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- Hammarberg, Stina Ingesson, et al.
(author)
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A qualitative interview study of patient experiences of receiving motivational enhancement therapy in a Swedish addiction specialist treatment setting
- 2023
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In: Addiction science & clinical practice. - : Springer Nature. - 1940-0632 .- 1940-0640. ; 18
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Journal article (peer-reviewed)abstract
- Background: Motivational enhancement therapy (MET) has shown to be efficacious as treatment of alcohol use disorder (AUD), in reducing alcohol consumption and related consequences. However, qualitative research on how patients perceive this treatment is lacking. The aim of this study was to explore how patients experience MET as a treatment for AUD.Methods: Fifteen patients (8/7 female/male) participated in semi-structured interviews after receiving MET at a specialized addiction outpatient clinic in Sweden. Data were analyzed by thematic analysis.Results: Five themes were identified: the therapist conveyed the MI-spirit, the therapist did not guide on how to reach the goal, participants were committed to change before starting treatment, participants were uncertain if treatment was enough to maintain change, and significant others were not wanted in sessions. Participants appreciated the supportive relationship with their therapist, but some experienced therapy as overly positive, with no room to talk about failure. Further, they experienced a low level of guidance in goal-setting. For some, this was empowering, while others requested more direction and advice. Participants perceived their motivational process to have started before treatment. MET was considered to be too brief. None of the participants brought a significant other to a session.Conclusions: Therapist behaviors in line with MI spirit were emphasized as key to the development of a positive therapeutic relationship. More specific advice on goal-setting may be effective for supporting change in some patients. Longer treatment is requested among patients to support the patient's self-efficacy for change. Significant others can support change without necessarily being present in sessions.
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| 2. |
- Walther, Lisa, et al.
(author)
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Phosphatidylethanol is Superior to Carbohydrate-Deficient Transferrin and -Glutamyltransferase as an Alcohol Marker and is a Reliable Estimate of Alcohol Consumption Level
- 2015
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In: Alcoholism-Clinical and Experimental Research. - : Wiley. - 0145-6008 .- 1530-0277. ; 39:11, s. 2200-2208
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Journal article (peer-reviewed)abstract
- BackgroundIn clinical practice as well as research situations, it is of great importance to get reliable information about a patient's alcohol consumption. The aim of the study was to investigate the correlation of alcohol biomarkers (phosphatidylethanol [PEth], carbohydrate-deficient transferrin [CDT], -glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase) to retrospective as well as diary-based alcohol self-reports and to examine whether it is possible to correlate a biomarker result to a more precise level of alcohol consumption. MethodsOne hundred and sixty alcohol-dependent patients were included in a randomized, placebo-controlled clinical trial of pharmacotherapy for alcohol dependence, of which 115 (76 men and 39 women) completed the study. Retrospective alcohol consumption data were collected at baseline, and alcohol diaries were used during the study. Blood samples for determination of alcohol biomarkers were collected on 5 occasions during the study. ResultsPEth and CDT showed a better correlation with alcohol consumption documented in the diary (PEth r(s)=0.56 and CDT r(s)=0.35) than with retrospective consumption data (PEth r(s)=0.23 and CDT r(s)=0.22). An even higher correlation (r(s)=0.63) was seen between the 2 alcohol biomarkers PEth and CDT. At all consumption levels, PEth had the highest sensitivity of all biomarkers studied. ConclusionsPEth was the biomarker with the best correlation to self-reported alcohol consumption. PEth was superior to CDT owing to its substantially higher sensitivity but also due to its closer correlation to self-report. PEth values can be translated into an approximate level of alcohol consumption and PEth appears to be a more reliable measure of alcohol consumption than self-reports.
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| 3. |
- deBejczy, Andrea, et al.
(author)
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Varenicline for Treatment of Alcohol Dependence: A Randomized, Placebo-Controlled Trial
- 2015
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In: Alcoholism-Clinical and Experimental Research. - : Wiley. - 0145-6008 .- 1530-0277. ; 39:11, s. 2189-2199
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Journal article (peer-reviewed)abstract
- BackgroundAlcohol dependence is a devastating illness affecting a large population, and new pharmacological treatments with good efficacy are greatly needed. One potential candidate is varenicline, a smoking cessation agent with partial agonist action at (42) nicotinic acetylcholine receptors. MethodsA total of 160 subjects, 30 to 70years of age, fulfilling DSM-IV criteria for alcohol dependence without any serious physical or mental disorders, were recruited through advertisement at 3 university clinics in Sweden during March 2009 to January 2011. After a 2-week placebo run-in period, subjects received 2mg varenicline daily (titrated from 0.5mg during first week) or placebo for 12weeks in a double-blind manner. ResultsThe primary outcome was the proportion of heavy drinking days, measured by self-reported alcohol consumption. Primary and secondary outcomes were calculated as a mean over the 10-week steady-state active treatment period. In the primary outcome analysis, no effect of varenicline over placebo was found (p=0.73 for the intention to treat [ITT] and 0.92 for per protocol [PP]). Secondary outcome analysis found a significant reduction of specific alcohol marker phosphatidylethanol (PEth) in the blood in the varenicline group compared to placebo (p=0.02 ITT). Craving (p=0.048 PP) and Alcohol Use Disorders Identification Test (AUDIT) scores (p=0.015 ITT) were also reduced in the active treatment group. PEth more strongly correlated with self-reported alcohol consumption than carbohydrate-deficient ttransferrin and -glutamyl transferase, and correlation coefficients were higher in the varenicline group than in the placebo group for all markers. ConclusionsAlthough the results of the main outcome of this study did not support an effect of varenicline in alcohol-dependent individuals, the secondary analyses of PEth, craving and AUDIT score support an effect of varenicline on alcohol consumption. The disclosure of a treatment effect and the lack of a clear placebo effect when using PEth as outcome variable, together with a nonsymmetric bias associated with self-reported data, strongly argue for using the specific biomarker PEth in studies of treatments of alcohol dependence.
