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- Ahlberg, Mona, 1966-
(författare)
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Being cared for in an Intensive Care Unit – family functioning and support
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- When COVID-19 came as an uninvited guest into our everyday lives, nursing in intensive care was affected and thus the studies contain data from both before and during the COVID-19 pandemic.Before the pandemic, most intensive care units, which care for patients with critical illness in a technical setting, allowed family members to visit the patient 24 hours a day. The intensive care unit is a stressful and frightening environment for both the patient and their family. They can be affected both mentally and physically, showing symptoms such as difficulty sleeping, stress and depression. The intensive cared patient often does not remember anything from the time they were cared for in the intensive care unit, and the family needs to explain and recount this unconscious time. During the pandemic, this changed, with restrictions and limited opportunities to visit the hospital and patient due to virus outbreaks. Family members received information about the patient's medical condition by phone from a physician. The overall aim of this thesis was to explore and conceptualise the family functioning of families with a family member treated in the intensive care unit. There was also an intention to describe and evaluate how an intervention affects the family and individual family members in families where a family member received intensive care.In these studies, qualitative, quantitative, as well as mixed methods were utilised. Participants were adult intensive cared patients from seven intensive care clinics, and their families. The results examined between families are based on the patient and family characteristics. The results from study I show that families who have experienced COVID-19 and with a family member who was cared for in an intensive care unit, have existential thoughts. Study II shows no major impact on family function between families, but the answers differ within the families who experienced intensive care. In study III, concerning families experiencing intensive care and attending family health conversations, there was an awareness of family function. The conversations brought the family closer together, through improved understanding of each other. In study IV family functioning, hope and sense of coherence were com-pared among the participants in two intervention groups: Family health conversations and support group conversations. Family functioning and hope were higher in the group that participated in the family health conversations and comprehensibility, meaningfulness and vitality were higher among the participants in the support group conversation. By exploring how family function affects the individual family member and the family as a unit during critical illness and intensive care, new ways of working can be strengthened in the care of patients and their families.
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- Ahlberg, Mona, et al.
(författare)
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Exploring family functioning and - hardiness in families' experiencing adult intensive care - A cross-sectional study
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:7
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Tidskriftsartikel (refereegranskat)abstract
- Being cared for in an intensive care unit affects both the patient being cared for and the family in various ways. The family is of great importance for the recovery of the former intensive-care patient. The aim is to explore family functioning and family hardiness in families of former intensive care patients. A cross-sectional study using two self-reported questionnaires. Former adult intensive care patients and their family were recruited to participate between December 2017 and June 2019. The data were coded and entered the Statistical Package for the Social Sciences version 25, for analysis. To explore questionnaire data, descriptive and inferential statistical analyses were performed. Scale values were calculated on, both family wise and between the patients and the family members. STROBE checklist was used. Data was collected from 60 families (60 former intensive cared patients and 85 family members) and showed that 50 families scored healthy family functioning and 52 high strengths in hardiness. The data showed small variations between and within families for family functioning and family hardiness, there were only two families scoring low for both family functioning and hardiness. The variation was higher within the families, but there was no significance level.The conclusions were that family functioning and hardiness was, to a large extent, assessed as good by the families. Nevertheless, it is important to help the family obtain information and support. So, the family need to continue to communicate, finding coping abilities and strengths in adopting new strategies to protect the family unit. The family are very important for members' mental and physical recovery as the health of one family member affects the family as a unit.
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3. |
- Ahlberg, Mona, et al.
(författare)
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Family Health Conversations Versus Support Group Conversations When a Family Member Has Been Critically Ill : A Mixed Methods Study
- 2021
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Ingår i: Families, Systems & Health. - : American Psychological Association (APA). - 1091-7527 .- 1939-0602. ; 39:2, s. 293-305
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: When a family member has been critically ill and cared for at an intensive care unit the individual family member as well as the family system are affected and in need of support. The aim of this study was to compare and contrast the responses from 2 different types of follow-up interventions for families of critically ill persons, focusing on individual hopes, health-related quality of life, family functioning and ability to cope with challenges.Method: Adult family members from 3 hospitals attended 1 of 2 interventions 2 months after intensive care. The family health conversation included the family. The support group conversation included just family members and not the patient who had experienced intensive care. Data were collected via self-reported questionnaires and follow-up interviews with family members. Quantitative and qualitative data were first analyzed separately, and the results were then integrated through mixed methods analysis.Results: A total of 38 family members took part in the interventions. Family members in the 2 intervention groups talked about how they had more hope for the future, and about how talking within the family and the group had helped them justify their feelings, which empowered them in the transition toward a healthier quality of life. Comparisons of the interventions show a higher significance of family function and hope in the family health conversation.Discussion: The article illustrates a disparity between how family members function and the needs they have for follow-up. We discuss what kind of follow-up these persons need.
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5. |
- Gustafsson, Annika, et al.
(författare)
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Predicting Non-Attendance: A Model of the Complex Relationships in Dental Care Non-Attendance among Adolescents in Örebro County, Sweden
- 2020
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Ingår i: SCIRP Psychology. ; 11, s. 1300-1314
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Tidskriftsartikel (refereegranskat)abstract
- Background: Understanding why adolescents miss dental appointments is central to promoting people’s oral health into adulthood. Studies on non-attendant adolescents are rare. Method: In our previous study using data from the 2014 population-based cross-sectional survey of schoolchildren in ?rebro County, Sweden we suggested a risk-factor model for non-attendance with five components (sociodemographic factors, self-rated health, perceived life events, health behaviour, social cohesion and social capital). The present study tested the external validity of the multivariate model for all components simultaneously developed from the 2014 study using a new population-based cross- sectional survey (n = 7576) of schoolchildren in ?rebro County, Sweden 2017. Using the predicted values from the 2014-logistic regression, we computed ROC-curves for the 2014 and 2017 study populations, respectively. Results: Of the 6 304 adolescents who answered the question of attendance to dental health care and all eleven independent items in 2017, 324 (5.1%) reported that they sought dental care only for acute pain or not at all, thus regarded as non-attendant. When using the risk model based on the 2014 data for the 2017 data, the area under the receiver operating curve (AUC) for non-attendance adolescents was 0.74 (95% CI 0.71 - 0.76). Conclusion: The present study shows that the model created from the 2014 population-based survey has excellent discriminative performance (AUC) in the 2017 population-based survey predicting non-attending adolescents. The methodology applied in this study may be useful to other health care services to develop predictive non-attending models based on their specific population.
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6. |
- Heikkilä, Kristiina, 1958-, et al.
(författare)
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Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model : An integrative review
- 2022
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 47, s. 171-182
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Tidskriftsartikel (refereegranskat)abstract
- Mealtimes are important events in care homes for physical and social well-being. However, residents usually have little input concerning meal timings, what food is offered, and how it is served. This integrative review explored mealtime interventions and their outcomes in care homes related to the Five Aspects Meal Model (FAMM). Research articles published 2010–2021 were searched for in ASSIA, CINAHL, PsycINFO, PubMed, and SveMed+ and resulted in 13 articles focusing on interventions. The analysis was based on the aspects of FAMM: room, meeting, product, management control system, and atmosphere. The result shows that even though interventions specifically focused on one aspect, they often evaluated outcomes related to several aspects. Different aspects can work together to foster effective mealtimes. FAMM eased to visualise the usefulness of mealtime interventions from a broad perspective and can be a useful tool for assessing and improving mealtime situations in clinical practice.
