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| 2. |
- Frandin, Kerstin, et al.
(författare)
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Long-Term Effects of Individually Tailored Physical Training and Activity on Physical Function, Well-Being and Cognition in Scandinavian Nursing Home Residents : A Randomized Controlled Trial
- 2016
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Ingår i: Gerontology. - : S. Karger AG. - 0304-324X .- 1423-0003. ; 62:6, s. 571-580
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Tidskriftsartikel (refereegranskat)abstract
- Background: The preservation of physical functions such as muscle strength, balance and mobility is fundamental to maintaining independence in activities of daily living (ADL). The physical activity level of most nursing home residents is very low, which implies that they are often subject to a decline in health, mobility, autonomy and social contacts and are also at risk of suffering a decline in mental well-being. In a previous study, we demonstrated that transfers, balance and physical activity level improved after 3 months of individually tailored intervention in nursing home residents. Objective: To evaluate the long-term effects on ADL, balance function, physical activity level, physical performance, falls related self-efficacy, well-being and cognitive function 3 months after the completion of our intervention in nursing home residents. Methods: The study was a multicenter randomized, controlled clinical trial with a parallel-group design. It was conducted in nursing homes in Sweden, Norway and Denmark, with an intervention period lasting 3 months and a follow-up at 6 months. Initially, 322 nursing home residents with a mean age of 85 years were included; 85 from Sweden, 171 from Norway and 66 from Denmark. Of these, 241 [129 intervention group (IG), 112 control group (CG)] were eligible for the 6-month follow-up tests. The level of dependence in ADL, physical activity level, several dimensions of physical function, well-being, falls-related self-efficacy and cognitive function were assessed with reliable and valid instruments at baseline, immediately after 3 months of intervention and 3 months later at the 6-month follow-up.Results: After 3 months of intervention and an additional period of 3 months without intervention, only the following 2 variables demonstrated significant group differences: social and cognitive function, measured by the Functional Independence Measure n-r, where the IG deteriorated while the CG was almost stable. However, regarding transfers, the IG deteriorated significantly less than the CG. Conclusion: Without supervised physical exercise that challenged the individuals' capability, gains in ADL function, balance and transfer ability deteriorated during the 3 months following the intervention period. Thus, continuous, individually adjusted and supported physical activity seems crucial for the maintenance of physical functions in these vulnerable elderly persons.
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| 3. |
- Hellström, Ann, 1959, et al.
(författare)
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Extreme prematurity, treated retinopathy, bronchopulmonary dysplasia and cerebral palsy are significant risk factors for ophthalmological abnormalities at 6.5years of age
- 2018
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 107:5, s. 811-821
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study evaluated the contributions of various prenatal and postnatal predictive factors to a documented high prevalence of ophthalmological abnormalities in children aged 6.5 years who were born extremely preterm. Methods: We carried out a prospective population-based study of all children born in Sweden at a gestational age of 22+0 to 26+6weeks based on the Extremely Preterm Infants in Sweden Study. The main outcome measures were a combined score of visual impairment, refractive errors and strabismus at 6.5years of age. Models of univariate and multivariable regression were used to analyse potential prenatal and postnatal predictive factors at different clinically relevant time-points from one minute after birth to 30months. Results: We focused on 399 known extremely preterm survivors and compared them to 300 full-term controls. Significant antecedents for ophthalmological abnormalities included prematurity per se, retinopathy of prematurity that required treatment, severe bronchopulmonary dysplasia and cerebral palsy. Severe intraventricular haemorrhage was no longer a significant risk factor when we adjusted it for the 30-month cognitive and neuromotor development outcomes. Conclusion: This time-course risk analysis model showed a changing panorama of significant risk factors for ophthalmological abnormalities in children aged 6.5years who were born extremely preterm.
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| 4. |
- Adolfsson, Hans, et al.
