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  • 1. Aceijas, Carmen
    et al.
    Brall, Caroline
    Schröder-Bäck, Peter
    Otok, Robert
    Maeckelberghe, Els
    Stjernberg, Louise
    Blekinge Institute of Technology, School of Health Science.
    Strech, Daniel
    Tulchinsky, Theodore H
    Teaching Ethics in Schools of Public Health in the European Region: Findings from a Screening Survey2012In: Public Health Reviews, ISSN 0301-0422, E-ISSN 2107-6952, Vol. 34, no 1Article in journal (Refereed)
    Abstract [en]

    A survey targeting ASPHER members was launched in 2010/11, being a first initiative in improving ethics education in European Schools of Public Health. An 8-items questionnaire collected information on teaching of ethics in public health. A 52% response rate (43/82) revealed that almost all of the schools (95% out of 40 respondents with valid data) included the teaching of ethics in at least one of its programmes. They also expressed the need of support, (e.g.: a model curriculum (n=25), case studies (n=24)), which indicates further work to be met by the ASPHER Working Group on Ethics and Values in Public Health.

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  • 2.
    Anderberg, Peter
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Abrahamsson, Linda
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    An instrument for measuring social participation to examine older adults' use of the internet as a social platform: Development and validation study2021In: JMIR Aging, E-ISSN 2561-7605, Vol. 4, no 2, article id e23591Article in journal (Refereed)
    Abstract [en]

    Background: Older people's use of the internet is increasingly coming into focus with the demographic changes of a growing older population. Research reports several benefits of older people's internet use and highlights problems such as various forms of inequality in use within the group. There is a need for consistent measurements to follow the development and use of the internet in this group and to be able to compare groups both within and between countries, as well as follow the changes over time. Objective: The aim of this study was to create an instrument to measure an older person's perception of the benefits of their online social participation, unconnected to specific applications and services. The instrument to measure internet social participation proposed in this paper builds on social participation factors and is a multidimensional construct incorporating both social relations and societal connectedness. Methods: A short instrument for measuring social participation over the internet was created. An exploratory factor analysis (EFA) was conducted in a random selection of persons aged 65 years or older (n=193) on 10 initial items. Further validation was made by confirmatory factor analysis (CFA) in the remaining group (n=193). Results: A 1-factor solution for the social internet score was decided upon after exploratory factor analysis (EFA; based on a random sample of half the data set). None of the questionnaire items were excluded based on the EFA, as they all had high loadings, the lowest being 0.61. The Cronbach α coefficient was.92. The 1-factor solution explained 55% of the variance. CFA was performed and included all 10 questionnaire items in a 1-factor solution. Indices of goodness of fit of the model showed room for improvement. Removal of 4 questions in a stepwise procedure resulted in a 6-item model (χ26=13.985; χ2/degrees of freedom=1.554; comparative fit index=0.992; root mean square error of approximation=0.054; standardized root mean square residual=0.025). Conclusions: The proposed instrument can be used to measure digital social participation and coherence with society. The factor analysis is based on a sufficient sample of the general population of older adults in Sweden, and overall the instrument performed as expected. © Peter Anderberg, Linda Abrahamsson, Johan Sanmartin Berglund. Originally published in JMIR Aging (https://aging.jmir.org),17.05.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Aging, is properly cited. The complete bibliographic information, a link to the original publication on https://aging.jmir.org, as well as this copyright and license information must be included.

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  • 3.
    Anderberg, Peter
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Eivazzadeh, Shahryar
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    A Novel Instrument for Measuring Older People's Attitudes Toward Technology (TechPH): Development and Validation2019In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 21, no 5, article id e13951Article in journal (Refereed)
    Abstract [en]

    Background: The use of health technology by older people is coming increasingly in focus with the demographic changes. Health information technology is generally perceived as an important factor in enabling increased quality of life and reducing the cost of care for this group. Age-appropriate design and facilitation of technology adoption are important to ensure functionality and removal of various barriers to usage. Development of assessment tools and instruments for evaluating older persons' technology adoption and usage as well as measuring the effects of the interventions are of high priority. Both usability and acceptance of a specific technology or service are important factors in evaluating the impact of a health information technology intervention. Psychometric measures are seldom included in evaluations of health technology. However, basic attitudes and sentiments toward technology (eg, technophilia) could be argued to influence both the level of satisfaction with the technology itself as well as the perception of the health intervention outcome. Objective: The purpose of this study is to develop a reduced and refined instrument for measuring older people's attitudes and enthusiasm for technology based on relevant existing instruments for measuring technophilia A requirement of the new instrument is that it should be short and simple to make it usable for evaluation of health technology for older people. Methods: Initial items for the TechPH questionnaire were drawn from a content analysis of relevant existing technophilia measure instruments. An exploratory factor analysis was conducted in a random selection of persons aged 65 years or older (N=374) on eight initial items. The scale was reduced to six items, and the internal consistency and reliability of the scale were examined. Further validation was made by a confirmatory factor analysis (CFA). Results: The exploratory factor analysis resulted in two factors. These factors were analyzed and labeled techEnthusiasm and techAnxiety. They demonstrated relatively good internal consistency (Cronbach alpha=.72 and .68, respectively). The factors were confirmed in the CFA and showed good model fit (chi(2)(8)=21.2, chi(2)/df=2.65, comparative fit index=0.97, adjusted goodness-of-fit index=0.95, root mean square error of approximation=0.067, standardized root mean square residual=0.036). Conclusions: The construed TechPH score showed expected relations to external real-world criteria, and the two factors showed interesting internal relations. Different technophilia personality traits distinguish clusters with different behaviors of adaptation as well as usage of new technology. Whether there is an independent association with the TechPH score against outcomes in health technology projects needs to be shown in further studies. The instrument must also be validated in different contexts, such as other countries.

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  • 4.
    Anderberg, Peter
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Skär, Lisa
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Abrahamsson, Linda
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Older People's Use and Nonuse of the Internet in Sweden2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 23, article id 9050Article in journal (Refereed)
    Abstract [en]

    The use of the internet has considerably increased over recent years, and the importance of internet use has also grown as services have gone online. Sweden is largely an information society like other countries with high reported use amongst European countries. In line with digitalization development, society is also changing, and many activities and services today take place on the internet. This development could potentially lead to those older persons who do not use the internet or do not follow the development of services on the internet finding it difficult to take part in information and activities that no longer occur in the physical world. This has led to a digital divide between groups, where the older generations (60+), in particular, have been affected. In a large study of Sweden's adult population in 2019, 95 percent of the overall population was said to be internet users, and the corresponding number for users over 66 years of age was 84%. This study shows that the numbers reported about older peoples' internet use, most likely, are vastly overestimated and that real use is significantly lower, especially among the oldest age groups. We report that 62.4% of the study subjects are internet users and that this number most likely also is an overestimation. When looking at nonresponders to the questionnaire, we find that they display characteristics generally attributed to non-use, such as lower education, lower household economy, and lower cognitive functioning.

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    Older People's Use and Nonuse of the Internet in Sweden
  • 5. Andersen, Pia
    et al.
    Olander, Ewy
    Blekinge Institute of Technology, School of Health Science.
    Utvärdering av implementeringen av hälsotorgen i Blekinge -med fokus på hälsotorgens utvecklingsmöjligheter2008Other (Other academic)
    Abstract [en]

    I den svenska folkhälsopolitiken betonas hälso- och sjukvårdens roll i folkhälsoarbetet genom ett eget målområde, ”En hälsofrämjande hälso- och sjukvård” År 2000 påbörjade Landstinget i Blekinge ett samarbete med Apoteket AB för utveckling av Hälsotorg som en ny typ av offentlig arena för hälsofrämjande och förebyggande arbete. Den är tänkt som en mötesplats för hälsoinformation, egenvårdsrådgivning och hälsosamtal med professionell personal från landsting och apotek. Syftet med denna utvärdering är att beskriva implementeringen av hälsotorgen i Blekinge och hälsotorgens utvecklingsmöjligheter. Enskilda intervjuer har genomförts med nyckelinformanter för att ta del av deras erfarenheter och upplevelser av hälsotorgsarbetet. Verksamhetschefer och hälsotorgspersonal intervjuades, sammanlagt tolv personer. Idag finns hälsotorg som har byggts upp i samverkan mellan Apoteket AB och Landstinget Blekinge i fyra av länets fem kommuner. Hälsotorgen har startat vid olika tidpunkter mellan år 2000 och 2006. De är något olika utformande, bemannade och lokaliserade. Resultatet visar en övervägande positiv bild av hälsotorgens verksamhet och det finns en framtidstro på fortsatt utveckling av hälsotorgen. Såväl ”uppifrån” stöd i form av direktiv och ekonomiska medel som ”underifrån” stöd genom lokalt engagemang och delaktighet har varit betydelsefulla faktorer i implementeringsprocessen. Det finns en ganska samstämmig uppfattning om hur de övergripande målen för hälsotorgen uppfyllts men målen är inte väl förankrade i verksamheten. Varje hälsotorg har utformat sin egen verksamhet utifrån befintligt avtal mellan Apoteket AB och Landstinget Blekinge samt utifrån hälsotorgspersonalens engagemang. Den mest framträdande svagheten är en otillräcklig marknadsföring, vilket har medfört att hälsotorgens verksamhet inte har blivit förankrad i önskvärd omfattning bland befolkningen och övrig personal på vårdcentralerna. Det råder en osäkerhet om hur det fortsatta samarbetet med Apoteket AB kan utvecklas med anledning av omregleringen av apoteksmarknaden 2009. Utvärderingen ger en positiv bild av hälsotorg både som fenomen och verksamhet. Informanterna anser att hälsotorgen har potential till att kunna vara en hälsofrämjande arena. För fortsatt utveckling till en sådan arena är det betydelsefullt med utbildningsinsatser som kan stärka hälsotorgspersonalens kompetens för hälsofrämjande arbete. Det är också betydelsefullt med informationsinsatser bland befolkning och hälso- och sjukvårdspersonal för att öka medvetenheten om hälsotorgens verksamhet och därmed skapa grund för samarbete och ett ökat utnyttjande av hälsotorgens service.

