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  • 1.
    Anderberg, Peter
    Certec, Lund University, Sweden.
    ANED country report on the implementation of policies supporting independent living for disabled people: Sweden2009Report (Other academic)
  • 2.
    Anderberg, Peter
    Lund University, Sweden.
    FACE: Disabled People, Technology and Internet2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis is based on the Internet experiences of people withsignificant mobility/physical impairments who are proficient andexperienced computer users in their computer world but havelimitations in mobility that severely restrict their functioning inthe physical world. The Internet functioning of this group isanalysed by means of the factors attitude, control and enabling,with the main focus on what is achievable when all accessproblems such as unadapted interfaces, beginners’ difficulties andthe digital divide are overcome. If the virtual world is fullyavailable but the real world is not – what are the effects onlearning, self image, communities of practice, sense of coherence,power and control? What are the effects on peer-to-peer learningand co-operation? Independent living concepts and theoriesmanifest themselves throughout the thesis, most obviously,perhaps, in the selection of issues that are studied and in theperspectives.

    The theoretical background and concepts are those of disabilitystudies, with a social model and independent living perspective,and with strong influences from rehabilitation engineering anddesign.

    Throughout the thesis elaborations and clarifications of thepossibilities of interplay and co-existence between rehabilitationengineering and design and disability studies are made. Differentaspects of function design and technology are examined from anexpanded view on functioning, where technology is put in anindividual and social context with the FACE (Function – Attitude, Control, Enabling) tool.

  • 3.
    Anderberg, Peter
    Centrum för rehabiliteringsteknik vid Lunds tekniska högskola, Lunds universitet.
    Funktionshinder och IT1999Report (Other academic)
  • 4.
    Anderberg, Peter
    Blekinge Institute of Technology, Sweden.
    Gerontechnology, Digitalization, and the Silver Economy2020In: XRDS: Crossroads, the ACM Magazine for Students, Vol. 26, no 3, p. 46-49Article in journal (Other academic)
    Abstract [en]

    Digitalization in healthcare is posed to change the way the older population is treated, the way health workers relate to them, and the participation of computing professionals in the mix.

  • 5.
    Anderberg, Peter
    Certec, Centrum för rehabiliteringsteknisk forskning, Institutionen för designvetenskap, Lunds tekniska högskola, Lunds universitet.
    Internetlärande för alla: Om insatser för de första fullvärdiga studiemöjligheterna förfunktionshindrade människor1999Licentiate thesis, monograph (Other academic)
  • 6.
    Anderberg, Peter
    Certec, Division of Rehabilitation Engineering Research Department of Design Sciences Lund University, Sweden.
    Making both ends meet2005In: Disability Studies Quarterly, ISSN 1041-5718, E-ISSN 2159-8371, Vol. 25, no 3Article in journal (Refereed)
    Abstract [en]

    The purpose of this article is to launch a new conceptual design tool in rehabilitation engineering,technology, and Disability Studies, useful both as guidance and help for people with disabilities inanalyzing their own functional aids, and as inspiration and meta-guidelines for designers. It is nondiscriminatingand classification-free and differs from a mere classification system like theInternational Classification of Functioning (ICF). The origin of the tool is twofold: experiences of myown disability and of research in rehabilitation engineering.

  • 7.
    Anderberg, Peter
    Lunds tekniska högskola, Sveirge.
    Makt & Maskiner2005In: Människonära design / [ed] Bodil Jönsson, Lund: Studentlitteratur AB, 2005, 1, p. 107-114Chapter in book (Other academic)
  • 8.
    Anderberg, Peter
    Lunds universitet.
    Makt & maskiner2005In: Människonära design / [ed] Bodil Jönsson, Lund: Studentlitteratur AB, 2005, 1, p. 107-114Chapter in book (Other academic)
  • 9.
    Anderberg, Peter
    Lund University, Sweden.
    Might and machines2006In: Design Side by Side / [ed] Bodil Jönsson, Lund: Studentlitteratur AB, 2006, 1, p. 109-117Chapter in book (Other academic)
  • 10.
    Anderberg, Peter
    Lund University, Sweden.
    Peer assistance for personal assistance: Analysis of online discussions about personal assistance from a Swedish web forum for disabled people2007In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 22, no 3, p. 251-265Article in journal (Refereed)
    Abstract [en]

    This paper describes and analyses a community of disabled people in Sweden that use an online forum to discuss personal assistance issues. The forum is a community of practice (CoP) that has its roots in everyday living with personal assistance. The contributions to the forum were studied over a 41/2 year period, including a total of 2755 postings from 146 persons. The levels of the CoP learning system were analysed using the FACE tool, which examines function based on attitude, control and enabling. The results indicate that a learning system was established within the CoP that made it possible for disabled people to complement, confront and counterbalance the influences of existing learning systems, theories and methods of professionals in the area of personal assistance.

  • 11.
    Anderberg, Peter
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Where does the person end and the technology begin?2017In: Disability, Space, Architecture: A Reader / [ed] Jos Boys, London: Routledge, 2017, 1, p. 189-193Chapter in book (Other academic)
    Abstract [en]

    It is difficult, often meaningless to try to figure out where the person ends and the technology starts. The boundaries one has for experiencing the world go beyond the physical limitations of his/her skin and are determined by the system for experiencing the world in which he/she exist. In his book, Steps to an Ecology of Mind, the cybernetics pioneer Gregory Bateson illustrates this point with the example of a blind man with a walking stick. In her book, The War of Desire and Technology at the Close of the Mechanical Age, Allucquere Roseanne Stone describes her feelings after attending a lecture given by the physicist, Stephen Hawking. Stone starts off listening to Hawking outside the overcrowded auditorium through the Public Audio system (PA), but decides she wants to go in and see and listen to him in person. Hernwall uses the concept "cyborg" when considering a human being with his or her technology as a functional unit.

  • 12.
    Anderberg, Peter
    Lund University, Sweden.
    WWW.Welcoming.Wide.World: Internet and mobility impairments2006Report (Other academic)
    Abstract [en]

    This report describes the everyday use of computers by two women and five men with significant mobility impairments. The seven people range in age from 25 to 54. They are all experienced in using computers and the Internet for personal purposes and their everyday work. All of the people in the study require a personal assistant (PA) from seven to 24 hours a day. Pseudonyms have been used to ensure anonymity.

    This specially selected group of users is not statistically representative of Internet users with disabilities. Their reflections and answers to questions presented here are based on extensive and rather specialized experience, and hence do not include aspects related to inexperience and/or poor adaptations of the user interfaces.

    In qualitative research, content validity is based on an existing, extensive and open knowledge about the subject under study. My knowledge comes from 20 years as a computer user, 15 years as a wheelchair and personal assistance user, more than 10 years as an Internet user, and more than five years of postgraduate studies the area of disability studies and independent living theory. The basis of the latter is that disability is situated and relative, which has greatly influenced and guided my work. This blend of experience and knowledge is the most important cornerstone of my career as a researcher in the field of rehabilitation engineering.

  • 13.
    Anderberg, Peter
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Abrahamsson, Linda
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    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.

