| 1. |
- Johansson, Karin Mauri, et al.
(author)
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Creating possibilities for action in the presence of environmental barriers in the process of 'ageing in place'
- 2009
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In: Ageing & Society. - 0144-686X .- 1469-1779. ; 29:1, s. 49-70
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Journal article (peer-reviewed)abstract
- The need for an understanding of 'ageing in place' as a progressive process has emerged among researchers in the field of environmental gerontology. The aim of this study was to explore this process, in relation to home modification services. Four older adults who had applied for home modification services in one Swedish municipality were included. Data were collected by open interviews with the participants in their homes on subsequent occasions, from before the modification had been installed until recognised stability in the situation relating to the home modification. In the analysis, the concept of place integration was used as a tool to explore the active relations that connect people and context over time. The main findings show that the participants used creativity and initiative to direct future situations towards increased possibilities for action. This indicates that services aiming to support people 'ageing in place' should be directed towards increasing possibilities for action rather than only facilitating activity performance. Furthermore, it can be concluded that if the service-users' creativity and efforts are recognised as resources in design and provision of services, services that aim to support individuals who are ageing in place have the potential to be empowering
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| 2. |
- Johansson, Karin Mauri, et al.
(author)
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Older persons' navigation through the service system towards home modification resources
- 2009
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 16:4, s. 227-237
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Journal article (peer-reviewed)abstract
- Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a "geographical map". Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system. ©
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| 3. |
- Johansson, Karin Mauri, et al.
(author)
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Performance of activities of daily living in a sample of applicants for home modification services
- 2007
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 44-53
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Journal article (peer-reviewed)abstract
- Home modification services are provided to support persons with functional limitations to live independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship between performance of activities of daily living, housing and living situation, and the home modification applied for in a sample of home modification applicants. Further, the aim was to examine differences in performance of activities of daily living between subgroups with different social support. A total of 102 participants were included in the study. Data on performance of activities of daily living was collected through interviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived difficulties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupational therapy interventions.
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| 4. |
- Larsson, Anna-Karin, 1975-
(author)
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Early life cytokines, viral infections and IgE-mediated allergic disease
- 2006
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Doctoral thesis (other academic/artistic)abstract
- Background: The reasons why some individuals become IgE-sensitised and allergic are largely unknown, though genetic- and early life environmental factors seem to be of importance.Objective: The overall aim of this thesis was to investigate the relationship between IgE-sensitisation and allergic disease, viral infections, genetic markers and early life cytokines.Results: IgE-sensitised children were found to have reduced numbers of IL-12 producing cord blood mononuclear cells (CBMC), whereas children diagnosed with eczema were found to have reduced numbers of IFN-γ producing CBMC. When dividing the children into early onset of IgE-sensitisation and late onset of IgE-sensitisation we found that the children with an early onset had low numbers of PHA-induced IL-4, IL-12 and IFN-γ secreting CBMC. At the age of two there was a general exacerbation of cytokine responses in the IgE-sensitised children, and the results were similar for the children with early onset IgE-sensitisation. Children with a late onset IgE-sensitisation were more similar to the non-sensitised children, but with a specific increase in the response to cat allergen (IL-4 and IFN-γ). The mothers of IgE-sensitised children, were just as their children, found to have an exaggerated cytokine response as compared to mothers of non-sensitised children. Maternal responses correlated well to the responses seen in the child, though the samples were taken two years after delivery.Cytomegalovirus (CMV) infection in early life was associated to reduced numbers of IL-4, and increased numbers of IFN-γ producing cells at the age of two. No association between CMV seropositivity and IgE-sensitisation was seen. Epstein-Barr virus (EBV) infection, on the other hand, was inversely correlated with IgE –sensitisation, whereas no statistically significant association to cytokine production could be seen.We also showed that the IL12B 1188 C-allele was associated to having a positive skin prick test at the age of two. The rare alleles of the three SNPs investigated (IL12B 1188C, IL12RB1132C and IRF1 1688A) were all associated to low IL-12 production at birth.Conclusions: Our results indicate that allergic diseases are complex traits, and that both the genetic and the cytokine background differ between the different allergic diseases. We can also conclude that the time of onset seem to play a role when investigating IgE-sensitisation, and that perhaps early and late onset IgE-sensitisation have partly different causes. CMV and EBV infection early in life are associated to a protective cytokine profile and to protection from IgE-sensitisation, respectively, again indicating the heterogeneity and the complexity of allergic diseases.
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| 5. |
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| 6. |
- Lilja, Karl, et al.
