| 1. |
- Johansson, Annica E M, et al.
(författare)
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Participation in the workforce after a traumatic brain injury : a matter of control
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:5, s. 423-432
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study sought to explore individual experience in developing a mastery of daily activities and roles after a traumatic brain injury (TBI) with the objective of returning to work.METHOD: Eight 30-60-year-old men, employed at the time of injury, were each interviewed three times over a 6-month period. Ten to 21 months after the injuries, four participants had returned to work at least part time. Grounded theory was adapted for analyses.RESULTS: A single core category emerged: a desire for control: focusing on high-priority issues. Still, 2 years after injury, the participants were uncertain about their abilities with respect to what was expected of them at work. They felt they would do better as time progressed.CONCLUSIONS: The participants' uncertainty about their efficacy cast doubt on their beliefs in improving their skills, balancing daily activities and work. They wondered about the sustainability of their health and efficacy at work. Wanting to control their own improvement, the participants asked for counselling in strategies and techniques to help with their progress. This issue could be taken into account in follow-up rehabilitation programmes. Additionally, the workplace might be the ideal context in which to develop the structures and routines necessary to master life in general. Implications for Rehabilitation Two years after injury, the participants remained uncertain about their abilities with respect to what was expected of them at work. The participants felt they would do better as time progressed. The participants, wanting to control their own improvement, sought counselling to help sort out their priorities and found it could contribute to help with their progress in finding a suitable balance between daily activities and work. A consequence of our main finding, in a multidisciplinary context, is that counselling in structures and routines with respect to work-related tasks should be considered to be an integral part of any rehabilitation programme after TBI.
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| 2. |
- Ward, Heather A., et al.
(författare)
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Measured adiposity in relation to head and neck cancer risk in the European Prospective Investigation into Cancer and Nutrition
- 2017
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Ingår i: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. - : AMER ASSOC CANCER RESEARCH. - 1538-7755 .- 1055-9965. ; 26:6, s. 895-904
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer (HNC). However, most studies have used self-reported anthropometry which is prone to error.METHODS: Among 363 094 participants in the European Prospective Investigation into Cancer and Nutrition study (EPIC) with measured anthropometry, there were 837 incident cases of HNC. HNC risk was examined in relation to body mass index (BMI) [lean: < 22.5 kg/m2, normal weight (reference): 22.5-24.9 kg/m2, overweight 25-29.9 kg/m2, obese: > 30 kg/m2], waist circumference (WC), hip circumference (HC) and waist to hip ratio (WHR) using Cox proportional hazards models.RESULTS: Among men, a BMI < 22.5 kg/m2 was associated with higher HNC risk [hazard ratio (HR) 1.62, 95% confidence interval (CI) 1.23 - 2.12)]; BMI was not associated with HNC among women. WC and WHR were associated with greater risk of HNC among women, (WC per 5 cm: HR 1.08, 95% CI 1.02 - 1.15; WHR per 0.1 unit: HR 1.64, 95% CI 1.38 - 1.93). After stratification by smoking status, the association for WHR was present only among smokers (p interaction 0.004). Among men, WC and WHR were associated with HNC only upon additional adjustment for BMI (WC per 5 cm: HR 1.16, 95% CI 1.07 - 1.26; WHR per 0.1 unit: HR 1.42, 95% CI 1.21 - 1.65).CONCLUSION: Central adiposity, particularly among women, may have a stronger association with HNC risk than previously estimated.IMPACT: Strategies to reduce obesity may beneficially impact HNC incidence.
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| 3. |
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| 4. |
- Ali, Imran, et al.
(författare)
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Exposure to polychlorinated biphenyls and prostate cancer : population-based prospective cohort and experimental studies
- 2016
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Ingår i: Carcinogenesis. - : Oxford University Press. - 0143-3334 .- 1460-2180. ; 37:12, s. 1144-1151
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Tidskriftsartikel (refereegranskat)abstract
- Polychlorinated biphenyls (PCBs) are highly persistent environmental pollutants and are undesirable components of our daily food. PCBs are classified as human carcinogens, but the evidence for prostate cancer is limited and available data are inconsistent. We explored the link between non-dioxin-like PCB and grade of prostate cancer in a prospective cohort as well as in cell experiments. A population-based cohort of 32496 Swedish men aged 45-79 years was followed prospectively through 1998-2011, to assess the association between validated estimates of dietary PCB exposure and incidence of prostate cancer by grade (2789 cases, whereof 1276 low grade, 756 intermediate grade, 450 high grade) and prostate cancer mortality (357 fatal cases). In addition, we investigated a non-dioxin-like PCB153-induced cell invasion and related markers in normal prostate stem cells (WPE-stem) and in three different prostate cancer cell lines (PC3, DU145 and 22RV1) at exposure levels relevant to humans. After multivariable-adjustment, dietary PCB exposure was positively associated with high-grade prostate cancer, relative risk (RR) 1.35 [95% confidence interval (CI): 1.03-1.76] and with fatal prostate cancer, RR 1.43 (95% CI: 1.05-1.95), comparing the highest tertile with the lowest. We observed no association with low or intermediate grade of prostate cancer. Cell invasion and related markers, including MMP9, MMP2, Slug and Snail, were significantly increased in human prostate cancer cells as well as in prostate stem cells after exposure to PCB153. Our findings both from the observational and experimental studies suggest a role of non-dioxin-like PCB153 in the development of high-grade and fatal prostate cancer.
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| 5. |
- Anantharaman, Devasena, et al.
