| 11. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Evaluation of skin reactions during proton beam radiotherapy – Patient-reported versus clinician-reported
- 2021
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Ingår i: Technical Innovations and Patient Support in Radiation Oncology. - : Elsevier Ireland Ltd. - 2405-6324. ; 19, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Skin reaction is a common side-effect of radiotherapy and often only assessed as clinician-reported outcome (CRO). The aim was to examine and compare patient-reported outcome (PRO) of skin reactions with CRO for signs of acute skin reactions for patients with primary brain tumour receiving proton beam radiotherapy (PBT). A further aim was to explore patients’ experiences of the skin reactions. Methods: Acute skin reactions were assessed one week after start of treatment, mid-treatment and end of treatment among 253 patients with primary brain tumour who underwent PBT. PRO skin reactions were assessed with the RSAS and CRO according to the RTOG scale. Fleiss’ kappa was performed to measure the inter-rater agreement of the assessments of skin reactions. Results: The results showed a discrepancy between PRO and CRO acute skin reactions. Radiation dose was associated with increased skin reactions, but no correlations were seen for age, gender, education, occupation, other treatment or smoking. There was a poor agreement between patients and clinicians (κ = −0.016) one week after the start of PBT, poor (κ = −0.045) to (κ = 0.396) moderate agreement at mid treatment and poor (κ = −0.010) to (κ = 0.296) moderate agreement at end of treatment. Generally, patients’ symptom distress toward skin reactions was low at all time points. Conclusion: The poor agreement between PRO and CRO shows that the patient needs to be involved in assessments of skin reactions for a more complete understanding of skin reactions due to PBT. This may also improve patient experience regarding involvement in their own care. © 2021 The Author(s)
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| 12. |
- Turunen, Jani, et al.
(författare)
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How do children and adolescents of separated parents sleep? : An investigation of custody arrangements, sleep habits, sleep problems, and sleep duration in Sweden
- 2021
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 7:6, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: An increasing number of children and adolescents divide their time between their separated parents' homes. Although marital conflict is disadvantageous for children's sleep, little is known about how children of separated parents sleep. The objective was to investigate the association between children's cus-tody arrangements and sleep habits and sleep initiation difficulties. Design: Cross sectional nationally representative samples of adolescents from the WHO study Health Behav-iour in School-aged Children (HBSC) (n = 11,802). Setting: Sweden in 2013/2014 and 2017/2018. Participants: Adolescents in grades 5, 7, and 9 from Swedish compulsory comprehensive school. Measurements: The survey included questions on sleep behaviors including bedtime, wake-up time and fre-quency of sleep onset problems. The analysis methods used were ordinary least squares and logistic regression. Results: The results show differences by custody arrangement, but they are not uniform across the dependent variables. Children and adolescents in sole maternal custody were less likely to sleep as much as recommended (P < .001), more likely to have late bedtimes (P < .001), report sleep initiation difficulties (P < .01) and to report social jetlag between school mornings and weekends (P < .05) compared to those in 2-parent families. Shared physical custody was associated with a higher likelihood of late bedtimes (P < .05) and sleep initiation difficulties (P < .05) compared to those in 2-parent families, but not of sleeping less than recommended or reporting social jetlag. Less-than-equal sharing was generally associated with worse sleep than in 2-parent families. Conclusions: As custody arrangements seem to be associated with sleep, it is important to understand the mechanisms behind the findings.
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| 13. |
- Callaghan, Terry, et al.
