| 1. |
- de Brun, Maryam, 1991-, et al.
(author)
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Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden : A stepped wedge cluster randomised trial
- 2024
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In: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 21:7
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Journal article (peer-reviewed)abstract
- BACKGROUND: The World Health Organisation (WHO) 2013 diagnostic criteria for gestational diabetes mellitus (GDM) has been criticised due to the limited evidence of benefits on pregnancy outcomes in different populations when switching from previously higher glycemic thresholds to the lower WHO-2013 diagnostic criteria. The aim of this study was to determine whether the switch from previous Swedish (SWE-GDM) to the WHO-2013 GDM criteria in Sweden following risk factor-based screening improves pregnancy outcomes.METHODS AND FINDINGS: A stepped wedge cluster randomised trial was performed between January 1 and December 31, 2018 in 11 clusters (17 delivery units) across Sweden, including all pregnancies under care and excluding preexisting diabetes, gastric bypass surgery, or multifetal pregnancies from the analysis. After implementation of uniform clinical and laboratory guidelines, a number of clusters were randomised to intervention (switch to WHO-2013 GDM criteria) each month from February to November 2018. The primary outcome was large for gestational age (LGA, defined as birth weight >90th percentile). Other secondary and prespecified outcomes included maternal and neonatal birth complications. Primary analysis was by modified intention to treat (mITT), excluding 3 clusters that were randomised before study start but were unable to implement the intervention. Prespecified subgroup analysis was undertaken among those discordant for the definition of GDM. Multilevel mixed regression models were used to compare outcome LGA between WHO-2013 and SWE-GDM groups adjusted for clusters, time periods, and potential confounders. Multiple imputation was used for missing potential confounding variables. In the mITT analysis, 47 080 pregnancies were included with 6 882 (14.6%) oral glucose tolerance tests (OGTTs) performed. The GDM prevalence increased from 595/22 797 (2.6%) to 1 591/24 283 (6.6%) after the intervention. In the mITT population, the switch was associated with no change in primary outcome LGA (2 790/24 209 (11.5%) versus 2 584/22 707 (11.4%)) producing an adjusted risk ratio (aRR) of 0.97 (95% confidence interval 0.91 to 1.02, p = 0.26). In the subgroup, the prevalence of LGA was 273/956 (28.8%) before and 278/1 239 (22.5%) after the switch, aRR 0.87 (95% CI 0.75 to 1.01, p = 0.076). No serious events were reported. Potential limitations of this trial are mainly due to the trial design, including failure to adhere to guidelines within and between the clusters and influences of unidentified temporal variations.CONCLUSIONS: In this study, implementing the WHO-2013 criteria in Sweden with risk factor-based screening did not significantly reduce LGA prevalence defined as birth weight >90th percentile, in the total population, or in the subgroup discordant for the definition of GDM. Future studies are needed to evaluate the effects of treating different glucose thresholds during pregnancy in different populations, with different screening strategies and clinical management guidelines, to optimise women's and children's health in the short and long term.TRIAL REGISTRATION: The trial is registered with ISRCTN (41918550).
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| 2. |
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| 3. |
- Annerbo, Kerstin, 1964-, et al.
(author)
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Bibliotekarier och forskningsutställningar : "Mission impossible"?
- 2021
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In: När nyfikenhet, driv och kreativitet möts. - Stockholm : Kungliga biblioteket. - 9789170004315 - 9789170004322 - 9789170004339 ; , s. 53-61
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Book chapter (pop. science, debate, etc.)abstract
- Att bibliotekens uppgifter kan skifta eller ändra fokus, så att?arbetsformer förändras och bibliotekariers roller därigenom?omformas, är varken nytt eller konstigt. Så har det alltid varit.?En av de nya rollerna för bibliotekarier som blivit vanligare?på senare år är utvecklings- och producentrollen. Ta del av ett?samtal om hur verksamheten med att skapa forskningsutställningar har utvecklats på Linköpings universitetsbibliotek.
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| 4. |
- Dotevall, Hans, 1958, et al.
(author)
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Treatment with head-lift exercise in head and neck cancer patients with dysphagia: results from a randomized, controlled trial with flexible endoscopic evaluation of swallowing (FEES)
- 2023
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In: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 31:1
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Journal article (peer-reviewed)abstract
- Background: This randomized study aimed to evaluate the effects of the Shaker head-lift exercise (HLE) to improve dysphagia following oncologic treatment for head and neck cancer (HNC). Methods: Patients with dysphagia following oncologic treatment for HNC were randomly assigned to intervention (n = 23) or control (standard dysphagia management, n = 24) groups. Swallowing was evaluated at baseline and at 8-week follow-up using flexible endoscopic evaluation of swallowing (FEES) and self-perceived swallowing with the Eating Assessment Tool (EAT-10). Analysis was performed regarding secretion, initiation of swallow, residue after swallowing, and penetration/aspiration. Results: Few statistically significant differences were found in the FEES analysis. Some improvement of self-perceived swallowing function was found in both groups. Adherence to training was high. Conclusions: This randomized study regarding the effect of the HLE demonstrated that swallowing outcome measures used in assessment of FEES did not improve in patients treated with radiotherapy for patients with dysphagia following HNC.
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| 5. |
- Hansson, Max, 1956-
(author)
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Att implementera med hjälp av samverkan : En studie av implementering av ett stödboende med samverkan som metod
- 2021
-
Licentiate thesis (other academic/artistic)abstract
- In this licentiate thesis studies how a systematic work of implementing a supported housing develops from idea to practice with the purpose to analyze collaboration and its impact on the development of the implementation. The study followed how the four organizations created a collaboration to implement a supported housing.; the social services in Kalmar municipality, the Swedish Prison and Probation Service in the form of the local probation service in Kalmar, the association KRIS (Kriminellas Revansch I Samhället, [Criminals' Revenge In Society]) in Kalmar and Kalmarhem AB a housing company, The starting point for the study consists of a process evaluation of an implementation process, how collaboration established between the organizations, how collaboration as a way of working affects the process and finally the split-up of the project. The study conducted in two parts: partly during the years 2006-2008 when implementation studied, partly during the years 2014-2015 when the split-up of the project studied. The methods used was interviews, participatory observations and document studies. The empirical evidence collected during the two periods forms the basis for the analysis.The results indicate that collaboration created between the actors of the implementation is of crucial importance. That is, how the actors confronted and solved the problems that arose during the implementation and that both time and various forms of resources are required to create a comprehensive collaboration. The concluding part of the study describes how a split-up of collaboration takes place. The change can attributed to a new arrangement with clear operational management in accordance with the impact of New Public Management [NPM]. A consequence for the supported housing, in line with this logic, was a separation and division of clients and contractors and division between businesses in accordance with a competitive mindset.At the time of writing, the supported housing remains, albeit in a different form. One explanation is that during the implementation, a close and sustainable collaboration was developed that could withstand some of the threats created through changed forms of governance. This indicates that the collaboration that developed between the four organizations can still provide some space if it is able to find forms that can fit into new control logics.
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| 6. |
- Henriksson, Pontus, et al.
(author)
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Body mass index and gestational weight gain in migrant women by birth regions compared with Swedish-born women : A registry linkage study of 0.5 million pregnancies
- 2020
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 15:10
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Women migrating to high-income countries may have increased risks of adverse pregnancy outcomes as compared with native-born women. However, little is known whether migrant women are more likely to have unhealthy body mass index (BMI) or gestational weight gain (GWG), which is of importance considering the well-established links between unhealthy BMI and GWG with adverse pregnancy outcomes. Hence, the aim of the study was to examine the prevalence and estimate odds ratios (ORs) of underweight and obesity in the first trimester as well as inadequate and excessive GWG across birth regions in migrant (first-generation) and Swedish-born women in a population-based sample of pregnant women in Sweden.METHODS: This population-based study included 535 609 pregnancies from the Swedish Pregnancy Register between the years 2010-2018. This register has a coverage of approximately 90% and includes data on body weight, height, birth country and educational attainment. BMI in the first trimester of pregnancy was classified as underweight, normal weight, overweight and obesity whereas GWG was classified as inadequate, adequate and excessive according to the recommendations from the National Academy of Medicine, USA. BMI and GWG were examined according to 7 birth regions and the 100 individual birth countries. Adjusted ORs of underweight, obesity as well as inadequate or excessive GWG by birth regions were estimated using multinomial logistic regression.RESULTS: There were large disparities in unhealthy BMI and GWG across birth regions. For instance, women born in North Africa and Middle East and Sub-Saharan Africa had 1.40 (95% CI 1.35-1.44) and 2.13 (95% CI 2.03-2.23) higher odds of obesity compared with women born in Sweden. However, women born in Sub-Saharan Africa had also considerably higher odds of underweight (OR, 2.93 [95% CI 2.70-3.18]) and inadequate GWG (OR, 1.97 [95% CI 1.87-2.07]). The limitations of the study include the lack of a validated measure of acculturation and that the study only had data on first-generation migration.CONCLUSIONS: The large differences across the 7 regions and 100 countries highlights the importance of considering birth region and country-specific risks of unhealthy BMI and GWG in first-generation migrant women. Furthermore, inadequate GWG was common among pregnant first-generation migrant women, especially in women born in Sub-Saharan Africa, which demonstrates the need to promote adequate GWG, not only the avoidance of excessive GWG. Thus, our findings also indicate that additional support and interventions may be needed for first-generation migrant women from certain birth regions and countries in order to tackle the observed disparities in unhealthy BMI and GWG. Although further studies are needed, our results are useful for identifying groups of women at increased risk of unhealthy BMI and weight gain during pregnancy.
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| 7. |
- Henriksson, Pontus, et al.
(author)
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Self-Rated Health in Migrant and Non-Migrant Women before, during and after Pregnancy : A Population-Based Study of 0.5 Million Pregnancies from the Swedish Pregnancy Register
- 2020
-
In: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 9:6
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Journal article (peer-reviewed)abstract
- Self-rated health is a strong health marker. Migrants have been suggested to have poorer self-rated health than non-migrants (i.e., native-born). However, little is known about whether there are disparities in self-reported health in relation to pregnancy. Therefore, the aim of the current study was to examine the odds of poor self-rated health before, during and after pregnancy in migrant women as compared to women born in Sweden. We utilized population-based data from the Swedish Pregnancy Register containing 0.5 million women born in Sweden (i.e., non-migrant women) and migrant women between 2010 and 2018. Self-rated health was reported on a 5-point scale (from very poor to very good). Very poor and poor health were categorized as poor self-rated health. Logistic regression was utilized to calculate odds ratios (ORs) that were unadjusted and adjusted for covariates (age, parity, educational attainment and body mass index). The results demonstrate disparities in self-rated health across birth regions. In comparison to women born in Sweden, women born in Latin America and the Caribbean, South Asia as well as North Africa and the Middle East had consistently higher odds of poor self-rated health before, during and after pregnancy (ORs ranging from 1.14 to 1.96 in both unadjusted and adjusted models). Although women born in Sub-Saharan Africa did have comparable self-rated health as to women born in Sweden before pregnancy, after accounting for covariates, they had lower odds of poor self-rated health during and after pregnancy (ORs: 0.71 and 0.80 respectively). Therefore, additional measures and support may be needed to tackle disparities in health between migrant and non-migrant women before, during and after pregnancy.
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| 8. |
- Holmgren, Kerstin, et al.
(author)
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Are perch (Perca fluviatilis L.) getting larger or smaller in Swedish lakes?
- 2023
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In: Ecology of Freshwater Fish. - : Wiley. - 0906-6691 .- 1600-0633. ; 32, s. 735-749
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Journal article (peer-reviewed)abstract
- Space-for-time approaches are often used to indicate current or future changes over time. A European gillnet standard facilitates spatial-scale comparisons of fish communities in European lakes. Fish size was generally lower and densities higher in warmer lakes, but less is known about trends over decadal time scales. We analysed the size of European perch (Perca fluviatilis L.) in 2121 Swedish lakes sampled during 1996–2021. The aim was to test whether size changed over time, and whether trends were similar in southern and northern regions. We analysed mean length and occurrence or relative abundance of size classes from the smallest (<100 mm) to the largest individuals (≥350 mm), and length at 1 and 5 years. The large data set was used to find general trends over time within regions, and within-lake trends were tested for 40 time-series lakes. The mean length of perch decreased in the southern and increased in the northern region. The proportion of the smallest perch increased in the southern, but not in the northern region. The most general trend was an increasing occurrence and proportion of the largest-sized perch in both regions in the large dataset. The average trends in the southern region of the large dataset also appeared as predominant trends within time-series lakes, although opposite trends occurred within some lakes in each region. This study also revealed that perch size at age 1 often increased within lakes over time, while more variable trends were found for size at age 5. The duration of the growth season has generally increased during the time frame of the present study, while other changes may differ between lakes in the same region. We recommend more studies based on time series of fish monitoring, including studies on possible reasons for the increased occurrence of very large perch in Swedish lakes.
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| 9. |
- Holmgren, Kerstin, et al.
(author)
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Effekter av kalkning på fisk i sjöar : Resultat av 48 års nätprovfisken
- 2021
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Reports (other academic/artistic)abstract
- Under 1970- och 1980-talen upptäcktes biologiska effekter av surt nedfall i sjöar och vattendrag i Sverige och i andra länder. Resultat från nätprovfisken under samma tid visade att försurningen gav upphov till effekter på fisk, till exempel rekryteringsproblem, minskat antal (minskad abundans) och förlust av fiskarter. Då inleddes också kalkning av många av de sjöar som fortfarande kalkas idag. I en del sjöar utfördes nätprovfisken både före och efter kalkning, och i flera fall rapporterades återupptagen rekrytering hos surhetskänsliga fiskarter efter kalkning. Samtidigt ökade antalet kalkade vatten snabbare än biologisk uppföljning av utförda åtgärder. Flertalet sjöar kalkades utan att föregås av inventering av fiskfaunan, och många provfiskades först efter påbörjad kalkning.Kalkningsuppgifter och vattenkemidata inhämtades från länsstyrelserna och kopplades till olika urval av provfiskade sjöar i den nationella databasen över sjöprovfisken. Totalt omfattar utvärderingen 4 292 provfisken från 1 343 kalkade sjöar och 2 190 provfisken från 698 okalkade sjöar. Med utgångspunkt från pH och alkalinitet klassades okalkade sjöar som sura, neutrala eller kalkrika. Det vanligaste biologiska motivet för kalkning var mört. De näst vanligaste motiven var öring och röding, men även abborre, gös, nors, sik och siklöja förekom som motiv för kalkning.Nuvarande standardnät fångar små och unga fiskar mer effektivt än de översiktsnät som användes på 1970-och 1980-talen, vilket försvårar tolkningen av fiskfaunans långsiktiga utveckling i såväl kalkade som okalkade sjöar. I provfisken med nuvarande standardnät var den ekologiska statusen (via två multimetriska fiskindex) högre i kalkade än i sura sjöar, men värdena för det surhetsspecifika indexet var lägre i kalkade än i neutrala sjöar.Med data från nuvarande standardnät undersökte vi också fiskvariabler i relation till medel-pH under tre år före provfisket. I analyserna ingick abundans och biomassa, multimetriska fiskindex samt storleks-och åldersbaserade mått relaterade till rekrytering av mört och abborre. Fiskvariablerna visade väntad respons i relation till pH i okalkade sjöar, men i kalkade sjöar hade fiskvariablerna svagare eller inte signifikanta samband med pH. Det kan finnas flera orsaker till detta.I denna rapport försöker vi också belysa flera fisk-och kalkningsrelaterade frågor som inte direkt kunde besvaras med befintliga data. Det var frågor om skillnader i biologisk respons mellan direktkalkade sjöar och sjöar med enbart uppströms kalkning, skillnader mellan överkalkning och normalkalkning, samt effekten av ytliga surstötar.
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| 10. |
- 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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| 11. |
- 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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| 12. |
- Kilander, Helena, et al.
(author)
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IMplementing best practice post-partum contraceptive services through a quality imPROVEment initiative for and with immigrant women in Sweden (IMPROVE it) : a protocol for a cluster randomised control trial with a process evaluation
- 2023
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In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Journal article (peer-reviewed)abstract
- Background: Immigrant women’s challenges in realizing sexual and reproductive health and rights (SRHR) are exacerbated by the lack of knowledge regarding how to tailor post-partum contraceptive services to their needs. Therefore, the overall aim of the IMPROVE-it project is to promote equity in SRHR through improvement of contraceptive services with and for immigrant women, and, thus, to strengthen women’s possibility to choose and initiate effective contraceptive methods post-partum.Methods: This Quality Improvement Collaborative (QIC) on contraceptive services and use will combine a cluster randomized controlled trial (cRCT) with a process evaluation. The cRCT will be conducted at 28 maternal health clinics (MHCs) in Sweden, that are the clusters and unit of randomization, and include women attending regular post-partum visits within 16 weeks post birth. Utilizing the Breakthrough Series Collaborative model, the study’s intervention strategies include learning sessions, action periods, and workshops informed by joint learning, co-design, and evidence-based practices. The primary outcome, women’s choice of an effective contraceptive method within 16 weeks after giving birth, will be measured using the Swedish Pregnancy Register (SPR). Secondary outcomes regarding women’s experiences of contraceptive counselling, use and satisfaction of chosen contraceptive method will be evaluated using questionnaires completed by participating women at enrolment, 6 and 12 months post enrolment. The outcomes including readiness, motivation, competence and confidence will be measured through project documentation and questionnaires. The project’s primary outcome involving women’s choice of contraceptive method will be estimated by using a logistic regression analysis. A multivariate analysis will be performed to control for age, sociodemographic characteristics, and reproductive history. The process evaluation will be conducted using recordings from learning sessions, questionnaires aimed at participating midwives, intervention checklists and project documents.Discussion: The intervention’s co-design activities will meaningfully include immigrants in implementation research and allow midwives to have a direct, immediate impact on improving patient care. This study will also provide evidence as to what extent, how and why the QIC was effective in post-partum contraceptive services.Trial registration: NCT05521646, August 30, 2022.
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| 13. |
- 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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| 14. |
- Larsson, E., et al.
(author)
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The Swedish study on improved contraceptive counselling for immigrant women postpartum
- 2020
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 30:Supplement_5
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Journal article (other academic/artistic)abstract
- Contraceptive choices postpartum have not previously been studied in Sweden. Being foreign born is a risk factor for induced abortion. Improving postpartum contraceptive counseling could potentially fulfill unmet needs for contraception.This is an organizational case study using a Quality Improvement Collaborative (QIC) within the regular healthcare setting at 3 maternal health clinics in Stockholm. The active phase of the study was Sep2018-Sep2019. Quantitative and qualitative methods were combined. Routine registration of choice of postpartum contraception was introduced at the clinics and analyzed focusing on Swedish born and foreign-born women. Midwives and researchers met continuously, and during the active phase every 2-3 months in learning seminars with around 20 participants. During the learning seminars PDSA-cycles were used and areas of improvements for continuous performance measures were chosen. The midwives decided on and tested multiple evidence-based changes in contraceptive counselling and services during action periods. Goals were set and competency building in areas chosen by the midwifes were held. In addition, both foreign- and Swedish born women gave their input to the improvement areas. Qualitative data was analyzed through content analysis from field notes and verbatim transcripts.Preliminary results show that the proportion of women choosing an effective contraceptive method (SARC or LARC) among immigrant women increased from 40% to 55% when comparing the start and the end of the project. The midwives reported how they had changed their approach when counselling women who were skeptical about contraception and tried to find a new way to meet women's needs.As much as the QIC showed positive results, it was a small-scale study in 3 clinics in one geographical area. A larger study to determine and explain the effectiveness of QIC on the proportion of immigrant women choosing an effective contraceptive method postpartum is planned for 2021-2024.
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| 15. |
- Munkombwe, Wisdom Muleya, et al.
(author)
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Nurses' experiences of providing non-pharmacological pain management in palliative care : a qualitative study.
- 2020
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In: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 29:9-10, s. 1643-1652
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Journal article (peer-reviewed)abstract
- AIM AND OBJECTIVES: To explore the experiences and views of nurses who provide non-pharmacological therapies for chronic pain management in palliative care.BACKGROUND: Nursing expertise in palliative care is essential in providing pain relief to patients with chronic diseases. Examinations of the use of non-pharmacological therapies for chronic pain management in palliative care have revealed what non-pharmacological therapies have been used, but there is insufficient knowledge regarding nurses' attitudes, views, and experiences regarding pain therapies in this context.DESIGN: A qualitative descriptive design was chosen.METHODS: Data were collected through individual interviews in a purposive sample with 15 nurses to ensure maximum variation. The data were analyzed using qualitative content analysis. This study aligns with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.RESULTS: The analysis yielded four categories, as follows: "Building and sustaining favorable therapeutic relationships" involved the creation of trust and a solid relationship; in "recognizing the diversity of patients' needs," person-centered care is expressed as being vital for individualized non-pharmacological pain management; "incorporating significant others" describes how nurses can help to ease the patient's pain by identifying positive encounters with family members or friends; and in "recognizing the existence of barriers," nurses highlight vulnerable groups such as children, for whom nurses require special education to enable optimal non-pharmacologic pain management.CONCLUSION: The unique knowledge that nurses gain about the patient through the nurse-patient relationship is central and crucial for successful non-pharmacological pain management.RELEVANCE TO CLINICAL PRACTICE: This study emphasizes the need for nurses to get to know their patient and to be open and sensitive to patients' descriptions of their unique life situations, as this provides the necessary knowledge for optimal care and pain management. Nurses should be encouraged and given the opportunity to attend specialized training in palliative care and pain management.
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| 16. |
- Munkombwe, Wisdom Muleya, et al.
(author)
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Nurses' experiences of providing non-pharmacological pain management in palliative care : a qualitative study.
- 2020
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In: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Ltd. - 0962-1067 .- 1365-2702. ; 29:9-10, s. 1643-1652
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Journal article (peer-reviewed)abstract
- AIM AND OBJECTIVES: To explore the experiences and views of nurses who provide non-pharmacological therapies for chronic pain management in palliative care. BACKGROUND: Nursing expertise in palliative care is essential in providing pain relief to patients with chronic diseases. Examinations of the use of non-pharmacological therapies for chronic pain management in palliative care have revealed what non-pharmacological therapies have been used, but there is insufficient knowledge regarding nurses' attitudes, views, and experiences regarding pain therapies in this context. DESIGN: A qualitative descriptive design was chosen. METHODS: Data were collected through individual interviews in a purposive sample with 15 nurses to ensure maximum variation. The data were analyzed using qualitative content analysis. This study aligns with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS: The analysis yielded four categories, as follows: "Building and sustaining favorable therapeutic relationships" involved the creation of trust and a solid relationship; in "recognizing the diversity of patients' needs," person-centered care is expressed as being vital for individualized non-pharmacological pain management; "incorporating significant others" describes how nurses can help to ease the patient's pain by identifying positive encounters with family members or friends; and in "recognizing the existence of barriers," nurses highlight vulnerable groups such as children, for whom nurses require special education to enable optimal non-pharmacologic pain management. CONCLUSION: The unique knowledge that nurses gain about the patient through the nurse-patient relationship is central and crucial for successful non-pharmacological pain management. RELEVANCE TO CLINICAL PRACTICE: This study emphasizes the need for nurses to get to know their patient and to be open and sensitive to patients' descriptions of their unique life situations, as this provides the necessary knowledge for optimal care and pain management. Nurses should be encouraged and given the opportunity to attend specialized training in palliative care and pain management.
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| 17. |
- Nilsson, Anne, et al.
(author)
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Influence of Interactive Behaviors Induced by a Therapy Dog and Her Handler on the Physiology of Residents in Nursing Homes : An Exploratory Study
- 2024
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In: Anthrozoos. - : Taylor & Francis Group. - 0892-7936 .- 1753-0377. ; 37:2, s. 323-342
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Journal article (peer-reviewed)abstract
- The aim of this exploratory study was to investigate interactive behaviors performed between residents at nursing homes and a therapy dog and her handler and explore if they influenced residents’ physiological variables such as fingertip temperature, heart rate, and systolic and diastolic blood pressure. The therapy dog–handler team visited 12 older people at three nursing homes for 60 min twice a week during a four-week period. The visits were videotaped, and the duration of interactive behaviors was recorded. The physiological variables were measured before (0 min) and after (60 min) the interaction between the residents and the dog–handler team, and the delta value was calculated. The interactive behaviors during the first two and the last two weeks were as follows: the resident looking at the dog (799 and 697 s/h), the resident in physical contact with the dog (183 and 109 s/h, p < 0.001, Wilcoxon signed-rank test), the resident playing with the dog (123 and 126 s/h), the resident talking with others (559 and 511 s/h), and the dog handler having physical contact with the resident (822 and 764 s/h). The mean values for fingertip temperature, heart rate, and systolic and diastolic blood pressure did not differ significantly between the first and two last weeks (paired t-test). However, the delta values varied largely between the different residents. The more physical contact the residents had with the dog handler, the more the fingertip temperature increased (p < 0.05, mixed linear model). The duration of physical contact between the residents and the dog tended to be associated with an increased fingertip temperature (p < 0.1). Furthermore, the more the residents were in verbal contact with the dog handler, the more their heart rate decreased (p < 0.05). These results demonstrate some associations between specific interactive behaviors and physiological changes in residents in connection with visits by a dog–handler team.
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| 18. |
- Nilsson, Anne, et al.
(author)
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Interacting With a Visiting Dog Increases Fingertip Temperature in Elderly Residents of Nursing Homes
- 2020
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In: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 11
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate whether interacting with a visiting dog influences fingertip temperature and cortisol levels in residents living in nursing homes for the elderly. The study included two groups, the dog group (n = 13) and the control group (n = 11–15) and lasted for 8 weeks for the dog group and 6 weeks for the control group. All participants were residents living at nursing homes for the elderly. The researchers visited small groups of the participants twice weekly during the entire study in both the dog and the control group. The visiting dog and the dog handler accompanied the researchers during weeks 3–6. Fingertip temperature was measured and saliva samples for cortisol determination were collected at 0, 20 and 60 min for the dog group and at 0 and 20 min for the control group. For analysis the study was divided into periods; Period 1 (week 1–2), Period 2 (week 3–4), Period 3 (week 5–6) and Period 4 (week 7–8, only the dog group). Mean values based on all data obtained at 0 and 20 min during period 1–3 were compared between groups. A second, separate analysis for the dog group also included data from 60 min and for period 4. For the dog group fingertip temperature increased significantly between period 1 and 2, 1 and 3 and 1 and 4 (p < 0.05). In addition, fingertip temperature rose significantly between 0 and 20 min and between 0 and 60 min within all periods. For the control group a significant decrease in fingertip temperature was observed between period 1 and 3 (p < 0.05). Fingertip temperature did not differ between the two groups during period 1, but was significantly higher for the dog group than for the control group during periods 2 and 3 (p < 0.05 and p < 0.001, respectively). Cortisol results are only presented descriptively due to that many samples had too low volume of saliva to be analyzed. In the present study interaction between elderly residents and a visiting dog resulted in increased fingertip temperature, probably reflecting a decrease in the activity of the sympathetic nervous system and therefore a decrease in stress levels.
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| 19. |
- Nyström, Anne, et al.
(author)
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Being different but striving to seem normal : the lived experiences of people aged 50+ with ADHD.
- 2020
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In: Issues in Mental Health Nursing. - : Informa Healthcare. - 0161-2840 .- 1096-4673. ; 41:6, s. 476-485
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Journal article (peer-reviewed)abstract
- This qualitative study explored the day-to-day life of people aged 50+ diagnosed with ADHD. A phenomenological-hermeneutical method was chosen for the analysis. Two themes including sub-themes were revealed. The first theme, Being different and trying to handle my inner self, concerned emotional self-regulation, emotional resilience, social skills, and personal resource management. The second theme, Trying to adapt to fit in with people around me, concerned relationships, work, and personal finances. The comprehensive understanding was interpreted as Being different but striving to seem normal.
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| 20. |
- Persson, Anna, et al.
(author)
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Alcohol and illicit and non-medical prescription drug use before and during pregnancy in Stockholm, Sweden : A cross-sectional study
- 2021
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In: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 29
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Journal article (peer-reviewed)abstract
- Objectives: To provide current estimates of alcohol and drug use among pregnant women attending antenatal care lectures in preparation for childbirth in Stockholm, Sweden.Study design: A cross-sectional study. Data was collected anonymously among women attending lectures in preparation for childbirth.Main outcome measures: The prevalence of alcohol and illicit and non-medical prescription drug use among pregnant women attending antenatal care lectures in preparation for childbirth.Results: Nine hundred and thirty-six pregnant women attending lectures in preparation for childbirth participated. Among those answering all questions about alcohol use during pregnancy, 4.2 percent reported use (95% confidence interval (CI), 3.0–5.7%) and among those answering all questions about illicit or non-medical prescription drug use during pregnancy, 0.5 percent reported such use (95% CI, 0.1–1.3%). The prevalences of binge drinking during pregnancy and alcohol and drug use before pregnancy are presented. Comparisons of anonymously and non-anonymously collected data are included.Conclusions: Approximately one in 25 women reported using alcohol and approximately one in 200 reported using illicit or non-medical prescription drugs while pregnant. Alcohol use during pregnancy may have decreased in Stockholm, Sweden.
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| 21. |
- Persson, Anna, et al.
(author)
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Potentially traumatic events, fear of childbirth and posttraumatic stress disorder during pregnancy in Stockholm, Sweden : A cross-sectional study
- 2020
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In: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 25
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Journal article (peer-reviewed)abstract
- Objectives: To estimate the prevalence of potentially traumatic events (PTEs), fear of childbirth (FOC), and support for it as well as posttraumatic stress disorder (PTSD) among pregnant women attending maternal care in Stockholm, Sweden.Methods: A cross-sectional study was conducted. Pregnant women attending lectures in preparation for childbirth at the major hospitals in Stockholm were asked to complete questionnaires anonymously. Main outcome measures were the prevalence of PTEs, FOC, support for FOC and PTSD.Results: One thousand one hundred fifty-seven women in late pregnancy attending lectures in preparation for childbirth at hospitals in Stockholm, Sweden, were asked to participate, 945 chose to participate, resulting in a response rate of 81.7 percent. Most pregnant women, 78.5 percent (95% confidence interval (CI) 75.6-81.3), reported having experienced at least one PTE. The prevalence of having experienced different types of violence is presented. FOC was found among 28.8 percent (95% CI 25.7-32.0) of pregnant women, while only 10.9 percent (95% CI 10.5-11.2) received support for FOC. The prevalence of current PTSD was 4.1 percent (95% CI 2.8-5.8).Conclusions: The majority of pregnant women had experienced PTEs, and experiences of violence were common, as was FOC. Approximately one in 25 women attending general maternal care in Stockholm, Sweden, was estimated to have current PTSD. This highlights the need to prevent violence, find pregnant women suffering from FOC or PTSD, to develop an evidence-based treatment for FOC and to provide such treatment for PTSD.
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| 22. |
- Petersson, Kerstin, et al.
(author)
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A randomized controlled study evaluating the head-lift exercise in head and neck cancer patients with radiation-induced dysphagia: effect on swallowing function and health-related quality of life over 12 months
- 2023
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In: European Archives of Oto-Rhino-Laryngology. - 0937-4477. ; 280:12, s. 5445-5457
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Journal article (peer-reviewed)abstract
- PurposeDysphagia is common after radiotherapy for head and neck cancer (HNC) and can affect health-related quality of life (HRQL). This randomized controlled trial aimed to evaluate the effect of the head-lift exercise (HLE) over 12 months in HNC patients with radiation-induced dysphagia.MethodsSixty-one patients with dysphagia were randomized to intervention group (n = 30) and control group (n = 31) at 6-36 months after completion of radiotherapy for HNC. Dysphagia-specific HRQL was measured with the MD Anderson Dysphagia Inventory (MDADI); general and HNC-specific HRQL was measured with the European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30) and QLQ-H & N35. Measurements were made at baseline, and at 8 weeks and 12 months after start of intervention.ResultsAdherence to the intervention was good throughout the year. When comparing change from baseline reports to each follow-up no statistically significant differences between the groups were found in any of the HRQL instruments. There were some statistically significant changes within groups compared to baseline. The intervention group improved self-rated swallowing function on the MDADI at 8 weeks (emotional domain, p = 0.03; functional domain, p = 0.007; total score, p = 0.01) and the control at twelve months (emotional domain, p = 0.03; functional domain, p = 0.02; physical domain, p = 0.004; total score, p = 0.002).ConclusionIn this randomized control study, no effect was observed short term or at 12 months on HRQL after use of the HLE as rehabilitation for radiation-induced dysphagia.
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| 23. |
- Petersson, Kerstin, et al.
(author)
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Predictors of severe dysphagia following radiotherapy for head and neck cancer
- 2021
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In: Laryngoscope Investigative Otolaryngology. - : Wiley. - 2378-8038. ; 6:6, s. 1395-1405
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Journal article (peer-reviewed)abstract
- Objective To investigate if severe dysphagia following radiotherapy for head and neck cancer (HNC) could be predicted by patient and tumor characteristics, feeding tube use, weight factors, jaw opening function, and saliva secretion. Methods Data was collected from 94 HNC patients 6 to 36 months post radiotherapy. Swallowing function was assessed by videofluroscopy (VFS). Severe dysphagia was defined by Penetration Aspiration Scale (PAS) as PAS >= 5 or a total score <= 60 on the M. D. Anderson Dysphagia Inventory (MDADI). Results Thirty-three patients (35%) had PAS >= 5 and 19 (20%) a MDADI <= 60, that is, presented with severe dysphagia. Univariable logistic regression analysis (UVA) gave that tumor of the tonsil, overweight at time of VFS and each unit increase in Body Mass Index (BMI) predicted less risk of PAS >= 5. Dependency of feeding tube at time of VFS and each month's continued use and weight loss >= 7.5% since treatment to time of VFS predicted increased risk of PAS >= 5. Predictive variables from the UVA of PAS >= 5 (tumor of the tonsil, overweight, and total duration of feeding tube), were analyzed by multivariate logistic regression analysis. All retained power as independent predictors. UVA for MDADI showed that use of feeding tube at time of VFS predicted MDADI <= 60 with the risk increasing each month. Each increasing unit of BMI decreased risk of MDADI <= 60. Conclusion Long time users of feeding tube and higher weight-loss are at risk of severe dysphagia. This makes collaboration between professionals working with dysphagia an important step in detecting severe dysphagia. Level of Evidence: 3.
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| 24. |
- Ramfelt, Kerstin, et al.
(author)
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Experiences From a Coaching Program for Parents of Children and Adolescents With Type 1 Diabetes Developed Through Experienced-Based Co-Design (EBCD)
- 2020
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In: Journal of Patient Experience. - : Sage Publications. - 2374-3735 .- 2374-3743. ; 7:6, s. 1181-1188
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Journal article (peer-reviewed)abstract
- Many children and adolescents with type 1 diabetes (T1D) have difficulties reaching the national treatment goal for HbA1c (long-term blood sugar) which is associated with increased risk for complications. This makes it important to explore what patients and their caregivers describe important in coping with everyday life. The study has been conducted within a pediatric diabetes team in the south of Sweden. The aim was to explore how Experienced-Based Co-Design (EBCD) can be used to identify, test, and evaluate improvement efforts in order to support the family with a child with T1D. A modified variant of EBCD based on focus groups, workshops, and interviews with stakeholders was used. The improvement proposal parental coaching was tested and was appreciated by the participants. The qualitative content analysis of the interviews showed that the coaching program contributed to better confidence and self-efficacy. Both coaches and coachees described that the coaching contributed to better competence and a feeling of hope after attending the coach program. Experienced-Based Co-Design gave an opportunity to explore what?s important to improve, based on experiences and needs of several stakeholders.
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| 25. |
- Ramfelt, Kerstin, et al.
(author)
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'It's like a never-ending diabetes youth camp' : Co-designing a digital social network for young people with type 1 diabetes.
- 2023
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In: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 26:2, s. 662-669
-
Journal article (peer-reviewed)abstract
- INTRODUCTION: Living with a chronic condition such as type 1 diabetes (T1D) affects everyday life and support from others experiencing a similar situation can be helpful. A way to receive such support is to use an online network where people can connect and share experiences. Research has described the benefits of using such tools for connecting patients. The aim of this study was to describe the co-design of a social network for young people with T1D and to describe their experiences when using this network.METHODS: A co-design approach was used, following three steps adapted from Sanders and Stappers (2008). In all, 36 adolescents with T1D participated. Data in the form of recordings and notes from telephone interviews, workshops and focus groups were collected and then analysed using content analysis. Numerical data from the digital platform were also used.FINDINGS: For the interpersonal values, supporting, learning and relating to emerge, the framework of the network must be appealing and user-friendly. The limits of time and place are eliminated, and there is a possibility for many more to join in.CONCLUSION: Co-design ensures that what stakeholders think is important forms the basis for the design. The interpersonal values that are promoted are ones that only the exchange of lived knowledge and experience can generate. It is complementary to the support that healthcare professionals can offer; thus, this kind of social network is important for improved, coproduced care.PATIENT OR PUBLIC CONTRIBUTION: The participants in the present study were persons living with T1D. They were active co-creators from the start to the end. An adult person with experience of living with T1D was involved as an advisor in the research team when drafting the manuscript.
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| 26. |
- 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
-
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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| 27. |
- Uvnäs-Moberg, Kerstin, et al.
(author)
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Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact - With a particular focus on the oxytocinergic system
- 2020
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In: Infant Behavior and Development. - : Elsevier. - 0163-6383 .- 1879-0453 .- 1934-8800. ; 61:November
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Research review (peer-reviewed)abstract
- The positive clinical effects caused by skin-to-skin contact immediately after birth or after repeated skin-to-skin contact of premature infants (kangaroo care) or fullterm infants are well documented in the literature. However, information regarding the physiological mechanisms mediating these effects are surprisingly scarce and incomplete. In this article the oxytocinergic system and the cutaneous sensory pathways by which the oxytocinergic system is activated in response to skin-to-skin contact are presented in more detail. In addition, we discuss how the effects of skin-to-skin treatment can be attributed to different aspects of the effect spectrum of the oxytocinergic or calm and connection system.The structure of the oxytocinergic system, comprising the peripheral (circulating, hormonal) and the central (neurotransmitter) components, as well as, the pathways and mechanisms by which these functions are coordinated are described. Also the various effects induced by the oxytocinergic system (the calm and connection system) are reviewed.The sensory pathways, which include visual, auditory, olfactory and tactile stimuli, given and received by both mother and newborn and which activate the oxytocinergic system in response to skin-to-skin contact, are reviewed. A special emphasis is placed on the role of cutaneous sensory nerves and their activation by touch, light pressure and in particular warmth. The important role of the rise and the pulsatility of maternal temperature in mediating the positive effects of skin-to-skin contact in the newborn is highlighted. The concept of maternal giving of warmth and its possible link to the experience of trust and safety in the newborn is discussed from an evolutionary perspective.The effects induced by skin-to-skin contact can be attributed to the different functions of the oxytocinergic system. Ameliorated social interaction (e.g., more tactile and auditory interaction, more sensitive and synchronous interaction between mother and baby, the baby’s crawling behavior) are expressions of oxytocin’s ability to stimulate social interaction. The decreased levels of fear and stress are expressions of oxytocin’s ability to reduce the activity of the amygdala and of the stress system, e.g. the activity in the HPA-axis and the sympathetic nervous system. Increased HRV, increased activity in endocrine system of the gastrointestinal tract as well as stimulation of growth and maturation are examples of oxytocin’s ability to stimulate the activity of the parasympathetic nervous system and other peripheral and central mechanisms related to restoration and growth.The propensity of different types of treatment with skin-to-skin contact to induce long-term effects is also highlighted. We propose that the sustained effects caused by skin-to-skin contact are induced by an enduring shift in the balance between the oxytocinergic system (the calm and connection system) and the stress system (fight flight reaction) in favor of the oxytocinergic system. This shift leads to a sustained decrease in the HPA-axis and the sympathetic nervous system probably involving alpha 2-adrenoceptors.It is of clinical importance to be aware of the mechanisms by which skin-to-skin contact induces short and longterm positive effects in parents and newborns. If ward routines are adapted to ascertain a maximal stimulation of these mechanisms, the function of the oxytocinergic system will be optimized, which will be linked to a better clinical outcome for parents and newborns.
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| 28. |
- 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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| 29. |
- 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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