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- Karlsson, Therese, 1979, et al.
(author)
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Effect of the New Nordic Diet compared with usual care on glucose control in gestational diabetes mellitus: Study protocol for the randomized controlled trial intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO)
- 2022
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In: Contemporary Clinical Trials. - : Elsevier BV. - 1559-2030 .- 1551-7144. ; 115
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Journal article (peer-reviewed)abstract
- Background: Gestational diabetes mellitus (GDM) is a pregnancy complication associated with short- and long-term health consequences for mother and child. First line treatment is diet and exercise but there is a recognized knowledge gap as to what diet treatment is optimal. A healthy Nordic diet has been associated with improved health but no studies in women with GDM exist. The New Nordic Diet (NND) is an initiative with the purpose to develop a healthy Nordic diet including foods with the potential to grow in Nordic countries; including fruit, berries, vegetables, whole-grain cereal products, nuts, fish, and rapeseed oil. The purpose of the intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO) is to test if the NND compared with usual care improves glucose control in women with GDM. Methods: The iNDIGO study is a randomized parallel controlled trial where 50 women with GDM will be randomized to either an NND or usual care for 14 days (30–32 weeks of gestation). Participants in the NND group will receive menus and food bags containing foods to be consumed. Primary outcome is glycemic control (time in target) measured using continuous glucose monitoring. Compliance to the dietary intervention will be tested using dietary biomarkers and adherence questionnaires. Conclusion: Diet treatment represents first line treatment in GDM but it remains unclear what type of diets are effective. iNDIGO is an efficacy study and will provide evidence as to whether a healthy Nordic diet can improve glucose control in women with GDM. Trial registration: ClinicalTrials.gov registration Number: NCT04169243. Registered 19 November 2019, https://clinicaltrials.gov/ct2/show/NCT04169243.
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- Kilander, Helena, et al.
(author)
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Developing contraceptive services for immigrant women postpartum : a case study of a quality improvement collaborative in Sweden
- 2022
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
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Journal article (peer-reviewed)abstract
- Background: Immigrant women use less effective contraceptive methods and have a higher risk of unintended pregnancies. Maternal health care services offer a central opportunity to strengthen contraceptive services, especially among immigrants. This study aimed to evaluate a Quality Improvement Collaborative QIC. Its objective was to improve contraceptive services for immigrant women postpartum, through health care professionals’ (HCPs) counselling and a more effective choice of contraceptive methods.Methods: The pilot study was designed as an organisational case study including both qualitative and quantitative data collection and analysis. Midwives at three maternal health clinics (MHCs) in Stockholm, Sweden participated in a QIC during 2018–2019. In addition, two recently pregnant women and a couple contributed user feedback. Data on women’s choice of contraceptive method at the postpartum visit were registered in the Swedish Pregnancy Register over 1 year.Results: The participating midwives decided that increasing the proportion of immigrant women choosing a more effective contraceptive method postpartum would be the goal of the QIC. Evidence-based changes in contraceptive services, supported by user feedback, were tested in clinical practice during three action periods. During the QIC, the proportion of women choosing a more effective contraceptive method postpartum increased at an early stage of the QIC. Among immigrant women, the choice of a more effective contraception increased from 30 to 47% during the study period. Midwives reported that their counselling skills had developed due to participation in the QIC, and they found using a register beneficial for evaluating women’s choice of contraceptive methods.Conclusions: The QIC, supported by a register and user feedback, helped midwives to improve their contraceptive services during the pregnancy and postpartum periods. Immigrant women’s choice of a more effective contraceptive method postpartum increased during the QIC. This implies that a QIC could increase the choice of a more effective contraception of postpartum contraception among immigrants.
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3. |
- Lagerstrand, Kerstin M, et al.
(author)
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Treatment decision in a 4-year-old-boy with left ventricular outpouching after advanced hemodynamical flow evaluation with 4Dflow CMR: A case report.
- 2022
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In: Frontiers in pediatrics. - : Frontiers Media SA. - 2296-2360. ; 10
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Journal article (peer-reviewed)abstract
- Background: The present study presents a diagnostic course for the characterization of a congenital left ventricular outpouching (LVO) in a 4-year-old boy with severe neonatal heart failure, evaluating the added value of cardiac magnetic resonance (CMR) 4Dflow. Case presentation: A boy, born at full term, presented with heart failure immediately after birth. Echocardiography showed dilated left ventricle with poor function and LVO was initially interpreted as an aneurysm. No infection, inflammation, or other cause for heart failure was found. With intensive medical treatment, the heart function returned to normal, and eventually, all medication was terminated. At follow-up, surgical treatment of the LVO was discussed but after CMR 4Dflow, a thorough evaluation of the function of the left ventricle as well as the LVO was possible and the LVO was determined a double-chambered left ventricle with a good prognosis. Conclusions: The present case demonstrates the clinical usability of CMR 4Dflow for improved decision-making and risk assessment, revealing advanced hemodynamic flow patterns with no need for operation.
