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  • 1.
    Ahlin, Karin
    et al.
    Computer and System Sciences, Mid Sweden University Östersund, Sweden.
    Zingmark, Magnus
    Health and Social Care Administration, Östersunds City, Sweden.
    Persson Slumpi, Thomas
    Computer and System Sciences, Mid Sweden University Östersund, Sweden.
    A transition towards digital home visits in social care and home health care during the corona pandemic2021In: Global health 2021: the tenth international conference on global health challenges / [ed] Manuela Popescu; Ah Choo Koo; Karin Ahlin, International Academy, Research and Industry Association (IARIA), 2021, p. 1-7Conference paper (Refereed)
    Abstract [en]

    During the pandemic, physical meetings were supposed to decrease as much as possible to avoid the virus to spread. Before the pandemic, the physical meeting favoured social care and home health care in Sweden. One solution was to digitize as many of these meetings as possible. Therefore, we investigated this transition in a web survey, including questions with predetermined and open-ended answers. The web-survey was sent to co-workers in home health care and social care in a middle-seized municipality in Sweden. The results showed that not all meetings could be transformed, like meetings with citizens with hearing or cognitive impairments. Challenges related to the transformation were instability in technical equipment, the professionals’ and citizens’ knowledge of handling technical equipment, and access to technical equipment support. Despite this did the co-workers digitize meetings whenever possible, adding operational and problem-solving attitude to the transformation. Due to this study’s limitation, like respondents from one municipality and the pandemic’s length, we intend to investigate further and understand the development of the transformation and how knowledge in the area increases.

  • 2.
    Andersson, Christina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Terapeuter rapporterar om bildterapi i fallstudier2015Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
    Abstract [en]

    Aims: The aim of this study has been first to investigate whether common characteristics exist in the field of art therapy or not, and second to illustrate the way art therapists write reports about their sessions.

    Methods: A literature study was made. Ten case studies were selected and analysed.

    Results: The results of the study showed that the art therapists often went beyond the concepts of the traditional therapy room and of materials used in their sessions. The results also showed shortcomings in the way art therapists reported.

    Conclusion: Art therapists need to refine and develop their way of writing reports in order for these reports to become more scholarly. Both general studies and investigations of more depth are needed to confirm or falsify the results of this study.

  • 3.
    Andersson, Jenni
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Stabil och lättare kognitions- och motoriknedsättning hos TIA-patienter över 10-års uppföljning2019Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 4.
    Andersson, Lina
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Brannelid, Maria
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Kylda matlådor inom äldreomsorgen: En studie om kundernas upplevelse kring beställning, leverans och mat2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background"Food is more than just the amount of food you eat” read the headline on an article from Skåne magazine from January 2014. The article arose because of the criticism levelled against the refrigerated lunch boxes served in senior care. The lunch boxes that were send to the elderly people were not assessed for nutrient content so there could be a lack of nutrients in the boxes. There were also a lack of procedures and controls, to show how much of the food they ate. Not getting enough nutrients and energy can lead to complications such as impaired immune system and depression.

     

    Objective The purpose of the study was to find out how customers in senior care in a selected municipality in the middle of Sweden experienced ordering, delivery, and the food that the municipality distributed them.

     

    Method A questionnaire was designed in collaboration with the dietician at the selected municipality. During the spring of 2014 170 questionnaires were distributed. It was calculated median and mean some of the results were compared with previous studies conducted in the municipality.

     

    Results From the 170 questionnaires sent out 89 samples were returned. The study came to consist of 39 male and 49 women. The informants felt overall that the food tasted good and they were satisfied with the order, delivery and food. There was some differences between the genders, men were more satisfied then the women.

     

    Conclusion The study shows that the customers in the municipality overall were satisfied with the lunch boxes. No major changes had occurred since previous studies carried out in the municipality. This indicates that the food was of good standard. What we saw in the comments were that the costumers were complaining about the vegetables that are included in the lunch boxes.  We believe that these complaints need to be resolved by the municipality. We also believe that further studies should be conducted to get at deeper picture of the consumers food experience. 

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  • 5.
    Andersson, Linus
    et al.
    Department of Occupational and Public Health Sciences, University of Gävle.
    Claeson, Anna-Sara
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Dantoft, Thomas Meinertz
    Department of Systems Biology, Center for Biological Sequence Analysis, Technical University of Denmark.
    Skovbjerg, Sine
    Danish Research Centre for Chemical Sensitivities, Copenhagen University Hospital Gentofte.
    Lind, Nina
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Chemosensory perception, symptoms and autonomic responses during chemical exposure in multiple chemical sensitivity2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 1, p. 79-88Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 6.
    Bengtsson, Sara K S
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Johansson, Maja
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology. Umecrine Cognit AB, Umea, Sweden.
    Bäckström, Torbjörn
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Long-term continuous allopregnanolone elevation causes memory decline and hippocampus shrinkage, in female wild-type B6 mice2016In: Hormones and Behavior, ISSN 0018-506X, E-ISSN 1095-6867, Vol. 78, p. 160-167Article in journal (Refereed)
    Abstract [en]

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

  • 7.
    Bergström, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum2016In: Chiropractic and Manual Therapies, E-ISSN 2045-709X, Vol. 24, article id 7Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 8.
    Bjuréen, Victoria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Allergisk multimorbiditet i relation till hälsorelaterad livskvalitet bland tonåringar2022Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 9.
    Blomberg, Anna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Food, Nutrition and Culinary Science.
    Wagner, Sara
    Umeå University, Faculty of Social Sciences, Department of Food, Nutrition and Culinary Science.
    Konsumtion av energidryck bland ungdomar i åk 9: En kvantitativ enkätstudie2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Energy drinks have become a part of today's consumer culture and have gone from being a simple soft drink to containing stimulants such as caffeine, taurine, B vitamins, guarana, and ginseng. The popularity of energy drinks spans different age groups and contexts. This beverage category has raised concerns from both scientists and society, especially with regard to its impact on health and its similarities to pharmaceuticals. Energy drinks have developed into a controversial product category, combining health perspectives, marketing issues and regulations, which has prompted the need for research and debate in the field. 

    Aim: To investigate the extent and motives behind young people in grade 9 drinking energy drinks.

    Method: The study was conducted with a web survey via Forms with students in grade 9. The data was processed in Excel and reported descriptively. 

    Results: The participants in the study were 229 adolescents in grade 9. Of these, 82% (n=188) stated that they had tasted energy drinks. The average age at which young people first tasted energy drinks was 12.0 (±2.2) years. 45% (n=83) drank less energy drinks than one day a week and 38% (n=71) drank energy drinks 1-4 days/week. Regarding the amount the adolescents drank, 70% (n=129) drank one can/occasion. The main motives for the consumption of energy drinks were taste, to get alert and to get extra energy. The adolescents drank energy drinks mostly at home or at friends' houses. The brand and price were the most common reasons for purchasing energy drinks. 82% (n=151) of the adolescents' parents knew about their consumption of energy drinks, although 29% (n=51) did not like it. 

    Conclusion: This study shows that a significant majority of adolescents have tried energy drinks at an average age of 12 years, despite the fact that there is a recommended age limit of 15 years when purchasing energy drinks. Most of the adolescents consumed energy drinks less often and in smaller amounts, but there was also a significant proportion who consumed them regularly and in larger quantities. The extensive digital marketing of energy drinks aimed at young people may be an important influencing factor that needs to be regulated. The study also identifies gender differences in consumption (not statistically tested) where boys tended to drink energy drinks slightly more often and in larger amounts than girls. Parents' awareness and acceptance of adolescent consumption indicates the need for increased understanding among adults about the impact of energy drinks on adolescent well-being.

