| 1. |
- Abbasi, Rasha, et al.
(författare)
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IceCube search for neutrinos from GRB 221009A
- 2023
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Ingår i: Proceedings of 38th International Cosmic Ray Conference (ICRC 2023). - : Sissa Medialab Srl.
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Konferensbidrag (refereegranskat)abstract
- GRB 221009A is the brightest Gamma Ray Burst (GRB) ever observed. The observed extremelyhigh flux of high and very-high-energy photons provide a unique opportunity to probe the predictedneutrino counterpart to the electromagnetic emission. We have used a variety of methods to searchfor neutrinos in coincidence with the GRB over several time windows during the precursor, promptand afterglow phases of the GRB. MeV scale neutrinos are studied using photo-multiplier ratescalers which are normally used to search for galactic core-collapse supernovae neutrinos. GeVneutrinos are searched starting with DeepCore triggers. These events don’t have directionallocalization, but instead can indicate an excess in the rate of events. 10 GeV - 1 TeV and >TeVneutrinos are searched using traditional neutrino point source methods which take into accountthe direction and time of events with DeepCore and the entire IceCube detector respectively. The>TeV results include both a fast-response analysis conducted by IceCube in real-time with timewindows of T0 − 1 to T0 + 2 hours and T0 ± 1 day around the time of GRB 221009A, as well asan offline analysis with 3 new time windows up to a time window of T0 − 1 to T0 + 14 days, thelongest time period we consider. The combination of observations by IceCube covers 9 ordersof magnitude in neutrino energy, from MeV to PeV, placing upper limits across the range forpredicted neutrino emission.
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| 2. |
- Barthoma, Soner, et al.
(författare)
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Reception Policies, Practices and Responses : Sweden Country Report
- 2020
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Rapport (refereegranskat)abstract
- This report explores reception policies, practices and humanitarian responses to the current refugee crisis in Sweden, focusing on the aftermath of 2015 unprecedented refugee migration, and also providing a brief historical perspective. Sweden has been known as one of the most generous countries in terms of welcoming refugees and providing an easy path to citizenship but its migration and reception policy has taken a ‘restrictive turn’ in recent years. The refugee crisis in 2015 has not only opened the window for ‘a major policy shift’ and ‘historical’ legislative changes to the Swedish migration and reception policy but also impacted the social, economic and political sphere instigating anti-immigrant sentiments.
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| 3. |
- Baskici, C., et al.
(författare)
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“Being in the digital box”. Academic staff experiences in online practical teaching : A qualitative study from six universities and countries
- 2024
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Ingår i: Heliyon. - : Elsevier. - 2405-8440. ; 10:2
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has caused radical changes in education, as in everything else, bringing many challenges. Despite all the difficulties, the COVID-19 pandemic has enormous opportunities for online teaching and the use of digital technologies. A comprehensive understanding of this period is needed to investigate these opportunities. Thus, this study aims to explore the academic staff's experiences of online teaching and the use of digital technologies in practical skills-based courses in health care education. This study was conducted at six universities from six countries (Türkiye, Sweden, Finland, Portugal, Latvia, Lithuania). Data were collected between June 17, 2021 and November 30, 2021 via a focus group with an in-depth interview technique. 22 focus group interviews were conducted with a total of 117 participants. Colaizzi's method was used to evaluate the data to discover, comprehend, and define the experiences of academic staff. The analysis of the interview data resulted in 6 themes, 25 subthemes and 56 categories that captured participants' experiences regarding online teaching of practical skills and using digital technologies in health care education. The findings of the study provide crucial information that will help online teaching and digital technology for practical skills be successfully integrated.
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| 4. |
- Blanton, Michael R., et al.
(författare)
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Sloan Digital Sky Survey IV : Mapping the Milky Way, Nearby Galaxies, and the Distant Universe
- 2017
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Ingår i: Astronomical Journal. - : IOP Publishing Ltd. - 0004-6256 .- 1538-3881. ; 154:1
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Tidskriftsartikel (refereegranskat)abstract
- We describe the Sloan Digital Sky Survey IV (SDSS-IV), a project encompassing three major spectroscopic programs. The Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2) is observing hundreds of thousands of Milky Way stars at high resolution and. high signal-to-noise ratios in the near-infrared. The Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey is obtaining spatially resolved spectroscopy for thousands of nearby galaxies (median z similar to 0.03). The extended Baryon Oscillation Spectroscopic Survey (eBOSS) is mapping the galaxy, quasar, and neutral gas distributions between z similar to 0.6 and 3.5 to constrain cosmology using baryon acoustic oscillations, redshift space distortions, and the shape of the power spectrum. Within eBOSS, we are conducting two major subprograms: the SPectroscopic IDentification of eROSITA Sources (SPIDERS), investigating X-ray AGNs. and galaxies in X-ray clusters, and the Time Domain Spectroscopic Survey (TDSS), obtaining spectra of variable sources. All programs use the 2.5 m Sloan Foundation Telescope at the. Apache Point Observatory; observations there began in Summer 2014. APOGEE-2 also operates a second near-infrared spectrograph at the 2.5 m du Pont Telescope at Las Campanas Observatory, with observations beginning in early 2017. Observations at both facilities are scheduled to continue through 2020. In keeping with previous SDSS policy, SDSS-IV provides regularly scheduled public data releases; the first one, Data Release 13, was made available in 2016 July.
