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  • 1.
    Abbott, Allan
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences.
    Limbäck-Svensson, Gunilla
    Zhou, Caddie
    Gustafsson, Kristin
    Rolfson, O
    Dispenced prescriptions of analgesics prior to entering an osteoarthritis care program. A national registry linkage study2020In: Osteoarthritis and Cartilage, 2020, Vol. 28, p. s59-s60Conference paper (Refereed)
  • 2.
    Abdelrahman, Islam
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Plastic Surgery Unit, Suez Canal University, Egypt.
    Elmasry, Moustafa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery. Plastic Surgery Unit, Suez Canal University, Egypt.
    Steinvall, Ingrid
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Turesson, Christina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Sjöberg, Folke
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Hansson, Thomas
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
    Needle Fasciotomy or Collagenase Injection in the Treatment of Dupuytren’s Contracture: A Retrospective Study2020In: Plastic and Reconstructive Surgery – Global Open, E-ISSN 2169-7574, Vol. 8, no 1Article, review/survey (Refereed)
    Abstract [en]

    Background: Dupuytren’s contracture is common among older people in Sweden. Previous studies comparing the treatment with an injection of collagenase with percutaneous needle fasciotomy found no differences. Methods: We retrospectively compared the degree of improvement in the deficit in extension of the joints in 2 groups of patients who had been treated with collagenase (71 fingers) or needle fasciotomy (109 fingers) before and 1 year after treatment. We compared the improvement of the extension deficit among the metacarpophalangeal (MCP) and proximal interphalangeal joints before and after the intervention; additionally, the level of improvement was classified into 3 levels (mild = 0° to 29°; moderate = 30° to 60°; considerable = 61° and more). Results: The degree of improvement of extension in the MCP joints was 11° greater in the collagenase group (P = 0.001). The number of patients who had an improvement of >60° (considerable) in extension was greater in the collagenase group (P = 0.02). Conclusion: Collagenase was more effective than needle fasciotomy in treating extension deficits of the MCP joints in Dupuytren’s contracture in this retrospective analysis. Further prospective studies are required to confirm the finding.

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  • 3.
    Abidi, Latifa
    et al.
    Maastricht Univ, Netherlands.
    Nilsen, Per
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Karlsson, Nadine
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Skagerström, Janna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Operations management Region Östergötland, Research and Development Unit.
    ODonnell, Amy
    Newcastle Univ, England.
    Conversations about alcohol in healthcare: cross-sectional surveys in the Netherlands and Sweden2020In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, BMC PUBLIC HEALTH, Vol. 20, no 1Article in journal (Refereed)
    Abstract [en]

    Background

    This study evaluated and compared the extent, duration, contents, experiences and effects of alcohol conversations in healthcare in the Netherlands and Sweden in 2017.

    Methods

    Survey data in the Netherlands and Sweden were collected through an online web panel. Subjects were 2996 participants (response rate: 50.8%) in Sweden and 2173 (response rate: 82.2%) in the Netherlands. Data was collected on socio-demographics, alcohol consumption, healthcare visits in the past 12 months, number of alcohol conversations, and characteristics of alcohol conversations (duration, contents, experience, effects).

    Results

    Results showed that Swedish respondents were more likely to have had alcohol conversations (OR = 1.99; 95%CI = 1.64–2.41; p = < 0.001) compared to Dutch respondents. In Sweden, alcohol conversations were more often perceived as routine (p = < 0.001), were longer (p = < 0.001), and more often contained verbal information about alcohol’s health effects (p = 0.007) or written information (p = 0.001) than in the Netherlands. In Sweden, 40+ year-olds were less likely to report a positive effect compared to the youngest respondents. In the Netherlands, men, sick-listed respondents, and risky drinkers, and in Sweden those that reported “other” occupational status such as parental leave, were more likely to have had alcohol conversations.

    Conclusions

    The results suggest that alcohol conversations are more common in healthcare practice in Sweden than in the Netherlands. However, positive effects of alcohol conversations were less likely to be reported among older respondents in Sweden. Our results indicate that alcohol preventative work should be improved in both countries, with more focus on risky drinkers and the content of the conversations in Sweden, and expanding alcohol screening in the Netherlands.

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  • 4.
    Ageberg, Eva
    et al.
    Lund Univ, Sweden.
    Bunke, Sofia
    Lund Univ, Sweden.
    Nilsen, Per
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Donaldson, Alex
    La Trobe Univ, Australia.
    Planning injury prevention training for youth handball players: application of the generalisable six-step intervention development process2020In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 26, no 2, p. 164-169Article in journal (Refereed)
    Abstract [en]

    Background Youth handball players are vulnerable to injuries. Because there is no available injury prevention training specifically developed for youth handball players targeting both upper and lower limbs or incorporating psychological aspects of injury, we undertook the Implementing injury Prevention training ROutines in TEams and Clubs in youth Team handball (I-PROTECT) project. We used an ecological participatory design incorporating the perspectives of multiple stakeholders (health beneficiaries, programme deliverers and policy makers). The aim of this paper was to describe the process of developing the I-PROTECT model, featuring injury prevention training and an accompanying implementation strategy. Design We used the generalisable six-step intervention development process, outlined to guide researchers when developing implementable, evidence-based sports injury prevention interventions, to develop the I-PROTECT model. The six-step process involves establishing a research-stakeholder collaborative partnership to (1) identify and synthesise research evidence and clinical experience; (2) consult with relevant experts; (3) engage end users to ensure their needs, capacity and values are considered; (4) test the feasibility and acceptability of the intervention; (5) evaluate the intervention against theory; and (6) obtain feedback from early implementers. Two community handball clubs in southern Sweden, offering organised training for youth male and female players, and the district handball federation, participate in the intervention development. Drafts of the I-PROTECT model will be developed and revised with key stakeholder advice and input throughout all six steps. Conclusion The I-PROTECT model described will be an end user-driven intervention, including evidence-based, theory-informed and context-specific injury prevention training for youth handball, and an associated implementation strategy.

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  • 5.
    Ahlberg, Mona
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Hollman Frisman, Gunilla
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Berterö, Carina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Family Health Conversations create awareness of family functioning.2020In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, no 2, p. 102-108Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The whole family is affected if one family member is critically ill. The Family Health Conversation Intervention may give the family tools that support healthier family functioning.

    AIMS AND OBJECTIVES: The aim of this study was to identify which components of family function are affected when families participate in Family Health Conversations.

    DESIGN: A secondary analysis was performed of existing qualitative interviews. The Family Health Conversation is an intervention where nurses ask the family reflective questions, and reflection is made possible in three conversation sessions.

    METHODS: This study included transcribed data from 13 follow-up interviews from seven families attending Family Health Conversations after three and 12 months. Data were analysed with narrative analysis, focusing on family function.

    RESULTS: Three themes were identified. The families' family functioning had been supported with: improved understanding of each other-there was an understanding of being in the same situation but still having totally different experiences; more concern for each other-they talked about their different experiences and felt they had become closer to each other; and a process of working through-they had experienced working through various experiences, standing by and supporting, and then being able to move on.

    CONCLUSIONS: The Family Health Conversation Intervention is provided to families, accompanied by nurses. The families in this study gained an awareness of their family function that brought the family closer because of improved understanding of each other and the situation. The families experienced openness, and the family members spoke more freely with each other, which facilitated the progress of working through the experience of critical illness and helped to maintain healthy family functioning.

    RELEVANCE TO CLINICAL PRACTICE: It is important to have an overall perspective and to recognize the patient and the family as equally important within the family for awareness of family function.

    The full text will be freely available from 2020-06-13 15:39
  • 6.
    Alehagen, Urban
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Alexander, J.
    Norwegian Inst Publ Hlth, Norway.
    Aaseth, J.
    Innlandet Hosp Trust, Norway.
    Larsson, A.
    Uppsala Univ, Sweden.
    Lindahl, Tomas
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Clinical Chemistry. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Significant decrease of von Willebrand factor and plasminogen activator inhibitor-1 by providing supplementation with selenium and coenzyme Q10 to an elderly population with a low selenium status2020In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed)
    Abstract [en]

    Purpose Endothelial dysfunction and inflammation are conditions which fuel atherosclerosis and ischaemic heart disease. We have previously reported reduced cardiovascular (CV) mortality following supplementation with selenium and coenzyme Q10 to 443 elderly individuals with low selenium status (mean 67 mu g/L) for 4 years. Here, we wanted to evaluate a possible association between the supplementation and the plasma concentrations of the von Willebrand factor (vWf), and the plasminogen activator inhibitor-1 (PAI-1), as they, besides other functions, are also strongly associated with endothelial function. Methods In this sub-study, 308 individuals (active substance: 157, placebo: 151) were included. Blood samples were drawn after 6 and 36 months and vWf and PAI-1 were determined in plasma by ELISA. Changes in concentrations of the biomarkers were evaluated by the use of T tests, repeated measures of variance, and ANCOVA analyses. Results The active treatment group presented a lower level of vWf after 36 months compared with the placebo group (1.08 U/mL vs. 5.10 U/mL; p = 0.0007). The results were validated through the repeated measures of variance evaluation. The PAI-1 levels showed an equally significant decrease in the active group (26.2 ng/mL vs. 49.2 ng/mL; p = 0.0002) and were also validated through repeated measures of variance evaluation. Conclusion In this sub-study on elderly receiving selenium and coenzyme Q10, or placebo we found significantly lower levels of vWf and PAI-1 in the active treatment group as compared to the placebo group. We interpret this as a better endothelial function because of the intervention, which accords with a previous finding of reduced CV mortality.

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  • 7.
    Ali, Zaheer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Cui, Dongmei
    Sun Yat Sen Univ, Peoples R China.
    Yang, Yunlong
    Fudan Univ, Peoples R China.
    Tracey-White, Dhani
    UCL Inst Ophthalmol, England.
    Vazquez Rodriguez, Gabriela
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Moosajee, Mariya
    UCL Inst Ophthalmol, England.
    Ju, Rong
    Sun Yat Sen Univ, Peoples R China.
    Li, Xuri
    Sun Yat Sen Univ, Peoples R China.
    Cao, Yihai
    Karolinska Inst, Sweden.
    Jensen, Lasse
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Synchronized tissue-scale vasculogenesis and ubiquitous lateral sprouting underlie the unique architecture of the choriocapillaris2020In: Developmental Biology, ISSN 0012-1606, E-ISSN 1095-564X, Vol. 457, no 2, p. 206-214Article in journal (Refereed)
    Abstract [en]

    The choriocapillaris is an exceptionally high density, two-dimensional, sheet-like capillary network, characterized by the highest exchange rate of nutrients for waste products per area in the organism. These unique morphological and physiological features are critical for supporting the extreme metabolic requirements of the outer retina needed for vision. The developmental mechanisms and processes responsible for generating this unique vascular network remain, however, poorly understood. Here we take advantage of the zebrafish as a model organism for gaining novel insights into the cellular dynamics and molecular signaling mechanisms involved in the development of the choriocapillaris. We show for the first time that zebrafish have a choriocapillaris highly similar to that in mammals, and that it is initially formed by a novel process of synchronized vasculogenesis occurring simultaneously across the entire outer retina. This initial vascular network expands by un-inhibited sprouting angiogenesis whereby all endothelial cells adopt tip-cell characteristics, a process which is sustained throughout embryonic and early post-natal development, even after the choriocapillaris becomes perfused. Ubiquitous sprouting was maintained by continuous VEGF-VEGFR2 signaling in endothelial cells delaying maturation until immediately before stages where vision becomes important for survival, leading to the unparalleled high density and lobular structure of this vasculature. Sprouting was throughout development limited to two dimensions by Bruchs membrane and the sclera at the anterior and posterior surfaces respectively. These novel cellular and molecular mechanisms underlying choriocapillaris development were recapitulated in mice. In conclusion, our findings reveal novel mechanisms underlying the development of the choriocapillaris during zebrafish and mouse development. These results may explain the uniquely high density and sheet-like organization of this vasculature.

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  • 8.
    Ali, Zaheer
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Zang, Jingjing
    Univ Zurich, Switzerland.
    Lagali, Neil
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Speech Therapy, Otorhinolaryngology and Audiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Ophthalmology in Linköping.
    Schmitner, Nicole
    Univ Innsbruck, Austria.
    Salvenmoser, Willi
    Univ Innsbruck, Austria.
    Mukwaya, Anthonny
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Speech Therapy, Otorhinolaryngology and Audiology. Linköping University, Faculty of Medicine and Health Sciences.
    Neuhauss, Stephan C. F.
    Univ Zurich, Switzerland.
    Jensen, Lasse
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pharmacology.
    Kimmel, Robin A.
    Univ Innsbruck, Austria.
    Photoreceptor Degeneration Accompanies Vascular Changes in a Zebrafish Model of Diabetic Retinopathy2020In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 61, no 2, article id UNSP 43Article in journal (Refereed)
    Abstract [en]

    PURPOSE. Diabetic retinopathy (DR) is a leading cause of vision impairment and blindness worldwide in the working-age population, and the incidence is rising. Until now it has been difficult to define initiating events and disease progression at the molecular level, as available diabetic rodent models do not present the full spectrum of neural and vascular pathologies. Zebrafish harboring a homozygous mutation in the pancreatic transcription factor pdx1 were previously shown to display a diabetic phenotype from larval stages through adulthood. In this study, pdx1 mutants were examined for retinal vascular and neuronal pathology to demonstrate suitability of these fish for modeling DR. METHODS. Vessel morphology was examined in pdx1 mutant and control fish expressing the fli1a:EGFP transgene. We further characterized vascular and retinal phenotypes in mutants and controls using immunohistochemistry, histology, and electron microscopy. Retinal function was assessed using electroretinography. RESULTS. Pdx1 mutants exhibit clear vascular phenotypes at 2 months of age, and disease progression, including arterial vasculopenia, capillary tortuosity, and hypersprouting, could be detected at stages extending over more than 1 year. Neural-retinal pathologies are consistent with photoreceptor dysfunction and loss, but do not progress to blindness. CONCLUSIONS. This study highlights pdx1 mutant zebrafish as a valuable complement to rodent and other mammalian models of DR, in particular for research into the mechanistic interplay of diabetes with vascular and neuroretinal disease. They are furthermore suited for molecular studies to identify new targets for treatment of early as well as late DR.

