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| 2. |
- Humble, Mats B., 1952-
(författare)
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Obsessive-compulsive disorder, serotonin and oxytocin : treatment response and side effects
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Obsessive-compulsive disorder (OCD), with a prevalence of 1-2 %, frequently leads a chronic course. Persons with OCD are often reluctant to seek help and, if they do, their OCD is often missed. This is unfortunate, since active treatment may substantially improve social function and quality of life. Serotonin reuptake inhibitors (SRIs) have welldocumented efficacy in OCD, but delayed response may be problematic. Methods to predict response have been lacking. Because SRIs are effective, pathophysiological research on OCD has focussed on serotonin. However, no clear aberrations of serotonin have been found, thus other mechanisms ought to be involved.Our aims were to facilitate clinical detection and assessment of OCD, to search for biochemical correlates of response and side-effects in SRI treatment of OCD and to identify any possible involvement of oxytocin in the pathophysiology of OCD.In study I, we tested in 402 psychiatric out-patients the psychometric properties of a concise rating scale, “Brief Obsessive Compulsive Scale” (BOCS). BOCS was shown to be easy to use and have excellent discriminant validity in relation to other common psychiatric diagnoses.Studies II-V were based on 36 OCD patients from a randomised controlled trial of paroxetine, clomipramine or placebo. In study II, contrary to expectation, we found that the change (decrease) of serotonin in whole blood was most pronounced in non-responders to SRI. This is likely to reflect inflammatory influence on platelet turnover rather than serotonergic processes within the central nervous system.In studies IV-V, we found relations between changes of oxytocin in plasma and the anti-obsessive response, and between oxytocin and the SRI related delay of orgasm, respectively. In both cases, the relation to central oxytocinergic mechanisms is unclear. In males, delayed orgasm predicted anti-obsessive response.
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| 8. |
- Oussi, Ninos, et al.
(författare)
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Trainee Performance After Laparoscopic Simulator Training Using a Blackbox versus LapMentor
- 2020
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Ingår i: Journal of Surgical Research. - : Elsevier BV. - 0022-4804 .- 1095-8673. ; 250, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Training using laparoscopic high-fidelity simulators (LHFSs) to proficiency levels improves laparoscopic cholecystectomy skills. However, high-cost simulators and their limited availability could negatively impact residents' laparoscopic training opportunities. We aimed to assess whether motivation and surgical skill performance differ after basic skills training (BST) using a low-cost (Blackbox) versus LHFS (LapMentor) among medical students.MATERIALS AND METHODS: Sixty-three medical students from Karolinska Institutet volunteered, completing written informed consent, questionnaire regarding expectations of the simulation training, and a visuospatial ability test. They were randomized into two groups that received BST using Blackbox (n = 32) or LapMentor (n = 31). However, seven students absence resulted in 56 participants, followed by another 9 dropouts. Subsequently, after training, 47 students took up three consecutive tests using the minimally invasive surgical trainer-virtual reality (MIST-VR) simulator, finalizing a questionnaire.RESULTS: More Blackbox group participants completed all MIST-VR tests (29/31 versus 18/25). Students anticipated mastering LapMentor would be more difficult than Blackbox (P = 0.04). In those completing the simulation training, a trend toward an increase was noted in how well participants in the Blackbox group liked the simulator training (P = 0.07). Subgroup analysis of motivation and difficulty in liking the training regardless of simulator was found only in women (Blackbox [P = 0.02]; LapMentor [P = 0.06]). In the Blackbox group, the perceived difficulty of training, facilitation, and liking the Blackbox training (significant only in women) were significantly correlated with the students' performance in the MIST-simulator. No such correlations were found in the LapMentor group.CONCLUSIONS: Results indicate an important role for low-tech/low-cost Blackbox laparoscopic BST of students in an otherwise high-tech surrounding. Furthermore, experience of Blackbox BST procedures correlate with students' performance in the MIST-VR simulator, with some gender-specific differences.
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| 9. |
- Oussi, Ninos, et al.
(författare)
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Video analysis in basic skills training : a way to expand the value and use of BlackBox training?
- 2018
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 32:1, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundBasic skills training in laparoscopic high-fidelity simulators (LHFS) improves laparoscopic skills. However, since LHFS are expensive, their availability is limited. The aim of this study was to assess whether automated video analysis of low-cost BlackBox laparoscopic training could provide an alternative to LHFS in basic skills training.MethodsMedical students volunteered to participate during their surgical semester at the Karolinska University Hospital. After written informed consent, they performed two laparoscopic tasks (PEG-transfer and precision-cutting) on a BlackBox trainer. All tasks were videotaped and sent to MPLSC for automated video analysis, generating two parameters (Pl and Prtcl_tot) that assess the total motion activity. The students then carried out final tests on the MIST-VR simulator. This study was a European collaboration among two simulation centers, located in Sweden and Greece, within the framework of ACS-AEI.Results31 students (19 females and 12 males), mean age of 26.2 ± 0.8 years, participated in the study. However, since two of the students completed only one of the three MIST-VR tasks, they were excluded. The three MIST-VR scores showed significant positive correlations to both the Pl variable in the automated video analysis of the PEG-transfer (RSquare 0.48, P < 0.0001; 0.34, P = 0.0009; 0.45, P < 0.0001, respectively) as well as to the Prtcl_tot variable in that same exercise (RSquare 0.42, P = 0.0002; 0.29, P = 0.0024; 0.45, P < 0.0001). However, the correlations were exclusively shown in the group with less PC gaming experience as well as in the female group.ConclusionsAutomated video analysis provides accurate results in line with those of the validated MIST-VR. We believe that a more frequent use of automated video analysis could provide an extended value to cost-efficient laparoscopic BlackBox training. However, since there are gender-specific as well as PC gaming experience differences, this should be taken in account regarding the value of automated video analysis.
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| 10. |
- Pelto-Piri, Veikko, 1959-, et al.