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| 5. |
- Catalan-Figueroa, Johanna, et al.
(författare)
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Nanomedicine and nanotoxicology: the pros and cons for neurodegeneration and brain cancer
- 2016
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Ingår i: Nanomedicine. - : Future Medicine Ltd. - 1743-5889 .- 1748-6963. ; 11:2, s. 171-187
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Forskningsöversikt (refereegranskat)abstract
- Current strategies for brain diseases are mostly symptomatic and noncurative. Nanotechnology has the potential to facilitate the transport of drugs across the blood–brain barrier and to enhance their pharmacokinetic profile. However, to reach clinical application, an understanding of nanoneurotoxicity in terms of oxidative stress and inflammation is required. Emerging evidence has also shown that nanoparticles have the ability to alter autophagy, which can induce inflammation and oxidative stress, or vice versa. These effects may increase neurodegenerative processes damage, but on the other hand, they may have benefits for brain cancer therapies. In this review, we emphasize how nanomaterials may induce neurotoxic effects focusing on neurodegeneration, and how these effects could be exploited toward brain cancer treatment.
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| 6. |
- Cetrez, Önver, Associate Professor, 1970-, et al.
(författare)
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Integration Policies, Practices and Experiences – Sweden Country Report
- 2020
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Rapport (refereegranskat)abstract
- This report explores the Swedish integration policies and practices as well as their implementation as experienced by newcomers. Integration refers to the permanent settlement period that sets in after the acquisition of a permanent residence permit, or when one starts mentally adapting to the host society. Through a multilevel governance approach, it highlights how legal, political, and institutional integration frameworks in Sweden affect integration outcomes. The latter refers specifically to the way newcomers establish themselves in the new society and negotiate their new social positions.The report compiles data from different sources (academic literature, research reports, official texts, policies and other relevant texts, interviews conducted both at micro and meso level) in order to provide comprehensive insights into regulations, policies, practices and experiences of integration in Sweden. Thus, the report aims to paint an integrated picture of how different components interact and affect migrant populations. The results are also relevant for future research that will specifically include host populations. The report specifically highlights the effects of a post-migration context on mental health and psychosocial integration, while emphasizing that all areas of daily functioning, namely housing, access to education and the labour market, as well as access to citizenship and a general feeling of belonging, are interconnected and combine in a comprehensive view.
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| 7. |
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| 8. |
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| 9. |
- Fritz, Johanna, et al.
(författare)
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CHRONIC PAIN AND SEDENTARY BEHAVIOR - WHAT TO DO?
- 2023
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Ingår i: International Journal of Behavioral Medicine. - : SPRINGER. - 1070-5503 .- 1532-7558. ; 30, s. S147-S148
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 10. |
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| 11. |
- Fritz, Johanna, et al.
(författare)
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Determinants of Implementing an Information and Communication Technology Tool for Social Interaction Among Older People : Qualitative Content Analysis of Social Services Personnel Perspectives
- 2024
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Ingår i: JMIR Aging. - : JMIR Publications Inc.. - 2561-7605. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older people are particularly vulnerable to social isolation and loneliness, which can lead to ill-health, both mentally and physically. Information and communication technology (ICT) can supplement health and social care and improve health among the vulnerable, older adult population. When ICT is used specifically for communication with others, it is associated with reduced loneliness in older populations. Research is sparse on how the implementation of ICT, used specifically for communication among older people in social services, can be performed. It is recommended to consider the determinants of implementation, that is, barriers to and facilitators of implementation. Determinants related to older people using ICT tools are reported in several studies. To the best of our knowledge, studies investigating the determinants related to the social services perspective are lacking. Objective: This study aims to explore the determinants of implementing the Fik@ room, a new, co-designed, and research-based ICT tool for social interaction among older people, from a social services personnel perspective. Methods: This study used an exploratory, qualitative design. An ICT tool called the Fik@ room was tested in an intervention study conducted in 2021 in 2 medium-sized municipalities in Sweden. Informants in this study were municipal social services personnel with experience of implementing this specific ICT tool in social services. We conducted a participatory workshop consisting of 2 parts, with 9 informants divided into 2 groups. We analyzed the data using qualitative content analysis with an inductive approach. Results: The results included 7 categories of determinants for implementing the ICT tool. Being able to introduce the ICT tool in an appropriate manner concerns the personnel’s options for introducing and supporting the ICT tool, including their competencies in using digital equipment. Organizational structure concerns a structure for communication within the organization. Leadership concerns engagement and enthusiasm as driving forces for implementation. The digital maturity of the social services personnel concerns the personnel’s skills and attitudes toward using digital equipment. Resources concern time and money. IT support concerns accessibility, and legal liability concerns possibilities to fulfill legal responsibilities. Conclusions: The results show that implementation involves an entire organization at varying degrees. Regardless of how much each level within the organization comes into direct contact with the ICT tool, all levels need to be involved to create the necessary conditions for successful implementation. The prerequisites for the implementation of an ICT tool will probably change depending on the digital maturity of future generations. As this study only included 9 informants, the results should be handled with care. The study was performed during the COVID-19 pandemic, which has probably affected the results.
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| 12. |
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| 13. |
- Fritz, Johanna, et al.
