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  • 2701.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Lindkvist, Markus
    Burström, Lage
    Karlsson, Stefan
    Sundelin, Gunnevi
    Trapezius muscle activity during simultaneous exposure to local vibration and static muscle load: a study of acute effectsManuscript (Other academic)
  • 2702.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lindkvist, Markus
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Karlsson, J Stefan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Changes in EMG activity in the upper trapezius muscle due to local vibration exposure.2009In: Journal of Electromyography & Kinesiology, ISSN 1050-6411, E-ISSN 1873-5711, Vol. 19, no 3, p. 407-415Article in journal (Refereed)
    Abstract [en]

    Exposure to vibration is suggested as a risk factor for developing neck and shoulder disorders in working life. Mechanical vibration applied to a muscle belly or a tendon can elicit a reflex muscle contraction, also called tonic vibration reflex, but the mechanisms behind how vibration could cause musculoskeletal disorders has not yet been described. One suggestion has been that the vibration causes muscular fatigue. This study investigates whether vibration exposure changes the development of muscular fatigue in the trapezius muscle. Thirty-seven volunteers (men and women) performed a sub-maximal isometric shoulder elevation for 3min. This was repeated four times, two times with induced vibration and two times without. Muscle activity was measured before and after each 3-min period to look at changes in the electromyography parameters. The result showed a significantly smaller mean frequency decrease when performing the shoulder elevation with vibration (-2.51Hz) compared to without vibration (-4.04Hz). There was also a slightly higher increase in the root mean square when exposed to vibration (5.7% of maximal voluntary contraction) compared to without (3.8% of maximal voluntary contraction); however, this was not statistically significant. The results of the present study indicate that short-time exposure to vibration has no negative acute effects on the fatiguing of upper trapezius muscle.

  • 2703.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Ahlgren, Christina
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Physiotherapy.
    Neuromusculoskeletal symptoms in the trunk and upper extremities among proffessional drivers of all-terrain vehicles in Sweden2007Conference paper (Other academic)
  • 2704.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rehn, Börje
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Ronnie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Burström, Lage
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hand-arm vibration syndrome (HAVS) and musculoskeletal symptoms in the neck and the upper limbs in professional drivers of terrain vehicles: a cross sectional study2006In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 37, no 6, p. 793-799Article in journal (Refereed)
  • 2705.
    Åström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Sundelin, Gunnevi
    Karlsson, Stefan
    Lindkvist, Markus
    Burström, Lage
    The effect of a combined hand-arm and whole-body vibration exposure on muscular activity in neck, lower back and armsManuscript (Other academic)
  • 2706.
    Åström, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, Vilhelm
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Arm Muscle Activation During Different Types of Isometric Loading in Stroke Subjects: A pilot study2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Tidigare studier har visat att personer med stroke har svårigheter att uppnå de resultat som förväntas av traditionell styrketräning. Isometrisk träning är en form av styrketräning, som kan utföras genom att muskeln utvecklar kraft mot ett fast motstånd och jobbar mot förkortning (koncentriskt) eller genom att en pålagd vikt gör att muskeln jobbar mot förlängning (excentriskt). Dessa former av kontraktioner kallas även Overcoming isometric och Yielding isometric.

    Syfte: Syftet var att jämföra EMG- amplitud mellan en isometriskt koncentrisk övning (Overcoming isometric) och en isometriskt excentrisk övning (Yielding isometric).

    Metod: Fyra personer med stroke och fyra friska kontroller deltog i studien. Belastningen till Overcoming isometric och Yielding isometric fastställdes genom att studera vilken belastning armen utsattes för i fyrfotastående, en övning kallad Dog to Cobra. Varje övning utfördes 10 gånger med fem sekunder arbete och fem sekunder vila. Muskelaktivering av valda muskler och medelkraft analyserades och jämfördes inom individerna och mellan grupperna.

    Resultat: Ingen utmärkande skillnad kunde ses mellan övningarna eller grupperna när EMG- amplitud analyserades. En något högre grad av ko-kontraktioner uppvisades i Overcoming isometric hos personerna med stroke.

    Konklusion: Resultaten visar en tendens mot att Yielding isometric skulle kunna vara fördelaktigt för personer med stroke men inga konkreta slutsatser kan dras.

  • 2707.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Nursing. Department of Geriatric Medicine, Karolinska Institute, Huddinge Hospital, Huddinge, Sweden.
    Attitudes, empathy and burnout among staff in geriatric and psychogeriatric care1990Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This study concerned assessments of attitudes towards demented patients among students and nursing staff as well as attitudes towards active euthanasia, wish to transfer to other jobs, ability of empathy and experience of burnout among nursing staff. The study aimed also to relate experience of burnout to attitudes towards demented patients, ability of empathy and experience of work with demented patients. The study was performed by use of questionnaires, scales measuring attitudes towards demented patients, experience of burnout and ability of empathy. Tape-recorded interviews were also included aiming to explore the staffs experience at work.

    The results showed that a majority of the students and staff held positive attitudes towards demented patients. A small proportion intended to work solely with demented patients. Staff working in psychogeriatric care and somatic long-term care held more positive attitudes than staff working in acute medical care. Proportions of staff with positive attitudes varied depending on age, duration of employment, education and place of work. A larger proportion of staff in geriatric care than in acute care reported a wish to transfer to another job. LPN’s in nursing homes to the largest proportion stated this wish to transfer.

    A majority of both students and staff expressed negative attitudes towards active euthanasia to severely demented patients in the finale stage of life. However, most favourable attitudes towards active euthanasia were found among students with shorter health care education and among nurse's aides and LPN’s.

    The staffs empathy was judged as moderately high and there were no differences found in relation to sex, staff category or place of work.

    Experience of burnout /tedium varied with the place of work and category of staff. Largest proportions at risk to develop burnout were found among those working in somatic long-term care and psychogeriatric care. RN’s showed lower burnout scores than nurse's aides and LPN’s.

