| 1. |
- Jansson-Fröjmark, Markus, et al.
(author)
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Paradoxical intention for insomnia : A systematic review and meta-analysis
- 2021
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In: Journal of Sleep Research. - : Wiley-Blackwell Publishing Inc.. - 0962-1105 .- 1365-2869. ; , s. 1-14
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Journal article (peer-reviewed)abstract
- Paradoxical intention (PI) has been considered an evidence-based treatment for insomnia since the 1990s, but it has not been evaluated with modern review techniques such as meta-analysis. The present study aimed to conduct the first systematic review and meta-analysis of studies that explore the effectiveness of PI for insomnia on insomnia symptomatology and theory-derived processes. A systematic review and meta-analysis was conducted by searching for eligible articles or dissertations in six online bibliographic databases. Randomised controlled trials and experimental studies comparing PI for insomnia to active and passive comparators and assessing insomnia symptoms as outcomes were included. A random effects model was estimated to determine the standardised mean difference Hedge's g at post-treatment. Test for heterogeneity was performed, fail-safe N was calculated, and study quality was assessed. The study was pre-registered at International Prospective Register of Systematic Reviews (PROSPERO, CRD42019137357). A total of 10 trials were identified. Compared to passive comparators, PI led to large improvements in key insomnia symptoms. Relative to active comparators, the improvements were smaller, but still moderate for several central outcomes. Compared to passive comparators, PI resulted in great reductions in sleep-related performance anxiety, one of several proposed mechanisms of change for PI. PI for insomnia resulted in marked clinical improvements, large relative to passive comparators and moderate compared to active comparators. However, methodologically stronger studies are needed before more firm conclusions can be drawn.
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| 2. |
- Jansson, Sven-Arne, et al.
(author)
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Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods
- 2013
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 3:21
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Journal article (peer-reviewed)abstract
- BackgroundOur aim was to investigate the factors that affect health related quality of life (HRQL) in adult Swedish food allergic patients objectively diagnosed with allergy to at least one of the staple foods cow’s milk, hen’s egg or wheat. The number of foods involved, the type and severity of symptoms, as well as concomitant allergic disorders were assessed.MethodsThe disease-specific food allergy quality of life questionnaire (FAQLQ-AF), developed within EuroPrevall, was utilized. The questionnaire had four domains: Allergen Avoidance and Dietary Restrictions (AADR), Emotional Impact (EI), Risk of Accidental Exposure (RAE) and Food Allergy related Health (FAH). Comparisons were made with the outcome of the generic questionnaire EuroQol Health Questionnaire, 5 Dimensions (EQ-5D). The patients were recruited at an outpatient allergy clinic, based on a convincing history of food allergy supplemented by analysis of specific IgE to the foods in question. Seventy-nine patients participated (28 males, 51 females, mean-age 41 years).ResultsThe domain with the most negative impact on HRQL was AADR, assessing the patients’ experience of dietary restrictions. The domain with the least negative impact on HRQL was FAH, relating to health concerns due to the food allergy. One third of the patients had four concomitant allergic disorders, which had a negative impact on HRQL. Furthermore, asthma in combination with food allergy had a strong impact. Anaphylaxis, and particularly prescription of an epinephrine auto-injector, was associated with low HRQL. These effects were not seen using EQ-5D. Analyses of the symptoms revealed that oral allergy syndrome and cardiovascular symptoms had the greatest impact on HRQL. In contrast, no significant effect on HRQL was seen by the number of food allergies.ConclusionsThe FAQLQ-AF is a valid instrument, and more accurate among patients with allergy to staple foods in comparison to the commonly used generic EQ-5D. It adds important information on HRQL in food allergic adults. We found that the restrictions imposed on the patients due to the diet had the largest negative impact on HRQL. Both severity of the food allergy and the presence of concomitant allergic disorders had a profound impact on HRQL.
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| 3. |
- Jansson, Sven-Arne, et al.
