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Sökning: WFRF:(Uden Alf)

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1.
  • Gyllén, Jenny, 1968, et al. (författare)
  • PECARE: Parental Feedback to Improve Congenital Cataract Care in Sweden
  • 2023
  • Ingår i: Journal of Pediatric Ophthalmology & Strabismus. - : SLACK, Inc.. - 0191-3913 .- 1938-2405. ; 60:4, s. 288-294
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To analyze non-directed parental feedback to health care providers responsible for pediatric cataract care in Sweden. Methods: A directed content analysis was used to analyze data consisting of text representing free comments provided by 40 parents. A deductive approach was employed by applying the model of balancing the child's inability and ability, which includes the categories mastering, collaborating, facilitating, and adapting. Results: Parents lacked piloting and self-management support. They experienced an absence of partnership with the health care team and not being taken seriously. They also felt abandoned by health care, resulting in emotional distress. Parents highlighted the impact of their social network and the challenges involved in accepting and adapting to the changes in everyday life. Conclusions: This study emphasizes the consequences of the lack of a caring partnership with health care professionals. Because parents act as mediators of care to the child with congenital cataract, persistence on the part of parents and a family-centered approach are essential for the child's visual development.
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2.
  • Johnsson, Karl-Erik, et al. (författare)
  • Preoperative and postoperative instability in lumbar spinal stenosis
  • 1989
  • Ingår i: Spine. - 0362-2436. ; 14:6, s. 591-593
  • Tidskriftsartikel (refereegranskat)abstract
    • Sixty-one patients operated on for spinal stenosis, without a fusion, were studied retrospectively. Preoperative instability, as revealed by functional myelography, was found to predict a poor prognosis (P less than 0.01). Women had less favorable results (P less than 0.05). The "slipping" group was significantly more often radically decompressed than the "nonslipping" group (P less than 0.01). Postoperative slipping was found in 26 patients, significantly more often in those with unsatisfactory results (P less than 0.001).
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3.
  • Larsson, Eva-Lena, 1947- (författare)
  • Pre- and postoperative evaluation of function and activity in patients with paralytic scoliosis
  • 2002
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis evaluates surgical correction in patients with paralytic scoliosis with emphasis on function and activity. The thesis includes four studies of 100 consecutive patients preoperatively evaluated and surgically corrected between 1992 and 1996 at Linköping University Hospital. Eighteen different diagnoses were represented. The postoperative follow-ups were at one year and in average seven years. Six patients dropped out during the first year and twelve during the long-term follow-up period. The assessments included general information, lung function, and measurements of radiographs, function and activity - seating posture, ADL, pain, care and need for rest. The patients or relatives view on the effects of surgery were evaluated in follow-up questionnaires.The preoperative results of the 100 patients described a heterogeneous group in terms of function and activity. Even when the patients were grouped into subgroups according to the Scoliosis Research Society classification, they remained heterogeneous. In patients who could understand verbal instructions assessments that needed co-operation could be used and in those who could not understand verbal instructions, assessments relied more heavily on measures of function and level of dependence. Preoperative results of weight distribution on the seating surface were explained by thoracolumbar/lumbar spinal imbalance and pelvic obliquity R2=0.45 (n=45).The one-year follow-up of 94 patients showed improvements in angle of scoliosis, sitting balance, weight distribution to the seating surface, seating supports in the wheelchair, time needed for rest. The results in subgroups were almost the same as in the whole group. The subjective results for patients or relatives in the follow-up questionnaire showed a positive outcome of surgery. In the comparison between the one-year follow-up and the long-term follow-up there were further improvements in sitting balance, ADL, and care given, but the angle of scoliosis was increased. These results were in line with patients’ and relatives’ assessments in the follow-up questionnaire and in the open-ended questions.Due to the heterogeneity of patients with paralytic scoliosis, irrespective of disorder, it is important to focus on different subgroups with regards to the patients’ total situation. The surgically corrected and stabilised spine resulted in the strength to keep the body upright with improvements in function, activity and possibilities to belong in social activities. Further improvements were shown between the one-year follow-up and the long-term follow-up. It is recommended that patients who have been surgically corrected for paralytic scoliosis are followed for more than one year.
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4.