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  • 9.
    Allemann, Hanna
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Poli, Arianna
    Linköping University, Department of Culture and Society, Division of Ageing and Social Change. Linköping University, Faculty of Arts and Sciences.
    Designing and evaluating information and communication technology-based interventions? Be aware of the needs of older people2020In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, article id 1474515119897398Article in journal (Refereed)
    Abstract [en]

    n/a

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  • 10.
    Andersson, Asa
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Vilhelmsson, Mattias
    Reg Hosp Vaxjo, Sweden.
    Fomichov Casaballe, Victoria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Business support and Development, Regional Cancer Center.
    Lindhoff Larsson, Anna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Björnsson, Bergthor
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Sandström, Per
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Drott, Jenny
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Patient involvement in surgical care-Healthcare personnel views and behaviour regarding patient involvement2020In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background All professions in surgical care have a responsibility to include patients in their health care. By Swedish law, all care should be done in dialogue with the patient. The essential part of health care is the meeting between patient and healthcare professional. In the interaction, a decision can be made, and needs can be identified to a safer care. Previous studies on patient participation have focussed on patients perspectives in surgical care, but there is a paucity of studies about the personnels perspective of estimated patient involvement in surgical care. Aim The aim of this study was to identify and describe healthcare personnels view and behaviour regarding patient involvement in surgical care. Method A quantitative study with various professions was conducted. A validated questionnaire was used, remaining questions grouped under following areas: patient involvement, acute phase, hospital time, discharge phase and questions on employment and workplace. Results A total of 140 questionnaires were sent out to a surgical clinic in Sweden, and 102 questionnaires were answered. All professionals stated that clear information is an important part of patient involvement in surgical care. Statistically significant differences existed between the professions in the subscale information. Physicians rated their information higher than the Registered Nurses (p = 0.005) and the practical nurses did (p = 0.001). Hindrances to involving patients were lack of time and other priority tasks. Conclusions Professionals in surgical care graded information to be the most important thing for patient involvement. Participation in important decisions, including the possibility to express personal views and ask questions, is important factors for patient involvement. Barriers against patient involvement are lack of time and prioritisation of other work activities.

    The full text will be freely available from 2021-01-31 15:54
  • 11.
    Appelgren, Daniel
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Enocsson, Helena
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Skogman, Barbro H
    Center for Clinical Research Dalarna-Uppsala University, Region Dalarna and Faculty of Medicine and Health Sciences, Örebro University.
    Nordberg, Marika
    Åland Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, Åland, Finland.
    Perander, Linda
    Åland Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, Åland, Finland.
    Nyman, Dag
    Bimelix AB, AX-22 100 Mariehamn, Åland, Finland.
    Nyberg, Clara
    Åland Central Hospital, Department of Infectious Diseases, AX-22 100 Mariehamn, Åland, Finland.
    Knopf, Jasmin
    Department of Internal Medicine 3-Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), DE-91 054 Erlangen, Germany.
    Muñoz, Luis E
    Department of Internal Medicine 3-Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), DE-91 054 Erlangen, Germany.
    Sjöwall, Christopher
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences.
    Sjöwall, Johanna
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
    Neutrophil Extracellular Traps (NETs) in the Cerebrospinal Fluid Samples from Children and Adults with Central Nervous System Infections.2020In: Cells, ISSN 2073-4409, Vol. 9, no 1, article id E43Article in journal (Refereed)
    Abstract [en]

    Neutrophils operate as part of the innate defence in the skin and may eliminate the Borrelia spirochaete via phagocytosis, oxidative bursts, and hydrolytic enzymes. However, their importance in Lyme neuroborreliosis (LNB) is unclear. Neutrophil extracellular trap (NET) formation, which is associated with the production of reactive oxygen species, involves the extrusion of the neutrophil DNA to form traps that incapacitate bacteria and immobilise viruses. Meanwhile, NET formation has recently been studied in pneumococcal meningitis, the role of NETs in other central nervous system (CNS) infections has previously not been studied. Here, cerebrospinal fluid (CSF) samples from clinically well-characterised children (N = 111) and adults (N = 64) with LNB and other CNS infections were analysed for NETs (DNA/myeloperoxidase complexes) and elastase activity. NETs were detected more frequently in the children than the adults (p = 0.01). NET presence was associated with higher CSF levels of CXCL1 (p < 0.001), CXCL6 (p = 0.007), CXCL8 (p = 0.003), CXCL10 (p < 0.001), MMP-9 (p = 0.002), TNF (p = 0.02), IL-6 (p < 0.001), and IL-17A (p = 0.03). NETs were associated with fever (p = 0.002) and correlated with polynuclear pleocytosis (rs = 0.53, p < 0.0001). We show that neutrophil activation and active NET formation occur in the CSF samples of children and adults with CNS infections, mainly caused by Borrelia and neurotropic viruses. The role of NETs in the early phase of viral/bacterial CNS infections warrants further investigation.

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  • 12.
    Arapovic-Johansson, Bozana
    et al.
    Karolinska Inst, Sweden.
    Wåhlin, Charlotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Region Östergötland, Heart and Medicine Center, Occupational and Environmental Medicine Center. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Hagberg, Jan
    Karolinska Inst, Sweden.
    Kwak, Lydia
    Karolinska Inst, Sweden.
    Axen, Iben
    Karolinska Inst, Sweden.
    Bjorklund, Christina
    Karolinska Inst, Sweden.
    Jensen, Irene
    Karolinska Inst, Sweden.
    Experience of Stress Assessed by Text Messages and Its Association with Objective Workload-A Longitudinal Study2020In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 17, no 3, article id 680Article in journal (Refereed)
    Abstract [en]

    Exploring stress trajectories in detail and over a long time may give valuable information in terms of both understanding and practice. We followed a group of primary health care employees in a randomized controlled trial. The objective was to describe their experience of stress, explore the intra-individual variability and examine the association between the experience of stress and the objective workload. Weekly text messages with a single item stress question were distributed in two time series: 12 weeks at the beginning of the trial and 26 weeks after the 6-month follow up. Aggregated objective data about workload were collected from their administration office and related to stress levels. There was a seasonal variation, with higher stress during the fall than in spring and summer. The analysis comparing high and low stress subgroups showed that the stress trajectory of a high-stress subgroup was different from that of a low-stress subgroup. Individuals with high exhaustion scores had higher odds of belonging to a subgroup of individuals with high intra-individual variability in stress experience. The objective workload was measured in two ways and was strongly associated with the stress experience. We found that the lower the productivity, the higher the feeling of stress.

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  • 13.
    Arias Tellez, Maria Jose
    et al.
    Univ Chile, Chile; Univ Granada, Spain.
    Acosta, Francisco M.
    Univ Granada, Spain.
    Sanchez-Delgado, Guillermo
    Univ Granada, Spain; Pennington Biomed Res Ctr, LA 70808 USA.
    Martinez-Tellez, Borja
    Univ Granada, Spain; Leiden Univ, Netherlands; Leiden Univ, Netherlands.
    Munoz-Hernandez, Victoria
    Univ Granada, Spain.
    Martinez-Avila, Wendy D.
    Univ Granada, Spain.
    Henriksson, Pontus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Univ Granada, Spain.
    Ruiz, Jonatan R.
    Univ Granada, Spain.
    Association of Neck Circumference with Anthropometric Indicators and Body Composition Measured by DXA in Young Spanish Adults2020In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, NUTRIENTS, Vol. 12, no 2, article id 514Article in journal (Refereed)
    Abstract [en]

    Background: Due to a clinical and public health interest of neck circumference (NC), a better understanding of this simple anthropometric measurement, as a valid marker of body composition is necessary. Methods: A total of 119 young healthy adults participated in this study. NC was measured over the thyroid cartilage and perpendicular to the longitudinal axis of the neck. Body weight, height, waist circumference (WC), and hip circumference were measured. A Dual X-ray absorptiometry (DXA) scan was used to determine fat mass, lean mass, and visceral adipose tissue (VAT). Additionally, body mass index (BMI) and triponderal mass index (TMI), the waist to hip and waist to height ratios, and the fat mass and lean mass indexes (FMI and LMI, respectively) were calculated. Results: NC was positively associated in women (W) and men (M), with BMI (rW = 0.70 and rM = 0.84, respectively), TMI (rW = 0.63 and rM = 0.80, respectively), WC (rW = 0.75 and rM = 0.86, respectively), VAT (rW = 0.74 and rM = 0.82, respectively), Waist/hip (rW = 0.51 and rM = 0.67, respectively), Waist/height (rW = 0.68 and rM = 0.83, respectively) and FMI (rW = 0.61 and rM = 0.81, respectively). The association between NC and indicators of body composition was however weaker than that observed by BMI, TMI, WC and Waist/height in both women and men. It is of note that in women, NC was associated with FMI, VAT and LMI independently of BMI. In men, adding NC to anthropometric variables did not improve the prediction of body composition, while slight improvements were observed in women. Conclusions: Taken together, the present study provides no indication for NC as a useful proxy of body composition parameters in young adults, yet future studies should explore its usefulness as a measure to use in combination with BMI, especially in women.

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  • 14.
    Awad, Amar
    et al.
    Umea Univ, Sweden.
    Levi, Richard
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Waller, Mikael
    Sunderby Hosp, Sweden.
    Westling, Goran
    Umea Univ, Sweden.
    Lindgren, Lenita
    Umea Univ, Sweden.
    Eriksson, Johan
    Umea Univ, Sweden.
    Preserved somatosensory conduction in complete spinal cord injury: Discomplete SCI2020In: Clinical Neurophysiology, ISSN 1388-2457, E-ISSN 1872-8952, Vol. 131, no 5, p. 1059-1067Article in journal (Refereed)
    Abstract [en]

    Objective: Spinal cord injury (SCI) disrupts the communication between brain and body parts innervated from below-injury spinal segments, but rarely results in complete anatomical transection of the spinal cord. The aim of this study was to investigate residual somatosensory conduction in clinically complete SCI, to corroborate the concept of sensory discomplete SCI. Methods: We used fMRI with a somatosensory protocol in which blinded and randomized tactile and nociceptive stimulation was applied on both legs (below-injury level) and one arm (above-injury level) in eleven participants with chronic complete SCI. The experimental design accounts for possible confounding mechanical (e.g. vibration) and cortico-cortical top-down mechanisms (e.g. attention/expectation). Results: Somatosensory stimulation on below-level insensate body regions activated the somatotopically corresponding part of the contralateral primary somatosensory cortex in six out of eleven participants. Conclusions: Our results represent afferent-driven cortical activation through preserved somatosensory connections to the brain in a subgroup of participants with clinically complete SCI, i.e. sensory discomplete SCI. Significance: Identifying patients with residual somatosensory connections might open the door for new rehabilitative and restorative strategies as well as inform research on SCI-related conditions such as neuropathic pain and spasticity. (C) 2020 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  • 15.
    Ax, Anna-Karin
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Johansson, Birgitta
    Department of Immunology, Genetics and Pathology and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Carlsson, Maria
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
    Nordin, Karin
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway.
    Börjeson, Sussanne
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology. Linköping University, Faculty of Medicine and Health Sciences.
    Exercise: A positive feature on functioning in daily life during cancer treatment – Experiences from the Phys-Can study2020In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Nursing, Vol. 44, article id 101713Article in journal (Refereed)
    Abstract [en]

    Purpose

    Impaired functioning due to cancer treatment is a challenge for daily life. Exercise during treatment can improve functioning. However, research describing experiences of how exercise affects activities of daily life is limited. We aimed to explore how individuals with cancer receiving curative treatment and participating in an exercise intervention experienced their functioning in daily life.

    Methods

    Twenty-one participants were recruited from Phys-Can, an exercise intervention study. Semi-structured interviews were conducted after the intervention had finished, and data was analysed using thematic analysis.

    Results

    Two main themes evolved: “Striving to maintain a normal life in a new context” and “Struggling with impairments from side effects of cancer treatment”. The supervised group exercise proved popular, and participants reported positive effects on physical and psychological functioning, as well as social and informative support from other participants. Participants struggled with impaired cognitive and physical functioning and exhaustion. They strove to maintain a normal life by adjusting their activities.

    Conclusions

    Perceived physical and psychological benefits from exercise during cancer treatment suggest that exercise should be a part of cancer rehabilitation to facilitate activities and participation in daily life. Striving to maintain a normal life during cancer treatment is vital, and adjustments are needed to maintain activities and participation in daily life. Cancer nurses should motivate patients to engage in physical activity and encourage the introduction of exercise as part of their rehabilitation. They could also support patients in making adjustments to maintain functioning in daily life.

