| 1. |
- Nilsson, Kerstin, et al.
(författare)
-
54 forskare: Inte alla klarar höjd pensions-ålder
- 2017
-
Ingår i: Svenska Dagbladet, Stockholm. - 1101-2412.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet, så att fler klarar att arbeta i högre ålder. Att enbart genom ekonomiska åtgärder höja pensionsåldern är inte långsiktigt hållbart, skriver 54 forskare.DEBATT | PENSIONForskning visar att cirka var fjärde har en diagnos eller skada orsakad av sitt arbete. Detta gör arbetsorsakad sjukdom och skada till ett betydelsefullt folkhälsoproblem. Att då enbart genom ekonomiska åtgärder höja pensionsåldern för samtliga (yrkes)grupper utifrån deras kronologiska ålder är inte långsiktigt hållbart när individers biologiska ålder är så olika bland annat till följd av arbetslivet. Detta är en demokratifråga. Forskning om äldre i arbetslivet och hållbart arbete visar att man då främst flyttar individer från pensionssystemet till sjukförsäkringssystemet och ökar klyftorna i samhället.Debatt Det här är en argumenterande text med syfte att påverka. Åsikterna som uttrycks är skribentens egna.Vi är 54 forskare som nu gemensamt har skrivit denna debattartikel. Anledningen är att vi är oroade över att cirka var fjärde blir sjuk av sitt arbete samtidigt som man i det förslag som ligger om att senarelägga ålderspensionen i princip utgår ifrån att arbetskraftsdeltagande enbart styrs av ekonomin. Vi vill trycka på betydelsen av åtgärder i arbetslivet för att komma tillrätta med ohälsan, det vill säga inte enbart ekonomiska restriktioner som tvingar folk som inte kan, vill och orkar att stanna kvar i arbetslivet till en högre kronologisk ålder.Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att förtjäna möjligheter till pension. Vi bör dock inte enbart utgå ifrån antalet år sedan en person föddes, då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Den svenska sjukförsäkringsreformen 2008 avsåg att få tillbaka människor i arbete. Men studien fann att den faktiskt bidrog till att fler gick i tidig ålderspension av dem som var i åldern 55–64 år. Ökningen var störst bland korttidsutbildade. Mer än 5 procent fler gick i tidig ålderspension då det blev svårare att få sjukpenning och sjukersättning. Vi kan notera att det är vanligare att manliga chefer tar ut tidig ålderspension, jämfört med kvinnliga maskinskötare inom tillverkningsindustrin. I vissa yrken är det dessutom vanligare att människor, trots pension, både orkar och faktiskt ges möjlighet att arbeta vidare om de har en specialkompetens som efterfrågas. Om vi endast kombinerar ekonomiska morötter med piskor finns en stor risk att vi ökar klyftan mellan grupper som både kan och vill fortsätta att yrkesarbeta och personer som av olika skäl inte längre kan eller orkar.Ta nytta av den forskning som vi har tagit fram. Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas och våra attityder som är kopplade till ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.”Morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi.Forskning visar att pedagogik som bygger på ”morötter” oftast är betydligt bättre än ”piskor” för att nå framgångsrika och långsiktiga mål. ”Morötter” i samhället, för organisationer, företag och individer är därför viktiga för god arbetshälsa och fortsatt produktivitet och kan bidra till ett längre arbetsliv även för grupper som tidigare inte ens klarat av att arbeta fram till pensionsåldern. Genom forskning inom området har bland annat swage-modellen utarbetats. Detta är ett verktyg som visar på komplexiteten i ett hållbart arbetsliv och tillsammans med systematiskt arbetsmiljöarbete, handlingsplaner och åtgärder syftar till ett mer hållbart arbetsliv. Morötter är enligt forskningen i detta sammanhang åtgärder för en god fysisk och mental arbetsmiljö, avpassad arbetsbelastning, stödjande teknik, att man kan anpassa arbetstakten, alternativa arbetstidsmodeller vid behov. Det är viktigt att man känner sig trygg och förväntas och tillåts vara delaktig, att man blir sedd av chefen och arbetskamraterna. Att de egna arbetsuppgifterna upplevs som meningsfulla och behövda av andra skapar självförverkligande och tillfredsställelse i arbetet. Att man känner att ens arbetsuppgifter och man själv är viktig för organisationen och företaget. Att man trots högre ålder inkluderas i olika nysatsningar och får tillgång till kompetensutveckling och inte blir åsidosatt eller åldersdiskriminerad. Utvärderingar visar att de äldre medarbetarna som fick några av dessa anpassningar och möjligheter var mer effektiva, utvilade, stimulerade när de var på arbetet samtidigt som sjukfrånvaron minskade. Vilket i sin tur bidrar till ett längre arbetsliv för grupper som tidigare inte klarat av att arbeta fram till pensionsåldern. I organisationer som bygger på en deltagar- och lärandekultur rustas de anställda för att klara omställningar, nya arbetsuppgifter och vid behov även yrkesbyten.Med en åldrande befolkning där allt fler lever allt längre behöver vi arbeta till en högre ålder i framtiden för att pensionssystemet ska hålla. Men ”morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi. Det kräver också att vi ändrar våra attityder och förhållningssätt till äldre på arbetsmarknaden, vilket vi bäst gör genom att organisationer och företag får incitament till och erbjuder mer individanpassade arbetsvillkor, särskilt för personer i högre ålder. Låt oss därför använda den framtagna kunskapen i praktiken för att göra arbetslivet friskt och hållbart för alla åldrar.
|
|
| 2. |
- Nilsson, Kerstin, et al.
(författare)
-
Vi är oroade över senare ålderspension
- 2017
-
Ingår i: Dagens Samhälle. - 1652-6511.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Var fjärde person blir i dag sjuk till följd av sitt arbete. Att höja pensionsåldern för alla yrkesgrupper, utan konkreta åtgärder för att minska ohälsan, är därför problematiskt och mycket oroande. Det är, enligt forskarna, inte långsiktigt samhällsekonomiskt lönsamt att utan andra åtgärder höja pensionsåldern för alla. Vi – 54 forskare – är mycket oroade över konsekvenserna av att, som föreslagits, senarelägga ålderspensionen.Förslaget utgår i princip från arbetskraftsdeltagande i princip enbart styrs av ekonomin, medan forskningen visar att det bara är en av flera faktorer som styr hur länge och hur mycket människor väljer att arbeta.Det här sättet att lösa problemet med en åldrande befolkning och ett sviktande pensionssystem är inte samhällsekonomiskt lönsamt på lång sikt, utan riskerar bara att flytta runt folk mellan olika ersättningssystem. Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att tjäna in vår pension. Vi bör dock inte enbart utgå ifrån ålder eller antalet år sedan en person föddes då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De med kortare utbildningstid har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har också oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Ta nytta av den forskning som vi har tagit fram. Ekonomin är självklart viktigt för att vi ska vilja arbeta, men den är som sagt enbart en av flera faktorer med betydelse vårt arbetsliv.Hälsotillståndet, både det fysiska och det mentala, har en avgörande betydelse för hur länge och hur mycket vi orkar arbeta. Ett fysiskt och mentalt belastande arbete är en stark riskfaktor för en nedsatt hälsa i slutet av arbetslivet. Arbetstid, arbetstakt och möjlighet till återhämtning spelar en allt större roll ju äldre vi blir. Andra aspekter är arbetsinnehåll, hur meningsfulla och stimulerande arbetsuppgifterna är, balansen mellan arbete och familjesituation och fritidsaktiviteter. Organisationskultur, ledarskapet, stöd i arbetet och kompetens har stor betydelse för om vi ska kunna och vilja arbeta till en högre ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.Ett hållbart och acceptabelt pensionssystem måste därför utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas samt de attityder som är kopplade till ålder.
|
|
| 3. |
|
|
| 4. |
- Jelley, Hannah, et al.