(författare)
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Betyg i högre utbildning
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- SUHF:s arbetsgrupp för betygsfrågor har varit verksam under perioden 1 mars 2014 – 31 december 2015. Uppdraget har varit att undersöka behovet av betygssystem med fler betygs-steg i högskolan mot bakgrund av den konkurrenssituation som en internationaliserad utbildnings- och arbetsmarknad medför. Uppdraget har också varit att sprida erfarenheter kring flergradiga betygsskalor inkluderande både nationella erfarenheter och exempel från andra europeiska länder. Arbetsgruppen har också uppmanats att föreslå rekommendationer om betygssystem till SUHF:s medlemslärosäten. Arbetsgruppen har främst inhämtat underlag genom intervjuer, en enkät till lärosätena och Ladok-statistik omfattande drygt tre miljoner betygssättningar som renderat godkända betyg över en period av tre år. Resultatet av utredningen visar att svenska lärosäten har en stark tradition av målrelaterad betygssättning som samtliga involverade i utredningen upplever som positiv och viktig att bevara, oavsett antal grader i betygsskalan. Gruppens arbete bekräftar att det finns olika problem med de svenska betygssystemen ur ett internationaliseringsperspektiv. Det går dock inte att säga att det finns någon tydlig samsyn mellan lärosätena om exakt vilka dessa problem är eller hur stora de anses vara. Det är svårt att entydigt koppla problemen till valet av betygsskala. Det finns också andra faktorer för valet av betygsskala som verkar väga minst lika tungt som internationaliseringsperspektivet och som gör att lärosäten inte inför betygsskalor med fler grader. Utredningen visar vidare att flera olika betygssystem används i svensk högskola och heterogeniteten framträder som betydande, såväl mellan lärosäten som inom ett lärosäte. Det finns starka ämnesmässiga traditioner och god argumentation kring enskilda lärosätens val av skala men nationellt saknas det gemensamma ramar för betygssättning, samordning och uppföljning. Huvudsakligen används fortfarande fågradiga betygsskalor i Sverige men 43% av alla betyg sätts numera i betygsskalor med minst tre godkända betygssteg. Ett antal lärosäten har de senaste tio åren gått över till en sjugradig skala för all utbildning eller för viss utbildning som riktar sig till en internationell målgrupp. Under perioden 2011−2014 är A–F-skalan den enda betygsskala som ökat i omfattning medan exempelvis användningen av G–U-skalan minskat med 18,5 %. Att ha en flergradig betygsskala ses som positivt ur flera aspekter: det underlättar internationellt studentutbyte, det kommunicerar tydligare utbildnings-resultaten och är ett bättre instrument för urval för både vidare utbildning och rekrytering på arbetsmarknaden. Flergradiga betyg ställer höga krav på tydliga betygskriterier och genom-tänkta pedagogiska metoder för målrelaterad bedömning. Flera av de problem som rapporten påvisar skulle kunna lösas genom att en gemensam nationell flergradig betygsskala implementerades. I nuläget bedömer arbetsgruppen dock inte att det är realistiskt att rekommendera detta. De svenska lärosätena använder flera olika betygsskalor. De problem fågradiga betyg kan skapa för internationellt studentutbyte verkar upp-vägas av andra värden för många lärosäten. Ett relativt stort antal lärosäten har redan valt att införa en sjugradig betygsskala för utbildning med internationell inriktning. Ett önskemål som lyfts fram i flera enkätsvar och intervjuer är att ett meritvärde eller betyg för hel utbildning, motsvarande grade point average (GPA) införs. GPA upplevs fungera väl för internationell jämförelse. Ladok-statistiken visar på skillnader mellan lärosätena i användningen av betygsskalorna som – åtminstone i avsaknad av fördjupat underlag – ter sig anmärkningsvärt stora. Dessa skillnader bör ses mot bakgrund av att betygssättning är myndighetsutövning och att betyg är ett myndighetsbeslut som studenterna inte kan överklaga. Undersökningen visar på stora skillnader i betygsfördelningen mellan olika betygsskalor även då antalet steg är identiska (5-U respektive AB-U). Det gäller även inom en och samma betygsskala såväl mellan lärosäten som inom lärosäten. Andelen studenter som exempelvis får högsta betyg kan skilja stort. Stickprov inom lärosäten visar på samma variationer i betygssättningen mellan olika kurser. Det finns också en genusskillnad, dock liten. En bättre uppföljning med årlig betygsstatistik kunde införas, dels för alla lärosäten för att ge en nationell överblick och nationella betygsutfall för varje betygsskala, dels för vissa specifika ämnesområden för att kunna jämföra betygsutfall t ex i större utbildningsprogram som ges vid många lärosäten, såsom juristprogrammet, ingenjörsutbildning, lärarutbildning, psykologutbildning, ekonomiutbildning, socionomutbildning. Sådant underlag skulle stimulera till utveckling av examination och bedömning inom högskolan. Arbetsgruppen föreslår därför att.....
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| 5. |
- Agreus, Lars, et al.
