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  • 101.
    Bondeson, Marie Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    A novel approach using long-read sequencing and ddPCR to investigate gonadal mosaicism and estimate recurrence risk in two families with developmental disorders2017In: Prenatal Diagnosis, ISSN 0197-3851, E-ISSN 1097-0223Article in journal (Refereed)
  • 102. Bondeson, Marie Louise
    Key insights into the protein tyrosine phosphatase PTPN11/SHP2 associated with noonan syndrome and cancer2017In: Human Mutation, ISSN 1059-7794, E-ISSN 1098-1004Article, book review (Other academic)
  • 103. Borg, Erik
    et al.
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences.
    Borg, Birgitta
    Behavioural awareness, interaction and counselling education in audiological rehabilitation: development of methods and application in a pilot study2002In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 41, no 5, p. 308-320Article in journal (Refereed)
    Abstract [en]

    In conventional audiological rehabilitation, the hearing therapist interacts with the hearing-impaired person and with significant others. In order to strengthen the personality and self-confidence of the hearing-impaired individual, a different strategy was designed and implemented whereby the pedagogic interaction was directed only towards the hearing-impaired individual, who in turn worked as a tutor/aid/counsellor to the communication partner. On the basis of an interactive communication model, new methods for rehabilitation of subjects with moderate hearing impairment were developed and evaluated in a pilot study on 13 men with noise-induced hearing loss. A course programme was developed with three main active components: (1) increased insight and knowledge; (2) education as counsellors with the ability to focus on the problems of the communication partner; and (3) motivation to change through group discussion and reflexive conversation. Increased insight and knowledge were obtained through test and training experiences in a sound environmental chamber, tutorials and discussions. The pedagogic training focused on helping the hearing-impaired subjects to become able communication counsellors in relation to their interlocutors. An act-react, offensive-defensive paradigm was used in conjunction with transactional analysis. Results of the pilot study were evaluated using questionnaires, interviews and a method of dialogue analysis. The results were evaluated for the hearing-impaired and the partner and in recordings of conversations in the home environment. There were clearly positive cognitive and emotional effects seen in the inquiries and interviews. The observations from the dialogue analysis indicated only small effects, with the exception of the two individuals with the most pronounced functional impairment, for whom dialogue was improved after the course. It was concluded that these new methods could contribute new possibilities in rehabilitation programmes, emphasizing the shared responsibility for communication and the unique competence and abilities of the hearing-impaired person.

  • 104.
    Borg, Kristin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Gustafsson, Madelene
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Patienter som inte medföljt ambulans: en journalgranskning2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    AbstraktBakgrund: Ambulanssjukvården som arbete och yrke har utvecklats de senaste årtiondena, från att enbart haft krav på att köra ambulans utan sjukvårdsutbildning till att idag vara bemannad med specialiserade ambulanssjuksköterskor. Med hjälp av en korrekt första bedömning kan patienter hänvisas till rätt vårdnivå. Syfte: Syftet med denna studie var att beskriva patienter som inte medföljer ambulans utifrån ambulanssjuksköterskans bedömning av sökorsak eller symtom, SOS prioritet, ålder samt variation över dygnet.Metod: En retroperspektiv journalgranskning med en kvantitativ ansats vilken 120 journaler inkluderades. Resultat: Svårigheten som SOS operatören står inför är att under tidspress göra en adekvat bedömning av sökorsak och brådskandegrad. Resultatet visar på 91 % av ambulansuppdragen, där patienter som inte medföljde ambulans, visade att SOS har prioriterat utkörning med prioritet 1 och 2. Det var en jämn fördelning mellan åldrarna, men två åldergrupper som lämnades hemma mer frekvent var mellan åldrarna 0-9 år och 60-69 år. Tidpunkten på dygnet var jämn spridning, men visade viss ökning mellan kl 18-21 och kl 21-00. Det ambulanssjuksköterskan klassade in som vanligast sökorsak var övrigt, då det inte finns någon annan sökorsak som anses lämplig. De andra större grupperna som lämnades i hemmet var sökorsaken bröstsmärta/bröstkorgsmärta, feber och andningsbesvär/dyspne/andnöd. Slutsats: Det visar på vikten av att SOS operatörens bedömning kompletteras med en bedömning av en sjuksköterska som har möjlighet att se patienten och mäta vitalparametrar. Samtidigt som patienten behöver bli bekräftad i sin upplevelse av sin akuta sjukdom. Ambulanssjuksköterskan besitter en kompetens och är en viktig resurs i vårdkedjan för att lotsa patienten till rätt vårdnivå.

  • 105.
    Borgestig, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Uppsala Univ, Sweden; Uppsala Univ, Sweden.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    The Benefits of Gaze-Based Assistive Technology in Daily Activities for Children with Disabilities2017In: HARNESSING THE POWER OF TECHNOLOGY TO IMPROVE LIVES, IOS PRESS , 2017, Vol. 242, p. 1082-1088Conference paper (Refereed)
    Abstract [en]

    This article reports research findings on how gaze-based assistive technology contributed to performance of daily activities for a group of children with severe physical impairments and without speech.

  • 106.
    Borgström, Juliana
    University of Skövde, School of Bioscience.
    Cyclical Women: Menstrual Cycle Effects on Mood and Neuro-Cognitive Performance2019Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    During roughly forty years of a woman’s life-span, the fertile female human body prepares itself monthly for the possibility of pregnancy. Science has shown that the fluctuation of the sex steroids progesterone and estrogen have a crucial role in the female body's physiology, determining the menstrual cycle and its general phases. This biological dance of hormones governing the cycle influences a lot of physical, mental and cognitive aspects of life for a fertile ovulating woman. Although the question of whether these changes also affect women's cognitive performance is still unclear, some evidence has been gathered that could bring us closer to answers. Recent research findings show that this hormonal interplay might have a significant role in cognitive and psychological development - modulating brain activity, cognitive performance, higher cognition, emotional status, sensory processing, appetite and more. This thesis aims to uncover to what extent the menstrual cycle affects brain functions, neurobiology, mood, well-being and cognitive performance in menstruating cisgender women.

  • 107.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer patients' experiences of care related to pain management before and after palliative care referral2004In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 13, no 3, p. 238-245Article in journal (Refereed)
    Abstract [en]

    Pain is the main problem for patients with cancer referred to palliative care (PC). Pain management in PC requires a multidimensional approach. A questionnaire was used to determine cancer patients' experiences of care related to pain management, before and after being referred to PC, and to also discover possible correlations between pain control and other aspects of care. Seventy-five consecutive patients from two PC teams were included in the study. The patients had experienced a statistically significant (P < 0.01) improvement in care after being referred to PC, despite the fact that pain control had not been optimized. Patients' description of 'pain control' after being referred to PC had a statistically significant correlation with their 'feeling of security' and 'continuity of care' throughout the same period. The conclusion is that care provided in PC is vital to successful pain management. Pain control depends not only on analgesics but also on many other aspects of care provided by the nurse. Continuity of care and the opportunity to talk increases the patients' feeling of security, which is also of utmost importance to successful pain management.

  • 108.
    Boström, Barbro
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Sandh, Marie
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Lundberg, Dag
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Cancer-related pain in palliative care: patients' perceptions of pain management2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 4, p. 410-419Article in journal (Refereed)
    Abstract [en]

    Background: Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer-related pain. The impact of pain cognition on patients' experiences of cancer-related pain remains relatively unexplored. Aim: The aim of this study was to describe how patients with cancer-related pain in palliative care perceive the management of their pain. Method: Thirty patients were strategically selected for interviews with open-ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach. Findings: Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer-related pain without access to a palliative care team. Conclusion: The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain-free, or attain as much pain relief as possible, with as few side effects as possible.

