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  • 51.
    Hua, Håkan
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten.
    Emilsson, Magnus
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Avdelningen för kognition, utveckling och handikapp (CDD). Linköpings universitet, Filosofiska fakulteten.
    Kähäri, Kim
    Department of Audiology, Sahlgrenska Academy, Gothenburg University.
    Widen, Stephen
    School of Health and Medical Sciences and Örebro University, Örebro, Sweden.
    Möller, Claes
    School of Health and Medical Sciences and Örebro University; Audiological Research Centre, Örebro University Hospital, Örebro, Sweden.
    Lyxell, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    The impact of different background noises: Effects on cognitive performance and perceived disturbance in employees with aided hearing impairment and normal hearing2014Ingår i: Journal of the American Academy of Audiology, Vol. 25, nr 9, s. 859-868Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Health care professionals frequently meet employees with hearing impairment (HI) who experience difficulties at work. There are indications that the majority of these difficulties might be related to the presence of background noise. Moreover, research has also shown that high level noise has a more detrimental effect on cognitive performance and selfrated disturbance in individuals with HI than low level noise.

    Purpose: To examine the impact of different types of background noise on cognitive performance and perceived disturbance (PD) in employees with aided HI and normal hearing.

    Research Design: A mixed factorial design was conducted to examine the effect of noise under four experimental conditions.

    Study Sample: Forty participants (21 men and 19 women) were recruited to take part in the study .The study sample consisted of employees with HI (n =20) and normal hearing (n = 20). The group with HI had a mild-moderate sensorineural HI and they were all frequent hearing aid users.

    Intervention: The current study was conducted by employing four general work-related tasks (mental arithmetic, orthographic decoding, phonological decoding and serial recall) in four different background conditions: (1) quiet, (2) office noise at 56 dBA, (3) daycare noise at 73.5 dBA and (4) traffic noise at 72.5 dBA. Reaction time (RT) and the proportion of correct answers in the working tasks were used as outcome measures of cognitive performance. The Borg CR-10 scale was used to assess PD.

    Data Collection and Analysis: Data collection occurred on two separate sessions, completed within four weeks of each other. All tasks and experimental conditions were employed in a counterbalanced order. Two-way analysis of variance (ANOVA) was performed to analyze the results. To examine interaction effects, pairwise t-tests were used. Pearson’s correlation coefficients between RT and proportion of correct answers, and cognitive performance and PD were also calculated to  examine the possible correlation between the different variables.

    Results: No significant between or within-group differences in cognitive performance were observed across the four background conditions. Ratings of PD showed that both groups rated PD according to noise level, where higher noise level generated a higher PD. The present findings also demonstrate that the group with HI was more disturbed by higher than lower levels of noise (i.e. traffic and daycare setting compared to the office setting). This pattern was observed consistently throughout four working tasks where the group with HI reported a significantly greater PD in the daycare and traffic setting compared to the office noise.

    Conclusions: The present results demonstrate that background noise does not impair cognitive performance in non-auditory tasks in employees with HI and normal hearing, but that PD is affected to a greater extent in employees with HI during higher level of background noise exposure. In addition, this study also supports previous studies regarding the detrimental effects high level noise has on employees with HI. We therefore emphasize the need of both self-rated and cognitive measurements in hearing care and occupational health services for both employees with normal hearing and HI.

  • 52.
    Håkan, Hua
    et al.
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Björn, Johansson
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Radi, Jönsson
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Lennart, Magnusson
    Department of Audiology, Sahlgrenska University Hospital, Gothenburg, Sweden .
    Cochlear Implant Combined with a Linear Frequency Transposing Hearing Aid2012Ingår i: Journal of the American Academy of Audiology, ISSN 1050-0545, Vol. 23, nr 9, s. 722-732Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Adults with cochlear implants (CIs) are usually implanted unilaterally. To preserve binaural advantages, a noninvasive method involves maintaining the hearing aid (HA) on the contralateral ear; the choice of HA for this purpose is therefore crucial. In recent years, the use of frequency transposition has gained a renewed interest in clinical practice. This type of processing records information from the high-frequency region and conveys it to a low-frequency region where there is still some residual hearing. Purpose: To conduct an investigation and examine whether adults with unilateral CI derive benefits from a HA utilizing linear frequency transposition (LFT) on the contralateral ear. Research Design: A two-period, single-blind, repeated-measures crossover design was conducted to examine the combination of LFT in conjunction with a CI. Speech recognition tests were performed in quiet and in noise with LFT either activated or deactivated. The Speech, Spatial and Qualities of Hearing Questionnaire (SSQ) was used to measure subjective benefit. Study Sample: The participants were nine frequent bimodal users, five males and four females, with a moderate to profound high-frequency sensorineural hearing loss in the nonimplanted ear. Intervention: The current study was conducted using the Widex Mind440 power (m4-19) behind-the-ear HA. The participants acted as their own control in a total of seven conditions: (1) bimodal with own HA, (2) CI only, (3) own HA alone, (4) bimodal new HA LFT-off, (5) new HA LFT-off, (6) bimodal new HA LFT-on, and (7) new HA LFT-on. Data Collection and Analysis: Monosyllabic words in quiet and the Swedish version of Hearing in Noise Test (HINT) were used as speech test materials. Stimuli were presented in sound field at a speech level of 65 dB sound pressure level (SPL) via a loudspeaker at a distance of 1 m from the participant in a sound-treated room. The SSQ was administered in each session evaluating the three bimodal conditions. SPSS software was used for statistical analyses. General linear model (GLM) analysis of variance for repeated measures was performed and followed with Bonferroni-adjusted post hoc pairwise comparisons. Results: Participants performed better with CI only than with HA alone, and the bimodal conditions were superior to the CI alone. No significant differences (p > .05) were observed when comparing the LFT-on with LFT-off regardless of whether the use of CI was included in the different listening conditions in objective and subjective measurements. Conclusions: The results suggest an advantage for CI patients with a HA in the opposite ear, and that the LFT neither degraded nor enhanced speech performance in conjunction with a CI in quiet or in noise in comparison to when it was deactivated.

  • 53.
    Johannesson, Eva
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk pedagogik. Linköpings universitet, Hälsouniversitetet.
    Hult, Håkan
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk pedagogik. Linköpings universitet, Hälsouniversitetet.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för medicin och hälsa, Medicinsk pedagogik. Linköpings universitet, Hälsouniversitetet.
    Simulating the real - manual clinical skills training: Conditions and practices of learning through simulation2013Ingår i: Realising exemplary practice-based education / [ed] Joy Higgs, Rotterdam, Nederländerna: Sense Publishers, 2013, s. 187-194Kapitel i bok, del av antologi (Övrigt vetenskapligt)
    Abstract [en]

    For educators, scholars, practitioners and researchers this book offers an opportunity to explore and engage with practice-based education theories and concepts in real life teaching spaces. It is a place to see theory embodied and situated within PBE practices. It is also an opportunity to see how educators and scholars from other disciplines are applying theory to understand teaching and learning in their particular area. This volume provides an opportunity for readers to deepen their understanding of practice-based education and broaden and critically appraise their strategies for engaging

  • 54.
    Johansson Capusan, Andrea
    et al.
    Region Östergötland, Närsjukvården i centrala Östergötland, Psykiatriska kliniken. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin.
    Kuja-Halkola, R.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Bendtsen, Preben
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i västra Östergötland, Medicinska specialistkliniken.
    Viding, E.
    Developmental Risk and Resilience Unit, University College, London UK.
    McCrory, E.
    Developmental Risk and Resilience Unit, University College, London UK.
    Marteinsdottir, Ina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Psykiatriska kliniken.
    Larsson, H.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden / Department of Medical Sciences, Örebro University, Örebro, Sweden.
    Childhood maltreatment and attention deficit hyperactivity disorder symptoms in adults: a large twin study2016Ingår i: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 46, nr 12, s. 2637-2646Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Childhood maltreatment (CM) has been associated with increased risk of attention deficit hyperactivity disorder (ADHD) in children and adults. It is, however, unclear whether this association is causal or due to familial confounding.