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  • 6.
    Andersson, Ewa
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Borglin, Gunilla
    Willman, Ania
    Younger people’s experiences of life after having survived an acute myocardial infarction: An interview study2011Conference paper (Refereed)
  • 7. Arman, Maria
    et al.
    Rehnsfeldt, Arne
    Living with breast cancer: a challenge to expansive and creative forces2002In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, p. 290-296Article in journal (Refereed)
    Abstract [en]

    The aim of this qualitative case study is to obtain a deeper and more profound understanding of the life world of women living with breast cancer focusing particularly on changes in life perspective. The study is based on a series of interviews carried out within the space of one year and involving four women with breast cancer; each woman was interviewed four times. The participants were between 42 and 54 years of age; three of the four interviewed were in an advanced stage, with metastasis or recurrent breast cancer. There was an increased awareness of the relationship between life and death, which constituted a disclosure rather than an actual change in life perspective. The four women were 'opening up' to the beauty and the essentials in life and experienced an increased desire to live their life in accordance with their own values. Their revitalised view of life increased their desire for authenticity. When it proved impossible to live in accordance with new insights the women were particularly frustrated. From a caring perspective our findings suggest that an awareness of patients' increased openness to their own needs and desires is an important resource in the healing and rehabilitative process of breast cancer patients. The paradoxes and the struggles involved disguise a hidden potential for health.

  • 8. Arman, Maria
    et al.
    Rehnsfeldt, Arne
    Blekinge Institute of Technology, Department of Health, Science and Mathematics.
    The hidden suffering among breast cancer patients: A qualitative metasynthesis2003In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, p. 510-527Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to review literature on how the lived experience of breast cancer and suffering was described in nursing/caring literature between 1990 and 2000, and to interpret and discuss the result from the perspective of suffering. The frequent reports of changing courses, called by various names, such as transition, transformation, transcendence, and finding meaning, werefound as paths whereby the person regained integrity, balance, and wholeness. When findings were interpreted from the perspective of suffering and an ontological health model, actions, values, and existential concerns were understood as both expedients for alleviating suffering and a sign of the patient's inner struggle.

  • 9.
    Axén, Anna
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Taube, Elin
    Malmö University.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Skär, Lisa
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Loneliness in Relation to Social Factors and Self-Reported Health Among Older Adults: A Cross-Sectional Study2023In: Journal of Primary Care & Community Health, ISSN 2150-1319, E-ISSN 2150-1327, Vol. 14Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Loneliness is described as a public health problem and can be both a consequence of aging and a cause of ill health. Lonely older adults tend to have difficulties making new social connections, essential in reducing loneliness. Loneliness often varies over time, but established loneliness tends to persist. Maintaining good health is fundamental throughout the life course. Social connections change with aging, which can contribute to loneliness. AIM: This study aimed to investigate loneliness in relation to social factors and self-reported health among older adults. METHOD: A cross-sectional research design was used based on data from the Swedish National Study on Aging and Care, Blekinge (SNAC-B), from February 2019 to April 2021. Statistical analysis consisted of descriptive and inferential analysis. RESULTS: Of n = 394 participants, 31.7% (n = 125) stated loneliness. Close emotional connections were necessary for less loneliness. Loneliness was more common among those who did not live with their spouse or partner and met more rarely. Furthermore, seeing grandchildren and neighbors less often increased loneliness, and a more extensive social network decreased loneliness. CONCLUSION: This study underlined the importance of social connections and having someone to share a close, emotional connection with to reduce loneliness.

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  • 10. Bai, Guohua
    A Sustainable Information System for e-home Services2004Conference paper (Refereed)
    Abstract [en]

    E-home related home-services (including homecare and home healthcare) in China is urgently needed. The population of aged people over 80 is increasing 5% every year in China, and to year 2050, one fourth of whole population or 0.4 billions people in China are aged staying at home. Meanwhile the government cannot afford with a national elderly care system like most western countries as Sweden. This is because China has had one-child/one-family policy since 1970’s, and this radical policy has made China step in aged society very quickly within only 20 years, while the same process took 40-80 years in western countries. Even worse, China becomes aged society when the country is still poor and under developing with GDP per capita less than 1000$, comparing to western countries with 5000 – 10000 $ when they became aged society. E-home provides China with a unique, and maybe the most effective solution to the problem. By applying effective IT&C at home, elder people are facilitated to manage their own daily life. If needed, they can always call help from their collective service centre that is located in their resident area and the collective service centre can provide with both homecare (cleaning, shopping, reparation, baby care etc.) and home healthcare (legitimate medical care). Elder people can be also monitored (if wished by all partners) both at home and out door by bearing sensors that can send singles directly to related care providers (including their children and relatives if wished). E-home will greatly increase the security of elder people, release great worry from both their children and elder people themselves, and can be afford by most people. However, e-home is more than just a technical problem, and it needs a systemic way and social-psychological study how to design e-home system. In the end, e-home system must provide with needed services to residents. I will introduce IMIS project ´Integrated Mobile Information System for Home Healthcare’ financed by Swedish Agency for Innovative Systems (VINNOVA). This project will continue to 2006, and one of the outputs will be a sustainable software platform which is based on a systemic study of social psychological factors involved in the home healthcare. I will provide with some Swedish experiences and the so called ‘Scandinavia Approach’ in conducting such complex system to my colleagues in China, and I hope the IMIS project will be also developed in China based up on some feasibility and desirability studies with some Chinese colleagues.

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  • 11.
    Bai, Guohua
    Blekinge Institute of Technology, School of Computing.
    E-hälsa: Utmaningen och Möjligheter2006Conference paper (Other academic)
    Abstract [en]

    As the organiser of the workshop 'IT-stöd för vård och omsorg i hemmet', the author presents a general picture of the subject, and call for one day's discussion with around 30 participants from all around Sweden.

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  • 12.
    Bai, Guohua
    Blekinge Institute of Technology, School of Computing.
    ICT PROJECTS: Case Study Reports2006Report (Other academic)
    Abstract [en]

    The case study of OVK (Seamless healthcare chain supported by ICT (Obruten vårdkedja med IT –stöd) describes some basic key factors for sucessful eHealth project, and is documented in the projects database in IANIS+

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  • 13. Bai, Guohua
    Integrerade Nätverk i Hemsjukvården För Personer Med Diabetes (IMIS)2005Conference paper (Refereed)
    Abstract [en]

    The presentation is a IMIS project report to VINNOVA's programkonferens IT i Hemsjukvård.

  • 14. Bai, Guohua
    Integrerade nätverk i hemsjukvården för personer med diabetes (IMIS)2007Report (Other academic)
    Abstract [sv]

    IT för sjukvård i hemmet är ett program inom VINNOVAs enhet Tjänster och IT användning.