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9. |
- Hussain, Netha, et al.
(författare)
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Function and activity capacity at 1 year after the admission to intensive care unit for COVID-19
- 2024
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Ingår i: CLINICAL REHABILITATION. - 0269-2155 .- 1477-0873.
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe hand grip strength, walking speed, functional mobility, and postural control at one year following intensive care unit admission for COVID-19, and to find any predictors that are associated with impaired hand grip strength, walking speed, functional mobility, or postural control at the 1-year follow-up.Design Retrospective cross-sectional and longitudinal observational study.Setting Intensive care unit and outpatient research clinic at Sahlgrenska University Hospital.Participants Of the 105 individuals in "The Gothenburg Recovery and Rehabilitation after COVID-19 and Intensive Care Unit" cohort, 78 participated in this study.Main measures Descriptive statistics for hand grip strength, walking speed, functional mobility, and postural control were presented and binary logistic regressions were performed to find their significant predictors.Results At 1-year following intensive care unit admission for COVID-19, impaired hand grip strength was found in 24.4% for the right hand and 23.1% for the left hand. Walking speed, functional mobility, and postural control were found to be impaired in 29.5%, 21.8%, and 5.1%, respectively. For impaired walking speed, longer length of stay at intensive care unit and presence of diabetes mellitus were risk factors. Diabetes mellitus was found to be the risk factor for impaired functional mobility.Conclusion In this study, 45% of the participants showed impairment in function, activity capacity or both. These results suggest that individuals who recovered after intensive care unit admission for COVID-19 would benefit from receiving long-term follow-up to enable identification of those with need of physical health assistance and rehabilitation.
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10. |
- Hussain, Netha, et al.
(författare)
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Prevalence of symptoms of anxiety and depression one year after intensive care unit admission for COVID-19
- 2024
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Ingår i: BMC PSYCHIATRY. - 1471-244X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundTo the best of our knowledge, the long term prevalence of symptoms of anxiety and depression in ICU admitted individuals after COVID-19 in Sweden during the first wave of the pandemic has not been investigated. Furthermore, no studies have exclusively investigated the risk factors for experiencing symptoms of anxiety and depression in this population.AimThe aim of this study was to determine the prevalence of symptoms of anxiety and depression at one year after ICU admission for COVID-19. An additional aim was to identify any early predictors that are associated with symptoms of anxiety and depression, at one year following ICU admission for COVID-19.MethodsThis multicenter cohort study had a cross-sectional and a longitudinal design. The primary outcomes and dependent variables, symptoms of anxiety and depression, were assessed using the Hospital Anxiety and Depression Scale (HADS). The independent variables were related to demographic factors, comorbidities, and complications during COVID-19-related ICU admission. Logistic regression analyses were performed to identify any predictors of symptoms of anxiety and depression.ResultsOut of 182 eligible individuals, 105 participated in the study. Symptoms of anxiety was found in 40 (38.1%) and depression in 37 (35.2%) of the participants. Using univariable logistic regression analyses, female sex was identified as a predictor of depression as defined by HADS at one year following ICU admission for COVID-19 (odds ratio 2.53, 95% confidence intervals 1.01-6.34, p-value 0.048).ConclusionsThe high prevalence of symptoms of anxiety and depression in ICU admitted individuals one year after COVID-19 is a public health issue of concern. Our findings imply that individuals who recovered after an ICU stay for COVID-19 may benefit from long-term follow-ups and continuous mental health support for more than a year following the ICU admission. For women specifically, this is true.
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11. |
- Larsson, Jenny, 1974-, et al.
(författare)
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Anti-inflammatory effects of a titanium-peroxy gel: role of oxygen metabolites and apoptosis.
- 2004
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Ingår i: Journal of biomedical materials research. Part A. - : Wiley. - 1549-3296 .- 0021-9304 .- 1097-4636. ; 68:3, s. 448-57
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Tidskriftsartikel (refereegranskat)abstract
- Polymorphonuclear neutrophils (PMN) are among the first inflammatory cells to arrive at an implant interface, where they encounter with the foreign material and may produce reactive oxygen species (ROS). During the interaction between titanium and ROS, titanium-peroxy (Ti-peroxy) compounds may be formed. We used a Ti-peroxy gel, made from titanium and hydrogen peroxide, to study the effects of Ti-peroxy compounds on PMN. In the absence of serum, the Ti-peroxy gel decreased the oxidative response of PMN to yeast and PMA and reduced PMN apoptosis without inducing necrosis. These effects could not be ascribed to the release of hydrogen peroxide from the Ti-peroxy gel, because a steady-state hydrogen peroxide producing system failed to mimic the effects of the gel. The effects were similarly unaffected when PMN were preincubated with beta(2)-integrin antibodies, questioning the involvement of adhesion molecules. Nevertheless, when a filter was used to separate the Ti-peroxy gel from the cells, the gel effect on PMN life span was abolished, pointing to a contact-dependent mechanism. In the presence of serum, the Ti-peroxy gel had no effect on the PMN oxidative response and life span, but appeared rather inert. In summary, this study demonstrates that the Ti-peroxy gel has potentially anti-inflammatory properties through a combined peroxide and physical contact effect, supporting the notion that interactions between titanium and inflammatory cells are responsible for the good performance of titanium in vivo.
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12. |
- Nielsen, Magdalena, et al.
(författare)
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The five aspects mealtime environment observation instrument for assessing mealtime environments in nursing homes : Development and validation
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:2, s. 512-522
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Tidskriftsartikel (refereegranskat)abstract
- Aims and ObjectivesTo further develop and validate the Mealtime instrument, an observational instrument for assessing mealtime environments in nursing homes originating from the theoretical framework: Five Aspects Meal Model (FAMM).Methodological Design and JustificationA mealtime experience is significant for a sense of well-being. In nursing homes, residents' personal preferences, combined with their diagnoses and different stages of illness, influence their mealtime experience and provide a complexity that has been found difficult to assess. Using FAMM, a theoretical framework as its base, this study, attempts to look at different parts of the mealtime environment. FAMM structures the mealtime environment in to five aspects: room, meeting, product, management control system and atmosphere.This study's design includes instrument development and validation.Ethical Issues and ApprovalThis study has been approved by the Swedish Ethical Review Authority (dnr 2019–05477).DesignMethodological study.Research MethodAn existing instrument, the Mealtime instrument with FAMM as a theoretical framework, was used as a foundation for the development of the Five Aspects Mealtime Environment Observation Instrument (FAME-OI). Content validity index (CVI) was used to validate FAME-OI.ResultsFAME-OI's item-CVI, scale-CVI and modified Kappa displayed high validity. Changes were made in its structure and phrasing. These developments resulted in having a distinct structure in FAME-OI, in reference to FAMM.ConclusionFAME-OI is applicable for clinical use in nursing homes and in research; however, adjustments may be needed before its use in other health care facilities.
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13. |
- Persson, Erik, et al.