(author)
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Okänt hur mycket astma och allergier kostar samhället : kostnadsstudier kan ge bättre planering av vård och forskning
- 2007
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 104:39, s. 2792-2796
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Journal article (peer-reviewed)abstract
- Få studier av kostnader för allergisjukdomar är genomförda nationellt och internationellt. I Sverige är det endast astma som är studerat, och för rinit och eksem finns endast ett fåtal internationella studier. Inom födoämnesöverkänslighet finns över huvud taget inga sjukdomskostnadsstudier publicerade. Det är svårt att jämföra olika studier, såväl nationellt som internationellt, på grund av olika studiedesign, hälso- och sjukvårdssystem och behandlingstraditioner. De svenska kostnaderna för de studerade allergisjukdomarna har skattats och uppgår sannolikt till över 10 miljarder kronor totalt per år, varav kostnaden för astma uppgår till cirka 7 miljarder kronor. Det är viktigt att studier kommer till stånd i Sverige för att få en uppfattning om de faktiska svenska kostnaderna för allergisjukdomarna.
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| 4. |
- Protudjer, Jennifer L. P., et al.
(author)
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Household Costs Associated with Objectively Diagnosed Allergy to Staple Foods in Children and Adolescents
- 2015
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In: Journal of Allergy and Clinical Immunology-In Practice. - : Elsevier BV. - 2213-2198 .- 2213-2201. ; 3:1, s. 68-75
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Journal article (peer-reviewed)abstract
- BACKGROUND: We previously reported that indirect and intangible costs burden households with a food allergic adult. We now extend our investigation to households with food allergic children and adolescents. OBJECTIVE: The objective of this study was to estimate direct, indirect, and intangible costs of food allergy in households with a child and/or adolescent with objectively diagnosed allergy to staple foods (cow's milk, hen's egg, and/or wheat), and to compare these costs with age-and sex-matched controls. METHODS: Direct and indirect cost parent-reported data collected via the Food Allergy Socio-Economic Questionnaire of 84 children (0-12 years) and 60 adolescents (13-17 years) with objectively diagnosed allergy to staple foods ("cases") and age- and sex-matched controls (n = 94 children; n = 56 adolescents) were compared. Annual household costs were calculated. Total household costs included direct plus indirect costs. Intangible costs included parent-reported health of their child and/or adolescent, standard of living, and perceptions of well-being. RESULTS: Amongst cases, total household costs were higher by (sic)3961 for children and (sic)4792 for adolescents versus controls (P < .05), and were driven by direct (eg, medications) and indirect (eg, time with health care professionals) costs. For children only, a history of anaphylaxis was associated with higher direct costs than no anaphylaxis ((sic)13,016 vs (sic)10,044, P < .05). Intangible costs (eg, parent-reported health of a child and/or adolescent) were significantly impacted amongst cases versus controls (P < .01). CONCLUSION: Households with a child and/or adolescent with objectively diagnosed allergy to staple foods have higher total household costs than controls. Direct and indirect costs were significantly higher for cases versus controls amongst children only. Amongst both age groups, such allergy adversely impacted intangible costs. (C) 2015 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.
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| 5. |
- Protudjer, Jennifer Lisa Penner, et al.
(author)
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Impaired health-related quality of life in adolescents with allergy to staple foods
- 2016
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In: Clinical and Translational Allergy. - : Wiley. - 2045-7022. ; 6
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Journal article (peer-reviewed)abstract
- Background: Cow's milk, hen's egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incompletely understood. The aims of this study were to make use of the Swedish version of EuroPrevall's disease-specific food allergy quality of life questionnaire-teenager form (FAQLQ-TF) and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents. Methods: In this cross-sectional study, 58 adolescents aged 13-17 years [n = 40 (69 %) boys] with objectively-diagnosed allergy to the staple foods cow's milk, hen's egg and/or wheat and living in Stockholm, Sweden were included. Adolescents completed the FAQLQ-TF, which has a corresponding scale of 1 = best HRQL, and 7 = worst HRQL. Overall HRQL and domain-specific HRQL were established. Adolescents also reported symptoms, adrenaline auto injector (AAI) prescription and presence of other food allergies. A history of anaphylaxis was defined among those reporting difficulty breathing, inability to stand/collapse, and/or loss of consciousness. Clinically different HRQL was set at a mean difference of >= 0.5. Results: Overall mean HRQL was poorer than average [mean: 4.70/7.00 (95 % CI 4.30-5.01)]. The domain risk of accidental exposure was significantly associated with clinically better HRQL than the domain allergen avoidance and dietary restrictions (mean difference = 0.76; p < 0.001). Girls had clinically worse, but not statistically significantly different mean HRQL than boys (mean difference = 0.71; p < 0.07). HRQL tended to be worse amongst those with allergies to more than three foods or an AAI prescription. The number and types of symptoms, including a history of anaphylaxis were not associated with worse HRQL. Conclusions: As ascertained via a food allergy-specific questionnaire, adolescents with staple food allergy report poorer than average HRQL, specifically in relation to emerging independence and the need for support. Girls have clinically worse HRQL than boys. The number and type of previous symptoms and history of anaphylaxis were not associated with worse HRQL.