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  • 15. Bai, Guohua
    et al.
    Malmqvist, Gustav
    Guide to REgional Good Practice eHealth2007Report (Other academic)
    Abstract [en]

    This report shows the result of the work of IANIS+ eHealth work group (WG). The WG has collected regional eHealth experiences from around Europe through a number of activities: • Regional eHealth case studies of which 17 (from 15 regions) are shown in this report • Four joint meetings of the group of which one was a policy seminar with invited guests from the EU Commission, relevant organisations in the field of eHealth and regional authorities • A meeting with the European Commission DG Information Society & Media, Unit H1 eHealth • Collaboration with the eHealth network within the organisation Assembly of European Regions (AER) • Attendance in recent major eHealth conferences: · Personal Health Systems arranged by the European Commission when launching the eHealth part of the 7th Framework Programme, 11-12 February 2007 · The EU-US eHealth Policy Workshop, 10 May 2007 · The final conference of the INTERREG IIIB project Baltic eHealth, 21-22 May 2007 • eHealth seminars at IANIS+ annual conferences in Blekinge 2006 and Bilbao 2007 The innovation perspective of eHealth in the regions has been the focus for the IANIS+ eHealth WG. Regional diversity regarding strategies, policies, and action plans for eHealth can act as a driving factor for successful eHealth projects, but leads also to challenges for interoperability, standardisation, integrity and security. It is important to learn from others. It may be about how to choose the right technology or what methods to use for implementation. Depending on what area of eHealth, there are numerous projects and up-and-running services from which we can learn. Not to forget there are also many experiences from unsuccessful trials. Even if an eHealth solution has failed in one setting, it can be a success under different circumstances. The aim of the IANIS+ eHealth Working Group was to share experience between regions belonging to the network, and bring up some issues of good practice for regional eHealth implementation. Projects brought up in the IANIS+ working group are projects in there own rights, with pros and cons. The projects cover different perspectives and types of eHealth. Some were difficult to evaluate while others are valuable comparable experiences from different settings and circumstances. In any case, we can learn something from all the cases as examples from reality and as a complement to formal evaluations and scientific studies of eHealth. We would rather use the term good practice than best practice. There is always something good to learn from others while there is hardly any best practice that works under every circumstance.

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  • 16. Bai, Guohua
    et al.
    Zhang, Peng
    Developing a Semantic Web Services for Interoperability2005Conference paper (Refereed)
    Abstract [en]

    This paper deals with the design problems in healthcare information systems on how to adapt to dynamic factors and diversities so as to reach the interoperability between healthcare actors. Those dynamic factors and diversities are caused by, for example, constant suggestions from users, changes in the applied technologies, and after-learning related stepwise progresses. We suggest applying Web services technology, especially the idea of Semantic Web to tackle the problem of diversity in healthcare branch. In order to tackle the problem of dynamic changes during the design process, we suggest an evolutionary design methodology based upon an organic development metaphor – embryonic prototyping approach (EmA). We demonstrate our idea by the project IMIS that is to design a semantic Web service for the diabetic healthcare.

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  • 17.
    Beiranvand, Samira
    et al.
    Ahvaz Jundishapur Univ Med Sci, IRN.
    Zarea, Kourosh
    Ahvaz Jundishapur Univ Med Sci, IRN.
    Ghanbari, Saeed
    Shiraz Univ Med Sci, IRN.
    Tuvesson, Hanna
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Keikhaei, Bijan
    Ahvaz Jundishapur Univ Med Sci, IRN.
    Ten years incidence of cancer in Iran: a systematic review and meta-analysis2018In: CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH, ISSN 2452-0918, Vol. 6, no 2, p. 94-102Article, review/survey (Refereed)
    Abstract [en]

    Background: Designing and implementation of screening programs depend on greatly epidemiologic basic data in every country. Also Variation in the incidence of various cancers in our country has been a favorite topic. Objectives: This systematic review was conducted to provide an overall perspective about incidence, geographical and age distribution of cancers in Iran. Methods: A comprehensive search were done according to MOOSE guideline criteria in national and international databases for selecting eligible articles from 2005 to 2015. After screening titles and abstracts, duplicated and irrelevant studies were excluded. Selected papers are written in Persian or English. The standard error of the cancer incidence was calculated based on the binomial distribution. Because of the significant heterogeneity observed among the results, we used a random-effects model combine the results of the primary studies. Moreover, a sensitivity analysis was undertaken to explore the effects of the risk of bias and other sources of heterogeneity. Results: Overall 16 articles met eligibility criteria for inclusion. The total incidence of cancer was 19.4 and 17.2 per hundred thousand of people in males and females respectively. The five most common cancers in male were: Lymphoma, leukemia, esophagus, stomach, colorectal and in the female are: breast, colorectal, stomach, thyroid and esophagus. The highest incidence rate was seen in Golestan Province and in the age group over 65 years. Conclusion: According to increasing incidence rate of cancers in Iran, Development, holding and accomplish of universal public cancer control program should be the first precedence for health policy. (c) 2017 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of INDIACLEN.

  • 18. Bennet, Louise
    et al.
    Berglund, Johan
    Reinfection with Lyme borreliosis: A retrospective follow-up study in southern Sweden2002In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, p. 183-186Article in journal (Refereed)
    Abstract [en]

    In a 5-y retrospective follow-up study in southern Sweden that initially included > 1000 individuals with previously diagnosed erythema migrans, factors that influenced the risk of reinfection with Lyme borreliosis were elucidated. The total frequency of reinfection was 4% and the number of tick bites influenced the risk of reinfection: those bitten > 10 times during the observation period had a 4-8-fold increased risk compared with those bitten < 5 times. Women manifested to a greater extent than men although both genders were bitten equally by ticks, thus indicating that women may be more susceptible to reinfection. All reinfected women were > 44 y old. The county of Kalmar including Oland was found to be highly endemic for reinfection with Lyme borreliosis. Thus the number of tick bites, gender, age and study area influenced the risk of reinfection.

  • 19. Bennet, Louise
    et al.
    Danell, Sven
    Berglund, Johan
    Clinical Outcome of Erythema Migrans after Treatment with Phenoxymethyl Penicillin2003In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 35, no 2, p. 129-131Article in journal (Refereed)
    Abstract [en]

    In a 5 y retrospective follow-up study in southern Sweden of 708 adult individuals with erythema migrans as the single manifestation of Lyme borreliosis, the clinical outcome and the antibiotic treatment were studied. 80%, were treated with phenoxymethyl penicillin, 15% with doxycycline and 5% with other antibiotics. Phenoxymethyl penicillin and doxycycline were extremely effective: 98 and 94% of the individuals reported complete recovery without complications. Few individuals reported the development of new symptoms following treatment and none developed any late manifestation of Lyme borreliosis during the observation period. Thus, in the area studied the treatment of the early localized manifestation of Lyme borreliosis (erythema migrans) with antibiotics was extremely successful. The current Swedish recommendation to use phenoxymethyl penicillin, when no sign of disseminated infection or coinfection with other tick-borne pathogens is present, seems excellent.

  • 20. Bennet, Louise
    et al.
    Fraenkel, Carl-Johan
    Garpmo, Ulf
    Halling, Anders
    Ingman, Mikael
    Ornstein, Katharina
    Stjernberg, Louise
    Berglund, Johan
    Clinical appearance of erythema migrans caused by Borrelia afzelii and Borrelia garinii: effect of the patient´s sex2006In: Wiener Klinische Wochenschrift, ISSN 0043-5325, E-ISSN 1613-7671, Vol. 118, no 17-18, p. 531-537Article in journal (Refereed)
    Abstract [en]

    Aim: The aim in this survey was to study the clinical characteristics of infections caused by Borrelia genospecies in patients with erythema migrans where Borrelial origin was confirmed by polymerase chain reaction. The aim was also to study factors influencing the clinical appearance of erythema migrans. Methods: The study was conducted in southern Sweden from May 2001 to December 2003 on patients 18 years and older attending with erythema migrans at outpatient clinics. All erythema migrans were verified by polymerase chain reaction, photographed and categorized into “annular” or “non-annular” lesions. A logistic regression model was used to analyze relations between the appearance of the erythema migrans (i.e., annular or non-annular) and factors that influenced its clinical appearances. Results: A total of 118 patients, 54 women (45.8%) and 64 men (54.2%), fulfilled the inclusion criteria. Of these patients, 74% were infected by B. afzelii, 26% by B. garinii ( p < 0.001). A total of 45% (38/85) of the erythema migrans were annular, 46% (39/85) were non-annular and 9.4% (8/85) were atypical. For men infected by B. afzelii the odds ratio of developing non-annular erythema migrans was 0.09 (95% CI: 0.03 - 0.33) in comparison with women with the same infection. Conclusions: In this prospective study of a large series of erythema migrans, where infecting genospecies were confirmed by polymerase chain reaction, the sex of patients infected with B. afzelii had a strong influence on the appearance of the rash. Patients infected by B. garinii more often had non-annular erythema migrans and a more virulent infection with more individuals presenting with fever, raised levels of C-reactive protein and seroreactivity in the convalescence sera.

