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  • 1.
    Abbas, Päivi Maria
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Stockholms stad.
    Kommunala riktlinjer för anhöriganställningar: En kvalitativ innehållsanalys med feministisk teoriansats2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The overall aim was to investigate municipal guidelines for paid dependent care which were available online, i.e. documents regarding situations where a relative is hired to care for a next-to-kin. The overall aim has been built on the following three research questions regarding how municipalities describe: 1) which situations qualify for paid dependent care, 2) how the elderly person’s needs are met in case of paid dependent care and 3) how the dependent caregivers’ rights and well-being are ensured?

    There is no legal basis for demanding cash-for-care setting, and the local self-government determines whether the municipality offers this form of care. Recently, paid dependent care has been restricted and banned in several Swedish municipalities, and according to some statistics paid dependent care is allowed in 55–65 % of the Swedish municipalities. It is mostly women of foreign origin who are dependent caregivers nowadays, and feminist care research and the media lift up cash-for-care settings as a trap for women and for migrant integration.

    The study included guidelines from a total of 21 municipalities, which were analyzed using qualitative content analysis according to Elo & Kyngäs (2007). The guidelines analysed were found from the websites of Sweden's 121 medium and large municipalities (more than 20 000 inhabitants). The results were processed using feminist theory (Hirdman 2012).

    The results show that overall there are few guidelines available in Sweden's municipalities and that the regulations differ in the different municipalities’ guidelines. The guidelines that are available often contain general or vague descriptions. One conclusion is therefore that many municipalities ensure their own discretion and prevail through vague and general rules in their guidelines. From a feminist perspective, these different municipal policies create unfair structures and differences in conditions and terms for the elderly and their family caregivers regarding cash-for-care settings. Finally, the result shows that the few detailed descriptions prioritize elder people's rights over their caregivers'. Ensuring the paid dependent caregivers’ rights is mainly described to be done by checking and controlling them. In other words, the paid dependent caregivers are often invisible in the guidelines, are often regarded as pseudo-employees and therefore fall between the cracks in terms of their need for support (Sand 2010).

  • 2.
    Abellan, Antonio
    et al.
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Perez, Julio
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Pujol, Rogelio
    Centre for Human and Social Sciences, Spanish National Research Council, Madrid, Spain.
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue).
    Jegermalm, Magnus
    School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Partner care, gender equality, and ageing in Spain and Sweden2017In: International Journal of Ageing and Later Life, ISSN 1652-8670, E-ISSN 1652-8670, Vol. 11, no 1, p. 69-89Article in journal (Refereed)
    Abstract [en]

    We used national surveys to study how older persons’ changing household patterns influence the gender balance of caregiving in two countries with distinct household structures and cultures, Spain and Sweden. In both countries, men and women provide care equally often for their partner in couple-only households. This has become the most common household type among older persons in Spain and prevails altogether in Sweden. This challenges the traditional dominance of young or middle-aged women as primary caregivers in Spain. In Sweden, many caregivers are old themselves. We focus attention to partners as caregivers and the consequences of changing household structures for caregiving, which may be on the way to gender equality in both countries, with implications for families and for the public services.

  • 3. Abellán, Antonio
    et al.
    Ayala, Alba
    Pérez, Julio
    Pujol, Rogelio
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ramos, María
    The new carers2018In: Ageing and care: How will we live and care for ourselves when we get old?, Palma: Observatorio Sociale de "la caxia" , 2018, p. 25-31Chapter in book (Other academic)
    Abstract [en]

    Usually it is women who take care of family members in the home, but with age, gender differences become less pronounced and, from 80 years onwards, there are more men caring for a family member – generally their partner – than women. Social and demographic changes are presenting new challenges for public services. In particular, in two-person households with elderly inhabitants, one of whom is dependent, it is necessary to tackle not only the needs of the dependent partner but also those of the carer partner. For this reason, carer support programmes are needed.

  • 4.
    Adanko, Carina
    et al.
    Jönköping University, School of Engineering, JTH. Research area Built Environment.
    Küller, Marianne
    Lunds universitet, LTH, Inst arkitektur och byggd miljö, Miljöpsykologi.
    LED-belysning och brukaren2014Report (Other academic)
    Abstract [en]

    Lighting research is diversified and includes theory and methodology from disciplines as different as technology, medicine and social sciences. There is also an expectation on research results to be directly applicable in real environments. The introduction of LED has furthermore made previous research on incandescent lamps, fluorescent lamps and other light sources, outdated.    New knowledge – and new research – is needed.

    An inventory of current LED-research was made during 2013. The result of this inventory is the basis of the research review here presented. The presentation includes more than 400 articles, reported under the headings: The biological clock; Flicker and dimming of LED: Energy efficiency: daylight and lighting control; Colour rendering; Glare, and finally; Perceived lighting qualities.

    Underlying theoretical considerations as well as actual knowledge are presented in the text of the different sections, and references are given to relevant research publications. All publications have been provided with two or more keywords in Swedish, describing the content of the publication. After the text given under each heading the references supporting this text are presented. In the final section all LED-publications are given in alphabetical order according to author and with keywords. 

  • 5.
    Adolfsson, Margareta
    et al.
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Johnson, Ensa
    Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa.
    Nilsson, Stefan
    Jönköping University, School of Education and Communication, HLK, CHILD. University of Gothenburg, Sweden.
    Pain management for children with cerebral palsy in school settings in two cultures: Action and reaction approaches2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 18, p. 2152-2162Article in journal (Refereed)
    Abstract [en]

    Background: Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings.

    Method: Participants’ statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model.

    Results: Findings indicated that pain management focused more on children’s attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain.

    Conclusion: Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children’s pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to “hands-on” pain management when needed.

  • 6.
    Agahi, Neda
    et al.
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kelfve, Susanne
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden; Department of Sociology, Stockholm University, Stockholm, Sweden.
    Lennartsson, Carin
    Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center, Karolinska Institutet/Stockholm University, Stockholm, Sweden.
    Alcohol consumption in very old age and its association with survival: a matter of health and physical function2016In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 159, p. 240-245Article in journal (Refereed)
    Abstract [en]

    Background

    Alcohol consumption in very old age is increasing; yet, little is known about the personal and health-related characteristics associated with different levels of alcohol consumption and the association between alcohol consumption and survival among the oldest old.

    Methods

    Nationally representative data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD, ages 76-101; n = 863) collected in 2010/2011 were used. Mortality was analyzed until 2014. Alcohol consumption was measured with questions about frequency and amount. Drinks per month were calculated and categorized as abstainer, light-to-moderate drinker (0.5–30 drinks/month) and heavy drinker (>30 drinks/month). Multinomial logistic regressions and Laplace regressions were performed.

    Results

    Compared to light-to-moderate drinkers, abstainers had lower levels of education and more functional health problems, while heavy drinkers were more often men, had higher levels of education, and no serious health or functional problems. In models adjusted only for age and sex, abstainers died earlier than drinkers. Among light-to-moderate drinkers, each additional drink/month was associated with longer survival, while among heavy drinkers, each additional drink/month was associated with shorter survival. However, after adjusting for personal and health-related factors, estimates were lower and no longer statistically significant.

    Conclusions

    The association between alcohol consumption and survival in very old age seems to have an inverse J-shape; abstention and heavy use is associated with shorter survival compared to light-to-moderate drinking. To a large extent, differences in survival are due to differences in baseline health and physical function.

    Graphical abstract

  • 7.
    Agahi, Neda
    et al.
    Karolinska Institutet.
    Lennartsson, Carin
    Karolinska Institutet.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Shaw, Benjamin A.
    School of Public Health, University at Albany, Rensselaer, NY, USA.
    Trajectories of social activities from middle age to old age and late-life disability: a 36-year follow-up2013In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 42, no 6, p. 790-793Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: to examine the association between 34-year trajectories of social activity, from middle age to old age and late-life disability.

