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  • 1. Agervi, Pia
    et al.
    Nilsson, Maria
    Martin, Lene
    Foveal function in children treated for amblyopia.2010Inngår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 88, nr 2, s. 222-226Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: This study aimed to evaluate foveal function, using three different methods, in children treated for monocular amblyopia. METHODS: A sample of 24 otherwise healthy children with treated amblyopia and an age-matched control group of 25 healthy children were examined for best corrected visual acuity (BCVA) using a standard decimal (KM) chart and the computerized TriVA method at 50% and 10% contrasts. Foveal function was also measured with the rarebit fovea test (RFT), which is included in the rarebit perimetry program package. This test uses very small and bright dots against a dark background. The result is expressed as mean hit rate (MHR). RESULTS: Amblyopic eyes showed significantly lower BCVA when evaluated with the KM chart and with the TriVA test at different contrast levels, compared with both fellow eyes and control eyes. No statistically significant difference between amblyopic and fellow eyes was found when foveal function was evaluated with the RFT (median MHRs 91.5% and 94.5%, respectively), although results for both amblyopic and fellow eyes were statistically lower than those of the control group (median MHR 97%) (p = 0.001 and p = 0.046, respectively). This might indicate that the RFT provides different information about foveal function than conventional VA tests. CONCLUSIONS: The findings in the current study accord with those of other studies reporting abnormalities in the fellow eyes of previously treated amblyopic patients. These findings may reflect a general disturbance in the visual system rather than a monocular adaptation to refractive error or ocular motor disturbance.

  • 2.
    Andersson, Anna Karin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Strand Brodd, Katarina
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Born too soon: a project about everyday functioning, health and welfare2014Konferansepaper (Fagfellevurdert)
  • 3.
    Andersson, Anna Karin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Strand Brodd, K.
    Uppsala University, Sweden.
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Patterns of everyday functioning in preschool children born preterm and at term2017Inngår i: Research in Developmental Disabilities, ISSN 0891-4222, E-ISSN 1873-3379, Vol. 67, s. 82-93Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background/Aim Children born preterm are at risk of neonatal complications but the long-term consequences for everyday functioning is not well known. The study aimed to identify patterns of everyday functioning in preschool children born preterm and at term in relation to perinatal data, neonatal risk factors, behaviour, and socioeconomic status. Registry data and data from parent rated questionnaires were collected for 331 children. Method A person-oriented approach with a cluster analysis was used. Results A seven cluster solution explained 65.91% of the variance. Most children (n = 232) showed patterns of strong everyday functioning. A minority of the children (n = 99), showed diverse patterns of weak everyday functioning. Perinatal characteristics, neonatal risk factors and socio-economics did not predict cluster group membership. Children born preterm were represented in all clusters. Conclusion, implications Most preschool children are perceived by their parents with strong everyday functioning despite being born preterm. However small groups of children are, for various reasons, perceived with weak functioning, but preterm birth is not the sole contributor to patterns of weak everyday functioning. More critical for all children's everyday functioning is probably the interaction between individual factors, behavioural factors and contextual factors. To gain a broader understanding of children's everyday functioning. Child Health Services need to systematically consider aspects of body function, activity and in addition participation and environmental aspects.

  • 4.
    Andersson, Anna Karin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Strand Brodd, K.
    Uppsala University, Sweden.
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Predictors for everyday functioning in preschool children born preterm and at term2016Inngår i: Early Human Development, ISSN 0378-3782, E-ISSN 1872-6232, Vol. 103, s. 147-153Artikkel i tidsskrift (Fagfellevurdert)
  • 5.
    Andersson, Anna Karin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Strand Brodd, Katarina
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Childrens and parents percpetions of everyday functioning in preschool children born preterm2017Konferansepaper (Fagfellevurdert)
  • 6.
    Bartling, Herman
    et al.
    Karolinska Institutet.
    Wanger, Peter
    Karolinska Institutet.
    Martin, Lene
    Karolinska Institutet.
    Automated quality evaluation of digital fundus photographs2009Inngår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 87, nr 6, s. 643-647Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Retinal images acquired by means of digital photography are often used for evaluation and documentation of the ocular fundus, especially in patients with diabetes, glaucoma or age-related macular degeneration. The clinical usefulness of an image is highly dependent on its quality. We set out to develop and evaluate an automatic method of evaluating the quality of digital fundus photographs. METHODS: A method for making a numerical quantification of image sharpness and illumination was developed using Matlab image analysis functions. Based on their sharpness and illumination measures, 1000 fundus photographs, randomly selected from a clinical database, were assigned to four predefined quality groups (not acceptable, acceptable, good, very good). Six independent observers, comprising three experienced ophthalmologists and three ophthalmic nurses with extensive experience in fundus image acquisition, classified a selection of 100 of these images into the corresponding quality groups. RESULTS: Automatic quality evaluation was more sensitive than evaluation by human observers in terms of ability to discriminate between good and very good images. The median concordance between the six human observers and the automatic evaluation was substantial (kappa = 0.64). CONCLUSIONS: The proposed method provides an objective quality assessment of digital fundus photographs which agrees well with evaluations made by qualified human observers and which may be useful in clinical practice.

  • 7.
    Bartling, Herman
    et al.
    Karolinska Institutet, Sweden .
    Wanger, Peter
    Karolinska Institutet, Sweden .
    Martin, Lene
    Karolinska Institutet, Sweden .
    Measurement of optic disc parameters on digital fundus photographs: algorithm development and evaluation.2008Inngår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 86, nr 8, s. 837-41Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To develop and evaluate a simple and rapid algorithm for optic disc measurements on digital fundus photographs, relying on the macula-disc centre distance as a reference when converting length expressed in pixels to metric distance. METHODS: Measurements were performed on fundus photographs from 68 normal subjects, acquired using five different cameras. The magnification factor and actual size in mum of 1 pixel was known for only one camera. The measurements from this camera were compared to corresponding measurements from a confocal scanning laser ophthalmoscope. RESULTS: Using the described algorithm, no significant differences in mean disc or cup size were observed between the tested cameras, despite differences in magnification factor (range 0.5-2.5). There were no significant differences between disc and cup measurements obtained with the confocal scanning laser ophthalmoscope and those obtained with the described algorithm in the 20 subjects examined. CONCLUSION: The algorithm described in the current study provided clinically relevant measurements of optic disc parameters. The final program can be used directly on the acquired images, with the examined subject still available for re-examination.

