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  • 1.
    Abbey, Susan E.
    et al.
    University of Toronto, Canada.
    De Luca, Enza
    University Health Network, University of Toronto, Canada.
    Mauthner, Oliver E.
    University Health Network, University of Toronto, Canada.
    McKeever, Patricia
    Bloorview Research Institute, Bloorview Kids Rehab, Canada.
    Shildrick, Margrit
    Queen's University, Belfast, Northern Ireland.
    Poole, Jennifer M.
    Ryerson University, Canada.
    Gewarges, Mena
    University Health Network, University of Toronto, Canada.
    Ross, Heather J.
    University Health Network, University of Toronto, Canada.
    Qualitative interviews versus standardised self-report questionnaires in assessing qualityb of life in heart transplant recipients2011In: The Journal of Heart and Lung Transplantation, ISSN 1053-2498, E-ISSN 1557-3117, Vol. 30, no 8, p. 963-966Article in journal (Refereed)
    Abstract [en]

    Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.06 ± 2.42 years). Self-report questionnaire data reported poor QoL and more distress compared with previous studies and normative population samples; in contrast, 52% of HTRs displayed pervasive distress according to visual methodology. Using qualitative methods to assess QoL yields information that would otherwise remain unobserved by the exclusive use of quantitative QOL questionnaires.

  • 2.
    Almberg, Maria
    et al.
    Mobil Centre Gothenburg, Sweden.
    Selander, Helena
    Mobil Centre Gothenburg, Sweden; University of Gothenburg, Sweden.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Vaz, Sharmila
    Curtin University, Australia.
    Ciccarelli, Marina
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin University, Australia.
    Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors2017In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, no 2, p. 59-67Article in journal (Refereed)
    Abstract [en]

    Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education. Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learners permit, from the perspective of the learner drivers and their driving instructors. Methods: Datawere collected from33 participants with ASD or ADHD, and nine of their driving instructors. Results: Participants with ASD required twice asmany driving lessons andmore on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to "unfamiliar driving situations to be the greatest challenges. Conclusion: Obtaining a driving license was associated with stressful training experience.

  • 3.
    Alwin, Jenny
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Bernfort, Lars
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Eckard, Nathalie
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Husberg, Magnus
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Fixartjänster i Sveriges kommuner: Kartläggning och samhällsekonomisk analys. Regeringsuppdrag2013Report (Other academic)
    Abstract [en]

    This report deals with so called minor home help services. These services are primarily meant for older persons with the aim to prevent injuries caused by falling in domestic environments (ones home). The minor home help services are mostly provided by the municipalities in Sweden, although it is not mandatory to provide these services. The extent of the provision and use of minor home help services has previously not been studied on a national level. The aim of this study was to delineate the minor home help services run by the municipalities in Sweden and further to examine and estimate the societal costs and consequences of providing these services.

    Out of the 290 municipalities in Sweden, 191 (66 %) offer minor home help services to their citizens. The tasks carried out are primarily aimed at preventing falls from furniture such as step stools or ladders, removing items that may cause falls (cords, carpets etc.) and providing an overhaul of injury risks in the home. A few municipalities also offer outdoor services such as removing snow in wintertime. In the majority of the municipalities (58 %) the services are offered free of charge but the user has to pay for the materials, in 32 % the services are completely free of charge and in 9 % of the municipalities an amount is charged for the services. The minor home help services are organized in various ways in the municipalities: the services can be completely run by the municipality where the services are carried out by one or several employed persons, by persons with disabilities (involved in daily activity programmes in the municipality) or by persons involved in work programmes; or the minor home help services can be carried out by the community rescue service or companies paid by the municipality to offer these services to the citizens. There are also organizations with volunteers that carry out minor home help services, these are however not included in the main results since the focus in this report is on municipal minor home help services. Ninety nine municipalities do not offer minor home help services to their citizens. Reasons for this are e.g. economic restraints and low demand.

    Experienced gains with minor home help services from the perspectives of the municipalities are prevention of falls, facilitation of the possibility to remain living in one’s own home, contribution to social wellbeing and being able to offer meaningful work tasks for persons in work programmes or persons with disabilities. Problems that have been brought forward are low demand of the services, problems with providing the target group with information and difficulties to measure the effect on fall injuries.

    A socioeconomic model was constructed for the analysis of costs and consequences of fall injuries. The model includes the large cost items as well as outcomes such as mortality and loss of quality of life when affected by a fall injury. The total direct costs in Sweden for fall injuries has previously been calculated to approximately 5 billion SEK, which includes only the direct costs during the first year of the injury. A calculation exercise was performed and applied to a hypothetical municipality with 50 000 inhabitants. This calculation exercise shows that if only a small amount of falls that lead to serious injuries (fractures) can be prevented by minor home help services, then the costs saved are approximately equivalent to the mean budget of minor home help services with one employed person. Calculations using real data including both costs and effects need to be performed.

  • 4.
    Andersen, Åsa
    et al.
    Uppsala University, Sweden.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Anderzen, Ingrid
    Uppsala University, Sweden.
    Kristiansson, Per
    Uppsala University, Sweden.
    Larsson, Kjerstin
    Uppsala University, Sweden.
    Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study2017In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 17, article id 790Article in journal (Refereed)
    Abstract [en]

    Background: The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individuals ability to work. The aim of this study was to investigate clients experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. Methods: A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. Results: The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. Conclusions: The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

  • 5.
    Andersson, Elinor
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Vad är speciellt med handledare vid klinisk undervisningsavdelning (KUA)?-En kvalitativ studie2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Supervising students in a clinical training ward (CTW) has been used for some 20 years. Studies show that interprofessional learning gives students an opportunity to get a comprehensive view of a particular patient’s health-care needs, as well as an increased and mutual understanding of their colleague’s position and knowledge. Only a few studies have focused on the supervisor’s view of his or her own role within the activity of the CTW. The purpose of the study was to describe the CTW supervisor and his or her own perception of her role as an interprofessional supervisor as well as to describe interprofessional learning on its own at the CTW. A qualitative method was used, and 19 interprofessional supervisors from and within occupational therapy, along with physicians, physiotherapists, and nurses, were interviewed.

    The texts were content-analysed. Three categories were identified: ‘the supervisor’, ‘the supervision’, and ‘the concept of CTW’. It turned out that the interprofessional supervisor has a genuine interest and commitment to supervise, to work pedagogically, to collaborate, and to work with students. The supervisors all used different strategies, and they worked with the team in focus, partly for the benefit of the students but also to show the team’s importance in relation to the patient’s health care situation. The CTW concept requires lots of time and dedication from the supervisor, but it is perceived as a good concept where students can develop interprofessional collaboration. The supervisor’s understanding and approach to student learning makes a huge difference in the process of supervision. Being an interprofessional supervisor requires a pedagogical knowledge and understanding of a group and of the group process. The student’s team knowledge influences the CTW, which affects the supervision. The concept of the CTW has a positive impact on the supervisors, and the interprofessional supervision is perceived to be stimulating and challenging.

  • 6.
    Arlinger, Stig
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Nordqvist, Peter
    Royal Institute Technology, Sweden.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    International Outcome Inventory for Hearing Aids: Data From a Large Swedish Quality Register Database2017In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 26, no 3, p. 443-450Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to analyze a database of completed International Outcome Inventory for Hearing Aids (IOI-HA) questionnaires obtained from over 100,000 clients fitted with new hearing aids in Sweden during the period of 2012-2016. Mean IOI-HA total scores were correlated with degree of hearing loss, unilateral versus bilateral fitting, first-time versus return clients, gender, and variation among dispensing clinics. The correlations with expectations, service quality, and technical functioning of the hearing aids were also analyzed. Method: Questionnaires containing the 7 IOI-HA items as well as questions concerning some additional issues were mailed to clients 3-6 months after fitting of new hearing aids. The questionnaires were returned to and analyzed by an independent research institute. Results: More than 100 dispensing clinics nationwide take part in this project. A response rate of 52.6% resulted in 106,631 data sets after excluding incomplete questionnaires. Forty-six percent of the responders were women, and 54% were men. The largest difference in mean score (0.66) was found for the IOI-HA item "use" between return clients and first-time users. Women reported significantly higher (better) scores for the item "impact on others" compared with men. The bilaterally fitted subgroup reported significantly higher scores for all 7 items compared with the unilaterally fitted subgroup. Experienced users produced higher scores on benefit and satisfaction items, whereas first-time users gave higher scores for residual problems. No correlation was found between mean IOI-HA total score and average hearing threshold level (pure-tone average [ PTA]). Mean IOI-HA total scores were found to correlate significantly with perceived service quality of the dispensing center and with the technical functionality of the hearing aids. Conclusions: When comparing mean IOI-HA total scores from different studies or between groups, differences with regard to hearing aid experience, gender, and unilateral versus bilateral fitting have to be considered. No correlation was found between mean IOI-HA total score and degree of hearing loss in terms of PTA. Thus, PTA is not a reliable predictor of benefit and satisfaction of hearing aid provision as represented by the IOI-HA items. Identification of a specific lower fence in PTA for hearing aid candidacy is therefore to be avoided. Large differences were found in mean IOI-HA total scores related to different dispensing centers.

  • 7.
    Arvidsson, Patrik
    et al.
    Uppsala University, Sweden; Jonköping University, Sweden; Jonköping University, Sweden.
    Granlund, Mats
    Jonköping University, Sweden; University of Oslo, Norway.
    Thyberg, Mikael
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    How are the activity and participation aspects of the ICF used? Examples from studies of people with intellectual disability2015In: NeuroRehabilitation (Reading, MA), ISSN 1053-8135, E-ISSN 1878-6448, Vol. 36, no 1, p. 45-49Article, review/survey (Refereed)
    Abstract [en]

    INTRODUCTION: Interdisciplinary differences regarding understanding the International Classification of Functioning, Disability and Health (ICF) concepts activity/participation may hinder its unifying purpose. In the ICF model, functioning (and disability) is described as a tripartite concept: 1) Body structures/functions, 2) Activities, and 3) Participation. Activities refer to an individual perspective on disability that does not tally with the basic structure of social models. OBJECTIVE: To review how activity and participation are actually used in studies of intellectual disability (ID). CONCLUSION: Based on 16 papers, four different usages of activity/participation were found. 1) Theoretical reference to tripartite ICF concept with attempts to use it. 2) Theoretical reference to tripartite ICF concept without actual use of activities. 3) "Atheoretical" approach with implicit focus on participation. 4) Theoretical reference to bipartite concept with corresponding use of terms. The highlighted studies have in common a focus on participation. However, the usage of the term "activity" differs both within and between studies. Such terminology will probably confuse interdisciplinary communication rather than facilitating it. Also, the use of an explicit underlying theory differs, from references to a tripartite to references to a bipartite concept of disability. This paper is focused on ID, but the discussed principles regarding the ICF and interdisciplinary disability theory are applicable to other diagnostic groups within rehabilitation practices.

  • 8.
    Ball, Martin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science.
    The Establishment of DisorderedSpeechBank: A digital archive of disordered speech across languages2016Conference paper (Refereed)
  • 9.
    Ball, Martin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Isaksson, Fredrik
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Larsson, Elias
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Müller, Nicole
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Dysarthria in Swedish2016Conference paper (Other academic)
  • 10.
    Ball, Martin J.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Principles of clinical phonology: theoretical approaches2016 (ed. 1)Book (Refereed)
    Abstract [en]

    Those working on the description of disordered speech are bound to be also involved with clinical phonology to some extent. This is because interpreting the speech signal is only the first step to an analysis. Describing the organization and function of a speech system is the next step. However, it is here that phonologists differ in their descriptions, as there are many current approaches in modern linguistics to undertaking phonological analyses of both normal and disordered speech.

    Much of the work in theoretical phonology of the last fifty years or so is of little use in either describing disordered speech or explaining it. This is because the dominant theoretical approach in linguists as a whole attempts elegant descriptions of linguistic data, not a psycholinguistic model of what speakers do when they speak. The latter is what is needed in clinical phonology. In this text, Martin J. Ball addresses these issues in an investigation of what principles should underlie a clinical phonology. This is not, however, simply another manual on how to do phonological analyses of disordered speech data, though examples of the application of various models of phonology to such data are provided. Nor is this a guide on how to do therapy, though a chapter on applications is included. Rather, this is an exploration of what theoretical underpinnings are best suited to describing, classifying, and treating the wide range of developmental and acquired speech disorders encountered in the speech-language pathology clinic.

  • 11.
    Ball, Martin J.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Howard, Sara
    Esling, John
    Dickson, Craig
    Revisions to the extIPA and VoQS symbol sets.2016Conference paper (Refereed)
  • 12.
    Bennett, Rebecca J.
    et al.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Res Ctr, Denmark.
    Meyer, Carly J.
    Univ Queensland, Australia.
    Eikelboom, Robert H.
    Ear Sci Inst Australia, Australia; Univ Western Australia, Australia; Univ Pretoria, South Africa.
    Exploring Hearing Aid Problems: Perspectives of Hearing Aid Owners and Clinicians2018In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 39, no 1, p. 172-187Article in journal (Refereed)
    Abstract [en]

    Objectives: To gather perspectives of hearing aid owners and hearing healthcare clinicians with regard to problems that arise after hearing aid fitting and use these perspectives to generate a conceptual framework to gain a better understanding of these problems. Design: Participants included a group of 17 hearing aid owners and a group of 21 hearing healthcare clinicians; data collection occurred separately for each group. Participants each attended two group sessions in Perth, Western Australia, wherein they: (1) generated statements describing the problems associated with hearing aids and (2) grouped and rated the statements to identify key themes. Concept mapping was used to generate a conceptual framework. Results: Participants identified four concepts regarding hearing aid problems as follows: (1) hearing aid management; (2) hearing aid sound quality and performance; (3) feelings, thoughts, and behaviors; and (4) information and training. While hearing aid owners and clinicians generated similar results regarding the concepts derived, the clinicians reported that the problems identified had a greater negative impact on hearing aid success than did hearing aid owners. Conclusions: The magnitude and diversity of hearing aid problems identified in this study highlight the ongoing challenges that hearing aid owners face and suggest that current processes for hearing aid fitting can be improved. Problems relating to hearing aid management were most often deemed to have the greatest impact on hearing aid success and be the most preventable/solvable, and thus are a good starting point when addressing hearing aid-related problems.

