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  • 101.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fältholm, Ylva
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Human Work Science.
    Gard, Gunvor
    Safety vs. privacy: elderly persons' experiences of a mobile safety alarm2008In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 16, no 4, p. 337-346Article in journal (Refereed)
    Abstract [en]

    The demographic development indicates an increased elderly population in Sweden in the future. One of the greatest challenges for a society with an ageing population is to provide high-quality health and social care. New information and communication technology (ICT) and services can be used to further improve health care. To enable elderly persons to stay at home as long as possible, various kinds of technology, such as safety alarms, are used at home. The aim of this study was to describe the experiences of elderly persons through testing a mobile safety alarm and their reasoning about safety, privacy and mobility. The mobile safety alarm tested was a prototype in development. Five elderly persons with functional limitations and four healthy elderly persons from a pensioner's organisation tested the alarm. The mobile alarm with a drop sensor and a positioning device was tested for six weeks. This intervention was evaluated with qualitative interviews, and analysed with latent content analysis. The result showed four main categories: feeling safe, being positioned and supervised, being mobile and reflecting on new technology. From these categories, the overarching category "Safety and mobility are more important than privacy" emerged. The mobile safety alarm was perceived to offer an increased opportunity for mobility in terms of being more active and as an aid for self-determination. The fact that the informants were located by means of the positioning device was not experienced as violating privacy as long as they could decide how to use the alarm. Conclusions: This mobile safety alarm was experienced as a tool to be active and mobile. As a way to promote self-determination and empowerment, the individual has to make a "cost-benefit" analysis where privacy is sacrificed to the benefit of mobility and safety. The participants were actively contributing to the development process.

  • 102.
    Sjödahl, Catharina
    et al.
    Lund University Hospital, Scandinavian Orthopaedic Laboratory.
    Gard, Gunvor
    Jarnlo, Gun-Britt
    University of Lund, Department of Physical Therapy.
    Transfemoral amputees' experiences of the first meeting and subsequent interactions with hospital staff2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 16, p. 1192-1203Article in journal (Refereed)
    Abstract [en]

    Purpose. To describe, by use of a phenomenological approach, how transfemoral amputees experience their first meeting and subsequent interaction with hospital staff in the acute phase, in the long term and suggestions for future care-giving. Method. Eleven transfemoral amputees, median age 33.5 years, were interviewed. The amputations, performed in median 7.5 years before the interview, were caused by tumour, motorcycle accidents or work-related traumas. The participants were community dwelling and managed well indoors. All, except one, worked or studied full time. The interviews were tape-recorded and transcribed verbatim. Results. Three themes emerged: (i) Communication/information - limitations in preparing the patient for the new situation, (ii) empathy and emotional support, and (iii) ability to meet the need of individually tailored rehabilitation. For future care-giving three categories emerged: (i) Individually tailored communication/information, (ii) rehabilitation to be prepared to adapt to one's new situation, and (iii) support in regaining control. Conclusion. The participants expressed a need for both professional and emotional support in the acute phase. Over time they preferred a patient-centred approach which improved coping skills and facilitated their own ability to gain control. Increased awareness of how meeting and interacting with hospital staff influences rehabilitation processes may further improve patient satisfaction and outcomes.

  • 103.
    Larsson, Ingalill L.
    et al.
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Jönsson, Carita
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Olsson, Ann C.
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Gard, Gunvor
    Johansson, Karin
    Lund University, Institution of Health Science, Division of Physiotherapy.
    Women's experience of physical activity following breast cancer treatment2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 422-429Article in journal (Refereed)
    Abstract [en]

    Physical activity is of great benefit to women treated for breast cancer and can even be vital. The aim of this qualitative study was to describe how women treated for breast cancer experience physical activity after surgery. Twelve women, strategically selected according to hospital, age and length of time since surgery, took part in a semi-structured interview. A qualitative method with a phenomenographic approach was used. The result indicates that the incentive to remain or return to a normal physical condition is an important motive for physical activity after breast cancer surgery. The experience of physical activity was, from the women's perspective, expressed in (i) compliance to instructions and need for support, (ii) struggle to get back to normal and fear of negative side-effects, (iii) a wish to stay normal and not allow limitations and (iv) getting control of the situation with new strategies. In conclusion, instructions and motivation are important in starting up and/or continuing physical activity after breast cancer treatment. While in considering the vital benefits of physical activity for breast cancer patients healthcare professionals, and in particular physiotherapists, must be aware of the need for information and the patients' motive for exercise and physical activity to be able to guide and encourage them individually. The professionals must also understand the need for empowerment for these women to take control over their lives and to allow the limitations that eventually occur.

  • 104.
    Winkel, A.
    et al.
    Department of Neurology, Hillerod Hospital.
    Ekdahl, Charlotte
    Jørgensen, Henrik Stig
    Department of Neurology, Hillerod Hospital.
    Gard, Gunvor
    Early discharge to therapy-based rehabiliation at home in patients with stroke: a systematic review2007In: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
  • 105.
    Sjödahl, Catharina
    et al.
    Lund University Hospital, Department of Psychiatry.
    Gard, Gunvor
    Jarnlo, Gun-Britt
    Lund University Hospital, Department of Psychiatry.
    Experience of the encountering process after transfemoral amputation from the patients' perspective2007In: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
  • 106. Gard, Gunvor
    Factors important for good interaction in physiotherapy treatment of persons who have undergone torture: a qualitative study2007In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 23, no 1, p. 47-55Article in journal (Refereed)
    Abstract [en]

