| 1. |
- Nybacka, Mikael, et al.
(författare)
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Project: CASTT - Centre for Automotive Systems Technologies and Testing
- 2007
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Annan publikation (populärvet., debatt m.m.)abstract
- Through the Centre for Automotive Systems Technologies and Testing, Luleå University of Technology aims to first of all support automotive winter testing in Northern Sweden. This means to support the local automotive test entrepreneurs and through them their customers: the car manufacturers and their suppliers. To succeed in this task, the center relies on the university's areas of leading research and most importantly on the cooperation between those areas.
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| 2. |
- Wallén-Mackenzie, Åsa, et al.
(författare)
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Restricted cortical and amygdaloid removal of vesicular glutamate transporter 2 in preadolescent mice impacts dopaminergic activity and neuronal circuitry of higher brain function.
- 2009
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Ingår i: The Journal of neuroscience : the official journal of the Society for Neuroscience. - 1529-2401 .- 0270-6474. ; 29:7, s. 2238-51
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Tidskriftsartikel (refereegranskat)abstract
- A major challenge in neuroscience is to resolve the connection between gene functionality, neuronal circuits, and behavior. Most, if not all, neuronal circuits of the adult brain contain a glutamatergic component, the nature of which has been difficult to assess because of the vast cellular abundance of glutamate. In this study, we wanted to determine the role of a restricted subpopulation of glutamatergic neurons within the forebrain, the Vglut2-expressing neurons, in neuronal circuitry of higher brain function. Vglut2 expression was selectively deleted in the cortex, hippocampus, and amygdala of preadolescent mice, which resulted in increased locomotor activity, altered social dominance and risk assessment, decreased sensorimotor gating, and impaired long-term spatial memory. Presynaptic VGLUT2-positive terminals were lost in the cortex, striatum, nucleus accumbens, and hippocampus, and a downstream effect on dopamine binding site availability in the striatum was evident. A connection between the induced late-onset, chronic reduction of glutamatergic neurotransmission and dopamine signaling within the circuitry was further substantiated by a partial attenuation of the deficits in sensorimotor gating by the dopamine-stabilizing antipsychotic drug aripiprazole and an increased sensitivity to amphetamine. Somewhat surprisingly, given the restricted expression of Vglut2 in regions responsible for higher brain function, our analyses show that VGLUT2-mediated neurotransmission is required for certain aspects of cognitive, emotional, and social behavior. The present study provides support for the existence of a neurocircuitry that connects changes in VGLUT2-mediated neurotransmission to alterations in the dopaminergic system with schizophrenia-like behavioral deficits as a major outcome.
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| 3. |
- Bryhn, Andreas, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2019 : Resursöversikt
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Fisken i havet är en resurs som rör sig fritt över nationella gränser. EU har därför en gemensam fiskeripolitik (GFP). Många arter som är viktiga för Sverige regleras inte i GFP och förvaltas därför nationellt.Denna rapport syftar till att:beskriva utvecklingen av fiskeripolitikenförklara den nuvarande politikens mål och regelverk och dess relation till mål och regler på miljöområdetförklara politikens nationella genomförande och det nationella handlingsutrymmetexemplifiera hur Havs- och vattenmyndigheten arbetat med att reglera fisket.
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| 4. |
- Bryhn, Andreas, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2020 : Resursöversikt
- 2021
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES). Totalt redovisas underlag och råd för 48 fisk- och skaldjursarter.De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.
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| 5. |
- Fredriksson, Lennart, et al.
(författare)
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Caring conversations - psychiatric patients' narratives about suffering
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 40:4, s. 396-404
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to increase and deepen the understanding of how psychiatric patients in conversations with nurses narrate their experience of suffering.METHODS: Data were obtained in the years 2001-2002 by audio recording of 20 individual caring conversations between eight patients and three psychiatric nurses at a psychiatric outpatient unit in Sweden. Before the data were gathered the study was approved by a local research ethics committee. The methodology is inspired by the hermeneutics of Paul Ricoeur. The data is given a naïve reading which is followed by two structural analyses which explain the text. Finally, the structural analyses and the pre-understanding are confronted in a critical reflection.FINDINGS: In the patients' narratives, suffering was at first concealed under a façade that helps the patient to cope with suffering and with shame. As they moved along to a turning point, something happened that made them able to risk everything, i.e. their very selves, but also gave them the possibility of regaining vital parts of themselves that where lost when the façade was constructed. As they took the suffering upon themselves, they grew to be fully visible as human beings and healing was possible as a re-establishment of the interpersonal bridge. This not only meant that the sufferer became open for relationships with others or an abstract other, but also that an opening in the relationship with themselves occurred.CONCLUSIONS: If psychiatric patients are allowed to narrate freely they develop different plot structures, which can either hide or reveal suffering. Patients who could establish an answer to the why-question of suffering could also interpret their suffering in a way that enabled growth and reconciliation. In order to do so, they had to abandon the shelter of the façade and confront suffering and shame. This turning point opened them up to life-sustaining relationships with themselves as well as with abstract and concrete others.
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| 6. |
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| 7. |
- Fredriksson, Lennart, et al.
(författare)
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The ethics of the caring conversation
- 2003
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Ingår i: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 10:2, s. 138-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the ethical foundations for a caring The analysis is based on the ethics of Paul Ricoeur and deals with questions such as what kind of person the nurse ought to be and how she or he engages in caring conversations with suffering others. According to Ricoeur, ethics (the aim of an accomplished life) has primacy over morality (the articulation of aims in norms). At the ethical level, self-esteem and autonomy were shown to be essential for a person (nurse) to act with respect and responsibility. The ethical relationship of a caring conversation was found to metrical, because of the passivity inflicted by suffering. This asymmetry was found to be potentially unethical if not balanced with reciprocity. In the ethical context, the caring conversation is one in which the nurse makes room through the ethos of caritas for a suffering person to regain his or her self-esteem, and thus makes a good life possible.
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| 8. |
- Fredriksson, Lennart, et al.
(författare)
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Vårdande kommunikation
- 2022. - 3
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Ingår i: Vårdvetenskapliga begrepp i teori och praktik. - Lund : Studentlitteratur AB. - 9789144161372 ; , s. 415-428
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 9. |
- Fredriksson, Odd, et al.
(författare)
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Critical Success Conditions for Enterprise Systems Change Projects
- 2010
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Konferensbidrag (refereegranskat)abstract
- Enterprise systems are configurable and customized computer-based information systems, claiming to provide a total, integrated solution to firms' information-processing needs. 'Management support', 'User Involvement', and 'Project Management Experience' are considered as three of the most important critical success conditions for Enterprise systems change projects. The main purpose of this paper is to identify and discuss new preconditions for established critical success conditions in Enterprise systems change projects. Traditional Enterprise systems technology and traditional plan-driven project management methods are not in an effective way supporting the established critical success conditions for Enterprise systems change projects. Supported by the findings from one case study, we propose that new preconditions, such as modern Enterprise systems technology, more narrowly defined projects and agile methods are matching each other. We also propose that this combination of new preconditions is more appropriate for supporting the realization of critical success conditions for Enterprise systems change projects
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| 10. |
- Fredriksson, Odd, et al.
(författare)
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Modern Enterprise Systems as Enablers of Agile Development
- 2010
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Konferensbidrag (refereegranskat)abstract
- Traditional ES technology and traditional project management methods are supporting and matching each other. But they are not in an effective way sup-porting the critical success conditions for ES development. Although the findings from one case study of a successful modern ES change project is not strong empirical evidence, we carefully propose that the new modern ES technology is sup-porting and matching agile project management methods. In other words, it pro-vides the required flexibility which makes it possible to put into practice the agile way of running projects, both for the system supplier and for the customer. In addition, we propose that the combination of modern ES technology and agile project management methods are more appropriate for supporting the realization of critical success conditions for ES development. The main purpose of this paper is to compare critical success conditions for modern enterprise systems development projects with critical success conditions for agile information systems development projects
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| 11. |
- Fredriksson, Per, et al.