  • 13.
    Berg, Jessica
    et al.
    Linköping University, NISAL - National Institute for the Study of Ageing and Later Life. Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden.
    Levin, Lena
    Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden.
    Abramsson, Marianne
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life.
    Hagberg, Jan-Erik
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life.
    “I want complete freedom”: car use and everyday mobility among the newly retired2015In: European Transport Research Review, ISSN 1867-0717, E-ISSN 1866-8887, Vol. 7, no 4Article in journal (Refereed)
    Abstract [en]

    Purpose

    To investigate car use among newly retired people, to explore to what extent car transport is used for everyday mobility and how it is valued in comparison to other transport modes.

    Methods

    The data consists of travel diaries and qualitative interviews with 24 individuals, aged between 61 and 67, living in a middle-sized Swedish city. They were recruited via the local branch of one of the main associations of pensioners, one large employer in the municipality, and through another study. The informants filled in a travel diary during 1 week that were analysed by VISUAL- TimePAcTS, an application for visualising and exploring activity diary data. The semi-structured qualitative interviews were analysed using a qualitative content analysis.

    Results

    The car was used for several trips daily and often for short trips. The informants had a lot of everyday projects that they would not be able to perform if they did not have access to a car. The importance of the car does not seem to have changed upon retirement, albeit it is partly used for other reasons than before. The informant’s social context implies new space-time constraints. Commitments to family members, engagement in associations and spouses’ occupations affect how much and when they use the car, and their overall mobility.

    Conclusions

    In contrast to much research on older people’s mobility that has studied slightly older people, this study have focused on a specific group that are relatively healthy, well-off, and have the possibility to choose between different modes of transport. By combining travel diaries and qualitative interviews, we have explored how newly retired people reason as regard their travel behaviour but also how they actually travel. Although the car was used more than other transport modes, being able to walk and cycle now that they had more time as retirees was highly valued. Our results indicate that urban residents that are retiring now and in the future are a key target group in transport planning when it comes to reduce car use in favour of slow modes of transport.

  • 14.
    Berglund, Josefin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Hasselquist, Kaisa
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Fonologi hos svenska 5- och 6-åringar med typisk språkutveckling: Referensmaterial till det fonologiska testmaterialet LINUS2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A new phonological test, LINUS, for Swedish-speaking children between the ages of three and seven, has been developed at the speech and language pathology department at Linköping University. The aim of the present study was to create a reference manual for the long version of the new test. The participants in the present study were children between the ages of five to seven in a medium-sized municipality in the Northern part of Kalmar County, Sweden. In total, 124 native Swedish-speaking children (58 girls and 66 boys) with typical language development participated. The children were divided into two age groups, 5;0-5;11;31 and 6;0-6;11;31 years. The collected data was analysed with respect to acquisition of phonemes and word structure processes. Percentage of correctly produced words (PWC), consonants (PCC) and vowels (PVC) were calculated.All phonemes, except /s/, were established in both age groups. The phoneme /s/ was found to be either substituted or distorted. Among the 5-year old children /s/ was established for 84%, substitutions of /s/ were found in 7% and distortions were found in 23%. Among the 6-year old children /s/ was established for 88%. Substitutions of /s/ were found in 3% and distortions in 16% of the 6-year old children. The phoneme /r/ proved to be a borderline case for acquisition in the younger age group (91%). The most common word structure process in both groups was assimilation. A significant difference between the two age groups was found for assimilation (p=0,022), with lower occurrence in the older group. Two-consonant clusters (CC) and three-consonant clusters (CCC) were not frequently reduced, although it was found that CC-clusters were reduced more frequently than CCC-clusters. Both the age groups had high percentages of correctly produced words, consonants and vowels. The analysis revealed the following results: PWC for 5-years olds was 93% and 6-years olds 97%. PCC for 5-year olds was 98% and for 6-year olds 99%. PVC for both age groups was 100%. An age difference was shown for PWC, but not for the other measures. No gender differences were found.

  • 15.
    Bernard, Christophe
    et al.
    Aix Marseille Université, INS, Marseille, France; Inserm, UMR_S 1106, Marseille, France.
    Simon, Daniel
    Linköping University, Department of Science and Technology, Physics and Electronics. Linköping University, Faculty of Science & Engineering.
    Malliaras, George G
    Department of Bioelectronics, Ecole Nationale Supérieure des Mines, CMP-EMSE, MOC, Gardanne, France.
    Organic Bioelectronics for Interfacing with the Brain2016In: The WSPC Reference on Organic Electronics: Organic Semiconductors: Volume 2: Fundamental Aspects of Materials and Applications / [ed] Seth R Marder, Jean-Luc Bredas, World Scientific, 2016, p. 345-368Chapter in book (Other academic)
    Abstract [en]

    Understanding how the brain works represents probably the most important fundamental endeavor of humankind and holds the key for the development of new technologies that can help improve the lives of people suffering from neurological conditions such as epilepsy and Parkinson's disease. Over the past decade, the use of organic electronic devices to interface with the biological world has received a great deal of attention and bloomed into a field now called “organic bioelectronics”. One of the key differences of organic from traditional electronic materials is their capacity to exchange ions with electrolytes. We discuss how this property can be leveraged to design new types of devices that interface with the brain.Read 

  • 16.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England.
    Baguley, David M.
    Anglia Ruskin Univ, England; Nottingham Biomed Res Ctr, England; Univ Nottingham, England.
    Allen, Peter M.
    Anglia Ruskin Univ, England.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial2018In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 39, no 3, p. 423-433Article in journal (Refereed)
    Abstract [en]

    Objectives: Specialist tinnitus services are in high demand as a result of the negative effect tinnitus may have on quality of life. Additional clinically and cost-effective tinnitus management routes are needed. One potential route is providing Cognitive Behavioural Therapy for tinnitus via the Internet (iCBT). This study aimed to determine the efficacy of guided iCBT, using audiological support, on tinnitus distress and tinnitus-related comorbidities, in the United Kingdom. A further aim was to establish the stability of intervention effects 2-months postintervention. The hypothesis was that iCBT for tinnitus would be more effective at reducing tinnitus distress than weekly monitoring. Design: A randomized, delayed intervention efficacy trial, with a 2-month follow-up was implemented to evaluate the efficacy of iCBT in the United Kingdom. Participants were randomly assigned to the experimental (n = 73) or weekly monitoring control group (n = 73) after being stratified for tinnitus severity and age. After the experimental group completed the 8-week long iCBT intervention, the control group undertook the same intervention. Intervention effects were, therefore, evaluated in two independent groups at two time points. The primary outcome was a change in tinnitus distress between the groups as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing disability, hyperacusis, cognitive failures, and satisfaction with life. These were completed at baseline, postintervention, and at a 2-month postintervention follow-up. Results: After undertaking the iCBT intervention, the experimental group had a greater reduction in tinnitus distress when compared with the control group. This reduction was statistically significant (Cohens d = 0.7) and was clinically significant for 51% of the experimental group and 5% of the control group. This reduction was evident 4 weeks after commencing the iCBT intervention. Furthermore, the experimental group had a greater reduction in insomnia, depression, hyperacusis, cognitive failures, and a greater improvement in quality of life, as evidenced by the significant differences in these assessment measures postintervention. Results were maintained 2 months postintervention. Conclusions: Guided (using audiological support) iCBT for tinnitus resulted in statistically significant reductions in tinnitus distress and comorbidities (insomnia, depression, hyperacusis, cognitive failures) and a significant increase in quality of life. These effects remained stable at 2-months postintervention. Further trials to determine the longer term efficacy of ICBT to investigate predictors of outcome and to compare iCBT with standard clinical care in the United Kingdom are required.

  • 17.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Allen, Peter M.
    Anglia Ruskin Univ, England; Anglia Ruskin Univ, England.
    Terlizzi, Paige M.
    Lamar Univ, TX 77710 USA.
    Baguley, David M.
    Anglia Ruskin Univ, England; Nottingham Biomed Res Ctr, England; Univ Nottingham, England.
    Situationally influenced tinnitus coping strategies: a mixed methods approach2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 24, p. 2884-2894Article in journal (Refereed)
    Abstract [en]

    Purpose: The primary aim of this study was to identify coping strategies used to manage problematic tinnitus situations. A secondary aim was to determine whether different approaches were related to the level of tinnitus distress, anxiety, depression, and insomnia experienced. Materials and methods: A cross-sectional survey design was implemented. The study sample was adults interested in undertaking an Internet-based intervention for tinnitus. Self-reported measures assessed the level of tinnitus distress, depression, anxiety, and insomnia. An open-ended question was used to obtain information about how problematic tinnitus situations were dealt with. Responses were investigated using qualitative content analysis to identify problematic situations. Further data analysis comprised of both qualitative and quantitative methods. Results: There were 240 participants (137 males, 103 females), with an average age of 48.16 years (SD: 22.70). Qualitative content analysis identified eight problematic tinnitus situations. Participants had either habituated to their tinnitus (7.9%), used active (63.3%), or passive (28.8%) coping styles to manage these situations. Those who had habituated to tinnitus or used active coping strategies had lower levels of tinnitus distress, anxiety, and depression. Conclusions: The main problematic tinnitus situations for this cohort were identified. Both active and passive coping styles were applied to approach these situations. The coping strategies used most frequently and utilised in the widest range of problematic situations were using sound enrichment and diverting attention.

  • 18.
    Beukes, Eldre W.
    et al.
    Anglia Ruskin Univ, England.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Baguley, David M.
    Anglia Ruskin Univ, England; NIHR, England; Univ Nottingham, England.
    Allen, Peter M.
    Anglia Ruskin Univ, England; Anglia Ruskin Univ, England.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Process evaluation of Internet-based cognitive behavioural therapy for adults with tinnitus in the context of a randomised control trial2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 2, p. 98-109Article in journal (Refereed)
    Abstract [en]

    Objective: The research objective was to identify processes that could either facilitate or hinder clinical implementation of an Internet-based cognitive behavioural therapy intervention for tinnitus in the UK. This was done by exploring the research context, the intervention components and the factors that contributed to the outcomes obtained. Design: This study investigated eight processes including the recruitment strategies, reach, research context, treatment dose delivered and received, implementation fidelity, barriers to implementation and effectiveness of the intervention. Study sample: Of the 169 registered participants, 146 were randomly assigned to the experimental or control groups (23 were excluded). The mean age was 55.57 years with an average tinnitus duration of 11.63 years. Results: The intended sample of people with distressing tinnitus who were underserved with evidence-based tinnitus interventions was reached. The full guided intervention was delivered. The recommended modules were read more than the optional modules. Intervention components such as the easily readable format and the benefits of the applied relaxation programme facilitated significant positive post-intervention outcomes. Barriers hampering the intervention application included time pressures and low self-motivation. Conclusions: Results of this process evaluation together with the outcome data can be used to facilitate translating this research into clinical practice.

  • 19.
    Bolic Baric, Vedrana
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Support in school and the occupational transition process: Adolescents and young adults with neuropsychiatric disabilities2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to describe and explore the experiences of support in school of adolescents and young adults with neuropsychiatric disabilities. Furthermore, the aim was to explore support that influences the occupational transition to upper secondary school, further education and work. The two first studies investigated computer use in educational activities and during leisure activities by adolescents with attention deficit hyperactivity disorder (ADHD). Study II also aimed to explore how traditional leisure activities and Internet activities interrelate among adolescents with ADHD. In Studies I and II data was collected using a questionnaire focusing on information and communication technology (ICT) use in school and leisure. Adolescents with ADHD (n = 102) aged 12-18 years were compared with adolescents with physical disabilities (Study I) and adolescents from the general population (Studies I and II). In Study III the aim was to describe the experiences of support at school among young adults with AS and ADHD, and to explore what support they, in retrospect, described as influencing learning. Study IV aimed to describe the occupational transition process to upper secondary school, further education and/or work and to explore what support influenced the process from the perspectives of young adults with AS or ADHD. Studies III (n=13) and IV (n=15) used qualitative semi-structured interviews with young adults with AS or ADHD, aged 18-30 years and were analysed using hermeneutics according to Gadamer.

    The findings of Study I showed that students with ADHD reported significantly less frequent use of computers for almost all educational activities compared with students with physical disabilities and students from the general population. They reported low satisfaction with computer use in school and a desire to use computers more often and for more activities in school compared with students with physical disabilities. Study II showed that Internet activities among adolescents with ADHD during leisure, tended to focus on online games. Furthermore, analysis demonstrated that Internet activities were broadening leisure activities among adolescents with ADHD, rather than being a substitute for traditional leisure activities. Study III found that young adults with AS or ADHD experienced difficulties at school that included academic, social, and emotional aspects, all of which influenced learning. Support addressing difficulties with academic performance was described as insufficient and only occasionally provided in school. In conclusion, support for learning among students with AS or ADHD needs to combine academic and psychosicial support. The findings of Study IV identified three different pathways following compulsory school. Support influencing the occupational transition process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. Support from community-based day centres was described both as an important step towards work in the regular labour market, as well as being too far away from the regular labour market.