  • 8.
    Fahnehjelm, Kristina
    et al.
    Karolinska Institutet, Sweden.
    Dahl, Sara
    Karolinska Universitetssjukhuset, Sweden.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Ek, Ulla
    Stockholms Universitet, Sweden.
    Optic nerve hypoplasia in children and adolescents; prevalence, ocular characteristics and behavioural problems2014Inngår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, nr 6, s. 563-570Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To report prevalence, ocular characteristics and coexisting behavioural problems in children and adolescents with optic nerve hypoplasia (ONH), which is a common cause of visual impairment in children in western countries, often associated with neurological or endocrinological problems and where autism has been reported in severe cases with blindness. Methods: This is a population-based cross-sectional study of patients <20 years of age who had been diagnosed with ONH and lived in the county of Stockholm in December 2009. Ophthalmological assessments including fundus photographs with optic disc analyses were made. A questionnaire was used to screen for behaviour and development. Results: The prevalence of ONH in all living children <18 years of age in Stockholm was 17.3/100 000 with a prevalence of visual impairment (<0.3) of 3.9/100 000. In total, 66 patients, median age 9.3 years (0.6-19.4), 36 with bilateral and 30 with unilateral ONH, were included in the current study; 53 were re-examined clinically, group A, and 13 agreed to retrospective analyses of existing medical records, group B. Analyses of the optic discs were made in fundus photographs from 53 patients comparing a semi-automated (Retinal Size Tool) and a manual method (Zeki). There was a strong curvilinear correlation (rS = -0.91 p < 0.0001 for both eyes). Behavioural problems were more common (p < 0.05) in bilateral ONH. Conclusion: Opticnerve hypoplasia is a common ocular malformation with a prevalence of 17.3/100 000 children and adolescents <18 years of age in Stockholm. Unilateral ONH seems as common as bilateral. 

  • 9.
    Fahnehjelm, Kristina
    et al.
    Inst för klinisk neurovetenskap, Karolinska Institutet.
    Fischler, B
    Karolinska Institutet.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Nemeth, Antal
    Karolinska Institutet.
    Occurrence and pattern of ocular disease in children with cholestatic disorders2011Inngår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 89, nr 2, s. 143-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To describe visual function and ocular manifestations in patients with onset of cholestasis during the neonatal period. Methods: Patients with neonatal cholestasis, either transitory or chronic, who came for assessment to our tertiary referral centre were included in a cross-sectional study and underwent ophthalmological examinations including fundus photography. A total of 57 patients (24 girls and 33 boys), aged 0.4-18.0 years, were included. Of these, 28 patients had biliary atresia, 11 had Alagille's syndrome, five had progressive familiar intrahepatic cholestasis and nine had different disorders such as pituitary insufficiency, alpha-1-antitrypsin deficiency, mitochondriopathy, congenital infections or cholestasis caused by unknown reasons. Results: Visual dysfunction and / or one or several ocularmanifestations occurred in 39 out of 57 patients. Major ocular malformations occurred in five patients. Out of three patients with biliary atresia, one patient had severe visual impairment caused by microphthalmia and chorioretinal coloboma, one patient with Cat Eye syndrome had bilateral uveochorioretinal coloboma and one patient had Rieger's anomaly. Two patients, both with pituitary deficiency and transient cholestasis, had severe unilateral visual impairment caused by optic nerve hypoplasia. Conclusion: The majority (68%) of the patients with cholestasis had ocular manifestations. Although the severity of ocular complications varied with diagnosis, and was most apparent among patients with biliary atresia or pituitary deficiency, no conclusion can be drawn regarding the connections between these conditions from the present study. Nevertheless, ocular assessment is important for diagnostic purposes and for early intervention in patients with cholestasis.

  • 10.
    Fahnehjelm, Kristina Teär
    et al.
    Karolinska Institutet.
    Olsson, Monica
    Karolinska Institutet.
    Naess, Karin
    Karolinska Institutet.
    Wiberg, Maria
    Karolinska University Hospital.
    Ygge, Jan
    Karolinska Institut.
    Martin, Lene
    Karolinska Institut.
    von Döbeln, Ulrika
    Karolinska Institut.
    Visual function, ocular motility and ocular characteristics in patients with mitochondrial complex I deficiency2012Inngår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 90, nr 1, s. 32-43Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract. Purpose: The aims of the present study were to investigate visual function, ocular motility and ocular characteristics in children and young adults with complex I deficiency. Material and Methods: In a prospective study with longitudinal follow-up, the visual and ocular outcome in 13 patients with deficiency in complex I [nicotine-amide adenine dinucleotide (NADH) dehydrogenase] in the mitochondrial respiratory chain is presented. The patients were diagnosed during 1995-2007 and assessed during 1997-2009 at a median age of 12.8 years (range 3.1-23.4). Results: Twelve of 13 patients had visual impairment and/or ocular pathology. Four of 10 patients who co-operated in visual assessment had a best corrected decimal visual acuity of A mutation in mitochondrial DNA. Only one patient had normal visual acuity and ocular outcome including refraction and visual fields. Follow-up time was median 3.0 years (range 0-11). Conclusion: Visual impairment, ocular motility problems and OA are common in children and young adults with complex I deficiency and should prompt the paediatric ophthalmologist to consider mitochondrial disorders.

  • 11.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Josefsson, Karin
    University of Borås, Faculty of Caring Science, Work Life and Social Welfare Department of Caring Science.
    Thors Adolfsson, Eva
    Västmanland County Hospital, Department of Primary Health Care, Västerås, Sweden.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Family Health Conversations Conductedby Telephone in Heart Failure Nursing Care: A Feasibility Study2018Inngår i: SAGE Open Nursing, Vol. 4, s. 1-13Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Registered nurses (RNs) in heart failure (HF) nursing care have a key role in providing family support, which positively affectsthe outcome for the patient. Telephone interventions conducted by RNs have been reported to be successful in HF nursingcare, but Family Health Conversations (FamHCs) involving the patient and the family, have not previously been tested. Thepurpose of the current study was to explore the experiences and feasibility of nurse-led FamHCs conducted by telephonewith patients and their family caregivers. A single-group intervention study with a pretest–posttest design was conducted inthree regional hospitals that had a nurse-led HF clinic. Five RNs, eight patients, and eight family caregivers participated. ThreeFamHCs were conducted by telephone with each family every 2 weeks. Qualitative and quantitative data were collectedthrough semistructured interviews and questionnaires. FamHCs improved the nurse–family relationships and relationshipswithin the families and provided RNs with new knowledge about the families. FamHCs conducted by telephone wereconsidered to be feasible for both families and RNs, although RNs preferred fewer and shorter FamHCs. The RNs preferredmeeting face-to-face with the families as nonverbal communication between the family members could be missed because oflack of visual input. On the other hand, RNs appreciated to focus entirely on the conversation without the need to performillness-related routine checks. In conclusion, the advantages of FamHCs conducted by telephone outweighed the disadvantages.Visual contact, provided by video telephony, and a shorter version of the tested FamHC would facilitate the use in HFnursing care.

