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  • 1.
    Aagaard, Hanne
    et al.
    Lovisenberg Diaconal University College, Oslo, Norway.
    Hall, ElisabethO.C.
    Health, Aarhus University, Aarhus, Denmark; Faculty of Health Sciences and Nursing University of Faroe Islands, Torshavn, Faroe Islands.
    Audulv, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ludvigsen, Mette S.
    Department of Clinical Medicine - Randers Regional Hospital, Aarhus University, Aarhus, Denmark; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
    Westergren, Thomas
    Department of Public Health, University of Stavanger, Norway; Department of Nursing Science, University of Agder, Norway.
    Fegran, Liv
    Department of Nursing Science, University of Agder, Norway.
    Parents’ experiences of transitioning to home with a very-low-birthweight infant: a meta-ethnography2023In: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 29, no 3, p. 444-452Article, review/survey (Refereed)
    Abstract [en]

    Medical-technological advances and neurodevelopmental care have improved the survival of extremely- and very-low-birthweight infants born before 32 weeks' gestation. After months in neonatal care, the infants are discharged, and parents exited but full of anxiety. This review is designed as a meta-ethnography, addressing parents' discharge experiences to comprehend the synthesised research, which includes 12 eligible studies. From the analysis, we constructed three themes: ‘approaching discharge with both uncertainty and confidence’; ‘discharge as a longed-for though disordering turning point’; and ‘facing joys, worries and multiple challenges when at home’. The overarching interpretation was ‘discharge as double-edged sword’. We conclude that bringing home very-low-birthweight infants is a joyful event, yet parents also experience discharge as never-endingly worrying, as a time filled with challenges to which parents must adapt and as necessitating continuous support from knowledgeable providers.

  • 2.
    Aalto, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Läckberg Holmquist, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nervrotsblockad i kombination med fysioterapi för patienter med diskbråck - en single subject experimental design2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Diskbråck i ländryggen med symtom av ischias, bensmärta, är en vanlig orsak till specifika ryggbesvär. Konservativa behandlingsmetoder rekommenderas före kirurgi. Diagnosen diskbråck är förknippad med kraftig smärta och begränsningar och är en vanlig orsak till att söka vård och behandling. Trots detta finns det idag ingen konsensus kring vilka behandlingsmetoder som är mest effektiva vid diskbråck.

    Syfte: Att undersöka effekten av nervrotsblockad i kombination med individanpassad fysioterapi på smärta och aktivitetsförmåga för patienter med symtomgivande lumbosakralt diskbråck.

    Metod: Studiens utformning var en Single Subject Experimental Design (SSED), med en A-B design. Under baslinjefasen, A och interventionsfasen, B utfördes systematiska och upprepade mätningar av smärtintensitet och aktivitetsförmåga över tid. Totalt fem patienter med lumbosakralt diskbråck rekryterades från en klinik. Studien omfattades av två interventioner. Två patienter behandlades med nervrotsblockad (NRB) i kombination med individanpassad fysioterapi och tre patienter behandlades endast med NRB. Mätdata presenteras med grafer i linjediagram och analyserades visuellt.

    Resultat: De två patienterna som fick NRB i kombination med individanpassad fysioterapi förbättrades avseende smärta respektive aktivitetsförmåga, under nio respektive fem veckors interventionsfas. Av de tre patienter som behandlades enbart med NRB upplevde en patient en försämring avseende smärta och aktivitetsförmåga, en valde att avsluta sin medverkan och en behandlades som bortfall.

    Slutsats: NRB i kombination med individanpassad fysioterapi kan minska smärta och förbättra aktivitetsförmåga för enskilda patienter med symtomgivande lumbosakralt diskbråck.

     

  • 3.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandsklinikens hälsocentral, Umeå, Sweden.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Individualized low-load motor control exercises and education versus a high-load lifting exercise and education to improve activity, pain intensity, and physical performance in patients with low back pain: a randomized controlled trial2015In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 45, no 2, p. 77-85Article in journal (Refereed)
    Abstract [en]

    Study Design Randomized controlled trial. Background Low back pain is a common disorder. Patients with low back pain frequently have aberrant and pain-provocative movement patterns that often are addressed with motor control exercises. Objective To compare the effects of low-load motor control (LMC) exercise and those of a high-load lifting (HLL) exercise. Methods Seventy participants with recurrent low back pain, who were diagnosed with nociceptive mechanical pain as their dominating pain pattern, were randomized to either LMC or HLL exercise treatments. Participants were offered 12 treatment sessions over an 8-week period. All participants were also provided with education regarding pain mechanisms. Methods Participants were assessed prior to and following treatment. The primary outcome measures were activity (the Patient-Specific Functional Scale) and average pain intensity over the last 7 days (visual analog scale). The secondary outcome measure was a physical performance test battery that included 1 strength, 3 endurance, and 7 movement control tests for the lumbopelvic region. Results Both interventions resulted in significant within-group improvements in pain intensity, strength, and endurance. The LMC group showed significantly greater improvement on the Patient-Specific Functional Scale (4.2 points) compared with the HLL group (2.5 points) (P<.001). There were no significant between-group differences in pain intensity (P = .505), strength, and 1 of the 3 endurance tests. However, the LMC group showed an increase (from 2.9 to 5.9) on the movement control test subscale, whereas the HLL group showed no change (from 3.9 to 3.1) (P<.001). Conclusion An LMC intervention may result in superior outcomes in activity, movement control, and muscle endurance compared to an HLL intervention, but not in pain intensity, strength, or endurance.

  • 4.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Hellqvist, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Michaelson, Peter
    Luleå Tekniska Universitet, Institutionen för hälsovetenskap, Avdelningen för hälsa och rehabilitering, Fysioterapi.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    A characterisation of pain, disability, kinesiophobia and physical capacity in patients with predominantly peripherally mediated mechanical low back pain2011Conference paper (Refereed)
  • 5.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics. Norrlandskliniken, Umeå.
    Lundström, Lena
    Pain Rehabilitation, Norrlands University Hospital, Umeå.
    Papacosta, Daniel
    Norrlandskliniken, Umeå.
    Sandlund, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Do we see the same movement impairments?: the inter-rater reliability of movement tests for experienced and novice physiotherapists2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 16, p. 173-182, article id 3Article in journal (Refereed)
    Abstract [en]

    Study design: Inter-rater reliability study. Background: Physiotherapists (PTs) use clinical tests including movement tests to identify faulty movement patterns. Aims: To investigate the inter-rater-reliability of active movement tests in the cervical spine, shoulder joint and scapulo-thoracic joint, and to describe the reasons for judgment of a positive test. Methodology: Four PTs, two experienced and two recently educated (novice), rated performance of five movement tests for 36 participants. Twenty-one of the participants were patients under treatment because of neck and/or shoulder problems, while 15 participants declared no problem from this region of the body. All tests were video recorded and the ratings were done by observing the video recordings. First, the PTs judged the tests as negative (the movement being ideally performed) or positive (the movement not being ideally performed). Then, the PTs described why the movements that they judged positive were not being ideally performed, using a predefined protocol, which represented different movement quality aspects. The inter-rater reliability was calculated for each test using Kappa statistics between the two experienced and the two novice PTs, respectively, and between each of the experienced and each of the novice PTs. Major findings: The experienced PTs had a higher inter-rater reliability than the novice PTs. The reasons for considering a movement test being positive differed highly between the (novice) PTs. Principal conclusion: This study supports previous studies concluding that the observation of active movement tests is reliable when assessed by experienced PTs. Novice PTs might benefit from further supervision.

  • 6.
    Aasa, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Sandlund, Jonas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Rudolfsson, Thomas
    Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden.
    Aasa, Ulrika
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Acuity of goal-directed arm movements and movement control: evaluation of differences between patients with persistent neck/shoulder pain and healthy controls2022In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 24, no 1, p. 47-55Article in journal (Refereed)
    Abstract [en]

    Background: The main aim was to examine whether patients with persistent upper quadrant pain have higher end-point variability in goal directed pointing movements than pain-free controls when the pointing task is performed in total darkness and under full vision. An additional aim was to study associations between the magnitude of end-point variability and a clinical movement control test battery and self-rated functioning among patients.

    Methods: Seventeen patients and 17 age- and gender-matched pain-free controls performed a pointing task that evaluated end-point variability of repetitive shoulder movements in horizontal adduction and abduction with full vision, and abduction with no visual information, completed a movement control test battery of neck and shoulder control tests and answered questionnaires.

    Results: Patients had higher end point variability for horizontal abduction when performed with no visual information. For horizontal adduction the variability was higher, but only when it was controlled for movement time. No significant correlations were found between end-point variability and self-rated functioning, nor between end-point variability and neuromuscular control of the glenohumeral joint.

    Conclusions: This study provides preliminary evidence that patients with persistent neck/shoulder pain can partly compensate proprioceptive deficits in goal-directed arm movement when visual feedback is present.

