| 1. |
- Santoft, Fredrik, et al.
(författare)
-
Mediators of Change in Cognitive Behavior Therapy for Clinical Burnout
- 2019
-
Ingår i: Behavior Therapy. - : Elsevier BV. - 0005-7894 .- 1878-1888. ; 50:3, s. 475-488
-
Tidskriftsartikel (refereegranskat)abstract
- Evidence supporting the effectiveness of cognitive behavior therapy (CBT) for stress-related illness is growing, but little is known about its mechanisms of change. The aim of this study was to investigate potential mediators of CBT for severe stress in form of clinical burnout, using an active psychological treatment as comparator. We used linear mixed models to analyze data from patients (N = 82) with clinical burnout who received either CBT or another psychological treatment in a randomized controlled trial. Potential mediators (i.e., sleep quality, behavioral activation, perceived competence, and therapeutic alliance) and outcome (i.e., symptoms of burnout) were assessed weekly during treatment. The results showed that the positive treatment effects on symptoms of burnout favoring CBT (estimated between-group d = 0.93) were mediated by improvements in sleep quality, ab = -0.017,95% CIasymmetric [-0.037, -0.002], and increase in perceived competence, ab = -0.037, 95% CIasymmetric [-0.070, -0.010]. Behavioral activation, ab = -0.004 [-0.016, 0.007], and therapeutic alliance, ab = 0.002 [-0.006, 0.011], did not significantly mediate the difference in effects between the treatments. Improving sleep quality and increasing perceived competence may thus constitute important process goals in order to attain symptom reduction in CBT for clinical burnout.
|
|
| 2. |
- Santoft, Fredrik, et al.
(författare)
-
Processes in cognitive behavior therapy for social anxiety disorder : Predicting subsequent symptom change
- 2019
-
Ingår i: Journal of Anxiety Disorders. - : Elsevier BV. - 0887-6185 .- 1873-7897. ; 67
-
Tidskriftsartikel (refereegranskat)abstract
- Although cognitive behavior therapy (CBT) is an effective treatment for social anxiety disorder, little is known about the processes during treatment that bring about change. The aim of this study was to investigate whether the proposed processes of change according to the cognitive model of social anxiety disorder predicted subsequent symptom reduction in CBT delivered as therapist-guided bibliotherapy. We analyzed data from patients with social anxiety disorder (N = 61) who participated in an effectiveness trial of CBT in primary care. Seven putative processes and outcome (i.e., social anxiety) were assessed on a weekly basis throughout treatment. We used linear mixed models to analyze within-person relations between processes and outcome. The results showed a unidirectional effect of reduced avoidance on subsequent decrease in social anxiety. Further, we found support for reciprocal influences between four of the proposed processes (i.e., estimated probability and cost of adverse outcome, self-focused attention, and safety behaviors) and social anxiety. The remaining two processes, (i.e., anticipatory and post-event processing) did not predict subsequent social anxiety, but were predicted by prior symptom reduction. The findings support that several of the change processes according to the cognitive model of social anxiety disorder are involved in symptom improvement.
|
|
| 3. |
|
|
| 4. |
- Gänsler, Tomas, et al.
(författare)
-
A double talk detector based on coherence
- 1997
-
Ingår i: IEEE Transactions on Communications. - : Institute of Electrical and Electronics Engineers (IEEE). - 0096-1965 .- 0090-6778. ; 44:11, s. 1421-1427
-
Tidskriftsartikel (refereegranskat)abstract
- We address the problem of detecting double-talk in a full duplex transmission line. A new double-talk detector (DTD) based on measuring the similarity between the far- and near-end speech signals is proposed. The detector is block oriented and operates in the frequency domain where the similarity between the signals is measured by means of the coherence function. The coherence is estimated with a short sequence of data by exploiting the multiple window spectrum estimation technique. Theoretical evaluation and examples of its performance are presented. The proposed DTD operates accurately in a wide range of situations, i.e., a difference in speech levels and hybrid attenuations ranging from 0 to 20 dB.
|
|
| 5. |
- Gänsler, Tomas, et al.
(författare)
-
A double talk detector based on coherence
- 1995
-
Ingår i: Proceedings of the 6th International Conference on Signal Processing Applications & Technology. ; 1, s. 332-336
-
Konferensbidrag (refereegranskat)
|
|
| 6. |
- Gänsler, Tomas, et al.
(författare)
-
A system for tracking the depth of anaesthesia
- 1995
-
Ingår i: Proceedings of 17th International Conference of the Engineering in Medicine and Biology Society. - 0780324757
-
Konferensbidrag (refereegranskat)abstract
- The latency and amplitude of the midlatency auditive evoked potential's (AEP) Nb-trough has been found to indicate the depth of anaesthesis. The aim of this paper is to present a system that reliably estimates these parameters without a long time delay. The result shows that it is possible to estimate and track changes in latency and amplitude of the Nb-trough with a delay below 1 minute at a stimulus rate of 8.4 Hz.
|
|
| 7. |
- Havelin, L. I., et al.
