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- Lydell, Marie, 1961-, et al.
(author)
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Thoughts and feelings of future working life as a predictor of return to work : a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders
- 2011
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In: Disability and Rehabilitation. - London : Taylor & Francis Group. - 0963-8288 .- 1464-5165. ; 33:13-14, s. 1262-1271
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Journal article (peer-reviewed)abstract
- Purpose. The main aim of this study was to describe the thoughts and feelings of future working life related to return to work (RTW) in sick-listed persons due to musculoskeletal disorders (MSD). Further aim was to compare these descriptions with the person’s actual working situation 1, 5 and 10 years after a rehabilitation period.Methods. This study consisted of two parts. The first part had an explorative design, and qualitative content analysis was chosen in order to analyse the response to an open question regarding future working life answered before, persons sick-listed due to MSD (n = 320), took part in a rehabilitation programme 10 years ago. The second part had a prospective design and quantitative analysis was used to compare the results of the qualitative analysis with RTW and the working situation 1, 5 and 10 years after baseline.Results. Three categories emerged from the data with a total of nine subcategories. In the categories Motivation and optimism and Limitations to overcome, there were significantly more persons who had RTW 1 year after baseline when compared with the category Hindrance and hesitation. There were also some significant differences between the subcategories.Conclusions. The question, regarding thoughts and feelings of future working life, may be a simple screening method to predict RTW in persons sick-listed with MSD. This will guide the rehabilitation team to adjust the rehabilitation to each person’s needs and facilitating RTW.
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| 2. |
- Marklund, Marie, 1949-, et al.
(author)
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Non-CPAP therapies in obstructive sleep apnoea : mandibular advancement device therapy
- 2012
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In: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 39:5, s. 1241-1247
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Journal article (peer-reviewed)abstract
- Mandibular advancement devices (MADs) represent the main non-continuous positive airway pressure (non-CPAP) therapy for patients with obstructive sleep apnoea (OSA). The aim of the European Respiratory Society Task Force was to review the evidence in favour of MAD therapy . Effects of tongue-retaining devices are not included in this report. Custom-made MADs reduce apnoea/hypopnoea index (AHI) and daytime sleepness compared with placebo devices. CPAP more effectively dIminishes AHI, while increasing data suggest fairly similar outcomes in relation to symptoms and cardiovascular health from these treatments. Patients often prefer MADs to CPAP. Milder cases and patients with a proven increase in upper airway size as a result of mandibular advancement are most likely to experience treatment success with MADs. A custom-made device titrated from an initial 50% of maximum mandibular advancement has been recommended. More research is needed to define the patients who will benefit from MAD treatment compared with CPAP, in terms of the effects on sleep—disordered breathing and on other diseases related to OSA. In conclusion, MADs are recommended for patients with mild to moderate OSA (Recommendation Level A) and for those who do not tolerate CPAP. The treatment must be followed up and the device adjusted or exchanged in relation to the outcome.
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| 3. |
- Randerath, W J, et al.
(author)
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Non-CPAP therapies in obstructive sleep apnoea
- 2011
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In: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 37:5, s. 1000-1028
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Journal article (peer-reviewed)abstract
- In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS. This report summarises the efficacy of alternative treatment options in OSAS. An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine. Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients.
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