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- Dahl, Sara, et al.
(author)
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Can sense of coherence be a predictor for treatment outcome in patients with TMD-pain?
- 2011
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In: Svenska tandläkaresällskapets 47:e odontologisk riksstämma 2011. - : Svenska tandläkaresällskapet. ; , s. 110-110
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Conference paper (other academic/artistic)abstract
- Aims. To investigate whether SOC (sense of coherence) changed after twelve months of treatment of TMD-pain, and if any such change could be correlated with treatment outcome. Another objective was to examine whether SOC was correlated with grade of depression and somatisation. Materials and Methods. 73 patients participated in the double-blind randomized controlled trial. The TMD-treatment was active for at least ten weeks and consisted of either a resilient or a non-occluding control appliance. Patients were diagnosed according to RDC/TMD and completed the SOC-29 at baseline and after twelve months. Treatment outcome was evaluated as a reduction of pain registered as characteristic pain intensity. No difference was found between the resilient appliance and the control appliance in reducing pain at the 12-months follow-up. Therefore the material was pooled together. Results. Of the 73 participating TMD-pain patients, a total of 44 patients filled in the SOC-29 at both baseline and after twelve months, and 42 of them also stated values for depression and somatisation. There was no correlation between high SOC and treatment outcome. No differences were found in the mean value of SOC for patients younger and older than 30 respectively 40 years. Significant correlations were found between mean differences of SOC and grade of depression, and between mean differences of grade of depression and somatisation. Conclusion. Our results showed that SOC was not a predictor for treatment outcome in TMD-pain patients previously treated with an appliance. SOC seems to be correlated to grade of depression.
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- Ekberg, Olle, et al.
(author)
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Flow properties of oral contrast medium formulations depend on the temperature
- 2010
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 51:4, s. 363-367
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Journal article (peer-reviewed)abstract
- Background: During the therapeutic videofluoroscopic examination of swallowing, gradation of bolus volume, texture, and viscosity can be implemented to determine the optimal bolus characteristics in that particular patient. When a thickened liquid is given to a dysphagic patient it is served at room temperature. However, in these patients with a delayed oral and/or pharyngeal stage of swallow, the bolus is held for a long time in the oral cavity. The temperature of the thickened liquid thereby increases. Purpose: To study the rheological exploration (variation of viscosity with temperature) of thickened food used for radiologic swallowing examinations in patients with oral and pharyngeal dysfunction, in particular in mixtures of barium sulfate suspensions and in iodine solutions. Material and Methods: Deep-frozen mango purée was thawed at room temperature. It was then mixed with barium sulfate contrast medium to a density of 25% w/w. Resorce® Thicken Up was mixed at room temperature at two concentrations: 4.3% w/w (4.5 g thickener + 100 g distilled water) and 6.0% w/w (4.5 g thickener + 70 g distilled water). The thickener consisted of modified corn starch. Resorce® Thicken Up was also mixed at room temperature with two concentrations of an iodine contrast material, iohexol (Omnipaque®, 350 mg I/ml). The two concentrations were: 4.3% w/w (4.5 g thickener + 100 g iohexol) and 6% w/w (6 g thickener + 100 g iohexol). Measurements were carried out from 20°C to 37°C using a Stresstech HR rheometer. The rheometer was equipped with a concentric cylinder measuring system (inner cylinder 15 mm). Results: The samples containing thickener in water as well as in iohexol showed a dependence on thickener concentration and temperature. The mango purée with barium sulfate displayed very small temperature dependence. The thickener solutions in iohexol had significantly higher viscosity compared with the other thickener solutions and the mango purée. The relative decrease shows that mango purée, the 6% thickener solution in water, and solutions with iohexol exhibited similar relative viscosity change at different temperatures. Conclusion: Our conclusion is therefore that it is important always to make the solution with high precision. It is also of importance to observe how long the patient keeps the bolus in the mouth. This might vary and actually it may not be possible to influence this factor. When different types of thickeners are compared, it is important to take into account the temperature at which the thickener is observed.
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- Karlfeldt Fedje, Karin, 1977, et al.
(author)
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Initial studies of the recovery of Cu from MSWI fly ash leachates using solvent extraction
- 2012
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In: Waste Management and Research. - 1096-3669 .- 0734-242X. ; 30:10, s. 1072-1080
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Journal article (peer-reviewed)abstract
- Large volumes of ash from combustion of municipal solid waste are produced and most of it is landfilled. As this type of ash contains significant amounts of metal compounds the landfilling strategy is not optimal when considered from a resource conservation perspective. A better situation would be created if metals were recovered from the ash. In the present study leaching and solvent extraction was applied for release and separation of copper from municipal solid waste combustion fly ashes. The results showed promising results with Cu yields of 50-95%. The yield was heavily dependent on the efficiency of the initial leaching of Cu from the ash.
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| 6. |
- Karlfeldt Fedje, Karin, 1977, et al.
