| 1. |
- Biganzoli, L., et al.
(författare)
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The requirements of a specialist breast centre
- 2020
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Ingår i: Breast. - : Elsevier BV. - 0960-9776 .- 1532-3080. ; 51, s. 65-84
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Tidskriftsartikel (refereegranskat)abstract
- This article is an update of the requirements of a specialist breast centre, produced by EUSOMA and endorsed by ECCO as part of Essential Requirements for Quality Cancer Care (ERQCC) programme, and ESMO. To meet aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this article, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship. The centrepiece of this article is the requirements section, comprising definitions; multidisciplinary structure; minimum case, procedure and staffing volumes; and detailed descriptions of the skills of, and resources needed by, members and specialisms in the multidisciplinary team in a breast centre. These requirements are positioned within narrative on European breast cancer epidemiology, the standard of care, challenges to delivering this standard, and supporting evidence, to enable a broad audience to appreciate the importance of establishing these requirements in specialist breast centres. (C) 2020 The Authors. Published by Elsevier Ltd.
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| 2. |
- Leopoulou, Marianna, et al.
(författare)
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Naxos disease – a narrative review
- 2020
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Ingår i: Expert Review of Cardiovascular Therapy. - : Taylor & Francis. - 1477-9072 .- 1744-8344. ; 18:11, s. 801-808
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionNaxos disease is a rare entity that manifests with woolly hair, keratosis of extremities, and cardiac manifestations that resemble arrhythmogenic right ventricular cardiomyopathy. It is inherited in an autosomal recessive pattern and mutations affecting plakoglobin and desmoplakin have been identified. There is an increased risk of arrhythmias, including sudden cardiac death at a young age. Right ventricular systolic dysfunction often progresses and left ventricular involvement may also occur.Areas coveredThis article reviews historic background, epidemiology, clinical characteristics, genetics, and pathogenesis as well as therapeutic management and future perspectives.Expert opinionThe principles of evaluation and treatment are based on arrhythmogenic right ventricular cardiomyopathy (ARVC) and general heart failure guidelines, because specific data on Naxos disease are limited. Therefore, larger registries on Naxos disease are welcome in order to gain more knowledge about clinical course and risk stratification. Translational research on pathophysiological mechanisms has evolved, including promising approaches using stem cells for novel targets.
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| 3. |
- Dahlkvist, Eva, et al.
(författare)
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Residents’ use and perceptions of residential care facility gardens: a behavior mapping and conversation study
- 2020
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Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- AimTo describe the gardens and their use by individuals living at residential care facilities (RCFs) with high ratings on restorative values.BackgroundBeing outdoors has been described as important to older people's well‐being. Use of outdoor gardens may increase residents’ well‐being through experiences of restorative qualities such as being away and fascination. Thus far, there has been little research on restorative experiences of gardens in the care of older people.DesignA descriptive design using behaviour mapping observations integrated with qualitative field notes and recorded conversations.MethodsA criterion sampling of two gardens (out of a total of 87) was made based on residents’ ratings of restorative values; the two with the highest values were chosen. Eleven residents at the two RCFs took part. Data were collected through behaviour mapping observations, field notes and conversations on five occasions in the respective facilities during residents’ visits to the garden.ResultsThe observations revealed that the main uses of the gardens were to socialise and relax. The conversations also showed that the garden stimulated residents’ senses and evoked memories from the past. These restorative values were interpreted as a sense of being away and fascination. Not having opportunities for outdoor visits was reported to result in disappointment and reduced well‐being.ConclusionsThe findings showed that two basic gardens with different characteristics and views could stimulate residents’ senses and evoke memories from the past; this supports the call for residents to be able to spend time in gardens to promote their well‐being.Implications for practiceFirst‐line managers, nurses and healthcare staff in the care of older people should consider that regular opportunities to spend time outdoors may promote older people's well‐being through feelings of being away and fascination.
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| 4. |
- Fjell, Maria, et al.
