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  • 201.
    Stålnacke, Britt-Marie
    et al.
    Institutionen för samhällsmedicin och rehabilitering, Umeå universitet.
    Bäckryd, Emmanuel
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Roeck Hansen, Elisabeth
    Rehabiliteringsmedicinska Universitetskliniken Stockholm, Danderyds Sjukhus AB.
    Novo, Mehmed
    Institutionen för samhällsmedicin och rehabilitering, Umeå universitet.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Smärtanalys och diagnossättning vid kroniska smärtor inom specialiserad smärtvård2014Rapport (Övrigt vetenskapligt)
    Abstract [sv]

    Vi har som modifiering av SoS diagnosriktlinje föreslagit att smärtdiagnostiken ska använda två system parallellt d.v.s. både ICD10 systemet som det föreslagits av Socialstyrelsen för den specialiserade smärtvården (exklusiveR52.2A-C och F45.4) (Bilaga 1) och en utvidgad smärtmekanistisk klassificering. Vid tillämpningen av det förra används lämpligen den lathund som har utarbetats av diagnosgruppen inom NRS (Bilaga 2). För den senare används kategorierna definierade i detta dokument (dvs. neuropatisk, nociceptiv, generaliserad, psykogen och/eller idiopatisk) tillsammans med ställningstagande till smärtkänslighet.

    Härigenom skapas mer enhetlig diagnossättning vilket är en förutsättning för kliniska riktlinjer, kliniska jämförelser och intensifierad forskning involverande diagnosaspekter.

  • 202.
    Svanberg, Mikael
    et al.
    Psychosomat Medical Clin, Västerås, Sweden; University of Örebro, Sweden.
    Stålnacke, Britt-Marie
    Umeå University, Sweden; Danderyd Hospital, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Brodda-Jansen, Gunilla
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Danderyd Hospital, Sweden; Institute Psychophysiol Behav Med, Sweden.
    Boersma, Katja
    University of Örebro, Sweden.
    IMPACT OF EMOTIONAL DISTRESS AND PAIN-RELATED FEAR ON PATIENTS WITH CHRONIC PAIN: SUBGROUP ANALYSIS OF PATIENTS REFERRED TO MULTIMODAL REHABILITATION2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 4, s. 354-361Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP. Design: Cohort study with a cross-sectional, prospective part. Patients: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics. Methods: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment. Results: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demographics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome. Conclusion: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

  • 203.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rehabgruppen NSC. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Östlund, Gunnel
    Mälardalen University, Eskilstuna, Sweden.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Valtersson, Eva
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Björk, Mathilda
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Rehabenheten. Jönköping University, Sweden.
    Dilemmas of participation in everyday life in early rheumatoid arthritis: a qualitative interview study (The Swedish TIRA Project)2015Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 14-15, s. 1251-1259Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

  • 204.
    Sverker, Annette
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Östlund, Gunnel
    Mälardalens högskola, Hälsa och välfärd, Sweden.
    Thyberg, Mikael
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Valtersson, Eva
    Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Björk, Mathilda
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin.
    Thyberg, Ingrid
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet.
    Dilemmas of participation in everyday life in early rheumatoid arthritis (RA),: a qualitative interview study (The Swedish TIRA study)2014Konferensbidrag (Övrigt vetenskapligt)
  • 205.
    Söderlund Schaller, Anne
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Impact of Pain and Evaluation of Education and Self-Care in Patients with Head and Neck Cancer2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    It is not unusual for patients with head and neck cancer (HNC) to suffer from both tumor and treatment-related pain that is difficult to alleviate despite individualized pharmacological treatment.

    The presence of concomitant various dimensions of pain in patients during the often difficult period following radiotherapy (RT) has not been elucidated. Several aspects concerning the importance of relatives for HNC patients have been addressed. However, little attention has been given to how relatives perceive patients with HNC pain and it is important to further elucidate this sparsely studied topic. Knowledge about health-related quality of life (HR-QoL) in this patient group during early RT is limited and needs to be assessed in relation to diagnosis and treatment. Self-care (SC) refers to what patients do on their own to achieve, maintain, and promote optimal health and may help reduce pain for several pain conditions. The impact of patient education and SC on pain and other common HNC symptoms need further clarification.

    The aims of this thesis were:

    1. to describe experiences and perceptions of pain in patients with HNC shortly after RT
    2. to describe how relatives perceived the patient’s situation, especially concerning pain, and how they experienced their own situation
    3. to identify factors that impact HR-QoL during early RT
    4. to develop effective pain management strategies, maintain activities of daily living, and promote HR-QoL in patients with HNC undergoing RT using patient education and SC instruction.

    In paper I patients with HNC described existential pain – expressed as fear of death, meaninglessness and guilt – already during and shortly after RT. Physical pain, psychological distress and social withdrawal played a significant role. Patients with HNC who were treated with RT should also proactively be offered treatment for the various dimensions of pain.

    In paper II relatives described their mental stress in response to a challenging situation that required their active support to help ease the patient's difficult condition. The interviews with relatives also revealed a lack of personal knowledge and frustration over the inability to participate in patient care, as well as inadequate support from the healthcare system. Early interventions from the healthcare system on behalf of the relatives may be necessary to meet these needs.

    In Paper III regression models revealed that pain intensity and symptoms of depression adversely affected HR-QoL in patients with HNC during early RT. Customized prehabilitation programs aimed at preventing pain and symptoms of depression could help preserve good HR-QoL.

    Paper IV assessed individual patient education and SC initiatives that resulted in a tendency for lower pain intensity during a portion of RT. One way to potentially enhance the benefits of education and SC could be to improve for example patient motivation and self-efficacy, as well as to optimize supportive efforts from caregivers.

    In conclusion, by identifying factors that can impact HR-QoL and evaluating the effect of patient education and SC, this thesis contributes to knowledge on perceived pain and the patient’s situation during and shortly after RT in patients with HNC and their relatives. This thesis points to the need for evaluation and further development of patient education and effective SC strategies for pain in patients with HNC undergoing RT, as well as for development and evaluation of support strategies for patients with pain and their families during and after RT.

    Delarbeten
    1. Experiences of Pain: A Longitudinal, Qualitative Study of Patients with Head and Neck Cancer Recently Treated with Radiotherapy
    Öppna denna publikation i ny flik eller fönster >>Experiences of Pain: A Longitudinal, Qualitative Study of Patients with Head and Neck Cancer Recently Treated with Radiotherapy
    2015 (Engelska)Ingår i: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 16, nr 3, s. 336-345Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    It is not unusual for patients with head and neck cancer (HNC) to suffer from both tumor- and treatment-related pain that is difficult to alleviate despite individualized pain management. The aim of this qualitative study was to describe how HNC patients experience pain and how pain influences those who are treated with radiotherapy (RT). Qualitative semistructured interviews were performed 1 and 6 months after patients completed RT. The interviews addressed symptoms, moods, and suffering. The study included 26 patients with HNC who had recently completed RT. The interviews were analyzed using manifest content analysis. The main category was: HNC patients did not report that their severe physical pain influenced their psychological suffering, but it did influence their social lives. Furthermore, four categories were revealed: pain in the head and neck region, overwhelming fatigue, altered mood and preoccupied mind, and decreased participation and changed relationships. Physical pain, psychological distress, and social withdrawal were prominent at both interviews and consequently their situation can be considered as chronic. Remarkably, patients did not express a clear relationship between pain and psychological load. This may imply a biomedical view of pain or may reflect the difficult situation patients were in (i.e., facing a possibly life-threatening cancer). Thus, their situation might require a prioritization and might negatively affect the possibility of identifying the interaction between the different pain dimensions. The biopsychosocial model of chronic pain aims to understand the interaction between pain and psychosocial factors. Interventions aiming to teach patients with HNC how to internalize the biopsychosocial model framework to manage pain could be useful and should be evaluated in future research.

