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- Balldin, J, et al.
(författare)
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A 6-month controlled naltrexone study: Combined effect with cognitive behavioral therapy in outpatient treatment of alcohol dependence
- 2003
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Ingår i: Alcoholism: Clinical and Experimental Research. - 0145-6008 .- 1530-0277. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: In several studies, patients with alcohol dependence treated with the opioid antagonist naltrexone have shown fewer relapses to heavy drinking than those receiving placebo. An interaction between the naltrexone effect and the type of psychological therapy has been observed. Methods: A 6-month, double-blind, placebo-controlled, parallel-group study was performed at 10 different investigation sites. After a placebo run-in period of 1 week, 118 patients were randomized into 4 treatment groups—50 mg of naltrexone daily or placebo in combination with either cognitive behavioral therapy (CBT) or supportive therapy. The CBT was performed over nine sessions according to the manual of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity). The supportive therapy was defined as "the treatment as usual." Alcohol consumption, craving, carbohydrate-deficient transferrin, medication compliance by tablet count, and adverse clinical events were assessed at all visits. Other liver enzymes and psychiatric symptoms were also determined. Results: Ninety-one (77%) patients completed the study, and 92 (78%) were 80% compliant with the medication regimen. A lower percentage of heavy-drinking days was shown in the naltrexone group (p = 0.045) compared with the placebo group, as was a lower craving score (p = 0.029). These results are supported by the lower levels of liver enzyme activities (p < 0.010 for aspartate aminotransferase, alanine aminotransferase, and γ-glutamyltransferase), but not by the carbohydrate-deficient transferrin levels, in the naltrexone group. The mean time period before the first day of heavy drinking was longer for the group treated with CBT (p = 0.010), especially in combination with naltrexone (p = 0.007). Naltrexone was well tolerated, and no patients discontinued the study due to side effects. Conclusions: This study supports the effect of naltrexone in outpatient treatment of alcohol dependence and suggests that a beneficial interaction effect with CBT can be expected.
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- Berglund, Anders, 1974-
(författare)
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Two facets of Innovation in Engineering Education : The interplay of Student Learning and Curricula Design
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis covers two main perspectives ofinnovation; first, innovation is regarded as an outcome-related mechanism wherelearning is expressed through artefact presentations at the end of adevelopment process; second, innovation comprises a change mechanism in theprocess of student learning, influencing educators to reconsider new methods andpractices. Building on qualitative data from engineering design courses, theaim has been to explore how learning elements in engineering educationinfluence students during early-phase innovation. By implementing andpracticing learning elements, early-phase innovation could strengthen both currentand future engineering curricula, courses, and programmes.This thesis put attention to authentic experiences in which learning elementsis acted upon by students and targeted, defined, and refined by educators.Introducing learning elements need educators to manifest learning efforts moreexplicitly to match students’ capability to interpret new knowledge. Adoptinglearning elements that challenge existing paths of action are characterized by diversity, proactivity, opennessand motivation. For students to excel in the exploration of early-phaseinnovation, it is important to identify when, how and to what extent leaningelements can be reinforced. Thestrengthened understanding by students is mirrored in improved ability to takeaction and apply relevant knowledge in distinct learning situations. Theopportunity to influence student learning provides the design and redesign of curricula,courses and programmes as a prime feature to leaning elements relevant to early-phaseinnovation. To successfully pursue innovation in engineering education abalance is necessary between responsible actors integrating learning elementsand by those determined to learn.
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- Brunnberg, Elinor, 1948-, et al.
(författare)
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Hard-of-hearing adolescents reporting some other disability or tinnitus : a replication study including an age-related analysis
- 2009
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In two previous studies based on the survey, Life & Health Young 2005 in Örebro county 15-16 years old Hard-of-hearing (HH) students with some other disability (HHDIS) and HH with tinnitus (HHTINN) reported considerably higher scores for mental symptoms and substance use than adolescents ‘just‘ HH or hearing adolescents. In order to replicate these findings we analysed the 2007 survey and included adolescents in grade 7, 9 and 2 in secondary school concerning substance use and depression. We also used reference data from the corresponding adult survey Life & Health 2008. In grade 9 HHDIS (2.0%) and HHTINN (2.0 %) both reported strongly increased rates of risky alcohol consumption (55/51% versus 13%), daily tobacco use (57/54% versus 10%) and depression (43/43% versus 14%) than hearing or ´just´ HH adolescents. Similar but less pronounced changes were present in grade 7 and grade 2. In HHDIS increased risk drinking was found until age 35, increased daily tobacco use until age 50 and increased depression until age 65. In HHTINN only rate of depression was increased in adult life. HHDIS and HHTINN thus are important targets for preventive measures. In addition tinnitus in young people can be a marker like disability of vulnerability.
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- Brunnberg, Elinor, et al.
(författare)
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School adjustment, mental symptoms and substance use in 16 year old students with hearing impairment and other disabilities
- 2007
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Konferensbidrag (refereegranskat)abstract
- There are few studies on substance use, mental symptoms and school problems in adolescents with multi-disabilities. This survey, “Life and health-young 2005”, included all children in mainstream schools class 9 in the county of Örebro, Sweden. Children attending special schools for deaf/hard-of-hearing and multi-disabled children were not included. There were 56 (1.9%) hard-of-hearing students with some other disability, 93 (3.1%) ‘just hard-of-hearing’ students, 282 (9.7%) students with some other disability than hearing impairment and 2488 (85.2%) without a disability. Hard-of-hearing/other disability group of students reported considerably higher scores on mental symptoms, substance use and school problems than the others. A logistic regression analysis showed that mental symptoms explained 17% of the variance, alcohol and drugs 15% and school problems 9%. The final model explained 24% and included use of illegal drugs (OR 8.3), often irritated (OR 4.2), feeling bad (OR 3.2) and bullied (OR 2.2). In the hard-of-hearing/other disability group 43% reported at least 2 of these symptoms and in the other groups 17%, 18% and 8%, respectively. The combination of hearing impairment and other disabilities increases the risk for mental symptoms, substance use and school problems. This group of students in mainstream schools ought to be an important target for preventive efforts.
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