| 1. |
- Bergström, Gunnar, Professor, et al.
(författare)
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Long-term, non-specific spinal pain: reliable and valid subgroups of patients
- 2001
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Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 39:1, s. 75-87
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to identify reliable and valid subgroups of spinal pain patients, using data from the Swedish version of the Multidimensional Pain Inventory (MPI-S). A second aim was to test the generalisability of the three patient profiles described in earlier studies on the MPI (”adaptive coper”, ”dysfunctional” and ”interpersonally distressed” patients). The study base consisted of two samples of individuals suffering from long-term, non-specific spinal pain and the results were validated across these samples. Cluster analysis was used to detect distinct groups of patients and the validity of these subgroups was evaluated on variables not used to generate the cluster solution. One subgroup was characterised by lower pain severity, lower interference with everyday activities, lower affective distress and higher life control than the other two subgroups. This patient profile was similar to the MPI adaptive coper patients. A second subgroup resembled the dysfunctional patient profile, thus displaying a worse adjustment to chronic pain than the AC patients. The third patient group reported significantly lower levels of social support from “significant others” than the other subgroups. This patient profile was similar to that of the interpersonally distressed patient group. Taken together, the results support the reliability, validity and generalisability of three subgroups of chronic pain patients derived from the MPI-S.
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| 2. |
- Bergström, Gunnar, Professor, et al.
(författare)
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The impact of psychologically different patient groups on outcome after a vocational rehabilitation program for long-term spinal pain patients
- 2001
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Ingår i: Pain. - : LWW. - 0304-3959 .- 1872-6623. ; 93:3, s. 229-237
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Tidskriftsartikel (refereegranskat)abstract
- A better knowledge of differential treatment outcomes for subgroups of chronic spinal pain patients may, for instance, help clinicians in treatment planning or pain researchers in treatment outcome research. The purpose of this prospective study was to evaluate the predictive validity of a subgroup classification based on the Swedish version of the (West Haven Yale) Multidimensional Pain Inventory, the MPI-S. Patients referred to a vocational rehabilitation program were classified into one of three groups, labeled ‘adaptive copers’, ‘dysfunctional’ patients, and ‘interpersonally distressed’ patients, and followed over an 18-month follow-up period. The outcome variables were absence from work (defined as sick listing plus early retirement), general health status, and utilization of health care resources. To our knowledge, the predictive validity of the MPI subgroups has not been evaluated regarding sick listing and early retirement after rehabilitation. As hypothesized, the results showed that the ‘dysfunctional’ patient group had significantly more registered absences from work and reported higher utilization of health care, over the follow-up period compared to the ‘adaptive copers’. Furthermore, as hypothesized, the ‘interpersonally distressed’ and ‘dysfunctional’ patient groups report a poorer general health status than the ‘adaptive copers’ over the whole follow-up period. However, contrary to our hypothesis, the proportion of improved patients did not differ significantly between the subgroups. Altogether, the predictive validity of the MPI-S subgroup classification was mainly confirmed. The clinical implications of this study suggest that the matching of treatment to patient needs may enhance treatment outcome, reduce pain and suffering among chronic spinal pain patients and facilitate a better health economic allocation of treatment resources.
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| 3. |
- Björkqvist, Maria, et al.
(författare)
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Defective neutrophil oxidative burst in preterm newborns on exposure to coagulase-negative staphylococci
- 2004
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Ingår i: Pediatric Research. - : Springer Science and Business Media LLC. - 0031-3998 .- 1530-0447. ; 55:6, s. 966-971
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Tidskriftsartikel (refereegranskat)abstract
- The neutrophil oxidative burst is a product of the regulated assembly of the multicomponent oxidase enzyme. Our aim was to compare the oxidative burst in term (n = 10) and preterm newborns <31 wk gestational age (n = 10) after stimulation with coagulase-negative staphylococci in vitro. Strains of Streptococcus epidermidis with different invasive and slime-producing properties, one strain of S. haemolyticus, and one strain of group B-streptococcus were investigated. A whole-blood flow cytometric assay using the oxidation of hydroethidine to ethidium bromide was used. The oxidative activity in unstimulated neutrophil granulocytes [polymorphonuclear leukocytes (PMNLs)] was similar in term and preterm newborns, but the preterm newborns showed a significantly lower capacity to up-regulate the oxidative burst intensity after bacterial stimulation (p = 0.004). In the term but not in the preterm group, the oxidative burst intensity after bacterial stimulation correlated with the baseline oxidative burst intensity. After bacterial stimulation, there was a trend toward a greater percentage of activated neutrophils in the term group than in the preterm group, but the difference was less pronounced than that in oxidative burst intensity. Significant differences in oxidative burst response to different bacterial strains were observed (p < 0.001), but the differences could not be correlated exclusively to invasive capacity or slime-producing properties. It is concluded that the baseline oxidative activity is similar in term and preterm PMNLs but that preterm PMNLs have a decreased capacity to increase the oxidative burst in response to bacterial stimulation.