(författare)
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Violence and aggression in psychiatric inpatient care in Sweden : a critical incident technique analysis of staff descriptions
- 2020
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Violence towards staff working in psychiatric inpatient care is a serious problem. The aim of the present study was to explore staff perspectives of serious violent incidents involving psychiatric inpatients through the following research questions: Which factors contributed to violent incidents, according to staff? How do staff describe their actions and experiences during and after violent incidents?METHODS: We collected data via a questionnaire with open-ended questions, and captured 283 incidents reported by 181 staff members from 10 inpatient psychiatric wards in four different regions. We used the Critical Incident Technique to analyse the material. Our structural analysis started by structuring extracts from the critical incidents into descriptions, which were grouped into three chronological units of analyses: before the incident, during the incident and after the incident. Thereafter, we categorised all descriptions into subcategories, categories and main areas.RESULTS: Staff members often attributed aggression and violence to internal patient factors rather than situational/relational or organisational factors. The descriptions of violent acts included verbal threats, serious assault and death threats. In addition to coercive measures and removal of patients from the ward, staff often dealt with these incidents using other active measures rather than passive defence or de-escalation. The main effects of violent incidents on staff were psychological and emotional. After violent incidents, staff had to continue caring for patients, and colleagues provided support. Support from managers was reported more rarely and staff expressed some dissatisfaction with the management.CONCLUSIONS: As a primary prevention effort, it is important to raise awareness that external factors (organisational, situational and relational) are important causes of violence and may be easier to modify than internal patient factors. A secondary prevention approach could be to improve staff competence in the use of de-escalation techniques. An important tertiary prevention measure would be for management to follow up with staff regularly after violent incidents and to increase psychological support in such situations.
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| 11. |
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| 12. |
- Schlickum, Marcus, et al.
(författare)
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Surgical Simulation Tasks Challenge Visual Working Memory and Visual-Spatial Ability Differently
- 2011
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 35:4, s. 710-715
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Tidskriftsartikel (refereegranskat)abstract
- Background New strategies for selection and training of physicians are emerging. Previous studies have demonstrated a correlation between visual-spatial ability and visual working memory with surgical simulator performance. The aim of this study was to perform a detailed analysis on how these abilities are associated with metrics in simulator performance with different task content. The hypothesis is that the importance of visual-spatial ability and visual working memory varies with different task contents.Methods Twenty-five medical students participated in the study that involved testing visual-spatial ability using the MRT-A test and visual working memory using the RoboMemo computer program. Subjects were also trained and tested for performance in three different surgical simulators. The scores from the psychometric tests and the performance metrics were then correlated using multivariate analysis.Results MRT-A score correlated significantly with the performance metrics Efficiency of screening (p = 0.006) and Total time (p = 0.01) in the GI Mentor II task and Total score (p = 0.02) in the MIST-VR simulator task. In the Uro Mentor task, both the MRT-A score and the visual working memory 3-D cube test score as presented in the RoboMemo program (p = 0.02) correlated with Total score (p = 0.004).Conclusions In this study we have shown that some differences exist regarding the impact of visual abilities and task content on simulator performance. When designing future cognitive training programs and testing regimes, one might have to consider that the design must be adjusted in accordance with the specific surgical task to be trained in mind.
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| 13. |
- Selvin, Mikael, 1978-, et al.
(författare)
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Patient and staff experiences of quality in Swedish forensic psychiatric care : a repeated cross-sectional survey with yearly sampling at two clinics
- 2019
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Ingår i: International Journal of Mental Health Systems. - : BMC. - 1752-4458. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Systematic efforts to improve the quality, safety and value of health care have increased over the last decades. Even so, it is hard to choose priorities and to know when the desired results are reached, especially in forensic psychiatric care where there can be a discrepancy between patient and staff expectations of what good quality of care is and how it should be reached. The aim of the present study was to describe and compare patient and staff experiences of quality of care in two forensic psychiatric clinics over a period of 4years.Methods: A quantitative design was used and yearly between 2011 and 2014, a total of 105 questionnaires were answered by patients and 598 by staff.Results: The sample consisted of four different groups; patient and staff in Clinic A and Clinic B respectively. The repeated measurements showed that quality of care, as described by the patients, varied over time, with significant changes over the 4years. The staff evaluations of the quality of care were more stable over time in both clinics compared with the patients. Generally, the staff rated the quality as being better than the patients but these differences tended to decrease when efforts were made to improve the care.Conclusions: It is important to highlight both what staff and patients perceive as both high and low quality care. With regular measurements and sufficient resources, training, support and leadership, the chances of successful improvement work increase. This knowledge is important in forensic nursing practice, for teaching and for management and decision makers in the constant work of improving forensic psychiatric care.
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| 14. |
- Ahlberg, Rickard, 1970-, et al.
(författare)
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Auricular acupuncture for substance use : a randomized controlled trial of effects on anxiety, sleep, drug use and use of addiction treatment services
- 2016
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Ingår i: Substance Abuse Treatment, Prevention, and Policy. - London, United Kingdom : BioMed Central. - 1747-597X. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: A common alternative treatment for substance abuse is auricular acupuncture. The aim of the study was to evaluate the short and long-term effect of auricular acupuncture on anxiety, sleep, drug use and addiction treatment utilization in adults with substance abuse.Method: Of the patients included, 280 adults with substance abuse and psychiatric comorbidity, 80 were randomly assigned to auricular acupuncture according to the NADA protocol, 80 to auricular acupuncture according to a local protocol (LP), and 120 to relaxation (controls). The primary outcomes anxiety (Beck Anxiety Inventory; BAI) and insomnia (Insomnia Severity Index; ISI) were measured at baseline and at follow-ups 5 weeks and 3 months after the baseline assessment. Secondary outcomes were drug use and addiction service utilization. Complete datasets regarding BAI/ISI were obtained from 37/34 subjects in the NADA group, 28/28 in the LP group and 36/35 controls. Data were analyzed using Chi-square, Analysis of Variance, Kruskal Wallis, Repeated Measures Analysis of Variance, Eta square (η(2)), and Wilcoxon Signed Ranks tests.Results: Participants in NADA, LP and control group improved significantly on the ISI and BAI. There was no significant difference in change over time between the three groups in any of the primary (effect size: BAI, η(2) = 0.03, ISI, η(2) = 0.05) or secondary outcomes. Neither of the two acupuncture treatments resulted in differences in sleep, anxiety or drug use from the control group at 5 weeks or 3 months.Conclusion: No evidence was found that acupuncture as delivered in this study is more effective than relaxation for problems with anxiety, sleep or substance use or in reducing the need for further addiction treatment in patients with substance use problems and comorbid psychiatric disorders. The substantial attrition at follow-up is a main limitation of the study.Trial registration: Clinical Trials NCT02604706 (retrospectively registered).
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| 15. |
- Ahlborg, Liv, et al.