  • 12.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Josefsson, Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thors Adolfsson, Eva
    Vastmanlands Hosp Vasteras, Sweden.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Informal caregivers’ experiences and needs in caring for near ones with chronic heart failure in ordinary homes: An interview study.2014Inngår i: European Journal of Heart Failure / [ed] Prof. Marco Metra, 2014, Vol. 16 (2), s. 124-124Konferansepaper (Annet vitenskapelig)
  • 13.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Josefsson, Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thors Adolfsson, Eva
    Centre for Clinical Research, Uppsala University, County Council of Västmanland, Västerås, Sweden.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Informal Caregivers' Experiences and Needs When Caring for a Relative With Heart Failure: An Interview Study2016Inngår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, nr 4, s. E1-E8, artikkel-id 25419945Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Informal caregivers play an important role for persons with heart failure in strengthening medication adherence, encouraging self-care, and identifying deterioration in health status. Caring for a relative with heart failure can affect informal caregivers' well-being and cause caregiver burden. Objective: The objective of this study was to explore informal caregivers' experiences and needs when caring for a relative with heart failure living in their own home. Methods: The study has a qualitative design with an inductive approach. Interviews were conducted with 14 informal caregivers. Data were analyzed using qualitative content analysis. Results: Two themes emerged: "living in a changed existence" and "struggling and sharing with healthcare." The first theme describes informal caregivers' experiences, needs, and ways of moving forward when living in a changed existence with their relative. Informal caregivers were responsible for the functioning of everyday life, which challenged earlier established roles and lifestyle. They experienced an ever-present uncertainty related to the relative's impending sudden deterioration and to lack of knowledge about the condition. Incongruence was expressed between their own and their relative's understanding and acceptance of the heart failure condition. They also expressed being at peace with their relative and managed to restore new strength and motivation to care. The second theme describes informal caregivers' experiences, needs, and ways in which they handled the healthcare. They felt counted upon but not accounted for, as their care was taken for granted while their need to be seen and acknowledged by healthcare professionals was not met. Informal caregivers experienced an ever-present uncertainty regarding their lack of involvement with healthcare. The lack of involvement with healthcare had a negative impact on the relationship between informal caregivers and their relative due to the mutual loss of important information about changes in medication regimens and the relative's symptoms and well-being. Another cause of negative impact was the lack of opportunity to talk with healthcare professionals about the emotional and relational consequences of heart failure. Healthcare professionals had provided them neither with knowledge on heart failure nor with information on support groups in the municipality. Informal caregivers captured their own mandate through acting as deputies for their relative and claiming their rights of involvement in their relative's healthcare. They also felt confident despite difficult circumstances. The direct access to the medical clinic was a source of relief and they appreciated the contacts with the registered nurses specialized in heart failure. Informal caregivers' own initiatives to participate in meetings were positively received by healthcare professionals. Conclusions: Informal caregivers' daily life involves decisive changes that are experienced as burdensome. They handled their new situations using different strategies to preserve a sense of "self" and of "us." Informal caregivers express a need for more involvement with healthcare professionals, which may facilitate informal caregivers' situation and improve the dyadic congruence in the relation with their relative.

  • 14.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Josefsson, Karin
    Univ Borås, Fac Caring Sci Work Life & Social Welf, Borås, Sweden..
    Thors Adolfsson, Eva
    Cty Council Västmanland, Västmanlands Hosp Västerås, Primary Hlth Care, Västerås, Sweden..
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Nurses’ Attitudes toward Family Importance in Heart Failure Care2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr 3, s. 256-266Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure (HF). To involve family members in HF care is thus valuable for the patients. Registered nurses (RNs) frequently meet family members to patients with HF and the quality of these encounters are likely to be influenced by the attitudes RNs hold toward families.

    Aims: To explore RNs' attitudes toward the importance of families' involvement in HF nursing care and to identify factors that predict the most supportive attitudes.

    Methods: Cross-sectional, multicentre web-survey study. A sample of 303 RNs from 47 hospitals and 30 primary health care centres (PHCC) completed the instrument Families’ Importance in Nursing Care - Nurses’ Attitudes.

    Results: Overall, RNs were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in HF nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a PHCC, a HF clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and or HF nursing care, and a competence to work with families.

    Conclusions: Experienced RNs in HF nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. RNs who have designated consultation time with patients and families, as in a nurse-led HF clinic, may have the most favourable condition for implementing a more supportive approach to families.

  • 15.
    Gusdal, Annelie K
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Josefsson, Karin
    Univ Borås, Fac Caring Sci Work Life & Social Welf, Borås, Sweden..
    Thors Adolfsson, Eva
    Cty Council Västmanland, Västmanlands Hosp Västerås, Primary Hlth Care, Västerås, Sweden.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Registered nurses' perceptions about the situation of family caregivers to patients with heart failure a focus group interview study2016Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 8, s. E1-E18Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION: Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes.

    AIMS: The aims of this study are to explore registered nurses' perceptions about the situation of family caregivers to patients with heart failure, and registered nurses' interventions, in order to improve family caregivers' situation.

    METHODS: The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis.

    RESULTS: Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area "Family caregivers' situation" includes two categories: "To be unburdened" and "To comprehend the heart failure condition and its consequences". The content area "Interventions to improve family caregivers' situation" includes two categories: "Individualized support and information" and "Bridging contact".

    CONCLUSIONS: Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care" and or Family-centred care. Registered nurses consider it necessary to have a coordinated individual care plan as a basis for collaboration between the county council and the municipality.