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| 4. |
- Emilsson, Kent, 1963-, et al.
(författare)
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Comparison between angiographic right coronary artery motion and echocardiographic tricuspid annulus motion
- 2004
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 38:2, s. 85-92
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare echocardiographic M-mode measurements of tricuspid annulus motion (TAM) with angiographic M-mode measurements of right coronary artery motion (RAM).DESIGN: Twenty-four patients were included and examined by echocardiography before the angiographic examination. The amplitudes and the velocities of TAM and the atrial contribution to the total amplitude of TAM were measured. The obtained values were compared with angiographic M-mode measurements of RAM at a proximal and a distal site of the second segment of the right coronary artery.RESULTS: There was no significant difference between several of the echocardiographic M-mode measurements of TAM and the angiographic M-mode measurements of RAM. However, the agreement was rather poor for some variables.CONCLUSION: Different parameters obtained from echocardiographic TAM are not interchangeable with values from angiographic RAM. If measurements of RAM are to be used in the assessment of right ventricular (RV) function further studies are needed to examine the correlation and agreement between RAM and different methods of measuring RV function, i.e. radionuclide angiography or magnetic resonance imaging.
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| 5. |
- Halfvarson, Jonas, 1970-, et al.
(författare)
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Inflammatory bowel disease in a Swedish twin cohort : a long-term follow-up of concordance and clinical characteristics
- 2003
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Ingår i: Gastroenterology. - 0016-5085 .- 1528-0012. ; 124:7, s. 1767-1773
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Tidskriftsartikel (refereegranskat)abstract
- Background & Aims:In 1988, we reported the first twin study in inflammatory bowel disease. The aim of the current study was to follow up these twins regarding new cases of inflammatory bowel disease and Crohn’s disease characteristics using the Vienna classification.Methods:The official Swedish population register and the cause of death register were used to search for the twins. All living patients were interviewed.Results:Three monozygotic twins earlier classified as healthy had been diagnosed with inflammatory bowel disease (ulcerative colitis, n = 2; Crohn’s disease, n = 1). Retrospectively, all 3 were symptomatic at the original survey. This changed the pair concordance in monozygotic twins from 6.3% to 18.8% in ulcerative colitis and from 44.4% to 50.0% in Crohn’s disease. A high degree of concordance regarding age at diagnosis, disease location at diagnosis and during the course, and disease behavior was found in concordant monozygotic twin pairs with Crohn’s disease. Seven of 9 pairs were identical in 3 or more of these disease characteristics compared with an expected number of 1.5 (P = 0.000076).Conclusions:This study confirms that the genetic influence is stronger in Crohn’s disease than in ulcerative colitis. A remarkable phenotype similarity within concordant pairs with Crohn’s disease was found using the Vienna classification.
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| 6. |
- Halfvarson, Jonas, 1970-, et al.
(författare)
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Inflammatory bowel disease in a Swedish twin cohort : a long-term follow-up of concordance and clinical characteristics
- 2003
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Ingår i: Gastroenterology. - : Elsevier BV. - 0016-5085 .- 1528-0012. ; 124:7, s. 1767-1773
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND & AIMS: In 1988, we reported the first twin study in inflammatory bowel disease. The aim of the current study was to follow up these twins regarding new cases of inflammatory bowel disease and Crohn's disease characteristics using the Vienna classification.METHODS: The official Swedish population register and the cause of death register were used to search for the twins. All living patients were interviewed.RESULTS: Three monozygotic twins earlier classified as healthy had been diagnosed with inflammatory bowel disease (ulcerative colitis, n = 2; Crohn's disease, n = 1). Retrospectively, all 3 were symptomatic at the original survey. This changed the pair concordance in monozygotic twins from 6.3% to 18.8% in ulcerative colitis and from 44.4% to 50.0% in Crohn's disease. A high degree of concordance regarding age at diagnosis, disease location at diagnosis and during the course, and disease behavior was found in concordant monozygotic twin pairs with Crohn's disease. Seven of 9 pairs were identical in 3 or more of these disease characteristics compared with an expected number of 1.5 (P = 0.000076).CONCLUSIONS: This study confirms that the genetic influence is stronger in Crohn's disease than in ulcerative colitis. A remarkable phenotype similarity within concordant pairs with Crohn's disease was found using the Vienna classification.
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| 7. |
- Hermansson, Liselotte, 1954-, et al.