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  • 14.
    Anderberg, Peter
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Barnestein-Fonseca, Pilar
    Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain.
    Guzman-Parra, Jose
    Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain.
    Garolera, Maite
    Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain.
    Quintana, Maria
    Brain, Cognition and Behavior - Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain.
    Mayoral-Cleries, Fermin
    Research Unit, La Unidad de Gestión Clínica de Mental Health, Instituto de Investigación Biomédica de Málaga, Hospital Regional Universitario Málaga, Malaga, Spain.
    Lemmens, Evi
    University Colleges Leuven-Limburg, Genk, Belgium.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    The Effects of the Digital Platform Support Monitoring and Reminder Technology for Mild Dementia (SMART4MD) for People With Mild Cognitive Impairment and Their Informal Carers: Protocol for a Pilot Randomized Controlled Trial2019In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 8, no 6, article id e13711Article in journal (Refereed)
    Abstract [en]

    Background: Many countries are witnessing a trend of growth in the number and proportion of older adults within the total population. In Europe, population aging has had and will continue to have major social and economic consequences. This is a fundamentally positive development where the added life span is of great benefit for both the individual and the society. Yet, the risk for the individual to contract noncommunicable diseases and disability increases with age. This may adversely affect the individual's ability to live his or her life in the way that is desired. Cognitive conditions constitute a group of chronic diseases that predominantly affects older people. Recent technology advancements can help support the day-to-day living activities at home for people with cognitive impairments. Objective: A digital platform (Support Monitoring and Reminder for Mild Dementia; SMART4MD) is created to improve or maintain the quality of life for people with mild cognitive impairment (PwMCI) and their carers. The platform will provide reminders, information, and memory support in everyday life, with the purpose of giving structure and lowering stress. In the trial, we will include participants with a diagnosed neurocognitive disorder as well as persons with an undiagnosed subjective memory problem and cognitive impairment, that is, 20 to 28 points on the Mini-Mental State Examination. Methods: A pragmatic, multicenter RCT is being conducted in Spain, Sweden, and Belgium. The targets for recruitment are 1200 dyads-split into an intervention group and a control group that are in usual care. Intervention group participants will be provided with a data-enabled computer tablet with the SMART4MD app. Its core functionalities, intended to be used daily at home, are based on reminders, cognitive supporting activities, and sharing health information. Results: Inclusion of participants started in December 2017, and recruitment is expected to end in February 2019. Furthermore, there will be 3 follow-up visits at 6, 12, and 18 months after the baseline visit. Conclusions: This RCT is expected to offer benefits at several levels including in-depth knowledge of the possibilities of introducing a holistic multilayered information and communication technology solution for this group. SMART4MD has been developed in a process involving the structured participation of PwMCI, their informal carers, and clinicians. The adoption of SMART4MD faces the challenge of this age group's relative unfamiliarity with digital devices and services. However, this challenge can also be an opportunity for developing a digital device tailored to a group at risk of digital exclusion. This research responds to the wider call for the development of digital devices which are accessible and affordable to older people and this full scale RCT can hopefully serve as a model for further studies in this field.

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  • 15.
    Anderberg, Peter
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Björling, Gunilla
    Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden ; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Stjernberg, Louise
    Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden ; Unit of Quality & Development, Region of Blekinge, Karlskrona, Sweden.
    Bohman, Doris
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Analyzing Nursing Students' Relation to Electronic Health and Technology as Individuals and Students and in Their Future Career (the eNursEd Study): Protocol for a Longitudinal Study2019In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 8, no 10, article id e14643Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students' internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study.

    OBJECTIVE: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students' knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge?

    METHODS: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study.

    RESULTS: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019.

    CONCLUSIONS: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students' attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students' knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14643.

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  • 16.
    Anderberg, Peter
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Eivazzadeh, Shahryar
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    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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  • 17.
    Anderberg, Peter
    et al.
    University of Lund, Sweden.
    Jönsson, Bodil
    University of Lund, Sweden.
    Being there2005In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 20, no 7, p. 719-733Article in journal (Refereed)
    Abstract [en]

    This paper examines the use of the Internet as experienced by people with significant mobility/physicalimpairments who are accustomed to using computers. The study is based on interviews andfocuses on computer usage in everyday action and interaction. In many cases, the possibilities thatthe computer and Internet offer have meant not only important improvements in quality of life, butfirst-time occurrences of great personal significance. The analysis is phenomenographic, resultingin main categories and subcategories, illustrated primarily through direct quotations. The threemain categories are independence, communication, and learning.

  • 18.
    Anderberg, Peter
    et al.
    Certec, Department of Design Sciences, Lund University, Sweden.
    Olander, Elin
    Industrial Design, Department of Design Sciences, Lund University, Sweden.
    Jönsson, Bodil
    Certec, Department of Design Sciences, Lund University, Sweden.
    Sperling, Lena
    Industrial Design, Department of Design Sciences, Lund University, Sweden.
    Enabling Design2009In: Ergonomics for Rehabilitation Professionals / [ed] Shrawan Kumar, Boca Raton: CRC Press, 2009, 1, p. 477-506Chapter in book (Other academic)
    Abstract [en]

    Designed to meet the diverse needs of therapists, this book presents a new approach to rehabilitation that integrates ergonomics concepts to address the wide range of problems commonly encountered by professionals. The first section addresses general concepts such as anthropometry and tissue mechanics. The next section explores whole body biomechanics, demonstrating the ergonomic effects of physiological and biomechanical factors. The third section focuses on regional biomechanics, explaining the rationale for ergonomic intervention. The final section of the text offers with a detailed discussion of the ergonomic paradigm in rehabilitation, including the use of physical demands analysis.

  • 19.
    Anderberg, Peter
    et al.
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Abrahamsson, Linda
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    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, p. 1-11, 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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  • 20.
    Andersson, Ewa K.
    et al.
    Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Dallora, Ana Luiza
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Marcinowicz, Ludmila
    Faculty of Health Sciences, Medical University of Bialystok, Poland.
    Stjernberg, Louise
    Department of Care Science, Malmö University, Sweden ; Swedish Red Cross University, Huddinge, Sweden.
    Björling, Gunilla
    School of Health and Welfare, Jönköping University, Sweden ; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden ; Faculty of Nursing, Kilimanjaro Christian Medical University College, Tanzania.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Bohman, Doris
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden ; Optentia Research Unit, North-West University, Vanderbijlpark Campus, South Africa.
    Self-Reported eHealth literacy among nursing students in Sweden and Poland: The eNursEd cross-sectional multicentre study2023In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 29, no 4Article in journal (Refereed)
    Abstract [en]

    This study aimed to provide an understanding of nursing students’ self-reported eHealth literacy in Sweden and Poland. This cross-sectional multicentre study collected data via a questionnaire in three universities in Sweden and Poland. Descriptive statistics, the Spearman’s Rank Correlation Coefficient, Mann–Whitney U, and Kruskal–Wallis tests were used to analyse different data types. Age (in the Polish sample), semester, perceived computer or laptop skills, and frequency of health-related Internet searches were associated with eHealth literacy. No gender differences were evidenced in regard to the eHealth literacy. Regarding attitudes about eHealth, students generally agreed on the importance of eHealth and technical aspects of their education. The importance of integrating eHealth literacy skills in the curricula and the need to encourage the improvement of these skills for both students and personnel are highlighted, as is the importance of identifying students with lacking computer skills. 

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  • 21.
    Behrens, Anders
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sleep disturbance predicts worse cognitive performance in subsequent years: A longitudinal population-based cohort study2023In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 106, article id 104899Article in journal (Refereed)
    Abstract [en]

    Background: Poor sleep is a potential modifiable risk factor for later life development cognitive impairment. The aim of this study is to examine if subjective measures of sleep duration and sleep disturbance predict future cognitive decline in a population-based cohort of 60, 66, 72 and 78-year-olds with a maximal follow up time of 18 years. Methods: This study included participants from the Swedish National Study on Ageing and Care – Blekinge, with assessments 2001–2021. A cohort of 60 (n = 478), 66 (n = 623), 72 (n = 662) and 78 (n = 548) year-olds, were assessed at baseline and every 6 years until 78 years of age. Longitudinal associations between sleep disturbance (sleep scale), self-reported sleep duration and cognitive tests (Mini Mental State Examination and the Clock drawing test) were examined together with typical confounders (sex, education level, hypertension, hyperlipidemia, smoking status, physical inactivity and depression). Results: There was an association between sleep disturbance at age 60 and worse cognitive function at ages 60, 66 and 72 years in fully adjusted models. The association was attenuated after bootstrap-analysis for the 72-year-olds. The items of the sleep scale most predictive of later life cognition regarded nightly awakenings, pain and itching and daytime naps. Long sleep was predictive of future worse cognitive function. Conclusion: Sleep disturbance was associated with worse future cognitive performance for the 60-year-olds, which suggests poor sleep being a risk factor for later life cognitive decline. Questions regarding long sleep, waking during the night, pain and itching and daytime naps should be further explored in future research and may be targets for intervention. 