(författare)
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Do Physical Therapists Practice a Behavioral Medicine Approach? : A Comparison of Perceived and Observed Practice Behaviors
- 2023
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Ingår i: Physical Therapy. - : NLM (Medline). - 0031-9023 .- 1538-6724. ; 103:5
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A behavioral medicine approach, incorporating a biopsychosocial view and behavior change techniques, is recommended in physical therapy for the management of musculoskeletal pain. However, little is known about physical therapists' actual practice behavior regarding the behavioral medicine approach. The aim of this study was to examine how physical therapists in primary health care judge their own practice behavior of a behavioral medicine approach in the assessment and treatment of patients with persistent musculoskeletal pain versus how they practice a behavioral medicine approach as observed by independent experts in video recordings of patient consultations. METHODS: A prospective cohort study was conducted. Video recordings of 23 physical therapists' clinical behavior in 139 patient consultations were observed by independent experts and compared with the physical therapists' self-reported practice behavior, using a protocol including 24 clinical behaviors. The difference between observed and self-reported clinical behaviors was analyzed with a Chi-square test and a Fisher exact test. RESULTS: The behavioral medicine approach was, in general, practiced to a small extent and half of the self-reported clinical behaviors were overestimated when compared with the observed behaviors. According to the observations, the physical perspective dominated in assessment and treatment, the functional behavioral analysis was never performed, and the mean number of behavior change techniques used was 0.7. CONCLUSION: There was a discrepancy between how physical therapists perceived the extent to which they practiced a behavioral medicine approach in their clinical behavior compared with what the independent researchers observed in the video recordings. IMPACT: This study demonstrates the importance of using observations instead of using self-reports when evaluating professionals' clinical behavior. The results also suggest that-to ensure that physical therapy integrates the biopsychosocial model of health-physical therapists need to increase their focus on psychosocial factors in clinical practice.
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| 14. |
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| 15. |
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| 16. |
- Fritz, Johanna, et al.
(författare)
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Implementation of a behavioral medicine approach in physiotherapy: a process evaluation of facilitation methods
- 2019
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In a quasi-experimental study, facilitation was used to support implementation of the behavioral medicine approach in physiotherapy. The facilitation consisted of an individually tailored multifaceted intervention including outreach visits, peer coaching, educational materials, individual goal-setting, video feedback, self-monitoring in a diary, manager support, and information leaflets to patients. A behavioral medicine approach implies a focus on health related behavior change. Clinical behavioral change was initiated but not maintained among the participating physiotherapists. To explain these findings, a deeper understanding of the implementation process is necessary. The aim was therefore to explore the impact mechanisms in the implementation of a behavioral medicine approach in physiotherapy by examining dose, reach, and participant experiences. Methods An explorative mixed-methods design was used as a part of a quasi-experimental trial. Twenty four physiotherapists working in primary health care were included in the quasi-experimental trial, and all physiotherapists in the experimental group (n = 15) were included in the current study. A facilitation intervention based mainly on social cognitive theory was tested during a 6-month period. Data were collected during and after the implementation period by self-reports of time allocation regarding participation in different implementation methods, documentation of individual goals, ranking of the most important implementation methods, and semi-structured interviews. Descriptive statistical methods and inductive content analysis were used. Results The physiotherapists participated most frequently in the following implementation methods: outreach visits, peer coaching, educational materials, and individual goal-setting. They also considered these methods to be the most important for implementation, contributing to support for learning, practice, memory, emotions, self-management, and time management. However, time management support from the manager was lacking. Conclusions The findings indicate that different mechanisms govern the initiation and maintenance of clinical behavior change. The impact mechanisms for initiation of clinical behavior change refers to the use of externally initiated multiple methods, such as feedback on practice, time management, and extrinsic motivation. The lack of self-regulation capability, intrinsic motivation, and continued support after the implementation intervention period were interpreted as possible mechanisms for the failure of maintaining the behavioral change over time.
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| 17. |
- Fritz, Johanna, et al.
(författare)
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Implementation of a behavioral medicine approach in physiotherapy: impact and sustainability
- 2020
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 42:24, s. 3467-3474
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore the effects on and sustainability of physiotherapists' clinical behavior when using facilitation to support the implementation of a behavioral medicine approach in primary health care for patients with persistent musculoskeletal pain. Methods: A quasi-experimental pre-/post-test trial was conducted. Fifteen physiotherapists were included in the experimental group, and nine in the control group. Based on social cognitive theory and the Promoting Action on Research Implementation in Health Services framework, facilitation with multifaceted implementation methods was used during a six-month period. Clinical behaviors were investigated with a study-specific questionnaire, structured observations, self-reports and patient records. Descriptive and non-parametric statistical methods were used for analyzing differences over time and effect size. Results: A sustained increase in self-efficacy for applying the behavioral medicine approach was found. Clinical actions and verbal expressions changed significantly, and the effect size was large; however, changes were not sustained at follow-ups. The behavioral changes were mainly related to the goal setting, self-monitoring and functional behavioral analysis components. No changes in clinical behavior were found in the control group. Conclusion: Tailored multifaceted facilitation can support the implementation of a behavioral medicine approach in physiotherapy in primary health care, but more comprehensive actions targeting sustainability are needed.
