| 1. |
- Alvarez, Gerard, et al.
(författare)
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A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths
- 2021
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP.OBJECTIVES: The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context.METHODS: National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online.RESULTS: A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant's attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to 'research conduct'. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases.CONCLUSIONS: Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use.
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| 2. |
- Boström, Cecilia, et al.
(författare)
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Design proposal of electrical system for linear generator wave power plants
- 2009
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Ingår i: 35TH ANNUAL CONFERENCE OF IEEE INDUSTRIAL ELECTRONICS. - : IEEE. - 9781424446483 - 9781424446506 ; , s. 4180-4185
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Konferensbidrag (refereegranskat)abstract
- This paper describes an electrical system layout for a wave power plant connecting linear generators to the grid. The electrical power out from the wave energy converters must be converted before they can be connected to the grid. The conversion is carried out in marine substations that will be placed on the seabed.The paper presents experimental power data from a wave energy converter that has been in operation at the Lysekil research site since March 2006. Moreover, results and analyses from experiments and simulations from tests with the generator connected to a rectifier and filter are presented. A simulation is made to show the difference between having the generator connected to a linear load and a nonlinear load, which would be the case when the generator is connected to the grid.
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| 3. |
- Carlsson, Tobias, et al.
(författare)
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Off-equilibrium response of grafted polymer chains subject to a variable rate of compression
- 2011
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Ingår i: Physical Chemistry, Chemical Physics - PCCP. - : Royal Society of Chemistry (RSC). - 1463-9076 .- 1463-9084. ; 13:24, s. 11757-11765
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Tidskriftsartikel (refereegranskat)abstract
- We present Brownian dynamics simulations of single grafted semiflexible chains (i.e., "polymer mushrooms'') with varying persistence lengths, intra-chain interactions, and subject to confinement. The results from different rates of compression are presented in the cases of an approaching infinite plane and a paraboloid tip. We discuss the different behaviour observed for grafted chains with strong and weak self-attraction (i.e., "hard'' and "soft'' polymer mushrooms). In both cases the effect on the size and shape is more pronounced for a slow compression rate, especially for "hard mushrooms''. We have also studied the relaxation of the chain while the compressing plane is maintained, and when it is removed suddenly. We find that the response depends strongly on the time allowed for relaxation in the compressed state. When using instead a paraboloid tip, the overall effects are similar yet less pronounced because the chain can dodge the confining object via an "escape transition.''
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| 4. |
- Cerritelli, Francesco, et al.
(författare)
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Evidence-based practice among Italian osteopaths : A national cross-sectional survey
- 2021
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Ingår i: BMC Complementary Medicine and Therapies. - : Springer Science and Business Media LLC. - 2662-7671. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths' attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context.METHODS: A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered.RESULTS: A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases.CONCLUSIONS: Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use.
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| 5. |
- Echternach, Matthias, et al.
(författare)
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Vocal tract and register changes analysed by real-time MRI in male professional singers - a pilot study
- 2008
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Ingår i: Logopedics, Phoniatrics, Vocology. - : Informa UK Limited. - 1401-5439 .- 1651-2022. ; 33:2, s. 67-73
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Tidskriftsartikel (refereegranskat)abstract
- Changes of vocal tract shape accompanying changes of vocal register and pitch in singing have remained an unclear field. Dynamic real-time magnetic resonance imaging (MRI) was applied to two professional classical singers (a tenor and a baritone) in this pilot study. The singers sang ascending scales from B3 to G#4 on the vowel /a/, keeping the modal register throughout or shifting to falsetto register for the highest pitches. The results show that these singers made few and minor modifications of vocal tract shape when they changed from modal to falsetto and some clear modifications when they kept the register. In this case the baritone increased his tongue dorsum height, widened his jaw opening, and decreased his jaw protrusion, while the tenor merely lifted his uvula. The method used seems promising and should be applied to a greater number of singer subjects in the future.
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| 6. |
- Echternach, Matthias, et al.
(författare)
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Vocal tract area functions and formant frequencies in opera tenors' modal and falsetto registers
- 2011
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Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 129:6, s. 3955-3963
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Tidskriftsartikel (refereegranskat)abstract
- According to recent model investigations, vocal tract resonance is relevant to vocal registers. However, no experimental corroboration of this claim has been published so far. In the present investigation, ten professional tenors' vocal tract configurations were analyzed using MRI volumetry. All subjects produced a sustained tone on the pitch F4 (349 Hz) on the vowel /a/(1) in modal and (2) in falsetto register. The area functions were estimated from the MRI data and their associated formant frequencies were calculated. In a second condition the same subjects repeated the same tasks in a sound treated room and their formant frequencies were estimated by means of inverse filtering. In both recordings similar formant frequencies were observed. Vocal tract shapes differed between modal and falsetto register. In modal as compared to falsetto the lip opening and the oral cavity were wider and the first formant frequency was higher. In this sense the presented results are in agreement with the claim that the formant frequencies differ between registers.
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| 7. |
- Edlund, Klara, et al.
(författare)
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Body image and compulsive exercise : Are there associations with depression among university students?