(författare)
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Multi-Decadal Changes in Tundra Environments and Ecosystems : Synthesis of the International Polar Year-Back to the Future Project (IPY-BTF)
- 2011
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Ingår i: Ambio. - : Springer Science and Business Media LLC. - 0044-7447 .- 1654-7209. ; 40:6, s. 705-716
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Tidskriftsartikel (refereegranskat)abstract
- Understanding the responses of tundra systemsto global change has global implications. Most tundraregions lack sustained environmental monitoring and oneof the only ways to document multi-decadal change is toresample historic research sites. The International PolarYear (IPY) provided a unique opportunity for such researchthrough the Back to the Future (BTF) project (IPY project#512). This article synthesizes the results from 13 paperswithin this Ambio Special Issue. Abiotic changes includeglacial recession in the Altai Mountains, Russia; increasedsnow depth and hardness, permafrost warming, andincreased growing season length in sub-arctic Sweden;drying of ponds in Greenland; increased nutrient availabilityin Alaskan tundra ponds, and warming at mostlocations studied. Biotic changes ranged from relativelyminor plant community change at two sites in Greenland tomoderate change in the Yukon, and to dramatic increasesin shrub and tree density on Herschel Island, and in subarcticSweden. The population of geese tripled at one sitein northeast Greenland where biomass in non-grazed plotsdoubled. A model parameterized using results from a BTFstudy forecasts substantial declines in all snowbeds andincreases in shrub tundra on Niwot Ridge, Colorado overthe next century. In general, results support and provideimproved capacities for validating experimental manipulation,remote sensing, and modeling studies.
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| 14. |
- Jansson-Fröjmark, Markus, et al.
(författare)
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Stimulus control for insomnia : A systematic review and meta-analysis
- 2024
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 33:1
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Tidskriftsartikel (refereegranskat)abstract
- Stimulus control (SC) is commonly viewed as an evidence-based treatment for insomnia, but it has not been evaluated comprehensively with modern review and meta-analytic techniques. The aim of the current study was thus to perform a systematic review and meta-analysis of trials that examine the efficacy of stimulus control for insomnia. A systematic search for eligible articles and dissertations was conducted in six online bibliographic databases. The 11 included studies, with the majority published between 1978 and 1998, were randomised controlled and experimental studies in adults, comparing stimulus control for insomnia with passive and active comparators and assessing insomnia symptoms as outcomes. A random effects model was used to determine the standardised mean difference Hedge's g at post-treatment and follow-up for three sleep diary measures: the number of awakenings, sleep onset latency, and total sleep time. A test for heterogeneity was conducted, forest plots were produced, the risk of publication bias was estimated, and the study quality was assessed. In the trials identified, stimulus control resulted in small to large improvements on sleep onset latency and total sleep time, relative to passive comparators (g = 0.38-0.85). Compared with active comparators, the improvements following stimulus control were negligible (g = 0.06-0.30). Although methodological uncertainties were observed in the included trials, stimulus control appears to be an efficacious treatment for insomnia when compared with passive comparators and with similar effects to active comparators. More robust studies are, however, warranted before stronger conclusions are possible to infer.
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| 15. |
- Jourdain, Elsa, et al.
(författare)
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Influenza Virus in a Natural Host, the Mallard : Experimental Infection Data
- 2010
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 5:1
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Tidskriftsartikel (refereegranskat)abstract
- Wild waterfowl, particularly dabbling ducks such as mallards (Anas platyrhynchos), are considered the main reservoir of low-pathogenic avian influenza viruses (LPAIVs). They carry viruses that may evolve and become highly pathogenic for poultry or zoonotic. Understanding the ecology of LPAIVs in these natural hosts is therefore essential. We assessed the clinical response, viral shedding and antibody production of juvenile mallards after intra-esophageal inoculation of two LPAIV subtypes previously isolated from wild congeners. Six ducks, equipped with data loggers that continually monitored body temperature, heart rate and activity, were successively inoculated with an H7N7 LPAI isolate (day 0), the same H7N7 isolate again (day 21) and an H5N2 LPAI isolate (day 35). After the first H7N7 inoculation, the ducks remained alert with no modification of heart rate or activity. However, body temperature transiently increased in four individuals, suggesting that LPAIV strains may have minor clinical effects on their natural hosts. The excretion patterns observed after both reinoculations differed strongly from those observed after the primary H7N7 inoculation, suggesting that not only homosubtypic but also heterosubtypic immunity exist. Our study suggests that LPAI infection has minor clinically measurable effects on mallards and that mallard ducks are able to mount immunological responses protective against heterologous infections. Because the transmission dynamics of LPAIVs in wild populations is greatly influenced by individual susceptibility and herd immunity, these findings are of high importance. Our study also shows the relevance of using telemetry to monitor disease in animals.