    METHODS: data from the Swedish Level of Living Survey (LNU) and the Swedish Panel Study of the Oldest Old (SWEOLD) were used. LNU data from 1968, 1981, 1991 and 2000 were merged with SWEOLD data from 1992, 2002 and 2004 to create a longitudinal data set with five observation periods. Trajectories of social activities covered 1968-2002, and late-life disability was measured in 2004. The sample consisted of 729 individuals aged 33-61 at baseline (1968), who participated in at least four observation periods and who were free from mobility limitations at baseline. Four trajectories of social activity were identified and used as predictors of late-life disability.

    RESULTS: reporting low/medium levels of social activity from mid-life to old age was the most common trajectory group. Persons reporting continuously low/medium or decreasing levels of social activity had higher odds ratios for late-life disability (OR = 2.33 and OR = 2.15, respectively) compared with those having continuously high levels of activity, even when adjusting for age, sex and mobility limitations, and excluding persons with baseline mobility limitations.

    CONCLUSIONS: results suggest that the disability risk associated with social activities is related to recent levels of activity, but also that risk may accumulate over time, as indicated by the higher disability risk associated with the continuously low/medium level social activity trajectory.

  • 8.
    Ahlgren, Jennie
    et al.
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Görman, Ulf
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Nordström, Karin
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Ethical considerations in relation to personalised nutrition: An overview of Work Package 5, with respect to ethics2015Report (Other academic)
    Abstract [en]

    The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.

  • 9.
    Aidemark, Jan
    et al.
    Linnéuniversitetet.
    Askenäs, Linda
    Linnéuniversitetet.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Strömberg, Anna
    Linköpings universitet.
    Challenges for heart failure patients’ self-care systems – analysis of patients’ needs2014In: Procedia Technology - Elsevier, ISSN 2212-0173, E-ISSN 2212-0173, Vol. 16, p. 1256-1264Article in journal (Refereed)
    Abstract [en]

    Self-care is important for heart failure patients. However, what are the views of patients on their situation when it comes to realizing self-care? The aim of the paper is to investigate the self-care needs of HF patients, by understanding the issues they embrace in their self-care processes. In this paper we make a review of 17 interviews and make a classification of what the needs are for possible information technology support systems. Based on the analysis of these interviews, we identify the diversity of needs in support of activities related to different background conditions and the dynamics of change of learning and changes in the heart failure condition. The contribution of the paper is a framework for understanding the diversity of needs and the specific situations of this group of patients.

  • 10. Al Ansari, A.
    et al.
    Strachan, K.
    Hashim, Sumaya
    RCSI Bahrain, Adliya, Kingdom of Bahrain.
    Otoom, S.
    Analysis of psychometric properties of the modified SETQ tool in undergraduate medical education2017In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 17, no 1, article id 56Article in journal (Refereed)
    Abstract [en]

    Background: Effective clinical teaching is crucially important for the future of patient care. Robust clinical training therefore is essential to produce physicians capable of delivering high quality health care. Tools used to evaluate medical faculty teaching qualities should be reliable and valid. This study investigates the psychometric properties of modification of the System for Evaluation of Teaching Qualities (SETQ) instrument in the clinical years of undergraduate medical education.

    Methods: This cross-sectional multicenter study was conducted in four teaching hospitals in the Kingdom of Bahrain. Two-hundred ninety-eight medical students were invited to evaluate 105 clinical teachers using the SETQ instrument between January 2015 and March 2015. Questionnaire feasibility was analyzed using average time required to complete the form and the number of raters required to produce reliable results. Instrument reliability (stability) was assessed by calculating the Cronbach’s alpha coefficient for the total scale and for each sub-scale (factor). To provide evidence of construct validity, an exploratory factor analysis was conducted to identify which items on the survey belonged together, which were then grouped as factors.

    Results: One-hundred twenty-five medical students completed 1161 evaluations of 105 clinical teachers. The response rates were 42% for student evaluations and 57% for clinical teacher self-evaluations. The factor analysis showed that the questionnaire was composed of six factors, explaining 76.7% of the total variance. Cronbach’s alpha was 0.94 or higher for the six factors in the student survey; for the clinical teacher survey, Cronbach’s alpha was 0.88. In both instruments, the item-total correlation was above 0.40 for all items within their respective scales.

    Conclusion: Our modified SETQ questionnaire was found to be both reliable and valid, and was implemented successfully across various departments and specialties in different hospitals in the Kingdom of Bahrain.

  • 11.
    Almborg, Ann-Helene
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Perceived Participation in Discharge Planning and Health Related Quality of Life after Stroke2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate the patients’ and their relatives’ perceived participation in discharge planning after stroke and the patients’ health-related quality of life, depressive symptoms, performance of personal daily activities and social activities in connection with discharge. Another aim was to evaluate the psychometric assumptions of the SF-36 for Swedish stroke patients.

    Prospective, descriptive and cross-sectional designs were used to study all patients with stroke admitted to the stroke unit at a hospital in southern Sweden from October 1, 2003 to November 30, 2005 each with one close relative. The total sample consisted of 188 patients (mean age=74.0 years) and 152 relatives (mean age=60.1 years). Data were collected during interviews, 2-3 weeks after discharge.

    The results showed that less depressive symptoms, more outdoor activities and performance of interests are important variables that related to higher HRQoL. SF-36 functions well as a measure of health related quality of life in Swedish stroke patients, but the two summary scales have shortcomings. Compared to a Swedish normal population, scores on all scales/components of the SF-36 were lower among stroke patients especially in the middle-aged group. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal setting. The relatives perceived that they need more information and they perceived low participation in goal setting and needs assessment. The professionals seem to lack effective practices for involving patients and their relatives to perceive participation in discharge planning. It is essential to develop and to implement methods for discharge planning, including sharing information, needs assessment with goal setting that facilitate patients’ and relatives’ perceived participation. The results suggest that ICF can be used in goal setting and needs assessment in discharge planning after acute stroke.

  • 12.
    Almborg, Ann-Helene
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Ulander, Kerstin
    Thulin, Anders
    Berg, Stig
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Discharged after stroke - important factors for health-related quality of life.2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 15-16, p. 2196-2206Article in journal (Refereed)
    Abstract [en]

    AIMS: This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke.

    BACKGROUND: HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge.

    DESIGN: Cross-sectional study.

    METHODS: The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL.

    RESULTS: Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL.

    CONCLUSIONS: Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests.

    RELEVANCE TO CLINICAL PRACTICE: These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.

  • 13. Andel, Ross
    et al.
    Kåreholt, Ingemar
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health. Jönköping University, School of Health Science, HHJ, Institute of Gerontology.
    The role of midlife ocupational complexity and leisure time activity in cognitive performance later in life.2013Conference paper (Other academic)
  • 14.
    Andel, Ross
    et al.
    School of Aging Studies, University of South Florida, Tampa, Florida.
    Silverstein, Merril
    Sociology Department and School of Social Work, Aging Studies Institute, Syracuse University, New York.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    The role of midlife occupational complexity and leisure activity in late-life cognition2015In: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 70, no 2, p. 314-321Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age.

    METHODS:

    We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition.

    RESULTS:

    Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive scores. The complexity-cognition link was moderated by leisure activity such that the cognitive benefit related to the complexity of work-especially complexity of working with people-was rendered insignificant when participation in leisure activities-especially social activities-was above average.

    DISCUSSION:

    Results are discussed in terms of using work complexity to compensate for lack of leisure activity as well as in terms of promoting leisure engagement to compensate for long-term cognitive disadvantage imposed by working in less challenging occupations.