- 2022
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Ingår i: Eating and Weight Disorders. - : Springer Science and Business Media LLC. - 1124-4909 .- 1590-1262. ; 27:7, s. 2397-2405
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Mental health problems among university students have been reported to be significantly increasing and suggested to be associated with college drop-out. Body dissatisfaction and compulsive exercise are both constructs relevant for mental health problems in general and eating disorders in particular. This study examined associations between body dissatisfaction, compulsive exercise and self-reported symptoms of depression among Swedish university students.METHODS: Participants (n = 4262) are students in an ongoing cohort study, and data from the baseline assessment were used. Four linear regression models were built to explore the associations between body dissatisfaction, compulsive weight control exercise and depressive symptoms.RESULTS: Our findings showed that females reported higher levels of body dissatisfaction than males. Body dissatisfaction and compulsive exercise were associated with self-reported symptoms of depression in this non-clinical population. Results showed that compulsive exercise was negatively associated with reported symptoms of depression, while body dissatisfaction was positively associated with symptoms of depression.CONCLUSION: In line with previous research, there was a gender difference in body dissatisfaction where females displayed higher levels of dissatisfaction than males. Body dissatisfaction was positively associated with reported symptoms of depression, suggesting support of previous research indicating body dissatisfaction to increase mental health problems. Compulsive exercise was negatively associated with symptoms of depression suggesting a behavior negatively reinforced, supporting both constructs to be of interest for reported symptoms of depression in a non-clinical population of Swedish university students.LEVEL OF EVIDENCE: III, cohort study.TRIAL REGISTRATION: http://clinicaltrials.gov/ID : NCT04465435.
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| 8. |
- Edlund, Klara, et al.
(författare)
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Sustainable UNiversity Life (SUN) study : Protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues.METHODS AND ANALYSIS: This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up.PROTOCOL AMENDMENTS: Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic.ETHICS AND DISSEMINATION: The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications.TRIAL REGISTRATION NUMBER: NCT04465435.
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| 9. |
- Grönblom Lundström, Lena, 1951-, et al.
(författare)
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Health care in light of different theories of health : A proposed framework for integrating a social humanistic perspective into health care
- 2019
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Ingår i: Journal of Integrative Medicine. - : Elsevier. - 2095-4964. ; 17:5, s. 321-327
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Forskningsöversikt (refereegranskat)abstract
- The objective of this paper is to provide an overview of the biomedical, the biopsychosocial, and the social humanistic theories of health and to propose a framework for integrating the latter into health care. In summary, the definitions of health, illness and disease are essential to the practice of health care and play fundamental roles in how patients’ experiences of being ill are valued and assessed within health care systems. Principally, the biomedical perspective proceeds from pathoanatomical deficiencies defining disease and malfunction; the addition of psychosocial components forms a biopsychosocial perspective. In addition, the social humanistic perspective extends from a person’s will, their ability to act, and the possibility to fulfill wanted actions. Thus, health care that does not address the social humanistic perspective may lack the power to describe how these entities are related to the patient on a personal level; thus, the will of the patient is not always fully addressed. Importantly, by targeting the will of the patient and the patient’s ability to act, the proposed framework of integrating a social humanistic perspective into health care may further emphasize and strengthen the interrelatedness of medical perspectives. A framework for integrating a social humanistic perspective into health care is proposed and its potential impact on health care is discussed.
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| 10. |
- Johansson, Fred
(författare)
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Aspects of the aetiology of mental health problems among university students
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Mental disorders are among the leading causes of years lost due to disability in young people globally. Students are no exception, both mental disorders and mental health problems are common among university students with dramatic increases reported in recent years. The aetiology of mental disorders and mental health problems is generally assumed to be multicausal, with factors at different levels contributing to their development. Given the complexity of the causal network underlying mental health problems, it has been argued that a clear causal framework is needed when studying the aetiology of mental health problems. This thesis aimed to investigate some aspects of the potential aetiology of mental health problems among university students. Specifically, it focuses on four exposures at the psychosocial level presented in four studies: 1) the coronavirus disease (COVID-19) pandemic, 2) poor sleep quality, 3) procrastination and 4) sexual harassment and sexual violence. In addition to the discussion provided in each respective paper, this thesis discusses limitations and possible interpretations of our results from a modern causal inference perspective.The four studies of this thesis are based on The Sustainable University Life (SUN) cohort. The SUN cohort followed 4262 university students from eight universities in and around Stockholm, Sweden, with web-surveys at five time-points over one year.In Study I, we aimed to determine the mean trajectories of depression, anxiety, and stress symptoms among university students in Stockholm before and during the first months of the COVID-19 pandemic. For this, we included a subsample of 1836 university students that entered the SUN cohort before the outbreak of the COVID-19 pandemic, and were followed during the months before the pandemic, during the first wave of the pandemic and in the summer, months following the first wave of the pandemic. We found that mean depression, anxiety, and stress symptom levels were largely stable during the first wave compared to the months before