    In conclusion, this thesis revealed that support in school among students with AS or ADHD needs to combine academic and psychosocial support. Despite being regarded as facilitating learning, individuals with ADHD or AS reported limited computer and Internet use in school. Based on the results it is suggested that Internet activities may provide adolescents with neuropsychiatric disabilities with new opportunities for social interaction and educational activities. On the basis of the results it is suggested that the occupational transition process should be viewed as a longitudinal one, starting in compulsory school and continuing on until young adults obtain and are able to remain in work or further education. This thesis revealed that extended transition planning, inter-service collaboration and support from communitybased day centres were aspects of the environment that influenced the occupational transition process.

    List of papers
    1. Computer use in educational activities by students with ADHD
    Open this publication in new window or tab >>Computer use in educational activities by students with ADHD
    Show others...
    2013 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 5, p. 357-364Article in journal (Refereed) Published
    Abstract [en]

    Aim: The aim of this study was to investigate computer use in educational activities by students with attention deficit hyperactivity disorder (ADHD) in comparison with that of students with physical disabilities and students from the general population.

    Methods: The design of the study was cross-sectional with group comparison. Students with ADHD (n = 102) were pair-matched in terms of age and sex with students with physical disabilities and students from the general population (n = 940) were used as a reference group.

    Results: The study showed that less than half of the students with ADHD had access to a computer in the classroom. Students with ADHD reported significantly less frequent use of computers for almost all educational activities compared with students with physical disabilities and students from the general population. Students with ADHD reported low satisfaction with computer use in school. In addition, students with ADHD reported a desire to use computers more often and for more activities in school compared with students with physical disabilities.

    Conclusions: These results indicate that occupational therapists should place more emphasize on how to enable students with ADHD to use computers in educational activities in school.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2013
    Keywords
    Information and communication technology (ICT), computer access, school-based practice, physical disabilities
    National Category
    Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-86782 (URN)10.3109/11038128.2012.758777 (DOI)000323943600006 ()
    Available from: 2013-01-04 Created: 2013-01-04 Last updated: 2017-12-06Bibliographically approved
    2. Internet Activities During Leisure: A Comparison Between Adolescents With ADHD and Adolescents From the General Population
    Open this publication in new window or tab >>Internet Activities During Leisure: A Comparison Between Adolescents With ADHD and Adolescents From the General Population
    2018 (English)In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 22, no 12, p. 1131-1139Article in journal (Refereed) Published
    Abstract [en]

    Objective: Adolescents’ leisure activities are increasingly focusing on Internet activities, and today, these coexist with traditional leisure activities such as sport and meeting friends. The purpose of the present study was to investigate leisure activities, particularly Internet activities, among boys and girls with ADHD, and compare these with boys and girls from the general population. The objective was also to explore how traditional leisure activities and Internet activities interrelate among adolescents with ADHD. 

    Method: Adolescents with ADHD (n = 102) were compared with adolescents from the general population on leisure activities and Internet use. 

    Results: Leisure activities among adolescents with ADHD tended to focus on Internet activities, particularly online games. Internet activities were broadening leisure activities among adolescents with ADHD, rather than being a substitute for traditional leisure activities. 

    Conclusion: Internet activities may provide adolescents with ADHD accessible means of social interaction.

    Place, publisher, year, edition, pages
    Sage Publications, 2018
    Keywords
    adolescent ADHD, computer games, principal components analysis, peer relationships
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Social Sciences Interdisciplinary
    Identifiers
    urn:nbn:se:liu:diva-123871 (URN)10.1177/1087054715613436 (DOI)000444488700005 ()26610742 (PubMedID)
    Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2018-09-27Bibliographically approved
    3. Support for learning- goes beyond academic support: voices of students with Asperger’s disorder and ADHD
    Open this publication in new window or tab >>Support for learning- goes beyond academic support: voices of students with Asperger’s disorder and ADHD
    2016 (English)In: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 20, no 2, p. 183-195Article in journal (Refereed) Published
    Abstract [en]

    The purpose of this study was to describe and explore the experiences of support at school among young adults with Asperger’s disorder (AS) and attention-deficit/hyperactivity disorder (ADHD), and also to examine what support they, in retrospect, described as influencing learning. Purposive sampling was used to enroll participants. Data were collected through semi-structured interviews with thirteen young adults aged between 20-29 years. A qualitative analysis, based on interpreting people’s experiences was conducted by grouping and searching for patterns in data. The findings indicate that the participants experienced difficulties at school that included academic, social and emotional conditions, all of which could influence learning. Support for learning included small groups, individualized teaching methods, teachers who cared, and practical and emotional support. These clusters together confirm the overall understanding that support for learning aligns academic and psychosocial support. In conclusion, academic support combined with psychosocial support at school seems to be crucial for learning among students with AS and ADHD.

    Place, publisher, year, edition, pages
    Sage Publications, 2016
    Keywords
    Autism Spectrum Disorders, ADHD/ADD, psychosocial support, education, educational provision, services, qualitative research, special needs students
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-115117 (URN)10.1177/1362361315574582 (DOI)000372880100007 ()
    Available from: 2015-03-10 Created: 2015-03-09 Last updated: 2017-04-21Bibliographically approved
    4. The Occupational Transition Process to Upper Secondary School, Further Education and/or Work in Sweden: As Described by Young Adults with Asperger Syndrome and Attention Deficit Hyperactivity Disorder
    Open this publication in new window or tab >>The Occupational Transition Process to Upper Secondary School, Further Education and/or Work in Sweden: As Described by Young Adults with Asperger Syndrome and Attention Deficit Hyperactivity Disorder
    2017 (English)In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 3, p. 667-679Article in journal (Refereed) Published
    Abstract [en]

    The aim of the study was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger’s disorder (AS) or attention deficit/hyperactivity disorder (ADHD). This qualitative study comprised semi-structured interviews with 15 young adults with AS or ADHD, eight men and seven women (aged 20 to 29 years). Most of the participants were attending community-based day centres at local businesses. Analysis identified three different occupational transition pathways following compulsory school. Support influencing the occupational transition process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults with AS and ADHD obtained and were able to remain in employment or further education. Support from community-based day centres was described both as an important step towards finding employment in the regular labour market in which participants could develop practical work experience, and as being too far away from the regular labour market.

    Place, publisher, year, edition, pages
    Springer, 2017
    Keywords
    Attention deficit hyperactivity disorder/attention deficit disorder, autism spectrum disorders, employment, education, qualitative research, services
    National Category
    Other Health Sciences Neurosciences
    Identifiers
    urn:nbn:se:liu:diva-123872 (URN)10.1007/s10803-016-2986-z (DOI)000396815400014 ()
    Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2018-01-15Bibliographically approved
  • 20.
    Bolic Baric, Vedrana
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Hemmingsson, Helena
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Hellberg, Kristina
    Linnaeus University, Växjö, Sweden .
    Kjellberg, Anette
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    The Occupational Transition Process to Upper Secondary School, Further Education and/or Work in Sweden: As Described by Young Adults with Asperger Syndrome and Attention Deficit Hyperactivity Disorder2017In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 47, no 3, p. 667-679Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger’s disorder (AS) or attention deficit/hyperactivity disorder (ADHD). This qualitative study comprised semi-structured interviews with 15 young adults with AS or ADHD, eight men and seven women (aged 20 to 29 years). Most of the participants were attending community-based day centres at local businesses. Analysis identified three different occupational transition pathways following compulsory school. Support influencing the occupational transition process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults with AS and ADHD obtained and were able to remain in employment or further education. Support from community-based day centres was described both as an important step towards finding employment in the regular labour market in which participants could develop practical work experience, and as being too far away from the regular labour market.

  • 21.
    Bolic, Vedrana
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hellberg, Kristina
    Specialpedagogiska institutionen, Stockholms universitet, Stockholm, Sweden.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Support for learning- goes beyond academic support: voices of students with Asperger’s disorder and ADHD2016In: Autism, ISSN 1362-3613, E-ISSN 1461-7005, Vol. 20, no 2, p. 183-195Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe and explore the experiences of support at school among young adults with Asperger’s disorder (AS) and attention-deficit/hyperactivity disorder (ADHD), and also to examine what support they, in retrospect, described as influencing learning. Purposive sampling was used to enroll participants. Data were collected through semi-structured interviews with thirteen young adults aged between 20-29 years. A qualitative analysis, based on interpreting people’s experiences was conducted by grouping and searching for patterns in data. The findings indicate that the participants experienced difficulties at school that included academic, social and emotional conditions, all of which could influence learning. Support for learning included small groups, individualized teaching methods, teachers who cared, and practical and emotional support. These clusters together confirm the overall understanding that support for learning aligns academic and psychosocial support. In conclusion, academic support combined with psychosocial support at school seems to be crucial for learning among students with AS and ADHD.

  • 22.
    Classon, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rudner, Mary
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Working memory compensates for hearing related phonological processing deficit2013Conference paper (Refereed)
    Abstract [en]

    Acquired hearing impairment is associated with gradually declining phonological representations. According to the Ease of Language Understanding (ELU) model, poorly defined representations lead to mismatch in phonologically challenging tasks. To resolve the mismatch, reliance on working memory capacity (WMC) increases. This study investigated whether WMC modulated performance in a phonological task in individuals with hearing impairment. A visual rhyme judgment task with congruous or incongruous orthography, followed by an incidental episodic recognition memory task, was used. In participants with hearing impairment, WMC modulated both rhyme judgment performance and recognition memory in the orthographically similar non-rhyming condition; those with high WMC performed exceptionally well in the judgment task, but later recognized few of the words. For participants with hearing impairment and low WMC the pattern was reversed; they performed poorly in the judgment task but later recognized a surprisingly large proportion of the words. Results indicate that good WMC can compensate for the negative impact of auditory deprivation on phonological processing abilities by allowing for efficient use of phonological processing skills. They also suggest that individuals with hearing impairment and low WMC may use a non-phonological approach to written words, which can have the beneficial side effect of improving memory encoding.

    LEARNING OUTCOMES:

    Readers will be able to: (1) describe cognitive processes involved in rhyme judgment, (2) explain how acquired hearing impairment affects phonological processing and (3) discuss how reading strategies at encoding impact memory performance.

  • 23.
    Dahlberg, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Nelson, Marie
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Abrandt Dahlgren, Madeleine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Blomberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Ten years of simulation-based shoulder dystocia training-impact on obstetric outcome, clinical management, staff confidence, and the pedagogical practice - a time series study2018In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 18, article id 361Article in journal (Refereed)
    Abstract [en]

    Background: To assess the impact of 10 years of simulation-based shoulder dystocia training on clinical outcomes, staff confidence, management, and to scrutinize the characteristics of the pedagogical practice of the simulation training. Methods: In 2008, a simulation-based team-training program (PROBE) was introduced at a medium sized delivery unit in Linkoping, Sweden. Data concerning maternal characteristics, management, and obstetric outcomes was compared between three groups; prePROBE (before PROBE was introduced, 2004-2007), early postPROBE (2008-2011) and late postPROBE (2012-2015). Staff responded to an electronic questionnaire, which included questions about self-confidence and perceived sense of security in acute obstetrical situations. Empirical data from the pedagogical practice was gathered through observational field notes of video-recordings of maternity care teams participating in simulation exercises and was further analyzed using collaborative video analysis. Results: The number of diagnosed shoulder dystocia increased from 0.9/1000 prePROBE to 1.8 and 2.5/1000 postPROBE. There were no differences in maternal characteristics between the groups. The rate of brachial plexus injuries in deliveries complicated with shoulder dystocia was 73% prePROBE compared to 17% in the late postPROBE group (p amp;gt; 0.05). The dominant maneuver to solve the shoulder dystocia changed from posterior arm extraction to internal rotation of the anterior shoulder between the pre and postPROBE groups. The staff questionnaire showed how the majority of the staff (48-62%) felt more confident when handling a shoulder dystocia after PROBE training. A model of facilitating relational reflection adopted seems to provide ways of keeping the collaboration and learning in the interprofessional team clearly focused. Conclusions: To introduce and sustain a shoulder dystocia training program for delivery staff improved clinical outcome. The impaired management and outcome of this rare, emergent and unexpectedly event might be explained by the learning effect in the debriefing model, clearly focused on the team and related to daily clinical practice.

  • 24.
    Dahlin, Emilia
    et al.
    Linköping University, Department of Clinical and Experimental Medicine.
    de Laval, Agnes
    Linköping University, Department of Clinical and Experimental Medicine.
    Par- och gruppintervention för personer med afasi och deras partner2016Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Afasi är ett samlingsbegrepp för förvärvade språkstörningar. Symptomen förekommer i högst utsträckning hos personer som drabbats av en stroke. Personer som drabbats av någon typ av afasi upplever ofta att deras kommunikativa förmåga i hög grad begränsats efter insjuknandet, vilket kan leda till stor eller mycket stor social inskränkning. De psykologiska faktorer som påverkas rör kognition och emotion, sociala strukturer och relationer, exempelvis personliga relationer, yrkesliv eller utbildning. Därmed relateras de psykosociala konsekvenserna av afasi till hur tillståndet påverkar vardagslivet och förmågan till att interagera med den sociala omgivningen. Idag sker intervention för personer med afasi individuellt och gruppintervention eller anhöriginkludering ses som sekundära komplement till den individuella behandlingen.