(författare)
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Visuospatial ability correlates with performance in simulated gynecological laparoscopy
- 2011
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 157:1, s. 73-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze the relationship between visuospatial ability and simulated laparoscopy performed by consultants in obstetrics and gynecology (OBGYN). Study design: This was a prospective cohort study carried out at two community hospitals in Sweden. Thirteen consultants in obstetrics and gynecology were included. They had previously independently performed 10-100 advanced laparoscopies. Participants were tested for visuospatial ability by the Mental Rotations Test version A (MRT-A). After a familiarization session and standardized instruction, all participants subsequently conducted three consecutive virtual tubal occlusions followed by three virtual salpingectomies. Performance in the simulator was measured by Total Time, Score and Ovarian Diathermy Damage. Linear regression was used to analyze the relationship between visuospatial ability and simulated laparoscopic performance. The learning curves in the simulator were assessed in order to interpret the relationship with the visuospatial ability. Results: Visuospatial ability correlated with Total Time (r = -0.62; p = 0.03) and Score (r = 0.57; p = 0.05) in the medium level of the virtual tubal occlusion. In the technically more advanced virtual salpingectomy the visuospatial ability correlated with Total Time (r = -0.64; p = 0.02), Ovarian Diathermy Damage (r = -0.65; p = 0.02) and with overall Score (r = 0.64; p = 0.02). Conclusions: Visuospatial ability appears to be related to the performance of gynecological laparoscopic procedures in a simulator. Testing visuospatial ability might be helpful when designing individual training programs.
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| 16. |
- Aila Gustafsson, Sanna, et al.
(författare)
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Characteristics measured by the Eating Disorder Inventory for children at risk and protective factors for disordered eating in adolescent girls
- 2010
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Ingår i: International Journal of Women's Health. - : Dove Medical Press. - 1179-1411. ; 2, s. 375-379
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to examine longitudinally the role of characteristics measured by the Eating Disorder Inventory-Child version (EDI-C) to find early predictors that might constitute risk and protective factors in the development of disordered eating.Method: Participants were divided into three groups based on eating attitudes at T2: disordered eating (n = 49), intermediate eating concern (n = 260), and healthy eating attitudes (n = 120). EDI-C from T1 (four to five years earlier) was then analyzed to find predictors of group classification at T2.Results: Drive for thinness and body dissatisfaction emerged as risk factors at T1, while drive for thinness, body dissatisfaction, and interoceptive awareness emerged as protective factors after controlling for initial eating concerns and body mass index.Discussion: Eating disorders should not be seen as a result of a premorbid personality type. Rather we should take a more social-psychological perspective to explain how individual and sociocultural factors work together in the development of these conditions.
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| 17. |
- Andersson, Mats, 1954, et al.
(författare)
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Evaluation of the response to treatment in patients with idiopathic achalasia by the timed barium esophagogram: results from a randomized clinical trial.
- 2009
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Ingår i: Diseases of the Esophagus. - : Oxford University Press (OUP). - 1442-2050 .- 1120-8694. ; 22:3, s. 264-73
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Tidskriftsartikel (refereegranskat)abstract
- To choose which treatment would be most effective for the individual patient with newly diagnosed achalasia is difficult for the tending physician. A diagnostic tool that would allow prediction of the symptomatic and functional response after treatment for achalasia is therefore needed. The timed barium esophagogram (TBE) is a method that allows objective assessment of esophageal emptying, but the value of TBE in the clinical management of achalasia remains to be clarified. The aim of this study was first, to assess the ability of TBE to predict symptoms and treatment failure during post-treatment follow-up. Second, to determine whether esophageal emptying as assessed by TBE differs after treatment with pneumatic dilatation or laparoscopic myotomy. Fifty-one patients with newly diagnosed achalasia were prospectively randomized to pneumatic dilatation (n = 26) or laparoscopic myotomy (n = 25). Evaluation with TBE was performed before (n = 46) and after treatment (n = 43). The median interval between treatment and post-treatment TBE was 6 months, and the median follow-up time after the post-treatment TBE was 18 months. Following therapeutic intervention, TBE parameters did not differ significantly between treatment groups. However, significant correlations were found between the height of the barium column at 1 min and the symptom scores at the end of follow up for 'dysphagia for liquids' (P < 0.05, rho = 0.47), 'chest pain' (P < 0.05, rho = 0.42), and the 'Watson dysphagia score' (P < 0.05, rho = 0.46). Patients with less than 50% improvement in this TBE-parameter (height at 1 min) post-treatment had a 40% risk of treatment failure during follow-up. In summary, pneumatic balloon dilatation and laparoscopic myotomy similarly affected esophageal function as assessed by TBE-emptying. Lack of improvement in barium-column height post-treatment was associated with an increased risk of treatment failure which should motivate close surveillance in order to detect symptomatic recurrence at an early stage.
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| 18. |
- Andersson, Pehr, et al.
(författare)
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Working memory and virtual endoscopy simulation
- 2004
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Ingår i: Proceedings of the twenty-sixth annual conference of the cognitive science society. - Mahwah : Lawrence Erlbaum Associates. - 9780805854640 ; , s. 1519-1519
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Konferensbidrag (refereegranskat)
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| 19. |
- Bergström, Lars Magnus, et al.
(författare)
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A small-angle X-ray scattering study of complexes formed in mixtures of a cationic polyelectrolyte and an anionic surfactant
- 2002
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1520-6106 .- 1520-5207. ; 106:44, s. 11412-11419
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Tidskriftsartikel (refereegranskat)abstract
- The internal structure of the solid phase formed in mixtures of the anionic surfactant sodium dodecyl sulfate (SDS) and a range of oppositely charged polyelectrolytes with different side chains and charge density has been investigated using small-angle X-ray scattering. Polyelectrolytes with short side chains ([3-(2-methylpropionamido)propyl]trimethylammonium chloride, MAPTAC, and poly{[(2-propionyloxy)ethyl]-trimethylammonium chloride}, PCMA) form a 2-dimensional hexagonal structure with SDS, whereas a polyelectrolyte without side chains (poly(vinlyamine), PVAm) forms a lamellar structure. The hexagonal structure of MAPTAC is retained either when a neutral monomer (acrylamide, AM) is included in the polymer backbone to reduce the charge density or when a nonionic surfactant is admixed to the SDS/polyelctrolyte complex.. The unit cell length of AM-MAPTAC increases with decreasing charge density from a=47.7 Angstrom (MAPTAC, 100% charge density) to 58.5 Angstrom (AM-MAPTAC, 30% charge density). The unit cell length in the lamellar SDS/PVAm complex (a=36.1 Angstrom) is significantly smaller than for the different hexagonal structures. It is conjectured that the cylinders in the hexagonal structure and the bilayers in the lamellar structure are based on self-assembled surfactant aggregates with the polyelectrolyte mainly located in the aqueous region adjacent to the charged surfactant headgroups.
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| 20. |
- Bergström, Lars Magnus, et al.