    Experience of burnout was correlated to attitudes towards demented patients, indicating that the lower burnout score the staff have the more positive are the attitudes. Burnout was also related to the staffs ability of empathy i.e. the lower degree of burnout the higher is the empathie ability. Regression analysis showed that "Experience of feed-back at work” and "Time spent at present place of work" were the most important factors for the staffs experience of burnout.

  • 2708.
    Åström, Sture
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sandvide, Asa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Eisemann, Martin
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Staff's experience of and the management of violent incidents in elderly care.2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 4, p. 410-6Article in journal (Refereed)
  • 2709.
    Åström, William
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Knee kinematics during a novel hop test with an unanticipated change of direction for female floorball athletes and controls: Evaluation of within-session and test-retest reliability and assessment of knee function2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: The incidence of anterior cruciate ligament (ACL) injuries in female floorball is relativley high, and the risk for sustaining a second ACL injury is greater compared to previously uninjured. Existing evaluation tests in rehabilition may not be discriminative enough to guide decisions on return to sport Aim: To evaluate the withinAsession and testAretest reliability of knee kinematics in floorball athletes and controls during a hop encompassing a sudden unanticipated change of direction. A second aim was to investigate the discriminative validity by comparing the test outcomes between the athletes and a control group of nonAathletes. Method: 11 elite floorball athletes and 8 controls were tested on two occassions separated by one to three weeks. Knee kinematics, ground contact time and number of succesfull hops were analyzed. Relative reliability was quantifyed by Intraclass correlation coefficient (ICC) and absolute reliability by standard error of measurement (SEM). Results: ICCs for knee kinematics withinAsession reliability were excellent (0.83A0.96) for athletes and poor to excellent (0.40A0.94) for the controls. For the testAretest reliability, the athletes had good to excellent (0.56A0.96) reliability and the controls had poor to excellent (0.26A0.93) reliability. Only two measured kinematic variables were significantly different between the groups. Conclusion: This pilot study indictate good to excellent reliability for the majority of the kinematic variables tested and, therefore, it could be assumed to be adequatley reliable. Discriminative validity needs to be further evaluated in a larger material.  

  • 2710.
    Åström, William
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nymark, Conny
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A systematic review of assessment methods of knee joint proprioception2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: For measuring knee proprioception there are different tests used, but it is not known which of them that has the best reliability. The importance of proprioception and the relationship with knee functions is not known, and for measuring this, a reliable and stable proprioceptive test is needed.

    Aim: The aim was to explore which tests that is used to exam proprioception in the knee, and how reliable they are. Also to see which test could be applied in a movement lab for testing ACL injured patients.

    Method: Five different databases were searched until 5 september 2014. Studies assessing the reliability of well described proprioceptive knee tests were included in the systematic review. The methological quality of the studies were assessed by a modified version of the STARD checklist.

    Results: 19 studies assessing the reliability of four different type of proprioceptive tests were included in the review. The four tests were joint position sense (JPS), treshold to detect passive motion (TTDPM), velocity replication and velocity treshold hunting paradigm. TTDPM presents the best reliability with an ICC median of 0,77.

    Conclusion: TTDPM is likely to be the most reliable of the existing tests for measuring knee proprioception, and is also the test we would recommend for use in a movement lab for testing ACL-patients.

  • 2711. Öhberg, F
    et al.
    Grip, Helena
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, K-G
    Edström, U
    Gustavsson, O
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundström, R
    Gait analysis using a portable motion sensor system: measurements in subjects with hip implants as compared with healthy controls2012Conference paper (Other academic)
  • 2712.
    Öhberg, Fredrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Claesson, Kenji
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Edström, Urban
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Holmner, Åsa
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Home-based system for recording pulmonary function and disease-related symptoms in patients with chronic obstructive pulmonary disease, COPD: a pilot study2016In: SM Journal of Pulmonary Medicine, ISSN 2574-240X, Vol. 2, no 1, article id 1011Article in journal (Refereed)
    Abstract [en]

    Introduction: Many patients with Chronic Obstructive Pulmonary Disease (COPD) suffer from acute exacerbations characterized by an increase in symptoms beyond normal day-to-day variation. The prognosis of patients with frequent exacerbations is poor and effort to curb these worsening episodes has great potential to improve the patient’s quality of life and to reduce associated costs. Telemonitoring has been proposed as a promising strategy in this respect. However, information on what physical signs or symptoms that should be recorded and how recorded data should be interpreted is largely missing in the literature.

    Methods: A new home-based system, based on a tablet computer, which can guide COPD patients to perform spirometry (inspiratory capacity, IC and forced expiratory volume in one and six seconds, FEV1 and FEV6) and record symptoms (COPD assessment test, CAT) was developed. The system was evaluated for 8-12 weeks in four patients with moderate to severe COPD with the aims to; i) assess the feasibility of the system to be used unsupervised by COPD patients and, ii) to evaluate the quality and ability of recorded parameters to reveal early signs of an exacerbation. Pearson bivariate correlation was performed between all outcome measures and descriptive information about inherent subject properties were presented.

    Results: The system was well accepted by all study subjects and the study generated a total of 253 measurements of which 94.5% were considered acceptable for analysis. One of the subjects developed an acute exacerbation towards the end of the study, whereas the other three subjects remained stable. Descriptive analysis of the data suggest that trends in the CAT score may indicate changes in health status and that IC tends to be more responsive to these changes compared to FEV1.

    Conclusion: The system developed in this study is well suited to be used unsupervised by COPD patients. Recorded data, in particular CAT, may be sensitive enough to detect early signs of an acute COPD exacerbation, although more data is needed to fully resolve the nature of such an association.

  • 2713.
    Öhlin, Jerry
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lavemark, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Fysisk aktivitet och kognition - Jämförelse mellan åldersgrupper: - Jämförelse mellan åldersgrupper2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Fysisk aktivitet har goda effekter på allmän hälsa och nya studier visar detsamma gällande kognitiv funktion. För att öka förståelsen av sambandet mellan fysisk aktivitet och kognitiv funktion vid olika åldrar utfördes en tvärsnittsstudie på en befintli g datamän gd (n=932).