  • Reigo, Tomas (författare)
  • The nature of back pain in a general adult population : A longitudal study
  • 2000
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The purpose of this thesis was to study in a general adult population the prevalence and incidence of back trouble, predictive factors for new episodes of back pain, new sick leave episodes, and factors important for recovery from back pain. The pain drawing method was used in an epidemiological survey to identify pain in the entire back area. The bias that knowledge of back pain history has on the interpretation of pain drawings was studied in a separate study.The cross-sectional main study population consisted of 2000 individuals aged 20-59 years. A prospective survey was conducted after one year on the study population of factors important for new sick leave, new back pain episodes and recovery and after five years on two age strata of factors important for retaining back health. After ten years the number of disability pensions granted for back pain during the time period was studied. The socio-demographic and work-related factors that predicted disability pension were studied.The prevalence of back pain was found to be 23%. Back pain with radiation was reported by 40%, according to the pain drawings. Only 4% reported localised neck pain. Sick leave was reported by 12% of those with back pain. The more generalised pain pattern suggested that back pain is more than a local back pain problem.The one-year incidence of new back pain was 24%. Seventy-nine percent of the episodes lasted less than 2 months. A history of previous back pain predicted new back pain episodes, while stress at work and low work satisfaction was associated factors. Low age, more qualified work tasks and residence predicted recovery from back pain. New sick leave periods were predicted by unqualified work tasks, pain debut at work, previous back pain history and pain at the primary survey.The clinical findings in the group with pain at the primary survey showed that the absence of tenderness in the trapezium muscle was the strongest predictor of recovery. It was also found that straighter lordosis and restricted mobility in the cervical spine were associated with new sick leaves in the prospective year.The pain drawing study showed that knowledge of the pain history affected the interpretation and reliability of the pain drawing evaluation.The five-year survey showed that absence of physical load in the old age group and absence of psychological stress at work in the younger age group predicted retained back health.The study of disabilities granted on the grounds of back pain during ten prospective years has shown that age over 40, sick leave at the primary survey together with perceiving the work tasks as meaningless predicted disability pension.The results of this thesis suggest that back pain should be seen as arecurrent problem, where previous episodes strongly predict new episodes. The complex nature of back pain as a health problem suggests that the rehabilitation should be individualised and include both work-related factors as well as a wide range of factors not related to paid work.
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5.
  • Sanfridson, Jan, et al. (författare)
  • Why is congenital dislocation of the hip still missed? Analysis of 96,891 infants screened in Malmo 1956-1987
  • 1991
  • Ingår i: Acta Orthopaedica Scandinavica. - : Medical Journals Sweden AB. - 0001-6470. ; 62:2, s. 87-91
  • Tidskriftsartikel (refereegranskat)abstract
    • During 1956 through 1987, 96,891 children have been screened for neonatal hip instability according to the tests of Ortolani and Barlow. In 1956 through 1972 only 4/58, 759 (0.07 permille) were missed, whereas during 1980 through 1987, 12/19, 398 (0.6 permille) were missed. This increase is not caused by any formal alteration of the screening programme. The screening has prevented a late diagnosis in all children born in breech presentation and in all boys except one. General factors such as female sex and joint laxity imply an increased risk for being missed in the screening, whereas mechanical factors such as breech presentation and the primogeniture effect likely facilitate an early diagnosis in the screening. The time between birth and the first examination is also of some importance.
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6.
  • Sörensen, John (författare)
  • Pain analysis : A study in patients with chronic low back pain or fibromyalgia
  • 1997
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Chronic low back pain (CLBP} and fibromyalgia (FM} are two common chronic pain conditions in which the pain processing mechanisms are not well understood. To identify the types of pain, we used different intravenous {t.v.} and epidural pharmacological test procedures as well as questionnaires with pain intensity ratings, pain drawings, self-assessment of functional status, disability and depression. 93 patients with CLBP and 49 women with FM were included in 7 studies. CLBP patients were classified, by response to t.v. morphine, t.v. lidocaine and epidurally administered fentanyl and local anaesthetic, into the different pain types; nociceptive, neuropathic, and idiopathic {non-responding) pain. In about 85% of CLBP patients it was possible to classify the pain of which about 300;6, admitted for assessment of suitability for surgery, had non-responding {idiopathic) pain. CLBP patients chosen for lumbar fusion surgery were prospectively evaluated as to whether preoperative pha:nnacological pain classification associated with the outcome of surgical treatment. A significantly poorer (P<0.05) outcome in the non-responding group suggests that pharmacological pain analysis might be useful as a predictor of surgical outcome. Patients with persistent pain after low back surgery were examined by standard clinical and radiological methods and different questionnaires. The pharmacological test battery was used to classify the patients into different pain groups. With the phannacologtcal classification taken as astandard, the clinical judgement seemed to have difficulty mainly in the differentiation between neuropathic pain and idiopathic pain. The pharmacological pain classification can support the surgeon in deciding when further surgery should be avoided and also be helpful in avoiding an inappropriate diagnostic label. The patients with "failed back surgery syndrome" were also assessed with t.v. phentolamine to identify those with sympathetically maintained pain (SMP). It was concluded that SMP is either an uncommon cause of persistent pain in this type of failed back surgery patients or, the phentolamine test as we performed it was unable to identify SMP. Patients with FM diagnosed according to tlle American College of Rheumatology (ACR) criteria were classified pharmacologtcally into responders and non-responders by response to t.v. morphine, i.v. lidocaine, i.v. ketamine and t.v. saline (placebo). The effects on muscle strength, static muscle endurance, pressure pain threshold, and pain tolerance at tender points and non-tender point areas were also assessed. Ketamine, an NMDA-receptor antagonist. significantly reduced pain intensity, and increased pressure pain threshold and pain tolerance at tender points and non-tender point areas. The ACR classification in FM seems to allow inclusion of patients with different pain processing mechanisms. An experimental study examined 1) whetller non-painful sites in FM patients showed evidence of lowered pressure pain thresholds and 2) lowered pain thresholds as a response to either single or repeated electrical stimulation of the skin and into a non-painful muscle, and 3) the responses to injection of an algesic substance, hypertonic saline, into the underlying, non-painful muscle. Compared to age-matched controls FM patients had lower pressure-pain thresholds, but unaltered electrical skin responstvity and greater pain duration and wider spatial distribution of pain following the injection of hypertonic saline. The results suggests an upregulation in the central nociceptive system in FM patients.
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