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Bucht, Gösta
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Publications (10 of 22) Show all publications
Fordell, H., Bodin, K., Bucht, G. & Malm, J. (2011). A virtual reality test battery for assessment and screening of spatial neglect. Acta Neurologica Scandinavica, 123(3), 167-174
Open this publication in new window or tab >>A virtual reality test battery for assessment and screening of spatial neglect
2011 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 123, no 3, p. 167-174Article in journal (Refereed) Published
Abstract [en]

Background – There is a need for improved screening methods for spatial neglect.

Aim – To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.

Method –  VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.

Results –  Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r2 = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47–0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was ‘easy’ to use. Eighty-eight percent reported that they felt ‘focused’, ‘pleased’ or ‘alert’. No patient had adverse symptoms. The test session took 15 min.

Conclusions –  The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.

Place, publisher, year, edition, pages
John Wiley & Sons, 2011
Keywords
perceptual disorder, hemispatial neglect, diagnosis, neuro psychological tests, task performance and analysis, visual perception, user computer interface, stroke complications, assessment
National Category
Neurology Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:umu:diva-51122 (URN)10.1111/j.1600-0404.2010.01390.x (DOI)000286667900003 ()20569225 (PubMedID)
Available from: 2012-01-11 Created: 2012-01-11 Last updated: 2018-06-08Bibliographically approved
Englund, U., Nordström, P., Nilsson, J., Bucht, G., Björnstig, U., Hallmans, G., . . . Pettersson Kymmer, U. (2011). Physical activity in middle-aged women and hip fracture risk: the UFO study. Osteoporosis International, 22(2), 499-505
Open this publication in new window or tab >>Physical activity in middle-aged women and hip fracture risk: the UFO study
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2011 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 22, no 2, p. 499-505Article in journal (Refereed) Published
Abstract [en]

Summary: In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.

Introduction: In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.

Methods: The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.

Results: Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05–0.53 for walking and OR 0.19; 95% CI; 0.08–0.46, OR 0.17, 95% CI; 0.05–0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.

Conclusion: An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.

Keywords
Epidemiology, Hip fracture, Physical activity, Risk factors, Women
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-29823 (URN)10.1007/s00198-010-1234-1 (DOI)
Available from: 2009-11-24 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Pellfolk, T., Gustafson, Y., Bucht, G. & Karlsson, S. (2010). Effects of a restraint minimization program on staff knowledge, attitudes, and practice: a cluster randomized trial. Journal of The American Geriatrics Society, 58(1), 62-69
Open this publication in new window or tab >>Effects of a restraint minimization program on staff knowledge, attitudes, and practice: a cluster randomized trial
2010 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 58, no 1, p. 62-69Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate the effects of a restraint minimization education program on staff knowledge and attitudes and use of physical restraints.

DESIGN: Cluster-randomized controlled trial with nursing units as the basis for randomization.

SETTING: Forty group dwelling units for people with dementia.

PARTICIPANTS: At baseline, there were 184 staff and 191 residents in the intervention group and 162 staff and 162 residents in the control group. At the 6-month follow-up, there were 156 staff and 185 residents (36 newly admitted) in the intervention group and 133 staff and 165 residents (26 newly admitted) in the control group.

INTERVENTION: A 6-month education program for all nursing staff.

MEASUREMENTS: Staff knowledge and attitudes and physical restraint use were measured before and after the education program.

RESULTS: In the intervention group, staff knowledge about and attitudes toward restraint use changed, and the overall use of physical restraints decreased. A comparison including only residents present during the whole study period showed that the level of use was similar between the groups at baseline, whereas it was significantly lower in the intervention group at follow-up. Adjusted analyses showed that the odds of being restrained at follow-up were lower in the intervention group than in the control group. There was no significant change in the number of falls or use of psychoactive medication.

CONCLUSION: The results indicate that staff education can increase knowledge, change attitudes, and reduce the use of physical restraints without any change in the incidence of falls or use of psychoactive drugs.