    Studien ämnade pröva hypotesen att fysisk aktivitet skulle påvisa ett positivt samband mellan utfallet av ett antal kognitiva tester och fysisk aktivitetsnivå.

    Resultatet från omfattande kognitiva tester på testdeltagarna sorterades in under 6 kognitiva funktioner: episodiskt minne, semantiskt minne,fluency, visuospatial förmåga, processing speed, exekutiv funktion. Dessa jämfördes  mot deras självsk attade fysiska aktivitetsnivå.

    Försöksdelta garna sorterades in i fyra åldersgrupper: 25-50, 55-60, 65-70, 75-90 år, då tidigare forskning visat att kognitionen förändras över tid och även dess samband med fysisk aktivitet. Regressionsanalyser utfördes med kontrollvariabler som, utöver fysisk aktivitet, visat sig påverka kognitiv funktion.

    Resultatet visade ett positivt samband mellan fysisk aktivitetsnivå och semantiskt minne, flu ency, processing speed samt exekutiv funktion , med en generell tendens att de äldre försöksdeltagarna uppvisade starkast  samband.

    Utifrån resultaten i denna studie diskuteras att fysisk aktivitet kan ge positiva effekter både genom att öka kognitiv funktion och stävja åldersrelaterad kognitiv nedsättning, med ökad effekt vid stigande ålder.

  • 2714.
    Öhlund, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Otillräknelig, psykiskt störd eller både och?2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Vård kontra fängelse. Frågan om hur man bör se på straffansvar och påföljd för personer som begår brott under inflytande av en allvarlig psykisk störning är en omdebatterad och dessutom en mycket känslig fråga. Hur ska man bedöma och bestraffa de personer som inte kan hållas till ansvar för sina handlingar?

    Det är allmänt accepterat att personer som inte kan ta ansvar för sig själv eller sina handlingar inte ska dömas enligt samma straffrättsliga principer som människor med full psykisk förmåga. I det svenska rättssystemet har denna uppfattning rättfärdigat principen om fängelseförbud för personer med en allvarlig psykisk sjukdom. Det svenska rättssystemet kunde tidigare döma en person till straffrättsligt ansvar men utan påföljd. Efter en lagändring 2008[1] har domstolarna numera möjligheten att döma en person som begått ett brott under påverkan av en allvarlig psykisk störning till fängelse om det finns synnerliga skäl.

    Presumtionen för att annan påföljd än fängelse ska användas gäller endast för allvarligt psykiskt störda lagöverträdare. Det räcker således inte med att den tilltalade bedöms som psykiskt störd utan måste bedömas som allvarligt psykiskt störd för att få straffrättslig särbehandling. Den psykiska bedömningen får därför en stor inverkan på påföljdsvalet och kan resultera i skillnaden mellan långvarig vård eller livstids fängelse. Klassificeringen av det psykiska tillståndet är därmed helt avgörande för påföljdsfrågan.

    I de flesta rättsstater finns krav på tillräknelighet för att döma någon till ansvar för en brottslig gärning. Enligt denna syn kan endast de personer som kan ta ansvar kan också begå brott, en svensk rätt skulle följden bli att barn under 15 år och psykiskt sjuka inte kan begå brott och därför inte dömas till ansvar i domstol. Sverige hade ett tillräknelighetskrav fram till 1965 men numera har en gärningsmans psykiska tillstånd endast betydelse vid påföljdsbestämningen.[2]

    [1] SFS 2008:320.

    [2] Asp, s. 399-400

  • 2715.
    Öhman, Ann
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Profession on the move: Changing conditions and gendered development in physiotherapy2001Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Physiotherapy in Sweden has developed from a practical, hands-on, assistant job predominantly taught at college level to a university-based academic discipline emphasising evidence-based practice and research. Women are in majority although an increasing number of men have entered the profession. Women and men physiotherapists tend to undertake different career paths. The overall aim of the present thesis was to use a gender perspective to describe and analyse attitudes to the professional role, health care work and the development of the profession among actors engaged in physiotherapy education.

    A questionnaire was distributed in 1997 to all Swedish physiotherapy students in the second semester of the education (n=273). The same cohort was investigated in 1999 at the completion of the education. The response rate was 93 percent at both occasions. For an international comparison, the same questionnaire was distributed in 1997 and in 1999 to a group of Canadian physiotherapy students in their first and last semesters (n=60). Qualitative research interviews were conducted with 8 novices in physiotherapy and with 14 women educators in academia. Five focus group discussions with clinical supervisors were conducted (10 women and 5 men). Methods used were Grounded theory, factor analysis, logistic regression and path analysis. Feminist theories and Bourdieu's theory of culture constituted a theoretical framework

    Four ideal types were identified among the novices representing attitudes to the professional role. The Treater and The Supervisor were attitudes found among the women, whereas The Coach and The Entrepreneur were attitudes among the men. Type of health care facility was important for their positioning in the organisational hierarchy. Swedish students favour future employment in private practice. Sports medicine clinics and fitness centres are health care facilities highly endorsed, as is health promotion. Neither care of elderly nor hospital work are preferable fields of practice. Research is not favoured. Men students are more likely to have chosen the profession because of their interest in physical activity and sports. They are also more likely to prefer owning a private clinic and working with alternative approaches such as fitness training in sports medicine clinics. Women students are more likely to prefer an employment in private practice. The Canadian men students favour private practice whereas the women prefer the public sector of health care. The academic educators experience a gap between theory and practice which causes conflicting messages to students. Competing professions, emergent societal change and a conservative clinical practice constitute threats to the profession. The uniqueness of professional competency, theoretical development and new arenas such as home rehabilitation, consulting and research constitute a vision for future development of the profession. Masculinity is highly valued for status and power whereas femininity symbolises empathy and caring. The clinical supervisors update their theoretical knowledge base through supervision of students, but claim that students lack hands-on skills. Stress at work, unequal power relations in the hierarchy and restructuring of health care are factors that influence work satisfaction negatively. To conclude, gendered habitus, different symbolic capital and different attitudes towards health care work and development of the profession were found in the sub-fields of physiotherapy.