    Method

    Data from 18 168 adult twins, aged 20–46 years, were drawn from the population-based Swedish twin registry. Retrospective self-ratings of CM (emotional and physical neglect, physical and sexual abuse and witnessing family violence), and self-ratings for DSM-IV ADHD symptoms in adulthood were analysed. Possible familial confounding was investigated using a within twin-pair design based on monozygotic (MZ) and dizygotic (DZ) twins.

    esults

    CM was significantly associated with increased levels of ADHD symptom scores in adults [regression coefficient: 0.40 standard deviations, 95% confidence interval (CI) 0.37–0.43]. Within twin-pair analyses showed attenuated but significant estimates within DZ (0.29, 95% CI 0.21–0.36) and MZ (0.18, 95% CI 0.10–0.25) twin pairs. Similar results emerged for hyperactive/impulsive and inattentive ADHD symptom scores separately in association with CM. We conducted sensitivity analyses for early maltreatment, before age 7, and for abuse and neglect separately, and found similarly reduced estimates in DZ and MZ pairs. Re-traumatization after age 7 did not significantly influence results.

    Conclusions

    CM was significantly associated with increased ADHD symptoms in adults. Associations were partly due to familial confounding, but also consistent with a causal interpretation. Our findings support cognitive neuroscience studies investigating neural pathways through which exposure to CM may influence ADHD. Clinicians treating adults with ADHD should be aware of the association with maltreatment.

  • 55.
    Johansson, Kerstin
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Strömbergsson, Sofia
    Karolinska Institute, Sweden.
    Robieux, Camille
    Karolinska Institute, Sweden; Aix Marseille University, France.
    McAllister, Anita
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Perceptual Detection of Subtle Dysphonic Traits in Individuals with Cervical Spinal Cord Injury Using an Audience Response Systems Approach2017Ingår i: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 31, nr 1, artikel-id UNSP 126.e7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. Reduced respiratory function following lower cervical spinal cord injuries (CSCIs) may indirectly result in vocal dysfunction. Although self-reports indicate voice change and limitations following CSCI, earlier efforts using global perceptual ratings to distinguish speakers with CSCI from noninjured speakers have not been very successful. We investigate the use of an audience response system-based approach to distinguish speakers with CSCI from noninjured speakers, and explore whether specific vocal traits can be identified as characteristic for speakers with CSCI. Methods. Fourteen speech-language pathologists participated in a web-based perceptual task, where their overt reactions to vocal dysfunction were registered during the continuous playback of recordings of 36 speakers (18 with CSCI, and 18 matched controls). Dysphonic events were identified through manual perceptual analysis, to allow the exploration of connections between dysphonic events and listener reactions. Results. More dysphonic events, and more listener reactions, were registered for speakers with CSCI than for noninjured speakers. Strain (particularly in phrase-final position) and creak (particularly in nonphrase-final position) distinguish speakers with CSCI from noninjured speakers. Conclusions. For the identification of intermittent and subtle signs of vocal dysfunction, an approach where the temporal distribution of symptoms is registered offers a viable means to distinguish speakers affected by voice dysfunction from non-affected speakers. In speakers with CSCI, clinicians should listen for presence of final strain and nonfinal creak, and pay attention to self-reported voice function and voice problems, to identify individuals in need for clinical assessment and intervention.

  • 56.
    Jonsson, Jerker
    et al.
    Public Health Agency Sweden, Sweden; Karolinska Institute, Sweden.
    Westman, Anna
    Danderyd Hospital, Sweden; Karolinska University Hospital Lab, Sweden.
    Bruchfeld, Judith
    Karolinska Institute, Sweden; Karolinska University Hospital Solna, Sweden.
    Sturegard, Erik
    Lund University, Sweden.
    Gaines, Hans
    Public Health Agency Sweden, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital Solna, Sweden.
    Schön, Thomas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för mikrobiologi och molekylär medicin. Linköpings universitet, Medicinska fakulteten. Kalmar County Hospital, Sweden.
    A borderline range for Quantiferon Gold In-Tube results2017Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, nr 11, artikel-id e0187313Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Interferon gamma release assays like Quantiferon Gold In-Tube (QFT) are used to identify individuals infected with Mycobacterium tuberculosis. A dichotomous cut-off (0.35 IU/ml) defines a positive QFT without considering test variability. Our objective was to evaluate the introduction of a borderline range under routine conditions. Methods Results of routine QFT samples from Sweden (2009-2014) were collected. A borderline range (0.20-0.99 IU/ml) was introduced in 2010 recommending a follow-up sample. The association between borderline results and incident active TB within 3 to 24 months was investigated through linkage with the national TB-register. Results Using the recommended QFT cut-off, 75.1 % tests were negative, 21.4% positive and 3.5% indeterminate. In total, 9% (3656/40773) were within the borderline range. In follow-up samples, individuals with initial results between 0.20-0.34 IU/ml and 0.35-0.99 IU/ml displayed negative results below the borderline range (amp;lt;0.20 IU/ml) in 66.1% (230/348) and 42.5% (285/671) respectively, and none developed incident TB. Among 6712 individuals with a positive initial test amp;gt;0.99 IU/ml, 65 (0.97%) developed incident TB within 3-24 months. Conclusions We recommend retesting of subjects with QFT results in the range 0.20-0.99 IU/ml to enhance reliability and validity of the test. Half of the subjects in the borderline range will be negative at a levelamp;lt;0.20 IU/ml when retested and have a very low risk of developing incident active TB.

  • 57.
    Kallioinen, Petter
    et al.
    Stockholm University, Sweden; Lund University, Sweden.
    Olofsson, Jonas
    Stockholm University, Sweden.
    von Mentzer, Cecilia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lindgren, Magnus
    Lund University, Sweden.
    Ors, Marianne
    Lund University, Sweden; Skåne University Hospital, Sweden.
    Sahlen, Birgitta S.
    Lund University, Sweden.
    Lyxell, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Engström, Elisabet
    Karolinska University Hospital, Sweden; Karolinska Institute CLINTEC, Sweden.
    Uhlen, Inger
    Karolinska University Hospital, Sweden; Karolinska Institute CLINTEC, Sweden.
    Semantic Processing in Deaf and Hard-of-Hearing Children: Large N400 Mismatch Effects in Brain Responses, Despite Poor Semantic Ability2016Ingår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 7, nr 1146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Difficulties in auditory and phonological processing affect semantic processing in speech comprehension for deaf and hard-of-hearing (DHH) children. However, little is known about brain responses related to semantic processing in this group. We investigated event-related potentials (ERPs) in DHH children with cochlear implants (CIs) and/or hearing aids (HAs), and in normally hearing controls (NH). We used a semantic priming task with spoken word primes followed by picture targets. In both DHH children and controls, cortical response differences between matching and mismatching targets revealed a typical N400 effect associated with semantic processing. Children with CI had the largest mismatch response despite poor semantic abilities overall; Children with CIalso had the largest ERP differentiation between mismatch types, with small effects in within-category mismatch trials (target from same category as prime) and large effects in between category mismatch trials (where target is from a different category than prime), compared to matching trials. Children with NH and HA had similar responses to both mismatch types. While the large and differentiated ERP responses in the CI group were unexpected and should be interpreted with caution, the results could reflect less precision in semantic processing among children with CI, or a stronger reliance on predictive processing.

  • 58.
    Karlsson, Anna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Nikkanen Johansson, Ronja
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Röst och kommunikation på förskola: Förskolepedagogers syn på ljudmiljöns påverkan på kommunikation och röst2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Kommunikation är ett sätt att överföra budskap mellan individer. Detta kan ske verbalt och icke-verbalt. För att kommunikationen ska fungera på ett tillfredsställande vis krävs ett samspel mellan samtalsparterna. I muntlig kommunikation finns det alltid faktorer som kan påverka överföringen negativt. Exempel på sådana är olika språkkunskap eller kulturell bakgrund samt höga ljudnivåer. Höga ljudnivåer kräver att förskolepedagoger använder en högre röststyrka. Då det hela tiden förekommer höga ljudnivåer på förskolor ställer det stora krav på pedagogernas röster. Med en ökad kunskap om rösten minskar riskerna att drabbas av en röststörning.