(författare)
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Reduced symptom burden with the support of an interactive app during neoadjuvant chemotherapy for breast cancer - A randomized controlled trial
- 2020
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Ingår i: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 51, s. 85-93
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Neoadjuvant chemotherapy causes distressing symptoms, which have to be managed by patients at home. Assessing and acting upon relevant patient-reported symptoms regularly with the support of mHealth such as apps, has shown to decrease symptom burden and improve health-related quality of life (HRQoL). There is a lack of apps for patients with breast cancer which are tested in rigorous trials and only a few include interactive components for immediate clinical management. The aim of this study was to evaluate whether the use of the interactive app Interaktor improves patients' levels of symptom burden and HRQoL during neoadjuvant chemotherapy for breast cancer.MATERIALS AND METHODS: This randomized controlled trial included patients in an intervention group (n = 74) and a control group (n = 75), recruited at two university hospitals in Stockholm, Sweden. The intervention group used Interaktor for symptom reporting, self-care advice and support from health-care professionals during treatment, and the control group received standard care alone. Self-reported symptoms and HRQoL were assessed at two time points to determine differences between the groups.RESULTS: The intervention group rated statistically significant less symptom prevalence in nausea, vomiting, feeling sad, appetite loss and constipation. Overall symptom distress and physical symptom distress were rated statistically significant lower in the intervention group. Further, emotional functioning was rated statistically significant higher in the intervention group.CONCLUSIONS: By using the Interaktor app in clinical practice, patients get individual support when managing treatment-related symptoms during neoadjuvant chemotherapy for breast cancer, leading to decreased symptom burden and improved emotional functioning.
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| 5. |
- Stenfelt, C., et al.
(författare)
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Effects of the colour and design of a new pelvic examination chair on comfort during gynaecological examination
- 2020
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Ingår i: Clinical and Experimental Obstetrics and Gynecology. - : IMR Press Limited. - 0390-6663 .- 2709-0094. ; 47:4, s. 556-559
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The main question was whether the colour of a new design of pelvic examination chair could affect how the examination procedure was perceived. A prototype was constructed without vertical leg support and with built-in heating in the upholstery. To improve integrity, the perineum was exposed only during the examination. Main Outcome Measures: The patients were invited to evaluate the two different chair colours used, light blue and off-white, respectively. After vaginal ultrasound, the patients answered an anonymous questionnaire about their experience of the examination and how they perceived the comfort, warmth, integrity and colour of the chair. There were also questions regarding the absence of vertical leg support. Results: The questionnaire evaluation demonstrated the importance of colour since integrity was rated significantly higher in the light-blue chair than in the off-white. Similarly, the blue chair was experienced as significantly more comfortable than the white. Conclusions: The effect of colour was investigated in a new pelvic examination chair without vertical leg support, developed to suit men, women and also non-binary and transgender persons. It was also designed for increased comfort and integrity. The experience of colour had a significant positive (p < 0.001) effect on how the comfort, integrity and the absence of vertical leg support were perceived.
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| 6. |
- Degerstedt, Frida, et al.
(författare)
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Inequity in physiotherapeutic interventions for children with Cerebral Palsy in Sweden - a national registry study
- 2020
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Ingår i: Acta Paediatrica. - : John Wiley & Sons. - 0803-5253 .- 1651-2227. ; 109:4, s. 774-782
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to investigate the distribution of physiotherapeutic interventions for children with Cerebral Palsy in Sweden from an equity perspective, considering sex, country of birth and geographical region.METHOD: This national cross-sectional registry study includes children with Cerebral Palsy aged 0-18 years who participated in 2015 in the Swedish national quality registry, the Cerebral Palsy follow-up program, CPUP. Comparisons and associations between physiotherapeutic interventions and sex, country of birth and geographical regions were conducted using Chi2 and logistic regression analysis, controlling for cognitive level, level of motor function, age group and dominating symptom.RESULTS: Of the 2855 participants, 2201 (79%) had received physiotherapy. Children born in Sweden had 1.60 times higher odds (95% CI 1.10-2.33) of receiving physiotherapy compared with children born in foreign countries. Distribution of physiotherapeutic interventions differed significantly between geographical regions. No associations between sex and physiotherapeutic interventions were observed.CONCLUSION: The results of this study indicate inequity in care in Sweden towards children with Cerebral Palsy born in other counties. Further, physiotherapeutic interventions were not equally distributed in different.
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| 7. |
- Livheim, Fredrik, et al.