(författare)
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Towards a healthy stomach? : Helicobacter pylori prevalence has dramatically decreased over 23 years in adults in a Swedish community
- 2016
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Ingår i: United European Gastroenterology journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 4:5, s. 686-696
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Tidskriftsartikel (refereegranskat)abstract
- Background In Western countries the prevalence of Helicobacter pylori (H. pylori) infection may be declining but there is a lack of recent longitudinal population studies. We evaluated the changing epidemiology over a 23-year period in Sweden.Materials and methods In 1989, the validated Abdominal Symptom Questionnaire (ASQ) was mailed to a random sample of inhabitants (ages 22-80 years) in a Swedish community, and 1097 (87%) responded. H. pylori serology was analysed in a representative subsample (n=145). Twenty-three years later, the ASQ was mailed again using similar selection criteria, and 388 out of 1036 responders had an upper endoscopy with assessment of H. pylori and corpus atrophy status.Results The prevalence of positive H. pylori serology decreased from 37.9% (1989) to 15.8% (2012), corresponding to a decrease in odds of 75% per decade (odds ratio (OR): 0.25; 95% confidence interval (CI): 0.11-0.59, p=0.001) independent of age, gender, body mass index (BMI) and level of education, with a pattern consistent with a birth cohort effect. The prevalence increased with increasing age (p=0.001). The prevalence of H. pylori on histology in 2012 was 11.4% (95% CI 8.6-15.0). The prevalence of corpus atrophy on serology and/or histology in 2012 was 3.2% (95% CI 1.8-5.5); all cases were 57 years old.Conclusion The stomach is healthier in 2012 compared with 1989. H. pylori prevalence in adults has decreased over the last two decades to a level where clinical management might be affected.
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| 6. |
- Ahlström, Isabell, et al.
(författare)
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Reliability of the Swedish version of the Exercise Self-Efficacy Scale (S-ESES) : a test-retest study in adults with neurological disease
- 2015
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 31:3, s. 194-199
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the test-retest reliability of the Swedish translated version of the Exercise Self-Efficacy Scale (S-ESES) in people with neurological disease and to examine internal consistency. Design: Test-retest study.Subjects: A total of 30 adults with neurological diseases including: Parkinson's disease; Multiple Sclerosis; Cervical Dystonia; and Charcot Marie Tooth disease.Method: The S-ESES was sent twice by surface mail. Completion interval mean was 16 days apart. Weighted kappa, intraclass correlation coefficient 2,1 [ICC (2,1)], standard error of measurement (SEM), also expressed as a percentage value (SEM%), and Cronbach's alpha were calculated.Results: The relative reliability of the test-retest results showed substantial agreement measured using weighted kappa (MD = 0.62) and a very high-reliability ICC (2,1) (0.92). Absolute reliability measured using SEM was 5.3 and SEM% was 20.7. Excellent internal consistency was shown, with an alpha coefficient of 0.91 (test 1) and 0.93 (test 2).Conclusion: The S-ESES is recommended for use in research and in clinical work for people with neurological diseases. The low-absolute reliability, however, indicates a limited ability to measure changes on an individual level.
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| 7. |
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| 8. |
- Andersson, Ola, et al.
(författare)
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Effect of Delayed Cord Clamping on Neurodevelopment at 4 Years of Age : A Randomized Clinical Trial
- 2015
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Ingår i: JAMA pediatrics. - : American Medical Association (AMA). - 2168-6203 .- 2168-6211. ; 169:7, s. 631-638
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Prevention of iron deficiency in infancy may promote neurodevelopment. Delayuci umbilical cord clamping (CC) prevents iron deficiency at 4 to 6 months of age, but long-term effects after 12 months of age have not been reported. OBJECTIVE To investigate the effects of delayed CC compared with early CC on neurodevelopment at 4 years of age. DESIGN, SETTING, AND PARTICIPANTS Follow-up of a randomized clinical trial conducted from April 16, 2008, through May 21, 2010, at a Swedish county hospital. Children who were included in the original study (n = 382) as full-term infants born after a low-risk pregnancy were invited to return for follow-up at 4 years of age. Wechsler Preschool and Primary Scale of Intelligence (WPPSI-111) and Movement Assessment Battery for Children (Movement ABC) scores (collected between April 18, 2012, and July 5, 2013) were assessed by a blinded psychologist. Between April 11, 2012, and August 13, 2013, parents recorded their child's development using the Ages and Stages Questionnaire, Third Edition (ASQ) and behavior using the Strengths and Difficulties Questionnaire. All data were analyzed by intention to treat. INTERVENTIONS Randomization to delayed CC (>= 180 seconds after delivery) or early CC (<= 10 seconds after delivery). MAIN OUTCOMES AND MEASURES The main outcome was full-scale IQ as assessed by the were development as assessed by the scales from the WPPSI-III and Movement ABC, development as recorded using the ASQ, and behavior using the Strengths and Difficulties Questionnaire. RESULTS We assessed 263 children (68.8%). No differences were found in WPPSI-III scores between groups. Delayed CC improved the adjusted mean differences (AMDs) in the ASQ personal-social (AMD, 2.8; 95% Cl, 0.8-4.7) and fine-motor (AMD, 2.1; 95% Cl, 0.2-4.0) domains and the Strengths and Difficulties Questionnaire prosocial subscale (AMD, 0.5; 95% Cl, >0.0-0.9). Fewer children in the delayed-CC group had results below the cutoff in the ASQ fine-motor domain (11.0% vs 3.7%; P =.02) and the Movement ABC bicycle-trail task (12.9% vs 3.8%; P =.02). Boys who received delayed CC had significantly higher AMDs in the WPPSI-III processing-speed quotient (AMD, 4.2; 95% Cl, 0.8-7.6; P =.02), Movement ABC bicycle-trail task (AMD, 0.8; 95% Cl, 0.1-1.5; P =.03), and fine-motor (AMD, 4.7; 95% Cl, 1.0-8.4; P =.01) and personal-social (AMD, 4.9; 95% Cl, 1.6-8.3; P =.004) domains of the ASQ. CONCLUSIONS AND RELEVANCE Delayed CC compared with early CC improved scores in the fine-motor at 4 years of age, especially in boys, indicating that optimizing the time to CC may affect neurodevelopment in a low-risk population of children born in a high-income country.