  • 16.
    Hellgren, K
    et al.
    Karolinska Institutet, Sweden.
    Hellström, A
    Göteborg University, Göteborg, Sweden.
    Jacobson, L
    Karolinska Institutet, Sweden.
    Flodmark, O
    Karolinska Institutet, Sweden.
    Wadsby, M
    Linköping University, Linköping, Sweden.
    Martin, Lene
    Karolinska Institutet, Sweden.
    Visual and cerebral sequelae of very low birth weight in adolescents.2007Inngår i: Archives of Disease in Childhood: Fetal and Neonatal Edition, ISSN 1359-2998, E-ISSN 1468-2052, Vol. 92, nr 4, s. F259-F264Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To describe the visual functions and relate them to MRI findings and the intellectual level in adolescents born with very low birth weight (VLBW). DESIGN: Population-based case-control study. PATIENTS: 59 15-year-old VLBW adolescents and 55 sex and age-matched controls with normal birth weight. MAIN OUTCOME MEASURES: Objective clinical findings (visual acuity, stereo acuity and cycloplegic refraction) were recorded. Structured history taking was used to identify visual difficulties. The intellectual level was assessed with the Wechsler Intelligence Scale for Children (WISC). All VLBW adolescents underwent MRI of the brain. RESULTS: Significant differences were found between the VLBW adolescents and controls regarding visual acuity (median -0.11 and -0.2, respectively; p=0.004), stereo acuity (median 60'' and 30'', respectively; p<0.001), prevalence of astigmatism (11/58 and 0/55, respectively; p<0.001) and in full-scale IQ (mean IQ 85 and 97, respectively; p<0.001) and performance IQ (mean 87 and 99, respectively; p=0.002). The structured history also revealed a borderline significant difference between the groups (mean problems 0.46 and 0.15 respectively; p=0.051). 30% (17/57) of the VLBW adolescents had abnormal MRI findings and performed worse in all tests, compared with both the VLBW adolescents without MRI pathology and the normal controls. CONCLUSION: This study confirms previous observations that VLBW adolescents are at a disadvantage regarding visual outcome compared with those with normal birth weight. In 47%, visual dysfunction was associated with abnormal MRI findings and in 33% with learning disabilities. The adolescents with abnormal MRI findings had more pronounced visual and cognitive dysfunction. The findings indicate a cerebral causative component for the visual dysfunction seen in the present study.

  • 17.
    Hellgren, Kerstin
    et al.
    Karolinska Institutet.
    Aring, Eva
    Göteborg University.
    Jacobson, Lena
    Karolinska Institutet.
    Ygge, Jan
    Karolinska Institutet.
    Martin, Lene
    Karolinska Institutet.
    Visuospatial skills, ocular alignment, and magnetic resonance imaging findings in very low birth weight adolescents2009Inngår i: Journal of AAPOS, ISSN 1091-8531, E-ISSN 1528-3933, Vol. 13, nr 3, s. 273-279Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To describe ocular alignment and stereoacuity in adolescents with very low birth weight (VLBW) in comparison with a matched control group and to investigate associations with white matter damage of immaturity (WMDI) and visuospatial skills in the VLBW group. METHODS: Fifty-nine 15-year-old VLBW subjects and 55 age- and sex-matched controls with normal birth weight underwent examination, including measurement of ocular alignment using cover test and Maddox rod and cycloplegic refraction. Stereoacuity was assessed with the TNO test, best-corrected visual acuity with a Konstantin Moutakis letter chart, and visuospatial skills with the performance tests, defined as performance intelligence quotient (IQ), in the Wechsler Intelligence Scale for Children (WISC-III). All VLBW subjects underwent magnetic resonance imaging of the brain. RESULTS: Ocular misalignment was significantly more common in the VLBW group than in the control group (22% compared with 4%; p = 0.004). Exophoria, subnormal stereoacuity, and subnormal performance IQ were significantly more common in the VLBW group than in the control group (p = 0.006, p = 0.011, and p = 0.015, respectively). Ocular misalignment was associated with WMDI (p = 0.035) and subnormal performance IQ (p = 0.020). Of the VLBW subjects with ocular misalignment, 69% had WMDI and/or subnormal performance IQ. CONCLUSIONS: The VLBW adolescents had more visuospatial problems, lower stereoacuity, and more ocular misalignment than the control subjects. Ocular misalignment was associated with visuospatial deficiencies and/or WMDI in the VLBW group and was a better predictor for visuospatial deficits than WMDI.

  • 18.
    Hellgren, Kerstin
    et al.
    Karolinska Institutet.
    Hellström, Ann
    Gothenburg University.
    Martin, Lene
    Karolinska Institutet.
    Visual fields and optic disc morphology in very low birthweight adolescents examined with magnetic resonance imaging of the brain.2009Inngår i: Acta ophthalmologica, ISSN 1755-3768, Vol. 87, nr 8, s. 843-848Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: We aimed to evaluate visual fields (VFs) and optic disc morphology in very low birthweight (VLBW) adolescents compared with age- and gender-matched controls, and to relate the findings to magnetic resonance imaging (MRI) results. METHODS: Fifty-nine VLBW adolescents and 55 age- and gender-matched controls with normal birthweight were examined. Visual fields were tested using computerized rarebit perimetry (RB). Optic nerve and retinal vessel morphology were evaluated by digital image analysis of fundus photographs. Brain MRI was conducted in the VLBW subjects. RESULTS: Ten of the 57 VLBW subjects (p = 0.022) had subnormal VF results defined as a mean hit rate below the fifth percentile of the controls (i.e. < 89%). All of these also had significantly lower mean hit rates (p = 0.039) in the inferior hemifield. Sixteen of 57 (28%) VLBW subjects had white matter damage of immaturity (WMDI) on MRI. Six of 15 subjects with WMDI (who underwent VF testing) also had subnormal RB results, compared with four of 39 with normal MRI findings (p = 0.02). The mean neural retinal rim area was 9% smaller (p = 0.018) in the VLBW group than in the control group. The VLBW adolescents had a significantly higher index for tortuosity of arterioles than the controls (p < 0.001). CONCLUSIONS: In the present study, 18% of all VLBW adolescents and 40% of those with WMDI had subnormal RB VF findings. The VLBW group had increased arterial tortuosity and a somewhat smaller (9%) mean neural retinal rim area than the control group. Thus sequels to VLBW appear to persist in adolescence.

