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- Wettergren, Lena, et al.
(författare)
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Comparison of two instruments for measurement of quality of life in clinical practice - a qualitative study
- 2014
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Ingår i: BMC Medical Research Methodology. - : Springer Science and Business Media LLC. - 1471-2288. ; 14, s. 115-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The study aimed to investigate the meaning patients assign to two measures of quality of life: the Schedule for Evaluation of Individual Quality of Life Direct Weighting (SEIQoL-DW) and the SEIQoL-DW Disease Related (DR) version, in a clinical oncology setting. Even though the use of quality of life assessments has increased during the past decades, uncertainty regarding how to choose the most suitable measure remains. SEIQoL-DW versions assesses the individual's perception of his or her present quality of life by allowing the individual to nominate the domains to be evaluated followed by a weighting procedure resulting in qualitative (domains) as well as quantitative outcomes (index score). Methods: The study applied a cross-sectional design with a qualitative approach and collected data from a purposeful sample of 40 patients with gastrointestinal cancer. Patients were asked to complete two measures, SEIQoL-DW and the SEIQoL-DR, to assess quality of life. This included nomination of the areas in life considered most important and rating of these areas; after completion patients participated in cognitive interviews around their selections of areas. Interviews were audiotaped and transcribed verbatim which was followed by analysis using a phenomenographic approach. Results: The analyses of nominated areas of the two measures resulted in 11 domains reflecting what patients perceived had greatest impact on their quality of life. Analysis of the cognitive interviews resulted in 16 thematic categories explaining the nominated domains. How patients reflected around their quality of life appeared to differ by version (DW vs. DR). The DW version more often related to positive aspects in life while the DR version more often related to negative changes in life due to having cancer. Conclusions: The two SEIQoL versions tap into different concepts; health-related quality of life, addressing losses and problems related to having cancer and, quality of life, more associated with aspects perceived as positive in life. The SEIQoL-DR and the SEIQoL-DW are recommended in clinical practice to take both negative and positive aspects into account and acting on the problems of greatest importance to the patient.
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- Hartelius, Lena, 1957, et al.
(författare)
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Short-term effects of repetitive transcranial magnetic stimulation on speech and voice in individuals with Parkinson's disease.
- 2010
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Ingår i: Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP). - : S. Karger AG. - 1421-9972. ; 62:3, s. 104-9
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Tidskriftsartikel (refereegranskat)abstract
- The main characteristics of dysarthria in Parkinson's disease (PD) are monotony of pitch and loudness, reduced stress, variable speech rate, imprecise consonants, and breathy and harsh voice. Earlier treatment studies have shown that dysarthria is less responsive to both pharmacological and surgical treatments than other gross motor symptoms. Recent findings have suggested that repetitive transcranial magnetic stimulation (rTMS) may have a beneficial effect on vocal function in PD. In the present study, 10 individuals with mild PD and no or minimal dysarthria were treated with rTMS as well as placebo stimulation in a blinded experiment. Stimulation was delivered using a frequency of 10 Hz and a stimulation intensity of 90% of the motor threshold. The site of stimulation was the cortical area corresponding to the hand, on the hemisphere contralateral to the patient's most affected side. The participants were audio-recorded before and after both rTMS and sham stimulation. Acoustic analysis was performed on 3 sustained /a:/ for each of the 4 conditions, and analyzed both for the whole group as well as for men and women separately. Results showed that there were no significant differences between any of the conditions regarding duration of sustained fricative or sustained vowel phonation, diadochokinetic rates or intelligibility. Above all, the results of acoustic analyses showed an effect of placebo; there was a significant reduction in fundamental frequency (F(0)) variation, pitch period perturbation, amplitude period perturbation, noise-to-harmonics ratio and coefficient of variation in F(0) between the recordings performed before compared to after sham stimulation.