(författare)
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Small-angle neutron scattering study of mixtures of cationic polyelectrolyte and anionic surfactant : Effect of polyelectrolyte charge density
- 2004
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1520-6106 .- 1520-5207. ; 108:6, s. 1874-1881
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Tidskriftsartikel (refereegranskat)abstract
- We have studied mixtures of an anionic surfactant (deuterated sodium dodecyl sulfate, SDS-d) and cationic polyelectrolytes with different charge densities (10%, 30%, 60%, and 100%) using small-angle neutron scattering (SANS). Near compositions corresponding to charge neutralization, the solutions phase separate into a complex phase (precipitate) consisting of, in the cases of 30%, 60%, and 100% charge density, a two-dimensional (213) hexagonal lattice of close-packed cylindrical micelles and a clear liquid. When either polyelectrolyte with charge density less than 100% or SDS-d is present in sufficient excess, the solution becomes clear and isotropic, and from the scattering data we may conclude that prolate or rod-shaped micelles are present. The micelles are seen to grow in length with increasing SDS-d concentration and polyelectrolyte charge density from about 80 Angstrom to 550 Angstrom, whereas the cross-sectional radius is 15 Angstrom and approximately constant. The number of micelles per polyelectrolyte chain is found to be slightly larger than unity (1-6). In some of the (turbid) samples rod-shaped micelles are found to coexist with larger polyelectrolyte-surfactant complexes. Solutions consisting of 10% charged polyelectrolyte and SDS-d are very viscous and gellike, and the complex phase is much less defined with a much larger distance between adjacent aggregates in the complex phase.
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| 22. |
- Björk, Tabita, 1966-, et al.
(författare)
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Criminal recidivism and mortality among patients discharged from a forensic medium secure hospital
- 2012
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Ingår i: Nordic Journal of Psychiatry. - London, United Kingdom : Informa Healthcare. - 0803-9488 .- 1502-4725. ; 66:4, s. 283-9
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Tidskriftsartikel (refereegranskat)abstract
- Background: One of the goals in forensic psychiatric care is to reduce the risk of recidivism, but current knowledge about the general outcome of forensic psychiatric treatment is limited.Aims: To analyse the rate of criminal recidivism and mortality after discharge in a sample of patients sentenced to forensic psychiatric treatment in a Swedish county.Methods: All offenders in Örebro County, Sweden, sentenced to forensic psychiatric treatment and discharged during 1992-2007 were included: 80 males and eight females. Follow-up data was retrieved from the Swedish National Council for Crime Prevention, the National Cause-of-Death register and clinical files. Mean follow-up time was 9.4 years.Results: The mean age at discharge was 40 years. Schizophrenia, other psychoses and personality disorders were the most prevalent diagnoses. Thirty-eight percent of those still alive and still living in the country re-offended and were sentenced to a new period of forensic psychiatric treatment or incarceration during follow-up. Four male re-offenders committed serious violent crimes. Substance-related diagnosis was significantly associated with risk of recidivism and after adjustment for diagnoses, age and history of serious violent crime, the Hazard Ratio was 4.04 (95% CI 1.51-10.86, P = 0.006). Of all included patients, 23% had died at the end of follow-up (standardized mortality rate 10.4).Conclusions: Since repetition of serious violent crimes was unusual, results indicate a positive development subsequent to treatment for those alive at follow-up.Clinical implications: The high mortality rate suggests that more attention should be paid in evaluation of the patients' somatic and psychiatric health during and after care in order to prevent premature death.
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| 23. |
- Björkdahl, Anna, et al.
(författare)
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Barriers and enablers to the implementation of Safewards and the alignment to the i-PARIHS framework : A qualitative systematic review
- 2024
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Ingår i: International Journal of Mental Health Nursing. - Richmond, VIC : John Wiley & Sons. - 1445-8330 .- 1447-0349. ; 33:1, s. 18-36
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Forskningsöversikt (refereegranskat)abstract
- Inpatient mental healthcare settings should offer safe environments for patients to heal and recover and for staff to provide high-quality treatment and care. However, aggressive patient behaviour, unengaged staff approaches, and the use of restrictive practices are frequently reported. The Safewards model includes ten interventions that aim to prevent conflict and containment. The model has shown promising results but at the same time often presents challenges to successful implementation strategies. The aim of this study was to review qualitative knowledge on staff experiences of barriers and enablers to the implementation of Safewards, from the perspective of implementation science and the i-PARIHS framework. A search of the Web of Science, ASSIA, Cochrane Library, SCOPUS, Medline, Embase, PsycINFO, and CINAHL databases resulted in 10 articles. A deductive framework analysis approach was used to identify barriers and enablers and the alignment to the i-PARIHS. Data most represented by the i-PARIHS were related to the following: local-level formal and informal leadership support, innovation degree of fit with existing practice and values, and recipients' values and beliefs. This indicates that if a ward or organization wants to implement Safewards and direct limited resources to only a few implementation determinants, these three may be worth considering. Data representing levels of external health system and organizational contexts were rare. In contrast, data relating to local (ward)-level contexts was highly represented which may reflect Safewards's focus on quality improvement strategies on a local rather than organizational level.
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| 24. |
- Callenmark, Björn, et al.
(författare)
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Explicit versus implicit social cognition testing in autism spectrum disorder
- 2014
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Ingår i: Autism. - : Sage Publications. - 1362-3613 .- 1461-7005. ; 18:6, s. 684-693
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Tidskriftsartikel (refereegranskat)abstract
- Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents with autism spectrum disorder and 19 carefully matched typically developing controls completed the Dewey Story Test. ‘Explicit’ (multiple-choice answering format) and ‘implicit’ (free interview) measures of social cognition were obtained. Autism spectrum disorder participants did not differ from controls regarding explicit social cognition performance. However, the autism spectrum disorder group performed more poorly than controls on implicit social cognition performance in terms of spontaneous perspective taking and social awareness. Findings suggest that social cognition alterations in autism spectrum disorder are primarily implicit in nature and that an apparent absence of social cognition difficulties on certain tests using rather explicit testing formats does not necessarily mean social cognition typicality in autism spectrum disorder.
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| 25. |
- Choque Olsson, Nora, et al.