(författare)
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Wedge indentation of thin films modelled by strain gradient plasticity
- 2008
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Ingår i: International Journal of Solids and Structures. - : Elsevier BV. - 0020-7683 .- 1879-2146. ; 45:21, s. 5556-5566
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Tidskriftsartikel (refereegranskat)abstract
- A plane strain study of wedge indentation of a thin film on a substrate is performed. The film is modelled with the strain gradient plasticity theory by Gudmundson [Gudmundson, P., 2004. A unified treatment of strain gradient plasticity. journal of the Mechanics and Physics of Solids 52, 1379-1406] and analysed using finite element simulations. Several trends that have been experimentally observed elsewhere are captured in the predictions of the mechanical behaviour of the thin film. Such trends include increased hardness at shallow depths due to gradient effects as well as increased hardness at larger depths due to the influence of the substrate. In between, a plateau is found which is observed to scale linearly with the material length scale parameter. It is shown that the degree of hardening of the material has a strong influence on the substrate effect, where a high hardening modulus gives a larger impact on this effect. Furthermore, pile-up deformation dominated by plasticity at small values of the internal length scale parameter is turned into sink-in deformation where plasticity is suppressed for larger values of the length scale parameter. Finally, it is demonstrated that the effect of substrate compliance has a significant effect on the hardness predictions if the effective stiffness of the substrate is of the same order as the stiffness of the film.
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| 12. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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Preschool teachers have an increased risk of hearing-related symptoms and report more occupational noise exposure compared to randomly selected women
- 2016
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Ingår i: Occupational Health: Think Globally, Act Locally, EPICOH 2016, September 4–7, 2016, Barcelona, Spain. Occupational & Environmental Medicine. ; 73:A191
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Noise-induced hearing disorder has been thoroughly studied among workers in industry-like settings, but less so in female-dominated occupations. In Sweden, noise-related occupational disease among women are reported most frequently in the education sector. We analysed questionnaires from 4,932 women with preschool teacher’s degree who have worked in preschool compared to 5,065 randomly selected women without preschool work-history (response rate 51% vs. 38%). The age range was 24–71 in both cohorts (mean 46 [SD 11] among preschool teachers and 51 [11] among controls). Prevalence and prevalence ratio in age-strata and Mantel-Haenszel pooled risk were calculated for hearing-related symptoms. Noise exposure was compared between the cohorts. A 5% level of significance was applied. Occupational noise exposure and noise annoyance were significantly more common among teachers than controls: 75% vs.31% and 69% vs.26%, respectively. Still, significantly fewer teachers used hearing protection: 3% vs. 4%. Prevalence of hearing-related symptoms was much higher among teachers than controls: sound-induced auditory fatigue (71% [95% CI: 70–72] vs. 31% [30–32]), difficulty perceiving speech (46% [45–47] vs. 26% [25–27] and hyperacusis (38% [37–39] vs. 18% [17–19] and slightly higher for hearing loss (19% [18–20] vs. 17% [6–18] and tinnitus (19% [18–20] vs. 15% [14–16]. Teachers had a twofold risk of sound-induced auditory fatigue (PR-MH 2.2 [95% CI: 2.1–2.3] and hyperacusis (PR-MH 2.1 [1.9–2.2] compared to controls, when adjusted for age. The risk was also increased for difficulty perceiving speech (PR-MH 1.8 [1.7–1.9], tinnitus (PR-MH 1.4 [1.3–1.6] and hearing loss (PR-MH 1.4 [1.3–1.5]. Mean age of onset was significantly lower among teachers for all symptoms, except for hyperacusis (p = 0.902). Leisure-noise was significantly more common among controls. Family history of hearing loss did not differ (p = 0.411). The study is the first to show that preschool teachers have an increased risk of hearing-related symptoms, which may be caused by the work environment.
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| 13. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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The Impact of Occupational Noise Exposure on Hyperacusis: a Longitudinal Population Study of Female Workers in Sweden.
- 2021
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Ingår i: Ear and Hearing. - 1538-4667. ; 43:4, s. 1366-1377
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to assess the risk of hyperacusis in relation to occupational noise exposure among female workers in general, and among women working in preschool specifically.A retrospective longitudinal study was performed. Survey data were collected in 2013 and 2014 from two cohorts: randomly selected women from the population in region Västra Götaland, Sweden, and women selected based on having received a preschool teacher degree from universities in the same region. The final study sample included n = 8328 women born between 1948 and 1989. Occupational noise exposure was objectively assigned to all time periods from the first to the last reported occupation throughout working life, using the Swedish Job-Exposure Matrix (JEM) with three exposure intervals: <75 dB(A), 75 to 85 dB(A), and >85 dB(A). The JEM assigns preschool teachers to the 75 to 85 dB(A) exposure interval. The outcome hyperacusis was assessed by self-report using one question addressing discomfort or pain from everyday sounds. In the main analysis, a hyperacusis event was defined by the reported year of onset, if reported to occur at least a few times each week. Additional sensitivity analyses were performed using more strict definitions: (a) at least several times each week and (b) every day. The risk (hazard ratio, HR) of hyperacusis was analyzed in relation to years of occupational noise exposure, using survival analysis with frailty regression modeling accounting for individual variation in survival times which reflect, for example, noise exposure during years prior to onset. Occupational noise exposure was defined by the occupation held at year of hyperacusis onset, or the occupation held at the survey year if no event occurred. Models were adjusted for confounders including age, education, income, family history of hearing loss, and change of jobs due to noise.In total, n = 1966 hyperacusis events between 1960 and 2014 were analyzed in the main analysis. A significantly increased risk of hyperacusis was found among women working in any occupation assigned to the 75 to 85 dB(A) noise exposure group [HR: 2.6, 95% confidence interval (CI): 2.4-2.9], compared with the reference group <75 dB(A). The risk was tripled among preschool teachers specifically (HR: 3.4, 95% CI: 3.0-3.7), with the crude Kaplan-Meier curve showing a higher rate of onset early in the working life in preschool teachers compared with all the other exposure groups. The risk was increased, but not statistically significant in the main analysis, for the highest exposure group >85 dB(A), where only six hyperacusis events were identified (HR: 1.4, 95% CI: 0.6-3.1). In the sensitivity analysis, where hyperacusis was defined as occurring every day, the HR was significant also in the highest exposure group (HR: 3.8, 95% CI: 1.4-10.3), and generally slightly higher in the other exposure groups compared to the main analysis.This study indicates increased risk of hyperacusis already below the permissible occupational noise exposure limit in Sweden (85 dB LAeq,8h) among female workers in general, and in particular among preschool teachers. Prospective studies and less wide exposure intervals could confirm causal effects and assess dose-response relationships, respectively, although this study at present suggest a need for risk assessment, improved hearing prevention measures, and noise abatement measures in occupations with noise levels from 75 dB(A). The results could also have implications for management of occupational disability claims.