(författare)
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Vad gör en växt främmande? : Några olika perspektiv
- 2021
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Ingår i: Växtvärk : Perspektiv på invasiva främmande växter i svensk natur - Perspektiv på invasiva främmande växter i svensk natur. - 9789198565904 ; , s. 31-42
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Bokkapitel (populärvet., debatt m.m.)abstract
- Det här kapitlet handlar om hur komplicerat det är att avgöra vilkainvasiva växter som ska räknas som främmande. Spelar det tillexempel någon roll hur de har kommit hit? Gör det skillnad om dehar kommit hit själva eller om de har förts hit av människor? Spelardet någon roll om de förts hit avsiktligt eller av misstag? Spelar detnågon roll när de kom hit? Hur länge ska arterna ha funnits härinnan de slutar räknas som främmande? 10 år? 100 år? 1000 år?10 000 år? Spelar det någon roll hur de har tagits emot av naturenoch av oss människor? Man kan också fråga vad ’hit’ och ’här’betyder i dessa sammanhang. Är det landsgränserna som gällereller kanske livsmiljön? Kan en art vara främmande i fjällen meninte i skogen? I Norrland men inte i Skåne? Låt oss titta närmarepå hur begreppet ‘främmande art’ används av Naturvårdsverketoch Havs- och vattenmyndigheten, vilka har regeringens uppdragatt utarbeta strategier för hantering av invasiva främmande arter,Artdatabanken som ligger bakom den riskklassificering som liggertill grund för den nationella listan över invasiva främmande arter,och respondenterna i vår digitala frågelista.
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14. |
- Samuelsson, Carina M, et al.
(författare)
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Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT).
- 2019
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 1477-0873 .- 0269-2155. ; 33:4, s. 773-783
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Tidskriftsartikel (refereegranskat)abstract
- To identify the incidence of falls and factors present shortly after stroke, which are associated with the occurrence of falls over the first 12months after stroke onset, following discharge from inpatient rehabilitation.Prospective follow-up study.Stroke unit and outpatient department.A total of 490 individuals with acute stroke.Postural control was assessed using the Swedish modified version of the Postural Assessment Scale for Stroke Patients. Data on self-reported falls were collected using a standardized questionnaire at threemonths after discharge and six and 12months after stroke onset. Associations between characteristics during the acute phase after a stroke and falls after six and 12months were investigated using univariable and multivariable regression analyses.The endpoint was a self-reported fall.Within threemonths after discharge, 38 of 165 respondents (23%) had experienced at least one fall. Within six and 12months after stroke onset, respectively, 108 of 376 (29%) and 140 of 348 (40%) of the respondents had experienced at least one fall. Poor postural control (odds ratio 3.92, 95% confidence interval 2.07-7.45, P<0.0001) and using a walking aid (odds ratio 2.84, 95% confidence interval 1.71-4.72, P<0.0001) were predictors of falls after discharge within 12months after stroke onset. The same variables were independent predictors of falls within sixmonths.Poor postural control and using a walking aid in the acute phase after a stroke are associated with falls after discharge from a stroke unit within 12months after stroke onset.
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15. |
- Schnitzer, Lior, et al.
(författare)
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Fatigue in stroke survivors: a 5-year follow-up of the Fall study of Gothenburg
- 2023
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Ingår i: Journal of Neurology. - 0340-5354 .- 1432-1459. ; 270:10, s. 4812-4819
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Tidskriftsartikel (refereegranskat)abstract
- Longer term knowledge of post-stroke fatigue (PSF) is limited. Our aim was to describe the prevalence of, and to identify baseline predictors associated with, PSF 5years after stroke. We undertook a follow-up of stroke survivors from the 504 consecutively recruited participants in the observational “The Fall Study of Gothenburg”, conducted between 2014 and 2016. The dependent variable, PSF, was assessed using the Swedish version of the Fatigue Assessment Scale (S-FAS) and defined as having a S-FAS score ≥ 24. The S-FAS questionnaire was mailed to potential participants in August 2020. The independent variables, previously obtained from medical records, included age; sex; comorbidities; stroke severity; hospital length of stay; body mass index (BMI); number of medications and lifestyle factors at index stroke. To identify predictors of PSF, univariable and multivariable logistic regression analyses were performed. Of the 305 eligible participants, 119 (39%) responded with complete S-FAS. Mean age at index stroke was 71 (SD 10.4) years and 41% were female. After a mean of 4.9years after stroke, the prevalence of PSF was 52%. Among those with PSF, almost two thirds were classified as having both physical and mental PSF. In the multivariable analysis, only high BMI predicted PSF with an odds ratio of 1.25 (95% CI 1.11–1.41, p < 0.01). In conclusion, half of the participants reported PSF 5years after index stroke and higher body mass index was identified as a predictor. The findings from this study are important for healthcare professionals, for planning health-related efforts and rehabilitation of stroke survivors. ClinicalTrials.gov, Identifier NCT02264470.
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16. |
- Segerdahl, Mårten, et al.
(författare)
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Health-related quality of life in stroke survivors: a 5-year follow-up of The Fall Study of Gothenburg (FallsGOT)
- 2023
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Ingår i: BMC Geriatrics. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are limited data on long-term prevalence and predictors of health-related quality of life (HRQoL) in stroke survivors. Therefore, the aim was to describe the prevalence of impaired HRQoL, and to identify factors in acute stroke that are associated with impaired HRQoL, 5years after stroke. Methods: The 305 (60.5%) stroke survivors of the original 504 participants from The Fall Study of Gothenburg were invited to participate in a 5-year follow-up including assessment of HRQoL using the EuroQol 5 Dimensions 3 Levels questionnaire (EQ-5D-3L). To identify baseline predictors of impaired HRQoL, based on the EQ-5D-3L’s five dimensions, univariate and multivariate logistic regression analyses were performed. Results: A total of 129 participants (42.3% of the survivors) completed the questionnaire at a median follow-up time of 58months. At baseline, their mean age was 70.6years, and they had a median NIHSS score of 1. The median (interquartile range [IQR]) EQ-5D-3L index score was 0.87 (0.71–0.93) and the median (IQR) EQ-visual analogue scale was 70 (49.8–88). In total, 102 (79%) participants were classified as having impaired HRQoL, stated primarily (among 68.5%) related to Pain/Discomfort. Higher age was identified as a predictor of impaired HRQoL related to Mobility (Odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01–1.10) and Self-Care (OR 1.09, 95% CI 1.02–1.17), and longer hospital stay at baseline was identified as a predictor related to Mobility (OR 1.09, 95% CI 1.01–1.18), Self-Care (OR 1.10, 95% CI 1.02–1.18)) and Usual Activities. (OR 1.10, 95% CI 1.03–1.18). Conclusion: At 5years after stroke, four out of five participants (79%) reported impaired HRQoL related to any of the five dimensions assessed by using the EQ-5D-3L. Most reported, impaired HRQoL was related to Pain/Discomfort. Higher age and longer hospital care period at index stroke were associated with impaired HRQoL. The findings could assist to identify individuals at high risk of low HRQoL, who might benefit from special attention and psychological support.
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17. |
- Sjöholm, Carina, et al.