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  • 7.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Bengtsson, Victor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Öhberg, Fredrik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Variability of lumbar spinal alignment among power- and weightlifters during the deadlift and barbell back squat2022In: Sports Biomechanics, ISSN 1476-3141, E-ISSN 1752-6116, Vol. 21, no 6, p. 707-717Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to evaluate the relative and absolute variability of upper (T11-L2) and lower (L2-S2) lumbar spinal alignment in power- and weightlifters during the deadlift and back squat exercises, and to compare this alignment between the two lifting groups. Twenty-four competitive powerlifters (n = 14) and weightlifters (n = 10) performed three repetitions of the deadlift and the back squat exercises using a load equivalent to 70% of their respective one-repetition maximum. The main outcome measures were the three-dimensional lumbar spinal alignment for start position, minimum and maximum angle of their spinal alignment, and range of motion measured using inertial measurement units. Relative intra-trial reliability was calculated using the two-way random model intraclass correlation coefficient (ICC) and absolute reliability with minimal detectable change (MDC). The ICC ranged between 0.69 and 0.99 and the MDC between 1 degrees-8 degrees for the deadlift. Corresponding figures for the squat were 0.78-0.99 and 1 degrees-6 degrees. In all participants during both exercises, spinal adjustments were made in both thoracolumbar and lumbopelvic areas in all three dimensions. In conclusion, when performing three repetitions of the deadlift and the squat, lumbar spinal alignment of the lifters did not change much between repetitions and did not differ significantly between power- and weightlifters.

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  • 8.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Umeå University, Faculty of Social Sciences, Umeå School of Sport Sciences.
    A descriptive analysis of functional impairments and patho-anatomical findings in eight powerlifters2020In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 60, no 4, p. 582-593Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Low back pain (LBP) is a common pain problem in powerlifters. There is a lack of evidence to guide powerlifters and health-care professionals in understanding the role of powerlifting in the development of LBP and treatment of injuries in powerlifters. This study aimed to describe functional impairments and patho-anatomical findings in eight powerlifters with and without LBP. METHODS: First, four powerlifters with LBP were recruited. Each powerlifter was then matched with a pain-free lifter (Control) by age, Body Mass Index and competition weight class. They all performed physical performance tests and were examined with magnetic resonance imaging. Four weeks prior to the examination the powerlifters also recorded training load. Powerlifters with LBP were also examined by a physiotherapist in order to define their pain and impairments. RESULTS: The four male powerlifters with LBP had a nociceptive pain associated with non-ideal squatting technique, higher flexibility in their lumbar spine than in their hips and patho-anatomical findings such as degenerated discs (four), spondylolysis (one) and spinal stenosis (one). However, the controls also showed similar functional impairments and patho-anatomical findings. CONCLUSIONS: Powerlifters with and without LBP show similar functional impairments and patho-anatomical findings. However, powerlifters' LBP seems associated with pain during movement and loading of the lumbar spine. The association and causation between specific functional impairments, patho-anatomical findings and LBP in powerlifters has to be further investigated in studies including more participants.

  • 9.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Orthopaedics.
    Krafttag ska stoppa styrkelyftarnas skador2015In: Svensk idrottsforskning, ISSN 1103-4629, no 4, p. 29-31Article in journal (Other (popular science, discussion, etc.))
  • 10.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Jensen, Bente R
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Sandfeld, Jesper
    Department of Exercise and Sport Sciences, University of Copenhagen, Denmark .
    Richter, Hans
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Lyskov, Eugene
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Crenshaw, Albert
    Centre for Musculoskeletal Research, University of Gävle, Sweden.
    The impact of object size and precision demands on fatigue during computer mouse use2011In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 13, no 3, p. 118-127Article in journal (Refereed)
    Abstract [en]

    Prolonged computer use, especially if fatigue ensues, is associated with visual and musculoskeletal symptoms. The aim was to determine the time-course of perceived fatigue in the wrist, forearm, shoulder and eyes during a 60-min mouse task (painting rectangles), and whether object size and/or mouse use demands were of infl uence. Also, we investigated performance (number of rectangles painted), and whether perceived fatigue was paralleled by local muscle fatigue or tissue oxygenation.

    Ten women performed the task for three conditions (crossover design). At condition 1, rectangles were 45 25 mm, square paint cursor size 1.3 1.3 mm, and mouse – pointer movement ratio 1:26. At condition 2, the same cursor size and mouse – pointer movement ratio was used, but rectangles were smaller. At condition 3, the smaller rectangles were used, but the cursor size was also smaller and mouse – pointer movement ratio was 1:8. The results showed increased self-reported fatigue over time, with the observed increase greater for the eyes, but no change in physiological responses. Condition 2 resulted in higher performance and increased eye fatigue. Perceived fatigue in the muscles or physiological responses did not differ between conditions. In conclusion, computer work tasks imposing high visual and motor demands, and with high performance, seemed to have an infl uence on eye fatigue.

  • 11.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Aasa, Björn
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Norrlandskliniken, Umeå, Sweden.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin, Karolinska institutet.
    Physical Activity Might Be of Greater Importance for Good Spinal Control Than If You Have Had Pain or Not: A Longitudinal Study2015In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, no 24, p. 1926-1933Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Longitudinal design. A cohort followed in 3 waves of data collection.

    OBJECTIVE: The aim of the study was to describe the relationships between the performance of 2 tests of spinal control at the age of 52 years and low back pain, physical activity level, and fitness earlier in life, as well as to describe the cross-sectional relationships between these measures.

    SUMMARY OF BACKGROUND DATA: Altered spinal control has been linked to pain; however, other stimuli may also lead to inability to control the movements of the spine.

    METHODS: Participants answered questions about physical activity and low back pain, and performed physical fitness tests at the age of 16, 34, and 52 years. The fitness test battery included tests of endurance in the back and abdominal muscles, a submaximal bicycle ergometer test to estimate maximal oxygen uptake, and measurements of hip flexion, thoracic spine flexibility, and anthropometrics. Two tests were aggregated to a physical fitness index. At the age of 52, also 2 tests of spinal control, the standing Waiter's bow (WB) and the supine double leg lower (LL) were performed.

    RESULTS: Logistic regression analyses showed that higher back muscle endurance at the age of 34 years could positively predict WB performance at 52 years and higher physical fitness at the age of 34 could positively predict LL performance at 52 years. Regarding cross-sectional relationships, an inability to perform the WB correctly was associated with lower physical fitness, flexibility and physical activity, and larger waist circumference. An inability to correctly perform the LL was associated with lower physical fitness. One-year prevalence of pain was not significantly associated with WB or LL test performance.

    CONCLUSION: An active life resulting in higher physical fitness is related to better spinal control in middle-aged men and women. This further strengthens the importance of physical activity throughout the life span.

    LEVEL OF EVIDENCE: 3.

  • 12.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundell, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Barnekow-Bergkvist, Margareta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Jansson, Eva
    Westerståhl, Maria
    The Swedish physical activity and fitness cohort born in 1958 - dropout analysis and overview at 36-year follow-up2017In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 27, no 4, p. 418-429Article in journal (Refereed)
    Abstract [en]

    The main aim of the Swedish physical activity and fitness cohort study (SPAF-1958) was to describe physical fitness, physical activity, health, and lifestyle across part of the lifespan, and to assess the influences on these factors from the environment, personal factors, and genetics. There is inevitable dropout from longitudinal studies, and it may be systematic. The aim of this first paper of the second follow-up of SPAF-1958 was to provide a dropout analysis to consider to what extent the participants, at 52 years of age, remain a representative sample of the original adolescent study population. Additional aims were to provide an overview of the study protocol and the ongoing study population. Ongoing study participants in SPAF born in 1958 were, at the second follow-up at the age of 52, still representative of the study cohort in terms of sex, adolescent geographical area, upper secondary school program, adolescent body composition, muscular strength, and muscular endurance. However, a higher physical activity and, among women, a higher aerobic capacity in adolescence decreased the risk for dropout. It is important when interpreting results from longitudinal studies to adjust for the systematic dropout that could bias the conclusions drawn from the results.

  • 13.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Paulin, Johan
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Madison, Guy
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Correspondence between physical self-concept and participation in, and fitness change after, bi-weekly body conditioning classes in sedentary women2017In: Journal of Strength and Conditioning Research, ISSN 1064-8011, E-ISSN 1533-4287, Vol. 31, no 2, p. 451-461Article in journal (Refereed)
    Abstract [en]

    The aims of the study were (1) to investigate the effects of participation in low impact body conditioning classes on physical fitness in sedentary women at different ages and (2) to examine the correspondence between physical self-concept and participation in, and fitness change after, the participation. Ninety-two sedentary women (mean age 44.2 years) participated in 11-weeks of bi-weekly classes that included cardiovascular, strength, core, endurance and mobility exercises, all performed in synchrony with music. Cardiorespiratory fitness, maximal lifting strength, mobility and balance tests were performed pre- and post the exercise period and the short-form Physical Self-Description Questionnaire (PSDQ-S) was completed. Zero-order Spearman correlation analyses showed that women who rated the PSDQ-S dimension Sport competence higher participated in a larger number of sessions (rs=0.24, p=0.040). At post-tests, all participants had increased their balance, the participants aged 20-34 years had increased their lifting strength, and the participants aged 35-65 years had increased their cardiorespiratory fitness and mobility. Most PSDQ-S dimensions did not affect performance change, but the perception of being physically active was related to increased cardiovascular fitness. We conclude that women with a sedentary lifestyle who wish to increase their physical capacity benefit from music exercise and that inquiries about perceived sport competence and physical activity can improve recommendations made by strength and conditioning professionals.

  • 14.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Svartholm, Ivar
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Andersson, Fredrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Berglund, Lars
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Social Sciences, Umeå Sport Sciences Center.
    Injuries among weightlifters and powerlifters: a systematic review2017In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 51, no 4, p. 211-219Article in journal (Refereed)
    Abstract [en]

    Background Olympic weightlifting and powerlifting are two sports that expose the body to great forces. Injury characteristics have not been systematically reviewed for these two growing sports.

    Objective The purpose of this study was to systematically review the literature regarding various definitions of injuries used, injury localisation, the prevalence and incidence of injuries and the associated risk factors for injuries in weightlifting and powerlifting.