(författare)
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Combined effects of smoking and HPV16 in oropharyngeal cancer
- 2016
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Ingår i: International Journal of Epidemiology. - : Oxford University Press (OUP). - 0300-5771 .- 1464-3685. ; 45:3, s. 752-761
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although smoking and HPV infection are recognized as important risk factors for oropharyngeal cancer, how their joint exposure impacts on oropharyngeal cancer risk is unclear. Specifically, whether smoking confers any additional risk to HPV-positive oropharyngeal cancer is not understood.Methods: Using HPV serology as a marker of HPV-related cancer, we examined the interaction between smoking and HPV16 in 459 oropharyngeal (and 1445 oral cavity and laryngeal) cancer patients and 3024 control participants from two large European multicentre studies. Odds ratios and credible intervals [CrI], adjusted for potential confounders, were estimated using Bayesian logistic regression.Results: Both smoking [odds ratio (OR [CrI]: 6.82 [4.52, 10.29]) and HPV seropositivity (OR [CrI]: 235.69 [99.95, 555.74]) were independently associated with oropharyngeal cancer. The joint association of smoking and HPV seropositivity was consistent with that expected on the additive scale (synergy index [CrI]: 1.32 [0.51, 3.45]), suggesting they act as independent risk factors for oropharyngeal cancer.Conclusions: Smoking was consistently associated with increase in oropharyngeal cancer risk in models stratified by HPV16 seropositivity. In addition, we report that the prevalence of oropharyngeal cancer increases with smoking for both HPV16-positive and HPV16-negative persons. The impact of smoking on HPV16-positive oropharyngeal cancer highlights the continued need for smoking cessation programmes for primary prevention of head and neck cancer.
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| 6. |
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| 7. |
- Bertilsson, Ann Sofie, et al.
(författare)
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A cluster randomized controlled trial of a client-centred, activities of daily living intervention for people with stroke : One year follow-up of caregivers
- 2016
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 30:8, s. 765-775
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Compare caregiver burden, provision of informal care, participation in everyday occupations and life satisfaction of caregivers to people with stroke, who either had received a client-centred, activities of daily living intervention or usual activities of daily living interventions. Design: A multicentre cluster randomized controlled trial in which 16 rehabilitation units were randomly assigned to deliver a client-centred, activities of daily living intervention or usual activities of daily living interventions. Caregiver outcomes were compared cross-sectionally at 12 months and changes in outcomes between three and 12 months after people with stroke were included in the study. Setting: Inpatient and outpatient rehabilitation. Participants: Caregivers of people with stroke enrolled in the trial. Intervention: A client-centred, activities of daily living intervention aiming to increase agency in daily activities and participation in everyday life for people after stroke. Main measures: Caregiver Burden Scale, Occupational Gaps Questionnaire, LiSat-11. Results: There were no differences in outcomes between caregivers in the client-centred, activities of daily living (n = 88) and the usual activities of daily living (n = 95) group at 12 months. The caregiver burden score was 42.7 vs. 41.8, p = 0.75, mean occupational gaps were 3.5 vs. 4.0, p = 0.52 and satisfaction with life was 53% vs. 50%, p = 0.87. There were no differences in changes between three and 12 months. However, within groups there were significant differences in caregiver burden, factor general strain, for caregivers in the client-centred, activities of daily living group, and in provision of informal care for the usual activities of daily living group. Conclusion: The client-centred intervention did not bring about any difference between caregiver-groups, but within groups some difference was found for caregiver burden and informal care.
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| 8. |
- Bertilsson, Ann-Sofie, et al.
(författare)
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Client-centred ADL intervention after stroke : Significant others' experiences
- 2015
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 22:5, s. 377-386
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Tidskriftsartikel (refereegranskat)abstract
- Background: Client-centredness is a prominent contemporary concept in rehabilitation. However, there is a lack of knowledge on if and how a client-centred rehabilitation approach is incorporated in the everyday life of significant others of people who receive such rehabilitation. Objective: Explore and describe if and how a client-centred ADL intervention (CADL) was integrated in the everyday lives of significant others of people with stroke. Materials and methods: Qualitative longitudinal design, with a grounded theory approach. Seven significant others, who cohabited with persons receiving a CADL intervention, were interviewed during the first year. Findings: One core category was identified: "Taking responsibility and achieving balance with respect to self-esteem in order to get on with everyday life". The integration of the CADL was a process. A key aspect was that as the person with stroke acted upon his/her own desired activity goals the significant others were encouraged to act on their own needs. Conclusions: Enablement is important also for the significant others of people with stroke. One way of enabling significant others to maintain an active lifestyle and find respite in everyday life might be to enable people with stroke to formulate and act upon their desired activity goals.
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| 9. |
- Blomberg, Karin, 1970-, et al.
(författare)
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Work stress among newly graduated nurses in relation to workplace and clinical group supervision
- 2016
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Ingår i: Journal of Nursing Management. - : Wiley-Blackwell Publishing Ltd.. - 0966-0429 .- 1365-2834. ; 24:1, s. 80-87
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate occupational stress among newly graduated nurses in relation to the workplace and clinicla group supervision. Being a newly graduated nurse is particulary stressful. Whar remains unclear is wehter teh workplace and clinical group supervision affect the stress. A cross-sectional comperative study was performed. Data were collected by means of a numerical scale measuring occupational stress, questions about workplace and clinicla group supervision. One hundred and thirteen nusres were included in the study. Conclusions: Newly graduated nurses experience great strss and need support. Nusrse participating in clinical group supervision reported significantly less stress.
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| 10. |
- Byström, Gustaf, et al.