    Torture can be defined as the deliberate or systematic infliction of physical or mental suffering to force another person to yield information, as a punishment or to destroy a person's identity. The aim of the physiotherapy treatment for persons who have undergone torture is to relieve or reduce pain, correct musculoskeletal dysfunctions, teach the client to cope with pain, and regain body awareness. A good interaction and communication with each refugee is needed to optimize the treatment. The aim of this study was to identify factors important for a good interaction between physiotherapist (PT) and the patient among PTs specialising in refugees who have been tortured. A qualitative multiple case study was done. Ten physiotherapists working within the Red Cross, psychiatry or primary health care, who held positions specialising in treating persons who have undergone torture were interviewed. The interviews were analysed with content analysis. The results showed that the factors important for a good interaction could be summarised into two themes; prerequisites for a good interaction and interaction factors. Five prerequisites for a good interaction with persons who have undergone torture were found: personal characteristics, professional and therapeutic competence and support, language factors, time, and frames. Five factors in the interaction situation were important for a good interaction: cultural factors, treatments tailored to the patient's needs, to develop confidence and trust, religious factors, and capacity to handle negative emotions. All these factors have to be considered to improve the interaction between PTs and persons who have undergone torture

  • 107.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Vikman, Irene
    Eriksson, Lisbeth
    Gard, Gunvor
    Hur kan information och kommunikationsteknik (IKT) användas inom sjukgymnastisk verksamhet?: en interaktiv workshop2007In: Abstraktbok Sjukgymnastdagarna 10-12 oktober 2007, Stockholm: LSR , 2007, p. 24-Conference paper (Other academic)
  • 108.
    Tibaek, Sigrid
    et al.
    Copenhgen University Hospital, Department of Geriatrics and Rheumatology.
    Gard, Gunvor
    Jensen, Rigmor
    Copenhgen University Hospital, Department of Neurology.
    Is there a long-lasting effect of pelvic floor muscle training in women with urinary incontinence after ischemic stroke?: a 6-month follow-up study2007In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023, Vol. 18, no 3, p. 281-7Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the long-lasting effect of pelvic floor muscle training (PFMT) in women with urinary incontinence after stroke measured by quality of life parameters. Twenty-four (24/24) women with urinary incontinence after stroke, who had completed a prospective, randomised controlled and single-blinded trial evaluating the effect of 12 weeks PFMT, were included in this follow-up study. The follow-up assessments were done by telephone interview 6 months after the intervention. The effect was evaluated by The Short Form 36 (SF-36) Health Survey Questionnaire and Incontinence Impact Questionnaire (IIQ). Twenty-four subjects completed the study. In the treatment group, the SF-36 showed a trend to a long-lasting effect in one of the eight domains and the IIQ showed a tendency to decreased impact of UI in two sub-scales compared to the control group. Our data indicated that PFMT may have a long-lasting effect measured by quality of life parameters.

  • 109.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fältholm, Ylva
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Human Work Science.
    Gard, Gunvor
    Safety versus privacy: elderly persons experiences of a mobile safety alarm2007In: Abstraktbok Sjukgymnastdagarna 10-12 oktober 2007, Stockholm: LSR , 2007, p. 40-Conference paper (Other academic)
  • 110.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fältholm, Ylva
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Human Work Science.
    Gard, Gunvor
    Safety versus privacy: elderly persons' experiences of a mobile safety alarm2007In: 15th International Congress of the World Confederation for Physical Therapy: 2-6 June 2007 Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
    Abstract [en]

    PURPOSE: The purpose was to develop and test mobile information and communication technology (mICT), in the form of a mobile safety alarm, and to explore how this mobile safety alarm was experienced from an empowerment perspective. RELEVANCE: Future demographic development means an increased elderly population in Sweden. One of the greatest challenges for a society with an ageing population is to provide high-quality health and social care. Many elderly people stay active and healthy at higher ages; however, an increased mean age does not always mean increased health. The demographic development is often described as a huge problem but there is also an approach where "the elderly boom", seen as a cluster, also can be seen as an opportunity for growth. New information and communication technology (ICT) and services aiming at the improvement of the health, comfort and safety of elderly people are being developed and tested. From research it is well known that dimensions of empowerment have an impact on preserving health; and it is also important for the individual to feel safe. In order to enable elderly people to stay at home as long as possible, various kinds of assisted technology are often used: safety alarms are common and are used by elderly people and also by those with functional limitations. PARTICIPANTS: The participants that tested the mobile safety alarm were five elderly people with functional limitation (for example, after a stroke) and four healthy elderly people from a pensioners' organisation. METHODS: The methodology used was an intervention with a mobile alarm containing a drop sensor and a positioning device, as well as qualitative interviews with the research persons. ANALYSIS: In order to analyse the results, qualitative content analysis was used. RESULTS: The result showed that the mobile safety alarm that was developed and tested was seen as offering increased opportunity for mobility, both in terms of being able to be more active and as an aid to self-determination. The fact that the test participants were located by means of the positioning device was not experienced as violating privacy as long as it was clear that the person her/himself could decide to use the alarm. The mobile safety alarm that was tested was a prototype in development and the research persons saw themselves as participants closely and actively involved in the development process, who contributed their recommendations for improvement. CONCLUSIONS: Conclusions that can be drawn are that it is important for elderly persons to actively participate in the development process of new assistive technologies. In development, methodologies for empowerment of the elderly should be used. IMPLICATIONS: Mobile safety alarms can in the future make it easier for elderly persons to be active and mobile and this might increase the options for elderly people to stay healthy. KEYWORDS: Elderly, Information and Communication Technology (ICT), Mobility, Privacy, Safety, FUNDING ACKNOWLEDGEMENTS: Norrbotten Research Council, Sweden and Centre for Distance-spanning Healthcare (CDH), Luleå University of Technology, Luleå, Sweden. CONTACT: anita.melander-wikman@ltu.se