  • 21. Bennet, Louise
    et al.
    Fraenkel, Carl-Johan
    Stjernberg, Louise
    Garpmo, Ulf
    Ingman, Mikael
    Ornstein, Katharina
    Berglund, Johan
    Clinical Aspects of Erythema Migrans in Southern Sweden2005Conference paper (Refereed)
    Abstract [en]

    Background: The aim of this study was to describe and categorize the different predominant patterns of PCR confirmed erythema migrans (EM) and to study possible correlations according to the clinical pictures and Borrelia substrains. Methods: Patients over 18 years old, seeking care with tick exposure and an EM were consecutively included during a study period of three years. We evaluated clinical and laboratory findings with regard to Borrelia burgdorferi s.l. spirochetes detected with nested Osp A PCR in skin biopsy specimens. Laboratory and serology testing were done acute, after 6 weeks and after 6 months. The patients were clinically evaluated at the initial visit and repeatedly after 14 days unitl recovery. Results: 118 patients (women=54, men=64) with a positive B. Burgdorferi s.l. PCR analysis were included. In this area totally 73.7% of the EM were caused by B. afzelii and 26.3% by B. garinii (p=0.0001). Leisons caused by B. garinii had a shorter duration from tick bite to the initial visit (p= 0.001) but there were no differences between the sizes of the EM, indicating a faster development of lesions caused by B. garinii. Patients with lesions caused by B. garinii to a greater extent had presented with fever at the initial visit (p=0.02). Also patients with B. garinii lesions to a greater extent had elevated levels of CRP at the initial visit (p=0.006). 45% of the EM were categorized as “annular”, 27% as “homogeneous”, 19% as “central erythemas” and 9% as “atypical”. The lesions caused by B. afzelii were predominately “annular” and the lesions caused by B. gaarinii were predominately “homogeneous”. Conclusions: In this study most EM were caused by B. afzelii. Leisons caused by B. garinii developed faster and the patients to a greater extent presented with fever and elevated levels of CRP at the initial visit. Leisons caused by B. garinii were mostly homogenous and by B. afzelii were mostly annular.

  • 22. Bennet, Louise
    et al.
    Halling, Anders
    Berglund, Johan
    Increased incidence of Lyme borreliosis in southern Sweden following mild winters and during warm, humid summers.2006In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 25, no 7, p. 426-432Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate the long-term incidence rate of Lyme borreliosis and, additionally, to determine whether a correlation exists between climatic factors and summer-season variations in the incidence of Lyme borreliosis. Climatic variability acts directly on tick population dynamics and indirectly on human exposure to Lyme borreliosis spirochetes. In this study, conducted in primary healthcare clinics in southeastern Sweden, electronic patient records from 1997-2003 were searched for those that fulfilled the criteria for erythema migrans. Using a multilevel Poisson regression model, the influence of various climatic factors on the summer-season variations in the incidence of erythema migrans were studied. The mean annual incidence rate was 464 cases of erythema migrans per 100,000 inhabitants. The incidence was significantly higher in women than in men, 505 and 423 cases per 100,000 inhabitants, respectively (p<0.001). The summer-season variations in the erythema migrans incidence rate correlated with the monthly mean summer temperatures (incidence rate ratio 1.12; p<0.001), the number of winter days with temperatures below 0 degrees C (incidence rate ratio 0.97; p<0.001), the monthly mean summer precipitation (incidence rate ratio 0.92; p<0.05), and the number of summer days with relative humidity above 86% (incidence rate ratio 1.04; p<0.05). In conclusion, Lyme borreliosis is highly endemic in southeastern Sweden. The climate in this area, which is favourable not only for human tick exposure but also for the abundance of host-seeking ticks, influences the summer-season variations in the incidence of Lyme borreliosis.

  • 23. Bennet, Louise
    et al.
    Stjernberg, Louise
    Berglund, Johan
    Effect of Gender on Clinical and Epidemiologic Features of Lyme Borreliosis2007In: Vector Borne and Zoonotic Diseases, ISSN 1530-3667, E-ISSN 1557-7759, Vol. 7, no 1, p. 34-41Article in journal (Refereed)
    Abstract [en]

    The aim is to highlight the influence of patients’ gender on Lyme borreliosis and especially erythema migrans (EM), focusing on exposure to tick bites, epidemiology, and the clinical picture. All studies were conducted in the county of Blekinge, located in southeastern Sweden. A prospective study was conducted in 235 individuals (women, n=110; men, n=125) engaged in recreational or occupational activities focusing on exposure to tick bites. A retrospective epidemiological study evaluating 123,495 electronic patients´ records (women, n=61,712; men, n=61,783) and a prospective clinical study including 118 patients (women, n=54; men, n=64) 18 years or older seeking care for EM > 5 cm in diameter with genospecies verified by polymerase chain reaction were conducted. Results: Women 40 years or older had a 48% higher risk than men 40 years or older and 42% higher risk than women younger than 40 years of attracting tick bites (0.0188 versus 0.0127 and 0.0188 versus 0.0132 tick bites respectively per hour). Additionally they had a 96% higher risk than men younger than 40 years of attracting tick bites (0.0188 versus 0.0096). The annual incidence rate of EM in women was 506 and in men 423 cases per 100,000 inhabitants (p<0.001). Significant differences in incidence rates occurred in those 40 years or older. Odds ratios for males infected with Borrelia afzelii developing nonannular EM were 0.09 (95% confidence interval [CI] 0.03 to 0.33) in comparison with females infected by Borrelia afzelii. Conclusions: Significant gender differences in the risk of contracting tick bites, incidence rates, and clinical picture of EM have been observed. Exposure to tick bites alone may not explain these observations and further studies need to be done to clarify the biologic, immunologic, and sociological mechanisms causing these differences.

  • 24. Berglund, Johan
    Association of diagnosis of ischaemic heart disease, diabetes mellitus and heart failure with cognitive function in the elderly population.2006In: European Journal of General Practice, ISSN 1381-4788, E-ISSN 1751-1402, Vol. 12, no 3, p. 114-119Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to describe the association between ischaemic heart disease (IHD), diabetes mellitus (DM) and heart failure (HF) and the prevalence of cognitive impairment. METHODS: In a cross-sectional, community-based study in Karlskrona, Sweden, 1402 participants of the Swedish National Study on Ageing and Care (60-96 y) underwent a medical examination and psychological testing including the Mini Mental State Examination (MMSE). Of these, 58% stated that they were treated for hypertension, IHD, DM or HF, or had ECG abnormalities (positive screen). RESULTS: The prevalence of cognitive impairment (MMSE score < 24) in patients treated for IHD, DM or HF was 28.5% compared to 16.1% in the population with a negative screen without cardiovascular disease or DM. After stratification by age, the difference was seen to be due to a higher prevalence of cognitive impairment in the age group 70-79 y, where 68.8% of the cognitively impaired came from the group treated for IHD, DM or HF. The odds ratio for cognitive impairment in this age group was 4.4 (95% CI 1.7-11.4), when compared to those with a negative screen as baseline. CONCLUSION: This study has shown that the patient group treated for IHD, DM or HF has a higher prevalence of cognitive impairment and a higher risk of developing early cognitive impairment between the ages of 70 and 79 y. Although this study has not provided conclusive evidence that cardiovascular disease and DM are associated with the early development of cognitive impairment, it provides incentive for further studies.

  • 25. Berglund, Johan
    et al.
    Stjernberg, Louise
    Ornstein, Katharina
    Tykesson/Joelsson, Katarina
    Walter, Hallstein
    5-y follow-up study of patients with neuroborreliosis2002In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 34, no 6, p. 421-425Article in journal (Refereed)
    Abstract [en]

    The objective of this follow-up study was to determine the long-term outcome of strictly classified cases of neuroborreliosis treated with antibiotics. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, between 1992 and 1993. A total of 349 identified cases with suspected neuroborreliosis were followed up 5 years later. Medical records were reviewed and all participants filled in a questionnaire. Of those classified with definite neuroborreliosis 114/130 completed the follow-up, of whom 111 had completed the initial antibiotic treatment. Of the 114 patients followed up, 86 (75%) had recovered completely and 70 (61%) had recovered within 6 months. Residual neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy were reported by 28/114. No significant differences between different antibiotic treatments were observed in terms of occurrence of sequelae. To conclude, we found that 25% (95% confidence interval 17-33%) of the patients suffered from residual neurological symptoms 5 years post-treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post-treatment. Early diagnosis and treatment would seem to be of great importance in order to avoid such sequelae.

  • 26. Berglund, Johan
    et al.
    Stjernberg, Louise
    Ornstein, Katharina
    Tykesson/Joelsson, Katarina
    Walter, Hallstein
    A 5-years follow-up of patients with neuroborreliosis.2002Conference paper (Refereed)
    Abstract [en]

    The objective of this follow-up study was to determine the long-term outcome in patients treated with antibiotics for strictly classified cases of neuroborreliosis. A one-year prospective population-based survey of Lyme borreliosis was conducted in southern Sweden, 1992-1993. Totally 349 identified cases with suspected neuroborreliosis were registered. Of those, 130 were classified as definitively neuroborreliosis and followed up five years later. Medical records were reviewed and all participants filled in a questionnaire. Totally, 114/130 (88%) completed the follow-up of whom 111/114 (97%) had fulfilled the initial antibiotic treatment. Of these, 86/114 (75%) had recovered completely and 70 (61%) recovered within six months. However 28/114 (25%) suffered from remaining neurological symptoms such as facial palsy, concentration disorder, paresthesia and/or neuropathy. The longer the duration from the neurological symptoms onset to antibiotic treatment the higher was the rate of sequelae. Of those who were treated within 30 days 5/32 (16%) and of those who were treated after 30 days 16/41 (39%) respectively, reported sequelae. Women suffered significantly more from sequelae compared to men, this difference was not seen among the children. No significant differences between the different antibiotic treatments given and experience of sequelae were seen. To conclude, we found that 25% (95% CI 17% to 33%) of the patients suffered from remaining neurological symptoms five years post treatment. However, the clinical outcome of treated neuroborreliosis is favourable as only 14/114 (12%) of the patients had sequelae that influenced their daily activity post treatment and early diagnosis and treatment seems to be of great importance to possibly avoid also these cases.