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  • 16.
    Bahr, Roald
    et al.
    Norwegian Sch Sport Sci, Norway; Aspetar Orthopaed and Sports Med Hosp, Qatar.
    Clarsen, Ben
    Norwegian Sch Sport Sci, Norway; Norwegian Inst Publ Hlth, Norway.
    Derman, Wayne
    Stellenbosch Univ, South Africa.
    Dvorak, Jiri
    Schulthess Clin, Switzerland.
    Emery, Carolyn A.
    Univ Calgary, Canada.
    Finch, Caroline F.
    Edith Cowan Univ, Australia.
    Hägglund, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Junge, Astrid
    Med Sch Hamburg, Germany; Schulthess Clin, Switzerland.
    Kemp, Simon
    Rugby Football Union, England; London Sch Hyg and Trop Med, England.
    Khan, Karim M.
    Univ British Columbia, Canada; British Journal Sports Med, England.
    Marshall, Stephen W.
    Univ N Carolina, NC USA; Univ N Carolina, NC USA.
    Meeuwisse, Willem
    Univ Calgary, Canada; Natl Hockey League, Canada.
    Mountjoy, Margo
    McMaster Univ, Canada; FINA Bur Sport Med, Switzerland.
    Orchard, John W.
    Univ Sydney, Australia.
    Pluim, Babette
    Royal Netherlands Lawn Tennis Assoc, Netherlands; AMC VUmc IOC Res Ctr Excellence, Netherlands; Univ Pretoria, South Africa.
    Quarrie, Kenneth L.
    New Zealand Rugby, New Zealand; AUT Univ, New Zealand.
    Reider, Bruce
    Univ Chicago, IL 60637 USA.
    Schwellnus, Martin
    Univ Pretoria, South Africa.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland; Fac Kinesiol, Canada.
    Stokes, Keith A.
    Univ Bath, England; Rugby Football Union, England.
    Timpka, Toomas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Verhagen, Evert
    Amsterdam UMC, Netherlands.
    Bindra, Abhinav
    Int Olymp Comm, Switzerland.
    Budgett, Richard
    Int Olymp Comm, Switzerland.
    Engebretsen, Lars
    Norwegian Sch Sport Sci, Norway; Int Olymp Comm, Switzerland.
    Erdener, Ugur
    Int Olymp Comm, Switzerland.
    Chamari, Karim
    Aspetar Sports Med and Orthoped Hosp, Qatar.
    International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS))2020In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 54, no 7, p. 372-389Article in journal (Refereed)
    Abstract [en]

    Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statements on sports injury (and, eventually, illness) epidemiology to date. Our objective was to further strengthen consistency in data collection, injury definitions and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups and a 3-day consensus meeting in October 2019. This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems; severity of health problems; capturing and reporting athlete exposure; expressing risk; burden of health problems; study population characteristics and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE Extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). The IOC encourages ongoing in- and out-of-competition surveillance programmes and studies to describe injury and illness trends and patterns, understand their causes and develop measures to protect the health of the athlete. Implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.

  • 17.
    Bahr, Roald
    et al.
    Norwegian Sch Sport Sci, Norway; Aspetar Orthopaed and Sports Med Hosp, Qatar.
    Clarsen, Ben
    Norwegian Sch Sport Sci, Norway; Norwegian Inst Publ Hlth, Norway.
    Derman, Wayne
    Stellenbosch Univ, South Africa.
    Dvorak, Jiri
    Schulthess Clin, Switzerland; Schulthess Clin, Switzerland.
    Emery, Carolyn A.
    Univ Calgary, Canada; Univ Calgary, Canada.
    Finch, Caroline F.
    Edith Cowan Univ, Australia.
    Hägglund, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Junge, Astrid
    Med Sch Hamburg, Germany; Schulthess Clin, Switzerland.
    Kemp, Simon
    Rugby Football Union, England; London Sch Hyg and Trop Med, England.
    Khan, Karim M.
    Univ British Columbia, Canada; British Journal Sports Med, England.
    Marshall, Stephen W.
    Univ N Carolina, NC 27515 USA; Univ N Carolina, NC 27515 USA.
    Meeuwisse, Willem
    Univ Calgary, Canada; Natl Hockey League, Canada.
    Mountjoy, Margo
    McMaster Univ, Canada; FINA Bur Sport Med, Switzerland.
    Orchard, John W.
    Univ Sydney, Australia.
    Pluim, Babette
    Royal Netherlands Lawn Tennis Assoc, Netherlands; AMC VUmc IOC Res Ctr Excellence, Netherlands.
    Quarrie, Kenneth L.
    New Zealand Rugby, New Zealand; AUT Univ, New Zealand.
    Reider, Bruce
    Univ Chicago, IL 60637 USA.
    Schwellnus, Martin
    Univ Pretoria, South Africa.
    Soligard, Torbjorn
    Int Olymp Comm, Switzerland; Fac Kinesiol, Canada.
    Stokes, Keith A.
    Univ Bath, England; Rugby Football Union, England.
    Timpka, Toomas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Verhagen, Evert
    Amsterdam UMC, Netherlands.
    Bindra, Abhinav
    Int Olymp Comm, Switzerland.
    Budgett, Richard
    Int Olymp Comm, Switzerland.
    Engebretsen, Lars
    Norwegian Sch Sport Sci, Norway; Int Olymp Comm, Switzerland.
    Erdener, Ugur
    Int Olymp Comm, Switzerland.
    Chamari, Karim
    Aspetar Sports Med and Orthoped Hosp, Qatar.
    International Olympic Committee Consensus Statement: Methods for Recording and Reporting of Epidemiological Data on Injury and Illness in Sports 2020 (Including the STROBE Extension for Sports Injury and Illness Surveillance (STROBE-SIIS))2020In: ORTHOPAEDIC JOURNAL OF SPORTS MEDICINE, ISSN 2325-9671, Vol. 8, no 2, article id 2325967120902908Article in journal (Refereed)
    Abstract [en]

    Background: Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statements on sports injury (and, eventually, illnesses) epidemiology to date. Objective: To further strengthen consistency in data collection, injury definitions, and research reporting through an updated set of recommendations for sports injury and illness studies, including a new Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist extension. Study Design: Consensus statement of the International Olympic Committee (IOC). Methods: The IOC invited a working group of international experts to review relevant literature and provide recommendations. The procedure included an open online survey, several stages of text drafting and consultation by working groups, and a 3-day consensus meeting in October 2019. Results: This statement includes recommendations for data collection and research reporting covering key components: defining and classifying health problems, severity of health problems, capturing and reporting athlete exposure, expressing risk, burden of health problems, study population characteristics, and data collection methods. Based on these, we also developed a new reporting guideline as a STROBE extension-the STROBE Sports Injury and Illness Surveillance (STROBE-SIIS). Conclusion: The IOC encourages ongoing in- and out-of-competition surveillance programs and studies to describe injury and illness trends and patterns, understand their causes, and develop measures to protect the health of the athlete. The implementation of the methods outlined in this statement will advance consistency in data collection and research reporting.

  • 18.
    Barra, Mathias
    et al.
    Akershus Univ Hosp, Norway.
    Broqvist, Mari
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Gustavsson, Erik
    Linköping University, Department of Culture and Society, Division of Philosophy, History, Arts and Religion. Linköping University, Faculty of Arts and Sciences.
    Henriksson, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Juth, Niklas
    Karolinska Inst, Sweden.
    Sandman, Lars
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Solberg, Carl Tollef
    Akershus Univ Hosp, Norway; Univ Bergen, Norway.
    Severity as a Priority Setting Criterion: Setting a Challenging Research Agenda2020In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 28, no 1, p. 25-44Article in journal (Refereed)
    Abstract [en]

    Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to todays severity criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda.

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  • 19.
    Bendelin, Nina
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Björkdahl, Pär
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Risell, Mimmi
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Nelson, Karin
    Linköping University, Department of Thematic Studies, Department of Child Studies. Linköping University, Faculty of Arts and Sciences.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Karolinska Inst, Sweden.
    Buhrman, Monica
    Uppsala Univ, Sweden.
    Patients experiences of internet-based Acceptance and commitment therapy for chronic pain: a qualitative study2020In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, BMC MUSCULOSKELETAL DISORDERS, Vol. 21, no 1, article id 212Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain is a globally widespread condition with complex clusters of symptoms within a heterogeneous patient group. Internet-delivered Acceptance and Commitment Therapy (IACT) has shown promising results in the treatment of chronic pain. How IACT is experienced by patients is less well known. Qualitative studies of patients experiences are needed to further understand factors behind both engagement and negative effects. The aim of this study was to explore how IACT was experienced by chronic pain patients who had participated in a controlled trial. Methods: Through an open and exploratory approach this study aimed to investigate how IACT was experienced when delivered as a guided self-help program to persons with chronic pain. Eleven participants were interviewed over telephone after completing IACT. Results: Qualitative analysis based on grounded theory resulted in 2 core categories and 8 subcategories. In treatment: Physical and cognitive restraints, Time and deadline, Therapist contact, and Self-confrontation. After treatment: Attitude to pain, Image of pain, Control or Command, and Acting with pain. Individual differences as well as specific conditions of the treatment may explain variations in how the treatment was approached, experienced and what consequences it led to. Therapist guidance and deadlines for homework play complex roles in relation to autonomy and change. Conclusions: Adjusting treatment content and format based on participants characteristics, such as expectations, motivation and restraints, might positively affect engagement, autonomy and change. Further research on attrition and negative effects of treatment might clarify what enables chronic pain patients to benefit from IACT.

  • 20.
    Bendtsen, Marcus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Science & Engineering.
    Heterogeneous treatment effects of a text messaging smoking cessation intervention among university students2020In: PLoS ONE, E-ISSN 1932-6203, Vol. 15, no 3, article id e0229637Article in journal (Refereed)
    Abstract [en]

    Introduction

    Despite tobacco being an important preventable factor with respect to ill health and death, it is a legal substance that harms and kills many of those who use it. Text messaging smoking cessation interventions have been evaluated in a variety of contexts, and are generally considered to have a positive effect on smoking cessation success. In order for text messaging interventions to continue to be useful as prevalence of smoking decreases, it may be necessary to tailor the interventions to specific individuals. However, little is known with regard to who benefits the most and least from existing interventions.

    Methods

    In order to identify heterogenous treatment effects, we analyzed data from a randomized controlled trial of a text messaging smoking cessation intervention targeting university students in Sweden. We used a Bayesian hierarchical model where the outcome was modelled using logistic regression, and so-called horseshoe priors were used for coefficients. Predictive performance of the model, and heterogeneous treatment effects, were calculated using cross-validation over the trial data.

    Results

    Findings from the study of heterogenous treatment effects identified less effect of the intervention among university students with stronger dependence of nicotine and students who smoke a greater quantity of cigarettes per week. No heterogeneity was found with respect to sex, number of years smoking, or the use of snuff.

    Discussion

    Results emphasize that individuals with a more developed dependence of nicotine may have a harder time quitting smoking even with support. This questions the dissemination and development of text messaging interventions to university students in the future, as they may not be the optimal choice of intervention for those with a more developed dependence. On the other hand, text messaging interventions may be useful to disseminate among university students that are at risk of developing a strong dependence.

    Trial registration

    International Standard Randomized Controlled Trial Number (ISRCTN): 75766527; http://www.controlled-trials.com/ISRCTN75766527.

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  • 21.
    Bendtsen, Marcus
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health.
    Müssener, Ulrika
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health.
    Linderoth, Catharina
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health.
    Thomas, Kristin
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health.
    A Mobile Health Intervention for Mental Health Promotion Among University Students: Randomized Controlled Trial2020In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 8, no 3, article id e17208Article in journal (Refereed)
    Abstract [en]

    Background: High positive mental health, including the ability to cope with the normal stresses of life, work productively, and be able to contribute to one’s community, has been associated with various health outcomes. The role of positive mental health is therefore increasingly recognized in national mental health promotion programs and policies. Mobile health (mHealth) interventions could be a cost-effective way to disseminate positive psychological interventions to the general population.

    Objective: The aim of this study was to estimate the effect of a fully automated mHealth intervention on positive mental health, and anxiety and depression symptomology among Swedish university students using a randomized controlled trial design.

    Methods: A 2-arm, single-blind (researchers), parallel-groups randomized controlled trial with an mHealth positive psychology program intervention group and a relevant online mental health information control group was employed to estimate the effect of the novel intervention. Participants were recruited using digital advertising through student health care centers in Sweden. Inclusion criteria were (1) university students, (2) able to read and understand Swedish, (3) and have access to a mobile phone. Exclusion criteria were high positive mental health, as assessed by the Mental Health Continuum Short Form (MHC-SF), or high depression and anxiety symptomology, as assessed by the Hospital Anxiety Depression Scale (HADS). The primary outcome was positive mental health (MHC-SF), and the secondary outcomes were depression and anxiety symptomatology (HADS). The subscales of MHC-SF were also analyzed as exploratory outcomes. Outcomes were measured 3 months after randomization through questionnaires completed on the participants’ mobile phones.

    Results: A total of 654 participants (median age 25 years), including 510 (78.0%) identifying as female, were randomized to either the intervention (n=348) or control group (n=306). At follow-up, positive mental health was significantly higher in the intervention group compared with the control group (incidence rate ratio [IRR]=1.067, 95% CI 1.024-1.112, P=.002). For both depression and anxiety symptomatology, the intervention group showed significantly lower scores at follow-up compared with the control group (depression: IRR=0.820, 95% CI 0.714-0.942, P=.005; anxiety: IRR=0.899, 95% CI 0.840-0.962, P=.002). Follow-up rates were lower than expected (58.3% for primary outcomes and 52.3% for secondary outcomes); however, attrition analyses did not identify any systematic attrition with respect to baseline variables.