  • 111.
    Skjerven, Liv H.
    et al.
    Bergen University College.
    Kristoffersen, Kjell
    University of Bergen.
    Gard, Gunvor
    Searching a movement vocabulary to describe healthy aspects of movement quality2007In: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
  • 112.
    Skjerven, Liv H,
    et al.
    Bergen University College.
    Kristofferssen, Kjell
    University of Bergen.
    Gard, Gunvor
    Seeing movement quality through the lens of new training aspects2007In: 15th International Congress of The World Confederation for Physical Therapy: 2-6 June 2007, Vancouver, Canada, WCPT , 2007Conference paper (Other academic)
  • 113.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Jansson, Maria
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Innovation and Design.
    Hallberg, Josef
    Luleå University of Technology, Department of Computer Science, Electrical and Space Engineering, Signals and Systems.
    Mörtberg, Christina
    Oslo universitet.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    The lighthouse alarm and locator trial: a pilot study2007In: Technology and Health Care, ISSN 0928-7329, E-ISSN 1878-7401, ISSN 0928-7329, Vol. 15, no 3, p. 203-212Article in journal (Refereed)
    Abstract [en]

    An important factor for health is the possibility to be active and mobile. To make this possible different kind of support are needed. Integrating geographical information systems technology and user experiences is important in the development of more user-friendly positioning devices. The Lighthouse Alarm and Locator trial aimed to test a new mobile alarm system with additional functionality such as positioning and monitoring of vital signs which can be used regardless of location (in hospital, at home). The system was tested by elderly persons from a pensioner organisation and home care personnel answered up on the alarms. After the tests qualitative interviews were performed with the two groups. The results showed that their experiences of the new mobile alarm system could be described in three main categories: to be supervised, to feel safe and to be mobile. These categories formed a theme: Positioning - an ethical dilemma. The clients' mobility was perceived to increase. The personnel did not think that positioning was ethical but the clients (elderly) did.

  • 114.
    Engström, Åsa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Vem kontrollerar smärtan?: patienters upplevelser av egenkontroll och behandlingsmål i sjukgymnastik2007In: Svensk rehabilitering, ISSN 1403-4468, Vol. 8/9, no 4:1, p. 56-62Article in journal (Other academic)
  • 115.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Activity: Triennial Congress of the International Ergonomics Association 2006: an empowerment process?2006Conference paper (Other (popular science, discussion, etc.))
  • 116.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Activity: Tromsø Telemedicine and eHealth Conference2006Conference paper (Other (popular science, discussion, etc.))
  • 117.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Activity: Tromsø Telemedicine and eHealth Conference2006Conference paper (Other (popular science, discussion, etc.))
  • 118.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Berggård, Glenn
    Luleå University of Technology, Department of Civil, Environmental and Natural Resources Engineering, Architecture and Water.
    Assessment of anti-slip devices from healthy individuals in different ages walking on slippery surfaces2006In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 37, no 2, p. 177-86Article in journal (Refereed)
    Abstract [en]

    The interest for effective preventive strategies for slips and falls is growing. Much remains to be done, however, to prevent slips and falls in the traffic environment. Using an appropriate anti-slip device may reduce the risk of slips and falls on different surfaces outdoors during winter. The aim of this study was to evaluate the best anti-slip devices of different designs in the Swedish market on a larger group of healthy individuals in different ages on five different slippery surfaces as a way to develop a standard method to test anti-slip devices. Three different designs of anti-slip devices: heel device, foot-blade device and whole-foot device were evaluated on ice surfaces uncovered or covered with gravel, sand, salt or snow. The evaluations were done according to subject's perceived walking safety and balance, videorecordings of walking postures and movements, time to take on and off each anti-slip device, advantages/disadvantages with each anti-slip device and a list of priorities for own use according to three criteria: safety, balance and appearance. The heel device was perceived to be the most safe on all five surfaces, followed by the toe device and the whole-foot device. The heel device was also perceived to be the one with the best walking balance on uncovered ice and on snow covered ice. There were some significant differences due to gender and age. Most subjects walked with a normal muscle function in the hip and knee when walking with or without an anti-slip device on all surfaces. The heel device was perceived as the most rapid one to take on and the toe device as the most rapid one to take off. All three devices were perceived as having a good foothold. The heel device was perceived to fit the shoe and to be stable at heel-strike. The toe device was easily portable and stable on uncovered ice. The whole-foot device was comfortable to walk with and safe on snow covered ice. The heel device had the highest priority according to walking safety, walking balance and choice for own use

  • 119. Gard, Gunvor
    et al.
    Larsson, Ingalill
    Lund University Hospital, Department of Health Sciences, Division of Physiotherapy.
    Conceptions of physiotherapy knowledge among Swedish physiotherapists: a phenomenographic study2006In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 92, no 2, p. 110-115Article in journal (Refereed)
    Abstract [en]

