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- Asplund, Mia
(författare)
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Development of novel and accessible treatments for trichotillomania and skin-picking disorder
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Trichotillomania (TTM) and Skin-picking disorder (SPD) are psychiatric conditions characterized by recurrent and excessive hair-pulling and skin-picking, respectively. These behaviors result in significant hair loss or skin lesions and often consume substantial amounts of time, leading to significant distress and functional impairment. Prevalence rates vary across studies but have been demonstrated to be as high as 3.5% for TTM and 5% for SPD. The recommended first-line treatment for TTM and SPD is behavior therapy (BT). Unfortunately, healthcare practitioners often lack sufficient knowledge about these disorders, limiting the availability of treatments, particularly for individuals in geographically distant areas. Group therapy offers a potential solution, allowing caregivers to treat more people in the same timeframe. Further enhancement of availability can be achieved through online delivery. While therapist-supported internet-delivered behavior therapy (iBT) has been extensively studied for related disorders, treatments specifically for TTM and SPD have only been explored through unguided or minimally supported online interventions, yielding modest effect-sizes. Objective: The thesis aimed to develop and evaluate formats for delivering BT to increase availability and accessibility for these disorders. Specifically, we aimed to: 1) test the feasibility and preliminary efficacy of ACT-enhanced group behavior therapy (AEGBT) for TTM and SPD in an open pilot study, 2) test the feasibility and preliminary efficacy iBT for TTM and SPD in an open pilot study, 3) explore the participants experiences of iBT for TTM and SPD in a qualitative study, and 4) test the feasibility and efficacy of iBT for adult patients with SPD compared to a wait-list condition in a randomized trial. Methods: In Study I, based on the original protocol for individual face-to-face therapy we developed AEGBT and conducted an open pilot study with 40 adult participants with TTM and/or SPD in mixed diagnosis groups to test the feasibility and preliminary efficacy of the treatment. In Study II, we developed iBT and conducted an open pilot study with 25 adult participants with TTM and/or SPD to test the feasibility and preliminary efficacy of the treatment. Both Study I and II were conducted in routine psychiatric care. In Study III, we explored the participants’ experiences of undergoing iBT in a qualitative study. In Study IV, conducted in an academic setting, we randomized 70 participants with SPD to either iBT or a waitlist of equal duration. Results: Study I demonstrated high group attendance and minimal treatment drop-out. AEGBT produced significant decreases in hair-pulling and skin-picking severity from pre- to post-treatment, with moderate to large within-group effects from d = 0.77 to 1.24. Symptom reduction was sustained for SPD participants, but not for those with TTM at the 12-month follow-up. The utilization of a group format allowed therapists to efficiently manage 25% more patients in comparison to an individual treatment format. Study II reported high levels of participant satisfaction and iBT credibility, reflected in high average module completion and few participants ending treatment prematurely. iBT resulted in significant decreases in hair-pulling and skin-picking severity with effect sizes ranging from d = 0.89 to 1.75. Similar to Study I, long-term efficacy favored SPD participants. Study III, identified five over-arching themes, unveiling that participants perceived iBT as beneficial and efficacious, albeit time-consuming, leading to stress in some. The treatment's flexibility was appreciated by some participants, while others expressed a need for increased support. Study IV demonstrated a significantly greater improvement in SPD symptoms in the iBT group compared to the control group at post-treatment, with a between-group effect-size in the large range (bootstrapped d = 1.3). The improvement compared to pre-treatment remained significant at the 6-month follow-up. Conclusions: In conclusion, both AEGBT and iBT proved to be effective, feasible, and safe treatment approaches for TTM and SPD in routine psychiatric care. iBT, while advantageous, presented challenges for participants. Tailoring the treatment to individual needs or blending iBT with face-to-face treatment could enhance efficacy and applicability. Additionally, iBT demonstrated preliminary efficacy and sustained long-term benefits for SPD compared to a passive control condition. Directions for future research includes evaluating AEGBT and iBT in studies with larger sample sizes and active control conditions alongside cost-effectiveness analyses comparing face-to-face behavior therapy versus these novel treatment approaches. Furthermore, in order to enable nationwide access to BT for individuals with TTM and SPD, evaluations of the implementation of these approaches in regular healthcare is needed.