(författare)
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Om växter, nostalgi och konstruktionen av minnesbilder
- 2021
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Ingår i: Växtvärk. Perspektiv på invasiva främmande växter i svensk natur. - 9789198565904 ; , s. 79-90
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Abstract för skriften: ”Invasiva främmande arter” är ett uttryck som hörs allt oftare, såväl i medier som i diskussioner vid fikabordet. Vad är då en invasiv främmande art och varför väcker dessa arter så starka känslor? Varför är de ett problem? Hur blir man av med dem? Har de några positiva egenskaper? Det är några av de frågor vi tar upp i den här boken som är ett resultat av det tvärvetenskapliga forskningstemat ”Perspektiv på invasiva främmande växter. Paradoxen växt, människa och individuella preferenser” som genomfördes under 2020–2021 vid Pufendorfinstitutet, Lunds universitet. Deltagare i temat har varit forskare från Lunds universitet och Sveriges lantbruksuniversitet som representerar flera olika ämnen: ekologi och botanik, miljövetenskap, etnologi, filosofi, landskapsplanering och växtvetenskap.
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18. |
- Svensson, Börje, et al.
(författare)
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Hela vårdkedjan i fokus : Forskningen på käkkirurgiska kliniken spänner från planering till rehabilitering
- 2009
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Ingår i: Tandläkartidningen. - Stockholm : Sveriges tandläkarförbund. - 0039-6982. ; 101:4, s. 64-
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- På Käkkirurgiska kliniken vid Universitetssjukhuset i Örebro (USÖ) har vi inom den högspecialiserade vården utvecklat en flerårig och bred erfarenhet av framför allt käkrekonstruktioner och käkledskirurgi. Utöver den kirurgiska verksamheten är samarbete, både nationellt och internationellt, en viktig del av vår vardag.
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19. |
- Svensson, Börje, et al.
(författare)
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Patientnära forskning ett prioriterat område
- 2009
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Ingår i: Tandläkartidningen. - Stockholm : Sveriges tandläkarförbund. - 0039-6982. ; 101:4, s. 65-69
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Käkkirurgiska forskningsenhetens pågående projekt består till stor del av klinisk patientnära forskning, vilket är ett av Örebro universitets prioriterade forskningsområden.
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20. |
- Adane, Abyot, et al.
(författare)
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Routine health management information system data in Ethiopia : consistency, trends, and challenges
- 2021
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Ingår i: Global Health Action. - : Taylor & Francis. - 1654-9716 .- 1654-9880. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Ethiopia is investing in the routine Health Management Information System. Improved routine data are needed for decision-making in the health sector.Objective: To analyse the quality of the routine Health Management Information System data and triangulate with other sources, such as the Demographic and Health Surveys.Methods: We analysed national Health Management Information System data on 19 indicators of maternal health, neonatal survival, immunization, child nutrition, malaria, and tuberculosis over the 2012-2018 time period. The analyses were conducted by 38 analysts from the Ministry of Health, Ethiopia, and two government agencies who participated in the Operational Research and Coaching for Analysts (ORCA) project between June 2018 and June 2020. Using a World Health Organization Data Quality Review toolkit, we assessed indicator definitions, completeness, internal consistency over time and between related indicators, and external consistency compared with other data sources.Results: Several services reported coverage of above 100%. For many indicators, denominators were based on poor-quality population data estimates. Data on individual vaccinations had relatively good internal consistency. In contrast, there was low external consistency for data on fully vaccinated children, with the routine Health Management Information System showing 89% coverage but the Demographic and Health Survey estimate at 39%. Maternal health indicators displayed increasing coverage over time. Indicators on child nutrition, malaria, and tuberculosis were less consistent. Data on neonatal mortality were incomplete and operationalised as mortality on day 0-6. Our comparisons with survey and population projections indicated that one in eight early neonatal deaths were reported in the routine Health Management Information System. Data quality varied between regions.Conclusions: The quality of routine data gathered in the health system needs further attention. We suggest regular triangulation with data from other sources. We recommend addressing the denominator issues, reducing the complexity of indicators, and aligning indicators to international definitions.
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21. |
- Adelmann, Kenneth, et al.
(författare)
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Språkutveckling, medier och demokrati
- 2014
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Ingår i: Medie- och informationskunnighet i Norden. - Göteborg : Nordicom. - 9789186523886 ; , s. 117-129
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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22. |
- Adelmann, Kent, et al.
(författare)
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Språkutveckling, medier och demokrati
- 2014
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Ingår i: Medie- och informationskunnighet i Norden. - : Nordicom. - 9789186523886 ; , s. 117-121
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Vi som har skrivit denna artikel är alla verksamma inom forskningsmiljön Svenska med didaktisk inriktning (SMDI) vid Malmö högskola. Frågor om språkutveckling i bred bemärkelse står här i centrum. För närvarande är vi engagerade i projektet ”SMDI och lärande i medielandskapet 2.0”. Vår teoretiska plattform kan beskrivas som medieekologisk, vilket kortfattat uttryckt innebär att vi är intresserade av de mångfaldiga och komplexa relationerna mellan medier och kommunikativa kompetenser (Elmfeldt & Erixon 2007; Erixon 2012; Hayles 2002). Dessa relationer förstås därför inte, som så ofta annars i skolsammanhang, i termer av enkelriktad påverkan eller effekter (exempelvis datorns och internets negativa inverkan på skriftspråket). Vår huvudpoäng i denna artikel är att medie- och informationskunnighet, MIK, handlar om, borde handla om, framför allt två saker: språkutveckling och demokrati.
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23. |
- Ademovski, Seida Erovic, et al.
(författare)
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The effect of periodontal therapy on intra-oral halitosis : a case series
- 2016
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Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 43:5, s. 445-452
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3 months after therapy.MATERIAL AND METHODS: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3 months after treatment using the organoleptic scores (OLS), Halimeter® , and a gas chromatograph.RESULTS: Significant reductions for OLS (p < 0.01), total sum of volatile sulphur compounds (T-VSC) (p < 0.01) and methyl mercaptan (MM) (p < 0.05) values were found after treatment. Hydrogen sulphide (H2 S) levels were not significantly reduced. The numbers of probing pockets 4 mm, 5 mm and 6 mm were significantly reduced as a result of therapy (p < 0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p < 0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a ≥50% reduction of total pocket depth) reductions in OLS (p < 0.01) and T-VSC scores (p < 0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160 ppb, a H2 S value <112 ppb and a MM value <26 ppb.CONCLUSION: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3 months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.
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24. |
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25. |
- Alt Murphy, Margit, 1970, et al.