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| 18. |
- Fritz, Johanna, 1974-
(författare)
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Implementation of a behavioural medicine approach in physiotherapy : Determinants, clinical behaviours, patient outcomes and the implementation process
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Current research shows that a behavioural medicine approach in physiotherapy increases the ability to participate in daily activities and decreases sick leave in patients with persistent musculoskeletal pain. A behavioural medicine approach means that the physiotherapist systematically considers biopsychosocial factors of importance for the patient's activity and participation. Active patient involvement is central, and behaviour change techniques are used. One in seven of the patients in primary health care suffers from persistent musculoskeletal pain. Therefore, primary health care needs to implement a behavioural medicine approach in physiotherapy. However, the implementation of new methods is challenging. It is important to increase the knowledge about how to implement a behavioural medicine approach into physiotherapy clinical practice to make recommended treatment available to more patients with persistent musculoskeletal pain. The overall aim of this thesis was therefore to develop and evaluate methods for supporting the implementation of a behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain.In study I, determinants of using a behavioural medicine approach in physiotherapy were identified using a qualitative multiple-case study design. An implementation intervention was developed based on these determinants and on theoretical assumptions regarding behaviour change and learning. The implementation intervention was tested in a quasi-experimental trial for six months and evaluated by focusing on physiotherapists' clinical behaviour changes in study II and the effects on patients' health in study III. In study IV, a process evaluation was conducted with a mixed methods design to explain the impact mechanisms of the implementation intervention. Altogether, 28 physiotherapists, 159 patients and three managers participated in the project.The determinants identified in study I were associated with the physiotherapist, the patient and the workplace. An implementation intervention was developed based on these determinants and on assumptions in the social cognitive theory, the constructivist learning theory, and the Promoting Action on Research Implementation in Health Services (PARIHS) framework. The implementation intervention consisted of outreach visits, peer coaching, educational materials, individual goalsetting, video feedback, self-monitoring in a diary, the stimulation of manager support and an information leaflet for patients. Immediately after the implementation period, the physiotherapists significantly changed their clinical behaviour, but these changes were not sustained. The patients treated by these physiotherapists achieved no further health improvement compared to a control group. Outreach visits, peer coaching, educational material and individual goalsetting were perceived by the physiotherapists as the most useful methods and supported the implementation through multiple learning methods, action planning, processing experiences, synergy effects with self-efficacy beliefs, and extrinsic motivation.In conclusion, this thesis contributes to an increased understanding of the complexity regarding what affects the implementation of a behavioural medicine approach in physiotherapy and the promising methods and their impact mechanisms that support this implementation. A distinction between achieving clinical behaviour changes and sustaining these changes is highlighted. This implies that an implementation intervention needs to support both factors in order for the implementation of a behavioural medicine approach to benefit the patients. The thesis also illustrates how combined theoretical perspectives can inform an implementation intervention in physiotherapy in a useful way.
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| 19. |
- Fritz, Johanna, et al.
(författare)
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Implementation of a behavioural medicine approach in physiotherapy – a process evaluation.
- 2017
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Ingår i: World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017..
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Konferensbidrag (refereegranskat)abstract
- Background: A behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain is recommended based on evidence. The approach aims at an individually tailored treatment targeting motor behaviour, cognition, disability and active patient involvement. The behavioural medicine approach is complex and it is challenging in implementation to achieve clinically relevant behaviours in physiotherapy. Process evaluation is an essential part of designing and testing implementation interventions to improve the quality of the implementation. However, studies evaluating the implementation process of a behavioural medicine approach in physiotherapy are sparse.Purpose: To explore the implementation process of a behavioural medicine approach in physiotherapy.Methods: Qualitative and quantitative methods were used. 15 physiotherapists working in six primary health care units were consecutively included. A theory based implementation intervention was tailored to the participating individual physiotherapists. Active and multifaceted implementation strategies were used during a total of seven days spread over a six months implementation period. The main implementation strategies were external facilitation and peer-learning. Ten two-hours outreach sessions were offered to each unit. The physiotherapists were encouraged to use individual goal setting and video recordings of treatment sessions to facilitate feedback and reflection during the sessions with the external facilitator. Process data were collected using semi-structured interviews, self-reports of time allocation for different implementation strategies and documented individual goals. Qualitative content analysis and quantitative frequency scorings were used for data analyses.Results: In median the physiotherapists participated in 9 (3-10) out of 10 sessions with the external facilitator. Discussing clinical experiences of the behavioural medicine approach together with the external facilitator was perceived as valuable. These discussions stimulated reflection and problem solving, and was also experienced as a reminder for practicing skills in behavioural medicine. Video recordings of treatment sessions were used by ten of the physiotherapists at 17 out of 57 possible sessions. Video recordings were experienced as too complicated to use in relation to the gains. Lack of time was also considered as a barrier for using video recordings. Individual goal-setting from one session to the next with the external facilitator was frequently used by all the participants. Relevant skills for the goals were practiced in between the sessions. However, goal setting was not considered important by the physiotherapists. In median the physiotherapists spent 3.25 (0-9.5) hours for peer discussions. Peer discussions were a strategy that the physiotherapists wanted to continue with, even after the implementation intervention period. Even though the physiotherapists had permission from the manager to spend time on the implementation intervention, it was challenging for the physiotherapists to prioritize the implementation intervention before patient care.Conclusion(s): External facilitation and peer discussions were perceived as important strategies for stimulating practice of behavioural medicine skills in physiotherapy. Further, peer discussions could stimulate sustainability of the implementation. The physiotherapists needed support to use the designated time for the implementation.Implications: Quantitative and qualitative analyses of the implementation process is useful for understanding the mechanisms of impact for the implementation intervention, how outcomes were achieved and for future replications.