    Nationell ämneskategori
    Medicinska och farmaceutiska grundvetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-115363 (URN)10.1016/j.pmn.2014.08.010 (DOI)000355212500022 ()25532691 (PubMedID)
    Tillgänglig från: 2015-03-13 Skapad: 2015-03-13 Senast uppdaterad: 2018-04-13
    2. How relatives of patients with head and neck cancer experience pain, disease progression and treatment: A qualitative interview study
    Öppna denna publikation i ny flik eller fönster >>How relatives of patients with head and neck cancer experience pain, disease progression and treatment: A qualitative interview study
    2014 (Engelska)Ingår i: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, nr 4, s. 405-410Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Purpose: This study of relatives to patients with head and neck cancer (HNC) treated with radiotherapy describes how the relatives experienced the patients situation, especially with respect to pain, and how the relatives themselves experienced the situation. Methods: Semi-structured interviews of 21 relatives to HNC patients who suffered from pain were conducted, and a qualitative content analysis was performed. Results: The relatives experienced that the patients suffered from physical, psychological, and social pain. A dark picture consisting of lack of participation and knowledge, psychological distress, and lack of support were reported. Thus, a main category: relatives struggle with loved ones pains related to head and neck cancer treatment and with their own demanding situation - was based on the following four categories: inability to relieve and comprehend the physical suffering of the patients; overwhelming emotions were experienced that affect the patients and the relatives themselves; in need of support from the health care service; and altered daily activities and family roles due to illness and treatment. Conclusion: In patients physical, psychological, and social pain were prominent and in relatives psychological distress, lack of knowledge and support were experienced. Thus, to reduce pain and anxiety in patients and relatives, the health care professionals should provide relevant knowledge about pain management. The health care professionals should also provide educational interventions that address the psychological and social factors that impact pain for HNC patients and their relatives. Well-thought supporting care and easily accessible information about practical concerns should be offered to HNC patients and their relatives.

    Ort, förlag, år, upplaga, sidor
    Elsevier, 2014
    Nyckelord
    Head and neck cancer; Relatives; Pain; Qualitative content analysis; Interviews
    Nationell ämneskategori
    Sociologi Medicinska och farmaceutiska grundvetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-109583 (URN)10.1016/j.ejon.2014.03.008 (DOI)000339533600010 ()24726013 (PubMedID)
    Tillgänglig från: 2014-08-21 Skapad: 2014-08-21 Senast uppdaterad: 2018-04-13
    3. Quality of life during early radiotherapy in patients with head and neck cancer and pain
    Öppna denna publikation i ny flik eller fönster >>Quality of life during early radiotherapy in patients with head and neck cancer and pain
    2017 (Engelska)Ingår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 1697-1704Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Patients with head and neck cancer (HNC) have a potentially severe diagnosis and often suffer from tumor-related pain as well as from adverse side effects of treatment such as radiotherapy (RT). Knowledge about quality of life (QoL) during early RT in this group is limited and should be assessed in relation to diagnosis and treatment. Purpose: The purpose of this cross-sectional study was to identify potential factors that may influence QoL in patients with HNC during the early stages of RT (no later than two weeks of ongoing RT). We hypothesized that pain intensity, pain interference, catastrophizing, and mood disturbances are associated with QoL during early RT. Patients and methods: In this study, 54 patients (53% of eligible patients) diagnosed with HNC were consecutively recruited from the regular flow to the Pain and Rehabilitation Center at Linkoping University. The patients completed self-reported questionnaires on sociodemo-graphics, pain intensity, pain interference, anxiety, depression, pain catastrophizing, and QoL. Results: The patients in this study scored high for QoL, low for pain intensity, and low for pain interference. The patients reported minor depressive symptoms and anxiety symptoms. Regression analyses showed that pain intensity and depressive symptoms negatively influenced QoL. Conclusion: No later than two weeks of RT, pain intensity and depression negatively influenced QoL in patients with HNC. Early screening for pain and depression in a targeted preventive strategy might maintain QoL during the course of the RT for patients with HNC. This assumption needs to be further investigated.

    Ort, förlag, år, upplaga, sidor
    DOVE MEDICAL PRESS LTD, 2017
    Nyckelord
    pain; quality of life; head and neck cancer; radiotherapy; cross-sectional study
    Nationell ämneskategori
    Sjukgymnastik
    Identifikatorer
    urn:nbn:se:liu:diva-139653 (URN)10.2147/JPR.S138113 (DOI)000405597700005 ()28761374 (PubMedID)
    Tillgänglig från: 2017-08-16 Skapad: 2017-08-16 Senast uppdaterad: 2019-06-27
  • 206.
    Söderlund Schaller, Anne
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Dragioti, Elena
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Liedberg, Gunilla
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Linköpings universitet, Medicinska fakulteten.
    Larsson, Britt
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Quality of life during early radiotherapy in patients with head and neck cancer and pain2017Ingår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 1697-1704Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Patients with head and neck cancer (HNC) have a potentially severe diagnosis and often suffer from tumor-related pain as well as from adverse side effects of treatment such as radiotherapy (RT). Knowledge about quality of life (QoL) during early RT in this group is limited and should be assessed in relation to diagnosis and treatment. Purpose: The purpose of this cross-sectional study was to identify potential factors that may influence QoL in patients with HNC during the early stages of RT (no later than two weeks of ongoing RT). We hypothesized that pain intensity, pain interference, catastrophizing, and mood disturbances are associated with QoL during early RT. Patients and methods: In this study, 54 patients (53% of eligible patients) diagnosed with HNC were consecutively recruited from the regular flow to the Pain and Rehabilitation Center at Linkoping University. The patients completed self-reported questionnaires on sociodemo-graphics, pain intensity, pain interference, anxiety, depression, pain catastrophizing, and QoL. Results: The patients in this study scored high for QoL, low for pain intensity, and low for pain interference. The patients reported minor depressive symptoms and anxiety symptoms. Regression analyses showed that pain intensity and depressive symptoms negatively influenced QoL. Conclusion: No later than two weeks of RT, pain intensity and depression negatively influenced QoL in patients with HNC. Early screening for pain and depression in a targeted preventive strategy might maintain QoL during the course of the RT for patients with HNC. This assumption needs to be further investigated.

  • 207.
    Tammimies, Kristiina
    et al.
    Karolinska Inst, Sweden.
    Li, Danyang
    Karolinska Inst, Sweden.
    Rabkina, Ielyzaveta
    Karolinska Inst, Sweden.
    Stamouli, Sofia
    Karolinska Inst, Sweden.
    Becker, Martin
    Karolinska Inst, Sweden.
    Nicolaou, Veronika
    Karolinska Inst, Sweden.
    Berggren, Steve
    Karolinska Inst, Sweden; Stockholm Hlth Serv, Sweden.
    Coco, Christina
    Karolinska Inst, Sweden; Stockholm Hlth Serv, Sweden.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin Univ, Australia.
    Jonsson, Ulf
    Karolinska Inst, Sweden; Stockholm Hlth Serv, Sweden; Uppsala Univ, Sweden.
    Choque-Olsson, Nora
    Karolinska Inst, Sweden.
    Bolte, Sven
    Karolinska Inst, Sweden; Stockholm Hlth Serv, Sweden; Curtin Univ, Australia.
    Association between Copy Number Variation and Response to Social Skills Training in Autism Spectrum Disorder2019Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, artikel-id 9810Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Challenges in social communication and interaction are core features of autism spectrum disorder (ASD) for which social skills group training (SSGT) is a commonly used intervention. SSGT has shown modest and heterogeneous effects. One of the major genetic risk factors in ASD is rare copy number variation (CNV). However, limited information exists whether CNV profiles could be used to aid intervention decisions. Here, we analyzed the rare genic CNV carrier status for 207 children, of which 105 received SSGT and 102 standard care as part of a randomized clinical trial for SSGT. We found that being a carrier of rare genic CNV did not have an impact on the SSGT outcome measured by the parent-report Social Responsiveness Scale (SRS). However, when stratifying by pathogenicity and size of the CNVs, we identified that carriers of clinically significant and large genic CNVs (amp;gt; 500 kb) showed inferior SRS outcomes at post-intervention (P = 0.047 and P = 0.036, respectively) and follow-up (P = 0.008 and P = 0.072, respectively) when adjusting for standard care effects. Our study provides preliminary evidence that carriers of clinically significant and large genic CNVs might not benefit as much from SSGT as non-carriers. Our results indicate that genetic information might help guide the modifications of interventions in ASD.