(författare)
-
Carers' experiences of timely access to and use of dementia care services in eight European countries
- 2021
-
Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:2, s. 403-420
-
Tidskriftsartikel (refereegranskat)abstract
- Timely access to care services is crucial to support people with dementia and their family carers to live well. Carers of people with dementia (N = 390), recruited from eight countries, completed semi-structured interviews about their experiences of either accessing or not using formal care services over a 12-month period in the Access to Timely Formal Care (Actifcare) study. Participant responses were summarised using content analysis, categorised into clusters and frequencies were calculated. Less than half of the participants (42.3%) reported service use. Of those using services, 72.8 per cent reported timely access and of those not using services 67.2 per cent were satisfied with this situation. However, substantial minorities either reported access at the wrong time (27.2%), or feeling dissatisfied or mixed feelings about not accessing services (32.8%). Reasons for not using services included use not necessary yet, the carer provided support or refusal. Reasons given for using services included changes in the condition of the person with dementia, the service's ability to meet individual needs, not coping or the opportunity to access services arose. Facilitators and barriers to service use included whether participants experienced supportive professionals, the speed of the process, whether the general practitioner was helpful, participant's own proactive attitude and the quality of information received. To achieve timely support, simplified pathways to use of formal care services are needed.
|
|
| 5. |
- Miloff, Alexander, et al.
(författare)
-
Automated virtual reality exposure therapy for spider phobia vs. in-vivo one-session treatment : A randomized non-inferiority trial
- 2019
-
Ingår i: Behaviour Research and Therapy. - : Elsevier BV. - 0005-7967 .- 1873-622X. ; 118, s. 130-140
-
Tidskriftsartikel (refereegranskat)abstract
- This study compared the efficacy of a technician-assisted single-session virtual reality exposure therapy (VRET) for the treatment of spider phobia featuring low-cost consumer-available hardware and novel automated software to gold-standard in-vivo one-session treatment (OST), using a parallel group randomized non-inferiority design. Method Participants (N = 100) were randomized to VRET and OST arms. Assessors blinded to treatment allocation evaluated participants at pre- and post-treatment as well follow-up (3 and 12 months) using a behavioral approach test (BAT) and self-rated fear of spider, anxiety, depression and quality-of-life scales. A maximum post-treatment difference of 2-points on the BAT qualified as non-inferiority margin. Results Linear mixed models noted large, significant reductions in behavioral avoidance and self-reported fear in both groups at post-treatment, with VRET approaching the strong treatment benefits of OST over time. Non-inferiority was identified at 3- and 12- months follow-up but was significantly worse until 12-months. There was no significant difference on a questionnaire measuring negative effects. Conclusions Automated VRET efficaciously reduced spider phobia symptoms in the short-term and was non-inferior to in-vivo exposure therapy in the long-term. VRET effectiveness trials are warranted to evaluate real-world benefits and non-specific therapeutic factors accruing from the presence of a technician during treatment. ClinicalTrials.gov (NCT02533310).
|
|
| 6. |
- Andersson, Katarina, 1963-, et al.
(författare)
-
Challenges in Elderly Night-Time Care : Dignity 24 Hours a Day in Swedish Elderly Home Care Services?
- 2017
-
Ingår i: Innovation in Aging. - : Oxford University Press. - 2399-5300. ; 1:Suppl 1, s. 302-302
-
Tidskriftsartikel (refereegranskat)abstract
- The research study explores a large knowledge gap within Swedish elderly care – namely the challenges of within home care services at night. Despite that home care services is the most common support given to the elderly in Sweden. The few National and International studies that exist on night-time care, have focused on residential care facilities for the elderly. Therefore, focus here is on night-time care in their own homes, given by the night patrol – which we know very little about.In the last decades, organizational transformation has taken place within elderly care towards increased rationalization and marketization. Along with demographical changes, this raises questions of dignified care, equal social rights and access to care. As the elderly are living longer and living in their own homes with severe disability and vulnerability, the pressure on home care services will increase – including at night. Dignity in care has been legislated in the Swedish Social Services Act, but is vaguely implemented, specifically at night.Discussed are results of an interview survey with managers responsible for night-time home care services in 50 Swedish municipalities. How night-time care is organized varies depending on local governance, location and size of municipalities. This indicates challenges for equal access to care, depending on where you live. Care workers experience time pressure at night with many fragile elderly in need of care. How efforts to secure dignity and safety for older people varies over night is therefore important to reveal, not the least from a social equality perspective.
|
|
| 7. |
- Andersson, Katarina, 1963-, et al.
(författare)
-
Challenges in Swedish elderly home care services at night-time
- 2022
-
Ingår i: ESA, 6th midterm conference of the research network on ageing in Europe (RN01) of the european sociological association. Ageing in europé. - Vienna : Universität Wien, European Sociological Association, European centre for social welfare policy and research. ; , s. 44-44
-
Konferensbidrag (refereegranskat)abstract
- Up to date, we know little about how home care services is organized and performed at nighttime. There are no official statistics of night time care or the number of older people havingassistance at night. This paper aims to report from a survey with operation managers and theiraccounts of organization and provision of care at night.The material consisted of a sample of 37 of Sweden’s 290 municipalities, covering for urbanas well as rural areas, smaller and larger municipalities as well as bigger cities. Individualtelephone interviews were conducted with 41 operation managers responsible for night timecare. Standardised and open ended questions were raised to capture strategies of night timehome care organization and provision. The material was analysed quantitatively andqualitatively.The results revealed similarities as well as differences in organization where smallermunicipalities often had to find special solutions. The care workers had to manage emergencyalarm from the older persons as well as scheduled care work at night. The care work includeda lot of car driving and insecurity at night, such as bad weather and violence in the streets.Safety and dignity were raised by the managers as important values in provision of care, bothfor the elderly and staff.There were several challenges in demographic development and local politics, but also inrecruitment problems and staff’s working conditions. To organize for ageing in place, homecare needs to be user friendly for vulnerable persons, also at night time.
|
|
| 8. |
|
|
| 9. |
|
|
| 10. |
- Andersson, Katarina, 1963-, et al.