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| 14. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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Validating self-reporting of hearing-related symptoms against pure-tone audiometry,otoacoustic emission, and speech audiometry
- 2016
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Ingår i: International Journal of Audiology. - : Informa UK Limited. - 1499-2027 .- 1708-8186. ; 55:8, s. 454-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To validate self-reported hearing-related symptoms among personnel exposed to moderately high occupational noise levels at an obstetrics clinic. Design: Sensitivity, specificity, and predictive values were calculated for questionnaire items assessing hearing loss, tinnitus, sound sensitivity, poor hearing, difficulty perceiving speech, and sound-induced auditory fatigue. Hearing disorder was diagnosed by pure-tone audiometry, distortion Product otoacoustic emissions, and HINT (Hearing In Noise Test). Study sample: Fifty-five female obstetrics personnel aged 22–63 participated; including 26 subjects reporting hearing loss, poor hearing, tinnitus, or sound sensitivity, and 29 randomly selected subjects who did not report these symptoms. Results: The questionnaire item assessing sound-induced auditory fatigue had the best combination of sensitivity 85% (95% CIs 56 to 100%)and specificity 70% (95% CIs 55 to 84%) for hearing disorder diagnosed by audiometry or otoacoustic emission. Of those reporting sound-induced auditory fatigue 71% were predicted to have disorder diagnosed by otoacoustic emission. Participants reporting any hearing-related symptom had slightly worse measured hearing. Conclusions: We suggest including sound-induced auditory fatigue in questionnaires for identification of hearing disorder among Healthcare personnel, though larger studies are warranted for precise estimates of diagnostic performance. Also, more specific and accurate hearing tests are needed to diagnose mild hearing disorder.
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| 15. |
- Fredriksson, Sofie, 1983, et al.
(författare)
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Working in preschool increases the risk of hearing-related symptoms: a cohort study among Swedish women
- 2019
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 92:8, s. 1179-90
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Tidskriftsartikel (refereegranskat)abstract
- © 2019, The Author(s). Purpose: To assess whether working in preschools increases the risk of hearing-related symptoms and whether age, occupational noise, and stressful working conditions affect the risk. Methods: Questionnaire data on hearing-related symptoms were analysed in women aged 24–65 (4718 preschool teachers, and 4122 randomly selected general population controls). Prevalence and risk ratio (RR) of self-reported hearing loss, tinnitus, difficulty perceiving speech, hyperacusis and sound-induced auditory fatigue were assessed by comparing the cohorts in relation to age and self-reported occupational noise and stressful working conditions (effort–reward imbalance and emotional demands). RR was calculated using log-binomial regression models adjusted for age, education, income, smoking, hearing protection, and leisure noise. Incidence rates and incidence rate ratios (IRR) were calculated for retrospectively reported onset of all symptoms except sound-induced auditory fatigue. Results: Compared to the controls, preschool teachers had overall more than twofold RR of sound-induced auditory fatigue (RR 2.4, 95% confidence interval 2.2–2.5) and hyperacusis (RR 2.3, 2.1–2.5) and almost twofold for difficulty perceiving speech (RR 1.9, 1.7–2.0). Preschool teachers had a threefold IRR of hyperacusis (IRR 3.1, 2.8–3.4) and twofold for difficulty perceiving speech (IRR 2.4, 2.2–2.6). Significantly although slightly less increased RR and IRR were observed for hearing loss and tinnitus. RR and IRR were generally still increased for preschool teachers when stratified by age and occupational exposure to noise and stress. Conclusions: This large cohort study showed that working as preschool teacher increases the risk of self-reported hearing-related symptoms, indicating a need of preventative measures.
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| 16. |
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| 17. |
- Färdig, Rickard, et al.
(författare)
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A randomized controlled trial of the illness management and recovery program for persons with schizophrenia.
- 2011
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Ingår i: Psychiatric Services. - : American Psychiatric Association Publishing. - 1075-2730 .- 1557-9700. ; 62:6, s. 606-12
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to evaluate the effects of the illness management and recovery (IMR) program on symptoms and psychosocial functioning of individuals with schizophrenia or schizoaffective disorder in an outpatient setting in Sweden.METHODS: A total of 41 persons with schizophrenia or schizoaffective disorder who were receiving treatment at six psychiatric outpatient rehabilitation centers were randomly assigned to either an IMR group for nine months or to treatment as usual (control condition). Assessments were conducted at baseline, posttreatment (nine months), and follow-up (21 months) and included self-reports and ratings by clinicians (both blind and nonblind to treatment assignment) of illness management, psychiatric symptoms, recovery, coping, quality of life, hospitalization, insight, and suicidal ideation.RESULTS: As measured by self-report and ratings of nonblinded clinicians, IMR program participants demonstrated significantly greater improvement in illness management than participants in the control condition. Ratings of psychiatric symptoms by blinded clinicians using the Psychosis Evaluation Tool for Common Use by Caregivers and self-reported ratings of psychosocial functioning on the Ways of Coping Questionnaire also showed better outcomes than for participants in treatment as usual. A statistically significant decrease in suicidal ideation between baseline and follow-up was found for IMR program participants.CONCLUSIONS: The study supports previous findings and suggests that the IMR program is effective in improving the ability of individuals with schizophrenia to better manage their illness.
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| 18. |
- Färdig, Rickard, et al.
(författare)
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A Randomized Controlled Trial of the Illness Management and Recovery Program for Persons With Schizophrenia
- 2011
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Ingår i: Psychiatric Services. - 1075-2730 .- 1557-9700. ; 62:6, s. 606-612
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to evaluate the effects of the illness management and recovery (IMR) program on symptoms and psychosocial functioning of individuals with schizophrenia or schizoaffective disorder in an outpatient setting in Sweden. Methods: A total of 41 persons with schizophrenia or schizoaffective disorder who were receiving treatment at six psychiatric outpatient rehabilitation centers were randomly assigned to either an IMR group for nine months or to treatment as usual (control condition). Assessments were conducted at baseline, posttreatment (nine months), and follow-up (21 months) and included self-reports and ratings by clinicians (both blind and nonblind to treatment assignment) of illness management, psychiatric symptoms, recovery, coping, quality of life, hospitalization, insight, and suicidal ideation. Results: As measured by self-report and ratings of nonblinded clinicians, IMR program participants demonstrated significantly greater improvement in illness management than participants in the control condition. Ratings of psychiatric symptoms by blinded clinicians using the Psychosis Evaluation Tool for Common Use by Caregivers and self-reported ratings of psychosocial functioning on the Ways of Coping Questionnaire also showed better outcomes than for participants in treatment as usual. A statistically significant decrease in suicidal ideation between baseline and follow-up was found for IMR program participants. Conclusions: The study supports previous findings and suggests that the IMR program is effective in improving the ability of individuals with schizophrenia to better manage their illness.
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| 19. |
- Färdig, Rickard, et al.
(författare)
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Evaluation of the Illness Management and Recovery Scale in schizophrenia and schizoaffective disorder
- 2011
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Ingår i: Schizophrenia Research. - : Elsevier BV. - 0920-9964 .- 1573-2509. ; 132:2-3, s. 157-164
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to evaluate the psychometric properties of the parallel client and clinician versions of the Illness Management and Recovery Scale (IMRS) developed to monitor the clients' progress in the Illness Management and Recovery (IMR) program in schizophrenia. A total of 107 study participants completed assessments of the IMRS, interview-based ratings of psychiatric symptoms, self-ratings of psychiatric symptoms, perception of recovery, and quality of life. Case managers completed the clinician version of the IMRS. Both versions of the scale demonstrated satisfactory internal reliability and strong test-retest reliability. The results also indicated convergent validity with interview-based ratings of psychiatric symptoms, self-rated symptoms, perception of recovery, and quality of life for both versions of the IMRS. These findings support the utility of the IMRS as a measure of illness self-management and recovery in clients with schizophrenia.