  • 15.
    Andersson, Ingvor
    Jönköping University, The Jönköping Academy for Improvement of Health and Welfare.
    Diabeteskonsulent - en möjlig funktion för att förbättra stödet till barn med typ 1 diabetes i skolan2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    AbstractBackground: Type 1 diabetes is one of the most common chronic diseases in children. The overall goal in treating diabetes is to normalize the blood sugar level, in order to avoid complications in adulthood. Since a child spends a large part of the day at school, the treatment has to work well during the school hours. In 2008, paediatric diabetes team in Sweden reported that about 50% of the children in lower primary school, suffering from diabetes, do not receive sufficient support in their diabetic treatment at school. A function such as diabetes resource nurse has been tested in Jönköping County Council for two years to offer the school staff necessary knowledge about diabetes. Purpose: Describe the diabetes resource nurse possibility to influence the support children with diabetes receive at school. Method: The collection of empirical data was done through interviews, questionnaires and comparison of HbA1c. Results: The diabetes resource nurse feels that she is able to convey the knowledge necessary for the school personnel. Parents whose children have been visited by a diabetes recourse nurse says that they less often fear that their child does not get good support at school, that more of the children have a person in charge in school and that more children have an individual communication plan, compared to parents whose children have not been visited by a diabetes resource nurse. The function of the diabetes resource nurse did not improve the metabolic control during the study period. Discussion: The result of the intervention shows that a diabetes resource nurse can successfully improve the support children with type 1 diabetes receive at school. Further studies are needed to clarify which grades benefits the most from the support of a diabetes resource nurse and inquire the school personnel's experience of the diabetes consultant's work.

  • 16.
    Arvidsson, Patrik
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Centre for Research & Development, Uppsala University/Region Gävleborg, Sweden.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    The Relationship Between Intelligence Quotient and Aspects of Everyday Functioning and Participation for People Who Have Mild and Borderline Intellectual Disabilities2018In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 31, no 1, p. e68-e78Article in journal (Refereed)
    Abstract [en]

    Background

    This study explored the relationship between intelligence quotient (IQ) and aspects of everyday functioning/participation in individuals (age 16–40) who have a mild/borderline intellectual disability (IQ 55–85).

    Method

    Correlations were examined between IQ and (i) self-rated (n = 72) ability, participation as performance (how often an activity is performed), important participation restriction (not/seldom performing an activity perceived as important) and general well-being and (ii) proxy-rated (n = 41) ability and participation as performance.

    Results

    No significant correlations between IQ and any of the explored measures were found. However, the effect sizes of the correlations between IQ and ability were considered as small but not negligible.

    Conclusions

    The results support the notion that IQ is a poor predictor of general aspects of everyday functioning in persons with mild/borderline intellectual disability. The result indicates that self-ratings partly generate other information than proxy ratings which may be important for assessments of supportive requirements and diagnosis.

  • 17.
    Baek Larsen, Louise
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Elgmark Andersson, Elisabeth
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Tranberg, Roy
    Ortopeden, Sahlgrenska Universitetssjukhuset, Gothenburg University, Göteborg.
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Jämförande studie av Svensk polis rörelseförmåga vid användandet av bål och/eller bäcken fixerad utrustning2014Report (Other (popular science, discussion, etc.))
    Abstract [sv]

    Under det senaste decenniet har det blivit allt vanligare med arbetsrelaterade besvär hos uniformerad polis i yttre tjänst, främst är det besvär från nedre delen av ryggen som uppgetts. Hälsohögskolan i Jönköping har fått i uppdrag av Rikspolisstyrelsen att belysa och utreda den uppkomna problematiken. Två tidigare rapporter, Polisens fysiska arbetsmiljö och Polisens psykosociala miljö, har presenterats. I rapporten om polisens fysiska arbetsmiljö framkom en hög förekomst av besvär från muskler och leder, främst nedre delen av ryggen under förhållande med bärande av utrustningsbältet i kombination med mycket stillasittande i tjänstebilar. I den andra rapporten framkom att en stor del av poliserna arbetar treskift och i många fall långa arbetspass, vilket yttrar sig i att de har svårt att psykiskt återhämta sig, inte har tid för familj och vänner samt att de ofta upplever sig trötta. I den tredje och sammanfattande rapporten presenteras vilka bakomliggande variabler som påverkar den fysiska och psykosociala arbetsmiljön.

    Syftet med studien var att analysera vilka variabler och vilka kombinationer av variabler som påverkar den fysiska och psykosociala arbetsmiljön för uniformerad polis i yttre tjänst i Sverige. Rapporten baseras på 4244 enkätsvar från poliser i yttre uniformerad tjänst.

    Resultatet från föreliggande studie har visat att det finns skillnaden i besvärsfrekvens mellan myndigheterna när det gäller otillräcklig fysisk och psykisk återhämtning samt besvär ifrån nedre delen av ryggen. Orsakerna till skillnaden mellan myndigheterna är inte utredda. Studien har visat att besvärsfrekvensen ökar då det föreligger krav att arbeta på ett rullande treskiftsschema. Utifrån detta föreslår vi att man:

    • utför benchmarking av polismyndigheter för att öka förståelsen för de stora skillnader som förekommer

    • utvärderar olika modeller av schemaläggning avseende treskift

    • fortsätter arbetet med att utreda hur polisens uniform och kroppsburna utrustning, i kombination med bilsätets utformning, påverkar besvär från nedre delen av ryggen.

  • 18.
    Bannon, Brittany L.
    et al.
    Univ Calif Riverside, San Diego, USA.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Pedersen, Nancy L.
    Karolinska Inst, Stockholm, Sweden.
    Reynolds, Chandra A.
    Univ Calif Riverside, Riverside, USA.
    Confirmatory factor analysis of illness behavior in the Swedish Adoption/Twin Study of Aging (SATSA)2017In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 51, no Suppl. 1, p. S2654-S2655Article in journal (Refereed)
    Abstract [en]

    Background: Illness behaviors—or affective, cognitive, and behavioral responses to symptoms of illness—predict patient outcomes, including symptom exacerbation and functional recovery, and they account for a large proportion of U.S. healthcare costs. Although priorcross-sectional work has examined illness behaviors like symptom reporting in isolation, the measurement of illness behavior using a longitudinal, multi-indicator approach has yet to be explored.

    Aim: We evaluated illness behavior as a latent, developmental construct in the Swedish Adoption/Twin Study of Aging (SATSA).

    Method: Participants were up to 1,886 individuals (from 1,223 twin pairs) ages 29 to 102 years (Mage baseline = 62.32 years; SD =13.69; 59% Female). Illness behavior indicators included somatic complaints, non-prescription medication use, pain-related disability and perceived illness complications. The psychomotor retardation subscale of the CES-D was used to index somatic complaints, and medication use was a simple composite of 9 dichotomous items on participants’ use of non-prescription medications, such as over-the-counter analgesics, in the previous month. Pain-related disability included a simple composite of three dichotomous items on the presence of neck,back, or shoulder pain that prevented participants from performing daily tasks or activities. Perceived illness disability was a composite of difference scores, calculated from subtracting a physician panel’s objective ratings of disability for each of 35 medical conditions (on a 3-pointscale; 1= Little or no disability; 3= Severe disability) from participants’ self-ratings of how much each of the same endorsed medical conditions interfered with their daily lives (on the same 3-point scale; 1= Not at all; 3= A lot). Positive composite scores reflected higher perceived disability relative to what was expected from the objective ratings, whereas a composite score of zero reflected “accuracy” or agreement in perceived illness complications. Confirmatory Factor Analysis (CFA) was used to evaluate invariance in the loadings of these four indicatorson a latent illness behavior factor across four questionnaire waves (1987-2004).

