| 1. |
- Nordanstig, Joakim, et al.
(author)
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Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease
- 2014
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In: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 59:3, s. 700-U492
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Journal article (peer-reviewed)abstract
- Background: Most commonly used outcome measures in peripheral arterial disease (PAD) provide scarce information about achieved patient benefit. Therefore, patient-reported outcome measures have become increasingly important as complementary outcome measures. The abundance of items in most health-related quality of life instruments makes everyday clinical use difficult. This study aimed to develop a short version of the 25-item Vascular Quality of Life Questionnaire (VascuQoL-25), a PAD-specific health-related quality of life instrument. Methods: The study recruited 129 individuals with intermittent claudication and 71 with critical limb ischemia from two university hospitals. Participants were a mean age of 70 +/- 9 years, and 57% were men. All patients completed the original VascuQoL when evaluated for treatment, and 127 also completed the questionnaire 6 months after a vascular procedure. The VascuQoL-25 was reduced based on cognitive interviews and psychometric testing. The short instrument, the VascuQoL-6, was tested using item-response theory, exploring structure, precision, item fit, and targeting. A subgroup of 21 individuals with intermittent claudication was also tested correlating the results of VascuQoL-6 to the actual walking capacity, as measured using global positioning system technology. Results: On the basis of structured psychometric testing, the six most informative items were selected (VascuQoL-6) and tested vs the original VascuQoL-25. The correlation between VascuQoL-25 and VascuQoL-6 was r = 0.88 before intervention, r = 0.96 after intervention, and the difference was r = 0.91 (P < .001). The Cronbach alpha for the VascuQoL-6 was .85 before and .94 after intervention. Cognitive interviews indicated that the responders considered all six items to be relevant and comprehensible. Rasch analysis was used to reduce response options from seven (VascuQoL-25) to four (VascuQoL-6). VascuQol-6 was shown to have high precision and discriminative properties. Item fit was excellent, with both "infit" and "outfit" between 0.7 and 1.3 for all six items. The standardized response mean after intervention was 1.15, indicating good responsiveness to clinical change. VascuQoL-6 results correlated strongly (r = 0.72; P < .001) with the actual measured walking ability (n = 21). Conclusions: VascuQoL-6 is a valid and responsive instrument for the assessment of health-related quality of life in PAD. The main advantage is the compact format that offers a possibility for routine use in busy clinical settings.
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| 3. |
- Johansson, Gunvi, 1950-, et al.
(author)
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Young adults' views on the relevance of three measures for oral health-related quality of life
- 2015
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In: International Journal of Dental Hygiene. - Malden, MA : John Wiley & Sons. - 1601-5029 .- 1601-5037. ; 13:3, s. 184-191
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Journal article (peer-reviewed)abstract
- OBJECTIVE: The aim of this study was to explore the views of young adults on the relevance of three measures of oral health-related quality of life (OHRQoL). METHODS: Sixteen young adults aged 21-29 years were interviewed. The selection was strategic with reference to age (21-25 years.; 26-30 years), sex and education (university degree; upper secondary school). The interview guide covered areas on the content and construction of the measures: The Oral Health Impact Profile (OHIP), the Oral Impacts on Daily Performances (OIDP) and the Oral Health-Related Quality of Life UK (OHRQoL-UK). The data were analysed using qualitative content analysis. RESULTS: A theme expressing the latent content was formulated during the data analysis: 'young adults' own experiences were reflected in their views on the OHRQoL measures'; that is, the experiences of young adults of own oral problems and aspects that were found to be especially important for their age group influenced their view on the measures. The self-reported ability to understand and answer the questions varied and the perceived advantages and disadvantages were almost equally distributed among the three measures. CONCLUSIONS: The OHIP, OIDP and OHRQoL-UK were evaluated as being equal by the young adults in this study, with regard both to their pros and cons. The clarity of the measures was regarded as the most important factor, while the length and assessment period were less significant.
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| 4. |
- Hedman, Annicka, et al.
(author)
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Challenge levels of everyday technologies as perceived over five years by older adults with mild cognitive impairment
- 2018
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In: International psychogeriatrics. - : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 30:10, s. 1447-1454
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Journal article (peer-reviewed)abstract
- Background: In clinical practice, efficient and valid functional markers are needed to detect subtle cognitive and functional decline in mild cognitive impairment (MCI). This prospective study explored whether changes in perceived challenge of certain everyday technologies (ETs) can be used to detect signs of functional change in MCI.Methods: Baseline and five-year data from 37 older adults (mean age 67.5 years) with MCI regarding their perceived ability to use ET were used to generate Rasch-based ET item measures reflecting the relative challenge of 46 ETs. Actual differential item functioning in relation to time was analyzed based on these item measures. Data collection took place in 2008-2014.Results: Seven (15%) of the ETs included were perceived to be significantly more challenging to use at year five compared to at baseline, while 39 ETs (85%) were perceived to be equally challenging to use, despite the fact that the participants' perceived ability to use ET had decreased. Common characteristics among the ETs that became more challenging to use could not be identified. The dropout rate was 43%, which limits the power of the study.Conclusions: Changes in the perceived challenge of ETs seem to capture functional change in persons with cognitive decline. Both easier and more challenging ETs typically used at home and in society need to be addressed to capture this functional change because significant changes occurred among ETs of all challenge levels and within all types of ETs.
