1. |
- Berglund, Helene, 1957, et al.
(author)
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Effects of a continuum of care intervention on frail older persons' life satisfaction: a randomized controlled study
- 2015
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:7-8, s. 1079-1090
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Journal article (peer-reviewed)abstract
- Aims and objectives The aim of this study was to analyse effects of a comprehensive continuum of care (intervention group) on frail older persons’ life satisfaction, as compared to those receiving usual care (control group). The intervention included geriatric assessment, case management, interprofessional collaboration, support for relatives and organising of care-planning meetings in older persons’ own homes. Background Improvements in older persons’ subjective well-being have been shown in studies including care planning and coordination by a case manager. However, effects of more complex continuum of care interventions on frail older persons’ life satisfaction are not well explored. Design Randomised controlled study. Methods The validated LiSat-11 scale was used in face-to-face interviews to assess older persons’ life satisfaction at baseline and at three, six and 12 months after the baseline. The odds ratio for improving or maintaining satisfaction was compared for intervention and control groups from baseline to three-month, three- to six-month as well as six- to 12-month follow-ups. Results Older persons who received the intervention were more likely to improve or maintain satisfaction than those who received usual care, between 6 and 12 month follow-ups, for satisfaction regarding functional capacity, psychological health and financial situation. Conclusions A comprehensive continuum of care intervention comprising several components had a positive effect on frail older persons’ satisfaction with functional capacity, psychological health and financial situation. Relevance to clinical practice Frail older persons represent a great proportion of the persons in need of support from the health care system. Health care professionals need to consider continuum of care interventions’ impact on life satisfaction. As life satisfaction is an essential part of older persons’ well-being, we propose that policy makers and managers promote comprehensive continuum of care solutions.
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2. |
- Berglund, Helene, 1957, et al.
(author)
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The impact of socioeconomic conditions, social networks, and health on frail older people's life satisfaction: a cross-sectional study
- 2016
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In: Health Psychology Research. - : Open Medical Publishing. - 2420-8124. ; 4:1, s. 26-31
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Journal article (peer-reviewed)abstract
- It has been shown that frailty is associated with low levels of wellbeing and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people's life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people's life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction such as social support should be promoted.
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3. |
- Wilhelmson, Helene, et al.
(author)
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Iron Age migration on the island of Öland : Apportionment of strontium by means of Bayesian mixing analysis
- 2015
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In: Journal of Archaeological Science. - : Elsevier BV. - 1095-9238 .- 0305-4403. ; 64:December 2015, s. 30-45
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Journal article (peer-reviewed)abstract
- Migration is a complex subject to approach in archeology and the new materials and methods available, such as isotope analysis and DNA, make it possible, and necessary, to ask new questions. The objective of this paper is to highlight the possibilities with using a new approach to migration on a population level by applying Bayesian mixing analysis of strontium isotopes. The selected case, the island of Öland in the Baltic, was based on 109 human samples dated to the Early (500 BC-AD 400,n=71) and Late (AD 400-1050, n=38) periods. The results from both periods demonstrate that the distribution of Strontium (Sr) is multimodal with several peaks not associated with the local variation. Our results show a large immigration to Öland from other geological areas, with 32% of the population in the Early period and 47% in the Late period being nonlocal. In order to unravel these distributions, we use a Bayesian mixing analysis. The Bayesian mixing analysis provides us with a mean to disentangle the distribution of Sr that is not uninformed. The gravity model, however simplistic, is relevant for explaining the strontium variation in the population in Öland both in the Early and Late period. Our results indicate a significant internal migration in Scandinavia that is increasing in the Late Iron Age at the same time as the Viking expansions (the more well studied external migration), which is usually the only migration discussed. We argue that the method proposed and tested on the case of Öland adds new perspectives for approaching migration patterns in general on a population level, a perspective that is hitherto lacking in archaeology.
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4. |
- Wilhelmson, Helene, et al.
(author)
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Migration and integration on the Baltic island of Öland in the Iron Age
- 2017
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In: Journal of Archaeological Science: Reports. - : Elsevier BV. - 2352-409X. ; 12, s. 183-196
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Journal article (peer-reviewed)abstract
- This study explores a bi-isotopic approach to migration, adding δ18O values to samples with 87Sr/86Sr values for 109 individuals from the Iron Age (500 BCE–1050 CE) on the island of Öland, Sweden. Determining a local baseline for 87Sr/86Sr was complicated due to the wide range of variation in faunal samples so we divided the human values into three groups: local, non-local and undetermined. The addition of δ18O isotopes allowed identifying further non locals than the data from the 87Sr/86Sr alone provided. We found significant migration rates in both the Early period (500 BCE–400 CE) with 30% non-locals and in the Late (400–1050 CE), more than doubling to 68%. In both periods the non-locals appear to have diverse geographical origins. In order to study integration and migration patterns we use a bioarchaeological approach to these non cremated individuals who come from all types of contexts, i.e. not just burials. This allows discussing the cultural and social integration of non-locals. Integration is apparent in both periods and in the Late period, with a higher proportion of non-locals, there is both integration and diversity. The proportion of female non-locals suggest a mobility in both periods, especially the Late, that is relatively large. Our results of diverse non-local origins, female mobility and integration on Öland throughout the Iron Age add a new perspective, a Scandinavian multi-isotopic bioarchaeological perspective, to current discussions of Viking movement and expansion.
