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| 2. |
- Hetland, M. L., et al.
(författare)
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Active conventional treatment and three different biological treatments in early rheumatoid arthritis: phase IV investigator initiated, randomised, observer blinded clinical trial
- 2020
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Ingår i: Bmj-British Medical Journal. - : BMJ. - 1756-1833. ; 371
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE To evaluate and compare benefits and harms of three biological treatments with different modes of action versus active conventional treatment in patients with early rheumatoid arthritis. DESIGN Investigator initiated, randomised, open label, blinded assessor, multiarm, phase IV study. SETTING Twenty nine rheumatology departments in Sweden, Denmark, Norway, Finland, the Netherlands, and Iceland between 2012 and 2018. PARTICIPANTS Patients aged 18 years and older with treatment naive rheumatoid arthritis, symptom duration less than 24 months, moderate to severe disease activity, and rheumatoid factor or anti-citrullinated protein antibody positivity, or increased C reactive protein. INTERVENTIONS Randomised 1:1:1:1, stratified by country, sex, and anti-citrullinated protein antibody status. All participants started methotrexate combined with (a) active conventional treatment (either prednisolone tapered to 5 mg/day, or sulfasalazine combined with hydroxychloroquine and intraarticular corticosteroids), (b) certolizumab pegol, (c) abatacept, or (d) tocilizumab. MAIN OUTCOME MEASURES The primary outcome was adjusted clinical disease activity index remission (CDAI <= 2.8) at 24 weeks with active conventional treatment as the reference. Key secondary outcomes and analyses included CDAI remission at 12 weeks and over time, other remission criteria, a non-inferiority analysis, and harms. RESULTS 812 patients underwent randomisation. The mean age was 54.3 years (standard deviation 14.7) and 68.8% were women. Baseline disease activity score of 28 joints was 5.0 (standard deviation 1.1). Adjusted 24 week CDAI remission rates were 42.7% (95% confidence interval 36.1% to 49.3%) for active conventional treatment, 46.5% (39.9% to 53.1%) for certolizumab pegol, 52.0% (45.5% to 58.6%) for abatacept, and 42.1% (35.3% to 48.8%) for tocilizumab. Corresponding absolute differences were 3.9% (95% confidence interval -5.5% to 13.2%) for certolizumab pegol, 9.4% (0.1% to 18.7%) for abatacept, and -0.6% (-10.1% to 8.9%) for tocilizumab. Key secondary outcomes showed no major differences among the four treatments. Differences in CDAI remission rates for active conventional treatment versus certolizumab pegol and tocilizumab, but not abatacept, remained within the prespecified non-inferiority margin of 15% (per protocol population). The total number of serious adverse events was 13 (percentage of patients who experienced at least one event 5.6%) for active conventional treatment, 20 (8.4%) for certolizumab pegol, 10 (4.9%) for abatacept, and 10 (4.9%) for tocilizumab. Eleven patients treated with abatacept stopped treatment early compared with 20-23 patients in the other arms. CONCLUSIONS All four treatments achieved high remission rates. Higher CDAI remission rate was observed for abatacept versus active conventional treatment, but not for certolizumab pegol or tocilizumab versus active conventional treatment. Other remission rates were similar across treatments. Non-inferiority analysis indicated that active conventional treatment was non-inferior to certolizumab pegol and tocilizumab, but not to abatacept. The results highlight the efficacy and safety of active conventional treatment based on methotrexate combined with corticosteroids, with nominally better results for abatacept, in treatment naive early rheumatoid arthritis.
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| 4. |
- Lindqvist, Anna-Karin, et al.