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| 20. |
- Färdig, Rickard, 1975-
(författare)
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Illness Management and Recovery : Implementation and evaluation of a psychosocial program for schizophrenia and schizoaffective disorder
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the present thesis was to examine the effectiveness of the Illness Management and Recovery (IMR) program for teaching clients with schizophrenia or schizoaffective disorder to better manage their illness and to promote recovery. This was accomplished through an examination of the program’s effects on psychosocial functioning and psychopathology, the evaluation of general and specific impact of neurocognition on learning the fundamentals of illness self-management, and the impact of symptom severity on outcome of the IMR program. The utility of the illness management and recovery scale to evaluate illness self-management of clients with schizophrenia and schizoaffective disorder was also investigated.The effects of the IMR program were evaluated in a randomized controlled trial that compared participants in the program to participants receiving treatment as usual. 41 participants were recruited at six psychiatric outpatient rehabilitation centers in Uppsala, Sweden, and were randomly assigned to IMR groups for approximately 40 sessions or to a treatment as usual control condition. The IMR program participants demonstrated greater improvement compared to participants in treatment as usual in illness self-management, reduced psychiatric symptoms, improved coping skills, and decreases in suicidal ideation. The findings suggest that the IMR program is effective in improving the ability of individuals with schizophrenia and schizoaffective disorder to better manage their illness.Possible association between neurocognitive functioning and the acquisition of illness self-management skills was investigated in a total of 53 participants who completed the IMR program. Speed of processing was related to client reported illness self-management skills acquisition, before and after controlling for psychiatric symptoms and medication, but neurocognitive functioning did not predict improvement in clinician ratings of client illness self-management skills. The findings suggest that compromised neurocognitive functioning does not reduce response to training in illness self-management.The impact of symptom severity on outcome of the IMR program was explored in 52 participants who completed the program. The results suggest that significantly more participants met the severity criterion of remission at post-treatment, and it appears that participants not reaching the severity criterion at post-treatment, also benefited from the IMR program, as indicated by the similar effect sizes of the two subgroups (meeting versus not meeting the severity criterion at post-treatment).The psychometric properties of the Illness Management and Recovery Scale (IMRS) were evaluated in 107 participants with a diagnosis of schizophrenia or schizoaffective disorder. And an item-by-item investigation was conducted in order to establish their utility in monitoring the clients' progress in the IMR program. Both the client and clinician version of the IMRS demonstrated satisfactory internal consistency, large test-retest reliability, and convergent validity with conceptually related measures of psychiatric symptoms, quality of life, and perception of recovery. The findings support the utility of the IMRS as a measure of illness self-management and recovery in clients with schizophrenia and schizoaffective disorder.The general findings of this thesis support the IMR program to be effective in improving the ability of the participants to manage their disorder. The impact of neurocognitive dysfunction on the participants’ ability to learn the fundamentals of illness self-management seems to be limited, and symptom severity did not limit the benefits of the IMR program. Support for the utility of the IMRS to monitor the participants’ progress in the program was also found, providing a brief and economical method for assessing outcome of the IMR program.
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| 21. |
- Färdig, Rickard, et al.
(författare)
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Neurocognitive functioning and outcome of the Illness Management and Recovery Program for clients with schizophrenia and schizoaffective disorder
- 2016
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Ingår i: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 70:6, s. 430-435
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Tidskriftsartikel (refereegranskat)abstract
- The relationship between psychosocial programming and neurocognition has been established in previous research, but has not been explored in the context of the Illness Management and Recovery Program (IMR). This study examined associations between neurocognition and illness self-management skills acquisition, based on two previous trials of IMR. Neurocognitive functioning was assessed at baseline and post-treatment in 53 participants with schizophrenia or schizoaffective disorder who completed the IMR. Illness self-management was measured by the client and clinician versions of the Illness Management and Recovery Scale. Statistical analyses investigated improvements in neurocognitive functioning and possible association between illness self-management skills acquisition and neurocognitive functioning. Speed of processing as measured by the Trail Making Test A, was related to client-reported acquisition of illness self-management skills, before and after controlling for psychiatric symptoms and medication, but did not predict improvement in clinician ratings of client illness self-management skills. However, when controlling for client session attendance rates, the association between speed of processing and client-reported illness self-management skills acquisition ceased to be statistically significant, which suggests that compromised neurocognitive functioning does not reduce response to training in illness self-management in itself. The association between the frequency of attended IMR sessions and outcome of the IMR seems to decrease the negative impact of compromised neurocognition on illness self-management skills acquisition. Also, clients with slower speed of processing may experience less benefit from the IMR and may attend fewer sessions.
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| 22. |
- Färdig, Rickard, et al.
(författare)
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Symptom severity and outcome of the Illness Management and Recovery (IMR) program for schizophrenia and schizoaffective disorder
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The present study explored the effects of the Illness Management and Recovery program on the severity criterion of symptomatic remission in schizophrenia and schizoaffective disorder, and whether participants meeting the severity criterion experienced greater improvement in the outcomes of the IMR program. The results suggest that significantly more participants met the severity criterion at post-treatment. Improvements in general psychopathology, self-rated and clinician rated illness self-management, and subjective satisfaction with life, were found for the total sample. Although demonstrating significantly higher levels of general psychopathology, compared to participants meeting the severity criterion, it appears that participants not meeting the severity criterion also benefited from the IMR program, as indicated by the similar effect sizes of the two subgroups (meeting versus not meeting the severity criterion at post-treatment).
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| 23. |
- Magnusson, Peter, et al.
(författare)
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Living with hypertrophic cardiomyopathy and an implantable defibrillator
- 2017
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Ingår i: BMC Cardiovascular Disorders. - : BIOMED CENTRAL LTD. - 1471-2261 .- 1471-2261. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: ICDs efficiently terminate life-threatening arrhythmias, but complications occur during long-term follow-up. Patients' own perspective is largely unknown. The aim of the study was to describe experiences of hypertrophic cardiomyopathy (HCM) patients with implantable defibrillators (ICDs).Methods: We analyzed 26 Swedish patient interviews using hermeneutics and latent content analysis.Results: Patients (aged 27-76 years) were limited by HCM especially if it deteriorates into heart failure. The ICD implies safety, gratitude, and is accepted as a part of the body even when inappropriate ICD shocks are encountered. Nobody regretted the implant. Both the disease and the ICD affected professional life and leisure time activities, especially at younger ages. Family support was usually strong, but sometimes resulted in overprotection, whereas health care focused on medical issues. Despite limitations, patients adapted, accepted, and managed challenges.Conclusion: HCM patients with ICDs reported good spirit and hope even though they had to adapt and accept limitations over time.
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| 24. |
- Nehlin, Christina, 1958-, et al.
(författare)
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Brief alcohol screening in a clinical psychiatric population : Special attention needed
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:4, s. 538-543
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and aims: Abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and single-item screeners show promising results but have not previously been investigated in a clinical psychiatric setting. The aim of the present study was to investigate the capacity of three brief screening methods to detect hazardous drinking in a psychiatric treatment-seeking population.Design and methods: Data was collected from consecutive patients (n = 1811) visiting a general psychiatric clinic. The screening capacity of the Heavy Episodic Drinking (HED) screener, AUDIT item # 3 (AUDIT-3) and the three consumption items of AUDIT (AUDIT-C) was compared to the result of the full 10-item AUDIT with cut-off points 6 for females and 8 for males.Results: The HED screener and AUDIT-3 with recommended cut-offs captured low rates of hazardous drinkers when compared to the full AUDIT. Lowering the cut-offs created rates far above those of the full AUDIT. AUDIT-C with recommended cut-off limits categorised nearly the same rates of males as the full AUDIT but much higher rates of females. Raising the cut-off for females approached the detection rate of AUDIT-C closely to that of the full AUDIT.Discussion and conclusions:The findings of this study suggest that the HED screener is not sensitive enough in the clinical psychiatric setting. When designing alcohol screening measures to be used all over health care organisations, special attention should be paid to psychiatric patients. If a somewhat more extensive screening tool is used, the full AUDIT is recommended.