  • 19.
    Jacobson, L.
    et al.
    Karolinska Univ.
    Lennartsson, F.
    Karolinska Univ.
    Pansell, T.
    Seimyr, G. Öqvist
    Karolinska Univ.
    Martin, Lene
    Mechanisms compensating for visual field restriction in adolescents with damage to the retro-geniculate visual system2012Inngår i: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, Vol. 26, nr 11, s. 1437-1445Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background To describe visual field (VF) outcome in three adolescents with damage to the optic radiation and to focus on mechanisms that may compensate the practical functional limitations of VF defects. Design Descriptive, prospective multi-case study in a hospital setting. Participants Three teenagers with cerebral visual dysfunction because of damage to the retro-geniculate visual pathways. Methods Best-corrected visual acuity and eye alignment were assessed. Visual field function was tested with Goldmann perimetry, and with Rarebit, Humphrey Visual Field Analyzer and Esterman computerized techniques. Fixation was registered with video oculography during Rarebit examination. Magnetic resonance imaging of the brain illustrated brain damage and its relation to the posterior visual system. Results One of the three subjects had bilateral asymmetric white matter damage of immaturity, early-onset exotropia, and a relative homonymous VF defect, but normal binocular VF. The second subject also had bilateral asymmetric white matter damage of immaturity and showed an inferior right quadrantanopia, confirmed by the binocular field. Registration of fixation revealed automatic scanning during perimetry. The third subject had an almost total left homonymous hemianopia after resection of a brain tumour in the right temporal lobe. The hemianopia could be compensated for by fast voluntary scanning. Conclusion Congenital and later-acquired homonymous VF defects may, at least in young subjects, be compensated for by scanning. Exotropia may compensate VF defects and, therefore, the VF should be tested before strabismus surgery. Eye (2012) 26, 1437-1445; doi:10.1038/eye.2012.190; published online 21 September 2012

  • 20.
    Jacobson, Lena
    et al.
    Karolinska University Hospital, Stockholm, Sweden .
    Flodmark, Olof
    Karolinska Institute, Stockholm, Sweden .
    Martin, Lene
    Karolinska Institute, Stockholm, Sweden .
    Visual field defects in prematurely born patients with white matter damage of immaturity: a multiple-case study.2006Inngår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 84, nr 3, s. 357-362Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: White matter damage of immaturity may affect visual, motor and cognitive functions. This multiple-case study presents standardized perimetry results in six teenagers and young adults born prematurely with visual dysfunction due to white matter damage of immaturity of pre- or perinatal origin. METHODS: Six subjects, aged 13-25 years, born at a gestational age of 28-34 weeks, with white matter damage of immaturity documented by MRI, and optic disc appearances documented by fundus photography, were examined with manual and computerized quantitative perimetry. RESULTS: All subjects had subnormal visual field (VF) function, although the depth and extension of the VF defects differed between subjects. The inferior VF function was more deviant than the superior in all cases. The concordance between the VF defects detected with the different techniques was good, although the static computerized techniques revealed slightly more abnormality. CONCLUSION: White matter damage of immaturity may affect the VF. The lower VF is often more affected than the upper. The abnormalities can be demonstrated by both manual and computerized perimetry.

  • 21.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Gustafsson, Lena-Karin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Fastbom, Johan
    Stockholm University, Stockholm.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Nurses' use of computerised decision support systems affects drug monitoring in nursing homes2017Inngår i: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 25, nr 1, s. 56-64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe variations in nurses' perceptions of using a computerised decision support system (CDSS) in drug monitoring. Background: There is an increasing focus on incorporating informatics into registered nurses' (RNs) clinical practice. Insight into RNs’ perceptions of using a CDSS in drug monitoring can provide a basis for further development of safer practices in drug management. Method: A qualitative interview study of 16 RNs. Data were analysed using a phenomenographic approach. Results: The RNs perceived a variety of aspects of using a CDSS indrug monitoring. Aspects of ‘time’ were evident, as was giving a ‘standardisation’ to the clinical work. There were perceptions of effects of obtained knowledge and ‘evidence’ and the division of ‘responsibilities’ between RNs and physicians of using the CDSS. Conclusion: The RNs perceived a CDSS as supportive in drug monitoring, in terms of promoting standardised routines, team-collaboration and providing possibilities for evidence-based clinical practice. Implications: Implementing a CDSS seems to be one feasible strategy to improve RNs’ preconditions for safe drug management. Nurse managers’ engagement and support in this process are vital for a successful result.

  • 22.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bastholm-Rahmner, P.
    Karolinska Institutet, Stockholm.
    Fastbom, J.
    Karolinska Institutet, Stockholm.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. City University London, United Kingdom.
    Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: A qualitative study of medication management2016Inngår i: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 34, nr 1, s. 37-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: To explore registered nurses experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Setting: Five focus groups in five different long-term care settings in two regions in Sweden. Subject: A total of 21 registered nurses (RNs), four men and 17 women, aged 27-65 years, with 4-34 years of nursing experience. Results: The findings reveal that RNs in municipal long-term care settings can be regarded as "vigilant intermediaries" in the patients drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. Conclusion: The RNs play a central but also complex role as "vigilant intermediaries" in the medication monitoring process, including the issue of responsibility. Improving RNs possibility to monitor their patients drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs pharmacovigilant activities. Key points This study contributes to the understanding of registered nurses (RNs) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems).RNs can be considered to be "vigilant intermediaries" in elderly patients drug treatments, working at a distance from staff, physicians, and patients. RNs occasionally take on responsibilities that exceed their formal competence, with the patients best interests in mind. In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs pharmacovigilant activities. 

  • 23.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Registered nurses’ use of computerised decision support in medication reviews: Implications in Swedish nursing homes2018Inngår i: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 31, nr 6, s. 531-544Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The purpose of this paper is to explore the implications of registered nurses’ (RNs) use of a computerized decision support system (CDSS) in medication reviews. Design/methodology/approach: The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs’ views on the CDSS, and changes in the quality of drug treatment. Findings: The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased. Practical implications: The RNs’ use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS. Originality/value: This is, to the best of the authors’ knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs’ role in relation to quality of drug treatments.