    Conclusions: The mHealth intervention was estimated to be superior to usual care in increasing positive mental health among university students. A protective effect of the intervention was also found on depressive and anxiety symptoms. These findings demonstrate the feasibility of using an automated mobile phone format to enhance positive mental health, which offers promise for the use of mHealth solutions in public mental health promotion.

    Trial Registration: International Standard Randomized Controlled Trial Registry ISRCTN54748632; http://www.isrctn.com/ISRCTN54748632

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  • 22.
    Bergström, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Sverker, Annette
    Linköping University, Department of Culture and Society, Division of Social Work. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Larsson, Åsa
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Valtersson, Eva
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health.
    Thyberg, Ingrid
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Ostlund, Gunnel
    Malardalen Univ, Sweden.
    Björk, Mathilda
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Significant others influence on participation in everyday life: the perspectives of persons with early diagnosed rheumatoid arthritis2020In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 42, no 3, p. 385-393Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe the meaning of significant others in relation to participation in everyday life of persons with early diagnosed rheumatoid arthritis (RA). Materials and methods: Fifty-nine persons participated in this interview study. Inclusion criteria were three years experience of diagnosis and being of working age. Semi-structured interviews were conducted using critical incident technique (CIT), and the material was analysed using content analysis. Results: Four categories were revealed: (1) My early RA causes activity adaptations for us all, referring to the person and significant others modifying activities. (2) Making the significant others balance between shortfalls and participation, where the participants distinguished between needing help and feeling involved in activities. (3) Physical interactions with significant others, referring to both the problematic and manageable impact RA could have on body contact. (4) Emotions in relation to activities with others, where participants described feelings of failing others, and anxiety about future activities. Conclusions: For persons with early diagnosed RA, significant others can be both hindering and facilitating for participation in everyday life. As a clinical implication, it is valuable to identify how significant others can be involved in the rehabilitation process, to enhance participation in everyday life early in the disease process.

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  • 23.
    Beygui, Farzin
    et al.
    Caen Univ Hosp, France.
    Castren, Maaret
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland; Karolinska Inst, Sweden.
    Brunetti, Natale Daniele
    Univ Foggia, Italy.
    Rosell-Ortiz, Fernando
    Empresa Publ Emergencias Sanitarias Andalucia, Spain.
    Christ, Michael
    Paracelsus Med Univ, Germany.
    Zeymer, Uwe
    Klinikum Stadt Ludwigshafen Rhein gGmbH, Germany.
    Huber, Kurt
    Wilhelminenhospital, Austria.
    Folke, Fredrik
    Copenhagen Univ Hosp, Denmark.
    Svensson, Leif
    Karolinska Inst Solna, Sweden.
    Bueno, Hector
    Hosp 12 Octubre, Spain.
    vant Hof, Arnoud
    ISALA Acad, Netherlands.
    Nikolaou, Nikolaos
    Konstantopouleio Gen Hosp, Greece.
    Nibbe, Lutz
    Univ Med Berlin, Germany.
    Charpentier, Sandrine
    Univ Hosp Rangueil, France.
    Swahn, Eva
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Tubaro, Marco
    San Filippo Neri Hosp, Italy.
    Goldstein, Patrick
    Lille Univ Hosp, France; Lille Univ Hosp, France.
    Pre-hospital management of patients with chest pain and/or dyspnoea of cardiac origin. A position paper of the Acute Cardiovascular Care Association (ACCA) of the ESC.2020In: European heart journal. Acute cardiovascular care., ISSN 2048-8726, Vol. 9, no 1_SUPPL, p. 59-81Article in journal (Refereed)
    Abstract [en]

    Chest pain and acute dyspnoea are frequent causes of emergency medical services activation. The pre-hospital management of these conditions is heterogeneous across different regions of the world and Europe, as a consequence of the variety of emergency medical services and absence of specific practical guidelines. This position paper focuses on the practical aspects of the pre-hospital treatment on board and transfer of patients taken in charge by emergency medical services for chest pain and dyspnoea of suspected cardiac aetiology after the initial assessment and diagnostic work-up. The objective of the paper is to provide guidance, based on evidence, where available, or on experts opinions, for all emergency medical services health providers involved in the pre-hospital management of acute cardiovascular care.

  • 24. Order onlineBuy this publication >>
    Bielsten, Therése
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    “Doing things together”: Towards a health promoting approach to couples’ relationships and everyday life in dementia2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Most people with dementia live in their own homes, often together with their partners, who become informal caregivers. Relationship quality and sense of couplehood can be threatened as a result of the transition from a mutually interdependent relationship to a caregiver-care-receiver relationship. This, in turn, may lead to many negative consequences for both partners. Support provided for couples is often divided into different types for the person with dementia and for the partner without dementia and lacks couple-based support that targets the relationship, resources and the couple’s everyday life together.

    Aim: The overall aim of this thesis is to explore couple-centred interventions in dementia and to develop and test a salutogenic, resource-oriented and couple-based intervention among couples in which one partner has dementia living at home.

    Methods and findings: This thesis comprises three parts: The first part Exploring involves two linked reviews, one narrative review (study I A) and one scoping review (study I B) that aim to identify and describe what previous couple-centred interventions comprised and why they were conducted. The results of the reviews revealed a knowledge gap in and a need for easily accessible support that targets couple relationships, resources and everyday life. The second part Developing (study II) refers to the development of an easily accessible resource-oriented couple-management intervention. The first step was to identify priority topics for such an intervention through a co-researcher process with couples living with dementia. This included a comprehensive literature review, interviews with couples in which one partner has dementia, and consultation meetings with expert groups of people with dementia and partners in both Sweden and the UK. The co-researcher process and the expert meetings informed four main themes with corresponding sub-themes that couples with dementia considered as important to their wellbeing in their everyday lives: (1) Home and Neighbourhood, (2) Meaningful Activities and Relationships, (3) Approach and Empowerment, and (4) Couplehood. The themes were further developed and integrated into the multimedia application DemPower, which was developed for the delivery of the intervention. The third part Testing and Evaluating describes a feasibility study (study III) in which the DemPower application was tested for feasibility and acceptability among couples in Sweden and the UK. The results of the feasibility study indicated that the DemPower intervention was feasible and acceptable among couples in which one partner has dementia living at home. The testing and evaluating part also comprise a qualitative study (study IV) that explores the experiences of engaging with DemPower together as a couple living with dementia in Sweden. The findings resulted in the three themes: (1) Growth of the relationship, (2) We are not alone, and (3) Positive approach, which the couples appreciated and associated with the resource-oriented and salutogenic approach of DemPower. The overall findings of the thesis are presented in a concluding synthesis at the end of the thesis. The concluding synthesis, focused on “Meaningfulness”, “Empowering health promotion”, “Normalization” and “Transitions and couplehood”, represents the core findings of this thesis.

    What this thesis adds: This thesis contributes to research, healthcare and the public by highlighting the need for a salutogenic approach toward couples living with dementia. The DemPower application, with its focus on couples’ relationships, resource-orientation and everyday life, has proven feasibility and acceptability and has meaningfully addressed a gap in the literature and in practice. As researchers, healthcare professionals and the public, we need to support couples where one partner has dementia to continue to live as normal life as possible. This can best be achieved by focusing on what couples can do, by inclusion and by valuing them as the experts within dementia research and of their life experiences.

    List of papers
    1. A review of couple-centred interventions in dementia: Exploring the what and why - Part A
    Open this publication in new window or tab >>A review of couple-centred interventions in dementia: Exploring the what and why - Part A
    2019 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 18, no 7-8, p. 2436-2449Article, review/survey (Refereed) Published
    Abstract [en]

    Introduction Symptoms of dementia bring about challenges to couples relationships. Relationship-focused support has been highlighted to be of significant importance for sustained relationship quality and to reduce the negative impact of dementia on the dyadic relationship. This review aimed to explore the what and why of interventions aimed at couples where one partner has a diagnosis of dementia and in which the couple jointly participate. Method Searches were performed in Academic Search Premier, CINAHL, PsycINFO, PubMed, Scopus and Web of Science from January 2000 to August 2017. Results Six studies were included. Objectives for the person with dementia was related to cognitive function and for the care partner the objectives were related to well-being. The majority of the outcomes were mirrored by the objectives and focused on cognitive function for people with dementia and depression and relationship quality for care partners. Our findings indicate that people with dementia should be included in the assessment of the relationship in order to gain an overall picture of relationship dynamics and to increase tailored support in couple-centred interventions. Conclusions The findings of this review indicate that joint interventions for people with dementia and care partners are lacking a genuine dyadic approach where both partners views of their relationship are valued. In order to identify targets for support and to use the appropriate outcome measures, the quality of the relationship should be recognised and taken into account. Moreover, there is a lack of a salutogenic approach in couple-centred interventions in which couples strengths and resources can be identified and supported.

    Place, publisher, year, edition, pages
    SAGE PUBLICATIONS LTD, 2019
    Keywords
    caregiver; dementia; mild cognitive impairment; review; spouses
    National Category
    Gerontology, specialising in Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-160998 (URN)10.1177/1471301217737652 (DOI)000485953300002 ()29096533 (PubMedID)
    Available from: 2019-10-31 Created: 2019-10-31 Last updated: 2020-03-13
    2. Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia
    Open this publication in new window or tab >>Living Life and Doing Things Together: Collaborative Research With Couples Where One Partner Has a Diagnosis of Dementia
    Show others...
    2018 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 28, no 11, p. 1719-1734Article in journal (Refereed) Published
    Abstract [en]

    The aim of this study is to identify relevant content for a self-management guide by using the outcomes of previous research in combination with knowledge and experiences from couples where one partner has a diagnosis of dementia. The study was carried out in three phases: (a) literature search of previous research related to well-being and couplehood in dementia; (b) interviews with couples with dementia based on the findings of the literature search; and (c) further authentication of the findings within expert groups of people with dementia and carers. For analysis of data, we used a hybrid approach of thematic analysis with combined deductive and inductive approaches. The findings of this study indicated that the four main themes Home and Neighborhood, Meaningful Activities and Relationships, Approach and Empowerment, and Couplehood with related subthemes could be appropriate targets for a self-management guide for couples where one partner has a diagnosis of dementia.

    Place, publisher, year, edition, pages
    SAGE PUBLICATIONS INC, 2018
    Keywords
    couples; collaborative research; dementia; salutogenesis; self-management; Sweden; thematic analysis; UK
    National Category
    Other Social Sciences not elsewhere specified
    Identifiers
    urn:nbn:se:liu:diva-151196 (URN)10.1177/1049732318786944 (DOI)000442412400004 ()30033851 (PubMedID)
    Available from: 2018-09-17 Created: 2018-09-17 Last updated: 2020-03-13
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  • 25.
    Black, Melissa H.
    et al.
    Curtin Univ, Australia; GPO Box U1987, Australia.
    Mahdi, Soheil
    Karolinska Inst, Sweden; Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Milbourn, Benjamin
    Curtin Univ, Australia.
    Scott, Melissa
    Curtin Univ, Australia.
    Gerber, Alan
    SUNY Stony Brook, NY 11794 USA.
    Esposito, Christopher
    SUNY Stony Brook, NY 11794 USA.
    Falkmer, Marita
    Curtin Univ, Australia; Jonkoping Univ, Sweden.
    Lerner, Matthew D.
    SUNY Stony Brook, NY 11794 USA.
    Halladay, Alycia
    Autism Sci Fdn, NY USA; Rutgers State Univ, NJ USA.
    Strom, Eva
    Swedish Publ Employment Serv, Sweden.
    DAngelo, Axel
    Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden.
    Falkmer, Torbjörn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Curtin Univ, Australia; Curtin Univ, Australia.
    Bolte, Sven
    Curtin Univ, Australia; Karolinska Inst, Sweden; Stockholm Hlth Care Serv, Sweden; Stockholm Hlth Care Serv, Sweden.
    Girdler, Sonya
    Curtin Univ, Australia.
    Multi-informant International Perspectives on the Facilitators and Barriers to Employment for Autistic Adults2020In: Autism Research, ISSN 1939-3792, E-ISSN 1939-3806Article in journal (Refereed)
    Abstract [en]

    Employment rates for autistic individuals are poor, even compared to those from other disability groups. Internationally, there remains limited understanding of the factors influencing employment across the stages of preparing for, gaining, and maintaining employment. This is the third in a series of studies conducted as part of an International Society for Autism Research (INSAR) policy brief intended to improve employment outcomes for autistic individuals. A multi-informant international survey with five key stakeholder groups, including autistic individuals, their families, employers, service providers, and researchers, was undertaken in Australia, Sweden, and the United States to understand the facilitators and barriers to employment for autistic adults. A total of 687 individuals participated, including autistic individuals (n = 246), family members (n = 233), employers (n = 35), clinicians/service providers (n = 123), and researchers (n = 50). Perceptions of the facilitators and barriers to employment differed significantly across both key stakeholder groups and countries, however, ensuring a good job match and focusing on strengths were identified by all groups as important for success. Key barriers to employment included stigma, a lack of understanding of autism spectrum disorder (ASD) and communication difficulties. Results suggest that a holistic approach to employment for autistic individuals is required, aimed at facilitating communication between key stakeholders, addressing attitudes and understanding of ASD in the workplace, using strength-based approaches and providing early work experience. Lay Summary Autistic individuals experience significant difficulty getting and keeping a job. This article presents a survey study involving autistic individuals, their families, employers, service providers and researchers in Australia, Sweden, and the United States to understand their perspectives on the factors that support or act as barriers to employment. While perspectives varied across key stakeholders, strategies such as using a holistic approach, targeting workplace attitudes and understanding, focusing on strengths, and providing early work experience are important for success. (c) 2020 International Society for Autism Research, Wiley Periodicals, Inc.