    I föreliggande studie undersöks en form av intervention där personer med afasi och deras anhöriga gemensamt får ta del av kommunikativa strategier och tilldelas individanpassade råd. Inspiration har hämtats från den befintliga anhöriginkluderande metoden SPPARC. Målet med interventionen var att den vardagliga kommunikationen skulle stärkas och effektiviseras. Interventionen skedde under en fem veckor lång period och utförts i två olika konstellationer; ett par och en mindre grupp. Gruppkonstellationerna har sedan jämförts med varandra. Båda koncepten utvärderades positivt av deltagarna. De förefaller därmed vara tillämpbara båda två, men beroende på deltagarnas förväntningar och psykosociala behov kan något av koncepten föredras på ett individuellt plan.

    Resultatet av föreliggande studie indikerar att det finns ett psykosocialt behov av att inkludera anhöriga till personer med afasi i intervention. En ökad medvetenhet hos deltagarna noterades gällande flera av de kommunikativa strategier som behandlades under interventionens gång, bland annat gestikulering och prompting. Deltagarnas utvärdering av perioden tyder på att interventionsperioden framför allt fungerat som ett forum för samtal kring afasi och kommunikation och att den har tjänat sitt syfte i psykosocial bemärkelse. Deltagarna uppgav dock under utvärderingen att interventionen är bäst lämpad som en tidig insats efter personen med afasis insjuknande.

  • 25.
    Danielsson, Henrik
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Linnaeus Centre HEAD.
    Pichora-Fuller, Kathleen
    University of Toronto, Department of Psychology .
    Dupuis, Kate
    Baycrest Health Sciences, Rotman Research Institute.
    Rönnberg, Jerker
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, Linnaeus Centre HEAD.
    Modeling the effect of early age-related hearing loss on cognition and participation in social leisure activities2015Conference paper (Other academic)
    Abstract [en]

    There are well-known age-related declines in hearing, cognition and social participation. Furthermore, previous studies have shown that hearing loss is associated with both cognitive decline and increased risk for social isolation and that engagement in social leisure activities is related to cognitive decline. However, it is unclear how the three concepts and age relate to each other. In the current study, behavioral measures of hearing and memory were examined in relation to self-reported participation in social leisure activities. Data from two different samples were analyzed with structural equation modeling. The first consisted of 297 adults from Umeå, Sweden, who participated in the Betula longitudinal study. The second consisted of 273 older adults who volunteered for lab-based research on aging in Toronto, Canada. Structural equation modeling yielded two models with similar statistical properties for both samples. The first model suggests that age contributes to both hearing and memory performance, hearing contributes to memory performance, and memory (but not hearing) contributes to participation in social leisure activities. The second model also suggests that age contributes to hearing and memory performance and that hearing contributes to memory performance, but that age also contributes to participation in social leisure activities, which in turn contributes to memory performance. The models were confirmed in both samples, indicating robustness in the findings, especially since the samples differed on background variables such as years of education and marital status. Few participants in both samples were candidates for hearing aids, but most of those who were candidates used them. This suggests that even early stages of hearing loss can increase demands on cognitive processing that may deter participation in social leisure activities.

  • 26.
    Dernroth, Elena
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Aldenholt, Annzofie
    En samtalsanalytisk studie av kommunikativa strategier och professionell interaktion mellan logoped-patient med afasi och arbetsterapeutpatient med afasi2012Independent thesis Basic level (university diploma), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In the present study, the institutional discourse in health care was examined, focusing onspeech therapists and occupational therapists in interaction with a common patient withaphasia. The purpose of the present study was to identify common communication strategiesused in the professional conversation between a speech therapist and a patient and between anoccupational therapist and the same patient. Specific research questions were: Whatcommunicative strategies are used in interaction between a speech therapist and a patient withaphasia and between the occupational therapist and the same patient? Are theredifferences/similarities between how speech therapists and occupational therapists interactwith patients with aphasia?Six people in total, two patients in interaction with a speech therapist and an occupationaltherapist respectively, were recorded during treatment sessions of each profession. Generaland specific aspects of the institutional interaction were then analysed according to principlesof conversation analysis.Similarities in the use of closed questions as a strategy to increase the effectiveness ininteraction could be seen between the two different professions studied. The use ofevaluations in interaction was also relatively similar between the two occupations.Some differences were identified in the ways that each profession used repetitious behavior,co-constructions and non-verbal communication. In terms of use of communication aids tosupport the patient's understanding, clear differences between the professions were observed.

  • 27.
    Dockens, Ashley L.
    et al.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
    Bellon-Harn, Monica L.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
    Burns, Erin S.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
    Manchaiah, Vinaya K. C.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA; Audiology India, Mysore, Karnataka, India.
    Hinojosa, Orlando
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
    Examination of an Audiologists Response to Patients Expression of Symptoms: A Pilot Study2017In: Journal of audiology and otology, ISSN 2384-1621, Vol. 21, no 2, p. 115-119Article in journal (Refereed)
    Abstract [en]

    This pilot study explores audiologist-patient interactions during initial evaluations or consultations. In particular, an audiologist’s response to patient symptoms is examined. Conversations between audiologist and patients were recorded using a digital recorder, which were transcribed, and analyzed using the Codes for Human Analysis of Transcripts and Child Language Analysis computer programs. Mean length of turn and frequency of utterances related to explicit discussion or description of symptoms or the patient’s interpretation of symptoms was determined. Study sample: six audiologist-patient interactions were recorded and transcribed. A single audiologist was used for this pilot investigation. Results suggest that during the initial audiological consultations related to hearing difficulties the audiologist produced more utterances related to explicit description of the symptoms, whereas when during the sessions about complex disorder and hearing aid consultation the audiologist produced more utterances related to the patient’s interpretation of the symptoms. Also, a more equitable distribution of words and utterances per turn are observed during the initial consultation about hearing difficulties when compared to complex disorders and hearing aid consultation sessions where the audiologist was dominant within the interaction. This preliminary study reveals unique insights to audiologist’s communication behavior during audiology consultation session. Efforts are needed to educate and promote appropriate communication between audiologists’ and patients, which could result in increased patient satisfaction.

  • 28.
    Eckard, Nathalie
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    The matter of economic evaluations in health policy decision-making: The case of the Swedish national guidelines for heart diseases2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Economic evaluations are used to inform decision makers about the efficient allocation of scarce healthcare resources and are generated with the direct intent to support decisions in healthcare. Producing guidelines is a complex process and the inclusion of health-economic aspects in the formulation of the Swedish national guidelines as a basis for the written recommendations (priority gradings), distinguishes them from their European counterparts. Despite the increased use of cost-effectiveness data in decision-making, little is known about the actual use of such data. This thesis covers issues concerning how economic evaluations matter in health policy decision-making. The thesis includes four papers based on the Swedish national guidelines for heart diseases, one of the most prominent examples in Sweden of following the notion of evidence-based policy (EBP), in order to inform explicit priority setting.

    Both Papers I and II followed a qualitative case study design, based on the same data set. Paper I explored how a specific working group, the Priority Setting Group (PSG), handled the various forms of evidence and values when producing the national guidelines. Two themes were identified in reaching collective agreement in priority gradings; group facilitation activities and avoiding deadlock in the discussion. The work process involved disagreement and negotiation as part of that task. Paper I contributes to the theoretical and practical debate on EBP. Paper II focused on the use of cost-effectiveness data as decision support in the PSG work process. The paper addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. Three themes were identified. The paper contributes to knowledge on how cost-effectiveness evidence was used in actual decision-making. The use of cost-effectiveness evidence was one of many tools employed to avoid deadlock in discussion and to reach a priority grading, when the overall evidence base was weak, in times of uncertainty and on the introduction of new expensive medical technologies.

    Quantitative research methods were used for both Papers III and IV. Paper III explored how the PSG was presented with cost-effectiveness evidence as decision support and as a basis for their priority gradings. Cost-effectiveness ratios (ICERs) were provided, based on a  systematic literature review, as well as how the results may be conveyed and communicated, for the treatment of heart diseases using a cost-effectiveness ranking or league and providing valid information within a limited space, aiding decision makers on the allocation of healthcare resources. The thesis also includes decision support in the form of cost-effectiveness analysis on catheter ablation treatment. Paper IV provides an example of presenting evidence in the form of a decision-analytic model. The modelling approach provides an analytic framework for decision-making, specifically under conditions of uncertainty as in the introduction of new medical technology. Catheter ablation was associated with reduced cost and an incremental gain in quality adjusted life years (QALYs), and was considered a cost-effective treatment strategy compared to the medical treatment strategy in a lifetime perspective.

    List of papers
    1. Reaching agreement in uncertain circumstances: the practice of evidence-based policy in the case of the Swedish National Guidelines for heart diseases
    Open this publication in new window or tab >>Reaching agreement in uncertain circumstances: the practice of evidence-based policy in the case of the Swedish National Guidelines for heart diseases
    2017 (English)In: Evidence and Policy: A Journal of Research, Debate and Practice, ISSN 1744-2648, no 4, p. 687-707Article in journal (Refereed) Published
    Abstract [en]

    This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that are based on both clinical and economic evidence and are established to support explicit priority-setting in healthcare. The study contributes to the theoretical and practical debate on evidence-based policy (EBP) by illustrating how the practical tensions of coming to agreement were managed, to a large extent, through deliberation and by creativity.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2017
    Keywords
    cost-effectiveness; evidence-based policy; healthcare; national guidelines; priority setting; sense-making
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy Other Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-121280 (URN)10.1332/174426416X14788795557982 (DOI)000417405400007 ()
    Available from: 2015-09-11 Created: 2015-09-11 Last updated: 2017-12-29Bibliographically approved
    2. Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden
    Open this publication in new window or tab >>Use of cost-effectiveness data in priority setting decisions: experiences from the national guidelines for heart diseases in Sweden
    2014 (English)In: International Journal of Health Policy and Management, ISSN 2322-5939, E-ISSN 2322-5939, Vol. 3, no 6, p. 323-332Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: The inclusion of cost-effectiveness data, as a basis for priority setting rankings, is a distinguishing feature in the formulation of the Swedish national guidelines. Guidelines are generated with the direct intent to influence health policy and support decisions about the efficient allocation of scarce healthcare resources. Certain medical conditions may be given higher priority rankings i.e. given more resources than others, depending on how serious the medical condition is. This study investigated how a decision-making group, the Priority Setting Group (PSG), used cost-effectiveness data in ranking priority setting decisions in the national guidelines for heart diseases.

    METHODS: A qualitative case study methodology was used to explore the use of such data in ranking priority setting healthcare decisions. The study addressed availability of cost-effectiveness data, evidence understanding, interpretation difficulties, and the reliance on evidence. We were also interested in the explicit use of data in ranking decisions, especially in situations where economic arguments impacted the reasoning behind the decisions.

    RESULTS: This study showed that cost-effectiveness data was an important and integrated part of the decision-making process. Involvement of a health economist and reliance on the data facilitated the use of cost-effectiveness data. Economic arguments were used both as a fine-tuning instrument and a counterweight for dichotomization. Cost-effectiveness data were used when the overall evidence base was weak and the decision-makers had trouble making decisions due to lack of clinical evidence and in times of uncertainty. Cost-effectiveness data were also used for decisions on the introduction of new expensive medical technologies.

    CONCLUSION: Cost-effectiveness data matters in decision-making processes and the results of this study could be applicable to other jurisdictions where health economics is implemented in decision-making. This study contributes to knowledge on how cost-effectiveness data is used in actual decision-making, to ensure that the decisions are offered on equal terms and that patients receive medical care according their needs in order achieve maximum benefit.

    Place, publisher, year, edition, pages
    Kerman University of Medical Sciences, 2014
    Keywords
    Health Policy, Cost-Effectiveness, Policy Decision-Making, Priority Setting, Heart Diseases
    National Category
    Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-112150 (URN)10.15171/ijhpm.2014.105 (DOI)25396208 (PubMedID)
    Available from: 2014-11-17 Created: 2014-11-17 Last updated: 2017-12-05Bibliographically approved
    3. Compilation of cost-effectiveness evidence for different heart conditions and treatment strategies
    Open this publication in new window or tab >>Compilation of cost-effectiveness evidence for different heart conditions and treatment strategies
    2011 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 45, no 2, p. 72-76Article, review/survey (Refereed) Published
    Abstract [en]

    Objectives. Despite the continuing interest in health economic research, we could find no accessible data set on cost-effectiveness, useful as practical information to decision makers who must allocate scarce resources within the cardiovascular field. The aim of this paper was to present cost-effectiveness ratios, based on a systematic literature search for the treatment of heart diseases. Design. A comprehensive literature search on cost-effectiveness analyses of intervention strategies for the treatment of heart diseases was conducted. We compiled available cost-effectiveness ratios for different heart conditions and treatment strategies, in a cost-effectiveness ranking table. The cost-effectiveness ratios were expressed as a cost per quality adjusted life year (QALY) or life year gained. Results. Cost-effectiveness ratios, ranging from dominant to those costing more than 1,000,000 Euros per QALY gained, and bibliographic references are provided for. The table was categorized according to disease group, making the ranking table readily available. Conclusions. Cost-effectiveness ranking tables provide a means of presenting cost-effectiveness evidence. They provide valid information within a limited space aiding decision makers on the allocation of health care resources. This paper represents an extensive compilation of health economic evidence for the treatment of heart diseases.

