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  • 1.
    Andersson, Christina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Terapeuter rapporterar om bildterapi i fallstudier2015Independent thesis Advanced level (degree of Master (One Year)), 40 poäng / 60 hpOppgave
    Abstract [sv]

    Syfte: Syftet med föreliggande studie var dels att undersöka om det fanns gemensamma drag i bildterapeuters yrkesutövning, dels att belysa bildterapeuters sätt att rapportera om sitt arbete.

    Metod: En litteraturstudie gjordes. Den omfattade ett urval av tio fallstudier som analyserades.

    Resultat: Resultaten visade att bildterapeuterna ofta tänjde på gränserna för terapirummet och materialanvändningen. Resultaten visade också att det fanns brister i bildterapeuternas sätt att rapportera.

    Slutsats: Bildterapeuter behöver förfina och utveckla sitt sätt att rapportera så att det blir mera vetenskapligt. Det behövs bredare och djupare studier för att bekräfta eller falsifiera föreliggande studies resultat.

  • 2.
    Andersson, Jenni
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stabil och lättare kognitions- och motoriknedsättning hos TIA-patienter över 10-års uppföljning2019Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 3.
    Andersson, Lina
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Brannelid, Maria
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för kostvetenskap.
    Kylda matlådor inom äldreomsorgen: En studie om kundernas upplevelse kring beställning, leverans och mat2014Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

    Bakgrund ”Mat är mer än bukfylla” löd rubriken på en artikel i Skånska tidningen från januari 2014. Artikeln kom av kritiken som riktats mot de kylda matlådorna som på flera ställen serveras inom äldreomsorgen. Artikelns huvudsakliga syfte var att belysa de brister som finns med maten som serveras till de äldre. Att inte få i sig tillräckligt med näring och energi kan leda till komplikationer som exempelvis nedsatt immunförsvar, svårläkta sår, orkeslöshet samt depressioner.

     

    Syfte Syftet med studien var att ta reda på hur kunder som utnyttjar tjänsten matdistribution inom äldreomsorgen i en utvald kommun i Mellansverige upplever beställning, leverans samt maten som de får distribuerad av kommunen.

     

    Metod En enkät togs fram i samarbete med dietist i utvald kommun. Under våren 2014 delades 170 enkäter ut. Det räknades ut median, genomfördes chi-2-test och t-test. Signifikansnivån sattes till P=0,05

     

    Resultat Utifrån de 170 enkäter som skickades ut samlades 89 enkäter in. Studien kom att bestå av 39 stycken män och 49 stycken kvinnor. Informanterna tyckte överlag att maten smakade bra och de var nöjda med beställning och leverans. Det fanns dock skillnader mellan könen, män tenderade att vara mer nöjda/mycket nöjda än kvinnorna.

     

    Slutsats Studien visar att kunderna i kommunen sammantaget är nöjda med de kylda matlådorna. Det har inte skett någon större förändring gentemot tidigare studier som gjorts i kommunen, vilket indikerar på att maten håller en god standard. Det vi anser att kommunen bör se över är grönsakerna som medföljer, eftersom de klagomål som framkom av kunderna berörde främst dessa. Vi anser också att vidare studier bör genomföras för att få en djupare bild av upplevelsen kring matsituationen. 

    Fulltekst (pdf)
    fulltext
  • 4.
    Andersson, Linus
    et al.
    Department of Occupational and Public Health Sciences, University of Gävle.
    Claeson, Anna-Sara
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Dantoft, Thomas Meinertz
    Department of Systems Biology, Center for Biological Sequence Analysis, Technical University of Denmark.
    Skovbjerg, Sine
    Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte.
    Lind, Nina
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Nordin, Steven
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity2016Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, nr 1, s. 79-88Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Multiple chemical sensitivity (MCS) is a prevalent medically unexplained symptom characterized by symptom reactions to everyday chemical exposure below hygienic thresholds. The aim of this study was to investigate the expressions of hyper-reactivity in MCS during whole-body exposure to low concentrations of the odorant n-butanol.

    Methods: We exposed 18 participants with MCS and 18 non-ill controls to a low concentration of the odorantn-butanol using an exposure chamber. The first 10 min constituted blank exposure, after which then-butanol concentration increased and reached a plateau at 11.5 mg/m3.

    Results: MCS participants, compared with controls, reported greater perceived odor intensities, more unpleasantness to the exposure and increasing symptoms over time. MCS participants also expressed higher pulse rate and lower pulse rate variability than controls did. No group differences were found for breathing rate or tonic electrodermal activity responses.

    Conclusions: We conclude that MCS sufferers differ from healthy controls in terms of autonomic responses, symptoms and chemosensory perception during chemical exposure.

  • 5.
    Bengtsson, Sara K S
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Johansson, Maja
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi. Umecrine Cognit AB, Umea, Sweden.
    Bäckström, Torbjörn
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Long-term continuous allopregnanolone elevation causes memory decline and hippocampus shrinkage, in female wild-type B6 mice2016Inngår i: Hormones and Behavior, ISSN 0018-506X, E-ISSN 1095-6867, Vol. 78, s. 160-167Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Chronic stress in various forms increases the risk for cognitive dysfunction, dementia and Alzheimer's disease. While the pathogenesis behind these findings is unknown, growing evidence suggests that chronic increase in neurosteroid levels, such as allopregnanolone, is part of the mechanism. We treated wild-type C57BL/6J mice with allopregnanolone for 5months, using osmotic pumps. This treatment led to moderately increased levels of allopregnanolone, equivalent to that of mild chronic stress. After an interval of no treatment for 1month, female mice showed impaired learning and memory function in the Morris water maze (MWM) in combination with diminished hippocampus weight and increased cerebellum weight, both correlating to MWM performance. Male mice showed a minor reduction in memory function and no differences in brain structure. We conclude that chronic allopregnanolone elevation can lead to cognitive dysfunction and negative brain alterations. We suggest that allopregnanolone could play a key role in the pathogenesis of stress-induced cognitive disturbances and perhaps dementia.

  • 6.
    Bergström, Cecilia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Persson, Margareta
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Mogren, Ingrid
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum2016Inngår i: Chiropractic and Manual Therapies, ISSN 2045-709X, E-ISSN 2045-709X, Vol. 24, artikkel-id 7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Pregnancy related low back pain (PLBP) and pelvic girdle pain (PGP) are considered common complications of pregnancy. The long-term consequences for women with persistent PLBP/PGP postpartum are under-investigated. The main objective was to investigate the prevalence, pattern and degree of sick leave as well as healthcare utilisation and its perceived effect in women with persistent PLBP/PGP at 12 months postpartum.

    Method: This is a follow-up study of a cohort involving of a sample of women, who delivered from January 1st 2002 to April 30th in 2002 at Umea University Hospital and Sunderby Hospital, and who reported PLBP/PGP during pregnancy. A total of 639 women were followed-up by a second questionnaire (Q2) at approximately 6 months postpartum. Women with persistent PLBP/PGP at the second questionnaire (N = 200) were sent a third questionnaire (Q3) at approximately 12 months postpartum.