    Objectives and design Knowledge in physiotherapy is based on both scientific evidence and clinical practice. Different perspectives of knowledge generate different implications for theory development. The aim of this qualitative, phenomenographic study was to describe physiotherapists’ conceptions of physiotherapy knowledge. Intervention and participants Open, semi-structured interviews were conducted with 10 physiotherapists working in different sectors of physiotherapy. The transcribed material was analysed according to phenomenographic analysis. Results The physiotherapists’ conceptions of various aspects of physiotherapy knowledge are described by four qualitatively different categories: (a) interaction, i.e. the ability to create opportunities for patients and develop patients’ competencies, equally influenced by both theoretical and practical knowledge, with a patient-oriented perspective conceiving the physiotherapist as a coach; (b) personal competencies, i.e. the ability to provide good therapy influenced more by practical knowledge oriented towards the physiotherapist; (c) professional demands, i.e. the ability to be professional according to rules and scientifically proven interventions, influenced more by theoretical knowledge oriented towards the physiotherapist; and (d) scientific areas, i.e. the ability to use different knowledge, as an expert, in the interaction with the patient, strongly influenced by theoretical knowledge and oriented towards the patient. Conclusions The results can contribute to physiotherapy students’ understanding of the multi-dimensional nature of physiotherapy. The paradigm of physiotherapy must be studied further in order to understand and explain its complexity

  • 120.
    Willen, Maria
    et al.
    Lunds universitet, Institutionen för hälsa, vård och samhälle.
    Törnberg, Anna
    Lunds universitet, Institutionen för hälsa, vård och samhälle.
    Gard, Gunvor
    Cystisk fibros2006In: Svensk rehabilitering, ISSN 1403-4468, Vol. 8, no 2, p. 22-25Article in journal (Other academic)
  • 121.
    Lischner, Katherine
    et al.
    Luleå tekniska universitet.
    Lundqvist, Daniel
    Mikaelsson, Katarina
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Fysiskt aktiv livsstil i unga år förebygger insjuknande i typ 2 diabetes: en litteraturstudie2006In: Svensk rehabilitering, ISSN 1403-4468, Vol. 8, no 2, p. 10-14Article in journal (Other academic)
  • 122.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    How can cooperation between rehabilitation professionals in rehabilitation planning be improved?2006In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 26, no 2, p. 191-6Article in journal (Refereed)
    Abstract [en]

    Research shows that there are often problems with cooperation between rehabilitation professionals within vocational rehabilitation. The aim of this study was to describe employers' experiences of how cooperation between different rehabilitation professionals can be improved in a vocational rehabilitation planning process. Ten employers who had sent their employees to vocational rehabilitation at a rehabilitation centre in the north of Sweden during 2000 and 2001 participated in the study. Qualitative interviews were performed and analysed by thematic content analysis. The employers' cooperation with clients could be improved by a focus on clients' needs and participation in the rehabilitation process. The employers cooperation with Social Insurance companies could be improved by, 1) early prevention and intervention, 2) knowledge of each other's roles, responsibilities and opportunities and 3) priority making. The employers' cooperation with rehabilitation professionals could be improved by, 1) early identification of rehabilitation needs and goals and early rehabilitation and, 2) increased focus on own responsibilities from each part in the process.

  • 123.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Mobilt larm och rörelsefrihet: upplevelser av ett mobilt trygghetslarm2006Report (Other academic)
    Abstract [sv]

    Den framtida demografiska utvecklingen innebär en allt högre andel äldre i befolkningen i Sverige. En av de största utmaningarna för ett samhälle med en åldrande befolkning är att ordna vården och omsorgen om de äldre i framtiden. Många äldre håller sig aktiva och friska upp i allt högre ålder men en ökad medellivslängd innebär inte detsamma som en ökad hälsa. Oftast har den demografiska utvecklingen framställts som ett stort problem men nu börjar det även komma en diskussion som innebär att äldreboomen, sedd som ett kluster, även kan innebära en möjlighet ett tillväxtområde. Nya tjänster och ny teknik som vänder sig till en växande del äldre i befolkningen utvecklas och testas. Man vet från forskning att faktorer som har med den enskildes upplevelse av egenmakt, integritet och rörelsefrihet, det vill säga empowerment är av stor betydelse för bibehållen hälsa. Trygghet är också av betydelse. För att göra det möjligt att bo kvar så länge som möjligt i hemmet används ofta olika former av teknik. Trygghetslarm är vanligt och används av framförallt äldre men även av funktionshindrade. Syftet med projektet Mobilt larm (MTL CDH) var att undersöka hur dagens trygghetslarm används, utveckla och testa ett mobilt trygghetslarm samt undersöka hur detta larm upplevs utifrån ett empowerment perspektiv. Metoder som använts är analys av alla inkomna larm i Luleå kommun under en 5 dagars period, en intervention i form av ett mobilt larm med fallsensor som testades av 9 äldre personer under 3 veckor, intervju med testpersonerna och två enkäter kring funktion, användarvänlighet samt graden av rörelsefrihet som besvarats av testpersonerna. Resultatet visar att dagens trygghetslarm används förutom till att påkalla hjälp även som kommunikationsmedel för att skapa trygghet. Det testade mobila larmet sågs som en möjlighet till ökad rörelsefrihet. Det faktum att man var positionerad genom larmet upplevdes inte som integritetskränkande så länge man upplevde att det var personen själv som bestämde att använda larmet. Det testade larmet var endast en prototyp under utveckling och testpersonerna bidrog med förslag till förbättring