the pandemic and decreased slightly during the following summer months. Our results indicate that mean levels of mental health symptoms did not change much during the early phase of the pandemic compared to before the pandemic.In Study II, we aimed to determine whether sleep quality statistically interacts cross-sectionally with loneliness, risky alcohol use, perfectionistic concerns and/or physical inactivity in relation to depressive symptoms in university students. We conducted a cross-sectional study using baseline-data from all 4262 participants in the SUN cohort. We found that while all factors were associated with depressive symptoms, only perfectionistic concerns interacted with sleep quality in its relation to depression. This interaction was quite weak and explainedonly a small proportion of the variance in depressive symptoms. Overall, we did not find support for our hypothesis that poor sleep quality could interact with several different potential risk factors for depressive symptoms.In Study III, we aimed to evaluate the associations between procrastination and sixteen subsequent health outcomes (including mental health symptoms, disabling pain, lifestyle behaviours and psychosocial health factors), measured 9 months later, among university students. We used data from all participants responding to the first follow-up in the SUN cohort (n=3525) and found that procrastination was related to several subsequent health outcomes, including symptoms of depression, anxiety and stress, while controlling for multiple potential confounders. Although we cannot rule out non-causal explanations for these associations, the results indicate that procrastination could have an effect on health outcomes among students, but that it is likely to be rather small for any specific health outcome.In Study IV, we investigated the impact of recent exposure to different forms of sexual harassment and sexual violence; 1) unwanted sexual attention, 2) offensive sexual remarks, 3) presentation or distribution of sexist material, 4) uncomfortable touching, 5) being offered benefits for sex and 6) sex against ones will, along with a wide definition of sexual harassment: sexual harassment (wide subjective definition) on levels of depression and anxiety symptoms three, six and nine months later, for women and men, respectively. We conducted a cohort study using data from all women and men responding to the first follow-up in the SUNcohort (n= 3503). Our results showed that women recently exposed to 1) sexual harassment (wide definition), 2) unwanted sexual attention and 3) sex against ones will showed higher subsequent levels of depression and/or anxiety symptoms. The general trend was that all exposures were related to higher symptom levels at three months, but that this difference between exposed and unexposed diminished over time, although these trends are uncertain with wide confidence intervals. The exception was exposure to sex against ones will, where exposed showed elevated symptom levels throughout the follow-up period. For men, the estimates were uncertain overall, and we refrain from interpreting these results. Our results indicate that recent exposure to different forms of sexual harassment and sexual violence may impact later depression and anxiety symptoms among women, and that there could be differences in the strength and long-term impact on mental health between different forms of sexual harassment and sexual violence. Again, we cannot, with certainty rule out non-causal reasons for these associations.Interpreting any of these results as causal effects rests on multiple assumptions, which are discussed in the thesis. Determination of causal effects preferably relies on triangulation of results from different studies with different methodology. Overall, however, I believe that this thesis has strengthened the evidence that procrastination and sexual harassment and sexual violence may be causes of mental health problems among university students. An equally important finding, is that mental health seemed rather stable during COVID-19 pandemic, indicating that the pandemic may not have caused increased mental health problems on the group level.
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| 11. |
- Johansson, Fred, et al.
(författare)
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Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden
- 2023
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Ingår i: JAMA Network Open. - : American Medical Association (AMA). - 2574-3805. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Importance Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce.Objective To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden.Design, Setting, and Participants This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later.Exposure Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 (“very rarely or does not represent me”) to 5 (“very often or always represents me”) and summed to give a total procrastination score ranging from 5 to 25.Main Outcomes and Measures Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health.Results The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders.Conclusions and Relevance This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students’ health.
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| 12. |
- Johansson, Fred, et al.
(författare)
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Depression, anxiety and stress among Swedish university students before and during six months of the COVID-19 pandemic : A cohort study
- 2021
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 49:7, s. 741-749
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The COVID-19 pandemic has had a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety and stress symptoms during the COVID-19 outbreak compared to before the outbreak, and to determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems.METHODS: We conducted a cohort study with 1836 Swedish university students entering the study before 13 March 2020, the onset of the pandemic, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications.RESULTS: We found small differences in mean levels of the depression, anxiety and stress scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to -0.45) at FU1 and decreased by 0.75/21 (95% CI:-0.97 to -0.53) at FU2. Anxiety decreased from baseline to FU1 by 0.09/21 (95% CI: -0.24 to -0.07) and by 0.77/21 (95% CI: -0.93 to -0.61) to FU2. Stress decreased from baseline to FU1 by 0.30/21 (95% CI: -0.52 to -0.09) and by 1.32/21 (95% CI: -1.55 to -1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality or pre-pandemic mental health problems did not have worse trajectories of mean mental health symptoms.CONCLUSIONS: Symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.
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| 13. |
- Johansson, Fred, et al.