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  • 22.
    Behrens, Anders
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    CoGNIT Automated Tablet Computer Cognitive Testing in Patients With Mild Cognitive Impairment: Feasibility Study2022In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 6, no 3, article id e23589Article in journal (Refereed)
    Abstract [en]

    Background: Early diagnosis of cognitive disorders is becoming increasingly important. Limited resources for specialist assessment and an increasing demographical challenge warrants the need for efficient methods of evaluation. In response, CoGNIT, a tablet app for automatic, standardized, and efficient assessment of cognitive function, was developed. Included tests span the cognitive domains regarded as important for assessment in a general memory clinic (memory, language, psychomotor speed, executive function, attention, visuospatial ability, manual dexterity, and symptoms of depression). Objective: The aim of this study was to assess the feasibility of automatic cognitive testing with CoGNIT in older patients with symptoms of mild cognitive impairment (MCI). Methods: Patients older than 55 years with symptoms of MCI (n=36) were recruited at the research clinic at the Blekinge Institute of Technology (BTH), Karlskrona, Sweden. A research nurse administered the Mini-Mental State Exam (MMSE) and the CoGNIT app on a tablet computer. Technical and testing issues were documented. Results: The test battery was completed by all 36 patients. One test, the four-finger-tapping test, was performed incorrectly by 42% of the patients. Issues regarding clarity of instructions were found in 2 tests (block design test and the one finger-tapping test). Minor software bugs were identified. Conclusions: The overall feasibility of automatic cognitive testing with the CoGNIT app in patients with symptoms of MCI was good. The study highlighted tests that did not function optimally. The four-finger-tapping test will be discarded, and minor improvements to the software will be added before further studies and deployment in the clinic. © 2022 JMIR Publications Inc.. All right reserved.

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  • 23.
    Berner, Jessica
    et al.
    Vrije Universiteit Amsterdam, the Netherlands.
    Aartsen, Marja
    Vrije Universiteit Amsterdam, the Netherlands ; NOVA Social research, Oslo, Norway.
    Wahlberg, Maria
    Aging Research Centre, Karolinska Institute and Stockholm University, Stockholm, Sweden.
    Elmståhl, Sölve
    Lund University Sweden & Skåne University Hospital, Lund, Sweden.
    Berglund, Johan
    Department of Health, Blekinge Institute of technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of technology, Karlskrona, Sweden.
    Deeg, Dorly
    Vrije Universiteit Amsterdam, the Netherlands.
    A cross-national and longitudinal study on predictors in starting and stopping Internet use (2001-2013) by Swedish and Dutch older adults 66 years and above2016In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 14, no 3, p. 157-168Article in journal (Refereed)
    Abstract [en]

    Background The Internet and information com-munication technology is today considered as a means to sustain active and healthy ag-ing, and to provide better care for the aging population. There is an increase in prevalence in older adults using the Internet, however many are still not using the Internet. This study therefore, investigated predictors in starting and stopping Internet use by older adults between 2001-2013 in Sweden and the Netherlands. These represent currently two of the highest older adult Internet users in Europe. The aim of this study was to examine, first, if there was a different starting and stopping rate in Sweden and the Netherlands; second, if the predictors age, gender, education, rural/urban living, living alone/not, cognition and functional limitations have different effects in either country.

    Methods A cross-national and longitudinal design was chosen. Data was used from the Longitudinal Aging study Amsterdam (LASA) and the Swedish National Study on Aging and Care (SNAC). Cox regression analyses were done to test the predictors over time with starting or stop-ping Internet use. An interaction term ‘variable*country’ was then considered for each variable, if significant, leading to a stratification into a multivariate model per country.

    Results More older adults started use in the Netherlands (19%); lower in age, normal cognitive functioning, living alone, fewer functional limitations and lower education were predictive of starting. In Sweden fewer started (10.3%), where being female was the only significant predictor of starting use. Both countries did not have many people stopping use; in the Netherlands (3%) they were younger in age and living urban, whereas in Sweden (1.7%), they had lower cognitive functioning.

    Conclusion Results indicate that there are differences between countries in starting use. These differences can possibly be explained by the early adoption of the Internet in Sweden. The new findings that the older adults living alone and lower educated are now going online, are positive regarding the theme of active aging. For those stopping use, the differences are more country-specific. More research is needed in order to understand better what an older adult was using the Internet for and why they stop.

  • 24.
    Berner, Jessica
    et al.
    Blekinge Institute of Technology, School of Health Science, Karlskrona, Sweden.
    Anderberg, Peter
    Blekinge Institute of Technology, School of Health Science, Karlskrona, Sweden.
    Rennemark, Mikael
    Department of Psychology, Linnaeus University, Växjö, Sweden.
    Berglund, Johan
    Blekinge Institute of Technology, School of Health Science, Karlskrona, Sweden.
    Case management for frail older adults through tablet computers and Skype2016In: Informatics for Health and Social Care, ISSN 1753-8157, E-ISSN 1753-8165, Vol. 41, no 4, p. 405-416Article in journal (Refereed)
    Abstract [en]

    Background: Frail older adults are high consumers of medical care due to their age and multiple chronic conditions. Regular contact with a case manager has been proven to increase well-being of frail older adults and reduce their number of health-care visits. Skype calls through tablet PCs can offer easier communication. Objective: This paper examines frail older adults’ use of tablet computers and Skype, with their case managers.Method: Interviews were conducted on 15 frail older adults. A content analysis was used to structure and analyze the data. Results: The results indicate that tablet computers were experienced in a positive way for most frail older adults. Conflicting feelings did emerge, however, as to whether the frail elderly would adopt this in the long run. Skype needs to be tested further as to whether this is a good solution for communication with their case managers. Strong technical support and well-functioning technology are important elements to facilitate use. Conclusion: Using Skype and tablet PCs do have potential for frail older adults, but need to be tested further.

  • 25.
    Berner, Jessica
    et al.
    Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands ; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
    Comijs, Hannie
    Amsterdam Public Health Research Institute, Amsterdam, the Netherlands ; Department of Psychiatry, VU University Medical Centre, Amsterdam, the Netherlands.
    Elmståhl, Sölve
    Lund University Sweden, Skåne University Hospital, Lund, Sweden.
    Welmer, Anna-Karin
    Aging Research Center, Karolinska Institutet, Stockholm, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Deeg, Dorly
    Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands ; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
    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.

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  • 26.
    Berner, Jessica
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Dallora, Ana Luiza
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Blekinge Institute of Technology, Department of Health, Karlskrona, Sweden.
    Technology anxiety and technology enthusiasm versus digital ageism2022In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 21, no 1Article in journal (Refereed)
    Abstract [en]

    Background: Europe has called attention to the importance of the e-inclusion of older adults. Society is indicating that the developers, websites, and devices are causing age bias in technology. This affects living independently, the values of ethical principles associated with an older person, and digital ageism: which is an age-related bias in artificial intelligence systems. Objective: This research attempts to investigate the instrument technology anxiety and enthusiasm, and assistive technology devices during the period 2019-2021. This instrument may be a way to redress misconceptions about digital ageism. The assistive technology device that we will investigate in this study is the adoption of a service that is designed for online health consultations. Method: The participants are part of the longitudinal Swedish National Study on Aging and Care. Technology anxiety and technology enthusiasm are two factors, which aim to measure technophilia (vs technophobia) in older adults. The age range is 63 -99 years of age in 2019 T1 and 66 -101 in 2021 T2. Wilcoxon rank test was conducted to investigate technology enthusiasm, technology anxiety, and how they changed with time. An Edwards Nunnally index was then calculated for both variables to observe a significant change in score from T1 to T2. Mann Whitney U test was used to investigate the variables sex and health status with technology anxiety & technology enthusiasm in T1 & T2. Age, Cognitive function MMSE, and digital social participation were investigated through a Kruskall-Wallis test. A logistic regression was conducted with the significant variable. Results: Between 2019-2021, change in technology enthusiasm was based on less digital social participation (OR: 0.608; CI 95%: 0.476-0.792). Technology anxiety was significantly higher due to age (OR: 1.086, CI 95%: 1.035-1.139) and less digital social participation (OR: 0.684; CI 95%: 0.522-0.895). The want for online healthcare consultations was popular but usage was low. Conclusion: Staying active online and participating digitally may be a way to reduce digital ageism. However, digital ageism is a complex phenomenon, which requires different solutions in order to include older people and reduce an inaccurate categorisation of this group in the digital society © 2022,Gerontechnology. All Rights Reserved.