  • 27.
    Berglund, Johan
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Vink, Peter
    Tavares Da Silva, Fernanda
    Lestrate, Pascal
    Boutriau, Dominique
    Safety, immunogenicity and antibody persistence following an investigational Streptococcus pneumoniae and Haemophilus influenzae tri-protein vaccine: a phase 1 randomized controlled study in healthy adults.2014In: Clinical and Vaccine Immunology, ISSN 1556-6811, E-ISSN 1556-679X, Vol. 21, no 1, p. 56-65Article in journal (Refereed)
    Abstract [en]

    We investigated a protein-based nontypeable Haemophilus influenzae (NTHi) and pneumococcal (HiP) vaccine containing pneumococcal histidine triad D (PhtD), detoxified pneumolysin (dPly), and NTHi protein D (PD) in adults. In a phase I study, 40 healthy 18- to 40-year-old subjects were randomized (2:2:1) to receive two HiP doses administered 60 days apart, with or without AS03 adjuvant (HiP-AS and HiP groups, respectively), or Engerix B (GlaxoSmithKline, Belgium) as a control. Safety, antibodies, and antigen-specific CD4+ T-cell immune responses were assessed before and until 480 days after vaccination. No serious adverse events were reported, and no subject withdrew due to an adverse event. Local and systemic symptoms were reported more frequently in the HiP-AS group than in the other two groups. The frequency and intensity of local and systemic symptoms appeared to increase after the second dose of HiP-AS or HiP but not Engerix B. Antibody geometric mean concentrations (GMCs) for PhtD, dPly, and PD increased after each dose of HiP-AS or HiP, with higher GMCs being observed in the HiP-AS group (statistically significant for anti-PD after dose 1 and anti-Ply after dose 2). GMCs remained higher at day 420 than prior to vaccination in both the HiP-AS and HiP groups. Antigen-specific CD4+ T cells increased after each dose but were unmeasurable by day 480. Two doses of an investigational PhtD-dPly-PD protein vaccine induced humoral immunity and antigen-specific CD4+ T-cell responses after each dose, with generally higher responses when the vaccine was administered with AS03. HiP combined with AS03 appeared to be more reactogenic than the antigens alone. (This study has been registered at ClinicalTrials.gov under registration no. NCT00814489.)

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  • 28. Bergman, Karl
    Staden, pesten, renhållning och modernitet, Karlskrona 1710-17122011In: Karolinska förbundets årsbok, ISSN 0348-9833, p. 7-71Article in journal (Other academic)
    Abstract [en]

    Den undersökning som redovisas behandlar en akut krissituation vid örlogsstaden Karlskrona då pesten slog till 1710. Den kris som står i centrum för undersökningen var inte bara en kris för örlogsstaden Karlkrona utan även för den svenska militärstat som vi i efterhand vet hade cirka ett årtionde kvar innan denna statsform stod vid vägs ände. Intresset har i undersökningen på ett mer konkret plan riktats mot de små upprepande rörelserna, beteenden, förhållningssätt och agerande som synliggjordes av kris och krishantering i samband med pesten. Frågan är huruvida dessa rörelser och upprepningar på ett verksamt sätt bidrog till att forma viktiga komponenter i det som senare kom att framstå som centrala inslag i den modernitet som växer fram under 1800- och 1900-talen. Det handlar om den maktförskjutning som möjliggjordes och där hälsa, sjukdom och hygien verkar ha varit en så kraftfull hävstång. En genomgående tematik, eller diskurs, under hela den undersökta perioden rör främlingen och hur främlingen inför hotet om den stora katastrofen kom att utgöra en av polerna i ett vi och den andra. Sjukdomen spreds av främlingen, hotet kom utifrån och riktades mot den egna gemenskapen eller de gemenskaper som individen kunde uppleva sig som inkluderade i. I en hierarkisk formation formulerades gemenskaperna utifrån både en rumslig och social skala. Människor från avlägsna, främmande orter var potentiella hot och i en mer näraliggande form var det människorna från landsbygden som utgjorde ett hot. Staden, eller mer specifikt den befästa örlogsstaden, förefaller vid en första anblick ha utgjort den rumslighet som var möjlig att överblicka och kontrollera. Landsbygden framstod däremot som den oordning mot vilket staden ställde ordning och kontroll. När väl pesten måste hanteras inom stadsgränsen blev kategorisering och diagnosticering verktyg för en separation mellan grupper och individer och medel för kontroll över det offentliga rummet. Denna kategorisering av människor var vid denna tid inte självklar eller helt möjlig att genomföra utifrån den enkla kategoriseringen sjuka och friska. De kunskaper, insikter, och de tekniker och krav på åtgärder som användes mötte en social och samhällelig struktur som gjorde motstånd. Centralt i hela denna diskurs återfinns frågor om makt och inflytande. En ytterligare komplikation som förhindrade amiralitet från att vidta mer restriktiva åtgärder var det komplicerade utrikespolitiska läget med direkta hot mot riket. Trots pesten måste både material och människor transporteras genom pestområden. Vad krisen 1710-1711 medförde var att den i koncentrerad form lyfte upp alla dessa konflikter till ytan under en relativt kort tidsperiod. Krisen blev i denna mening en katalysator och förändringarna möjliggjorde det Foucault kallade en ny uppställning. Innebörden av denna förändring var inte nödvändigtvis att det nya helt slog igenom. Dethandlade snarare om förskjutningar, introducerandet av eller en etablering av något nytt. Ett exempel på hur en ”ny uppställning” börjat bryta fram var den organisering av staden som utvecklades med hänvisning till pesten. I en mycket rudimentär mening utvecklades en ”välfärdsorganisation” med bestämda organisationsområden, klart definierade ansvarsområden och utsedda tjänstemän som kontrollerade människors rörelser och möten i staden. Endast med hänvisning till de motiv som makten angav som legitima var det möjligt att röra sig i staden eller inom örlogsflottans område. Den roll som amiralitetsläkaren och tidens medicinska kunskap spelade för att legitimera den form av maktutövning som kom till stånd framgår av de återkommande konsultationerna där amiralitetet ständigt lät amiralitetsläkaren eller hans personal tillhandahålla underlag för sina analyser och förslag till åtgärder. Staden kom att utgöra ett analytiskt rum där det blev möjligt för den medicinska personalen att iaktta, kontrollera, diagnosticera, jämföra och dokumentera större grupper av människor. Analyserna presenterades för amiralitetet i form av översikter över tillståndet och de resulterade i någon form av prognos. Det vills säga pesten framstod inte enbart som ett utslag av Guds något svårförklarliga hämnd eller vrede, det var möjligt att kalkylera, kontrollera och påverka förloppet. Prästen som rådgivare fick ta ett steg tillbaka till förmån för ett synsätt där läkarens systematiska iakttagelseförmågan och erfarenhet stod i centrum. Expertens iakttagelser av och förmåga att analysera de konkreta bölderna, att utifrån jämförelser kalkylera och prognosticera vann insteg. Pest, modernitet, hälsa, tidigmodern krishantering, Foucault, örlogsstaden.

  • 29.
    Berner, Jessica
    et al.
    Amsterdam UMC, NLD.
    Comijs, Hannie
    Amsterdam UMC, NLD.
    Elmståhl, Sölve
    Lunds Universitet, SWE.
    Welmer, Anna Karin
    Stockholms universitet, SWE.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Deeg, Dorly
    Amsterdam UMC, NLD.
    Maintaining cognitive function with internet use: A two-country, six-year longitudinal study2019In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 31, no 7, p. 929-936Article in journal (Refereed)
    Abstract [en]

    Objectives: Maintaining good cognitive function with aging may be aided by technology such as computers, tablets, and their applications. Little research so far has investigated whether internet use helps to maintain cognitive function over time.Design: Two population-based studies with a longitudinal design from 2001/2003 (T1) to 2007/2010 (T2).Setting: Sweden and the Netherlands.Participants: Older adults aged 66 years and above from the Swedish National Study on Ageing and Care (N = 2,564) and from the Longitudinal Aging Study Amsterdam (N = 683).Measurements: Internet use was self-reported. Using the scores from the Mini-Mental State Examination (MMSE) from T1 and T2, both a difference score and a significant change index was calculated. Linear and logistic regression analysis were performed with difference score and significant change index, respectively, as the dependent variable and internet use as the independent variable, and adjusted for sex, education, age, living situation, and functional limitations. Using a meta-analytic approach, summary coefficients were calculated across both studies.Results: Internet use at baseline was 26.4% in Sweden and 13.3% in the Netherlands. Significant cognitive decline over six years amounted to 9.2% in Sweden and 17.0% in the Netherlands. Considering the difference score, the summary linear regression coefficient for internet use was-0.32 (95% CI:-0.62,-0.02). Considering the significant change index, the summary odds ratio for internet use was 0.54 (95% CI: 0.37, 0.78).Conclusions: The results suggest that internet use might play a role in maintaining cognitive functioning. Further research into the specific activities that older adults are doing on the internet may shine light on this issue. © 2019 International Psychogeriatric Association.