  • 208.
    Tang, Julia
    et al.
    Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Horlin, Chiara
    Curtin University, Australia.
    Tan, Tele
    Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Vaz, Sharmila
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia; Cooperat Research Centre Living Autism Spectrum Disorders, Australia.
    Face Recognition and Visual Search Strategies in Autism Spectrum Disorders: Amending and Extending a Recent Review by Weigelt et al2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 8, s. e0134439-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The purpose of this review was to build upon a recent review by Weigelt et al. which examined visual search strategies and face identification between individuals with autism spectrum disorders (ASD) and typically developing peers. Seven databases, CINAHL Plus, EMBASE, ERIC, Medline, Proquest, PsychInfo and PubMed were used to locate published scientific studies matching our inclusion criteria. A total of 28 articles not included in Weigelt et al. met criteria for inclusion into this systematic review. Of these 28 studies, 16 were available and met criteria at the time of the previous review, but were mistakenly excluded; and twelve were recently published. Weigelt et al. found quantitative, but not qualitative, differences in face identification in individuals with ASD. In contrast, the current systematic review found both qualitative and quantitative differences in face identification between individuals with and without ASD. There is a large inconsistency in findings across the eye tracking and neurobiological studies reviewed. Recommendations for future research in face recognition in ASD were discussed.

  • 209.
    Thompson, Craig
    et al.
    Cooperat Res Ctr Living Autism Autism CRC, Australia; Curtin Univ, Australia.
    Bolte, Sven
    Cooperat Res Ctr Living Autism Autism CRC, Australia; Curtin Univ, Australia; Karolinska Inst, Sweden; Stockholm Cty Council, Sweden.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Cooperat Res Ctr Living Autism Autism CRC, Australia; Curtin Univ, Australia; Jonkoping Univ, Sweden.
    Girdler, Sonya
    Cooperat Res Ctr Living Autism Autism CRC, Australia; Curtin Univ, Australia.
    Viewpoints on how students with autism can best navigate university2019Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 26, nr 4, s. 294-305Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Despite recognition of the challenges faced by students with autism spectrum disorders (ASD) there is limited understanding of the barriers and facilitators to participation in major life areas, such as being a university student. Aim/Objective: This research aimed to examine viewpoints on what affects the success of Australian university students with ASD. Material and Method: Q-methodology was used to describe the viewpoints of university students with ASD, their parents and their mentors, on success at university for students with ASD. A total of 57 participants completed the Q-sort. Results/Findings: Three viewpoints emerged; Individualised Support, Contextual Support and Social Support. Conclusions: This study highlighted that supports need to be individualized to the barriers and facilitators faced by Australian students with ASD. Supports also need to be contextualized to the built and social environments of universities. Significance: This study supports the premise that environmental interventions can be effective in facilitating participation in major life areas, such as university education. Peer mentoring for students with ASD may have utility for this group, but should be extended to include social, emotional and psychological support.

  • 210.
    Thyberg, Ingrid
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Östlund, Gunnel
    Mälardalens högskola, Hälsa och välfärd, Sverige.
    Björk, Mathilda
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för arbetsterapi. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland. Linköpings universitet, Hälsouniversitetet.
    Thyberg, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Valtersson, Eva
    Region Östergötland, Närsjukvården i centrala Östergötland, Rehabgruppen NSC.
    Stenström, Birgitta
    Reumatolog förbundet, Sweden.
    Sverker, Annette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa. Linköpings universitet, Hälsouniversitetet.
    Känslor relaterade till delaktighets begränsningar vid reumatoid artrit.: En kvalitativ intervjustudie.2015Konferensbidrag (Refereegranskat)
  • 211.
    Thyberg, Mikael
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Arvidsson, Patrik
    Uppsala University/County Council of Gävleborg, Ga¨vle,Jönköping University, Jönköpng Sweden,.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Nordenfelt, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Hälsa och samhälle. Ersta Sköndal University Colege Stockholm .
    Simplified bipartite concepts of functioning and disability recommended for interdisciplinary use of the ICF.2015Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, nr 19, s. 1783-1792Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To argue for and propose bipartite concepts of functioning and disability, to tally with the structure of the ICF classification list, concepts of social models and clinical needs.

    METHOD: The ICF concepts are discussed in relation to the history of ideas regarding disability concepts and the needs for such concepts in interdisciplinary rehabilitation.

    RESULTS: Bipartite concepts are presented; they refer to actual functioning, simply body functions/structures and participation, including functioning in standardized environments. Participation refers to actually performed "activities", with "activities" simply denoting things that people may do. Bipartite concepts are congruent with the ICF classification and the structure of social models of disability, suitable for clinical and interdisciplinary use and easy to understand. The issue of standardized environments represents a methodological issue rather than the conceptual issue of defining functioning and disability. An individual perspective on activity and activity limitations, i.e. the middle part of the tripartite ICF concept, is somewhat similar to concepts of traditional language that were regarded as too generalizing already in 1912, when the interactional concept of "disability in a social sense" was introduced in rehabilitation practices.

    CONCLUSION: Bipartite concepts of functioning and disability are recommended for interdisciplinary use of the ICF.

    IMPLICATIONS FOR REHABILITATION: The ICF classification is useful, but the ICF concept of activities in an individual perspective is confusing. We suggest a use of the term "activities" simply to denote things that people may do and "participation" to denote actually performed activities. Estimations of ability should be explicit about how they are related to environmental factors.

  • 212.
    Tobieson, Lovisa
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Zsigmond, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Rossitti, Sandro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Hillman, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Marklund, Niklas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Lund Univ, Sweden.
    Dynamic protein changes in the perihaemorrhagic zone of Surgically Treated Intracerebral Haemorrhage Patients2019Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, artikel-id 3181Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The secondary injury cascades exacerbating the initial brain injury following intracerebral haemorrhage (ICH) are incompletely understood. We used dual microdialysis (MD) catheters placed in the perihaemorrhagic zone (PHZ) and in seemingly normal cortex (SNX) at time of surgical ICH evacuation in ten patients (range 26-70 years). Routine interstitial MD markers (including glucose and the lactate/pyruvate ratio) were analysed and remaining microdialysate was analysed by two-dimensional gel electrophoresis (2-DE) and nano-liquid chromatography tandem mass spectrometry (nLC-MS/MS). Two time intervals were analysed; median 2-10 hours post-surgery (time A) and median 68-76 hours post-ICH onset (time B). Using 2-DE, we quantified 232 +/- 31 different protein spots. Two proteins differed between the MD catheters at time A, and 12 proteins at time B (p amp;lt; 0.05). Thirteen proteins were significantly altered between time A and time B in the SNX and seven proteins in the PHZ, respectively. Using nLC-MS/MS ca 800 proteins were identified out of which 76 were present in all samples. At time A one protein was upregulated and two downregulated, and at time B, seven proteins were upregulated, and four downregulated in the PHZ compared to the SNX. Microdialysis-based proteomics is feasible for study of secondary injury mechanisms and discovery of biomarkers after ICH.