(författare)
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Social Skills Training for Children and Adolescents With Autism Spectrum Disorder : A Randomized Controlled Trial
- 2017
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Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567 .- 1527-5418. ; 56:7, s. 585-592
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Social skills group training (SSGT) for children and adolescents with autism spectrum disorder (ASD) is widely applied, but effectiveness in real-world practice has not yet been properly evaluated. This study sought to bridge this gap.METHOD: This 12-week pragmatic randomized controlled trial of SSGT compared to standard care alone was conducted at 13 child and adolescent psychiatry outpatient units in Sweden. Twelve sessions of manualized SSGT ("KONTAKT") were delivered by regular clinical staff. Participants (N = 296; 88 females and 208 males) were children (n = 172) and adolescents (n = 124) aged 8 to 17 years with ASD without intellectual disability. The primary outcome was the Social Responsiveness Scale rating by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and 3-month follow-up. Moderator analyses were conducted for age and gender.RESULTS: Significant treatment effects on the primary outcome were limited to parent ratings for the adolescent subgroup (posttreatment: -8.3; 95% CI = -14.2 to -1.9; p = .012, effect size [ES] = 0.32; follow-up: -8.6; 95% CI = -15.4 to -1.8; p = .015, ES = 0.33) and females (posttreatment: -8.9; 95% CI = -16.2 to -1.6; p = .019, ES = 0.40). Secondary outcomes indicated moderate effects on adaptive functioning and clinical severity.CONCLUSION: SSGT for children and adolescents with ASD in regular mental health services is feasible and safe. However, the modest and inconsistent effects underscore the importance of continued efforts to improve SSGT beyond current standards.CLINICAL TRIAL REGISTRATION INFORMATION: Social Skills Group Training ("KONTAKT") for Children and Adolescent With High-functioning Autism Spectrum Disorders; https://clinicaltrials.gov/; NCT01854346.
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| 26. |
- Claesson, Per M., et al.
(författare)
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Mixtures of cationic polyelectrolyte and anionic surfactant studied with small-angle neutron scattering
- 2000
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Ingår i: Journal of Physical Chemistry B. - : American Chemical Society (ACS). - 1089-5647 .- 1520-6106 .- 1520-5207. ; 104:49, s. 11689-11694
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Tidskriftsartikel (refereegranskat)abstract
- Small-angle neutron scattering (SANS) data for solutions containing a highly charged cationic polyelectrolyte and an anionic surfactant are presented. The scattering data were obtained in pure D2O, emphasizing the scattering from the polyelectrolyte, and in a H2O/D2O mixture that contrast matches the polyelectrolyte. In the absence of surfactant, a broad scattering peak due to the mesh size of the polyelectrolyte solution is the most characteristic feature. This peak moves to larger q-values (smaller distances) as the polyelectrolyte concentration is increased, as expected for a semidilute polyelectrolyte solution. Addition of a small amount of surfactant reduces and finally removes this peak. Instead a sharp diffraction peak appears at high q-values. This Bragg peak corresponds to a characteristic distance of 37-39 Angstrom, and it is observed when either the polyelectrolyte or the surfactant is contrast matched by the solvent. Once this peak has appeared, its position does not change when the surfactant concentration is increased. The intensity of the peak grows, however, until a stoichiometric polyelectrolyte-surfactant complex has been formed. The Bragg peak remains in excess surfactant solution. These results are discussed in relation to the structure of the polyelectrolyte-surfactant aggregates and in connection with recent results from surface force and turbidity measurements using the same polyelectrolyte-surfactant pair.
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| 27. |
- Cronquist, Björn, et al.
(författare)
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Communication Enabling the Implementation of Innovation
- 2006
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Ingår i: Proceedings of the 29th IRIS. ; , s. 15-
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Konferensbidrag (refereegranskat)abstract
- This paper describes the proposed research approach of a research projectcalled, Communication Enabling the Implementation of Innovation. The point of departurefor the project is a view on innovation described as hard work rather than mere creativityor inventions. This leads to the conclusion that innovation processes can be supportedand enhanced through planned activities. The paper promotes a perspective linkinginnovation to the well established concept of a learning organization. The aim for theresearch project is threefold; 1) to generate a method for the development on an indexmeasuring “innovation maturity” of organizations. 2) to generate specific measures ofinnovation processes and 3) to develop a feedback system enhancing the innovativeorganizations towards a learning organization.
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| 28. |
- Eklund, Mona, et al.
(författare)
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Outcomes of activity-based assessment (BIA) compared with standard assessment in occupational therapy
- 2008
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 15:4, s. 196-203
-
Tidskriftsartikel (refereegranskat)abstract
- This study was aimed at investigating the outcomes of an activity-based assessment (BIA) compared with standard assessment (SA) for evaluating clients undergoing psychiatric occupational therapy. Patients admitted to a psychiatric occupational therapy unit were randomized into the BIA or the SA assessment. The outcome indicators were (a) clients' satisfaction with the occupational therapy during the assessment period, (b) clients' awareness of capacities and occupational problems, (c) satisfaction with the assessment among the referring physicians, and (d) outcomes of the intervention following the assessment, in terms of changes in occupational performance and satisfaction. The groups did not differ in awareness of occupational problems, but the BIA group was more satisfied than the SA group with the support of their contact person and with the group leader during the period of assessment. Furthermore, physicians receiving feedback on patients in the BIA group were more satisfied than those receiving feedback on patients in the SA group. However, the groups did not differ concerning change during the treatment period in occupational performance or satisfaction. Thus, there was no difference between the assessment methods regarding the outcomes of the treatment following assessment. Minor advantages from the patients' perspective were found, in terms of better satisfaction in the BIA group, and from the referring physicians' perspective the BIA clearly seemed more satisfying than the SA. Thus, the findings showed that the BIA possessed better qualities than the SA regarding the indicators pertaining to satisfaction, but not concerning awareness of capacities and problems or the outcome of the subsequent treatment.
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| 29. |
- Elwin, Marie, 1953-, et al.
(författare)
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Autobiographical Accounts of Sensing in Asperger Syndrome and High-Functioning Autism
- 2012
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Ingår i: Archives of Psychiatric Nursing. - Philadelphia, USA : Elsevier BV. - 0883-9417 .- 1532-8228. ; 26:5, s. 420-429
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Tidskriftsartikel (refereegranskat)abstract
- Sensory experiences in Asperger syndrome (AS) or high-functioning autism (HFA) were explored by qualitative content analysis of autobiographical texts by persons with AS/HFA. Predetermined categories of hyper- and hyposensitivity were applied to texts. Hypersensitivity consists of strong reactions and heightened apprehension in reaction to external stimuli, sometimes together with overfocused or unselective attention. It was common in vision, hearing, and touch. In contrast, hyposensitivity was frequent in reaction to internal and body stimuli such as interoception, proprioception, and pain. It consists of less registration, discrimination, and recognition of stimuli as well as cravings for specific stimuli. Awareness of the strong impact of sensitivity is essential for creating good environments and encounters in the context of psychiatric and other health care.