  • 24.
    Johansson-Pajala, Rose-Marie
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Jorsäter-Blomgren, Kerstin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Implications of computer-supported medication reviews in Swedish nursing homes, led by nursesManuskript (preprint) (Annet vitenskapelig)
  • 25.
    Larsson, Eva
    et al.
    Uppsala University Hospital, Uppsala, Sweden.
    Martin, Lene
    Karolinska Institute, Stockholm, Sweden.
    Holmström, Gerd
    Uppsala University Hospital, Uppsala, Sweden .
    Peripheral and central visual fields in 11-year-old children who had been born prematurely and at term2004Inngår i: Journal of pediatric ophthalmology and strabismus, ISSN 0191-3913, E-ISSN 1938-2405, Vol. 41, nr 1, s. 39-45Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To examine the peripheral and central visual fields in children who had been born prematurely and at term. METHODS: Four groups of 11-year-old children were examined: group 1 included 24 children who had been born at term (control group); group 2 included 20 children who had been born prematurely without ROP; group 3 included 22 children who had been born prematurely with untreated ROP (stages 2 and 3); and group 4 included 21 children who had been born prematurely and underwent cryotreatment for severe ROP. Their peripheral visual fields were examined with Goldmann perimetry. Static high-pass resolution perimetry was used to evaluate their central visual fields within 30 degrees. RESULTS: The peripheral visual fields were constricted in children who had undergone cryotreatment (group 4), as compared with the other groups (1 to 3). We found no difference between the groups of children who had been born prematurely with or without ROP (groups 2 and 3) and the control group. The function of the central visual fields, expressed as neural capacity, was reduced in the children who had been born prematurely compared with the controls, significantly in their left eyes only. The children who underwent cryotreament did not differ from the other children who had been born prematurely in this respect. CONCLUSIONS: The peripheral visual fields were constricted in children who had undergone cryotreatment. It is uncertain whether this was caused by the treatment or by severe ROP. The central visual fields showed a tendency of reduced neural capacity in the children who had been born prematurely, reflecting a reduced density of retinocortical neural channels. However, this was not related to ROP or cryotreatment.

  • 26.
    Malmer, L
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Martin, Lene
    Karolinska Institutet, Stockholm, Sweden.
    Microdot test of foveal function. A comparison with visual acuity at high and low contrast2005Inngår i: Ophthalmic & physiological optics, ISSN 0275-5408, E-ISSN 1475-1313, Vol. 25, nr 2, s. 81-86Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To define normal values across age from novel computerized tests of foveal vision and to compare the findings with visual acuity (VA) at high and low contrast. SUBJECTS AND METHODS: Sixty-one healthy volunteers, aged 22-87, with subjectively normal vision participated in the study. The right eye from each subject was tested with Snellen letter VA at high contrast, at 10% contrast using the Tri-VA test and with the Rarebit Microdot Fovea Test (RMFT), in addition to biomicroscopy and fundus examination. RESULTS: The median letter VA was 0.77 minimum angle of resolution (MAR; range 0.63-1.54) with a significant decline in letter VA with increasing age (r = 0.7, p < 0.001). The median Tri-VA resolution threshold at 10% contrast was 1.8 MAR (range 0.9-4.1) and a significant age effect (r = 0.7) was observed, most pronounced above 65 years. The median RMFT hit rate was 100% (range 97-100) in the age group below 65 years and 87.5% (range 34-98) in subjects older than 65 years. CONCLUSION: The study shows a decline in foveal function with age with all three methods, reflecting the loss of neural detectors with increasing age. The hit rate to microdot stimuli appears to be a sensitive measure, which can be used for fine-graded evaluation of foveal function.

  • 27.
    Martin, L M
    Karolinska Institute, Stockholm, Sweden.
    Working with glaucoma patients - prospects for "shared care".1999Inngår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, nr 1, s. 103-106Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To investigate the prospects for "shared care" by evaluating to what extent ophthalmic nurses are involved in ophthalmic care decision tasks in the management of glaucoma patients, how well prepared the nurses feel they are for these tasks and their level of satisfaction in those tasks they actually are performing. METHODS: A questionnaire was sent to the ophthalmic nurses at 13 eye clinics in Sweden. The clinics were selected to represent different parts of Sweden as well as university clinics and smaller rural clinics. RESULTS: A difference was found between clinics regarding the number of tasks independently performed by the ophthalmic nurses and a significant correlation was found between level of participation and satisfaction (p=0.008). The nurses felt prepared for (61/62) and satisfied (58/62) when performing the glaucoma management tasks, and a high and very significant correlation (r=0.96, p= 0.0001) was found between the mean preparedness and satisfaction scores for each of the 14 tasks. CONCLUSIONS: The findings in the study show that the ophthalmic nurses feel prepared for their tasks and regard their involvement in glaucoma care as subjectively satisfactory. These observations support the idea of "shared care" in glaucoma management.

  • 28.
    Martin, L M
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Lindblom, B
    Sahlgrenska University Hospital, Göteborg, Sweden.
    Gedda, U K
    St. Erik Eye Hospital, Stockholm, Sweden.
    Concordance between results of optic disc tomography and high-pass resolution perimetry in glaucoma2000Inngår i: Journal of glaucoma, ISSN 1057-0829, E-ISSN 1536-481X, Vol. 9, nr 1, s. 28-33Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate concordance between results obtained with the Heidelberg Retina Tomograph (HRT) (Heidelberg Engineering GmbH, Heidelberg, Germany) and those obtained with the high-pass resolution perimeter (HRP) in glaucoma diagnosis. METHODS: A total of 217 patients from the glaucoma services at St. Erik Eye Hospital, Stockholm, Sweden (n = 107) and Sahlgrenska University Hospital, Göteborg, Sweden (n = 110) were included in the study. All patients were examined because of known or suspected glaucoma in at least one eye. The conventional indices presented by the instruments were used, i.e., glaucoma index from the HRT (negative values = abnormal, positive = normal) and combined deviation (upper normal limit 2.1 dB) from the HRP. RESULTS: The concordance regarding the classification of normal or glaucomatous by the two instruments was 71% (153/217 eyes). The HRT indicated glaucoma but HRP findings were normal in 47 patients, and the reverse occurred in 17 patients. There was a significant difference in optic disc area between patients with abnormal HRT findings and normal HRP findings and in patients with normal HRT findings and abnormal HRP findings. The concordance could not be improved by adjusting for disc size. The correlation between combined deviation on HRP and the HRT glaucoma index was r = -0.53. CONCLUSION: A significant correlation was found between the combined index given by HRP and the HRT glaucoma index in 217 patients examined for known or suspected glaucoma. Discordant findings were observed in 64 patients; in 22 this discordance was explained by the influence of disc size. No other reasons for differences in examination results could be detected.