(författare)
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GIS-based methods for sustainable wind power planning
- 2017
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Konferensbidrag (refereegranskat)abstract
- Research motivationRenewable energy has great importance in the work to counteract the global climate changes. The Swedish government has seta target that in 2020, 50% of the energy use shall come from renewable energy, and the government has also declared a longterm commitment for Sweden to be independent of fossil fuels. To reach these targets wind power is expected to play a greatpart, and approximately 50 TWh of new wind power is needed to meet this objective, compared to the current annual production of approximately 16 TWh. However, climate change is not the only issue at hand, and there is a risk of conflicts between meetingthe targets for renewable energy and other sustainability objectives, e.g. concerning ecosystem services, such as habitatsupporting biodiversity, recreation and cultural landscapes. Hence to steer towards a sustainable planning of wind power, targets and objectives as well as decision support has to be dealt with systematically, encompassing social, economic, technical and ecological perspectives.ObjectiveThe objective of the project is to develop GIS-based methods that can be used as planning support in sustainable planning of wind power, in cooperation with regional and municipal actors. The method will function as decision support, which will helpplanners and decision makers at local and regional level to systematically handle the different aspects related to wind power localisation.MethodologyThe project is performed in collaboration with the County Administrative Board of Västernorrland County, which is the study areafor the project. Initially, a literature study is performed to gain knowledge about earlier research in the field and identify importantfactors to include in the methodology. Workshops are held with the included actors, to gain further understanding of what information is relevant when planning for wind power, and to gain local knowledge about the study area; what issues are at hand,and what factors govern wind power planning in the particular area. During the workshops different scenarios related to theplanning process are also developed. The method will include the development of a number of GIS-models to be used in a multicriteria analysis that can be used for design and evaluation of the different planning scenarios.Preliminary resultsThe literature study as well as the workshops reveals that the location of wind turbines often can have impact on, and render conflict between, different interests and objectives. Factors of high concern when planning for locating wind turbines in the County of Västernorrland are, besides wind speed and technical considerations; noise impact, visual impact, and impact on certain bird species, reindeer hearding and recreation. In order to handle these factors, multi-criteria decision analysis within a GIS environment can support planning in the face of complex problems, with capabilities to handle multiple and often conflicting objectives, and to find sustainable solutions to decision-making problems.Management implicationsThe project will result in a General GIS-based Planning Support (GPS) methodology to integrate important sustainability issuesin wind power planning, which can be applied generally in future spatial planning. The project will contribute to a morepredictable planning process, where disparate sustainability targets will be handled in an integrated and systematic way, therebyincreasing the possibility of reaching the targets.
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| 11. |
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| 12. |
- Bäck, Maria, et al.
(författare)
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Home-based supervised exercise versus hospital-based supervised exercise or unsupervised walk advice as treatment for intermittent claudication : a systematic review.
- 2015
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 47:9, s. 801-808
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effects of home-based supervised exercise vs hospital-based supervised exercise, and the effects of home-based supervised exercise vs unsupervised "go home and walk advice" on daily life and corridor-walking capacity, health-related quality of life and patient-reported functional walking capacity in patients with intermittent claudication.DATA SOURCES: Systematic literature searches were conducted in PubMed, EMBASE, ProQuest, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), the Cochrane Library, and a number of Health Technology Assessment (HTA)-databases in October 2014.STUDY SELECTION: Randomized controlled trials and non-randomized controlled trials (> 100 patients) were considered for inclusion.DATA EXTRACTION: Data extraction and risk of bias assessment was performed independently and discussed in meetings.DATA SYNTHESIS: Seven randomized controlled trials and 2 non-randomized controlled studies fulfilled the inclusion criteria. The included studies had some, or major, limitations.CONCLUSION: Based on a low quality of evidence, home-based supervised exercise may lead to less improvement in maximum and pain-free walking distance, and in more improvement in daily life walking capacity, compared with hospital-based supervised exercise. Home-based supervised exercise may improve maximum and pain-free walking distance compared with "go home and walk advice" and result in little or no difference in health-related quality of life and functional walking capacity compared with hospital-based supervised exercise or "go home and walk advice". Further research is needed to establish the optimal exercise modality for these patients.
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| 13. |
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| 14. |
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| 15. |
- de Wit, Cynthia A., et al.
(författare)
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Mass balance study of brominated flame retardants in female captive peregrine falcons
- 2019
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Ingår i: Environmental Science-Processes & Impacts. - : Royal Society of Chemistry (RSC). - 2050-7887 .- 2050-7895. ; 21:7, s. 1115-1131
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about brominated flame retardant (BFR) dynamics in birds, especially large molecules such as decabromodiphenyl ether (BDE-209). In particular, bioaccumulation from food and transfer dynamics to eggs are poorly understood. Therefore, an input-output mass balance study of tri-decaBDEs, DBDPE and HBCDD was performed in three female peregrine falcons from a captive breeding program by analyzing their naturally contaminated food (quail, chicken (cockerels)), plasma, feces and eggs. Predominant BFRs in cockerels and quail were BDE-209 and DBDPE, as well as HBCDD in quail. The predominant BFRs found in falcon plasma were BDE-209, -153 and -183, in eggs, HBCDD, BDE-209 and -153 and in feces, BDE-209. Mean absorption efficiencies (AE) for the tetra-octabrominated BDEs ranged from 84-100% and 70% for HBCDD. The AEs for BDE-206, -207, -208 and -209 varied due to the large variability seen for feces fluxes. All egg/plasma ratios for BDEs were similar and greater than one (range 1.1-2.7), including for BDE-209, indicating efficient transfer from females to the eggs. Excretion via egg-laying was approximately 6.0-29% of the initial, pre-breeding body burden of individual penta-decaBDE congeners, (15-45% for BDE-206). HBCDD was not detected in plasma but was found in eggs, also indicating efficient transfer and excretion via eggs. Input fluxes from food exceeded the output fluxes (feces, eggs) indicating considerable metabolism for tetra-octaBDEs, possibly also for the nona-decaBDEs and HBCDD. Bioaccumulation factors calculated from lipid weight concentrations in plasma and food (BAF(p)) were highest for BDE-208 (31), -153 (23), -209 (19) and -207 (16) and from eggs and food (BAF(e)), were highest for HBCDD (140), BDE-153 (41), -208 (42), BDE-207 (24) and BDE-209 (21). BAF(e) and BAF(p) values were below 10 for BDE-47, -99 and -100. For one falcon, egg results were available from three different years and estimated half-lives were 65 d (BDE-99), 624 d (BDE-153), 31 d (BDE-154), 349 d (BDE-183), 77 d (BDE-196) and 89 d (BDE-197).