    Syftet med denna studie har varit att få kunskap om hur förskolpedagoger upplever ljudmiljöns påverkan på kommunikationen på förskolan. För att ta reda på detta har intervjuer och mätningar gjorts på två olika förskolor.

    Sex kvinnliga förskolepedagoger intervjuades. Intervjuerna genomfördes på två förskolor i områden med hög frekvens av flerspråkighet, för att få en inblick i hur kommunikationen mellan flerspråkiga barn och pedagog i en bullrig miljö ser ut. En tematisk analys av materialet gjordes och temana kunskap, miljö, ljudens påverkan samt strategier erhölls.

    Resultatet visar att det föreligger en bristande kunskap om röst hos de intervjuade förskolepedagogerna och att de inte har fått utbildning inom varken röst eller röstergonomi. De har en större kunskap kring hörsel och hyser större oro angående hörselfunktionen. Det uppges att den största bullerkällan på förskolorna är ljud från barnen. Bullernivåerna på de båda förskolorna varierade mellan 35 dBA och 95 dBA beroende på om rummet var tomt eller vilken aktivitet som utfördes.

    De höga ljudnivåerna gör det svårt för förskolpedagogerna att vara fokuserade och koncentrerade. De tycker vidare att en liknande påverkan kan ses hos barnen. Vad gäller kommunikationen med flerspråkiga barn uppger pedagogerna att det krävs mer tydlighet och koncentration för att förstå varandra än vid kommunikation med barn med svenska som modersmål. På förskolorna finns hjälpmedel som minskar bullernivåerna, men pedagogerna upplever att de stora barngrupperna har störst betydelse för de höga ljudnivåerna.

  • 59.
    Karlsson, Daniel
    et al.
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Nyström, Mikael
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Cornet, Ronald
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Does SNOMED CT post-coordination scale?2014Ingår i: e-Health – For Continuity of Care / [ed] Christian Lovis, Brigitte Séroussi, Arie Hasman, Louise Pape-Haugaard, Osman Saka, Stig Kjær Andersen, IOS Press, 2014, Vol. 205, s. 1048-52Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    SNOMED CT is a compositional terminology. Construction of post-coordinated expressions allows users to specify new meaning by referencing existing SNOMED CT concepts. The use of post-coordinated expressions in information systems requires special software, a reasoner, to give the exact relations between post-coordinated expressions and existing SNOMED CT content. Thus, the performance characteristics of reasoners are important for implementation of post-coordination in information systems. This study aims to test how reasoners perform when a large number of post-coordinated expressions are added to SNOMED CT. The time needed to classify an ontology consisting of SNOMED CT plus an increasing number of post-coordinated expressions is measured. The best performing reasoner in this test classifies SNOMED CT plus 1 million post-coordinated expressions in 42 seconds. The time to classify grows a little less than quadratic as the size of the ontology increases. In conclusion, classification time is not a problem using current reasoners and current SNOMED CT releases even if a large number of post-coordinated expressions are added.

  • 60.
    Karlsson, Jan Olof
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Gastrointestinal AEs seen in the POP trial due to SOD mimetic activity of calmangafodipir?2019Ingår i: EBioMedicine, E-ISSN 2352-3964, Vol. 47, s. 27-27Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 61.
    Kleinstaeuber, Maria
    et al.
    Univ Auckland, New Zealand; Philipps Univ, Germany.
    Weise, Cornelia
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Univ Auckland, New Zealand.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Karolinska Inst, Sweden.
    Probst, Thomas
    Donau Univ, Austria.
    Personality traits predict and moderate the outcome of Internet-based cognitive behavioural therapy for chronic tinnitus2018Ingår i: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, nr 7, s. 538-544Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this study is to investigate whether the Big Five personality traits predict the outcome of Internet-based cognitive behavioural therapy (ICBT) and whether they moderate the outcome between ICBT and face-to-face group cognitive behavioural therapy (GCBT). Design: This study investigated the Big Five personality traits as predictors and moderators of the outcome (tinnitus handicap) in a trial comparing ICBT and GCBT for chronic tinnitus. Study sample: N= 84 patients with chronic tinnitus were randomised to either ICBT (n = 41) or GCBT (n = 43). Results: A multilevel model for discontinuous change was performed. Higher scores on the "openness" scale of the Big Five Personality inventory (BFI-10) predicted a lower tinnitus handicap (Tinnitus Handicap Inventory, THI) at post-treatment in ICBT (p amp;lt;0.05). Openness moderated the outcome at post-treatment in favour of ICBT (p amp;lt;0.05). Higher scores on the BFI-10 "conscientiousness" scale predicted a more favourable outcome in ICBT at 6-month (p amp;lt;0.05) and 12-month follow-up (pamp;lt; 0.05), but the BFI-10 "conscientiousness" scale was positively associated with the THI at baseline (pamp;lt;0.05). Conclusions: ICBT might be the preferred treatment choice for tinnitus patients being open towards new experiences. Moreover, ICBT requires autonomous work and self-motivation by the patient in order to have an impact.

  • 62.
    Klinthäll, Martin
    et al.
    Centre for Economic Demography, Lund University, Lund, Sweden;Department of Economic History, Lund University, Lund, Sweden.
    Lindström, Martin
    Lund University, Centre for Economic Demography) (Social Medicine and Health Policy, Department of Clinical Sciences in Malmö.
    Migration and health: A study of effects of early life experiences and current socio-economic situation on mortality of immigrants in Sweden2011Ingår i: Ethnicity and Health, ISSN 1355-7858, E-ISSN 1465-3419, Vol. 16, nr 6, s. 601-623Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. Previous research has demonstrated mortality differences between immigrants and natives living in Sweden. The aim of this study is to investigate the effects of early life conditions in the country of birth and current socio-economic conditions in adult life in Sweden on cardiovascular, cancer, all other cause and total mortality among immigrants and natives in Sweden.

    Design. The cohort data concerning individual demographic characteristics and socio-economic conditions stems from the Swedish Longitudinal Immigrant Database (SLI), a register-based representative database, and consists of individuals from 11 countries of birth, born between 1921 and 1939, who were residents in Sweden between 1980 and 2001. The associations between current socio-economic conditions as well as infant mortality rates (IMR) and Gross Domestic Product (GDP) per capita in the year and country of birth, and total, cardiovascular, cancer and ‘all other’ mortality in 1980–2001 were calculated by survival analysis using Cox proportional hazards regression to calculate hazard rate ratios.

    Results. The effects of current adult life socio-economic conditions in Sweden on mortality are both stronger and more straightforward than the effects of early life conditions in the sense that higher socio-economic status is significantly associated with lower mortality in all groups of diagnoses; however, we find associations between infant mortality rates (IMR) in the year and country of birth, and cancer mortality among men and women in the final model.

    Conclusions. Socioeconomic conditions in Sweden are more strongly associated with mortality than early life indicators IMR and GDP per capita in the year of birth in the country of origin. This finding has health policy and other policy implications.

  • 63.
    Klompstra, Leonie
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Physical activity in patients with heart failure: motivations, self-efficacy and the potential of exergaming2016Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Adherence to recommendations for physical activity is low in patients with heart failure (HF). It is essential to explore to what extent and why patients with HF are physically active. Self-efficacy and motivation for physical activity are important in becoming more physically active, but the role of self-efficacy in the relationship between motivation and physical activity in patients with HF is unknown. Alternative approaches to motivate and increase self-efficacy to exercise are needed. One of these alternatives might be using exergames (games to improve physical exercise). Therefore, it is important to obtain more knowledge on the potential of exergaming to increase physical activity.

    The overall aim was to describe the physical activity in patients with HF, with special focus on motivations and self-efficacy in physical activity, and to describe the potential of exergaming to improve exercise capacity.

    Methods: Study I (n = 154) and II (n = 101) in this thesis had a cross-sectional survey design. Study III (n = 32) was a 12-week pilot intervention study, including an exergame platform at home, with a pretest-posttest design. Study IV (n = 14) described the experiences of exergaming in patients who participated in the intervention group of a randomized controlled study in which they had access to an exergame platform at home.