  • 124.
    Tibaek, Sigrid
    et al.
    Copenhgen University Hospital, Department of Geriatrics and Rheumatology.
    Gard, Gunvor
    Jensen, Rigmor
    Copenhgen University Hospital, Department of Neurology.
    Pelvic floor muscle training is effective in women with urinary incontinence after stroke: a randomised, controlled and blinded study2006In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 24, no 4, p. 348-57Article in journal (Refereed)
    Abstract [en]

    AIMS: The aim of this study was to evaluate the effect of Pelvic Floor Muscle Training (PFMT) in women with urinary incontinence (UI) after ischemic stroke. MATERIALS AND METHODS: Three hundred and thirty-nine medical records of stroke patients were searched. Twenty-six subjects were randomised to a Treatment Group (14 subjects) or a Control Group (12 subjects) in a single blinded, randomised study. The intervention included 12 weeks of standardised PFMT. The outcome measures were: (1) diary recording the frequency of voiding, the number of incontinence episodes and used pads; (2) 24-hr home pad test; and (3) vaginal palpation of pelvic floor muscle evaluating function, strength, static and dynamic endurance. RESULTS: Twenty-four subjects with urge, stress and mixed stress/urge incontinence, completed the study, 12 in each group. A significant improvement in frequency of voiding in daytime (Treatment Group/Control Group: 7/8 at pre-test, 6/9 at post-test (median values), P=0.018), 24-hr pad test (Treatment Group/Control Group: 8/12 to 2/8 g P=0.013) and dynamic endurance of pelvic floor muscle (Treatment Group/Control Group: 11/20 to 20/8 contractions of Pelvic Floor Muscle, P=0.028) was demonstrated in the Treatment Group compared to the Control Group. A significant improvement in frequency of voiding in daytime (decreased from seven to six, P=0.036), pelvic floor muscle function (P=0.034), strength (P=0.046), static endurance increased from 9 to 30 sec (P=0.028) and dynamic endurance increased from 11 to 20 contractions (P=0.020) was also demonstrated within the Treatment Group, but not in the Control Group. CONCLUSION: PFMT had a significant effect in women with UI after stroke measured by diaries, pad tests and vaginal palpation

  • 125.
    Taebek, Sigrid
    et al.
    Copenhgen University Hospital, Department of Geriatrics and Rheumatology.
    Jensen, Rigmor
    Copenhgen University Hospital, Department of Neurology.
    Klarskov, Peter
    Glostrup Hospital, Department of Urology.
    Iversen, Helle K.
    University of Copenhagen, Department of Neurology, Gentofte Hospital.
    Gard, Gunvor
    The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire is reliable in stroke patients2006In: Neurourology and Urodynamics, ISSN 0733-2467, E-ISSN 1520-6777, Vol. 25, no 4, p. 319-23Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate the test-retest reliability of Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire in a sample of stroke patients. METHODS: A prospective study design was used in which the stroke patients were invited to complete a postal self-administrated DAN-PSS-1 questionnaire twice. The questionnaire consists of 12 questions related to lower urinary tract symptoms (LUTS). The participants were asked to state the frequency and severity of their symptoms (symptom score) and its impact on their daily life (bother score). Seventy-one stroke patients were included and 59 (83%) answered the questionnaire twice. The reliability test was done in two aspects: (a) detecting the frequency of each symptom and its bother factor, the scores were reduced to a two-category scale (=0, >0) and simple kappa statistics was used; (b) detecting the severity of each symptom and its bother factor, the total scale (0-3) and weighted kappa statistics was used. RESULTS: The proportion of agreement for the frequency symptom scores ranged from 76% to 97% and the simple kappa coefficient ranged from poor (kappa = 0.00) to excellent (kappa = 0.91). The proportion of agreement for the corresponding bother scores ranged from 76% to 95% and the simple kappa coefficient ranged from good (kappa = 0.61) to excellent (kappa = 0.84). The weighted kappa coefficient for the severity symptom scores ranged from moderate (kappa(w) = 0.43) to good (kappa(w) = 0.75) and the corresponding bother scores ranged from moderate (kappa(w) = 0.48) to good (kappa(w) = 0.68). CONCLUSIONS: The DAN-PSS-1 questionnaire had acceptable test-retest reliability and may be suitable for measuring the frequency and severity of LUTS and its bother factor in stroke patients.

  • 126.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Body awareness therapy for patients with fibromyalgia and chronic pain2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, no 12, p. 725-8Article in journal (Refereed)
    Abstract [en]

    There are several therapies designed to increase body awareness. They are commonly known as body awareness therapies (BAT) and include Basic BAT, Mensendieck and Feldenkrais therapy. A focus on emotions is important in all these therapies. In this article the aim and development of Basic BAT is described together with evaluations of treatments including Basic BAT. Multidisciplinary studies have shown that Basic BAT can increase health-related quality of life and cost-effectiveness. However Basic BAT needs to be further studied in relation to patients with fibromyalgia (FM) and chronic pain. Studies so far indicate that Basic BAT has positive effects.