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| 16. |
- Ding, Ming, et al.
(författare)
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Dairy consumption, systolic blood pressure, and risk of hypertension : Mendelian randomization study
- 2017
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Ingår i: The BMJ. - : BMJ Publishing Group Ltd. - 1756-1833 .- 0959-8138. ; 356
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. DESIGN Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable. SETTING CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium. PARTICIPANTS Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis. MAIN OUTCOME MEASURES The instrumental variable estimation was conducted using the ratio of coefficients approach. Using metaanalysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized. RESULTS Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P<0.001) and was not associated with systolic blood pressure (0.31, 95% confidence interval -0.05 to 0.68 mm Hg; P=0.09) or risk of hypertension (odds ratio 1.01, 95% confidence interval 0.97 to 1.05; P=0.27). Using LCT-13910 rs4988235 as the instrumental variable, genetically determined dairy consumption was not associated with systolic blood pressure (beta=1.35, 95% confidence interval -0.28 to 2.97 mm Hg for each serving/day) or risk of hypertension (odds ratio 1.04, 0.88 to 1.24). Moreover, meta-analysis of the published clinical trials showed that higher dairy intake has no significant effect on change in systolic blood pressure for interventions over one month to 12 months (intervention compared with control groups: beta=-0.21, 95% confidence interval -0.98 to 0.57 mm Hg). In observational analysis, each serving/day increase in dairy consumption was associated with -0.11 (95% confidence interval -0.20 to -0.02 mm Hg; P=0.02) lower systolic blood pressure but not risk of hypertension (odds ratio 0.98, 0.97 to 1.00; P=0.11). CONCLUSION The weak inverse association between dairy intake and systolic blood pressure in observational studies was not supported by a comprehensive instrumental variable analysis and systematic review of existing clinical trials.
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| 17. |
- Dolinska, Monika, et al.
(författare)
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Leukotriene signaling via ALOX5 and cysteinyl leukotriene receptor 1 is dispensable for in vitro growth of CD34+CD38- stem and progenitor cells in chronic myeloid leukemia
- 2017
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Ingår i: Biochemical and Biophysical Research Communications. - : Elsevier BV. - 0006-291X .- 1090-2104. ; 490:2, s. 378-384
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Tidskriftsartikel (refereegranskat)abstract
- Tyrosine kinase inhibitors targeting the BCR-ABL oncoprotein in chronic myeloid leukemia (CML) are remarkably effective inducing deep molecular remission in most patients. However, they are less effective to eradicate the leukemic stem cells (LSC), resulting in disease persistence. Therefore, there is great need to develop novel therapeutic strategies to specifically target the LSC. In an experimental mouse CML model system, the leukotriene pathway, and specifically, the expression ALOX5, encoding 5-lipoxygenase (5-LO), has been reported as a critical regulator of the LSC. Based on these results, the 5-LO inhibitor zileuton has been introduced in clinical trials as a therapeutic option to target the LSC although its effect on primary human CML LSC has not been studied. We have here by using multiplex single cell PCR analyzed the expression of the mediators of the leukotriene pathway in bone marrow (BM) BCR-ABL+CD34+CD38- cells at diagnosis, and found low or undetectable expression of ALOX5. In line with this, zileuton did not exert significant overall growth inhibition in the long-term culture-initiating cell (LTC-IC) and colony (CFU-C) assays of BM CD34+CD38- cells from 7 CML patients. The majority of the single leukemic BCR-ABL +CD34+CD38- cells expressed cysteinyl leukotriene receptors CYSLT1 and CYSLT2. However, montelukast, an inhibitor of CYSLT1, also failed to significantly suppress CFU-C and LTC-IC growth. These findings indicate that targeting ALOX5 or CYSLT1 signaling with leukotriene antagonists, introduced into the clinical practice primarily as prophylaxis and treatment for asthma, may not be a promising pharmacological strategy to eradicate persisting LSC in CML patients.
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| 18. |
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| 19. |
- Dreij, Kristian, et al.
(författare)
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Cancer Risk Assessment of Airborne PAHs Based on in Vitro Mixture Potency Factors
- 2017
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Ingår i: Environmental Science and Technology. - : American Chemical Society (ACS). - 0013-936X .- 1520-5851. ; 51:15, s. 8805-8814
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Tidskriftsartikel (refereegranskat)abstract
- Complex mixtures of polycyclic aromatic hydrocarbons (PAHs) are common environmental pollutants associated with adverse human health effects including cancer. However, the risk of exposure to mixtures is difficult to estimate, and risk assessment by whole mixture potency evaluations has been suggested. To facilitate this, reliable in vitro based testing systems are necessary. Here, we investigated if activation of DNA damage signaling in vitro could be an endpoint for developing whole mixture potency factors (MPFs) for airborne PAHs. Activation of DNA damage signaling was assessed by phosphorylation of Chid and H2AX using Western blotting. To validate the in vitro approach, potency factors were determined for seven individual PAHs which were in very good agreement with established potency factors based on cancer data in vivo. Applying the method using Stockholm air PAH samples indicated MPFs with orders of magnitude higher carcinogenic potency than predicted by established in vivo-based potency factors. Applying the MPFs in cancer risk assessment suggested that 45.4 (6% of all) cancer cases per year in Stockholm are due to airborne PAHs. Applying established models resulted in <1 cancer case per year, which is far from expected levels. We conclude that our in vitro based approach for establishing MPFs could be a novel method to assess whole mixture samples of airborne PAHs to improve health risk assessment.
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| 20. |
- Ekstam, Lisa, et al.