    Results: In total, 34% of the patients with HF had a low level of physical activity, 46% had a moderate level, 23% reported a high level. Higher education, higher selfefficacy, and higher motivation were significantly associated with a higher amount of physical activity. Barriers to exercise were reported to be difficult to overcome and psychological motivations were the most important motivations to be physically active. Women had significantly higher total motivation to be physically active. Self-efficacy mediated the relationship between exercise motivation and physical activity; motivation leads to a higher self-efficacy towards physical activity.

    More than half of the patients significantly increased their exercise capacity after 12 weeks of using an exergame platform at home. Lower NYHA-class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The mean time spent exergaming was 28 minutes per day. Having grandchildren and being male were related to more time spent exergaming.

    The analysis of the qualitative data resulted in three categories describing patients’ experience of exergaming: (i) making exergaming work, (ii) added value of exergaming, (iii) no appeal of exergaming.

    Conclusion: One-third of the patients with HF had a low level of physical activity in their daily life. Level of education, exercise self-efficacy, and motivation were important factors to take into account when advising patients with HF about physical activity. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of exercise self-efficacy.

    Exergaming has the potential to increase exercise capacity in patients with HF. The results also showed that this technology might be suitable for some patients while others may prefer other kinds of physical activity.

    Delarbeten
    1. Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences
    Öppna denna publikation i ny flik eller fönster >>Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences
    2015 (Engelska)Ingår i: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 9, s. 1603-1610Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Adherence to recommendations for physical activity is low in both male and female patients with heart failure (HF). Men are more physically active than women. In order to successfully promote physical activity, it is therefore essential to explore how much and why HF patients are physically active and if this is related to sex. The aim of this study was therefore to evaluate physical activity in HF patients, to describe the factors related to physical activity, and to examine potential barriers and motivations to physical activity with special focus on sex differences. Methods: The study had a cross-sectional survey design. HF patients living at home received a questionnaire during May-July 2014, with questions on physical activity (from the Short Form-International Physical Activity Questionnaire), and potential barriers and motivations to physical activity. Results: A total of 154 HF patients, 27% women, with a mean age of 70 +/- 10 were included. In total, 23% of the patients reported a high level of physical activity, 46% a moderate level, and 34% a low level. Higher education, self-efficacy, and motivation were significantly associated with a higher amount of physical activity. Symptoms or severity of the disease were not related to physical activity. All the potential barriers to exercise were reported to be of importance. Psychological motivations were most frequently rated as being the most important motivation (41%) to be physically active. Physical motivations (33%) and social motivations were rated as the least important ones (22%). Women had significantly higher total motivation to be physically active. These differences were found in social, physical, and psychological motivations. Discussion: One-third of the HF patients had a low level of physical activity in their daily life. Severity of the disease or symptoms were not related, whereas level of education, exercise self-efficacy, and motivation were important factors to take into account when advising a HF patient about physical activity. Women reported higher motivation to be physically active than men, but there was no difference in the reported level of physical activity.

    Ort, förlag, år, upplaga, sidor
    DOVE MEDICAL PRESS LTD, 2015
    Nyckelord
    barriers; sex differences; heart failure; motivation; physical activity; self-efficacy
    Nationell ämneskategori
    Omvårdnad Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
    Identifikatorer
    urn:nbn:se:liu:diva-123091 (URN)10.2147/PPA.S90942 (DOI)000364289900001 ()26635469 (PubMedID)
    Tillgänglig från: 2015-12-03 Skapad: 2015-12-03 Senast uppdaterad: 2019-06-27
    2. Exergaming to increase the exercise capacity and daily physical activity in heart failure patients: a pilot study
    Öppna denna publikation i ny flik eller fönster >>Exergaming to increase the exercise capacity and daily physical activity in heart failure patients: a pilot study
    2014 (Engelska)Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 14, nr 119Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background

    Regular daily physical activity is recognised as important in heart failure (HF) patients, but adherence to physical activity is low (<50%). To improve adherence to exercise in HF patients, alternative approaches to motivate and increase self-efficacy to exercise are needed. Therefore, we have studied a new phenomenon: exergames (games to improve physical exercise). The aims of the study were to assess the influence of the exergame platform Nintendo Wii on exercise capacity and daily physical activity in heart failure patients, to study factors related to exercise capacity and daily physical activity, and to assess patients’ adherence to exergaming.

    Methods

    A 12-week pilot study with a pretest-posttest design was conducted. The intervention consisted of an instruction on how to use the Wii and 12 weeks’ access to Wii at home. The main variables tested were exercise capacity (measured with a six-minute walking test), daily physical activity (measured with an activity monitor), and time exergaming (daily self-report with a diary). Bivariate correlations were used to assess associations between symptom experience, self-efficacy, motivation, anxiety, and depression.

    Results

    In total, 32 heart failure patients were included. More than half of the patients (53%) significantly increased their exercise capacity after 12 weeks. No significant difference was found in daily physical activity between baseline and 12 weeks. Lower NYHA class and shorter time since diagnosis were factors significantly related to the increase in exercise capacity. The daily mean time spent exergaming was 28 minutes, and having grandchildren and being male were related to more time spent exergaming.

    Conclusion

    Exergaming has the potential to increase exercise capacity in elderly, chronically ill cardiac patients. Although the daily physical activity did not change over time, exergaming was feasible for heart failure patients and might be a rehabilitation option for patients with heart failure

    Ort, förlag, år, upplaga, sidor
    BioMed Central, 2014
    Nyckelord
    Active video game, Adherence, Exercise capacity, Exergame, Heart failure, Physical activity
    Nationell ämneskategori
    Hälsovetenskaper
    Identifikatorer
    urn:nbn:se:liu:diva-112402 (URN)10.1186/1471-2318-14-119 (DOI)000346030500004 ()25407612 (PubMedID)
    Tillgänglig från: 2014-11-25 Skapad: 2014-11-25 Senast uppdaterad: 2019-06-27Bibliografiskt granskad
  • 64.
    Klompstra, Leonie
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Strömberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    van der Wal, Martje H. L.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Univ Groningen, Netherlands.
    Seasonal variation in physical activity in patients with heart failure2019Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 48, nr 5, s. 381-385Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and objectives: Physical activity is important for all heart failure (HF) patients to improve quality of life and physical function. Since adherence to physical activity is low and could differ between seasons, it is essential to explore factors related to change that may depend on seasonal changes. The purpose of this study was to describe the seasonal differences in physical activity and assess factors that influence these differences in a country with markedly different winter-to-summer weather conditions (in temperature, hours of daylight and snow fall). Methods: The study had a cross-sectional survey design. Outpatients with HF completed a questionnaire on physical activity, motivation and self-efficacy to exercise and I-IF symptom severity in the summer and the winter in a northern hemisphere country. We used analysis of variance to evaluate seasonal differences in physical activity, motivation, self-efficacy and HF symptom severity. Results: Eighty-seven patients with HF (29% women, mean age 70 +/- 9 years) were included and 35% performed less physical activity (METs) in the winter, compared to the summer. Increased symptom severity during the winter was associated with lower activity levels. Conclusion: One-third of the patients performed less physical activity during the winter compared to the summer, and this was associated with symptom severity. Decreased physical activity was not related with motivation and self-efficacy. This study emphasises the need for personalised physical activity programmes that also assess symptom severity and change in symptom severity depending between seasons. (C) 2019 The Authors. Published by Elsevier Inc.