(författare)
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A quasi-experimental, multicenter study of acceptance and commitment therapy for antisocial youth in residential care
- 2020
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier BV. - 2212-1447. ; 16, s. 119-127
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Tidskriftsartikel (refereegranskat)abstract
- Treatment of youth in residential care may be a challenging task for most providers because comorbid problems are common and general psychosocial functioning is low. Cognitive behavioral therapy (CBT) is found to be the most effective treatment but results in only rather small improvements. Hence, there is potential to improve treatment approaches. Acceptance and Commitment Therapy (ACT) could be one such approach. The purpose of this study was to test the effectiveness and feasibility of a brief trans diagnostic ACT group intervention for youth with comorbid problems in residential care. We also wanted to see whether increased psychological flexibility (PF) mediated potential positive outcomes, and to test the intervention under real-world conditions in residential care when delivered by less-specialized staff. With a quasi-experimental design, 69 youth (mean age 17.3 years) received Treatment-As-Usual (TAU), and 91 youth received TAU with an additional 12 h of ACT in a group setting (TAU + ACT). Follow-ups were conducted two weeks, 1 month, 6 months and 18 months after baseline. Intention-to-Treat (ITT) analyses showed statistically significant improvements 18 months after baseline, measured by the interaction of treatment and time for the primary outcomes of, anxiety [ACT * Months = -0.885 (0.445), p < 0.05, d = 0.34], depression [ACT * Months = -1.058 (0.526), p < 0.05, d = 0.39] and psychological flexibility [ACT * Months = -0.970 (0.413), p < 0.05; ACT * Months(2) = 0.053 (0.023), p < 0.05; d = 0.44] in TAU + ACT youth compared to TAU alone. Regarding secondary outcomes 6 months after baseline, the TAU + ACT group showed a significant decrease in anger, disruptive behavior, and increased self-concept, with small to medium effect sizes. We also observed that psychological flexibility mediated the decrease in the primary outcome of decreased anxiety. ACT in group format may be of help in promoting various positive outcomes for youth in residential care when added to treatment as usual. Increasing PF is a promising process variable that can be targeted to increase the effectiveness of interventions for this population.
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| 8. |
- Mather, Lisa, et al.
(författare)
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Sick leave due to mental disorders, morbidity and mortality : a prospective study of discordant twin pairs
- 2020
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Berlin/Heidelberg. - 0933-7954 .- 1433-9285. ; 55, s. 25-32
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. Methods: An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005–2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. Results: Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66–2.17) and women (HR: 1.39, CI 1.27–1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87–2.31), after which it was attenuated (HR: 1.32, CI 1.02–1.70). For women, the HR was 1.57 (CI 1.47–1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70–4.99), but not among women (HR: 0.84, CI 0.53–1.35). Conclusions: Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex.
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| 9. |
- Nilsson, Ulrica, et al.
(författare)
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A journey to a new stable state-further development of the postoperative recovery concept from day surgical perspective : a qualitative study
- 2020
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Ingår i: BMJ Open. - : BMJ PUBLISHING GROUP. - 2044-6055. ; 10:9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims to further develop the concept analysis by Allvinet alin 2007 and Lundmarket alin 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.Design: Descriptive qualitative design with a theoretical thematic analysis.Setting: Six day-surgery departments in Sweden.Participants: Thirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.Results: Four dimensions-physical, psychological, social and habitual-were confirmed. A total of eight subdimensions were also confirmed, two from Allvinet al's study and six from Lundmarket al's study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.Conclusion: Postoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.
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| 10. |
- Visuri, Ingela, 1976-, et al.
(författare)
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Autism and the panoply of religious belief, disbelief and experience
- 2020
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Ingår i: The Neurology of Religion. - Cambridge : Cambridge University Press. - 9781316014165 ; , s. 139-148
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- While the cognitive mechanisms that incline us towards theistic belief in superhuman agents have been well documented over the past twenty-five years, unbelief has not received nearly so much attention. Recent studies however suggest that just as with theistic belief, various psychic mechanisms and processes might incline one toward unbelief, such as a propensity for analytic thinking. It has also been suggested that the connection between atheism and analytic thinking may be mediated by mentalizing constraints in autism. In this essay, we will present and evaluate a few such studies and then consider some additional ideas that we hope will contribute to a fuller understanding of possible approaches to religion and spirituality in autistic individuals.
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