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| 25. |
- Nehlin, Christina Gordh, et al.
(författare)
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Alcohol and Drug Use, Smoking, and Gambling Among Psychiatric Outpatients : A 1-Year Prevalence Study
- 2013
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Ingår i: Substance Abuse. - : Informa UK Limited. - 0889-7077 .- 1573-6733 .- 1547-0164. ; 34:2, s. 162-168
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims: Studies of alcohol habits in general psychiatric populations are scarce. The objective was to investigate alcohol and drug use, smoking, and gambling in a clinical sample of psychiatric outpatients. A further aim was to study age and gender differences in the rates of these habits. Methods: Data were collected among psychiatric outpatients with mainly mood (47%) and anxiety (35%) disorders. A questionnaire package was distributed, including AUDIT (Alcohol Use Disorders Identification Test), DUDIT (Drug Use Disorders Identification Test), tobacco items, and gambling items. Two major drinking categories were formed: Nonhazardous alcohol use (NH) and Alcohol use above hazardous levels (AH). Results: In total, 2160 patients (65% females) responded to the questionnaire package. The AH rate was high among psychiatric outpatients (28.4%), particularly among young females (46.6%). Young female patients also reported a high prevalence of problematic drug use (13.8%). Problematic drug use, daily smoking, and problematic gambling were frequent. The unhealthy habits were linked to AH. Conclusions: Alcohol and drug use, smoking, and gambling are all highly prevalent among psychiatric outpatients. Young females are in particular need of attention. Interventions should be tailored for co-occurring psychiatric disorders and applied within routine psychiatric care.
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| 26. |
- Nehlin, Christina, 1958-, et al.
(författare)
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Three hours of training improve psychiatric staff’s self-perceived knowledge and attitudes toward problem-drinking patients
- 2012
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Ingår i: Drug and Alcohol Review. - : Wiley. - 0959-5236 .- 1465-3362. ; 31:4, s. 544-549
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and aimsStaff attitudes are an important factor in the successful implementation of systematic alcohol strategies and policies. The forms and extent of training needed to improve therapeutic attitude among psychiatric staff to problem drinking are unclear. The aim of the investigation was to study the knowledge and attitudes of psychiatric staff toward problem drinking patients. A further aim was to investigate whether a short three-hour training is sufficient to improve knowledge and therapeutic attitude toward problem drinking.Design and methodsA tailored training model for psychiatric staff (non-physicians) was carried out at a medium size university clinic. Participants were medical (nurses and psychiatric aides) and non-medical staff (psychologists and social workers). The training consisted of a two-hour workshop and a one-hour follow-up session. Knowledge and attitudes were measured at baseline and follow-up by a questionnaire including vignettes assessment and the Short Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ).Results In total, 115 persons completed the questionnaire (follow-up rate 83.5 %). The distribution was even (50 % for the medical and 50 % for the non-medical staff). After training, the non-medical staff estimated vignette case severity higher than before. Both staff groups estimated their capacity to help a patient with complex problems higher after training. Role adequacy was higher in both subgroups after training. Medical staff scored Work satisfaction higher after the training. Discussion and conclusionsThree hours of tailored training for psychiatric staff improve their knowledge and therapeutic attitude to problem drinking patients.
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| 27. |
- Nehlin Gordh, Christina, 1958-
(författare)
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Alcohol Use and Secondary Prevention in Psychiatric Care
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Although alcohol plays an important role in psychiatric morbidity, there is a general lack of strategies within psychiatric care to intervene at alcohol problems in an early stage (secondary prevention). The aim of this thesis was to increase knowledge of adequate forms of secondary alcohol prevention in psychiatric care. The capacity of three brief screening instruments was investigated in a psychiatric outpatient sample (n=1811). The results indicate that the HED (heavy episodic drinking) screener, strongly recommended for health care settings, is not sufficiently sensitive in a psychiatric setting. Instead, the full AUDIT (Alcohol Use Disorders Identification Test) is recommended.The knowledge and attitudes of psychiatric staff members to problem-drinking patients were studied and the effects of a three-hour training course were investigated. Confidence in self-perceived capacity to intervene in more severe alcohol problems was raised among all staff after training. Awareness of early signs of problem drinking was raised among psychologists and social workers. The therapeutic attitude of the psychiatric staff was higher when compared with primary care staff.Two forms of brief intervention were delivered by clinical psychiatric staff. At 12 months, 29% of all participants had improved their drinking habits, moving from hazardous to non-hazardous level (21%) or from harmful to hazardous level (8%). In the improved group, mean AUDIT score was reduced from 11.0 points at baseline to 5.5 points. Differences in outcome between the two interventions could not be identified.Nine high-risk drinking young female psychiatric patients were interviewed, focusing on reasons for excessive drinking and factors facilitating a change in drinking habits. Alcohol played an important role in the lives of the young women. It made them feel social and helped them deal with unbearable emotions. It was also used as a means of self-harm, representing the first stage in an escalating self-harm process. They expressed a need for help from their caregivers in addressing the underlying reasons for drinking.Secondary alcohol prevention strategies including appropriate screening methods, staff training and the elaboration of tailored interventions are urgently needed in psychiatric care. The findings of this thesis can be used when forming such strategies.
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| 28. |
- Nehlin Gordh, Christina, 1958-, et al.
(författare)
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Brief alcohol intervention in a psychiatric outpatient setting : A randomized controlled study
- 2012
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Ingår i: Addiction Science & Clinical Practice. - : Springer Science and Business Media LLC. - 1940-0640. ; 7:23
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Tidskriftsartikel (refereegranskat)abstract
- Background:Although brief alcohol intervention (BI) is widely studied, studies from psychiatric outpatient settings are rare. The aim of this study was to investigate the effects of two variants of BI in psychiatric outpatients. By using clinical psychiatric staff to perform the interventions, we sought to collect information of the usefulness of BI in the clinical setting.Methods: Psychiatric outpatients with Alcohol Use Disorders Identification Test (AUDIT) scores indicating hazardous or harmful drinking were invited to participate in the study. The outpatients were randomized to minimal (assessment, feedback, and an informational leaflet) or BI (personalized advice added). Measurements were performed at baseline and at six and 12 months after the intervention. The primary outcome was change in AUDIT score at the 12-month follow-up.Results: In all, 150 patients were enrolled and received either a minimal intervention (n = 68) or BI (n = 82). At 12 months, there was a small reduction in AUDIT score in both groups, with no significant differences in outcome between groups. At 12-month follow-up, 21% of participants had improved from a hazardous AUDIT score level to a nonhazardous level, and 8% had improved from a harmful level to a hazardous level (8%).Conclusions: Brief alcohol interventions may result in a reduction of AUDIT score to a small extent in psychiatric patients with hazardous or harmful alcohol use. Results suggest that BI may be of some value in the psychiatric outpatient setting. Still, more profound forms of alcohol interventions with risky-drinking psychiatric patients need elaboration.
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| 29. |
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| 30. |
- Persson Waye, Kerstin, 1959, et al.