  • 65.
    Kraai, I. H.
    et al.
    Univ Groningen, Netherlands.
    Vermeulen, K. M.
    Univ Groningen, Netherlands.
    Hillege, H. L.
    Univ Groningen, Netherlands.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Australian Catholic Univ, Australia.
    Hoekstra, T.
    Univ Groningen, Netherlands.
    Optimism and quality of life in patients with heart failure2018Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 16, nr 6, s. 725-731Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives. Health-related quality of life (HR-QoL) of patients with heart failure (HF) is low despite the aim of HF treatment to improve HR-QoL. To date, most studies have focused on medical and physical factors in relation to HR-QoL, few data are available on the role of emotional factors such as dispositional optimism. This study examines the prevalence of optimism and pessimism in HF patients and investigates how optimism and pessimism are associated with different patient characteristics and HR-QoL. Methods. Dispositional optimism was assessed in 86 HF patients (mean age 70 +/- 9 years, 28% female, mean left ventricular ejection fraction 33%) with the Revised Life Orientation Test (LOT-R). HR-QoL was assessed with the Minnesota Living with Heart Failure Questionnaire and the EuroQol. Results. The (mean +/- SD) total score on the LOT-R was 14.6 +/- 2.9 (theoretical range 0-24) and the scores on the subscales optimism and pessimism were 8.1 +/- 1.9 and 5.5 +/- 2.5, respectively. Higher age was related to more optimism (r = 0.22, p amp;lt; 0.05), and optimism was associated with higher generic HR-QoL (B = 0.04, p amp;lt; 0.05). Significance of results. The association found between optimism and generic HR-QoL of HF patients can lead to promising strategies to improve HF patients HR-QoL, particularly because the literature has indicated that optimism is a modifiable condition.

  • 66.
    Kramer, Sophia E.
    et al.
    Vrije University of Amsterdam Medical Centre, Netherlands.
    Teunissen, Charlotte E.
    Vrije University of Amsterdam Medical Centre, Netherlands.
    Zekveld, Adriana
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Institutet för handikappvetenskap (IHV). Linköpings universitet, Filosofiska fakulteten. Vrije University of Amsterdam Medical Centre, Netherlands.
    Cortisol, Chromogranin A, and Pupillary Responses Evoked by Speech Recognition Tasks in Normally Hearing and Hard-of-Hearing Listeners: A Pilot Study2016Ingår i: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 37, s. 126S-135SArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pupillometry is one method that has been used to measure processing load expended during speech understanding. Notably, speech perception (in noise) tasks can evoke a pupil response. It is not known if there is concurrent activation of the sympathetic nervous system as indexed by salivary cortisol and chromogranin A (CgA) and whether such activation differs between normally hearing (NH) and hard-of-hearing (HH) adults. Ten NH and 10 adults with mild-to-moderate hearing loss (mean age 52 years) participated. Two speech perception tests were administered in random order: one in quiet targeting 100% correct performance and one in noise targeting 50% correct performance. Pupil responses and salivary samples for cortisol and CgA analyses were collected four times: before testing, after the two speech perception tests, and at the end of the session. Participants rated their perceived accuracy, effort, and motivation. Effects were examined using repeated-measures analyses of variance. Correlations between outcomes were calculated. HH listeners had smaller peak pupil dilations (PPDs) than NH listeners in the speech in noise condition only. No group or condition effects were observed for the cortisol data, but HH listeners tended to have higher cortisol levels across conditions. CgA levels were larger at the pretesting time than at the three other test times. Hearing impairment did not affect CgA. Self-rated motivation correlated most often with cortisol or PPD values. The three physiological indicators of cognitive load and stress (PPD, cortisol, and CgA) are not equally affected by speech testing or hearing impairment. Each of them seem to capture a different dimension of sympathetic nervous system activity.

  • 67.
    Krögerström, Sanna
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi.
    Liljebäck, Anna-Maja
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi.
    Wuotila Isaksson, Jakob
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Kartläggning av barnlogopedisk intervention i dagens Sverige2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Det saknas en nutida nationell kartläggning av barnlogopedisk intervention. Tidigare studier har undersökt specifika enheter eller granskat interventionen historiskt. Syftet med föreliggande studie var att utifrån en enkät besvarad av kliniskt aktiva logopeder kartlägga det barnlogopediska behandlingsläget i dagens Sverige. Målet var att kunna beskriva interventionens karaktär samt vilka metoder och material som används. Enkäten bestod av 30 frågor och riktade sig till logopeder som för tillfället var verksamma inom det barnlogopediska fältet, exklusive barnhabilitering. Totalt deltog 57 personer i studien och samtliga var kvinnor.

    Svensk barnlogopedi överensstämmer med rekommendationer i litteraturen gällande exempelvis genomsnittlig längd på behandlingsperioder och -kontakter, medan antalet individuella besök per vecka ligger under den frekvens som i forskning har visat sig vara effektiv. Indirekt intervention tillämpas av majoriteten, men huvudfokus ligger överlag på individuell direkt behandling. Litteraturen är inte enig vad gäller effektiviteten hos någon av de olika interventionsformerna. Av deltagarna använder 70 % evidensbaserade metoder och material i någon utsträckning. Mer studier av behandlingseffekt behövs inom flertalet interventionsområden för att stärka evidensen. Praxis och Metafon är de vanligast tillämpade behandlingsmaterialen, tillsammans med egenhändigt tillverkat material samt spel och bilder.

  • 68.
    Kvarnryd, Erica
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Pettersson, Rasmus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet.
    Logopedinsatser vid afasi: arbete med omgivningsfaktorer med fokus på närstående2013Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Afasi, en förvärvad språkstörning som påverkar kommunikationsförmågan, kan följa som sekundärt symtom till hjärnskada, exempelvis stroke. Störningar i kommunikationsförmågan kan påverka delaktigheten. Tidigare forskning har uppmärksammat arbetet med omgivningsfaktorer vid afasi och påtalat att det behövs utökad kartläggning. Syftet med studien är att ge en bild av hur logopeder upplever arbete med omgivningsfaktorer vid afasi med särskilt fokus på arbetet med närstående. Datainsamlingsmetod var fokusdiskussioner där logopeder (n=6), i Sydostsverige, från tre olika verksamheter deltog. I studien framkom att logopederna eftersöker tydligare struktur, rutiner och metoder i arbetet med såväl närstående som med alternativa kommunikationslösningar. De största skillnaderna mellan det akuta skedet och de senare rehabiliteringsskedena tycks vara längd av kontaktperiod med patient och närstående och som följd av det olika fokus i behandling samt olika möjligheter till närståendekontakt. Hur mycket de närstående involveras i rehabiliteringen verkar bero dels på logopedens arbetssätt, dels på närståendes engagemang. Studien är enbart baserad på logopedernas upplevelse av arbete med omgivningsfaktorer. Ett utvecklingsområde kan vara implementering och utvärdering av metoder i kliniskt arbete. Tidigare forskning har belyst närståendes behov av information, men det tycks vara mindre beforskat hur logopeder bör involvera närstående i olika skeden av rehabiliteringsprocessen.

  • 69.
    Lampi, Maria
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Katastrofmedicinskt centrum.
    Junker, Johan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Katastrofmedicinskt centrum.
    Berggren, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Katastrofmedicinskt centrum.
    Jonson, Carl-Oscar
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Katastrofmedicinskt centrum.
    Vikström, Thore
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Katastrofmedicinskt centrum.
    Pre-hospital triage performance after standardized trauma courses2017Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 25, artikel-id 53Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The pre-hospital triage process aims at identifying and prioritizing patients in the need of prompt intervention and/or evacuation. The objective of the present study was to evaluate triage decision skills in a Mass Casualty Incident drill. The study compares two groups of participants in Advanced Trauma Life Support and Pre-Hospital Trauma Life Support courses. Methods: A questionnaire was used to deal with three components of triage of victims in a Mass Casualty Incident: decision-making; prioritization of 15 hypothetical casualties involved in a bus crash; and prioritization for evacuation. Swedish Advanced Trauma Life Support and Pre-Hospital Trauma Life Support course participants filled in the same triage skills questionnaire just before and after their respective course. Results: One hundred fifty-three advanced Trauma Life Support course participants were compared to 175 Pre-Hospital Trauma Life Support course participants. The response rates were 90% and 95%, respectively. A significant improvement was found between pre-test and post-test for the Pre-Hospital Trauma Life Support group in regards to decision-making. This difference was only noticeable among the participants who had previously participated in Mass Casualty Incident drills or had experience of a real event (pre-test mean +/- standard deviation 2.4 +/- 0.68, post-test mean +/- standard deviation 2.60 +/- 0.59, P = 0.04). No improvement was found between pre-test and post-test for either group regarding prioritization of the bus crash casualties or the correct identification of the most injured patients for immediate evacuation. Conclusions: Neither Advanced Trauma Life Support nor Pre-Hospital Trauma Life Support participants showed general improvement in their tested triage skills. However, participation in Mass Casualty Incident drills or experience of real events prior to the test performed here, were shown to be advantageous for Pre-Hospital Trauma Life Support participants. These courses should be modified in order to assure proper training in triage skills.