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  • 10.
    Boström, Gustaf
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Conradsson, Mia
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Hörnsten, Carl
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Rosendahl, Erik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lindelöf, Nina
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Holmberg, Henrik
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Littbrand, Håkan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Effects of a high-intensity functional exercise program on depressive symptoms among people with dementia in residential care: a randomized controlled trial2016In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 31, no 8, p. 868-878Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 11.
    Brodén, Karin
    et al.
    Service Research Centre, Karlstad University, Karlstad, Sweden.
    Snyder, Kristen
    Quality Management, Mid Sweden University, Östersund, Sweden.
    Sörensen, Helle
    Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden.
    Zingmark, Magnus
    Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden.
    Determining value in welfare-technology: the need for a multi-perspective framework2023In: International Journal of Health Economics and Policy, ISSN 2578-9295, Vol. 8, no 4, p. 76-88Article in journal (Refereed)
    Abstract [en]

    Background: Stakeholders in health and social care are implementing digital solutions to facilitate person-centred care for citizens. One problem is choosing which digital solution to implement. Ordinary cost-benefit analysis implicates the measurable parts of the value, leaving the immeasurable without any trace in an analysis.

    Results: We used design thinking to design a framework that implicates what to add as valuable factors on individual, organisational, and governmental levels. The design is based on empirical material from workshops and literature reviews on systems thinking, quality management, and value factors. The valuable factors at an individual level could include independence, autonomy, and empowerment, and the factors at the organisational level accessibility, competence, and independence. On a central level, the factors are related to person-centred care and its value proposals, such as autonomy and independence.

    Conclusions: While conducting a cost-benefit analysis, focusing on a standard definition of the value concept is essential. The designed framework needs to be dynamic due to the broad range of welfare technology. The created rubrics cube model, including strategic, organisational-operational and individual levels, should be used by decision-making groups as a flexible foundation. Forthcoming research will test this framework, including the proposed scale for measurement and focusing on welfare technology for older citizens.

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  • 12.
    Byenfeldt, Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Faktorer som kan påverka mätresultaten vid shear wave elastografi av lever. En litteraturstudie.2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Hepatitis B and hepatitis C virus causes inflammation of the liver which can lead to fibrosis development, liver cirrhosis, chronic liver inflammation and liver cancer. Assessments of each patient’s progression of fibrosis are important for start of treatment on time and avoid the development of severe liver disease and in the worst cases, hepatocellular carcinoma (HCC). It is therefore of great importance that these patients are monitored and that patients' liver fibrosis development is continuously monitored and graded. Shear wave elastography (SWE) of the liver is a new technology that easily can be performed in conventional ultrasound. SWE has both nursing and medical advantages compared to liver biopsy and transient elastography (TE) with FibroScan®, making it reasonable to assume that there are also economic benefits and resources to save. However, there are factors that affect the result in SWE and these factors have been investigated in several studies. Aim: The aim of the study was to identify factors that may influence the result with shear wave elastography of the liver. Methods:  The study is a literature review where 22 quantitative articles, published between the years 2010 to 2015, were studied. Searches were made in four databases with keywords elasticity imaging techniques, shear wave and ultrasound elastography. Results: The study was able to identify several factors that may influence the result, which should be considered before determining the degree of fibrosis of the liver. These factors were in this study divided into two domains; factors related to the patient as well as factors related to technology and analysis of measurement results. Conclusion: This review is of great importance for radiography when a large number of factors that may influence the measuring result with SWE of the liver were identified. It is very important that these factors are considered before determining the degree of fibrosis in the liver.

  • 13.
    Calander, Björn
    Umeå University, Faculty of Medicine, Department of Medical Biosciences, Pathology.
    The effects of Clopidogrel on neuroinflammation and learning impairment related to Alzheimer´s disease2017Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

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

  • 14.
    Carlberg, Joakim
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Oresten, Hampus
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    EFFEKTEN AV EN ENSTAKA MINDFULNESSÖVNING PÅ INHIBERING I ERIKSEN FLANKER TASK2021Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The present study examined the connection between inhibition and a short mindfulness exercise on a sample of media-multitaskers, defined as a person using more than one media at the same time. The study was an internet-based experiment in which the partcipants were randomly assigned to a mindfulness condition (n = 18) or a control condition (n = 22) in which listened to classical music. Participants (20–60 years) were recruited through facebook, university and posters, the selection was a convenience sample. They had no former experience of mindfulness meditation and had no psychiatric diagnosis. The primary measure was the ability of inhibition measured with the Eriksen flanker task. Additional measures were state mindfulness and self-perceived stress. Both groups improved their inhibition-ability with no significant difference between groups. There was no additional difference in self-assessed mindfulnessstate between groups. Results indicate that the inhibition-ability does not depend on the level of self-assessed stress but this should in addition be interpreted with caution because of methodological shortcomings. As a focused attention (FA) mindfulness exercise to classical music didn’t significantly differ in mindfulness state future research should examinethe validity of the construct mindfulness.

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  • 15.
    Carstensen, Emil
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Prevalence, trends and socioeconomic and demographic risk factors for self-reported diabetes in adults in Northern Sweden2017Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 16.
    Catoni, Anna
    et al.
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Backsten, Sofia
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Socionomrollens relevans i hospiceverksamhet2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vård av svårt sjuka döende människor innefattar fysiska, psykiska, sociala och existentiella aspekter. En vårdform som beaktar detta är hospice. Tidigare forskning visar att socionomers arbetsfält är vitt och brett och saknar jurisdiktion, socionomyrket saknar legitimation vilket medför att jurisdiktionen behöver skapas på annat sätt. Den svåra avgränsningen kring socionomers arbetsfält väcker i hospiceverksamhetens kontext, frågor kring hur en socionoms roll i detta nu är, anses vara och kan vara. Ingen tidigare svensk forskning nämner kuratorers eller socionomers roll inom hospiceverksamhet trots att forskningen belyser att palliativ vård helst ska utföras i team med bland annat socialarbetare och kuratorer. Denna studies syfte är att undersöka socionomrollens relevans inom svensk hospiceverksamhet genom att intervjua verksamhetschefer på svenska hospice. De frågor som ställs är: hur beskriver verksamhetschefer för svensk hospiceverksamhet sitt arbete med sociala och existentiella frågor samt hur kan socionomer bidra till vården på hospice enligt verksamhetschefer för svensk hospiceverksamhet? För att besvara dessa frågeställningar har semistrukturerade intervjuer genomförts med verksamhetschefer för fem olika hospice i Sverige. Den teoretiska grunden är teori om fridfullt slut på livet för dödssjuka patienter samt teorier om makt. Resultatet visade att verksamhetschefer genom helhetssyn, relationer, samtal och praktiska aspekter arbetar med sociala och existentiella problem på hospice. Temana kompetens och utveckling, tid och närvaro, samtal och stöd visade hur och vad socionomer kan bidra med i verksamheten. 

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  • 17.
    Diderichsen, Saima
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    It's just a job: a new generation of physicians dealing with career and work ideals2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

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

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

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

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

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

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

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

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

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

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

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

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

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  • 18.
    Edelbring, Samuel
    et al.
    Institutionen för hälsovetenskaper, Örebro universitet, Örebro, Sverige.
    Edgren, Gudrun
    Medicinska fakulteten, Lunds universitet, Lund, Sverige.
    Hultin, Magnus
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
    Lindgren, Stefan
    Medicinska fakulteten, Lunds universitet, Lund, Sverige.
    Svensk medicinpedagogisk forskningsproduktion och förutsättningar för tillämpning för kvalitet och innovation2023Conference paper (Refereed)
    Abstract [sv]

    Bakgrund: Beslut och metoder inom hälso- och sjukvården bygger på vetenskaplig grund vilket förutsätter en forskningsbas. Inom detta område är svensk vetenskaplig produktion och tillämpning relativt stark, däremot ser vi inte motsvarande styrka i kunskapsbasen för utbildningsuppdraget. I diskussionen om utbildningens forskningsförankring är det vanligtvis innehållet som avses eller kontakt med aktiva forskare, mer sällan hur utbildningen bör utformas för att stödja lärande eller förutsättningarna för lärarskicklighet.

