| 1. |
- Acosta, Stefan, et al.
(författare)
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Vacuum-Assisted wound closure and mesh-mediated fascial traction for open abdomen therapy - a systematic review
- 2017
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Ingår i: Anaesthesiology Intensive Therapy. - 1642-5758 .- 1731-2515. ; 49:2, s. 139-145
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Forskningsöversikt (refereegranskat)abstract
- Background: The aim of this paper was to review the literature on vacuum-Assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies. Methods: A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure". Results: Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-Atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias. Conclusions: A high primary fascial closure rate can be achieved with the vacuum-Assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-Trauma patients, in need of prolonged open abdomen therapy.
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| 2. |
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| 3. |
- Eriksson, Maria Christina, 1981, et al.
(författare)
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Long-term effects of Internet-delivered cognitive behavioral therapy for depression in primary care - the PRIM-NET controlled trial.
- 2017
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Ingår i: Scandinavian journal of primary health care. - : Informa UK Limited. - 1502-7724 .- 0281-3432. ; 35:2, s. 126-136
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Tidskriftsartikel (refereegranskat)abstract
- Internet-delivered cognitive behavioral therapy (ICBT) is recommended as an efficient treatment alternative for depression in primary care. However, only few previous studies have been conducted at primary care centers (PCCs). We evaluated long-term effects of ICBT treatment for depression compared to treatment as usual (TAU) in primary care settings.Randomized controlled trial.Patients were enrolled at16 PCCs in south-west Sweden.Patients attending PCCs and diagnosed with depression (n=90).Patients were assessed by a primary care psychologist/psychotherapist and randomized to ICBT or TAU. The ICBT included an ICBT program consisting of seven modules and weekly therapist e-mail or telephone support during the 3-month treatment period.Questionnaires on depressive symptoms (BDI-II), quality of life (EQ-5D) and psychological distress (GHQ-12) were administered at baseline, with follow-ups at 3, 6 and 12 months. Antidepressants and sedatives use, sick leave and PCC contacts were registered.Intra-individual change in depressive symptoms did not differ between the ICBT group and the TAU group during the treatment period or across the follow-up periods. At 3-month follow-up, significantly fewer patients in ICBT were on antidepressants. However, the difference leveled out at later follow-ups. There were no differences between the groups concerning psychological distress, sick leave or quality of life, except for a larger improvement in quality of life in the TAU group during the 0- to 6-month period.ICBT with weekly minimal therapist support in primary care can be equally effective as TAU among depressed patients also over a 12-month period.The trial was registered in the Swedish Registry, researchweb.org, ID number 30511.
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| 4. |
- Gutlic, Nihad, et al.
(författare)
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Impact of mesh fixation on chronic pain in total extraperitoneal inguinal hernia repair (TEP) : a nationwide register-based study
- 2016
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Ingår i: Annals of Surgery. - Philadelphia : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 263:6, s. 1199-1206
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mesh fixation is used to prevent recurrence at the potential risk for chronic pain in TEP. The aim was to compare the impact of permanent fixation (PF) with no fixation (NF)/nonpermanent fixation (NPF) of mesh on chronic pain after TEP repair for primary inguinal hernia.METHODS: Men, 30 to 75 years old, consecutively registered in the Swedish Hernia Register for a TEP primary repair in 2005 to 2009, were included in a mail survey using SF-36 and the Inguinal Pain Questionnaire (IPQ). Primary endpoint was IPQ question "Did you have pain during past week that could not be ignored." Risk factors for chronic pain and recurrent operations were analyzed.RESULTS: A total of 1110 patients were included (325 PF, 785 NF/NPF) with 7.7% reporting pain at median 33 months follow-up. No difference regarding primary endpoint pain (P < 0.462), IPQ and SF-36 subscales were seen. Recurrent operation was carried out in 1.4% during 7.5 years follow-up with no difference between PF- and NF-groups including subgroups of medial hernias. All SF-36 subscale-scores were equal to or better than the Swedish norm. A postoperative complication was a risk factor for chronic pain (OR 2.44, 95% CI 1.23-5.25, P < 0.023).CONCLUSIONS: The TEP procedure for primary inguinal hernia repair in men is associated with a low frequency of chronic pain and recurrent operations, with no difference between permanent fixation and no/nonpermanent fixation of mesh in a nationwide population-based study. TEP without fixation reduces costs and is safe for all patients.