  • 109. Bravi, Luca
    et al.
    Rudini, Noemi
    Cuttano, Roberto
    Giampietro, Costanza
    Maddaluno, Luigi
    Ferrarini, Luca
    Adams, Ralf H.
    Corada, Monica
    Boulday, Gwenola
    Tournier-Lasserve, Elizabeth
    Dejana, Elisabetta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Vascular Biology.
    Lampugnani, Maria Grazia
    Sulindac metabolites decrease cerebrovascular malformations in CCM3-knockout mice2015In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 112, no 27, p. 8421-8426Article in journal (Refereed)
    Abstract [en]

    Cerebral cavernous malformation (CCM) is a disease of the central nervous system causing hemorrhage-prone multiple lumen vascular malformations and very severe neurological consequences. At present, the only recommended treatment of CCM is surgical. Because surgery is often not applicable, pharmacological treatment would be highly desirable. We describe here a murine model of the disease that develops after endothelial-cell-selective ablation of the CCM3 gene. We report an early, cell-autonomous, Wnt-receptor-independent stimulation of beta-catenin transcription activity in CCM3-deficient endothelial cells both in vitro and in vivo and a triggering of a beta-catenin-driven transcription program that leads to endothelial-tomesenchymal transition. TGF-beta/BMP signaling is then required for the progression of the disease. We also found that the anti-inflammatory drugs sulindac sulfide and sulindac sulfone, which attenuate beta-catenin transcription activity, reduce vascular malformations in endothelial CCM3-deficient mice. This study opens previously unidentified perspectives for an effective pharmacological therapy of intracranial vascular cavernomas.

  • 110. Breimer, Lars H
    et al.
    Nilsson, Torbjörn K
    Örebro University Hospital, Örebro, Sweden.
    A longitudinal and cross-sectional study of Swedish biomedical PhD processes 1991-2009 with emphasis on international and gender aspects2010In: Scientometrics, ISSN 0138-9130, E-ISSN 1588-2861, Vol. 85, no 2, p. 401-414Article in journal (Refereed)
    Abstract [en]

    This longitudinal survey of Swedish biomedical PhDs from 1991 to 2009 found a 2.5-fold increase in biomedical PhD graduates, especially women, and mainly non-MDs, while the number of MDs remained fairly constant. The proportion obtaining a biomedical PhD in Sweden in 2006 was two and a half times that in USA compared to population and three and a half times by GDP, but similar to that of the Netherlands. Female non-MD but not female MD candidates were more likely than men to be examined by female examiners. Fewer of the non-MD than MD women continued to publish in English after their PhD. The median number of authors per paper in a thesis had increased by 1 (from 4 to 5) compared with 15–20 years ago. Swedish biomedical research was already well internationalized in 1991, when 38% of the external examiners came from abroad. This rose to 53% in 2003 but in 2009 had returned to 42%. USA and UK were the most common countries but Australia accounted for 2%. When assessed by connection with foreign research teams, Swedish researchers were also internationally well connected. Studies in other countries are needed to assess how generally applicable these findings are. Our findings suggest that the policy and management of Swedish scientific research systems needs revision to harmonize with the national economic capacity.

  • 111.
    Briere, John
    Keck School of Medicine, University of Southern California, USA.
    Svedin, Carl Göran (Translator, Contributor)
    Linköping University, Department of Clinical and Experimental Medicine, Barnafrid. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    TSCYC, Trauma Symptom Checklist for Young Children: Manual, Svensk version2012Other (Other academic)
    Abstract [sv]

    TSCYC är ett frågeformulär som används för att mäta ett brett spektrum av akuta eller kroniska posttraumatiska symptom hos barn som har upplevt traumatiska händelser såsom övergrepp eller misshandel eller har bevittnat våld i hemmet eller i sin närmiljö. Den svenska versionen av TSCYC har översatts av docent Doris Nilsson och professor Carl-Göran Svedin som även har översatt, normerat och standardiserat den svenska versionen av traumainstrumentet TSCC för äldre barn och ungdomar.

    Den svenska standardiseringen och normeringen av TSCYC har gjorts i en grupp om 629 barn ur normalpopulation och en klinisk grupp om 59 barn i åldrarna 3–11 år. Normerna är uppdelade utifrån ålder och kön.

    TSCYC-formuläret innehåller 90 frågor och handlar om olika typer av traumasymptom som barnet kan uppvisa. Frågorna besvaras av barnets förälder eller vårdnadshavare. TSCYC ger en detaljerad utvärdering av posttraumatiska symptom på åtta kliniska skalor. En summaskala ger värdefull information om akuta och kroniska symptom samt andra vanligt förekommande symptom hos traumatiserade barn. PTSD-diagnosbladet, som ingår i svarsblanketten, kan användas som stöd i evalueringen av möjlig PTSD-diagnos.

  • 112. Brinson, Robert G.
    et al.
    Marino, John P.
    Delaglio, Frank
    Arbogast, Luke W.
    Evans, Ryan M.
    Kearsley, Anthony
    Gingras, Genevieve
    Ghasriani, Houman
    Aubin, Yves
    Pierens, Gregory K.
    Jia, Xinying
    Mobli, Mehdi
    Grant, Hamish G.
    Keizer, David W.
    Schweimer, Kristian
    Ståhle, Jonas
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Widmalm, Göran
    Stockholm University, Faculty of Science, Department of Organic Chemistry.
    Zartler, Edward R.
    Lawrence, Chad W.
    Reardon, Patrick N.
    Cort, John R.
    Xu, Ping
    Ni, Feng
    Yanaka, Saeko
    Kato, Koichi
    Parnham, Stuart R.
    Tsao, Desiree
    Blomgren, Andreas
    Rundlof, Torgny
    Trieloff, Nils
    Schmieder, Peter
    Ross, Alfred
    Skidmore, Ken
    Chen, Kang
    Keire, David
    Freedberg, Daron I.
    Suter-Stahel, Thea
    Wider, Gerhard
    Ilc, Gregor
    Plavec, Janez
    Bradley, Scott A.
    Baldisseri, Donna M.
    Sforca, Mauricio Luis
    de Mattos Zeri, Ana Carolina
    Wei, Julie Yu
    Szabo, Christina M.
    Amezcua, Carlos A.
    Jordan, John B.
    Wikström, Mats
    Enabling adoption of 2D-NMR for the higher order structure assessment of monoclonal antibody therapeutics2019In: mAbs, ISSN 1942-0862, E-ISSN 1942-0870, Vol. 11, no 1, p. 94-105Article in journal (Refereed)
    Abstract [en]

    The increased interest in using monoclonal antibodies (mAbs) as a platform for biopharmaceuticals has led to the need for new analytical techniques that can precisely assess physicochemical properties of these large and very complex drugs for the purpose of correctly identifying quality attributes (QA). One QA, higher order structure (HOS), is unique to biopharmaceuticals and essential for establishing consistency in biopharmaceutical manufacturing, detecting process-related variations from manufacturing changes and establishing comparability between biologic products. To address this measurement challenge, two-dimensional nuclear magnetic resonance spectroscopy (2D-NMR) methods were introduced that allow for the precise atomic-level comparison of the HOS between two proteins, including mAbs. Here, an inter-laboratory comparison involving 26 industrial, government and academic laboratories worldwide was performed as a benchmark using the NISTmAb, from the National Institute of Standards and Technology (NIST), to facilitate the translation of the 2D-NMR method into routine use for biopharmaceutical product development. Two-dimensional H-1,N-15 and H-1,C-13 NMR spectra were acquired with harmonized experimental protocols on the unlabeled Fab domain and a uniformly enriched-N-15, 20%-C-13-enriched system suitability sample derived from the NISTmAb. Chemometric analyses from over 400 spectral maps acquired on 39 different NMR spectrometers ranging from 500 MHz to 900 MHz demonstrate spectral fingerprints that are fit-for-purpose for the assessment of HOS. The 2D-NMR method is shown to provide the measurement reliability needed to move the technique from an emerging technology to a harmonized, routine measurement that can be generally applied with great confidence to high precision assessments of the HOS of mAb-based biotherapeutics.

  • 113.
    Brock, Lucas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    In silico and in vitro study of peptidomimetic protease inhibitors against Ziks and Ticke-Borne Encephalitis Virus2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 114.
    Brunnegård, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Lohmander, Anette
    van Doorn, Jan
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
    Comparison between perceptual assessments of nasality and nasalance scores2012In: International journal of language and communication disorders, ISSN 1368-2822, E-ISSN 1460-6984, Vol. 47, no 5, p. 556-566Article in journal (Refereed)
    Abstract [en]

    Background: There are different reports of the usefulness of the Nasometer™ as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli.

    Aims: To compare nasalance scores from the Nasometer with perceptual assessments, for the same and different Swedish speech stimuli, using three groups of listeners with differing levels of experience in judging speech nasality. Methods & Procedures: To compare nasalance scores and blinded listener ratings of randomized recordings using three groups of listeners and two groups of speakers. Speakers were either classified as having hypernasal speech or speech with typical speech resonance. Listeners were speech-language pathologists (SLPs) working predominantly with resonance disorders, other SLPs and untrained listeners.