    Results: The final study sample consisted of 176 women reporting PLBP/PGP postpartum where N = 34 (19.3 %) reported 'no' pain, N = 115 (65.3 %) 'recurrent' pain, and N = 27 (15.3 %) 'continuous' pain. The vast majority (92.4 %) of women reported that they had neither been on sick leave nor sought any healthcare services (64.1 %) during the past 6 months at Q3. Women with 'continuous' pain at Q3 reported a higher extent of sick leave and healthcare seeking behaviour compared to women with 'recurrent' pain at Q3. Most women with persistent PLBP/PGP had been on sick leave on a full-time basis. The most commonly sought healthcare was physiotherapy, followed by consultation with a medical doctor, acupuncture and chiropractic.

    Conclusion: Most women did not report any sick leave or sought any healthcare due to PLBP/PGP the past 6 months at Q3. However, women with 'continuous' PLBP/PGP 14 months postpartum did report a higher prevalence and degree of sick leave and sought healthcare to a higher extent compared to women with 'recurrent' PLBP/PGP at Q3. Women with more pronounced symptoms might constitute a specific subgroup of patients with a less favourable long-term outcome, thus PLBP/PGP needs to be addressed early in pregnancy to reduce both individual suffering and the risk of transition into chronicity.

    Fulltekst (pdf)
    fulltext
  • 7.
    Boström, Gustaf
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Conradsson, Mia
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Hörnsten, Carl
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Lindelöf, Nina
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Holmberg, Henrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Effects of a high-intensity functional exercise program on depressive symptoms among people with dementia in residential care: a randomized controlled trial2016Inngår i: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 31, nr 8, s. 868-878Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: The aim of this study is to evaluate the effect of a high-intensity functional exercise program on depressive symptoms among older care facility residents with dementia.

    METHODS: Residents (n = 186) with a diagnosis of dementia, age ≥ 65 years, Mini-Mental State Examination score ≥ 10, and dependence in activities of daily living were included. Participants were randomized to a high-intensity functional exercise program or a non-exercise control activity conducted 45 min every other weekday for 4 months. The 15-item Geriatric Depression Scale (GDS) and the Montgomery-Åsberg Depression Rating Scale (MADRS) were administered by blinded assessors at baseline, 4, and 7 months.

    RESULTS: No difference between the exercise and control activity was found in GDS or MADRS score at 4 or 7 months. Among participants with GDS scores ≥ 5, reductions in GDS score were observed in the exercise and control groups at 4 months (-1.58, P = 0.001 and -1.54, P = 0.004) and 7 months (-1.25, P = 0.01 and -1.45, P = 0.007). Among participants with MADRS scores ≥ 7, a reduction in MADRS score was observed at 4 months in the control group (-2.80, P = 0.009) and at 7 months in the exercise and control groups (-3.17, P = 0.003 and -3.34, P = 0.002).

    CONCLUSIONS: A 4-month high-intensity functional exercise program has no superior effect on depressive symptoms relative to a control activity among older people with dementia living in residential care facilities. Exercise and non-exercise group activities may reduce high levels of depressive symptoms.

    Fulltekst (pdf)
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  • 8.
    Byenfeldt, Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Faktorer som kan påverka mätresultaten vid shear wave elastografi av lever. En litteraturstudie.2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Hepatit B- och hepatit C-virus orsakar inflammation i levern vilket kan leda till fibrosutveckling, levercirros, kronisk leverinflammation och levercancer.  En bedömning av varje patients fibrosutveckling är viktig för att kunna sätta in behandling i rätt tid och undvika utveckling av allvarlig leversjukdom och i värsta fall hepatocellulär cancer (HCC). Det är således av stor vikt att dessa patienter monitoreras och att patienternas leverfibrosutveckling kontinuerligt övervakas och graderas.  Shear wave elastografi (SWE) av lever är en ny teknik som enkelt kan utföras vid konventionell ultraljudsundersökning. SWE har därmed både omvårdnads- och medicinska fördelar jämfört med leverbiopsi och transient elastografi (TE) med FibroScan®, vilket gör det rimligt att anta att det även finns ekonomiska vinster och resurser att spara. Det finns dock faktorer som påverkar resultatet vid SWE och dessa faktorer har undersökts i ett flertal studier. Syfte: Syftet med studien var att identifiera faktorer som kan påverka mätresultatet vid shear wave elastografi av lever. Metod: Studien har utförts som en litteraturstudie där 22 kvantitativa artiklar, publicerade i årsspannet 2010 till 2015, granskats. Sökningar gjordes i fyra databaser med sökorden elasticity imaging techniques, shear wave och ultrasound elastography. Resultat: Studien visade att det finns ett flertal faktorer som påverkar mätresultatet vilka bör beaktas innan bestämning av fibrosgraden. Dessa faktorer delades i denna litteraturstudie in i två domäner; faktorer relaterade till patienten samt faktorer till tekniken och analys av mätresultat. Slutsats: Den här litteraturstudien är av stor betydelse för radiografi då den på ett överskådligt identifierar ett antal faktorer som kan påverka mätresultatet vid SWE av lever. Det är av stor vikt att dessa faktorer beaktas innan gradering av leverns fibrosgrad.

  • 9.
    Calander, Björn
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    The effects of Clopidogrel on neuroinflammation and learning impairment related to Alzheimer´s disease2017Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
    Abstract [en]

    Neuroinflammation has been intensively studied the last two decades and has been shown to take part in neurodegenerative diseases such as Alzheimer’s disease (AD). The microglial cells, which are macrophages of the central nervous system (CNS), are the main actors in this chronic inflammatory state. Together with the neurons, the microglia are thought to control the complex dynamic remodeling of neuronal dendrites and synapses seen during both healthy and pathologic conditions. As a surface receptor of microglia, the purinergic receptor P2Y12 transmits intracellular signals for their chemotaxis towards tissue damage within the CNS. Clopidogrel, which is an inhibitor of P2Y12, is prescribed to patients with cerebrovascular diseases, which have high comorbidity with AD. In the present study, upregulated motor behavior, sensitization, has been studied in amyloid-beta (Aβ)-injected zebrafish larvae as a model for cognitive decline in AD. Although the behavioral experiments indicated a protective effect on learning from Clopidogrel in Aβ-injected fish, this effect was not reaching significance when several experiments were pooled together. Neuronal cell death numbers measured by confocal imaging showed an increase in Aβ-injected zebrafish larvae when treated with Clopidogrel. In conclusion, the experiments show that P2Y12 is important for removal of dead cells in the CNS of larval zebrafish following injury, and therefore could be relevant for neurodegenerative processes in humans.

  • 10.
    Carstensen, Emil
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Prevalence, trends and socioeconomic and demographic risk factors for self-reported diabetes in adults in Northern Sweden2017Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 11.
    Diderichsen, Saima
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    It's just a job: a new generation of physicians dealing with career and work ideals2017Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: Today, women constitute about half of medical students. However, women are still underrepresented in prestigious specialties such as surgery. Some suggest that this could be explained by women being more oriented towards work-life balance.

    Aim: The overall aim of this dissertation was to explore aspects of gender in work-life priorities, career plans, clinical experiences and negotiations of professional ideals among medical students and newly graduated doctors, all in a Swedish setting.