(författare)
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Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There is an evidence-practice gap in assessment of the upper extremities during acute and subacute stroke rehabilitation. The aim of this study was to target this gap by describing and evaluating the implementation of, and adherence to, an evidence-based clinical practice guideline for occupational therapists and physiotherapists. Methods: The upper extremity assessment implementation process at Sahlgrenska University Hospital comprised 5 stages: mapping clinical practice, identifying evidence-based outcome measures, development of a guideline, implementation, and evaluation. A systematic theoretical framework was used to guide and facilitate the implementation process. A survey, answered by 44 clinicians (23 physiotherapists and 21 occupational therapists), was used for evaluation. Results: The guideline includes 6 primary standardized assessments (Shoulder Abduction, Finger Extension (SAFE), 2 items of the Actions Research Arm Test (ARAT-2), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), 9-Hole Peg Test (9HPT), and grip strength (Jamar hand dynamometer)) performed at specified time-points post-stroke. More than 80% (35 to 42) clinicians reported reported being content with the guideline and the implementation process. Approximately 60-90% of the clinicians reported good adherence to specific assessments, and approximately 50% reported good adherence to the agreed time-points. Comprehensive scales were more difficult to implement compared with the shorter screening scales. High levels of work rotation among staff, and the need to prioritize other assessments during the first week after stroke, hindered to implementation. Conclusion: The robustness of evidence, adequate support and receptive context facilitated the implementation process. The guideline enables a more structured, knowledge-based and consistent assessment, and thereby supports clinical decision-making and patient involvement.
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26. |
- Alwin, Jenny, 1978-, et al.
(författare)
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Health economic and process evaluation of AT interventions for persons with dementia and their relatives - A suggested assessment model
- 2007
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Ingår i: Technology and Disability. - 1055-4181. ; 19:2-3, s. 61-71
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Tidskriftsartikel (refereegranskat)abstract
- There is growing interest in assistive technology (AT) as a means of enabling participation in everyday activities for persons with dementia and their relatives. Health economic assessment of AT in dementia is of importance due to the consequences of the disease for both patients and relatives and to the high societal costs for dementia care. The aim of this article is to outline a model for assessment of AT interventions for persons with dementia. The model expands existing assessment models as it also includes evaluation of the intervention process. Methodological challenges and possibilities in making health economic assessments, including outcomes and costs, as well as process evaluation, are discussed in the article. © 2007 IOS Press. All rights reserved.
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27. |
- Andersson, Kent, et al.
(författare)
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Military utility : A proposed concept to support decision-making
- 2015
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Ingår i: Technology in society. - : Elsevier. - 0160-791X .- 1879-3274. ; 43, s. 23-32
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Tidskriftsartikel (refereegranskat)abstract
- A concept called Military Utility is proposed for the study of the use of technology in military operations. The proposed concept includes a three-level structure representing key features and their detailed components. On basic level the Military Utility of a technical system, to a military actor, in a specific context, is a compound measure of the military effectiveness, of the assessed technical system's suitability to the military capability system and of the affordability. The concept is derived through conceptual analysis and is based on related concepts used in social sciences, the military domain and Systems Engineering. It is argued that the concept has qualitative explanatory powers and can support military decision-making regarding technology in forecasts, defense planning, development, utilization and the lessons learned process. The suggested concept is expected to contribute to the development of the science of Military-Technology and to be found useful to actors related to defense.
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28. |
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29. |
- Axelsson, Lena, et al.
(författare)
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End-of-life and palliative care of patients on maintenance hemodialysis treatment : a focus group study
- 2019
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 18:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite complex illness trajectories and a high symptom burden, palliative care has been sub-optimal for patients with end-stage kidney disease and hemodialysis treatment who have a high rate of hospitalization and intensive care towards end of life. There is a growing awareness that further development of palliative care is required to meet the needs of these patients and their family members. In this process, it is important to explore healthcare professionals' views on provision of care. The aim of this study was therefore to describe nurses' and physicians' perspectives on end-of-life and palliative care of patients treated with maintenance hemodialysis. Methods: Four focus group interviews were conducted with renal nurses (17) and physicians (5) in Sweden. Qualitative content analysis was used to analyze data. Results: Participants were committed to giving the best possible care to their patients, but there were challenges and barriers to providing quality palliative care in nephrology settings. Professionals described palliative care as end-of-life care associated with hemodialysis withdrawal or palliative dialysis, but also identified care needs and possibilities that are in line with an earlier integrated palliative approach. This was perceived as complex from an organizational point of view. Participants identified challenges related to coordination of care and different perspectives on care responsibilities that impacted symptom management and patients' quality of life. Communication issues relating to the provision of palliative care were revealed where the hemodialysis setting was regarded as an impediment, and personal and professional experiences, beliefs and knowledge were considered of major importance. Conclusions: Nurses and physicians identified a need for the improvement of both late and earlier palliative care approaches. The results highlighted a requirement for and possibilities of training, counselling and support of health care professionals in the dialysis context. Further, multi-professional palliative care collaborations should be developed to improve the coordination and organization of end-of-life and palliative care of patients and their family members. A climate allowing conversations about advance care planning throughout the illness trajectory may facilitate the gradual integration of palliative care alongside life-prolonging treatment for improved support of patients and families.
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30. |
- Axelsson, Lena, et al.
(författare)
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Processes toward the end of life and dialysis withdrawal Physicians' and nurses' perspectives
- 2020
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Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 27:2, s. 419-432
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nurses and physicians in nephrology settings provide care for patients with end-stage kidney disease receiving hemodialysis treatment along a complex illness trajectory. Aim: The aim was to explore physicians' and nurses' perspectives on the trajectories toward the end of life involving decisions regarding hemodialysis withdrawal for patients with end-stage kidney disease. Research design and participants: A qualitative research approach was used. Four mixed focus group interviews were conducted with renal physicians (5) and nurses (17) in Sweden. Qualitative content analysis was used to analyse data. Ethical considerations: Ethical approval was obtained (Dnr 2014/304-31). Findings and discussion: Findings illuminated multi-faceted, intertwined processes encompassing healthcare professionals, patients, and family members. The analysis resulted in four themes: Complexities of initiating end-of-life conversations, Genuine attentiveness to the patient's decision-making process, The challenge awaiting the family members' processes, and Negotiating different professional responsibilities. Findings showed complexities and challenges when striving to provide good, ethical care which are related to beneficence, nonmaleficence, and self-determination, and which can give rise to moral distress. Conclusion: There are ethical challenges and strains in the dialysis context that healthcare professionals may not always be prepared for. Supporting healthcare professionals in not allowing complexities to hinder the patient's possibilities for shared decision-making seems important. An open and continual communication, including family meetings, from dialysis initiation could serve to make conversations involving decisions about hemodialysis withdrawal a more natural routine, as well as build up a relationship of trust necessary for the advance care planning about the end of life. Healthcare professionals should also receive support in ethical reasoning to meet these challenges and handle potential moral distress in the dialysis context.
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31. |
- Barragán, O., et al.
(författare)
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K2-139 b: a low-mass warm Jupiter on a 29-d orbit transiting an active K0 V star
- 2018
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Ingår i: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 475:2, s. 1765-1776
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Tidskriftsartikel (refereegranskat)abstract
- We announce the discovery of K2-139 b (EPIC 218916923 b), a transiting warm-Jupiter (Teq = 547 ± 25 K) on a 29-d orbit around an active (log R'_HK = -4.46 ± 0.06) K0V star in K2 Campaign 7. We derive the system's parameters by combining the K2 photometry with ground-based follow-up observations. With a mass of 0.387_-0.075^+0.083 M_J and radius of 0.808_-0.033^+0.034 R_J, K2-139 b is one of the transiting warm Jupiters with the lowest mass known to date. The planetary mean density of 0.91_-0.20^+0.24 g/cm^3 can be explained with a core of ~50 M⊕. Given the brightness of the host star (V = 11.653 mag), the relatively short transit duration (~5 h), and the expected amplitude of the Rossiter-McLaughlin effect (~25m/s), K2-139 is an ideal target to measure the spin-orbit angle of a planetary system hosting a warm Jupiter.