    Design Systematic review.

    Data sources Five databases, PubMed, MEDLINE, SPORTDiscus, Scopus and Web of Science, were searched between 9 March and 6 April 2015.

    Eligibility criteria for selecting studies Studies assessing injury incidence and prevalence in Olympic weightlifting and powerlifting were included. The Quality assessment tool for observational cohort and cross-sectional studies was used to assess methodological quality.

    Results 9 studies were included in the review. Injury was defined fairly consistently across studies. Most studies were of low methodological quality. The spine, shoulder and the knee were the most common injury localisations in both sports. The injury incidence in weightlifting was 2.4–3.3 injuries/1000 hours of training and 1.0–4.4 injuries/1000 hours of training in powerlifting. Only one retrospective study had analysed possible risk factors.

    Summary/conclusions The risk of injury in both sports were similar to other non-contact sports also requiring strength/power, but low compared to contact sports. The severity of injuries differed in the included studies. Since little has been studied regarding possible risk factors to injuries, further research is therefore warranted to explain why athletes get injured and how to prevent injuries.

    Trial registration number PROSPERO CRD42015014805.

  • 15.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Westerståhl, Maria
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Barnekow-Bergkvist, Margareta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Jansson, Eva
    Institutionen för laboratoriemedicin avd för klinisk fysiologi Karolinska institutet .
    Hälsoresan till medelåldern2011In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, no 2, p. 4p. 40-43Article in journal (Other academic)
    Abstract [sv]

    Vad är viktigast för att få en god hälsa som vuxen? Sedan 1974 har vi följt samma personer från 16 års ålder in i medelåldern och studerat deras hälsa från flera olika synvinklar. Nu pågår den tredje mätomgången.

  • 16.
    Aasa, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Wiitavaara, Birgitta
    Högskolan i Gävle.
    Personalens hälsa och arbetsmiljö2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud och Leif Svensson, Stockholm: Liber, 2009, p. 33-38Chapter in book (Other (popular science, discussion, etc.))
  • 17.
    Aasted, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Danielsson, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Den laddade gymspegeln: - Unga styrketränande kvinnors förhållande till speglar på gymmet2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Spegeln har en lång historia som en väsentlig del i rehabilitering och används med varierade syften inom olika fysioterapeutiska områden. Forskning har dock visat att träning i speglade miljöer kan ge en negativ påverkan på självkänslan. Det är därför av stor vikt för fysioterapeuter att vara medveten om och inventera speglarnas olika påverkan.

    Syfte: Syftet med studien var att utforska unga styrketränande kvinnors förhållande till speglar på gymmet och hur det påverkar deras kroppsuppfattning och självkänsla.

    Metod: Studien baseras på kvalitativa intervjuer med fyra unga kvinnor. Inkluderingskriterierna är var unga styrketränande kvinnor i åldrarna 20-25 år. Intervjuguiden som användes är var semistrukturerade och analysmetoden är var Grounded Theory.

    Resultat: Resultatet av analysen utmynnade i kärnkategorin ”Den laddade gymspegeln” och kategorier med tillhörande underkategorier. De kategorier som formulerades fram var: ”Speglad trygghet och motivation”, ”Reflekterad osäkerhet”, ”Den dömande gymspegeln”, ”Gymspegeln skapar bidrar till stressig gymmiljö”, ”Gymspegeln som förstärkare av krävande kroppsideal”. Som sista steg i analysen skapades en modell.

    Konklusion: Unga styrketränande kvinnor upplevdeer att det finns en såväl positiv som negativ laddning med speglar på gymmet. Det var viktigt med speglar ur teknik- och skadepreventionssyfte. Samtidigt bidrog den speglade miljön till ett jämförande och ökat dömande. Det är fördelaktigt för fysioterapeuter att vara medvetna om speglarnas påverkan på unga styrketränande kvinnors självkänsla och kroppsuppfattning. Mer forskning krävs inom området.

  • 18. Abat, F
    et al.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine. Alfredson Tendon Clinic Inc, Umeå, Sweden; Pure Sports Medicine Clinic, ISEH, UCLH, London, UK.
    Cucchiarini, M
    Madry, H
    Marmotti, A
    Mouton, C
    Oliveira, J M
    Pereira, H
    Peretti, G M
    Spang, Christoph
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy.
    Stephen, J
    van Bergen, C J A
    de Girolamo, L
    Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II2018In: Journal of experimental orthopaedics, ISSN 2197-1153, Vol. 5, no 38Article in journal (Refereed)
    Abstract [en]

    The treatment of painful chronic tendinopathy is challenging. Multiple non-invasive and tendon-invasive methods are used. When traditional non-invasive treatments fail, the injections of platelet-rich plasma autologous blood or cortisone have become increasingly favored. However, there is little scientific evidence from human studies supporting injection treatment. As the last resort, intra- or peritendinous open or endoscopic surgery are employed even though these also show varying results. This ESSKA basic science committee current concepts review follows the first part on the biology, biomechanics and anatomy of tendinopathies, to provide a comprehensive overview of the latest treatment options for tendinopathy as reported in the literature.

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  • 19.
    Abat, Ferran
    et al.
    ReSport Clinic Barcelona, Blanquerna-Ramon Llull University School of Health Science, Rosselló, Barcelona, Spain.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Sonosurgery ultrasound-guided arthroscopic shaving for the treatment of patellar tendinopathy when conservative treatment fails2023In: Anterior knee pain and patellar instability / [ed] Vicente Sanchis-Alfonso, Cham: Springer Nature, 2023, 3, p. 403-413Chapter in book (Refereed)
    Abstract [en]

    Proximal patellar Tendinopathy, commonly denominated as Jumper´s Knee, is widely considered to be a challenge to treat (Abat et al. in J Exp Orthop. 3:34, 2016). The treatment of patellar tendinopathy focuses on reducing if not eliminating the pain and improving function. At present, there are a several distinct treatments oriented to that end, and a “gold-standard” treatment might be in sight. (Abat F, Alfredson H, Cucchiarini M, Madry H, Marmotti A, Mouton C, Oliveira JM, Pereira H, Peretti GM, Spang C, Stephen J, van Bergen CJA, de Girolamo L. Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part II: treatment options. J Exp Orthop. 2018 Sep 24;5(1):38. https://doi.org/10.1186/s40634-018-0145-5.)

  • 20.
    Abat, Ferran
    et al.
    Department of Sports Orthopaedic, ReSport Clinic Barcelona, Barcelona, Spain.
    Maffulli, Nicola
    Centre for Sports and Exercise Medicine, Queen Mary University of London Barts and The London School of Medicine, London, United Kingdom.
    Alfredson, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Lopez-Vidriero, E.
    Department of Orthopaedic, International Sports Medicine Clinic and Ibermutuamur Sevilla, Sevilla, Spain.
    Myers, C.
    Complete Physio, Tendon Performance, Sports Medicine Ultrasound Group (SMUG), London, United Kingdom.
    Gomes, S.
    Department of MSK Radiology, Clinica do Dragao Espregueira Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal.
    Chan, O.
    Department of MSK Radiology, BMI London Independent Hospital, London, United Kingdom.
    Clinical utility of diagnostic ultrasound in athletes with tendinopathy (ICL 22)2016In: Esska instructional course lecture book: Barcelona 2016 / [ed] Roland Becker; Gino M.M.J. Kerkhoffs; Pablo E. Gelber; Matteo Denti; Romain Seil, Springer Berlin/Heidelberg, 2016, p. 217-223Chapter in book (Refereed)
    Abstract [en]

    Chronic painful tendinopathy is common in elite and recreational athletes and in sedentary subjects; all may have to stop or decrease their level of physical activity [1, 2]. Midportion Achilles tendinopathy and for the younger and heavy loading population also patellar tendinopathy are problematic injuries. However, recent research on innervation patterns histopathology and pain mechanisms in Achilles and patellar tendons has led to an increased knowledge about the chronic painful tendon [3–6].

  • 21.
    Abbara, Aula
    et al.
    Imperial College, London, United Kingdom.
    Almalla, Mohamed
    American University of Beirut, Beirut, Lebanon.
    AlMasri, Ibrahim
    O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
    AlKabbani, Hussam
    Department of Health and Nutrition Al-Ameen for Humanitarian Support, Gaziantep, Turkey.
    Karah, Nabil
    Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    El-Amin, Wael
    King's College Hospital London, United Arab Emirates.
    Rajan, Latha
    Tulane University School of Public Health and Tropical Medicine, Tulane University, LA, New Orleans, United States.
    Rahhal, Ibrahim
    Hand in Hand for Aid and Development, Gaziantep, Turkey.
    Alabbas, Mohammad
    Hand in Hand for Aid and Development, Gaziantep, Turkey.
    Sahloul, Zaher
    Department of Pulmonology and Critical Care, University of Illinois, IL, Chicago, United States.
    Tarakji, Ahmad
    Syrian American Medical Society, Washington DC, United States.
    Sparrow, Annie
    Department of Population Health Sciences and Policy, Icahn School of Medicine at Mount Sinai, New York, United States.
    The challenges of tuberculosis control in protracted conflict: The case of Syria2020In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, International Journal of Infectious Diseases, ISSN 1201-9712, Vol. 90, p. 53-59Article, review/survey (Refereed)
    Abstract [en]

    Objectives: Syria's protracted conflict has resulted in ideal conditions for the transmission of tuberculosis (TB) and the cultivation of drug-resistant strains. This paper compares TB control in Syria before and after the conflict using available data, examines the barriers posed by protracted conflict and those specific to Syria, and discusses what measures can be taken to address the control of TB in Syria.