    Det saknas inte forskning inom området, på den internationella arenan ser vi en växande högskolepedagogisk forskningsproduktion med medicin och hälsa som kontext, sk. medicinsk pedagogik. Däremot finns anledning att uppmärksamma från vilken kontext forskningen kommer och förutsättningarna att omsätta den till kvalitet och innovation i utbildningarna. Merparten av fältets forskningsproduktion kommer från USA, UK, Canada och Australien (Thomas, 2019). Den internationella prägeln på kunskapsbasen är inte alltid optimal för implementering i svenska förhållanden då resultaten och slutsatser är dragna från en kontext som i flera avseenden skiljer sig från vår. Förutom tillgång till forskning behövs möjligheter att ta del av den och omsätta till godo för utbildningen. Europeiska lärare anser inte att ny forskning når deras arbetsgrupper i någon hög utsträckning (Thomas et al., 2019).  Medicinskt skolade lärare är ofta ovana vid den högskolepedagogiska forskningsgenren som evidensgrund (Kneebone, 2002). Nederländerna, som är mer befolkat än Sverige men har snarligt antal läkarutbildningar samt likartade förhållanden för högre utbildning, har satsat på en medicinpedagogisk utveckling som givit avtryck i fältet.

    Syftet med denna studie är att undersöka svensk forskningsproduktion inom det medicinpedagogiska området samt att föreslå en förstärkning av förutsättningar för denna produktion och dess tillämpning i utbildningar för medicin och hälsa.

    Metod: Författarna är pedagogiska aktörer vid tre medicinska fakulteter och har granskat svensk och nederländsk kunskapsproduktion för medicinsk pedagogik och aspekter av dess tillämpning.  En bibliometrisk analys genomfördes av antal svenska och nederländska publikationer i 9 etablerade medicinpedagogiska tidskrifter för åren 1995-2021. Svenska affilieringar och finansieringskällor samt antal svenskar i tidskriftsredaktionerna analyserades också. Tidskrifterna var Medical education, Medical teacher, BMC medical education, Advances in health sciences education, Academic medicine, Perspectives on medical education, Anatomical sciences education, Teaching and learning in medicine samt International journal of medical education. Förutsättningar för forskning i medicinsk pedagogik identifierades genom sökningar på medicinska fakulteternas hemsidor samt på respektive lärosätes forskningsämnen/institutioner/forskargrupper. 

    Resultat: Under tioårsperioden 2012–2021 publicerades 17 013 artiklar i dessa tidskrifter varav 1 441 från Nederländerna och 217 från Sverige. Nederländska publikationer ökade dramatiskt i det längre perspektivet för att plana ut till en hög produktion med 117–187 årliga publikationer under perioden, medan svenska publikationer ökade makligt till 16–33 årliga publikationer. Samtliga svenska medicinska fakulteter bidrog till produktionen, men andelen från KI dominerade. Tidskrifternas redaktioner bestod sammanlagt av 466 personer varav 31 (7%) nederländare och fyra svenskar (<1%). Organisatoriskt stöd till pedagogisk forskningsanknytning finns på alla medicinska fakulteter men i de flesta fall som en del av universitetets pedagogiska utveckling, inte anpassat till professionsutbildningar inom medicin och hälsa.

    Diskussion och slutsats: Forskningsbaserad kunskap bör vägleda utbildningarna, och eget forskningsengagemang i fältet skapar omdöme i utveckling och strategiska beslut. Hög forskningsproduktion är inte per se ett kvalitetsmått på utbildningarna, dock är det rimligt att anta att en satsning på produktion avspeglas i högre pedagogisk medvetenhet och säkrare beslutsunderlag i såväl fakultets- och kursledningar som hos lärare och handledare. En stark produktion och engagemang skapar delaktighet i det internationella forskarsamhället som vi både kan lära av och bidra i. Nederländerna har visat att även ett europeiskt land kan göra avtryck i fältet (Doja et al., 2014). Vi föreslår specifika svenska satsningar för en hållbar kvalitetssäkring och innovationskraft. 

  • 19.
    Enetjärn, My
    Umeå University, Faculty of Science and Technology, Umeå Institute of Design.
    Floae: En utforskning av vaginal bakterieflora genom flytningar // Exploring vaginal bacterial flora through discharge2022Independent thesis Basic level (degree of Bachelor of Fine Arts), 180 HE creditsStudent thesis
    Abstract [en]

    This project aims towards offering people with vulva an insight in their vaginal bacterial flora through vaginal discharge. Together with users, experts and collaboration partners, a problem space is defined. There are tabooin the society concerning how we relateto female genitalia which creates issues regarding shame and obstacles in seeking medical care when its needed. This is what the project hopes to contribute a small change to. Throughout this project process there is a sense of working together and creating together. The result is a vaginal discharge tracking device that offers peoplea visualization of their discharge in theform of colored light. The aim is to bring the conversation of vulvae, vaginal discharge and vaginal problems to a tangible space in order to normalize and actively work against shame connected to female genitalia. The concept also aims to enncourage people to be more open to talking to other people about the subject and seek medical care when needed. 

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  • 20.
    Eriksson Sörman, Daniel
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Sundström, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology. Umeå University, Faculty of Social Sciences, Centre for Population Studies (CPS).
    Rönnlund, Michael
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Adolfsson, Rolf
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Nilsson, Lars-Göran
    Department of Psychology, Stockholm University, Sweden .
    Leisure Activity in Old Age and Risk of Dementia: a 15-Year Prospective Study2014In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 69, no 4, p. 493-501Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 21.
    Gentile, Ambra
    et al.
    Sport and Exercise Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy.
    Ficarra, Salvatore
    Sport and Exercise Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy.
    Thomas, Ewan
    Sport and Exercise Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy.
    Bianco, Antonino
    Sport and Exercise Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. School of Sport Sciences, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway.
    Nature through virtual reality as a stress-reduction tool: a systematic review2023In: International Journal of Stress Management, ISSN 1072-5245, E-ISSN 1573-3424, Vol. 30, no 4, p. 341-353Article, review/survey (Refereed)
    Abstract [en]

    The current systematic review aims to assess the acute stress-reduction effects of virtual reality (VR) natural environments. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, while the inclusion criteria were established through population, intervention, comparison, outcome, and study design (PICOS). The studies were included if (a) based on a nonclinical population; (b) compared the exposure to virtual nature through 360° images, biophilic elements, VR prerecorded videos, or immersive environments, excluding augmented reality; (c) objective (physiological parameters) or subjective (e.g., self-report questionnaires) measures were reported; (d) the reported measures contained quantitative outcomes; and (e) the records were published between 2010 and 2023. Four hundred nine studies were initially retrieved, 19 of which were finally included for synthesis. The eligible studies comprised a total of 1,168 participants. The quality assessment of the studies revealed a score of 10.1/15, indicating that studies were of overall "moderate quality." Heterogeneity among the type of natural environment, type of stress induction, and type of comparator (nonnatural environment) was retrieved. Differences were also present regarding either the physiological or psychological variables analyzed. The exposure to natural environments through VR seemingly reduces objective and subjective stress levels. The presence of (a) natural sounds, (b) natural lighting, and (c) water elements seem to be key elements that help VR users reducing stress.