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| 5. |
- Gutlic, Nihad, et al.
(författare)
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The Relevance of Sexual Dysfunction Related to Groin Pain After Inguinal Hernia Repair : The SexIHQ Short Form Questionnaire Assessment
- 2018
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Ingår i: Frontiers in surgery. - : Frontiers Media SA. - 2296-875X. ; 5, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic postoperative pain after inguinal hernia surgery can affect sexual function. A new short form questionnaire for inguinal hernia pain related sexual dysfunction (SexIHQ) was introduced and applied to a register based cohort of total extra-peritoneal hernioplasty (TEP) operated patients. Methods: Sexually active men, 30–60 years old, recorded in the Swedish Hernia Register for a primary inguinal hernia TEP operation were included. Two initial questions of the SexIHQ identify patients with pain at sexual activity. Only these patients proceeded to answer the specific questions on pain-induced impairment of sexual activity, pain frequency and intensity, physical functions (erection and ejaculation), and symptoms of depression. SexIHQ, the Short Form-36 (SF-36), the Inguinal Pain Questionnaire (IPQ) were mailed to participants for long term follow up. Results: In 538 included patients, 44 (8.2%) reported pain during sexual activity at mean 33 months after surgery. Sexual dysfunction was seen in 33 of these patients. A postoperative complication was a risk factor for pain during sexual activity; OR 4.89 (95% CI 1.92–12.43; p < 0.001). Quality-of-life was reduced in almost all SF-36 domains in patients with pain during sexual activity. Conclusions: A short form questionnaire, suitable for large cohorts, was developed to assess sexual dysfunction due to groin pain after inguinal hernia repair in male patients. Sexual dysfunction due to groin pain after hernia surgery by TEP is surprisingly common. Patients should preoperatively be informed of the risk of having pain during sexual activity following groin hernia surgery.
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| 6. |
- Lindström, Ulf, et al.
(författare)
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Back pain and health status in patients with clinically diagnosed ankylosing spondylitis, psoriatic arthritis and other spondyloarthritis: a cross-sectional population-based study
- 2016
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Ingår i: Bmc Musculoskeletal Disorders. - London : Springer Science and Business Media LLC. - 1471-2474. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: In the broader spectrum of back pain, inflammatory back pain (IBP) is a symptom that may indicate axial spondyloarthritis (SpA). The objectives of this study were to determine the frequency of current IBP, as a hallmark sign of possible axial SpA, in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) and other SpA and to compare self-reported health between the groups with current IBP. Methods: Five-thousand seven hundred seventy one patients identified in the regional healthcare register of the most southern county of Sweden, diagnosed at least once by a physician (based on ICD-codes) with any type of SpA in 2003-2007, were sent a postal survey in 2009. Patients with current IBP were identified, based on self-reported back pain >= 3 months in the preceding year and fulfilling the Berlin criteria for IBP. The frequencies of IBP in AS, PsA and other SpA (including the remaining subgroups of SpA) were determined, and the groups were compared with regard to patient reported outcome measures (PROMs). Results: The frequency and proportion of patients with current IBP in AS, PsA and other SpA were 319 (43 %), 409 (31 %) and 282 (39 %) respectively, within the responders to the survey (N = 2785). The proportion was statistically higher in AS, compared to PsA (p < 0.001), but not for AS compared to other SpA (p = 0.112). PsA and other SpA, with current IBP, had similar (BASFI, EQ-5D, patients global assessment, fatigue, spinal pain) or worse (BASDAI) PROMs, compared to AS with current IBP. PsA with current IBP received pharmacological, anti-rheumatic, treatment more frequently than AS with current IBP, while AS and other SpA received treatment to a similar degree. Conclusion: The proportion of patients with current IBP was substantial in all three groups and health reports in the non-AS groups were similar or worse compared to the AS group supporting the severity of IBP in these non-AS SpA groups. These findings may indicate a room for improvement concerning detection of axial disease within different subtypes of non-AS SpA, and possibly also for treatment.