(författare)
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Upper limb deficiencies in Swedish children : a comparison between a population-based and a clinic-based register
- 2001
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Ingår i: Early Human Development. - 0378-3782 .- 1872-6232. ; 63:2, s. 131-144
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To validate information in the Swedish Register for Congenital Malformations (SRCM).METHODS: A comparison was made with a clinic-based register kept at the Limb Deficiency and Arm Prosthesis Centre (LDAPC). The report frequency and the quality of the information in SRCM were analysed. Cases were classified according to a detailed, clinically relevant classification, the ISO 8548-1:89 method.OUTCOME MEASURES: The completeness of SRCM was first estimated. The Kappa statistic was then used to assess the agreement between the two registers regarding individual categories and across all categories.RESULTS: For the period 1973-1987, we found 125 cases of upper limb reduction deficiencies (ULRD) in the clinic-based register, of which 117 was found in the national register. The completeness of SRCM was thus estimated to be 94% (95% confidence interval 89-98%). The inter-register agreement varied from almost perfect agreement in laterality of deficiency (Kappa 0.98) to substantial agreement in type and level of deficiency (Kappa 0.72-0.79). For specific levels of transverse deficiency, however, the agreement varied between -0.05 and 0.66.CONCLUSIONS: The results indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.
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| 8. |
- Härenstam, Annika, et al.
(författare)
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Patterns of working and living conditions : a holistic, multivariate approach to occupational health studies
- 2003
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Ingår i: Work & Stress. - : Informa UK Limited. - 0267-8373 .- 1464-5335. ; 17:1, s. 73-92
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to develop a multivariate approach to occupational health studies that is: capable of identifying groups with similar working conditions; relevant for studies of associations between working and living conditions and health; and an appropriate basis for preventive actions. Data at the individual level were obtained through measurements, observations, interviews and questionnaires, and at the organizational level, through interviews with managers. Cluster analyses were applied with the purpose of identifying groups of individuals with small, within-group differences. Eighty work sites and a sample of employees at each site were strategically selected. The study group comprised 203 men and women, and was characterized by large variation. The final analysis produced eight clusters of individuals, denoted according to their best-defining characteristic, i.e. 'decent', 'boundary-less', 'locked', 'exposed', 'heavy and monotonous', 'changed', 'mobile' and 'restrained'. The clusters differed with regard to 'what' characterized working conditions, 'where' on the labour market they were found, and 'who' clustered in these groups. The holistic approach revealed conditions that were important for health and had higher explanatory power in relation to ill-health than applying socio-economic groupings or the demand-control-support model. It showed how psychosocial, ergonomic-physical and occupational hygiene factors combine and interact to create settings with different risks of ill-health. The chosen strategy is recommended for future occupational health studies and is particularly suitable as guidance for preventive actions relevant to specific clusters of working and living conditions.
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| 9. |
- Härenstam, Annika, 1949, et al.
(författare)
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Patterns of working and living conditions. A person-oriented, multivariate approach for occupational health studies
- 2003
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Ingår i: Work & Stress. - 0267-8373. ; 17:1, s. 73-92
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to develop a multivariate approach to occupational health studies that is: capable of identifying groups with similar working conditions; relevant for studies of associations between working and living conditions and health; and an appropriate basis for preventive actions. Data at the individual level were obtained through measurements, observations, interviews and questionnaires, and at the organizational level, through interviews with managers. Cluster analyses were applied with the purpose of identifying groups of individuals with small, within-group differences. Eighty work sites and a sample of employees at each site were strategically selected. The study group comprised 203 men and women, and was characterized by large variation. The final analysis produced eight clusters of individuals, denoted according to their best-defining characteristic, i.e. ‘decent’, ‘boundary-less’, ‘locked’, ‘exposed’, ‘heavy and monotonous’, ‘changed’, ‘mobile’ and ‘restrained’. The clusters differed with regard to ‘what’ characterized working conditions, ‘where’ on the labour market they were found, and ‘who’ clustered in these groups. The holistic approach revealed conditions that were important for health and had higher explanatory power in relation to illhealth than applying socio-economic groupings or the demand-control-support model. It showed how psychosocial, ergonomic-physical and occupational hygiene factors combine and interact to create settings with different risks of ill-health. The chosen strategy is recommended for future occupational health studies and is particularly suitable as guidance for preventive actions relevant to specific clusters of working and living conditions.
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| 10. |
- Jackson, Karin, 1947-, et al.
(författare)
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Utilization of healthcare by very-low-birthweight infants during their first year of life
- 2001
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 90:2, s. 213-217
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Tidskriftsartikel (refereegranskat)abstract
- New knowledge in perinatal medicine has resulted in increased survival of very-low-birthweight (VLBW) infants. After leaving hospital, the child is seen at regular medical check-ups, but there is often a persistent worry about the child which affects the family as a whole. This can lead to an increased utilization of healthcare. Our objective was therefore to describe the utilization of healthcare by VLBW infants during their first year of life and its relation to high-risk diagnoses in the neonatal period. The study group comprised 36 infants born at gestational ages of < or = 31 wk and with a birthweight of < or = 1500 g, and was compared with a control group of 36 full-term infants. Utilization of healthcare by the VLBW infants was higher than that by the control group in paediatric and ophthalmic outpatient clinics. The total number of contacts with healthcare was on average 38.7 versus 17.4. High-risk diagnoses in the neonatal period did not correlate with utilization of care, except for visits to the paediatric outpatient clinic, especially planned visits. Further studies focusing on how to support these families after leaving hospital are therefore needed.
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