  • 213.
    Tour, Jeanette
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Löfgren, Monika
    Karolinska Institute, Sweden; Danderyd Hospital, Sweden.
    Mannerkorpi, Kaisa
    University of Gothenburg, Sweden.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Larsson, Anette
    University of Gothenburg, Sweden.
    Palstam, Annie
    University of Gothenburg, Sweden.
    Bileviciute-Ljungar, Indre
    Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden.
    Bjersing, Jan
    University of Gothenburg, Sweden.
    Martin, Ingvar
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Ernberg, Malin
    Karolinska Institute, Sweden.
    Schalling, Martin
    Karolinska University Hospital, Sweden.
    Kosek, Eva
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden; Lowenstromska Hospital, Sweden.
    Gene-to-gene interactions regulate endogenous pain modulation in fibromyalgia patients and healthy controls-antagonistic effects between opioid and serotonin-related genes2017Ingår i: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 158, nr 7, s. 1194-1203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic pain is associated with dysfunctional endogenous pain modulation, involving both central opioid and serotonergic (5-HT) signaling. Fibromyalgia (FM) is a chronic pain syndrome, characterized by widespread musculoskeletal pain and reduced exercise-induced hypoalgesia (EIH). In this study, we assessed the effects of 3 functional genetic polymorphisms on EIH in 130 patients with FM and 132 healthy controls. Subjects were genotyped regarding the mu-opioid receptor (OPRM1) gene (rs1799971), the serotonin transporter (5-HTT) gene (5-HTTLPR/rs25531), and the serotonin-1a receptor (5-HT1a) gene (rs6296). The patients with FM had increased pain sensitivity and reduced EIH compared with healthy controls. None of the polymorphisms had an effect on EIH on their own. We found significant gene-to-gene interactions between OPRM1 x 5-HTT and OPRM1 x 5-HT1a regarding activation of EIH, with no statistically significant difference between groups. Better EIH was found in individuals with genetically inferred strong endogenous opioid signaling (OPRM1 G) in combination with weak 5-HT tone (5-HTT low/5-HT1a G), compared with strong 5-HT tone (5-HTT high/5-HT1a CC). Based on the proposed mechanisms of these genetic variants, the findings indicate antagonistic interactions between opioid and serotonergic mechanisms during EIH. Moreover, despite different baseline pain level, similar results were detected in FM and controls, not supporting an altered interaction between opioid and 5-HT mechanisms as the basis for dysfunction of EIH in patients with FM. In summary, our results suggest that, by genetic association, the mu-opioid receptor interacts with 2 major serotonergic structures involved in 5-HT reuptake and release, to modulate EIH.

  • 214.
    Tsartsalis, D.
    et al.
    Department of Cardiology, "Hippokration" Hospital, Athens; 1st Department of Cardiology, University of Athens, Medical School, "Hippokration" Hospital, Athens, Greece.
    Dragioti, Elena
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Kontoangelos, K.
    1st Department of Psychiatry, University of Athens, Medical School, Eginition University Hospital, Athens, Greece; University Mental Health Research Institute, Athens, Greece.
    Pitsavos, C.
    1st Department of Cardiology, University of Athens, Medical School, "Hippokration" Hospital, Athens, Greece.
    Sakkas, P.
    1st Department of Psychiatry, University of Athens, Medical School, Eginition University Hospital, Athens, Greece.
    Papadimitriou, G. N.
    1st Department of Psychiatry, University of Athens, Medical School, Eginition University Hospital, Athens, Greece.
    Stefanadis, C.
    1st Department of Cardiology, University of Athens, Medical School, "Hippokration" Hospital, Athens, Greece.
    Kallikazaros, I.
    Department of Cardiology, "Hippokration" Hospital, Athens, Greece.
    The impact of depression and cardiophobia on quality of life in patients with essential hypertension.2016Ingår i: Psychiatrike = Psychiatriki, ISSN 1105-2333, Vol. 27, nr 3, s. 192-203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Patients with chronic conditions like hypertension may experience many negative emotions which endorse the development of anxiety and depression symptomatology, thus they increase their risk for poor quality of life. Several studies have shown an association between symptoms of psychological distress and hypertension. In this study we aimed to quantify the link between depression, cardiophobia and quality of life in hypertensive patients. A cross-sectional design was employed. A sample of 197 hypertensive patients (89 men-108 women, mean age 53 years, SD=12 ranged 25-78) from a university outpatient hypertension clinic in Greece participated. Ninety-four (47.7%) of the participants suffered from essential grade I hypertension; 68 (34.5%) were grade II; 16 (8.1%) were categorized as grade III, while only 11 (5.6%) patients were recorded as normotensives with high normal values. The questionnaires included: (a) question for the recording of social-demographic characteristics and clinical features, (b) The Short Form (SF-36) Health Survey, (c) The Beck Depression Inventory -I, and (d) The Cardiac Anxiety Questionnaire. There were no significant differences between the two genders with exception of marital status (p=0.010), dyslipidemia (p=0.050), grade of hypertension (p=0.014), cardiac left ventricular hypertrophy (p=0.004), renal failure (p=0.043) and stroke (p=0.024). Lower levels of quality of life and higher levels of depression and cardiophobia were observed compared to the general population. There were no significant differences on psychological measures between the two sexes (p>0.05). Cardiophobia was positively related to depressive symptomatology (r=0.533, p=0.000) while negatively to both physical and mental health summary measures of SF-36 health survey (r=-0.467, p=0.000 r=-0.537, p=0.000 respectively). Multiple linear regression models found that for psychical health depression and cardiac anxiety, avoidance activities had an influence on levels of quality of life in hypertensive patients, after controlling for age and other socio-demographic variables and clinical characteristics (Beta=-0.133, p=0.007, Beta=-0.364 p=0.000 and Beta=-0.167 p=0.006, respectively). For mental component summary depression and cardiophobia, heart focused attention had also impact on mental health in hypertensives (Beta=-0.438, p=0.016, Beta=-0.564, p=0.000 and Beta=-0.223, p=0.037, respectively) after adjustments. Heart focused anxiety symptoms-as avoidance activities and/or attention and monitoring cardiac activity, are related to hypertensive patients' present deteriorated depressive symptoms and levels of quality of life. Both depressive symptomatology and heart focused anxiety may be a mechanism partly responsible for hypertensive patients' present impaired levels of quality of life.

  • 215.
    Tseli, Elena
    et al.
    Karolinska Inst, Sweden.
    Boersma, Katja
    Orebro Univ, Sweden.
    Stalnacke, Britt-Marie
    Karolinska Inst, Sweden; Danderyd Hospital, Sweden; Umea Univ, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ang, Bjorn O.
    Karolinska Inst, Sweden; Dalarna Univ, Sweden; Uppsala Univ, Sweden.
    Grooten, Wilhelmus J. A.
    Karolinska Inst, Sweden; Karolinska Univ Hosp, Sweden.
    Prognostic Factors for Physical Functioning After Multidisciplinary Rehabilitation in Patients With Chronic Musculoskeletal Pain A Systematic Review and Meta-Analysis2019Ingår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 35, nr 2, s. 148-173Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objectives: This systematic review aimed to identify and evaluate prognostic factors for long-term (amp;gt;= 6 mo) physical functioning in patients with chronic musculoskeletal pain following multidisciplinary rehabilitation (MDR). Materials and Methods: Electronic searches conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and Cochrane CENTRAL revealed 25 original research reports, published 1983-2016, (n=9436). Potential prognostic factors relating to initial pain and physical and psychological functioning were synthesized qualitatively and quantitatively in random effects meta-analyses. The level of evidence (LoE) was evaluated with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Pain-related factors (intensity and chronicity) were not associated with function/disability at long-term follow-up, odds ratio (OR)=0.84; 95% confidence interval (CI), 0.65-1.07 and OR=0.97; 95% CI, 0.93-1.00, respectively (moderate LoE). A better function at follow-up was predicted by Physical factors; higher levels of initial self-reported functioning, OR= 1.07; 95% CI, 1.02-1.13 (low LoE), and Psychological factors; low initial levels of emotional distress, OR= 0.77; 95% CI, 0.65-0.92, low levels of cognitive and behavioral risk factors, OR=0.85; 95% CI, 0.77-0.93 and high levels of protective cognitive and behavioral factors, OR=1.49; 95% CI, 1.17-1.90 (moderate LoE). Discussion: While pain intensity and long-term chronicity did not predict physical functioning in chronic pain patients after MDR, poor pretreatment physical and psychological functioning influenced the prognosis negatively. Thus, treatment should further target and optimize these modifiable factors and an increased focus on positive, psychological protective factors may perhaps provide an opening for yet untapped clinical gains.