  • 29.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att Mäta Syn2010 (oppl. 2)Bok (Annet (populærvitenskap, debatt, mm))
  • 30.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Att Mäta Syn – från bokstavstavlor till datorskärm2007Inngår i: Incitament, ISSN 1103-503X, Vol. 16, nr 2, s. 107-110Artikkel, forskningsoversikt (Annet (populærvitenskap, debatt, mm))
  • 31.
    Martin, Lene
    Stockholm Univ.
    Cataract and high-pass resolution perimetry.1997Inngår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 75, nr 2, s. 174-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The present study describes the influence of cataract on high-pass resolution perimetry results. Twenty-five otherwise healthy patients were examined before and after cataract surgery. Their preoperative visual acuities ranged from 0.1 to 0.8 and their mean resolution thresholds from 3.9 to 12.3 dB. Both elevated mean thresholds and local visual fields defects were observed. In patients with low-grade cataract, i.e. preoperative visual acuity 0.3 to 0.65, the mean improvement in perimetric results after operation was approximately 1 dB. In patients with higher degrees of lens opacity, visual acuity 0.1 to 0.25, the difference between pre- and postoperative perimetry results showed a wide range, 1.4-6.2 dB. In conclusion, cataract induced different types of visual field defects. The general threshold increase due to low-grade cataract (VA > or = 0.3) could be compensated for by subtracting 1 dB from the measured value.

  • 32.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden.
    Clinical experience with Latanoprost: a retrospective study of 153 patients1999Inngår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 77, nr 3, s. 336-339Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To evaluate the pressure-reducing effect of latanoprost in a clinical setting. Patients and methods: Data from 153 consecutive patients with open angle glaucoma receiving latanoprost were recorded at baseline (=153), 2 weeks (n=151) and 8 to 12 months (n=89) after starting latanoprost treatment, In 82 patients (54%) latanoprost was added to ongoing treatment, Two patients terminated treatment because of side effects before the first follow-up examination, Results: 56% (84/151) of the patients showed an intraocular pressure reduction of 20% or more after 2 weeks, regardless of baseline therapy. The difference between intraocular pressure before (24.4+/-5.8 mm Hg) and after 2 weeks of latanoprost treatment (19.9+/-6.9 mm Hg) in the total group (n=151) was highly significant (p<0.0001). The pressure reduction was significantly correlated,vith the pretreatment intraocular pressure level (r=0.48, p<0.0001). In the 89 patients who could be followed for 8 to 12 months no significant upward drift in mean intraocular pressure was observed, but in fourteen patients intraocular pressure increased with 5 mm Hg or more. Thirteen patients reported side effects, five of these discontinued the treatment. Conclusion: Latanoprost is obviously an efficient pressure reducing drug which can be used in glaucoma patients as an adjunct to any ongoing therapy with the expectation of clinically relevant intraocular pressure reduction in 45-71% of the patients.

  • 33.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Collaboration between Opticians/Optometrists & Eye Health Care  in Glaucoma2009Konferansepaper (Annet vitenskapelig)
  • 34.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Computer-aided drug therapy monitoring in elderly patients2012Konferansepaper (Annet vitenskapelig)
  • 35.
    Martin, Lene
    Stockholm University, Sweden.
    Computer-assisted management of primary open-angle glaucoma. Knowledge acquisition and prototype testing1996Inngår i: Computers in Nursing, ISSN 0736-8593, Vol. 14, nr 5, s. 267-271Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Primary open-angle glaucoma is a common disease afflicting 1% to 2% of people older than 50 years of age. The care of patients with glaucoma is a subject of debate because the disease is incompletely understood. The diagnosis relies on a number of examinations, many of them performed by ophthalmic nurses, and the care of patients with glaucoma has become one of the main tasks for ophthalmic nurses in Sweden. This study describes a knowledge-based system for decision support in glaucoma management, which uses seven data elements about the patient to arrive at one of 25 different recommendations for appropriate action. In 267 patient visits to five different eye clinics, the program recommendations were compared with the actual decisions made by the responsible physician. The concordance was 92% to 100% when policy differences among the clinics were taken into account. The program appears to provide substantial decision support in the management of primary open-angle glaucoma. The program's ability to support the ophthalmic nurses in the care of patients with open-angle glaucoma is being evaluated.

  • 36.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Computerized Decision Support in Eye Care2007Konferansepaper (Annet vitenskapelig)
  • 37.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Karolinska Institutet, Stockholm, Sweden.
    Computerized method to measure glare and contrast sensitivity in cataract patients1999Inngår i: Journal of cataract and refractive surgery, ISSN 0886-3350, E-ISSN 1873-4502, Vol. 25, nr 3, s. 411-415Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To evaluate computerized methods for measuring glare sensitivity and visual acuity at 3 contrast levels in cataract patients. Setting: St. Erik's Eye Hospital, Stockholm, Sweden. Methods: In a prospective study, 25 consecutive cataract patients meeting the inclusion criteria were examined before and 12 weeks after cataract surgery. Measured were glare sensitivity and visual acuity at 3 contrast levels using the Ophthimus Y-VA Contrast Sensitivity lest and Glare Test. Results: Preoperatively, ail patients had impaired values compared with those in a group of age-matched normal volunteers (control group). Postoperatively, median values were similar to those in the age-matched control group in all parameters except glare sensitivity, which was significantly higher in the pseudophakic group (P = .03). Correlation coefficients between preoperative visual acuity and contrast sensitivity at 90%, 25%, and 10% were 0.50 (P = .01), 0.53 (P = .006), and 0.45 (P = .02), respectively, and between preoperative visual acuity and preoperative glare difference, 0.45 (P = .02). A significant correlation was found between age and visual acuity in the control group at all contrast levels: 90% (r = 0.61, P = .0018 ), 25% (r = 0.52, P = .01), and 10% (r = 0.42, P = .04). Median differences between Y-VA examinations (repeatability) were 0 LogMAR except between examinations 1 and 2 at the 25% contrast level, where it was 0.3 LogMAR. Conclusion: The Ophthimus Y-VA Test and Glare Test were useful in the preoperative evaluation of patients with cataract and mild to moderate visual impairment.