(författare)
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Sexual harassment, sexual violence and subsequent depression and anxiety symptoms among Swedish university students : A cohort study
- 2024
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: To determine the gender-specific impact of recent exposure to different forms of sexual harassment and sexual violence (SHV) on depression and anxiety symptoms three, six, and nine months later.Methods: We recruited 2229 women and 1274 men studying at Swedish universities and followed them with web-surveys every three months over one year. We estimated mean differences (MDs) of depression and anxiety symptoms between exposed and unexposed at each follow-up, adjusting for prior SHV, prior depression and anxiety symptoms and potential confounders.Results: For women, sexual harassment (wide subjective definition) was associated with higher symptom levels of depression (MD 1.0 [95% CI: 0.3; 1.7]) and anxiety (MD 0.8 [95% CI: 0.3; 1.4]) three months later. Unwanted sexual attention was associated with higher symptom levels of anxiety three (MD 0.5 [95% CI: 0.1; 0.8]) and six months later (MD 0.4 [95% CI: 0.0; 0.7]). Exposure to sex against ones will was associated with higher depression symptoms three (MD 1.7 [95% CI: 0.1;3.4]), and six months later (MD 3.1 [95% CI: 1.0; 5.2]). Trends indicated that associations with subsequent mental health differed between forms of SHV among women, and that most associations were more pronounced in temporal proximity to the exposures. For men, we refrain from interpreting the results since they showed high variability and were not robust to sensitivity analyses using multiple imputation to account for missing outcome data.Conclusions: Among women, several forms of SHV were associated with higher subsequent depression and anxiety symptoms.
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| 14. |
- Johansson, Fred, et al.
(författare)
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Strengths of associations between depressive symptoms and loneliness, perfectionistic concerns, risky alcohol use and physical activity across levels of sleep quality in Swedish university students : A cross-sectional study
- 2023
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Ingår i: Journal of Sleep Research. - : Wiley. - 0962-1105 .- 1365-2869. ; 32:2
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Tidskriftsartikel (refereegranskat)abstract
- Previous research shows that sleep quality may interact with some other predictors of depression, such that poor sleep could strengthen the association between these factors and depression. We aimed to determine the presence of statistical interactions between sleep quality and loneliness, risky alcohol use, perfectionistic concerns and/or physical inactivity in relation to depressive symptoms. Further, we aimed to describe the functional form of the statistical interactions and associations. We used a cross-sectional design and included 4262 Swedish university students. All measures were self-reported, sleep quality was measured with the Pittsburgh Sleep Quality Index, and depressive symptoms with the short-form Depression, Anxiety and Stress Scale. Regression models of increasing complexity (linear and non-linear, with and without interactions) were compared to determine the presence of associations and statistical interactions, and to explore the best functional form for these associations and interactions. Out-of-sample R2 from repeated cross-validation was used to select the final models. We found that sleep quality was associated with depressive symptoms in all final models. Sleep quality showed a linear interaction with perfectionistic concerns in relation to depressive symptoms, such that perfectionistic concerns were more strongly associated with depressive symptoms when sleep quality was poor. Loneliness, risky alcohol use and physical inactivity were non-linearly associated with depressive symptoms but did not interact with sleep quality. We concluded that out of the four examined variables, only perfectionistic concerns interacted with sleep quality in relation to depressive symptoms. This interaction was weak and explained little of the overall variance in depressive symptoms.
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| 15. |
- Larsson, Kristina, et al.
(författare)
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Lifestyle behaviors in Swedish university students before and during the first six months of the COVID-19 pandemic : A cohort study
- 2022
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Changes in Swedish university students' lifestyle behaviors during the COVID-19 pandemic are unknown. This study aimed to assess physical activity, sitting time, meal frequency and risk substance use (alcohol, tobacco, and illicit use of drugs) in Swedish university students before and during the first six months of the COVID-19 pandemic, for all and stratified by age and sex.METHODS: Data were obtained from the Sustainable University Life cohort study in which web-based surveys were sent to university students repeatedly for one year. Baseline assessment (before the pandemic) was between August 2019-March 2020, follow-up 1 (FU1) between March-June 2020, and follow-up 2 (FU2) between June-September 2020. Participants reported weekly minutes of physical activity, daily sitting hours, meal frequency by weekly intake of different meals, and motivation for eating irregularly, if so. Also, harmful use of alcohol, tobacco and illicit drugs was assessed. Population means and differences with 95% confidence intervals (95% CI) in lifestyle behaviors between time points were calculated with Generalized Estimating Equations.RESULTS: 1877 students (73% women, mean age 26.5 years) answered the baseline survey. Weekly exercise decreased by -5.7 min (95% CI: -10.0, -1.5) and -7.7 min (95% CI: -12.6, -2.8) between baseline and FU1 and FU2, respectively. Weekly daily activities increased by 5.6 min (95% CI: 0.3, 11.7) and 14.2 min (95% CI: 7.9, 20.5) between baseline and FU1 and FU2. Daily sitting time decreased by -1.4 h (95% CI: -1.7, -1.2) between baseline and FU2. Breakfast intake increased by 0.2 days per week (95% CI: 0.1, 0.3) between baseline and FU2. Lunch intake decreased by -0.2 days per week (95% CI: -0.2, -0.1) between baseline and FU1 and by -0.2 days per week (95% CI: -0.3, -0.0) between baseline and FU2. Dinner intake decreased by -0.1 days per week (95% CI: -0.2, -0.0) between baseline and both FU1 and FU2. Only minor differences in risk substance use were observed. Similar changes were observed in analyses stratified by age and sex.CONCLUSIONS: Lifestyle behaviors in Swedish university students slightly improved during the first six months of the COVID-19 pandemic compared to before.TRIAL REGISTRATION: ClinicalTrials.gov, NCT04465435 . 10/07/2020.