  • 127. Gard, Gunvor
    et al.
    Rivano, Marcelo
    Department of Rehabilitation, Lund University Hospital, Sweden.
    Grahn, Birgitta
    Kronoberg county council, R&D centre.
    Development and reliability of the Motivation for Change Questionnaire2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, no 17, p. 967-76Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study was to describe the development of the Motivation for Change Questionnaire (MCQ) and to test its intra-patient reliability on musculoskeletal pain patients in interdisciplinary rehabilitation as a basis for use in rehabilitation planning. METHOD: The MCQ questionnaire was developed from a literature search in the Medline, Cinahl and Psychlit databases concerning motivating factors for change in the life and work situation. Questions covering these factors were developed (item generation). Factor analysis of the questions implied a reduction of the number of questions (item reduction). Inter-item correlation was assessed on the baseline administration of the questionnaire by calculating Cronbach's alpha. When testing the structure of the scales, it was shown that the MCQ questionnaire could be described in two scales, one scale relating to motivation for change in the life situation and the other focusing on motivation for change in the work situation and in total 49 questions. RESULTS: The test -- retest reliability was calculated using the intra-class correlation coefficient (ICC) and 95% confidence intervals were calculated. One question was excluded due to the threshold limit of > 0.5. Seven scales relating to the life situation were accepted by the analysis: social support, mastery in life, challenges in life, control in life, values, self-efficacy and self-confidence. Six scales relating to the work situation were also accepted: co-worker support, supervisory support, challenges in work, job control, interaction and job-satisfaction. CONCLUSIONS: The MCQ questionnaire with 48 questions is reliable for use on musculoskeletal pain patients in interdisciplinary rehabilitation. It can be used to identify each individual's motivating factors for change in life and work situation as a basis for motivational work within rehabilitation and/or to measure within-subject changes in motivation over time. The validity and the responsiveness of the MCQ, need to be studied.

  • 128. Larsson, Agneta
    et al.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Employer's experiences of an effective vocational planning process at the workplace2005In: First international conference on lifestyle, health and technology, Luleå: Luleå tekniska universitet, 2005Conference paper (Refereed)
  • 129.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Melander-Wikman, Anita
    Majamaa, Marja-Liisa
    Kemi-Tornio Polytechnic.
    Empowerment dimensions in the use of mobile information technology2005In: HCI International 2005: 11th International Conference on Human-Computer Interaction ; July 22 - 27, 2005, Caesars Palace, Las Vegas, Nevada, USA, Mahwah, NJ, 2005Conference paper (Other academic)
  • 130.
    Dahlberg, Kristina
    et al.
    Outokumpu stainless AB.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Friskfaktorer i arbetslivet: En jämförande studie av män 55+ inom Avesta jernverk2005In: Svensk rehabilitering, ISSN 1403-4468, Vol. 7, no 2, p. 8-12Article in journal (Other academic)
  • 131.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    How can a work rehabilitation process be improved?: a qualitative study from a perspective of the social insurance officers2005In: Proceedings of the 3rd World Congress of the International Society of Physical and Rehabilitation Medicine ISPRM, São Paulo, Brazil, April 10-15, 2005 / [ed] Linamara Rizzo Battistella; Marta Imamura, Bologna: Medimond International Proceedings , 2005Conference paper (Other academic)
  • 132.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Increased focus on values: a tool in stress prevention?2005In: First international conference on lifestyle, health and technology, Luleå: Luleå tekniska universitet, 2005Conference paper (Refereed)
  • 133. Arvidsson, Mialinn
    et al.
    Patel, Sonal
    Luleå tekniska universitet.
    Calner, Tommy
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Kroppsmedvetande hos unga indiska kvinnor2005In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 9, no 1, p. 40-47Article in journal (Other academic)
    Abstract [en]

    Body image is a concept, referring to feelings and attitudes toward: the body. There are many di fervent factors affecting the body image; historical, cultural, social and individual factors. The aim ofthis study was to describe young Indian women's body image. One hundred female university students in India answered the Ben-Tovim Walker Body attitudes questionnaire (BAQ). The result showed that Indian women had a sound body image.

  • 134. Gard, Gunvor
    et al.
    Cavlak, Ugur
    Pamukkale University, School of Physical therapy and Rehabilitation.
    Sundén, Bente Thrane
    Lund University, Department of Physical Therapy.
    Ozdinceler, Arzu Razak
    Istanbul University, School of Physical Therapy and Rehabilitation.
    Life-views and ethical viewpoints among physiotherapy students in Sweden and Turkey: a comparative study2005In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, no 1, p. 20-31Article in journal (Refereed)
    Abstract [en]

    There is a need for a deeper understanding of and discussion about different cultures' influences on life-views and ethical reasoning among professionals within healthcare. A culture can be seen as a set of guidelines, both explicit and implicit, which individuals inherit as members of a particular society, and which tells them how to view the world and how to behave in it in relation to other people. Do the cultural differences between Sweden, a culture predominantly influenced by Christian religion, and Turkey, a culture predominantly influenced by Muslim religion, influence physiotherapy students' life-views and ethical reasoning? The aim of this study was to compare life-views and questions of ethics between Swedish and Turkish physiotherapy students at the beginning of their studies. A reliable and valid questionnaire about life-views, together with questions covering ethical aspects was used. Three hundred and thirty-two physiotherapy students (186 Swedish, 146 Turkish) answered the same life-view questionnaire. Non-parametric statistics were used. Significant differences between the Swedish and Turkish students' opinions were analyzed with non-parametric statistics (Mann-Whitney U-test, two independent samples). Students' priorities in ethical questions were also compared between the groups. The Turkish students had significantly higher mean values in questions that belonged to a scientific life-view; the Swedish students had significantly higher mean values in questions belonging to an evolutionary life-view. There were significant differences between the groups in 14/20 individual life-view questions. The Swedish students were more patient-centered in their attitudes, had more positive attitudes to unconventional lifestyles and accepted to a higher extent than Turkish students suicide and euthanasia in special situations. Concerning priorities in ethical questions, there were significant differences between the groups concerning justice in healthcare and happiness for all, with higher priorities for happiness and justice in healthcare from the Turkish students.