  • 26.
    Bogelund Hansen, Matilde
    et al.
    Univ Copenhagen, Denmark.
    Arpi, Magnus
    Univ Copenhagen, Denmark.
    Hedin, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Futurum, Reg Jonkoping Cty, Linkoping, Sweden; Lund Univ, Sweden.
    Melander, Eva
    Skane Reg, Sweden; Lund Univ, Sweden.
    Hertz, Frederik Boetius
    Univ Copenhagen, Denmark; Slagelse Hosp, Denmark.
    Thorsted, Anne Bonde
    Univ Southern Denmark, Denmark.
    Jakobsen, Helle Neel
    Bispebjerg and Frederiksberg Hosp, Denmark.
    Hyllebusk, Lena
    Dept Clin Microbiol, Sweden.
    Brogaard, Emma
    Skane Reg, Sweden.
    Jensen, Jette Nygaard
    Univ Copenhagen, Denmark; Capital Reg Denmark, Denmark.
    Antibiotic-prescribing and antibiotic-resistance patterns among elderly citizens residing in two Nordic regions2020In: Infectious Diseases, ISSN 2374-4235, E-ISSN 2374-4243Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to compare antibiotic-prescribing rates in 2016 and antibiotic-resistance rates in 2017 among citizens aged amp;gt;= 85 years between the Capital Region in Denmark and the Skane Region in Sweden, with regards to overall antibiotic use and antibiotics of choice for urinary tract infections (UTIs) and skin and soft tissue infections (SSTIs). Methods: Inhabitants amp;gt;= 85 year old on the date of prescription during 2016 and residing in the Capital Region or the Skane Region were included for antibiotic-prescription analyses. Samples from 2017 from residents of the same regions who were amp;gt;= 85 years old were included for antibiotic-resistance analyses. Antimicrobial use was determined according to the drugs of choice for UTIs and SSTIs in Denmark and Sweden. Students t-tests were used to compare antibiotic prescribing while a Chi-Squared test was performed to compare antibiotic resistance. Results: There was a significantly higher overall prescription rate among citizens amp;gt;= 85 years in the Capital Region than in the Skane Region. The same pattern was evident for the antibiotics of choice for UTIs and SSTIs except for clindamycin. Antibiotic resistance against all antibiotics included was more prominent in the Capital Region than in the Skane Region. Conclusion: Considerable variation in antibiotic prescribing and resistance exists among elderly citizens between these two adjacent Nordic regions. Information and reflection on current practices and resistance patterns may direct attention towards antimicrobial stewardship as a higher priority and may help inform and motivate prescribing behaviours.

  • 27.
    Bransvik, Vanja
    et al.
    Lund Univ, Sweden.
    Granvik, Eva
    Skane Univ Hosp, Sweden.
    Minthon, Lennart
    Lund Univ, Sweden; Skane Univ Hosp, Sweden.
    Nordstrom, Peter
    Umea Univ, Sweden.
    Nägga, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics. Linköping University, Faculty of Medicine and Health Sciences. Lund Univ, Sweden.
    Mortality in patients with behavioural and psychological symptoms of dementia: a registry-based study2020In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915Article in journal (Refereed)
    Abstract [en]

    Objectives: Behavioural and psychological symptoms of dementia (BPSD) are common in patients with dementia. In the elderly population, comorbidities frequently coexist with dementia and mortality in dementia is high. The aim of this study was to investigate the impact of BPSD on mortality in severe dementia. Methods: This study of 11,448 individuals was based on linked information from the Swedish BPSD registry, the National Patient Register and the Cause of Death register. BPSD was assessed with the Neuropsychiatric Inventory (NPI). Cox proportional hazards regressions were performed for survival analysis. To study different degrees of BPSD, data was categorized into groups: no (NPI, 0 points), mild (NPI, 1-3 points on amp;gt;= 1 item), moderate (NPI, 4-8 points on amp;gt;= 1 item) and severe (NPI, 9-12 points on amp;gt;= 1 item) BPSD based on the highest score on any of the BPSD assessed (NPI items). Results: The presence of moderate or severe BPSD was associated with a stepwise increased risk of mortality (hazard ratio (HR), 1.31; 95% confidence interval (CI), 1.08-1.60 and HR 1.74; 95% CI 1.44-2.12, respectively) compared with individuals with no BPSD. In addition, there was an association between total NPI score and mortality (HR 1.01; 95% CI 1.007-1.010). The results remained significant after multivariable adjustment for age, sex, dementia diagnosis, medication, previous myocardial infarction, hip fracture and stroke. Conclusions: The results show a stepwise increase in mortality risk with increased BPSD, highlighting the importance of adequate management of BPSD to reduce mortality in dementia.

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  • 28.
    Broqvist, Mari
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    von Goes, Lovisa
    Hjälpmedelscentralen, Region Jönköpings län.
    Svensson, Carina
    Hjälpmedelscentralen, Region Jönköpings län.
    Volmevik Lundberg, Pernilla
    Hjälpmedelscentralen, Region Jönköpings län.
    Winberg, Anette
    Tidigare anställd vid Hälsa och habilitering, Region Uppsala.
    Beslutsstöd för prioriteringar på individnivå: Exempel från hjälpmedelsverksamhet2019Report (Other academic)
    Abstract [en]

    Since 1997, when the ethical platform for resource allocation was introduced in the Swedish health care system, methods have been in development with the aim of supporting the healthcare providers in the difficult decisions of assigning priorities. The methodological focus has been on the major issues, on the allocation of resources at regional level and policy decisions in various activities, but the large number of priorities are made on a daily basis in interactions between health care staff and patients.

    This report is addressed to those who strive to prioritize at individual level on more equal and explicit grounds, in line with the guidelines on priorities that the Riksdag has decided on. The tool presented here is called Decision support for priorities at the individual level. It aims to guide the analysis of the persons´ health care needs so that the need-solidarity and the cost-effectiveness principle are taken into account in the assessment. It is the result of many years of development work and tested in practice in Center for assistive technology in different regions for several years. In addition to being used in prescribing such technology, decision support is also possible to test for other types of health care interventions.

    The decision support consists of an assessment form and a manual. Severity, patient benefit and patient benefit in relation to costs are the variables that should be assessed and direct the health care staff in assigning a priority.

    One aim of using the decision support is to facilitate priorities on more equal grounds. Introduced in a well-organized manner, it can contribute to, but not alone, create such priorities. In order to create mutual understanding and acceptance for grounds and transparency in priorities, a thought-out implementation process is also required. In this report, such an example is given from Region Jönköpings län and prescribers of assistive devices. The main ingredients for succeeding in such work seem to be support from the management and political level, methodological support and constant perseverance.

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  • 29.
    Burstrom, Kristina
    et al.
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Teni, Fitsum Sebsibe
    Karolinska Inst, Sweden.
    Gerdtham, Ulf-G.
    Lund Univ, Sweden.
    Leidl, Reiner
    German Res Ctr Environm Hlth, Germany; Ludwig Maximilians Univ Munchen, Germany.
    Helgesson, Gert
    Karolinska Inst, Sweden.
    Rolfson, Ola
    Karolinska Inst, Sweden; Univ Gothenburg, Sweden; Sahlgrens Univ Hosp, Sweden; Ctr Registers Vastra Gotaland, Sweden.
    Henriksson, Martin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Experience-Based Swedish TTO and VAS Value Sets for EQ-5D-5L Health States2020In: PharmacoEconomics (Auckland), ISSN 1170-7690, E-ISSN 1179-2027Article in journal (Refereed)
    Abstract [en]

    Background and Objective Although value sets for the five-level version of the generic health-related quality-of-life instrument EQ-5D are emerging, there is still no value set available in the literature based on time trade-off valuations made by individuals experiencing the valued health states. The aim of this study was to estimate experience-based value sets for the EQ-5D-5L for Sweden using time trade-off and visual analogue scale valuation methods. Methods In a large, cross-sectional, population-based, self-administered postal health survey, the EQ-5D-5L descriptive system, EQ visual analogue scale and a time trade-off question were included. Time trade-off and visual analogue scale valuations of the respondents current health status were used in statistical modelling to estimate a single-index value of health for each of the 3125 health states. Ordinary least-squares and generalised linear models were estimated with the main effect within each of the five dimensions represented by 20 dummy variables reflecting the additional decrement in value for levels 2-5 when the severity increases by one level sequentially beginning from having no problem. Interaction variables representing the occurrence of severity levels in at least one of the dimensions were tested: severity level 2 or worse (N2); severity level 3 or worse (N3); severity level 4 or worse (N4); severity level 5 (N5). Results A total of 896 health states (28.7% of the 3125 possible EQ-5D-5L health states) were reported by the 25,867 respondents. Visual analogue scale (n = 23,899) and time trade-off (n = 13,381) responders reported valuations of their currently experienced health state. The preferred regression models used ordinary least-squares estimation for both time trade-off and visual analogue scale values and showed consistency in all coefficients after combining certain levels. Levels 4 and 5 for the dimensions of mobility, self-care and usual activities were combined in the time trade-off model. Including the interaction variable N5, indicating severity level 5 in at least one of the five dimensions, made it possible to distinguish between the two worst severity levels where no other dimension is at level 5 as this coefficient is applied only once. In the visual analogue scale regression model, levels 4 and 5 of the mobility dimension were combined. The interaction variables N2-N4 were included, indicating that each of these terms reflect a statistically significant decrement in visual analogue scale value if any of the dimensions is at severity level 2, 3 or 4, respectively. Conclusions Time trade-off and visual analogue scale value sets for the EQ-5D-5L are now available for Sweden. The time trade-off value set is the first such value set based on experience-based time trade-off valuation. For decision makers with a preference for experience-based valuations of health states from a representative population-based sample, the reported value sets may be considered fit for purpose to support resource allocation decision as well as evaluating population health and healthcare performance.

  • 30.
    Cadenas-Sanchez, Cristina
    et al.
    Univ Granada, Spain.
    Migueles, Jairo H.
    Univ Granada, Spain.
    Esteban-Cornejo, Irene
    Univ Granada, Spain; Northeastern Univ, MA 02115 USA.
    Mora-Gonzalez, Jose
    Univ Granada, Spain.
    Henriksson, Pontus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Rodriguez-Ayllon, Maria
    Univ Granada, Spain.
    Molina-Garcia, Pablo
    Univ Granada, Spain.
    Löf, Marie
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Labayen, Idoia
    Univ Publ Navarra, Spain.
    Hillman, Charles H.
    Northeastern Univ, MA 02115 USA; Northeastern Univ, MA 02115 USA.
    Catena, Andres
    Univ Granada, Spain.
    Ortega, Francisco B.
    Univ Granada, Spain; Karolinska Inst, Sweden.
    Fitness, physical activity and academic achievement in overweight/obese children2020In: Journal of Sports Sciences, ISSN 0264-0414, E-ISSN 1466-447XArticle in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine the associations of fitness and physical activity with academic achievement in children with overweight/obesity. A total of 106 (10.0 +/- 1.1y, 61 boys) children participated. The fitness components were assessed by field and laboratory-based tests. Physical activity was measured via accelerometry. The academic achievement was assessed by a standardised test and school-grades. Field-based cardiorespiratory fitness was associated with language skills (ss-standardised- ranging from 0.281 to 0.365, p amp;lt; 0.01). The field-based muscular strength was associated with grade point average, natural and social sciences, and foreign language (ss = 0.280-0.326, all p amp;lt;= 0.01). Speed-agility was associated with some language-related skills (ss = 0.325-0.393, all p amp;lt;= 0.01). The laboratory-based muscular strength also showed an association with mathematics skills (ss = 0.251-0.306, all p amp;lt;= 0.01). Physical activity did not show significant association with academic achievement (p amp;gt; 0.01). Overall, the significant associations observed for muscular strength and speed/agility were attenuated and disappeared in many cases after additional adjustments for body mass index and cardiorespiratory fitness, indicating that these associations are inter-dependent. Our study contributes by indicating that other fitness components apart from cardiorespiratory fitness, such as muscular strength and speed-agility, are positively associated with academic achievement. However, these associations appear to be dependent on body mass index and cardiorespiratory fitness.