    Findings: Confirmatory factor analyses revealed moderate factor loadings of the four indicators (standardized loadings ranged from .49 to .52, all ps < .0001). Also, practical fit indices from the nested model comparisons suggested strong factorial invariance in the loadings across time (CFI = .96; TLI = .95, RMSEA= .03, 90% CI: [.026, .035]).

    Conclusion: Illness behavior as a latent, multi-indicator construct represents a promising focus for longitudinal work on behavior change and maintenance.

  • 19.
    Bannon, Brittany L.
    et al.
    Univ Utah, Salt Lake City, USA.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Pedersen, Nancy L.
    Karolinska Inst, Stockholm, Sweden.
    Reynolds, Chandra A.
    Univ Calif Riverside, USA.
    Illness behaviors mediate the link between social support and functional decline in the Swedish Adoption Twin Study of Aging2018In: Annals of Behavioral Medicine, ISSN 0883-6612, E-ISSN 1532-4796, Vol. 52, no Suppl. 1, p. S314-S314Article in journal (Refereed)
  • 20.
    Bengnér, Malin
    et al.
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Béziat, Vivien
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Ernerudh, Jan
    Division of Clinical Immunology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Nilsson, Bengt-Olof
    Department of Infectious Diseases, Ryhov County Hospital, Jönköping, Sweden.
    Löfgren, Sture
    Department of Laboratory Medicine, Clinical Microbiology, Ryhov County Hospital, Jönköping, Sweden.
    Wikby, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Malmberg, Karl Johan
    Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Stockholm, Sweden.
    Strindhall, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Independent skewing of the T cell and NK cell compartments associated with cytomegalovirus infection suggests division of labor between innate and adaptive immunity.2014In: Age (Omaha), ISSN 0161-9152, E-ISSN 1574-4647, Vol. 36, no 2, p. 571-582Article in journal (Refereed)
    Abstract [en]

    Cytomegalovirus (CMV) infection induces profound changes in different subsets of the cellular immune system. We have previously identified an immune risk profile (IRP) where CMV-associated changes in the T cell compartment, defined as a CD4/CD8 ratio < 1, are associated with increased mortality in elderly people. Since natural killer (NK) cells have an important role in the defense against viral infections, we examined whether the expansion of CD8 + T cells seen in individuals with CD4/CD8 ratio < 1 is coupled to a parallel skewing of the NK cell compartment. A number of 151 subjects were examined with CMV serology and a flow cytometry panel for assessment of T cell and NK cell subsets. CMV-seropositive individuals had higher frequencies of CD57 + and NKG2C + NK cells and lower frequencies of NKG2A + NK cells, in line with a more differentiated NK cell compartment. Intriguingly, however, there was no correlation between CD4/CD8 ratio and NK cell repertoires among CMV-seropositive donors, despite the profound skewing of the T cell compartment in the group with CD4/CD8 ratio < 1. Conversely, donors with profound expansion of NK cells, defined as NKG2C + NK cells with high expression of CD57 and ILT-2, did not display more common changes in their T cell repertoire, suggesting that NK cell expansion is independent of the T cell-defined IRP. Altogether, these results indicate that the effect of CMV on CD8 T cells and NK cells is largely nonoverlapping and independent.

  • 21.
    Bjursell, Cecilia
    et al.
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Nystedt, Paul
    Jönköping University, Jönköping International Business School, JIBS, Economics. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Sternäng, Ola
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Stockholm Centre for Health and Social Change (SCOHOS).
    Education level explains participation in work and education later in life2017In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 43, no 10, p. 511-521Article in journal (Refereed)
    Abstract [en]

    A prolonged working life is crucial for sustaining social welfare and fiscal stability for countries facing ageing populations. The group of older adults is not homogeneous; however, differences within the group may affect the propensity to continue working and to participate in continuing education. The aim of this paper is to explore how participation in work and education vary with gender, age, and education level in a sample of older adults. The study was performed in Sweden, a context characterized by high female labour-market-participation rates and a high average retirement age. The participants were 232 members of four of the major senior citizens? organizations. We found no differences in participation in work and education based on gender. People older than 75 years were found to be as active as people 65?75 years old in education, but the older group worked less. There were positive associations between education level and participation in both work and education. Hence, this study implies that socio-economic inequalities along these dimensions are widened later in life. This highlights the importance of engaging workers with lower education levels in educational efforts throughout life. It also emphasizes the need for true lifelong learning in society.

  • 22.
    Björklund Carlstedt, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bridge employment - ett fortsatt arbetsliv2018In: Äldre i centrum, ISSN 1653-3585, no 2, p. 44-47Article in journal (Other (popular science, discussion, etc.))
  • 23.
    Blaakilde, Anne Leonora
    et al.
    Region Zealand.
    Wilinska, MonikaJönköping University, School of Health and Welfare, HHJ, Dep. of Behavioural Science and Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).Mosberg Iversen, SaraUniversity of Southern Denmark.
    Special issue: Growing old with and via media. MedieKultur: Journal of media and communication research, 33(63)2017Collection (editor) (Other academic)
  • 24.
    Blane, A.
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, H. C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Lee, M.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Parsons, R.
    School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
    The cognitive and socio-demographic influences on driving performance and driving cessation in post-stroke drivers2016In: Advances in Transportation Studies, ISSN 1824-5463, no 38, p. 75-90Article in journal (Refereed)
    Abstract [en]

    Background: Driving is a complex activity requiring highly integrated cognitive and perceptual functions that can be negatively affected following a stroke. The decision to continue or cease with driving after a stroke may not be exclusively dependent on deficits in cognitive and motor abilities. Instead, it is possible that social supports, alternative means of transportation, education level, income, self-regulation ability and the awareness of personal health problems may also influence the decision.

    Aim: The aim of this research was to explore the influence of personal and socioeconomic factors, in addition to existing cognitive impairment, on the decision of post-stroke adults to return to driving.

    Method: A case control design was employed to compare driving performance of 48 individuals who had experienced a stroke and 22 volunteer healthy control participants. Half of the post-stroke cohort (N=24) had continued driving and the other half had ceased driving. Socio-demographic and driving-related cognitive performance data were collected to characterise the comparison groups before driving performance was assessed in a driving simulator.

    Results: Overall, the post-stroke groups did not perform as well as the control participants in the cognitive and driving assessments. The perceived ability to drive after a stroke was not significantly correlated with participants'€™ actual driving ability. Post-stroke adults were more likely to continue driving if they reported having a tertiary level education and a greater income.

    Conclusion: The decision to return to driving after a stroke is a complicated, multifactorial process. This study confirms previous research, which found that cognition and driving performance are impaired poststroke. The findings also suggest that post-stroke drivers'€™ decision to return to driving was not linked to their ability to drive, but more to socio-demographic and environmental factors. Further screening tools and assessments to identify those at risk when returning to the road post-stroke are required. 

  • 25.
    Blane, Alison
    et al.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Lee, Hoe C.
    School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ. CHILD. School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia.
    Willstrand, Tania Dukic
    Swedish National Road and Transport Research Institute (VTI), Human Factors, Göteborg, Sweden.
    Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults2017In: Behavioural Neurology, ISSN 0953-4180, E-ISSN 1875-8584, article id 1378308Article in journal (Refereed)
    Abstract [en]

    Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed.