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32. |
- Barragán, O., et al.
(författare)
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K2-141 b: A 5-M⊕ super-Earth transiting a K7 V star every 6.7 hours
- 2018
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 612
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Tidskriftsartikel (refereegranskat)abstract
- We report on the discovery of K2-141 b (EPIC 246393474 b), an ultra-short-period super-Earth on a 6.7 h orbit transiting an active K7 V star based on data from K2 campaign 12. We confirmed the planet's existence and measured its mass with a series of follow-up observations: seeing-limited Muscat imaging, NESSI high-resolution speckle observations, and FIES and HARPS high-precision radial-velocity monitoring. K2-141 b has a mass of 5.31 ± 0.46 M ⊗ and radius of 1.54 -0.09 +0.10 R ⊗ , yielding a mean density of 8.00 -1.45 +1.83 g cm -3 and suggesting a rocky-iron composition. Models indicate that iron cannot exceed ∼70% of the total mass. With an orbital period of only 6.7 h, K2-141 b is the shortest-period planet known to date with a precisely determined mass.
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33. |
- Barragán, O., et al.
(författare)
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Radial velocity confirmation of K2-100b: A young, highly irradiated, and low-density transiting hot Neptune
- 2019
-
Ingår i: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 490:1, s. 698-708
-
Tidskriftsartikel (refereegranskat)abstract
- We present a detailed analysis of HARPS-N radial velocity observations of K2-100, a young and active star in the Praesepe cluster, which hosts a transiting planet with a period of 1.7 d. We model the activity-induced radial velocity variations of the host star with a multidimensional Gaussian Process framework and detect a planetary signal of 10.6 ± 3.0 m s−1, which matches the transit ephemeris, and translates to a planet mass of 21.8 ± 6.2 M. We perform a suite of validation tests to confirm that our detected signal is genuine. This is the first mass measurement for a transiting planet in a young open cluster. The relatively low density of the planet, 2.04+−006661 g cm−3, implies that K2-100b retains a significant volatile envelope. We estimate that the planet is losing its atmosphere at a rate of 1011–1012 g s−1 due to the high level of radiation it receives from its host star.
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34. |
- Barragan, O., et al.
(författare)
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The young HD 73583 (TOI-560) planetary system: two 10-M-circle plus mini-Neptunes transiting a 500-Myr-old, bright, and active K dwarf
- 2022
-
Ingår i: Monthly Notices of the Royal Astronomical Society. - : Oxford University Press (OUP). - 0035-8711 .- 1365-2966. ; 514:2, s. 1606-1627
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Tidskriftsartikel (refereegranskat)abstract
- We present the discovery and characterization of two transiting planets observed by TESS in the light curves of the young and bright (V = 9.67) star HD73583 (TOI-560). We perform an intensive spectroscopic and photometric space- and ground-based follow-up in order to confirm and characterize the system. We found that HD73583 is a young (similar to 500 Myr) active star with a rotational period of 12.08 +/- 0.11 d, and a mass and radius of 0.73 +/- 0.02 M-circle dot and 0.65 +/- 0.02 R-circle dot, respectively. HD 73583 b (P-b = 6.3980420(-0.0000062)(+0.0000067 )d) has a mass and radius of 10.2(-3.1)(+3.4) M-circle plus and 2.79 +/- 0.10 R-circle plus, respectively, which gives a density of 2.58(-0.81)(+0.95) g cm(-3). HD 73583 c (P-c = 18.87974(-0.00074)(+0.00086) d) has a mass and radius of 9.7(-1.7)(+1.8) M-circle plus and 2.39(-0.09)(+0.10) R-circle plus, respectively, which translates to a density of 3.88(-0.80)(+0.91) g cm(-3). Both planets are consistent with worlds made of a solid core surrounded by a volatile envelope. Because of their youth and host star brightness, they both are excellent candidates to perform transmission spectroscopy studies. We expect ongoing atmospheric mass-loss for both planets caused by stellar irradiation. We estimate that the detection of evaporating signatures on H and He would be challenging, but doable with present and future instruments.
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35. |
- Beckers, Manfred, et al.
(författare)
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The influence of substrate temperature and Al mobility on the microstructural evolution of magnetron sputtered ternary Ti-Al-N thin films
- 2009
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Ingår i: Journal of Applied Physics. - : AIP Publishing. - 0021-8979 .- 1089-7550. ; 106:6, s. 064915-
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Tidskriftsartikel (refereegranskat)abstract
- Ternary Ti-Al-N films were deposited onto Al2O3 (0001) substrates by reactive co‑sputtering from elemental Ti and Al targets and analyzed by in situ and ex situ x-ray scattering, Rutherford backscattering spectroscopy, transmission electron microscopy and x-ray photoemission spectroscopy. The deposition parameters were set to values that yield Ti:Al:N ratios of 2:1:1 and 4:1:3 at room temperature. 2TiAlN depositions at 675 °C result in epitaxial Ti2AlN growth with basal planes parallel to the substrate surface. Nominal 4TiAl3N depositions at 675 °C and above, however, yield TiN and Ti2AlN domains due to Al loss to the vacuum. Depositions at a lower temperature of 600 °C yield films with correct 4:1:3 stoichiometry, but Ti4AlN3 formation is supposedly prevented by insufficient adatom mobility. Instead, an incoherent Tin+1AlNn structure with random twinned stacking sequences n is obtained, that exhibits both basal plane orientations parallel as well as nearly perpendicular to the substrate interface. X‑ray photoemission spectroscopy shows that in contrast to stoichiometric nitrides the Al is metallically bonded and hence acts as twinning plane within the Tin+1AlNn stackings. Domains with perpendicular basal plane orientation overgrowth those with parallel ones in a competitive growth mode. The resulting morphology is a combination of smooth‑surfaced parallel basal plane orientation domains interrupted by repeated facetted hillock-like features with perpendicular basal plane orientation.
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36. |
- Benzein, Eva, 1951-, et al.
(författare)
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Metoder inom familjecentrerad forskning
- 2017. - 2
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Ingår i: Att möta familjer inom vård och omsorg. - Lund : Studentlitteratur AB. - 9789144115870 ; , s. 107-122
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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37. |
- Benzein, Eva, et al.
(författare)
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‘You put it all together’ : families' evaluation of participating in family health conversations
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:1, s. 136-144
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo evaluate the Family Health Conversations from the perspective of families living with chronic illness.Methodological design and justificationThis study has a descriptive qualitative design using semi-structured evaluative family interviews and conventional content analysis.Ethical issues and approvalThe study was approved by a Regional Ethical Review Board.Research methodsFamily Health Conversations were used as an intervention with 14 families living with chronic illness. The outcome measures consisted of evaluative family interviews.ResultsFamilies' experiences of the conversations embraced their structure and the interactions with the conversation leaders. All families were satisfied with the conversations, pointing to the importance of having them early in the illness process. The opportunity to talk with someone outside the family was strongly emphasised as promoting well-being. The experienced significance of the conversations was captured in four categories: creating a whole picture, that is, being given the opportunity to listen to other family members' experiences and fill in potential memory gaps; making the situation manageable, that is, receiving support from other participants in order to handle problems and gain control; facilitating healing, that is, being able to tell their story about what had previously been ‘the unspeakable’; and strengthened family cohesion, that is, increased understanding for each other's experiences, thus bringing family members closer together.Study limitationsMost families were partners, which could possibly limit transferability of the findings to families constituted by couples.ConclusionsFamily Health Conversations should be offered as a part of standard care shortly after diagnosis and at various transitions in life.