    Method: We based the analysis on data from two different sources: an extensive questionnaire exploring gender and career plans among medical students (paper I-III) and interviews with newly graduated doctors (study IV).

    In paper I, four classes of first- and final-year medical (N=507, response rate 85%) answered an open-ended question about their future life, 60% were women. We conducted a mixed methods design where we analyzed the answers qualitatively to create categories that could be analyzed quantitatively in the second stage.

    In paper II, five classes of final-year medical students  were included (N = 372, response rate 89%), and 58% were women. We studied their specialty preference and how they rated the impact that the motivational factors had for their choice. In order to evaluate the independent impact of each motivational factor for specialty preference, we used logistic regression.

    In paper III, final-year medical students answered two open-ended questions: “Can you recall an event that made you interested of working with a certain specialty?” and “Can you recall an event that made you uninterested of working with a certain specialty?”. The response rate was 62% (N = 250),  and 58% were women. The analysis was similar to paper I, but here we focused on the qualitative results.

    In paper IV, thematic interviews were conducted in 2014 and 2015. We made a purposeful sampling of 15 junior doctors, including nine women and six men from eight different hospitals. Data collection and analysis was inspired by constructivist grounded theory methodology.

    Results: When looking at the work-life priorities of medical students and junior doctors it is clear that both men and women want more to life than work in their ideal future. The junior doctors renounced fully devoted and loyal ideal and presented a self-narrative where family and leisure was important to cope and stay empathic throughout their professional lives.

    The specialty preferences and the highly rated motives for choosing them were relatively gender neutral. However, the gender neutrality came to an end when the final-year medical students described clinical experiences that affected their specialty preference. Women were more often deterred by workplace cultures, whereas men were more often deterred by knowledge area, suggesting that it is a male privilege to choose a specialty according to interest.

    Among the newly graduated doctors, another male privilege seemed to be that men were able to pass more swiftly as real doctors, whereas the women experienced more dissonance between their self-understanding and being perceived as more junior and self-doubting.

    Conclusions: The career plans and work-life priorities of doctors-to-be were relatively gender neutral. Both female and male doctors, intended to balance work not only with a family but also with leisure. This challenges the health care system to establish more adaptive and flexible work conditions.

    Gender segregation in specialty choice is not the result of gender-dichotomized specialty preferences starting in medical school. This calls for a re-evaluation of the understanding where gender is seen as a mere background characteristic, priming women and men for different specialties. 

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  • 12.
    Eriksson Sörman, Daniel
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Sundström, Anna
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi. Umeå universitet, Samhällsvetenskapliga fakulteten, Centrum för befolkningsstudier (CBS).
    Rönnlund, Michael
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.
    Adolfsson, Rolf
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Nilsson, Lars-Göran
    Department of Psychology, Stockholm University, Sweden .
    Leisure Activity in Old Age and Risk of Dementia: a 15-Year Prospective Study2014Inngår i: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 69, nr 4, s. 493-501Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives. The aim of this study was to investigate whether leisure activity is associated with incident dementia in an older sample.

    Method. We examined a sample of 1,475 elderly (>= 65 years) who were dementia free at baseline over a follow-up period of up to 15 years. In addition to analyses involving the total time period, separate analyses of three time periods were performed, 1-5, 6-10, and 11-15 years, following baseline measurement of leisure activity.

    Results. After controlling for a variety of potential confounders, analyses of data for the total time period revealed that higher levels of "Total activity" and "Social activity," but not "Mental activity," were associated with decreased risk of dementia. However, analyses of the separate time periods showed that this association was only significant in the first time period, 1-5 years after baseline.

    Discussion. The results from this study provide little support for the hypothesis that frequent engagement in leisure activities among elderly serve to protect against dementia diseases across a longer time frame. The finding of a relationship for the first time period, 1-5 years after baseline, could indicate short-term protective effects but could also reflect reverse causality.

  • 13. Godbolt, Alison K
    et al.
    Lindgren, Marie
    Stenberg, Maud
    Norrlands universitetssjukhus.
    Cronberg, Tobias
    Tengvar, Christer
    Sörbo, Ann
    Långvarig svår medvetandestörning efter hjärnskada hos vuxna: nya rekommendationer ger underlag för utredning och rehabilitering2014Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, nr 49-50, s. 2230-2234Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    After severe acquired brain injury some patients develop a prolonged disorder of consciousness (vegetative state or minimally conscious state), and as such cannot actively participate in neurorehabilitation. However, international opinion and recent research developments emphasize the need for involvement of rehabilitation medicine units in the care of these patients. The article presents recommendations for the care of adult patients with prolonged disorders of consciousness, which have been developed by a multidisciplinary working party, in order to promote good care, and identify areas for further improvements.

  • 14.
    Goicolea, Isabel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Christianson, Monica
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Hurtig, Anna-Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Marchal, Bruno
    San Sebastian, Miguel
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
    Wiklund, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Searching for best practices of youth friendly services - a study protocol using qualitative comparative analysis in Sweden2016Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 16, artikkel-id 321Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Swedish youth clinics constitute one of the most comprehensive and consolidated examples of a nationwide network of health care services for young people. However, studies evaluating their 'youth-friendliness' and the combination of factors that makes them more or less 'youth-friendly' have not been conducted. This protocol will scrutinise the current youth-friendliness of youth clinics in northern Sweden and identify the best combination of conditions needed in order to implement the criteria of youth-friendliness within Swedish youth clinics and elsewhere.

    Methods/design: In this study, we will use qualitative comparative analysis to analyse the conditions that are sufficient and/or necessary to implement Youth Friendly Health Services in 20 selected youth-clinics (cases). In order to conduct Qualitative Comparative Analysis, we will first identify the outcomes and the conditions to be assessed. The overall outcome - youth-friendliness - will be assessed together with specific outcomes for each of the five domains - accessible, acceptable, equitable, appropriate and effective. This will be done using a questionnaire to be applied to a sample of young people coming to the youth clinics. In terms of conditions, we will first identify what might be the key conditions, to ensure the youth friendliness of health care services, through literature review, interviews with professionals working at youth clinics, and with young people. The combination of conditions and outcomes will form the hypothesis to be further tested later on in the qualitative comparative analysis of the 20 cases. Once information on outcomes and conditions is gathered from each of the 20 clinics, it will be analysed using Qualitative Comparative Analysis.

    Discussion: The added value of this study in relation to the findings is twofold: on the one hand it will allow a thorough assessment of the youth-friendliness of northern Swedish youth clinics. On the other hand, it will extract lessons from one of the most consolidated examples of differentiated services for young people. Methodologically, this study can contribute to expanding the use of Qualitative Comparative Analysis in health systems research.

    Fulltekst (pdf)
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  • 15. Hellström, Fredrik
    et al.
    Gouveia-Figueira, Sandra
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Kemiska institutionen. Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi.
    Nording, Malin L.
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi.
    Björklund, Martin
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering. Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Fowler, Christopher J.
    Umeå universitet, Medicinska fakulteten, Institutionen för farmakologi och klinisk neurovetenskap, Farmakologi.
    Association between plasma concentrations of linoleic acid-derived oxylipins and the perceived pain scores in an exploratory study in women with chronic neck pain2016Inngår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 17, artikkel-id 103Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Chronic musculoskeletal pain may be associated with changes in the balance of algogenic and anti-nociceptive compounds, and such changes may be visible in plasma samples. We have undertaken an exploratory study to measure the levels of endocannabinoids, related N-acylethanolamines and oxylipins (primarily those derived from linoleic acid) in plasma samples from women with chronic neck pain (NP) and chronic widespread pain (CWP), and to investigate whether the observed levels are associated with the pain experienced by these women.