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  • 30.
    Berner, Jessica
    et al.
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Rennemark, Mikael
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Jogreus, Claes
    Blekinge Institute of Technology, Faculty of Engineering, Department of Mathematics and Natural Sciences.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Sköldunger, Anders
    Wahlberg, Maria
    Elmståhl, Sölve
    Berglund, Johan
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden2015In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 21, no 3, p. 237-249Article in journal (Refereed)
    Abstract [en]

    Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.

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  • 31.
    Berner, Jessica
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Rennemark, Mikael
    Blekinge Institute of Technology, School of Health Science.
    Jogréus, Claes
    Blekinge Institute of Technology, School of Engineering, Department of Mathematics and Natural Sciences.
    Berglund, Johan
    Blekinge Institute of Technology, School of Health Science.
    Distribution of personality, individual characteristics and internet usage in Swedish older adults2012In: Aging and Mental Health, ISSN 1360-7863 , Vol. 16, no 1, p. 119-126Article in journal (Refereed)
    Abstract [en]

    Objectives: This paper investigated factors associated with internet usage in the Swedish older adults ranging in age from 60 to 96. Personality traits and individual characteristics have been previously noted to influence internet usage, where older adults have not been the focus population. In this study the relationships between personality, individual characteristics and internet usage were investigated. Methods: A descriptive analysis of the personality tests of a total of 1402 subjects included in the Swedish National Study on Aging and Care (SNAC) was conducted. Three variables were controlled for: sex, age and education. Descriptive statistics, Mann-Whitney and Kruskal-Wallis tests, chi square tests and a logistic regression were used in order to detect the relationships with internet usage. Results: Men differ significantly from women in the personality traits analysis. Those with higher education were more open and neuroticism was lower in the oldest older adults. Internet usage declined significantly with age and those with middle to higher education were using the internet the most. No other associations with internet use were found Conclusion: Personality traits and individual characteristics do not seem to influence the Swedish older adult and their internet usage. What one needs to account for is the age and education of the person. The more educated and the youngest cohorts were using the internet more frequently.

  • 32.
    Berner, Jessica
    et al.
    Blekinge Institute of Technology, School of Health Science.
    Rennemark, Mikael
    Blekinge Institute of Technology, School of Health Science.
    Jogréus, Claes
    Blekinge Institute of Technology, School of Engineering, Department of Mathematics and Natural Sciences.
    Berglund, Johan
    Blekinge Institute of Technology, School of Health Science.
    Factors associated with change in Internet usage of Swedish older adults (2004-2010)2013In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 19, no 2, p. 152-162Article in journal (Refereed)
    Abstract [en]

    The increased reliance on Internet use in social functions has presumably left out a part of the population: the oldest-older adults. These are people who have not kept themselves up to date with the technological developments for various reasons. There are, however, exceptions from whom we have something to learn. This study investigates the older people in Sweden who started to use the Internet over a period of 6 years. Cognition, extraversion, openness, functional disability, household economy, sex, age and education were investigated in relation to starting to use the Internet. A chi-square test, Spearman correlation and a logistic regression analysis were conducted. It was found that higher cognition, being male and being between the ages of 60 and 80 years were determining factors in starting to use the Internet for the Swedish older adult. Our results indicate that the oldest-older adults are slow to adapt to using the Internet and more attention should be paid on how to support this group.

  • 33. Bjegovic-Mikanovic, Vesna
    et al.
    Laaser, Ulrich
    Vukovic, Dejana
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Otok, Robert
    Czabanowska, Katarzyna
    The way forward in partnerships for education and training in public health2014Conference paper (Refereed)
    Abstract [en]

    Today schools and departments of public health (SDPHs), as well as public health professionals are searching for interface and synergies between public health science and practice. They are increasingly relying on partnerships in order to achieve common goals. To collect more information on the fragmented institutional landscape the Association of Schools of Public Health in the European Region (ASPHER) organised a survey among its full institutional 81 members with the core objective to assess the exit competences of master of public health graduates according to the new Essential Public Health Operations (EPHO) of WHO-EURO. The survey results indicate that usually European SDPHs are small units, funded from tax money. A total of 130 academic programmes released 3035 graduates per last year All selected competences within each EPHO showed high reliability and high internal consistency (alpha>0.75, p<0.01). SDPH assess their best teaching output to be in the field of health promotion, followed by disease prevention and identification of priority health problems and health hazards in the community, while they see the least success regarding preparedness and planning for public health emergencies. Given the fragmentation of the institutional infrastructure, the harmonization of programme content and thinking is impressive. Even more surprising is the observation that the determination of the desired performance by employers of public health professionals for most EPHOs (6 out of 10) is almost congruent with the estimated output of SDPHs. The main objective of the workshop was to continue with permanent dialogue on innovation and good practice in public health education, continuing training and lifelong learning and to strengthen everlasting collaboration of European schools in efforts to improve public health performance.

  • 34.
    Björksten, Cecilia
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Ölander, Ida
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Upplevelser av livsstilsförändringar hos personer med övervikt eller fetma: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Övervikt och fetma är ett växande problem som ökar över hela världen och anses vara en förändringsbar riskfaktor, vilket innebär att de följdsjukdomar som kan drabba en person som en direkt följd av övervikt eller fetma till stora delar skulle kunnat undvikas genom förändrade levnadsvanor. Förändringsprocessen hos en person kan starta först då personen börjar ifrågasätta sina levnadsvanor. Huruvida en livsstilsförändring är möjlig att genomföra handlar inte enbart om egna uppfattningar om beteendet utan även om hur redo personen är att genomföra en förändring.

    Syfte: Syftet med studien var att beskriva vuxna personers upplevelser vid genomförandet av livsstilsförändringar vid övervikt eller fetma.

    Metod: Litteraturstudie med kvalitativ design som är baserad på 13 vetenskapliga artiklar. Analysen utfördes på manifest nivå med hjälp av Graneheim och Lundmans beskrivning av innehållsanalys.

    Resultat: Ur resultatet framkom kategorierna Upplevelse av att socialt stöd är av betydelse, Attityder och inställning påverkar genomförandet av livsstilsförändring, Personliga insikter har betydelse, Upplevelser av att motgångar kan påverka processen av livsstilsförändringar och Motivation kan erhållas på olika sätt. Resultatet visade att behovet av stöd från omgivning och att samtala med människor i liknande situation var av stor betydelse. Att möta fördomar visade sig vara problematiskt för en del. För att komma vidare i sin förändringsprocess hade personliga insikter stor betydelse och det förekom även upplevelser av motgångar i vardagen hos personer som påverkade livsstilsförändringen. Genom upplevelsen att hitta sig själv kunde personen skapa sig samt upprätthålla sin motivation.

    Slutsats: Stöd och motivation ger högre möjligheter för personer att främja sin hälsa genom att skapa sig nya goda hälsosamma levnadsvanor och därmed reducera riskerna för följdsjukdomar. Genom egenvårdshandlingar kan personen uppnå välbefinnande då det främjar egen hälsa och personens utveckling hos sig själv.

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    BTH2017Björksten
  • 35. Bohman, Doris
    et al.
    Ekman, Sirkka-Liisa
    Wyk, Neltjie van
    Symposium: Qualitative methods can contribute to an understanding in nursing practice2006Conference paper (Refereed)
  • 36.
    Bohman, Doris
    et al.
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Mattsson, Linda
    Borglin, Gunilla
    Primary healthcare nurses' experiences of physical activity referrals: an interview study2015In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, no 3, p. 270-280Article in journal (Refereed)
    Abstract [en]

    CONCLUSION: Our findings suggest that viewing the PAR as a complex intervention, with all that this entails, might be one approach to increasing the number of PARs being issued. Simpler systems, more time and the potential for testing the effectiveness of follow-ups could be possible ways of achieving this. AIM: The aim of this study is to illuminate primary health care (PHC) nurses' experiences of physical activity referrals (PARs). BACKGROUND: Despite extensive knowledge about the substantial health effects physical activities can produce, fewer and fewer people in our modern society regularly engage in physical activity. Within health care and, particularly, within the PHC arena, nurses meet people on a daily basis who need help to engage in a healthier lifestyle. The possibility of issuing written prescriptions for physical activities, often referred to as PARs, has been introduced as a tool to support such lifestyles. However, even though PHC nurses can prescribe physical activities, studies investigating their experience in this type of nursing intervention are rare. METHODS: For this study, 12 semi-structured interviews were conducted with PHC nurses, and the transcribed texts were analysed using a qualitative content analysis. FINDINGS: Two categories--PARs, an important nursing intervention, and PARs, the necessity of organisational support--reflected the nurses' experiences in using PARs.