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38. |
- Berciano Alba, A., et al.
(författare)
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DEMON: a proposal for a satellite-borne experiment to study dark matter and dark energy
- 2006
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Ingår i: Proceedings of the SPIE: Space Telescopes and Instrumentation II: Ultraviolet to Gamma Ray, eds, M.J.L. Turner and G. Hasinger. ; 6266, s. 91-
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- We outline a novel satellite mission concept, DEMON, aimed at advancing our comprehension of both dark matter and dark energy, taking full advantage of two complementary methods: weak lensing and the statistics of galaxy clusters. We intend to carry out a 5000 deg2 combined IR, optical and X-ray survey with galaxies up to a redshift of z~2 in order todetermine the shear correlation function. We will also find ~100000 galaxy clusters, making it the largest survey of this type to date. The DEMON spacecraft will comprise one IR/optical and eight X-ray telescopes,coupled to multiple cameras operating at different frequency bands. To a great extent, the technology employed has already been partially tested on ongoing missions, therefore ensuring improved reliability.
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39. |
- Bergqvist, Gunilla M, et al.
(författare)
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Authors' response.
- 2019
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Ingår i: Topics in stroke rehabilitation. - : Informa UK Limited. - 1945-5119 .- 1074-9357. ; 27:2
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Tidskriftsartikel (refereegranskat)
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40. |
- Bergqvist, G. M., et al.
(författare)
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Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke
- 2019
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Ingår i: Topics in Stroke Rehabilitation. - : Informa UK Limited. - 1074-9357 .- 1945-5119. ; 26:5, s. 366-372
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke. Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance. Results: The raters showed a percentage agreement of >= 75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between -0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance. Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.
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41. |
- Bergström, Anna, et al.
(författare)
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Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings
- 2015
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.
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42. |
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43. |
- Bjartling, Carina, et al.
(författare)
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Clinical Manifestations and Epidemiology of the New Genetic Variant of Chlamydia trachomatis.
- 2009
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Ingår i: Sexually Transmitted Diseases. - 1537-4521. ; 36, s. 529-535
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:: In 2006, a new genetic variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. Clinical manifestations of this infection were studied in a high-risk population. METHODS:: During 2007, a prospective case-control study on sexual lifestyle and urogenital infections was performed at the Centre for Sexual Health (CSH), affiliated to Malmo University Hospital. A total of 629 C. trachomatis positive cases and 1252 negative controls were included. At Malmo University Hospital, Department of Obstetrics and Gynecology, all cases of pelvic inflammatory disease (PID) were assessed and correlated to the prevalence of nvCT. RESULTS:: Patients with nvCT or wild type C. trachomatis (wtCT) infection did not differ regarding their sexual lifestyle. Men with nvCT or wtCT infection did not differ in uro-genital symptoms or clinical findings. Women with nvCT infection reported painful urination (12.2% vs. 25.8%, P = 0.02) and were diagnosed with urethritis (11.1% vs. 40.0%, P = 0.04) less often than women with wtCT infection. The ratio of lower abdominal pain in women with nvCT infection was only half of that in women with wtCT infection (13.4% vs. 27.8%, P = 0.02). PID was detected in 0.8% of women with C. trachomatis infection in Malmo. All these cases were due to wtCT infection. CONCLUSIONS:: Symptomatic urethral infection and lower abdominal pain was less common in women with nvCT as compared to wtCT. Infection with nvCT was more frequently asymptomatic suggesting a possible difference in virulence between the nvCT strain and the wtCT strain.
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44. |
- Bjartling, Carina, et al.
(författare)
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Deoxyribonucleic acid of Chlamydia trachomatis in fresh tissue from the Fallopian tubes of patients with ectopic pregnancy.
- 2007
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115. ; 134:1, s. 95-100
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The role of persistent chlamydial infection of the Fallopian tubes in ectopic pregnancy is still unresolved. Therefore, we examined tissue of the Fallopian tubes from patients with ectopic pregnancy for the presence of Chlamydia trachomatis. In addition, other markers of C. trachomatis infection implicated in the pathogenesis of tubal damage were studied including antibodies to heat shock protein 60 of chlamydial and human origin. Study design: Fresh frozen tubal tissue from 55 patients with ectopic pregnancy in a hospital setting were examined for the presence of C. trachomatis DNA by polymerase chain reaction (PCR) and blood sample were analysed for antibodies to C. trachomatis including heat shock protein 60 (hsp60). Results: Chlamydial DNA was not detected in any of the 55 tubal specimens using a commercial test, Cobas Amplicor, Roche, and an in-house real time PCR able to detect a few copies of the organism. Logistic regression showed that chlamydial IgG antibodies were more common in a subgroup of patients with previous PID than in controls (OR = 7.84, CI 1.78-34.6). Specific antibodies to hsp60 of chlamydial (OR = 7.00, CI 1.50-32.6) but not of human origin (OR = 2.13, CI 0.14-31.6) were associated with ectopic pregnancy in this group. Conclusions: No evidence of persistent infection of C. trachomatis in the fallopian tubes at the time of ectopic pregnancy was found in this study. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
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45. |
- Bjartling, Carina, et al.
(författare)
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Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service.
- 2012
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 1097-6868 .- 0002-9378. ; 206:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We sought to analyze the prevalence and clinical manifestations of Mycoplasma genitalium infection in a heterogeneous population of women. STUDY DESIGN: The study was designed as a cross-sectional case-control study. Women attending a gynecological outpatient service from 2003 through 2008 were invited to participate. RESULTS: The prevalence of M genitalium was 2.1% and of Chlamydia trachomatis was 2.8% among 5519 tested women. A total of 679 women were included. Both pelvic inflammatory disease (PID) and cervicitis were independently associated with M genitalium (odds ratio, 9.00; 95% confidence interval, 1.62-49.89 and odds ratio, 3.80; 95% confidence interval, 2.06-7.03, respectively). Women with C trachomatis had a higher frequency of both PID (18.3% vs 4.9%, P < .001) and cervicitis (33.4% vs 22.3%, P < .001) than women with M genitalium. CONCLUSION: M genitalium was an independent and strong risk factor for both cervicitis and PID although, compared to C trachomatis, clinical manifestations were less frequent.
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46. |
- Bjartling, Carina, et al.