    Methods: Blood samples from 35 women with NP, 15 with CWP and 27 age-matched controls were analysed for the lipids using ultra performance liquid chromatography coupled to tandem mass spectrometry. Current pain (“NRSday”) and the average pain during the last week (“NRSweek”) were rated by the participants using a numerical rating scale.

    Results: There were no significant differences in the plasma concentrations of the fifteen lipids investigated between the women with pain and the controls. However, significant correlations were seen for the NP group between the NRSday scores and the plasma concentrations of the linoleic acid derivatives 9- and 13-hydroxy-octadecadienoic acid (Spearman’s rho values 0.51 [P = 0.0016]) and 0.53 [P = 0.0011], respectively).

    Conclusions: The data obtained in this exploratory study indicate that although no group differences are seen in plasma lipid concentrations, there is an association between the NRSday scores and the 9- and 13-hydroxy-octadecadienoic acid levels. Whether or not the association reflects a causality (i.e. that the circulating lipids contribute to the perceived pain of the pain participants), requires further investigation.

    Fulltekst (pdf)
    fulltext
  • 16.
    Hirvelä, Timo
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Professionell utveckling.
    Are doctors and assistant nurses equally good at informing patients? A randomized controlled trial comparing information recall regarding postoperative self-care.2018Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 17.
    Hägg, Hampus
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Patienters upplevelser av en magnetkameraundersökning2015Independent thesis Basic level (professional degree), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Magnetresonans (MR) är en radiologisk undersökning som blir allt mer vanlig, bland annat eftersom MR-undersökningen inte utsätter patienten för skadlig strålning. Undersökningsmetoden utmärker sig också genom sina goda diagnostiska egenskaper. Röntgensjuksköterskan är ansvarig för patientsäkerhet och innehar en viktig roll i att trygga patienten, då en röntgenundersökning kan upplevas påfrestande. Det är därför viktigt för hen att ha kunskaper om hur patienter upplever såväl undersökningssituationen som förberedelser. Syfte: Syftet med denna litteraturstudie är att undersöka hur patienter upplever en MR-undersökning. Metod: Denna studie är genomförd som en kvalitativ litteraturstudie. Sökning efter lämpliga artiklar skedde i databaserna Cinahl och Scopus. Åtta artiklar som uppfyllde inklusionskriterierna identifierades. Innehållet analyserades vidare av författaren med syfte att identifiera kategorier. Resultat: Fem kategorier som sammanfattar patienters upplevelser av en MR- undersökning identifierades: oro och rädsla; förhandsinformation; känslor, sinnesstämning och copingstrategier; kommunikation samt besked. Konklusion: MR-kamerans utformning samt information och kommunikation rörande undersökningen har inverkan på patientens upplevelse. Röntgensjuksköterskans bemötande har visat sig vara av betydelse. Nyckelord: Magnetresonanstomografi, Kommunikation, Patientens upplevelse, Oro, Röntgensjuksköterska

  • 18.
    Jonasson, Johanna
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    Vänman, Emma
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
    En brinnande fråga-  Förekomst av stressrelaterade symtom och samband med krav, kontroll och socialt stöd hos brandpersonal i Sverige2014Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Många arbetsmiljöproblem kretsar kring psykosociala faktorer. Relationen mellan krav, kontroll och socialt stöd har betydelse för hälsan. Riskökning för psykiskt lidande ses när både lågt socialt stöd och låg kontroll upplevs. Arbetstid och bristande kontroll har visat samband med bl.a. gastrointestinala problem och sömnstörningar. Brandpersonal har ett farligt yrke och inom brandmannayrket finns många stressorer som påverkar hälsan. Få studier finns gällande brandpersonals upplevelse av krav, kontroll och stöd kopplat till stressrelaterade symtom i arbetet. Det är betydelsefullt att undersöka förekomst av detta, då ohälsa kan få konsekvenser för individen, arbetsgruppen och hela samhället.

    Syfte: Kartlägga förekomst av stressrelaterade symtom och samband med krav, kontroll och socialt stöd hos brandpersonal i Sverige.

    Metod: Studien var en del av en tvärsnittsundersökning gällande brandpersonals hälsa där 476 personer deltog. Korrelationsanalyser med Spearmans korrelationskofficient utfördes.

    Resultat: Låg förekomst av sömn- och magbesvär sågs hos brandpersonalen. Samband påvisades där krav och socialt stöd korrelerade med sömnbesvär och magbesvär. Sömnbesvär och magbesvär korrelerade signifikant. Kön korrelerade med magbesvär.

    Konklusion: Förekomsten av mag- och sömnbesvär var låg och deltagarna mådde relativt bra. Vidare forskning kring friskfaktorer hos brandpersonal samt fler studier med andra variabler jämfört med krav, kontroll och stöd behövs.

    Fulltekst (pdf)
    fulltext
  • 19.
    Khan, Nida A.
    Umeå universitet, Medicinska fakulteten, Institutionen för integrativ medicinsk biologi (IMB).
    Interaction of adipose derived stem cells with breast cancer cells: An in vitro study with MCF-7 breast cancer cells examining the oncological safety of autologous human adipose stem cells used in reconstructive surgery2017Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 20. Leask, Calum F.
    et al.
    Sandlund, Marlene
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering.
    Skelton, Dawn A.
    Chastin, Sebastien F. M.
    Co-creating a tailored public health intervention to reduce older adults' sedentary behaviour2017Inngår i: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 76, nr 5, s. 595-608Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The increasing health care costs associated with an ageing population and chronic disease burden are largely attributable to modifiable lifestyle factors that are complex and vary between individuals and settings. Traditional approaches to promoting healthy lifestyles have so far had limited success. Recently, co-creating public health interventions with end-users has been advocated to provide more effective and sustainable solutions. The aim of this study was to document and evaluate the co-creation of a public health intervention to reduce sedentary behaviour in older adults.

    Design: Community-dwelling older adults (N = 11, mean age = 74 years) and academic researchers attended 10 interactive co-creation workshops together.

    Setting: Workshops took place on university campus and the co-creators completed fieldwork tasks outside the workshops.

    Method: Workshops were informed by the Participatory and Appreciative Action and Reflection methodology. Data were collected using field notes, video recording and worksheet tasks. Analysis was conducted using a qualitative content analysis approach.

    Results: The co-creators developed a tailored intervention delivered through a mode congruent with older adults’ lives. Key elements of the intervention included (1) education on sedentary behaviour, (2) resources to interrupt sedentary behaviour, (3) self-monitoring, (4) action planning and (5) evaluating the benefits of interrupting sedentary behaviour.

    Conclusion: Co-creation is a feasible approach to develop public health interventions; however, it is limited by the lack of a systematic framework to guide the process. Future work should aim to develop principles and recommendations to ensure co-creation can be conducted in a more scientific and reproducible way. The effectiveness and scalability of the intervention should be assessed.