Place, publisher, year, edition, pages
United Kindom: Wiley Interscience, 2010
Keywords
physical restraints, cluster-randomized trial, dementia care, staff education, knowledge, attitudes
National Category
Geriatrics
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-31950 (URN)10.1111/j.1532-5415.2009.02629.x (DOI)000273311500009 ()20122041 (PubMedID)
Available from: 2010-02-24 Created: 2010-02-24 Last updated: 2018-06-08Bibliographically approved
Englund, U., Littbrand, H., Sondell, A., Bucht, G. & Pettersson, U. (2009). The beneficial effects of exercise on BMC are lost after cessation: a 5-year follow-up in older post-menopausal women. Scandinavian Journal of Medicine and Science in Sports, 19(3), 381-388
Open this publication in new window or tab >>The beneficial effects of exercise on BMC are lost after cessation: a 5-year follow-up in older post-menopausal women
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2009 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 19, no 3, p. 381-388Article in journal (Refereed) Published
Abstract [en]

This study investigates whether the positive effects on bone mineral density (BMD, g/cm2) and neuromuscular function following a combined weight-bearing program are sustained in older women, a longer period after cessation of training. Thirty-four women (18 exercisers and 16 controls) aged 73–88 years, who completed a 12-month randomized-controlled trial, were invited to a 5-year follow-up assessment of BMD and neuromuscular function. Both groups sustained significant losses in BMD of the femoral neck, trochanter, and Ward's triangle during the follow-up period. Significant losses were also seen in all neuromuscular function tests. The inter-group change was, however, significant only for maximal walking speed where the exercise group had a significantly greater loss. In conclusion, this study suggests that gains in bone density and neuromuscular functions achieved by training are lost after cessation of training. Continuous high-intensity weight-loading physical activity is probably necessary to preserve bone density and neuromuscular function in older women.

Place, publisher, year, edition, pages
Copenhagen: Munksgaard, 2009
Keywords
bone density, muscle strength, detraining, post-menopausal, women
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-29822 (URN)10.1111/j.1600-0838.2008.00802.x (DOI)
Available from: 2009-11-24 Created: 2009-11-24 Last updated: 2018-06-08Bibliographically approved
Jónsson, P. V., Noro, A., Finne-Soveri, H., Jensdóttir, A. B., Ljunggren, G., Bucht, G., . . . Schroll, M. (2008). Admission profile is predictive of outcome in acute hospital care.. Aging Clinical and Experimental Research, 20(6), 533-9
Open this publication in new window or tab >>Admission profile is predictive of outcome in acute hospital care.
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2008 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, no 6, p. 533-9Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND AIMS: The purpose of this study is to describe predictors for discharge and one-year outcomes of acute-care hospital patients, 75 years of age or over, based on admission status information. We carried out a prospective study of a randomly selected patient population, from one urban acute-care hospital in each of the Nordic countries. 763 persons aged 75+ were randomly selected from acute admissions to the participating hospitals. 749 observations at discharge and 655 observations at one year were used in analyses. METHODS: Data were collected with the MDS-AC 1.1 instrument within 24 hours of admission, and at day 7 or discharge, whichever came first. Outcome information was collected either by interviewing the patient or from patient records or registers. Discharge and one-year outcome (home, institution, death) were modeled by multinomial logistic regression, with admission status variables as predictors. RESULTS: At discharge, 84% of subjects returned home, 11% went to an institution and 5.6% had died. At one year, 64% were still living at home, 24% had died, and 12% had moved to an institution. For discharge outcome, those having hospital admission due to a new problem or exacerbation of an old one had a higher risk of dying (OR 3.3) than returning home. Moderate to severe cognitive problems predicted death (OR 2.2) and institutionalization (OR 8.6) compared with discharge home. Problems in instrumental activities of daily living predicted death (OR 3.1) and institutionalization (OR 6.0). At one year, those with exacerbation of an old problem (OR 2.1) or with a new or exacerbated existing problem (OR 2.3) had a higher risk of dying than of institutionalization or discharge home. Having some cognitive problems (OR 2.8) or moderate to severe cognitive problems (OR 6.6) predicted institutionalization, but not dying or discharge home. Those with some problems in activities of daily living had a higher risk of both dying (OR 1.7) and of institutional care (OR 2.7). Those with moderate to severe problems in activities of daily living had also a higher risk of institutional care (OR 4.7) compared with those living at home. CONCLUSIONS: Evidence predictive of discharge and one-year outcomes in older acute hospital medical care patients seems to be visible from the beginning of the hospital stay. In order to increase the efficient use of health care services and quality of care, systematic standardized and streamlined assessment should be performed during the admission process.

Identifiers
urn:nbn:se:umu:diva-23168 (URN)19179837 (PubMedID)
Available from: 2009-06-02 Created: 2009-06-02 Last updated: 2018-06-08
Sahlin, C., Sandberg, O., Gustafson, Y., Bucht, G., Carlberg, B., Stenlund, H. & Franklin, K. (2008). Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up. Archives of Internal Medicine, 168(3), 297-301
Open this publication in new window or tab >>Obstructive sleep apnea is a risk factor for death in patients with stroke: a 10-year follow-up
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2008 (English)In: Archives of Internal Medicine, ISSN 0003-9926, E-ISSN 1538-3679, Vol. 168, no 3, p. 297-301Article in journal (Refereed) Published
Abstract [en]

 

Background: Sleep apnea occurs frequently among stroke patients, but it is still unknown whether a diagnosis of sleep apnea is an independent risk factor for mortality. We aimed to investigate whether obstructive or central sleep apnea was related to a reduced long-term survival among stroke patients.