(författare)
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The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke : a mixed methods study
- 2015
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.
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| 21. |
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| 22. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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Nurse teacher models in clinical education from the perspective of student nurses : A mixed method study
- 2015
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:12, s. 1289-1294
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses. Design and Settings: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design. Participants: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study. Methods: A questionnaire including the CLES + T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception. Results: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor. Conclusions: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students. (C) 2015 Elsevier Ltd. All rights reserved.
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| 23. |
- Gäddman Johansson, Richard, et al.
(författare)
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Developing Care Professionals : Changing Disability Services in Sweden
- 2018
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Ingår i: Professions & Professionalism. - : OsloMet - Oslo Metropolitan University. - 1893-1049. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- In Sweden, professionalization projects in disability care services are currently being undertaken in order to differentiate and establish a professional identity for professionals within care work. The aim of this paper was to analyse the experiences of care workers’ meaning of the professionalization process concerning their occupation and their occupational identity in relation to tasks they perform in front-line contacts with persons with intellectual and developmental disabilities at respite care service homes. Semi-structured interviews were conducted with ten care workers. The meaning of the professionalization projects is an ongoing process of a connected mission, meaning that the care work is performed in close contact with care receivers and that it takes place within an informal and free framework, predicated on a logic of possessing a particular kind of “care-feeling.”
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| 24. |
- Hellman, Therese, et al.
(författare)
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Return to work after stroke : Important aspects shared and contrasted by five stakeholder groups
- 2016
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Ingår i: Work. - 1051-9815 .- 1875-9270. ; 55:4, s. 901-911
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Poor co-operation between the various stakeholders underscores the need for reviewing important factors that facilitate return to work (RTW) after stroke. OBJECTIVE: To explore and describe important aspects expressed by Swedish stakeholders in the RTW process for persons post stroke and to contrast the stakeholders' aspects exploring different perspectives that may influence optimal RTW. METHODS: Data from seven focus group interviews with the stakeholders were analyzed using qualitative content analysis. RESULTS: Three main categories made up the findings; the prolonged RTW process, the need for extended knowledge, and the assessment of work ability in the RTW process. Despite the stakeholders' agreement on these important aspects, they presented divergent views of the categories, representing their diverse agendas. CONCLUSIONS: A stroke coordinator may remediate the stakeholders' divergent perspectives. The coordinator should be versed in stroke specific knowledge and in a person centered approach to inform the decision process regarding RTW, while finding optimal solutions within regulatory boundary conditions. A coordinator could increase collaboration of the various stakeholders, provide support and coordinate services for the client with stroke and the employer throughout the whole process facilitating RTW after stroke. Future studies are needed to confirm this proposal.
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| 25. |
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| 26. |
- Huang, Tao, et al.
(författare)
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Dairy Consumption and Body Mass Index Among Adults : Mendelian Randomization Analysis of 184802 Individuals from 25 Studies
- 2018
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Ingår i: Clinical Chemistry. - : Oxford University Press (OUP). - 0009-9147 .- 1530-8561. ; 64:1, s. 183-191
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Associations between dairy intake and body mass index (BMI) have been inconsistently observed in epidemiological studies, and the causal relationship remains ill defined.METHODS: We performed Mendelian randomization (MR) analysis using an established dairy intake-associated genetic polymorphism located upstream of the lactase gene (LCT-13910 C/T, rs4988235) as an instrumental variable (IV). Linear regression models were fitted to analyze associations between (a) dairy intake and BMI, (b) rs4988235 and dairy intake, and (c) rs4988235 and BMI in each study. The causal effect of dairy intake on BMI was quantified by IV estimators among 184802 participants from 25 studies.RESULTS: Higher dairy intake was associated with higher BMI (β = 0.03 kg/m2 per serving/day; 95% CI, 0.00–0.06; P = 0.04), whereas the LCT genotype with 1 or 2 T allele was significantly associated with 0.20 (95% CI, 0.14–0.25) serving/day higher dairy intake (P = 3.15 × 10−12) and 0.12 (95% CI, 0.06–0.17) kg/m2 higher BMI (P = 2.11 × 10−5). MR analysis showed that the genetically determined higher dairy intake was significantly associated with higher BMI (β = 0.60 kg/m2 per serving/day; 95% CI, 0.27–0.92; P = 3.0 × 10−4).CONCLUSIONS: The present study provides strong evidence to support a causal effect of higher dairy intake on increased BMI among adults.
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| 27. |
- Johansson, Anette, et al.
(författare)
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Prevalence of shoulder pain in Swedish flatwater kayakers and its relation to range of motion and scapula stability of the shoulder joint
- 2016
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Ingår i: Journal of Sports Sciences. - : Informa UK Limited. - 0264-0414 .- 1466-447X. ; 34:10, s. 951-958
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n=17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs 60.0 (P=0.017) and the left shoulder 51.9 vs 66.0 (P=0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n=15 of 17 kayakers) to a significantly higher degree (P=0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers.