    Outcomes & Results: Correlations (r(s) ) between hypernasality ratings and nasalance scores for each listener group and speech stimuli were calculated. For both groups of SLPs all correlations between perceptual ratings and nasalance scores were significant at p= 0.01. The correlations between the nasalance scores and ratings by listeners in the SLP groups were higher than those for the untrained listener group regardless of stimulus type. Post-hoc Mann-Whitney U-tests showed that the only difference that was significant was expert SLP group versus untrained listener group. Secondly, correlations between perceptual ratings and oral stimulus nasalance scores were higher when the perceptual ratings were based on spontaneous speech rather than on the oral stimulus. However, a Wilcoxon signed rank test showed that the difference was not significant. A third finding was that correlations between oral stimulus nasalance scores and perceptual scores were higher than those between mixed stimulus nasalance scores and perceptual scores. A Wilcoxon signed rank test showed that the difference was significant.

    Conclusions & Implications: The Nasometer might be useful for the SLP with limited experience in assessing resonance disorders in differentiating between hyper- and hyponasality. With listener reliability for ratings of hypernasality still being an issue, the use of a nasalance score as a complement to the perceptual evaluation will also aid the expert SLP. It will give an alternative way of quantifying speech resonance and might help in especially hard to judge cases.

  • 115.
    Brännström, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Lundbäck, Åsa
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Corrective emotional experience: förändringsmekanism i psykoterapi2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Corrective emotional experience (CEE) innebär att patienten känslomässigt upplever och erfar nya och mer adaptiva sätt att möta tidigare, olösta konflikter i en trygg relation. Denna studie syftar till att undersöka och tydliggöra vad ”corrective emotional experience” består i och vilka metoder som kan skapa sådana erfarenheter. Vad händer i patienten, vilka interventioner använder terapeuten för att möjliggöra CEE för patienten, samt vilka indikationer finns för dessa interventioner?

    Som metod för detta examensarbete genomfördes en systematisk litteraturstudie. Via databassökning identifierades 16 kliniska studier om CEE från de senaste 15 åren. Studierna som hade måttlig (3 studier) till svag (13 studier) evidensstyrka utgör bas för analysen. Resultaten visade bl a på att CEE är viktigt för att patienten ska kunna förändra maladapativa mönster och att terapeuten har en avgörande roll i att erbjuda en trygg relation. Vikten av terapeutens förmåga till intersubjektivitet, ”bonding”, att kunna vara en trygg bas samt att anpassa sig efter patientens anknytningsmönster är kunskap som framkommer i denna studie.

    Slutsatser som kan dras av studien är att CEE är en viktig förändringsmekanism i psykoterapi. Mer forskning omkring CEE behövs dock för att ytterligare påvisa vad som är verksamt och varför, förslagsvis med särskilt fokus på psykoterapeutens uppdrag att bygga relation och allians.

  • 116.
    Brüde, Ulf
    et al.
    Swedish National Road and Transport Research Institute.
    Björketun, Urban
    Swedish National Road and Transport Research Institute.
    Vem har kolliderat med vem och var?: analys av omkomna 1996-20052007Report (Other academic)
    Abstract [sv]

    This study has been performed by VTI for the Swedish Road Traffic Inspectorate. The aim was to collect data which will make it possible to describe, analyse and try to explain the changes in the number killed in traffic over the period 1996-2005. Previously it was possible to observe long term changes on the basis of a breakdown by state/ municipal road management authorities and a breakdown by accident type. This was no longer possible after the introduction of a new accident data system in 2003. In this project, an alternative breakdown and description of the development in the number killed is proposed. For each individual year (1996-2005) a "collision matrix" is constructed. This matrix shows which road user categories have been killed and whether this has occurred without a collision (single vehicle accident) or in collision with some other traffic element. Breakdowns by "urban/rural", sex and age group are also made in the matrix. Both the assessment of the police and the definition of urban areas by Statistics Sweden SCB have been used as regards the urban/rural breakdown. The breakdown urban/rural is a substitute for municipal/state road management authority, and the breakdown non-collision/collision is a substitute for accident type.

  • 117.
    Burström, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Patient Safety in the Emergency Department: Culture, Waiting, and Outcomes of Efficiency and Quality2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to investigate patient safety in the emergency department (ED) and to determine whether this varies according to patient safety culture, waiting, and outcomes of efficiency and quality variables.

    I: Patient safety culture was described in the EDs of two different hospitals before and after a quality improvement project. The questionnaire “Hospital Survey on Patient Safety Culture” was used to investigate the patient safety culture. The main finding was that the staff at both hospitals scored more positively in the dimension Team-work within hospital after implementing a new work model aimed at improving patient flow and patient safety in the ED. Otherwise, we found only modest improvements.

    II: Grounded theory was used to explore what happens in the ED from the staff perspective. Their main concern was reducing patients’ non-acceptable waiting time. Management of waiting was improved either by increasing the throughput of patient flow by structure pushing and by shuffling patients, or by changing the experience of waiting by calming patients and by feinting to cover up.

    III: Three Swedish EDs with different triage models were compared in terms of efficiency and quality. The median length of stay was 158 minutes for physician-led team triage compared with 243 and 197 minutes for nurse–emergency physician and nurse–junior physician triage, respectively. Quality indicators (i.e., patients leaving before treatment was completed, the rate of unscheduled return within 24 and 72 hours, and mortality rate within 7 and 30 days) improved under the physician-led team triage.

    IV: Efficiency and quality variables were compared from before (2008) to after (2012) a reorganization with a shift of triage model at a single ED. Time from registration to physician decreased by 47 minutes, and the length of stay decreased by 34 minutes. Several quality measures differed between the two years, in favour of 2012. Patients leaving before treatment was completed, unscheduled return within 24 and 72 hours, and mortality rate within 7 and 30 days all improved despite the reduced admission rate.

    In conclusion, the studies underscore the need to improve patient safety in the ED. It is important to the patient safety culture to reduce patient waiting because it dynamically affects both patients and staff. Physician-led team triage may be a suitable model for reducing patient waiting time and increasing patient safety.

  • 118. Burström, Lena
    et al.
    Engström, Marie-Louise
    Castrén, Maaret
    Wiklund, Tony
    Enlund, Mats
    Change of triage model to physician-led team triage explains better quality and efficiency at one emergency department.Article in journal (Refereed)
  • 119.
    Burström, Lena
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Letterstal, Anna
    Engström, Marie-Loise Walker
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Berglund, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Enlund, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    The patient safety culture as perceived by staff at two different emergency departments before and after introducing a flow-oriented working model with team triage and lean principles: a repeated cross-sectional study2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, p. 296-Article in journal (Refereed)
    Abstract [en]

    Background: Patient safety is of the utmost importance in health care. The patient safety culture in an institution has great impact on patient safety. To enhance patient safety and to design strategies to reduce medical injuries, there is a current focus on measuring the patient safety culture. The aim of the present study was to describe the patient safety culture in an ED at two different hospitals before and after a Quality improvement (QI) project that was aimed to enhance patient safety. Methods: A repeated cross-sectional design, using the Hospital Survey On Patient Safety Culture questionnaire before and after a quality improvement project in two emergency departments at a county hospital and a university hospital. The questionnaire was developed to obtain a better understanding of the patient safety culture of an entire hospital or of specific departments. The Swedish version has 51 questions and 15 dimensions. Results: At the county hospital, a difference between baseline and follow-up was observed in three dimensions. For two of these dimensions, Team-work within hospital and Communication openness, a higher score was measured at the follow-up. At the university hospital, a higher score was measured at follow-up for the two dimensions Team-work across hospital units and Team-work within hospital. Conclusion: The result showed changes in the self-estimated patient safety culture, mainly regarding team-work and communication openness. Most of the improvements at follow-up were seen by physicians, and mainly at the county hospital.

  • 120.
    Byass, Peter
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Dr Tedros Adhanom Ghebreyesus is the best candidate for WHO DG2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 389, no 10084, p. E6-E7Article in journal (Refereed)
  • 121.
    Bylund, Bengt
    et al.
    Västerviks sjukhus.
    Cervin, Torsten
    Finnström, Orvar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Gäddlin, Per-Olof
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Leijon, Ingemar
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
    Mård, Selina
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Samuelsson, Stefan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Sandstedt, Per
    Wärngård, Olof
    Very low birth weight children at 9 years:  School performance and behaviour in relation to risk factors2000In: Prenatal and Neonatal Medicine, ISSN 1359-8635, E-ISSN 1473-0774, Vol. 5, no 2, p. 124-133Article in journal (Refereed)
    Abstract [en]

    Objectives To investigate the school performance and behavior of very low-birth-weight children in comparison with controls, and relate the findings to risk factors.