(författare)
-
Nighttime home care in Sweden: "a constant struggle to manage unforeseen events" : operations managers’ perceptions of organization and provision of care for older people
- 2023
-
Ingår i: Health & Social Care in the Community. - : Hindawi Publishing Corporation. - 0966-0410 .- 1365-2524. ; 2023
-
Tidskriftsartikel (refereegranskat)abstract
- This article aims to explore how community home care of older people is provided and organized at night. In times of welfare decline, organizational changes, and an increasing aged population, questions arise about home care and support for older people. In Sweden as in many other western countries ‘ageing in place’ is a guiding principle in care provision for older people, which put increasing pressure on home care services. Still, night-time care represents a research gap within health and social care research, nationally and internationally. This telephone interview survey examines 41 operations managers’ perceptions of organization and care provision and how they account for the goals and work of home care at night-time in a selection of 37 Swedish municipalities. The analysis was inspired by thematic content analysis where three central themes were categorized: organizational context of night-time care, working conditions, and challenges of night-time care. Our results reveal that organizational context varied depending on the demography and size of the municipality. The work situation was characterizeded by constantly unforeseen events to manage. Multiple challenges were identified on societal and political levels, as were limited resources and recruitment problems. In conclusion, our analysis has identified unpredictability as a core feature of night-time care work. The complexity of the provision of night-time care was not recognized as important for the municipal organization. To provide high quality care at night in ordinary housing, there is a need to both focus on organizational aspects and to have sufficient resources and time.
|
|
| 11. |
- Andersson, Katarina, 1963-, et al.
(författare)
-
Swedish eldercare within home care services at night-time : perceptions and expressions of 'good care' from the perspective of care workers and care unit managers
- 2022
-
Ingår i: Nordic Social Work Research. - : Routledge. - 2156-857X .- 2156-8588. ; 12:5, s. 640-653
-
Tidskriftsartikel (refereegranskat)abstract
- This article aims to explore and analyse how good and dignified care is perceived and expressed at night-time within elder home care services, in which night-time care represents a knowledge gap. Dignity has become a legislated value in Swedish eldercare, aiming to increase the quality of care and to clarify the ethical values of everyday care practice. The data presented here come from a qualitative case study with in-depth interviews with six care unit managers and 14 care workers in four municipalities. The analysis of the interviewees’ perceptions and expressions of good care were informed by Nodding’s concepts: responsiveness, receptivity, and relatedness. The results showed that there was a relative unawareness of the new goals of the dignity policy and there was no specific guidance regarding dignity during night-time care. The care unit managers’ perspective was mainly administrative and related to the policy level and the staff’s ability to care. The care workers’ view of good and dignified care included aspects of ideal characteristics and user-centredness with a focus on older people’s individual needs. However, good care was conditioned by time. The dignity policy, as described in national documents, was perceived by the interviewees as vague and with unreachable goals constructed on the structural level. In social care practice, however, expressions of good and dignified care were already found in care ethics, regardless of the dignity policy. By bringing relationality to the dignity discourse on the structural policy level, recognition of care may be emphasized.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
- Bjuhr, Marie, et al.
(författare)
-
Health and work-related factors as predictors of still being active in working life at age 66 and 72 in a Swedish population : A longitudinal study
- 2023
-
Ingår i: Work. - 1051-9815 .- 1875-9270. ; 76:4, s. 1481-1492
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Health and work environment are known factors in being active in working life beyond legal retirement. OBJECTIVE: To investigate sociodemographic, health and work environment factors as possible predictors of being active in working life at ages 66 and 72. Secondly, investigate eventual changes over time, shortly after a major reform in the Swedish pension system, and predictors of still being active in working life at age 66. METHODS: We used a longitudinal design with two separate cohorts of people at age 60. One baseline assessment was made in 2001-2003 with two 6 years follow-ups, and one in 2007-2009 with one 6 years follow-up. Data were accessed through a Swedish national population-based study and analysed using logistic regression. To examine possible differences between the two cohorts, interaction terms with each independent variable were analysed. RESULTS: Being a man and working in a profession that requires at least three years of university education predicted that the person would still be active in working life at age 66 and 72. Additionally, having a light level of physical activity at work and being diagnosed with fewer than two diseases, also predicted still being active in working life at age 66. Only physical activity at work showed significant changes over time. CONCLUSION: Shortly after a major reform of the public pension system, there was an increase in participation in working life after age 66 and 72. However, gender, profession, and health factors are still important considerations regarding older people's participation in working life.
|
|
| 15. |
- Bjuhr, Marie, et al.
(författare)
-
Health and work-related factors as predictors of still being active in working life at age 66 and 72 in a Swedish population: A longitudinal study
- 2023
-
Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 76:4, s. 1481-1492
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Health and work environment are known factors in being active in working life beyond legal retirement.OBJECTIVE: To investigate sociodemographic, health and work environment factors as possible predictors of being active in working life at ages 66 and 72. Secondly, investigate eventual changes over time, shortly after a major reform in the Swedish pension system, and predictors of still being active in working life at age 66.METHODS: We used a longitudinal design with two separate cohorts of people at age 60. One baseline assessment was made in 2001–2003 with two 6 years follow-ups, and one in 200–2009 with one 6 years follow-up. Data were accessed through a Swedish national population-based study and analysed using logistic regression. To examine possible differences between the two cohorts, interaction terms with each independent variable were analysed.RESULTS: Being a man and working in a profession that requires at least three years of university education predicted that the person would still be active in working life at age 66 and 72. Additionally, having a light level of physical activity at work and being diagnosed with fewer than two diseases, also predicted still being active in working life at age 66. Only physical activity at work showed significant changes over time.CONCLUSION: Shortly after a major reform of the public pension system, there was an increase in participation in working life after age 66 and 72. However, gender, profession, and health factors are still important considerations regarding older people’s participation in working life.
|
|
| 16. |
- Bjuhr, Marie, et al.
(författare)
-
Incentives behind and Experiences of Being Active in Working Life after Age 65 in Sweden
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:23
-
Tidskriftsartikel (refereegranskat)abstract
- Since individual and societal expectations regarding the possibility of an extended working life after the expected retirement age are increasing, research on sustainable working life combined with healthy ageing is needed. This study explores the incentives behind and experiences of an extended working life after the expected retirement age of 65 among Swedish people. The inductive qualitative content analyses are based on 18 individual semi-structured interviews among persons 67–90 years old with varying characteristics and varying experiences of extended working lives. The analyses revealed that working contributed to (1) sustained internal resources, i.e., cognitive function, physical ability and increased vigor; (2) sustained external resources, i.e., social enrichment, better daily routines and economic benefits; (3) added meaningfulness to life, i.e., being needed, capability and satisfaction with working tasks. Meanwhile, having flexible working conditions enabled a satisfying balance between work and leisure. Altogether, these different aspects of overall health and working life were interpreted as contributing to increased feelings of vitality, the innermost dimension of health. Conclusions: regardless of biological age, our results indicate that being able to remain active in working life can be beneficial to vitality and could make these results valuable for both health-care personnel and employers.
|
|
| 17. |
- Bjuhr, Marie, et al.
