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Sökning: swepub > Karlstads universitet > Örebro universitet

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1.
  • Bergman, Åke, et al. (författare)
  • Science and policy on endocrine disrupters must not be mixed : a reply to a "common sense" intervention by toxicology journal editors
  • 2013
  • Ingår i: Environmental Health. - : BioMed Central (BMC). - 1476-069X. ; 12
  • Tidskriftsartikel (refereegranskat)abstract
    • The "common sense" intervention by toxicology journal editors regarding proposed European Union endocrine disrupter regulations ignores scientific evidence and well-established principles of chemical risk assessment. In this commentary, endocrine disrupter experts express their concerns about a recently published, and is in our considered opinion inaccurate and factually incorrect, editorial that has appeared in several journals in toxicology. Some of the shortcomings of the editorial are discussed in detail. We call for a better founded scientific debate which may help to overcome a polarisation of views detrimental to reaching a consensus about scientific foundations for endocrine disrupter regulation in the EU.
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2.
  • Gustavsson, Anders, et al. (författare)
  • Cost of disorders of the brain in Europe 2010.
  • 2011
  • Ingår i: European Neuropsychopharmacology. - Amsterdam : Elsevier BV. - 0924-977X .- 1873-7862. ; 21:10, s. 718-79
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people.AIMS: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country.METHODS: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27+Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010.RESULTS: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US.DISCUSSION: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges.RECOMMENDATIONS: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.
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3.
  • Olsson, Helén, 1961-, et al. (författare)
  • Reducing or increasing violence in forensic care : A qualitative study of inpatient experiences
  • 2015
  • Ingår i: Archives of Psychiatric Nursing. - Maryland Heights, USA : Elsevier BV. - 0883-9417 .- 1532-8228. ; 29:6, s. 393-400
  • Tidskriftsartikel (refereegranskat)abstract
    • Semi-structured interviews with 13 forensic psychiatric inpatients that had decreased their assessed risk of violence were analyzed using interpretive description. The main contribution from this study is a detailed description of patients' own strategies to avoid violence. Participants described having an ongoing inner dialog in which they encouraged themselves, thereby increasing their self-esteem and trying to accept their current situation. An unsafe and overcrowded ward with uninterested and nonchalant staff increased the risk of aggressive behavior. In the process of decreasing violence, the patients and the forensic psychiatric nursing staff interacted to create and maintain a safe environment.
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4.
  • Johles, Lis, et al. (författare)
  • Is a Brief Body Scan Helpful for Adolescent Athletes' Sleep Problems and Anxiety Symptoms?
  • 2023
  • Ingår i: Mindfulness. - : Springer. - 1868-8527 .- 1868-8535. ; 14:6, s. 1522-1530
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesThe aim of the studywas to compare the effects of a brief body scan with relaxation as an active control group to better understand their respective contributions to the reduction of sleep problems and anxiety symptoms among adolescent athletes.MethodTwo hundred and six adolescent athletes were recruited during the school year 2016/2017 and randomized into four arms: 4 weeks body scan, 8 weeks body scan, 4 weeks relaxation, and 8 weeks relaxation. Sleep problems and anxiety were measured at baseline and 4, 8, and 16 weeks after baseline. Time trends in sleep problems and anxiety were estimated using linear repeated measures models and compared between the four groups.ResultsOverall, there were beneficial time changes for sleep problems and anxiety symptoms in all four intervention groups, but significantly so only for anxiety symptoms. Specifically, the reduction of anxiety symptoms varied between - 11% per month for 8 weeks body scan, - 12% per month for 8 weeks relaxation, - 13% per month for 4 weeks relaxation, and - 16% per month for 4 weeks body scan. However, the time trends did not differ by intervention type or duration.ConclusionsBoth types of interventions had beneficial effects on anxiety independent of length of intervention, suggesting that a brief body scan as well as a brief relaxation could be part of a daily recovery practice for adolescent athletes.PreregistrationThis study was not preregistered.
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5.