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| 6. |
- Agrell, J., et al.
(author)
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Production of hydrogen by partial oxidation of methanol over Cu/ZnO catalysts prepared by microemulsion technique
- 2001
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In: Applied Catalysis A. - 0926-860X .- 1873-3875. ; 211:2, s. 239-250
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Journal article (peer-reviewed)abstract
- Production of hydrogen by partial oxidation of methanol, using air as oxidant. has been studied over a series of Cu/ZnO catalysts prepared by microemulsion technique. The catalytic activity was compared to that of a reference catalyst prepared by conventional co-precipitation. The BET surface areas of the microemulsion catalysts (30-70 wt.% Cu) ranged from 22 to 36 m(2)/g and were considerably lower than that of the reference (60 m(2)/g). Nevertheless, the microemulsion catalysts were more active in the partial oxidation reaction and exhibited high hydrogen and carbon dioxide selectivities. At a molar O-2/CH3OH ratio of 0.1, hydrogen production was initiated at about 185 degreesC over the microemulsion catalysts. Over the reference, hydrogen production began at 215 degreesC under the same conditions. The catalytic activity was Found to be strongly dependent on the partial pressure of oxygen, which also plays an important role in determining the product distribution. By increasing the O-2/CH3OH ratio, the methanol conversion and carbon dioxide selectivity increase. while production of water occurs at the expense of hydrogen. By TEM and TPR, it was observed that Cu is less well-dispersed in the microemulsion catalysts than in the reference. The higher catalytic activity is not expected considering the lower number of exposed Cu sites, i.e, the turnover frequencies are substantially higher over the microemulsion catalysts. It is possible that, a strong interaction between a small part of CuO and the ZnO lattice is responsible for the higher turnover frequencies of the microemulsion catalysts, or that particular crystallographic Cu planes or surface imperfections are the active sites of the reaction.
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| 7. |
- Ahlman, Håkan, 1947, et al.
(author)
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Cytotoxic treatment of adrenocortical carcinoma.
- 2001
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In: World journal of surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 25:7, s. 927-33
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Journal article (peer-reviewed)abstract
- Adrenocortical carcinoma (ACC) is a rare, aggressive tumor that is often detected in an advanced stage. Medical treatment with the adrenotoxic drug mitotane has been used for decades, but critical prospective trials on its role in residual disease or as an adjuvant agent after surgical resection are still lacking. The concept of a critical threshold plasma level of the drug must be confirmed in controlled studies. Because individual responsiveness cannot be predicted, the use mitotane is still advised for nonresectable disease. In case of cortisol or other steroid overproduction, several drugs (e.g., ketoconazole or aminoglutethimide) may be used. Chemotherapy with single agents (e.g., doxorubicin or cisplatin) have been disappointing, with low response rates (< 30%) and a short response duration. Part of this refractoriness may be explained by the fact that ACC tumors express the multidrug-resistance gene MDR-1. Chemotherapy with multiple agents has been tested in smaller series and has resulted in significant side effects. The best results were achieved by the combination of etoposide, doxorubicin, and cisplatin associated with mitotane, achieving a response rate of 54%, including individual complete responses. To be able to make progress in treating advanced ACC disease, adjuvant multicenter trials must be encouraged. When mitotane-based therapies are used, monitored drug levels are mandatory.