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| 16. |
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| 17. |
- Leach, Matthew J, et al.
(författare)
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Skills, attitudes and uptake of evidence-based practice : A cross-sectional study of chiropractors in the Swedish Chiropractic Association
- 2021
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Ingår i: Chiropractic and Manual Therapies. - : Springer Science and Business Media LLC. - 2045-709X. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Evidence-based practice (EBP) is integral to the delivery of high-quality health care. Chiropractic has been a licensed health profession in Sweden since 1989, but little is known of the uptake of EBP in this professional group. This study explored the self-reported skills, attitudes and uptake of EBP, and the enablers and barriers of EBP uptake, among licensed chiropractors in Sweden.METHODS: Licensed chiropractors (n = 172) of the Swedish Chiropractic Association (Legitimerade Kiropraktorers Riksorganisation) were invited to participate in an anonymous online questionnaire, using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) in February 2019.RESULTS: Fifty-six (33%) chiropractors completed the survey. Participants were predominantly male, aged 30-49 years, held a Master's degree, and had received their highest qualification and practiced chiropractic for over a decade. Chiropractors rated their EBP skill-level mostly in the moderate to moderate-high range. The majority of chiropractors reported positive attitudes towards EBP, with most agreeing or strongly agreeing that EBP is necessary in the practice of chiropractic, and that EBP assists in making decisions about patient care. Chiropractors reported an average level of engagement in EBP activities. All participants indicated professional literature and research findings were useful in their day-to-day chiropractic practice. The main perceived enabler of EBP uptake was internet access in the workplace, whereas the main barrier to EBP uptake was lack of clinical evidence in chiropractic.CONCLUSIONS: Participating chiropractors of the Swedish Chiropractic Association were generally favourable of EBP, though only reported modest levels of EBP-related skills and engagement in EBP activities. Our findings suggest future studies investigating interventions focussed on improving chiropractors' skills and uptake of EBP are warranted.
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| 18. |
- Lilje, Stina, et al.
(författare)
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Naprapathy versus orthopaedic standard care for common musculoskeletal disorders : Aan 8-year follow-up of a pragmatic randomized controlled trial in Sweden
- 2021
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Ingår i: Chiropractic and Manual Therapies. - : Springer Science and Business Media LLC. - 2045-709X. ; 29:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Musculoskeletal pain is among the most common reasons for seeking care, specialist competence for its treatment in primary care limited and waiting lists for orthopaedics often amongst the longest. Many referrals to orthopaedics do not concern disorders that benefit from surgery. Manual therapy is effective, yet not integrated in national health care systems, and there is a lack of research on other than neck and low back pain, and a lack of long-term follow-ups. The present study evaluates the long-term effects of a manual therapy (naprapathy) for common orthopaedic disorders.METHODS: An 8-year follow-up (96 months) of a pragmatic randomized controlled trial of naprapathy (experimental group) versus standard orthopaedic care (control group) for non-surgical patients of working age with the most common musculoskeletal disorders on the waiting lists (n = 78). Bodily pain, physical function (SF36), Quality of life (QoL; SF6D), and data on health care utilization were collected. The treatments lasted from January 2007 to November 2007.RESULTS: N = 75 participants in the original study sample completed the 8-year follow-up. The differences in bodily pain (21.7 (95% CI: 9.1-34.3)), physical function (17.6 (6.7-28.4)), and QoLs (0.823 (95% CI: 0.785-0.862) compared with 0.713 (95% CI: 0.668-0.758)) were statistically significantly in favor of the experimental group (p-values < 0.01). After sensitivity analysis the experimental group had altogether 260 health care visits compared with 1161 in the control group.CONCLUSIONS: Naprapathy is a continuously effective treatment. Together with earlier research our study suggests that specialized manual therapy should be considered when triaging patients with common non-surgical musculoskeletal disorders in national health care systems.TRIAL REGISTRATION: Not applicable, as per information given by ClinicalTrials.gov.
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| 19. |
- Millgård, Moa, et al.
(författare)
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Flow Glottogram Characteristics and Perceived Degree of Phonatory Pressedness
- 2016
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Ingår i: Journal of Voice. - : Elsevier BV. - 0892-1997 .- 1873-4588. ; 30:3, s. 287-292
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Phonatory pressedness is a clinically relevant aspect of voice, which generally is analyzed by auditory perception. The present investigation aimed at identifying voice source and formant characteristics related to experts' ratings of phonatory pressedness. Study Design. Experimental study of the relations between visual analog scale ratings of phonatory pressedness and voice source parameters in healthy voices. Methods. Audio, electroglottogram, and subglottal pressure, estimated from oral pressure during /p/ occlusion, were recorded from five female and six male subjects, each of whom deliberately varied phonation type between neutral, flow, and pressed in the syllable /pae/, produced at three loudness levels and three pitches. Speech-language pathologists rated, along a visual analog scale, the degree of perceived phonatory pressedness in these samples. Results. The samples were analyzed by means of inverse filtering with regard to closed quotient, dominance of the voice source fundamental, normalized amplitude quotient, peak-to-peak flow amplitude, as well as formant frequencies and the alpha ratio of spectrum energy above and below 1000 Hz. The results were compared with the rating data, which showed that the ratings were closely related to voice source parameters. Conclusions. Approximately, 70% of the variance of the ratings could be explained by the voice source parameters. A multiple linear regression analysis suggested that perceived phonatory pressedness is related most closely to subglottal pressure, closed quotient, and the two lowest formants.