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- Baden, Fannie Frederikke
(författare)
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Nuclear Images of Bleak Joys
- 2022
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- 2011 öppnade ukrainska regeringen upp för turister att besöka staden Prypjat och området runt kärnkraftverket Tjernobyl. Vad kan man se i dessa tusentals turistbilder på en Sovjetisk utopi som övergavs efter kärnkraftskatastrofen? Fannie Frederikke Baden, doktorand i konsthistoria och visuella studier vid Institutionen för kulturvetenskaper, berättar. Inspelat den 8 april 2022 i Lux aula i Lund. Arrangör: Lunds universitet.
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- Collin, Betty, 1976-
(författare)
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Characterization and persistence of potential human pathogenic vibrios in aquatic environments
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Vibrio spp., natural inhabitants of aquatic environments, are one of the most common causes of bacterial gastroenteritis in the world, being spread to humans via the ingestion of seafood, contaminated drinking water or exposure to seawater. The majority of Vibrio spp. are avirulent, but certain strains may sporadically be human pathogenic. Vibrio cholerae may cause cholera and fatal wound infections, Vibrio parahaemolyticus may cause gastroenteritis and Vibrio vulnificus may cause wound infections and sepsis. To expand current knowledge of the occurrence, ecological niche and persistence of potential human pathogenic Vibrio spp. in aquatic environments, occurrence and laboratory studies were performed. The seasonal variation of Vibrio spp. in clams and mussels from Mozambique and Sweden were studied, with isolated strains characterized and compared with those isolated from water samples collected in India. Results showed that the numbers of Vibrio spp. in Mozambican clams peaked during the warmer rainy season and that the dominating species was V. parahaemolyticus. Biochemical fingerprinting and virulence screened by PCR revealed a high similarity among strains from the different aquatic environments. However, isolate functional hemolytic analyses and antibiotic resistance patterns differed between strains; Swedish and Indian strains were less sensitive to the tested antibiotics and had a lower hemolytic capacity than those from Mozambique. Molecular analysis of bacterial DNA from Swedish mussels showed the presence of the three Vibrio spp. most commonly linked with human illness, as well as their associated virulence genes. The strains isolated from marine and clinical environments were equally and highly harmful to the tested eukaryotic cells. The persistence of clinical V. cholerae in aquatic environments was investigated in vivo. Strains were exposed to mussels, with bacterial uptake and elimination then examined. The mussels were able to avoid the most potent strain by complete closure of shells. The less potent strain was accumulated in mussel tissue in low levels and one marine control strain to a higher degree. Mussels eliminated the pathogenic strain less efficiently than they did the marine strain. One clinical and one marine strain were then exposed to 4°C for 21 days, with the temperature then increased to 20°C. The clinical strain was more prone to lose culturability than the marine strain at 4°C, the former performed significantly better in regaining culturability after the temperature up-shift. Subsequently, the persistence of the clinical strain in natural bottom sediment, incubating as above, was studied and results showed a similar decrease in culturable numbers in the sediment as in the water. As the clinical V. cholerae strains did not carry any of the standard set of virulence genes, the ability to change from non-culturable to culturable may be of great importance to strain pathogenicity. The results also show that natural bottom sediment may be a potential reservoir of human pathogenic Vibrio spp.
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- Formenti, A., et al.
(författare)
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Solidification sequence and carbide precipitation in Ni-base superalloys IN718, IN625 AND IN939
- 2005
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Ingår i: High Temperature Materials and Processes. - 0334-6455 .- 2191-0324. ; 24:4, s. 239-258
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Tidskriftsartikel (refereegranskat)abstract
- Differential Thermal Analysis (DTA) and Directional Solidification and Quenching (DSQ) were used to evaluate the solidification and precipitation sequence for the Ni-base superalloys IN718, IN625 and IN939. They all showed a similar precipitation sequence, with an initial precipitation of gamma dendrites, followed by an intermediate non-invariant divorced eutectic reaction of type L -> gamma + MC, and a final eutectic precipitation of Laves phase for alloy IN718 and IN625 and of eta-phase for alloy IN939. The reaction temperatures and the amounts of carbides and of final precipitates were evaluated. Precipitated nitrides were found to act as nucleation sites for the precipitation of blocky carbides/carbonitrides, at low interdendritic supersaturation, while in interdendritic regions with high supersaturation, a 'script-like' carbide formation was found instead.
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