Methods: One hundred and thirty-two of 151 patients admitted for in-hospital stroke rehabilitation in the catchment area of Umeå from 1 April 1995 to 1 May 1997 underwent overnight sleep apnea recordings at 23 ± 8 days after onset of stroke. All patients were followed-up prospectively for a mean (SD) of 10.0 ± 0.6 years, with death as the primary outcome and no one was lost to follow-up. Obstructive sleep apnea was defined when the obstructive apnea-hypopnea index was over 15 and central sleep apnea when the central apnea-hypopnea index was over 15. Patients with an obstructive and a central apnea-hypopnea index below 15 served as controls.

Results: Of 132 enrolled patients, 116 had died at follow-up. The risk of death was higher among the 23 patients with obstructive sleep apnea than controls (adjusted hazard ratio, 1.76; 95% confidence interval 1.05 to 2.95, p=0.03), independent of age, gender, body-mass index, smoking, hypertension, diabetes mellitus, atrial fibrillation, mini-mental state examination and Barthel activity of daily living There was no difference in mortality between the 28 patients with central sleep apnea and controls (adjusted hazard ratio, 1.07; 95 percent confidence interval 0.65 to 1.76, p=0.053).

Conclusions: Stroke patients with obstructive sleep apnea run an increased risk of early death. Central sleep apnea was not related to early death among the present patients.

Place, publisher, year, edition, pages
Chicago: American medical association, 2008
Keywords
obstructive sleep apnéa, stroke, death, positive airway pressure, Cheyne-Stokes respiration, breathing disorders, ischemic stroke, 1st-ever stroke, prognosis, disease, night
National Category
Cardiac and Cardiovascular Systems General Practice
Research subject
Lung Medicine
Identifiers
urn:nbn:se:umu:diva-18814 (URN)10.1001/archinternmed.2007.70 (DOI)000252962300009 ()
Available from: 2009-02-25 Created: 2009-02-25 Last updated: 2018-06-09Bibliographically approved
Grue, E. V., Ranhoff, A. H., Noro, A., Finne-Soveri, H., Jensdóttir, A. B., Ljunggren, G., . . . Jónsson, P. V. (2008). Vision and hearing impairments and their associations with falling and loss of instrumental activities in daily living in acute hospitalized older persons in five Nordic hospitals. Scandinavian Journal of Caring Sciences, 23(4), 635-643
Open this publication in new window or tab >>Vision and hearing impairments and their associations with falling and loss of instrumental activities in daily living in acute hospitalized older persons in five Nordic hospitals
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2008 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 4, p. 635-643Article in journal (Refereed) Published
Abstract [en]

Background: Many older people believe sensory problems are inevitably, a part of growing old, and avoid assessment and help. Such problems are often also overlooked by health professionals. The aim of this study was to find the prevalence of hearing and vision impairment and their associations with loss of instrumental activities in daily living (IADL) and risk of falling in patients aged 75 years or older, admitted to a medical ward in an acute hospital in each of the five Nordic countries. Method: The Minimum Data Set for Acute Care was used for data collection in 770 patients. Premorbid data, admission data and history of falls over 3 months were obtained on admission by interview and observation. Hearing impairment was present if the patient required a quiet setting to be able to hear normal speech. Vision impairment was defined as unable to read regular print in a newspaper. Results: Bivariate and logistic regression analyses were performed. Forty-eight per cent of the patients had a hearing impairment, 32.3% had vision impairment and 20.1% had both. Hearing impairment was associated with falling but not in the logistic regression model. Hearing and vision impairment were associated with loss of IADL but only combined impairment was independently. Conclusion: Hearing and vision impairments were frequent among older patients in the medical wards. Falling was associated with hearing loss and IADL loss with hearing, vision and combined impairments. Sensory loss was also associated with fear of falling. It is recommended routinely to screen sensory functions in older patients in a medical setting. Intervention studies are needed to determine whether improvements in hearing and vision can prevent falls and further loss of function in this patient population.

