| 1. |
- Amin, Khabat, et al.
(författare)
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Injury Reducing Effect of GSHP-Heated Pedestrian Paths
- 2024
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Ingår i: International Ground Source Heat Pump Association-Research Conference. ; , s. 227-235
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Konferensbidrag (refereegranskat)abstract
- In Sweden, falls amongst pedestrians during wintertime, due to slipping on ice and snow, is a costly and growing problem. Using data on pedestrian falls from four Swedish cities, the injury-reducing effect of heated surfaces was studied. The results indicate that heated surfaces have a significant injury-reducing effect especially in cities with more ice and snow. Currently, district heating is used as a heat source and at an increasing cost. By using GSHP systems as a heat source, the cost could be considerably lowered, and in this way secure the further use and expansion of heated pedestrian paths.
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| 2. |
- Axén, Elin, et al.
(författare)
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Degree of Preservation of Neurovascular Bundles in Radical Prostatectomy and Recurrence of Prostate Cancer
- 2021
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Ingår i: European Urology Open Science. - : Elsevier BV. - 2666-1691 .- 2666-1683. ; 30, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reports on possible benefits for continence with nerve-sparing (NS) radical prostatectomy have expanded the indications beyond preservation of erectile function. It is unclear whether NS surgery affects oncological outcomes. Objective: To determine whether the degree of NS during radical prostatectomy influences oncological outcomes. Design, setting, and participants: Of 4003 patients enrolled in a prospective, controlled trial comparing open and robotic radical prostatectomy during 2008–2011, we evaluated 2401 patients who received robotic radical prostatectomy at seven Swedish centres. Patients were followed for 8 yr. Outcome measurements and statistical analysis: Data for recurrence and positive surgical margin status were assessed using validated patient questionnaires, patient interviews, and clinical record forms before and at 3, 12, and 24 mo and 6 and 8 yr after surgery. Cox and logistic regressions were used to model the effect on recurrence and positive surgical margins (PSM), respectively. Results and limitations: A total of 481 men had PSM and 467 experienced recurrence during follow-up. Median follow-up for men without recurrence was 6.6 yr. There were no statistically significant differences in recurrence rate between degrees of NS. The PSM rate was significantly higher with a higher degree of NS: interfascial NS, odds ratio (OR) 2.32 (95% confidence interval [CI] 1.69–3.16); intrafascial NS, OR 3.23 (95% CI 2.17–4.80). Recurrence rates were higher for patients with pT2 disease and PSM (hazard ratio [HR] 3.32, 95% CI 2.43–4.53) than for patients with pT3 disease without PSM (HR 2.08, 95% CI 1.66–2.62). The lack of central review of pathological specimens is a limitation. Conclusions: A higher degree of NS significantly increased the risk of PSM but did not significantly increase the risk of cancer recurrence. Combined with the known functional benefits of NS surgery, these results underscore the need to identify an individualised balance. Patient summary: In this report we looked at the effect of a nerve-sparing approach during removal of the prostate on cancer outcomes for patients having robot-assisted surgery at seven Swedish hospitals. We found that a high degree of nerve-sparing increased the rate of cancer positivity at the margins of surgical specimens and that positive surgical margins increased the risk of recurrence of prostate cancer. © 2021 The Authors
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| 3. |
- Blom Johansson, Monica, 1965-, et al.
(författare)
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Self-reported changes in everyday life and health of significant others of people with aphasia : a quantitative approach
- 2022
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Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 36:1, s. 76-94
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Tidskriftsartikel (refereegranskat)abstract
- Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO’s working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs’ perceptions of the PWA’s stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation.
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| 4. |
- Carlsson, Gunilla, et al.
(författare)
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A hundred days in confinement : Doing, being, becoming, and belonging among older people in Sweden during the COVID-19 pandemic
- 2022
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Ingår i: Journal of Occupational Science. - : Informa UK Limited. - 1442-7591 .- 2158-1576. ; 29:3, s. 402-416
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Tidskriftsartikel (refereegranskat)abstract
- Background: When and how people were able to engage in everyday occupations changed suddenly with the coronavirus pandemic. Defined as a risk group due to their age, people 70 years and older in Sweden experienced confinement, as did older adults globally. Aim: To explore how doing, being, becoming, and belonging as dimensions of occupation were manifested in the lives of Swedish people 70 years or older, 100 days into the coronavirus pandemic. Method: Data were elicited through semi-structured interviews with 17 participants (11 women, 6 six men, mean age 76 years), living in ordinary housing in Sweden. Interviews were conducted in June 2020 as part of a larger longitudinal research project. A directed content analysis approach was used to analyse the data based on the occupational dimensions of doing, being, becoming, and belonging. Results: After 100 days of confinement, daily occupations had been changed, and habits and routines disrupted. However, the need to engage in occupations was strong. Participants expressed how they adapted their occupations to the restrictions, but also how their doing affected their well-being, further development, and opportunities for social interactions. Conclusion: The participants, who were older people without any specific diagnosis, reflected upon their daily occupations during an unrehearsed natural experiment when, more than anything else, the social environmental circumstances changed. The analysis elucidates how doing, being, becoming, and belonging is embedded in people’s lives. The study can serve as a foundation to further research on understanding people’s individual needs as occupational beings.