(författare)
-
Sustained health in working life among an aging population and an aging working force
- 2023
-
Konferensbidrag (refereegranskat)abstract
- Background. A crucial factor for social sustainability is equal health and social justice. With an aging population andincreased expectations on senior workers to prolong their working life, research focusing on sustainable working life incombination with healthy aging is needed.Purpose. To explore factors related to and experiences of prolonging working life after the expected retirement age of65 among Swedish people.Methods. Cross-sectional and longitudinal data were used to assess associations with participation in working life atages 66 and 72. Additionally, qualitative data, based on 18 individual semi-structured interviews with workers 67–90years were used to gain an extended understanding of incentives for prolonged working life.Findings. Male gender and profession were associated with participating in working life at age 72, additionally, fewerdiagnosed diseases and a light level of physical activity at work at 66. Senior workers described that workingcontributed to sustained internal and external resources, added meaningfulness to life and flexible working conditionsenabled a satisfying balance between work and leisure. Altogether, these different aspects of working life wereinterpreted as contributing to increased feelings of vitality, the innermost dimension of health.Conclusion. Regardless of biological age, being able to remain active in working life can be beneficial to vitality.Actions to provide flexible working conditions, especially for disadvantaged senior workers, may facilitate working lifeafter the expected retirement age with extended equality.
|
|
| 18. |
|
|
| 19. |
- Broda, Anja, et al.
(författare)
-
Perspectives of policy and political decision makers on access to formal dementia care : expert interviews in eight European countries
- 2017
-
Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers.METHODS: Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4-7 experts (total N = 38). The interview guide addressed the topics "Complexity and Continuity of Care", "Formal Services", and "Public Awareness". Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries.RESULTS: The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness.CONCLUSIONS: Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations.
|
|
| 20. |
- Bånkestad, Maria, et al.
(författare)
-
Variational Elliptical Processes
- 2023
-
Ingår i: Transactions on Machine Learning Research. - 2835-8856.
-
Tidskriftsartikel (refereegranskat)abstract
- We present elliptical processes—a family of non-parametric probabilistic models that subsumes Gaussian processes and Student's t processes. This generalization includes a range of new heavy-tailed behaviors while retaining computational tractability. Elliptical processes are based on a representation of elliptical distributions as a continuous mixture of Gaussian distributions. We parameterize this mixture distribution as a spline normalizing flow, which we train using variational inference. The proposed form of the variational posterior enables a sparse variational elliptical process applicable to large-scale problems. We highlight advantages compared to Gaussian processes through regression and classification experiments. Elliptical processes can supersede Gaussian processes in several settings, including cases where the likelihood is non-Gaussian or when accurate tail modeling is essential.
|
|
| 21. |
- Ekesbo, Rickard, et al.
(författare)
-
Chronic Helicobacter pylori infection in a population in southern Sweden analysed by histopathology, immunoblot and ELISA serology.
- 2006
-
Ingår i: European Journal of Gastroenterology and Hepathology. - 1473-5687. ; 18:6, s. 589-593
-
Tidskriftsartikel (refereegranskat)abstract
- Background. Many individuals are infected with the bacterium Helicobacter pylori. Some develop ulcers or mucosal atrophy. Aims. To correlate the histological characteristics of the H. pylori-induced gastritis to the immunoblot pattern of the H. pylori infection and to compare the presence of H. pylori bacteria in tissue specimens with ELISA serology and immunoblot analysis. Methods. One hundred and sixty-six consecutive patients were referred to gastroscopy. Forty patients were excluded for various reasons and 126 were included in the study. Results. Twenty-three patients had ulcerations and 25 erosions. Ninety-two (73%) had a chronic gastritis and in 90 (71%) it involved both the antrum and corpus. Ninety-one (72%), of whom 96% had a chronic gastritis, had visible bacteria in the tissue specimens, used as the 'gold standard' for the detection of infection. In patients with chronic gastritis 65 (70%) had positive H. pylori ELISA serology, 27 (30%) had negative H. pylori ELISA, while 76 (83%) had a positive immunoblot pattern. The ELISA positive patients had more advanced chronic gastritis but a lower frequency of metaplasia and atrophy. Acute inflammatory activity in the chronic gastritis had a high immunoreactivity to 120 kDa (CagA) protein and was significantly correlated to antibody reactivity to proteins in the 53-65 kDa range (heat shock proteins) and to a 43 kDa subunit. Metaplasia and atrophy in antrum was associated with a 62 kDa protein band. Conclusion. Almost all H. pylori-infected patients had a pangastritis, visible in both antrum and corpus. Acute inflammatory activity in the chronic gastritis and the presence of metaplasia and atrophy in antrum were associated with a specific immunoblot pattern, indicating infection with more virulent strains. Immunoblot analysis had a better sensitivity than ELISA H. pylori serology.
|
|
| 22. |
- Ekström, Ingrid, et al.
(författare)
-
Smell Loss Predicts Mortality Risk Regardless of Dementia Conversion
- 2017
-
Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 65:6, s. 1238-1243
-
Tidskriftsartikel (refereegranskat)abstract
- ObjectivesTo determine whether dementia could explain the association between poor olfactory performance and mortality risk within a decade-long follow-up period.DesignProspective cohort study.SettingBetula Study, Umeå, Sweden.ParticipantsA population-based sample of adult participants without dementia at baseline aged 40 to 90 (N = 1,774).MeasurementsOlfactory performance using the Scandinavian Odor-Identification Test (SOIT) and self-reported olfactory function; several social, cognitive, and medical risk factors at baseline; and incident dementia during the following decade.ResultsWithin the 10-year follow-up, 411 of 1,774 (23.2%) participants had died. In a Cox model, the association between higher SOIT score and lower mortality was significant (hazard ratio (HR) = 0.74 per point interval, 95% confidence interval (CI) = 0.71-0.77, P < .001). The effect was attenuated, but remained significant, after controlling for age, sex, education, and health-related and cognitive variables (HR = 0.92, 95% CI = 0.87-0.97, P = .001). The association between SOIT score and mortality was retained after controlling for dementia conversion before death (HR = 0.92, 95% CI = 0.87-0.97, P = .001). Similar results were obtained for self-reported olfactory dysfunction.ConclusionPoor odor identification and poor self-reported olfactory function are associated with greater likelihood of future mortality. Dementia does not attenuate the association between olfactory loss and mortality, suggesting that olfactory loss might mark deteriorating health, irrespective of dementia.
|
|
| 23. |
|
|
| 24. |
- Gottvall, Maria, 1980-, et al.
(författare)
-
Health-related quality of life among Syrian refugees resettled in Sweden
- 2020
-
Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 29:2, s. 505-514
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose The main purpose of this study was to assess health-related quality of life (HRQoL) among Syrian refugees resettled in Sweden. Further, we wanted to investigate whether sex, age, education, area of residence, cohabitation and social support were associated with HRQoL in this population. Methods This is a cross-sectional study including 1215 Syrian refugees from a randomly selected sample frame resettled in Sweden between the years 2011 and 2013. HRQoL was measured by the EQ-5D-5L descriptive system, and EQ-5D-5L index values were calculated. Associations between sex, age, education, area of residence, cohabitation, social support and EQ-5D-5L were investigated using multiple linear regression analysis. Results Depression/anxiety was the most commonly (61.9%) reported EQ-5D-5L problem among the group of Syrian refugees. The mean EQ-5D-5L index value was found to be 0.754. Male sex, younger age, cohabitation and social support were found associated with a higher EQ-5D-5L index score. Conclusions Our results concerning long-lasting health problems among the study population indicate that there is a profound need for policies and interventions promoting refugees' health. Our results also show that social support, a modifiable factor, is relevant to refugees' overall health, pointing to the importance of public health interventions and policies targeting the facilitation, mobilization and enhancing of refugees' social support.
|
|
| 25. |
- Gustafsson, Ingegerd, et al.