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  • 27.
    Berner, Jessica
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Dallora, Ana Luiza
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Palm, Bruna
    Department of Mathematics, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Five-factor model, technology enthusiasm and technology anxiety2023In: Digital Health, E-ISSN 2055-2076, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Older adults need to participate in the digital society, as societal and personal changes and what they do with the remaining time that they have in their older years has an undeniable effect on motivation, cognition and emotion. Changes in personality traits were investigated in older adults over the period 2019–2021. Technology enthusiasm and technology anxiety are attitudes that affect the relationship to the technology used. The changes in the score of technology enthusiasm and technology anxiety were the dependent variables. They were investigated with personality traits, age, gender, education, whether someone lives alone, cognitive function, digital social participation (DSP) and health literacy as predictors of the outcome. The Edwards-Nunnally index and logistic regression were used. The results indicated that DSP, lower age, lower neuroticism and higher education were indicative of less technology anxiety. High DSP and high extraversion are indicative of technology enthusiasm. DSP and attitude towards technology seem to be key in getting older adults to stay active online. 

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  • 28.
    Berner, Jessica
    et al.
    Blekinge Institute of Technology, Sweden.
    Rennemark, Mikael
    Blekinge Institute of Technology, Sweden ; Linnaeus University, Sweden.
    Jogréus, Claes
    Blekinge Institute of Technology, Sweden.
    Anderberg, Peter
    Blekinge Institute of Technology, Sweden.
    Sköldunger, Anders
    Karolinska Institute, Sweden ; Stockholm University, Sweden.
    Wahlberg, Maria
    Karolinska Institute, Sweden ; Stockholm University, Sweden.
    Elmståhl, Sölve
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Berglund, Johan
    Blekinge Institute of Technology, Sweden.
    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.

  • 29. Brantmark, Anette
    et al.
    Chamoun, Karin
    Al Nima, Ali
    Anderberg, Peter
    Fagerström, Cecilia
    Hälsa, sysselsättningoch levnadsvanor: Brukarundersökning av funktionshinder och funktionsnedsättningar och dess stödresurser i Blekinge 3 (BUFUS 3)2018Report (Other academic)
    Abstract [sv]

    Bakgrund

    Folkhälsan i Sverige har blivit bättre men det finns skillnader i hälsa mellan olika grupper. Tobak, alkohol, fysisk aktivitet och kostvanor är levnadsvanor som har betydelse för hälsan. Personer som tillhör någon av de tre personkretsarna inom Lagen om stöd och service till vissa funktionshindrade (LSS) blir ofta exkluderade från studier varför det är svårt att beskriva hälsa och skillnader i levnadsvanor som har betydelse för hälsan i denna grupp. En tidigare brukarundersökning (BUFUS 1) beskriver förekomsten av sysselsättning och hälsa hos personer som har personlig assistans varför syftet med denna undersökning var att skapa en ökad förståelse kring eventuella samband mellan hälsa, sysselsättning och levnadsvanor i en större grupp dvs. personer med funktionsnedsättning som har beslut om LSS-insatser i Blekinge. Syftet var också att få kunskap om hur personer (LSS 1 och 2) beskrev områden som var betydelsefulla för hälsan.

    Metod

    Totalundersökning bland vuxna (18-64 år) och äldre (65 år och äldre) med beslut om LSS-insats, innefattande en tvärsnittstudie (n=574) och en kvalitativ intervjustudie (n=27). Data har analyserats med beskrivande statistik och regressionsanalys samt innehållsanalys.

    Resultat

    Hälsan skilde sig signifikant mellan de tre LSS-grupperna. Färre personer som tillhör LSS 3 skattade sin hälsa som bra jämfört med övriga (LSS 1 och 2). Bland vuxna som tillhör LSS 1 och 2 hade sysselsättning och fysisk aktivitet betydelse för hälsan medan för vuxna som tillhör LSS 3 hade enbart fysisk aktivitet betydelse för hälsan. Fler personer, som tillhör LSS 3 hade fler läkarkontakter jämfört med övriga men oavsett grupp hade läkarkontakt en betydelse för hälsan.

    Slutsats

    Fysisk aktivitet har storbetydelse för hälsa hosvuxna personer oavsett LSS-tillhörighet. Det finns en medvetenhet om vad som behövs för att må bra och att ha någonstans att gå till utanför bostaden har positiv inverkan på hälsan. Det finns skillnader i självskattad hälsa i de olikaLSS-grupperna, och förekommande skillnader i den självskattade hälsa kan vara möjlighet till aktivitet. Modellen som visade att aktivitet förklarar hälsa i grupperna, förklarade dock enbart en liten del av variationen av hälsa. Det behövs fler studier som tar hänsyn tillandra faktorer än de som använts i denna undersökning för att kunna förstå vad som är av betydelse för personernas hälsa i olika ålders-och LSS grupper.

  • 30.
    Brennan, Ciara
    et al.
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Rice, James
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Traustadóttir, Rannveig
    Department of Anthropology and Department of Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Blekinge, Sweden.
    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.

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  • 31.
    Brennan, Ciara
    et al.
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavík, Iceland.
    Traustadóttir, Rannveig
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavík, Iceland.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Rice, James
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavík, Iceland ; Department of Anthropology, University of Iceland, Reykjavík, Iceland.
    Are Cutbacks to Personal Assistance Violating Sweden’s Obligations under the UN Convention on the Rights of Persons with Disabilities?2016In: Laws, E-ISSN 2075-471X, Vol. 5, no 2Article in journal (Refereed)
    Abstract [en]

    Article 19 of the UN Convention on the Rights of Persons with Disabilities requires statesto ensure that disabled people can choose where and with whom they live with access to a rangeof services including personal assistance. Based on qualitative research of the implementationof Article 19 in Nordic countries, this paper focuses on Sweden, which was at the forefront ofimplementing personal assistance law and policy and has been the inspiration for many Europeancountries. Instead of strengthening access to personal assistance, this study found that since theSwedish government ratified the Convention in 2008, there has been an increase in the numbers ofpeople losing state-funded personal assistance and an increase in rejected applications. This paperexamines the reasons for the deterioration of eligibility criteria for accessing personal assistance inSweden. The findings shed light on how legal and administrative interpretations of “basic needs”are shifting from a social to a medical understanding. They also highlight a shift from collaborativepolicy making towards conflict, where courts have become the battleground for defining eligibilitycriteria. Drawing on the findings, we ask if Sweden is violating its obligations under the Convention.

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  • 32.
    Brennan, Ciara
    et al.
    Centre for Disability Studies, School of Social Sciences, University of Iceland, Iceland.
    Traustadóttir, Rannveig
    Centre for Disability Studies, School of Social Sciences, University of Iceland, Iceland.
    Rice, James
    Department of Anthropology and Centre for Disability Studies, School of Social Sciences, University of Iceland, Iceland.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Sweden.
    “Being Number One is the Biggest Obstacle”2018In: Nordisk välfärdsforskning | Nordic Welfare Research, ISSN 1799-4691, E-ISSN 2464-4161, Vol. 3, no 1, p. 18-32Article in journal (Refereed)
    Abstract [en]

    This paper was inspired by a peculiar theme that emerged from qualitative interviews in Iceland, Norway and Sweden with leaders of Centres for Independent Living (CILs). CILs are peer-led organisations that maximise user-control of disability services. Paradoxically, the Nordic reputation as forerunners in deinstitutionalisation and independent living was considered an impediment to implementing Article 19 of the UN Convention on the Rights of Persons with Disabilities which requires “access to a range of support services, including personal assistance necessary to support living and inclusion in the community”. This contradiction prompted the questions: How is Article 19 implemented in Nordic welfare services? And why is previous progress towards independent living and personal assistance seen as an impediment to implementing the rights-based approach required by the Convention? The findings suggest that it is difficult to change a developed welfare system in which there are vested interests in maintaining the status quo. The reputation of “being number one” conceals problems such as inflexible services and the imbalance of power where the control of services lies with the system and the professionals, not the users. 