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| 16. |
- Störe, Siri Jakobsson, et al.
(författare)
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Mind, Body and Machine : Preliminary Study to Explore Predictors of Treatment Response After a Sleep Robot Intervention for Adults with Insomnia
- 2023
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Ingår i: Nature and Science of Sleep. - : Dove Medical Press. - 1179-1608. ; 15, s. 567-577
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The study aimed to explore characteristics of responders to a sleep robot intervention for adults with insomnia, and the likelihood that participants responded to the intervention. Methods: Data from the intervention and the control group in a randomized waitlist-controlled trial (n = 44) were pooled together after both had undergone the intervention. A repeated measures ANOVA and Friedman tests were used to explore changes over time. Differences in baseline characteristics between responders (n = 13), defined as a reduction of -5 on the Insomnia Severity Index from pre- to post-intervention, and non-responders (n = 31) were analyzed with t-tests and chi-square tests. Finally, logistic regression models were estimated.Results: Baseline anxiety was the only statistically significant difference between responders and non-responders (p = 0.03). A logistic regression model with anxiety and sleep quality as predictors was statistically significant, correctly classifying 83.3% of cases. Discussion: The results imply that people with lower anxiety and higher sleep quality at baseline are more likely to report clinically significant improvements in insomnia from the sleep robot intervention.
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| 17. |
- Störe, Siri Jakobsson, et al.
(författare)
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The effects of a sleep robot intervention on sleep, depression and anxiety in adults with insomnia : A randomized waitlist-controlled trial
- 2022
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Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 32:3
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Tidskriftsartikel (refereegranskat)abstract
- The study objective was to assess if a 3-week intervention with the Somnox sleep robot had effects on symptoms of insomnia, somatic arousal, and/or concurrent symptoms of depression and anxiety in adults with insomnia, compared with a waitlist-control group. The participants (n = 44) were randomized to a 3-week intervention with the sleep robot (n = 22), or to a waitlist-control group (n = 22). The primary outcome measure was the Insomnia Severity Index administered at baseline, mid-intervention, post-intervention and at 1-month follow-up. Secondary outcome measures were the Pre-Sleep Arousal Scale, and the Hospital Anxiety and Depression Scale. Additionally, sleep-onset latency, wake time after sleep onset, total sleep time and sleep efficiency were measured the week prior to and the last week of the intervention, both subjectively with the Consensus Sleep Diary and objectively with wrist actigraphy. Mixed-effects models were used to analyse data. The effect of the sleep robot on the participants' insomnia severity was not statistically significant. The differences between the intervention group and the control group on the measures of arousal, anxiety and depression were also not statistically significant, and neither were the sleep diary and actigraphy variables. In conclusion, a 3-week intervention with daily at-home use of the robot was not found to be an effective method to relieve the symptom burden in adults with insomnia.
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| 18. |
- Thurang, Anna, 1968-, et al.