  • 26.
    Bogl, Leonie H.
    et al.
    Institute for Molecular Medicine FIMM, Finland and University of Helsinki, Finland.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Sweden.
    Kaprio, Jaakko
    Institute for Molecular Medicine FIMM, Finland and University of Helsinki, Finland.
    Does the sex of one’s co-twin affect height and BMI in adulthood?: A study of dizygotic adult twins from 31 cohorts2017In: Biology of Sex Differences, ISSN 2042-6410, Vol. 8, no 1, article id 14Article in journal (Refereed)
    Abstract [en]

    Background: The comparison of traits in twins from opposite-sex (OS) and same-sex (SS) dizygotic twin pairs is considered a proxy measure of prenatal hormone exposure. To examine possible prenatal hormonal influences on anthropometric traits, we compared mean height, body mass index (BMI) and the prevalence of being overweight or obese between men and women from OS and SS dizygotic twin pairs.

    Methods: The data were derived from COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) database, and included 68,494 SS and 53,808 OS dizygotic twin individuals above the age of 20 years from 31 twin cohorts representing 19 countries. Zygosity was determined by questionnaires or DNA genotyping depending on the study. Multiple regression and logistic regression models adjusted for cohort, age and birth year with the twin type as a predictor were carried out to compare height and BMI in twins from OS pairs with those from SS pairs and to calculate the adjusted odds ratios and 95% confidence intervals for being overweight or obese.

    Results: OS females were, on average, 0.31 cm (95% confidence interval (CI): 0.20, 0.41) taller than SS females. OS males were also, on average, taller than SS males, but this difference was only 0.14 cm (95% CI: 0.02, 0.27). Mean BMI and the prevalence of overweight or obesity did not differ between males and females from SS and OS twin pairs. The statistically significant differences between OS and SS twins for height were small and appeared to reflect our large sample size rather than meaningful differences of public health relevance.

    Conclusions: We found no evidence to support the hypothesis that prenatal hormonal exposure or postnatal socialization (i.e., having grown up with a twin of the opposite sex) has a major impact on height and BMI in adulthood.

  • 27.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet.
    Pedersen, Nancy
    Karolinska Institutet.
    Gatz, Margaret
    University of Southern California.
    Dahl, Anna
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    The Type A behavior pattern and cardiovascular disease as predictors of dementia2014In: Health Psychology, ISSN 0278-6133, E-ISSN 1930-7810, Vol. 33, no 12, p. 1593-1601Article in journal (Refereed)
    Abstract [en]

    Objective: Research has suggested that greater psychophysiological reactivity to stress increases risk of dementia and that those with the Type A behavior pattern (TABP) are predisposed to elevated stress reactivity and cardiovascular disease (CVD), but no study has evaluated the associations among TABP, CVD, and dementia, prospectively. Hence, the present study aimed to investigate dementia risk in relation to TABP and CVD.

    Methods: A population-based cohort of 1,069 persons with a baseline mean age of 64.81 years from the Swedish Twin Registry was followed consecutively for up to 23 years. Based on self-reported items, TABP was measured using 6 scales: Ambition, Stress, Hard-driving, Neuroticism, Cynicism, and Paranoia. CVD was self-reported and dementia was diagnosed adhering to Diagnostic and Statistical Manual of Mental Disorders, third edition, revised (DSM-III-R) or Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria.

    Results: TABP was generally not associated with dementia risk. However, significant interaction effects of stress, paranoia, and cynicism with CVD on dementia risk were observed. That is, for those with CVD, high scores on stress, paranoia, and cynicism were associated with increased risk of dementia (hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 0.95-2.15; HR = 1.39, 95% CI = 0.83-2.33; HR = 1.25, 95% CI = 0.76-2.06, respectively), whereas for those who did not have CVD, high scores on these measures appeared to be protective (HR = 0.76, 95% CI = 0.50-1.14; HR = 0.55, 95% CI = 0.34-0.89; HR = 0.50, 95% CI = 0.29-0.84, respectively).

    Conclusion: Some features of TABP confer an increased risk for dementia in those with CVD, whereas those without CVD are protected. When evaluating the risk of dementia, CVD and personality traits should be taken into consideration.

  • 28.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet.
    Ström, Peter
    Karolinska Institutet.
    Aslan, Anna K. Dahl
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Johansson, Anna
    Karolinska Institutet.
    Åkerstedt, Torbjörn
    Stockholms universitet.
    Pedersen, Nancy L.
    Karolinska Institutet.
    The effect of shift work on cognitive aging across the late adult life course2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, article id 360Article in journal (Other academic)
  • 29.
    Bokenberger, Kathleen
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Ström, Peter
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Anna L. V.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Gatz, Margaret
    Department of Psychology, University of Southern California, Los Angeles CA, USA.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Åkerstedt, Torbjörn
    Stress Research Institute, Stockholm University, Sweden.
    Association between sleep characteristics and incident dementia accounting for baseline cognitive status: A prospective population-based study2017In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 72, no 1, p. 134-139Article in journal (Refereed)
    Abstract [en]

    Background: While research has shown that sleep disorders are prevalent among people with dementia, the temporal relationship is unclear. We investigated whether atypical sleep characteristics were associated with incident dementia while accounting for baseline cognitive functioning.

    Methods: Screening Across the Lifespan Twin Study (SALT) participants were 11,247 individuals from the Swedish Twin Registry who were at least 65 years at baseline (1998-2002). Sleep and baseline cognitive functioning were assessed via the SALT telephone screening interview. Data on dementia diagnoses came from national health registers. Cox regression was performed to estimate hazard ratios (HR) for dementia.

    Results: After 17 years of follow-up, 1,850 dementia cases were identified. Short (≤ 6 hours) and extended (> 9 hours) time-in-bed (TIB) compared to the middle reference group (HR=1.40, 95% CI=1.06-1.85, HR=1.11, 95% CI=1.00-1.24, respectively) and rising at 8:00AM or later compared to earlier rising (HR=1.12, 95% CI=1.01-1.24) were associated with higher dementia incidence. Bedtime, sleep quality, restorative sleep, and heavy snoring were not significant predictors. Findings stratified by baseline cognitive status indicated that the association between short TIB and dementia remained in those cognitively intact at the start.

    Conclusions: Short and extended TIB as well as delayed rising among older adults predicted increased dementia incidence in the following 17 years. The pattern of findings suggests that extended TIB and late rising represent prodromal features whereas short TIB appeared to be a risk factor for dementia.

  • 30.
    Bokenberger, Kathleen
    et al.
    Karolinska Institutet, Sweden.
    Ström, Peter
    Karolinska Institutet, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Sweden.
    Åkerstedt, Torbjörn
    Karolinska Institutet, Sweden and Stockholm University, Sweden.
    Pedersen, Nancy L.
    Karolinska Institutet, Sweden and University of Southern California, USA.
    Shift work and cognitive aging: A longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed.

    Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986–2012. Night work history (ever/never) from 1998–2002 was available from a subsample (N=320). Early adult cognitive test scores were available for 77 men.

    Results In latent growth curve modeling, there were no main effects of "any-type" or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand.

    Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

  • 31.
    Boström, Martina
    Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Trygghet - på vems villkor? Uppfattningar om och erfarenheter av trygghet hos äldre personer med behov av omsorg2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to increase the knowledge and understanding of how older people with varying needs of care perceive and experience sense of security in ordinary homes and in nursing homes.

    This thesis comprised four studies, which are to be found at the end of this manuscript. The first two studies were based on the same data material, collected using focus group interviews with 45 elderly individuals living in senior housing with minimal care needs. The interviews were analyzed using qualitative content analysis (I, II). The third study was based on secondary analysis of a user survey of 350 older individuals in ordinary housing with some kind of elder care/service and 145 older individuals with around-the-clock care needs living in nursing homes. The material was processed using descriptive and analytical statistics (III). The fourth study followed three older individuals for 12-16 weeks, using four in-depth interviews and observations to examine the move from ordinary into nursing homes. This material was also analyzed using qualitative content analysis. The use of a personal emergency response system (PERS) was perceived as limiting the lives of elderly people, because the alarm only functions within a person’s apartment. The limited range of the PERS was perceived as reducing elders’ freedom and increasing insecurity, anxiety, and fear (I). Increased reliance on care interventions using monitoring technology, with which the individual and their position is monitored on a larger scale, was not considered a problem, as long as it led to increased security and allowed older individuals to maintain control and a sense of self (II). Perceived health, secure relationships, knowledge, and control were factors that were related to perceived sense of security in the daily lives of older individuals with care, both in ordinary homes and in nursing homes (III).