  • 135.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Mobil informations- och kommunikationsteknik inom rehabilitering2005In: Abstractbok för sjukgymnastdagarna 2005, Stockholm: Legitimerade sjukgymnasters riksförbund , 2005, p. 30-Conference paper (Other academic)
  • 136.
    Brauer, Angela
    et al.
    Lunds universitet, Institutionen för hälsa, vård och samhälle. Sektionen för sjukgymnastik.
    Nilsson, Ann-Maj
    Lunds universitet, Institutionen för hälsa, vård och samhälle. Sektionen för sjukgymnastik.
    Höglund, Ingegerd
    Lunds universitet, Institutionen för hälsa, vård och samhälle. Sektionen för sjukgymnastik.
    Gard, Gunvor
    Natur och trädgårdsterapi - stressreducerande effekter?: en literaturstudie2005In: Svensk rehabilitering, ISSN 1403-4468, Vol. 7, no 2, p. 42-53Article in journal (Other academic)
  • 137.
    Odenhall, Malin
    et al.
    Lunds universitet, Institutionen för vård, hälsa och samhälle. Sektionen för sjukgymnastik.
    Ward, Andreas
    Lunds universitet, Institutionen för vård, hälsa och samhälle. Sektionen för sjukgymnastik.
    Nilsson, Maria Ovesson
    Lunds universitet, Institutionen för vård, hälsa och samhälle. Sektionen för sjukgymnastik.
    Gard, Gunvor
    Optimal interaktion mellan sjukgymnast och patient ur sjukgymnastens perspektiv2005In: Svensk rehabilitering, ISSN 1403-4468, Vol. 7, no 2, p. 22-27Article in journal (Other academic)
  • 138.
    Romé, Åsa
    et al.
    Rehabhuset, Tomelilla.
    Gard, Gunvor
    "Rehabakuten": Tidig rehabilitering inom primärvården2005In: Svensk rehabilitering, ISSN 1403-4468, Vol. 7, no 1, p. 42-44Article in journal (Other academic)
  • 139.
    Eriksson, Lisbeth
    et al.
    Norrbottens Läns Landsting.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Lysholm, Jack
    Winternet.
    Shoulder rehabilitation at a distance: the patients and therapists perceptions!2005In: First international conference on lifestyle, health and technology, Luleå: Luleå tekniska universitet, 2005Conference paper (Refereed)
  • 140.
    Larsson, Ingalill
    et al.
    Lunds universitet, Institutionen för vård, hälsa och samhälle.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Sjukgymnasters uppfattningar om sjukgymnastisk kunskap: en fenomenografisk studie2005In: Abstractbok för sjukgymnastdagarna 2005, Stockholm: Legitimerade sjukgymnasters riksförbund , 2005, p. 55-Conference paper (Other academic)
  • 141.
    Melander-Wikman, Anita
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Jansson, Maria
    Luleå University of Technology, Department of Health Sciences.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences.
    The MobiHealth usability evaluation questionnaire2005In: eHealth International, ISSN 1476-3591, E-ISSN 1476-3591, Vol. 2, no 1, p. 9-14Article in journal (Refereed)
    Abstract [en]

    There is a need for high quality evaluation instruments when testing new mobile devices and services. The aim of this study was to describe the development of the MobiHealth Usability Evaluation Questionnaire. It was developed in a step-wise consensus process with close interaction between researchers, technology developers and end-users. The questionnaire ten dimensions: functionality, user interface, effectiveness, efficiency, satisfaction, safety, functional and aspirational needs, mastery and empowerment, mobility and activity, quality of life and ethical considerations. These dimensions are defined and their usage as parameters in an evaluation instrument is discussed. The conclusion is that the MobiHealth Evaluation Questionnaire can be used as a basis for method development when evaluating mobile care and rehabilitative devices, but it should be tested for reliability before actual use.

  • 142.
    Romé, Åsa
    et al.
    Rehabhuset, Tomelilla.
    Gard, Gunvor
    Tidig rehabilitering av muskoloskeletala besvär inom primärvårdens sjukgymnastik: en utvärdering av ett fyra-veckors rehabiliteringsprogram inom primärvården2005In: Abstractbok från Sjukgymnastdagarna 2005, Stockholm: Legitimerade sjukgymnasters riksförbund , 2005, p. 69-Conference paper (Other academic)
  • 143. Gard, Gunvor
    et al.
    Gyllensten, Amanda Lundvik
    Lund University, Department of Physical Therapy.
    Are emotions important for good interaction in treatment situations?2004In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 20, no 2, p. 107-19Article in journal (Refereed)
  • 144.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Bättre och effektivare rehabiliteringsplaner?2004In: Svensk rehabilitering, ISSN 1403-4468, Vol. 6, no 2, p. 14-17Article in journal (Other academic)
  • 145.
    Söderberg, Siv
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Jumisko, Eija
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Clients' experiences of a work rehabilitation process2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 7, p. 419-24Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to describe clients' experiences of a work rehabilitation process. METHOD: Ten clients who had participated in work-related rehabilitation at a rehabilitation centre in the northern parts of Sweden were interviewed using a narrative approach. The interviews were analysed using qualitative content analysis focusing on clients' descriptions of the goals, contents and results of the work rehabilitation process. RESULTS: At the beginning of the rehabilitation the goal was often to confirm a diagnosis, to become healthy and able to return to work. It was hard to be forced to change the goals. When fortunate the rehabilitation provided more profound guidance and function assessment. It resulted in changes varying from practical alterations to important insights into life. It was important to get support and understanding. When the rehabilitation was not adjusted to clients' needs, feelings of disappointment emerged and life became a struggle with various authorities in order to gain understanding and other forms of rehabilitation. CONCLUSIONS: This study shows the need to develop truly client-centred practice. Therefore, we emphasized, based on this study, the importance of professionals involved in rehabilitation working on different levels and in various settings having regular discussions about what the term client-centred practice means to them. Integrating individual perceptions is essential to advancing a multidimensional approach in return-to-work research.