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  • 33.
    Brennan, Ciara
    et al.
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Traustadóttir, Rannveig
    Centre for Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Rice, James
    Department of Anthropology and Department of Disability Studies, Faculty of Social and Human Sciences, University of Iceland, Reykjavik, Iceland.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Negotiating independence, choice and autonomy: experiences of parents who coordinate personal assistance on behalf of their adult son or daughter2016In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 31, no 5, p. 604-621Article in journal (Refereed)
    Abstract [en]

    Article 19 of the UN Convention on the Rights of Persons with Disabilities requires states to provide personal assistance services. This article is based on qualitative research in Iceland, Norway and Sweden, carried out between 2012 and 2013. The overall study focused broadly on the implementation of Article 19. This article, however, reports findings based on a particular group of participants within the larger study: non-disabled parents who coordinate personal assistance schemes for their adult son or daughter. The article examines the various ways in which the parents, the majority of whom were mothers, negotiate principles of independence, choice and autonomy for their adult son or daughter who requires intensive support, including assistance with communicating. The aim is to explore, in the context of the Convention and the principles of the independent living movement, how to acknowledge and conceptualise personal assistance schemes that require another person to manage on behalf of the user.

  • 34.
    Christiansen, Line
    et al.
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Blekinge Institute of Technology, Karlskrona, Sweden.
    Cellek, Selim
    Anglia Ruskin University, Chelmsford, United Kingdom.
    Zhang, Jufen
    Anglia Ruskin University, Chelmsford, United Kingdom.
    Lemmens, Evi
    University Colleges Leuven-Limburg, Genk, Belgium.
    Garolera, Maite
    Brain, Cognition and Behavior—Clinical Research, Consorci Sanitari de Terrassa, Barcelona, Spain.
    Mayoral-Cleries, Fermin
    Regional University Hospital of Málaga, Spain.
    Skär, Lisa
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Associations Between Mobile Health Technology use and Self-rated Quality of Life: A Cross-sectional Study on Older Adults with Cognitive Impairment2021In: Gerontology and geriatric medicine, E-ISSN 2333-7214, Vol. 7, p. 1-8, article id 23337214211018924Article in journal (Refereed)
    Abstract [en]

    Background: Quality of life (QoL) is affected even at early stages in older adults with cognitive impairment. The use of mobile health (mHealth) technology can offer support in daily life and improve the physical and mental health of older adults. However, a clarification of how mHealth technology can be used to support the QoL of older adults with cognitive impairment is needed. Objective: To investigate factors affecting mHealth technology use in relation to self-rated QoL among older adults with cognitive impairment. Methods: A cross-sectional research design was used to analyse mHealth technology use and QoL in 1,082 older participants. Baseline data were used from a multi-centered randomized controlled trial including QoL, measured by the Quality of Life in Alzheimer’s Disease (QoL-AD) Scale, as the outcome variable. Data were analyzed using logistic regression models. Results: Having moderately or high technical skills in using mHealth technology and using the internet via mHealth technology on a daily or weekly basis was associated with good to excellent QoL in older adults with cognitive impairment. Conclusions: The variation in technical skills and internet use among the participants can be interpreted as an obstacle for mHealth technology to support QoL. © The Author(s) 2021.

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  • 35.
    Christiansen, Line
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Lindberg, Catharina
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Using Mobile Health and the Impact on Health-Related Quality of Life: Perceptions of Older Adults with Cognitive Impairment2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 8, article id 2650Article in journal (Refereed)
    Abstract [en]

    Digital health technologies such as mobile health (mHealth) are considered to have the potential to support the needs of older adults with cognitive impairment. However, the evidence for improving health with the use of mHealth applications is of limited quality. Few studies have reported on the consequences of technology use concerning the older adults' quality of life. The purpose of this study was to describe perceptions of mHealth and its impact on health-related quality of life (HRQoL) among older adults with cognitive impairment. The study was conducted using a qualitative design with a phenomenographic approach. A total of 18 older participants with cognitive impairment were interviewed. The interviews were analyzed in order to apply phenomenography in a home-care context. The results showed variations in the older adults' perceptions that were comprised within three categories of description; Require technology literacy, Maintain social interaction, and Facilitate independent living. In conclusion, the development and design of mHealth technologies need to be tailored based on older adults´ needs in order to be understood and perceived as useful in a home-care context. For mHealth to support HRQoL, healthcare should be provided in a way that encourages various forms of communication and interaction.

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  • 36.
    Christiansen, Line
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Lindberg, Catharina
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Skär, Lisa
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Health-related quality of life and related factors among a sample of older people with cognitive impairment2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 849-859Article in journal (Refereed)
    Abstract [en]

    Aim: This study aimed to identify factors affecting health-related quality of life (HRQoL) of older adults with cognitive impairment and to describe the association of these factors with different components of HRQoL. Design: A cross-sectional, descriptive research design was used. Methods: Data were collected from 247 individuals aged 60 years and older from a Swedish longitudinal cohort study. The Short-Form Health Survey-12 (SF-12) and EuroQol (EQ-5D) were used to assess HRQoL. The data were analysed using descriptive and comparative statistics. Results: The present study identified several factors that influenced HRQoL of older adults with cognitive impairment. The results of a multiple logistic regression analysis revealed that the following factors were associated with physical and mental HRQoL: dependency in activities of daily living (ADL), receiving informal care and feelings of loneliness and pain.

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  • 37.
    Dallora, Ana Luiza
    et al.
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Eivazzadeh, Shahryar
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Mendes, Emilia
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Machine learning and microsimulation techniques on the prognosis of dementia: A systematic literature review2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 6, article id e0179804Article, review/survey (Refereed)
    Abstract [en]

    Background Dementia is a complex disorder characterized by poor outcomes for the patients and high costs of care. After decades of research little is known about its mechanisms. Having prognostic estimates about dementia can help researchers, patients and public entities in dealing with this disorder. Thus, health data, machine learning and microsimulation techniques could be employed in developing prognostic estimates for dementia. Objective The goal of this paper is to present evidence on the state of the art of studies investigating and the prognosis of dementia using machine learning and microsimulation techniques. Method To achieve our goal we carried out a systematic literature review, in which three large databases -Pubmed, Socups and Web of Science were searched to select studies that employed machine learning or microsimulation techniques for the prognosis of dementia. A single backward snowballing was done to identify further studies. A quality checklist was also employed to assess the quality of the evidence presented by the selected studies, and low quality studies were removed. Finally, data from the final set of studies were extracted in summary tables. Results In total 37 papers were included. The data summary results showed that the current research is focused on the investigation of the patients with mild cognitive impairment that will evolve to Alzheimer's disease, using machine learning techniques. Microsimulation studies were concerned with cost estimation and had a populational focus. Neuroimaging was the most commonly used variable. Conclusions Prediction of conversion from MCI to AD is the dominant theme in the selected studies. Most studies used ML techniques on Neuroimaging data. Only a few data sources have been recruited by most studies and the ADNI database is the one most commonly used. Only two studies have investigated the prediction of epidemiological aspects of Dementia using either ML or MS techniques. Finally, care should be taken when interpreting the reported accuracy of ML techniques, given studies' different contexts.

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  • 38.
    Dallora, Ana Luiza
    et al.
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Eivazzadeh, Shahryar
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Mendes, Emilia
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Blekinge Institute of Technology, Karlskrona, Sweden.
    Prognosis of dementia employing machine learning and microsimulation techniques: a systematic literature review2016In: International Conference on ENTERprise Information Systems/International Conference on Project MANagement/International Conference on Health and Social Care Information Systems and Technologies, CENTERIS/ProjMAN / HCist 2016 / [ed] João Eduardo Quintela Varajão; Maria Manuela Cruz-Cunha; Ricardo Martinho; Rui Rijo; Niels Bjørn-Andersen; Rodney Turner; Domingos Alves, Elsevier, 2016, Vol. 100, p. 480-488Conference paper (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of this paper is to investigate the goals and variables employed in the machine learning and microsimulation studies for the prognosis of dementia. METHOD: According to preset protocols, the Pubmed, Socups and Web of Science databases were searched to find studies that matched the defined inclusion/exclusion criteria, and then its references were checked for new studies. A quality checklist assessed the selected studies, and removed the low quality ones. The remaining ones (included set) had their data extracted and summarized. RESULTS: The summary of the data of the 37 included studies showed that the most common goal of the selected studies was the prediction of the conversion from mild cognitive impairment to Alzheimer's Disease, for studies that used machine learning, and cost estimation for the microsimulation ones. About the variables, neuroimaging was the most frequent used. CONCLUSIONS: The systematic literature review showed clear trends in prognosis of dementia research in what concerns machine learning techniques and microsimulation.