(author)
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Removal of hazardous metals from MSW fly ash-An evaluation of ash leaching methods
- 2010
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In: Journal of Hazardous Materials. - : Elsevier BV. - 1873-3336 .- 0304-3894. ; 173:1-3, s. 310-317
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Journal article (peer-reviewed)abstract
- Incineration is a commonly applied management method for municipal solid waste (MSW). However, significant amounts of potentially hazardous metal species are present in the resulting ash, and these may be leached into the environment. A common idea for cleaning the ash is to use enhanced leaching with strong mineral acids. However, due to the alkalinity of the ash, large amounts of acid are needed and this is a drawback. Therefore, this work was undertaken in order to investigate some alternative leaching media (EDTA, ammonium nitrate, ammonium chloride and a number of organic acids) and to compare them with the usual mineral acids and water. All leaching methods gave a significant increase in ash specific surface area due to removal of soluble bulk (matrix) compounds, such as CaCO3 and alkali metal chlorides. The use of mineral acids and EDTA mobilised many elements, especially Cu, Zn and Pb, whereas the organic acids generally were not very effective as leaching agents for metals. Leaching using NH4NO3 was especially effective for the release of Cu. The results show that washing of MSW filter ash with alternative leaching agents is a possible way to remove hazardous metals from MSW fly ash.
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- Leijon, Matti E., 1970-, et al.
(author)
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Factors associated with patients self-reported adherence to prescribed physical activity in routine primary health care
- 2010
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In: BMC Family Practice. - London, UK : BioMed Central. - 1471-2296. ; 11:38
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Journal article (peer-reviewed)abstract
- Background: Written prescriptions of physical activity, so‐called physical activity referral (PAR) schemes, have increased in popularity in recent years. Such schemes have mostly been evaluated in terms of efficacy. This study reports on a Swedish PAR scheme implemented in routine primary health care (PHC) measuring patients’ self‐reported adherence to physical activity prescriptions. The aim of this study was to evaluate adherence to physical activity prescriptions issued in everyday PHC at 3 and 12 months and to analyse the different characteristics associated with adherence to these prescriptions.Methods: Prospective prescription data were obtained for 37 of the 42 PHC centres in Östergötland County, Sweden, during 2004. The study population consisted of 3300 patients issued PARs by ordinary PHC staff members. Odds ratios were calculated to identify the factors associated with adherence.Results: The average adherence rate was 56% at 3 months and 50% at 12 months. In the descriptive analyses, higher adherence was associated with increased age, higher activity level at baseline, home‐based activities, prescriptions issued by professional groups other than physicians, and among patients issued PARs due to diabetes, high blood pressure and “other PAR reasons”. In the multiple logistic regression models, higher adherence was associated with higher activity level at baseline, and to prescriptions including home‐based activities, both at 3 and 12 months.Conclusions: Prescriptions from ordinary staff in routine PHC yielded adherence in 50% of the patients in this routine care PAR scheme follow‐up. Patients’ activity level at baseline (being at least somewhat physically inactive) and being issued homebased activities were associated with higher adherence at both 3 and 12 months.
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- Nordström, Karin, 1982-, et al.
(author)
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Sick leave and the impact of job-to-job mobility on the future vocational situation
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14:305
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Journal article (peer-reviewed)abstract
- Background: Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave.Methods: In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20–60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration.Results: Women with more than 180 days’ sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999.Conclusions: The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.
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| 12. |
- Nordström, Karin, et al.
(author)
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Sick leave and the impact of job-to-job mobility on the likelihood of remaining on the labour market - a longitudinal Swedish register study
- 2014
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 14, s. 305-
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Journal article (peer-reviewed)abstract
- Background: Change of job could be a strategy in vocational rehabilitation when return to the original job is not possible, but research is very limited concerning the effects of job mobility on the future vocational situation. The aim of the study was to investigate whether job-to-job mobility affects the likelihood of remaining on the labour market over time among persons who are employed and have experienced long-term sick leave. Methods: In a longitudinal register study, cohorts from three base years (1994, 1999 and 2004) were created, based on the Swedish population who were 20-60 years old, had sickness allowance insurance, and were employed in the base year and the following year (n > 3,000,000). The likelihood that individuals on long-term sick leave were employed later depending on whether or not they changed workplace during the present or next year of long-term sick leave was analyzed using logistic regression analysis. Age, sector, industry, children, marital status, education, income, rate of sick leave and earlier sick leave and earlier mobility were taken into consideration. Results: Women with more than 180 days' sick leave who changed workplaces were more likely to have a job later compared with those who did not change jobs. For men, the association was statistically significant with 1994 and 2004 as base years, but not in the cohort from 1999. Conclusions: The present study indicates that for those on long-term sick leave that changed workplaces, the opportunities to stay on the labour market might increase. However, the study has methodological limitations and the results for men are ambiguous. We do not therefore have enough evidence for recommending job change as a strategy for vocational rehabilitation.
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| 13. |
- Wendin, Karin, 1963-, et al.