    Methods All children with birth weight below 1501 g (VLBW) and normal birth weight (NBW) controls, born in the south-east region of Sweden during a 15-month period in 1987-88, were enrolled in a prospective follow-up study; 81 % (n = 70) and 82% (n = 72), respectively, were re-examined at the age of 9 years regarding growth, neurological status, neurofunctional classification and academic achievement tests (Raven's matrices, mathematics, vocabulary, reading ability). The need for special education at school was assessed and four behavioral problem scores were also assessed (hyperactivity, fine motor skills, gross motor skills, social skills). Children with known handicaps were not re-examined.

    Results VLBW children were shorter and lighter than controls, and differed from them with regard to neurological functional classification. As a group, they produced poorer results in all academic achievement tests except vocabulary, and also in two out of four behavioral subscales (hyperactivity and fine motor skills). When the comparison was restricted to children with normal Raven scores, almost all the differences disappeared. VLBW children had more reading difficulties but were less often than expected defined as dyslexic compared to NEW children.

  • 122.
    Bylund Grenklo, Tove
    et al.
    Karolinska Institutet, Stockholms Sjukhem.
    Kreicbergs, Ulrika
    Karolinska Institutet, Sophiahemmet.
    Hauksdóttir, Arna
    Island. Göteborgs universitet, Sverige..
    Valdimarsdóttir, Unnur A
    Island.
    Nyberg, Tommy
    Karolinska Institutet.
    Steineck, Gunnar
    Karolinska Institutet, Göteborgs universitet.
    Fürst, Carl Johan
    Karolinska Institutet, Stockholms Sjukhem.
    Self-injury in teenagers who lost a parent to cancer: a nationwide, population-based, long-term follow-up.2013In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 167, no 2, p. 133-140Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the risk of self-injury in parentally cancer-bereaved youth compared with their nonbereaved peers.

    DESIGN: Population-based study of cancer-bereaved youth and a random sample of matched population controls.

    SETTING: Sweden in 2009 and 2010.

    PARTICIPANTS: A total of 952 youth (74.8%) confirmed to be eligible for the study returned the questionnaire: 622 (73.1%) of 851 eligible young adults who lost a parent to cancer between the ages of 13 and 16 years, in 2000 to 2003, and 330 (78.4%) of 451 nonbereaved peers.

    MAIN EXPOSURE: Cancer bereavement or nonbreavement during the teenage years.

    MAIN OUTCOME MEASURES: Unadjusted and adjusted odds ratios (ORs) of self-injury after January 1, 2000.

    RESULTS: Among cancer-bereaved youth, 120 (19.5%) reported self-injury compared with 35 (10.6%) of their nonbereaved peers, yielding an OR of 2.0 (95% CI, 1.4-3.0). After controlling for potential confounding factors in childhood (eg, having engaged in self-destructive behavior, having been bullied, having been sexually or physically abused, having no one to share joys and sorrows with, and sex), the adjusted OR was 2.3 (95% CI, 1.4-3.7). The OR for suicide attempts was 1.6 (95% CI, 0.8-3.0).

    CONCLUSIONS: One-fifth of cancer-bereaved youth reported self-injury, representing twice the odds for self-injury in their nonbereaved peers, regardless of any of the adjustments we made. Raised awareness on a broad basis in health care and allied disciplines would enable identification and support provision to this vulnerable group.

  • 123.
    Bylund Grenklo, Tove
    et al.
    Karolinska Institutet, Stockholms Sjukhem.
    Kreicbergs, Ulrika
    Karolinska Institutet, Sophiahemmet.
    Valdimarsdóttir, Unnur A
    Island, USA.
    Nyberg, Tommy
    Karolinska Institutet.
    Steineck, Gunnar
    Karolinska Institutet, Göteborgs universitet.
    Fürst, Carl Johan
    Karolinska Institutet, Stockholms sjukhem, Lunds universitet.
    Self-injury in youths who lost a parent to cancer: nationwide study of the impact of family-related and health-care-related factors.2014In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 23, no 9, p. 989-997Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-injury, a manifestation of severe psychological distress, is increased in cancer-bereaved youths. Little is known about the potential influence on the risk for self-injury of factors that could be clinically relevant to and modifiable by the health-care professionals involved in the care of the dying parent.

    METHODS: In a nationwide population-based anonymous study, 622 (73.1%) youths (aged 18-26) who, 6 to 9 years earlier at ages 13 to 16, had lost a parent to cancer answered study-specific questions about self-injury and factors related to the family and parental health care.

    RESULTS: Univariable analyses showed that the risk for self-injury was increased among cancer-bereaved youths who reported poor family cohesion the years before (relative risk [RR], 3.4, 95% confidence interval [CI], 2.5-4.6) and after the loss (RR, 3.3, 95% CI, 2.4-4.4), distrust in the health care provided to the dying parent (RR, 1.7, 95% CI, 1.2-2.4), perceiving poor health-care efforts to cure the parent (RR 1.5, 95% CI, 1.1-2.1) and poor efforts to prevent suffering (RR, 1.6, 95% CI, 1.1-2.4), that at least one of their parents had been depressed or had troubles in life (RR, 1.5, CI, 1.1-2.1) and believing 3 days before the loss that the treatment would probably cure the parent (RR, 1.6, CI, 1.1-2.3). In the total multivariable models, only poor family cohesion before and after the loss remained statistically significantly associated with self-injury.

    CONCLUSION: Poor family cohesion before and after the loss of a parent to cancer is associated with an increased risk of self-injury in teenage children.

  • 124.
    Bylund-Grenklo, Tove
    et al.
    Karolinska Institutet, Linnéuniversitetet.
    Fürst, C J
    Lunds universitet.
    Nyberg, T
    Karolinska Institutet.
    Steineck, G
    Karolinska Institutet, Göteborgs universitet.
    Kreicbergs, Ulrika
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska Institutet.
    Unresolved grief and its consequences: A nationwide follow-up of teenage loss of a parent to cancer 6-9 years earlier.2016In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 7, p. 3095-3103Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The early loss of a parent is a tragedy and a serious life event. This study investigated grief resolution and morbidity in cancer-bereaved teenagers 6 to 9 years after the loss of a parent to cancer.

    METHODS: In a nationwide population-based study of 622 of 851 (73 %) youths who as teenagers 6 to 9 years earlier had lost a parent to cancer, we explored the magnitude of unresolved grief and its association with psychological and physiological morbidity. Participants answered a study-specific anonymous questionnaire including questions about if they had worked through their grief and about their current health.

    RESULTS: Six to nine years post-loss 49 % reported unresolved grief (8 % no and 41 % a little grief resolution). They had, in comparison with youths reporting resolved grief, statistically significantly elevated risks, e.g. for insomnia (sons' relative risk (RR) 2.3, 95 % CI 1.3-4.0; daughters' RR 1.7, 95 % CI 1.1-2.7), fatigue (sons' RR 1.8, 95 % CI 1.3-2.5; daughters' RR 1.4, 95 % CI 1.1-1.7) and moderate to severe depression, i.e. score >9, PHQ-9 (sons' RR 3.6, 95 % CI 1.4-8.8; daughters' RR 1.8, 95 % CI 1.1-3.1). Associations remained for insomnia in sons, exhaustion in daughters and fatigue in both sons and daughters when depression, negative intrusive thoughts and avoiding reminders of the parents' disease or death were included in a model.

    CONCLUSIONS: Approximately half of cancer-bereaved youth report no or little grief resolution 6 to 9 years post-loss, which is associated with fatigue, sleeping problems and depressive symptoms.

  • 125.
    Bylund-Grenklo, Tove
    et al.
    Karolinska Institutet, Stockholms Sjukhem .
    Kreicbergs, Ulrika
    Ersta Sköndal University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
    Uggla, Charlotta
    Karolinska Institutet .
    Valdimarsdóttir, Unnur A
    Island, USA.
    Nyberg, Tommy
    Karolinska Institutet.
    Steineck, Gunnar
    Karolinska Institutet, Göteborgs universitet.
    Fürst, Carl Johan
    Karolinska Institutet, Stockholms Sjukhem Foundation, Lunds universitet .
    Teenagers want to be told when a parent's death is near: A nationwide study of cancer-bereaved youths' opinions and experiences.2015In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 54, no 6, p. 944-950Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We aimed to investigate cancer-bereaved youths' opinions and experiences of being told about a parent's imminent death from cancer and of barriers to this communication.