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| 30. |
- Elwin, Marie, 1953-
(författare)
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Description and measurement of sensory symptoms in autism spectrum
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Unusual responses to sensory stimuli have been reported in nearly all children with autism spectrum conditions (ASC). A few studies on adults indicate that the sensory and perceptual problems persist into adulthood. Sensory symptoms have not been included in the diagnostic criteria for ASC but in the new diagnostic manual (DSM-5, 2013) hyper- or hyporeactivity or unusual sensory interests were included in the diagnostic criteria for ASC. Sensory phenomena are mostly investigated in studies involving children and the scales used to measure sensory reactivity have been constructed on the basis of the scientific literature and parents’ reports. The experiences of adults with ASC are not well understood and have not been systematically used to develop measures.The overall aim of the thesis was to capture the first-hand experiences of and perspectives on sensory reactivity and translate them into a self-rating scale. To fulfil this overarching aim the personal sensory experiences of adults with ASC were investigated and the variations and range of atypical sensory phenomena explored and described in two qualitative studies (study I and II). The analyses of the firstperson descriptions enabled the development of items for a scale. These were reduced in steps and the final scale which was named the Sensory Reactivity in Autism Spectrum scale (SR-AS) comprised 32 items in four subscales: high awareness/ hyperreactivity, low awareness/hyporeactivity, strong sensory interests and sensory/motor. The SR-AS was validated using content and factor analyses. Its discriminative validity was then investigated as well as its reliability in the form of internal consistency (study III). In the final step the scale was used to identify clusters of atypical sensory functioning in adults with ASC by hierarchical cluster analysis (study IV). Three different sensory clusters were found.The main contribution of this thesis is its presentation of individual experience and perspectives and the creation of an clinical tool to measure atypical sensory reactivity frequently experienced by people with ASC. The ways in which the SR-AS can be used comprise assessment of individual sensory patterns for self-knowledge and awareness, to enable the development of coping strategies and to provide information on environmental adjustments required. In diagnostic processes where other criteria for ASC are fulfilled the SR-AS can be used for assessing sensory symptoms according to the DSM-5.
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| 31. |
- Elwin, Marie, 1953-, et al.
(författare)
-
Development and pilot validation of a sensory reactivity scale for adults with high functioning autism spectrum conditions : Sensory Reactivity in Autism Spectrum (SR-AS)
- 2016
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Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 70:2, s. 103-110
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Unusual reactions to sensory stimuli are experienced by 90-95% of people with an autism spectrum condition (ASC). Self-reported sensory reactivity in ASC has mainly been measured with generic questionnaires developed and validated on data from the general population. Interest in sensory reactivity in ASC increased after the inclusion of hyper- and hypo-reactivity together with unusual sensory interest as diagnostic markers of ASC in the DSM-5.Aims: To develop and pilot validate a self-report questionnaire designed from first-hand descriptions of the target group of adults diagnosed with high functioning ASC. Psychometric properties of the questionnaire were evaluated on a sample of participants with ASC diagnoses (N = 71) and a random sample from the general population (N = 162).Results: The Sensory Reactivity in Autism Spectrum (SR-AS is intended to be used as a screening tool in diagnostic processes with adults and for support in adapting compensating strategies and environmental adjustments. The internal consistency was high for both the SR-AS and its subscales. The total scale Cronbach's alpha was 0.96 and the subscales alphas were 0.80. Confirmatory factor analysis (CFA) showed best fit for a four-factor model of inter-correlated factors: hyper and hypo-reactivity, strong sensory interest and a sensory/motor factor. The questionnaire discriminated well between ASC-diagnosed participants and participants from the general population.Conclusions: The SR-AS displayed good internal consistency and discriminatory power and promising factorial validity.
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| 32. |
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| 33. |
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| 34. |
- Elwin, Marie, 1953-, et al.
(författare)
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Sensory Clusters of Adults With and Without Autism Spectrum Conditions
- 2017
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Ingår i: Journal of autism and developmental disorders. - New York, USA : Springer. - 0162-3257 .- 1573-3432. ; 47:3, s. 579-589
-
Tidskriftsartikel (refereegranskat)abstract
- We identified clusters of atypical sensory functioning adults with ASC by hierarchical cluster analysis. A new scale for commonly self-reported sensory reactivity was used as a measure. In a low frequency group (n = 37), all subscale scores were relatively low, in particular atypical sensory/motor reactivity. In the intermediate group (n = 17) hyperreactivity, sensory interests and sensory/motor issues were significantly elevated in relation to the first group, but not hyporeactivity. In a high frequency subgroup (n = 17) all subscale scores were significantly elevated and co-occurrence of hyper- and hyporeactivity was evident. In a population sample, a cluster of low scorers (n = 136) and high scorers relative to the other cluster (n = 26) was found. Identification of atypical sensory reactivity is important for targeting support.
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| 35. |
- Elwin, Marie, 1953-, et al.
(författare)
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Too much or too little : hyper- and hypo-reactivity in high-functioning autism spectrum conditions
- 2013
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Ingår i: Journal of Intellectual & Developmental Disability. - : Taylor & Francis. - 1366-8250 .- 1469-9532. ; 38:3, s. 232-241
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described.Method: Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis.Results: Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life.Conclusions: The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.
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| 36. |
- Fiorillo, A., et al.
(författare)
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How to improve clinical practice on involuntary hospital admissions of psychiatric patients : suggestions from the EUNOMIA study
- 2011
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Ingår i: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 26:4, s. 201-207
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Tidskriftsartikel (refereegranskat)abstract
- Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.
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| 37. |
- Fiorillo, A., et al.
(författare)
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Patient characteristics and symptoms associated with perceived coercion during hospital treatment
- 2012
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Ingår i: Acta Psychiatrica Scandinavica. - Malden, USA : Wiley-Blackwell. - 0001-690X .- 1600-0447. ; 125:6, s. 460-467
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Large numbers of psychiatric patients either are involuntarily admitted to hospital treatment or feel coerced despite a legally voluntary admission. For ethical and clinical reasons, their perceived coercion should be reduced as far as possible. There is however limited evidence on patient characteristics associated with perceived coercion during hospital treatment. This study aimed to identify i) sociodemographic and clinical characteristics associated with perceived coercion at admission and ii) changes in symptoms and global functioning associated with changes in perceived coercion over time.Method: Three thousand and ninety three in-patients who were involuntarily admitted or felt coerced to hospital treatment despite a legally voluntary admission were recruited in the European evaluation of coercion in psychiatry and harmonization of best clinical practice EUNOMIA project in 11 European countries. Perceived coercion, global functioning and symptoms were assessed after admission and at a 3-month follow-up.Results: Involuntary admission, female gender, poorer global functioning and more positive symptoms were associated with higher levels of perceived coercion at admission. Perceived coercion significantly decreased over time, and the improvements in global functioning and positive symptoms were associated with reduction in perceived coercion.Conclusion: Female patients perceive more coercion in psychiatric hospital treatment. Effective treatment for positive symptoms and improving patients global functioning may lead to a reduction in perceived coercion.