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| 20. |
- Myhrvold, Birgitte Lawaetz, et al.
(författare)
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Investigating attitudes, skills, and use of evidence-based practice among Norwegian chiropractors : A national cross-sectional study
- 2023
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Ingår i: BMC Health Services Research. - 1472-6963. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Evidence-based practice (EBP) is essential in improving the quality of healthcare and of importance for all health care personnel. No study in Norway has investigated attitudes, skills and use related to EBP among chiropractors. The aim of this study was to describe Norwegian chiropractors' attitudes, skills, and use of EBP, as well as the barriers and facilitators to their use of EBP.METHODS: A national cross-sectional survey, the online version of the Evidence Based practice Attitudes & Utilisation SurvEy (EBASE), was sent by email to 770 Norwegian practicing chiropractors, all members of the Norwegian Chiropractic Association. Three EBASE sub-scores were generated (Attitudes, Skills and Use), and the demographic characteristics of the sample were reported. Linear regression analyses were conducted to examine the association between responses of the three sub-scores and demographic characteristics. Information on main barriers and facilitators of EBP was collected and described.RESULTS: A total of 312 (41%) chiropractors responded to the survey, and 95% agreed that EBP is necessary for chiropractic practice. While overall use of EBP activities was low participants were interested in learning and improving their skills to incorporate EBP into practice. Chiropractors' attitudes, skills, and use of EBP were positively associated with being female and having spent more than one hour per week on research, but negatively associated with having practiced more than 10 years. Main barriers of EBP were lack of skills to critically evaluate, interpret, and apply research findings to practice. Main facilitators of EBP included access to the internet and free online databases in the workplace.CONCLUSION: Although chiropractors in Norway reported positive attitudes and moderate skills in EBP, their use of EBP activities was limited. The main barriers and facilitators to EBP were primarily related to perceived skills deficits, whilst enablers of EBP were mostly related to infrastructure requirements.
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| 21. |
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| 22. |
- Palmgren, Per J., et al.
(författare)
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Reassessing the educational environment among undergraduate students in a chiropractic training institution : A study over time
- 2015
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Ingår i: Journal of Chiropractic Education. - 1042-5055. ; 29:2, s. 110-126
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was twofold: (1) to compare the perceived educational environment at 2 points in time and (2) to longitudinally examine potential changes in perceptions of the educational environment over time. Methods: The validated Dundee Ready Educational Environment Measure (DREEM), a 50-item, self-administered Likert-type inventory, was used in this prospective study. Employing convenience sampling, undergraduate chiropractic students were investigated at 2 points in time: 2009 (n = 124) and 2012 (n = 127). An analysis of 2 matching samples was performed on 27% (n = 34) of the respondents in 2009. Results: A total of 251 students (79%) completed the inventory, 83% (n = 124) in 2009 and 75% (n = 127) in 2012. The overall DREEM scores in both years were excellent: 156 (78%) and 153 (77%), respectively. The students' perceptions of teachers differed significantly between the 2 cohort years, decreasing from 77% to 73%. Three items received deprived scores: limited support for stressed students, authoritarian teachers, and an overemphasis on factual learning; the latter significantly decreased in 2012. In the longitudinal sample these items also displayed scores below the expected mean. Conclusion: Students viewed the educational environment as excellent both in 2009 and 2012. The perceptions of teachers declined with time; however, this could be attributed to teachers' new roles. Certain aspects of the educational environment factored prominently during the comparative points in time, as well as longitudinally, and these ought to be further investigated and addressed to provide an enhanced educational environment.
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| 23. |
- Ståhle, Alexander, et al.
(författare)
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Designguide för Smarta gator
- 2022
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Designguiden för smarta gator konkretiserar hur de fyra megatrenderna urbanisering, digitalisering, samhällsförändringar och miljöförändringar leder till nya krav och utformningsprinciper för framtidens gator. Guiden är tänkt att fungera som en inspiration och ett underlag för att förnya svensk gatupolicy på nationell, regional och kommunal nivå.Guiden innehåller utöver en inledning följande kapitel: en historisk tillbakablick (gatans utveckling), gatans användning, gatans delar, gatans design, designprocessen, guidens genomförande.
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| 24. |
- Sundberg, Mikael, et al.