  • 146.
    Sjödahl, Catharina
    et al.
    Lund University Hospital, Scandinavian Orthopaedic Laboratory.
    Gard, Gunvor
    Jarnlo, Gun-Britt
    University of Lund, Department of Physical Therapy.
    Coping after trans-femoral amputation due to trauma or tumour: a phenomenological approach2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 14/15, p. 851-61Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe, by use of a phenomenological approach, how relatively young trans-femoral amputees experienced their amputation and their coping strategies in the acute phase and over time. METHOD: Eleven trans-femoral amputees, median age 33.5 years, were interviewed. The amputation was caused by tumour, motorcycle accidents or work-related traumas. Amputation was made in median 7.5 years before the interview. The informants were community dwelling and managed well indoors. One had a half disablement pension and all the others were working or studying full time. The interviews were tape-recorded and transcribed verbatim. RESULTS: Two themes emerged. In the first theme 'Experiences of the amputation' denial and avoidance were the coping strategies mainly used. In the second theme 'Coping strategies to relate to a new norm' the informants used downward comparison, positive comparison and repression. Only one informant indicated a full acceptance of his situation. CONCLUSION: Relatively young, trans-femoral amputees within this sample, have not reached the acceptance level, though a long time has passed since the amputation. They might have benefited from professional support and guidance during the rehabilitation process in order to improve coping strategies to relate to a new norm.

  • 147.
    Gard, Gunvor
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Ergonomi: en kunskapsöversikt2004In: Arbetsmiljö: kunskap och handling, Lund: Studentlitteratur AB, 2004, p. 212-243Chapter in book (Other academic)
  • 148.
    Skjaerven, Liv H.
    et al.
    Bergen University College, Institute of Postgraduate Courses, Faculty of Health and Social Sciences.
    Gard, Gunvor
    Kristofferssen, Kjell
    University of Bergen, Department of Public Health and Primary Health Care Section of Nursing Science.
    Greek sculpture as a tool in understanding the phenomenon of movement quality2004In: Journal of Bodywork & Movement Therapies, ISSN 1360-8592, E-ISSN 1532-9283, Vol. 8, no 3, p. 227-236Article in journal (Refereed)
    Abstract [en]

    Previous research has shown that movement quality may be described as offering a general impression of a whole unified person, understood as a relation between postural stability, free breathing and awareness, which combined produce a refinement of movement as well as enhancing well-being. The phenomenon could further be structured in terms of four movement dimensions: structural, physiological, psychological/relational and a purely human dimension. So far we have little knowledge about these dimensions. The aim of this study is to deepen the understanding of the phenomenon of movement quality through close observation of Greek sculpture, reflection and literature studies relating to Greek sculpture. The aim was to see if these methods could be a tool for achievement of a deeper understanding of movement quality, in clinical observation and reasoning. A phenomenological method was used to study the essence of the phenomenon of movement quality. A study of Greek sculpture was chosen because of the way ancient Greek sculptors sought to express several dimensions of human existence. The results show that close observation, reflection and literature studies of Greek sculptures deepened the knowledge of the four dimensions of movement quality and provided a way in which this knowledge could be expressed in words. These methods may represent a tool for achieving a deeper understanding of movement quality in clinical observation and reasoning

  • 149.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Larsson, Agneta
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    How can a work rehabilitation process be improved2004In: Final programme and abstracts, Vienna: Austrian society of physical medicine and rehabilitation , 2004Conference paper (Other academic)
  • 150.
    Gard, Gunvor
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    How can a work rehabilitation process be improved?: a qualitative study from the perspective of social insurance officers2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 5, p. 299-305Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study is to describe social insurance officers' experiences of a work rehabilitation process at a rehabilitation centre in the northern parts of Sweden. In Sweden the social insurance company has a key role to coordinate all efforts concerning work rehabilitation planning between all rehabilitation actors. METHOD: Ten social insurance officers at the social insurance company in a city in northern Sweden were interviewed using a narrative approach about their experiences of work rehabilitation processes in general. The interviews were analysed by qualitative content analysis with a focus on their experiences of goals, content and results of a work rehabilitation process. RESULTS: The social insurance officers' experiences of how a work rehabilitation process could be improved were described in six categories; (1) Early identification of problems, needs and interventions (2) clear goal formulations, (3) a focus on psychosocial factors (4) a greater variety of possible interventions, (5) activating employers to a higher extent in work rehabilitation and (6) a closer cooperation and information exchange with other rehabilitation actors. CONCLUSIONS: It is possible to improve a work rehabilitation process by focusing on early identification of problems, needs and interventions, with a variety of interventions to choose between and with clear goal formulations and recognizing psychosocial factors in the process. To activate employers to a higher extent in work rehabilitation and to make the information exchange between rehabilitation actors more frequent may also improve work rehabilitation processes

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