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| 38. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
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A qualitative analysis of participants’ reflections on body image during participation in a randomized controlled trial of acceptance and commitment therapy
- 2016
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Ingår i: Journal of Eating Disorders. - : Springer Science and Business Media LLC. - 2050-2974. ; 4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Negative body image is a risk factor for development and relapse in eating disorders (ED). Many patients continue to be dissatisfied with their body shape or weight after treatment. This study presents a qualitative analysis of written reflections on body image from patients with an ED and a negative body image before and after an Acceptance and Commitment Therapy group treatment at a specialized ED-unit. Method: Before and after the treatment participants (n = 47) answered a questionnaire with open ended questions on their thoughts on body image. Data were analyzed through conventional content analysis. Results: Body image meant different things for different participants. For some it had to do with how you evaluate your body, whereas others focused on whether their body image was realistic or not. Some emphasized their relationship with their body, while some described body image as strongly related to global self-esteem. These different views on the concept of body image affected the participants' descriptions of their own body image, and how they wanted it to change. Body image was considered a state that fluctuated from day to day. After treatment the participants described changes in their body image, for instance perceiving oneself as less judgmental towards one's body, and a shift in focus to the important things in life. Conclusions: The participants had different views on body image and how they wished it to change. Thus treatment interventions targeting negative body image needs to address various aspects of this complex construct.
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| 39. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
-
Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms : A randomized controlled trial
- 2020
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Ingår i: Body image. - : Saunders Elsevier. - 1740-1445 .- 1873-6807. ; 32, s. 155-166
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Tidskriftsartikel (refereegranskat)abstract
- Body image problems are central aspects of eating disorders (ED), and risk factors both for the development of and relapse into an ED. Acceptance and commitment therapy (ACT) aims at helping patients accept uncomfortable internal experiences while committing to behaviors in accordance with life values. The aim of the present study was to compare the effectiveness of a group intervention, consisting of 12 sessions, based on ACT to treatment as usual (TAU) for patients with residual ED symptoms and body image problems. The study was a randomized controlled superiority trial. Patients with residual ED symptoms and body image problems were recruited from a specialized ED clinic in Sweden. The final sample consisted of 99 women, randomized to ACT or TAU. At the two-year follow-up, patients who received ACT showed a significant greater reduction in ED symptoms and body image problems and received less specialized ED care than patients in TAU. In conclusion, ACT was superior in reducing ED symptoms and body image problems.
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| 40. |
- Fogelkvist, Maria, 1983-
(författare)
-
Body image in patients with residual eating disorder symptoms : treatment effects of acceptance and commitment therapy and participants' reflections
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to evaluate an acceptance and commitment (ACT) group intervention targeting body image in patients with residual eating disorder (ED) symptoms, including treatment effects and participants’ reflections on body image and the intervention. Studies I, II and III are based on a randomized controlled trial including 99 patients that were randomized to the ACT intervention or to continue treatment as usual (TAU). Different self-assessment questionnaires were administered before and after the intervention and at follow up by one and two years. Study IV is based on interviews with patients that had completed the intervention, and did not participate in the trial. From written evaluations in study I body image was shown to mean different things for different individuals. This was also shown by different expectations on treatment. Study II showed that the ACT intervention was superior to TAU in reducing ED symptoms and body dissatisfaction, while care consumption was lower. In addition, ratings of dropout was low. In study III, it was shown that symptom improvement from the ACT intervention rather than TAU was more pronounced in participants with restrictive ED psychopathology. Participants who displayed binge eating and/or purging ED psychopathology, showed improvement on ED symptoms regardless of intervention. Participants younger than 25, and with lower ratings at baseline, showed no improvement on ED symptoms if continuing with TAU. From interviews with participants in study IV, the intervention was described as demanding, and participants described the importance of their own efforts. Specific processes of the intervention were helpful and the context of the group and context outside of treatment could facilitate or hinder progress. Perceived changes in body image differed between participants in study I, showing the potential breadth of the intervention.Conclusions from this thesis was that an intervention based on ACT targeting body image was suitable and helpful for patients with residual EDsymptoms. Though the intervention was demanding, dropout was low, and specific processes were described as helpful.
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| 41. |
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| 42. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
-
Live with your body - participants' reflections on an acceptance and commitment therapy group intervention for patients with residual eating disorder symptoms
- 2021
-
Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 20, s. 184-193
-
Tidskriftsartikel (refereegranskat)abstract
- Acceptance and commitment therapy (ACT) is a transdiagnostic approach to human suffering that has been trialed in a range of different contexts. This study aimed to examine participants' view of helpful and hindering aspects of an in person ACT group intervention targeting body image in patients with residual eating disorder (ED) symptoms. Thirteen women who completed the intervention were interviewed, and transcripts were analyzed through thematic analysis. Nine themes were identified and sorted into three main themes. The first main theme, "Taking the plunge", pointed to the importance of participants own effort, and included subthemes of self-efficacy, self as description, and self-exploration. The second main theme, "A push towards valued ends", indicated that content of the intervention was helpful, and included subthemes of commitment and behavioral change processes, mindfulness and acceptance processes, and assignments in and between sessions. The third main theme, "The context matters", described the importance of the contexts of the intervention and life outside of treatment, and included subthemes of the group format, the context outside of treatment, and the timing of the intervention. Through the description of specific content, we conclude that ACT seems to help women with residual ED symptoms and body image issues by fostering motivation to engage in avoided situations and behaviors while striving to live a more valued life.