    Place, publisher, year, edition, pages
    Informa Healthcare, 2011
    Keywords
    Cost, cost-effectiveness, rankings, heart disease, priority setting, evidence-based medicine
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-67153 (URN)10.3109/14017431.2011.557438 (DOI)000288326200002 ()
    Note
    Original Publication: Nathalie Eckard, Magnus Janzon and Lars-Åke Levin, Compilation of cost-effectiveness evidence for different heart conditions and treatment strategies, 2011, Scandinavian Cardiovascular Journal, (45), 2, 72-76. http://dx.doi.org/10.3109/14017431.2011.557438 Copyright: Informa Healthcare http://informahealthcare.com/ Available from: 2011-04-01 Created: 2011-04-01 Last updated: 2017-12-11
    4. Cost-Effectiveness of Catheter Ablation Treatment for Patients with Symptomatic Atrial Fibrillation
    Open this publication in new window or tab >>Cost-Effectiveness of Catheter Ablation Treatment for Patients with Symptomatic Atrial Fibrillation
    2009 (English)In: Journal of Atrial Fibrillation, ISSN 1941-6911, Vol. 1, no 8, p. 461-470Article in journal (Refereed) Published
    Abstract [en]

    Background:  Atrial Fibrillation is the most common cardiac arrhythmia.  It increases the risk of thromboembolic events and many atrial fibrillation patients suffer quality of life impairment due to disturbed heart rhythm.  Pulmonary vein isolation using radiofrequency catheter ablation treatment is aimed at maintaining sinus rhythm ultimately improving quality of life.  Randomized clinical trial have shown that catheter ablation is more effective than antiarrhythmic drugs for the treatment of atrial fibrillation, but its impact on quality of life and cost-effectiveness has not been widely studied.  Aims:  To assess the cost-effectiveness of radiofrequency ablation (RFA) vs. antiarrhythmic drug (AAD) treatment, among symptomatic atrial fibrillation patients not previously responding to AAD.  Methods:  A decision-analytic Markov model was developed to assess costs and health outcomes in terms of quality adjusted life years (QALYs) of RFA and AAD over a lifetime time horizon.  We conducted a literature search and used data from several sources as input variables of the model.  One-year rates of atrial fibrillation with RFA and AAD, respectively, were available from published randomized clinical trials.  Other data sources were published papers and register data.  Results:  The RFA treatment strategy was associated with reduced costs and an incremental gain in QALYs compared to the AAD treatment strategy.  The results were sensitive to whether long-term quality of life improvement is maintained for the RFA treatment strategy and the risk of stroke in the different atrial fibrillation health states.  Conclusion:  This study shows that the short-term improvement in atrial fibrillation associated with RFA is likely to lead to long-term quality of life improvement and lower costs indicating that RFA is cost-effective compared to AAD. 

    Keywords
    Cost, cost-effectiveness, decision-analytic model, ablation, atrial fibrillation, cardiovascular disease
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-20923 (URN)10.4022/jafib.v1i8.543 (DOI)
    Available from: 2009-09-25 Created: 2009-09-25 Last updated: 2015-09-11
  • 29.
    Eckard, Nathalie
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Nedlund, Ann-Charlotte
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Janzon, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Levin, Lars-Åke
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Reaching agreement in uncertain circumstances: the practice of evidence-based policy in the case of the Swedish National Guidelines for heart diseases2017In: Evidence and Policy: A Journal of Research, Debate and Practice, ISSN 1744-2648, no 4, p. 687-707Article in journal (Refereed)
    Abstract [en]

    This paper explores the practice of evidence-based policy in a Swedish healthcare context. The study focused on how policymakers in the specific working group, the Priority-Setting Group (PSG), handled the various forms of evidence and values and their competing rationalities, when producing the Swedish National Guidelines for heart diseases that are based on both clinical and economic evidence and are established to support explicit priority-setting in healthcare. The study contributes to the theoretical and practical debate on evidence-based policy (EBP) by illustrating how the practical tensions of coming to agreement were managed, to a large extent, through deliberation and by creativity.

  • 30.
    Eliasson, Ann-Christin
    et al.
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Ullenhag, Anna
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Wahlström, Ulla
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Habilitation.
    Krumlinde-Sundholm, Lena
    Department of Womens and Childrens Health, Karolinska Institutet, Stockholm, Sweden.
    Mini-MACS: development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy2017In: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 59, no 1, p. 72-78Article in journal (Refereed)
    Abstract [en]

    To develop the Mini-Manual Ability Classification System (Mini-MACS) and to evaluate the extent to which its ratings are valid and reliable when children younger than 4 years are rated by their parents and therapists.

  • 31.
    Elisabet, Sundewall Thorén
    et al.
    Eriksholm Reserach Centre, Denmark.
    Öberg, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Wänström, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Eriksholm Research Centre, Denmark.
    Rehabiliteringsprogram för vuxna hörapparatanvändare2012Conference paper (Other academic)
  • 32.
    Fagerlind Ståhl, Anna-Carin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Gustavsson, Maria
    Linköping University, Department of Behavioural Sciences and Learning, Education and Sociology. Linköping University, Faculty of Arts and Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Karlsson, Nadine
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Johansson, Gun
    Karolinska Institutet, Stockholm, Sweden.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Lean production tools and decision latitude enable conditions for innovative learning in organizations: a multilevel analysis2015In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 47, p. 285-291Article in journal (Refereed)
    Abstract [en]

    The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations.

  • 33.
    Fagher, Kristina
    et al.
    Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden.
    Jacobsson, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Dahlström, Örjan
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Timpka, Toomas
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Department of Health and Care Development.
    Lexell, Jan
    Rehabilitation Medicine Research Group, Department of Health Sciences, Lund University, Lund, Sweden; Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden; Department of Health Science, Luleå University of Technology, Luleå, Sweden.
    An eHealth Application of Self-Reported Sports-Related Injuries and Illnesses in Paralympic Sport: Pilot Feasibility and Usability Study2017In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 4, no 4, article id e30Article in journal (Refereed)
    Abstract [en]

    Sport participation is associated with a risk of sports-related injuries and illnesses, and Paralympic athletes additional medical issues can be a challenge to health care providers and medical staff. However, few prospective studies have assessed sports-related injuries and illnesses in Paralympic sport (SRIIPS) over time. Advances in mobile phone technology and networking systems offer novel opportunities to develop innovative eHealth applications for collection of athletes self-reports. Using eHealth applications for collection of self-reported SRIIPS is an unexplored area, and before initiation of full-scale research of SRIIPS, the feasibility and usability of such an approach needs to be ascertained.

  • 34.
    Finke, Mareike
    et al.
    Hannover Medical Sch, Germany; Cluster Excellence Hearing4all, Germany; Cluster Excellence Hearing4all, Germany.
    Boenitz, Hanna
    Hannover Medical Sch, Germany.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping. Linköping University, The Swedish Institute for Disability Research.
    Illg, Angelika
    Hannover Medical Sch, Germany.
    Cochlear implant effectiveness in postlingual single-sided deaf individuals: whats the point?2017In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 6, p. 417-423Article in journal (Refereed)
    Abstract [en]

    Objectives: By extending the indication criteria for cochlear implants (CI), the population of CI candidates increased in age, as well as range and type of hearing loss. This qualitative study identified factors that contributed to seek CI treatment in single-sided deaf individuals and gained insights how single-sided deafness (SSD) and hearing with a CI affect their lives. Design: An open-ended questionnaire and a standardised inventory (IOI-HA) were used. Qualitative data reflecting the reasons to seek CI treatment and the individual experiences after CI switch-on were collected. Study sample: A total of 19 postlingually deafened single-sided deaf CI users. Results: Participants use their CI daily and stated that their life satisfaction increased since CI activation. The analysis of the qualitative data revealed four core categories: sound localisation, tinnitus and noise sensitivity, fear to lose the second ear and quality of life. Conclusions: Our results show how strongly and diversely quality of hearing and quality of life is affected by acquired SSD and improved after CI activation. Our data suggest that the fear of hearing loss (HL) on the normal hearing (NH) ear is an important but so far neglected reason to seek treatment with a CI in individuals with postlingual SSD.

  • 35.
    Fletcher, Paul
    et al.
    University College Cork, Ireland.
    Ball, MartinLinköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.Crystal, DavidUniversity of Bangor, UK.
    Profiling grammar: more languages of LARSP2016Collection (editor) (Other academic)
    Abstract [en]

    This book brings together twelve previously unpublished language profiles based on the original Language Assessment, Remediation and Screening Procedure (LARSP). The languages featured are: Afrikaans, Bulgarian, Cantonese, Finnish, Greek, Hindi, Hungarian, Japanese, Kannada, Korean, Malay and Swedish. Each chapter includes a grammatical sketch of the language, details of typical language development in speakers of the language, as well as a description of and justification for the profile itself. The book will be an invaluable resource for speech-language pathologists and others wishing to analyse the grammatical abilities of individuals speaking one of these languages. This new collection complements a previous book in this series on the same theme: Assessing Grammar: The Languages of LARSP (Ball et al., 2012,).

  • 36.
    Folkmarson Käll, Lisa
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Dimensions of Pain: Humanities and Social Science Perspectives2013Collection (editor) (Other academic)
    Abstract [en]

    Pain research is still dominated by biomedical perspectives and the need to articulate pain in ways other than those offered by evidence based medical models is pressing. Examining closely subjective experiences of pain, this book explores the way in which pain is situated, communicated and formed in a larger cultural and social context.

    Dimensions of Pain

    explores the lived experience of pain, and questions of identity and pain, from a range of different disciplinary perspectives within the humanities and social sciences. Discussing the acuity and temporality of pain, its isolating impact, the embodied expression of pain, pain and sexuality, gender and ethnicity, it also includes a cluster of three chapters discusses the phenomenon and experience of labour pains.

    This volume revitalizes the study of pain, offering productive ways of carefully thinking through its different aspects and exploring the positive and enriching side of world-forming pain as well as its limiting aspects. It will be of interest to academics and students interested in pain from a range of backgrounds, including philosophy, sociology, nursing, midwifery, medicine and gender studies.

  • 37.
    Gabrielsson, Erik
    et al.
    Linköping University, Department of Science and Technology, Physics and Electronics. Linköping University, Faculty of Science & Engineering.
    Simon, Daniel
    Linköping University, Department of Science and Technology, Physics and Electronics. Linköping University, Faculty of Science & Engineering.
    Berggren, Magnus
    Linköping University, Department of Science and Technology, Physics and Electronics. Linköping University, Faculty of Science & Engineering.
    Biocompatible Circuits for Human–Machine Interfacing2017In: Green Materials for Electronics / [ed] Mihai Irimia-Vladu, Eric D. Głowacki, Niyazi Sariciftci, Siegfried Bauer, Wiley-VCH Verlagsgesellschaft, 2017, p. 91-118Chapter in book (Other academic)
    Abstract [en]

    Conventional electronic devices have evolved from the first transistors introduced in the 1940s to integrated circuits and today's modern (CMOS) computer chips fabricated on silicon wafers using photolithography. This chapter reviews such iontronic devices for signal translation and their application in bioelectronics. It begins with a brief description of the ion transport mechanisms that lay the conceptual groundwork for this type of iontronic devices. The chapter presents various iontronic devices aimed at bioelectronic applications. It outlines the future possible developments of iontronics for human-machine interfacing. The physical interface between electronic devices and biological tissues is of particular interest, as this interface bridges the gap between artificial, humanmade technologies and biological "circuits". Ion-conducting diodes and transistors can be used to build circuits for modulation of ion flow, with the possibility of mimicking the dynamic and nonlinear processes occurring in the body.

  • 38.
    Germundsson, Per
    et al.
    Malmo Univ, Sweden.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Ratinaud, Pierre
    Univ Toulouse, France.
    Tympas, Aristotle
    Univ Athens, Greece.
    Danermark, Berth
    Orebro Univ, Sweden.
    Patterns in the social representation of "hearing loss" across countries: how do demographic factors influence this representation?2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 12, p. 925-932Article in journal (Refereed)
    Abstract [en]

    This study aims to understand patterns in the social representation of hearing loss reported by adults across different countries and explore the impact of different demographic factors on response patterns. The study used a cross-sectional survey design. Data were collected using a free association task and analysed using qualitative content analysis, cluster analysis and chi-square analysis. The study sample included 404 adults (18 years and over) in the general population from four countries (India, Iran, Portugal and UK). The cluster analysis included 380 responses out of 404 (94.06%) and resulted in five clusters. The clusters were named: (1) individual aspects; (2) aetiology; (3) the surrounding society; (4) limitations and (5) exposed. Various demographic factors (age, occupation type, education and country) showed an association with different clusters, although country of origin seemed to be associated with most clusters. The study results suggest that how hearing loss is represented in adults in general population varies and is mainly related to country of origin. These findings strengthen the argument about cross-cultural differences in perception of hearing loss, which calls for a need to make necessary accommodations while developing public health strategies about hearing loss.

  • 39.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Carlton, Australia.
    Patient-centred audiological rehabilitation: Perspectives of older adults who own hearing aids2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S68-S75Article in journal (Refereed)
    Abstract [en]

    Objective: Patient-centred care is a term frequently associated with quality health care. Despite extensive literature from a range of health-care professions that provide description and measurement of patient-centred care, a definition of patient-centredness in audiological rehabilitation is lacking. The current study aimed to define patient-centred care specific to audiological rehabilitation from the perspective of older adults who have owned hearing aids for at least one year. Design: Research interviews were conducted with a purposive sample of older adults concerning their perceptions of patient-centredness in audiological rehabilitation, and qualitative content analysis was undertaken. Study sample: The participant sample included ten adults over the age of 60 years who had owned hearing aids for at least one year. Results: Data analysis revealed three dimensions to patient-centred audiological rehabilitation: the therapeutic relationship, the players (audiologist and patient), and clinical processes. Individualised care was seen as an overarching theme linking each of these dimensions. Conclusions: This study reported two models: the first model describes what older adults with hearing aids believe constitutes patient-centred audiological rehabilitation. The second provides a guide to operationalised patient-centred care. Further research is required to address questions pertaining to the presence, nature, and impact of patient-centred audiological rehabilitation.