(författare)
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Monte Carlo simulations of backscattered light intensity from convex and concave surfaces with an optical fiber array sensor
- 2006
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Ingår i: Proceedings of the SPIE - Optical Interactions with Tissue and Cells XVII. - : SPIE - International Society for Optical Engineering. ; , s. 8-18
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In a previous study, we presented a new technique for representationof the shape of a scattering surface. A sensor basedon two parallel fiber arrays yielded a source-detector intensity matrix(SDIM). In that study, it was shown that convex andconcave polyacetal plastic (Delrin) surfaces could be accurately distinguished usingthe proposed technique. A simplified simulation model for calculating theSDIM was used, assuming that backscattered light was generated byLambertian sources in the illuminated surface. These simulations showed discrepanciescompared to measurements, probably due to the absence of lightscattering in the model.Here, we will present an improved model,based on the Monte Carlo technique for light transport inturbid media. The optical properties of the Delrin phantoms wereestimated by means of different measurement techniques. The optical propertiesand the geometry of the Delrin phantoms were implemented inthe model along with the spatial distribution of the sourceand detector fibers of the sensor. The SDIM was extractedfrom backscattered photons exiting the turbid medium from the curvedsurface. The SDIM:s obtained with the Monte Carlo model, showeda much closer agreement with the measurements than those obtainedwith the Lambertian model. The small discrepancies observed are probablydue to spatially varying optical properties of the plastic phantoms.Measurements, using the previously described sensor, of the SDIM fromDelrin pieces with convex and concave surfaces, are compared tothe SDIM extracted from simulations using the Monte Carlo model.
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| 25. |
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| 26. |
- Sundberg, Per, et al.
(författare)
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Character-matrix based descriptions of two new nemertean (Nemertea) species
- 2009
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Ingår i: Zoological Journal of the Linnean Society. - : Oxford University Press (OUP). - 0024-4082 .- 1096-3642. ; 157, s. 264-294
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Tidskriftsartikel (refereegranskat)abstract
- Ribbon worms (phylum Nemertea) have traditionally been described and classified based on a combination of internal and external morphological characters. The extent, and wealth of details, of these descriptions vary both over time and amongst authors. In addition, definitions of characters and character states are in many cases vague, causing problems both for identification and in phylogenetic analyses. Here, we suggest a system of describing nemerteans based on a list of characters and their states with the actual description in the form of a vector of character state symbols. We argue that this system makes it easier for other systematists to extract the necessary characters/character states for comparative and phylogenetic analyses. The proposed list of characters can also act as a checklist for nemertean description, whereby hopefully ambiguities (such as does the nonmentioning of a character actually mean ‘missing’ or just not looked for) can be avoided in the future. We describe two new species and one new genus Carinina ochracea sp. nov. and Raygibsonia bergi gen. et sp. nov. using this concept in combination with molecular analyses based on 18S and cytochrome oxidase I (COI) DNA sequences.
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| 27. |
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| 28. |
- Sundberg, Tobias, et al.
(författare)
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Attitudes, skills and implementation of evidence-based practice : A national cross-sectional survey of licensed naprapaths in Sweden
- 2023
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Ingår i: Chiropractic and Manual Therapies. - : Springer Science and Business Media LLC. - 2045-709X. ; 31
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden.METHODS: Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019.RESULTS: Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths' self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake.CONCLUSIONS: The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.
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| 29. |
- Sundberg, Tobias, et al.
(författare)
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Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses : A cohort study
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 52:4, s. 427-433
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.METHODS: The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.RESULTS: The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.CONCLUSIONS: Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.
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| 30. |
- Sundberg, Tobias, et al.
(författare)
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Evidence-informed integrative care systems-The way forward
- 2014
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Ingår i: European Journal of Integrative Medicine. - : Elsevier BV. - 1876-3820 .- 1876-3839. ; 6:1, s. 12-20
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The concept of integrative medicine/care - often referred to as the new medicine - typically signifies a sound combination of safe and effective ancient traditional medicine or complementary and alternative medicine, and state-of-the-art conventional medicine. In this opinion article, we draw on a decade of research and development including our own experiences in low-, middle- and high-income countries, by means of qualitative and quantitative research approaches, and explore trends vital to the development of evidence-informed integrative care and communication systems. Discussion: Proponents suggest that an integrative health care system with a diversity of therapeutic options - and no particular differentiation between any evidence-informed health care paradigms - might be the best way to revitalize health care and reduce societal health care costs. Opponents argue - based on reasoning common to followers of scientism - that such developments constitute pseudoscience and will effectively overburden the healthcare system. Integrating insights from medicine, the humanities, ethics and philosophy in a health care model, which combines high-tech conventional health care with ancient health care systems and therapies, with the aim to achieve a pluralistic, accessible, affordable, safe and effective health system is clearly a challenge, but one which in fact has been recommended by the Director General of the WHO. Conclusion: To maintain a polarized situation in the light of the growing demand for person-centred health care services, is unhelpful to nations and patients alike, detrimental to therapeutic relationships and may even occasionally be dangerous. (C) 2013 Elsevier GmbH. All rights reserved.