  • 70.
    Lerner, Henrik
    Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för kulturvetenskaper, KVA. Linköpings universitet, Filosofiska fakulteten.
    Virchow2012Ingår i: Filosofi och medicin: från Platon till Foucault / [ed] Lennart Nordenfelt, Stockholm: Thales, 2012, s. 135-150Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 71.
    Liljeroos, Maria
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Caring needs in patient-partner dyads affected by heart failure: An evaluation of the long-term effects of a dyadic psycho-educational intervention2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: As medical treatment has improved, patients with heart failure (HF) now live longer and care mostly takes place at home with partners providing the main assistance. Taking care of an ill or disabled individual imposes a well-documented burden on the partner’s healthrelated quality of life. The awareness of partners’ burdensome situation is increasing, but few interventions have targeted the needs of patientpartner dyads with HF. The results have been inconclusive and give no clear guidance on how interventional programmes should be designed to improve both patient and partner outcomes.

    Aim: The overall aim of this thesis was to evaluate the effects of a psychoeducational intervention delivered to patient-partner dyads with HF during long-term follow-up, and to explore the dyads’ perceived caring needs.

    Methods: The thesis is based on four papers that used both quantitative and qualitative data. Study I and II used a randomized controlled design with a follow-up assessment after 24 months including 155 patientpartner dyads. The control group received care as usual. The intervention group received care as usual, and in addition they participated in the nurse-led psycho-educational intervention. Data was collected using questionnaires before and 24 months after the intervention, in order to determine the long-term effects on patients and partners regarding health related quality of life, perceived control, symptoms of depression and partners’ caregiver burden (I, II). A conceptual health promotion model inspired the intervention. To describe how the model was applied, a qualitative approach analysing nurses’ documentation of the sessions with 71 dyads in the intervention group (III) was used. Study IV has an explorative design. To further explore the dyads’ perceived caring needs, focus groups interviews with 19 patient-partner dyads with heart failure (IV) were performed.

    Results: The intervention did not have any significant effect on physical or mental health- related quality of life, depressive symptoms, or perceived control over the heart failure among the dyads (I) or caregiver burden in the partners (II) after 24 months. Furthermore, time to first event did not differ significantly between the dyads in the intervention group and the control group (I, II). As for the partners, both the intervention and control group reported decreased physical health between the baseline assessment and the 24-month follow-up (I). The intervention was composed of three components; 1) cognitive 2) supportive, and 3) behavioural component. The analysis of the nurses’ documentation confirmed the coverage of all the components and the analysis revealed a vide range of caring needs among the dyads (III). The dyads described a need to learn about HF to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital and both the patient and the partner need to be present at the clinic visits. Meeting others who are in the same situation and sharing the burden in nurse-led group sessions was proposed as an opportunity to support each other and others (IV).

    Conclusions: Over the 24-month follow-up period, the intervention had a neutral effect on health- related quality of life, depressive symptoms and perceived control over the HF among the dyads, and on partners’ caregiver burden. Considering the fact that partners serve as a critical extension of the formal healthcare system, and that both patients and partners ask for more support, it will become crucial to find new ways to support dyads affected by heart failure. This thesis may be viewed as a first step in trying to understand dyads’ perceived caring needs, and it can serve as a guide in clinical work and when designing new dyadic interventions.

    Delarbeten
    1. Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure
    Öppna denna publikation i ny flik eller fönster >>Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure
    Visa övriga...
    2015 (Engelska)Ingår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 9, s. e0138058-Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background To date, contemporary heart failure care remains patient-focused, but awareness of the partners and families situation is increasing. Randomized studies have mainly evaluated the short-term effects of dyadic interventions. Therefore, the aim of this study was to determine the 24-month effects of an intervention with psych-educational support in dyads of heart failure patients and their partners. Methods This study used a randomized study design and 155 patient-partner dyads were enrolled. The intervention included a nurse-led program of three sessions addressing psychoeducational support. Results The intervention did not have any effect on health, depressive symptoms or perceived control among the patient-partner dyads after 24 months. Furthermore, time to first event did not differ significantly between the intervention group and the control patients. Conclusion This study may be regarded as a first step in trying to understand dyads need for supportive care. Individualized and more targeted interventions seem necessary to achieve a higher impact on dyad outcomes.

    Ort, förlag, år, upplaga, sidor
    PUBLIC LIBRARY SCIENCE, 2015
    Nationell ämneskategori
    Klinisk medicin Sociologi
    Identifikatorer
    urn:nbn:se:liu:diva-122211 (URN)10.1371/journal.pone.0138058 (DOI)000361800700030 ()26406475 (PubMedID)
    Anmärkning

    Funding Agencies|Centre for Clinical Research Sormland; Linkoping University; Swedish Research Council; Swedish Institute for Health Sciences

    Tillgänglig från: 2015-10-26 Skapad: 2015-10-23 Senast uppdaterad: 2019-06-27
    2. Long-term effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure: a randomized controlled trial
    Öppna denna publikation i ny flik eller fönster >>Long-term effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure: a randomized controlled trial
    Visa övriga...
    2017 (Engelska)Ingår i: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 26, nr 2, s. 367-379Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background

    Partners of patients with heart failure provide both practical and emotional support. Many partners assume caregiving responsibilities without being aware of the burden related with this role.

    Objective

    Our work has established that a psycho-educational intervention has benefits at 3, but not at 12 months for patients with heart failure. Further we had not described the long-term effects in caregivers. This study aimed to determine the 24-months effects of a dyadic psycho-educational intervention on caregiver burden and morbidity in partners of patients with heart failure and study factors associated with a change in caregiver burden.

    Design

    A randomized controlled study design, with a follow-up assessment after 24 months.

    Setting and participants

    Partners to patients with heart failure were recruited from two hospitals in the southeast of Sweden.

    Intervention

    A three session nurse-led psycho-educational program was tested and included psychosocial support to maintain the partners’ physical and mental functions, and perceived control. Several instrument were used to measure caregiver burden, perceived control, physical and mental health, depression and morbidity.

    Results

    One hundred fifty-five partners were included. There were no significant differences in any index of caregiver burden or morbidity among the partners in the intervention and control groups after 24 months. Overall, the mean total caregiver burden was found to be significantly increased compared to baseline (36 ± 12 vs 38 ± 14, p < 0.05). A younger partner, less comorbidity, higher levels of perceived control, better physical health and less symptoms of depression in patients, and better mental health in the partners were factors associated with absence of increased caregiver burden over time.

    Discussion and conclusion

    Our intervention did not significantly decrease caregiver burden or morbidity. Over time, several aspects of burden increased in both groups. To improve outcomes, individualized and targeted interventions might be beneficial.

    Ort, förlag, år, upplaga, sidor
    Dordrecht: Springer Netherlands, 2017
    Nyckelord
    Heart failure, Partner, Intervention, Caregiver, Caregiver burden, Perceived control
    Nationell ämneskategori
    Omvårdnad Sjukgymnastik Allmänmedicin Psykiatri Geriatrik
    Identifikatorer
    urn:nbn:se:liu:diva-133178 (URN)10.1007/s11136-016-1400-9 (DOI)000394145600013 ()27631892 (PubMedID)2-s2.0-84986309447 (Scopus ID)
    Anmärkning

    Funding agencies: Swedish Institute for Health Sciences

    Tillgänglig från: 2016-12-13 Skapad: 2016-12-13 Senast uppdaterad: 2019-06-27Bibliografiskt granskad
    3. Perceived caring needs in patient-partner dyads affected by heart failure: A qualitative study.
    Öppna denna publikation i ny flik eller fönster >>Perceived caring needs in patient-partner dyads affected by heart failure: A qualitative study.
    2014 (Engelska)Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, nr 19-20, s. 2928-2938Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the perceived caring needs in patient-partner dyads affected by heart failure to develop an understanding of potential areas of support.