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| 5. |
- Sharma, Sonia, et al.
(author)
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A new instrument for assessing work-related body mechanics and strain in the general population
- 2023
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In: Journal of Pain. - : Elsevier. - 1526-5900 .- 1528-8447. ; 24:2, s. 237-250
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Journal article (peer-reviewed)abstract
- Clinical pain is often linked to poor body mechanics, with individuals sometimes presenting multiple painful disorders. Such disorders may be influenced by behaviors that affect the general resiliency and health of the musculoskeletal system. We aimed to develop a self-reported scale using the Malmö Diet and Cancer Study questions on work-related body mechanical exposures. An expert panel identified 41 variables having content validity for musculoskeletal problems. Exploratory factor analysis was conducted on a random selection of 50% of the cohort (n=6,789 adults); the remaining was reserved for confirmatory factor analyses (CFA), item response theory (IRT) item calibration, and differential item functioning investigations. Supported by standard measure development methods and fit criteria, the final unidimensional item bank contains 13 items. Overall CFA statistics (root mean square error of approximation=0.09; comparative fit index=0.96; Tucker-Lewis index=0.96; standardized root mean residuals=0.05) indicated excellent single-factor model fit and appropriateness of IRT modeling and calibration. Expert review and item information values (score-precision) guided selection of an 8-item short form with acceptable score-level reliabilities (≥0.70) for T-scores=39-80+. This measure provides reliable assessment of body mechanics strain in adults and can be useful when evaluating different contributions to musculoskeletal problems affecting pain-treatment success in future clinical research. Perspective: This article presents the development and psychometric properties of a new measure, "Work-related Body Mechanics and Strain Scale (WR-BMSS)." The scale has 13-items or alternatively an 8-item short form. This measure could potentially help clinicians who seek to assess how musculoskeletal problems may contribute to patient pain and disability.
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| 6. |
- Enander, Viveka, 1967, et al.
(author)
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Before the killing: Intimate partner homicides in a process perspective, part I
- 2021
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In: Journal of Gender-Based Violence. - : Policy Press. - 2398-6808 .- 2398-6816. ; 5:1, s. 59-74
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Journal article (peer-reviewed)abstract
- This paper puts intimate partner homicide (IPH) into a process perspective, and describes the situational precursors that constitute the build-up, i.e. the first stage of the IPH process that precedes the deed. Fifty court files, from cases involving 40 male and 10 female perpetrators, underwent thematic analysis. Our findings indicate that the build-up phase of an IPH is complex and encompasses several different features, of which some are clearly gendered. The results point to an escalation during the build-up: of possessiveness and violent behaviour in male-to-female cases, of alcohol/drug abuse, of mental health problems and/or of fears for the future, often connected to separation. Concurrent with previous research we found that women often kill in the context of their own victimisation. However, also other situations and motives protruded as pertinent. The practical implications of these findings are that practitioners should be particularly attentive to escalation of known risk factors, especially male possessiveness, and be aware that (the victim wanting) a separation may initiate escalation with lethal consequences.
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| 7. |
- Gaber, Sophie, et al.
(author)
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Social Citizenship Through Out-of-Home Participation Among Older Adults With and Without Dementia
- 2022
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In: Journal of Applied Gerontology. - : Sage Publications. - 0733-4648 .- 1552-4523. ; 41:11, s. 2362-2373
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Journal article (peer-reviewed)abstract
- There is limited empirical knowledge about how older adults living with dementia enact their social citizenship through out-of-home participation. This study aimed: (a) to investigate out-of-home participation among older adults with and without dementia in four countries and (b) to compare aspects of stability or change in out-of-home participation. Using a cross-sectional design, older adults with mild-to-moderate dementia and without dementia, aged 55 years and over, were interviewed using the Participation in ACTivities and Places OUTside the Home questionnaire in Canada (n = 58), Sweden (n = 69), Switzerland (n = 70), and the United Kingdom (n = 128). Data were analyzed using descriptive statistics and a two-way analysis of variance. After adjustment for age, diagnosis of dementia and country of residence had significant effects on total out-of-home participation (p <.01). The results contribute to policies and development of programs to facilitate social citizenship by targeting specific activities and places.