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| 7. |
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| 8. |
- Olsson, Ulf, et al.
(författare)
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Elevcentrering som nutidshistoriskt problem
- 2015. - 1:1
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Ingår i: Utbildning. - Lund : Studentlitteratur AB. - 9789144076836 ; , s. 67-80
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Huvudsyftet med detta kapitel är att problematisera de föreställningar om lärande och elevcentrering som utgör grunden i dagens berättelser om skola och utbildning. Det sker mot bakgrund av att begreppet lärande under de senaste årtiondena blivit ett självklart inslag - eller kanske till och med etablerats som en dogm - i talandet, skrivandet och tänkandet om oss själva, andra människor, utbildning, arbetsliv och samhället
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| 9. |
- Olsson, Ulf, et al.
(författare)
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Lärandemålens politik
- 2015. - 1:1
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Ingår i: Utbildning. - Lund : Studentlitteratur AB. - 9789144076836 ; , s. 181-194
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Förutsättningarna för att organisera de nordiska lärarutbildningarna har förändrats under de senaste åren eftersom utbildningarna har blivit en del av ett större europeiskt projekt, nämligen Bolognaprocessen. Denna process syftar emellertid inte till att all lärarutbildning ska bli lika. Den syftar i stället till att göra Europas högre utbildningar, och därmed också lärarutbildningarna, jämförbara genom införandet av en gemensam utbildningsstruktur med tydliga och jämförbara examina på tre olika nivåer, nämligen utbildning på grundnivå, på avancerad nivå samt på forskarnivå. För att möjliggöra jämförelser ska målen för alla europeiska lärarutbildningar uttryckas i termer av lärandemål som ska ange vad medlemsländernas studenter förväntas kunna, förstå och vara i stånd att göra efter ett helt utbildningsprograms eller en enskild kurs slut.Syftet med kapitlet har inte varit att diskutera Bolognaprocessen som sådan utan snarare att visa att Bolognaprocessen ur ett styrningsperspektiv kan uppfattas som mer än en pedagogisk process. I termer av lärandemål fungerar den nämligen också som ett politiskt verktyg i formandet av samtidens nationella och europeiska identiteter samt i formandet av samtidens Europa som föreställd gemenskap.
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| 10. |
- Petersson, Christina, et al.
(författare)
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Impact of type 1 diabetes on health-related quality of life among 8–18-year-old children
- 2016
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Ingår i: Comprehensive Child and Adolescent Nursing. - : Taylor & Francis. - 2469-4207 .- 2469-4193. ; 39:4, s. 245-255
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Tidskriftsartikel (refereegranskat)abstract
- Measuring the health-related quality of life (HRQOL) is one way to understand an individual’s perspective on health, and, more specifically, how type 1 diabetes (T1D) affects a child’s everyday life. Early detection of poor HRQOL is considered a crucial factor for identifying children who are at risk of psychosocial problems. The aim of this study was to describe the differences in the HRQOL of children with T1D according to age, gender, and metabolic control (HbA1c). Cross-sectional data were collected from children with T1D using the DISABKIDS Chronic Generic Measure-37 (DCGM-37) and the diabetes specific module (DM-10). Non-parametric tests were used to investigate differences. There were differences between girls and boys, and girls reported lower HRQOL than boys (HRQOL total score: mean 74 and 67 respectively; p = .005). Adolescents described more worries and fears about the future compared with younger children. Children with poor metabolic control reported a lower HRQOL than those with better metabolic control (HRQOL total score:mean 68 and 76 respectively; p = .006), but the social dimensions were not affected. The findings of the present study elucidate the importance for paediatric nurses to explore potential problems in children with T1D and use this knowledge in clinical practice. Assessment of the HRQOL can provide the patient’s perspective on the quality of diabetes care. The HRQOL is correlated with HbA1c, gender, and age, and the HRQOL as well as HbA1c levels should be regularly assessed to establish a comprehensive care for children with T1D.
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