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| 28. |
- Johansson, Barbro, 1957-
(författare)
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Tonårsflickor berättar om att vara eller inte vara i behov av särskilt stöd : En longitudinell fallstudie
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to describe teenage girls’ experiences and perceptions of participation and influence during learning processes. The UN Convention on the Rights of the Child and the view that children are social actors with their own agency were central to the study. The girls, who were 13 years old when the study began, and 16 when it ended, were interviewed once per semester for three years. Classroom observations formed the basis of the interviews, which provided insight into the learning environment and its working methods. These, in turn, were discussed during the interviews. Nine girls were selected through the IEPs that the school had established for them. They attended regular classes for most of the school day, but received at least one session of special education in smaller groups each week. Their special needs were due to reading and writing difficulties. All of them received special support in English, while seven of the girls also received special support in mathematics. The girls described current events in their life, regarding both school and their spare time, as well as their thoughts about the future, and how efforts to accommodate their special educational needs have affected their schooling. In addition to the girls’ narratives, the IEPs and grades provided the school’s narrative about the girls. The theoretical basis of the thesis comprises cultural-historical ideas of teaching and learning, and the importance of relationships to group-based learning. Descriptive qualitative analyses were based on the teenage girls’ narratives and resulted in five themes; a sixth theme discussed the school’s assessment of the girls through the IEPs and their grades from lower secondary school. Feeling included or not in the group was the overarching theme of all the stories, which involved the girls’ perceptions of how they were treated by the people around them. The results indicate that the girls needed to have instructions repeated to them. There was also a need for continuous encouragement and affirmation in order for them to dare to take on assignments. When it came to collaborative learning together with classmates, the girls preferred to hide their perceived weaknesses, which only made them more dependent on the teacher’s aid. In addition, the girls felt that the teachers were unhappy with the way they handled their school work, and felt overlooked rather than “seen”. In both the stories and the IEPs, concentration difficulties were highlighted as a consistent problem. The analyses show that it is not possible to speak of concentration difficulties without further specification. Since the girls also explained that they were able to maintain concentration, it is necessary to identify which conditions allow pupils to maintain their skills, and when these skills are lost. One finding was that experiences of playing sports created unexpected development opportunities for performing under pressure, even in test situations. According to the girls, visual strengths could compensate for difficulties remembering comprehensive information. The teaching provided opportunities to demonstrate an understanding of facts through visual expression, but creative elements were not included in graded assessments. The study shows that the girls’ leisure-time experiences created opportunities for generalisation regarding learning strategies in school situations.
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| 29. |
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| 30. |
- Lebeda Henriksson, Charlotte
(författare)
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Barns och ungdomars bilder av poliser : En studie i två lokala sammanhang
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- SammanfattningI fokus för denna licentiatuppsats är barns och ungdomars bilder av poliser. Syftet är att beskriva dessa bilder och placera dem i en senmodern samhällelig kontext. Vägledande i beskrivningarna är tre meningsbärande begrepp – föreställningar, erfarenheter och förväntningar – vilka har utkristalliserats ur det empiriska materialet. Utgångspunkten är att bilderna är socialt konstruerade, med hänsyn till maktordning, habitus, sociala positioner och symboliskt kapital. För att förstå den betydelse unga tillskriver poliser är ansatsen därtill kulturellt sociologisk. Studien bygger på ett enkätmaterial med 1 945 barn och ungdomar utan specifik erfarenhet av kriminella handlingar, i åldern 10-22 år. 35 grundskolor och 11 gymnasieskolor har deltagit och svarsfrekvensen är 58 procent i vardera kommunen. Dessutom genomfördes samtalsintervjuer i grupp med sammanlagt 50 deltagare i direkt anslutning till enkätstudien. Analysmetoden är inspirerad av tematisk analys.Materialet visar att barns och ungdomars uppfattning om Polisen som institution är positiv, men att de är något mer kritiska till Polisen som organisation och betydligt mer kritiska till enskilda poliser. Den övervägande andelen av deltagarna har varit i kontakt med poliser, främst i skolan eller när de har ansökt om pass. Förväntningarna på poliser är att de ska rikta sin verksamhet mot vuxna. Den yngre gruppen, 10-12 år är i större utsträckning, positiva till poliser. Den något äldre gruppen, 13-16 år, är mer negativa, medan den äldsta gruppen, 17-22 år, har en betydligt mer nyanserad bild av poliser.Vidare visar det sig att föreställningar, erfarenheter och förväntningar intimt hänger samman. Föreställningar bygger på olika erfarenheter, vilket i sin tur genererar olika förväntningar mot bakgrund av olika förutsättningar i tillvaron. En del bilder är mer generellt förekommande medan andra framställs främst i mer avgränsade kategoriserade grupper med unga.Ungas bilder kan tolkas som en kamp inom fältet där habitus och symboliskt kapital utgör maktmedel. Om vi väljer att se på unga som seismografer kan deras bilder vara tecken på en allmänt hållen bild av poliser även bland vuxna. Det visar sig också finnas en mystik runt poliser. Samtidigt som de kan upplevas vara i vägen är det spännande att se dem agera i skarpt läge. Skrönor spär på mystiken samtidigt som Polisens sätt att vara förtegna om hur de verkar, bidrar till de bilder vi har av dem.
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| 31. |
- Nilchian, Azadeh, et al.
(författare)
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CXADR-Mediated Formation of an AKT Inhibitory Signalosome at Tight Junctions Controls Epithelial-Mesenchymal Plasticity in Breast Cancer.
- 2019
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Ingår i: Cancer Research. - : American Association for Cancer Research. - 0008-5472 .- 1538-7445. ; 79:1, s. 47-60
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Tidskriftsartikel (refereegranskat)abstract
- Tight junctions (TJ) act as hubs for intracellular signaling pathways controlling epithelial cell fate and function. Deregulation of TJ is a hallmark of epithelial-mesenchymal transition (EMT), which contributes to carcinoma progression and metastasis. However, the signaling mechanisms linking TJ to the induction of EMT are not understood. Here we identify a TJ-based signalosome, which controls AKT signaling and EMT in breast cancer. The coxsackie- and adenovirus receptor (CXADR), a TJ protein with an essential yet uncharacterized role in organogenesis and tissue homeostasis, was identified as a key component of the signalosome. CXADR regulated the stability and function of the phosphatases and AKT inhibitors PTEN and PHLPP2. Loss of CXADR led to hyper-activation of AKT and sensitized cells to TGF-β1-induced EMT. Conversely, restoration of CXADR stabilized PHLPP2 and PTEN, inhibited AKT, and promoted epithelial differentiation. Loss of CXADR in luminal A breast cancer correlated with loss of PHLPP2 and PTEN and poor prognosis. These results show that CXADR promotes the formation of an AKT-inhibitory signalosome at TJ and regulates epithelial-mesenchymal plasticity in breast cancer cells. Moreover, loss of CXADR might be used as a prognostic marker in luminal breast cancer.