    Moving to a nursing home and gradually transferring the control of one’s belongings and daily routines to care staff led to a feeling of greater safety for the older person, but not necessarily a sense of security (IV). In summary, older individuals value, prioritize, and perceive sense of security as very important in their life, but do not always experience a sense of security in ordinary housing and nursing homes. Security is perceived as something so important in life that older people will consider sacrificing their privacy and integrity in lieu of security. Because the sense of security is not always perceived and experienced as good, older individuals search for strategies that contribute to their sense of security through material objects and through relationships with other people. These results indicate that it is essential to support older individuals’ everyday life, regardless of care type, to promote a sense of security on their terms.

  • 32.
    Bouillon, Kim
    et al.
    Department of Epidemiology and Public Health, University College London, London, UK.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, UK.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, UK.
    Sabia, Severine
    Department of Epidemiology and Public Health, University College London, London, UK.
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, UK.
    Gale, Catharine R.
    MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, UK.
    Measures of frailty in population-based studies: An overview2013In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, no 64Article in journal (Refereed)
    Abstract [en]

    Background: Although research productivity in the field of frailty has risen exponentially in recent years, there remains a lack of consensus regarding the measurement of this syndrome. This overview offers three services: first, we provide a comprehensive catalogue of current frailty measures; second, we evaluate their reliability and validity; third, we report on their popularity of use.

    Methods: In order to identify relevant publications, we searched MEDLINE (from its inception in 1948 to May 2011); scrutinized the reference sections of the retrieved articles; and consulted our own files. An indicator of the frequency of use of each frailty instrument was based on the number of times it had been utilized by investigators other than the originators.

    Results: Of the initially retrieved 2,166 papers, 27 original articles described separate frailty scales. The number (range: 1 to 38) and type of items (range of domains: physical functioning, disability, disease, sensory impairment, cognition, nutrition, mood, and social support) included in the frailty instruments varied widely. Reliability and validity had been examined in only 26% (7/27) of the instruments. The predictive validity of these scales for mortality varied: for instance, hazard ratios/odds ratios (95% confidence interval) for mortality risk for frail relative to non-frail people ranged from 1.21 (0.78; 1.87) to 6.03 (3.00; 12.08) for the Phenotype of Frailty and 1.57 (1.41; 1.74) to 10.53 (7.06; 15.70) for the Frailty Index. Among the 150 papers which we found to have used at least one of the 27 frailty instruments, 69% (n = 104) reported on the Phenotype of Frailty, 12% (n = 18) on the Frailty Index, and 19% (n = 28) on one of the remaining 25 instruments.

    Conclusions: Although there are numerous frailty scales currently in use, reliability and validity have rarely been examined. The most evaluated and frequently used measure is the Phenotype of Frailty.

  • 33.
    Brodin, Jane
    Jönköping University, School of Education and Communication, HLK, School Based Research, Preschool Education Research. Jönköping University, School of Education and Communication, HLK, CHILD.
    Sweden: Children in unsafe environments and life situations2014In: Children Violence and Bullying: International perspectives / [ed] J. Merrick, I. Kandel, & H.A. Omar (Eds.), New York: Nova Science Publishers Inc. , 2014, 1, p. 115-125Chapter in book (Refereed)
  • 34.
    Dahl, Anna
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Kan man undvika demens genom en sund och aktiv livsstil?2008In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, Vol. 3, p. 22-26Article in journal (Other academic)
    Abstract [sv]

    En vanlig föreställning om åldrandet är att de flesta äldre för eller senare blir glömska. Även om hög ålder är en av de största riskfaktorerna för sämre minnesfunktioner, så har merparten av den åldrande befolkningen väl fungerande minne och andra intellektuella funktioner. Faktum kvarstår dock att det finns stora individuella skillnader, en del äldre har mycket gott minne, medan andra inte minns namnen på sina barn eller ens att de har barn. Hur kommer det sig? Beror det på gener, livsstil, eller är det slumpen som avgör vem som drabbas av glömska på ålderns höst?

  • 35.
    Dahl, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Hassing, Linda
    Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
    Obesity and cognitive aging2013In: Epidemiologic reviews, ISSN 0193-936X, E-ISSN 1478-6729, Vol. 35, no 1, p. 22-32Article in journal (Refereed)
    Abstract [en]

    Obesity is a health problem that has reached epidemic proportions. Given the high prevalence of obesity, even a small adverse impact of obesity on cognitive aging might have a serious effect on public health. The purpose of this systematic review was to examine the relation between obesity and cognitive function in late life among persons not diagnosed with dementia and to evaluate the evidence for a causal association. Medline was used to search for the following terms: obesity, overweight, cognition, cognitive, age, and aged. To be included, studies must have had a population-based, dementia-free sample and a 5-year minimum interval between measurement of the predictor and the outcome. Only 11 studies met the criteria. Of these, 7 studies assessed obesity in midlife and cognitive function in later life, and 4 studies assessed obesity and cognitive function in late life. The reviewed studies showed clear evidence that midlife obesity was associated with cognitive aging, whereas this association was weaker in late life; thus, no firm conclusions could be drawn. The findings of this review suggest that, although there is evidence for an association between midlife obesity and low cognitive abilities in late life, the direction of the association and the causality remain to be clarified.

  • 36.
    Dahl, Anna
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Hassing, Linda
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health. Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Margaret, Gatz
    Reynolds, Chandra
    Pedersen, Nancy
    Body mass index across midlife and cognitive change in late life2013In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 37, no 2, p. 296-302Article in journal (Refereed)
    Abstract [en]

    Background: High midlife body mass index (BMI) has been linked to a greater risk of dementia in late life, but few have studied the effect of BMI across midlife on cognitive abilities and cognitive change in a dementia-free sample.

    Methods: We investigated the association between BMI, measured twice across midlife (mean age 40 and 61 years, respectively), and cognitive change in four domains across two decades in the Swedish Adoption/Twin Study of Aging.

    Results: Latent growth curve models fitted to data from 657 non-demented participants showed that persons who were overweight/obese in early midlife had significantly lower cognitive performance across domains in late life and significantly steeper decline in perceptual speed, adjusting for cardio-metabolic factors. Both underweight and overweight/obesity in late midlife were associated with lower cognitive abilities in late life. However, the association between underweight and low cognitive abilities did not remain significant when weight decline between early and late midlife was controlled for.

    Conclusion: There is a negative effect on cognitive abilities later in life related to being overweight/obese across midlife. Moreover, weight decline across midlife rather than low weight in late midlife per se was associated with low cognitive abilities. Weight patterns across midlife may be prodromal markers of late life cognitive health.