(författare)
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The association between Mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy
- 2010
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Ingår i: BJOG: An International Journal of Obstetrics & Gynaecology. - : Wiley. - 1471-0528 .- 1470-0328. ; 117:3, s. 361-364
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence and complications of Mycoplasma genitalium and Chlamydia trachomatis infections among women undergoing termination of pregnancy were studied in this nested case-control study at Malmo University Hospital, Sweden, during 2003 to 2007. The study comprised 2079 women presenting for termination of pregnancy. Forty-nine women with M. genitalium infection and 51 women with C. trachomatis infection, together with 168 negative control women, were evaluated. The prevalences of M. genitalium and C. trachomatis were 2.5% and 2.8%, respectively. The M. genitalium was strongly associated with post-termination pelvic inflammatory disease (odds ratio 6.29, 95% CI 1.56-25.2). The increased risk for pelvic inflammatory disease associated with M. genitalium infection after termination of pregnancy suggests a causal relationship.
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47. |
- Bluhm, P., et al.
(författare)
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Precise mass and radius of a transiting super-Earth planet orbiting the M dwarf TOI-1235: a planet in the radius gap?
- 2020
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 639
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Tidskriftsartikel (refereegranskat)abstract
- We report the confirmation of a transiting planet around the bright weakly active M0.5 V star TOI-1235 (TYC 4384-1735-1, V ≈ 11.5 mag), whose transit signal was detected in the photometric time series of sectors 14, 20, and 21 of the TESS space mission. We confirm the planetary nature of the transit signal, which has a period of 3.44 d, by using precise RV measurements with the CARMENES, HARPS-N, and iSHELL spectrographs, supplemented by high-resolution imaging and ground-based photometry. A comparison of the properties derived for TOI-1235 b with theoretical models reveals that the planet has a rocky composition, with a bulk density slightly higher than that of Earth. In particular, we measure a mass of Mp = 5.9 ± 0.6 M⊕ and a radius of Rp = 1.69 ± 0.08 R⊕, which together result in a density of ρp = 6.7- 1.1+ 1.3 g cm-3. When compared with other well-characterized exoplanetary systems, the particular combination of planetary radius and mass places our discovery in the radius gap, which is a transition region between rocky planets and planets with significant atmospheric envelopes. A few examples of planets occupying the radius gap are known to date. While the exact location of the radius gap for M dwarfs is still a matter of debate, our results constrain it to be located at around 1.7 R⊕ or larger at the insolation levels received by TOI-1235 b (~60 S⊕). This makes it an extremely interesting object for further studies of planet formation and atmospheric evolution.
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48. |
- Botö, Sara, et al.
(författare)
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Physical inactivity after stroke: Incidence and early predictors based on 190 individuals in a 1-year follow-up of the Fall Study of Gothenburg.
- 2021
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Ingår i: Journal of rehabilitation medicine. - : Medical Journals Sweden AB. - 1651-2081. ; 53:9
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Tidskriftsartikel (refereegranskat)abstract
- To determine the incidence of physical inactivity and factors prior to stroke and in acute stroke that are associated with physical inactivity 1 year after stroke Design: Prospective longitudinal cohort Patients: A total of 190 consecutively included individuals with acute stroke Methods: A follow-up questionnaire, relating to physical activity level using the Saltin-Grimby Physical Activity Scale, was sent to participants in The Fall Study of Gothenburg 1 year after stroke. Predictors of physical inactivity at baseline were identified using univariable and multivariable logistic regression analyses.Physical inactivity 1 year after stroke was reported by 70 (37%) of the 190 patients who answered the questionnaire and was associated with physical inactivity before the stroke, odds ratio (OR) 4.07 (95% confidence interval (95% CI) 1.69-9.80, p=0.002); stroke severity (assessed by National Institutes of Health Stroke Scale (NIHSS), score 1-4), OR 2.65 (95% CI) 1.04-6.80, p=0.042) and fear of falling in acute stroke, OR 2.37 (95% CI 1.01-5.60, p=0.048).Almost 4 in 10 participants reported physical inactivity 1 year after stroke. Physical inactivity before the stroke, stroke severity and fear of falling in acute stroke are the 3 main factors that predict physical inactivity 1 year after stroke.
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49. |
- Brunnberg, Elinor, 1948-, et al.
(författare)
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Att höra eller nästan inte höra : Liv & hälsa ung 2005 och 2007 i Örebro län
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I linje med FN:s barnkonvention och Konventionen om rättigheter förpersoner med funktionshinder ska ungdomars röst göras hörd. Den härrapporten bygger helt på ungdomars uppgifter om sin verklighet.Studierna Liv & hälsa ung 2005 och 2007 visar att i den reguljära skolanupplever drygt fem procent av eleverna att de har ett funktionshinder närdet gäller hörseln och de rapporterar ofta en utsatt situation. Det finns även hörselskadade ungdomar på specialskolan/riksgymnasiet för döva och hörselskadade. De hörselskadade ungdomarna är en grupp som rapporterar en mängd hälsorelaterade problem, många känner sig mobbade av kamrater eller kränkta av vuxna i skolan. Det är också en grupp som förhållandevis ofta rapporterar bruk av alkohol, tobak och narkotika. De kan även ha andra funktionsnedsättningar eller tinnitus. De hörselskadade ungdomarna är en högriskgrupp som behöver uppmärksammas och få ett bättre anpassat stöd. Det behövs fördjupade studier hur stödet kan utformas på ett relevant sätt, speciellt gäller det dem med flera funktionshinder. För att göra detta är det viktigt att ungdomarna själva involveras i arbetet. Fördjupade studier behövs också om hur hörselskadade ungdomars delaktighet i den reguljära skolan kan förbättras samt om vad som skapar exempelvis stress, trötthet och olyckor. Det behövs åtgärder för att minska den mobbning som sker och inte minst minska det ungdomar rapporterar om kränkning från vuxna. Det behövs riktade insatser för att öka de hörselskadade ungdomarnas simkunnighet och fysiska aktivitet. Det är också av stor betydelse för de hörselskadade och döva ungdomarna att det finns kompetent tvåspråkig (svenska och teckenspråk) personal på ungdomsmottagningar och barnahus.
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50. |
- Brunnberg, Elinor, 1948-, et al.
(författare)
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Hard-of-hearing adolescents reporting some other disability or tinnitus : a replication study including an age-related analysis
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In two previous studies based on the survey, Life & Health Young 2005 in Örebro county 15-16 years old Hard-of-hearing (HH) students with some other disability (HHDIS) and HH with tinnitus (HHTINN) reported considerably higher scores for mental symptoms and substance use than adolescents ‘just‘ HH or hearing adolescents. In order to replicate these findings we analysed the 2007 survey and included adolescents in grade 7, 9 and 2 in secondary school concerning substance use and depression. We also used reference data from the corresponding adult survey Life & Health 2008. In grade 9 HHDIS (2.0%) and HHTINN (2.0 %) both reported strongly increased rates of risky alcohol consumption (55/51% versus 13%), daily tobacco use (57/54% versus 10%) and depression (43/43% versus 14%) than hearing or ´just´ HH adolescents. Similar but less pronounced changes were present in grade 7 and grade 2. In HHDIS increased risk drinking was found until age 35, increased daily tobacco use until age 50 and increased depression until age 65. In HHTINN only rate of depression was increased in adult life. HHDIS and HHTINN thus are important targets for preventive measures. In addition tinnitus in young people can be a marker like disability of vulnerability.
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