  • 22. Godbolt, Alison K
    et al.
    Lindgren, Marie
    Stenberg, Maud
    Norrlands universitetssjukhus.
    Cronberg, Tobias
    Tengvar, Christer
    Sörbo, Ann
    Långvarig svår medvetandestörning efter hjärnskada hos vuxna: nya rekommendationer ger underlag för utredning och rehabilitering2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 49-50, p. 2230-2234Article in journal (Refereed)
    Abstract [en]

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

  • 23.
    Goicolea, Isabel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Christianson, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hurtig, Anna-Karin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Marchal, Bruno
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Wiklund, Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Searching for best practices of youth friendly services - a study protocol using qualitative comparative analysis in Sweden2016In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 16, article id 321Article in journal (Refereed)
    Abstract [en]

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

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

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

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  • 24.
    Gotfredsen, Anne
    et al.
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Linander, Ida
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Young trans people's experiences of leisure and mental health: belonging, creativity, and navigation2023In: Wellbeing, Space and Society, ISSN 2666-5581, Vol. 4, article id 100139Article in journal (Refereed)
    Abstract [en]

    There is a lack of research on young trans people's everyday leisure. This article analyses how leisure, defined within a broad spatial context beyond sport and physical activity, is perceived and experienced by trans youth in relation to their mental health and wellbeing. We draw upon theoretical concepts of cisnormativity and spatiality to our analysis of sixteen interviews with young trans people (16-25 years old) in Sweden. Three themes emerged. The first refers to how both queer- and non-queer-specific leisure spaces connect people with similar (and different) experiences regarding queer and trans identities and shows how these identities can shift in importance. The second highlights how creative spaces (e.g., theatre, cosplay) can offer opportunities to carve out a leisured space to explore different gender identity/ies and expressions that are often crucial and life changing. The final theme illustrates how leisure is avoided, postponed, waited for, and reclaimed by trans youth. Excluding mechanisms such as transphobia, cisnormativity, and the lack of access to gender-confirming care can hinder young people's leisure participation. Our analysis illustrates the complex connections between leisure and mental health among young people with trans experiences. Leisure can be a source of discomfort and distress but also of belongingness and affirmation of one's identity. Finding and accessing strengthening leisure spaces demands emotional investment, engagement, and navigation.

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  • 25.
    Granholm Valmari, Elin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Ghazinour, Mehdi
    Umeå University, Faculty of Social Sciences, Police Education Unit at Umeå University.
    Nygren, Ulla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Gilenstam, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Life contexts among patrolling police officers in the European Union, investigating environmental characteristics and health: a protocol for a scoping review and a systematic review2023In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 7, p. 1135-1142Article in journal (Refereed)
    Abstract [en]

    Introduction: The police officer occupation is a high-risk profession, with significantly more traumatic and stressful events than other occupations. Key factors for the health of police officers have been found to be related to intra-interpersonal, occupational, and organizational factors. However, the mechanisms underlying why is inconclusive. This protocol therefore intends to explain the approach for conducting both a scoping review, and systematic review. The overall aim of the reviews is to investigate patrolling police officers' life contexts with the intention to identify barriers and resources that affect their lifestyle and health.

    Methods: The protocol is reported according to the PRISMA-P guidelines, with PROSPERO number: CRD42020190583. Searches will be carried out in SCOPUS, Web of Science, PubMed, OpenGrey, and EBSCO (Academic Search Premiere, APA PsychINFO, CINAHL, SocINDEX). Two independent raters will screen articles and conduct the critical appraisal. Analyses include Arksey and O'Malley's methodology for the scoping review, and a narrative synthesis for the systematic review, including critically appraising the total body of evidence in the systematic review.

    Discussion: The purpose of the reviews is to understand patrolling police officers' life contexts, and support future development of an assessment that measures patrolling police officers' life balance from a contextual viewpoint.

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  • 26. Hellström, Fredrik
    et al.
    Gouveia-Figueira, Sandra
    Umeå University, Faculty of Science and Technology, Department of Chemistry. Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Nording, Malin L.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Björklund, Martin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation. Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Sweden.
    Fowler, Christopher J.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Association between plasma concentrations of linoleic acid-derived oxylipins and the perceived pain scores in an exploratory study in women with chronic neck pain2016In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 17, article id 103Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 27.
    Henje Blom, Eva
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Wiberg, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Dennhag, Inga
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry.
    Translation and validation of the Swedish version of the self-compassion scale for youth2024In: Australian psychologist, ISSN 0005-0067, E-ISSN 1742-9544, Vol. 59, no 1, p. 24-35Article in journal (Refereed)
    Abstract [en]

    Objective: Compassion-focused interventions for young people have started to emerge to treat depressive symptoms, and reliable and valid measures of the construct “self-compassion” is needed for this age-group in Swedish. This study aims to validate the Swedish translation of the Self-Compassion Scale for Youth (SCS-Y).

    Method: Self-report questionnaires were collected from students (N = 316) aged 15–20 recruited from schools in Sweden, in a cross-sectional design. Confirmatory factor analyses, internal consistency, test-retest reliability, measurement invariance and convergent and divergent validity were calculated.

    Results: A model with one general bi-factor and six specific factors had the best fit and confirmed the factor structure of SCS-Y. Internal consistencies were good, except for the subscale mindfulness for boys which was questionable. Three-week test-retest reliability was good. We found measurement invariance for age and no equivalence for sex. Evidence was found for convergent and divergent validity using correlations. Sex differences were found: girls scored higher on self-judgement, feelings of isolation and showed more over-identification, than boys.

    Conclusions: The Swedish version of SCS-Y (SCS-Y-SE) is a reliable and valid self-report questionnaire, with some limitations, to assess self-compassion in clinical practice and research.

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  • 28.
    Hirvelä, Timo
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professionell Development.
    Are doctors and assistant nurses equally good at informing patients? A randomized controlled trial comparing information recall regarding postoperative self-care.2018Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 29.
    Hultqvist, Sara
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden; Department of Social Work, Linnaeus University, Växjö, Sweden.
    Ekstam, Lisa
    Department of Health Sciences, Lund University, Lund, Swede.
    Andersson, Janicke
    Department of Social Work, Halmstad University, Halmstad, Sweden.
    Nilsson, Maria H.
    Department of Health Sciences, Lund University, Lund, Sweden; Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
    Overton, Marieclaire
    Division of Geriatric Medicine, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.
    Zingmark, Magnus
    Department of Health Sciences, Lund University, Lund, Sweden; Health and Social Care Administration, Municipality of Östersund, Östersund, Sweden.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Conditions for uptake of evidence-based knowledge in municipal care for older people in Sweden: a developmental evaluation2022In: BMC Research Notes, E-ISSN 1756-0500, Vol. 15, no 1, article id 243Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this paper is to describe the initial phase of a long-term collaboration initiative between a municipality and the Faculty of Medicine at a university in Sweden. The overall ambition of the collaboration is to strengthen the quality of care for older people. The concrete goal is to equip academically trained registered health care professionals (HCP) with tools for transferring evidence-based knowledge into practice. As municipal healthcare for older people is mainly carried out by staff lacking academic education, reg. HCP are key actors to bring in and consolidate an evidence-based approach in this setting. Developmental evaluation (DE) has been used to evaluate four separate activities in the initial phase. The activities where sequenced in a cumulative design to provide knowledge for further development of adequate tools.

    Results: The cumulative design originally planned did not fit the internal logic of the municipality. Therefore, workflow and pace adjustments were made to proceed towards the joint ambition; the creation of fruitful conditions for the uptake of evidence-based knowledge. Long-term collaboration between academia and organizations outside academia demands a sensitive and flexible research approach, recognizing that collaboration implies mutuality and restricts the sovereignty of academia in designing research.

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  • 30.
    Hylander, Johan
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Westman, Anton
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Time-efficiency factors in road tunnel rescue as perceived by Swedish operative personnel – an interview study2022In: International Journal of Emergency Services, ISSN 2047-0894, E-ISSN 2047-0908, Vol. 11, no 2, p. 312-324Article in journal (Other academic)
    Abstract [en]

    Purpose: Major incidents in road tunnels remain a collaborative challenge for the emergency services (fire and rescue service, police and ambulance), emergency dispatch centres (EDCs) and infrastructure owners. The aim of this paper is to investigate how collaborative partners to the ambulance services perceive the rescue effort and to identify factors that may influence its efficiency.