    MATERIAL AND METHODS: This nationwide population-based survey included 622/851 (73%) youths (aged 18-26) who at age 13-16, 6-9 years earlier had lost a parent to cancer.

    RESULTS: In total 595 of 610 (98%) of the participants stated that teenage children should be informed when the parent's death was imminent (i.e. a matter of hours or days, not weeks). 59% stated that they themselves had been told this, 37% by the parents, 7% by parents and healthcare professionals together and 8% by professionals only. Frequent reasons for why the teenager and parents did not talk about imminent death before loss were that one (n=106) or both (n=25) of the parents together with the teenage child had pretended that the illness was not that serious, or that none of the parents had been aware that death was imminent (n=80). Up to a couple of hours before the loss, 43% of participants had not realized that death was imminent.

    CONCLUSION: In this population-based study virtually all youth who at ages 13-16 had lost a parent to cancer afterwards stated that teenagers should be told when loss is near, i.e. a matter of hours or days, not weeks. Many stated that they had not been given this information and few were informed by professionals, with implications for future improvements in end-of-life care of patients with teenage children.

  • 126.
    Bäck, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens University Hospital, Sweden; University of Gothenburg, Sweden.
    Cider, Åsa
    Sahlgrens University Hospital, Sweden; University of Gothenburg, Sweden.
    Herlitz, Johan
    University of Borås, Sweden.
    Lundberg, Mari
    University of Gothenburg, Sweden.
    Jansson, Bengt
    University of Gothenburg, Sweden.
    Kinesiophobia mediates the influences on attendance at exercise-based cardiac rehabilitation in patients with coronary artery disease2016In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 32, no 8, p. 571-580Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify predictors of attendance at exercise-based cardiac rehabilitation (CR) and to test the hypothesis that kinesiophobia mediates the influence on attendance at CR in patients with coronary artery disease (CAD). Patients: In total, 332 patients (75 women; mean age 65 +/- 9.1 years) with a diagnosis of CAD were recruited at Sahlgrenska University Hospital, Sweden. Methods: The patients were tested in terms of objective measurements, self-rated psychological measurements, and level of physical activity. A path model with direct and indirect effects via kinesiophobia was used to predict participation in CR. An exploratory selection of significant predictors was made. Results: A current incidence of coronary bypass grafting (p amp;lt; 0.001) and a diagnosis of ST-elevation myocardial infarction (p = 0.004) increased the probability of attendance at CR, while kinesiophobia (p = 0.001) reduced attendance. As a mediator, kinesiophobia was influenced by four predictors and the following indirect effects were found. General health and muscle endurance increased the probability of attendance at CR, while self-rated anxiety and current incidence of heart failure had the opposite effect. Conclusions: This study suggests that kinesiophobia has an influence on and a mediating role in attendance at CR. The results need to be further investigated in relation to clinical practice.

  • 127.
    Bäckryd, Emmanuel
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Persson, Elisabeth B.
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Larsson, Annelie Inghilesi
    Qual Stat AB, Sweden.
    Fischer, Marcelo Rivano
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Gerdle, Björn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Chronic pain patients can be classified into four groups: Clustering-based discriminant analysis of psychometric data from 4665 patients referred to a multidisciplinary pain centre (a SQRP study)2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 2, article id e0192623Article in journal (Refereed)
    Abstract [en]

    Objective To subgroup chronic pain patients using psychometric data and regress the variables most responsible for subgroup discrimination. Design Cross-sectional, registry-based study. Setting and subjects Chronic pain patients assessed at a multidisciplinary pain centre between 2008 and 2015. Methods Data from the Swedish quality registry for pain rehabilitation (SQRP) were retrieved and analysed by principal component analysis, hierarchical clustering analysis, and partial least squares-discriminant analysis. Results Four subgroups were identified. Group 1 was characterized by low "psychological strain", the best relative situation concerning pain characteristics (intensity and spreading), the lowest frequency of fibromyalgia, as well as by a slightly older age. Group 2 was characterized by high "psychological strain" and by the most negative situation with respect to pain characteristics (intensity and spreading). Group 3 was characterized by high "social distress", the longest pain durations, and a statistically higher frequency of females. The frequency of three neuropathic pain conditions was generally lower in this group. Group 4 was characterized by high psychological strain, low "social distress", and high pain intensity. Conclusions The identification of these four clusters of chronic pain patients could be useful for the development of personalized rehabilitation programs. For example, the identification of a subgroup characterized mainly by high perceived "social distress" raises the question of how to best design interventions for such patients. Differentiating between clinically important subgroups and comparing how these subgroups respond to interventions is arguably an important area for further research.

  • 128.
    Bäckström, Caroline
    et al.
    University of Skövde, School of Life Sciences.
    Hertfelt Wahn, Elisabeth
    University of Skövde, School of Life Sciences.
    Support during labour: first-time fathers' descriptions of requested and received support during the birth of their child2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 1, p. 67-73Article in journal (Refereed)
    Abstract [en]

    Objective:  to explore how first-time fathers describe requested and received support during a normal birth. Design:  qualitative research design. Ten first-time fathers were interviewed during the first postpartum week.  Individual  open-ended  interviews  were  used  to  explore  the  fathers’  descriptions,  and  the interviews were analysed using qualitative analysis. Setting:  a labour ward at one hospital in a south-western county of Sweden in November and December 2006. Participants:  first-time  fathers  who  had  experienced  a  normal  birth  at  the  hospital  during  the study period. Findings:  the support described is presented as one main theme, ‘being involved or being left out’, which included four underlying categories: ‘an allowing atmosphere’, ‘balancing involvement’, ‘being seen’ and ‘feeling left out’. Key conclusions:  fathers perceived that they were given good support when they were allowed to ask questions during labour, when they had the opportunity to interact with the midwife and their partner, and when they could choose when to be involved or to step back. Fathers want to be seen as individuals who are part of the labouring couple. If fathers are left out, they tend to feel helpless; this can result in a feeling of panic and can put their supportive role of their partner at risk. Implications  for practice:  the  results  of  this  study could  initiate  discussions  about  how  health-care professionals can develop support given to the labouring couple, with an interest in increasing paternal involvement.

  • 129. Bärkås, Annika
    et al.
    Scandurra, Isabella
    Hägglund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Analysis of Voluntary User Feedback of the Swedish National PAEHR Service.2019In: MEDINFO 2019: Health and Wellbeing e-Networks for All: Proceedings of the 17th World Congress on Medical and Health Informatics, 2019, Vol. 264, p. 1126-1130Conference paper (Refereed)
    Abstract [en]

    "Journalen" is a patient accessible electronic health record (PAEHR) and the national eHealth service for Sweden's citizens to gain access to their EHR. The Swedish national eHealth organization Inera, responsible for Journalen, created an inbox to receive voluntary user feedback about Journalen in order to improve the service from the user perspective. Based on voluntary user feedback via email. This study explored patients' experiences of using the national eHealth service and identified pros and cons. A mixed method content analysis was performed. In total, 1084 emails from 2016-2017 have been analyzed. 9 categories were identified, the most frequent ones related to questions about why some information was not accessible (due to regional differencies), feedback (including only positive or negative comments as well as constructive improvement suggestions), and emails about errors that user found in their record. These data can be successfully used to continuously improve an already implemented eHealth service.

  • 130.
    Bävits, Nina
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Torpman, Ida
    Ersta Sköndal University College, Department of Health Care Sciences.
    Obotligt cancersjuka patienters tankar om att vilja avsluta sitt liv i förtid: En litteraturstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 131.
    Callmar, Cicci
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    ”Då blir det tre va”: En studie i hur föräldrar uttrycker mentalisering över sig själva och sitt nyfödda barn före och strax efter förlossning2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den här uppsatsen undersöker mentalisering och dess betydelse vid starten av ett föräldraskap, bildandet av en familj.

    – Studien utgår ifrån affektteori och anknytningsteori som en grund för mentaliseringsförmågans framväxande.

    – Via en kvalitativ studie undersöks hur föräldrar uttrycker mentalisering över sig själva och sina barn i ett redan genomfört intervjumaterial med 4 föräldrapar under graviditet och fyra veckor efter barnets födelse. Intervjuerna genomfördes för 15 år sedan av Monica Hedenbro.