  • 21. Lundström, Staffan
    et al.
    Axelsson, Bertil
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Heedman, Per-Anders
    Fransson, Greger
    Fürst, Carl Johan
    Developing a national quality register in end-of-life care: The Swedish experience2012Inngår i: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 26, nr 4, s. 313-321Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The complexity of end-of-life care, represented by a large number of units caring for dying patients, different types of organizations and difficulties in identification and prognostication, signifies the importance of finding ways to measure the quality of end-of-life care. Aim: To establish, test and manage a national quality register for end-of-life care. Design: Two questionnaires were developed with an attempt to retrospectively identify important aspects of the care delivered during the last week in life. An internet-based IT platform was created, enabling the physician and/or nurse responsible for the care during the last week in life to register answers online. Setting: Units caring for dying people, such as hospital wards, home care units, palliative in-patient care units and nursing facilities. Results: The register received status as a National Quality Register in 2006. More than 30,000 deaths in nursing facilities, hospital wards, palliative in-patient units and private homes were registered during 2010, representing 34% of all deaths in Sweden and 58% of the cancer deaths. Conclusions: We have shown that it is feasible to establish a national quality register in end-of-life care and collect data through a web-based system. Ongoing data analyses will show in what way this initiative can lead to improved quality of life for patients and their families. There is an ongoing process internationally to define relevant outcome measures for quality of care at the end-of-life in different care settings; the registry has a potentially important role in this development.

  • 22.
    Lundälv, Jörgen
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi. Department of Social Work, University of Gothenburg, Gothenburg, Sweden.
    Larsson, Per-Olof
    Törnbom, Marie
    Sunnerhagen, Katharina Stibrant
    The ICF: International Classification of Functioning, Disability and Health (ICF) - A Swiss army knife? Accessibility and disability in a Scandinavian disability magazine (SDM) - A quantitative content analysis2012Inngår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 108, nr 1, s. 67-75Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The study describes the extent to which the concept of accessibility and accessibility issues has been reported in a national Scandinavian disability magazine. In this study particular attention is paid to how the compatibility between the various domains of the international classification - International Classification of Functioning, Disability and Health (ICF) - has been covered in the magazine over a decade. Furthermore, other types of descriptions that the magazine has made of accessibility for people with physical disabilities are considered. Methods: The study is based on a quantitative content analysis of a total of 326 articles from the Swedish disability magazine (SDM); 450 text pages published during the years 2000-2009. The magazine's coverage has been comprehensive. Results and conclusions: More than half of the studied texts were news items about various accessibility issues. Every third article can be characterised as a news article or feature article. The most frequently reported of the ICF domains consist of two perspectives: environmental accessibility and civil rights. Public opinion articles in the form of letters to editors and editorials focused on accessibility have a low frequency. Likewise, research reports are few. The study has included a review of illustrations and photographs. The illustrations are generally of high quality, reinforcing the disability message of the article.

  • 23.
    Malmberg, Bo
    et al.
    Institutet för gerontologi, Hälsohögskolan i Jönköping.
    Sandström, Mattias
    Umeå universitet, Samhällsvetenskapliga fakulteten, Demografiska databasen.
    Sundström, Gerdt
    Institutet för gerontologi, Hälsohögskolan i Jönköping.
    Lennartsson, Carin
    Aging Research Center (ARC) & Karolinska Institutet, Stockholm.
    När barnen går först: historiska aspekter på att förlora barn2015Rapport (Annet vitenskapelig)
  • 24.
    Martinsson, Lisa
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Fürst, Carl Johan
    Lundström, Staffan
    Nathanaelsson, Lena
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Axelsson, Bertil
    Registration in a quality register: a method to improve end-of-lifecare—a cross-sectional study2012Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, nr 4, artikkel-id e001328Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Structured methods to assess and support improvement in the quality of end-of-life care are lacking and need to be developed. This need is particularly high outside the specialised palliative care. This study examines whether participation in a national quality register increased the quality of end-of-life care.

    DESIGN: This study is a cross-sectional longitudinal register study.

    SETTING: The Swedish Register of Palliative Care (SRPC) collects data about end-of-life care for deaths in all types of healthcare units all over Sweden. Data from all 503 healthcare units that had reported patients continuously to the register during a 3-year period were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES: Data on provided care during the last weeks of life were compared year-by-year with logistic regression.

    PARTICIPANTS: The study included a total 30 283 patients. The gender distribution was 54% women and 46% men. A total of 60% of patients in the study had a cancer diagnosis.

    RESULTS: Provided end-of-life care improved in a number of ways. The prevalence of six examined symptoms decreased. The prescription of 'as needed' medications for pain, nausea, anxiety and death rattle increased. A higher proportion of patients died in their place of preference. The patient's next of kin was more often offered a follow-up appointment after the patient's death. No changes were seen with respect to providing information to the patient or next of kin.

    CONCLUSIONS: Participation in a national quality register covariates with quality improvements in end-of-life care over time.

    Fulltekst (pdf)
    fulltext
  • 25.
    Merrick, Daniel
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Five years post whiplash injury: symptom and psychological factors in recovered versus non-recovered2010Inngår i: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 3, s. 190-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI).

    Methods A set of questionnaires was answered by 158 persons (75 men, 83 women) to assess disability (NDI), pain intensity (VAS), whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), post-traumatic stress (Impact of Event Scale, IES), depression (Beck's depression inventory, BDI) and life satisfaction (LiSat-11).

    The participants were divided into three groups based on the results of the NDI: recovered (34.8%), mild disability (37.3%) and moderate/severe disability (27.3%).

    Results The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups.

    Conclusions The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.

  • 26.
    Mårtensson, Sophia
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Evaluation of prehospital medical management during a disaster exercise in an underground mining environment2018Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 27. Nygren DeBoussard, Catharina
    et al.
    Lannsjö, Marianne
    Stenberg, Maud
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Godbolt, Alison K
    Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study2017Inngår i: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, nr 4, s. 555-566Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To investigate the occurrence of behavioural problems in patients with severe traumatic brain injury during the first year after injury and potential associations with outcome. An additional post hoc objective was to analyse the frequency of behaviours with need for intervention from staff.

    DESIGN AND SETTING: In a prospective population based cohort study 114 patients with severe traumatic brain injury were assessed at three weeks, three months and one year after injury.

    MAIN MEASURES: Assessments included clinical examination and standardised instruments. Agitation was assessed with the Agitated Behaviour Scale, the course of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale Extended.

    RESULTS: Agitation were most common at 3 weeks post injury and 28% (n=68) of the patients showed at least one agitated behaviour requiring intervention from staff. Presence of significant agitation at 3 weeks after injury was not associated with poor outcome. At 3 months agitation was present in 11% (n=90) and apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were associated with poor outcome at one year.

    CONCLUSIONS: Most agitated behaviours in the early phase are transient and are not associated with poor outcome. Agitation and apathy are uncommon at three months but when present are associated with poor outcome at one year after injury. In the early phase after a severe traumatic brain injury agitated behaviour in need of interventions from staff occur in a substantial proportion of patients.