    Design/methodology/approach: Focus group and individual interviews were conducted with 19 participants who were infrastructure owners or had operational or tactical responsibilities with the emergency services or EDCs in two regions in Sweden with multiple road tunnels. The collected data were analysed using qualitative content analysis.

    Findings: Three main categories described efficiency factors during and after an incident: (1) coordinating the initial information (using a shared terminology), (2) achieving situational awareness (identifying those persons in need) and (3) lessons (not) learnt (lack of joint tactical plans and exercises). The emerging theme was access, assess and evaluate.

    Practical implications: The findings suggest that establishing national policies and collaborative forums might yield more efficiently managed rescue efforts in road tunnel incidents in Sweden and other countries with similar organisational structures.

    Originality/value: This study offers new insights on interoperability during responses to complex underground incidents.

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  • 31.
    Hägg, Hampus
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patienters upplevelser av en magnetkameraundersökning2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Magnetic resonance imaging (MRI) is a frequently used medical imaging technique. It has the great advantage of not exposing the patient to ionizing radiation. The radiographer is responsible for the safety during the scanning- procedure. It is important that the radiographer has good knowledge of the patients’ experiences of both the MRI scanning procedure and the preparations. Aim: The aim of this study is to examine patients' experiences of an MRI-scan. Method: This work is a qualitative literature study. Searches for articles suitable for inclusion were made in the research databases CINAHL and Scopus. Eight articles fulfilling the inclusion criteria were found and the content was further analysed to identify categories. Result: Five categories summarizing patients’ experiences of an MRI-scan were identified: anxiety and fear; preceding information; communication; feelings, frame of mind and copingstrategies and waiting for results. Conclusion: The design of the MRI-scanner and the information and communication during the procedure affect the patients' experiences of the examination. It was shown that the radiographers treatment of the patient was of significance. Keywords: Magnetic resonance imaging, communication, patients' experiences, anxiety, radiographer

  • 32.
    Höglund, Per
    et al.
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Hakelind, Camilla
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Steven
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Sundström, Anna
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Nordin, Maria
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Impact of group interventions on stress and sleep problems in primary careManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: The majority of patients who seek help for stress and sleep problems do so in primary health care in Sweden. However, the resources for psychological treatment are limited. The aim of this study was to assess the effectiveness of a low-intensity student-led group interventions, applying cognitive behavioral therapy (CBT) with an indicated prevention approach in primary care for recovery and reducing symptoms of stress and sleep disturbance.

    Methods: Using a quasi-experimental design, interventions were conducted for stress (n=274, mean age=38 years, 75% women) and sleep (n=106, mean age=44 years, 56% women) problems in consecutively recruited primary care patients. These were compared with a control group (n=221, mean age=45 years, 91% women) recruited via social media. The interventions were CBT-based psychoeducative group interventions that consisted of four 90-min sessions and led by psychology students. Assessment was completed at pre- and post-intervention and at 3-month follow-up. Main outcome measures were the 10-item Perceived Stress Scale and the Shirom-Melamed Burnout Questionnaire for the stress intervention, and the Karolinska Sleep Questionnaire for the sleep intervention. The Hospital Anxiety and Depression Scale and the 15-item Patient Health Questionnaire were used to assess anxiety, depression and somatization as secondary outcome measures for both interventions. Analysis of covariance (pre- vs post-intervention) and reliable change index (pre-intervention vs three-month follow-up) were applied.

    Results: Statistically significant, but small effects of improved health in comparison to the control group were found on stress and burnout (η2=.021-.030) in the stress intervention, and on sleep (η2=.017) in the sleep intervention. The proportion of patients in the stress intervention with a reliable improvement at three-month follow-up was 28% for stress and 59% for burnout, and 0% and 33%, respectively, for the control group. Among those with a reliable improvement in burnout, 31% also met a recovery criterion (<4.0). In the sleep intervention, 25% of the patients showed a reliable improvement in sleep and 61% in burnout, and 6% and 33%, respectively, for the control group. The effects of the stress intervention were statistically significant, but small on anxiety and depression (η2=.021-.047), as were the effects of the sleep intervention on stress and burnout (η2=.017-.026). 

    Conclusion: The results suggest that psychology students can effectively provide a low-intensity group-delivered CBT intervention for patients exhibiting symptoms of stress, burnout and sleep disturbance in routine general medical practice, offering promising opportunities for scalability expansion. Although the average treatment effects were small, a substantial proportion of the patients showed reliable improvement or recovery at 3-month follow-up. This suggests that the interventions decrease the prevalence of burnout and sleep disturbance or improve the well-being of individuals experiencing mental distress. 

  • 33.
    Jacobowitz, Ofer
    et al.
    Sleep Department, ENT and Allergy Associates, NY, New York, USA.
    Afifi, Lamia
    Clinical Neurophysiology, School of Medicine, Cairo University, Egypt.
    Penzel, Thomas
    Interdisciplinary Sleep Medicine Center, Charite Universitätsmedizin Berlin, Germany.
    Poyares, Dalva
    Psychobiology Department, Sleep Medicine Division, Universidade Federal de Sao Paulo, Brazil.
    Marklund, Marie
    Umeå University, Faculty of Medicine, Department of Odontology.
    Kushida, Clete
    Sleep Clinic and Center for Human Sleep Research, Stanford University School of Medicine, CA, Redwood City, USA.
    Endorsement of: “treatment of adult obstructive sleep apnea with positive airway pressure: an American academy of Sleep Medicine Clinical Practice Guideline” by World Sleep Society2022In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 89, p. 19-22Article in journal (Refereed)
    Abstract [en]

    Guidelines for the evaluation and management of sleep disorders from national societies provide recommendations that may be regionally appropriate but may not always be practical or relevant in other parts of the world. A task force of experts from the World Sleep Society's (WSS) International Sleep Medicine Guidelines Committee and Sleep and Breathing Disorders Taskforce reviewed the American Academy of Sleep Medicine's Clinical Practice Guideline on the Treatment of Adult Obstructive Sleep Apnea (OSA) with Positive Airway Pressure with respect to its relevance and applicability to the practice of sleep medicine by sleep specialists in various regions of the world. To improve the evaluation of the guideline, surveys were sent by the senior author and the WSS to approximately 800 sleep doctors around the world to query the availability of OSA treatments in their respective region. The task force and the WSS guidelines committee endorsed the AASM's CPAP guidelines with respect to the indications for PAP therapy, utilization of different PAP modalities, and concurrent strategies to improve outcomes, noting appropriate caveats for universal applicability.

  • 34. Jarvis, Jessica M
    et al.
    Kaelin, Vera C.
    Anaby, Dana
    Teplicky, Rachel
    Khetani, Mary A.
    Electronic participation-focused care planning support for families: A pilot study2020In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 62, no 8, p. 954-961Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate the feasibility, acceptability, and preliminary effects of Participation andEnvironment Measure-Plus (PEM+) 2.0, an optimized version of a web-based, participation-focused, care-planning tool.

    METHOD: Twenty-two caregivers of children aged 0 to 5 years receiving rehabilitation services, who reported dissatisfaction with their child’s participation, had internet access, and could read and write English, were recruited for this 2-week, single-arm pilot trial. Feasibility was assessed through retention rates, completion time, percentage of care plans developed relative to caregiver reported need, and independent completion of PEM+ 2.0. Acceptability was assessed by the Usefulness, Satisfaction, and Ease of Use Questionnaire. Preliminary effects were assessed by two items on caregiver reported impact of PEM+ 2.0 on confidence for addressing their child’s participation.