(författare)
-
Bacteria with increased mutation frequency and antibiotic resistance are enriched in the commensal flora of patients with high antibiotic usage
- 2003
-
Ingår i: Journal of Antimicrobial Chemotherapy. - : Oxford University Press (OUP). - 0305-7453 .- 1460-2091. ; 52:4, s. 645-650
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We examined how prolonged antibiotic treatment affected the resistance and mutation frequency of human microflora isolated from intestine (Escherichia coli, enterococci spp.), pharynx (alpha-streptococci) and nostril (coagulase-negative staphylococci, CoNS).METHODS: Samples were collected from patients at the Center of Cystic Fibrosis (n=18) and the haematology ward (n=18) of the University Hospital, Uppsala, Sweden. The individually used amount of antibiotics for 1 year was recorded as the defined daily dose (DDD). Primary health care patients (n=30), with no antibiotic treatment for 1 year before sampling, were used as controls. Three isolates of each bacterium from each patient were examined. Antibiotic susceptibilities were determined by disc diffusion. Mutation frequencies to rifampicin resistance were measured on 30 independent cultures of each bacterial species from each individual by plating on rifampicin agar plates. For alpha-streptococci the mutation frequency to streptomycin resistance was also determined.RESULTS: Isolates from patients with high antibiotic use showed a pronounced shift towards increased resistance and a small but significant increase in the mutation frequency compared with isolates from the controls. For E. coli, enterococci and CoNS the increase in geometric mean mutation frequency in the patient group was 3-, 1.8- and 1.5-fold, respectively (P values 0.0001, 0.016 and 0.012). For alpha-streptococci there was a significant difference in geometric mean mutation frequency between patient and control groups for streptomycin resistance (P=0.024) but not for rifampicin resistance (P=0.74).CONCLUSIONS: High antibiotic use selected for commensals with highly increased resistance and a slight increase in mutation frequency.
|
|
| 26. |
- Hering, Alessa, et al.
(författare)
-
Learn2Reg: comprehensive multi-task medical image registration challenge, dataset and evaluation in the era of deep learning
- 2023
-
Ingår i: IEEE Transactions on Medical Imaging. - : Institute of Electrical and Electronics Engineers (IEEE). - 0278-0062 .- 1558-254X. ; 42:3, s. 697-712
-
Tidskriftsartikel (refereegranskat)abstract
- Image registration is a fundamental medical image analysis task, and a wide variety of approaches have been proposed. However, only a few studies have comprehensively compared medical image registration approaches on a wide range of clinically relevant tasks. This limits the development of registration methods, the adoption of research advances into practice, and a fair benchmark across competing approaches. The Learn2Reg challenge addresses these limitations by providing a multi-task medical image registration data set for comprehensive characterisation of deformable registration algorithms. A continuous evaluation will be possible at https:// learn2reg.grand-challenge.org. Learn2Reg covers a wide range of anatomies (brain, abdomen, and thorax), modalities (ultrasound, CT, MR), availability of annotations, as well as intra- and inter-patient registration evaluation. We established an easily accessible framework for training and validation of 3D registration methods, which enabled the compilation of results of over 65 individual method submissions from more than 20 unique teams. We used a complementary set of metrics, including robustness, accuracy, plausibility, and runtime, enabling unique insight into the current state-of-the-art of medical image registration. This paper describes datasets, tasks, evaluation methods and results of the challenge, as well as results of further analysis of transferability to new datasets, the importance of label supervision, and resulting bias. While no single approach worked best across all tasks, many methodological aspects could be identified that push the performance of medical image registration to new state-of-the-art performance. Furthermore, we demystified the common belief that conventional registration methods have to be much slower than deep-learning-based methods.
|
|
| 27. |
|
|
| 28. |
- Hultén, Johan, et al.
(författare)
-
New food waste data for reference year 2022 from manufacturing sector and from retail and distribution sector in Sweden : Deliverable “D1.1 Project report” of the project SWEFOODWASTE
- 2023
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this project was to improve the capacity and quality of food waste reporting in Sweden, specifically for two sectors: Processing and Manufacturing, and Retail and other distribution of food.During the first reporting year (reference year 2020) of the collection of food waste data, several challenges were found within these two sectors. In the Processing and Manufacturing sector, there was a need for improvement due to uncertainties according to the EU food waste definition in terms of what residues ought to be classified as food waste, food loss, by-product or other waste. There were also uncertainties how water content should be reported according to the EU food waste reporting obligation. For the Retail and other distribution of food sector, data from only few actors were available for wholesalers, convenience stores, and e-stores which affected data quality.Processing and ManufacturingTo improve reporting and data quality from the food processing and manufacturing sector, a survey was produced asking about food waste and other residues that may constitute food losses. This was to get self-reported data from a large random sample of respondents and to better understand food loss and waste flows in this sector.The survey of Processing and Manufacturing revealed a large volume of previously unknown food waste. 305 000 tonnes of food waste were reported for reference year 2022 compared to 53 000 tonnes for 2020. This is attributed to a better representation of the reality rather than an actual increase in food waste generation.Amounts of food losses seem to be even larger. However, these amounts are also very uncertain due to few respondents from most sectors. Apart from food waste, the dairy and ice cream sector accounted for 180 500 tonnes of food loss, which mainly is whey that goes to feed. Food loss from other sectors cannot be published due to high uncertainties and risk or revealing respondents.The new results on food waste generation, corresponding to 29 kg food waste per capita 2022, align better with international figures. In a European context, the Swedish food waste generation in the industry was low, with 5 kg per capita in 2020 compared to the EU27 average of 27 kg per capita.The new method of self-reporting by respondents improves the accuracy of results, as they know their own operations best. However, there was a challenge in aligning the new EU common definition of food waste with the common understanding of food waste in the Swedish food sector.The different types of food waste to include in the food waste definition were broadened to better align with the intent of EU legislation. The EU definition was for this study interpreted to include most parts of animals and plants that have entered processing as food and become waste. This is a change from former interpretation and the main reason for accounting larger amounts of food waste than previous years. The survey was also designed to enable the distribution of the resulting quantities between different subsectors of manufacturing and processing, as they are grouped by “NACE-codes” in the Business register. Retail and other distribution of foodMost national and regional wholesalers, convenience store chains and e-stores were contacted but unfortunately only a few were able or willing to provide data. This study revealed 13 800 tonnes of food waste from these businesses 2022. This is less compared to 18 200 tonnes in 2021. Note that both these numbers exclude retail and that no scaling occurred for wholesale or e-stores. Although several smaller companies started sharing data, a few large wholesalers did not submit data for 2022 as in 2021 which is the reason for the decrease of reported amounts.Data collection in the wholesale sector yielded limited insights due to only a few companies providing data, and mostly aggregated data. This seems to be due to low technical maturity of their internal data collection and sharing. However, these companies collectively constitute a substantial portion of the wholesale sector in Sweden. It is challenging to precisely quantify their contribution, since many food industry and retail entities also engage in wholesale activities without being formally registered as wholesalers.Convenience stores provided data that could be upscaled to the national level together with data from retail, showing that these do not add up much food waste compared to retail stores. For specialized e-stores selling food, their contribution to food waste is estimated to be minimal, as their operational models and product types result in low waste generation compared to other retail sectors. A large portion of e-stores selling food are part of the retail sector and already included in reported food waste amounts from retail.
|
|
| 29. |
- Ingard, Cecilia, et al.