    Results: Forced mass displacement and systematic violations of humanitarian law have resulted in overcrowding and the destruction of key infrastructure, leading to an increased risk of both drug-sensitive and resistant TB, while restricting the ability to diagnose, trace contacts, treat, and follow-up. Pre-conflict, TB in Syria was officially reported at 22 per 100 000 population; the official figure for 2017 of 19 per 100 000 is likely a vast underestimate given the challenges and barriers to case detection. Limited diagnostics also affect the diagnosis of multidrug- and rifampicin-resistant TB, reported as comprising 8.8% of new diagnoses in 2017.

    Conclusions: The control of TB in Syria requires a multipronged, tailored, and pragmatic approach to improve timely diagnosis, increase detection, stop transmission, and mitigate the risk of drug resistance. Solutions must also consider vulnerable populations such as imprisoned and besieged communities where the risk of drug resistance is particularly high, and must recognize the limitations of national programming. Strengthening capacity to control TB in Syria with particular attention to these factors will positively impact other parallel conditions; this is key as attention turns to post-conflict reconstruction.

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  • 22. Abbara, Aula
    et al.
    Rawson, Timothy M.
    Karah, Nabil
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR).
    El-Amin, Wael
    Hatcher, James
    Tajaldin, Bachir
    Dar, Osman
    Dewachi, Omar
    Abu Sitta, Ghassan
    Uhlin, Bernt Eric
    Umeå University, Faculty of Medicine, Umeå Centre for Microbial Research (UCMR). Umeå University, Faculty of Medicine, Molecular Infection Medicine Sweden (MIMS). Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Sparrow, Annie
    A summary and appraisal of existing evidence of antimicrobial resistance in the Syrian conflict2018In: International Journal of Infectious Diseases, ISSN 1201-9712, E-ISSN 1878-3511, Vol. 75, p. 26-33Article, review/survey (Refereed)
    Abstract [en]

    Antimicrobial resistance (AMR) in populations experiencing war has yet to be addressed, despite the abundance of contemporary conflicts and the protracted nature of twenty-first century wars, in combination with growing global concern over conflict-associated bacterial pathogens. The example of the Syrian conflict is used to explore the feasibility of using existing global policies on AMR in conditions of extreme conflict. The available literature on AMR and prescribing behaviour in Syria before and since the onset of the conflict in March 2011 was identified. Overall, there is a paucity of rigorous data before and since the onset of conflict in Syria to contextualize the burden of AMR. However, post onset of the conflict, an increasing number of studies conducted in neighbouring countries and Europe have reported AMR in Syrian refugees. High rates of multidrug resistance, particularly Gram-negative organisms, have been noted amongst Syrian refugees when compared with local populations. Conflict impedes many of the safeguards against AMR, creates new drivers, and exacerbates existing ones. Given the apparently high rates of AMR in Syria, in neighbouring countries hosting refugees, and in European countries providing asylum, this requires the World Health Organization and other global health institutions to address the causes, costs, and future considerations of conflict-related AMR as an issue of global governance. (c) 2018 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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  • 23. Abbas, S
    et al.
    Linseisen, J
    Rohrmann, S
    Beulens, JWJ
    Buijsse, B
    Amiano, P
    Ardanaz, E
    Balkau, B
    Boeing, H
    Clavel-Chapelon, F
    Fagherazzi, G
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Gavrila, D
    Grioni, S
    Kaaks, R
    Key, TJ
    Khaw, KT
    Kuehn, T
    Mattiello, A
    Molina-Montes, E
    Nilsson, PM
    Overvad, K
    Quiros, JR
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sacerdote, C
    Saieva, C
    Slimani, N
    Sluijs, I
    Spijkerman, AMW
    Tjonneland, A
    Tumino, R
    van der A, DL
    Zamora-Ros, R
    Sharp, SJ
    Langenberg, C
    Forouhi, NG
    Riboli, E
    Wareham, NJ
    Dietary vitamin D intake and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition: the EPIC-InterAct study2014In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 68, no 2, p. 196-202Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: Prospective cohort studies have indicated that serum vitamin D levels are inversely related to risk of type 2 diabetes. However, such studies cannot determine the source of vitamin D. Therefore, we examined the association of dietary vitamin D intake with incident type 2 diabetes within the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct study in a heterogeneous European population including eight countries with large geographical variation.

    SUBJECTS/METHODS: Using a case-cohort design, 11 245 incident cases of type 2 diabetes and a representative subcohort (N = 15 798) were included in the analyses. Hazard ratios (HR) and 95% confidence intervals (CIs) for type 2 diabetes were calculated using a Prentice-weighted Cox regression adjusted for potential confounders. Twenty-four-hour diet-recall data from a subsample (N = 2347) were used to calibrate habitual intake data derived from dietary questionnaires.

    RESULTS: Median follow-up time was 10.8 years. Dietary vitamin D intake was not significantly associated with the risk of type 2 diabetes. HR and 95% CIs for the highest compared to the lowest quintile of uncalibrated vitamin D intake was 1.09 (0.97-1.22) (P-trend = 0.17). No associations were observed in a sex-specific analysis. The overall pooled effect (HR (95% CI)) using the continuous calibrated variable was 1.00 (0.97-1.03) per increase of 1 mg/day dietary vitamin D.

    CONCLUSIONS: This observational study does not support an association between higher dietary vitamin D intake and type 2 diabetes incidence. This result has to be interpreted in light of the limited contribution of dietary vitamin D on the overall vitamin D status of a person.

  • 24.
    Abdelaziz, Amr Abdelaziz Badrawy
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Troeller, Kenan Craig
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Cost-Effectiveness Analysis of Endovascular versus Open Repair of Ruptured Abdominal Aortic Aneurysm in Sweden2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately 600 people die from ruptured abdominal aortic aneurism annually in Sweden. Abdominal aortic aneurysm (AAA) is a widening of the abdominal aorta. If a ruptured aortic aneurysm occurs (RAAA), it is a medical emergency and it is a life-threatening condition. The two interventions used to treat RAAA patients are known as the endovascular strategy (EVAR) and the open repair method (OR). Given the life-threatening nature of RAAA, mortality rates are quite high especially considering that this medical condition affects predominantly the elderly. Determining whether a patient is more suitable for EVAR or OR depends on —among other clinical factors— whether technical expertise and resources are available to perform EVAR. The Swedish Agency for Health and Technology Assessment (SBU) explain that it is currently unclear as to which of the two intervention is the cost-effective alternative in treating RAAA in Sweden. 

    Objective: The aim of this study is to evaluate whether the non-invasive EVAR (endovascular) or traditional surgery known as OR (open repair) is more cost-effective in treating RAAA in Sweden.

    Methods: A Cost-effectiveness analysis with healthcare provider perspective using secondary data from relevant peer-reviewed literature from Sweden, other European countries, Swedvascs' and Socialstyrelsens' registries. The model of choice for this evaluation is a decision tree. The target population is males and females who suffer from RAAA in Sweden ranging from ages 50 – 90+, the majority of which were >65. Two subgroups were analyzed; RAAA patients treated with EVAR  and RAAA patients treated with OR. Total RAAA patients n=178. EVAR n= 73. OR n= 105. The time horizon in the base-case is 90 days. The outcome measures are incremental cost-effectiveness ratio (ICER), QALYs and cost/QALY. A one-way deterministic sensitivity analyses, in addition to a probabilistic sensitivity analysis were performed in order to assess the level of confidence that may be associated with the conclusion of this economic evaluation

    Results: Results from the base-case analysis shows that EVAR's cost per QALY gained is SEK 715,823.82 with an ICER of SEK 1,113,499.44 per QALY gained. Results of the base-case analysis shows that EVAR is not cost-effective when considering the commonly accepted threshold of SEK 500,000 per QALY gained. Results of the deterministic sensitivity analyses show that under all suggested scenarios EVAR was not cost-effective. However, results of the probabilistic sensitivity analysis result shows that there is a considerable uncertainty around the cost-effectiveness of EVAR.

    Conclusion: EVAR is not cost-effective with marginal clinical benefits compared to OR. Since it is a high cost intervention which lacks national guidelines from "Socialstyrelsen", individual county councils in Sweden will likely have to make the decision individually if they want to adopt EVAR as a treatment method for RAAA. While RAAA is a very severe health condition it also has a low prevalence in Sweden meaning county councils with larger population centers, budgets and availability of technical expertise/equipment can still introduce EVAR to treat RAAA even if the cost-effectiveness analysis results exceed the commonly accepted threshold value of SEK 500,000 per QALY gained. Due to uncertainties vis-à-vis a lack of more conclusive data in a Swedish context, further investigation is required before recommending EVAR for subsidization. It would however be worth pursuing this end given the promise of EVAR as a non-invasive and more benign treatment method for patients. 

  • 25.
    Abdelhay, Amro Gaber
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Antibiotic misuse in Egypt from the community pharmacists' perspective.: A study protocol.2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction/Background: Antibiotic resistance (AR) has become a danger threats to all countries and regions in the world. Decreased effectiveness of antibiotics in treating some infections due to antibiotic resistance is leading to more suffering for patients, increased treatment costs, increased days of hospitalization as well as increasing morbidity and mortality. In order to tackle AR, a much more responsible use of antibiotics is needed including avoidance of overuse, overprescribing and any other type of inappropriate use of antibiotics. Egypt is one of the countries with high rate of antibiotic misuse- In the study that this study protocol is outlining, the reasons for misuse will be explored from the community pharmacists’ perspectives in order to suggest possible solutions.