(författare)
-
The Nordic Arthroplasty Register Association
- 2009
-
Ingår i: Acta Orthopaedica. - 1745-3682. ; 80:4, s. 1-9
-
Tidskriftsartikel (refereegranskat)abstract
- Background and purpose The possibility of comparing results and of pooling the data has been limited for the Nordic arthroplasty registries, because of different registration systems and questionnaires. We have established a common Nordic database, in order to compare demographics and the results of total hip replacement surgery between countries. In addition, we plan to study results in patient groups in which the numbers are too small to be studied in the individual countries. Material and methods Primary total hip replacements (THRs) from 1995-2006 were selected for the study. Denmark, Sweden, and Norway contributed data. A common code set was made and Cox multiple regression, with adjustment for age, sex, and diagnosis was used to calculate prosthesis survival with any revision as endpoint. Results 280,201 operations were included (69,242 from Denmark, 140,821 from Sweden, and 70,138 from Norway). Females accounted for 60% of the patients in Denmark and Sweden, and 70% in Norway. Childhood disease was the cause of 3.1%, 1.8%, and 8.7% of the operations in Denmark, Sweden, and Norway, respectively. Resurfacing of hips accounted for 0.5% or less in all countries. The posterior approach was used in 91% of cases in Denmark, 60% in Sweden, and 24% in Norway. Cemented THRs were used in 46% of patients in Denmark, in 89% of patients in Sweden, and in 79% of patients in Norway. Of the 280,201 primary THRs, 9,596 (3.4%) had been revised. 10-year survival was 92% (95% CI: 91.6-92.4) in Denmark, 94% (95% CI: 93.6-94.1) in Sweden, and 93% (95% CI: 92.3-93.0) in Norway. In Denmark, 34% of the revisions were due to dislocation, as compared to 23% in Sweden and Norway. Replacement of only cup or liner constituted 44% of the revisions in Denmark, 29% in Sweden, and 33% in Norway. Interpretation This unique common Nordic collaboration has shown differences between the countries concerning demographics, prosthesis fixation, and survival. The large number of patients in this database significantly widens our horizons for future research.
|
|
| 8. |
- Hovelius, Lennart, et al.
(författare)
-
Non-operative treatment of primary anterior shoulder dislocation in patients forty years of age and younger : a prospective twenty-five-year follow-up
- 2008
-
Ingår i: Journal of Bone and Joint Surgery. American volume. - : Journal of Bone and Joint Surgery. - 0021-9355 .- 1535-1386. ; 90:5, s. 945-952
-
Tidskriftsartikel (refereegranskat)abstract
- Background: During 1978 and 1979, we initiated a prospective multicenter study to evaluate the results of nonoperative treatment of primary anterior shoulder dislocation. In the current report, we present the outcome after twenty-five years.Methods: Two hundred and fifty-five patients (257 shoulders) with an age of twelve to forty years who had a primary anterior shoulder dislocation were managed with immobilization (achieved by tying the arm to the torso with use of a bandage) or without immobilization. All 227 living patients (229 shoulders) completed the follow-up questionnaire, and 214 patients completed the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.Results: Ninety-nine (43%) of 229 shoulders had not redislocated, and seventeen (7%) redislocated once. Thirty-three recurrent dislocations had become stable over time (14.4%), and eighteen were considered to be still recurrent (7.9%). Sixty-two shoulders (27%) had undergone surgery for the treatment of recurrent instability. Immobilization after the primary dislocation did not change the prognosis. Only two of twenty-four shoulders with a fracture of the greater tuberosity at the time of the primary dislocation redislocated (p < 0.001). When shoulders with a fracture of the greater tuberosity were excluded, forty-four (38%) of 115 shoulders in patients who had been twelve to twenty-five years of age at the time of the original dislocation and sixteen (18%) of ninety shoulders in patients who had been twenty-six to forty years of age had undergone surgical stabilization. At twenty-five years, fourteen (23%) of sixty-two shoulders that had undergone surgical stabilization were in patients who subsequently had a contralateral dislocation, compared with seven (7%) of ninety-nine shoulders in patients in whom the index dislocation had been classified as solitary (p = 0.01). Gender and athletic activity did not appear to affect the redislocation rate; however, women had worse DASH scores than men did (p = 0.006).Conclusions: After twenty-five years, half of the primary anterior shoulder dislocations that had been treated nonoperatively in patients with an age of twelve to twenty-five years had not recurred or had become stable over time.Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.
|
|
| 9. |
|
|
| 10. |
- Nemes, Szilard, 1977, et al.
(författare)
-
Crosswalk algorithms for the conversion of mean EQ-5D indices calculated with different value sets
- 2016
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 44:5, s. 455-461
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: The EQ-5D questionnaire of EuroQol is an important tool, not only for researchers, but also for quality registers. Until 2013, Sweden did not have a country-specific value set to convert the EQ-5D health states into a single index. Commonly, the UK time trade-off (UK TTO) value set has been used. The study reported here aimed to establish an easy to use tool for the bidirectional crosswalk of the mean EQ-5D values based on two different value sets: the UK TTO and the Swedish TTO value sets. Methods: Using an artificial data set encompassing all possible EQ-5D outcomes, we calculated the EQ-5D index using both the UK TTO and Swedish TTO value sets. Thereafter we modelled the relationship between the two indices using least-squares regression and major axis regression. A series of simulations was run to assess the feasibility of the obtained crosswalk algorithms. Results: Major axis regression was superior to ordinary least-squares regression. Converting the mean EQ-5D values from the UK TTO scale to the Swedish TTO scale was more accurate than the inverse conversion. Values close to the floor and ceiling of the EQ-5D index were more challenging to crosswalk. Conclusions: We established algorithms based on major axis regression to crosswalk EQ-5D values based on the UK TTO and the Swedish TTO value sets. The presented algorithm may facilitate comparisons of EQ-5D values when only mean values are available. The existence of a crosswalk algorithm will ease the transition from the UK TTO to the Swedish TTO value set.
|
|