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| 8. |
- Alfonsson, Sven
(author)
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Treatment Adherence in Internet-Based CBT : The Effects of Presentation, Support and Motivation
- 2016
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Doctoral thesis (other academic/artistic)abstract
- Homework assignments that patient work with between sessions is a key component in both face-to-face and Internet-based Cognitive Behavior Therapy (CBT). However, adherence to assignments is often low and it is largely unclear what factors predict or affect treatment adherence, and in the end, treatment outcomes. The overall aim of this thesis was to investigate if treatment presentation and therapist support can affect adherence and treatment outcome in internet-based CBT, whether adherence can be predicted by motivation variables and to compare differences in face-to-face and online conditions in this regard.A randomized controlled trial with a brief online relaxation program for people with stress and anxiety symptoms was conducted (n = 162). Participants in the enhanced support conditions completed a larger proportion of the online treatment but adherence was not affected by enhanced treatment presentation (Study I). Participants reported reduced symptoms of stress and anxiety after the relaxation program but there were no significant additional effects of enhanced presentation or support (Study II). Participants who adhered to the prescribed assignments reported lower symptom levels at study end, regardless of treatment conditions. Adherence to the online treatment was predicted by subject factors such as treatment credibility prior to the treatment and intrinsic motivation during the treatment (Study III). To further elucidate how motivation may affect adherence, an experiment with a one-session psychotherapy model was subsequently conducted (n = 100). Participants who were randomized to the face-to-face condition reported higher motivation for the assignment and completed significantly more of the homework compared to participants in the online condition (Study IV). Self-reported intrinsic motivation could predict adherence in both conditions while new motivational variables were identified specifically for the online condition.The results from these studies confirm that adherence to assignments in Internet-based CBT is difficult to affect with treatment features but can be predicted early in treatment by subject factors such as treatment credibility and motivation. How such motivational variables can be affected to improve treatments is still unclear.
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| 9. |
- Almqvist, Monica, et al.
(author)
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European Medical Imaging Technology Training, EMIT – ett prisbelönt EU-utbildningsprojekt
- 2005
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In: [Host publication title missing].
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Conference paper (peer-reviewed)abstract
- I ett sameuropeiskt Leonardo da Vinci-projekt har utvecklats ett internationellt utbildnings- och praktikpa- ket för blivande sjukhusfysiker [1-3]. Utbildningspaketet innehåller praktiska och kliniska övningsuppgifter där delta- garna tränas i för en sjukhusfysiker vanligt förekommande arbetsuppgifter. Målet har varit att det skall ge sjukhusfysi- kern den praktiska kompetens som krävs av det europeiska regelverket inom ämnesområdena magnetresonans (MRI), ultraljud, röntgendiagnostik, nuklearmedicin och strålbe- handling. Utbildningsmaterialet är webbaserat med en stor bilddata- bas och används redan i nära 70 länder runt om i världen. EMIT-projektet (European Medical Imaging Technology Training) belönades i december 2004 med det första Leonar- do da Vinci priset som delades ut till de tre bästa av totalt 4000 EU-projekt inom praktisk yrkesrelaterad utbildning. I projektet har vi konfronterats med den pedagogiska ut- maningen att förmedla praktisk kunskap, i sjukhusmiljöer med mycket olika förutsättningar beroende på vilket land deltagarna arbetar i. En omöjlig uppgift kan tyckas, men eftersom materialet är sammanställt av några av Europas starkaste forsknings- och utbildningsgrupper inom respekti- ve område så har det visat sig vara en stor tillgång och varje användare utnyttjar materialet efter sina egna behov. En an- nan erfarenhet är samarbetet över nationsgränser där vi har utnyttjat och konfronterats med likheter och oliktänkande inte minst vad gäller pedagogik och didaktik. Vi har dessut- om fått ett stort kontaktnät och många goda vänner. Den här presentationen beskriver delar av utbildningspaketet och erfarenheter av samarbetsprojektet.
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| 10. |
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