  • 28. Olofsson, N.
    et al.
    Lindqvist, K.
    Danielsson, Ingela
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Obstetrik och gynekologi.
    Fear of crime and psychological and physical abuse associated with ill health in a Swedish population aged 65-84 years2012Inngår i: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 126, nr 4, s. 358-364Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To assess the association between fear of crime and/or psychological and/or physical abuse in relation to self-reported physical and psychological health, using a large representative sample of elderly women and men in Sweden. Study design: Cross-sectional national survey. Methods: Data were taken from a nationwide representative public health survey (2006). Men and women between the ages of 65 and 84 years were selected for the present analyses (4386 men and 4974 women). The response rate for this age group was 59% for men and 70% for women. Results: Psychological and physical abuse against elderly women and men led to higher odds ratios for negative health outcomes, independently of socio-economic status. Strong correlation was found between psychological abuse and negative health outcomes in both men and women, while the correlation was less strong for physical abuse, especially among women. The men had high odds ratios for suicidal thoughts and even for attempted suicide in connection with physical and psychological abuse and fear of crime. Conclusions: The study provides representative results addressing an extensive negative health outcome panorama caused by fear of crime and exposure to abuse. (C) 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  • 29.
    Olsson, Frida
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
    Crash direction in relation to spine injury - The relationship between crash direction and injury to vertebrae and spinal cord of belted car occupants2018Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 30.
    Pietilä Holmner, Elisabeth
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Multimodal rehabilitation of patients with chronic musculoskeletal pain, focusing on primary care2018Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Background: Chronic pain is a complex condition that has consequences both for individual people and for society. The individual often experiences impact on function, activity and participation. Society is affected by high healthcare and sick leave costs and a loss of workforce. Multimodal rehabilitation programmes (MMRP) have mainly been provided through specialist care but it is now also available through primary care. The overall aim of this thesis was to evaluate the effects of MMRP in patients with chronic musculoskeletal pain and to explore patients’ and healthcare professionals’ experiences of MMRP.

    Study I: Aim: To evaluate the effects of an interdisciplinary team assessment and MMRP for patients with chronic pain in a specialist care setting. Design: Longitudinal cohort study. Method: Pain intensity, pain dimensions, anxiety and depression were measured at assessment and at the start and end of MMRP.  A total of 93 women were evaluated. Result: Pain and pain-related measures were significantly improved both after the interdisciplinary assessment and after MMRP.

    Study II: Aim: To explore healthcare professionals’ experiences of MMRP in primary care. Design: Individual interviews, analysed with qualitative content analysis. Method: Fourteen healthcare professionals (11 women, 3 men) were interviewed about their work with MMRP. Result: Healthcare professionals considered that MMRP was useful but also challenging. It was difficult to select appropriate patients, and health care professionals felt they were torn between following healthcare legislation and the goals of MMRP. They had to deal with ethical dilemmas as well as decide what constitutes good results.

    Study III: Aim: To explore patients’ experiences of participating in MMRP in primary care. Design: Individual interviews, analysed with qualitative content analysis. Method: Twelve former patients (7 women and 5 men) were interviewed about their experiences of MMRP in primary care. Result: Patients in primary care experienced a complex, ongoing process of accepting chronic pain. Obtaining redress, learning about chronic pain, and experiencing fellowship with others with the same condition contributed to the acceptance process.

    Study IV: Aim: To evaluate the effects of MMRP in primary care at one-year follow-up for all patients together and for men and women separately and to identify predictive factors for being employable at follow-up. Design: Prospective longitudinal cohort study. Method: Pain, physical and emotional functioning, coping, health-related quality of life, work-related factors, sick leave extent and sickness compensation were evaluated prior to and one year after MMRP in 234 patients, 34 men and 200 women. Result: All patients improved significantly in most measures at one-year follow-up, and the effect was larger in women. Sick leave decreased while no significant difference was found for total sickness compensation. Patients’ self-reported rating of current work ability before MMRP was significantly associated with being employable at follow-up.

    General conclusions and implications: 

    MMRP seems to be effective for patients with chronic musculoskeletal pain, both in specialist care and in primary care. MMRP was more effective for women than for men, and the reasons for this need to be investigated further. An interdisciplinary team assessment could also be beneficial for decreasing pain and pain-related measures. Patients in primary care experience a complex, ongoing process of accepting chronic pain. Healthcare professionals have to deal with conflicting emotions with regard to different commitments from healthcare legislation and the goals of MMRP.                         

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  • 31.
    Pietilä Holmner, Elisabeth
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Stålnacke, Britt-Marie
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Enthoven, Paul
    Stenberg, Gunilla
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    "The acceptance" of living with chronic pain – an ongoing process: A qualitative study of patient experiences of multimodal rehabilitation in primary care2018Inngår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 1, s. 73-79Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To explore patient experiences of participating in multimodal pain rehabilitation in primary care.

    SUBJECTS: Twelve former patients (7 women and 5 men) in multimodal rehabilitation in primary care were interviewed about their experiences of multimodal rehabilitation.

    METHODS: The interviews were analysed using qualitative content analysis.

    RESULTS: Analysis resulted in 4 categories: (i) from discredited towards obtaining redress; (ii) from uncertainty towards knowledge; (iii) from loneliness towards togetherness; and (iv) "acceptance of pain": an ongoing process. The results show that having obtained redress, to obtain knowledge about chronic pain, and to experience fellowship with others with the same condition were helpful in the acceptance process. However, there were patients who found it difficult to reconcile themselves with a life with chronic pain after multimodal rehabilitation. To find what was "wrong" and to have a medical diagnosis and cure were important.

    CONCLUSION: Patients in primary care multimodal rehabilitation experience a complex, ongoing process of accepting chronic pain. Four important categories were described. These findings will help others to understand the experience and perspective of patients with chronic pain who engage in multimodal rehabilitation.

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  • 32.
    Rajalin, Mia
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Hirvikoski, Tatja
    Salander Renberg, Ellinor
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri.
    Jokinen, Jussi
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Psykiatri. Karolinska Univ Hosp, Karolinska Inst, Dept Clin Neurosci Psychiat, SE-17176 Stockholm, Sweden.
    DBT-based skills training for family members of suicidal patients: open clinical feasibility trial in a psychiatric outpatient contextManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    The involvement of significant others is an objective in suicide prevention and there is a need for development of interventions for this group. The aim of this open naturalistic study was to evaluate the feasibility and the preliminary efficacy of Family Connections (FC) for significant others of suicidal patients, a nine-week manualized skills training program based on dialectical behavior therapy (DBT) in a clinical context.

    The intervention program aims to enhance the knowledge of symptoms and behaviors connected with attempted suicide. Furthermore it introduces stress-coping strategies and emotion regulation skills. Out of 132 participants in total, 104 (79%) completed the program. Included in the analysis were the 86 (65%) participants who completed the program, and who also had both pre- and post-intervention assessments. The Burden assessment scale, BAS, the Questions About Family Members scale, QAFM, and the Five Facet Mindfulness Questionnaire, FFMQ, were used to assess perceived burden, relationship climate and five facets of mindfulness respectively.

    The results showed a significant reduction in perceived burden, measured by BAS, and a significant change in the mindfulness scale FFMQ subscale Acting with Awareness, which indicates an enhanced ability to be present in the moment. None of the four subscales in QAFM showed significant changes between the pre- and post-intervention assessments.