    BACKGROUND: Being affected by heart failure has a great impact on both the patient and the partner but until now contemporary care has remained patient focused.

    DESIGN: A qualitative study design was used.

    METHODS: Eight focus group interviews were performed, which included nineteen patients diagnosed with heart failure and their cohabiting partner. Patients were aged between 55-89 years and partners' ages ranged from 48-87 years. Data were analysed using qualitative content analyses.

    RESULTS: The dyads perceived that caring needs could be summarised in two themes 'Dyads perceive a need for continuous guidance through the different phases of the illness trajectory' and 'Dyads perceive a need to share burden and support with each other and others'. The dyads described a need to learn more about heart failure to be able to manage everyday life. Regular outpatient clinic visits and access to telephone support were vital, and having someone who cared about the well-being of the partners was perceived as comforting. Both the patient and the partner need to be present at the clinic visits. Receiving the same information and being able to ask questions reduce insecurity. Meeting others in the same situation and sharing the burden in group sessions were proposed as an opportunity to support each other and others.

    CONCLUSIONS: There is a need to improve education and support for patient-partner dyads affected by heart failure.

    RELEVANCE TO CLINICAL PRACTICE: The result shows the importance to provide continuous healthcare contacts throughout the illness trajectory. Furthermore, partners should be included at follow-up, and support groups should be organised so that dyads can meet and support each other.

    Ort, förlag, år, upplaga, sidor
    Wiley-Blackwell, 2014
    Nyckelord
    heart failure, family, partner, focus groups, qualitative study, psychosocial nursing
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-107727 (URN)10.1111/jocn.12588 (DOI)000343857700023 ()24698101 (PubMedID)
    Tillgänglig från: 2014-06-19 Skapad: 2014-06-19 Senast uppdaterad: 2019-06-27
  • 72.
    Lindh Falk, Annika
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Hopwood, Nick
    University of Technology, Sydney, Australia.
    Abrandt Dahlgren, Madeleine
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Unfolding Practices: A Sociomaterial View of Interprofessional Collaboration in Health Care2017Ingår i: Professions & Professionalism, ISSN 1893-1049, E-ISSN 1893-1049, Vol. 7, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract: Knowledge sharing is an essential part of interprofessional practice and will be even more important in the future in regard to the opportunities and chal-lenges in practices for delivering safe and effective healthcare. The aim of this ethnographic study was to explore how professional knowledge can be shared in an interprofessional team at a spinal cord injury rehabilitation unit. A sociomaterial per-spective on practice was used to analyse the data, and by theorizing upon this, we captured different aspects of interprofessional collaboration in health care. The find-ings illuminate how knowledge emerges and is shared between professionals, and how it passes along as chain of actions between professionals, in various ways. The findings offer a novel perspective on how interprofessional collaboration as a prac-tice, involving ongoing learning, unfolds. This reveals the mechanisms by which different forms of expertise are mobilized between professions as health care work.

  • 73.
    Lindskog, Alma
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Renström, Frida
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    En jämförelse av expressiv fonologisk förmåga hos barn remitterade till logoped och en åldersmatchad kontrollgrupp2018Självständigt arbete på avancerad nivå (magisterexamen), 20 poäng / 30 hpStudentuppsats (Examensarbete)
    Abstract [en]

    The phonological system can be described and analyzed on three levels; word, syllable and segment. The non-linear nature of the system enables an analysis from different viewpoints on phonology. LINköpingsUnderSökningen (LINUS) is a phonological test for children between the ages of 3 to 6 years which enables a non-linear analysis. Previous studies at  Linköping University have shown that children with phonological language impairment have phonological deviations on all three levels. Even though there is research involving Swedish-speaking children with expressive phonological impairment, further research is needed due to lacking in sample size and age span of participants. The purpose of this thesis is to compare the expressive phonological ability of children between the ages of 3 to 5 years who have been referred to a speech and language pathologist (SLP) for suspected phonological difficulties with a control group consisting of peers without known difficulties.

    In the study 10 children participated who were recruited from a speech and language pathologist clinic in a big city in Sweden, and raw data was also used from a previous study on an additional 11 children. Children with language impairment were matched with a control group with children of the same age. The age interval of participating children was between 3 years and 2 months and 4 years and 11 months.  The LINUS test was issued at a speech and language pathologist clinic together with a SLP. 

    The results showed similar deviations on word, syllable and segment level for both the study group and the control group. However the results of the study group contained a higher amount of deviations. The word and syllable level caused the greatest challenge for both groups. Additionally, both the study group and the control group exhibited deviations in terms of word structure where the most frequent shortcoming was reduction of consonant clusters.

    To conclude, similar types of deviations occurred in both groups, although the study group had a higher amount of deviations on all levels. For stronger conclusions, a larger sample size and younger participants are needed.

  • 74.
    Ljungcrantz, Desireé
    Linköpings universitet, Institutionen för tema, Tema Barn. Linköpings universitet, Filosofiska fakulteten.
    A positive positive?: Intersectional analysis of identifications and counter-identifications in three contemporary HIV narratives2018Ingår i: A Visual History of HIV/AIDS: Exploring The Face of AIDS film archive / [ed] Elisabet Björklund and Mariah Larsson, New York & London: Routledge, 2018, s. 159-178Kapitel i bok, del av antologi (Refereegranskat)
    Abstract [en]

    In “A Positive Positive? Intersectional Analysis of Identification and Counter-identification in three Contemporary HIV Narratives,” Desireé Ljungcrantz focuses on the documentary The Longest Journey Is the Journey Within (2015), about Steve Sjöquist, an HIV-positive activist, and the autobiographies Ophelias resa (“Ophelia’s Journey,” Larsson and Haanyama Ørum, 2007) and Mitt positiva liv (“My Positive Life,” Lundstedt and Blankens, 2012). Using the analytical concepts of identifications and counter-identifications, the chapter explores how normativities and deviations are negotiated through portraits of distance and closeness, identificatory narratives, and counter-identifications – relating to a wellness discourse of happiness and positivity normalizing HIV. The analysis of the representations of HIV and people with HIV in three contemporary HIV narratives shows how normative lines are being drawn with the potential to both widen the cultural imaginaries of HIV and reproduce and draw more narrow ideas of who are living with HIV.

  • 75.
    Ludvigsson, Johnny
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Linköping.
    Fakulteterna bör granska kraven på professionella medicinetiker [The faculties should review the requirements for professional medical ethicists].2016Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 113Artikel i tidskrift (Övrigt vetenskapligt)
  • 76.
    Lundeborg Hammarström, Inger
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Word-initial /r/-clusters in Swedish speaking children with typical versus protracted phonological development2018Ingår i: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 32, nr 5-6, s. 446-458Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study investigated word-initial (WI) /r/-clusters in Central Swedish-speaking children with and without protracted phonological development (PPD). Data for WI singleton /r/ and singleton and cluster /l/ served as comparisons. Participants were twelve 4-year-olds with PPD and twelve age- and gender-matched typically developing (TD) controls. Native speakers audio-recorded and transcribed 109 target single words using a Swedish phonology test with 12 WI C+/r/-clusters and three WI CC+/r/-clusters. The results showed significantly higher match scores for the TD children, a lower match proportion for the /r/ targets and for singletons compared with clusters, and differences in mismatch patterns between the groups. There were no matches for /r/-cluster targets in the PPD group, with all children except two in that group showing deletions for both /r/-cluster types. The differences in mismatch proportions and types between the PPD group and controls suggests new directions for future clinical practice.