     

    Studien visar att det är möjligt att avläsa föräldrars försök till mentalisering över sina barn men att mentalisering också uppstår i den dialog som paret har med varandra. Studien visar också att det går att se en skillnad mellan olika familjer.

    När en förälder har möjlighet att dela sina egna tankar/farhågor och bli lyssnade på av den andra föräldern ev. även få bekräftelse så ökar antalet kommentarer om mentalisering.

    Kommentarer om reglering av barnets fysiska behov föregår kommentarer om mentala tillstånd/mentalisering .

     

    Forskning visar på sambandet mellan trygg anknytning och att föräldrar tillskriver sina barn egna känslor, tankar och intentioner och kommenterar barnets inre värld i ”mental states”.

     

    Studien som helhet visar på vikten av att stödja föräldrars kommunikation med varandra och med sitt barn tidigt i blivandet av en familj, redan under graviditeten.

     

  • 132. Calounova, Gabriela
    et al.
    Livera, Gabriel
    Zhang, Xiao-Qun
    Liu, Kui
    Umeå University, Faculty of Medicine, Department of Medical Biochemistry and Biophysics.
    Gosden, Roger G.
    Welsh, Michael
    The Src Homology 2 Domain-Containing Adapter Protein B (SHB) Regulates Mouse Oocyte Maturation2010In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 5, no 6, article id e11155Article in journal (Refereed)
    Abstract [en]

    SHB (Src homology 2 domain-containing adapter protein B) is involved in receptor tyrosine kinase signaling. Mice deficient in the Shb gene have been found to exhibit a transmission ratio distortion with respect to inheritance of the Shb null allele among offspring and this phenomenon was linked to female gamete production. Consequently, we postulated that Shb plays a role for oocyte biology and thus decided to investigate oocyte formation, meiotic maturation, and early embryo development in relation to absence of the Shb gene. Oogenesis was apparently accelerated judging from the stages of oocyte development on fetal day 18.5 and one week postnatally in Shb(-/-) mice; but in adulthood ovarian follicle maturation was impaired in these mice. Completion of meiosis I (first polar body extrusion) was less synchronized, with a fraction of oocytes showing premature polar body extrusion in the absence of Shb. In vitro fertilization of mature oocytes isolated from Shb +/+, +/- and -/- mice revealed impaired early embryo development in the -/- embryos. Moreover, the absence of Shb enhanced ERK (extracellular-signal regulated kinase) and RSK (ribosomal S6 kinase) signaling in oocytes and these effects were paralleled by an increased ribosomal protein S6 phosphorylation and activation. It is concluded that SHB regulates normal oocyte and follicle development and that perturbation of SHB signaling causes defective meiosis I and early embryo development.

  • 133.
    Cameron, Camilla
    et al.
    Clinical Nutrition and Dieietics Karolinska University Hospital Stockholm.
    Andersson, Agneta
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Faxén Irving, Gerd
    Clinical Nutrition Karolinska Institute Stockholm.
    Dietary phosphorous intake among haemodialysis patients in relation to dosage of phosphate binders and hyperphosphatemia2012In: International Congress on Renal Nutrition and Metabolism (ICRNM) Honolulu, Hawaii 26-30 juni 2012, 2012, p. pos3-13-Conference paper (Other academic)
  • 134.
    Carballeira Suarez, Nivia
    et al.
    Umeå Universitet.
    Levi, Richard
    Umeå Universitet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Regaining health and wellbeing after traumatic spinal cord injury2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 10, p. 1023-1027Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Traumatic spinal cord injury is typically a devastating event, leading to permanent physical disability. Despite the severity of the condition, many persons with traumatic spinal cord injury manage to lead both active and independent lives. The aim of this study was to investigate the experience of health and wellbeing of persons living with a traumatic spinal cord injury for at least 20 years. Design and methods: A qualitative design was used. Data was analysed using a phenomenological-hermeneutical method. Rich narratives were obtained from 14 persons with paraplegia due to traumatic spinal cord injury sustained at least 20 years ago. RESULTS: The key finding was that health and wellbeing were attained when persons were able to perceive themselves as being “normal” in everyday relationships and circumstances. The normalization process involved learning to negotiate and/or prevent potentially embarrassing situations by acting in a “parallel world”, covertly “behind the scenes”. CONCLUSION: The subjective experience of wellbeing and health after traumatic spinal cord injury depends upon the ability to prevent or resolve potentially embarrassing situations without this being noticed by others. Performing this work “behind the scenes”, enables persons with traumatic spinal cord injury to interact smoothly with others and thereby be perceived as normal, despite substantial disability.

  • 135.
    Carlander, Ida
    et al.
    Karolinska institutet, Stockholm, Sweden.
    Ternestedt, Britt-Marie
    Örebro University, School of Health and Medical Sciences. Ersta Sköndal högskola, Stockholm, Sweden.
    Sahlberg-Blom, Eva
    Örebro University, School of Health and Medical Sciences.
    Hellström, Ingrid
    Linköpings universitet, Linköping, Sweden.
    Sandberg, Jonas
    Ersta Sköndal högskola, Stockholm, Sweden.
    Being me and being us in a family living close to death at home2011In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 21, no 5, p. 683-695Article in journal (Refereed)
    Abstract [en]

    We used interpretive description to describe how everyday life close to death was experienced and dealt with in families with one member who had a life-threatening illness. We performed 28 individual, couple, and group interviews with five families. We found two patterns, namely, “being me in a family living close to death” and “being us in a family living close to death.” “Being me” meant that every individual in the family had to deal with the impending death, regardless of whether or not he or she was the person with the life-threatening illness. This was linked to ways of promoting the individual’s self-image, or “me-ness.” This pattern was present at the same time as the pattern of “being us,” or in other words, being a family, and dealing with impending death and a new “we-ness” as a group. “Striving for the optimal way of living close to death” was the core theme.

  • 136.
    Carlsson, Lars
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Lytsy, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health.
    Anderzén, I
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Motivationfor return to work and actual return to work among people on long-term sickleave due to pain syndrome or mental health conditions2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    ABSTRACTPurpose:The purpose of this study was to investigate associations between motivation for return towork and actual return to work, or increased employability among people on long-term sick leave.Materials and methods:Data by responses to questionnaires was collected from 227 people on long-term sick leave (mean¼7.9years) due to pain syndrome or mild to moderate mental health conditionswho had participated in a vocational rehabilitation intervention. The participants’motivation for return towork was measured at baseline. At 12-month follow-up, change in the type of reimbursement betweenbaseline and at present was assessed and used to categorise outcomes as:“decreased work and employ-ability”,“unchanged”,“increased employability”,and“increased work”. Associations between baselinemotivation and return to work outcome were analysed using logistic and multinomial regression models.Results:Motivation for return to work at baseline was associated with return to work or increasedemployability at 12-month follow-up in the logistic regression model adjusting for potential confounders(OR 2.44, 95% CI 1.25–4.78).Conclusions:The results suggest that motivation for return to work at baseline was associated withactual chances of return to work or increased employability in people on long-term sick leave due topain syndrome or mild to moderate mental health conditions.

  • 137.
    Carlsson, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    The significance of fatigue in relatives of palliative patients2010In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 8, p. 137-142Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore the significance of fatigue among relatives of palliative patients. 

    Method: This pilot study has a descriptive and cross-sectional design and is the report of four open-ended questions focusing on the relatives' experiences of fatigue. The study population consisted of relatives of patients who were cared for in palliative care settings either at home or in an institution in Uppsala County during a specific day. 

    Results: The relatives were very tired and identified worries, uncertainty, the patient's suffering, and many demands as the causes for the fatigue. The most obvious consequences of the tiredness were a lack of motivation, feelings of insufficiency and apathy, and putting their own interests aside. Many relatives expressed that having the company of close family members, taking exercise and spending time outdoors gave them strength to carry on. The health care system could make the situation easier for relatives of patients in palliative care by providing good care for the patient, and psychosocial support and respite care for the relatives. 

    Significance of results: The result of the pilot study is only preliminary, but it showed that relatives caring for patients in a late palliative phase suffer from great fatigue and require more attention, both scientifically and in the clinical settings.