  • 38.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Computerized Perimetry in Children2004Konferansepaper (Annet vitenskapelig)
  • 39.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Dense cataracts lead to amblyopia and visual field impairment in children2008Inngår i: Ocular Surgery NewsArtikkel, forskningsoversikt (Annet vitenskapelig)
  • 40.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Frequency doubling technology - a non-conventional way to test the visual field2011Inngår i: International Journal of Ophthalmic Practice, ISSN 2044-5504, Vol. 2, nr 4, s. 154-156Artikkel i tidsskrift (Fagfellevurdert)
  • 41.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    High-pass resolution perimetry in glaucoma follow-up1995Inngår i: Perimetry Update 1994/1995 / [ed] Mills RP, Amsterdam: Kugler Publ , 1995, s. 181-183Konferansepaper (Fagfellevurdert)
  • 42.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    High-Pass Resolution Perimetry in patients with chiasmal and other lesions of the optic pathways2003Konferansepaper (Annet vitenskapelig)
  • 43.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    How computers can contribute to ophthalmic nursing2011Inngår i: International Journal of Ophthalmic Practice, Vol. 2, nr 2, s. 90-92Artikkel i tidsskrift (Annet vitenskapelig)
  • 44.
    Martin, Lene
    Karolinska Institutet, Stockholm, Sweden.
    Intraocular pressure before and after visual field examination2007Inngår i: Eye (London. 1987), ISSN 0950-222X, E-ISSN 1476-5454, Vol. 21, nr 12, s. 1479-1481Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To evaluate the influence of visual field (VF) examinations using modern techniques with short examination times on the intraocular pressure (IOP). METHODS: Sixty-one consecutive patients, aged 28-90 years, 40 women and 21 men, were examined. Forty patients were treated for glaucoma and 21 were untreated patients with ocular hypertension or suspected glaucoma. Twenty-one subjects were examined using the Humphrey Field Analyzer, using SITA programs, and 40 with high-pass resolution perimetry (HRP). Goldmann applanation tonometry was performed immediately before and after the VF examinations. RESULTS: A difference in IOP of more than 2 mm Hg before and after the VF examination was observed in 14 of the 61 patients (23%). The maximum change in each direction was 4 mm Hg. The mean differences were not significant. All eight subjects with increasing IOP after VF examinations were examined using the HRP technique (P=0.04). CONCLUSION: Modern VF techniques with short examination time do not seem to significantly influence IOP.

  • 45.
    Martin, Lene
    Karolinska Institutet, Sweden.
    Knowledge acquisition and evaluation of an expert system for managing disorders of the outer eye2001Inngår i: Computers in Nursing, ISSN 0736-8593, Vol. 19, nr 3, s. 114-117Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the current study was to develop and evaluate an expert system for diagnosing outer eye disorders, intended to support family physicians and nurse practitioners in the management of patients with minor eye complaints. The knowledge in the program was gathered from the scientific literature and from 6 experienced ophthalmologists and 6 ophthalmic nurses. Fourteen diagnoses must be considered, and the differential diagnosis is dependent upon 32 signs and symptoms. The program calculates the most likely diagnosis, presents photographs of the typical ocular findings, and provides information regarding management and treatment. The program's output was compared with the diagnosis made by 8 other ophthalmologists at a Swedish university clinic, based on data from 157 patients with disorders of the outer eye, who visited the emergency ward during a one-week period. The concordance between the diagnosis made by the ophthalmologists and the program was 96%. In conclusion, the expert system for disorders of the outer eye provided essentially the same diagnostic information as an examination by an ophthalmologist. Support from the program would make it possible for family physicians and nurse practitioners to manage most of these patients.

  • 46.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Learning perimetry: the Swedish way2010Inngår i: International Journal of Ophthalmic Practice, ISSN 2044-5504, Vol. 1, nr 1, s. 18-22Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To report experiences from teaching perimetry to ophthalmic nurses during their education at the Karolinska Institutet, Stockholm, Sweden.Subjects and methods: The number of occasions for performing perimetry, both under supervision and independently, during clinical practice were counted and the students' comments analyzed. A computer program for simulation of manual perimetry using the Goldmann apparatus was developed and tested by 20 students.Results: The number of occasions during which students could practise perimetry was variable, depending on the site where the clinical practice period took place, especially regarding manual Goldmann perimetry. The median number of computerized perimetry examinations performed, both under supervision and independent, was approximately 40. The median number Goldmann perimetry examinations performed was two (range zero to five), all under supervision. The students underwent 5-25 training sessions with the computer program. They reported that the program was easy to use, even fun, and that they appreciated the opportunity to practise when and where they wanted. Some student also reported that the simulation training improved confidence and performance in the real perimetry testing situation.Conclusion: Training in planning, performing and evaluating visual field examinations using computerized perimetry appears to be sufficient during current clinical practice periods, but there is a lack of training possibilities for Goldmann Perimetry. A simulation program provides unlimited training opportunities and can be used in parallel to clinical practice.

  • 47.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Measuring structure and function - where do we stand today?2012Inngår i: International Journal of Ophthalmic Practice, ISSN 2044-5504, Vol. 3, nr 2, s. 82-86Artikkel i tidsskrift (Fagfellevurdert)
  • 48.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Measuring Vision in Children2007Konferansepaper (Annet vitenskapelig)
  • 49.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Medical treatment after argon laser trabeculoplasty in glaucoma1989Inngår i: Chibret International Journal of Ophthalmology, ISSN 0748-9501, Vol. 6, nr 1, s. 18-21Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Medical therapy was reduced or withdrawn in 80 of 160 glaucoma patients with normalized intraocular pressure (IOP) after argon lasertrabeculoplasty (ALT). In the 80 patients with unchanged medical therapy, mean IOP was stable during the six-month follow-up period. Timolol could be withdrawn in a significantly smaller proportion of patients [14 of 28 (50%)] compared to pilocarpine [26 of 32 (81%)]. Acetazolamide could be withdrawn in 14 of 20 patients (70%). The mean IOP increase one month after discontinuance of timolol was 6.6 ± 5.7 mm Hg; after pilocarpine, 4.4 ± 4.7 mm Hg; and after acetazolamide, 4.8 ± 6.3 mm Hg. After six months, IOP remained normal in 13 of the 14 patients (93%) from whom timolol had been withdrawn. Corresponding values were 20 of 26 (77%) for pilocarpine and nine of 14 (64%) for acetazolamide. Thus, medicaltherapy could be discontinued in 54% of patients with normalized IOP after ALT without IOP increase to pathological levels for at least six months.

  • 50.
    Martin, Lene
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Nursing research2010Konferansepaper (Annet vitenskapelig)
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