  • 216.
    Tseli, Elena
    et al.
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Sweden.
    Grooten, Wilhelmus Johannes Andreas
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Sweden; Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
    Stålnacke, Britt-Marie
    Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Department of Rehabilitation Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
    Boersma, Katja
    School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden.
    Enthoven, Paul
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för fysioterapi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Forsknings- och utvecklingsenheten för Närsjukvården i Östergötland.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Äng, Björn Olov
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Sweden; Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
    Predictors of multidisciplinary rehabilitation outcomes in patients with chronic musculoskeletal pain: protocol for a systematic review and meta-analysis2017Ingår i: Systematic Reviews, E-ISSN 2046-4053, Vol. 6, nr 1, artikel-id 199Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Chronic musculoskeletal pain is a major public health problem. Early prediction for optimal treatment results has received growing attention, but there is presently a lack of evidence regarding what information such proactive management should be based on. This study protocol, therefore, presents our planned systematic review and meta-analysis on important predictive factors for health and work-related outcomes following multidisciplinary rehabilitation (MDR) in patients with chronic musculoskeletal pain.

    Methods

    We aim to perform a synthesis of the available evidence together with a meta-analysis of published peer-reviewed original research that includes predictive factors preceding MDR. Included are prospective studies of adults with benign, chronic (> 3 months) musculoskeletal pain diagnoses who have taken part in MDR. In the studies, associations between personal and rehabilitation-based factors and the outcomes of interest are reported. Outcome domains are pain, physical functioning including health-related quality of life, and work ability with follow-ups of 6 months or more. We will use a broad, explorative approach to any presented predictive factors (demographicsymptoms-relatedphysicalpsychosocialwork-related, and MDR-related) and these will be analyzed through (a) narrative synthesis for each outcome domain and (b) if sufficient studies are available, a quantitative synthesis in which variance-weighted pooled proportions will be computed using a random effects model for each outcome domain. The strength of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation.

    Discussion

    The strength of this systematic review is that it aims for a meta-analysis of prospective cohort or randomized controlled studies by performing an extensive search of multiple databases, using an explorative study approach to predictive factors, rather than building on single predictor impact on the outcome or on predefined hypotheses. In this way, an overview of factors central to MDR outcome can be made and will help strengthen the evidence base and inform a wide readership including health care practitioners and policymakers.

  • 217.
    Turkina, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelning för neurobiologi. Linköpings universitet, Medicinska fakulteten.
    Ghafouri, Nazdar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Evaluation of dynamic changes in interstitial fluid proteome following microdialysis probe insertion trauma in trapezius muscle of healthy women2017Ingår i: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, artikel-id 43512Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Microdialysis ( MD) has been shown to be a promising technique for sampling of biomarkers. Implantation of MD probe causes an acute tissue trauma and provokes innate response cascades. In order to normalize tissue a two hours equilibration period for analysis of small molecules has been reported previously. However, how the proteome profile changes due to this acute trauma has yet to be fully understood. To characterize the early proteome events induced by this trauma we compared proteome in muscle dialysate collected during the equilibration period with two hours later in "post-trauma". Samples were collected from healthy females using a 100 kDa MW cut off membrane and analyzed by high sensitive liquid chromatography tandem mass spectrometry. Proteins involved in stress response, immune system processes, inflammatory responses and nociception from extracellular and intracellular fluid spaces were identified. Sixteen proteins were found to be differentially abundant in samples collected during first two hours in comparison to "post-trauma". Our data suggests that microdialysis in combination with mass spectrometry may provide potentially new insights into the interstitial proteome of trapezius muscle, yet should be further adjusted for biomarker discovery and diagnostics. Moreover, MD proteome alterations in response to catheter injury may reflect individual innate reactivity.

  • 218.
    Vaz, Sharmila
    et al.
    Curtin University, Australia.
    Cordier, Reinie
    Curtin University, Australia.
    Boyes, Mark
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia.
    Joosten, Annette
    Curtin University, Australia.
    Ciccarelli, Marina
    Curtin University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    Is Using the Strengths and Difficulties Questionnaire in a Community Sample the Optimal Way to Assess Mental Health Functioning?2016Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 1, s. e0144039-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    An important characteristic of a screening tool is its discriminant ability or the measures accuracy to distinguish between those with and without mental health problems. The current study examined the inter-rater agreement and screening concordance of the parent and teacher versions of SDQ at scale, subscale and item-levels, with the view of identifying the items that have the most informant discrepancies; and determining whether the concordance between parent and teacher reports on some items has the potential to influence decision making. Cross-sectional data from parent and teacher reports of the mental health functioning of a community sample of 299 students with and without disabilities from 75 different primary schools in Perth, Western Australia were analysed. The study found that: a) Intraclass correlations between parent and teacher ratings of childrens mental health using the SDQ at person level was fair on individual child level; b) The SDQ only demonstrated clinical utility when there was agreement between teacher and parent reports using the possible or 90% dichotomisation system; and c) Three individual items had positive likelihood ratio scores indicating clinical utility. Of note was the finding that the negative likelihood ratio or likelihood of disregarding the absence of a condition when both parents and teachers rate the item as absent was not significant. Taken together, these findings suggest that the SDQ is not optimised for use in community samples and that further psychometric evaluation of the SDQ in this context is clearly warranted.

  • 219.
    Vaz, Sharmila
    et al.
    Curtin University, Australia.
    Cordier, Reinie
    Curtin University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Ciccarelli, Marina
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia; Curtin University, Australia.
    McAuliffe, Tomomi
    James Cook University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    Should Schools Expect Poor Physical and Mental Health, Social Adjustment, and Participation Outcomes in Students with Disability?2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 5, s. e0126630-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The literature on whether students with disabilities have worse physical and mental health, social adjustment, and participation outcomes when compared to their peers without disabilities is largely inconclusive. While the majority of case control studies showed significantly worse outcomes for students with disabilities; the proportion of variance accounted for is rarely reported. The current study used a population cross-sectional approach to determine the classification ability of commonly used screening and outcome measures in determining the disability status. Furthermore, the study aimed to identify the variables, if any, that best predicted the presence of disability. Results of univariate discriminant function analyses suggest that across the board, the sensitivity of the outcome/screening tools to correctly identify students with a disability was 31.9% higher than the related Positive Predictive Value (PPV). The lower PPV and Positive Likelihood Ratio (LR+) scores suggest that the included measures had limited discriminant ability (17.6% to 40.3%) in accurately identifying students at-risk for further assessment. Results of multivariate analyses suggested that poor health and hyperactivity increased the odds of having a disability about two to three times, while poor close perceived friendship and academic competences predicted disability with roughly the same magnitude. Overall, the findings of the current study highlight the need for researchers and clinicians to familiarize themselves with the psychometric properties of measures, and be cautious in matching the function of the measures with their research and clinical needs.

  • 220.
    Vaz, Sharmila
    et al.
    Curtin University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Ciccarelli, Marina
    Curtin University, Australia.
    Passmore, Anne
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia; Curtin University, Australia.
    Black, Melissa
    Curtin University, Australia.
    Cuomo, Belinda
    Curtin University, Australia.
    Tan, Tele
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    Belongingness in Early Secondary School: Key Factors that Primary and Secondary Schools Need to Consider2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 9, s. e0136053-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is unknown if, and how, students redefine their sense of school belongingness after negotiating the transition to secondary school. The current study used longitudinal data from 266 students with, and without, disabilities who negotiated the transition from 52 primary schools to 152 secondary schools. The study presents the 13 most significant personal student and contextual factors associated with belongingness in the first year of secondary school. Student perception of school belongingness was found to be stable across the transition. No variability in school belongingness due to gender, disability or household-socio-economic status (SES) was noted. Primary school belongingness accounted for 22% of the variability in secondary school belongingness. Several personal student factors (competence, coping skills) and school factors (low-level classroom task-goal orientation), which influenced belongingness in primary school, continued to influence belongingness in secondary school. In secondary school, effort-goal orientation of the student and perception of their schools tolerance to disability were each associated with perception of school belongingness. Family factors did not influence belongingness in secondary school. Findings of the current study highlight the need for primary schools to foster belongingness among their students at an early age, and transfer students belongingness profiles as part of the handover documentation. Most of the factors that influenced school belongingness before and after the transition to secondary are amenable to change.