Identifiers
urn:nbn:se:umu:diva-29938 (URN)10.1111/j.1471-6712.2008.00654.x (DOI)19068040 (PubMedID)
Available from: 2009-11-27 Created: 2009-11-27 Last updated: 2018-06-08
Jonsén, E., Ljunggren, G., Jonsson, P. V. & Bucht, G. (2007). Functional status in elderly people after acute care and quality of life at one-year follow-up.. Health Science Journal, 1(January-March), 1-14
Open this publication in new window or tab >>Functional status in elderly people after acute care and quality of life at one-year follow-up.
2007 (English)In: Health Science Journal, Vol. 1, no January-March, p. 1-14Article in journal (Refereed) Published
Keywords
Quality of life, hospitalization, ADL, elderly people, resident assessment instrument
Identifiers
urn:nbn:se:umu:diva-6705 (URN)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
Edlund, A., Lundström, M., Sandberg, O., Bucht, G., Brännström, B. & Gustafson, Y. (2007). Symptom profile of delirium in older people with and without dementia.. Journal of Geriatric Psychiatry and Neurology, 20(3), 166-171
Open this publication in new window or tab >>Symptom profile of delirium in older people with and without dementia.
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2007 (English)In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 20, no 3, p. 166-171Article in journal (Refereed) Published
Keywords
Aged, Aged; 80 and over, Aggression/psychology, Aging/*psychology, Analgesics/administration & dosage, Anxiety/epidemiology/psychology, Circadian Rhythm, Delirium/*epidemiology/*psychology, Delusions/epidemiology/psychology, Dementia/*epidemiology/*psychology, Female, Geriatric Assessment/methods/statistics & numerical data, Hallucinations/epidemiology/psychology, Humans, Male, Orientation, Psychiatric Status Rating Scales/statistics & numerical data, Psychomotor Agitation/epidemiology/psychology, Recognition (Psychology), Sweden/epidemiology, Verbal Behavior
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-8280 (URN)10.1177/0891988707303338 (DOI)17712100 (PubMedID)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
Jónsson, P. V., Finne-Soveri, H., Jensdóttir, A. B., Ljunggren, G., Bucht, G., Grue, E. V., . . . Schroll, M. (2006). Co-morbidity and functional limitation in older patients underreported in medical records in Nordic Acute Care Hospitals when compared with the MDS-AC instrument. Age and Ageing, 35(4), 434-438
Open this publication in new window or tab >>Co-morbidity and functional limitation in older patients underreported in medical records in Nordic Acute Care Hospitals when compared with the MDS-AC instrument
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2006 (English)In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 35, no 4, p. 434-438Article in journal (Refereed) Published
Abstract [en]

SIR—Older persons are characterised by age-related changes, multiple diseases, multiple drug use and functional deficits. For optimal care, a holistic approach is needed; however, the health care systems of today are still essentially organised to provide acute medical care to relatively younger populations with little or no co-morbidity [ 1]. Health systems will have to adapt to this new situation.

The value of geriatric assessment has been proven, where targeting is the key to success [ 2]. With shorter hospital stays, it is of importance to do this targeting quickly and effectively. According to a systematic literature review in the older patients, the most important predictors for adverse outcomes of acute care (mortality, frequent readmissions, institutionalisation and long length of stay) are current illness, decline in physical functions and age. In addition, illness severity, co-morbidity, polypharmacy, cognitive decline, poor nutrition and gender are predictive for one or more of the outcomes [ 3].

The Minimum Data Set for Acute Care (MDS-AC) instrument was developed to guide care within the hospital and to facilitate the transfer and sharing of information to the next provider of care, thus supporting integrated care. The MDS-AC instrument provides an opportunity to systematically collect information that is reliable on function and co-morbidity and could thus be a valuable addition to the future electronic medical record [ 4].

The aim of this study is to investigate to what degree important predictors of adverse outcomes, if present according to the MDS-AC instrument during the first 24 h of care for older patients, were not documented in traditional hospital records in acute care wards in five Nordic countries. Hence, the MDS-AC information is assumed to be a gold standard. A secondary aim is to show that suspected deficient documentation is an international issue.

Place, publisher, year, edition, pages
Oxford: Oxford Univ. Press, 2006
Keywords
Activities of Daily Living, Aged, Aged; 80 and over, Aging/*pathology, Catchment Area (Health), Comorbidity, Female, Forms and Records Control, Geriatric Assessment, Hospitals, Humans, Male, Medical Records/*standards, Scandinavia
Identifiers
urn:nbn:se:umu:diva-6745 (URN)10.1093/ageing/afj060 (DOI)16540491 (PubMedID)
Available from: 2008-01-16 Created: 2008-01-16 Last updated: 2018-06-09Bibliographically approved
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