    Objective: The general objective is to study factors contributing to antibiotic misuse in Egypt from the perspective of community pharmacists.

    Method: A cross sectional study will be conducted using structured questionnaire. Answers will be collected from community pharmacists in Fayoum governorate in Egypt whereafter data analysis will be done.

    Study work plan: It is intended that the study period altogether will be six months.

  • 26.
    Abdelmoety, Ahmed
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    An investigation into the lived experiences of parents and health professionals involved in the treatment of children with cleft lip and/ or cleft palate in Egypt2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 27.
    Abdi, Yakoub Aden
    et al.
    Amoud University College of Health Sciences, Borama, Somaliland; Somali-Swedish Researchers’ Association (SSRA), Stockholm, Sweden.
    Said, Nasir Ibrahim
    Amoud University College of Health Sciences, Borama, Somaliland.
    Abdi Hared, Yusuf
    Amoud University College of Health Sciences, Borama, Somaliland.
    Ayeh, Ismail
    Amoud University College of Health Sciences, Borama, Somaliland.
    Walhad, Said Ahmed
    Amoud University College of Health Sciences, Borama, Somaliland.
    Mental health care delivery in poor settings through trained female community health workers: a five-year intervention program in Somaliland2021In: Somali Health Action Journal, E-ISSN 2004-1985, Vol. 1, no 1Article in journal (Refereed)
    Abstract [en]

    Background: The situation of mental health globally is alarming particularly in developing countries. In Somaliland/Somalia, every third person may be suffering from some sort of mental illness according to the World Health Organization. Major barriers to improve mental health include stigma and lack of skilled human resources.

    Objectives: The aim was to explore the feasibility of organizing integrated community-based mental, epilepsy and mother and child health services delivered by trained female community health workers (FCHWs) in three urban sites (Borama, Baki and Dila) in the Awdal Region, Somaliland.

    Methods: After selection of the 3 project sites and recruitment and training of project staff, a baseline survey was carried out. First, the sites were properly mapped based on existing geographical administrative sectors and sub-sectors of the sites. Then a representative sample of 2,722 households was randomly selected from all the 3 sites. The female head of each of those households were then interviewed using a questionnaire containing 22 questions on the target groups. The questionnaire responses were coded, and data analysed using Statistical software program, SPSS. After the baseline survey, the FCHWs were deployed in the sites assigning a specified area to each female worker. The FCHWs worked 6 hours per day 6 days per week and were required to visit 6 families each day including follow-ups. Their activities included identification of patients with severe mental illness (SMI) or with epilepsy, counselling, distribution of medications, follow-up of patients already on medication, referral, stigma reduction and documentation of their daily activities in logbooks.

    Results: The baseline study showed that 12% of the households were taking care of at least one person with SMI each, while 7% had one person with epilepsy each. Of the patients with SMI, 18% were on chains. During the project period (2015-2019), the number of people with SMI or with epilepsy who benefited from the project was 2.225 and 738 respectively and their families empowered through increased mental health awareness. Among the patients with SMI, 237 were on chains before intervention and 85% of them were successfully released from their shackles.

    Conclusions: This project has shown that deployment of trained and supported FCHWs can be used to reduce the mental health care gap in Somaliland. It is suggested as a model project which could, hopefully, be replicated and tested in other similar settings.

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  • 28.
    Abdou, Ahmed
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Experiences and Perspectives of Arabic- speaking Migrants about Healthcare in Sweden2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 29.
    Abduljalel, Hassan
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Johansson, Julia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskors erfarenheter i mötet med inneliggande suicidala patienter - En litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Suicidal patients constitute a large patient group within psychiatric inpatient care and can be a challenging patient group for the healthcare staff. Suicidal patients need help and support from nurses to feel better. Dealing with suicidal thoughts, feelings and behaviors can evoke difficult feelings for healthcare professionals.

    Aim: The purpose of this literature study was to describe nurses’ experiences of meeting suicidal inpatients.

    Methods: This is a literature review that includes eight scientific articles retrieved from Pubmed and CINAHL. After a quality review, the results in the selected articles were analyzed with the support of Friberg's analysis model. Common areas in the selected articles are identified and presented in sub-themes and themes.

    Results: From the articles, two themes and four subthemes have been formed. The first theme is “Being Engaged” and the second theme is “Being Frustrated and Suffering”. In the results it is mentioned that being engaged is about balancing professionalism and creating a safe care relationship in the meeting with hospitalised suicidal patients. Being frustrated and suffering is about feeling worry and resentment as well as feeling self-blame and self-doubt.

    Conclusion: Dealing with suicidal patients can arouse difficult feelings in nurses, which are incredibly important to address and discuss. With more knowledge in the field, care will develop more in the right direction.

    Keywords: Inpatient care, Nurse experiences, Psychiatric care, Suicide, Suicide attempt.

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  • 30.
    Abdullahi, Mohamed Farah
    et al.
    Department of Research and Development, Puntland University of Science and Technology , Galkayo City, Somalia..
    Stewart Williams, Jennifer
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle , Callaghan, Australia.
    Sahlen, Klas-Göran
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Bile, Khalif
    enior National Advisor Health Systems and Policy and Board Member Somali and Swedish Researchers' Association (SSRA) , Vällingby, Sweden.
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet , Stockholm, Sweden.
    Factors contributing to the uptake of childhood vaccination in Galkayo District, Puntland, Somalia2020In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 13, no 1, article id 1803543Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: As in many Sub-Saharan African countries, the health system in Somalia is not operating at the capacity needed to lift childhood vaccination coverage to ninety percent or above, as recommended by United Nations Children's Fund. Current national estimates of coverage for the six major vaccine preventable childhood diseases range from thirty to sixty percent. Infectious disease outbreaks continue to pose significant challenges for the country's health authorities.

    OBJECTIVE: This important qualitative study, conducted in Galkayo District, Somalia, investigates limiting factors associated with childhood vaccination uptake from the perspective of both communities and health care workers.

    METHODS: Qualitative information was collected through six focus group discussions with parents (n = 48) and five one-to-one interviews with health workers (n = 15) between March and May 2017, in three settings in the Galkayo District - Galkayo city, Bayra and Bacadwayn.

    RESULTS: From a health system perspective, the factors are: awareness raising, hard to reach areas, negative attitudes and perceived knowledge of health workers, inadequate supplies and infrastructure, and missed vaccination opportunities. From the perspective of individuals and communities the factors are: low trust in vaccines, misinterpretation of religious beliefs, vaccine refusals, Somalia's patriarchal system and rumours and misinformation. Parents mostly received immunization information from social mobilizers and health facilities. Fathers, who are typically family decision-makers, were poorly informed. The findings highlight the need for in-service training to enable health workers to improve communication with parents, particularly fathers, peripheral communities and local religious leaders.

    CONCLUSIONS: Enhancing knowledge and awareness of vaccination among parents is crucial. Fathers' involvement is lacking. This may be boosted by highlighting fathers' obligation to protect their children's health through vaccination. It is also important that men engage with the wider community in decision-making and advance towards the global vaccination targets.

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  • 31.
    Abedpour Dehkordi, Adel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Mental health in Northern Sweden: focusing on depressive symptoms; a risk factors analysis2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: World Health Organization (WHO) and Global Burden of Disease (GBD) have classified depressive disorders as the unique most burdensome disease from the point of overall DALYs (disability-adjusted life years) among individuals in working ages. The continuous monitoring is of great importance for prevention and controlling strategies and it could be linked to economic development in the country via reducing DALYs. The rate of mental disorders has increased in Sweden during last years. In the present thesis, we aim to analyze the risk factors and prevalence of clinical depression in Northern Sweden.

    Material & Methods:An empirical cross-sectional study performed based on a questionnaire distributed to a random sample of inhabitants in Northern Sweden. 23560 individuals responded to the question about taking medicine for depression in last three months, which considered as the target sample. Descriptive statistics was used to measure prevalence of depression across different sociodemographic, social and behavioral factors. Pearson Chi square test was used for comparative purposes. Univariate/Multiple logistic regressions were conducted to estimate crude and adjusted odds ratio for depression across different explanatory variables (P<0.05 considered significant). Hosmer-Lemeshow test was applied for goodness of fit in regression models (P>0.05 considered good fit).

    Results & Discussion:The point prevalence of clinical depression estimated 6.06% (4.24% in male and 7.61% in female) in Northern Sweden for 2014. Logistic regression showed that using medicines (for anxiety, sleeplessness, diabetes), physical inactivity, vegetable-free diet were all associated with increased risk of depression in north of Sweden (P<0.00.5-0.05). High physical activity, being Farmer and Self-employed, high social support were strongly associated with low risk of depression (P<0.00.5-0.05). No ascending linear association was observed for clinical depression in relation to increasing age, education, and vegetable (P>0.05). However, a gradient was detected for income, physical activity and social support (P<0.05).

    Conclusion:This study shows that the depressive symptoms is relatively higher in Northern Sweden than whole Sweden on average. There is a slight increase in the rate of depression in Northern Sweden compared to 2009. Meanwhile, women are more susceptible to get diagnosed with clinical depression in Northern Sweden. Protective factors for clinical depression are being employed as a farmer and being physically active. Nevertheless, a combination of different risk factors related to depression was observed. Further research is required to find underlying causes of the higher rate of depression in women, risk factors related to different age groups.