  • 37.
    Dahl, Anna
    et al.
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Hassing, Linda
    Fransson, Eleonor
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine.
    Reynolds, Chandra
    Gatz, Margaret
    Pedersen, Nancy
    Body Mass Index across midlife and cognitive change in late life: delayed and cumulative effects2011In: 64th Annual Scientific Meeting of Gerontological Society of America, 2011Conference paper (Refereed)
  • 38.
    Dahl, Anna K.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet.
    Starr, J. M.
    University of Edinburgh, Scotland.
    Allerhand, M.
    University of Edinburgh, Scotland.
    Deary, I. J.
    University of Edinburgh, Scotland.
    Acceptance of bodily appearance in young-old and old age - Prevalence and predictors2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, p. 355-355Article in journal (Other academic)
  • 39.
    Dahl Aslan, Anna K.
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Starr, John M.
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Pattie, Alison
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Deary, Ian
    Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh.
    Cognitive consequences of overweight and obesity in the ninth decade of life?2015In: Age and Ageing, ISSN 0002-0729, E-ISSN 1468-2834, Vol. 44, no 1, p. 59-65Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/OBJECTIVES: the association between late-life obesity and late-life cognitive abilities is poorly understood. We studied the association between body mass index (BMI) and cognitive change in longitudinal population-based study spanning over the ninth decade of life.

    SUBJECTS/METHODS: in total, 475 participants free of dementia at baseline from the Lothian Birth Cohort 1921 (mean age: 79.1 years, SD: 0.6) were included. Height and weight were assessed at baseline. BMI was calculated as kg/m(2). Cognitive abilities were assessed at age ∼11 years and at age ∼79, ∼83, ∼87 and ∼90 years.

    RESULTS: latent growth models showed that men being overweight and obese had a 0.65 (SD: 0.3) and 1.10 (SD: 0.5) points less steep decline in general cognitive ability (as measured by the Moray House Test) for each year than people of normal weight. These associations were to some extent confounded by childhood intelligence. No other association between BMI and cognition was significant, either for men or women. People who were obese in old age had significantly lower childhood intelligence (m = 43.6, SD: 1.3) than people who were normal in weight (m = 47.0, SD: 0.8) and persons being overweight (m = 47.5, SD: 0.8), F (472, 3) = 3.2, P = 0.043.

    CONCLUSIONS: the current study shows weak or no evidence for an association between BMI in old age and cognitive function, especially not when childhood intelligence is controlled for. Lower intelligence at the age of 11 years predicted obesity at the age of 79 years.

  • 40. Dahl Öberg, Camilla
    et al.
    Olofsson, Mimmi
    Anhörigas involvering vid återambulering efter amputation av nedre extremitet, deras synvinkel; en kvalitativ studie.2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
  • 41.
    Darin-Mattsson, Alexander
    et al.
    Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Sweden.
    Andel, Ross
    University of South Florida and International Clinical Research Center, Tampa, USA.
    Celeste, Roger Keller
    Federal University of Rio Grande do Sul, Faculdade de Odontologia, Department Preventive and Social Dentistry, Porto Alegre, Brazil.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Sweden.
    Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses.2018In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Elsevier, Vol. 201, p. 111-119Article in journal (Refereed)
    Abstract [en]

    The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.

    The full text will be freely available from 2019-02-17 00:00
  • 42.
    Darin-Mattsson, Alexander
    et al.
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden .
    Andel, Ross
    School af Aging Studies, University of South Florida, Tampa, USA; International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic .
    Fors, Stefan
    Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet, Solna, Sweden; Stockholm University, Sweden.
    Are Occupational Complexity and Socioeconomic Position Related to Psychological Distress 20 Years Later?2015In: Journal of Aging and Health, ISSN 0898-2643, E-ISSN 1552-6887, Vol. 27, no 7, p. 1266-1285Article in journal (Refereed)
    Abstract [en]

    Objective: To assess occupational complexity in midlife in relation to psychological distress in older adulthood (69+ years) and explore the role of socioeconomic position.

    Method: Baseline data from the Swedish Level of Living Survey and follow-up data from the Swedish Longitudinal Study ofLiving Conditions of the Oldest Old were combined, resulting in 20+ years of follow-up. Data were analyzed using ordered logistic regressions.

    Results: Higher occupational complexity was associated with less psychological distress 20 years later adjusted for age, sex, follow-up year, hours worked the year before baseline, and psychological distress at baseline. Higher socioeconomic position yielded the same pattern of results. Socioeconomic position partially accounted for the association between occupational complexity and psychological distress.

    Discussion: With social gradient not easily amenable to modification, efforts to increase engagement at work may offer a viable option to attenuate the influence of work environment on psychological distress later in life.

  • 43.
    Darin-Mattsson, Alexander
    et al.
    Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Fors, Stefan
    Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Aging Research Centre (ARC), Karolinska Institutet, Stockholm University, Sweden.
    Different indicators of socioeconomic status and their relative importance as determinants of health in old age2017In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 16, no 1, article id 173Article in journal (Refereed)
    Abstract [en]

    Background: Socioeconomic status has been operationalised in a variety of ways, most commonly as education, social class, or income. In this study, we also use occupational complexity and a SES-index as alternative measures of socioeconomic status. Studies show that in analyses of health inequalities in the general population, the choice of indicators influence the magnitude of the observed inequalities. Less is known about the influence of indicator choice in studies of older adults. The aim of this study is twofold: i) to analyse the impact of the choice of socioeconomic status indicator on the observed health inequalities among older adults, ii) to explore whether different indicators of socioeconomic status are independently associated with health in old age.

    Methods: We combined data from two nationally representative Swedish surveys, providing more than 20 years of follow-up. Average marginal effects were estimated to compare the association between the five indicators of SES, and three late-life health outcomes: mobility limitations, limitations in activities of daily living (ADL), and psychological distress.

    Results: All socioeconomic status indicators were associated with late-life health; there were only minor differences in the effect sizes. Income was most strongly associated to all indicators of late-life health, the associations remained statistically significant when adjusting for the other indicators. In the fully adjusted models, education contributed to the model fits with 0-3% (depending on the outcome), social class with 0-1%, occupational complexity with 1-8%, and income with 3-18%.

    Conclusions: Our results indicate overlapping properties between socioeconomic status indicators in relation to late-life health. However, income is associated to late-life health independently of all other variables. Moreover, income did not perform substantially worse than the composite SES-index in capturing health variation. Thus, if the primary objective of including an indicator of socioeconomic status is to adjust the model for socioeconomic differences in late-life health rather than to analyse these inequalities per se, income may be the preferable indicator. If, on the other hand, the primary objective of a study is to analyse specific aspects of health inequalities, or the mechanisms that drive health inequalities, then the choice of indicator should be theoretically guided. 

  • 44.
    Darin-Mattsson, Alexander
    et al.
    Karolinska Institutet, Sweden.
    Kåreholt, Ingemar
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Karolinska Institutet, Sweden.
    Andel, Ross
    University of South Florida, Tampa, USA.
    Economic hardship and income before retirement in relation to anxiety and depression in older adulthood. (2015) Work-related stress in midlife and all-cause mortality: the role of sense of coherence.2015In: Life Courses in Cross-­National Comparison: Similarities and Differences: Abstract book, 2015, p. 69-Conference paper (Refereed)
  • 45.
    Davey, Adam
    et al.
    Department of Public Health, Temple University, Philadelphia, Pennsylvania.
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Sundström, Gerdt
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Aging in Sweden: Local variation, local control2014In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 54, no 4, p. 525-532Article in journal (Refereed)
    Abstract [en]

    Aging in Sweden has been uniquely shaped by its history—most notably the long tradition of locally controlled services for older adults. We considered how local variations and local control shape the experience of aging in Sweden and organized the paper into 3 sections. First, we examine aging in Sweden along demography, economy, and housing. Next, we trace the origins and development of the Swedish welfare state to consider formal supports (service provision) and informal supports (caregiving and receipt of care). Finally, we direct researchers to additional data resources for understanding aging in Sweden in greater depth. Sweden was one of the first countries to experience rapid population aging. Quality of life for a majority of older Swedes is high. Local control permits a flexible and adaptive set of services and programs, where emphasis is placed on improving the quality and targeting of services that have already reached a plateau as a function of population and expenditures.