(author)
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Objective and quantitative definitions of modified food textures based on sensory and rheological methodology.
- 2010
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In: Food & Nutrition Research. - 1654-6628 .- 1654-661X. ; 54
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Patients who suffer from chewing and swallowing disorders, i.e. dysphagia, may have difficulties ingesting normal food and liquids. In these patients a texture modified diet may enable that the patient maintain adequate nutrition. However, there is no generally accepted definition of 'texture' that includes measurements describing different food textures.OBJECTIVE: Objectively define and quantify categories of texture-modified food by conducting rheological measurements and sensory analyses. A further objective was to facilitate the communication and recommendations of appropriate food textures for patients with dysphagia.DESIGN: About 15 food samples varying in texture qualities were characterized by descriptive sensory and rheological measurements.RESULTS: Soups were perceived as homogenous; thickened soups were perceived as being easier to swallow, more melting and creamy compared with soups without thickener. Viscosity differed between the two types of soups. Texture descriptors for pâtés were characterized by high chewing resistance, firmness, and having larger particles compared with timbales and jellied products. Jellied products were perceived as wobbly, creamy, and easier to swallow. Concerning the rheological measurements, all solid products were more elastic than viscous (G'>G''), belonging to different G' intervals: jellied products (low G') and timbales together with pâtés (higher G').CONCLUSION: By combining sensory and rheological measurements, a system of objective, quantitative, and well-defined food textures was developed that characterizes the different texture categories.
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| 14. |
- Wåhlin, Charlotte, 1961-
(author)
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The Rehabilitation Process for Individuals with Musculoskeletal and Mental Disorders : Evaluation of Health, Functioning, Work Ability and Return to Work
- 2012
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Doctoral thesis (other academic/artistic)abstract
- Musculoskeletal disorders (MSD) and mental disorders (MD) are common among working-age individuals, and reduced work ability is often a problem that influences functioning in working life. Having MSD and MD is also a common cause of seeking health care and these conditions account for the majority of sick leave in most western countries. The overall aims of the thesis were to increase knowledge about biopsychosocial assessment of health, functioning and work ability for individuals with MSD and MD seeking care. A further aim was to gain better understanding of praxis behaviour in the rehabilitation process for sick-listed patients by evaluating patient-reported work ability, type of interventions given, usefulness of interventions, and return to work.This thesis comprises four studies based on two different cohorts. A cross-sectional design was used for studies I and II, which included 210 individuals diagnosed with MSD and MD seeking occupational health services. Data collection consisted of questionnaires to patients on self-reported health, functioning, work conditions, work ability and reports of professional assessment of diagnosis, main clinical problem, recommended intervention and sick leave. Studies III (n=699) and IV (n=810) were based on a longitudinal cohort study, ReWESS, with a 3-month follow-up comprising individuals who sought primary health care or occupational health services for MSD or MD and were sick-listed. The data collection included repeated questionnaires to the patients on self-reported health, functioning, work conditions, work ability, type and usefulness of intervention and return to work.There was an association between the professional biopsychosocial assessment and patients’ self-reported measures of health, functioning and work ability in clinical reasoning. Self-reported health and work measures can complement the expert-based diagnosis. Patients who had MSD and MD with co-morbid conditions reported more problems with mental functioning, had higher psychological demands at work and reported poorer work ability compared with those with MSD only. Patients with co-morbid conditions also had worse outcome compared to having mental disorders only. Psychosocial problems and activity limitations concerning social interaction skills were a frequent problem. This can be identified in clinical screening by physiotherapists in dialogue with the patient using the Patient-Specific Functional Scale. Three-quarters of sick-listed individuals with MSD or MD returned to work within 90 days. The treatment approach to sick-listed persons is still very medical and clinically oriented. Access to work-related interventions seems to be limited in the early rehabilitation process and may not be equal in practice. Those who were younger, had higher educational level and reported stronger health resources were favoured. There is a need to strive for access to work-related interventions.Return to work was associated with receiving combined clinical- and work-related interventions for patients with MD, and with better health-related quality of life, positive return to work expectations and better work ability for patients with MSD. Factors associated with return to work can be identified using self-reported measures. Patients with MD who received a combination of work-related and clinical interventions perceived best usefulness and best effect of health care contacts on work ability. Patients with MSD did not report as good usefulness. There seems to be a gap between scientific evidence and praxis behaviour in the early rehabilitation process; unimodal rehabilitation was widely applied, use of a multimodal treatment approach was limited and only one-third received work-related interventions. For patients with MSD, behavioural treatment seems to be underutilized in clinical practice considering the effect it may have on developing coping strategies and reducing symptoms. In order to meet recommendations in guidelines, physical activity needs to increase as a treatment strategy for patients with MD. A clinical implication is that the rehabilitation process needs to adopt a broader perspective for patients with MSD and MD to include patients’ individual health-related needs, aspects of employment and work conditions. Still, it remains a challenge to understand who needs what type of intervention.
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