(author)
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Screening study on occurrence of hazardous substances in the eastern Baltic Sea
- 2009
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Reports (other academic/artistic)abstract
- IVL and NILU have during 2008/2009 as an assignment from HELCOM, performed a screening study in the eastern Baltic Sea environment on the occurrence of eight of the substances/substance groups identified as hazardous under the Baltic Sea Action Plan. Of the eight substances or substance classes included in the study, six of them were found above LOQ; organic tin compounds, PBDEs, PFAS, nonylphenol, chlorinated paraffins and endosulfan (endosulfan sulphate). Substances that occurred in fish samples from all sampling sites were; TBT, PBDEs (BDE 47 and BDE 100), PFAS (PFOS), chlorinated paraffins (SCCP), and endosulfan (endosulfan sulphate). Additionally, bisphenol A was found in fish from almost all sampling sites. PFAS (PFOS and PFOA), octyphenol and nonylphenol were found in one, one and six water samples, respectively. No obvious differences in concentrations could be seen between the sampling sites classified as background areas and affected areas. Furthermore, no clear general differences between affected sites could be seen. Concentrations found for the different substances were lower or in the same range as previously reported from other areas of the Baltic Sea, thus the eastern Baltic Sea environment does not seem to be more polluted compared to the Baltic Sea in general. For all the substances, except TBT, concentrations found were below reported PNEC values. However, for TBT, concentrations in several fish muscle samples were close to or above the PNEC value estimated for protection of human health considering consumption of fishery products. Additionally, PFOS levels in fish liver exceeded the PNEC value regarding secondary poisoning of predators in six samples, but PFOS levels in fish muscle were not measured in this study.
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| 7. |
- Remberger, Mikael, et al.
(author)
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Results from the Swedish National Screening Programme 2008. Sub-report 2. Biocides: Glutaraldehyde
- 2009
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Reports (other academic/artistic)abstract
- As an assignment from the Swedish EPA, IVL has during 2008/2009 performed a 'Screening Study' of glutaraldehyde. In addition, formaldehyde and acetaldehyde were also measured. In Sweden the major usage of glutaraldehyde is as a slimicide in the paper and pulp industry. The compound is also used as a disinfectant in hospitals, as a biocide for water treatment in water recirculating systems and off-shore operations, in the petroleum industry, in the live stock and aquaculture industries, as a fixative in histology, as hardener in x-ray film processing, for tanning of leather, and also in cosmetics. The compund has high water solubility, is reactive and is of low persistence. It is not expected to accumulate in soil, sediment or biota. Thus in the environment, water is the compartment that may be of concern. In previous studies, glutaraldehyde has been found in air and effluent water sampled at hospitals, and in water from pulp and paper industry. A sampling program was developed based on usage pattern, chemical properties and fate, and results from previous studies. It included samples from the vicinity of potential point sources, samples representing diffuse emission pathways, and samples from background areas. Glutaraldehyde could only be found in samples associated with the identified point sources related to the usage of the compound, i.e. in effluent water from a paper mill and in air and effluent water from an hospital. It could however not be found in samples from potential point sources representing the end of product life cycles, i.e. air and water from recycling companies or leachate water from a landfill. Further, it could not be found in samples representing diffuse sources or background areas. Glutaraldehyde may thus affect the environment at the site of usage, but the results indicate a low potential for dispersal in the environment. Concentrations found were below toxicity values found in the literature. Thus, all together glutaraldehyde does not appear to pose a risk to the environment.
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| 8. |
- Westergren, Albert, 1967-, et al.
(author)
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Study circles improve the precision in nutritional care in special accommodations
- 2009
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In: Food and Nutrition Research. - 1654-6628. ; 53
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Journal article (peer-reviewed)abstract
- Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition, appropriate nutritional care can be provided.Objectives: Do study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high BMI?Design: Pre and post intervention study.Setting: Special accommodations (nursing homes) within six municipalities were involved.Participants: In 2005, 1726 (90.4%) out of 1910 residents agreed to participate and in 2007, 1526 (81.8%) out of 1866 residents participated.Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities.Measurements: Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. Overweight was defined as high BMI.Results: In 2005 and 2007, 64% of 1726 and 66% of 1526 residents respectively were at the risk of undernutrition. In 2007 significantly more patients in the study circle municipality were accurately provided protein and energy enriched food compared to in the no intervention municipalities. There was a decrease in the prevalence of low BMI in the study circle municipality and the prevalence of overweight increased in the policy document municipality between 2005 and 2007.
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| 9. |
- Westergren, Albert, et al.
(author)
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Study circles improve the precision in nutritional care in special accommodations
- 2009
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In: Food and Nutrition Research. - : Swedish Nutrition Foundation. - 1654-6628 .- 1654-661X. ; 53
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Journal article (peer-reviewed)abstract
- Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition, appropriate nutritional care can be provided. Objectives: Do study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high BMI? Design: Pre and post intervention study. Setting: Special accommodations (nursing homes) within six municipalities were involved. Participants: In 2005, 1726 (90.4%) out of 1910 residents agreed to participate and in 2007, 1526 (81.8%) out of 1866 residents participated. Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities. Measurements: Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. Overweight was defined as high BMI. Results: In 2005 and 2007, 64% of 1726 and 66% of 1526 residents respectively were at the risk of undernutrition. In 2007 significantly more patients in the study circle municipality were accurately provided protein and energy enriched food compared to in the no intervention municipalities. There was a decrease in the prevalence of low BMI in the study circle municipality and the prevalence of overweight increased in the policy document municipality between 2005 and 2007.
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