  • 39.
    Dallora, Ana Luiza
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Kvist, Ola
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Ruiz, Sandra Diaz
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Boldt, Martin
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Flodmark, Carl-Erik
    Department of Clinical Sciences, Lund University, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Chronological Age Assessment in Young Individuals Using Bone Age Assessment Staging and Nonradiological Aspects: Machine Learning Multifactorial Approach2020In: JMIR Medical Informatics, E-ISSN 2291-9694, Vol. 8, no 9, article id e18846Article in journal (Refereed)
    Abstract [en]

    Background: Bone age assessment (BAA) is used in numerous pediatric clinical settings, as well as in legal settings when entities need an estimate of chronological age (CA) when valid documents are lacking. The latter case presents itself as critical since the law is harsher for adults and granted rights along with imputability changes drastically if the individual is a minor. Traditional BAA methods suffer from drawbacks such as exposure of minors to radiation, do not consider factors that might affect the bone age and they mostly focus on a single region. Given the critical scenarios in which BAA can affect the lives of young individuals it is important to focus on the drawbacks of the traditional methods and investigate the potential of estimating CA through BAA.

    Objective: This paper aims to investigate CA estimation through BAA in young individuals of 14 to 21 years with machine learning methods, addressing the drawbacks in the research using magnetic resonance imaging (MRI), assessment of multiple ROIs and other factors that may affect the bone age.

    Methods: MRI examinations of the radius, distal tibia, proximal tibia, distal femur and calcaneus were carried out on 465 males and 473 females subjects (14-21 years). Measures of weight and height were taken from the subjects and a questionnaire was given for additional information (self-assessed Tanner Scale, physical activity level, parents' origin, type of residence during upbringing). Two pediatric radiologists assessed, independently, the MRI images as to their stage of bone development (blinded to age, gender and each other). All the gathered information was used in training machine learning models for chronological age estimation and minor versus adults classification (threshold of 18 years). Different machine learning methods were investigated.

    Results: The minor versus adults classification produced accuracies of 90% and 84%, for male and female subjects, respectively, with high recalls for the classification of minors. The chronological age estimation for the eight age groups (14-21 years) achieved mean absolute errors of 0.95 years and 1.24 years for male and female subjects, respectively. However, for the latter lower error occurred only for the ages of 14 and 15.

    Conclusions: This paper proposed to investigate the CA estimation through BAA using machine learning methods in two ways: minor versus adults classification and CA estimation in eight age groups (14-21 years), while addressing the drawbacks in the research on BAA. The first achieved good results, however, for the second case BAA showed not precise enough for the classification.

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  • 40.
    Dallora, Ana Luiza
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Minku, Leandro
    School of Computer Science, University of Birmingham, United Kingdom.
    Mendes, Emilia
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Rennemark, Mikael
    Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Berglund, Johan Sanmartin
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Multifactorial 10-year prior diagnosis prediction model of dementia2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 18, p. 1-18, article id 6674Article in journal (Refereed)
    Abstract [en]

    Dementia is a neurodegenerative disorder that affects the older adult population. To date, no cure or treatment to change its course is available. Since changes in the brains of affected individuals could be evidenced as early as 10 years before the onset of symptoms, prognosis research should consider this time frame. This study investigates a broad decision tree multifactorial approach for the prediction of dementia, considering 75 variables regarding demographic, social, lifestyle, medical history, biochemical tests, physical examination, psychological assessment and health instruments. Previous work on dementia prognoses with machine learning did not consider a broad range of factors in a large time frame. The proposed approach investigated predictive factors for dementia and possible prognostic subgroups. This study used data from the ongoing multipurpose Swedish National Study on Aging and Care, consisting of 726 subjects (91 presented dementia diagnosis in 10 years). The proposed approach achieved an AUC of 0.745 and Recall of 0.722 for the 10-year prognosis of dementia. Most of the variables selected by the tree are related to modifiable risk factors; physical strength was important across all ages. Also, there was a lack of variables related to health instruments routinely used for the dementia diagnosis. 

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  • 41.
    Dallora Moraes, Ana Luiza
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Kvist, Ola
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Mendes, Emilia
    Department of Computer Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Ruiz, Sandra
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Bone age assessment with various machine learning techniques: A systematic literature review and meta-analysis2019In: PLOS ONE, E-ISSN 1932-6203, Vol. 14, no 7, article id e0220242Article, review/survey (Refereed)
    Abstract [en]

    Background The assessment of bone age and skeletal maturity and its comparison to chronological age is an important task in the medical environment for the diagnosis of pediatric endocrinology, orthodontics and orthopedic disorders, and legal environment in what concerns if an individual is a minor or not when there is a lack of documents. Being a time-consuming activity that can be prone to inter- and intra-rater variability, the use of methods which can automate it, like Machine Learning techniques, is of value. Objective The goal of this paper is to present the state of the art evidence, trends and gaps in the research related to bone age assessment studies that make use of Machine Learning techniques. Method A systematic literature review was carried out, starting with the writing of the protocol, followed by searches on three databases: Pubmed, Scopus and Web of Science to identify the relevant evidence related to bone age assessment using Machine Learning techniques. One round of backward snowballing was performed to find additional studies. A quality assessment was performed on the selected studies to check for bias and low quality studies, which were removed. Data was extracted from the included studies to build summary tables. Lastly, a meta-analysis was performed on the performances of the selected studies. Results 26 studies constituted the final set of included studies. Most of them proposed automatic systems for bone age assessment and investigated methods for bone age assessment based on hand and wrist radiographs. The samples used in the studies were mostly comprehensive or bordered the age of 18, and the data origin was in most of cases from United States and West Europe. Few studies explored ethnic differences. Conclusions There is a clear focus of the research on bone age assessment methods based on radiographs whilst other types of medical imaging without radiation exposure (e.g. magnetic resonance imaging) are not much explored in the literature. Also, socioeconomic and other aspects that could influence in bone age were not addressed in the literature. Finally, studies that make use of more than one region of interest for bone age assessment are scarce.

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  • 42.
    Dallora Moraes, Ana Luiza
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Brogren, Martin
    Optriva AB, Stockholm, Sweden.
    Kvist, Ola
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Ruiz, Sandra Diaz
    Department of Pediatric Radiology, Karolinska University Hospital, Stockholm, Sweden.
    Dübbel, André
    Optriva AB, Stockholm, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Age Assessment of Youth and Young Adults Using MagneticResonance Imaging of the Knee: A Deep Learning Approach2019In: JMIR Medical Informatics, E-ISSN 2291-9694, Vol. 7, no 4, article id e16291Article in journal (Refereed)
    Abstract [en]

    Background: Bone age assessment (BAA) is an important tool for diagnosis and in determining the time of treatment in a number of pediatric clinical scenarios, as well as in legal settings where it is used to estimate the chronological age of an individual where valid documents are lacking. Traditional methods for BAA suffer from drawbacks, such as exposing juveniles to radiation, intra- and interrater variability, and the time spent on the assessment. The employment of automated methods such as deep learning and the use of magnetic resonance imaging (MRI) can address these drawbacks and improve the assessment of age. Objective: The aim of this paper is to propose an automated approach for age assessment of youth and young adults in the age range when the length growth ceases and growth zones are closed (14-21 years of age) by employing deep learning using MRI of the knee. Methods: This study carried out MRI examinations of the knee of 402 volunteer subjects-221 males (55.0%) and 181 (45.0%) females-aged 14-21 years. The method comprised two convolutional neural network (CNN) models: the first one selected the most informative images of an MRI sequence, concerning age-assessment purposes; these were then used in the second module, which was responsible for the age estimation. Different CNN architectures were tested, both training from scratch and employing transfer learning. Results: The CNN architecture that provided the best results was GoogLeNet pretrained on the ImageNet database. The proposed method was able to assess the age of male subjects in the range of 14-20.5 years, with a mean absolute error (MAE) of 0.793 years, and of female subjects in the range of 14-19.5 years, with an MAE of 0.988 years. Regarding the classification of minors-with the threshold of 18 years of age-an accuracy of 98.1% for male subjects and 95.0% for female subjects was achieved. Conclusions: The proposed method was able to assess the age of youth and young adults from 14 to 20.5 years of age for male subjects and 14 to 19.5 years of age for female subjects in a fully automated manner, without the use of ionizing radiation, addressing the drawbacks of traditional methods.