(författare)
-
Moral distress and moral agency : staff experience of supporting self-determination for people with dementia
- 2024
-
Ingår i: Social Sciences. - : MDPI. - 2076-0760. ; 13:5
-
Tidskriftsartikel (refereegranskat)abstract
- People living in nursing homes have the right to self-determination, and difficulty in accommodating this right can create moral distress in staff. This study aimed to explore experiences of situations of moral distress and to identify nursing home staffs’ needs to act with moral agency. Six group interviews were conducted with nursing home staff. Content analysis of the interview responses showed that moral distress can be rooted in both concrete situations with residents and factors related to the work environment and policy requirements. Personnel can address moral distress through both active and passive means. Staff acted to address moral distress mainly in situations with residents and sometimes in relation to co-workers, but they did not try to influence the policy level.
|
|
| 30. |
- Ingard, Cecilia, et al.
(författare)
-
People with dementia as active agents in nursing homes : a scoping review
- 2023
-
Ingår i: SAGE Open. - : Sage Publications. - 2158-2440. ; 13:2
-
Forskningsöversikt (refereegranskat)abstract
- People with dementia (PWD) are fragile and need aid and care in their daily lives. This scoping review explores the extent to which PWD can be involved in society and their daily lives. Publications were selected according to PRISMA guidelines. We graded the level of participation/involvement in daily life and research using a five-level participation model developed by Shier. A higher grade means a greater ambition to involve PWD in decisions. Of the 11 included studies, three reached level three according to Shier’s model. The studies describe ways of and potentials for participation, capabilities of PWD, caregivers’ opportunities to foster involvement, and cooperation between PWD caregivers and relatives. Caregivers and managers must have the attitude that PWD can be involved in decisions and caregivers need opportunities to actively promote such involvement. Shier’s model can be a tool with which organizations strive to involve PWD.
|
|
| 31. |
|
|
| 32. |
|
|
| 33. |
- Kerpershoek, Liselot, et al.
(författare)
-
Optimizing access to and use of formal dementia care : Qualitative findings from the European Actifcare study
- 2019
-
Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 27:5, s. e814-e823
-
Tidskriftsartikel (refereegranskat)abstract
- This paper reports on qualitative data from the Actifcare study investigating experiences, attitudes, barriers and facilitators concerning access to and use of formal care. A total of 85 semi-structured in-depth interviews were conducted in eight European countries. Results were analysed with a deductive content analysis, first within country and then integrated in a cross-national analysis. Overall, analysis of the in-depth interviews revealed two major themes with five subcategories. The results can be summarised in an optimal pathway for access to dementia care. This pathway includes fixed factors such as disease-related factors and system-related factors. In addition there are personal factors that are subject to change such as attitudes towards care. An important finding consisted of the necessity of having sufficient information about the disease and available care and having a key contact person to guide you through the process of finding suitable care while monitoring your needs. In addition, it is important to involve your social network as they can take on care-giving tasks. It is helpful to have a diagnosis (in most countries). Concerning decision-making, the person closest to the person with dementia is in the majority of cases the one who makes the ultimate decision to access and use services and he/she should therefore be supported in this process. These results provide insight into the factors that influence the pathway to formal care use and help professionals to enhance access to formal dementia care by focusing on factors that can be modified.
|
|
| 34. |
- Larsson, Maria, et al.
(författare)
-
Loss of Olfactory Function Predicts Mortality Irrespective of Dementia Conversion : 10-year follow-up of an age-varied sample
- 2016
-
Ingår i: Chemical Senses. - : Oxford University Press (OUP). - 0379-864X .- 1464-3553. ; 41:9, s. e111-e288
-
Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to examine the association between performance in odor identification and future mortality in a community cohort of adults aged between 40 and 90 years. We assessed olfactory performance with a 13-item-version of the Scandinavian Odor Identification Test (SOIT). The results showed that during follow-up (mean=9.4 years, standard deviation=2.23), 411 of 1774 (23.2%) participants died. In a Cox model, the association between higher SOIT score and mortality was highly significant (hazard ratio [HR]=0.74, per point interval, 95% confidence interval [CI]=0.71–0.77, p<0.001). The effect was attenuated, but remained significant after controlling for age, sex, education, and health and cognitive variables that were also associated with an increased risk of mortality (HR=0.92, 95% CI=0.87–0.97, p=0.001). Controlling for dementia conversion prior to death did not attenuate the association between SOIT score and mortality (HR=0.92, 95% CI=0.87–0.97, p=0.001). Similar results were obtained for olfactory sensitivity as assessed by self-report. Overall, the present findings show that poor odor identification performance is associated with an increased likelihood of future mortality in middle-aged and older adults, after controlling for social, cognitive, and medical risk factors. Most importantly, controlling for the development of dementia did not attenuate the association between odor identification and mortality, suggesting that olfactory decline might mark deteriorating health also irrespective of dementia.
|
|
| 35. |
- Mamhidir, Anna-Greta, 1952-, et al.
(författare)
-
Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach
- 2017
-
Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 17
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundChronic pain affects nursing home residents’ daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention.MethodsA cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.ResultsUsing both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.ConclusionThe implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.Trial registrationThe study was registered in ISRCTN71142240 in September 2012, retrospectively registered.
|
|
| 36. |
- Marques, Maria J., et al.
(författare)
-
Relationship quality and sense of coherence in dementia : results of a European cohort study
- 2019
-
Ingår i: International Journal of Geriatric Psychiatry. - : John Wiley & Sons. - 0885-6230 .- 1099-1166. ; 34:5, s. 745-755
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives.Methods: Cross-sectional data from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC).Results: Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and with discrepancies was carer stress (negative feelings sub-score). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two.Conclusions: In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
|
|
| 37. |
- Michelet, Mona, et al.