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| 43. |
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| 44. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
-
Predictors of outcome following a body image treatment based on acceptance and commitment therapy for patients with an eating disorder
- 2022
-
Ingår i: Journal of Eating Disorders. - : BioMed Central. - 2050-2974. ; 10:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is important to target body image in individuals with an eating disorder (ED). Acceptance and commitment therapy (ACT) has been trialed in a few studies for individuals with an ED. Although ACT outcomes in ED patients hold promise, studies of predictors are scarce. The aim of the present study was to explore differences in ED symptom outcome at two-year follow-up in subgroups of participants attending either treatment as usual (TAU), or a group intervention based on ACT targeting body image. Additionally, we aimed to compare subjective recovery experiences between groups.METHODS: The study took place at a specialized ED outpatient clinic, and included patients diagnosed with an ED that had received prior treatment and achieved a somewhat regular eating pattern. Study participants were randomly assigned to continue TAU or to participate in a group intervention based on ACT for body image issues. Only participants that completed the assigned intervention and had completed follow up assessment by two-years were included. The total sample consisted of 77 women.RESULTS: In general, ACT participants showed more favorable outcomes compared to TAU, and results were more pronounced in younger participants with shorter prior treatment duration and lower baseline depression ratings. Participants with restrictive ED psychopathology had three times higher ED symptom score change if participating in ACT in comparison to TAU.CONCLUSIONS: An ACT group intervention targeting body image after initial ED treatment may further enhance treatment effects. There is a need for further investigation of patient characteristics that might predict response to body image treatment, particularly regarding ED subtypes and depression ratings.
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| 45. |
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| 46. |
- Fortugno, Federico, et al.
(författare)
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Symptoms associated with victimization in patients with schizophrenia and related disorders
- 2013
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:3, s. e58142-
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with psychoses have an increased risk of becoming victims of violence. Previous studies have suggested that higher symptom levels are associated with a raised risk of becoming a victim of physical violence. There has been, however, no evidence on the type of symptoms that are linked with an increased risk of recent victimization.Methods: Data was taken from two studies on involuntarily admitted patients, one national study in England and an international one in six other European countries. In the week following admission, trained interviewers asked patients whether they had been victims of physical violence in the year prior to admission, and assessed symptoms on the Brief Psychiatric Rating Scale (BPRS). Only patients with a diagnosis of schizophrenia or related disorders (ICD-10 F20-29) were included in the analysis which was conducted separately for the two samples. Symptom levels assessed on the BPRS subscales were tested as predictors of victimization. Univariable and multivariable logistic regression models were fitted to estimate adjusted odds ratios.Results: Data from 383 patients in the English sample and 543 patients in the European sample was analysed. Rates of victimization were 37.8% and 28.0% respectively. In multivariable models, the BPRS manic subscale was significantly associated with victimization in both samples.Conclusions: Higher levels of manic symptoms indicate a raised risk of being a victim of violence in involuntary patients with schizophrenia and related disorders. This might be explained by higher activity levels, impaired judgement or poorer self-control in patients with manic symptoms. Such symptoms should be specifically considered in risk assessments.
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| 47. |
- Giacco, Domenico, et al.
(författare)
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Caregivers' appraisals of patients' involuntary hospital treatment : European multicentre study
- 2012
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Ingår i: British Journal of Psychiatry. - : The Royal College of Psychiatrists. - 0007-1250 .- 1472-1465. ; 201:6, s. 486-491
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mental health policies emphasise that caregivers' views of involuntary psychiatric treatment should be taken into account. However, there is little evidence on how caregivers view such treatment.Aims: To explore caregivers' satisfaction with the involuntary hospital treatment of patients and what factors are associated with caregivers' appraisals of treatment.Method: A multicentre prospective study was carried out in eight European countries. Involuntarily admitted patients and their caregivers rated their appraisal of treatment using the Client Assessment of Treatment Scale 1 month after admission.Results: A total of 336 patients and their caregivers participated. Caregivers' appraisals of treatment were positive (mean of 8.5 on a scale from 0 to 10) and moderately correlated with patients' views. More positive caregivers' views were associated with greater patients' symptom improvement.Conclusions: Caregivers' appraisals of involuntary in-patient treatment are rather favourable. Their correlation with patients' symptom improvement may underline their relevance in clinical practice.
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| 48. |
- Goel, Suchi, et al.
(författare)
-
RIFINs are adhesins implicated in severe Plasmodium falciparum malaria
- 2015
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Ingår i: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 21:4, s. 314-317
-
Tidskriftsartikel (refereegranskat)abstract
- Rosetting is a virulent Plasmodium falciparum phenomenon associated with severe malaria. Here we demonstrate that P. falciparum-encoded repetitive interspersed families of polypeptides (RIFINs) are expressed on the surface of infected red blood cells (iRBCs), bind to RBCs-preferentially of blood group A-to form large rosettes and mediate microvascular binding of iRBCs. We suggest that RIFINs have a fundamental role in the development of severe malaria and thereby contribute to the varying global distribution of ABO blood groups in the human population.
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| 49. |
- Gustafsson, Sanna Aila, 1972-, et al.
(författare)
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How to deal with perceived expectations in daily life : reflections of adolescent girls suffering from eating disorders
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to investigate how adolescent girls with eating disorders reflect upon various ways of dealing with societal expectations in daily life. Eighteen interviews with girls in the age span 15-19 were analysed using the phenomenographic approach.The results could be summarized into three qualitatively different conceptions: A) being oneself, B) adapting to different situations and C) presenting oneself in a positive light. These conceptions were expressed in five courses of action.
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| 50. |
- Gustafsson, Sanna Aila, et al.
(författare)
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How to deal with sociocultural pressures in daily life : reflections of adolescent girls suffering from eating disorders
- 2011
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Ingår i: Journal of Multidisciplinary Healthcare. - : Dove Medical Press Ltd. - 1178-2390. ; 4, s. 103-110
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Tidskriftsartikel (refereegranskat)abstract
- Adolescent girls with eating disorders experience unattainable and contradictory expectations in daily life, which create stress and negatively affect their self-evaluation. Disordered eating may function as a way of seeking control and consistency. In order to make progress in the understanding of eating disorders, the aim of this study was to describe how adolescent girls with eating disorders reflect upon ways of dealing with sociocultural pressures in daily life. Eighteen interviews with girls aged 15–19 years were analyzed using a phenomenographic approach. The results were summarized into three conceptions: ‘Striving to be oneself" (conception A) was described as the most desirable, but also the hardest. "Adapting to various situations’ (conception B) was used without much reflection, as long as it worked, but when this way of dealing with everyday expectations was unsuccessful it was evaluated negatively. "Presenting oneself in a positive light" (conception C) was described negatively even when it was successful. Within these conceptions, the participants described various strategies that could be used more or less effectively depending on the circumstances. A common theme was their difficulties in finding a balance between trying harder to live up to perceived expectations from others on one hand, and trying to accept the situation as it was, without trying to change themselves or the situation, on the other hand. The participants believed that their eating disorder was partly a result of being unable to deal with sociocultural pressures in an effective way, and they experienced a conflict between societal values of being assertive and values of being interpersonally oriented. Implications for treatment are discussed.
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