  • 32.
    Abelseth Eriksson, Jeanita
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Frykland, Tove
    Umeå University, Faculty of Medicine, Department of Nursing.
    Operationssjuksköterskors erfarenheter relaterade till blodsmitta2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: During surgery there is a risk of exposure to blood-borne pathogens due to the handlings of sharp objects and exposure from blood splash. Blood-borne pathogens like HIV, hepatitis B and hepatitis C spread when contaminated blood comes in contact with damaged skin, mucous membranes or by an injury with a contaminated instrument. Sharps-injuries and blood-splash are the most common forms of exposure in the operating theatre. Patients with a blood-borne infection can feel stigmatized due to their illness. Health care personnel must provide equal care, and not discriminate against patients

    Motive: Theatre nurses work in an environment where there is risk of exposure of blood-borne pathogens, it is therefore of value to examine theatre nurses' experiences related to blood-borne pathogensAim: To shed light on operating theatre nurses' experiences related to blood-borne pathogens.

    Methods: Individual semi-structured interviews were conducted with operating theatre nurses (n=8). Collected data were analyzed according to qualitative content analysis.

    Result: The analysis resulted in three different categories: "Experiencing risk", "Feeling safe" and "Constantly developing".

    Conclusion: The theatre nurse gains confidence in working with patients with known blood-borne pathogens with experience. Availability of information and good routines are important factors as it can otherwise create uncertainty due to the constantly developing nature of the operating theatre nurse's work, and the adding of new routines. There is a risk that patients avoid disclosure of infection in fear of stigmatization and discrimination, and not all carriers of blood-borne pathogens have been tested and diagnosed.  Therefore, all patients should be seen as potential carriers.

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  • 33. Aboagye, Emmanuel
    et al.
    Hagberg, Jan
    Axén, Iben
    Kwak, Lydia
    Lohela-Karlsson, Malin
    Skillgate, Eva
    Dahlgren, Gunilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Jensen, Irene
    Individual preferences for physical exercise as secondary prevention for non-specific low back pain: a discrete choice experiment2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 12, article id e0187709Article in journal (Refereed)
    Abstract [en]

    Background: Exercise is effective in improving non-specific low back pain (LBP). Certain components of physical exercise, such as the type, intensity and frequency of exercise, are likely to influence participation among working adults with non-specific LBP, but the value and relative importance of these components remain unknown. The study's aim was to examine such specific components and their influence on individual preferences for exercise for secondary prevention of non-specific LBP among working adults. Methods: In a discrete choice experiment, working individuals with non-specific LBP answered a webbased questionnaire. Each respondent was given ten pairs of hypothetical exercise programs and asked to choose one option from each pair. The choices comprised six attributes of exercise (i.e., type of training, design, intensity, frequency, proximity and incentives), each with either three or four levels. A conditional logit regression that reflected the random utility model was used to analyze the responses. Results: The final study population consisted of 112 participants. The participants' preferred exercise option was aerobic (i.e., cardiovascular) rather than strength training, group exercise with trainer supervision, rather than individual or unsupervised exercise. They also preferred high intensity exercise performed at least once or twice per week. The most popular types of incentive were exercise during working hours and a wellness allowance rather than coupons for sports goods. The results show that the relative value of some attribute levels differed between young adults (age <= 44 years) and older adults (age <= 45 years) in terms of the level of trainer supervision required, exercise intensity, travel time to exercise location and financial incentives. For active study participants, exercise frequency (i.e., twice per week, 1.15; CI: 0.25; 2.06) influenced choice of exercise. For individuals with more than one child, travel time (i.e., 20 minutes, - 0.55; CI: 0.65; 3.26) was also an influential attribute for choice of exercise, showing that people with children at home preferred to exercise close to home. Conclusions: This study adds to our knowledge about what types of exercise working adults with back pain are most likely to participate in. The exercise should be a cardiovascular type of training carried out in a group with trainer supervision. It should also be of high intensity and preferably performed twice per week during working hours. Coupons for sports goods do not appear to motivate physical activity among workers with LBP. The findings of the study could have a substantial impact on the planning and development of exercise provision and promotion strategies to improve non-specific LBP. Providers and employers may be able to improve participation in exercise programs for adults with non-specific LBP by focusing on the exercise components which are the most attractive. This in turn would improve satisfaction and adherence to exercise interventions aimed at preventing recurrent non-specific LBP.

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  • 34.
    Aboka, Deliana
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Prescribing practices of oral anticoagulants in atrial fibrillation stroke prophylaxis: An online survey among practitioners from Sweden and the United Kingdom2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 35. AbouZahr, Carla
    et al.
    Boerma, Ties
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Univ Witwatersrand, Sch Publ Hlth, Johannesburg, South Africa ; Univ Aberdeen, Inst Appl Hlth Sci, Aberdeen, Scotland.
    Bridging the data gaps: do we have the right balance between country data and global estimates?2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, article id 1299978Article in journal (Refereed)
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  • 36.
    Abraha, Atakelti
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Tigray Health Bureau, Tigray and Ethiopian Health Insurance Agency, Addis Ababa, Ethiopia.
    Myléus, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Institutes of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, United Kingdom; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
    Kahsay, Asmelash
    Tigray Health Bureau, Tigray and Ethiopian Health Insurance Agency, Addis Ababa, Ethiopia.
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institute, Stockholm, Sweden.
    Social determinants of under-5 child health: A qualitative study in Wolkayit Woreda, Tigray Region, Ethiopia2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 6, article id e0218101Article in journal (Refereed)
    Abstract [en]

    Despite the significant reductions seen in under-5 child mortality in Ethiopia over the last two decades, more than 10,000 children still die each year in Tigray Region alone, of whom 75% die from preventable diseases. Using an equity lens, this study aimed to investigate the social determinants of child health in one particularly vulnerable district as a means of informing the health policy decision-making process. An exploratory qualitative study design was adopted, combining focus group discussions and qualitative interviews. Seven Focus Group Discussions with mothers of young children, and 21 qualitative interviews with health workers were conducted in Wolkayit district in May-June 2015. Data were subjected to thematic analysis. Mothers’ knowledge regarding the major causes of child mortality appeared to be good, and they also knew about and trusted the available child health interventions. However, utilization and practice of these interventions was limited by a range of issues, including cultural factors, financial shortages, limited female autonomy on financial resources, seasonal mobility, and inaccessible or unaffordable health services. Our findings pointed to the importance of a multi-sectoral strategy to improve child health equity and reduce under-5 mortality in Wolkayit. Recommendations include further decentralizing child health services to local-level Health Posts, and increasing the number of Health Facilities based on local topography and living conditions.

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  • 37.
    Abraha, Atakelti
    et al.
    Tigray Health Bureau, Tigray, Ethiopia;Ethiopian Health Insurance Agency, Addis Ababa, Ethiopia.
    Myléus, Anna
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK; MRC/Wits Rural Public Health and Health Transitions Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
    Kahsay, Asmelash
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden.
    The effects of maternal and child HIV infection on health equity in Tigray Region, Ethiopia, and the implications for the health system: a case-control study2019In: AIDS Care, ISSN 0954-0121, E-ISSN 1360-0451, Vol. 31, no 10, p. 1271-1281Article in journal (Refereed)
    Abstract [en]

    Services that aim to prevent mother-to-child HIV transmission (PMTCT) can simultaneously reduce the overall impact of HIV infection in a population while also improving maternal and child health outcomes. By taking a health equity perspective, this retrospective case control study aimed to compare the health status of under-5 children born to HIV-positive and HIV-negative mothers in Tigray Region, Ethiopia. Two hundred and thirteen HIV-positive women (cases), and 214 HIV-negative women (controls) participated through interviews regarding their oldest children. Of the children born to HIV-positive mothers, 24% had not been tested, and 17% of those who had been tested were HIV-positive themselves. Only 29% of the HIV-positive children were linked to an ART programme. Unexpectedly, exposed HIV-negative children had fewer reports of perceived poor health as compared to unexposed children. Over 90% of all the children, regardless of maternal HIV status, were breastfed and up-to-date with the recommended immunizations. The high rate of HIV infection among the babies of HIV-positive women along with their low rates of antiretroviral treatment raises serious concerns about the quality of outreach to pregnant women in Tigray Region, and of the follow-up for children who have been exposed to HIV via their mothers.

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  • 38.
    Abraha Derbew, Atakelti
    et al.
    Ministry of Health, Addis Ababa, Ethiopia; Department of health promotion and disease prevention, Tigray Health Bureau, Mekelle, Tigray, Ethiopia.
    Debeb, Hagos Godefay
    Tigray Health Bureau, Meklle, Tigray, Ethiopia.
    Kinsman, John
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Myléus, Anna
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. MRC-Wits Rural Public Health and Health Transitions Research, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Gauteng, Johannesburg, South Africa.
    Assessing the performance of the family folder system for collecting community-based health information in Tigray Region, North Ethiopia: a capture–recapture study2024In: BMJ Open, E-ISSN 2044-6055, Vol. 14, no 2, article id e067735Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess completeness and accuracy of the family folder in terms of capturing community-level health data.

    Study design: A capture–recapture method was applied in six randomly selected districts of Tigray Region, Ethiopia.

    Participants: Child health data, abstracted from randomly selected 24 073 family folders from 99 health posts, were compared with similar data recaptured through household survey and routine health information made by these health posts.

    Primary and secondary outcome measures: Completeness and accuracy of the family folder data; and coverage selected child health indicators, respectively.

    Results: Demographic data captured by the family folders and household survey were highly concordant, concordance correlation for total population, women 15–49 years age and under 5-year child were 0.97 (95% CI 0.94 to 0.99, p<0.001), 0.73 (95% CI 0.67 to 0.88) and 0.91 (95% CI 0.85 to 0.96), respectively. However, the live births, child health service indicators and child health events were more erratically reported in the three data sources. The concordance correlation among the three sources, for live births and neonatal deaths was 0.094 (95% CI −0.232 to 0.420) and 0.092 (95% CI −0.230 to 0.423) respectively, and for the other parameters were close to 0.