(författare)
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A Screening Approach for Classroom Acoustics Using Web-Based Listening Tests and Subjective Ratings
- 2015
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Perception of speech is crucial in school where speech is the main mode of communication. The aim of the study was to evaluate whether a web based approach including listening tests and questionnaires could be used as a screening tool for poor classroom acoustics. The prime focus was the relation between pupils' comprehension of speech, the classroom acoustics and their description of the acoustic qualities of the classroom. In total, 1106 pupils aged 13-19, from 59 classes and 38 schools in Sweden participated in a listening study using Hagerman's sentences administered via Internet. Four listening conditions were applied: high and low background noise level and positions close and far away from the loudspeaker. The pupils described the acoustic quality of the classroom and teachers provided information on the physical features of the classroom using questionnaires. In 69% of the classes, at least three pupils described the sound environment as adverse and in 88% of the classes one or more pupil reported often having difficulties concentrating due to noise. The pupils' comprehension of speech was strongly influenced by the background noise level (p<0.001) and distance to the loudspeakers (p<0.001). Of the physical classroom features, presence of suspended acoustic panels (p<0.05) and length of the classroom (p<0.01) predicted speech comprehension. Of the pupils' descriptions of acoustic qualities, clattery significantly (p<0.05) predicted speech comprehension. Clattery was furthermore associated to difficulties understanding each other, while the description noisy was associated to concentration difficulties. The majority of classrooms do not seem to have an optimal sound environment. The pupil's descriptions of acoustic qualities and listening tests can be one way of predicting sound conditions in the classroom.
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| 31. |
- Priebe, Åsa, et al.
(författare)
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A sanctuary of safety : A study of how patients with dual diagnosis experience caring conversations
- 2018
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Ingår i: International Journal of Mental Health Nursing. - : WILEY. - 1445-8330 .- 1447-0349. ; 27:2, s. 856-865
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously-used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self-esteem is restored. When synthesized, these themes gave rise to a main theme - a sanctuary of safety - where suffering is alleviated and dignity and self-esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients' recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self-esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses' caring expertise.
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| 32. |
- Sandström, Alfred, et al.
(författare)
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Fisk- och skaldjursbestånd i hav och sötvatten 2018 : Resursöversikt
- 2019
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Den 14:e utgåvan av den samlade resursöversikten av fisk- och kräftdjursbeståndens status i våra vatten.I rapporten kan du ta del av bedömningen som görs av situationen för bestånd som regleras inom ramen för EU:s gemensamma fiskeripolitik (GFP). Bedömningarna baseras på det forskningssamarbete och den rådgivning som sker inom det Internationella Havsforskningsrådet (ICES).De bestånd som förvaltas nationellt baseras på de biologiska underlagen, och rådgivningen i huvudsak på den forskning och övervakning samt analys som bedrivs av Institutionen för akvatiska resurser vid Sveriges lantbruksuniversitet (SLU Aqua) samt yrkesfiskets rapportering.Rapporten omfattar 41 fiskarter och åtta skaldjursarter.Nytt för i år är att flodkräftan och signalkräftan har fått egna presentationer. Vi har även ett nytt kapitel "Hållbarhetsbedömning av fisk- och skaldjursbestånd i havsområden runt Sverige”. Det består av en sammanfattning av den årliga bedömningen av hållbarheten i nyttjandet av fisk- och skaldjursbestånd i kust och hav runt Sverige. Bedömningenär baserad på de senaste tre åren vilket möjliggör en jämförelse över tid iantalet hållbart nyttjade bestånd. Jämförelsen visar inga tydliga förändringar över de senaste tre åren.Det finns ett nytt avsnitt i kapitlet ”Från biologi till förvaltning” om hur Havs- och vattenmyndighetens tillståndsgivning går till, och hur bedömningen baseras på resursöversikten vid ansökan om fiskelicens eller annan tillståndsgivning. Kapitlet har också utökats med ett avsnitt där SCB:s fritidsfiskeundersökning beskrivs och hur resultatet används i beståndsanalyserna.
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| 33. |
- Spetz, Anna-Clara, 1973-, et al.
(författare)
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Testosterone correlated to symptoms of partial androgen deficiency in aging men (PADAM) in an elderly Swedish population
- 2007
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Ingår i: Menopause. - : Ovid Technologies (Wolters Kluwer Health). - 1072-3714 .- 1530-0374. ; 14:6, s. 999-1005
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the prevalence of different symptoms of partial androgen deficiency in aging men (PADAM) and to correlate them with blood concentrations of testosterone and bioavailable testosterone. DESIGN: A total of 370 men, aged 55 to 75 years, were invited to one of three primary healthcare centers in Sweden. They were asked to complete a questionnaire regarding demographic data, medical history, mood status, medication, castration therapy and smoking, exercise and alcohol habits, as well as different symptoms of PADAM. The 10 questions from a previously used questionnaire (the ADAM questionnaire) were included. The men were offered blood tests for analyses of testosterone, follicle stimulating hormone, luteinizing hormone, steroid hormone-binding globulin, and albumin. From these test results, we calculated the bioavailable testosterone. RESULTS: Of the questionnaires sent out, 81.6% were returned and eligible for evaluation. Blood samples were obtained from 85.8% of men answering the questionnaire. Many of the symptoms, including five from the ADAM questionnaire, were more common in older age groups (P < 0.05). Three symptoms, deterioration in work performance, decreased strength and/or endurance, and bothersome hot flushes, were associated with low bioavailable testosterone and/or testosterone (P < 0.05). Testosterone and bioavailable testosterone did not differ between age groups, but bioavailable testosterone was higher in men with three or fewer symptoms on the ADAM questionnaire. CONCLUSIONS: Symptoms associated with PADAM often occur in an elderly population, but we could only find an association between three symptoms and blood testosterone concentrations, one being bothersome hot flushes. It is likely that these symptoms have a more complex background than only PADAM. ©2007The North American Menopause Society.
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| 34. |
- Staf, Hjalmar, et al.
(författare)
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On the Influence from Pressing Agent (PEG) on the Elastic and Plastic Mechanical Behavior of Hard Metal Powder Compacts
- 2023
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Ingår i: Crystals. - : MDPI AG. - 2073-4352. ; 13:6
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Tidskriftsartikel (refereegranskat)abstract
- During unloading, pressed hard metal powder compacts expand (spring back), leading to unwarranted tensile stresses and, subsequently, crack initiation in the green body. Here, the elastic spring back and the green strength are analyzed for different types and amounts of the pressing agent PEG (polyethylene glycol). The results show that the plastic behavior, but not the elastic behavior, is influenced by a change of the pressing agent PEG. In this context, it should be stated that the risk for the initiation of cracks is influenced by both the elastic and plastic behavior after compaction. The spring back after compaction and the green strength defines to a large extent the risk for cracks. In addition, it is concluded that a standard three-point bending test is sufficient to analyze the risk for the initiation of cracks when comparing different spray-dried powders.
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| 35. |
- Sundgren, Elisabet, 1975-, et al.
(författare)
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Health for smokers with schizophrenia : a struggle to maintain a dignified life
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:5, s. 416-422
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To investigate the health and lifestyle habits of smokers with schizophrenia and describe their experience of smoking in relation to health.METHODS: Semi-structured interviews with 10 smokers with schizophrenia were conducted in Sweden from May to October 2013. A hermeneutic phenomenological approach was used to describe and interpret respondents' experiences.FINDINGS: Good health for a person with schizophrenia was defined as accepting their mental illness, having strategies to gain control over psychotic symptoms, and engaging in activities and good relationships. Lifestyle habits were described as structures in the respondents' daily life: arising in the morning, taking a cigarette, reading the newspaper, eating breakfast and doing the things planned for the day.CONCLUSION: The meaning of health for smokers with schizophrenia is not the same as being well or ill. Rather, health is an experience of a struggle to maintain a dignified life, including self-acceptance of the mental illness and control over the psychotic symptoms. People with schizophrenia have high willingness but low motivation to stop smoking because they fear that cigarette withdrawal will increase their psychotic symptoms. Therefore, they find it difficult to stop smoking. To succeed with health care intervention, health care providers must understand the life style habits and experiences specific to smokers with schizophrenia and the unique experience of health and life style habits that people with schizophrenia experience.