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  • 43.
    Ehn, Bodil
    et al.
    Department of Obstetrics and Gynecology, Hospital of Karlskrona, Kvinnokliniken, Blekingesjukhuset, Karlskrona, Sweden.
    Anderberg, Peter
    Blekinge Institute of Technology, BTH, Karlskrona Blekinge tekniska högskola, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Blekinge Institute of Technology, BTH, Karlskrona Blekinge tekniska högskola, Karlskrona, Sweden.
    Lilje, Stina
    Karolinska Institutet, Stockholm, Sweden.
    The process of opting for female permanent contraception: A qualitative study of women's experiences in Sweden2021In: Contraception, ISSN 0010-7824, E-ISSN 1879-0518, Vol. 103, no 1, p. 48-52Article in journal (Refereed)
    Abstract [en]

    Objectives: We aimed to explore Swedish women's decision-making experiences regarding permanent contraception. Study design: In this study, we included 17 women aged 30–48 who were scheduled to undergo female permanent contraceptive procedures. We conducted semistructured interviews using two broad open-ended questions. We analyzed these data using systematic text condensation based on the principles of psychological phenomenological analysis. Results: The interviewees experienced no counseling or support from health care workers regarding permanent contraception until they specifically asked for it. Participants reported that they themselves place the responsibility of permanent contraception solely on women. Consequently, our participants described feeling hesitancy and ambivalence in the process of deciding to have the procedure. Once the decision was made and the women were on the waiting lists for surgery, they experienced relief and empowerment. Conclusions: Our findings suggest that health care providers in Sweden miss opportunities to support patient-centered decision-making regarding permanent contraception. This study indicates that women make deliberate and considered decisions regarding permanent contraception and are best positioned to know when the procedure should take place in their reproductive lives. Implication statements: Health care professionals should discuss permanent contraception as an option with all women desiring contraception to allow them to decide if that method is right for them. © 2020 Elsevier Inc.

  • 44.
    Eivazzadeh, Shahryar
    et al.
    Blekinge Inst Technol, Blekinge, Sweden.
    Anderberg, Peter
    Blekinge Inst Technol, Blekinge, Sweden.
    Johan, Berglund
    Blekinge Inst Technol, Blekinge, Sweden.
    Tobias, Larsson
    Blekinge Inst Technol, Blekinge, Sweden.
    Designing with Priorities and Thresholds for Health Care Heterogeneity: The Approach of Constructing Parametric Ontology2015In: Proceedings of the International Conference on Engineering Design (ICED 15): Volume 2 - Design Theory and Research Methodology Deisgn Processes / [ed] C Weber; S Husung; M Cantamessa; G Cascini; D Marjanovic; S Venkataraman, The Design Society , 2015, p. 277-284Conference paper (Refereed)
    Abstract [en]

    Designing systems working in health care needs complying with the heterogeneous, overlapping, non-overlapping, competing, or even contradicting requirements expressed by the various actors of the health care complex environment, including regulatory bodies. The unification method introduced in this paper, utilized ontological struc- tures to unify heterogeneous requirements in different levels of ab- straction. Also the weighting and threshold algorithms defined upon the ontology structure allows to both prioritize the requirements and align design resources upon that priority, at the same time to enforce regulatory requirements in an easy, clear and integrated way and reject designs which cannot comply with them. Application of the method introduced in this paper is not limited to health care, but it might be applied in design for any heterogeneous environment.

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  • 45.
    Eivazzadeh, Shahryar
    et al.
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Larsson, Tobias
    Department of Mechanical Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Fricker, Samuel
    Software Engineering Research Laboratory (SERL-Sweden), Blekinge Institute of Technology, Karlskrona, Sweden ; Centre for Requirements Engineering (CeRE), i4DS, University of Applied Sciences and Arts Northwestern Switzerland, Windisch, Switzerland.
    Berglund, Johan
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Evaluating Health Information Systems Using Ontologies2016In: JMIR Medical Informatics, E-ISSN 2291-9694, Vol. 4, no 2, article id e20Article in journal (Refereed)
    Abstract [en]

    Background: There are several frameworks that attempt to address the challenges of evaluation of health information systems by offering models, methods, and guidelines about what to evaluate, how to evaluate, and how to report the evaluation results. Model-based evaluation frameworks usually suggest universally applicable evaluation aspects but do not consider case-specific aspects. On the other hand, evaluation frameworks that are case specific, by eliciting user requirements, limit their output to the evaluation aspects suggested by the users in the early phases of system development. In addition, these case-specific approaches extract different sets of evaluation aspects from each case, making it challenging to collectively compare, unify, or aggregate the evaluation of a set of heterogeneous health information systems.

    Objectives: The aim of this paper is to find a method capable of suggesting evaluation aspects for a set of one or more health information systems—whether similar or heterogeneous—by organizing, unifying, and aggregating the quality attributes extracted from those systems and from an external evaluation framework.

    Methods: On the basis of the available literature in semantic networks and ontologies, a method (called Unified eValuation using Ontology; UVON) was developed that can organize, unify, and aggregate the quality attributes of several health information systems into a tree-style ontology structure. The method was extended to integrate its generated ontology with the evaluation aspects suggested by model-based evaluation frameworks. An approach was developed to extract evaluation aspects from the ontology that also considers evaluation case practicalities such as the maximum number of evaluation aspects to be measured or their required degree of specificity. The method was applied and tested in Future Internet Social and Technological Alignment Research (FI-STAR), a project of 7 cloud-based eHealth applications that were developed and deployed across European Union countries.

    Results: The relevance of the evaluation aspects created by the UVON method for the FI-STAR project was validated by the corresponding stakeholders of each case. These evaluation aspects were extracted from a UVON-generated ontology structure that reflects both the internally declared required quality attributes in the 7 eHealth applications of the FI-STAR project and the evaluation aspects recommended by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. The extracted evaluation aspects were used to create questionnaires (for the corresponding patients and health professionals) to evaluate each individual case and the whole of the FI-STAR project.

    Conclusions: The UVON method can provide a relevant set of evaluation aspects for a heterogeneous set of health information systems by organizing, unifying, and aggregating the quality attributes through ontological structures. Those quality attributes can be either suggested by evaluation models or elicited from the stakeholders of those systems in the form of system requirements. The method continues to be systematic, context sensitive, and relevant across a heterogeneous set of health information systems.

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  • 46.
    Eivazzadeh, Shahryar
    et al.
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Larsson, Tobias
    Department of Mechanical Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
    Fiedler, Markus
    Department of Technology and Aesthetics, Blekinge Institute of Technology, Karlskrona, Sweden.
    Anderberg, Peter
    Department of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
    Most Influential Qualities in Creating Satisfaction Among the Users of Health Information Systems: Study in Seven European Union Countries2018In: JMIR Medical Informatics, E-ISSN 2291-9694, Vol. 6, no 4, article id e11252Article in journal (Refereed)
    Abstract [en]

    Background:

    Several models suggest how the qualities of a product or service influence user satisfaction. Models, such as the Customer Satisfaction Index (CSI), Technology Acceptance Model (TAM), and Delone and McLean Information Systems Success (D&M IS), demonstrate those relations and have been used in the context of health information systems.

    Objective:

    We want to investigate which qualities foster greater satisfaction among patient and professional users. In addition, we are interested in knowing to what extent improvement in those qualities can explain user satisfaction and if this makes user satisfaction a proxy indicator of those qualities.