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| 4. |
- Dzhigaev, Dmitry, et al.
(author)
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Strain mapping inside an individual processed vertical nanowire transistor using scanning X-ray nanodiffraction
- 2020
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In: Nanoscale. - : Royal Society of Chemistry (RSC). - 2040-3372 .- 2040-3364. ; 12:27, s. 14487-14493
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Journal article (peer-reviewed)abstract
- Semiconductor nanowires in wrapped, gate-all-around transistor geometry are highly favorable for future electronics. The advanced nanodevice processing results in strain due to the deposited dielectric and metal layers surrounding the nanowires, significantly affecting their performance. Therefore, non-destructive nanoscale characterization of complete devices is of utmost importance due to the small feature sizes and three-dimensional buried structure. Direct strain mapping inside heterostructured GaSb-InAs nanowire tunnel field-effect transistor embedded in dielectric HfO2, W metal gate layers, and an organic spacer is performed using fast scanning X-ray nanodiffraction. The effect of 10 nm W gate on a single embedded nanowire with segment diameters down to 40 nm is retrieved. The tensile strain values reach 0.26% in the p-type GaSb segment of the transistor. Supported by the finite element method simulation, we establish a connection between the Ar pressure used during the W layer deposition and the nanowire strain state. Thus, we can benchmark our models for further improvements in device engineering. Our study indicates, how the significant increase in X-ray brightness at 4th generation synchrotron, makes high-throughput measurements on realistic nanoelectronic devices viable.
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| 6. |
- Falk, Malin Värmå, et al.
(author)
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A qualitative study of facilitators and barriers to participate in a needle exchange program for women who inject drugs
- 2020
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In: Harm Reduction Journal. - : BMC. - 1477-7517. ; 17:1
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Journal article (peer-reviewed)abstract
- Background Women who inject drugs (WWID) show higher levels of injecting risk behaviour compared to men, putting them at risk of contracting HIV and hepatitis C (HCV). Compared to men, WWID are also less present in harm reduction programs such as needle exchange programs (NEP). The aim of this study is to investigate reasons for, and barriers to, participation in NEP among WWID in Sweden, and to identify measures that could be taken to strengthen the program and increase participation among WWID. Method In-depth interviews (IDIs) were conducted with 20 WWID who had participated in the Stockholm NEP for at least six months and was over 18 years old. IDIs were audio recorded and transcribedet verbatim. Qualitative content analysis was used to identify themes. Results The need for sterile injection equipment was identified as the main driver to join and remain in the NEP program. Continuous participation in the NEP was further driven by easy access to a multitude of health-related services. The most valued service was the sexual and reproductive health services (SRHR), allowing participants to access contraceptives, cervical cancer screening and sexually transmitted infections testing (STI-testing). NEP staffs' respectful treatment of participants further contributed to program participation. However, participants also expressed a number of concerns around NEP participation, which created barriers to joining. These included losing custody or visitation rights to children, male partner jealousy and violence, unwillingness to spend time in the waiting area and fear of receiving positive HIV/HCV test results. Practical barriers included limited opening hours and travel distance to the NEP. To strengthen the program, most participants requested additional SRHR services. Most participants also proposed some form of "women only" access to the NEP, to strengthen the feeling of the NEP as a safe space. Conclusion This study identified factors that may increase uptake of NEP among WWID. Additional SRHR services and "women only" access are recommended to be implemented and evaluated as part of NEP. These findings may inform and improve the current scale-up of NEPs in Sweden to ensure equal access to services.
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| 9. |
- Hammarberg, Anders, et al.
(author)
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Drinking motives of adult patients seeking treatment for problematic alcohol use
- 2017
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In: Journal of Addictive Diseases. - : Informa UK Limited. - 1055-0887 .- 1545-0848. ; 36:2, s. 127-135
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Journal article (peer-reviewed)abstract
- The Drinking Motives Questionnaire measures motives for alcohol consumption on four subscales. Coping with negative affect and enhancement of positive affect have been shown to be associated with high levels of alcohol consumption and alcohol-related problems. Few studies exist concerning drinking motives among treatment-seeking patients. The aims of the study were to investigate the factor structure of the shortened-form of the revised Drinking Motives Questionnaire, map main drinking motives, explore group differences in motives due to sex, age, level of drinking problems, and symptoms of depression/anxiety and to investigate whether different drinking motives predict alcohol-related problems in this group. There were 274 treatment-seeking patients recruited from four addiction treatment clinics in Sweden. The shortened-form of the revised Drinking Motives Questionnaire was administered in conjunction with a regular visit to the clinics together with measures of degree of alcohol-related problems, psychiatric symptoms, and demographic factors. Main drinking motives were identified. A confirmatory factor analysis was run to confirm the factor structure of the shortened-form of the revised Drinking Motives Questionnaire. A logistic regression using the Enter method was performed to investigate associations between predictors and Alcohol Use Disorder Identification Test scores. The results confirmed the four-factor structure reported in studies on non-treatment-seeking individuals. Coping was the most commonly expressed motive. Not previously found in a clinical sample, the results showed that coping motives, together with being male and having elevated anxiety scores, were associated to Alcohol Use Disorder Identification Test scores indicative of alcohol dependence. The shortened-form of the revised Drinking Motives Questionnaire is a brief and valid instrument that holds potential for clinical use in mapping drinking motives among treatment seekers.
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