    The results support the feasibility and potential value of the implementation of an intervention for family members and friends of suicidal patients in psychiatric care. Randomized controlled studies are needed to generate further evidence.

  • 33.
    Rajalin, Mia
    et al.
    Södermalm Psychiatric Out patient Services, Stockholm County Council; Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden.
    Wickholm-Pethrus, Lina
    Hursti, Timo
    Uppsala universitet, Institutionen för psykologi.
    Jokinen, Jussi
    Karolinska Univ Hosp, Karolinska Inst, Dept Clin Neurosci Psychiat, Stockholm, Sweden.
    Dialectical Behavior Therapy-Based Skills Training for Family Members of Suicide Attempters2009Inngår i: Archives of Suicide Research, ISSN 1381-1118, E-ISSN 1573-8159, Vol. 13, s. 257-263Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This pilot study evaluated the effect of Family Connections (FC), a Dialectical Behavior Therapy-based manualized skills training program, for family members of suicide attempters. The DBT-based skills training program aims to enhance the knowledge of wide range research based aspects of suicidal behavior and treatment recommendations. Furthermore it includes skills training for interpersonal relationships and also offers family members an opportunity to share their experiences. Thirteen participants completed the 9-week program with pre- and post selfreport questionnaires. The results showed significant reduction in burden, improved psychic health and an increase in well-being regarding the relation with the patient. These results provide support for the need and importance of a DBT-based skills training program addressed specifically to family members of suicide attempters.

  • 34.
    Reher, David Sven
    et al.
    Universidad Complutense de Madrid, Spain.
    Requena, Miguel
    UNED, Spain.
    De Santis, Gustavo
    Università degli Studi di Firenze, Italy.
    Esteve, Albert
    Centre d’Estudis Demogràfics, Spain.
    Livi Bacci, Massimo
    Università degli Studi di Firenze, Italy.
    Padyab, Mojgan
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Sandström, Glenn
    Umeå universitet, Humanistiska fakulteten, Institutionen för idé- och samhällsstudier. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    The COVID-19 pandemic in an aging world2020Manuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Since death rates from the COVID-19 are highest among the oldest, the impact of the current pandemic in a given society depends to a large extent on the share of elderly persons and their living arrangements. Whereas the former is well known, the latter is not. Arguably, contagion itself and the severity of its symptoms are likely to vary among elderly persons living alone, co-residing with family members or dwelling in institutions. Arguments in favour and against the premise that single-living elderly are better able to self-isolate can be made. Long-term care facilities have worsened the effects of the epidemic because they have often become death traps in some but not all countries. Once contagion takes place, living arrangements can make a huge difference in the way the disease can be managed by the individual, his family and society. Properly understanding the dynamics of contagion and the handling of the disease in terms of living arrangements of elderly people is essential for effectively tackling future outbreaks of similar epidemics.

    Fulltekst (pdf)
    fulltext
  • 35. Religa, Dorota
    et al.
    Fereshtehnejad, Seyed-Mohammad
    Cermakova, Pavla
    Edlund, Ann-Katrin
    Garcia-Ptacek, Sara
    Granqvist, Nicklas
    Hallbäck, Anne
    Kåwe, Kerstin
    Farahmand, Bahman
    Kilander, Lena
    Mattsson, Ulla-Britt
    Nägga, Katarina
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Wijk, Helle
    Wimo, Anders
    Winblad, Bengt
    Eriksdotter, Maria
    SveDem, the Swedish dementia registry: a tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 2, artikkel-id e0116538Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods: SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results: The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to informmedical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion: SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.

    Fulltekst (pdf)
    fulltext
  • 36.
    Salander, Pär
    et al.
    Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för socialt arbete.
    Hamberg, Katarina
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Allmänmedicin.
    Why "spirituality" instead of "the humanistic side of medicine"?2014Inngår i: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 89, nr 11, s. 1430-1430Artikkel i tidsskrift (Annet vitenskapelig)
  • 37. Selander, John
    et al.
    Marnetoft, Sven-Uno
    Åsell, Malin
    Umeå universitet, Medicinska fakulteten, Institutionen för odontologi, Klinisk oral fysiologi.
    Predictors for successful vocational rehabilitation for clients with back pain problems2007Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, nr 3, s. 215-220Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: The aim of this study was to identify predicting factors for successful vocational rehabilitation for people with back pain problems.

    METHOD: The study was based on data from 347 long-term sick-listed clients collected at the onset of vocational rehabilitation. The outcome was measured 6 months after the conclusion of rehabilitation.

    RESULTS: In a first bi-variate analysis, a considerable number of variables were associated with the rehabilitation outcome. In a second multivariate analysis, only four associations remained. These were age, general health, vitality and internal locus of control. Young vital clients in good general health, with a high internal locus of control were more likely than others to return to work.

    CONCLUSION: The findings regarding age, general health and vitality are well in line with previous studies. The findings regarding internal locus of control are more unique.

  • 38.
    Sturesson, Marine
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Edlund, Curt
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Falkdal, Annie H.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi. Swedish Association of Local Authorities and Regions, Stockholm, Sweden.
    Bernspång, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Arbetsterapi.
    Healthcare encounters and return to work: a qualitative study on sick-listed patients' experiences2014Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, nr 4, s. 464-475Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Sickness absence is a complex phenomenon affected by aspects other than disease. One important factor that can affect sick leave is the individual's experience of healthcare encounters. It is therefore essential to consider the quality of the encounter with health professionals and its impact on the patient's rehabilitation and return to work.

    AIM: The aim was to explore how sick-listed patients in Sweden perceive their contact with healthcare professionals in primary healthcare and to analyse what they view as crucial components for returning to work.

    METHODS: A qualitative approach was used. Data were collected by semi-structured telephonic interviews with patients who were or had been on sick leave. The transcribed interview text was analysed according to qualitative content analysis.

    FINDINGS: The analysis revealed two themes that highlight important areas for persons on sick leave in their healthcare encounters. The theme 'Trust in the relationship' contains categories describing the patients' feelings of participation, and of being believed, confirmed, and listened to, and also dedication on the part of healthcare providers. Healthcare encounters that were characterised by professionalism, knowledge, continuity, and a holistic approach seemed to create trust. The theme 'Structure and balance' contains the participants' views on important factors that could support the return-to-work process. All participants stated the importance of follow-up and a plan for rehabilitation. Sick leave itself can make a person passive, and participants in this study asked for support to balance activity, exercise, and work demands, which could facilitate their return to work.

    CONCLUSION: Healthcare professionals can facilitate sick-listed persons' rehabilitation back to work by providing a clear structure in the process and support in occupational balance. The healthcare encounters must build on a mutual trust.