  • 221.
    Vaz, Sharmila
    et al.
    Curtin University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Ciccarelli, Marina
    Curtin University, Australia.
    Passmore, Anne
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia; Curtin University, Australia.
    Tan, Tele
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    The Personal and Contextual Contributors to School Belongingness among Primary School Students2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 4, s. e0123353-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    School belongingness has gained currency among educators and school health professionals as an important determinant of adolescent health. The current cross-sectional study presents the 15 most significant personal and contextual factors that collectively explain 66.4% (two-thirds) of the variability in 12-year old students perceptions of belongingness in primary school. The study is part of a larger longitudinal study investigating the factors associated with student adjustment in the transition from primary to secondary school. The study found that girls and students with disabilities had higher school belongingness scores than boys, and their typically developing counterparts respectively; and explained 2.5% of the variability in school belongingness. The majority (47.1% out of 66.4%) of the variability in school belongingness was explained by student personal factors, such as social acceptance, physical appearance competence, coping skills, and social affiliation motivation; followed by parental expectations (3% out of 66.4%), and school-based factors (13.9% out of 66.4%) such as, classroom involvement, task-goal structure, autonomy provision, cultural pluralism, and absence of bullying. Each of the identified contributors of primary school belongingness can be shaped through interventions, system changes, or policy reforms.

  • 222.
    Vaz, Sharmila
    et al.
    Curtin University, Australia.
    Wilson, Nathan
    University of Western Sydney, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Sim, Angela
    Curtin University, Australia.
    Scott, Melissa
    Curtin University, Australia.
    Cordier, Reinie
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia.
    Factors Associated with Primary School Teachers Attitudes Towards the Inclusion of Students with Disabilities2015Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 8, s. e0137002-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Teachers attitudes toward inclusion are often based on the practical implementation of inclusive education rather than a specific ideology and understanding of inclusiveness. This study aimed to identify the factors associated with primary school teachers attitudes towards inclusion of students with all disabilities in regular schools. Method Seventy four primary school teachers participated in a cross-sectional survey conducted in Western Australia. Teachers attitudes and efficacy toward integration of students with disabilities were measured using the Opinions Relative to Integration of Students with Disabilities scale and Banduras Teacher Efficacy scale respectively. Results Four teacher attributes-age, gender, teaching self-efficacy and training collectively explained 42% of the variability in teachers attitude toward including students with disabilities. Conclusion The current study further contributes to the accumulation of knowledge that can unpack the complex pattern of factors that should be considered to promote positive attitudes towards inclusive schools.

  • 223.
    Veenstra, Helene
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Centrum för social och affektiv neurovetenskap. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Lundberg, Peter
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Diagnostikcentrum, Medicinsk strålningsfysik. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Alföldi, Péter
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Södermark, Martin
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Graven-Nielsen, Thomas
    Aalborg Univ, Denmark.
    Sjors, Anna
    Univ Gothenburg, Sweden.
    Engström, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV.
    Chronic widespread pain patients show disrupted cortical connectivity in default mode and salience networks, modulated by pain sensitivity2019Ingår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 12, s. 1743-1755Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The remodeling of functional neuronal connectivity in chronic widespread pain (CWP) patients remains largely unexplored. This study aimed to investigate functional connectivity in CWP patients in brain networks related to chronic pain for changes related to pain sensitivity, psychological strain, and experienced pain.

    Patients and methods: Functional connectivity strength of the default mode network (DMN) and the salience network (SN) was assessed with functional magnetic resonance imaging. Between-group differences were investigated with an independent component analysis for altered connectivity within the whole DMN and SN. Then, changes in connectivity between nodes of the DMN and SN were investigated with the use of a seed-target analysis in relation to the covariates clinical pain intensity, pressure pain sensitivity, psychological strain, and as an effect of experienced experimental cuff-pressure pain.

    Results: CWP patients showed decreased connectivity in the inferior posterior cingulate cortex (PCC) in the DMN and increased connectivity in the left anterior insula/superior temporal gyrus in the SN when compared to controls. Moreover, higher pain sensitivity in CWP when compared to controls was related to increased connectivity within the SN (between left and right insula) and between SN and DMN (between right insula and left lateral parietal cortex).

    Conclusion: This study shows that connectivity within the DMN was decreased and connectivity within the SN was increased for CWP. Furthermore, we present a novel finding of interaction of pain sensitivity with SN and DMN-SN functional connectivity in CWP.

  • 224.
    Ward, Liam
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten.
    Olausson, Patrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Li, Wei
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Yuan, Ximing
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Proteomics and multivariate modelling reveal sex-specific alterations in distinct regions of human carotid atheroma2018Ingår i: Biology of Sex Differences, ISSN 2042-6410, Vol. 9, artikel-id 54Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundAtherosclerotic lesions are comprised of distinct regions with different proteomic profiles. Men and women develop differences in lesion phenotype, with lesions from women generally being more stable and less prone to rupture. We aimed to investigate the differences in proteomic profiles between sexes, including distinct lesion regions, to identify altered proteins that contribute to these differences observed clinically.MethodsCarotid endarterectomy samples (ten men/ten women) were obtained, and intraplaque biopsies from three distinct regions (internal control, fatty streak and plaque) were analysed by tandem-mass spectrometry. Multivariate statistical modelling, using orthogonal partial least square-discriminant analysis, was used to discriminate the proteomes between men and women.ResultsMultivariate discriminant modelling revealed proteins from 16 functional groups that displayed sex-specific associations. Additional statistics revealed ten proteins that display region-specific alterations when comparing sexes, including proteins related to inflammatory response, response to reactive oxygen species, complement activation, transport and blood coagulation. Transport protein afamin and blood coagulation proteins antithrombin-III and coagulation factor XII were significantly increased in plaque region from women. Inflammatory response proteins lysozyme C and phospholipase A2 membrane-associated were significantly increased in plaque region from men. Limitations with this study are the small sample size, limited patient information and lack of complementary histology to control for cell type differences between sexes.ConclusionsThis pilot study, for the first time, utilises a multivariate proteomic approach to investigate sexual dimorphism in human atherosclerotic tissue, and provides an essential proteomic platform for further investigations to help understand sexual dimorphism and plaque vulnerability in atherosclerosis.

  • 225.
    Wigston, Christine
    et al.
    Curtin University, Australia.
    Falkmer, Marita
    Curtin University, Australia; Jonköping University, Sweden.
    Vaz, Sharmila
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia; La Trobe University, Australia.
    Participation in extracurricular activities for children with and without siblings with autism spectrum disorder2017Ingår i: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, nr 1, s. 25-39Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To compare the number, frequency, enjoyment and performance in extracurricular activities of siblings of children with autism spectrum disorders (ASD) to their typically developing (TD) peers, and to identify differences between actual and desired participation. Methods: A case-control study with 30 siblings of children with ASD and 30 siblings of TD children was conducted using the Paediatric Interest Profiles and a questionnaire. Results: Siblings of children with ASD participated in fewer extracurricular activities than those with TD siblings. ASD symptoms were significantly associated with the sibling participating in fewer extracurricular activities. Children with TD siblings had higher enjoyment scores in relaxation activities than children with siblings with ASD. Conclusion: While results were mainly positive, some differences indicated that having a sibling with ASD may impact participation in extracurricular activities. Assessments of participation barriers, as well as support to minimise participation restrictions among siblings of children with ASD are required.