  • 138.
    Carlsson, Per-Inge
    et al.
    ENT-clinic, Central Hospital, Karlstad, Sweden.
    Hall, Malin
    Lind, Karl-Johan
    Danermark, Berth
    Örebro University, School of Health and Medical Sciences.
    Quality of life, psychosocial consequences and audiological rehabilitation after sudden sensorineural hearing loss2011In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 50, no 2, p. 139-144Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    Sudden sensorineural hearing loss (SSHL) is characterized by a rapid loss of hearing, most often of cochlear origin. Very little attention has been paid in the literature to quality of life (QoL), psychosocial consequences and audiological rehabilitation after SSHL.

    DESIGN:

    We studied how level of hearing loss, hearing recovery, tinnitus and vertigo affect QoL after SSHL and the psychosocial consequences of SSHL in terms of sick leave. Furthermore, the audiological rehabilitation given to patients in connection with SSHL and the benefit of the rehabilitation were studied.

    STUDY SAMPLE:

    Three hundred and sixty-nine (369) patients with SSHL were analysed in the present study.

    RESULTS:

    Annoying tinnitus and remaining vertigo after SSHL were the strongest predictors of negative effects on QoL.

    CONCLUSIONS:

    The study indicates that patients with SSHL require extended audiological rehabilitation including a multi-disciplinary rehabilitation approach (medical, social and psychological) to cope with the complex issues that can arise after SSHL.

  • 139.
    Carlstrand, Alexandra
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Eriksson, Emmelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Kan fonologisk språkstörning leda till läs- och skrivsvårigheter?: En studie om samband mellan fonologiska svårigheter under förskoleåren och läs- och skrivsvårigheter under skolåren.2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Phonological language impairment is the most common type of specific language impairment (SLI). The diagnosis includes difficulties with pronunciation and/or poor phonological awareness. The purpose of this study was to investigate whether children with the diagnosis are at risk for developing reading and writing disabilities. 14 children in third grade, who were diagnosed with phonological language impairment in kindergarten, were tested in phonological awareness, decoding of words and nonwords and spelling. The results showed that eight of the children have difficulties with reading- and writing and five of these showed signs of dyslexia. In an attempt to find correlations between components of the phonological ability in kindergarten and poor reading- and writing abilities , the children's medical records regarding speech-language treatment were analyzed. The authors found that the phonological awareness, which has been identified as the most reliable predictor of reading achievement, only had been tested in one out of 14 children. Any pattern of pronunciation difficulties in the children who showed signs of reading- and writing disabilities could not be found. The literature suggests that it should be possible to identify children at risk of developing reading and writing disabilities very early; perhaps even before they begin to learn how to read and write. The results of the present study indicate that children with phonological language impairment are at high risk of developing reading and writing disabilities, if their phonological awareness is poor, and that the phonological awareness therefore should be tested in all children with the diagnosis.

  • 140.
    Carlsund, Åsa
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sellström, Eva
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Eriksson, Ulrika
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Swedish Parent’s Experiences of Joint Physical Custody2014In: Open Family Studies Journal, ISSN 1874-9224, Vol. 6, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Abstract: Aim: This study’s aim was to learn more about parent experiences, when living in joint physical custody with their children. Methods: The study design was descriptive, using a qualitative approach. Interviews were conducted with 28 parents who lived in joint physical custody with their children. Content was analysed using inductive content analysis. Results: Participants with joint custody reported many positive experiences, and a similar process of adapting to the new living- arrangement. Results indicate that shortly after the separation parents were mainly occupied with emotional reactions to the new family situation. After two to three years, or in some cases longer, things seemed to settle down and the participants became more accustomed to the arrangements. Conclusion: This qualitative study provides insights into parents’ experiences of living in joint physical custody with their children. Many positive experiences and a similar process of adapting to the new arrangement were revealed. In the initial period, the parents seemed mainly to have been occupied with emotional reactions to the new family situation.

  • 141.
    Cassidy, Tanja
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Svensson, Linda
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Ett utforskande av hur ABFT yttrar sig i klinisk process2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inledning: Allt fler ungdomar i Sverige mår psykiskt dåligt. Depressioner och suicid ökar bland unga och det är viktigt att hitta effektiva terapimetoder. Vi har i denna uppsats valt att granska ABFT, Anknytningsbaserad familjeterapi, då den påvisat goda resultat. ABFT har sin grund bl.a. i interpersonella teorier som menar att depression hos unga kan motverkas av kvalitativa interpersonella relationer inom familjen. Denna pilotstudies syfte är att undersöka hur väl ABFT metoden genomförs i två kliniska terapiprocesser. Frågeställning: – Hur väl följer terapeuten manualens riktlinjer? – Hur väl uppnår terapeuten ABFT:s mål för varje deluppgift och hur påverkar det terapiprocessen? – Hur ser alliansen och den intersubjektiva kommunikationen ut mellan terapeut och familjemedlem och hur påverkar det terapiprocessen? Metod: Pilotstudien är en kvalitativ induktiv processtudie som vilar på en hermeneutisk grund. Grunden för studien är två ABFT behandlingar filmade från uppgifter 1-4, totalt 15 sessioner. Skattning av manualtrohet och deluppgifter har gjorts. Ett antal episoder har analyserat närmare utifrån teman som allians och intersubjektiv kommunikation. Resultat: Manualtrohet är låg till medel för ABFT terapeuter under utbildning. Manualtroheten blir lägre framförallt för att affektdjup inte skapas vilket visar sig i att både familjemedlemmar och terapeuter har svårt att stanna kvar i, dela och fördjupa de känslomässiga upplevelserna i terapin. Målen för ABFT:s deluppgifter uppnås delvis, terapiprocesserna blir något forcerade. Den intersubjektiva kommunikationens kvalité samt alliansen påverkar behandlingsprocessen och är av stor vikt för att få till en förändringsprocess och ett affektdjup. Diskussion: Vi har i studien belyst problematiken och svårigheten i att lära sig ABFT modellen och vidareutvecklat vad utbildare inom ABFT kan beakta för fortsatt implementering av ABFT modellen i Sverige.

  • 142.
    Cavellan, Nicklas
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Wedebrand, Marcus
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Det är min sjukdom också: Hur en livspartner till någon som drabbas av en hjärtinfarkt påverkas, en systematisk litteraturstudie.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 143.
    Cederqvist, Lena
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Att mötas i samtal: Pilotstudie om samtalets betydelse vid Samtalsbyrån2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna uppsats har till syfte att undersöka vad som gör att människor känner sig bra bemötta och nöjda med besöket hos Samtalsbyrån. Tidigare enkätundersökning i kommunen har visat att människor generellt känner sig bra bemötta men inte anledningen till detta.

    Samtliga besökare, 41 personer, i tre kommuner erbjöds under en femveckorsperiod att delta anonymt i undersökningen genom att besvara en enkät. Av dessa besvarade 26 personer enkäten, ca 62 %. Ett stort bortfall av den möjliga svarsfrekvensen begränsar tolkningen av resultatet. Resultatet visar att människor som väljer att komma till Samtalsbyrån upplever sig bli bemötta med respekt, lyssnad på, känner sig delaktig och vägledda utifrån sin egen problemformulering. Enkäten föreslås bli en del av kvalitetssäkringen av Samtalsbyråns verksamhet om än i en något omarbetad form.

     

  • 144. Chen, Tian-Jiao
    et al.
    Modin, Bitte
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Ji, Cheng-Ye
    Hjern, Anders
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Regional, socioeconomic and urban-rural disparities in child and adolescent obesity in China: a multilevel analysis2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 12, p. 1583-1589Article in journal (Refereed)
    Abstract [en]

    Aim:  To study socio-demographic patterns of obesity in Chinese children and adolescents. Methods:  Data came from the 2005 cycle of the Chinese National Survey on Student's Constitution and Health. In all, 231 326 subjects aged 7-18 years, distributed across 622 schools and 30 provinces, were analysed. Multilevel modelling was used to estimate variations at individual, school area and province levels. Results:  The prevalence of obesity varied enormously across different areas. Young people living in high socioeconomic and urban areas had higher body mass index (BMI) and higher odds of overweight and obesity than those living in lower socioeconomic and rural areas. Subjects living in provinces with a higher standard of living, as indicated by less perinatal mortality, lower Engel coefficient, and higher personal expenditure on health had higher BMI and higher odds of overweight and obesity than those living in less affluent provinces. An interaction between gender and urbanicity revealed that boys in urban areas were especially prone to obesity. Conclusion:  In contrast to most present-day high income countries, obesity among young people in China is associated with affluence and urban residence. Intervention and strategy for obesity prevention should be targeting high socioeconomic families in urban areas, perhaps with particular focus on boys.