  • 31.
    Cauwenberghs, Nicholas
    et al.
    Univ Leuven, Belgium.
    Cornelissen, Veronique
    Univ Leuven, Belgium.
    Christle, Jeffrey W.
    Stanford Sch Med, CA 94305 USA.
    Hedman, Kristofer
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
    Myers, Jonathan
    Stanford Sch Med, CA 94305 USA; Vet Adm Palo Alto Hlth Care Syst, CA USA.
    Haddad, Francois
    Stanford Univ, CA 94305 USA.
    Kuznetsova, Tatiana
    Univ Leuven, Belgium.
    Impact of age, sex and heart rate variability on the acute cardiovascular response to isometric handgrip exercise2020In: Journal of Human Hypertension, ISSN 0950-9240, E-ISSN 1476-5527Article in journal (Refereed)
    Abstract [en]

    Isometric handgrip exercise (IHG) triggers acute increases in cardiac output to meet the metabolic demands of the active skeletal muscle. An abnormal cardiovascular response to IHG might reflect early stages of cardiovascular disease. In a large community-based cohort, we comprehensively assessed the clinical correlates of acute cardiovascular changes during IHG. In total, 333 randomly recruited subjects (mean age, 53 +/- 13 years, 45% women) underwent simultaneous echocardiography and finger applanation tonometry at rest and during 3 min of IHG at 40% maximal handgrip force. We calculated time-domain measures of short-term heart rate variability (HRV) from finger pulse intervals. We assessed the adjusted associations of changes in blood pressure (BP) and echocardiographic indexes with clinical characteristics and HRV measures. During IHG, men presented a stronger absolute increase in heart rate, diastolic BP, left ventricular (LV) volumes and cardiac output than women, even after adjustment for covariables. In adjusted continuous and categorical analyses, age correlated positively with the increase in systolic BP and pulse pressure, but negatively with the increase in LV stroke volume and cardiac output during exercise. After full adjustment, a greater increase in systolic and diastolic BP during exercise was associated with lower absolute real variability (P amp;lt;= 0.026) and root mean square of successive differences (P amp;lt;= 0.032) in pulse intervals at rest. In a general population sample, women presented a weaker cardiovascular response to IHG than men. Older age was associated with greater rise in BP pulsatility and diminished cardiac reserve. Low HRV at rest predicted a higher BP increase during isometric exercise.

  • 32.
    Cavaliere, Carlo
    et al.
    IRCCS SDN, Italy.
    Longarzo, Mariachiara
    IRCCS SDN, Italy.
    Fogel, Stuart
    Western Univ, Canada; Univ Ottawa, Canada; Univ Ottawa, Canada; Univ Ottawa, Canada.
    Engström, Maria
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Soddu, Andrea
    Western Univ, Canada.
    Neuroimaging of Narcolepsy and Primary Hypersomnias2020In: The Neuroscientist, ISSN 1073-8584, E-ISSN 1089-4098, article id 1073858420905829Article, review/survey (Refereed)
    Abstract [en]

    Advances in neuroimaging open up the possibility for new powerful tools to be developed that potentially can be applied to clinical populations to improve the diagnosis of neurological disorders, including sleep disorders. At present, the diagnosis of narcolepsy and primary hypersomnias is largely limited to subjective assessments and objective measurements of behavior and sleep physiology. In this review, we focus on recent neuroimaging findings that provide insight into the neural basis of narcolepsy and the primary hypersomnias Kleine-Levin syndrome and idiopathic hypersomnia. We describe the role of neuroimaging in confirming previous genetic, neurochemical, and neurophysiological findings and highlight studies that permit a greater understanding of the symptoms of these sleep disorders. We conclude by considering some of the remaining challenges to overcome, the existing knowledge gaps, and the potential role for neuroimaging in understanding the pathogenesis and clinical features of narcolepsy and primary hypersomnias.

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  • 33.
    Changa Zetterström, Anna
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences.
    Hasselblad, Theodor
    Linköping University, Department of Health, Medicine and Caring Sciences.
    Fysioterapeuters upplevelser av Basal Kroppskännedom som behandling vid posttraumatiskt stressyndrom: En kvalitativ intervjustudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Posttraumatic Stress Disorder (PTSD) is a psychiatric diagnosis as a result of an exposure to an earlier traumatic experience. Basic Body Awareness Therapy (BBAT) is a physiotherapeutic treatment where the purpose is to make the patient more aware of their own body. Earlier studies have investigated the effects and experiences of the BBAT as treatment for PTSD but the physiotherapist’s perspective in the field have not yet been investigated. 

    Purpose: To investigate physiotherapist’s experiences of Basic Body Awareness Therapy as treatment for Posttraumatic Stress Disorder.

    Method: Qualitative interview study. Seven physiotherapist’s with therapeutic competence in BBAT were interviewed using semi-structured interview. Qualitative content analysis where used to analyse data. 

    Results: Three categories and ten subcategories where identified. Approaches and roles between patient and physiotherapist described experiences of the interaction between the physiotherapist and patient. The physiotherapist’s strategy and treatment described reasoning about evaluation and treatment of patients. BBAT:s function as a treatment described experiences of the patient group, BBAT:s role as treatment together with other therapies and experiences of the situation in the health-care system for PTSD today. 

    Conclusion: BBAT is described by physiotherapist’s as a respectful and adaptable method to implement in treating post-traumatic issues. There is an experienced need in using the body as a starting point in order to process and manage trauma. BBAT can be used as a complement or first-line treatment in treating patients with PTSD.

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  • 34.
    Chisalita, Ioana Simona
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Wijkman, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping.
    Davidson, Lee Ti
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Emergency Medicine in Linköping.
    Spångeus, Anna
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Nyström, Fredrik H
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Cityhälsan Centrum, Norrköping.
    Östgren, Carl Johan
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Ödeshög.
    Toe brachial index predicts major acute cardiovascular events in patients with type 2 diabetes independently of arterial stiffness2020In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 161, article id 108040Article in journal (Refereed)
    Abstract [en]

    Objective: Our aim was to analyze the predictive value of toe brachial index (TBI) as a risk marker for future major adverse cardiovascular events (MACE) and all-cause mortality in patients with type 2 diabetes (T2D). Methods: TBI was measured in 741 patients with T2D in 2005-2008. Conventional risk factors for vascular disease as well as non-invasive measurements such as pulse-wave velocity (PWV) and intima-media thickness (IMT) of the carotid arteries were estimated. MACE was defined as cardiovascular death or hospitalization for non fatal myocardial infarction or non fatal stroke. Patients were followed for incidence of MACE using the national Swedish Cause of Death Registry and the Inpatient Register. Results: During the follow-up for a period of 9 years MACE occurred in 97 patients and 85 patients died. TBI tertile, 1 versus 3, was significantly related to MACE (HR 2.67, 95%CI 1.60-4.50; p &lt; 0.001) and to all-cause mortality (HR 1.98, 95%CI 1.16-3.83; p = 0.01). TBI tertile 1 as compared to TBI tertile 3 predicted MACE, but not all-cause mortality, independently of age, sex, diabetes duration and treatment, antihypertensive treatment, previous cardiovascular diseases, office systolic blood pressure, HbA1c, LDL cholesterol, estimated glomerular filtration rate, body mass index, current smoking PWV, IMT and carotid plaque presence (HR 3.39, 95%CI 1.53-7.51; p = 0.003 and HR 1.81, 95%CI 0.87-3.76; p = 0.1, respectively). Conclusions: Low TBI predicts an increased risk for MACE independently of arterial stiffness in patients with type 2 diabetes. Trial registration: Clinical Trials.gov number NCT 01049737. Registered January 14, 2010. (C) 2020 Elsevier B.V. All rights reserved.

  • 35.
    Chougar, Lydia
    et al.
    Juntendo Univ, Japan; Hop Cochin, France.
    Hagiwara, Akifumi
    Juntendo Univ, Japan; Univ Tokyo, Japan.
    Takano, Nao
    Juntendo Univ, Japan.
    Andica, Christina
    Juntendo Univ, Japan.
    Cohen-Adad, Julien
    Juntendo Univ, Japan; Polytech Montreal, Canada; Univ Montreal, Canada.
    Warntjes, Marcel Jan Bertus
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV). SyntheticMR AB, Linkoping, Sweden.
    Maekawa, Tomoko
    Juntendo Univ, Japan; Univ Tokyo, Japan.
    Hori, Masaaki
    Juntendo Univ, Japan.
    Koshino, Saori
    Juntendo Univ, Japan; Univ Tokyo, Japan.
    Nakazawa, Misaki
    Juntendo Univ, Japan.
    Abe, Osamu
    Univ Tokyo, Japan.
    Aoki, Shigeki
    Juntendo Univ, Japan.
    Signal Intensity within Cerebral Venous Sinuses on Synthetic MRI2020In: MAGNETIC RESONANCE IN MEDICAL SCIENCES, ISSN 1347-3182, Vol. 19, no 1, p. 56-63Article in journal (Refereed)
    Abstract [en]

    Purpose: Flowing blood sometimes appears bright on synthetic T-1-weighted images, which could be misdiagnosed as a thrombus. This study aimed to investigate the frequency of hyperintensity within cerebral venous sinuses on synthetic MR images and to evaluate the influence of increasing flow rates on signal intensity using a flow phantom. Materials and Methods: Imaging data, including synthetic and conventional MRI scans, from 22 patients were retrospectively analyzed. Signal intensities at eight locations of cerebral venous sinuses on synthetic images were graded using the following three-point scale: 0, "dark vessel"; 1, "hyperintensity within the walls"; and 2, "hyperintensity within the lumen:" A phantom with gadolinium solution inside a U-shaped tube was acquired without flow and then with increasing flow rates (60, 100, 200, 300, 400 ml/min). Results: Considering all sinus locations, the venous signal intensity on synthetic T-1-weighted images was graded as 2 in 79.8% of the patients. On synthetic T-2-weighted images, all sinuses were graded as 0. On fluid-attenuated inversion recovery (FLAIR) images, sinuses were almost always graded as 0 (99.4%). In the phantom study, the signal initially became brighter on synthetic T-1-weighted images as the flow rate increased. Above a certain flow rate, the signal started to decrease. Conclusion: High signal intensity within the cerebral venous sinuses is a frequent finding on synthetic T-1-weighted images. This corresponds to the hyperintensity noted at certain flow rates in the phantom experiment.

  • 36.
    Christiansen, Morten K.
    et al.
    Aarhus Univ Hosp, Denmark; Aarhus Univ, Denmark.
    Haugaa, Kristina H.
    Oslo Univ Hosp, Norway.
    Svensson, Anneli
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Gilljam, Thomas
    Sahlgrens Univ Hosp, Sweden.
    Madsen, Trine
    Aalborg Univ Hosp, Denmark.
    Hansen, Jim
    Univ Copenhagen, Denmark.
    Holst, Anders G.
    Rigshosp, Denmark; Univ Copenhagen, Denmark.
    Bundgaard, Henning
    Rigshosp, Denmark; Univ Copenhagen, Denmark.
    Edvardsen, Thor
    Oslo Univ Hosp, Norway.
    Svendsen, Jesper H.
    Rigshosp, Denmark; Univ Copenhagen, Denmark.
    Platonov, Pyotr G.
    Lund Univ, Sweden.
    Jensen, Henrik K.
    Aarhus Univ Hosp, Denmark; Aarhus Univ, Denmark.
    Incidence, Predictors, and Success of Ventricular Tachycardia Catheter Ablation in Arrhythmogenic Right Ventricular Cardiomyopathy (from the Nordic ARVC Registry)2020In: American Journal of Cardiology, ISSN 0002-9149, E-ISSN 1879-1913, Vol. 125, no 5, p. 803-811Article in journal (Refereed)
    Abstract [en]

    Catheter ablation may reduce ventricular tachycardia (VT) burden in arrhythmogenic right ventricular cardiomyopathy (ARVC) patients. However, little is known about factors predicting need for ablation. Therefore, we sought to investigate predictors and use of VT ablation and to evaluate the postprocedural outcome in ARVC patients. We studied 435 patients from the Nordic ARVC registry including 220 probands with definite ARVC according to the 2010 task force criteria and 215 mutation-carrying relatives identified through cascade screening. Patients were followed until first-time VT ablation, death, heart transplantation, or January 1st 2018. Additionally, patients undergoing VT ablation were further followed from the time of ablation for recurrent ventricular arrhythmias. The cumulative use of VT ablation was 4% (95% confidence interval [CI] 3% to 6%) and 11% (95% CI 8% to 15%) after 1 and 10 years. All procedures were performed in probands in whom cumulative use was 8% (95% CI 5% to 12%) and 20% (95% CI 15% to 26%). In adjusted analyses among probands, only young age predicted ablation. In patients undergoing ablation, risk of recurrent arrhythmias was 59% (95% CI 44% to 71%) and 74% (95% CI 59% to 84%) 1 and 5 years after the procedure. Despite high recurrence rates, the burden of ventricular arrhythmias was reduced after ablation (p = 0.0042). Young age, use of several antiarrhythmic drugs and inducibility to VT after ablation were associated with an unfavorable outcome. In conclusion, twenty percent of ARVC probands developed a clinical indication for VT ablation within 10 years whereas mutation-carrying relatives were without such need. Although the burden of ventricular arrhythmias decreased after ablation, risk of recurrence was substantial. (C) 2019 Elsevier Inc. All rights reserved.

  • 37.
    Clark, Andrew
    et al.
    School of Health and Society, University of Salford, Salford, Greater Manchester, UK.
    Campbell, Sarah
    School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
    Keady, John
    School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
    Kullberg, Agneta
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health.
    Manji, Kainde
    University of Salford, Salford, Greater Manchester, UK.
    Rummery, Kirstein
    Faculty of Social Science, University of Stirling, Colin Bell Building, Stirling, UK.
    Ward, Richard
    Faculty of Social Science, University of Stirling, Colin Bell Building, Stirling, UK.
    Neighbourhoods as relational places for people living with dementia2020In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 252Article in journal (Refereed)
    Abstract [en]

    An increase in the number of people living independently with dementia across the developed world has focused attention on the relevance of neighbourhood spaces for enabling or facilitating good social health and wellbeing. Taking the lived experiences and daily realities of people living with dementia as a starting point, this paper contributes new understanding about the relevance of local places for supporting those living with the condition. The paper outlines findings from a study of the neighbourhood experiences, drawing on new data collected from a creative blend of qualitatively-driven mixed methods with people living in a diverse array of settings across three international settings. The paper details some of the implications of neighbourhoods as sites of social connection based on material from 67 people living with dementia and 62 nominated care-partners. It demonstrates how neighbourhoods are experienced as relational places and considers how people living with dementia contribute to the production of such places through engagement and interaction, and in ways that may be beneficial to social health. We contend that research has rarely focused on the subjective, experiential and ‘everyday’ social practices that contextualise neighbourhood life for people living with dementia. In doing so, the paper extends empirical and conceptual understanding of the relevance of neighbourhoods as relational sites of connection, interaction, and social engagement for people living with dementia.