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5. |
- Wilhelmson, Helene
(author)
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Perspectives from a human-centred archaeology : Iron Age people and society on Öland
- 2017
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Doctoral thesis (other academic/artistic)abstract
- The objective of this study was to develop, test and evaluate a specifically defined interdisciplinary approach—the human-centred approach—as applied to a case study, Iron Age Öland. Four themes were selected to highlight different aspects of particular interest in Öland: taphonomy, diet, migration, and social organization. The uncremated human skeletal remains from Öland are the basis for this study. Different aspects of the bones, such as spatial distribution and chemical and physical properties, were investigated. The methods used include osteological methods, image-based modelling, isotopic analysis of bone (δ13C and δ15N; 14C) and enamel (87Sr/86Sr, δ18O), statistical modelling, and graph-based network analysis.The great impact of the choice of methodology in the different papers was apparent in evaluating how the human-centred approach could be practiced.The concept developed in Paper I, Virtual Taphonomy, provided deeper insight into the specific case study of Öland but also showed the potential of this methodology for archaeology and osteology in general.The approach to migration in Paper II gave results differing from those in Paper IV. The use of a second isotope (δ18O) in Paper IV showed how some individuals were clearly not from an area close by enough to fit within the proposed areas in Paper II. Paper IV also questioned the definitions of 87Sr/86Sr baseline and the interpretation process for deciding whether an individual is determined as a migrant. While the population level approach to migration in Paper II allowed for a discussion on the mechanisms behind migration, the approach in Paper IV instead gave insight into the nature and expression of migration within Öland’s society.In Paper III, it was demonstrated that a shift in diet (isotope variation) did not coincide with the relative typological chronology but instead should be studied by more independent chronology (such as 14C). The isotope results for Öland could also be interpreted completely differently today due to new standards for understanding how isotope values relate to human diet.Paper V showed how a transparent analysis of isotope results, osteological analysis, and archaeological parameters could be used to discuss societal development using graph-based network analysis.Using the human-centred approach to Iron Age Öland resulted in some new insights and a rethinking of society, particularly regarding diet and migration. The interpretation of the diet isotopes means that the pastoralist subsistence likely transformed the Ölandic landscape much earlier than previously thought. The dietary shift places the start of this in the final two centuries BC, not AD 200. In the Late Iron Age, the migration levels doubled, especially as women were immigrating. The people settling Öland were coming from diverse geographical areas in both periods, with the addition of more distant migrants in the Late period. I argue this is part of a creolization process in Öland in the Late Iron Age, detectable in burial practice and diet. The starting point of this great immigration is difficult to define as uncremated human remains are largely lacking in the period AD 200–700. Around AD 200, there is also a change in social organization indicated through the perceptible use of violence. I interpret this as a society where elders had diminished social power compared to earlier times, and when the increasing military focus throughout Scandinavia was also established in Öland.In conclusion, the exploration of a human-centred archaeology gave new insights of relevance to archaeology at large, not just Iron Age Öland. In particular, the strong interpretational aspects of isotopes could be demonstrated, as well as the great advantages of applying digital archaeological theory and method to human skeletal remains.
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6. |
- Wilhelmson, Helene
(author)
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Shifting diet, shifting culture? : A bioarchaeological approach to island dietary development on Iron-Age Öland, Baltic Sea
- 2017
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In: American Journal of Physical Anthropology. - : Wiley. - 0002-9483. ; 163:2, s. 264-284
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Journal article (peer-reviewed)abstract
- ObjectivesThe diet and subsistence in Iron-Age Öland is debated as earlier studies and different archaeological sources seemingly provide conflicting interpretations. The objectives of this study are therefore to: (i) add new insights on diet and (ii) investigate the chronological variation in detail. It is common in studies of diet to investigate differences between datasets defined by archaeological periods (determined by artefact typology), but it is rare to explore whether these dietary changes are, in fact, well correlated with these temporal categories or not.Materials and methodsStable isotope analysis of 108 individuals and 25 animals was used to interpret diet in comparison with data from earlier studies. Different values of TLE (Trophic Level Effect) for δ15N were compared for interpretations of diet. Of the 108 individuals, 42 were subjected to 14C analysis in this study.ResultsThe isotopes from Iron-Age animals on Öland indicate that the local, contemporary ecology is specific. The human isotope values show chronological development both when pooled in chronological groups by typology and by more specific 14C chronology.DiscussionThe new samples of animals as well as the use of 5‰ TLE for δ15N values results in the diet reinterpreted as mainly domesticate-based, with at least two shifts in diet occurring in the Iron Age. The use of 14C dates in connection with the stable isotope results indicates a dietary transition occurring between 200 BC and AD 200, a date range that spans two typologically determined time periods.
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7. |
- Wilhelmson, Helene, et al.
(author)
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Virtual Taphonomy : a New Method Integrating Excavation and Post-processing of Human Remains
- 2015
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In: American Journal of Physical Anthropology. - : Wiley. - 0002-9483. ; 157:2, s. 305-321
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Journal article (peer-reviewed)abstract
- The objective of this paper was to integrate excavation and post-processing of archaeological and osteological contexts and material to enhance the interpretation of these with specific focus on the taphonomical aspects. A method was designed, Virtual Taphonomy, based on the use and integration of image-based 3D modeling techniques into a 3D GIS platform, and tested on a case study. Merging the 3D models and a database directly in the same virtual environment allowed the authors to fully integrate excavation and post-processing in a complex spatial analysis reconnecting contexts excavated on different occasions in the field process. The case study further demonstrated that the method enabled a deeper understanding of the taphonomic agents at work and allowed the construction of a more detailed interpretation of the skeletal remains than possible with more traditional methods. The method also proved to add transparency to the entire research process from field to post-processing and interpretation. Other benefits were the timesaving aspects in documentation, not only in the excavation process but also in post-processing without creating additional costs in material, as the equipment used is available in most archaeological excavations. The authors conclude that this methodology could be employed on a variety of investigations from archaeological to forensic contexts and add significant value in many different respects (for example, detail, objectivity, complexity, time-efficiency) compared to methods currently used.
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