  • 226.
    Wiklund, Tobias
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Linton, Steven J.
    Örebro Univ, Sweden.
    Alföldi, Peter
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Is sleep disturbance in patients with chronic pain affected by physical exercise or ACT-based stress management? - A randomized controlled study2018Ingår i: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 19, artikel-id 111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Most people suffering chronic pain are plagued by sleeping difficulties. Cognitive behaviour therapy has produced promising results for insomnia comorbid with chronic pain, but the access to such treatment is often limited. Over the last ten years, interventions aiming to increase cognitive flexibility and physical activity have been assumed to be effective treatments for a variety of conditions, including insomnia and chronic pain. If proven effective, these treatments could constitute the first steps in a stepped care model for chronic pain and insomnia. Methods: Two hundred ninety-nine chronic pain subjects were randomized to Exercise, ACT-based stress management (ACT-bsm), or an active control group. Two hundred thirty-two participants (78%) received their allocated intervention at least to some extent. These participants were evaluated using mixed model analyses for changes in sleep (Insomnia Severity Index, ISI), pain intensity, depression, and anxiety immediately after treatment, six months and twelve months after treatment. Results: The mixed model analyses revealed that Exercise had a positive effect on insomnia compared with the control group and the effect remained after 12 months. No clear effect (i.e., both for completers and for completers together with treatment non-completers) upon ISI was found for the ACT-bsm. Pain intensity decreased significantly both in the exercise group and in the control group. For the two psychological variables (i.e., symptoms of anxiety and depression) were found significant improvements over time but no group differences. The treatment effects for ISI and pain intensity did not reach clinical significance per definitions presented in other relevant studies. Conclusions: Beneficial significant effects on insomnia was confirmed in the exercise condition. However, these changes were probably not clinically important. For pain intensity a general decrease was found in the Exercise condition and in the control condition, while no change occurred in ACT-bsm. No group differences were found for the two psychological variables.

  • 227.
    Wåhlén, Karin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Fornander, Louise
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Olausson, Patrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ydreborg, Kjell
    Clinic of Otorhinolaryngology, County Hospital Ryhov, Jönköping, Sweden.
    Flodin, Ulf
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Graff, Pål
    Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lindahl, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Protein profiles of nasal lavage fluid from individuals with work-related upper airway symptoms associated to moldy and damp buildings2016Ingår i: Indoor Air, ISSN 0905-6947, E-ISSN 1600-0668, Vol. 26, nr 5, s. 743-754Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Upper airway irritation is common among individuals working in moldy and damp buildings. The aim was to investigate effects on the protein composition of the nasal lining fluid. The prevalence of symptoms in relation to work was examined in 37 individuals working in two damp buildings. Microbial growth was confirmed in one of the buildings. Nasal lavage fluid was collected from 29 exposed subjects and 13 controls. Protein profiles were investigated with a proteomic approach and evaluated by multivariate statistical models. Subjects from both workplaces reported upper airway and ocular symptoms. Based on protein profiles, symptomatic subjects in the two workplaces were discriminated from each other and separated from healthy controls. The groups differed in proteins involved in inflammation and host defense. Measurements of innate immunity proteins showed a significant increa e of protein S100-A8 and decrease of SPLUNC1 in subjects from one workplace while alpha-1-antitrypsin was elevated in subjects from the other workplace, compared to healthy controls. The results show that protein profiles in nasal lavage fluid can be used to monitor airway mucosal effects in personnel working in damp buildings and indicate that the profile may be separate when the dampness is associated with the presence of molds.

  • 228.
    Wåhlén, Karin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ghafouri, Nazdar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Plasma Protein Pattern Correlates With Pain Intensity and Psychological Distress in Women With Chronic Widespread Pain2018Ingår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 9, artikel-id 2400Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Although generalized muscle pain, tiredness, anxiety, and depression are commonly present among chronic widespread pain (CWP) patients, the molecular mechanisms behind CWP are not fully elucidated. Moreover, the lack of biomarkers often makes diagnosis and treatment problematic. In this study, we investigated the correlation between pain intensity, psychological distress, and plasma proteins among CWP patients and controls (CON). Methods: The plasma proteome of CWP (n = 15) and CON (n = 23) was analyzed using two-dimensional gel electrophoresis. Orthogonal Partial Least Square analysis (OPLS) was used to determine proteins associated with pain intensity (numeric rating scale) in CWP and psychological distress (Hospital and Depression Scale, HADS) in CWP and CON. Significant proteins were identified by MALDI-TOF and tandem MS. Results: In CWP, pain intensity was associated with plasma proteins mostly involved in metabolic and immunity processes (e.g., kininogen-1, fibrinogen gamma chain, and ceruloplasmin), and psychological distress was associated with plasma proteins related to immunity response, iron ion, and lipid metabolism (e.g., complement factor B, complement C1r subcomponent, hemopexin, and clusterin). Discussion: This study suggests that different plasma protein patterns are associated with different pain intensity and psychological distress in CWP. Proteins belonging to the coagulation cascade and immunity processes showed strong associations to each clinical outcome. Using the plasma proteome profile of CWP to study potential biomarker candidates provides a snapshot of ongoing systemic mechanisms in CWP.

  • 229.
    Wåhlén, Karin
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Olausson, Patrik
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Carlsson, Anders K
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ghafouri, Nazdar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Gerdle, Björn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Systemic alterations in plasma proteins from women with chronic widespread pain compared to healthy controls: a proteomic study2017Ingår i: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 10, s. 797-809Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Chronic widespread pain (CWP) is a complex pain condition that is difficult to treat. The prevalence of CWP approximates similar to 10% of the general population, with higher prevalence in women. Lack of understanding of molecular mechanisms has been a challenge for diagnosis and treatment of chronic pain. The aim of this study was to explore the systemic protein changes in CWP compared to those in healthy controls (CON). By applying 2-dimensional gel electrophoresis, we analyzed the protein pattern of plasma samples from women with CWP (n=16) and healthy women (n=23). The proteomic data were analyzed using multivariate statistical models, and altered proteins were identified using mass spectrometry. The proteome analysis was further validated by gel-free Western blot. Multivariate statistical data analysis of quantified proteins revealed 22 altered proteins in women with CWP, compared to CON group. Many of the identified proteins are previously known to be involved in different parts of the complement system and metabolic and inflammatory processes, e.g., complement factor B, vitamin D-binding protein, ceruloplasmin, transthyretin and alpha-2-HS-glycoprotein. These results indicate that important systemic protein differences exist between women with CWP and healthy women. Further, this study illustrates the potential use of proteomics to detect biomarkers that may provide new insights into the molecular mechanism(s) of chronic pain. However, further larger investigations are required in order to confirm these findings before it will be possible to identify proteins as potential pain biomarkers for clinical use.

  • 230.
    Yan-Ting Chee, Derserri
    et al.
    Curtin University, Australia.
    Chung-Yeung Lee, Hoe
    Curtin University, Australia.
    Falkmer, Marita
    Jonkoping Univ, Inst Disabil Res, CHILD Programme, Sch Educ and Commun, Linkoping, Sweden; Curtin University, Australia.
    Barnett, Tania
    Curtin University, Australia.
    Falkmer, Olov
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Siljehav, Jessica
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia; La Trobe University, Australia.
    Viewpoints on driving of individuals with and without autism spectrum disorder2015Ingår i: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 18, nr 1, s. 26-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: Understanding the viewpoints of drivers with autism spectrum disorder (ASD) is crucial in the development of mobility support and driver training that is responsive to their needs. Methods: Fifty young adults with ASD and fifty seven typically developed adults participated in the study to form a contrasting group. Q-methodology was used to understand viewpoints on driving as a main mode of transportation. Data were analysed using a PQ by-person varimax rotation factor analysis. Results: Although some ASD participants perceived themselves as confident and independent drivers, others preferred other modes of transportation such as public transport and walking. Anxiety was also found to be a barrier to driving. The contrast group revealed consistent viewpoints on their driving ability. They preferred driving as their main mode of transportation and believed that they were competent, safe and independent drivers. Conclusion: These results are important in the planning of transport policies and driver training for individuals with ASD. Driver training manuals can be developed to address anxiety issues, hazard perception and navigation problems in the ASD population. Their use of public transport could be further facilitated through more inclusive transport policies.