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- Hedlund, Lena
(författare)
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Basal kroppskännedom och psykomotorisk funktion hos personer med allvarlig psykisk sjukdom
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Det övergripande syftet med avhandlingen var att belysa och kontextualisera fysioterapeutiska insatser för personer med schizofreniforma psykoser utifrån aktuell forskning om psykomotorisk funktion och självmedvetande. Självmedvetandeforskning, både experimentell och fenomenologisk, kopplar de mest grundläggande självmedvetandenivåerna till vårt kroppsliga ursprung; hur vi via den sensomotoriska funktionen förankras i kroppen och blir medvetna om vår plats i världen. Personer med allvarlig psykisk sjukdom har visat sig ha olika självmedvetandestörningar och psykomotoriska avvikelser. Fysioterapeuten behöver utifrån ett kliniskt resonerande värdera olika aspekter av patienternas svårigheter inför ett behandlingsupplägg. Vår kroppshållning och våra rörelser uttrycker vår personlighet och berättar hur vi mår men visar också om vi har olika funktionsnedsättningar som inverkar begränsande på rörelseförmågan. Vetenskapligt beprövade bedömningsinstrument och en evidensbaserad behandling är en viktig utgångspunkt. Denna avhandling består av två psykometriska studier; en reliabilitets- och validitetsstudie av ett självskattningsinstrument för trötthetsupplevande, Multidimensional Fatigue Inventory (MFI-20) och en reliabilitets- och validitetststudie av BAS Rörelsekvalitet och Kroppsupplevelse (BAS MQ-E). Avhandlingen består därtill av två kvalitativa studier, baserade på innehållsanalys, om patienters respektive fysioterapeuters erfarenheter av behandling med basal kroppskännedom. Resultaten visar att både MFI-20 och BAS MQ-E har tillfredställande psykometriska profiler och visar på god klinisk känslighet och relevans. De kvalitativa studierna visar på att patienterna har positiva erfarenheter av behandling med basal kroppskännedom, och de beskriver olika kroppsliga, känslomässiga och kognitiva effekter. Även fysioterapeuterna beskriver positiva effekter av behandlingen och hur de i processen guidar patienterna till större kroppslig kontakt och ett ökat självmedvetande.
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- Hedlund, Lena, et al.
(författare)
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The experiences of basic body awareness therapy in patients with schizophrenia.
- 2010
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Ingår i: Journal of Bodywork & Movement Therapies. - : Elsevier BV. - 1360-8592. ; 14:3, s. 245-254
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Basic Body Awareness Therapy (BBAT) is a physiotherapeutic treatment method that is commonly used in Scandinavian mental health services. However, for patients with schizophrenia, there are few studies that verify the effectiveness of BBAT, or explain which dysfunctions or disabilities BBAT has an effect on in this group of patients. The aim of the present study was thus to describe patients' experiences of BBAT, focusing on perceived main treatment effects. The areas of perceived effects are to be investigated in future research. METHOD: In a qualitative study, eight patients with schizophrenia were interviewed. The interview transcriptions were analysed with content analysis methodology. RESULT: Patients with schizophrenia report positive treatment effects of physiotherapy with BBAT. Four main categories were identified: affect regulation, body awareness and self-esteem, effects described in a social context and effects on the ability to think. These should be targeted in a future randomized and controlled study.
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| 7. |
- Hedlund, Lena, et al.
(författare)
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The physiotherapists' experience of Basic Body Awareness Therapy in patients with schizophrenia and schizophrenia spectrum disorders.
- 2013
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Ingår i: Journal of Bodywork & Movement Therapies. - : Elsevier BV. - 1360-8592. ; 17:2, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- Scandinavian physiotherapists (PT) treat patients with schizophrenia and schizophrenia spectrum disorder, mainly because of the latter's bodily difficulties. One commonly used method is Basic Body Awareness Therapy (BBAT), targeting the difficulties with sensory motor dysfunction and disembodiment. The aim of the study is to describe the physiotherapist's experiences of using BBAT for patients with Schizophrenia.
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| 8. |
- Tugues, Sònia, et al.
(författare)
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Genetic deficiency in plasma protein HRG enhances tumor growth and metastasis by exacerbating immune escape and vessel abnormalization
- 2012
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Ingår i: Cancer Research. - 0008-5472 .- 1538-7445.
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Tidskriftsartikel (refereegranskat)abstract
- Histidine-rich glycoprotein (HRG) is a 75 kDa heparin-binding plasma protein implicated in the regulation of tumor growth and vascularization. In this study, we show that hrg-/- mice challenged with fibrosarcoma or pancreatic carcinomas grow larger tumors with increased metastatic properties. Compared with wild type mice, fibrosarcomas in hrg-/- mice were more hypoxic, necrotic and less perfused, indicating enhanced vessel abnormalization. HRG-deficiency was associated with a suppressed anti-tumor immune response, with both increased infiltration of M2-marker-expressing macrophages and decreased infiltration of dendritic cells and cytotoxic T cells. Analysis of transcript expression in tumor-associated as well as peritoneal macrophages from hrg-/- mice revealed an increased expression of genes associated with a pro-angiogenic and immunoinhibitory phenotype. In accordance, expression arrays performed on HRG-treated peritoneal macrophages showed induction of genes involved in extracellular matrix biology and immune responsiveness. In conclusion, our findings demonstrate that macrophages are a direct target of HRG. HRG loss influences macrophage gene regulation, leading to excess stimulation of tumor angiogenesis, suppression of tumor immune response, and increased tumor growth and metastatic spread.
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