  • 2716.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Hägg, Kerstin
    Umeå University, Faculty of Social Sciences, Department of Child and Youth education, Special Education and Counselling (BUSV).
    Attitudes of novice physiotherapists to their professional role: A gender perspective1998In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 14, no 1, p. 23-32Article in journal (Refereed)
    Abstract [en]

    Most Swedish physiotherapists are women, but an increasing number of men are entering the profession. The aim of this qualitative study was to examine the experience of eight novice physiotherapists. In-depth interviews with four female and four male novice physiotherapists were conducted. The analyses used Grounded Theory and ideal model. Gender, context and time were identified as important analytical categories. Four ideal types, which reflect the attitudes of the novices to the profession, were constructed. The attitudes of the female physiotherapists were used to construct the ideal types called the 'Supervisor' and the 'Treater'. They were patient-oriented and experienced great job satisfaction in their close relationship with patients. They had an open mind as to their future professional activities. The attitudes of the male physiotherapists were used to construct the ideal types called the 'Coach' and the 'Entrepreneur'. They were team-oriented and unsatisfied with team leaders, salaries and organisation. They were choice-decided as to their future professional activities. In the primary health care setting, the physiotherapists wished to cooperate upwards with others in the organisational hierarchy as well as outside the health care organisation. In hospitals, the physiotherapists wished to cooperate horizontally or downwards with others in the hierarchy.

  • 2717.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Hägg, Kerstin
    Umeå University, Faculty of Social Sciences, Department of Child and Youth education, Special Education and Counselling (BUSV).
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Competent women and competing professions: Physiotherapy educators' perceptions of the field1999In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 1, no 2, p. 59-72Article in journal (Refereed)
    Abstract [en]

    Career choices are still strongly gendered in health care professions. In Sweden, physiotherapy is a middle-class women's profession that nowadays also attracts men. Career strategies and professional development in physiotherapy are sparsely studied from a gender perspective. The purpose of this qualitative study was to describe and analyse perceptions of individual professional development, physiotherapy education and the profession in general, among a group of women educators in physiotherapy, using a gender theoretical framework and some of Bourdieu's theoretical concepts in the analysis. Thematized in-depth interviews with fourteen educators in physiotherapy were performed. The analysis used the Grounded Theory method of constant comparison. To increase credibility, the study design used triangulation in interviewers and investigators, member checking and reference group checking. Three core categories were identified. The Competent Woman category involves the professional development of the educators, including aspects of competence, success, efficiency and flexibility. Perceptions of femininity and masculinity reflect the symbolic dimension of gender. Femininity is regarded as symbolic capital for empathy and care, while masculinity represents status and power. The core category Theory-Practice Gap describes the isolated position of physiotherapy education in relation to the field of health care. The fragmented and disintegrated professional knowledge base does not facilitate the development of the profession. The core category Profession under Change reflects ideas about physiotherapy in society. Other female health care professions, ongoing societal change and conservative physiotherapy practices constitute a threat to the future development of the field. Visions for future development of the field emphasized the importance of professional competence and engagement in innovative activities in new arenas and new professional roles. The results shed light on the symbolic dimension of gender in a professional field where femininity is connected with academic success, empathy and care, while masculinity is related to business mentality, status and power. Notions of competition include both internal and external factors affecting the field of physiotherapy.

  • 2718.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS). Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Keisu, Britt-Inger
    Umeå University, Faculty of Social Sciences, Department of Sociology.
    Enberg, Birgit
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Team social cohesion, professionalism, and patient-centeredness: gendered care work, with special reference to elderly care – a mixed methods study2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, article id 381Article in journal (Refereed)
    Abstract [en]

    Background: Healthcare organisations are facing large demands in recruiting employees with adequate competency to care for the increasing numbers of elderly. High degrees of turnover and dissatisfaction with working conditions are common. The gendered notion of care work as 'women's work', in combination with low salaries and status, may contribute to negative work experiences. There is abundant information about the negative aspects of elderly care health services, but little is known about positive aspects of this work. The study aim was to investigate work satisfaction from a gender perspective among Swedish registered nurses, physiotherapists, and occupational therapists, focusing specifically on healthcare services for the elderly.

    Methods: A mixed methods approach was adopted in which we combined statistics and open-ended responses from a national survey with qualitative research interviews with healthcare professionals in elderly care organisations. The survey was administered to a random sample of 1578 registered nurses, physiotherapists, and occupational therapists. Qualitative interviews with 17 professionals were conducted in six elderly care facilities. Qualitative and quantitative content analyses, chi2 and constructivist grounded theory were used to analyse the data.

    Results: There was a statistically significant difference in overall work satisfaction between those who worked in elderly care and those who did not (64 and 74,4% respectively, p < 0.001). Nine themes were derived from open-ended responses in the questionnaire. The qualitative interviews revealed four prominent storylines: 'Team social cohesion', 'Career development and autonomy', 'Client-centeredness', and 'Invisible and ignored power structures'.

    Conclusions: The results show the complexity of elderly care work and describe several aspects that are important for work satisfaction among health professionals. The results reveal that work satisfaction is dependent on social interrelations and cohesion in the work team, in possibilities to use humour and to have fun together, and in the ability to work as professionals to provide client-centered elderly care. Power relations such as gendered hierarchies were less visible or even ignored aspects of work satisfaction. The storylines are clearly linked to the two central discourses of professionalism and gender equality.