  • 40.
    Grenness, Caitlin
    et al.
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Hickson, Louise
    HEARing Cooperative Research Centre, Melbourne, Australia.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Eriksholm Research Centre, Snekkersten, Denmark.
    Davidson, Bronwyn
    University of Melbourne, Australia.
    Patient-centred care: A review for rehabilitative audiologists2014In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 53, no S1, p. S60-S67Article in journal (Refereed)
    Abstract [en]

    Objective: This discussion paper aims to synthesise the literature on patient-centred care from a range of health professions and to relate this to the field of rehabilitative audiology. Through review of the literature, this paper addresses five questions: What is patient-centred care? How is patient-centred care measured? What are the outcomes of patient-centred care? What are the factors contributing to patient-centred care? What are the implications for audiological rehabilitation? Design: Literature review and synthesis. Study sample: Publications were identified by structured searches in PubMed, Cinahl, Web of Knowledge, and PsychInfo, and by inspecting the reference lists of relevant articles. Results: Few publications from within the audiology profession address this topic and consequently a review and synthesis of literature from other areas of health were used to answer the proposed questions. Conclusion: This paper concludes that patient-centred care is in line with the aims and scope of practice for audiological rehabilitation. However, there is emerging evidence that we still need to inform the conceptualisation of patient-centred audiological rehabilitation. A definition of patient-centred audiological rehabilitation is needed to facilitate studies into the nature and outcomes of it in audiological rehabilitation practice.

  • 41.
    Gärskog, Malin
    et al.
    Linköping University, Department of Clinical and Experimental Medicine.
    Hedström, Ingrid
    Linköping University, Department of Clinical and Experimental Medicine.
    Ordflödesförmåga och analogiskt resonerande hos barn med cochleaimplantat i jämförelse med normalhörande barn2018Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Previous studies have shown that children with cochlear implant (CI) have worse word fluency abilities and analogical reasoning abilities compared to normal-hearing children. There is a relationship between language and analogical reasoning. However, a possible relationship between word fluency and analogical reasoning has not been studied before among children with CI or among normal-hearing children. This warrants the present study, which aimed to examine if there are differences between children with CI and normal-hearing children regarding word fluency and analogical reasoning. The study also aimed to examine the relationship between word fluency and analogical reasoning in children with CI and normal-hearing children. The present study involved nine children with CI aged 6;4–8;2 years and thirty normal-hearing children aged 6;1–7;1 years. Word fluency was examined using the phonological word fluency test FAS and the semantic word fluency test Animal. Visual analogical reasoning was examined using AnimaLogica and verbal analogical reasoning using Spoken Analogies from Illinois Test of Psycholinguistic Abilities-3 (ITPA-3). The results of the present study show that the children with CI had poorer word fluency ability and analogical reasoning compared to the normal-hearing children. A relationship between semantic word fluency and verbal analogical reasoning in normal-hearing children was found, with the children with CI showing the same trend. Word fluency ability and analogical reasoning and their relationship has a clinical relevance for speech-language pathologists since this must be considered when investigating and treating language difficulties in children with CI as well as normal-hearing children.

  • 42.
    Hall, Deborah A.
    et al.
    Natl Inst Hlth Res NIHR, England; Univ Nottingham, England.
    Domingo, Silvia Zaragoza
    Neuropsychol Res Org, Spain.
    Hamdache, Leila Z.
    Carlton Acad, England.
    Manchaiah, Vinaya
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Lamar State Univ, TX USA; Manipal Univ, India; All India Inst Speech and Hearing, India.
    Thammaiah, Spoorthi
    All India Inst Speech and Hearing, India.
    Evans, Chris
    Univ Roehampton, England.
    Wong, Lena L. N.
    Univ Hong Kong, Peoples R China.
    A good practice guide for translating and adapting hearing-related questionnaires for different languages and cultures2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 3, p. 161-175Article, review/survey (Refereed)
    Abstract [en]

    Objectives: To raise awareness and propose a good practice guide for translating and adapting any hearing-related questionnaire to be used for comparisons across populations divided by language or culture, and to encourage investigators to publish detailed steps. Design: From a synthesis of existing guidelines, we propose important considerations for getting started, followed by six early steps: (1) Preparation, (2, 3) Translation steps, (4) Committee Review, (5) Field testing and (6) Reviewing and finalising the translation. Study sample: Not applicable. Results: Across these six steps, 22 different items are specified for creating a questionnaire that promotes equivalence to the original by accounting for any cultural differences. Published examples illustrate how these steps have been implemented and reported, with shared experiences from the authors, members of the International Collegium of Rehabilitative Audiology and TINnitus research NETwork. Conclusions: A checklist of the preferred reporting items is included to help researchers and clinicians make informed choices about conducting or omitting any items. We also recommend using the checklist to document these decisions in any resulting report or publication. Following this step-by-step guide would promote quality assurance in multinational trials and outcome evaluations but, to confirm functional equivalence, large-scale evaluation of psychometric properties should follow.

  • 43.
    Hengen, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Lundeborg Hammarström, Inger
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences.
    Stenfelt, Stefan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, The Swedish Institute for Disability Research.
    Perceived Voice Quality and Voice-Related Problems Among Older Adults With Hearing Impairments2018In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 61, no 9, p. 2168-2178Article in journal (Refereed)
    Abstract [en]

    The auditory system helps regulate phonation. A speakers perception of their own voice is likely to be of both emotional and functional significance. Although many investigations have observed deviating voice qualities in individuals who are prelingually deaf or profoundly hearing impaired, less is known regarding how older adults with acquired hearing impairments perceive their own voice and potential voice problems. Purpose: The purpose of this study was to investigate problems relating to phonation and self-perceived voice sound quality in older adults based on hearing ability and the use of hearing aids. Method: This was a cross-sectional study, with 290 participants divided into 3 groups (matched by age and gender): (a) individuals with hearing impairments who did not use hearing aids (n = 110), (b) individuals with hearing impairments who did use hearing aids (n = 110), and (c) individuals with no hearing impairments (n = 70). All participants underwent a pure-tone audiometry exam; completed standardized questionnaires regarding their hearing, voice, and general health; and were recorded speaking in a soundproof room. Results: The hearing aid users surpassed the benchmarks for having a voice disorder on the Voice Handicap Index (VHI; Jacobson et al., 1997) at almost double the rate predicted by the Swedish normative values for their age range, although there was no significant difference in acoustical measures between any of the groups. Both groups with hearing impairments scored significantly higher on the VHI than the control group, indicating more impairment. It remains inconclusive how much hearing loss versus hearing aids separately contribute to the difference in voice problems. The total scores on the Hearing Handicap Inventory for the Elderly (Ventry amp; Weinstein, 1982), in combination with the variables gender and age, explained 21.9% of the variance on the VHI. Perceiving ones own voice as being distorted, dull, or hollow had a strong negative association with a general satisfaction about the sound quality of ones own voice. In addition, groupwise differences in own-voice descriptions suggest that a negative perception of ones voice could be influenced by alterations caused by hearing aid processing. Conclusions: The results indicate that hearing impairments and hearing aids affect several aspects of vocal satisfaction in older adults. A greater understanding of how hearing impairments and hearing aids relate to voice problems may contribute to better voice and hearing care.

  • 44.
    Hickson, Louise
    et al.
    University of Queensland, Brisbane, Australia.
    Laplante-Lévesque, Ariane
    University of Queensland, Brisbane, Australia.
    Wong, Lena
    University of Hong Kong, Pokfulam.
    Evidence-based practice in audiology: rehabilitation options for adults with hearing impairment2013In: American Journal of Audiology, ISSN 1059-0889, E-ISSN 1558-9137, Vol. 22, p. 329-331Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Three questions are addressed: 1) What is Evidence-Based Practice (EBP) and why is it important for adults with hearing impairment? 2) What is the evidence about intervention options for adults who fail a hearing screening and are identified with hearing impairment? 3) What intervention options do adults choose when identified with hearing impairment for the first time?

    METHODS:

    The five steps of the EBP process are discussed in relation to a clinical question about whether hearing aids and communication programs reduce activity limitations and participation restrictions compared to no treatment for adults who fail a hearing screening and are identified with hearing impairment.

    RESULTS:

    Systematic reviews of the evidence indicate that both hearing aids and communication programs reduce activity limitations and participation restrictions for this population and are therefore appropriate options. A study is then described in which these options were presented to 153 clients identified with hearing impairment for the first time: 43% chose hearing aids, 18% chose communication programs and the remaining 39% chose not to take any action.

    CONCLUSIONS:

    EBP supports the offer of intervention options to adults who fail a hearing screening and are identified with hearing impairment.

  • 45.
    Håkan, Hua
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Johansson, Björn
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Magnusson, Lennart
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ellis, Rachel J.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Speech Recognition and Cognitive Skills in Bimodal Cochlear Implant Users2017In: Journal of Speech, Language and Hearing Research, ISSN 1092-4388, E-ISSN 1558-9102, Vol. 60, no 9, p. 2752-2763Article in journal (Refereed)
    Abstract [en]

    Purpose: To examine the relation between speech recognition and cognitive skills in bimodal cochlear implant (CI) and hearing aid users.

    Method: Seventeen bimodal CI users (28-74 years) were recruited to the study. Speech recognition tests were carried out in quiet and in noise. The cognitive tests employed included the Reading Span Test and the Trail Making Test (Daneman & Carpenter, 1980; Reitan, 1958, 1992), measuring working memory capacity and processing speed and executive functioning, respectively. Data were analyzed using paired-sample t tests, Pearson correlations, and partial correlations controlling for age.

    Results: The results indicate that performance on some cognitive tests predicts speech recognition and that bimodal listening generates a significant improvement in speech in quiet compared to unilateral CI listening. However, the current results also suggest that bimodal listening requires different cognitive skills than does unimodal CI listening. This is likely to relate to the relative difficulty of having to integrate 2 different signals and then map the integrated signal to representations stored in the long-term memory.

    Conclusions: Even though participants obtained speech recognition benefit from bimodal listening, the results suggest that processing bimodal stimuli involves different cognitive skills than does unimodal conditions in quiet. Thus, clinically, it is important to consider this when assessing treatment outcomes.

  • 46.
    Ingadóttir, Brynja
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Learning as a patient: What and how individuals want to learn when preparing for surgery, and the potential use of serious games in their education2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Surgical patients need knowledge to participate in their own care and to engage in self-care behaviour in the perioperative period which is important for their recovery. Patient education facilitates such knowledge acquisition and several methods can be used to facilitate it, for example, face-to-face education and brochures or using information technology such as website or computer games. Healthcare professionals have been slow to seize the possibilities that information technology has to offer within the field, including the use of serious games. To optimise patient education, the information is needed on the patients’ needs and preferences and what they think about the idea of using a serious game to learn about self-care.

    Aim: The overall aims of this thesis were to describe the knowledge expectations of surgical patients, to describe how surgical patients want to learn, and to explore the potential use of serious games in patient education.

    Methods: This thesis includes four studies that used both quantitative and qualitative data to describe aspects of patient learning in relation to surgery. Study I has a prospective and comparative design with survey data collected before surgery and before hospital discharge from 290 patients with osteoarthritis undergoing knee arthroplasty. Data was collected on fulfilment of knowledge expectations and related factors. Study II is a cross-­‐sectional study in 104 patients with heart failure who had been scheduled for cardiac resynchronisation therapy (CRT) device implantation. Data was collected on knowledge expectations and related factors. In Study III the perceptions of 13 surgical patients towards novel and traditional methods to learn about post-operative pain management are explored in a qualitative interview study using content analysis. Study IV describes the development and evaluation of a serious game to learn about pain management with the participation of 20 persons recruited from the public. The game was developed by an interdisciplinary team following a structured approach. Data on the efficacy and usability of the game was collected in one session with questionnaires, observations and interviews.

    Results: Participants reported high knowledge expectations. Knowledge expectations were highest within the bio-physiological knowledge dimension on disease, treatment and complications and the functional dimension on how daily activities are affected, both of which include items on self-care. Most participants wanted to know about the possible complications related to the surgery procedure. In none of the knowledge dimensions the expectations of participants were fulfilled. Participants received most knowledge on the physical and functional issues and received least on the financial and social aspects of their illness. The main predictor of fulfilment of knowledge expectations was having access to knowledge in the hospital from doctors and nurses. Trust in the information source and own motivation to learn shaped how the participants thought about different learning methods. Although the participants were open to using novel learning methods such as websites or games they were also doubtful about their use and called for advice by healthcare professionals. To develop a serious game with the goal to learn about pain management, theories of self-care and adult learning, evidence on the educational needs of patients about pain management and principles of gamification were found useful. The game character is a surgical patient just discharged home from hospital who needs to attend to daily activities while simultaneously managing post-operative pain with different strategies. Participants who evaluated a first version of the serious game improved their knowledge and described usability of the game as high. They were positive towards this new learning method and found it suitable for learning about pain management after surgery in spite of some technical obstacles.