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| 36. |
- Sving, Eva, et al.
(författare)
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A multifaceted intervention for evidence-based pressure ulcer prevention : a 3 year follow-up.
- 2020
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Ingår i: International Journal of Evidence-Based Healthcare. - : JBI Evidence Implementation. - 1744-1595 .- 1744-1609. ; 18:4, s. 391-400
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To assess sustainability of an intervention used to implement pressure ulcer prevention.BACKGROUND: The Promoting Action on Research Implementation in Health Service, framework was used to develop an intervention aimed to implement evidence-based pressure ulcer prevention in a hospital setting. A short-term follow-up showed that significantly more patients received pressure ulcer prevention. A qualitative process evaluation gave support that the intervention and the implementation process changed the understanding and approach to working with pressure ulcer prevention from treating to preventing.METHOD: The study had a sequential mixed method approach, combining quantitative and qualitative data. For the quantitative data, baseline and short-term follow-up (6-8 months) data reported in an initial study were compared with long-term follow-up (36-42 months) data (n = 259 patients). For the qualitative data, interviews with registered nurses (n = 20), assistant nurses (n = 7) and first-line managers (n = 5) were performed.RESULTS: The performance of pressure ulcer prevention was sustained 3 years from its conception. The number of patients with pressure ulcers was reduced (P = 0.021). Systematic work with quality measurements, support from first-line managers, internal facilitation, collaboration and pressure ulcer prevention skills could explained the sustainability. Obstacles to achieve high-quality pressure ulcer prevention were inadequate communication, high workloads and high rates of new and substitute nurses.CONCLUSION: Three different components for sustainability on the micro-level are described; benefits for the patients, the need for routinization and development over time. Threats to sustainability are described as factors on the macro-level. There needs to be collaboration in the healthcare organization from the micro-to-macro levels, and committed experienced nurses are needed to obtain high-quality sustainable pressure ulcer prevention.
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| 37. |
- Sving, Eva, et al.
(författare)
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Getting evidence-based pressure ulcer prevention into practice: a process evaluation of a multi-faceted intervention in a hospital setting
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 26:19-20, s. 3200-3211
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Tidskriftsartikel (refereegranskat)abstract
- AIM:The aim of the present study was to describe registered nurses', assistant nurses' and first-line managers' experiences and perceptions of a multi-faceted hospital setting intervention focused on implementing evidence-based pressure ulcer prevention.BACKGROUND:Pressure ulcer prevention is deficient. Different models exist to support implementation of evidence-based care. Little is known about implementation processes.DESIGN:A descriptive qualitative approach.METHOD:Five focus-group nurse interviews and five individual first-line manager interviews were conducted at five Swedish hospital units. Qualitative content analysis was used.RESULT:The findings support that the intervention and the implementation process changed the understanding and way of working with pressure ulcer prevention: from treating to preventing. This became possible as 'Changed understanding enables changed actions - through one's own performance and reflection on pressure ulcer prevention'. Having a common outlook on pressure ulcer prevention, easy access to pressure-reducing equipment, and external and internal facilitator support were described as important factors for changed practices. Bedside support, feedback and discussions on current results increased the awareness of needed improvements.CONCLUSION:The multi-faceted intervention approach and the participants' positive attitudes seemed to be crucial for changing understanding and working more preventatively. The strategies used and the skills of the facilitators need to be tailored to the problems surrounding the context. Feed-back discussions among the staff regarding the results of the care provided also appear to be vital.
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| 38. |
- Vestin Fredriksson, Malin, et al.
(författare)
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Clinical Manifestations and Symptoms of Maxillary Sinusitis of Odontogenic Origin Demonstrated by Cone Beam Computed Tomography
- 2019
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Ingår i: Journal of General Practice. - : OMICS Publishing Group. - 2329-9126. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare the symptomatology of patients with maxillary sinusitis of dental origin (MSDO) with sinusitis due to upper respiratory tract infection (URTI) with a special focus on time to correct diagnosis. To define the accuracy of cone beam computed tomography (CBCT) in detecting the dental origin of the sinusitis.Methods: Retrospective review of the otolaryngology specialist care, primary health care and dental health care medical records of patients with maxillary sinusitis who has been referred for radiology. All patients were examined by CBCT, which has a better resolution regarding bony structures than low-dose computed tomography. To the best of our knowledge there is no previous study on this topic based on CBCT as diagnostic method.Results: Sixty-one patients were included in the study; of these, 25 had MSDO and 36 had URTI sinusitis. The MSDO patients more frequently reported foul odour and foul taste than patients with URTI sinusitis. The URTI sinusitis patients more frequently reported symptoms such as facial pain, facial congestion and cold-related symptoms. Both the time from the onset of symptoms to the first medical visit and the subsequent time to a correct diagnosis were significantly longer in the MSDO group. The accuracy of CBCT for detecting dental pathology as the underlying cause of sinusitis was 97%.Conclusion: The present study verifies that maxillary sinusitis of dental origin differs from viral-induced rhinosinusitis concerning symptomatology and clinical findings. Certain findings and symptoms could serve as valuable indicators of an underlying dental pathology, because although MSDO is well known, the present study shows that these patients are often misdiagnosed and the correct diagnose and treatment is often delayed several months. Consequently, better assessment is important. The suspicion of MSDO should be raised for patients with unilateral sinusitis presenting little pain, foul odour or foul taste and a long time course. These patients should be referred for radiology, preferably CBCT, to rule out odontogenic cause. CBCT is easy to perform for sinusitis examinations and has advances to common CT, especially regarding detection of pathology in bony structures as the periapical area. Because of this CBCT is a reliable tool in order to detect maxillary sinusitis of dental origin.
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| 39. |
- Vestin Fredriksson, Malin, 1977-, et al.
(författare)
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Construction and evaluation of a modular anthropomorphic phantom of the skull with an exchangeable specimen jar to optimize the radiological examination of temporal bone pathology
- 2024
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Ingår i: Recent Progress in Materials. - : Lidsen Publishing. - 2689-5846. ; 06:03
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Tidskriftsartikel (refereegranskat)abstract
- To develop a modular anthropomorphic phantom to evaluate the performance of radiological techniques for detecting pathologies in the temporal bone region. A phantom was constructed using a human skull, temporal bone specimen, and 3D-printed contour of a human skull. The human skull was embedded in tissue-equivalent plastic, with a cavity to hold the plastic jars containing the exchangeable freshly frozen human temporal bones. Subsequently, stepwise introduction and examination of different clinicopathological scenarios were conducted. Radiological images were nearly identical to those acquired from patients using computed tomography (CT) and cone beam computed tomography (CBCT). The radiological attenuation of polyurethane plastic (PUR) and alginate were similar to those of the soft tissues of living human patients. The mean Hounsfield unit values of the CT slices representing tissue at the brain and temporal bone level were 184 and 171 in the phantom and patient groups, respectively. The modular phantom developed in this study can evaluate radiological techniques and diagnostic possibilities without exposing patients to radiation. To our knowledge, no such modular phantom has been reported in the literature or made available commercially.