  • 2719.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Solomon, Patricia
    McMaster University, Faculty of Health Sciences, School of Rehabilitation Science, IAHS, Hamilton, Canada.
    Finch, Elspeth
    McMaster University, Faculty of Health Sciences, School of Rehabilitation Science, IAHS, Hamilton, Canada.
    Career choice and professional preferences in a group of Canadian physiotherapy students2002In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 4, no 1, p. 16-22Article in journal (Refereed)
    Abstract [en]

    This article focuses on reasons for the career choice and the longitudinal development of attitudes to healthcare work and the physiotherapy profession. The study is part of a larger project on professional development in physiotherapy. A cohort of 60 Canadian physiotherapy students was surveyed on two occasions during their educational programme. The questionnaire was constructed using a theoretical framework about professional socialization. Forty students completed both versions of the questionnaire yielding a response rate of 67%. Seventy-two per cent were women and 28% were men. Job accessibility or economic (25.5%) were the most frequently indicated reasons for the career choice. The most frequently chosen role models were the preceptors in clinical placements (52%). None of the students indicated having a faculty member as a role model. The desire to work in private practice and with adults was ranked highly in both administrations of the questionnaire. Few students regarded home care and community health as preferable healthcare facilities after graduation. Research, managerial work or occupational health were not given as preferable areas of practice. There advantages were statistically significant differences between women and men in their preferences for private practice work and the public sector of healthcare. The results are discussed in relation to gendered division of labour in healthcare and to the development of the profession.

  • 2720.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Dahlgren, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Career choice, professional preferences and gender ?:  the case of Swedish physiotherapy students2001In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 3, no 3, p. 94-107Article in journal (Refereed)
    Abstract [en]

    The aim was to identify reasons for the career choice and professional preferences among students enrolled in the Swedish physiotherapy education. The study design was longitudinal and used a questionnaire administered to a cohort of 273 students in the beginning of the university programme in 1997 as well as at the completion of the programme in 1999, yielding a response rate of 93%. Data were analysed with factor analysis and univariate and multivariate logistic regression analysis. To test the relationship between the factors and outcomes that showed significant effect in the logistic regression analysis, a path analysis was performed. The two most preferred healthcare facilities after graduation were sports medicine clinics and fitness centres. Future work in private practice was highly endorsed by a majority of students. Health promotion was highly valued. Care of elderly and hospital work were not preferred. Significant differences between men and women appeared. Men were more likely to have chosen the programme because of their interest in sports and physical activity. Men were also more choice decided about future professional activities, whereas women were more open for several areas of practice. Men preferred to become the owner of a private clinic and to work with alternative approaches to healthcare, such as fitness training in sports medicine clinics.

  • 2721.
    Öhman, Ann
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Åström, Lena
    Malmgren-Olsson, Eva-Britt
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Feldenkrais(®) therapy as group treatment for chronic pain: a qualitative evaluation2011In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 15, no 2, p. 153-161Article in journal (Refereed)
    Abstract [en]

    Positive experiences from the Feldenkrais group treatment were reported, especially concerning movement ability and body awareness. The exercises were however regarded as difficult to perform as self-training on a daily basis.

  • 2722.
    Öhman, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Validering av utredningsdelen av Habiliteringsprogram "Stöd för bättre hälsa genom anpassad fysisk aktivitet": En Pilotstudie2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att utvärdera kriterierelaterad   validitet av självskattad aktivitetsnivå i utredningsmaterialet i   ”Habiliteringsprogram för bättre hälsa genom anpassad fysisk aktivitet” (HP)   i jämförelse med International Physical Activity Questionaire (IPAQ) och med   accelerometer.

    Metod: Sexton deltagare mellan 14-20 år   rekryterades. Inklusionskriterium: lätt- måttlig   utvecklingsstörning och/eller rörelsehinder, med eller utan fler diagnoser.   Frågeformulär i HP och IPAQ för självskattning av tid i aktivitet och vila   genomfördes samt accelerometermätning under en vecka. Sambandsanalyser   genomfördes avseende fysisk aktivitet, vardagsaktivitet, stillasittande och   tid i liggande där HP jämfördes mot IPAQ och accelerometer. Även IPAQ   jämfördes avseende fysisk aktivitet med accelerometer.

    Resultat: Spearman rank correlation   visade medelgod överensstämmelse mellan självskattad tid i liggande i HP   jämfört med accelerometermätt tid i liggande (rs 0,51) (p=0,04)   och mellan självskattad tid i sittande i jämförelse mellan HP och IPAQ (rs   0,58) (p=0,018). Bland   Altmandiagram visade en svag tendens till underskattning av fysisk aktivitet   i HP jämfört med accelerometermätt tid och svag tendens till överskattning av   tid i liggande i HP jämfört med accelerometermätt tid. Överensstämmelsen var   enligt Intra Class Correlation (ICC) medelgod 0,53 (95% CI 0,05-0,81) mellan   HP och IPAQ för självskattad tid i sittande.   

    Slutsats: Varken HP eller IPAQ visade i   den här studien en tillfredsställande överensstämmelse för att utvärdera tid   i fysisk aktivitet, vardagsaktivitet, stillasittande och tid i liggande   jämfört med accelerometer. Tillsammans med accelerometer/aktivitetsarmband   kan HP vara ett sätt att utvärdera effekt av insatser på längre sikt samt   vara ett bra underlag för motiverande samtal.

  • 2723.
    Öhman, Lilja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Muskelaktiveringsmönster i quadriceps i relation till dynamisk valgus vid ett drop-landingtest.: – En studie gjord på kvinnliga fotbollsspelare2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Both biomechanical and neuromuscular factors affect the risk of suffering an ACL rupture among female soccer players. Unbalanced muscle activation around the knee has been found to affect the joint stability. The aim of this study was therefor to investigate the muscle activation in vastus medialis and vastus lateralis in relation to dynamic valgus among female soccer players. The study was conducted in cooperation with the Finnish company Fibrux OY, who has developed a portable sEMG testing equipment. The participants consisted of 15 female soccer players who were tested with sEMG electrodes on vastus medialis and vastus lateralis during a drop-landingtest that was filmed to enable 2D analysis of valgus angle. The results show a tendency to correlation between the activation ratio and valgus(r=0,51) (p>0,05), and between activation delay in vastus medialis and valgus (r=0,32) (p>0,05). But both correlations lack significance. The results could be explained by that there might be other muscles around the knee at that affects the joint stability even more than vastus lateralis and medialis do. Future studies should be conducted with larger sample size and focus on prospective epidemiological research because that is the only study design that reveals what variables can be associated with the risk of suffering a knee injury.