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| 32. |
- Nilsson, Annika Öst, et al.
(författare)
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Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme
- 2017
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 24:5, s. 349-356
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Sweden, less than 50% of those getting stroke in working age return to work (RTW). Effective rehabilitation programmes need to be developed and therapeutic aspects understood.Aim: To explore and describe how persons with stroke experience their RTW process while participating in a person-centred rehabilitation programme focusing on RTW.Materials and methods: Seven persons with mild or moderate stroke were interviewed twice during the intervention in the vocational training phase using semi-structured interviews. Data were analysed using grounded theory.Results: Having a coordinator by their side gave support and guidance during the RTW process. Knowledge of stroke, strategies and a straightforward communication created a structure for the RTW process. Expressing one's own wishes increased opportunities to influence and decide which path to follow in order to reach the goal.Conclusion: Straightforward, open and recurring communication facilitated the possibility to adapt to the situation. These aspects increased insight and awareness which facilitated the RTW process.Significance: The findings indicate that a precondition for a fruitful RTW process was that suitable platforms at work were created in which the actors involved could cooperate. This knowledge might also be valuable in the RTW process for people with other diagnosis.
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| 33. |
- Ozanne, Anneli, 1978, et al.
(författare)
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Wearables in epilepsy and Parkinson's disease : A focus group study
- 2018
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 137:2, s. 188-194
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Wearable sensors that measure movement and physiological variables are attractive for clinical evaluation of neurological diseases such as epilepsy and Parkinson's disease (PD). The aim of this study was to explore perceptions regarding the use of wearable technology in disease monitoring and management as reported by individuals with epilepsy and Parkinson's disease as well as health professionals working with these patient groups.MATERIALS AND METHODS: Six patient groups (n=25) and two groups with health professionals (n=15) participated in this qualitative, descriptive study with focus group interviews. A manifest qualitative content analysis was used.RESULTS: Four categories and nine subcategories emerged from the analysis. Participants saw possible benefits for improved treatment effect and valued this benefit more than possible inconvenience of wearing the sensors. Discrete design and simplicity were considered as facilitators for improved usability. They emphasized the importance of interactive information between patients and health professionals. However, they were concerned about unclear information and inconclusive recordings and some fears about personal integrity were at odds with the expectations on interactivity.CONCLUSIONS: Patients need to feel well informed and find an added value in using wearables. Wearables need to be user-friendly, have an attractive design, and show clinical efficacy in improving disease management. Variations in perceptions regarding integrity, benefits, and effectiveness of monitoring indicate possible conflicts of expectations among participants. The engagement of end users, patients, and health professionals, in the design and implementation process, is crucial for the development of wearable devices that enhance and facilitate neurological rehabilitation practice.
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| 34. |
- Palumbo, Alessandro
(författare)
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Skriftsystem i förändring : en grafematisk och paleografisk studie av de svenska medeltida runinskrifterna
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this dissertation is to study the development of Swedish runic writing during the Middle Ages in terms of runic shapes and orthography. It comprises three related investigations. A preparatory investigation surveys the runic shapes employed during the Middle Ages in Sweden. The second investigation aims to identify the graphematic distinctions used and developed during the Middle Ages, the chronological and geographical patterns evident in the use of the system of runic writing as well as the phonological conclusions which can be drawn from the graphematic analysis. The third and final section of the dissertation focuses on the use of certain long-branch and short-twig runes from a palaeographic perspective.The Swedish runic writing system changed during the course of the Middle Ages and varied in accordance with different factors, including chronology as well as local traditions. Västergötland, especially the area of Falbygden, appears the most prominent Swedish centre of innovation. As regards to the vowel system, the new grapheme <æ> was consistently used there in the 12th century, whereas not even in the 13th century was it completely established in Uppland. The grapheme <ø> instead was introduced only in the beginning of the 13th century and does not appear to have ever been consistently employed in any province. The analysis of the vowel system, in particular as regards to the unrounded front vowels, has also revealed several graphematic changes that can be explained phonologically and attest to ongoing dialectal developments.Even though no dotted graph type for consonants is used without exception and the double marking of long consonants is employed in less than a third of the attestations of long consonants, greater consistency in the use of both practices can be observed during the 13th century than during earlier periods. Also in this case, the development proceeded more rapidly in Västergötland than in Uppland. Among other provinces, several new features also occur in Småland. Also the inscriptions in Östergötland attest to an advanced use of writing, but the mediaeval innovations there seem to be younger than in Västergötland and western Småland, which indicates that they spread to more easterly areas at a later stage.Medieval innovations such as dotted runes with a consonantal value seem to have their origin and focus in East Scandinavia. Many of the earliest attestations occur on coins minted in Lund, and it is possible that they spread from there to Småland and Västergötland. In other cases, for example as regards the dotted f-rune, these Swedish areas may themselves have acted as centres of innovation. Here, closer contact between carvers and the Church and the introduction of the Roman script may have contributed to creating a more dynamic writing culture.As regards the alleged existence of a "completely dotted runic alphabet", the analyses in this dissertation have shown that there was no uniform use of those features which are often maintained to be characteristic of the completely dotted rune row. These results make it clear that the introduction of innovations could not have occurred via a reform and confirm that no completely dotted rune row was ever established.
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| 35. |
- Peterson, Tiina, et al.