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| 5. |
- Carlsson, Gunilla, et al.
(författare)
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Exploration of a Web-based accessibility tool for public facilities
- 2023
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Ingår i: Facilities. - 0263-2772. ; 41:15/16, s. 66-84
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – This study aims to explore how an accessibility database (AD) has been developed and implemented as a tool for facility managers to evaluate and increase the accessibility of public facilities.Design/methodology/approach – Eight participants were strategically sampled for semi-structured interviews, and documents on the AD were gathered. The Consolidated Framework for Implementation Research (CFIR) was used for a directed content analysis of the data. The CFIR domains used for the analysis were: intervention characteristics, outer setting, inner setting, characteristics of individuals and process.Findings – The development and implementation of the AD demonstrated the complexity in assessing and planning for increased accessibility. The communication and iterative processes within the inner as well as with the outer setting was an important part of the development and implementation, as well as anchoringeach step locally, regionally and nationally, within public authorities and disability organizations.Practical implications – The assessments of environmental barriers and the results reported in the AD can serve as a guide for identification of accessibility issues. However, singular identified barriers were reported as a fragmentation of the building regulations, and thereby when retrofitting is carried out, experts who have the competence to suggest solutions based on the entirety need to be involved to reach the goals of increased accessibility and countering of exclusion and discrimination.Originality/value – By structuring the implementation process by means of the CFIR, facilitators and barriers of using an AD as a basis for retrofitting were revealed. The practical challenges outlined in assessing and increasing accessibility can guide facility managers when considering actions to increase accessibility.
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| 6. |
- Carlsson, Ingela K., et al.
(författare)
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Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire : a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery
- 2021
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Ingår i: Hand Therapy. - : SAGE Publications. - 1758-9983 .- 1758-9991. ; 26:1, s. 3-16
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The aim of this study was to evaluate the construct validity, floor and ceiling effects, data completeness and magnitude of change over time for the eight-item patient questionnaire (HQ-8) in the Swedish Healthcare Quality Registry for hand surgery (HAKIR). Methods: Construct validity was investigated through predefined hypotheses and correlation statistics between the single items in HQ-8 (pain on load, pain on motion without load, pain at rest, stiffness, weakness, numbness, cold sensitivity and ability to perform daily activities) and QuickDASH. Floor and ceiling effects and data completeness were analysed at preoperative (n = 13,197), three months (n =10,702) and one year (n = 9,986) responses from hand surgery patients. Effect sizes were calculated for pre- and postoperative change scores in elective conditions and postoperative scores for acute conditions. Results: Correlation coefficients at pre, 3 and 12 months ranged from 0.44 to 0.79 in the total group. No ceiling effect occurred, but a floor effect for the total group was noted for all items at all follow-ups. Missing responses were < 2.6% except for cold sensitivity. The effect sizes varied from small to large for individual items in elective diagnoses. For acute injuries, small effect sizes were found. Discussion: This study provides evidence of construct validity of HQ-8, lack of ceiling effect, expected floor effect, good data completeness and an ability to detect changes over time. The results indicate that HQ-8 measures unique aspects of disability. The HQ-8 could complement the Quick-DASH in describing patient-reported outcomes after hand surgery.
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| 7. |
- Carlsson, Marianne
(författare)
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Self-reported competence in female and male nursing students in the light of theories of hegemonic masculinity and femininity
- 2020
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 76:1, s. 191-198
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In most parts of the world, nursing historically has been considered an occupation for women. Gender stereotypes are associated with the nursing profession.AIM: The aim was to describe and compare the self-reported competence in female and male nursing students. The students were also compared according to their different background college educations. The theoretical framework of hegemonic masculinity and femininity was used.DESIGN: A cross-sectional design with a questionnaire was used at two points in time, 2012 and 2017.METHODS: Nursing students completed a questionnaire on graduation from a three-year university nursing program from 12 universities/university colleges in Sweden. In total, 1,810 students were participating, 1577 female and 227 male students. The Nurse Professional Competence scale was used for data collection.RESULTS: There were statistical significant differences in the self-reported competence between female and male students (t-tests and ANOVAs). These differences are in agreement with the patterns of hegemonic masculinity and femininity. Female students estimated their competence in giving value-based nursing care as higher than male did. Male students estimated their competence in development and leadership higher than female did.CONCLUSION: The pattern of hegemonic masculinity and femininity could be identified. This indicates a difference in power between female and male students.IMPACT: The study addresses the self-reported competence of female and male nursing students. The results indicated that male students possibly looked on themselves as superior to the female students. In order to change the image of nursing as a woman's work, the self-images should be discussed in nursing education as well as in college education. Women interested in development, research and leadership and men interested in nursing care and administration must feel that nursing is a suitable profession for them. The stereotypical image of nursing as a women's work is a barrier to nurses' professional development.
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| 8. |
- Carlsson, Sigrid, 1982, et al.