  • 46.
    Dennis, Carol
    et al.
    Ithaca college, USA.
    Johansson, Ann
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    An ocean apart: Building bridges through an international student/faculty exchange2012Conference paper (Other academic)
    Abstract [en]

    Introduction: Rapid globalization has led universities to place a priority on building international experiences for students. Substantial gains have been noted from study abroad for students and faculty, including increased global understanding, intercultural sensitivity, content-specific competence, and self-confidence. Intercultural experiences may be invaluable for occupational therapy students and faculty to create a profession that is inclusive of diverse social and cultural realities.

    Aim: We will present a successful international student and faculty exchange as an example of one way that occupational therapy programs may meet personal, instructional, and institutional goals related to internationalism.

    Methods: We will chronicle barriers encountered, problems solved, and benefits realized from this exchange program over its ten year history.

    Results: Changes in professional educational standards, legal requirements, and curricula present continuous challenges to maintaining a successful international exchange program in occupational therapy.

    Conclusion: Interpersonal connectedness and mutual commitment have fostered the success of our exchange program.

  • 47.
    Dickson, Roana
    et al.
    Glasgow Caledonian University, Scotland.
    Dubois, Bénédicte
    IFPEK Rennes, France.
    Engelen, AnneMie
    University College Ghent, Belgium.
    Johansson, Ann
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Schiller, Sandra
    HAWK, Germany.
    Zinkstok, Ruth
    Hogeschool van Amsterdam, Netherlands.
    A European survey on community development/community based occupational therapy in practice and education2012Conference paper (Other academic)
  • 48.
    Edvinsson, Joakim
    et al.
    Qulturum, Center for Development, Jönköping County Council, Jönköping, Sweden.
    Rahm, Magnus
    Qulturum, Center for Development, Jönköping County Council, Jönköping, Sweden.
    Trinks, Anna
    Qulturum, Center for Development, Jönköping County Council, Jönköping, Sweden.
    Höglund, Pär J.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Senior alert: A quality registry to support a standardized, structured, and systematic preventive care process for older adults2015In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 24, no 2, p. 96-101Article in journal (Refereed)
    Abstract [en]

    The average life expectancy and the proportion of the elderly in the Western countries are increasing. The care processes used for the elderly are known to differ between the care providers in Sweden. Accordingly, the need to develop a system to support the processes in order to attain a standardized, structured, and systematic approach to improve preventive care processes for the elderly has been called for. The County Council of Jönköping developed a national Web-based quality registry, Senior Alert, with a focus on the following areas: falls, pressure ulcers, malnutrition, and oral health. The patients are evaluated using validated risk assessment instruments, and the care is planned, executed, evaluated. The registry supports the users to work with preventive care systematically and in a standardized way and provides feedback to the care providers on their preventive care processes. The registry helps the caregivers fulfill the preventive care according to the best available clinical knowledge and practice. The registry also provides the government and health care politicians with data for setting aims for elderly care. The registry is used in 90% of the municipalities and county councils throughout the country. The total number of risk assessments completed from 2009 to 2014 exceeded 1 000 000.

  • 49.
    Eide, Leslie S. P.
    et al.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Ranhoff, Anette H.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Haaverstad, Rune
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Hufthammer, Karl Ove
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Kuiper, Karel K. J.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Nordrehaug, Jan E.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Norekvål, Tone M.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Delirium as a predictor of physical and cognitive function in individuals aged 80 and older after transcatheter aortic valve implantation or surgical aortic valve replacement2016In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 64, no 6, p. 1178-1186Article in journal (Refereed)
    Abstract [en]

    Objectives: To determine how development of delirium after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) could predict activity of daily living (ADL) and instrumental ADLs (IADL) disability, cognitive function, and self-reported health in individuals aged 80 and older.

    Design: Prospective cohort study. Setting: Tertiary university hospital.

    Participants: Individuals aged 80 and older undergoing elective SAVR or TAVI (N = 136).

    Measurements: Delirium was assessed for 5 days using the Confusion Assessment Method. The Barthel Index, Nottingham Extended ADL Scale, and SF-12 were used to determine ADL and IADL ability and self-reported health at baseline and 1- and 6-month follow-up. Cognition was assessed using the Mini-Mental State Examination at baseline and 6-month follow-up.

    Results: Participants had lower IADL scores 1 month after SAVR than at baseline (baseline 58, 1 month: delirium 42, no delirium 50, P ≤.02), but scores had returned to baseline levels at 6 months. The Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) score was higher at 6-month follow-up (48) than at baseline (39), especially in participants who did not develop delirium (P <.001). No differences in other outcomes were found. Regression models suggest that delirium may help predict IADL disability 1 month after baseline (P ≤.07) but does not predict large differences in ADL disability, cognitive function, or SF-12-scores. Individuals who underwent TAVI and developed delirium had lower ADL (baseline 19, 1-month 16, P <.001) and IADL (baseline 49, 1-month 40, P =.003) scores at 1-month follow-up. SF-12 PCS score (baseline 30) increased from baseline to 1- (35, P =.04) and 6- (35, P =.02) month follow-up in individuals who underwent TAVI and did not develop delirium. Delirium after TAVI predicted greater ADL and IADL disability at 1-month but not at 6-month follow-up.

    Conclusion: Individuals who develop delirium after SAVR and TAVI have poorer short-term IADL function but do not seem to have long-term reductions in physical, mental, or self-reported health.

  • 50.
    Eide, Leslie S. P.
    et al.
    Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway.
    Ranhoff, Anette H.
    Department of Clinical Science, University of Bergen, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Haaverstad, Rune
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Hufthammer, Karl Ove
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Kuiper, Karel K. J.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Nordrehaug, Jan Erik
    Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
    Norekval, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway .
    Readmissions and mortality in delirious versus non-delirious octogenarian patients after aortic valve therapy: A prospective cohort study2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 10, article id e012683Article in journal (Refereed)
    Abstract [en]

    Objectives: To determine whether postoperative delirium predicts first-time readmissions and mortality in octogenarian patients within 180 days after aortic valve therapy with surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI), and to determine the most common diagnoses at readmission.

    Design: Prospective cohort study of patients undergoing elective SAVR or TAVI.

    Setting: Tertiary university hospital that performs all SAVRs and TAVIs in Western Norway.

    Participants: Patients 80+ years scheduled for SAVR or TAVI and willing to participate in the study were eligible. Those unable to speak Norwegian were excluded. Overall, 143 patients were included, and data from 136 are presented. Primary and secondary outcome measures: The primary outcome was a composite variable of time from discharge to first all-cause readmission or death. Secondary outcomes were all-cause first readmission alone and mortality within 180 days after discharge, and the primary diagnosis at discharge from first-time readmission. Delirium was assessed with the confusion assessment method. First-time readmissions, diagnoses and mortality were identified in hospital information registries.

    Results: Delirium was identified in 56% of patients. The effect of delirium on readmissions and mortality was greatest during the first 2 months after discharge (adjusted HR 2.9 (95% CI 1.5 to 5.7)). Of 30 first-time readmissions occurring within 30 days, 24 (80%) were patients who experienced delirium. 1 patient (nondelirium group) died within 30 days after therapy. Delirious patients comprised 35 (64%) of 55 first-time readmissions occurring within 180 days. Circulatory system diseases and injuries were common causes of first-time readmissions within 180 days in delirious patients. 8 patients died 180 days after the procedure; 6 (75%) of them experienced delirium. Conclusions: Delirium in octogenarians after aortic valve therapy might be a serious risk factor for postoperative morbidity and mortality. Cardiovascular disorders and injuries were associated with first-time readmissions in these patients.

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