    Conclusion: The family folder system comprises a promising development. However, operational issues concerning the seamless capture and recording of events and merging community and facility data at the health centre level need improvement.

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  • 39.
    Abrahams-Gessel, Shafika
    et al.
    Center for Health Decision Science, Harvard T.H. Chan School of Public Health, MA, Boston, United States.
    Gómez-Olivé, F. Xavier
    Harvard Center for Population and Development Studies, Harvard University, MA, Cambridge, United States; Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa; Africa Wits-INDEPTH Partnership for Genomic Studies, University of the Witwatersrand, Johannesburg, South Africa.
    Tollman, Stephen M.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa; Africa Wits-INDEPTH Partnership for Genomic Studies, University of the Witwatersrand, Johannesburg, South Africa.
    Wade, Alisha N.
    Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa; Africa Wits-INDEPTH Partnership for Genomic Studies, University of the Witwatersrand, Johannesburg, South Africa.
    Du Toit, Jacques D.
    Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa.
    Ferro, Enrico G.
    Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, MA, Boston, United States; Harvard Medical School, MA, Boston, United States.
    Kabudula, Chodziwadziwa W.
    Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa; Africa Wits-INDEPTH Partnership for Genomic Studies, University of the Witwatersrand, Johannesburg, South Africa.
    Gaziano, Thomas A.
    Center for Health Decision Science, Harvard T.H. Chan School of Public Health, MA, Boston, United States; Harvard Center for Population and Development Studies, Harvard University, MA, Cambridge, United States; Cardiovascular Medicine Division, Brigham & Women's Hospital, MA, Boston, United States.
    Improvements in Hypertension Control in the Rural Longitudinal HAALSI Cohort of South African Adults Aged 40 and Older, From 2014 to 20192023In: American Journal of Hypertension, ISSN 0895-7061, E-ISSN 1941-7225, Vol. 36, no 6, p. 324-332Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Over half of the South African adults aged 45 years and older have hypertension but its effective management along the treatment cascade (awareness, treatment, and control) remains poorly understood.

    METHODS: We compared the prevalence of all stages of the hypertension treatment cascade in the rural HAALSI cohort of older adults at baseline and after four years of follow-up using household surveys and blood pressure data. Hypertension was a mean systolic blood pressure >140 mm Hg or diastolic pressure >90 mm Hg, or current use of anti-hypertension medication. Control was a mean blood pressure <140/90 mm Hg. The effects of sex and age on the treatment cascade at follow-up were assessed. Multivariate Poisson regression models were used to estimate prevalence ratios along the treatment cascade at follow-up.

    RESULTS: Prevalence along the treatment cascade increased from baseline (B) to follow-up (F): awareness (64.4% vs. 83.6%), treatment (49.7% vs. 73.9%), and control (22.8% vs. 41.3%). At both time points, women had higher levels of awareness (B: 70.5% vs. 56.3%; F: 88.1% vs. 76.7%), treatment (B: 55.9% vs. 41.55; F: 79.9% vs. 64.7%), and control (B: 26.5% vs. 17.9%; F: 44.8% vs. 35.7%). Prevalence along the cascade increased linearly with age for everyone. Predictors of awareness included being female, elderly, or visiting a primary health clinic three times in the previous 3 months, and the latter two also predicted hypertension control.

    CONCLUSIONS: There were significant improvements in awareness, treatment, and control of hypertension from baseline to follow-up and women fared better at all stages, at both time points.

  • 40.
    Abrahamsson, Amanda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sörlin, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att vara förälder till ett barn med Diabetes typ 1: En kvalitativ litteraturstudie som beskriver föräldraras självupplevda erfarenheter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Title: Being a parent of a child with type 1 diabetes

    Background: Type 1 diabetes is a common chronic childhood disease. The prevalence is increasing in several countries worldwide. Type 1 diabetes require a lifelong treatment. There is a risk of complications unless the blood sugar is maintained at normal levels.

    Aim: To describe parents self-perceived experiences of living with children with type 1 diabetes.

    Method: A literature study was conducted. The article search was done in PubMed and CINAHL databases. The results of ten qualitative studies were reviewed, analyzed and compiled. 

    Result: The result is presented in four main categories: Entering a new parent role, relate to a new everyday situation, the need for support and take and give responsibility.

    Conclusion: Parents are constantly exposed to challenges and adaptations in their daily lives. Transferring responsibility of the child was hard for the parents because of distrust and concern. Through the nurses encouragement and support about parents self-care ability, parent could be helped to feel safe about their children's daily care.

     

     

     

  • 41.
    Abrahamsson, Ellinor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Säll, Marielle
    Umeå University, Faculty of Medicine, Department of Nursing.
    Distriktssköterskors upplevelser av att vårda patienter inom hemsjukvård i glesbygd: En intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakgrund: Sveriges befolkning blir äldre och andelen med beviljade hemsjukvårdsinsatser ökar. Troligtvis kommer mer hälso- och sjukvårdsinsatser att utföras av distriktssköterskor inom kommunal hemsjukvård istället för på sjukhus i framtiden. Kraven kommer därmed att öka på distriktssköterskan i hemsjukvården och detta kan i synnerhet gälla i glesbygd där tillgänglighet till hälso- och sjukvård redan är begränsad. Motiv: Det går att se en brist på kunskap gällande distriktssköterskor och hemsjukvård. Det finns dessutom få studier som riktar sig till distriktssköterskor som vårdar patienter i glesbygd.

    Syfte: Syftet med denna studie var att belysa distriktssköterskors upplevelse av att vårda patienter inom kommunal hemsjukvård i glesbygd.

    Metod: En kvalitativ studie där 11 distriktssköterskor inom hemsjukvården i en glesbygdskommun i norra Sverige deltog. Data samlades in genom semi-strukturerade intervjuer och analyserades med hjälp av innehållsanalys.

    Resultat: Analysen resulterade i 13 subkategorier, vilket mynnade ut i fyra kategorier: Familjära möten i hemmet gynnar alla, trivsam & utmanande arbetsmiljö, omväxlande vårdbehov sätter distriktssköterskan på prov och kollegor & resurser - alla är viktiga.

    Diskussion: Virginia Hendersons omvårdnadsteori diskuterades i resultatet angående främjandet av patientens oberoende samt autonomi. Dessutom diskuterades teknikens möjligheter i glesbygd och hur läkarbristen försvårade för distriktssköterskan, detta jämfördes med andra studier.

    Konklusion: För att kunna bedriva en bra hemsjukvård i glesbygd behövs det satsas på en mer utvecklad telemedicin och en större andel fasta läkare, för en trygg och jämlik hemsjukvård - dygnet runt - även i glesbygd.

  • 42.
    Abrahamsson, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Vingsle, Maja
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Trädgårdsterapi för personer med stressrelaterad psykisk ohälsa - ur ett arbetsterapeutiskt perspektiv2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Stressrelaterad ohälsa är idag den vanligaste orsaken till nya sjukskrivningar i Sverige. Idag används trädgårdsterapi i ett rehabiliterande syfte för personer med stressrelaterad psykisk ohälsa. Det finns fortfarande ett kunskapsbehov angående behandlingsprocesser rörande målgruppen samt terapeutiska insatser i trädgårdsmiljö. Syftet med studien var att beskriva arbetsterapeuters erfarenheter av att arbeta i trädgårdsterapi för personer med stressrelaterad psykisk ohälsa. Fyra arbetsterapeuter med erfarenhet av trädgårdsterapi intervjuades och materialet analyserades med kvalitativ innehållsanalys. Resultatet visade att trädgårdsterapi främjar deltagarnas återhämtningsprocess. Trädgårdsterapins aktiviteter bidrar i synnerhet till återhämtning genom aktivitetsbalans, något som ej uppmärksammats i tidigare forskning. Vidare forskning behövs för att belysa ett deltagarperspektiv i trädgårdsterapi.

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  • 43.
    Abrahamsson, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Larsson, Madeleine
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Supramaximala cykelsprintintervaller - hur påverkas autonom kontroll?: En gruppträningsintervention för äldre2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Fysisk inaktivitet är vanligt, och många äldre uppnår inte WHO:s rekommendationer om fysisk aktivitet, vilket kan leda till ohälsa. Fysisk aktivitet har positiv hälsopåverkan på autonoma nervsystemet, ANS, vilket kan återspeglas i hög hjärtfrekvensvariabilitet, HRV. Högintensiv intervallträning, HIT, är tidseffektivt och har påvisats påverka HRV och autonom kontroll.

    Syfte: Syftet med studien är att i) undersöka hur autonom funktion hos äldre, mätt som hjärtfrekvensvariabilitet i vila samt hjärtfrekvens under aktivitet, påverkas av högintensiv intervallträning ,HIT, i form av extremt korta cykelsprintintervaller, samt ii) undersöka genomförbarheten av självständiga mätningar av autonom funktion i hemmet.

    Metod: Åtta friska, fysiskt aktiva forskningspersoner, 65-75 år, genomförde modifierat Borgs Cycle Strength test och modifierat submaximalt Åstrandstest för att estimera maximal aerob och anaerob förmåga. Sju forskningspersoner (ett bortfall) genomförde en gruppträningsintervention av 6-sekunders HIT-intervaller. Självständiga HRV-mätningar genomfördes med pulsklocka, fyra ggr/vecka, under fem veckor. HRV, mätt i rMSSD,  samt hjärtfrekvens under uppvärmning och nedvarvning analyserades hos tre forskningspersoner i en single-subject-analys. Genomförbarheten av HRV-mätningarna studerades.