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| 20. |
- Fritz, Johanna, et al.
(författare)
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Patients' health outcomes after an implementation intervention targeting the physiotherapists' clinical behaviour.
- 2021
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Ingår i: Archives of physiotherapy. - : Springer Science and Business Media LLC. - 2057-0082. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A behavioural medicine approach in physiotherapy has shown positive effects on increased and sustained activities and participation, including reduced sick leave for patients with persistent musculoskeletal pain. The aim of this study was to explore the health outcomes of patients with persistent musculoskeletal pain treated by physiotherapists who had received active compared with passive support when implementing a behavioural medicine approach.METHODS: An explorative and comparative pre-/post-test trial was conducted. A total of 155 patients with musculoskeletal pain ≥4 weeks were consecutively recruited by physiotherapists in primary healthcare who had received active or passive support when implementing a behavioural medicine approach. Data concerning health outcomes for patients were collected using questionnaires before and after the physiotherapy treatment and at half-, one- and two-year follow-ups. Descriptive, non-parametric and parametric bi- and multivariate statistics were used.RESULTS: There were no differences over time between the patients treated by physiotherapists who had received active compared to passive implementation support regarding pain-related disability, pain intensity, self-rated health, self-efficacy in performing daily activities, catastrophic thinking related to pain, and fear of movement. Significant improvements over time were identified in both groups regarding all variables and the effect sizes were large. The percentage of patients on sick leave significantly decreased in the patient group treated by physiotherapists who had received active implementation support.CONCLUSION: It is very important to include patient outcomes when evaluating the implementation of multicomponent interventions. It seems that the implementation method did not play a major role for the patients' outcomes in this study. Most of the patients' health outcomes improved regardless of whether they were treated by physiotherapists who had received active or passive support when implementing a behavioural medicine approach. This was likely because the active implementation support was not extensive enough to enable the physiotherapists to sustain the behavioural medicine approach.TRIAL REGISTRATION: The study protocol was retrospectively registered in ClinicalTrials.gov . ID NCT03118453 , March 20, 2017.
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| 21. |
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| 22. |
- Fritz, Johanna, et al.
(författare)
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The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice
- 2019
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 35:12, s. 1182-1193
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Tidskriftsartikel (refereegranskat)abstract
- Introduction and Aim: The implementation of a behavioral medicine (BM) approach in physiotherapy is challenging, and studies regarding the determinants are sparse. Thus, the aim of this study was to explore determinants of applying a BM approach in physiotherapy for patients with persistent pain across the micro-, meso-, and macro-levels. Methods: A qualitative multiple-case study design was used. Data were collected from four cases through semi-structured interviews with physiotherapists (PTs), patients, and managers; observations of video-recorded treatment sessions; and reviews of local directives and regulations. Data were analyzed with inductive content analysis and cross-case analysis, followed by mapping to the domains of determinants at the micro-, meso-, and macro-levels within the Implementation of Change Model. Results: Similar determinants were found across the cases. At the micro-level, these determinants concerned the PTs’ ambivalence toward a BM approach, a biomedical focus, embarrassment asking about psychosocial factors, BM knowledge, skills for applying the approach, and self-awareness. Others concerned the patients’ role expectations of the PT, patients as active or passive agents in the treatment process, patients’ focus on biomedical aspects, and confidence in the PT. At the meso-level, support from managers and peers, allocation of time, and expectations from the organization were identified as determinants. No determinants were identified at the macro-level. Conclusion: The complexity of integrating a BM approach into physiotherapy clinical practice arises from multiple determinants functioning as both facilitators and barriers. By selecting strategies to address these determinants, the implementation of a BM approach could be supported.
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| 23. |
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| 24. |
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| 25. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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Older Adults’ Use of a Research-Based Web Platform for Social Interaction
- 2023
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- Loneliness and social isolation are triggers for unfavorable changes in older adults’ health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults’ use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction “the Fik@ room” for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults’ use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.
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| 26. |
- Klein, Jan Philipp, et al.
(författare)
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The EVIDENT-trial: protocol and rationale of a multicenter randomized controlled trial testing the effectiveness of an online-based psychological intervention
- 2013
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Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDepressive disorders are among the leading causes of worldwide disability with mild to moderate forms of depression being particularly common. Low-intensity treatments such as online psychological treatments may be an effective way to treat mild to moderate depressive symptoms and prevent the emergence or relapse of major depression.Methods/DesignThis study is a currently recruiting multicentre parallel-groups pragmatic randomized-controlled single-blind trial. A total of 1000 participants with mild to moderate symptoms of depression from various settings including in- and outpatient services will be randomized to an online psychological treatment or care as usual (CAU). We hypothesize that the intervention will be superior to CAU in reducing depressive symptoms assessed with the Personal Health Questionnaire (PHQ-9, primary outcome measure) following the intervention (12 wks) and at follow-up (24 and 48 wks). Further outcome parameters include quality of life, use of health care resources and attitude towards online psychological treatments.DiscussionThe study will yield meaningful answers to the question of whether online psychological treatment can contribute to the effective and efficient prevention and treatment of mild to moderate depression on a population level with a low barrier to entry.