  • 37. Borglin, Gunilla
    et al.
    Hentzel, Johanna
    Bohman, Doris
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Public health care nurses' views of mothers' mental health in paediatric healthcare services: a qualitative study2015In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 16, no 5, p. 470-480Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate public health nurses' perceptions and experiences of mental health and of the prevention of mental ill health among women postpartum, within paediatric healthcare services. Background: Although maternal health following childbirth should be a priority within primary care, it is known that women postpartum do not always receive the support they need to adapt to and cope with motherhood. Research implies that postnatal problems lack recognition and are not always acknowledged in routine practice. Few studies have been presented on this topic or from the perspective of nurses. Methods: For this study, eight semi-structured interviews were conducted with public health nurses, and the transcribed texts were analysed through a process inspired by Burnard's description of the four-step qualitative content analysis. Findings: Three categories - external influences on postpartum mental health, screening for and preventing postpartum mental ill health and paediatric healthcare services as a platform for support - were interpreted to reflect the nurses' perceptions and experiences of mental health among women postpartum and of the prevention of mental ill health among women postpartum. Conclusion: We found that public health nurses can have an important role in supporting mothers' mental health postpartum. Although caution is warranted in interpreting our results, the findings concur with those of other studies, highlighting that an equal care emphasis on both the mother and child can be an important aspect of successful support. Implementing person-centred care might be one strategy to create such an emphasis, while also promoting the mental health of new mothers. Public health nurses have a unique opportunity to support mothers' transition into healthy motherhood, especially because they are likely to meet both mothers and children on a regular basis during the first year after birth.

  • 38.
    Bratt, Anna
    et al.
    Linnéuniversitetet, SWE.
    Stenström, Ulf
    Linnéuniversitetet, SWE.
    Rennemark, Mikael
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    Exploring the Most Important Negative Life Events in Older Adults Bereaved of Child, Spouse, or Both2018In: Omega, ISSN 0030-2228, E-ISSN 1541-3764, Vol. 76, no 3, p. 227-236Article in journal (Refereed)
    Abstract [en]

    Losing a child or a spouse is described as the worst of experiences. However, it is not known whether older adults bereaved of a child, spouse, or both child and spouse experience these losses as among the most important negative events in their lifetime. The aim of this study was to investigate whether the 1,437 older adults bereaved of a child, spouse, or both included in the southern part of the Swedish National Study of Aging and Care mentioned these losses when asked about their three most important negative life events. Gender differences in their choices of important negative life events were also explored. About 70% of those bereaved of a child or a spouse mentioned these losses as among their three most important negative life experiences. In the child-and-spouse-bereaved group, 48% mentioned both the loss of their child and spouse, while 40% mentioned either the loss of a child or a spouse. Gender differences were only found in the child-and-spouse-bereaved group, with a few more women mentioning the loss of the child but not the spouse, and the men showing the opposite pattern. © The Author(s) 2016.

  • 39.
    Brennan, Ciara
    et al.
    University of Iceland, ISL.
    Rice, James Gordon
    University of Iceland, ISL.
    Traustadóttir, Rannveig
    University of Iceland, ISL.
    Anderberg, Peter
    Blekinge Institute of Technology, Faculty of Engineering, Department of Health.
    How can states ensure access to personal assistance when service delivery is decentralized?: A multi-level analysis of Iceland, Norway and Sweden2017In: Scandinavian Journal of Disability Research, ISSN 1501-7419, E-ISSN 1745-3011, Vol. 19, no 4, p. 334-346Article in journal (Refereed)
    Abstract [en]

    Article 19 of the United Nations (UN) Convention on the Rights of Persons with Disabilities requires states to ensure that persons with disabilities have access to a range of support services, including personal assistance. The Convention is an agreement between state parties and the UN. However, in practice, disability services are often implemented at the local level. Drawing on the findings of qualitative research in Iceland, Norway and Sweden, this paper examines a paradox whereby states commit to ensure access to support services, but decentralize responsibility to autonomous and independent local governments. A multi-level governance framework is applied to analyse the findings of qualitative inquiry with policy-makers, local government officials and leaders of independent living organizations in all three Nordic countries. A multi-level analysis highlights the tensions and contradictions between decentralization and human rights commitments. © 2016 Nordic Network on Disability Research

  • 40. Bunikis, Jonas
    et al.
    Garpmo, Ulf
    Tsao, J.
    Berglund, Johan
    Fish, Durland
    Barbour, AG
    Sequence typing reveals extensive strain diversity of the Lyme borreliosis agents Borrelia burgdorferi in North America and Borrelia afzelii in Europe.2004In: Microbiology, ISSN 1350-0872, E-ISSN 1465-2080, Vol. 150, no 6, p. 1741-1755Article in journal (Refereed)
    Abstract [en]

    The genetic polymorphism of Borrelia burgdorferi and Borrelia afzelii, two species that cause Lyme borreliosis, was estimated by sequence typing of four loci: the rrs-rrlA intergenic spacer (IGS) and the outer-membrane-protein gene p66 on the chromosome, and the outer-membrane-protein genes ospA and ospC on plasmids. The major sources of DNA for PCR amplification and sequencing were samples of the B. burgdorferi tick vector Ixodes scapularis, collected at a field site in an endemic region of the north-eastern United States, and the B. afzelii vector Ixodes ricinus, collected at a similar site in southern Sweden. The sequences were compared with those of reference strains and skin biopsy isolates, as well as database sequences. For B. burgdorferi, 10-13 alleles for each of the 4 loci, and a total of 9 distinct clonal lineages with linkage of all 4 loci, were found. For B. afzelii, 2 loci, ospC and IGS, were examined, and 11 IGS genotypes, 12 ospC alleles, and a total of 9 linkage groups were identified. The genetic variants of B. burgdorferi and B. afzelii among samples from the field sites accounted for the greater part of the genetic diversity previously reported from larger areas of the north-eastern United States and central and northern Europe. Although ospC alleles of both species had higher nucleotide diversity than other loci, the ospC locus showed evidence of intragenic recombination and was unsuitable for phylogenetic inference. In contrast, there was no detectable recombination at the IGS locus of B. burgdorferi. Moreover, beyond the signature nucleotides that specified 10 IGS genotypes, there were additional nucleotide polymorphisms that defined a total of 24 subtypes. Maximum-likelihood and parsimony cladograms of B. burgdorferi aligned IGS sequences revealed the subtype sequences to be terminal branches of clades, and the existence of at least three monophyletic lineages within B. burgdorferi. It is concluded that B. burgdorferi and B. afzelii have greater genetic diversity than had previously been estimated, and that the IGS locus alone is sufficient for strain typing and phylogenetic studies.

  • 41. Bunikis, Jonas
    et al.
    Tsao, J.
    Garpmo, Ulf
    Berglund, Johan
    Fish, Durland
    Barbour, AG
    Typing of Borrelia relapsing fever group strains.2004In: Emerging Infectious Diseases, ISSN 1080-6040, E-ISSN 1080-6059, Vol. 10, no 9, p. 1661-1664Article in journal (Refereed)
    Abstract [en]

    Partial sequencing of the 16S-23S rDNA intergenic spacer showed two to four genotypes each for Borrelia hermsii and B. turicatae, both relapsing fever agents transmitted by argasid ticks, and for B. miyamotoi and B. lonestari, transmitted by ixodid ticks. Field surveys of Ixodes ticks in Connecticut and Sweden showed limited local diversity for B. miyamotoi.

  • 42. Carlsson, Marianne
    et al.
    Arman, Maria
    Backman, Marie
    Flatters, U
    Hatschek, T
    Hamrin, Elisabeth
    Evaluation of quality of life/life satisfaction in women with breast cancer in complementary and conventional care2004In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 43, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    The aim was to study the perceived quality of life/life satisfaction in a sample of women with breast cancer who were treated in a hospital with alternative/complementary care and the same variables in individually matched patients who received only conventional medical treatment. A non-randomized controlled trial design with repeated measurements was used. Sixty women with breast cancer treated with anthroposophic medicine (ABCW) and 60 with conventional medicine (CBCW) were included and 36 matched pairs took part on all occasions. The quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire (LSQ). The comparisons were calculated as effect sizes (ES). The women in the ABCW group reported small or moderate effects, expressed as ES, on their quality of life/life satisfaction compared to their matched "twins'' in the CBCW group at the 1-year follow-up in 15 out of 21 scales/factors. It was concluded that the women who had chosen anthroposophic care increased their perceived quality of life/life satisfaction according to the methodology of the study.