(författare)
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Womens experience of caring when in treatment for alcohol dependency
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 24:4, s. 700-706
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Tidskriftsartikel (refereegranskat)abstract
- Despite the fact of increased levels of alcohol dependency in women and gender differences in how the disease affects men and women, the research on alcohol dependency continues to have a dominating perspective on men. The meaning of the phenomenon of caring in formal care for women with alcohol dependency is not well known. Thus, formal caregivers may find it problematic to know what is caring for women with alcohol dependency. The aim of the study was to illuminate the meaning of caring in formal care for women with alcohol dependency, as narrated by the women. The study was performed using a phenomenological-hermeneutic method. Data were collected in ten in-depth interviews with alcohol-dependent women. The themes presented are availability, being a patient and being a learner. The findings reveal that the women with alcohol dependency receiving a mandate from formal care, experience the relation between them and their caregiver as a mutual transformation. Within the mutual transformation, the participants experienced being respected as a responsible human being which renders possibilities for the women with alcohol dependency to continue in formal care even when the struggle against the disease became hard. Continual meetings with the caregiver allowed the women to gain structure in their daily life as well as allowing the women and their caregivers to develop mutual transformation, which both relieved the women’s suffering and increased their experience of being involved in the care process
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| 19. |
- Sjövall, K., et al.
(författare)
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Evaluating patient reported outcomes and experiences in a novel proton beam clinic : challenges, activities, and outcomes of the ProtonCare project
- 2023
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Ingår i: BMC Cancer. - : Springer Nature. - 1471-2407 .- 1471-2407. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ProtonCare Study Group (PCSG) was formed with the purpose to develop and implement a framework for evaluation of proton beam therapy (PBT) and the related care at a novel clinic (Skandionkliniken), based on patient reported data.METHOD: A logic model framework was used to describe the process of development and implementation of a structured plan for evaluation of PBT for all diagnoses based on patient reported data. After the mission for the project was determined, meetings with networks and stakeholders were facilitated by PCSG to identify assumptions, resources, challenges, activities, outputs, outcomes, and outcome indicators. RESULT: This paper presents the challenges and accomplishments PCSG made so far. We describe required resources, activities, and accomplished results. The long-term outcomes that were outlined as a result of the process are two; 1) Improved knowledge about health outcomes of patients that are considered for PBT and 2) The findings will serve as a base for clinical decisions when patients are referred for PBT. CONCLUSION: Using the logical model framework proved useful in planning and managing the ProtonCare project. As a result, the work of PCSG has so far resulted in long-lasting outcomes that creates a base for future evaluation of patients' perspective in radiotherapy treatment in general and in PBT especially. Our experiences can be useful for other research groups facing similar challenges. Continuing research on patients´ perspective is a central part in ongoing and future research. Collaboration, cooperation, and coordination between research groups/networks from different disciplines are a significant part of the work aiming to determine the more precise role of PBT in future treatment options.
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| 20. |
- Beck, Ingela, et al.
(författare)
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Translation and cultural adaptation of the Integrated Palliative care Outcome Scale including cognitive interviewing with patients and staff
- 2017
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Ingår i: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To expand our clinical and scientific knowledge about holistic outcomes within palliative care, there is a need for agreed-upon patient-reported outcome measures. These patient-reported outcome measures then require translation and cultural adaptation, either from country-specific languages to English, or the other way around. The aim of this study was to translate and cross-culturally adapt the Integrated Palliative care Outcome Scale (IPOS) to the Swedish care context.METHODS: Swedish versions of IPOS Patient and IPOS Staff were developed and culturally adapted using recommended guidelines including cognitive interviews with patients (n = 13) and staff (n = 15) from different care contexts including general and specialised palliative care.RESULTS: The comprehension and judgement difficulties identified in the pre-final patient and staff versions were successfully solved during the cognitive interviewing process. IPOS was well accepted by both patients and staff, none of the questions were experienced as inappropriate, and all questions were judged important.CONCLUSIONS: In this study, we translated and culturally adapted the patient and staff versions of IPOS, and demonstrated face and content validity and acceptability of the scale through cognitive interviewing with patients and staff within residential care facility, surgical and specialised palliative home care units. Cognitive interviewing in parallel with patients and staff in rounds, with tentative analysis in between, was a suitable method for identifying and solving challenges with comprehension and evaluation in the pre-final version of IPOS. The Swedish IPOS is now available for use in a variety of clinical care settings.
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