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| 27. |
- Meyer, Björn, et al.
(författare)
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Effects of an Internet intervention (Deprexis) on severe depression symptoms : Randomized controlled trial
- 2015
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Ingår i: Internet Interventions. - : Elsevier. - 2214-7829. ; 2:1, s. 48-59
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundStudies have shown that certain Internet interventions can help alleviate depression. However, many such interventions contain personal support elements, making it difficult to ascertain whether the program or the support drives the effects. Studies are needed to investigate whether Internet interventions contribute to symptom reduction even when they are delivered without personal support, and even among severely depressed individuals who often receive other forms of treatment.ObjectiveThis randomized controlled trial aimed to examine the effect of an Internet intervention that was deployed without personal support (“Deprexis”) among adults with initially severe depression symptoms.MethodsAdults recruited from a range of sources who had exceeded the threshold for severe depression (PHQ-9 ≥ 15) in a pre-screening assessment and met inclusion criteria were randomized (N = 163) to the intervention (3 months program access; n = 78) or care-as-usual/waitlist control (n = 85). A diagnostic screening interview was administered by telephone at baseline to all participants. Online assessments were administered at baseline, 3 months (post-treatment), and 6 months (follow-up). The main outcome was the Patient Health Questionnaire (PHQ-9) between baseline and post-treatment.ResultsEighty-two percent of randomized participants were reached for the post-treatment assessment. Results for the intention-to-treat (ITT) sample showed significant intervention effects on depression reduction between baseline and post-treatment (linear mixed model [MM], F1,155.6 = 9.00, p < .01, for the time by condition interaction), with a medium between-group effect size, Cohen's d = 0.57 (95% CI: 0.22–0.92). Group differences in depression severity at follow-up were marginally significant in the ITT sample, t (119) = 1.83, p = 0.07, and smaller than at post-treatment (PHQ-9, d = 0.33, 95% CI: − 0.03–0.69). The number needed to treat (NNT) at post-treatment was 5, with 38% of participants in the intervention group achieving response (at least 50% PHQ-9 symptom change, plus post-treatment score < 10), compared to 17% in the control group, p < 0.01. Effects on secondary outcomes, including anxiety, health-related quality of life, and somatic symptoms, were not significant, with the exception of significant effects on anxiety reduction in PP analyses. Early ratings of program helpfulness/alliance (after 3 weeks) predicted pre–post depression reduction, controlling for baseline severity and early symptom change.ConclusionsThese results replicate and extend previous findings by showing that Deprexis can facilitate symptomatic improvement over 3 months and, perhaps to a lesser degree, up until 6 months among adults with initially severe depression.
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| 28. |
- Philipp Klein, Jan, et al.
(författare)
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Effects of a Psychological Internet Intervention in the Treatment of Mild to Moderate Depressive Symptoms: Results of the EVIDENT Study, a Randomized Controlled Trial
- 2016
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Ingår i: Psychotherapy and Psychosomatics. - : KARGER. - 0033-3190 .- 1423-0348. ; 85:4, s. 218-228
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mild to moderate depressive symptoms are common but often remain unrecognized and treated inadequately. We hypothesized that an Internet intervention in addition to usual care is superior to care as usual alone (CAU) in the treatment of mild to moderate depressive symptoms in adults. Methods: This trial was controlled, randomized and assessor-blinded. Participants with mild to moderate depressive symptoms (Patient Health Questionnaire, PHQ-9, score 5-14) were recruited from clinical and non-clinical set-tings and randomized to either CAU or a 12-week Internet intervention (Deprexis) adjunctive to usual care. Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The primary outcome measure was self-rated depression severity (PHQ-9). The main analysis was based on the intention-to-treat principle and used linear mixed models. Results: A total of 1,013 participants were randomized. Changes in PHQ-9 from baseline differed significantly between groups (t(825) = 6.12, p amp;lt; 0.001 for the main effect of group). The post-assessment between-group effect size in favour of the intervention was d = 0.39 (95% CI: 0.13-0.64). It was stable at follow-up, with d = 0.32 (95% CI: 0.06-0.69). The rate of participants experiencing at least minimally clinically important PHQ-9 change at the post-assessment was higher in the intervention group (35.6 vs. 20.2%) with a number needed to treat of 7 (95% CI: 5-10). Conclusions: The Internet intervention examined in this trial was superior to CAU alone in reducing mild to moderate depressive symptoms. The magnitude of the effect is clinically important and has public health implications. (C) 2016 S. Karger AG, Basel
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| 29. |
- Sandborgh, Maria, 1955-, et al.
(författare)
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Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program : Rationale, Process and Ten-year Review
- 2020
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Ingår i: Physiotherapy Theory and Practice. - Philadelphia : Taylor & Francis. - 0959-3985 .- 1532-5040. ; 36:3, s. 365-377
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Forskningsöversikt (refereegranskat)abstract
- In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.
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| 30. |
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| 31. |
- Söderlund, Anne, 1957-, et al.