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  • 38.
    Cooper, Lauren B.
    et al.
    Inova Heart and Vasc Inst, VA 22042 USA; Duke Univ, NC 27706 USA.
    Benson, Lina
    Karolinska Inst, Sweden.
    Mentz, Robert J.
    Duke Univ, NC 27706 USA.
    Savarese, Gianluigi
    Karolinska Inst, Sweden.
    DeVore, Adam D.
    Duke Univ, NC 27706 USA.
    Carrero, Juan-Jesus
    Karolinska Inst, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Anker, Stefan D.
    Berlin Brandenburg Ctr Regenerat Therapies, Germany; Charite, Germany.
    Lainscak, Mitja
    Gen Hosp Murska Sobota, Slovenia; Univ Ljubljana, Slovenia.
    Hernandez, Adrian F.
    Duke Univ, NC 27706 USA.
    Pitt, Bertram
    Univ Michigan, MI USA.
    Lund, Lars H.
    Karolinska Inst, Sweden.
    Association between potassium level and outcomes in heart failure with reduced ejection fraction: a cohort study from the Swedish Heart Failure Registry2020In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844Article in journal (Refereed)
    Abstract [en]

    Aims Hyperkalaemia and hypokalaemia are common in heart failure and associated with worse outcomes. However, the optimal potassium range is unknown. We sought to determine the optimal range of potassium in patients with heart failure and reduced ejection fraction (amp;lt; 40%) by exploring the relationship between baseline potassium level and short- and long-term outcomes using the Swedish Heart Failure Registry from 1 January 2006 to 31 December 2012. Methods and results We assessed the association between baseline potassium level and all-cause mortality at 30 days, 12 months, and maximal follow-up, in uni- and multivariable stratified and restricted cubic spline Cox regressions. Of 13 015 patients, 93.3% had potassium 3.5-5.0 mmol/L, 3.7% had potassium amp;lt;3.5 mmol/L, and 3.0% had potassium amp;gt;5.0 mmol/L. Potassium 5.0 mmol/L were more common with lower estimated glomerular filtration rate and heart failure of longer duration and greater severity. The potassium level associated with the lowest hazard risk for mortality at 30 days, 12 months, and maximal follow-up was 4.2 mmol/L, and there was a steep increase in risk with both higher and lower potassium levels. In adjusted strata analyses, lower potassium was independently associated with all-cause mortality at 12 months and maximal follow-up, while higher potassium levels only increased risk at 30 days. Conclusion In this nationwide registry, the relationship between potassium and mortality was U-shaped, with an optimal potassium value of 4.2 mmol/L. After multivariable adjustment, hypokalaemia was associated with increased long-term mortality but hyperkalaemia was associated with increased short-term mortality.

  • 39.
    Cui, Xiaotong
    et al.
    Fudan Univ, Peoples R China; Shanghai Inst Cardiovasc Dis, Peoples R China; Univ Gothenburg, Sweden.
    Zhou, Jingmin
    Fudan Univ, Peoples R China; Shanghai Inst Cardiovasc Dis, Peoples R China.
    Pivodic, Aldina
    Stat Konsultgrp, Sweden; Univ Gothenburg, Sweden.
    Dahlström, Ulf
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.
    Ge, Junbo
    Fudan Univ, Peoples R China; Shanghai Inst Cardiovasc Dis, Peoples R China.
    Fu, Michael
    Univ Gothenburg, Sweden.
    Temporal trends in cause-specific readmissions and their risk factors in heart failure patients in Sweden2020In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 306, p. 116-122Article in journal (Refereed)
    Abstract [en]

    Background: It remains unclear whether readmissions of patients with heart failure (HF) have decreased over time in an era of improved therapy and management of HF. This study aimed to determine the temporal short- and long-term trends of cause-specific rehospitalization and their risk factors in a Swedish context. Methods: HF patients in the Swedish Heart Failure Registry (SwedeHF) were investigated. Maximum follow-up time was 1 year. Outcomes included the first occurrence of all-cause, cardiovascular (CV) and HF rehospitalizations. Cox proportional hazards models were performed to determine the impact of increasing years on risk for rehospitalization and its known risk factors. Results: Totally, 25,644 index-hospitalized HF patients in SwedeHF from 2004 to 2011 were enrolled in the study. For 8 years, the incidence risk of 1-year all-cause rehospitalization remained unchanged, whereas the incidence risk of CV (P = 0.038) or HF (P = 0.0038) rehospitalization decreased. After adjustment for age and sex, a 3% decrease per every second year was observed for 1-year CV and HF rehospitalizations (P &lt; 0.05). However, time to the first occurring all-cause, CV and HF rehospitalization did not change significantly from 2004 to 2011 (P-values 0.13-0.87). When two study periods (2004-2005 vs. 2010-2011) were compared, the risk factor profile for rehospitalization was found to change. Conclusions: Throughout the 8-year study period, CV- and HF-related rehospitalizations decreased, whereas all-cause rehospitalization remained unchanged, indicating a parallel increase in non-CV rehospitalization in the HF patients. (c) 2020 Elsevier B.V. All rights reserved.

  • 40.
    Dong, Huan-Ji
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. Linköping University, Faculty of Medicine and Health Sciences.
    Larsson, Britt
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Dragioti, Elena
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Bernfort, Lars
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Levin, Lars-Åke
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Gerdle, Björn
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Factors Associated with Life Satisfaction in Older Adults with Chronic Pain (PainS65+)2020In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 13, p. 475-489Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain in later life is a worldwide problem. In younger patients, chronic pain affects life satisfaction negatively; however, it is unknown whether this outcome will extend into old age.

    Objective: This study examines which factors determine life satisfaction in older adults who suffer from chronic pain with respect to socio-demographics, lifestyle behaviors, pain, and comorbidities.

    Methods: This cross-sectional study recruited a random sample of people ≥ 65 years old living in south-eastern Sweden (N= 6611). A postal survey addressed pain aspects and health experiences. Three domains from the Life Satisfaction Questionnaire (LiSat-11) were used to capture the individual’s estimations of overall satisfaction (LiSat-life), somatic health (LiSat-somhealth), and psychological health (LiSat-psychhealth).

    Results: Respondents with chronic pain (2790, 76.2± 7.4 years old) rated lower on life satisfaction than those without chronic pain, with medium effect size (ES) on LiSat-somhealth (r = 0.38, P < 0.001) and small ES on the other two domains (r < 0.3). Among the respondents with chronic pain, severe pain (OR 0.29– 0.59) and pain spreading (OR 0.87– 0.95) were inversely associated with all three domains of the LiSat-11. Current smoking, alcohol overconsumption, and obesity negatively affected one or more domains of the LiSat-11. Most comorbidities were negatively related to LiSat-somhealth, and some comorbidities affected the other two domains. For example, having tumour or cancer negatively affected both LiSat-life (OR 0.62, 95% CI 0.44– 0.88) and LiSat-somhealth (OR 0.42, 95% CI 0.24– 0.74). Anxiety or depression disorders had a negative relationship both for LiSat-life (OR 0.54, 95% CI 0.38– 0.78) and LiSat-psychhealth (OR 0.10, 95% CI 0.06– 0.14).Conclusion: Older adults with chronic pain reported lower life satisfaction but the difference from their peers without chronic pain was trivial, except for satisfaction with somatic health. Pain management in old age needs to consider comorbidities and severe pain to improve patients’ life satisfaction.

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  • 41.
    Drott, Jenny
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping. Linköping University, Faculty of Medicine and Health Sciences.
    Fomichov Casaballe, Victoria
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Regional Cancer Center South East Sweden.
    Börjeson, Sussanne
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Berterö, Carina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Sense of coherence and health-related quality of life in patients with neurotoxicity after cancer chemotherapy: Assessment from a real-time mobile phone-based system2020In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 29, no 1, p. 107-113Article in journal (Refereed)
    Abstract [en]

    Objective

    In the present study, we aimed to assess sense of coherence (SOC) and health‐related quality of life (HRQOL) during and after adjuvant chemotherapy by mobile phone‐based reporting in patients with colorectal cancer experiencing neurotoxicity.

    Methods

    In this prospective descriptive cohort study, a mobile phone‐based system was used to receive a series of real‐time longitudinal patient‐reported assessments of SOC (13‐item), HRQOL (Functional Assessment of Cancer Therapy‐General (FACT‐G) 27‐item), and neurotoxicity (OANQ 29‐item) from 43 patients with colorectal cancer after being treated with chemotherapy including oxaliplatin. Measurements were conducted during the whole treatment period (mean 5 cycles) and up to 12 months after completing chemotherapy.

    Results

    In total, 817 questionnaire responses (226 SOC, 221 FACT‐G, 370 OANQ) answered during and after chemotherapy treatment were available for analysis. Even though all patients experienced neurotoxicity during the treatment period, HRQOL was stable over time. Over time, the ratings of physical wellbeing tended to increase, while the subscale of social wellbeing tended to decrease. Overall SOC, including the three components comprehensibility, manageability, and meaningfulness was stable during the entire study period. No internal data was missing due to the mobile phone‐based system.

    Conclusions

    All patients had neurotoxicity during the treatment period that seemed to affect the social wellbeing component of HRQOL, but SOC seemed unaffected. Real‐time patient‐reported assessment using mobile phone technology could be valuable in the clinical setting to provide continuous individualised monitoring to help identify patients who need further evaluation to maintain or improve their psychosocial health.

    The full text will be freely available from 2020-10-31 13:43
  • 42.
    Dunlop, Gordon
    et al.
    Arsenal Football Club, England; Edinburgh Napier Univ, Scotland.
    Ardern, Clare
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Andersen, Thor Einar
    Oslo Sports Trauma Res Ctr, Norway.
    Lewin, Colin
    Lewin Sports Injury Clin, England.
    Dupont, Gregory
    French Football Federat, France.
    Ashworth, Ben
    Arsenal Football Club, England.
    ODriscoll, Gary
    AC Sparta Prague Football Club, Czech Republic.
    Rolls, Andrew
    Bristol City Football Club, England.
    Brown, Susan
    Edinburgh Napier Univ, Scotland.
    McCall, Alan
    Edinburgh Napier Univ, Scotland.
    Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams2020In: Sports Medicine, ISSN 0112-1642, E-ISSN 1179-2035, Vol. 50, no 4, p. 829-840Article in journal (Refereed)
    Abstract [en]

    Purpose Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. Methods We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. Results One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. Conclusions General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.

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  • 43.
    Dybjer, E.
    et al.
    Lund Univ, Sweden.
    Engstrom, G.
    Lund Univ, Sweden.
    Helmer, C.
    Univ Bordeaux, France.
    Nägga, Katarina
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics. Lund Univ, Sweden.
    Rorsman, P.
    Univ Gothenburg, Sweden; Univ Oxford, England.
    Nilsson, P. M.
    Lund Univ, Sweden.
    Incretin hormones, insulin, glucagon and advanced glycation end products in relation to cognitive function in older people with and without diabetes, a population-based study2020In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this observational study was to investigate relationships between physiological levels of glucometabolic biomarkers and cognitive test results in a population-based setting. Methods Cross-sectional data were obtained from the Swedish population-based Malmo Diet and Cancer Study Re-examination 2007-2012 comprising 3001 older people (mean age 72 years). Through oral glucose tolerance testing (OGTT), fasting and post-load levels of serum insulin, plasma glucagon, serum glucose-dependent insulinotropic peptide (GIP) and plasma glucagon-like peptide-1 (GLP-1) were measured. Insulin resistance and insulin sensitivity levels were calculated. In 454 participants, advanced glycation end products (AGEs) were estimated through skin autofluorescence. Associations between biomarkers and two cognitive tests, the Mini-Mental State Examination (MMSE) and A Quick Test of Cognitive Speed (AQT) respectively, were explored in multiple regression analyses. Results Positive associations following adjustments for known prognostic factors were found between MMSE scores and insulin sensitivity (B = 0.822, P = 0.004), 2-h plasma glucagon (B = 0.596, P = 0.026), 2-h serum GIP (B = 0.581, P = 0.040) and 2-h plasma GLP-1 (B = 0.585, P = 0.038), whereas negative associations were found between MMSE scores and insulin resistance (B = -0.734, P = 0.006), fasting plasma GLP-1 (B = -0.544, P = 0.033) and AGEs (B = -1.459, P = 0.030) were found. Conclusions Higher levels of insulin sensitivity, GIP and GLP-1 were associated with better cognitive outcomes, but AGEs were associated with worse outcomes, supporting evidence from preclinical studies. Glucagon was linked to better outcomes, which could possibly reflect neuroprotective properties similar to the related biomarker GLP-1 which has similar intracellular properties. Longitudinal and interventional studies are needed to further evaluate neuromodulating effects of these biomarkers. presented at the European Association for the Study of Diabetes (EASD) 2019, Barcelona, Spain

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  • 44.
    Edelbring, Samuel
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Orebro Univ, Sweden.
    Alehagen, Siw
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Mörelius, Evalotte
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus Linköping/Motala. Edith Cowan Univ, Australia.
    Johansson, AnnaKarin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Rytterström, Patrik
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Should the PBL tutor be present?: A cross-sectional study of group effectiveness in synchronous and asynchronous settings2020In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, BMC MEDICAL EDUCATION, Vol. 20, no 1Article in journal (Refereed)
    Abstract [en]

    Background

    The tutorial group and its dynamics are a cornerstone of problem-based learning (PBL). The tutor’s support varies according to the setting, and it is pertinent to explore group effectiveness in relation to different settings, for example online or campus-based. The PBL groups’ effectiveness can partly be assessed in terms of cognitive and motivational aspects, using a self-report tool to measure PBL group effectiveness, the Tutorial Group Effectiveness Instrument (TGEI).