    RESULTS: Eighteen caregivers completed at least one iteration of PEM+ 2.0; of those, 17 were female and 15 were 30 to 39 years old. The median completion time was 12.99 minutes (quartile 1, 6.30; quartile 3, 17.33), mean care plan creation relative to need was 50% (standard deviation [SD] 31), and 17 completed PEM+ 2.0 independently. Mean acceptability scores were 3.80 to 4.97 (SD 1.25–1.97) and mean preliminary effect scores were 4.61 to 4.72(SD 1.85–2.24), out of 7.0. There were strong and significant positive associations between two of the three estimates of PEM+ 2.0 acceptability and caregiver confidence (r=0.577–0.793,p<0.01).

    INTERPRETATION: Electronic health tools have the potential for facilitating family-centered care in pediatric rehabilitation. PEM+ 2.0 is a feasible tool within pediatric rehabilitation and has potential to be an acceptable tool for improving caregiver confidence for promoting their child’s participation in valued activities.

  • 35.
    Johansson, Sanna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Niklasson, Johan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    A clinically feasible short version of the 15-item geriatric depression scale extracted using item response theory in a sample of adults aged 85 years and older2022In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 26, no 2, p. 431-437Article in journal (Refereed)
    Abstract [en]

    Objectives: To extract the items most suitable for a short version of the 15-item Geriatric Depression Scale (GDS-15) in a sample of adults aged ≥ 85 years using item response theory (IRT).

    Method: This population-based cross-sectional study included 651 individuals aged ≥ 85 years from the Umeå 85+/GErontological Regional DAtabase (GERDA) study. Participants were either community dwelling (approximately 70%) or resided in institutional care (approximately 30%) in northern Sweden and western Finland in 2000–2002 and 2005–2007. The psychometric properties of GDS-15 items were investigated using an IRT-based approach to find items most closely corresponding to the GDS-15 cut off value of ≥5 points. Receiver operating characteristic curves were used to compare the performance of the proposed short version with that of previously proposed short GDS versions.

    Results: GDS-15 items 3, 8, 12, and 13 best differentiated respondents’ levels of depressive symptoms corresponding to the GDS-15 cut off value of ≥5, regardless of age or sex, and thus comprise the proposed short version of the scale (GDS-4 GERDA). For the identification of individuals with depression (total GDS-15 score ≥ 5), the GDS-4 GERDA with a cut-off score of ≥2 had 92.9% sensitivity and 85.0% specificity.

    Conclusion: The GDS-4 GERDA could be used as an optimized short version of the GDS-15 to screen for depression among adults aged ≥ 85 years.

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  • 36.
    Jonasson, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vänman, Emma
    Umeå University, Faculty of Medicine, Department of Nursing.
    En brinnande fråga-  Förekomst av stressrelaterade symtom och samband med krav, kontroll och socialt stöd hos brandpersonal i Sverige2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Many health and safety problems revolve around psychosocial factors. The relationship between demand, control and social support affect our health. Increased risk for mental suffering exists when low social support and low control is experienced. Working hours and lack of control can be associated with gastrointestinal- and sleeping problems. Firefighters have a dangerous occupation and many stressors affect the firefighter´s health. Few studies have investigated demand, control and support linked to stress-related symptoms at work for firefighters, it is important to investigate this though it may affect the individual, workgroup and society.

    Purpose: Identify occurrence of stress related symptoms and their relationship with demand, control and social support in Swedish firefighters.

    Method: The study was part of a cross-sectional study of firefighter's health, 476 people attended. Correlation analyzes with Spearman's korrelationskofficiens was performed.

    Results: Low prevalence of sleep- and stomach problems was seen. Correlation was found where demand and social support correlated with sleep- and stomach problems. Sleep- and stomach problems correlated significantly. Gender and stomach problems also correlated.

    Conclusion: The incidence of sleep- and stomach problems was low and participants felt relatively good. Further research on health factors of firefighters and more studies with other variables compared with demand, control and support is needed.

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  • 37. Kacperczyk-Bartnik, Joanna
    et al.
    Nowosielski, Krzysztof
    Razumova, Zoia
    Bizzarri, Nicolò
    Pletnev, Andrei
    Lindquist, David
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Professional Development.
    Lanner, Maximilian
    Nikolova, Tanja
    Theofanakis, Charlampos
    Strojna, Aleksandra Natalia
    Bartnik, Paweł
    Gómez-Hidalgo, Natalia R.
    Vlachos, Dimitrios-Efthymios
    Selcuk, Ilker
    Zalewski, Kamil
    Clinician attitude towards sexual counseling in women with gynecologic malignancies: European Network of Young Gynaecological Oncologists (ENYGO) survey2022In: International Journal of Gynecological Cancer, ISSN 1048-891X, E-ISSN 1525-1438, Vol. 32, no 10, p. 1309-1315Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Both the location of primary disease and treatment side effects may have an impact on sexual function in oncogynecological patients. The aim of this study was to examine the prevalence, strategies, difficulties, and ideas for improvement in sexual counseling among specialists managing patients with gynecologic malignancies.

    METHODS: This was a cross-sectional survey study performed among healthcare professionals treating patients with gynecologic malignancies. A self-prepared questionnaire included 61 questions concerning general demographic information and different aspects of sexual counseling in the gynecologic oncology practice. Analysis included attitudes, behaviors, management strategies, difficulties, and ideas for possible systemic improvements. Statistical analysis involved descriptive statistics, two-sided chi-square test, and Fisher's exact test.

    RESULTS: A total of 150 respondents from 46 countries answered the survey. The majority of survey participants stated that sexual counseling of oncological patients is very important (n=73, 49%) or important (n=46, 31%). One hundred and two (68%) respondents agreed that sexual counseling of gynecologic oncology patients should be routinely provided by the specialist managing the primary disease. However, collecting information concerning sexual function is performed often or always by only 21% of respondents and 19% discuss the topic rarely or never. The most frequently indicated barriers leading to difficulties in sexual counseling include lack of time (74%), lack of specialist knowledge (55%), and patient embarrassment (48%). One hundred and seven (71%) respondents expressed interest in participating in sexual counseling workshops organized by the European Society of Gynaecological Oncology (ESGO)/European Network of Young Gynaecological Oncologists (ENYGO), 74 (49%) would like to access webinars on the topic, and 120 (80%) would be interested in materials in the ESGO online educational resources.

    CONCLUSION: One of the proposed solutions to insufficient access to sexual care for women with gynecologic malignancies is providing access to specialist educational programs for both patients and healthcare specialists.

  • 38. Kaelin, Vera C.
    et al.
    Anaby, Dana
    Werler, Martha M.
    Khetani, Mary A.
    School participation among young people with craniofacial microsomia and other childhood-onset disabilities2023In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749Article in journal (Refereed)
    Abstract [en]

    Aim: To examine how school environment, physical functioning problems, and behavioral problems explain levels of school participation (i.e. attendance and involvement) among young people with craniofacial microsomia (CFM) and other childhood-onset disabilities, and whether participation-focused caregiver strategies play a role in these relationships.

    Method: We conducted secondary analyses of a subset of data (n = 260 families: 120 with CFM and 140 with other childhood-onset disabilities) from the second follow-up phase of a longitudinal cohort study. We applied structural equation modeling with data collected from the Participation and Environment Measure – Children and Youth version, the Child Behavior Checklist, and the Pediatric Quality of Life Inventory physical functioning scale.

    Results: Model fit was acceptable to close (comparative fit index = 0.973; root mean square error of approximation = 0.055; standardized root mean squared residual = 0.043; Tucker–Lewis index = 0.958). School environmental support had a positive effect on young people's participation attendance and involvement, and physical functioning problems had a negative effect on participation involvement. The number of disclosed caregiver strategies had a significant positive effect on the relationship between school environmental support and school participation attendance.

    Interpretation: Findings confirm the effect of school environmental support and physical functioning problems on school participation and highlight the role of participation-focused caregiver strategies to intensify the positive effect of school environmental support on school participation attendance.