(författare)
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Implementing a behavioral medicine approach in physiotherapy for patients with musculoskeletal pain : a scoping review
- 2020
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Ingår i: Pain Reports. - 2471-2531. ; 5:5
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Forskningsöversikt (refereegranskat)abstract
- In intervention research on musculoskeletal pain, physiotherapists often study behavioral and cognitive components. Evidence on applying these components has increased during the past decade. However, how to effectively integrate behavioral and cognitive components in the biopsychosocial management of musculoskeletal pain is challenging. The aim was to study the intervention components and patient outcomes of studies integrating behavioral and cognitive components in physiotherapy, to match the interventions with a definition of behavioral medicine in physiotherapy and to categorize the behavior change techniques targeted at patients with musculoskeletal pain in (1) randomized controlled effect trials or (2) implementation in clinical practice trials. A scoping review was used to conduct this study, and the PRISMA-ScR checklist was applied. Relevant studies were identified from the PubMed, MEDLINE, PsycINFO, CINAHL Plus, and Web of Science Core databases separately for the (1) randomized controlled effect trials and (2) implementation in clinical practice trials. Synthesis for the matching of the patient interventions with the existing definition of behavior medicine in physiotherapy showed that the interventions mostly integrated psychosocial, behavioral, and biomedical/physical aspects, and were thus quite consistent with the definition of behavioral medicine in physiotherapy. The reported behavior change techniques were few and were commonly in categories such as “information of natural consequences,” “feedback and monitoring,” and “goals and planning.” The patient outcomes for long-term follow-ups often showed positive effects. The results of this scoping review may inform future research, policies, and practice.
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| 32. |
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| 33. |
- Zahajská, Petra, et al.
(författare)
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Impact of Holocene climate change on silicon cycling in Lake 850, Northern Sweden
- 2021
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Ingår i: The Holocene. - : SAGE Publications. - 0959-6836 .- 1477-0911. ; 31:10, s. 1582-1592
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Tidskriftsartikel (refereegranskat)abstract
- Diatom-rich sediment in a small subarctic lake (Lake 850) was investigated in a 9400 cal. yr BP sediment record in order to explore the impact of Holocene climate evolution on silicon cycling. Diatom stable silicon isotopes (δ30SiBSi ) and biogenic silica (BSi) indicate that high BSi concentrations in sediment throughout the Holocene are associated with a lighter Si isotope source of dissolved silica (DSi), such as groundwater or freshly weathered primary minerals. Furthermore, higher BSi concentrations were favoured during the mid-Holocene by low detrital inputs and possibly a longer ice-free period allowing for more diatom production to occur. The diatom δ30SiBSi signature shows a link to changes in regional climate and is influenced by length of diatom growth period and hydrological fluctuations. Lighter Si isotopic values occur during the mid Holocene, when climate is inferred to be more continental and drier, with pronounced seasonality. In contrast, a heavier Si isotopic signature is observed in the early and late Holocene, when oceanic influences are thought to be stronger and the climate wetter. The δ30SiBSi values have generally lighter signatures as compared with other studies, which supports a light DSi source.
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| 34. |
- Zahajská, Petra, et al.
(författare)
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Modern silicon dynamics of a small high-latitude subarctic lake
- 2021
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Ingår i: Biogeosciences. - : Copernicus GmbH. - 1726-4189. ; 18:7, s. 2325-2345
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Tidskriftsartikel (refereegranskat)abstract
- High biogenic silica (BSi) concentration occurs sporadically in lake sediments throughout the world, however, the processes leading to high BSi concentrations varies. While BSi formation and preservation is expected to occur in silica-rich environments with high dissolved silicon (DSi) concentrations such as volcanic and hydrothermal inputs, the factors and mechanisms explaining high DSi and BSi concentrations in lakes remain unclear. We explored the factors responsible for the high BSi concentration in sediments of a small, high-latitude subarctic lake (Lake 850). To do this, we combined measurements of variations in stream discharges, DSi concentrations and stable Si isotopes in both lake and stream water with measurements of BSi content in lake sediments. Water, radon, and Si mass balances revealed the importance of groundwater discharge as a main source of DSi to the lake, with groundwater-derived DSi inputs 3 times higher than those from ephemeral stream inlets. After including all external DSi sources (i.e., inlets and groundwater discharge) and estimating the total BSi accumulation in the sediment, we show that diatom production consumes up to 79 % of total DSi input. Additionally, low sediment accumulation rates were observed based on the dated core. Our findings thus demonstrate that groundwater discharge and low mass accumulation rate can account for the high BSi accumulation during the last 150 cal. yr BP. Globally, lakes have been estimated to retain one fifth of the annual DSi delivery into the ocean. Well constrained lake mass balances, such as presented here, bring clarity to those estimates of the terrestrial Si cycle sinks.
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| 35. |
- Zahajská, Petra, et al.