(författare)
-
Associations between unmet needs for daytime activities and company and scores on the Neuropsychiatric Inventory-Questionnaire in people with dementia : a longitudinal study
- 2021
-
Ingår i: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 26:4, s. 725-734
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES To examine prospectively the association between unmet needs for daytime activities and company and behavioural and psychological symptoms of dementia.METHODS We included 451 people with mild or moderate dementia, from eight European countries, who were assessed three times over 12 months. Unmet needs were measured with the Camberwell Assessment of Need for the Elderly. Three sub-syndromes of the Neuropsychiatric Inventory-Questionnaire were regressed, one-by-one, against unmet needs for daytime activities and company, adjusting for demographic and clinical-functional covariates.RESULTS Unmet needs for daytime activities were associated with more affective symptoms at baseline, six and twelve months, mean 0.74 (p < 0.001), 0.76 (p < 0.001) and 0.78 (p = 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.39 points, p = 0.007) and at six months follow-up (mean 0.31 points, p = 0.006). Unmet needs for company were associated with more affective symptoms at baseline, six and twelve months, mean 0.44 (p = 0.033), 0.67 (p < 0.001) and 0.91 (p < 0.001) points higher score respectively, and with more psychotic symptoms at baseline (mean 0.40 points, p = 0.005) and at six months (mean 0.35 points, p = 0.002) follow-up.CONCLUSION Interventions to reduce unmet needs for daytime activities and company could reduce affective and psychotic symptoms in people with dementia.
|
|
| 38. |
- Olofsson, Jonas K., et al.
(författare)
-
Smell-based memory training : Evidence of olfactory learning andtransfer to a visual task
- 2024
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- In cognitive training interventions, engaging in visual processing tasks rarely stimulate transfer of learning to untrained tasks. Human and animal research suggests that the sense of smell, olfaction, are intimately associated with visual-spatial orientation and memory encoding networks. In this study, we investigated if olfactory enhancement would facilitate visuo-spatial learning. We devised an odor memory intervention to investigate “asymmetric” transfer effects such that odor-based memory training would transfer to a visual-based memory gain, but not vice versa. Participants were randomly assigned to daily memory training for 40 days with either the odor task or a visual control task with a similar difficulty level. Results showed that while visual training did not produce transfer, olfactory training produced transfer to the untrained visual memory task. Furthermore, odor training uniquely improved participants’ performance on odor discrimination and naming tasks to achieve the performance level of wine experts. Our results indicate that the olfactory system is highly responsive to training, and the sense of smell might be a promising vehicle to achieve perceptual and cognitive enhancement.
|
|
| 39. |
- Reid, Steven E, et al.
(författare)
-
Cancer-associated fibroblasts rewire the estrogen receptor response in luminal breast cancer, enabling estrogen independence
- 2024
-
Ingår i: Oncogene. - 1476-5594.
-
Tidskriftsartikel (refereegranskat)abstract
- Advanced breast cancers represent a major therapeutic challenge due to their refractoriness to treatment. Cancer-associated fibroblasts (CAFs) are the most abundant constituents of the tumor microenvironment and have been linked to most hallmarks of cancer. However, the influence of CAFs on therapeutic outcome remains largely unchartered. Here, we reveal that spatial coincidence of abundant CAF infiltration with malignant cells was associated with reduced estrogen receptor (ER)-α expression and activity in luminal breast tumors. Notably, CAFs mediated estrogen-independent tumor growth by selectively regulating ER-α signaling. Whereas most prototypical estrogen-responsive genes were suppressed, CAFs maintained gene expression related to therapeutic resistance, basal-like differentiation, and invasion. A functional drug screen in co-cultures identified effector pathways involved in the CAF-induced regulation of ER-α signaling. Among these, the Transforming Growth Factor-β and the Janus kinase signaling cascades were validated as actionable targets to counteract the CAF-induced modulation of ER-α activity. Finally, genes that were downregulated in cancer cells by CAFs were predictive of poor response to endocrine treatment. In conclusion, our work reveals that CAFs directly control the luminal breast cancer phenotype by selectively modulating ER-α expression and transcriptional function, and further proposes novel targets to disrupt the crosstalk between CAFs and tumor cells to reinstate treatment response to endocrine therapy in patients.
|
|
| 40. |
- Sjölund, Britt-Marie, 1958-, et al.
(författare)
-
Factors associated with improvement in depressive symptoms among older persons after hospitalisation - a prospective design with two follow-ups
- 2021
-
Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:3, s. 923-928
-
Tidskriftsartikel (refereegranskat)abstract
- Background Depression is a common disorder in old age and increases with hospitalisation. The aim was to investigate whether improvement in depressive symptoms after hospitalisation is associated with education level, age, gender, living situation, self-efficacy, activities in daily living and quality of life by (1) examining the prevalence of depressive symptoms at baseline and at 1st and 2nd follow-up (2) examining different factors' association with depressive symptoms at baseline and (3) examining different factors' association with improvement in depressive symptoms at baseline and at 1st and 2nd follow-up. Methods The study consisted of 145 patients, 65 years and older. Data were collected between February 2015 and September 2016 through interviews conducted using structured protocols. The instrument used was Katz index of ADL, Geriatric Depression Scale-20, Life Satisfaction Questionnaire and the General Self-Efficacy Scale. The participants were interviewed before discharge from hospital, after 1.5 month and after 3 months. Results The prevalence of depressive symptoms in older persons was high after hospitalisation. Factors associated with improvement of depressive symptoms after hospitalisation were higher educational level, improvement in activities in daily living and quality of life. Non-significant results were found for improvement of depressive symptoms and gender, age, living situation or self-efficacy. Conclusions Depression is a common health problem in older persons, especially after hospitalisation. It is therefore important that healthcare staff screen older persons for depression during hospitalisation, as this allows identification of those in need and a possibility to help them in an appropriate manner. Persons with lower educational level and depressive symptoms need special attention.
|
|
| 41. |
- Sjölund, Britt-Marie, et al.
(författare)
-
Incidence of ADL Disability in Older Persons, Physical Activities as a Protective Factor and the Need for Informal and Formal Care : Results from the SNAC-N Project
- 2015
-
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:9
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the study was to examine 1) the incidence of disability in Activities of Daily Living (ADL), in persons 78 years and older 2) explore whether being physical active earlier is a significant predictor of being disability free at follow-up and 3) describe the amount of informal and formal care in relation to ADL-disability.METHODS: Data were used from a longitudinal community-based study in Nordanstig (SNAC-N), a part of the Swedish National Study on Aging and Care (SNAC). To study objectives 1) and 2) all ADL-independent participants at baseline (N = 307) were included; for objective 3) all participants 78 years and older were included (N = 316). Data were collected at baseline and at 3- and 6-year follow-ups. ADL-disability was defined as a need for assistance in one or more activities. Informal and formal care were measured using the Resource utilization in Dementia (RUD)-instrument.RESULTS: The incidence rates for men were similar in the age groups 78-81and 84 years and older, 42.3 vs. 42.5/1000 person-years. For women the incidence rate for ADL-disability increased significantly from the age group 78-81 to the age group 84 years and older, 20.8 vs.118.3/1000 person-years. In the age group 78-81 years, being physically active earlier (aOR 6.2) and during the past 12 month (aOR 2.9) were both significant preventive factors for ADL-disability. Both informal and formal care increased with ADL-disability and the amount of informal care was greater than formal care. The incidence rate for ADL-disability increases with age for women and being physically active is a protective factor for ADL-disability.CONCLUSION: The incidence rate for ADL-disability increases with age for women, and being physical active is a protective factor for ADL-disability.
|
|
| 42. |
- Sjölund, Britt-Marie, 1958-, et al.
