Chronic pain and kinesiophobia among older adults. Prevalence, characteristics and impact on physical activity.

Background: Chronic pain is common in older adults, yet little is known of its development in old age. Although fear-avoidance beliefs in chronic pain have been explored in younger adults, the relationship between chronic pain, kinesiophobia and physical activity levels has not been investigated in older adults.Objectives: The overall aim was to explore prevalence, development and related factors of chronic pain and kinesiophobia in older adults with a focus on psychosocial and pain related factors and their impact on physical activity among older adults.Methods: The study had a longitudinal design and data were obtained through posted surveys and collected at baseline and after 12 and 24 months during 2011–2013. Participants (N=2000) were selected through simple randomization of the Swedish register of inhabitants using the whole Swedish population aged 65+, as sampling frame. A total of 1141 older adults were included at baseline (aged 65–103 years). Prevalence, incidence rate and cumulative incidence of chronic pain over 2 years in different age strata were estimated. To estimate associations for demographic, psychosocial and pain-related variables as functions of chronic pain (persistence and onset), kinesiophobia and physical activity linear/logistic regression analysis were performed.Results: In paper I, chronic pain was reported by 38.5% of the participants, more common among females and those over 85 years. The incidence was estimated at 5.4%. Being female, having lower BMI, high intensity/severity, long duration and multiple locations of pain were able to predict persistence of chronic pain among older women. Paper II showed that TSK-11 had acceptable construct validity, factor structure and test-retest reliability. In Papers III–IV generally low levels of kinesiophobia were found among those with chronic pain, except among frailer and older adults living in care homes. Despite this, it was found that kinesiophobia was independently associated with levels of physical activity and significantly lower levels of physical activity among those with chronic pain.Conclusions: Even though chronic pain was often highly prevalent and persistent, both onset and recovery occurred over time. The findings highlight the importance of early pain management in prevention of future pain among older adults. It must also be considered that older adults with chronic pain are at higher risk of functional decline and additional chronic diseases, due to significantly lower levels of physical activity compared to older without chronic pain. Kinesiophobia among older adults can be captured by the TSK-11 and plays an important role in predicting future physical activity levels and is hence important to consider. Potential interventions against kinesiophobia among older adults should aim to decrease pain intensity and strengthen health beliefs

Fast simulation of 3D elastic response for wheel–rail contact loading using Proper Generalized Decomposition

To increase computational efficiency, we adopt Proper Generalized Decomposition (PGD) to solve a reduced-order problem of the displacement field for a three-dimensional rail head exposed to different contact scenarios. The three-dimensional solid rail head is modeled as a two-dimensional cross-section, with the coordinate along the rail being treated as a parameter in the PGD approximation. A novel feature is that this allows us to solve the full three-dimensional model with a nearly two-dimensional computational effort. Additionally, we incorporate the distributed contact load predicted from dynamic vehicle-track simulations as extra coordinates in the PGD formulation, using a semi-Hertzian contact model. The problem is formulated in two ways; one general ansatz which considers the treatment of numerous parameters, some of which exhibit a linear influence, and a linear ansatz where multiple PGD solutions are solved for. In particular, situations where certain parameters become invariant are handled. We assess the accuracy and efficiency of the proposed strategy through a series of verification examples. It is shown that the PGD solution converges towards the FE solution with reduced computational cost. Furthermore, solving for the PGD approximation based on load parameterization in an offline stage allows expedient handling of the wheel-rail contact problem online

Evaluation of MyRelief Serious Game for Better Self-Management of Health Behaviour Strategies on Chronic Low-Back Pain

Low back pain is a leading cause of disability worldwide, putting a significant strain on individual sufferers, their families, and the economy as a whole. It has a significant economic impact on the global economy because of the costs associated with healthcare, lost productivity, activity limitation, and work absence. Self-management, education, and adopting healthy lifestyle behaviors, such as increasing physical activity, are all widely recommended treatments. Access to services provided by healthcare professionals who provide these treatments can be limited and costly. This evaluation study focuses on the application of the MyRelief serious game, with the goal of addressing such challenges by providing an accessible, interactive, and fun platform that incorporates self-management, behavior change strategies, and educational information consistent with recommendations for managing low-back pain, based on self-assessment models implemented through ontology-based mechanics. Functional disability measured using the Oswestry Disability Questionnaire showed the statistically significant (p < 0.001) improvement in subjects’ self-evaluation of their health status. System Usability Scale (SUS) test score of 77.6 also suggests that the MyRelief serious game can potentially influence patient enablement

Redovisning av pensioner med anledning av RR29 - en analys mellan Sverige och USA

Vårt syfte med denna uppsatsen är att utifrån fallstudier identifiera hur förändringen i redovisning av pensioner i Sverige, genom införandet av IAS, påverkar företagens resultat samt förändrar jämförbarheten med företag i USA. Uppsatsen innehåller en fallstudie som präglas av en kvalitativ metod vilket innebär en djupare förståelse av det vi studerar. Övergången till RR 29 kommer att leda till kortsiktiga konsekvenser för svenska företag som förmodligen kommer att synas i det eget kapital. Vi tror att trots införandet av den nya rekommendationen, RR 29, kommer koncerner med liknande förutsättningar ändå att göra olika antaganden, vilket försvårar jämförbarheten mellan koncernföretagen. Det ökade kravet på noter kommer endast att leda till en ökad inblick och förståelse i företagets verksamhet

Effektivitetsmått för byggnader- En modell för effektivitetsmätning applicerad på ytterväggar i flerbostadshus

I byggbranschen finns olika system och mätetal som kan ligga till grund för jämförelser mellan byggdelar eller projekt inom de flesta områden. Däremot saknas modeller för hur dessa mätetal skulle kunna vägas samman. Rapportens syfte är att ta fram en metod som utifrån olika aspekter granskar effektiviteten hos ytterväggar i flerbostadshus

Healthcare professionals' perceptions of a digital parental support, Childbirth Journey, constructed as a serious game—An intervention study

BackgroundGlobally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents.MethodsData were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods.ResultsThe perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development.ConclusionsCurrent study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions