| 1. |
- King, Carina, et al.
(författare)
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COVID-19—a very visible pandemic
- 2020
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 396:10248, s. 15-15
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Folke, Fredrik, et al.
(författare)
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Behavioral Activation Between Acute Inpatient and Outpatient Psychiatry : Description of a Protocol and a Pilot Feasibility Study
- 2015
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Ingår i: Cognitive and Behavioral Practice. - : Elsevier BV. - 1077-7229 .- 1878-187X. ; 22:4, s. 468-480
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Gaps in the continuity of care between acute inpatient and outpatient psychiatric services are common and potentially detrimental for service users. In this paper we provide the rationale for and description of a 12-session behavioral activation intervention for acute inpatients with depression and comorbid psychiatric disorders. The intervention was tailored to be initiated during acute inpatient care and to continue after discharge into outpatient services. We also describe a small pilot investigation (N = 13) of the intervention’s preliminary feasibility. Treatment retention, self-ratings, and participants’ adherence to treatment principles indicate preliminary feasibility of behavioral activation in this complex context. Self-rated activation and avoidance improved during the intervention. The value of a parsimonious inpatient therapy that can bridge the gap between services is discussed along with the limitations of this study.
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| 3. |
- Folke, Fredrik, et al.
(författare)
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Behavioral activation in acute inpatient psychiatry : A multiple baseline evaluation
- 2015
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Ingår i: Journal of Behavior Therapy and Experimental Psychiatry. - : Elsevier BV. - 0005-7916 .- 1873-7943. ; 46, s. 170-181
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVES: The present study employed a multiple baseline study design with repeated measures to explore clinical outcomes, therapy mechanisms, and feasibility of Behavioral Activation for persons admitted to inpatient psychiatry.METHODS: Six adult inpatients with depressive symptoms and different psychiatric disorders were randomized to different lengths of baseline standard inpatient treatment. Subsequently a 5-day, 10-session Behavioral Activation protocol was added. Daily self-report outcome and process measures were administered and supplemented with hourly self-reports and clinician assessments before and after each study phase.RESULTS: After a relatively stable baseline, at least four participants showed marked gradual improvements both in terms of outcome as well as activation and avoidance as Behavioral Activation was initiated. The temporal relation between process and outcome differed somewhat across metrics. In most instances however, change in activation and avoidance either coincided or preceded decreased depression.LIMITATIONS: We did not include some relatively common disorders, did not control for the effects of increased attention, did not investigate treatment integrity, and did not conduct follow-up after discharge. Raters were not blind and measures were mainly focused on depressive symptoms. All received concurrent medical treatment.CONCLUSIONS: This preliminary study further supports the promise of Behavioral Activation as an inpatient treatment for persons with a variety of psychiatric disorders. Results also lends preliminary support for the purported mechanisms of Behavioral Activation.
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| 4. |
- Söderberg, Per, et al.
(författare)
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GAF-skalans reliabilitet i kliniskt arbete
- 2004
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom psykiatrin finns idag rutiner för att systematiskt följa upppatientarbetet och ett resultatmått som används är skalan GlobalAssessment of Functioning (GAF). I denna studie har vi undersöktskalans reliabilitet och analyserat faktorer som kan påverka skattningen när skalan används rutinmässigt inom kliniskt arbete.81 bedömare från olika psykiatriska öppenvårdsenheter fickbedöma 8 olika patientfall. Huvudresultatet visar att den personalsom ansvarar för diagnostik och bedömningar av nybesöken inomöppenvårdspsykiatrin använder GAF-skalan med tillfredställandereliabilitet, ICC (1,1) = 0.81. Den faktor som tydligast påverkadereliabiliteten var bedömarens subjektiva inställning till att användaGAF-skalan och andra mätinstrument inom psykiatrin. När bedömarna var positivt inställda till att använda mätinstrument var mätfelen färre och vice versa. Studien visar att GAF-skalan kan användas med relativt god tillförlitlighet för att uttala sig om förändringar och resultat på gruppnivå under förutsättning att grupperna är relativt lika.
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| 5. |
- Söderberg, Per, 1955-, et al.
(författare)
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Outcome in psychiatric outpatient services : reliability, validity and outcome based on routine assessments with the GAF scale
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of the studies presented in this thesis is to investigate the possibility of using clinical data to measure outcomes in psychiatric outpatient services. The specific aims are to investigate whether routine clinical assessments and ratings are reliable and have adequate validity, and then to use these data to calculate treatment outcomes and explore factors that affect these outcomes.The main result shows that ratings of global mental health made by clinicians in routine clinical work can be used to evaluate treatment outcomes in outpatient settings. The clinicians responsible for diagnosing and assessing patients used the GAF scale with satisfactory reliability (ICC1,1 = 0.81) and fair interrater reliability (overall kappa = 0.53) when categorizing main diagnostic groups of the DSM-IV axis I. The GAF scale can thus be used to assess global mental health and to monitor outcomes in clinical settings. However, a GAF culture bias was observed. This bias can probably be corrected with feedback and training.Psychiatric treatment in outpatient settings had a generally positive effect on patients’ global mental heath (ES = 0.65). The overall result when clinical significance methodology was used showed that 28.1% of the patients had recovered and a further 6.6% showed reliable improvement. Patients being treated with psychotherapeutically influenced methods showed a considerably better effect (ES = 1.00). There is a dose of sessions effect that is particularly marked for short treatment episodes. Thirteen sessions are required for 50% of the patients to show reliable improvement. The strongest influence on treatment outcome was whether the termination of a patient’s treatment was planned or unplanned.In conclusion: Clinical databases can be used to study the outcome of psychiatric services provided they a) include a large number of subjects representing an intention-to-treat perspective; b) the instruments used are clinically relevant and reliable; c) the raters contributing to the data base are motivated to decrease attrition; d) the database includes extensive data to allow for control of confounding factors; and e) data are collected at critical occasions in treatment, such as at the start of treatment and at discharge from treatment, making it possible to focus on effects. Psychiatric outpatient treatment has a positive effect, but considerable improvements may be possible with more stringent use of psychotherapeutic methods, sufficient doses of sessions, and planned terminations. However, the progress of treatment is also affected by such factors as pre-treatment severity and diagnoses.
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| 6. |
- Bixby, H., et al.
(författare)
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Rising rural body-mass index is the main driver of the global obesity epidemic in adults
- 2019
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Ingår i: Nature. - : Springer Science and Business Media LLC. - 0028-0836 .- 1476-4687. ; 569:7755, s. 260-4
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Tidskriftsartikel (refereegranskat)abstract
- Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.
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| 7. |
- Sjögren, Stefan, 1965, et al.
(författare)
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Productivity for Airline Carriers and its Relation to Deregulation, Privatisation and Membership in Strategic Alliances
- 2011
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Ingår i: Transportation Research Part E: Logistics and Transportation Review. - : Elsevier BV. - 1366-5545. ; 47:2
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Tidskriftsartikel (refereegranskat)abstract
- This study looks at how deregulation, privatisation and the formation of strategic alliances have affected the productivity of international airlines. We evaluate all three factors simultaneously and disaggregate the carriers’ operations into production and sales and allow for unobserved firm-level heterogeneity through random parameters. Estimations of stochastic frontier models reveal that on the aggregate level, deregulation increases productivity, membership in alliances has an ambiguous effect and state ownership has no significant effect. Disaggregating the carriers’ operations confirms the productivity gains from deregulation, and that state ownership and alliances have contradictory effects.
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| 8. |
- Söderberg, Per, et al.
(författare)
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Outcome in psychiatric outpatient services
- 2007
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of the studies presented in this thesis is to investigate the possibility of using clinical data to measure outcomes in psychiatric outpatient services. The specific aims are to investigate whether routine clinical assessments and ratings are reliable and have adequate validity, and then to use these data to calculate treatment outcomes and explore factors that affect these outcomes.The main result shows that ratings of global mental health made by clinicians in routine clinical work can be used to evaluate treatment outcomes in outpatient settings. The clinicians responsible for diagnosing and assessing patients used the GAF scale with satisfactory reliability (ICC1,1 = 0.81) and fair interrater reliability (overall kappa = 0.53) when categorizing main diagnostic groups of the DSM-IV axis I. The GAF scale can thus be used to assess global mental health and to monitor outcomes in clinical settings. However, a GAF culture bias was observed. This bias can probably be corrected with feedback and training.Psychiatric treatment in outpatient settings had a generally positive effect on patients’ global mental heath (ES = 0.65). The overall result when clinical significance methodology was used showed that 28.1% of the patients had recovered and a further 6.6% showed reliable improvement. Patients being treated with psychotherapeutically influenced methods showed a considerably better effect (ES = 1.00). There is a dose of sessions effect that is particularly marked for short treatment episodes. Thirteen sessions are required for 50% of the patients to show reliable improvement. The strongest influence on treatment outcome was whether the termination of a patient’s treatment was planned or unplanned.In conclusion: Clinical databases can be used to study the outcome of psychiatric services provided they a) include a large number of subjects representing an intention-to-treat perspective; b) the instruments used are clinically relevant and reliable; c) the raters contributing to the data base are motivated to decrease attrition; d) the database includes extensive data to allow for control of confounding factors; and e) data are collected at critical occasions in treatment, such as at the start of treatment and at discharge from treatment, making it possible to focus on effects. Psychiatric outpatient treatment has a positive effect, but considerable improvements may be possible with more stringent use of psychotherapeutic methods, sufficient doses of sessions, and planned terminations. However, the progress of treatment is also affected by such factors as pre-treatment severity and diagnoses.
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