    Methods:

    The Unified eValuation using ONtology (UVON) method was utilised to construct an ontology of the required qualities for seven e-health applications being developed in the FI-STAR project, a European Union (EU) project in e-health. The e-health applications were deployed across seven EU countries. The ontology included and unified the required qualities of those systems together with the aspects suggested by the Model for ASsessment of Telemedicine applications (MAST) evaluation framework. Two similar questionnaires, for 87 patient users and 31 health professional users, were elicited from the ontology. In the questionnaires, user was asked if the system has improved the specified qualities and if the user was satisfied with the system. The results were analysed using Kendall correlation coefficients matrices, incorporating the quality and satisfaction aspects. For the next step, two Partial Least Squares Structural Equation Modelling (PLS-SEM) path models were developed using the quality and satisfaction measure variables and the latent construct variables that were suggested by the UVON method.

    Results:

    Most of the quality aspects grouped by the UVON method are highly correlated. Strong correlations in each group suggest that the grouped qualities can be measures which reflect a latent quality construct. The PLS-SEM path analysis for the patients reveals that the effectiveness, safety, and efficiency of treatment provided by the system are the most influential qualities in achieving and predicting user satisfaction. For the professional users, effectiveness and affordability are the most influential. The parameters of the PLS-SEM that are calculated allow for the measurement of a user satisfaction index similar to CSI for similar health information systems.

    Conclusions:

    For both patients and professionals, the effectiveness of systems highly contributes to their satisfaction. Patients care about improvements in safety and efficiency, while professionals care about improvements in the affordability of treatments with health information systems. User satisfaction is reflected more in the users' evaluation of system output and fulfilment of expectations, but slightly less in how far the system is from ideal. Investigating satisfaction scores can be a simple, fast way to infer if the system has improved the abovementioned qualities in treatment and care.

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  • 47.
    Ekelin, Annelie
    et al.
    Blekinge Institute of Technology, School of Computing, School of Health, Karlskrona, Sweden.
    Anderberg, Peter
    Blekinge Institute of Technology, School of Computing, School of Health, Karlskrona, Sweden.
    Reddy, Kishore
    Dept.of Computer Science, Indian Institute of Technology in Madras (IIT-M), India.
    The AUGMENT Project: Co-constructive Mapping and Support of Accessibility and Participation2010In: Electronic Participation: Second IFIP WG 8.5 International Conference, ePart 2010, Lausanne, Switzerland, August 29 – September 2, 2010. Proceedings / [ed] Efthimios Tambouris; Ann Macintosh; Olivier Glassey, Springer, 2010, p. 95-103Conference paper (Refereed)
    Abstract [en]

    This paper presents an ongoing multi-disciplinary research-and development project in which we are exploring emerging methods and practices for participatory design of tools and content of accessibility information in India and Sweden, based on user created content. The initial development of the AUGMENT-Project also includes the production of a prototype for sharing information. The joint set up and unfolding of public digital spaces and cooperative creation of processes and infrastructure for user-driven accessibility information is making use of existing handheld mobile phones which offer the possibility to upload pictures and comments via an application with a map-based interface. The research initiative is exploring and comparing cross-cultural participatory methods for cultivation of shared transformational spaces. The paper discusses both the notion of user-driven content and co-creation of tools and methods, drawing upon the tradition of Scandinavian Systems Design, explicitly arguing for direct user-representation in systems development.

  • 48.
    Ferati, Mexhid
    et al.
    Department of Informatics, Linnaeus University, Växjö & Kalmar, Sweden.
    Bertoni, Marco
    Mechanical Engineering Department, Blekinge Institute of Technology, Karlskrona, Sweden.
    Dalipi, Fisnik
    Department of Informatics, Linnaeus University, Växjö & Kalmar, Sweden.
    Kurti, Arianit
    Department of Informatics, Linnaeus University, Växjö & Kalmar, Sweden.
    Jokela, Päivi
    Department of Informatics, Linnaeus University, Växjö & Kalmar, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Mirijamdotter, Anita
    Department of Informatics, Linnaeus University, Växjö & Kalmar, Sweden.
    Tackling the Sustainability of Digital Aging Innovations Through Design Thinking and Systems Thinking Perspectives2021In: ICT for Health, Accessibility and Wellbeing: First International Conference, IHAW 2021, Larnaca, Cyprus, November 8–9, 2021, Revised Selected Papers / [ed] Edwige Pissaloux; George Angelos Papadopoulos; Achilleas Achilleos; Ramiro Velázquez, Cham: Springer, 2021, p. 179-184, article id 1Chapter in book (Refereed)
    Abstract [en]

    The digitalization of society brings many opportunities and challenges, especially on how we organize the welfare society in the future. This becomes especially pertinent as we are heading toward a global increase of older people, which will strain healthcare and bring the challenge of building sustainable solutions. In this paper, we argue that the unsustainable solutions within healthcare are due to them being defined and ‘solved’ with a single approach or approaches used in silos. We advocate that a more sustainable solution could be achieved by combining systems thinking and design thinking perspectives throughout the entire process—from problem definition to solution offering. A benefit of such combined perspectives is the ability to develop a shared context among all stakeholders, which helps uncover unique tacit knowledge from their experience. This will serve as a solid foundation to generate unconventional ideas that will lead to sustainable and satisfactory solutions. 

  • 49.
    Flyborg, Johan
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Renvert, Stefan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden ; Faculty of Health Sciences, Kristianstad University, Sweden.
    Anderberg, Peter
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Isaksson, Ulrika
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Measurement of body temperature in the oral cavity with a temperature sensor integrated with a powered toothbrush2023In: SN Applied Sciences, ISSN 2523-3963, E-ISSN 2523-3971, Vol. 5, no 1, article id 22Article in journal (Refereed)
    Abstract [en]

    This paper presents a method for collecting core body temperature data via a temperature sensor integrated into a powered toothbrush. The purpose is to facilitate the collection of temperature data without any extended effort from the user. Twelve participants use a powered toothbrush with a temperature sensor mounted on the brush head twice daily for two months. The obtained values are compared with those from a conventional fever thermometer approved for intraoral use. The results show that the temperature sensor–integrated powered toothbrush can measure the core body temperature and provide values comparable to those provided by a traditional oral thermometer. The use of the device can facilitate disease monitoring, fertility control, and security solutions for the elderly. © 2022, The Author(s).

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  • 50.
    Flyborg, Johan
    et al.
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Renvert, Stefan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden ; Faculty of Health Sciences, Kristianstad University, Sweden.
    Anderberg, Peter
    University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Larsson, Tobias
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Sanmartin-Berglund, Johan
    Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden.
    Results of objective brushing data recorded from a powered toothbrush used by elderly individuals with mild cognitive impairment related to values for oral health2024In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, no 1, article id 8Article in journal (Refereed)
    Abstract [en]

    Objectives: The study aimed to investigate how the objective use of a powered toothbrush in frequency and duration affects plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm in elderly individuals with MCI. A second aim was to compare the objective results with the participants’ self-estimated brush use.

    Materials and methods: Objective brush usage data was extracted from the participants’ powered toothbrushes and related to the oral health variables plaque index, bleeding on probing, and periodontal pocket depth ≥ 4 mm. Furthermore, the objective usage data was compared with the participants’ self-reported brush usage reported in a questionnaire at baseline and 6- and 12-month examination.

    Results: Out of a screened sample of 213 individuals, 170 fulfilled the 12-month visit. The principal findings are that despite the objective values registered for frequency and duration being lower than the recommended and less than the instructed, using powered toothbrushes after instruction and information led to improved values for PI, BOP, and PPD ≥ 4 mm in the group of elderly with MIC.

    Conclusions: Despite lower brush frequency and duration than the generally recommended, using a powered toothbrush improved oral health. The objective brush data recorded from the powered toothbrush correlates poorly with the self-estimated brush use.

    Clinical relevance: Using objective brush data can become one of the factors in the collaboration to preserve and improve oral health in older people with mild cognitive impairment. Trial registration: ClinicalTrials.gov Identifier: NCT05941611, retrospectively registered 11/07/2023. 

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