(författare)
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Modern silicon dynamics of a small high-latitude subarctic lake
- 2021
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Ingår i: Biogeosciences. - : European Geosciences Union (EGU). - 1726-4170 .- 1726-4189. ; 18:7, s. 2325-2345
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Tidskriftsartikel (refereegranskat)abstract
- High biogenic silica (BSi) concentrations occur sporadically in lake sediments throughout the world; however, the processes leading to high BSi concentrations vary. We explored the factors responsible for the high BSi concentration in sediments of a small, high-latitude subarctic lake (Lake 850). The Si budget of this lake had not been fully characterized before to establish the drivers of BSi accumulation in this environment. To do this, we combined measurements of variations in stream discharge, dissolved silica (DSi) concentrations, and stable Si isotopes in both lake and stream water with measurements of BSi content in lake sediments. Water, radon, and Si mass balances revealed the importance of groundwater discharge as a main source of DSi to the lake, with groundwater-derived DSi inputs 3 times higher than those from ephemeral stream inlets. After including all external DSi sources (i.e., inlets and groundwater discharge) and estimating the total BSi accumulation in the sediment, we show that diatom production consumes up to 79 % of total DSi input. Additionally, low sediment accumulation rates were observed based on the dated gravity core. Our findings thus demonstrate that groundwater discharge and low mass accumulation rate can account for the high BSi accumulation during the last 150 cal yr BP. Globally, lakes have been estimated to retain one-fifth of the annual DSi terrestrial weathering flux that would otherwise be delivered to the ocean. Well-constrained lake mass balances, such as presented here, bring clarity to those estimates of the terrestrial Si cycle sinks.
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| 36. |
- Zahajská, Petra, et al.
(författare)
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The Holocene silicon biogeochemistry of Yellowstone Lake, USA
- 2023
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Ingår i: Quaternary Science Reviews. - 0277-3791. ; 322
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Tidskriftsartikel (refereegranskat)abstract
- Silicon (Si) is an essential macronutrient for diatoms, an important component of lacustrine primary productivity that represents a link between the carbon and silicon cycles. Reconstructions of lake silicon cycling thus provide an underexploited window onto lake and catchment biogeochemistry. Silicon isotope geochemistry has potential to provide these reconstructions, given the competing source and process controls can be deconvolved. The silica-rich volcanic and hydrothermal systems in Yellowstone National Park are a great source of dissolved silicon into Yellowstone Lake, a system with high silicon, and thus carbon, export rates and the formation of diatom–rich sediment. Yellowstone Lake sediments should be an archive of past silicon biogeochemistry, although the effect of sublacustrine hydrothermal activity or hydrothermal explosion events is unclear. Here, we analysed lake water, tributaries, and hydrothermal vent fluids from Yellowstone Lake for their dissolved Si concentrations, isotope composition (δ30Si) and Ge/Si ratios to evaluate the sources of variability in the lake's Si cycle. Bulk elemental composition and biogenic SiO2 (bSiO2) content, together with δ30Si and Ge/Si ratios from a single diatom species, Stephanodiscus yellowstonensis, were analysed in two sediment cores spanning the last 9880 cal. yr BP. We investigate these datasets to identify long term Holocene changes in hydrothermal activity and effects of large and short-term events i.e., hydrothermal and a volcanic eruption. Combinations of bSiO2, δ30Si and Ge/Si with XRF and lithology data revealed that Yellowstone Lake has a resilient biogeochemical system: hydrothermal explosions are visible in the lithology but have no identifiable impact on bSiO2 accumulation or on the δ30Si signature. Both cores show similarities that suggest a stable and homogeneous dSi source across the entire lake. A narrow range of δ30Si and Ge/Si values suggests that the productive layer of the lake was well mixed and biogeochemically stable, with consistently high hydrothermal inputs of Si throughout the Holocene to buffer against the disturbance events. Variation in bSiO2 concentration through time is weakly correlated with an increase towards younger sediment in the δ30Si fossil diatom record in both cores. This increase mirrors that seen in ocean records, and follows changes known in summer insolation, summer temperatures and lake water-column mixing since the deglaciation. This suggests that climate forcing, and soil formation ultimately govern the silicon isotope record, which we suggest is via a combination of changes in weathering stoichiometry, diatom production, and relative proportion of dSi sources.
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| 37. |
- Zahajská, Petra, et al.
(författare)
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What is diatomite?
- 2020
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Ingår i: Quaternary Research. - : Cambridge University Press (CUP). - 0033-5894 .- 1096-0287. ; , s. 48-52
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Forskningsöversikt (refereegranskat)abstract
- Different types of biogenic remains, ranging from siliceous algae to carbonate precipitates, accumulate in the sediments of lakes and other aquatic ecosystems. Unicellular algae called diatoms, which form a siliceous test or frustule, are an ecologically and biogeochemically important group of organisms in aquatic environments and are often preserved in lake or marine sediments. When diatoms accumulate in large numbers in sediments, the fossilized remains can form diatomite. In sedimentological literature, "diatomite"is defined as a friable, light-coloured, sedimentary rock with a diatom content of at least 50%, however, in the Quaternary science literature diatomite is commonly used as a description of a sediment type that contains a "large"quantity of diatom frustules without a precise description of diatom abundance. Here we pose the question: What is diatomite? What quantity of diatoms define a sediment as diatomite? Is it an uncompacted sediment or a compacted sediment? We provide a short overview of prior practices and suggest that sediment with more than 50% of sediment weight comprised of diatom SiO2 and having high (>70%) porosity is diatomaceous ooze if unconsolidated and diatomite if consolidated. Greater burial depth and higher temperatures result in porosity loss and recrystallization into porcelanite, chert, and pure quartz.
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| 38. |
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| 39. |
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