  • 43. Carlsson, Marianne
    et al.
    Arman, Maria
    Backman, Marie
    Hamrin, Elisabeth
    Perceived quality of life and coping for Swedish women with breast cancer who choose complementary medicine2001In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, p. 395-401Article in journal (Refereed)
    Abstract [en]

    The aim of the present study, which is part of a major clinical controlled study of the life situation of women with breast cancer, was to compare two groups of women concerning perceived quality of life and coping. The women were treated in two different cancer treatment programs: complementary treatment, which included anthroposophic therapy, and conventional cancer treatment. A total of 120 women were included, 60 women treated with anthroposophic medicine, and 60 individually matched women treated with conventional medicine only. Quality of life was measured by the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire, Core 30, and the Life Satisfaction Questionnaire. Coping was measured by the Mental Adjustment to Cancer scale. The results showed that the women who chose anthroposophic therapy perceived their quality of life to be lower on admission to the hospital and showed more anxious preoccupation than the women in conventional medicine. It can be concluded that, due to the careful matching procedure, the women in the two groups are comparable in a medical sense but not from the perspective of quality of life and coping.

  • 44.
    Cheddad, Abbas
    et al.
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science.
    Kusetogullari, Hüseyin
    Blekinge Institute of Technology, Faculty of Computing, Department of Computer Science.
    Hilmkil, Agrin
    Peltarion AB,SWE.
    Sundin, Lena
    Independent Researcher, SWE.
    Yavariabdi, Amir
    KTO Karatay Univ, TUR.
    Aouache, Mustapha
    Dev Technol Avancees CDTA, Div Telecom, DZA.
    Hall, Johan
    Arkiv Digital AD AB, SWE.
    SHIBR-The Swedish Historical Birth Records: a semi-annotated dataset2021In: Neural Computing & Applications, ISSN 0941-0643, E-ISSN 1433-3058, Vol. 33, no 22, p. 15863-15875Article in journal (Refereed)
    Abstract [en]

    This paper presents a digital image dataset of historical handwritten birth records stored in the archives of several parishes across Sweden, together with the corresponding metadata that supports the evaluation of document analysis algorithms' performance. The dataset is called SHIBR (the Swedish Historical Birth Records). The contribution of this paper is twofold. First, we believe it is the first and the largest Swedish dataset of its kind provided as open access (15,000 high-resolution colour images of the era between 1800 and 1840). We also perform some data mining of the dataset to uncover some statistics and facts that might be of interest and use to genealogists. Second, we provide a comprehensive survey of contemporary datasets in the field that are open to the public along with a compact review of word spotting techniques. The word transcription file contains 17 columns of information pertaining to each image (e.g., child's first name, birth date, date of baptism, father's first/last name, mother's first/last name, death records, town, job title of the father/mother, etc.). Moreover, we evaluate some deep learning models, pre-trained on two other renowned datasets, for word spotting in SHIBR. However, our dataset proved challenging due to the unique handwriting style. Therefore, the dataset could also be used for competitions dedicated to a large set of document analysis problems, including word spotting.

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    fulltext
  • 45. Czabanowska, Katarzyna
    et al.
    Laaser, Ulrich
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Shaping and Authorising a Public Health Profession2014Conference paper (Refereed)
    Abstract [en]

    The aim of the presentation and the following paper was to stimulate debate on the state of a public health profession in Europe and measures and actions which need to be taken to authorise public health professionals based on their competencies.

  • 46. Czabanowska, Katarzyna
    et al.
    Stjernberg, Louise
    Blekinge Institute of Technology, Faculty of Health Sciences, Department of Health.
    Laaser, Ulrich
    Shaping and Authorising a Public Health Profession.2014In: The South Eastern European Journal of Public Health, ISSN 2197-5248, Vol. 31 MayArticle in journal (Refereed)
    Abstract [en]

    The aim of this short communication is to stimulate a discussion on the state of a public health profession in Europe and actions which need to be taken to authorise public health professionals based on their competencies. While regulated professions such as medical doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/ 36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these elite. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself, second, we explain who public health professionals are and what usually is required for shaping the public health profession, and thirdly, we attempt to sketch the road to the authorisation or licencing of public health professionals. Finally, we will propose some recommendation.

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    FULLTEXT01
  • 47.
    Doering, Nicola
    et al.
    Tech Univ Ilmenau, DEU.
    De Moor, Katrien
    Norwegian Univ Sci & Technol, NOR.
    Fiedler, Markus
    Blekinge Institute of Technology, Faculty of Computing, Department of Technology and Aesthetics.
    Schoenenberg, Katrin
    Berg Univ Wuppertal, DEU.
    Raake, Alexander
    Tech Univ Ilmenau, DEU.
    Videoconference Fatigue: A Conceptual Analysis2022In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 4Article in journal (Refereed)
    Abstract [en]

    Videoconferencing (VC) is a type of online meeting that allows two or more participants from different locations to engage in live multi-directional audio-visual communication and collaboration (e.g., via screen sharing). The COVID-19 pandemic has induced a boom in both private and professional videoconferencing in the early 2020s that elicited controversial public and academic debates about its pros and cons. One main concern has been the phenomenon of videoconference fatigue. The aim of this conceptual review article is to contribute to the conceptual clarification of VC fatigue. We use the popular and succinct label "Zoom fatigue" interchangeably with the more generic label "videoconference fatigue" and define it as the experience of fatigue during and/or after a videoconference, regardless of the specific VC system used. We followed a structured eight-phase process of conceptual analysis that led to a conceptual model of VC fatigue with four key causal dimensions: (1) personal factors, (2) organizational factors, (3) technological factors, and (4) environmental factors. We present this 4D model describing the respective dimensions with their sub-dimensions based on theories, available evidence, and media coverage. The 4D-model is meant to help researchers advance empirical research on videoconference fatigue.

    Download full text (pdf)
    fulltext
  • 48. Ekelin, Annelie
    et al.
    Ranerup, Agneta
    Enrolling Local Strategic Actors in Public Portal Development2011Conference paper (Refereed)
    Abstract [en]

    The focus of this paper is on seemingly mundane but essential aspects of network formation between actors in E-government contexts. It is based on a qualitative case study of portal development in public healthcare. The theoretical framework applied is Actor-Network Theory (ANT). The research question is: What factors contribute to the enrolment of strategic local actors in technology development in E-government? It was found that seemingly simple but basic functionalities like e.g. information about illnesses, rights, healthcare providers as well as personal e-services were of strategic importance for enrolling local actors to the process and to the portal, serving as a kind of “enrolment devices.” The reason is their capacity to provide useful functionality and communicate usefulness. Due to the complexity of the environment, local support based on perceived and future usefulness as well as long-term project organization safeguarding future development were seen as critical success factors.

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    FULLTEXT01
  • 49. Emami, A
    et al.
    Benner, PE
    Lipson, JG
    Ekman, Sirkka-Liisa
    Health as continuity and balance in life2000In: Western Journal of Nursing Research, ISSN 0193-9459, E-ISSN 1552-8456, Vol. 22, no 7, p. 812-825Article in journal (Refereed)
    Abstract [en]

    Research on immigrant health emphasizes that the elderly are more vulnerable than other age groups in many immigrant populations. This study describes the meanings of health, illness, and disease for Iranian elderly immigrants in Sweden and their relationships with life disruptions. Analysis of interviews using an interprerive-phenomenological method illustrates that the participants experience health as continuity and balance in life. Any disruption of this balance creates a sense of illness that is only partially related to the emergence of disease. Participants did nor view health and disease as polarized. Rather disease is just one component among many that may disrupt the experience of health. Health is perceived as a sense of well-being, can be achieved in spite of disease, and can be disrupted even in the absence of disease. This description of the meaning of health, disease, and illness contrasts with the Western biomedical perspective and is similar in its holism to various non-Western medical systems and complementary approaches. This knowledge can foster more culturally sensitive care.

  • 50.
    Faisal, Mohammed
    et al.
    Blekinge Institute of Technology, School of Engineering, Department of Electrical Engineering.
    Uddin, Jia
    Blekinge Institute of Technology, School of Engineering, Department of Electrical Engineering.
    Shil, Shimul
    Blekinge Institute of Technology, School of Engineering, Department of Electrical Engineering.
    Performance of VoIP networks using MPLS traffic engineering2012In: Advanced Materials Research, Trans Tech Publications , 2012, Vol. 457-458, p. 927-930Conference paper (Refereed)
    Abstract [en]

    The implementation of Voice over Internet Protocol (VoIP) technology is on the increase because of its ability to enhance operating efficiency and reduce infrastructure cost. Voice and data packets traverse over IP networks with fixed maximum capacity. But susceptibility to traffic congestion which results in delay and packet losses is still a major challenge of VoIP technology. Multiprotocol Label Switching Protocol (MPLS) with Traffic Engineering (TE) is an approved standard technology that has the capabilities to minimize network congestion and improve network performance by reducing delay and packet loss to yield a higher throughput. In this paper, we investigate how MPLS Traffic Engineering can be implemented to reduce traffic congestion on VoIP networks.

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