(författare)
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Professionalism of preschool teachers in Estonia, Finland, Sweden and Hungary
- 2016
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Ingår i: European Early Childhood Education Research Journal. - 1350-293X .- 1752-1807. ; 24:1, s. 136-156
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Tidskriftsartikel (refereegranskat)abstract
- The current study investigated the ratings of Estonian, Finnish, Swedish and Hungarian preschool teachers and principals regarding the professionalism of preschool teachers within a cross-cultural context. According to reports commissioned by the European Commission and OECD, the professionalism of preschool teachers is a key factor in ensuring the quality of early childhood education. The study is based on the contextual approach in the bio-ecological theory and critical ecology theory of early childhood professionalism. The research question was: what are ratings of principals and teachers regarding the professionalism of preschool teachers in interaction and family involvement, the planning of education and the evaluation of children's development, using teaching strategies and support for professional development, creating a growth environment and the development of values. Structured questionnaires were conducted, the sample consisted of teachers and principals in Estonian (174/118), Finnish (82/84), Swedish (117/96) and Hungarian (111/99) preschools. In the comparison of the results from the four countries, there were similarities between the views of Finnish and Swedish teachers and principals and between Estonian and Hungarian teachers and principals. Differences between the countries were significant and depended on the context of the individual countries. Highest mean ratings were given by Estonian and Hungarian principals and Estonian teachers to creating growth environment. Development of values was evaluated highest by Finnish principals and teachers. Swedish teachers evaluated teaching strategies highly. The statements that got the lowest evaluation rate by all interest groups were family involvement and professional development.
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| 36. |
- Radon, Anita, et al.
(författare)
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What happens when retail meets research? : Special session
- 2016
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- special session InformationWe are witnessing the beginning of a seismic shift in retail due to digitalization. However, what is meant by digitalization is less clear. Sometimes it is understood as means for automatization and sometimes it is regarded as equal to e-commerce. Sometimes digitalization is considered being both automatization and e-commerce trough new technology. In recent years there has been an increase in Internet and mobile devise usage within the retail sector and e-commerce is growing, encompassing both large and small retailers. Digital tools such as, new applications are developing rapidly in order to search for information about products based on price, health, environmental and ethical considerations, and also to facilitate payments. Also the fixed store settings are changing due to digitalization and at an overall level; digitalization will lead to existing business models being reviewed, challenged and ultimately changed. More specifically, digitalization has consequences for all parts of the physical stores including customer interface, knowledge creation, sustainability performance and logistics. As with all major shifts, digitalization comprises both opportunities and challenges for retail firms and employees, and these needs to be empirically studied and systematically analysed. The Swedish Institute for Innovative Retailing at University of Borås is a research centre with the aim of identifying and analysing emerging trends that digitalization brings for the retail industry.
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| 37. |
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| 38. |
- Vroland-Nordstrand, Kristina, et al.
(författare)
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Can children identify and achieve goals for intervention? : A randomized trial comparing two goal-setting approaches
- 2016
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Ingår i: Developmental Medicine & Child Neurology. - : Mac Keith Press. - 0012-1622 .- 1469-8749. ; 58:6, s. 589-596
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The efficacy of two different goal-setting approaches (children's self-identified goals and goals identified by parents) were compared on a goal-directed, task-oriented intervention.METHOD: In this assessor-blinded parallel randomized trial, 34 children with disabilities (13 males, 21 females; mean age 9y, SD 1y 4mo) were randomized using concealed allocation to one of two 8-week, goal-directed, task-oriented intervention groups with different goal-setting approaches: (1) children's self-identified goals (n=18) using the Perceived Efficacy and Goal-Setting System, or (2) goals identified by parents (n=16) using the Canadian Occupational Performance Measure (COPM). Participants were recruited through eight paediatric rehabilitation centres and randomized between October 2011 and May 2013. The primary outcome measure was the Goal Attainment Scaling and the secondary measure, the COPM performance scale (COPM-P). Data were collected pre- and post-intervention and at the 5-month follow-up.RESULTS: There was no evidence of a difference in mean characteristics at baseline between groups. There was evidence of an increase in mean goal attainment (mean T score) in both groups after intervention (child-goal group: estimated mean difference [EMD] 27.84, 95% CI 22.93-32.76; parent-goal group: EMD 21.42, 95% CI 16.16-26.67). There was no evidence of a difference in the mean T scores post-intervention between the two groups (EMD 6.42, 95% CI -0.80 to 13.65). These results were sustained at the 5-month follow-up.INTERPRETATION: Children's self-identified goals are achievable to the same extent as parent-identified goals and remain stable over time. Thus children can be trusted to identify their own goals for intervention, thereby influencing their involvement in their intervention programmes.
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| 39. |
- Vroland-Nordstrand, Kristina, et al.
(författare)
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Parents' experiences of conducting a goal-directed intervention based on children's self-identified goals, a qualitative study
- 2018
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 25:4, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- AIM/OBJECTIVE: To explore and describe parents' perceptions and experiences of conducting a goal-directed intervention focused on children's self-identified goals.MATERIAL AND METHODS: Individual semi-structured interviews were performed with nine parents (8 mothers, 1 father). All the parents had participated actively in conducting a goal-directed intervention addressing their children's self-identified goals. The interviews were analyzed using qualitative content analysis.RESULTS: From a parental perspective, working on children's self-identified goals was a positive experience. The findings revealed three categories: Goals challenged the parents describes the parents' experiences of the complexity of goal setting. The intervention demanded an intensive and flexible parental engagement; here the parents expressed the importance of active parental engagement, which for some parents could be challenging. The child's personal goals gave more than anticipated describes the parents' experiences of how the children's personal goals positively influenced the children's self-esteem, increased the children's motivation for practice, and helped the children develop more than the parents had anticipated.CONCLUSIONS AND SIGNIFICANCE: In the parents' experience, goal-directed intervention comprehensively relies on their engagement. Follow up's from the occupational therapist motivated the parents and their own child's personal goals gave them more than they could have expected. This indicates the importance of supporting parents and letting children actively participate in the goal setting process.
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