  • 39.
    Svensson, Elin
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Barn- och ungdomspsykiatri.
    Nilsson, Karin
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Barn- och ungdomspsykiatri.
    Levi, Richard
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    Suarez, Nivia Carballeira
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Barn- och ungdomspsykiatri.
    Parents' experiences of having and caring for a child with an eating disorder2013Inngår i: Eating Disorders, ISSN 1064-0266, E-ISSN 1532-530X, Vol. 21, nr 5, s. 395-407Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Eating disorders (ED) are serious conditions that affect both patients and their families. Little is known about the influence of these disorders on family life in a Swedish population and the ways that affected families actually attempt to cope. The aim of this study was to specifically investigate parental experiences of having and caring for a child with ED. A qualitative approach was used and rich narratives were obtained from interviews with 10 parents. Results promote insights into lived experiences concerning social disruption, emotional impact, and coping strategies related to ED. This knowledge can be utilized to further develop programs to help affected families.

  • 40.
    van Doorn, Janis
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Ahlinder, Annie
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Labba, Julia
    Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Logopedi.
    Development of a speech assessment tool (SIV) for use by health professionals who work with DBS patients2013Inngår i: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 28, nr Suppl 1, s. S452-S453Artikkel i tidsskrift (Fagfellevurdert)
  • 41.
    Vikström, Lotta
    et al.
    Umeå universitet, Humanistiska fakulteten, Institutionen för idé- och samhällsstudier. Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Haage, Helena
    Umeå universitet, Umeå universitetsbibliotek (UB).
    Häggström Lundevaller, Erling
    Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).
    Marriages among people with disabilities in 19th-century Sweden: marital age and spouse’s characteristics2020Inngår i: The History of the Family, ISSN 1081-602X, E-ISSN 1873-5398Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    While marrying was an expected event in 19th-century Western society and has been subject to much historical research, there are few studies on how disabilities influenced people’s marriage patterns and spouse selection. The aim of this analysis is to contribute clarification on this issue by examining with whom disabled men and women married and the marital age and socio-demographic characteristics of them and their spouses. In total, 188 disabled individuals born in the first half of the 19th century and who married in the Sundsvall region, Sweden, are studied. The results reveal that disabled men and women did not marry each other, and they entered into marriage at a slightly higher age than the average, although there was usually no marked age gap between them and their spouse. Endogamous patterns were primarily found regarding the socio-spatial background of the two spouses. This analysis is one of the few studies identifying the marriages among a comparatively large number of disabled people using demographic data. Their participation in the partner pool highlight their agency historically and emphasize that disability did not lead to distance from social life in past society.

    Fulltekst (pdf)
    fulltext
  • 42.
    Waller, Simon
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin.
    The presence of post-concussion symptoms among Swedish elite female football players2017Independent thesis Basic level (professional degree), 20 poäng / 30 hpOppgave
  • 43.
    Weidung, Bodil
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Department of Public Health and Caring Sciences, Geriatric Medicine, Uppsala University, Uppsala.
    Toots, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Rehabiliteringsmedicin. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Nordström, Peter
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Carlberg, Bo
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umea85+/GERDA2017Inngår i: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, nr 51, artikkel-id e9161Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umea85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and 95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umea85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean changestandard deviation in SBP was -12 +/- 25mm Hg. SBP decline was associated independently with later investigation year (P=.009), higher baseline SBP (P<.001), baseline antidepressant prescription (P=.011), incident acute myocardial infarction during follow-up (P=.003), new diuretic prescription during follow-up (P=.044), and a decline in the Barthel Activities of Daily Living index at follow-up (P<.001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors.

    Fulltekst (pdf)
    fulltext
  • 44.
    Wiklund, Robert
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Toots, Annika
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Conradsson, Mia
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Olofsson, Birgitta
    Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Ortopedi.
    Holmberg, Henrik
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
    Rosendahl, Erik
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Gustafson, Yngve
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik.
    Littbrand, Håkan
    Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Geriatrik. Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.
    Risk factors for hip fracture in very old people: a population-based study2016Inngår i: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 27, nr 3, s. 923-931Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Knowledge of risk factors for hip fracture among very old people is limited. Walking indoors with help from ≤1 person, Parkinson's disease, currently smoking, delirium in the previous month, underweight, and age were associated with increased risk of hip fracture and could be important for preventive strategy development.

    INTRODUCTION: The purpose of this study is to investigate risk factors for hip fracture among a representative sample of very old people.

    METHODS: In total, 953 participants from the Umeå 85+/Gerontological Regional Database population-based cohort study were interviewed and assessed during home visits. Associations of baseline characteristics with hip fracture during the maximum 5-year follow-up period were analyzed using Cox proportional hazards regression.

    RESULTS: Participants had a mean age of 89.3 ± 4.7 years; 65.8 % were women, 36.8 % lived in residential care facilities, 33.6 % had dementia, and 20.4 % had histories of hip fracture. During a mean follow-up period of 2.7 years, 96 (10.1 %) individuals sustained hip fracture. Walking indoors with help from no more than one person (hazard ratio [HR] = 8.57; 95 % confidence interval [CI], 1.90-38.71), Parkinson's disease (HR = 5.12; 95 % CI, 1.82-14.44), currently smoking (HR = 4.38; 95 % CI 2.06-9.33), delirium in the previous month (HR = 2.01; 95 % CI, 1.15-3.49), underweight (body mass index <22; HR = 1.74, 95 % CI, 1.09-2.77), and age (HR = 1.09; 95 % CI, 1.04-1.14) were associated independently with an increased risk of hip fracture. Hip prosthesis at baseline decreased the risk of hip fracture (HR = 0.37; 95 % CI, 0.15-0.91), but only for those with bilateral hip prostheses.

    CONCLUSIONS: Seven factors were associated independently with incident hip fracture during follow-up in this sample of very old people. These factors could have important clinical implications in identifying persons at high risk of hip fracture, as well as in the development of effective preventive strategies.

  • 45. Zhuo, Lang
    et al.
    Xu, Ling
    Ye, Jingtao
    Sun, Sun
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Health Outcomes and Economic Evaluation Research Group, Stockholm, Sweden; Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Zhang, Yaoguang
    Burstrom, Kristina
    Chen, Jiaying
    Time Trade-Off Value Set for EQ-5D-3L Based on a Nationally Representative Chinese Population Survey2018Inngår i: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 21, nr 11, s. 1330-1337Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To obtain a nationally representative Chinese three-level EuroQol five-dimensional questionnaire value set based on the time trade-off (TTO) method.

    Methods: A multistage, stratified, clustered random nationally representative Chinese sample was used. The study design followed an adapted UK Measurement and Valuation of Health protocol. Each respondent valued 11 random states plus state 33333 and "unconscious" using the TTO method in face-to-face interviews. Three types of models were explored: ordinary least squares, general least squares, and weighted least squares models.

    Results: In total, 5939 inhabitants aged 15 years and older were interviewed. Of these, 5503 satisfactorily interviewed participants were included in constructing models. An ordinary least squares model including 10 dummies without constant and N3 had a mean absolute error of 0.083 and a correlation coefficient of 0.899 between the predicted and mean values. Goodness-of-fit indices of two models based on split subsample were similar.

    Conclusions: TTO values were higher in our study compared with those in a study carried out in urban areas, which is mirrored by the higher values in rural areas. Several other aspects, in addition to the valuation procedure, might have influenced the results, such as factors beyond demographic factors such as view on life and death and believing in an afterlife, which need further investigation. Future studies using the three-level EuroQol five-dimensional questionnaire should consider using this value set based on a nationally representative sample of the Chinese population.

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