(författare)
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User Perception of a Smartphone App to Promote Physical Activity through Active Transportation : An Inductive Qualitative Content Analysis within the Smart City Active Mobile Phone Intervention (SCAMPI) Study
- 2020
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Ingår i: JMIR mhealth and uhealth. - : JMIR Publications. - 2291-5222. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Physical inactivity is globally recognized as a major risk factor for morbidity, particularly the incidence of non-communicable diseases, and mortality. Engaging in active transportation (AT) is a viable approach toward increasing physical activity (PA) on a daily basis. Mobile (mHealth) interventions enable promoting AT to a larger population. The Smart City Active Mobile Phone Intervention (SCAMPI) study is a randomized controlled trial designed to evaluate a smartphone application (app)’s ability to motivate participants to increase their PA by engaging in AT.Objective: This qualitative study examines the acceptance and usability of the SCAMPI app from the participants’ perspectives.Methods: Seventeen residents of Stockholm county (13 women; age range 25-61 years), who had completed the three-month, app-based behavioral change program in the SCAMPI randomized controlled trial during 2018 agreed to participate in a semi-structured telephone-based interview. These 17 participants were well representative of the whole intervention group (n = 127) in terms of baseline characteristics such as age, sex, and area of residence. The interviews were audio-recorded, transcribed verbatim, and analyzed using inductive qualitative content analysis.Results: The content analysis revealed two themes and four subcategories. The first theme “Main motivators: monitoring and messages” highlighted that monitoring AT and being able to set weekly goals using the app were the primary motivators reported among study participants. The second theme “Acceptable but modifiable” reflects that the app was well accepted and effectively encouraged many participants to use more AT. Nevertheless, there were functions in the app that require modification. For example, while the automated travel tracking feature was appreciated, participants found it time-consuming and unreliable at times.Conclusions: This study contributes novel insight into healthy adults’ experiences of using a mobile app to promote the use of AT. The results showed that the app was well-accepted and that self-monitoring and goal setting were the main motivators to engage in more AT. The automated tracking of AT was appreciated; however, it was also reported to be energy- and time-consuming when it failed to work. Thus, this feature should be improved going forward.
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- Forsberg, Hanna, et al.
(författare)
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It’s about being the good parent : exploring attitudes and beliefs towards active school transportation
- 2020
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Ingår i: International Journal of Circumpolar Health. - : Taylor & Francis. - 1239-9736 .- 2242-3982. ; 79:1
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Tidskriftsartikel (refereegranskat)abstract
- In recent decades, there has been a decline in active school transportation (AST). Parents play an important role as the key decision-makers of children’s AST, and there is a need of more knowledge about the decision-making process and parents’ beliefs towards AST. The overall aim of this study was to explore parents’ attitudes and beliefs towards AST in the northern part of Sweden. Twenty parents participated in semi-structured interviews, which was based on the theory of planned behaviour. Qualitative content analysis was used to analyse the interviews. The analysis yielded one main theme, “Parenting and active school transportation – making route choices in a changed landscape” and four subthemes, “Knowing that it is beneficial while struggling with daily life”, “Considering barriers and solutions to enable AST”, “Parenting is challenging and about balancing”, and “Reflecting and contemplating about what we and others do”. Winter conditions affect parents’ decisions, and this needs to be considered when facilitating AST in these regions. Overall better health, increased physical activity, time spent outdoors, and free play were revealed as positive outcomes of AST. Decisions were also influenced by social norms and how the idea of parenting has changed through generations. The findings of this study are likely to be important when promoting AST.
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| 6. |
- Laine, Teemu H., et al.
(författare)
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A Distributed Multiplayer Game to Promote Active Transport at Workplaces : User-Centred Design, Implementation and Lessons Learned
- 2020
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Ingår i: IEEE Transactions on Games. - : IEEE. - 2475-1502 .- 2475-1510. ; 12:4, s. 386-397
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Tidskriftsartikel (refereegranskat)abstract
- Recent decline in active transport and increase in motorised transport decreases physical activity and increases air pollution. Using games to motivate people to change their behaviour towards active transport can mitigate this. We proposed Tic-Tac-Training, a distributed, collaborative and competitive game for promoting active transport at workplaces. Tic-Tac-Training was developed through a multidisciplinary and iterative user-centred design (UCD) process in four stages: (i) paper prototype, (ii) low-fidelity prototypes, (iii) high-fidelity prototypes, (iv) digital prototype. User testing and playtesting (N=12) yielded a number of improvement suggestions. We also analysed how Tic-Tac-Training supports the eight core drives of gamification (Octalysis), and presented 17 lessons learned in four categories. Findings suggest that UCD can be useful for developing exergame interventions for workplaces. Moreover, the lessons learned can benefit exergame designers. More research is needed to measure the behaviour change effect of Tic-Tac-Training and its applicability to other use cases.