     

  • 2724.
    Ölund, Ann-Charlott
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Utvärdering av den rökstoppsinformation som patienterna får under vårdtiden på strokeenheten Piteå Älvdals Sjukhus: En registerstudie med data från Riksstroke2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Utvärdera den rökstoppsinformation som patienterna får på strokeenheten vid  Piteå Älvdals sjukhus. Huvudsyftet var att utvärdera om andelen som slutat röka tre månader efter insjuknandet var större bland de som fått information. Delsyftet var att studera vad som skiljde de patienter åt som a) fått information jämfört med de som inte fått, samt b) de som slutat röka jämfört med de som inte slutat tre månader efter insjuknandet.

    Metod: Registerstudie med kvantitativ ansats. Data på studiepopulationen har inhämtats från Riks-Stroke mellan januari 2004 till juni 2015. Inkluderade patienter var registrerade rökare innan insjuknandet, diagnostiserad stroke samt överlevt tre månader efter insjuknandet.

    Resultat: En signifikant mindre andel hade slutat röka tre månader efter insjuknandet bland de som fått rökstoppsinformation på avdelningen jämfört med de som inte fått information (p=0,003). Det som skilde mellan de patienter som fick rökstoppsinformation på avdelningen och inte var att patienterna som fick information var yngre och en mindre andel hade ett diagnostiserat förmaksflimmer, samt att en större andel kunde återgå till eget boende och blev självständiga i ADL. Det som skilde patienterna åt som slutat röka tre månader efter insjuknandet, jämfört med de som inte slutat röka, var att de i större utsträckning var fullt vakna vid ankomst till sjukhuset, bodde ensamma samt blev mindre ADL-beroende.

    Slutsats: Denna rapport indikerar ett behov av att se över kvalitén på den rökstoppsinformation som patienterna på avdelningen får och inte bara se till antalet patienter som får rökstoppsinformation.

  • 2725.
    Önnhall, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Sundberg, Cecilia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Upplevd autonomi hos äldre personer med hemtjänst2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Andelen äldre i Sverige som får vård och omsorg i hemmet ökar. Det kan komma att påverka de äldres autonomi då de blir beroende av andra. Autonomi är ett begrepp som innebär möjligheten att själv bestämma i de frågor som rör den egna individen. Syftet med studien var att beskriva äldre personers upplevelse av autonomi, i samband med hjälp och stöd av hemtjänsten, i aktiviteter i det dagliga livet (ADL). Studien genomfördes i form av intervjuer med sex äldre personer, både män och kvinnor, i åldern 72 till 91 år. Därefter transkriberades intervjuerna och en innehållsanalys utfördes. Resultatet visade att alla deltagarna anser att det är viktigt att få vara med och bestämma om det som rör deras dagliga liv och att de har möjlighet att kunna ändra på överenskomna tider samt att avboka hemtjänstbesök. Det framkom även att de har begränsat självbestämmande inom olika områden och att de ibland undviker att uttrycka sina åsikter för att inte besvära hemtjänstpersonalen.  Det förekom att deltagare får lägga sig och stiga upp tidigare än de själva önskat. Det kan tyda på att deltagarna har en känsla av att inte ha fullständig kontroll över alla sina aktiviteter, vilket kan påverka deras upplevda självständighet.

  • 2726.
    Östberg, Emilia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stillasittande i kontorsmiljö En kvalitativ studie om kontorsarbetares tankar kring stillasittande och kroppslig variation i kontorsmiljö: En kvalitativ studie om kontorsarbetares tankar kring stillasittande och kroppslig variation i kontorsmiljö2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Samhällets teknologiska utveckling har bidragit till att människor blir alltmer stillasittande exempelvis via TV-tittande, dataarbete och bilåkning. Utöver en alltmer stillasittande fritid så består arbetslivet idag för många av någon form av dataarbete. Kontorsarbete ses som ett karaktäristiskt stillasittande arbete. Stillasittande är en oberoende riskvariabel för att utveckla diabetes, hjärt/kärlsjukdom och fetma. Syftet med studien var att fånga kontorsarbetares tankar kring stillasittande och kroppslig variation i kontorsmiljö. Datainsamlingen skedde med hjälp av två fokusgrupper där samtliga deltagare hade kontorsarbete. Deltagarna var anställda på ett större privat företag i en småstad i Sverige. Intervjuerna bearbetades på ett textnära sätt enligt kvalitativ innehållsanalys. Textanalysen gav fyra kategorier: Variation, Kunskap, Motivation och Ansvar.  Resultatet visade att det delvis fanns variationsmöjligheter på arbetsplatsen men majoriteten av deltagarna arbetade i sittande position. Det saknades kunskap kring sambandet mellan långvarigt stillasittande och metabola risker. Påminnelser ansågs var viktigt för att förändra ett stillasittande beteende. Deltagarna tyckte att arbetsgivaren hade ett arbetsmiljöansvar men att det främst var individens ansvar att variera sig under arbetsdagen.

    Slutsats: Det saknas kunskap om metabola risker med långvarigt stillasittande hos individer i kontorsmiljö. Ökad kunskap och information skulle kunna vara ett sätt att motivera kontorsarbetare till ökad variation och minska stillasittandet. Ett hinder för variation är att man glömmer av att variera sig varför påminnelser av olika slag är viktigt för att förändra ett stillasittande beteende. Det är till stor del individens eget ansvar att minska stillasittandet och skapa variation under arbetsdagen.