(författare)
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Young Age on Starting Prostate-specific Antigen Testing Is Associated with a Greater Reduction in Prostate Cancer Mortality: 24-Year Follow-up of the Goteborg Randomized Population-based Prostate Cancer Screening Trial
- 2023
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Ingår i: European Urology. - : Elsevier BV. - 0302-2838. ; 83:2, s. 103-109
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Tidskriftsartikel (refereegranskat)abstract
- Background: The risk of death from prostate cancer (PC) depends on age, but the age at which to start prostate-specific antigen (PSA) screening remains uncertain. Objective: To study the relationship between risk reduction for PC mortality and age at first PSA screening. Design, setting, and participants: The randomized Goteborg-1 trial invited men for bien-nial PSA screening between the ages of 50 and 70 yr (screening, n = 10 000) or no invi-tation but exposure to opportunistic PSA testing (control, n = 10 000). Intervention: Regular versus opportunistic PSA screening or no PSA. Outcome measurements and statistical analysis: We modeled the nonlinear association between starting age and the absolute risk reduction in PC mortality in three settings: (1) intention-to-screen (randomized arms); (2) historical control (screening group and 1990-1994 registry data); and (3) attendees only (screening attendees and matched controls). We tested whether the effect of screening on PC mortality depends on the age at starting screening by comparing survival models with and without an interaction between trial arm and age (intention-to-screen and attendees only). Results and limitations: Younger age on starting PSA testing was associated with a greater reduction in PC mortality. Starting screening at age 55 yr approximately halved the risk of PC death compared to first PSA at age 60 yr. The test of association between starting age and the effect of screening on PC mortality was slightly greater than the con-ventional level of statistical significance (p = 0.052) for the entire cohort, and statistically significant among attendees (p = 0.002). This study is limited by the low number of disease-specific deaths for men starting screening before age 55 yr and the difficulty in discriminating between the effect of starting age and screening duration. Conclusions: Given that prior screening trials included men aged up to 70 yr on starting screening, our results suggest that the effect size reported in prior trials underestimates that of currently recommended programs starting at age 50-55 yr. Patient summary: In this study from the Goteborg-1 trial, we looked at the effect of prostate-specific antigen (PSA) screening in reducing men's risk of dying from prostate cancer given the age at which they begin testing. Starting at a younger age reduced the risk of prostate cancer death by a greater amount. We recommend that PSA screen-ing should start no later than at age 55 yr. (c) 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.
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| 9. |
- Evertsson, Linda, et al.
(författare)
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Incidence, demographics and rehabilitation after digital nerve injury: A population-based study of 1004 adult patients in Sweden
- 2023
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 18:4
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe main objective of this study was to describe the epidemiology of surgically repaired digital nerve injuries in a Swedish population. Secondary objectives were to describe the demographics of the patient population, injury characteristics, post-operative care and rehabilitation. MethodsFrom 2012 to 2018, 1004 patients with a surgically repaired digital nerve injury resident in the Stockholm region were identified in the Swedish national quality registry for hand surgery and all medical records were thoroughly reviewed. ResultsThe incidence rate was 8.3 per 100.000 person-years and these injuries were more common in men than women. The median age at the time of injury was 37 years and a sharp cut was the most common mechanism of injury. Injuries were equally distributed over weekdays and the year, but surgery was most often performed on Mondays. There were no differences in treatment and rehabilitation regimens between sexes, except women were more likely than men to be operated within three days from injury. Timing and content of rehabilitation varied largely between individuals. One third of patients did not receive any sensory relearning and sensory assessment was performed in only 7%. ConclusionThe epidemiology shows no major changes over the last decade. However, we found a large individual variation in follow up visits, rehabilitation content and assessments indicating large differences in consumption of health care resources. Our findings expose the need to further improve and evaluate rehabilitation regimens after digital nerve injury.
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| 10. |
- Fristedt, Sofi, 1969-, et al.
(författare)
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Changes in daily life and wellbeing in adults, 70 years and older, in the beginning of the COVID-19 pandemic
- 2021
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis. - 1103-8128 .- 1651-2014. ; 29:6, s. 511-521
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the beginning of the COVID-19 pandemic, Swedish authorities enforced specific recommendations on social distancing for adults 70 years and older (70+). Day-to-day life changed for 15% of the Swedish population. The aim of the study was to explore how adults 70+ experienced and managed changes in everyday life due to the COVID-19 pandemic and how those changes affected wellbeing at the beginning of the virus outbreak.METHODS: Eleven women and six men, (mean age 76 years), living in ordinary housing, participated in remote semi-structured interviews in April 2020. The interviews were analysed with qualitative content analysis.FINDINGS: The theme Suddenly at risk - '…but it could have been worse' included four categories My world closed down; Negotiations, adaptations and prioritizations to manage staying at home; Barriers and facilitators to sustain occupational participation; and Considerations of my own and other's health and wellbeing emerged from the data analysis.CONCLUSION: Everyday life changes had implications for health and well-being. The participants questioned previous conceptions of meaning in relation to habitual activities, likely leading to consistent occupational changes. However, these long-term effects remain to be explored, and considered to enable older adult's health during the pandemic and beyond.
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