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| 7. |
- Lindqvist, Anna-Karin, 1952-, et al.
(författare)
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Arkeologiska undersökningar av den förromerska boplatsen i Gene, Raä 59:1 i Själevads socken, Ångermanland
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Excavation report of an important site close to the farm from the Roman Iron Age and Migration Period site at Gene, in northern Ångermanland. The reported site shows new aspects of the transition from the traditional mobile and semi-mobile hunter-gatherer society to the new way of life style with three-aisled longe house and stalled animials. The closeness in time and space illuminate in a new way the how this transition took place. On this world-wide issue it is suggested that regional causes may be seeked.
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| 8. |
- Mikaelsson, Katarina, et al.
(författare)
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Physically inactive adolescents’ experiences of engaging in physical activity
- 2020
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Ingår i: European Journal of Physiotherapy. - : Taylor & Francis. - 2167-9169 .- 2167-9177. ; 22:4, s. 191-196
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to describe physically inactive adolescents’ experiences and reflections about engaging in physical activity. Methods: Nine graduate students from the third year of upper secondary school (six women and three men) participated in this study. Narrative interviews were used for data collection and qualitative content analysis was used to analyse the interviews. Results: The analysis revealed three themes ‘Acknowledging resistance and barriers to performing physical activity’, ‘Knowing that it is good is not enough’, and ‘Feeling included and accepted is fun and motivating’. These themes show that the adolescent’s experienced barriers, acknowledged pros and cons and identified possibilities to be physically active. Conclusions: Identifying experiences that impact on inactive adolescents’ attitude and willingness to perform physical activity can be useful to understand the needs of the individual. By relating these experiences to the different stages of the transtheoretical model, this study could provide valuable knowledge for designing future interventions to enhance physical activity in this target group.
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| 9. |
- Rutberg, Stina, et al.
(författare)
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Grit as Perseverance in Physical Activity Participation
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:3
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Tidskriftsartikel (refereegranskat)abstract
- Childhood is a critical period for the acquisition of healthy behaviors, and the promotion of sustainable healthy behavior among children is greatly important. Therefore, an increased understanding of the relationship between grit and physical activity in a school context is needed. The purpose of this study is to describe and develop an understanding of students’ and teachers’ awareness and experiences concerning grit as a health-promoting factor. Fifty-five students and three teachers participated in the study. Data were collected through the Short Grit Scale and focus group interviews. There were weak to non-significant correlations between the three teachers’ ratings of their students’ grit and the children’s own ratings. The qualitative results show that children and teachers understood the construct of grit but had slightly different perceptions of it and that grit is not considered to be set in stone. The participants made an association between grit, motivation, meaningfulness, and setting goals. The findings indicate that grit might be an ideal target for making physical activity interventions sustainable.
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| 10. |
- Savolainen, Eva, et al.
(författare)
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Long-Term Perspectives of a School-Based Intervention to Promote Active School Transportation
- 2020
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 17:14
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Tidskriftsartikel (refereegranskat)abstract
- There is a global need for sustainable interventions that increase physical activity among children, and active school transportation (AST) can promote physical activity among schoolchildren. Therefore, an intervention based on gamification, empowerment, and social cognitive theory was initiated in 2016 to promote AST. The aim of this study was to follow up on participants’ experiences one and two years after the AST intervention was initiated. Data were collected through focus groups and individual interviews which were analyzed using qualitative content analysis. Thirty-one pupils (2017), and forty pupils (2018) aged 9–10 years, two teachers (2017, 2018) and one principal (2018) participated in the study. The result is presented as one main theme; “Unity for an active community-An intervention towards making the active choice the easy choice” and three sub-themes; “Well begun is half done-Engagement sparks motivation”, “It takes two to tango-Keep moving with gamifications and togetherness” and “Jumping on the bandwagon–From project to everyday use.” The results show that the concept of the intervention was attractive to re-use and that it created a habit to use AST among the children. Interventions to promote AST can benefit from the use of engagement, togetherness, and gamification.
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