  • Holländare, Fredrik, 1972-, et al. (författare)
  • Therapist behaviours in internet-based cognitive behaviour therapy (ICBT) for depressive symptoms
  • 2016
  • Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 3:1, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Internet-based cognitive behaviour therapy (ICBT) is efficacious for treating depression, with therapist guidance identified as important for favourable outcomes. We have limited knowledge, however, about the fundamental components of therapist guidance in ICBT. The purpose of this study was to systematically examine therapist messages sent to patients during the course of ICBT for depressive symptoms in order to identify common “therapist behaviours” and the extent to which these behaviours correlate with completion of modules and improvements in symptoms at post-treatment, one- and two-year follow-up. A total of 664 e-mails from 5 therapists to 42 patients were analysed using qualitative content analysis. The most frequent behaviour was encouraging that accounted for 31.5% of the total number of coded behaviours. This was followed by affirming (25.1%), guiding (22.2%) and urging (9.8%). Less frequently the therapists clarified the internet treatment framework, informed about module content, emphasised the importance of patient responsibility, confronted the patient and made self-disclosures. Six of the nine identified therapist behaviours correlated with module completion. Three behaviours correlated with symptom improvement. Affirmingcorrelated significantly (r = .42, p = .005) with improvement in depressive symptoms at post-treatment and after two years (r = .39, p = .014). Encouraging was associated with outcome directly after treatment (r = .52, p = .001). Self-disclosure was correlated with improvement in depressive symptoms at post-treatment (r = .44, p = .003). The study contributes to a better understanding of therapist behaviours in ICBT for depressive symptoms. Future directions for research are discussed.
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6.
  • Turunen, Jani, et al. (författare)
  • How do children and adolescents of separated parents sleep? : An investigation of custody arrangements, sleep habits, sleep problems, and sleep duration in Sweden
  • 2021
  • Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 7:6, s. 716-722
  • 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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7.
  • Baraldi, Enrico, 1970-, et al. (författare)
  • Start-ups and networks : Interactive perspectives and a research agenda
  • 2019
  • Ingår i: Industrial Marketing Management. - : Elsevier. - 0019-8501 .- 1873-2062. ; 80, s. 58-67
  • Tidskriftsartikel (refereegranskat)abstract
    • This article introduces Industrial Marketing Management's special issue on start-ups and networks. To begin with, we stress the relevance of understanding the context wherein entrepreneurship unfolds – a context filled with social, technical and economic connections to which the start-up needs to relate. We also present and confront three network perspectives which bring different insights to the interplay between start-ups and networks: Social Network (SN) theory, the Industrial Marketing & Purchasing (IMP) view, and Actor-Network Theory (ANT). Next, we introduce the 12 papers of this special issue and place them on a continuum covering a start-up's process of network embedding and including the three periods of establishment, consolidation and stabilization. We conclude with a research agenda suggesting five avenues for further research: (1) tracing start-ups' process of network embedding, (2) mapping the connections between the different networks affecting a start-up, (3) grasping the negative effects of networks on start-ups, (4) making longitudinal case studies on start-ups and networks more comparable via common analytical tools, and (5) investigating how policy influences the complex interplay between start-ups and networks.
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8.
  • Geissinger, Andrea, 1987-, et al. (författare)
  • The sharing economy and the transformation of work : evidence from Foodora
  • 2022
  • Ingår i: Personnel review. - : Emerald Group Publishing Limited. - 0048-3486 .- 1758-6933. ; 51:2, s. 584-602
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: This article explores the various stakeholders' perceptions of the ways digital work is organised within the sharing economy and the social implications of the transformation of work.Design/methodology/approach: Applying social media analytics (SMA) concerning the sharing economy platform Foodora, a total of 3,251 user-generated content was collected and organised throughout the social media landscape in Sweden over 12 months, and 18 stakeholder groups were identified, discussing digital work within seven thematic categories.Findings: The results show that the stakeholder groups in the Swedish context primarily expressed negative views of Foodora's way of organising digital work. The social media posts outlined the distributive and procedural justice related to the working conditions, boycott and protests and critical incidents, as well as the collective bargaining of Foodora.Originality/value: By utilising a novel SMA method, this study contributes to the extant literature on the sharing economy by providing a systematic assessment concerning the impact of the sharing economy platform on the transformation of work and the associated social consequences.
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9.
  • Gustafsson, Margareta, 1952-, et al. (författare)
  • Nurse teacher models in clinical education from the perspective of student nurses : A mixed method study
  • 2015
  • Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 35:12, s. 1289-1294
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses. Design and Settings: The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design. Participants: The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study. Methods: A questionnaire including the CLES + T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception. Results: Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor. Conclusions: In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students. (C) 2015 Elsevier Ltd. All rights reserved.
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10.
  • Jansson-Fröjmark, Markus, et al. (författare)
  • Stimulus control for insomnia : A systematic review and meta-analysis
  • 2024
  • Ingår i: Journal of Sleep Research. - : John Wiley & Sons. - 0962-1105 .- 1365-2869. ; 33:1
  • 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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