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| 9. |
- Anens, Elisabeth, et al.
(författare)
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Exploratory Study of Physical Activity in Persons With Charcot-Marie-Tooth Disease
- 2015
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier BV. - 0003-9993 .- 1532-821X. ; 96:2, s. 260-268
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To explore and describe the perceived facilitators and barriers to physical activity, and to examine the physical activity correlates in people with Charcot-Marie-Tooth (CMT) disease. Design: Cross-sectional survey study. Setting: Community-living subjects. Participants: Swedish people with CMT disease (N=44; men, 54.5%; median age, 59.5y [interquartile range, 45.3-64.8y]). Interventions: Not applicable. Main Outcome Measures: The survey included open-ended questions and standardized self-reported scales measuring physical activity, fatigue, activity limitation, self-efficacy for physical activity, fall-related self-efficacy, social support, and enjoyment of physical activity. Physical activity was measured by the Physical Activity Disability Survey-Revised. Results: Qualitative content analysis revealed that personal factors such as fatigue, poor balance, muscle weakness, and pain were important barriers for physical activity behavior. Facilitators of physical activity were self-efficacy for physical activity, activity-related factors, and assistive devices. Multiple regression analysis showed that self-efficacy for physical activity (beta=.41) and fatigue (beta=-.30) explained 31.8% of the variation in physical activity (F-2,F-40=10.78, P=.000). Conclusions: Despite the well-known benefits of physical activity, physical activity in people with CMT disease is very sparsely studied. These new results contribute to the understanding of factors important for physical activity behavior in people with CMT disease and can guide health professionals to facilitate physical activity behavior in this group of patients. (C) 2015 by the American Congress of Rehabilitation Medicine
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| 10. |
- Anens, Elisabeth, et al.
(författare)
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Self-reported physical activity correlates in Swedish adults with multiple sclerosis : a cross-sectional study
- 2017
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: The benefits of physical activity in persons with Multiple Sclerosis (MS) are considerable. Knowledge about factors that correlate to physical activity is helpful in order to develop successful strategies to increase physical activity in persons with MS. Previous studies have focused on correlates to physical activity in MS, however falls self-efficacy, social support and enjoyment of physical activity are not much studied, as well as if the correlates differ with regard to disease severity. The aim of the study was to examine associations between physical activity and age, gender, employment, having children living at home, education, disease type, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, social support and enjoyment of physical activity in a sample of persons with MS and in subgroups with regard to disease severity.Methods: This is a cross-sectional survey study including Swedish community living adults with MS, 287 persons, response rate 58.2%. The survey included standardized self-reported scales measuring physical activity, disease severity, fatigue, self-efficacy for physical activity, falls self-efficacy, and social support. Physical activity was measured by the Physical Activity Disability Survey – Revised.Results: Multiple regression analyzes showed that 59% (F(6,3)=64.9, p=0.000) of the variation in physical activity was explained by having less severe disease (β=-0.30), being employed (β=0.26), having high falls self-efficacy (β=0.20), having high self-efficacy for physical activity (β=0.17), and enjoying physical activity (β=0.11). In persons with moderate/severe MS, self-efficacy for physical activity explained physical activity.Conclusions: Consistent with previous research in persons with MS in other countries this study shows that disease severity, employment and self-efficacy for physical activity are important for physical activity. Additional important factors were falls self-efficacy and enjoyment. More research is needed to confirm this and the subgroup differences.
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