    Conclusions: Surgical patients have high knowledge expectations about all aspects of their upcoming surgery and although they prefer direct communication with healthcare professionals as a source for knowledge they might be open to try using more novel methods such as games. Preliminary short-­‐term results demonstrate that a serious game can help individuals to learn about pain management, and has the potential to improve knowledge. A careful introduction, recommendation, and support from healthcare professionals is needed for implementation of such a novel method in patient education.

    List of papers
    1. The fulfilment of knowledge expectations during the perioperative period of patients undergoing knee arthroplasty - a Nordic perspective
    Open this publication in new window or tab >>The fulfilment of knowledge expectations during the perioperative period of patients undergoing knee arthroplasty - a Nordic perspective
    Show others...
    2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 19-20, p. 2896-2908Article in journal (Refereed) Published
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the possible differences between knowledge expectations and received knowledge of patients undergoing elective knee arthroplasty in Iceland, Sweden and Finland and also to determine the relationship between such a difference and both background factors and patient satisfaction with care.

    BACKGROUND: Knee arthroplasty is a fast-growing and a successful treatment for patients with osteoarthritis. Patient education can improve surgery outcomes, but it remains unknown what knowledge patients expect to receive and actually acquire during the perioperative period and what factors are related to that experience.

    DESIGN: Descriptive, prospective survey.

    METHODS: In total, 290 patients answered questionnaires about their expectations (Knowledge Expectations of hospital patients - scale) before surgery and about received knowledge (Received Knowledge of hospital patients - scale) and satisfaction with hospital care (Patient Satisfaction Scale) at discharge. Sociodemographics, clinical information, accessibility to knowledge from healthcare providers (Access to Knowledge Scale), and preferences for information and behavioural control (Krantz Health Opinion Survey) were collected as background data.

    RESULTS: Patients` knowledge expectations were higher (mean 3·6, SD 0·4) than their perception of received knowledge (mean 3·0, SD 0·7). Multiple linear regression analysis showed that access to knowledge, information preferences and work experience within health- or social care explained 33% (R²) of the variation in the difference between received and expected knowledge. Patients reported high satisfaction with their care except regarding how their family was involved.

    CONCLUSION: Patients undergoing knee arthroplasty receive less knowledge than they expect, and individual factors and communication with healthcare providers during hospitalisation are related to their experience. The content of patient education and family involvement should be considered in future care.

    RELEVANCE TO CLINICAL PRACTICE: The results strengthen the knowledge base on the educational needs of knee arthroplasty patients and can be used to develop and test new interventions.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2014
    Keywords
    Knee arthroplasty, osteoarthritis, patient education, patient expectations, patient satisfaction, surgery
    National Category
    Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-105225 (URN)10.1111/jocn.12552 (DOI)000343857700020 ()24476393 (PubMedID)
    Projects
    EEPO
    Available from: 2014-03-13 Created: 2014-03-13 Last updated: 2017-12-05Bibliographically approved
    2. Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation
    Open this publication in new window or tab >>Knowledge expectations, self-care, and health complaints of heart failure patients scheduled for cardiac resynchronization therapy implantation
    2015 (English)In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 9, p. 913-921Article in journal (Refereed) Published
    Abstract [en]

    Purpose: To describe what knowledge heart failure patients expect to acquire in relation to their upcoming cardiac resynchronization therapy (CRT) device implantation, to describe their self-care and health complaints, and to explore the relationship between knowledge expectations and self-care, health complaints, and background factors. Patients and methods: Cross-sectional multicenter study with 104 patients scheduled for a first-time, elective CRT implantation in Swedish and Icelandic hospitals. Data were collected with the Knowledge Expectations of hospital patient Scale, European Heart Failure Self-care Behavior Scale, and Adjusted Postoperative Recovery Profile. Results: Patients expected most knowledge related to their disease and its treatment (median 4.0, interquartile range 0.13) and least on social issues (median 3.5, interquartile range 0.83). Their self-care was average (standardized mean 51.0 +/- 19.6) before the procedure. Patients had on average 8.2 (+/- 4.7) health complaints and rated fatigue and sexual problems as the most severe. Age was independently associated with knowledge expectations (Exp beta 0.049, P= 0.033). Conclusion: Heart failure patients waiting for a CRT device implantation have high expectations for multiple aspects of knowledge, including self-care issues, before their procedure. These expectations are similar to those of other surgical patients and they increase with age.

    Place, publisher, year, edition, pages
    Dove Medical Press, 2015
    Keywords
    cardiac devices; CRT treatment; patient education
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Identifiers
    urn:nbn:se:liu:diva-120368 (URN)10.2147/PPA.S83069 (DOI)000357535000001 ()26170641 (PubMedID)
    Note

    Funding Agencies|Landspitali University Hospital Research Fund, Landspitali - The National University Hospital of Iceland; Icelandic Nurses Association Research Fund; Ingibjorg Magnusdottir in Iceland; Medtronic-Vingmed AB; St. Jude Medical Sweden AB in Sweden

    Available from: 2015-07-31 Created: 2015-07-31 Last updated: 2017-12-04
    3. Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.
    Open this publication in new window or tab >>Perceptions about traditional and novel methods to learn about post-operative pain management: - a qualitative study.
    2016 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 11, p. 2672-2683Article in journal (Refereed) Published
    Abstract [en]

    Aim: To explore the perceptions of surgical patients about traditional and novel methods to learn about post-operative pain management.Background: Patient education is an important part of post-operative care. Contemporary technology offers new ways for patients to learn about self-care, although face-to-face discussions and brochures are the most common methods of delivering education in nursing practice.Design: A qualitative design with a vignette and semi-structured interviews used for data collection.Methods: A purposeful sample of 13 post-surgical patients, who had been discharged from hospital, was recruited during 2013 - 2014. The patients were given a vignette about anticipated hospital discharge after surgery with four different options for communication (face-to-face, brochure, website, serious game) to learn about post-operative pain management. They were asked to rank their preferred method of learning and thereafter to reflect on their choices. Data were analysed using an inductive content analysis approach.Findings: Patients preferred face-to-face education with a nurse, followed by brochures and websites, while games were least preferred. Two categories, each with two sub-categories, emerged from the data. These conceptualised the factors affecting patients' perceptions: 1) 'Trusting the source', sub-categorised into 'Being familiar with the method' and 'Having own prejudgments'; and 2) 'Being motivated to learn' sub-categorised into 'Managing an impaired cognition' and 'Aspiring for increased knowledge'.Conclusion: In order to implement successfully novel educational methods into post-operative care, healthcare professionals need to be aware of the factors influencing patients' perceptions abouthow to learn, such as trust and motivation.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2016
    Keywords
    Content analysis; educational methods; nursing; patient education; patient learning; post-operative self-care; vignettes
    National Category
    Nursing
    Identifiers
    urn:nbn:se:liu:diva-129199 (URN)10.1111/jan.13021 (DOI)000386079500010 ()27205900 (PubMedID)
    Note

    Funding agencies: Landspitali University Hospital Research Fund; Icelandic Nurses Association Research Fund

    Available from: 2016-06-13 Created: 2016-06-13 Last updated: 2017-06-13
  • 47.
    Ingo, Elisabeth
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Brännström, K. Jonas
    Department of logopedics, phoniatrics and audiology, Lund University, Sweden and Institutet för handikappvetenskap (IHV), The Swedish Institute for Disability Research.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Lunner, Thomas
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Oticon AS, Denmark.
    Laplante-Lévesque, Ariane
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Oticon AS, Denmark.
    Stages of change in audiology: comparison of three self-assessment measures2017In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 56, no 7, p. 516-520Article in journal (Refereed)
    Abstract [en]

    Objective: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a persons journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance. A short self-assessment measure of stages of change may guide the clinician and facilitate first appointments. This article describes correlations between three stages of change measures of different lengths, one 24-item and two one-item. Design: Participants were recruited through an online hearing screening study. Adults who failed the speech-in-noise recognition screening test and who had never undergone a hearing aid fitting were invited to complete further questionnaires online, including the three stages of change measures. Study sample: In total, 224 adults completed the three measures. Results: A majority of the participants were categorised as being in one of the information- and help-seeking stage of change (contemplation or preparation). The three stages of change measures were significantly correlated. Conclusions Our results support further investigating the use of a one-item measure to determine stages of change in people with hearing impairment.

  • 48.
    Jansson, Lisa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Höglund, Emelie
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Logopeders samtal med närstående till en person med afasi: En samtalsanalys2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In institutional interactions such as conversations between a speech and language therapist, a person closely related to a person with aphasia and the individual with aphasia there is an asymmetry considering the power. The asymmetry arising in institutional interactions may mean that the participant with the least power will experience a face threatening act. Understanding is seen as a dynamic process and when understanding is a problem in the conversation the ongoing activity is disturbed. The receiver can solve the problem by giving the speaker a candidate understanding. How these strategies are used in conversations between a speech and language therapist with a person closely related to a person with aphasia is a relatively unexplored field and an important area which is a common for speech therapists. The aim of the present study was to investigate a number of communication strategies in the conversation with a person closely related to a person with aphasia; how understanding was reached and how face threatening acts were reduced when the speech therapists delivered test results and gave counseling. Three conversations between speech and language therapists, persons closely related to a person with aphasia and in two of the recordings the person with aphasia were recorded, transcribed and analyzed according to principles of Conversation Analysis (CA). Two speech and language therapists, three persons closely related to a person with aphasia and two persons with aphasia participated in the study. In total, the recorded material is one hour and 37 minutes. Participating speech and language therapists also filled in a questionnaire. Strategies for mitigation and understanding were identified. The strategies were divided into two categories; strategies to mitigate FTA:s when delivering the test results and counseling, the other categorie was the use of candidate understandings for gaining an mutual understanding. The study revealed that candidate understandings were often initiated by the person closely related to a person with aphasia. The study also revealed that the test results with positive outcome where not mitigated and often emphasized and test results that could be perceived as negative were mitigated with hedging.

  • 49.
    Jarkman Björn, Gunilla
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Gustafsson, Per A.
    Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Child and Adolescent Psychiatry in Linköping.
    Sydsjö, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Family therapy sessions with regugee families: a qualitative study2013In: Conflict and Health, ISSN 1752-1505, E-ISSN 1752-1505, Vol. 7, article id 7Article in journal (Refereed)
    Abstract [en]

    Background

    Due to the armed conflicts in the Balkans in the 1990s many families escaped to other countries. The main goal of this study was to explore in more detail the complexity of various family members’ experiences and perceptions from their life before the war, during the war and the escape, and during their new life in Sweden. There is insufficient knowledge of refugee families’ perceptions, experiences and needs, and especially of the complexity of family perspectives and family systems. This study focused on three families from Bosnia and Herzegovina who came to Sweden and were granted permanent residence permits. The families had at least one child between 5 and 12 years old.

    Method

    Family therapy sessions were videotaped and verbatim transcriptions were made. Nine family therapy sessions were analysed using a qualitative method with directed content analysis.

    Results

    Three main categories and ten subcategories were found - 1. Everyday life at home, with two subcategories: The family, Work and School/preschool; 2. The influence of war on everyday life, with three subcategories: The war, The escape, Reflections; 3. The new life, with five subcategories: Employment, Health, Relatives and friends, Limited future, Transition to the new life.

    Conclusions

    Health care and social welfare professionals need to find out what kind of lives refugee families have lived before coming to a new country, in order to determine individual needs of support. In this study the families had lived ordinary lives in their country of origin, and after experiencing a war situation they escaped to a new country and started a new life. They had thoughts of a limited future but also hopes of getting jobs and taking care of themselves and their families. When analysing each person’s point of view one must seek an all-embracing picture of a family and its complexity to tie together the family narrative. To offer refugee families meetings with family-oriented professionals to provide the opportunity to create a family narrative is recommended for the health and social welfare sector. Using this knowledge by emphasizing the salutogenic perspectives facilitates support to refugee families and individuals. This kind of support can help refugee families to adapt to a new system of society and recapture a sense of coherence, including all three components that lead to coherence: comprehensibility, manageability and meaningfulness. More studies are needed to further investigate the thoughts, experiences and needs of various refugee families and how refugee receiving societies can give the most effective support.

  • 50.
    Jedliński, Adam
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Understanding the Role of EGFR in the Treatment of Head and Neck Squamous Cell Carcinoma2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Head and neck squamous cell carcinoma (HNSCC) originates from the epithelial lining of the upper aerodigestive tract. It accounts for over 90 % of the malignancies found in the head and neck region. 600,000 new cases of HNSCC occur each year worldwide. Apart from causing painful lesions, HNSCC directly impacts the patient’s fundamental functions such as breathing and eating and also can disrupt the patient’s senses such as smell, taste, speech and even vision. Most cases of HNSCC require a combination of different treatments such as surgery, chemotherapy (primarily cisplatin based), and radiotherapy. Treatment decisions are largely based on the size of the tumor, the involvement of local lymph nodes, and distant spread. Treatment resistance and local recurrence are significant problems and to date no form of clinical treatment sensitivity  prediction is available.

    A majority of HNSCC tumors overexpresses the epidermal growth factor receptor (EGFR). This receptor is involved in proliferation and DNA repair and is the target of a monoclonal antibody named cetuximab that selectively binds and inhibits EGFR. It is the only targeted therapy available to HNSCC patients and reserved for late stage patients in  Sweden.