  • 231.
    Yi, Jewel
    et al.
    Curtin University, Australia.
    Chung-Yeung Lee, Hoe
    Curtin University, Australia.
    Parsons, Richard
    Curtin University, Australia.
    Falkmer, Torbjörn
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Curtin University, Australia; La Trobe University, Australia.
    The Effect of the Global Positioning System on the Driving Performance of People with Mild Alzheimers Disease2015Ingår i: Gerontology, ISSN 0304-324X, E-ISSN 1423-0003, Vol. 61, nr 1, s. 79-88Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The initial symptoms of Alzheimers disease (AD) include attention deficits, memory loss and deficiencies in topographic and spatial orientation. People with AD may have way-finding difficulties in driving due to the deterioration of their navigation ability. Although the use of the Global Positioning System (GPS) has been proven to be a useful aid for older people in driving, there is no evidence to suggest that the benefit could extend to drivers with AD. Aim: This study aims to investigate the effectiveness of the GPS in assisting drivers with mild AD in finding their destination safely. Method: Twenty-eight drivers with mild to very mild AD, diagnosed by a general practitioner or a psychogeriatrician, completed all clinical and psychometric assessments including the Mini Mental State Examination, Trail Making Test B and Doors and People Test. During the driving assessment, 3 driving trials with different settings (normal, visualonly and audio-only) of the GPS were administered to all participants. The participants were required to follow instructions from the GPS and perform a variety of driving tasks on a driving simulator. The driving performances of participants were assessed by criteria specific to AD drivers. The driving assessment criteria were first combined to form the overall driving performance score: a higher score indicated a better overall driving performance. The other outcome of this study was the success of participants to navigate to a predetermined destination. Results: The driving performance of participants was different among the 3 settings (F = 72.8, p less than 0.001) and the pairwise comparison between the 3 settings was significant (p less than 0.001). The driving performance score was highest in the audio-only setting (mean: 20.0, SD: 2.2), moderate in the normal setting (mean: 16.7, SD: 2.6) and lowest in the visual-only setting (mean: 14.3, SD: 3.3). When compared with the visual-only setting, drivers using the audioonly setting (OR: 37.2, 95% CI: 9.2-151.2) and normal setting (OR: 37.2, 95% CI: 4.8-286.9) were more likely to successfully find their destination (p less than 0.05). Conclusion: This study has found that using single, simple auditory instructions with the absence of the visual output of the GPS could potentially help people with mild AD to improve their driving ability and reach their destination.

  • 232.
    Yuan, Xi-Ming
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Sultana, Nargis
    Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Siraj, Nabeel
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten.
    Ward, Liam J
    Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Li, Wei
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper.
    Autophagy Induction Protects Against 7-Oxysterol-induced Cell Death via Lysosomal Pathway and Oxidative Stress2016Ingår i: Journal of cell death, ISSN 1179-0660, nr 9, s. 1-7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    7-Oxysterols are major toxic components in oxidized low-density lipoprotein and human atheroma lesions, which cause lysosomal mem-brane permeabilization (LMP) and cell death. Autophagy may function as a survival mechanism in this process. Here, we investigated whether 7-oxysterols mixed in an atheroma-relevant proportion induce autophagy, whether autophagy induction influences 7-oxysterol-mediated cell death, and the underlying mechanisms, by focusing on cellular lipid levels, oxidative stress, and LMP in 7-oxysterol-treated macrophages. We found that 7-oxysterols induced cellular lipid accumulation, autophagy dysfunction, and cell death in the form of both apoptosis and necrosis. Exposure to 7-oxysterols induced autophagic vacu-ole synthesis in the form of increased autophagy marker microtubule-associated protein 1A/1B-light chain 3 (LC3) and LC3-phosphatidylethanolamine conjugate (LC3-II) and autophagic vacuole formation. This led to an accumulation of p62, indicating a reduction in autophagic vacuole degradation. Importantly, autophagy induction significantly reduced 7-oxysterol-mediated cell death by diminishing LMP and oxidative stress. Moreover, autophagy induction minimized cellular lipid accumulation induced by 7-oxysterols. These findings highlight the importance of autophagy in combating cellular stress, LMP, and cell death in atherosclerosis. Therefore, activation of the autophagy pathway may be a potential therapeutic strategy for prevention of necrotic core formation in atherosclerotic lesions.

  • 233.
    Zsigmond, Peter
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Neurokirurgiska kliniken US.
    Ljunggren, Stefan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Arbets- och miljömedicin.
    Ghafouri, Bijar
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum.
    Proteomic Analysis of the Cerebrospinal Fluid in Patients With Essential Tremor Before and After Deep Brain Stimulation Surgery: A Pilot Study2019Ingår i: Neuromodulation (Malden, Mass.), ISSN 1094-7159, E-ISSN 1525-1403Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Electrical neuromodulation by deep brain stimulation (DBS) is a well-established method for treatment of severe essential tremor (ET). The mechanism behind the tremor relieving effect remains largely unknown. Our aim of this study was to evaluate alterations in proteomics pre- and post-DBS in patients diagnosed with severe ET. Materials and Methods Ten right-handed ET patients were included in this study. Cerebrospinal fluid (CSF) was obtained by lumbar puncture preoperatively (N = 10) and six months postoperatively (N = 7). The samples were analyzed by high sensitive liquid chromatography tandem mass spectrometry. Results Twenty-two proteins were statistically significantly altered in the CSF of ET patients before and after DBS treatment. Downregulated proteins were involved in regulatory processes of protein activation, complement activation, humoral immune response as well as acute inflammatory response. The upregulated proteins were involved in pathways for cell secretion, adhesion as well as response to axon injury. Conclusions DBS in ET patients effects the neurochemical environment in the CSF. These findings further elucidate the mechanisms of DBS and may lead to new biomarkers for evaluating the effect of DBS treatment.

  • 234.
    Östlund, Gunnel
    et al.
    Mälardalens högskola, Hälsa och välfärd, Sweden.
    Björk, Mathilda
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa. Region Östergötland, Sinnescentrum, Smärt och rehabiliteringscentrum. Department of Rehabilitation, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Thyberg, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Valtersson, Eva
    Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
    Sverker, Annette
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Socialt arbete. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Rörelse och Hälsa.
    Adjustment, avoidance, interaction, and acceptance strategies where used by men with participation restrictions due to early RA2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background: Approximately 1/3 of patients diagnosed with the chronic disease Rheumatoid Arthritis (RA) are men, however few studies describe experiences and strategies to handle daily activities [2]. Daily life with a chronic disease means learning to live under new circumstances. This also foresee a continuous adaptation to new ways of living. The process of coping in which the individual change the perceived cause of stress as in problem-focused coping or when managing the emotions of stress, as in emotion-focused coping where first mentioned by Lazarus and Folkman [1]. Coping is described as an individual style to handle stressful events that might be changed over time.

    Objectives: The aim was to explore men's strategies for dealing with participation restrictions in everyday life due to early RA.

    Methods: This study is associated with the prospective multi-centre early arthritis project under the Swedish acronym “TIRA-2” [3]. Participants were 25 males of which 22 were work active, mean age 53 years, contemporary treated with mean disease duration of 3 years. Individual interviews were done using the Critical Incident Technique (CIT) [4]. The verbatim transcribed text were analyzed and categorized using content analysis. The study has been approved by the Ethics Committee.

    Results: The men experienced that RA partly required a changed life style and most of them used a combination of strategies to deal with the participation restrictions in relation to RA. In the adjustment strategy new behaviors and tools were used to solve participation restrictions. The avoidance strategy included deliberate avoidance of possible participation restrictions, such as staying at home in the evenings and avoiding socializing with friends. The interaction strategy included to verbally express needs and give demands in relation to others both at work and in the family and ask for help when needed. The acceptance strategy was identified by the wordings used when talking about the experienced participation restrictions as “I accept that everything takes longer time”.

    Conclusions: The interviewed men with early RA were contemporary treated and active in the work force, still, all of them had to deal with some participation restrictions. Moreover, this study claims that most men used a combination of strategies to deal with the experienced participation restriction.

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