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4. |
- Tuomi, Lisa, 1985, et al.
(author)
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The effect of the Shaker head-lift exercise on swallowing function following treatment for head and neck cancer: Results from a randomized, controlled trial with videofluoroscopic evaluation
- 2022
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In: Head and Neck-Journal for the Sciences and Specialties of the Head and Neck. - : Wiley. - 1043-3074 .- 1097-0347. ; 44:4, s. 862-875
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Journal article (peer-reviewed)abstract
- Background Dysphagia is common following treatment for head and neck cancer (HNC) and intervention to improve swallowing function is warranted. This study aimed to evaluate the efficacy of the Shaker head-lift exercise (HLE) to improve dysphagia in HNC patients. Methods Patients treated for HNC with radiochemotherapy and with subsequent dysphagia were randomly assigned to intervention (HLE, n = 25) and control (standard dysphagia management, n = 27) groups. Videofluoroscopic evaluation of penetration-aspiration, initiation, residue, movement of selected structures, and self-perceived swallowing function, before and after 8 weeks of treatment, were compared. Results Although adherence to training was high, no statistically significant differences in objectively measured swallowing function between the groups or within-group changes were found. Self-perceived swallowing function improved in the intervention group. Conclusions In this HNC population, neither HLE nor standard dysphagia management improved objectively measured swallowing function as evaluated after 8 weeks. Future research focusing on finding effective interventions for dysphagia is warranted.
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5. |
- Uvnäs-Moberg, Kerstin, et al.
(author)
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Physiological effects induced by stimulation of cutaneous sensory nerves, with a focus on oxytocin
- 2022
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In: Current Opinion in Behavioral Sciences. - : Elsevier BV. - 2352-1546. ; 43, s. 159-166
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Journal article (peer-reviewed)abstract
- Gentle touch is mediated by CT afferents and is linked to the experience of pleasure by effects in the insular cortex. It is also associated with some antistress effects, lower levels of anxiety and pain reduction. A similar effect pattern is induced by oxytocin. In the present article, we describe the structure of the hypothalamic oxytocinergic system, in particular the pathways involved in reduction of anxiety, stress and pain. We detail how oxytocin exerts powerful anti-stress effects by antagonizing the release of and effects of corticotrophin releasing factor (CRF) and noradrenaline (NA), the main central regulators of the hypothalamo-pituitary-adrenal (HPA) axis and of the autonomic nervous system. It is suggested that CT fibers connect to the oxytocin system, and that oxytocin mediates the decrease of sympathetic nerve activity, increase of parasympathetic nerve activity as well as the reduction of pain and anxiety, induced by gentle touch. Thus, by reducing stress, repeated activation of CT afferents may be linked to better health.
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6. |
- Uvnäs-Moberg, Kerstin, et al.
(author)
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Sensory Stimulation and Oxytocin : Their Roles in Social Interaction and Health Promotion
- 2022
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In: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 13
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Journal article (peer-reviewed)abstract
- The aim of this call was to collect papers describing how oxytocin may be released by different kinds of sensory stimulation to induce wellbeing and restorative processes and to inhibit pain, stress and inflammation. A large number of interesting articles of very high quality were received and 19 papers were accepted for publication. All the included articles have contributed to expand the knowledge about oxytocin in a very substantial way both regarding its effect spectrum and regarding its association with sensory, somatosensory stimulation, in particular. In fact, the obtained data contribute to prove the hypothesis that the oxytocinergic system is a widespread integrative system, which is linked to social interaction, wellbeing, reduction of stress and pain as well as to reproductive, growth promoting and restorative effects. The activity of this archaic oxytocin system is under control of hormones and sensory nerves, which convey information regarding the state of the internal and the external environment. The oxytocin linked effects may be induced in the short-term as well as in the long-term perspective. All of the articles which were accepted and included in this issue, in their own unique way, contribute to describe oxytocin beyond its classical role in birth and milk ejection in accordance with the concept described above. We describe and discuss the data after having categorized the results presented in the articles according to certain subjects.
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