  • 2727.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Tavelin, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Edberg Thyme, Karin
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Art therapy during radiotherapy – A five-year follow-up study with women diagnosed with breast cancer2014In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 41, no 1, p. 36-40Article in journal (Refereed)
    Abstract [en]

    Follow-up studies on art therapy are lacking. In a randomised art therapy intervention study from 2001 to 2004 with women with breast cancer, results showed that patients benefitted from participating in art therapy for up to four months after the intervention. The aim of this study was to describe the coping resources and quality of life amongst women treated for breast cancer five to seven years after participating in individual art therapy during radiotherapy as compared to a control group. In 2009, thirty-seven women, 18 from the intervention group and 19 from the control group, answered questionnaires about their coping resources and quality of life. The results showed no significant difference between the groups regarding their coping resources or quality of life, except for an unexpected significantly lower score in the domain 'Social relations' in the study group as compared to baseline, at the time of the follow up. However, our study from 2001 to 2004 supports various positive effects of art therapy within six months of participation as compared to a control group. Consequently, attending art therapy during the treatment period for breast cancer can be of great importance to support health, coping and quality of life in a short-term perspective.

  • 2728. Österlind, Jonas
    et al.
    Eriksson, Margareta K
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Östenson, Claes-Göran
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    [The Swedish Björknäs study: fewer physician visits in primary health care. A randomized study of intensive life style intervention]2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 15, p. 976-980Article in journal (Refereed)
    Abstract [en]

    Intensive lifestyle interventions can reduce incidence of type 2 diabetes and cardiovascular risk factors in high-risk individuals. We aimed to assess the effect of the lifestyle intervention used in the The Swedish Björknäs study, previously shown to reduce cardiovascular risk factors, on health care use. In 2003, 145 high-risk individuals were randomly assigned to either a 3 months intensive lifestyle modification undertaken in the primary care setting or control. In 2009, participants' medical records were reviewed. Primary outcome was primary care health use. Secondary outcome was hospital care use. Analysis was by intention to treat. Primary care physician visits were 21% (95% CI 2%; 36%) lower in the lifestyle group during the first three years. The difference was significant for all six years when adjusting for baseline (GLM Repeated Measures; p=0.019). There were no significant differences in visits to nurses in primary health care or hospital physicians and nurses, hospitalizations or hospital days. A program of intensive lifestyle modification can not only favourably influence cardiovascular risk factors but also reduce health care use in high-risk individuals.

  • 2729.
    Österlind, Per Olov
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Medical and social conditions in the elderly gender and age differences: the Umeå longitudinal study1993Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In 1981, no representative study of the medical and social conditions among elderly persons in northern Scandinavia was performed. Nor was there such a study in a smaller Swedish town than Gothenburg. This study was initiated to fill that knowledge gap. The aim of the study was to evaluate gender and age differences in medical and social conditions among elderly people, including the reference intervals of clinical chemistry parameters and characteristic features of the 24-hour electrocardiogram (ECG) in healthy elderly. By way of longitudinal design with birth cohorts stratified by gender, it was assumed that the effects could be demonstrated. Also, the death risk of various social and medical variables was to be assessed.

    During the study period 1981 to 1990, the subjects were between 70 and 88 years of age. The proportion of persons living in private housing decreased from almost all at the age of 70 to slightly more than half at 88 years of age. The number of socially active persons decreased considerably during the period. The need of help increased from almost none to 60 % of the persons.

    The proportions of persons with normal sight and hearing decreased from two thirds to around one tenth The most frequent symptoms were general tiredness, pains, dyspnoea, constipation and dryness of the mouth. Cardiovascular diseases were the most frequent. Hypertensive disease became less, and congestive heart failure more frequent with age. The frequency of dementia increased steeply among the oldest persons; at 88 years of age, 40 % were demented.

    Drug consumption increased; the oldest persons in both age cohorts used 5 different drugs or more per person regularly. The consumption increase was mainly due to the increasing morbidity accompanying age. The most common drugs taken were cardiovascular preparations, psychoactive agents, drugs to alleviate gastrointestinal symptoms, and analgesics. Drug intake and symptom prevalence were generally higher in women, despite the fact that there was no gender difference in the number of diseases.

    The reference intervals of many blood components in healthy elderly were shown to be broader than those of younger persons. The intervals of P(lasma)-folate and P- potassium were on a lower and those of the erythrocyte sedimentation rate, P-creati- nine and, in women, S(erum)-cholesterol, were on a higher level than among younger persons.

    Several features of the 24-hour ECG, e.g. the number of episodes of supraventricular tachycardia as well as supraventricular and ventricular premature beats in healthy elderly were more frequent than among younger persons.

    Between 80 and 88 years of age, many functions crucial to the chances of living a rich and vital life were found deteriorating in the elderly persons. High age, male sex, dementia, congestive heart failure, and low values of S-creatinine were shown to be independent factors connected with an increased death risk.

  • 2730.
    Österlund, Catharina
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology.
    Nilsson, Evelina
    Umeå University, Faculty of Medicine, Department of Odontology.
    Hellström, Fredrik
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Häggman-Henrikson, Birgitta
    Jaw-neck movement integration in 6-year-old children differs from that of adults2019In: Journal of Oral Rehabilitation, ISSN 0305-182X, E-ISSN 1365-2842Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A functional integration between the jaw and neck regions during purposive jaw movements is well described in adults, but there is a lack of knowledge of such integration during jaw function in children.

    OBJECTIVES: To determine the movement integration between the jaw and neck during jaw motor tasks in 6-year-olds, whether there is a difference between children and adults.

    METHODS: Jaw and neck movements were recorded with an optoelectronic 3D system in 25 healthy 6-year-olds (12 girls, 13 boys) and 24 healthy adults (12 women, 12 men) during paced jaw opening-closing and self-paced gum chewing. Jaw and neck movement amplitudes, intra-individual variation in movement amplitude, ratio between neck-jaw movement amplitudes and movement cycle time were analysed. Differences between children and adults were evaluated with Mann-Whitney U test for independent samples.

    RESULTS: Compared to adults, 6-year-old children showed larger neck movement amplitudes (P = .008) during chewing, higher intra-individual variability in amplitudes of jaw (P = .008) and neck (P = .001) movements, higher ratio between neck-jaw movement amplitudes for jaw opening-closing (P = .026) and chewing (P = .003), and longer jaw movement cycle time (P ≤ .0001) during the jaw opening-closing task.