  • 39.
    Kaelin, Vera C.
    et al.
    Department of Occupational Therapy, University of Illinois Chicago, 1919 West Taylor Street, Room 316A, Chicago, IL 60612−7250, USA; Department of Computer Science, University of Illinois Chicago, 851 South Morgan Street, Room 1132, Chicago, IL 60607-7042, USA; Children’s Participation in Environment Research Lab, University of Illinois Chicago, Chicago, IL, USA.
    Boyd, Andrew D.
    Werler, Martha M.
    Parde, Natalie
    Khetani, Mary A.
    Natural language processing to classify caregiver strategies supporting participation among children and youth with craniofacial microsomia and other childhood-onset disabilities2023In: Journal of Healthcare Informatics Research, ISSN 2509-4971, E-ISSN 2509-498XArticle in journal (Refereed)
    Abstract [en]

    Customizing participation-focused pediatric rehabilitation interventions is an important but also complex and potentially resource intensive process, which may benefit from automated and simplified steps. This research aimed at applying natural language processing to develop and identify a best performing predictive model that classifies caregiver strategies into participation-related constructs, while filtering out non-strategies. We created a dataset including 1,576 caregiver strategies obtained from 236 families of children and youth (11–17 years) with craniofacial microsomia or other childhood-onset disabilities. These strategies were annotated to four participation-related constructs and a non-strategy class. We experimented with manually created features (i.e., speech and dependency tags, predefined likely sets of words, dense lexicon features (i.e., Unified Medical Language System (UMLS) concepts)) and three classical methods (i.e., logistic regression, naïve Bayes, support vector machines (SVM)). We tested a series of binary and multinomial classification tasks applying 10-fold cross-validation on the training set (80%) to test the best performing model on the held-out test set (20%). SVM using term frequency-inverse document frequency (TF-IDF) was the best performing model for all four classification tasks, with accuracy ranging from 78.10 to 94.92% and a macro-averaged F1-score ranging from 0.58 to 0.83. Manually created features only increased model performance when filtering out non-strategies. Results suggest pipelined classification tasks (i.e., filtering out non-strategies; classification into intrinsic and extrinsic strategies; classification into participation-related constructs) for implementation into participation-focused pediatric rehabilitation interventions like Participation and Environment Measure Plus (PEM+) among caregivers who complete the Participation and Environment Measure for Children and Youth (PEM-CY). 

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  • 40. Kaelin, Vera C.
    et al.
    Valizadeh, Mina
    Salgado, Zurisadai
    Parde, Natalie
    Khetani, Mary A.
    Artificial intelligence in rehabilitation targeting the participation of children and youth with disabilities: Scoping review2021In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 23, no 11, article id e25745Article, review/survey (Refereed)
    Abstract [en]

    Background: In the last decade, there has been a rapid increase in research on the use of artificial intelligence (AI) to improve child and youth participation in daily life activities, which is a key rehabilitation outcome. However, existing reviews place variable focus on participation, are narrow in scope, and are restricted to select diagnoses, hindering interpretability regarding the existing scope of AI applications that target the participation of children and youth in a pediatric rehabilitation setting.

    Objective: The aim of this scoping review is to examine how AI is integrated into pediatric rehabilitation interventions targeting the participation of children and youth with disabilities or other diagnosed health conditions in valued activities.

    Methods: We conducted a comprehensive literature search using established Applied Health Sciences and Computer Science databases. Two independent researchers screened and selected the studies based on a systematic procedure. Inclusion criteria were as follows: participation was an explicit study aim or outcome or the targeted focus of the AI application; AI was applied as part of the provided and tested intervention; children or youth with a disability or other diagnosed health conditions were the focus of either the study or AI application or both; and the study was published in English. Data were mapped according to the types of AI, the mode of delivery, the type of personalization, and whether the intervention addressed individual goal-setting.

    Results: The literature search identified 3029 documents, of which 94 met the inclusion criteria. Most of the included studies used multiple applications of AI with the highest prevalence of robotics (72/94, 77%) and human-machine interaction (51/94, 54%). Regarding mode of delivery, most of the included studies described an intervention delivered in-person (84/94, 89%), and only 11% (10/94) were delivered remotely. Most interventions were tailored to groups of individuals (93/94, 99%). Only 1% (1/94) of interventions was tailored to patients’ individually reported participation needs, and only one intervention (1/94, 1%) described individual goal-setting as part of their therapy process or intervention planning.

    Conclusions: There is an increasing amount of research on interventions using AI to target the participation of children and youth with disabilities or other diagnosed health conditions, supporting the potential of using AI in pediatric rehabilitation. On the basis of our results, 3 major gaps for further research and development were identified: a lack of remotely delivered participation-focused interventions using AI; a lack of individual goal-setting integrated in interventions; and a lack of interventions tailored to individually reported participation needs of children, youth, or families.

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  • 41. Kaelin, Vera C.
    et al.
    Wallace, Erin R.
    Werler, Martha M.
    Collett, Brent R.
    Khetani, Mary A.
    Community participation in youth with craniofacial microsomia2022In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 44, no 2, p. 253-260Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine differences in community participation and environmental support for youth with and without craniofacial microsomia.

    Methods: This study involved secondary analyses of a subset of data (n = 396) from a longitudinal cohort study. Multiple linear and Poisson regression analyses and Wilcoxon Mann–Whitney tests were used to estimate differences in community participation and environmental support between youth with craniofacial microsomia and youth without craniofacial microsomia, stratified based on their history of education and health-related service use. Chi-square analyses were used to explore item-level group differences in change desired across community activities.

    Results: Statistically significant differences were found in community participation frequency (ES = −0.52; p < 0.001), level of involvement (r = −0.16; p = 0.010), and desire for change in participation when comparing youth with craniofacial microsomia and non-affected peers not receiving services (p < 0.001). There were no statistically significant differences between youth with craniofacial microsomia and non-affected peers receiving services.

    Conclusions: Results suggest lower community participation in youth with craniofacial microsomia as compared to non-affected peers not receiving services. This may suggest opportunities for designing and testing interventions to promote community participation among youth with craniofacial microsomia, so as to support their transition to adulthood.

  • 42. Kaelin, Vera C.
    et al.
    Wallace, Erin R.
    Werler, Martha M.
    Collett, Brent R.
    Rosenberg, Janine
    Khetani, Mary A.
    Caregiver perspectives on school participation among students with craniofacial microsomia2021In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 75, no 2, article id 7502205100Article in journal (Refereed)
    Abstract [en]

    Importance: Knowledge of unmet school participation needs for students with craniofacial microsomia (CFM) can inform decisions regarding intervention support.

    Objective: To compare students with and without CFM on school participation (i.e., frequency, involvement, desire for participation to change) and caregivers’ perceptions of environmental support for participation in occupations.

    Design: Cross-sectional design using secondary analyses of a subset of data.

    Setting: Multisite cohort study.

    Participants: Caregivers of students with CFM (n = 120) and of students without CFM (n = 315), stratified by history of educationand health-related service use.

    Outcomes and Measures: School participation and environmental support, obtained with the Participation and Environment Measure–Children and Youth.

    Results: Significant group differences were found in frequency of school participation (effect size [ES] = −0.38, 95% confidence interval [−0.64, −0.12], p = .005), level of involvement (ES = −0.14, p = .029), and desired change (p = .001), with students with CFM exhibiting greater participation restriction than students without CFM and no history of service use. No statistically significant group differences were found in environmental support for participation in the school setting. Item-level findings showed statistically significant higher desire for participation to change in three of five school occupations (odds ratio = 1.77–2.39, p = .003–.045) for students with CFM compared with students without CFM and no history of service use.

    Conclusions and Relevance: The results suggest that students with CFM experience restriction in participation at school.

    What This Article Adds: Students with CFM may benefit from targeted school-based interventions to optimize their inclusion.