(författare)
-
Pain prevalence among residents living in nursing homes and its association with quality of life and well-being
- 2021
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 35:4, s. 1332-1341
-
Tidskriftsartikel (refereegranskat)abstract
- Pain is common and often more complex to assess among nursing homes residents with cognitive impairments. Thus, more research is needed of different pain assessment methods in elderly care and how these assessments outcomes are related to quality of life, as there mostly should be a negative relationship. There is a risk that pain are under diagnosed among persons with cognitive impairment.The aim was to describe and compare pain prevalence among nursing home residents (1) using different pain assessment methods (2) in relation to cognitive status and to (3) examine associations between pain and quality of life or well‐being.A cross‐sectional correlational design was used, participants were 213 nursing home residents and data were collected through interviews using standardised protocols. Instrument used were Katz index of ADL, Mini‐Mental‐State‐Examination, Quality of Life in Late‐Stage Dementia scale, WHO‐5 well‐being index, Numeric Rating Scale and Doloplus‐2 scale.The results showed high pain prevalence, but no significant difference based on cognitive level. Pain classification at the individual level varied somewhat when different instruments are used. The results indicated that use of a single‐item proxy‐measure for pain tends to show higher pain prevalence and was not statistically significant related to quality of life. The relationship with quality of life was statistically significant when self‐rated pain instruments or multi‐component observation were used.The study shows that it is difficult to estimate pain in residents living at nursing homes and that it continues to be a challenge to solve. Self‐rated pain should be used primarily to assess pain, and a multi‐component observation scale for pain should be used when residents are cognitively impaired. Both self‐rated pain and multi‐component observation also support the well‐known link between pain and quality of life. Single‐item proxy assessments should only be used in exceptional cases.
|
|
| 43. |
- Sjölund, Britt-Marie, et al.
(författare)
-
Time trends in prevalence of activities of daily living (ADL) disability and survival : Comparing two populations (aged 78+years) living in a rural area in Sweden
- 2014
-
Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 58:3, s. 370-375
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to study time trends in prevalence of disability in ADL and survival among men and women 78 years and older comparing two cohorts. The study was a time trend study based on two population-based community cohorts, the Nordanstig Project (NP), collected 1995-1998 and the Swedish National Study on Aging and Care in Nordanstig (SNAC-N), collected 2001-2003. The participants were people aged 78 years and older from the NP cohort (N = 303) and from the SNAC-N cohort (N = 406). All were clinically examined by physicians and nurses using standardized protocols. Disability was defined as a need for assistance in one or more ADL activities. The prevalence of disability and survival were compared using logistic and Cox models. The prevalence of ADL disability was stable for men, while women became more disabled in ADL during the time period, OR 2.36 (1.12-4.94). There was no significant difference in survival time between the cohorts in either ADL disabled persons or nondisabled persons. There was a tendency for increased survival for non-disabled persons in SNAC-N compared with NP, although not significant; this was particularly true for women. In general, women survived longer than men did regardless of whether they were ADL disabled or not. The time trends for ADL disability found in the study show that ADL disability had increased in women but not in men. More studies are needed to identify risk factors for ADL disability with a view to preventing it in time.
|
|
| 44. |
- Sjölund, Jens, 1987-, et al.
(författare)
-
Bayesian uncertainty quantification in linear models for diffusion MRI
- 2018
-
Ingår i: NeuroImage. - : Elsevier BV. - 1053-8119 .- 1095-9572. ; 175, s. 272-285
-
Tidskriftsartikel (refereegranskat)abstract
- Diffusion MRI (dMRI) is a valuable tool in the assessment of tissue microstructure. By fitting a model to the dMRI signal it is possible to derive various quantitative features. Several of the most popular dMRI signal models are expansions in an appropriately chosen basis, where the coefficients are determined using some variation of least-squares. However, such approaches lack any notion of uncertainty, which could be valuable in e.g. group analyses. In this work, we use a probabilistic interpretation of linear least-squares methods to recast popular dMRI models as Bayesian ones. This makes it possible to quantify the uncertainty of any derived quantity. In particular, for quantities that are affine functions of the coefficients, the posterior distribution can be expressed in closed-form. We simulated measurements from single- and double-tensor models where the correct values of several quantities are known, to validate that the theoretically derived quantiles agree with those observed empirically. We included results from residual bootstrap for comparison and found good agreement. The validation employed several different models: Diffusion Tensor Imaging (DTI), Mean Apparent Propagator MRI (MAP-MRI) and Constrained Spherical Deconvolution (CSD). We also used in vivo data to visualize maps of quantitative features and corresponding uncertainties, and to show how our approach can be used in a group analysis to downweight subjects with high uncertainty. In summary, we convert successful linear models for dMRI signal estimation to probabilistic models, capable of accurate uncertainty quantification. © 2018 Elsevier Inc.
|
|
| 45. |
- Sjölund, Maria, 1978-, et al.
(författare)
-
Att avvärja omsorg
- 2017. - 1
-
Ingår i: Social omsorg i socialt arbete. - Malmö : Gleerups Utbildning AB. - 9789140696236 ; , s. 203-216
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 46. |
|
|
| 47. |
- Sjölund, Maria, 1975-
(författare)
-
Development and Stability of Antibiotic Resistance
- 2004
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Antibiotic resistance is of current concern. Bacteria have become increasingly resistant to commonly used antibiotics and we are facing a growing resistance problem. The present thesis was aimed at studying the impact of antibiotic treatment on pathogenic bacteria as well as on the normal human microbiota, with focus on resistance development.Among the factors that affect the appearance of acquired antibiotic resistance, the mutation frequency and biological cost of resistance are of special importance. Our work shows that the mutation frequency in clinical isolates of Helicobacter pylori was generally higher than for other studied bacteria such as Enterobacteriaceae; ¼ of the isolates displayed a mutation frequency higher than Enterobacteriaceae defective mismatch repair mutants and could be regarded as mutator strains.In H. pylori, clarithromycin resistance confers a biological cost, as measured by decreased competitive ability of the resistant mutants in mice. In clinical isolates, this cost could be reduced, consistent with compensatory evolution stabilizing the presence of the resistant phenotype in the population. Thus, compensation is a clinically relevant phenomenon that can occur in vivo.Furthermore, our results show that clinical use of antibiotics selects for stable resistance in the human microbiota. This is important for several reasons. First, many commensals occasionally can cause severe disease, even though they are part of the normal microbiota. Therefore, stably resistant populations increase the risk of unsuccessful treatment of such infections. Second, resistance in the normal microbiota might contribute to increased resistance development among pathogens by interspecies transfer of resistant determinants.
|
|
| 48. |
- Sjölund, Maria, et al.
(författare)
-
Dissemination of multidrug-resistant bacteria into the Arctic
- 2008
-
Ingår i: Emerging Infectious Diseases. - Atlanta, GA, United States : Centers for Disease Control and Prevention (CDC). - 1080-6040 .- 1080-6059. ; 14:1, s. 70-72
-
Tidskriftsartikel (refereegranskat)abstract
- We show that Escherichia coli isolates originating from Arctic birds carry antimicrobial drug resistance determinants. This finding implies that dissemination of drug-resistant bacteria is worldwide. Resistance genes can be found even in a region where no selection pressure for resistance development exists.
|
|
| 49. |
|
|
| 50. |
|
|