    CONCLUSION: Despite integrated jaw-neck movements in 6-year-old children, the movement pattern differs from that of adults and may be interpreted as an immature programming of jaw-neck motor behaviour. The well-integrated movements observed in adults most likely develop over years, perhaps into adolescence, and needs further research including well-controlled longitudinal studies to map this development in order to provide appropriate age-related clinical treatment for functional disorders.

  • 2731.
    Öström, Mats
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Vehicle-related injuries: with emphasis on fatality prevention1993Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    According to WHO, Sweden should aim to reduce unintentional fatalities, particularly vehicle-related injuries, by 25% by the year 2000. The aim of this thesis was to analyze vehicle-related injuries and injury events, especially the contributory effects of alcohol and disease and the injury reducing capacity of helmets and airbags in order to point out some preventive measures.

    Alcohol: Alcohol is the main contributing factor in fatal traffic crashes. In a study on 121 traffic fatalities in Washtenaw County, Michigan, USA, different sources of data for alcohol involvement were compared. In police reports alcohol involvement was found in 51% of the fatalities, in autopsy reports in 63%, and in hospital emergency records in 91%. To avoid bias in the estimation of the fraction of alcohol-related fatalities, it is important to routinely investigate all severe and fatally injured cases in traffic crashes, ideally as soon as possible after the crash.

    In a study on traumatic car fatalities (n=597) in northern Sweden, 58% of the single vehicle (SV) drivers were inebriated (multi-vehicle, MV 10%), the mean blood alcohol concentration (BAC) was 1.9 g /l (MV 1.6 g/1), and liver steatosis was found in 37% of the cases (MV 2%). Increased BAC was associated with fatty liver, indicating chronic alcohol abuse. To reduce injuries among these types of victims, passive protection is of great importance.

    Disease: Autopsied drivers (n=126) in northern Sweden who had died from natural causes in traffic were studied. This fraction was 25% of all driver fatalities. Cardiovascular causes of death were found in 96% of the deceased. Neither the victims nor other occupants suffered severe traumatic injuries. A minority of the victims had experienced previous symtoms of disease. Further restriction of individuals with, for example, cardiovascular diseases would probably have no significant impact on traffic safety since at present the identification of high-risk individuals is difficult.

    Helmets: Head injuries in 948 injured bicyclists, including 105 fatalities, were analysed. Head/face injuries were found in 64% of the fatal and 38% of the nonfatal cases with a median age of 55 years and 18 years, respectively. Head trauma was mostly blunt with only a few severe face injuries. Of the nonfatal cases with head injuries, 48% might have had an injury reduction effect if a bicycle helmet had been used, compared with 67% of the fatalities with head injuries.

    A helmet with a hard shell, chin cover, accurate retention system, that reduces rotation and translation impact is recommended. To increase helmet use among bicyclists, a law is probably the most effective measure as has been shown for motorcyclists. However, head injuries were less frequent among snowmobile riders than among bicyclist and motorcyclist riders, and in most cases the snowmobile riders with head injuries but without helmet had broken other traffic laws, indicating that in this crash category there was a low compliance to compulsary laws.

    Airbags: In a field study of car crashes where an airbag deployed, the effectiveness of the bag, as well as injuries to the skin and eye from the deployment of the bag, is reported. In laboratory tests with airbag deployment on human volunteers, tethering was found to eliminate skin abrasion within a distance of 250-300 mm. At a distance of 225 mm, the folding technique had the optimal influence on abrasions followed by a marginal effect of tethering. However, injuries due to airbag deployment must be considered as negligible compared with the airbag's role in reduction of severe and fatal injuries.

  • 2732.
    Öström, Mats
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Ahlm, Kristin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Brister i handläggningen av onaturliga dödsfall1999In: Svenska Läkaresällskapets Handlingar Hygiea, 1999Conference paper (Other (popular science, discussion, etc.))
    Abstract [sv]

    Enligt gällande svenska rättsregler förutsätts att i princip samtliga onaturliga dödsfall, inkluderande samtliga fall där misstanke finns om yttre våld, förgiftning, missbruk eller om fel eller försummelse inom sjukvården, ska anmälas till polis och genomgå rättsmedicinsk undersökning. Syftet med den föreliggande undersökningen var att närmare studera de dödsfall som inte genomgått rättsmedicinsk undersökning trots att så borde ha skett enligt gällande regelverk, och att belysa varför så inte blivit fallet.

  • 2733.
    Öström, Mats
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Snowmobile fatalities aspects on preventive measures from a 25-year review.2002In: Accident; analysis and prevention, ISSN 0001-4575, Vol. 34, no 4, p. 563-8Article in journal (Other academic)
    Abstract [en]

    During October 1973 through May 1998, 157 snowmobile fatalities were autopsied in Northern Sweden, including 131 riders, 15 passengers, six occupants with unknown position and five victims pulled by a snowmobile. Most fatalities occurred during March and April (41%), on weekends/holidays (75%), between 18:00 and 02:00 h (59%), during darkness (63%), in clear weather (84%) and at leisure time (94%). The median age was 39 years and 92% were men. The most common causes of death were blunt trauma (53%) and drowning (38%). A total of 64% were inebriated by alcohol, with a mean blood alcohol concentration of 1.7 g/l. More inebriated victims were found during weekends/holidays than on weekdays (75 vs. 51%) and during nighttime than during daytime (92 vs. 52). Driving into water was the most common event (38%) followed by collisions with immobile objects (20%). Alcohol and speeding were the most common contributors to the crashes, while flotation snowmobile suit and helmet use were considered to be the most important injury prevention factors.

  • 2734.
    Öström, Mats
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Snowmobilie fatalities in Sweden1999In: Proceeding annual meeting American Academy of Forensic Sciences, 1999Conference paper (Other (popular science, discussion, etc.))
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