  • 145.
    Code, Chris
    et al.
    University of Exeter.
    Ball, Martin
    University of Lousiana at Lafayette, Lafayette, LA, USA.
    Tree, Jeremy
    University of Swansea.
    Dawe, Karen
    Bristol University.
    The effects of initiation, termination and inhibition impairments on speech rate in a case of progressive nonfluent aphasia with progressive apraxia of speech with frontotemporal degeneration2013In: Journal of Neurolinguistics, ISSN 0911-6044, E-ISSN 1873-8052, Vol. 26, no 6, p. 602-618Article in journal (Refereed)
    Abstract [en]

    Recent research into nonfluent forms of primary progressive aphasia and progressive apraxia of speech has highlighted the importance of speech rate as a diagnostic feature. We describe detailed investigation and comparison of speech rate (latencies and utterance length in single word/nonword production and speech rate in connected speech) on a range of experimental tasks in a man with progressive speech deterioration of 10 years duration from Pick's Disease. C.S. had a progressive nonfluent aphasia (PNFA) together with progressive apraxia of speech (pAOS) with an absence of significant interlectual, phonological or semantic impairment. C.S. showed increased latencies but reduced word length compared to matched controls on single word and nonword repetition and reading, an absence of a syllabic length effect in either single word/nonword tasks or connected speech tasks. Further investigation suggested that underlying his speech production impairments were problems with speech initiation, termination and inhibition. Most impairments worsened with progression over a 12-month period. Results provide support for the view that progressive apraxia of speech presents differently to apraxia of speech following stroke and, especially at advanced stages, involves deterioration in more central and supportive cognitive processes.

  • 146.
    Collin, Eva-Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Hedmark, Ann-Kristin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    "Där tror jag att vi har mycket att hämta!": Om parrelationens plats i ett psykoterapeutiskt arbete kring ett barn2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka hur behandlare, som har i uppdrag att arbeta med barn med olika svårigheter och med samspelsproblem, reflekterar kring och förhåller sig till föräldrarnas parrelation i det psykoterapeutiska arbetet.

    En kvalitativ ansats har använts och sex behandlare har intervjuats. Behandlarna är verksamma både på familjemottagningar i landstingets och i kommunens regi.

    Studien åskådliggör att behandlarna uppvisar en spridning i åsikter om vilken plats parrelationen ska ha i samtalen. I behandlarnas berättelse framkommer att flertalet brottas med frågor om hur viktig parrelationen är i förhållande till barnets symtom samt om det är gångbart att arbeta med parrelationen utifrån föräldrarnas behandlingsuppdrag och verksamhetens riktlinjer. Behandlarna funderar även kring den egna verksamhetens uppdrag kontra familjerådgivningens.

    Flera behandlare berättar att parrelationen inte inledningsvis är i fokus, men att parrelationen många gånger senare i behandlingen lyfts upp, för att behandlaren inte kan undgå att se hur den påverkar barnet.

    Samtliga behandlare berättar om positiva erfarenheter av att ha arbetat med parrelationen. De positiva erfarenheterna handlar både om att barnets symtom har upphört och om att föräldrarnas relation har förbättrats.

    Studien har gjort det tydligt att det inte är enkelt att avgöra vad som ska fokuseras på och vad som ska uteslutas i ett behandlingsarbete på en familjemottagning, när föräldrar söker för symtom hos

  • 147. Conradsson, D.
    et al.
    Friden, C.
    Nilsson-Wikmar, L.
    Äng, Björn
    Ankle-joint mobility and standing squat posture in elite junior cross-country skiers. A pilot study2010In: Journal of Sports Medicine and Physical Fitness, ISSN 0022-4707, E-ISSN 1827-1928, Vol. 50, no 2, p. 132-8Article in journal (Refereed)
  • 148. Courteille, O.
    et al.
    Ho, Johnson
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Fahlstedt, Madelen
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Fors, U.
    Felländer-Tsai, L.
    Hedman, L.
    Möller, H.
    Face validity of VIS-Ed: A visualization program for teaching medical students and residents the biomechanics of cervical spine trauma2013In: Medicine Meets Virtual Reality 20, IOS Press, 2013, p. 96-102Conference paper (Refereed)
    Abstract [en]

    This RCT study aimed to investigate if VIS-Ed (Visualization through Imaging and Simulation - Education) had the potential to improve medical student education and specialist training in clinical diagnosis and treatment of trauma patients. The participants' general opinion was reported as high in both groups (lecture vs. virtual patient (VP)). Face validity of the VIS-Ed for cervical spine trauma was demonstrated and the VP group reported higher stimulation and engagement compared to the lecture group. No significant difference in the knowledge test between both groups could be observed, confirming our null hypothesis that VIS-Ed was on par with a lecture.

  • 149. Courteille, Olivier
    et al.
    Fahlstedt, Madelen
    Ho, Johnson
    Hedman, Leif
    Umeå University, Faculty of Social Sciences, Department of Psychology.
    Fors, Uno
    Von Holst, Hans
    Felländer-Tsai, Li
    Möller, Hans
    Learning through a virtual patient vs. recorded lecture: a comparison of knowledge retention in a trauma case2018In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 9, p. 86-92Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare medical students' and residents' knowledge retention of assessment, diagnosis and treatment procedures, as well as a learning experience, of patients with spinal trauma after training with either a Virtual Patient case or a video-recorded traditional lecture. Methods: A total of 170 volunteers (85 medical students and 85 residents in orthopedic surgery) were randomly allocated (stratified for student/resident and gender) to either a video-recorded standard lecture or a Virtual Patient-based training session where they interactively assessed a clinical case portraying a motorcycle accident. The knowledge retention was assessed by a test immediately following the educational intervention and repeated after a minimum of 2 months. Participants' learning experiences were evaluated with exit questionnaires. A repeated-measures analysis of variance was applied on knowledge scores. A total of 81% (n = 138) of the participants completed both tests. Results: There was a small but significant decline in first and second test results for both groups (F-(1,F-135) = 18.154, p = 0.00). However, no significant differences in short-term and long-term knowledge retention were observed between the two teaching methods. The Virtual Patient group reported higher learning experience levels in engagement, stimulation, general perception, and expectations. Conclusions: Participants' levels engagement were reported in favor of the VP format. Similar knowledge retention was achieved through either a Virtual Patient or a recorded lecture.

  • 150.
    Cronelöv, Mathilda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förekomst av corneal och conjunctival hyperfluorescens associerad till skötselprodukter i kombination med kontaktlinsen Biofinity2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to evaluate if a greater amount of preservative-associated transient hyperfluorescence (PATH) is appearing when using a multipurpose-solution compared to using a hydrogen peroxide system as a cleaning and disinfecting scheme for contact lenses.

     

    The subjects who participated in this study were contact lens wearers and had healthy eyes. Subjects were fitted with the soft contact lens Biofinity. The cornea and conjunctiva were examined with and without the color agent fluorescein using a slit lamp. The subjects received two different contact lens care systems: Refine One Step and BioTrue. The subjects were randomly assigned which lens that would go with which care system. The subjects came back the next day after having the contact lenses in the eyes for two hours. The contact lenses were removed, and fluorescein was instilled in order to grade corneal and conjunctival staining with the slit lamp. The contact lenses were then inserted again. The subject then came back after having the contact lenses in the eyes for four hours and another grading of corneal and conjunctival staining with the slit lamp was made. Seven and fourteen days later the subjects came back for the same procedure as day two.

     

    Mean values for PATH when using both of the contact lens solutions (BioTrue and Refine One Step) were calculated and a paired t-test was used to analyze the results: BioTrue visit 1-2 (p<0.05), 3-4 (p<0.05) and 5-6 (p<0.05); Refine One Step visit 1-2 (p=1), 3-4 (p=0.42) and 5-6 (p=1). This shows a statistically significant difference between PATH and PHMB-based contact lens solutions and silicone hydrogel contact lenses; no statistically significant difference between PATH and contact lens care system containing hydrogen peroxide in combination with a silicone hydrogel contact lens.

     

    PATH is appearing when combining a silicone hydrogel contact lens together with a multipurpose solution containing the preservative agent PHMB but gave no decreased comfort. In the clinical work PATH is non-significant, the presence of PATH does not show bio incompatibility between silicone hydrogel lenses and preservative agents but is simply the fluorescein which binds to the preservative agent PHMB.

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