    Resultat: Positiv påverkan på autonom kontroll, mätt i Root Mean Square of Successive Differences, rMSSD,, påvisades med statistik signifikans hos två av tre forskningspersoner, a=0,05. Hjärtfrekvens under uppvärmning och nedvarvning, HRex, var lägre under nedvarvning vid sista träningstillfället än det första hos alla forskningspersoner. HRex under uppvärmning minskade från första till sista träningstillfället för en forskningsperson, och var densamma för två forskningspersoner. Genomförbarhetsundersökningen resulterade i 20/20 insamlade mätpunkter för HRV.

    Konklusion: HIT tycks ha positiv påverkan på autonom kontroll, i form av ökad HRV, hos friska, fysiskt aktiva äldre personer. Det är möjligt för äldre personer att självständigt mäta HRV med pulsklocka i hemmet.

  • 44.
    Abrahamsson, Klara
    et al.
    Folkhälsomyndigheten.
    Jonzon, Robert
    Folkhälsomyndigheten.
    Goicolea, Isabel (Contributor)
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Baroudi, Mazen (Contributor)
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Hurtig, Anna-Karin (Contributor)
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Migration, sexuell hälsa och hiv/STI prevention: en sammanfattande rapport2020Report (Other academic)
  • 45.
    Abrahamsson, Lillemor
    et al.
    Institutionen för kostvetenskap, Uppsala universitet.
    Hörnell, Agneta
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Ekblad, Jenny
    FoU Malmö stad, Malmö.
    Nutrition under livscykeln2013In: Näringslära för högskolan: från grundläggande till avancerad nutrition / [ed] Abrahamsson Lillemor, Andersson Agneta, Nilsson Gerd, Stockholm: Liber, 2013, 6, p. 379-403Chapter in book (Other academic)
  • 46.
    Abrahamsson, Linnéa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ljungdahl Ristare, Martin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att vara man i ett kvinnodominerat yrke: Manliga vårdares upplevelser av att bemöta kvinnor i situationer som kan upplevas intima och de hanteringsstrategier som används2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Throughout history, the healthcare has been dominated primarily by female caregivers. There are areas for men in nursing which can be considered as taboo. These areas can often be related to intimate care of the opposite sex. Men do primarily work in technical positions in healthcare, for example as a radiographer. At present there is a knowledge gap regarding male radiographers’ intimate care of the opposite sex.

    Aim: Illuminate male caregivers' experiences of dealing with women in situations that can be experienced intimate in Western culture, and management strategies used.

    Method: Nine quality controlled qualitative studies were used in the result. These studies have been analysed by means of qualitative content analysis. The outcome resulted in two domains divided into three categories each, illuminating the experiences and handling strategies for how male caregivers perform and experiences giving intimate care to female patients.

    Results: Male caregivers’ express concern about sexual charges. They also experience prejudice and feel placed in stereotypical compartments that may affect their work with intimate care. To protect themselves they use methods such as communication, breaking the ice or taking help of female colleagues. Several male caregivers describe shortcomings in their education to learn how to handle intimate care.

    Conclusion: Further research is needed in the field of gender in healthcare and radiography linked to the male caregivers’ perspective of providing care. 

  • 47.
    Abrahamsson, Marléne
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Viklund, Mikael
    Personers upplevelse av att leva med diabetesfotsår: En litteraturstudie2016Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Peoples experience of living with diabetic foot ulcers

    Abstract

    Background: Foot ulcers related to diabetes is a global problem. These ulcers can be difficult to heal and very painful for the affected person. Risk for infections and amputations are high. Diabetic foot ulcers can change the affected person’s life world.

    Aim: The purpose of the literature study was to illustrate people's experiences of living with diabetic foot ulcers.

    Method: A literature study based on twelve articles with qualitative approach. The results from respective article has been reviewed, analyzed and compiled. The databases that were used was CINAHL, PubMed, MEDLINE och PsycINFO.

    Result: The analyze resulted in two categories and a total of five subcategories. The categories were: Lost autonomy and Emotional suffering.

    Conclusion: The experience of living with diabetic foot ulcers varies between individuals, but common to many is that they suffer in different ways and that the quality of life deteriorate. The nurse can be a cause of the suffering, but also a hopeful mainstay. To provide person-centered care and see the whole individual is a prerequisite for good nursing care.

    Keywords: Diabetic foot ulcers, experience, suffering.

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    fulltext
  • 48.
    Abrahamsson, Mirjam
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Furufalk, Helena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jämställdhet är...en alldeles för stor fråga: Barnmorskors uppfattningar om unga mäns ansvarstagande, delaktighet och möjlighet till råd och stöd, vid oönskade eller oplanerade graviditeter.2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Objective: The aim of this study was to investigate midwives perceptions about young men’s responsibility and participation in case of unwanted and unplanned pregnancies and their ideas of support aimed at men, from an equality standpoint.

    Design: Semi-structured interviews with seven midwives in the north of Sweden. The interviews were analyzed with a qualitative content-analysis and from a Critical theory-perspective. It resulted in eleven sub-categories, four categories and one theme.

    Result: Four categories as follows, The excluded young men, shows midwives attitudes regarding that young women, the society and sexual and reproductive healthcare tends to exclude young men when it comes to men´s issues. It is a woman’s world: The midwives saw that their primary work was all about the women, where pregnancy and contraceptives overall was a woman´s matter, in which only women made the decisions. Young men acts according to the masculinity norms of the society: The young men were perceived as rarely looking for support and help with their reproductive and sexual health and were often perceived as having an immature approach to sex. Long way until the sexual and reproductive health is equal: Sex education for young men took place in large groups and was - according to the midwives, often focusing on the wrong things. Sex education needs to start early on and preferably with the support of parents. The midwives had the knowledge requested by young men, but were not routinely sharing it. The theme: Equal responsibility for reproduction no reality in practice includes all categories.

    Conclusion: Young men are considered important in theory but not in practice. The young men are perceived as absent from unplanned pregnancies. With their great knowledge within sexual and reproductive healthcare, midwives are considered ideal working with this group.

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    fulltext
  • 49.
    Abrahamsson, Pernilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bemötandets betydelse - ur de allergiska och överkänsliga individernas synvinkel2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Trots att individer med allergier själv vidtar åtgärder för att undvika allergiexponering och försöker minimera risker för insjuknande, utsätts de inför situationer i sin omgivande miljö som de inte kan kontrollera. Omgivningens kunskaper och synsätt kring allergier varierar. Syftet med denna studie var då att belysa hur individer med astma, allergi- och överkänsligheter upplever att omgivningens indirekta- och direkta bemötande inverkar på sättet att se på sig själva, sin livssituation och sin delaktighet i aktivitet. Fyra kvinnor med olika typer av astma, allergi och överkänslighet intervjuades. Kvalitativ innehållsanalys användes för att bearbeta det insamlade intervjumaterialet. Resultatet presenterades i fem huvudkategorier: Viljan att berätta beror på vem du möter. Att tvingas prioritera och acceptera risker för att få vara delaktig. Familj och vänners stöd underlättar. Vårdens och samhällets bemötande skapar osäkerhet. Andras agerande och kunskap påverkar. Denna studie visar bland hur omgivningens sätt att bemöta kan ha en försvårande och underlättande effekt för individer med allergiers självbild, livssituation och delaktighet i samhället, både fysiskt och socialt. Slutsatsen är att andra människors bemötanden, beteenden och sätt att vara har betydelse för hur individer med allergier påverkas av sin sjukdom. Arbetsterapeuter kan med sina kunskaper bidra till ökad förståelse och delaktighet för målgruppen i samhället.

     

    Sökord: allergi, hanteringsstrategier, bemötande, delaktighet, aktivitetsorättvisor, arbetsterapi   

  • 50.
    Abrahamsson, Pernilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bemötandets betydelse - ur de allergiska och överkänsliga individernas synvinkel2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Trots att individer med allergier själv vidtar åtgärder för att undvika allergiexponering och försöker minimera risker för insjuknande, utsätts de inför situationer i sin omgivande miljö som de inte kan kontrollera. Omgivningens kunskaper och synsätt kring allergier varierar. Syftet med denna studie var då att belysa hur individer med astma, allergi- och överkänsligheter upplever att omgivningens indirekta- och direkta bemötande inverkar på sättet att se på sig själva, sin livssituation och sin delaktighet i aktivitet. Fyra kvinnor med olika typer av astma, allergi och överkänslighet intervjuades. Kvalitativ innehållsanalys användes för att bearbeta det insamlade intervjumaterialet. Resultatet presenterades i fem huvudkategorier: Viljan att berätta beror på vem du möter. Att tvingas prioritera och acceptera risker för att få vara delaktig. Familj och vänners stöd underlättar. Vårdens och samhällets bemötande skapar osäkerhet. Andras agerande och kunskap påverkar. Denna studie visar bland hur omgivningens sätt att bemöta kan ha en försvårande och underlättande effekt för individer med allergiers självbild, livssituation och delaktighet i samhället, både fysiskt och socialt. Slutsatsen är att andra människors bemötanden, beteenden och sätt att vara har betydelse för hur individer med allergier påverkas av sin sjukdom. Arbetsterapeuter kan med sina kunskaper bidra till ökad förståelse och delaktighet för målgruppen i samhället.

     

    Sökord: allergi, hanteringsstrategier, bemötande, delaktighet, aktivitetsorättvisor, arbetsterapi   

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