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| 8. |
- Samuelsson, Eva, et al.
(author)
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Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: A systematic review
- 2015
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In: Geriatrics & Gerontology International. - : Wiley. - 1444-1586 .- 1447-0594. ; 15:5, s. 521-534
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Journal article (peer-reviewed)abstract
- Aim: The prevalence and severity of urinary incontinence (UI) increase with age and comorbidity. The benefits of pharmacotherapy for UI in the elderly are questionable. The aim of the present study was to systematically review the efficacy of pharmacological treatment for UI in the elderly and frail elderly. Methods: We searched PubMed, EMBASE, Cochrane library and Cinahl databases through October 2013 to identify prospective controlled trials that evaluated pharmacological treatment for UI in persons aged >= 65 years. Elderly persons living in nursing homes were regarded as frail elderly. Outcomes were urinary leakage, quality of life and adverse events. Results: We screened 1038 abstracts and assessed 309 full-text articles. We identified 13 trials of high or moderate quality; 11 evaluated anticholinergic drugs and two evaluated duloxetine. Oxybutynin, the only drug studied in the frail elderly population, had no effect on urinary leakage or quality of life in elderly with urgency UI (UUI). Seven trials evaluated the effects of darifenacin, fesoterodine, solifenacin, tolterodine or trospium. Urinary leakage decreased (standard mean difference: -0.24, 95% confidence interval -0.32-0.15), corresponding to a reduction of half a leakage per 24 h. Common side-effects of treatment were dry mouth and constipation. Data were insufficient for evaluation of the effect on quality of life or cognition. The evidence was insufficient to evaluate the effects of duloxetine. No eligible studies on mirabegron and estrogen were found. Conclusions: Anticholinergics have a small, but significant, effect on urinary leakage in older adults with UUI. Treatment with drugs for UUI in the frail elderly is not evidence based.
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| 9. |
- Chrcanovic, Bruno, et al.
(author)
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A retrospective study on clinical and radiological outcomes of oral implants in patients followed up for a minimum of 20 years
- 2018
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In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:2, s. 199-207
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Journal article (peer-reviewed)abstract
- Background: Very long-term follow-up of oral implants is seldom reported in the literature. Purpose: To assess oral implant failure rates and marginal bone loss (MBL) of patients followed up for a minimum of 20 years. Materials and Methods: Implants placed in patients followed up for 20+ years were included. Descriptive statistics, survival analyses, generalized estimating equations were performed. Three-hundred implants were randomly selected for MBL. Results: 1,045 implants (227 patients) were included. Implant location, irradiation, and bruxism affected the implant survival rate. Thirty-five percent of the failures occurred within the first year after implantation, and another 26.8% in the second/third year. There was a cumulative survival rate of 87.8% after 36 years of follow-up. In the last radiological follow up, 35 implants (11.7%) had bone gain, and 35 implants (11.7%) presented at least 3 mm of MBL. Twenty-six out of 86 failed implants with available radiograms presented severe MBL in the last radiological register before implant failure. Conclusions: Most of the implant failures occurred at the first few years after implantation, regardless of a very long follow up. MBL can be insignificant in long-term observations, but it may, nevertheless, be the cause of secondary failure of oral implants in some cases.
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| 10. |
- Chrcanovic, Bruno, et al.
(author)
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Factors influencing the fracture of dental implants
- 2018
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In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:1, s. 58-67
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Journal article (peer-reviewed)abstract
- Background: Implant fractures are rare but offer a challenging clinical situation. Purpose: To determine the prevalence of implant fracture and the possible risk factors predisposing an implant to a higher fracture risk. Materials and Methods: This retrospective study is based on 2670 patients consecutively treated with implant-supported prostheses. Anatomical-, patient-, and implant-related factors were collected. Descriptive statistics and survival analyses were performed. Generalized estimating equations (GEE) evaluated the effect of explanatory variables on implant fracture. Results: Forty-four implants (out of 10 099; 0.44%) fractured. The mean ± standard deviation time for fracture to occur was 95.1 ± 58.5 months (min-max, 3.8-294.7). Half of the occurrences of fracture happened between 2 and 8 years after implantation. Five factors had a statistically significant influence on the fracture of implants (increase/decrease in fracture probability): use of higher grades of titanium (decrease 72.9%), bruxism (increase 1819.5%), direct adjacency to cantilever (increase 247.6%), every 1 mm increase in implant length (increase 22.3%), every 1 mm increase in implant diameter (decrease 96.9%). Conclusions: It is suggested that 5 factors could influence the incidence of implant fractures: grade of titanium, implant diameter and length, cantilever, bruxism.
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