    Numerous investigators have searched for predictive markers and we hypothesized that since HNSCC is a very heterogeneous disease a single factor would not be able to predict the treatment outcome. In paper I we explore a panel of predictive factors using a point system, called the number of negative points (NNP), in which we could combine both proteins and genetic variations in an attempt to find a set of markers that could predict the intrinsic cisplatin sensitivity (ICS). The expression level of EGFR, Hsp70, Bax, Bcl-XL, survivin, and COX-2 was determined in 39 HNSCC cell lines. Moreover, the p53, MDM2, FGFR4, XPC, XPD, XRCC1, and XRCC3 genes were analyzed for the presence of specific single nucleotide polymorphisms (SNPs). Pearson’s correlation tests showed that EGFR was the only protein that alone correlated to ICS (r=0.388, P=0.015). The strongest correlation to ICS was found when combining SNPs in XRCC3 and XPD with the expression of EGFR, Hsp70, Bax, and Bcl-2 using the NNP system (r=0.614 P≤0.001).

    In paper II we assess the intrinsic radiosensitivity (IR), the ICS, and the intrinsic cetuximab sensitivity (ICmabS) as well as their combinations in 25 HNSCC cell lines established from HNSCC biopsies taken at the Department of Otorhinolaryngology and Head and Neck Surgery at Linköping University Hospital. Furthermore we investigate the EGFR status (consisting of EGFR gene copy number, EGFR mRNA, EGFR protein, pEGFR), pAkt and mRNA levels of the seven known EGFR ligands. No correlation was found between the different treatment sensitivities. Cetuximab treatment response was significantly correlated to epiregulin (EREG) mRNA expression (r=-0.408, P=0.043). Cetuximab resistant cell lines tended to have low levels of pEGFR (P=0.13) while resistant cell lines had a significantly lower expression of EGFR protein (P=0.04) and tended to have decreased levels of pAkt (P=0.13) and amphiregulin (AREG) mRNA (p=0.18).

    In paper III the functional importance of EGFR ligands in relation to proliferation and cetuximab sensitivity was investigated. Here we tried to diminish the tumor heterogeneity by selecting three cell lines that are derived from the same anatomical location but display different ICmabS. Signaling through the EGFR was stimulated with recombinant EGF, AREG or EREG or reduced by siRNA-mediated silencing of the aforementioned EGFR ligands. EGF downregulation suppressed the proliferation of all investigated tumor cell lines whereas the response to an increased level of EGF differed between EGFR overexpressing and EGFR non-overexpressing cell lines. Furthermore, tumor cells consistently displayed increased cetuximab resistance upon the addition of EGF, whereas EGF silencing was associated with an improved cetuximab response. The data regarding AREG and EREG were inconclusive.

    In paper IV we wanted to validate in vitro drug sensitivity testing of HNSCC cell lines in an in vivo xenograft model, and to identify treatment-induced changes in the EGFR signaling pathway that could be used as markers for cetuximab treatment response. In vitro ICmabS for the HNSCC cell lines UT-SCC-14 and UT-SCC-45 was established using a crystal violet assay. In order to determine the corresponding in vivo sensitivity, UT-SCC-14 and UT-SCC-45 xenografts were generated in female BALB/c (nu/nu) nude mice. Mice were given three injections of intraperitoneal cetuximab or PBS and the tumor volume was recorded continuously. The expression of EGFR, pEGFR, pSrc, and Ki67 in the tumor tissue was investigated by immunohistochemistry. The in vitro sensitivity was reproduced in the in vivo model. Furthermore a clear reduction of EGFR, pEGFR, and pSrc after cetuximab treatment was noted in UT-SCC-14, the cetuximab sensitive cell line while the cetuximab resistant UT-SCC-45 showed a slight increase in EGFR, pEGFR and pSrc.

    In conclusion, the EGFR ligand EGF is a potential predictive marker of poor cetuximab response and a possible treatment target. Moreover, treatment-induced downregulation of EGFR and pEGFR is associated with a good cetuximab response.

    List of papers
    1. Proteins and single nucleotide polymorphisms involved in apoptosis, growth control, and DNA repair predict cisplatin sensitivity in head and neck cancer cell lines
    Open this publication in new window or tab >>Proteins and single nucleotide polymorphisms involved in apoptosis, growth control, and DNA repair predict cisplatin sensitivity in head and neck cancer cell lines
    Show others...
    2009 (English)In: International Journal of Molecular Medicine, ISSN 1107-3756, E-ISSN 1791-244X, Vol. 24, no 4, p. 549-556Article in journal (Refereed) Published
    Abstract [en]

    The present study was undertaken to evaluate the possibility of using a panel of proteins and single nucleotide polymorphisms (SNPs) involved in apoptosis, growth control, and DNA repair as predictive markers for cisplatin sensitivity. For this purpose the intrinsic cisplatin sensitivity (ICS) was determined in 39 cell lines derived from squamous cell carcinomas of the head and neck using a colony-forming assay. In these cell lines and in normal oral keratinocytes (NOK), the expression of epidermal growth factor receptor (EGFR), Hsp70, Bax, Bcl-2, Bcl-XL, survivin, and COX-2 was determined. Moreover, the p53, MDM2, FGFR4, XPC, XPD, XRCC1, and XRCC3 genes were analyzed for the presence of specific single nucleotide polymorphisms (SNPs). Pearsons correlation test showed that EGFR was the only protein that was significantly correlated to the ICS (r=0.388, p=0.015). The combination of EGFR, Hsp70, Bax, and Bcl-2 gave the strongest correlation (r=0.566, p andlt;= 0.001), whereas Bax alone had the second highest influence on the ICS. Furthermore, all four SNPs within genes involved in DNA repair, i.e. XPC, XPD, XRCC1, and XRCC3, tended to influence the ICS. In order to find the combination of factors, on both protein and gene levels, with the highest correlation to ICS, a multivariate statistical calculation was performed. Our results indicate that SNPs in DNA repair genes (XRCC3(241) and XPD751) influence the ICS and together with the expression of EGFR, Hsp70, Bax, and Bcl-2, they could predict the cisplatin sensitivity of head and neck cancer cell lines (r=0.614, p andlt;= 0.001).

    Keywords
    epidermal growth factor receptor, Bax, Bcl-2, heat shock protein 70, DNA repair genes
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-21513 (URN)10.3892/ijmm_00000264 (DOI)
    Available from: 2009-10-02 Created: 2009-10-02 Last updated: 2017-12-13
    2. EGFR status and EGFR ligand expression influence the treatment response of head and neck cancer cell lines
    Open this publication in new window or tab >>EGFR status and EGFR ligand expression influence the treatment response of head and neck cancer cell lines
    2013 (English)In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 42, no 1, p. 26-36Article in journal (Refereed) Published
    Abstract [en]

    Background: Combination treatment (chemoradiotherapy) is the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC); however, treatment resistance and local recurrence are significant problems. A high level of epidermal growth factor receptor (EGFR) has been associated with a more aggressive phenotype as well as decreased responsiveness to radio- or chemotherapy. We examined the role of EGFR status and EGFR ligand expression for the treatment response. Methods: Intrinsic sensitivity to radiotherapy, cisplatin, and cetuximab treatments was investigated in 25 HNSCC cell lines. EGFR gene copy number, mRNA and protein expression, EGFR and Akt phosphorylation status, and mRNA expression of the EGFR ligands were analyzed using quantitative PCR and ELISA and assessed for their impact on treatment sensitivity. Results: Different treatment modalities yielded great diversity in outcome; of note, cetuximab treatment stimulated growth in one cell line. When treatments were combined primarily additive effects were observed. While radioresistance tended to be associated with a high level of phosphorylated EGFR (pEGFR; P = 0.09), cetuximab-resistant cells had low levels of pEGFR (P = 0.13). The three most cetuximab-sensitive cell lines had high EGFR gene copy numbers. Furthermore, cetuximab treatment response was significantly correlated with epiregulin mRNA expression (r = -0.408, P = 0.043). Cisplatin-resistant tumor cells expressed significantly lower levels of EGFR protein (P = 0.04) compared to cisplatin-sensitive cells and tended to have lower levels of phosphorylated Akt (pAkt; P = 0.13) and lower expression levels of amphiregulin (P = 0.18). Conclusions: Epidermal growth factor receptor status and ligand expression influence the treatment sensitivity of HNSCC cells and may be useful as predictive markers.

    Place, publisher, year, edition, pages
    John Wiley and Sons, 2013
    Keywords
    chemoradiotherapy, EGFR, epiregulin, Erbitux (R), HB-EGF, SCCHN, TGF-a, treatment response
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-87963 (URN)10.1111/j.1600-0714.2012.01177.x (DOI)000312998500004 ()
    Note

    Funding Agencies|Swedish Laryng Foundation||Foundation of Olle Engkvist, Building Contractor||Linkoping University Hospital||

    Available from: 2013-01-28 Created: 2013-01-28 Last updated: 2017-12-06
    3. Epidermal growth factor is a biomarker for poor cetuximab response in tongue cancer cells
    Open this publication in new window or tab >>Epidermal growth factor is a biomarker for poor cetuximab response in tongue cancer cells
    2016 (English)In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 45, no 1, p. 9-16Article in journal (Refereed) Published
    Abstract [en]

    Background: Epidermal growth factor receptor (EGFR) is a target for treatment in tongue cancer. Here, EGFR ligands were evaluated for their potential uses as predictive biomarkers of cetuximab treatment response.

    Methods: In three tongue cancer cell lines the influences of epidermal growth factor (EGF), amphiregulin (AR), and epiregulin (EPR) on tumour cell proliferation and cetuximab response were evaluated by the addition of recombinant human (rh) proteins or the siRNA-mediated downregulation of endogenous ligand production.

    Results: EGF or AR downregulation suppressed the proliferation of all investigated cell lines. Furthermore, all cell lines displayed increased cetuximab resistance upon the addition of rhEGF, whereas EGF silencing resulted in an improved cetuximab response in one cell line.

    Conclusions: Our data suggest that EGF and AR are critical components of the EGFR signalling network required for full proliferative potential. Moreover, EGF is a potential predictive biomarker of poor cetuximab response and a possible treatment target.

    Place, publisher, year, edition, pages
    Wiley-Blackwell, 2016
    Keywords
    Head and neck cancer; Tongue cancer; Erbitux; EGFR ligands; treatment response
    National Category
    Cancer and Oncology
    Identifiers
    urn:nbn:se:liu:diva-100675 (URN)10.1111/jop.12310 (DOI)000369990100003 ()
    Note

    Funding agencies: Foundation of Ake Wiberg; Swedish Cancer Society [2008/552, 2010/545]; County Council of Ostergotland; Linkoping University Hospital; Foundation of Magnus Bergvall; Cancer Foundation of Ostergotland

    Vid tiden för disputation förelåg publikationen endast som manuskript

    Available from: 2013-11-11 Created: 2013-11-11 Last updated: 2017-05-03
    4. Cetuximab sensitivity of head and neck squamous cell carcinoma xenografts is associated with treatment-induced reduction of EGFR, pEGFR, and pSrc
    Open this publication in new window or tab >>Cetuximab sensitivity of head and neck squamous cell carcinoma xenografts is associated with treatment-induced reduction of EGFR, pEGFR, and pSrc
    Show others...
    2017 (English)In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, no 9, p. 717-724Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: The aim of this study was to validate in vitro drug sensitivity testing of head and neck squamous cell carcinoma (HNSCC)cell lines in an in vivo xenograft model, and to identify treatment-induced changes in the EGFR signaling pathway that could be used as markersfor cetuximab treatment response.

    METHODS: The in vitro cetuximab sensitivity of two HNSCC cell lines, UT-SCC-14 and UTSCC-45, was assessed using a crystal violet assay. In order to determine the corresponding in vivo sensitivity, UT-SCC-14 and UT-SCC-45 xenografts were generated in female BALB/c (nu/nu) nude mice. Mice were given three injections of intraperitoneal cetuximab or PBS and the tumor volume was recorded continuously. The expression of epidermal growth factor receptor (EGFR), phosphorylated EGFR (pEGFR), phosphorylated Src (pSrc), and Ki67 was investigated by immunohistochemistry.

    RESULTS: The treatment sensitive UT-SCC-14 cells were found to have an intrinsic cetuximab sensitivity (ICmabS) of 0.15 whereas the ICmabS of the insensitive cell line UT-SCC-45 was 0.78. The corresponding size ratio between untreated and cetuximab treated xenografts was 0.22 and 0.83 for UT-SCC-14 and UT-SCC-45, respectively. UT-SCC-14 cells had a higher baseline expression of pEGFR as compared to UT-SCC-45. Furthermore, in UT-SCC-14 xenografts there was a decrease in EGFR, pEGFR and pSrc upon cetuximab treatment. In contrast, a slight cetuximab-induced increase in EGFR, pEGFR and pSrc was observed in treatment-resistant UT-SCC-45 xenografts.

    CONCLUSIONS: The in vitro treatment sensitivity was reproduced in the in vivo model and cetuximab sensitivity was found to associate with a treatment-induced reduction in pEGFR and pSrc.

    Place, publisher, year, edition, pages
    John Wiley & Sons, 2017
    National Category
    Medical and Health Sciences Clinical Medicine
    Identifiers
    urn:nbn:se:liu:diva-113742 (URN)10.1111/jop.12545 (DOI)000412303500009 ()28036101 (PubMedID)
    Note

    Funding agencies: Foundation of Ake Wiberg; County Council of Ostergotland; Research Funds of Linkoping University Hospital; Cancer Foundation of Ostergotland; Foundation of Magn. Bergvall; The Swedish Cancer Society [2010/545]

    The previous status of this publication was Manuscript

    Available from: 2015-01-29 Created: 2015-01-29 Last updated: 2018-05-03Bibliographically approved
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