partners by, for example, the use of responses signaling newness and surprise (cf. Hydén et al., 2013). Conversational partners are also actively involved in the telling of recycled stories by, for example, asking guiding questions expanding the stories and use prompting techniques in cases where the person with dementia seem to have difficulties telling the whole story. In our analyses, we have also seen examples where conversational partners to people with dementia not only support the telling of recycled stories, but actually initiate such stories by instructing the person with dementia to talk about a specific topic.
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