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| 40. |
- Vestin Fredriksson, Malin, 1977-
(författare)
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Radiological evaluation of maxillary sinusitis and temporal bone structures
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: In the field of otorhinolaryngology, the paranasal sinuses and the middle and inner ear present a clinical challenge. Radiological methods offer a stable foundation for diagnostics and preoperative decisions in this context. While many studies have explored the prevalence of maxillary sinusitis of dental origin (MSDO), the use of MSDO detected on cone beam computed tomography (CBCT) scans, rather than conventional computed tomography (CT), is a relatively new approach to detect MSDO. CBCT, with its higher ability to assess bony details, is becoming a valuable tool in detecting MSDO. Photon-counting Computed Tomography (PCCT), a cutting-edge diagnostic imaging method, enables radiological examinations with high spatial resolution at a low radiation dose compared with conventional CT. However, the question of how much the dose can be reduced while maintaining still diagnostic value in radiological examinations remains unanswered.Aims: This thesis aimed to further develop the use of radiology in the ear, nose and throat (ENT) medical field, which could impact how we interpret radiological findings to obtain useful clinical information. The objectives for this thesis were as follows: 1) to investigate the proportion of MSDO among patients with suspected sinusitis referred for radiological examination; 2) to compare the symptomatology of MSDO with sinusitis due to upper respiratory tract infection (URTI); 3) to develop a modular anthropomorphic phantom that could be used to evaluate the performance of radiological techniques in detecting pathology in the temporal bone (TB) region; and 4) to investigate whether the diagnostic quality of TB imaging is maintained even at significantly lower radiation doses using PCCT compared to conventional energy integrated computed tomography (EICT).Material and methods: Paper I was a retrospective study in which our research team reviewed 303 CBCT sinus examinations and analysed the data to determine the prevalence of MSDO among patients with suspected sinusitis who had been referred for radiological examination.A retrospective study was conducted in Paper II, in which the medical records from 61 patients with maxillary sinusitis confirmed via CBCT were thoroughly reviewed. Two independent observers reviewed all cases; when the observers disagreed, the examinations were re-reviewed to reach a consensus, ensuring the reliability of the findings. For comparison, the patients were divided into MSDO and URTI sinusitis groups. Information including self-reported symptoms, clinical findings, and time between first medical contact to correct diagnosis were collected and compared between the groups, providing a comprehensive understanding of the differences between the two conditions.In Paper III, a modular anthropomorphic phantom was constructed. 'To evaluate anatomical structures and image quality, the phantom was used in paper IV to scan 10 human TB specimens using PCCT and conventional CT systems.Results: In paper I, we found that the prevalence of unilateral MSDO was 40 %. Maxillary sinus mucosal swelling adjacent to periapical destruction was found in 91 % of the studied patients.In paper II, we found that the MSDO patients reported a foul odour and foul taste more often, and the time from their first symptom to the correct diagnosis was significantly longer. The URTI sinusitis patients reported toothache, bilateral facial pain, and symptoms associated with a cold more often than the MSDO patients. The accuracy of CBCT for detecting MSDO was 97%.In paper III, we found that the radiological attenuation of the polyurethane (PUR) plastic and alginate plastic used for the phantom was similar to those of the soft tissues of a living human. The mean Hounsfield unit (HU) values of the CT slices representing tissue at the TB and brain level were comparable in the phantom and patient groups.In paper IV, we found that reviewers preferred PCCT scans for the majority of structures being evaluated and for overall image quality. This was true even at a radiation dose below 15 % of that in the clinical EICT protocol.Conclusion: The close relationship between dental infections and unilateral sinusitis should not be overlooked. MSDO differs from URTI sinusitis regarding symptoms and clinical findings, and should be suspected in patients with unilateral symptoms presenting little pain and experiencing a foul odour and/or foul taste. CBCT is a reliable method of detecting MSDO. The modular phantom developed in the third study can be used to evaluate examination methods in a set-up corresponding to a living human without exposing patients to radiation. Finally, PCCT was found to be superior to EICT in terms of image quality.
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| 41. |
- Vestin Fredriksson, Malin, et al.
(författare)
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When Maxillary Sinusitis Does Not Heal : Findings on CBCT Scans of the Sinuses With a Particular Focus on the Occurrence of Odontogenic Causes of Maxillary Sinusitis
- 2017
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Ingår i: Laryngoscope Investigative Otolaryngology (LIO). - : John Wiley & Sons. - 2378-8038. ; 2:6, s. 442-446
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study sought to investigate the proportion of patients with suspected sinusitis referred for radiological examination who have radiologically verified sinusitis of odontogenic origin and to describe this type of sinusitis. Study Design: This investigation is a retrospective study. Methods: A total of 303 sinus examinations involving cone beam computed tomography (CBCT) performed at Sunderby Hospital, Lulea, Sweden in 2012 were independently reviewed by two radiologists. The number of cases of maxillary sinusitis and the correlation between maxillary sinusitis and odontogenic infections were determined. Results: Overall, 24% of the verified cases of sinusitis were odontogenic. An odontogenic origin was identified in 40% of unilateral maxillary sinusitis cases but only 6% of bilateral maxillary sinusitis cases (p=0.0015). Forty-nine out of 54 patients with periapical destruction had adjacent mucosal swelling in the maxillary sinus, but only 15 of these patients satisfied the criteria for sinusitis. Conclusion: The present study confirms the close relationship between odontogenic infections and unilateral maxillary sinusitis.
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| 42. |
- Vincze, Mattias, et al.
(författare)
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To do good might hurt bad : Exploring nurses' understanding and approach to suffering in forensic psychiatric settings
- 2015
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Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 24:2, s. 149-157
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Tidskriftsartikel (refereegranskat)abstract
- Patients in forensic psychiatric settings not only have to deal with their mental illness, but also memories of criminal activities and being involuntarily hospitalized. The aim of the present study was to explore how nurses working in forensic psychiatric services understand and approach patients' experiences of suffering. Data were generated by semistructured interviews with psychiatric nurses from two different forensic psychiatric units in Sweden. Data were analysed by means of a hermeneutic approach inspired by Ricoeur's hermeneutics. The findings are reflected in four main themes: (i) ignoring suffering; (ii) explaining suffering as a natural and inevitable part of daily life in the forensic context; (iii) ascribing meaning to suffering; and, (iv) being present in suffering. To engage in alleviating suffering is a struggle that demands courage and the strength to reflect on its character and consequences. To encounter suffering means that nurses are not only confronted with patients' suffering, but also their own reactions to those patients. If suffering is not recognized or encountered, there is a risk that actions may have a negative impact on patients.
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| 43. |
- Wiklund Gustin, Lena, 1960-, et al.
(författare)
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Nursing teachers’ experiences of the process of recovery while participating in a group programme for reducing work-related stress: A qualitative content analysis
- 2020
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 48
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Tidskriftsartikel (refereegranskat)abstract
- Work-related stress is an increasing health problem among nursing teachers, contributing to health problems, disengagement and poor job satisfaction. Negative coping strategies impact on both teachers' and students' teaching-learning experiences. Several interventions have been developed to address work-related stress. There has been less focus on how nursing teachers can learn to recover from work-related stress before it has severe consequences for their health, and to understand it from a nursing perspective. The aim of this study was to explore how nursing teachers who participated in a cognitive relational group programme experienced the process of recovery from work-related stress. Data were collected by means of three focus groups and subjected to qualitative content analysis, resulting in three categories: relatedness, evoking the inner caregiver, and re-orientation in life. These categories were reflected on in relation to Benner and Wrubel's “primacy of caring and synthesised into a metaphorical theme: “finding one's footings”. The findings imply that the development of positive coping strategies as well as knowledge and understanding about psychological processes are vehicles in the process of recovery. We conclude that interventions also need to account for the process of recovery as related to an ontological level and the persons Being-in-the-World.
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| 44. |
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