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| 31. |
- Sundberg, Tobias
(författare)
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Exploring integrative medicine for back and neck pain : on the integration of manual and complementary therapies in Swedish primary care
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and aims: The integration of complementary therapies (CTs) with an emerging evidence base into conventional care services is common, despite limited evidence as to the clinical effectiveness of comprehensive models delivering such care, i.e. integrative medicine (IM). Low back and neck pain (LBP/NP) are two of the most common reasons for people to use CTs. The objectives of this thesis were to develop, implement and explore the relevance of IM as a potential health service option in Swedish primary care. Methods: Acknowledging IM as a complex health care intervention, both qualitative and quantitative research approaches were used in this thesis. During the development of the IM model, an action research approach with focus groups and key informant meetings with multiple conventional and CT stakeholders was utilised. The development progressed through iterative cycles of data collection, analysis, refinement of strategies and actions following research group consensus, followed by further data collection (immersion/crystallisation). Perceived facilitators, barriers and strategies were identified and findings were categorised within a public health science framework of IM model structures, processes and outcomes. The feasibility and comparative effectiveness of IM vs. conventional primary care was investigated in a pragmatic pilot randomised clinical trial (RCT) of 80 patients with LBP/NP. Parametric and nonparametric statistics were used to explore outcome changes between groups after four months: SF-36 (main); self-rated disability, stress and well-being (0-10 scales), days in pain and the use of health care resources including analgesics, conventional care and CTs. Perspectives on receiving care were explored through focus group discussions with patients from the RCT and analysed by content analysis. A health economic evaluation was conducted alongside the RCT to explore the likelihood of the IM model being a cost-effective health service option. Results: The developed IM model adhered to standard clinical practice procedures and involved active partnership between a gatekeeping general practitioner collaborating with a team of certified/licensed CT providers (Swedish massage therapy, manipulative therapy/naprapathy, shiatsu, acupuncture and qigong) in a consensus case conference model of care. The implementation of the IM model was feasible and most patients were women with chronic (≥3 months) LBP/NP. The conventional care mainly consisted of pain management advice (stay active) and analgesics, occasionally complemented by short-term sick leave or a physiotherapy referral. In addition to this, the IM model integrated seven sessions of two different CTs over 10 weeks on average. It was found that the pilot RCT was underpowered to detect statistically significant differences between groups, and that a full-scale RCT would require a minimum of 120 patients. However, the trend in the clinical quantitative results with an increase in the SF-36 domain Vitality and a decrease in the use of analgesics favoured IM. In addition, the qualitative findings indicated that the interviewed patients valued the IM combination of conventional biomedical diagnostic procedures with empowering CT self-help strategies. There was a conservative likelihood (67%) of the IM model being cost-effective at a threshold of EUR 50,000 per quality-adjusted life year gained. Conclusion: Identification of IM facilitators, barriers and strategies by the different stakeholders contributed to feasible implementation within Swedish primary care. Triangulation of the various results suggests that IM is at least as effective as conventional care, with potential clinical benefits including empowerment and reduced need for analgesics. To verify the relevance of IM in Swedish primary care, future research should prioritise larger trials considering large variability, chronic pain duration, small to moderate effects, indirect costs and longer-term follow-up while adopting a mixed methods approach considering both general and disease-specific outcomes.
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| 32. |
- Sundberg, Tobias, et al.
(författare)
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Exploring Sick Leave in Integrative Care-Retrospective Observations and Future Study Recommendations.
- 2019
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Ingår i: Journal of alternative and complementary medicine. - : Mary Ann Liebert Inc. - 1557-7708 .- 1075-5535. ; 25:4, s. 377-384
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Tidskriftsartikel (refereegranskat)abstract
- To describe and contrast the prevalence and trends of sick leave in patients with pain or stress disorders referred to inpatient care that integrates conventional and complementary therapies, that is, integrative care (IC).County council and social insurance data were used to retrospectively observe cross-sectional sick leave prevalence at four time points: 1 year before the first registered inpatient visit with the target diagnosis, after referral at index, and at 1 and 2 years after index. To contrast the IC findings, observations of patients with similar background characteristics referred to conventional care (CC) were used.The sick leave prevalence of IC pain patients and IC stress patients increased from the preceding year to peak at index, where after it decreased back toward preindex levels over 2 years. Overall sick leave prevalence was higher in IC than in CC, where analogous but lower prevalence trends of sick leave changes were observed.Observed sick leave prevalences, which were higher in IC than in CC, gradually decreased over time following IC or CC referral. While natural recovery or other reasons for change of sick leave cannot be excluded, future prospective and randomized clinical trials are recommended.
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| 33. |
- Veitonmäki, Niina, et al.
(författare)
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A human icam-1 antibody isolated by a function-first approach has potent macrophage-dependent antimyeloma activity in vivo.
- 2013
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Ingår i: Cancer Cell. - : Elsevier BV. - 1878-3686 .- 1535-6108. ; 23:4, s. 502-515
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Tidskriftsartikel (refereegranskat)abstract
- We isolated a tumor B-cell-targeting antibody, BI-505, from a highly diversified human phage-antibody library, using a pioneering "function-first" approach involving screening for (1) specificity for a tumor B cell surface receptor, (2) induction of tumor programmed cell death, and (3) enhanced in vivo antitumor activity compared to currently used treatments. BI-505 bound to intercellular adhesion molecule-1, identifying a previously unrecognized role for this receptor as a therapeutic target in cancer. The BI-505 epitope was strongly expressed on the surface of multiple myeloma cells from both newly diagnosed and relapsed patients. BI-505 had potent macrophage-dependent antimyeloma activity and conferred enhanced survival compared to currently used treatments in advanced experimental models of multiple myeloma.
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