  • 43.
    Khan, Nida A.
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB).
    Interaction of adipose derived stem cells with breast cancer cells: An in vitro study with MCF-7 breast cancer cells examining the oncological safety of autologous human adipose stem cells used in reconstructive surgery2017Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 44. Khetani, Mary A.
    et al.
    McManus, Beth M.
    Albrecht, Erin C.
    Kaelin, Vera C.
    Dooling-Litfin, Jodi K.
    Scully, Elizabeth A.
    Early intervention service intensity and young children's home participation2020In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 20, no 1, article id 330Article in journal (Refereed)
    Abstract [en]

    Background: Young children with developmental disabilities and delays spend significant amounts of time at home, show decreased participation in home-based activities, and receive home-based early intervention services to improve participation in activities. Yet, knowledge about the relationship between EI service use and children’s home participation in activities remains poorly understood but needed for program improvement. The purpose of this study was to understand the relationships between EI service use and children’s home participation.

    Methods: In a cross-sectional design, data were gathered from caregivers (N = 139) who enrolled in a pilot trial of the Young Children’s Participation in Environment Measure (YC-PEM) electronic patient-reported outcome (e-PRO), as implemented within 1 month of their child’s next EI progress evaluation. A series of path analytic models were used to estimate EI service intensity as a predictor of parent-reported young children’s home participation 1) frequency, 2) level of involvement, and 3) desired change, adjusting for family and child social and functional characteristics. Models included caregiver perceptions of home environmental support to test its indirect (i.e., mediation) effects on the relationship between EI service intensity and each of the three home participation dimensions.

    Results: All three models fit the data well (comparative fit index = 1.00). EI service intensity was not a significant predictor of participation frequency. However, EI service intensity had a significant direct effect on a child’s participation according to level of involvement and desired change, explaining between 13.3–33.5% of the variance in home participation. Caregiver perceptions of environmental support had a small yet significant indirect effect on the relationship between EI service intensity and level of involvement and desired change; these models explained between 18.5–38.1% of the variance in home participation.

    Conclusions: EI service intensity has important links with involvement in and desired change for home-based activities. Caregiver perceptions of environmental support appears to be a factor in the relationship between EI service intensity and home participation. Results warrant longitudinal replication with a control group, which would be possible with the implementation of the YC-PEM e-PRO in a routine EI clinical workflow.

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  • 45. Leask, Calum F.
    et al.
    Sandlund, Marlene
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Skelton, Dawn A.
    Chastin, Sebastien F. M.
    Co-creating a tailored public health intervention to reduce older adults' sedentary behaviour2017In: Health Education Journal, ISSN 0017-8969, E-ISSN 1748-8176, Vol. 76, no 5, p. 595-608Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

  • 46.
    Lexell, Jan
    et al.
    Lunds universitet; Skånes universitetssjukhus Lund.
    Hu, Xiao-Lei
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Rehabiliteringsmetodiken är läkarspecialitetens kärnpunkt2021In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 118, article id 21028Article in journal (Refereed)
  • 47.
    Libäck, Anssi Sven-Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine.
    Kanninen, Katjaana Anni-Maria
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports Medicine.
    Methods to assess nonfunctional overreaching in wrestlers: A literature review2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction Wrestling is a competitive and intermittent combat sport characterised mainly by strength components. Few researchers have examined nonfunctional overreaching in strength-based athletes, such as wrestlers, despite being prevalent. To prevent the more severe condition of overtraining syndrome, it is important to detect early maladaptation, i.e., nonfunctional overreaching. Due to its complex nature, most studies have not managed to develop nonfunctional overreaching conditions in athletes. The purpose of this review is to broadly summarize previous research on functional overreaching, nonfunctional overreaching, and overtraining syndrome to examine useful methods to assess nonfuntional overreaching in wrestlers.

    Method Google Scholar, PubMed, and Web of Science were used with various combinations of nonfuntional overreaching OR overreaching OR overtraining syndrome. Subjective and objective methods that could be useful to adapt to wrestling to assess nonfunctional overreaching were summarized and discussed. Studies conducted on athletes or physically active individuals in various sports engaging in seasonal training or a moderate to high-intensity training intervention of at least six days or are nonfunctionally overreached were included. Included studies are published original articles and reviews.

    Results There are few studies on wrestlers regarding nonfunctional overreaching. Biochemical and physiological factors have been inconsistent, a relation between nonfunctional overreaching and decrements in maximal muscular strength and vertical jump height have been reported. Profile of Mood States, Perceived Recovery Status, and Recovery-Stress Questionnaire for Athletes have been successfully used to detect nonfunctional overreaching, only the latter being a comprehensive enough monitoring tool.

    Conclusion To adequately assess nonfunctional overreaching in wrestlers, psychological tools together with performance testing with baseline and follow-up values are emphasised. As specific objective or subjective markers seem to be lacking, coaches should use an individual approach when monitoring wrestlers. Consequently, more studies are needed to determine the validity and reliability of these methods in assessing nonfunctional overreaching in wrestlers.

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  • 48.
    Lif Holgerson, Pernilla
    et al.
    Umeå University, Faculty of Medicine, Department of Odontology, School of Dentistry.
    Esberg, Anders
    Umeå University, Faculty of Medicine, Department of Odontology.
    Sjödin, Andreas
    West, Christina E.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    A longitudinal study of the development of the saliva microbiome in infants 2 days to 5 years compared to the microbiome in adolescents2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 9629Article in journal (Refereed)
    Abstract [en]

    Understanding oral microbiota programming attracts increasing interest due to its importance for oral health and potential associations with systemic diseases. Here the oral microbiota was longitudinally characterized in children from 2 days (n = 206) to 5 years of age and in young adults (n = 175) by sequencing of the v3-v4 region of the 16S rRNA gene from saliva extracted DNA. Alpha diversity increased by age, with 2-day- and 3-month-old infants in one sub-group, and 18-month- and 3-year-old children in another. Firmicutes decreased up to 3 years of age, whereas Proteobacteria, Actinobacteria, Bacteroidetes and Fusobacteria abundances increased. Abiotrophia, Actinomyces, Capnocytophaga, Corynebacterium, Fusobacterium, Kingella, Leptotrichia, Neisseria and Porphyromonas appeared from 18-months of age. This was paralleled by expansions in the core microbiome that continued up to adulthood. The age-related microbiota transformation was paralleled by functional alterations, e.g., changed metabolic pathways that reflected e.g., breastfeeding and increasing proportions of anaerobic species. Oral microbiotas differed by feeding mode and weakly by mode of delivery, but not gender, pacifier use or cleaning method or probiotic intake. The study shows that the saliva microbiota is diverse 2 days after birth and under transformation up to 5 years of age and beyond, with fluctuations possibly reflecting age-related environmental influences.

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  • 49.
    Ljunggren, Mirjam
    et al.
    Uppsala University, Uppsala, Sweden.
    Zhou, Xingwu
    Uppsala University, Uppsala, Sweden.
    Theorell-Haglöw, Jenny
    Uppsala University, Uppsala, Sweden.
    Janson, Christer
    Uppsala University, Uppsala, Sweden.
    Franklin, Karl A.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Emilsson, Össur
    Uppsala University, Uppsala, Sweden.
    Lindberg, Eva
    Uppsala University, Uppsala, Sweden.
    Sleep apnea indices associated with markers of inflammation and cardiovascular disease: a proteomic study in the MUSTACHE cohort2024In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 21, no 1, p. 165-169Article in journal (Other academic)
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  • 50. Lundström, Staffan
    et al.
    Axelsson, Bertil
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Heedman, Per-Anders
    Fransson, Greger
    Fürst, Carl Johan
    Developing a national quality register in end-of-life care: The Swedish experience2012In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 26, no 4, p. 313-321Article in journal (Refereed)
    Abstract [en]

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

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