    This study’s aim was to explore tutor participation in variations of online and campus-based tutorial groups in relation to group effectiveness. A secondary aim was to validate a tool for assessing tutorial group effectiveness in a Swedish context.

    Methods

    A cross-sectional study was conducted with advanced-level nursing students studying to become specialised nurses or midwives at a Swedish university. The TGEI was used to measure motivational and cognitive aspects in addition to overall group effectiveness. The instrument’s items were translated into Swedish and refined with an expert group and students. The responses were calculated descriptively and compared between groups using the Mann–Whitney U and Kruskal–Wallis tests. A psychometric evaluation was performed using the Mokken scale analysis. The subscale scores were compared between three different tutor settings: the tutor present face-to-face in the room, the tutor present online and the consultant tutor not present in the room and giving support asynchronously.

    Results

    All the invited students (n = 221) participated in the study. There were no differences in motivational or cognitive aspects between students with or without prior PBL experience, nor between men and women. Higher scores were identified on cognitive aspects (22.6, 24.6 and 21.3; p < 0.001), motivational aspects (26.3, 27 and 24.5; p = 002) and group effectiveness (4.1, 4.3, 3.8, p = 0.02) for the two synchronously tutored groups compared to the asynchronously tutored group. The TGEI subscales showed adequate homogeneity.

    Conclusions

    The tutor’s presence is productive for PBL group effectiveness. However, the tutor need not be in the actual room but can provide support in online settings as long as the tutoring is synchronous.

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  • 45.
    Edouard, Pascal
    et al.
    Univ Jean Monnet, France; Univ Hosp St Etienne, France; French Athlet Federat FFA, France; EAA, Switzerland; CHU Vaudois, Switzerland.
    Glover, Danny
    Hlth Educ Yorkshire and Humber, England; Univ Edinburgh, Scotland.
    Murray, Andrew
    Univ Edinburgh, Scotland.
    Timpka, Toomas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Sorg, Marine
    Univ Hosp St Etienne, France.
    Depiesse, Frederic
    French Athlet Federat FFA, France; EAA, Switzerland; Univ Hosp Martin, France; IAAF, Monaco.
    Branco, Pedro
    EAA, Switzerland; IAAF, Monaco.
    Junge, Astrid
    MSH Med Sch Hamburg, Germany; Swiss Concuss Ctr, Switzerland; Schulthess Clin, Switzerland.
    Infographic. Useful steps in the prevention of illnesses during international athletics championships2020In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 54, no 4, p. 251-252Article in journal (Other academic)
    Abstract [en]

    n/a

  • 46.
    Edouard, Pascal
    et al.
    Univ Jean Monnet, France; Univ Hosp St Etienne, France; CHU Vaudois, Switzerland; EAA, Switzerland; FFA, France.
    Navarro, Laurent
    Univ Jean Monnet, France.
    Branco, Pedro
    EAA, Switzerland; IAAF, Monaco.
    Gremeaux, Vincent
    CHU Vaudois, Switzerland; Univ Lausanne, Switzerland.
    Timpka, Toomas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Health and Developmental Care, Center for Public Health.
    Junge, Astrid
    MSH Med Sch Hamburg, Germany; Schulthess Klin, Switzerland.
    Injury frequency and characteristics (location, type, cause and severity) differed significantly among athletics (track and field) disciplines during 14 international championships (2007-2018): implications for medical service planning2020In: British Journal of Sports Medicine, ISSN 0306-3674, E-ISSN 1473-0480, Vol. 54, no 3, p. 159-167Article in journal (Refereed)
    Abstract [en]

    Objective To analyse differences between athletic disciplines in the frequency and characteristics of injuries during international athletics championships. Methods Study design, injury definition and data collection procedures were similar during the 14 international championships (2007-2018). National medical teams and local organising committee physicians reported all newly incurred injuries daily on a standardised injury report form. Results were presented as number of injuries and number of injuries per 1000 registered athletes, separately for male and female athletes, and for each discipline. Results From a total of 8925 male and 7614 female registered athletes, 928 injuries were reported in male and 597 in female athletes. The discipline accounting for the highest proportion of injuries was sprints, for both men (24%) and women (26%). The number of injuries per 1000 registered athletes varied between disciplines for men and women: highest in combined events for male athletes (235 (95% CI 189 to 281)) and female athletes (212 (95% CI 166 to 257)), and lowest for male throwers (47 (95% CI 35 to 59)) and female throwers (32 (95% CI 21 to 43)) and for female race walkers (42 (95% CI 19 to 66)). Injury characteristics varied significantly between disciplines for location, type, cause and severity in male and female athletes. Thigh muscle injuries were the main diagnoses in the disciplines sprints, hurdles, jumps, combined events and race walking, lower leg muscle injuries in marathon running, lower leg skin injury in middle and long distance running, and trunk muscle and lower leg muscle injuries in throws. Conclusions Injury characteristics differed substantially between disciplines during international athletics championships. Strategies for medical service provision (eg, staff, facilities) during athletics championships should be discipline specific and be prepared for targeting the main injuries in each discipline.

  • 47.
    Ekstrand, Jan
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences. Aspetar Orthopaed and Sports Med Hosp, Qatar.
    Spreco, Armin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Society and Health. Linköping University, Faculty of Medicine and Health Sciences.
    Windt, Johann
    Linköping University, Faculty of Medicine and Health Sciences. US Olymp Comm, CO USA; US Coalit Prevent Illness and Injury Sport, CO USA.
    Khan, Karim M.
    Linköping University, Faculty of Medicine and Health Sciences. Univ British Columbia, Canada.
    Are Elite Soccer Teams Preseason Training Sessions Associated With Fewer In-Season Injuries? A 15-Year Analysis From the Union of European Football Associations (UEFA) Elite Club Injury Study2020In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, article id 0363546519899359Article in journal (Refereed)
    Abstract [en]

    Background: Preseason training develops players physical capacities and prepares them for the demands of the competitive season. In rugby, Australian football, and American football, preseason training may protect elite players against in-season injury. However, no study has evaluated this relationship at the team level in elite soccer. Purpose/Hypothesis: The aim of this study was to investigate whether the number of preseason training sessions completed by elite soccer teams was associated with team injury rates and player availability during the competitive season. It was hypothesized that elite soccer teams who participate in more preseason training will sustain fewer injuries during the competitive season. Study Design: Descriptive epidemiology study. Methods: We used the Union of European Football Associations (UEFA) injury dataset to analyze 44 teams for up to 15 seasons (total, 244 team-seasons). Separate linear regression models examined the association between the number of team preseason training sessions and 5 in-season injury measures. Injury-related problems per team were quantified by totals of the following: (1) injury burden, (2) severe injury incidence, (3) training attendance, (4) match availability, and (5) injury incidence. Results: Teams averaged 30 preseason training sessions (range, 10-51). A greater number of preseason training sessions was associated with less injury load during the competitive season in 4 out of 5 injury-related measures. Our linear regression models revealed that for every 10 additional preseason training sessions that the team performed, the in-season injury burden was 22 layoff days lower per 1000 hours (P = .002), the severe injury incidence was 0.18 severe injuries lower per 1000 hours (P = .015), the training attendance was 1.4 percentage points greater (P = .014), and the match availability was 1.0 percentage points greater (P = .042). As model fits were relatively low (adjusted R-2 = 1.3%-3.2%), several factors that contribute to in-season injury outcomes were unaccounted for. Conclusion: Teams that performed a greater number of preseason training sessions had "healthier" in-season periods. Many other factors also contribute to in-season injury rates. Understanding the benefit of preseason training on in-season injury patterns may inform sport teams planning and preparation.

  • 48.
    Eleftheriou, Andreas
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Neurology in Linköping.
    Blystad, Ida
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Tisell, Anders
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Region Östergötland, Center for Diagnostics, Medical radiation physics. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Medicine and Health Sciences.
    Gasslander, Johan
    Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Norrköping.
    Lundin, Fredrik
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Neurobiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Neurology in Linköping.
    Indication of Thalamo-Cortical Circuit Dysfunction in Idiopathic Normal Pressure Hydrocephalus: A Tensor Imaging Study2020In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 10, no 1Article in journal (Refereed)
    Abstract [en]

    Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Thirteen consecutive iNPH-patients underwent a pre- and post-operative clinical work-up: 10m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs); for cognitive function MMSE. Nine HI were included. DTI was performed before and 3 months after surgery, HI underwent DTI once. DTI differences analyzed by manually placing 12 regions-of-interest. In patients motor and balance function improved significantly after surgery (p=0.01, p=0.025). Higher nearly significant FA values found in the patients vs HI pre-operatively in the thalamus (p=0.07) accompanied by an almost significant lower ADC (p=0.08). Significantly FA and ADC-values were found between patients and HI in FWM (p=0.02, p=0.001) and almost significant (p=0.057) pre- vs postoperatively. Postoperatively we found a trend towards the HIs FA values and a strong significant negative correlation between FA changes vs. gait results in the FWM (r=-0.7, p=0.008). Our study gives a clear indication of an ongoing pathological process in the periventricular white matter, especially in the thalamus and in the frontal white matter supporting the hypothesis of a shunt reversible thalamo-cortical circuit dysfunction in iNPH.

  • 49.
    Enblom, Anna
    et al.
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences.
    Steineck, Gunnar
    Karolinska Inst, Sweden; Gothenburg Univ, Sweden.
    Börjeson, Sussanne
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Nursing Sciences and Reproductive Health. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Oncology.
    Methodology Aspects of Nausea Measuring During Pelvic Radiotherapy: Daily Nausea Measuring Is Successful to Identify Patients Experiencing Nausea2020In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 43, no 2, p. 93-104Article in journal (Refereed)
    Abstract [en]

    Background Nausea seems underreported during pelvic radiotherapy. Objective The aims of this study were to investigate if a 5-week recall measure of nausea covering the entire radiotherapy period was comparable with accumulated daily nausea measurements and to investigate if the measuring method affected potential difference in quality of life (QoL) between nauseated patients and patients free from nausea. Methods This longitudinal methodology study covered 200 patients (mean age, 64 years; 84% women; 69% had gynecological cancer). The patients graded QoL (Functional Assessment of Cancer Therapy-General). They registered nausea daily and at a 5-week recall at the end of radiotherapy. Results The nausea-intensity category scale and visual analog scale correlated well (Spearman correlation coefficient = 0.622). According to the 5-week recall, 57 of 157 answering patients (36%) experienced nausea during the radiotherapy period. Using the daily nausea measurements, 94 of 157 patients (60%) experienced nausea (relative risk, 1.65; 95% confidence interval, 1.29-2.10). Of these 94 nauseated patients, 39 (42%) did not report nausea using the 5-week recall. The nauseated patients experienced worse QoL (physical/functional subscores) than patients free from nausea whether nausea was registered daily or at the 5-week recall. Conclusions Almost half, 42%, of the patients who experienced nausea according to daily nausea measurements did not report having had nausea according to the 5-week recall. Nauseated patients graded worse QoL than patients who were free from nausea. Implications for Practice Nursing professionals should measure nausea repeatedly to identify patients at risk of nausea and worsened QoL, to be able to deliver evidence-based antiemetic treatment strategies.

  • 50.
    Engström, Karolina
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.
    Vanky, Farkas
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Diagnostics and Specialist Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Rehnberg, Malin
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Trinks, Cecilia
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Jonasson, Jon
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Green, Anna
    Orebro Univ, Sweden.
    Gunnarsson, Cecilia
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Clinical genetics.
    Novel SMAD3 p.Arg386Thr genetic variant co-segregating with thoracic aortic aneurysm and dissection2020In: Molecular Genetics & Genomic Medicine, ISSN 2324-9269, article id e1089Article in journal (Refereed)
    Abstract [en]

    Background Pathogenic variants in the SMAD3 gene affecting the TGF-beta/SMAD3 signaling pathway with aortic vessel involvement cause Loeys-Dietz syndrome 3, also known as aneurysms-osteoarthritis syndrome. Methods Description of clinical history of a family in Sweden using clinical data, DNA sequencing, bioinformatics, and pedigree analysis. Results We report a novel SMAD3 variant, initially classified as a genetic variant of uncertain clinical significance (VUS), and later found to be co-segregating with aortic dissection in the family. The index patient presented with a dissecting aneurysm of the aorta including the ascending, descending, and abdominal parts. Genotype analysis revealed a heterozygous missense SMAD3 variant: NM_005902.3(SMAD3): c.11576G amp;gt; C (p.Arg386Thr). The same variant was also identified in a 30 years old formalin-fixed paraffin-embedded block of tissue from a second cousin, who died at 26 years of age from a dissecting aneurysm of the aorta. Conclusion A "variant of uncertain significance" according to the ACMG guidelines has always a scope for reappraisal. Genetic counselling to relatives, and the offering of surveillance service is important to families with aortic aneurysm disease. The report also highlight the potential use of FFPE analysis from deceased relatives to help in the interpretation of variants.

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