  • 77.
    Lundeborg Hammarström, Inger
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten.
    Svensson, Rose-Marie
    Uppsala Univ, Sweden.
    Myrberg, Karin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Logopedi, Audiologi och Otorhinolaryngologi. Linköpings universitet, Medicinska fakulteten. Uppsala Univ, Sweden.
    A shift of treatment approach in speech language pathology services for children with speech sound disorders - a single case study of an intense intervention based on non-linear phonology and motor-learning principles2019Ingår i: Clinical Linguistics & Phonetics, ISSN 0269-9206, E-ISSN 1464-5076, Vol. 33, nr 6, s. 518-531Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Even though there are documented benefits of direct intensive intervention for children with speech sound disorders (SSDs), the intensity given at Swedish Speech Language Pathology services rarely exceeds once a week. Also, indirect therapy approaches are commonly employed. The purpose of the present case study was to investigate the effects of an intensive specialist therapy, based on non-linear phonological analysis and motor learning principles. The participant was a boy aged 4:10 years with severe SSD, who previously had received indirect therapy from age 3 with, very limited results. A single subject ABA design was used. At baseline, whole word match was 0%, Word shape CV match was 39% and PCC was 22, 7%. He had no multisyllabic words, no consonant clusters and no established coronals. Intervention was given 4 days weekly for 3 weeks in two periods with a 7-week intervening break and a post therapy assessments. Therapy was focused on establishing multisyllabic words, iambic stress pattern, clusters and coronals with the principle of using already established elements for targeting new elements. At post therapy assessment, whole word match was 39%, word shape CV match was 71% and PCC 69.1%. Multisyllabic words (86%), coronals (82%) and word initial clusters (80%) were established. Without being targeted, back vowels were also present and segment timing improved. The strong treatment effects of this study demonstrate that at least severe cases of SSD require the clinical knowledge and skills that only a SLP can provide and that frequent direct therapy is both beneficial and needed.

  • 78.
    Lundgren, Charlotte
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för språk och kultur. Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för svenska och litteratur.
    Longitudinal development of stance-taking in an interdisciplinary cancer assessment team2012Ingår i: COMET 2012 Trondheim: The 10th conference on Communication, Medicine and Ethics / [ed] Thomassen, Göril, Trondheim, 2012Konferensbidrag (Refereegranskat)
  • 79.
    Lundgren, Charlotte
    Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för svenska och litteratur. Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för språk och kultur. Linköpings universitet, Filosofiska fakulteten.
    "Tvärvetenskaplig följeforskning inom försöksverksamheten med patientfokuserad och sammanhållen cancervård"2011Konferensbidrag (Övrigt vetenskapligt)
  • 80.
    Lundgren, Charlotte
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för språk och kultur. Linköpings universitet, Institutionen för kultur och kommunikation, Avdelningen för svenska och litteratur.
    Lagerfelt, Marie
    Östergötlands Läns Landsting, Centrum för kirurgi, ortopedi och cancervård, Kirurgiska kliniken US.
    Kommunikation och lärande i multidisciplinärt samarbete: exemplet CUUS2012Konferensbidrag (Övrigt vetenskapligt)
  • 81.
    Lundgren, Johan Gustav
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Dahlström, Örjan
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Jaarsma, Tiny
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Kärner Köhler, Anita
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Johansson, Peter
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    The Effect of Guided Web-Based Cognitive Behavioral Therapy on Patients With Depressive Symptoms and Heart Failure: A Pilot Randomized Controlled Trial.2016Ingår i: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 18, nr 8, s. 1-13, artikel-id e194Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Depressive symptoms, and the associated coexistence of symptoms of anxiety and decreased quality of life (QoL), are common in patients with heart failure (HF). However, treatment strategies for depressive symptoms in patients with HF still remain to be established. Internet-based cognitive behavioral therapy (ICBT), as guided self-help CBT programs, has shown good effects in the treatment of depression. Until now, ICBT has not been evaluated in patients with HF with depressive symptoms.

    OBJECTIVE: The aims of this study were to (1) evaluate the effect of a 9-week guided ICBT program on depressive symptoms in patients with HF; (2) investigate the effect of the ICBT program on cardiac anxiety and QoL; and (3) assess factors associated with the change in depressive symptoms.

    METHODS: Fifty participants were randomized into 2 treatment arms: ICBT or a Web-based moderated discussion forum (DF). The Patient Health Questionnaire-9 was used to measure depressive symptoms, the Cardiac Anxiety Questionnaire (CAQ) was used to measure cardiac-related anxiety, and the Minnesota Living with Heart Failure questionnaire was used to measure QoL. Data were collected at baseline and at follow-up at the end of the 9-week intervention. Intention-to-treat analysis was used, and missing data were imputed by the Expectation-Maximization method. Between-group differences were determined by analysis of covariance with control for baseline score and regression to the mean.

    RESULTS: No significant difference in depressive symptoms between the ICBT and the DF group at the follow-up was found, [F(1,47)=1.63, P=.21] and Cohen´s d=0.26. Secondary within-group analysis of depressive symptoms showed that such symptoms decreased significantly in the ICBT group from baseline to the follow-up (baseline M=10.8, standard deviation [SD]=5.7 vs follow-up M=8.6, SD=4.6, t(24)=2.6, P=.02, Cohen´s d=0.43), whereas in the DF group, there was no significant change (baseline M=10.6, SD=5.0, vs follow-up M=9.8, SD=4.3, t(24)=0.93, P=.36. Cohen´s d=0.18). With regard to CAQ and QoL no significant differences were found between the groups (CAQ [d(1,47)=0.5, P=.48] and QoL [F(1,47)=2.87, P=.09]). In the ICBT group in the CAQ subscale of fear, a significant within-group decrease was shown (baseline M=1.55 vs follow-up M=1.35, P=.04). In the ICBT group, the number of logins to the Web portal correlated significantly with improvement in depressive symptoms (P=.02), whereas higher age (P=.01) and male sex (P=.048) were associated with less change in depressive symptoms. This study is underpowered because of difficulties in the recruitment of patients.

    CONCLUSIONS: Guided ICBT adapted for persons with HF and depressive symptoms was not statistically superior to participation in a Web-based DF. However, within the ICBT group, a statically significant improvement of depressive symptoms was detected.

    CLINICALTRIAL: Clinicaltrials.gov NCT01681771; https://clinicaltrials.gov/ct2/show/NCT01681771 (Archived by WebCite at http://www.webcitation.org/6ikzbcuLN).

  • 82.
    Lundgren, Oskar
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, H.K.H. Kronprinsessan Victorias barn- och ungdomssjukhus.
    Garvin, Peter
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Regionstyrelsen, Enheten för forskningsstöd Ledningsstaben.
    Kristenson, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Jonasson, Lena
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    Thylén, Ingela
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Kardiologiska kliniken US.
    A journey through chaos and calmness: experiences of mindfulness training in patients with depressive symptoms after a recent coronary event - a qualitative diary content analysis.2018Ingår i: BMC Psychology, E-ISSN 2050-7283, Vol. 6, nr 1, artikel-id 46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Psychological distress with symptoms of depression and anxiety is common and unrecognized in patients with coronary artery disease (CAD). Efforts have been made to treat psychological distress in CAD with both conventional methods, such as antidepressant drugs and psychotherapy, and non-conventional methods, such as stress management courses. However, studies focusing on the experiences of mindfulness training in this population are still scarce. Therefore, the aim of this study was to explore immediate experiences of mindfulness practice among CAD patients with depressive symptoms.

    METHODS: A qualitative content analysis of diary entries, written immediately after practice sessions and continuously during an 8-week long Mindfulness Based Stress Reduction course (MBSR), was applied.

    RESULTS: Twelve respondents participated in the study. The main category: a journey through chaos and calmness captured the participants' concurrent experiences of challenges and rewards over time. This journey appears to reflect a progressive development culminating in the harvesting of the fruits of practice at the end of the mindfulness training. Descriptions of various challenging facets of mindfulness practice - both physical and psychological - commonly occurred during the whole course, although distressing experiences were more predominant during the first half. Furthermore, the diary entries showed a wide variety of ways of dealing with these struggles, including both constructive and less constructive strategies of facing difficult experiences. As the weeks passed, participants more frequently described an enhanced ability to concentrate, relax and deal with distractions. They also developed their capacity to observe the content of their mind and described how the practice began to yield rewards in the form of well-being and a sense of mastery.

    CONCLUSIONS: Introducing MBSR in the aftermath of a cardiac event, when depressive symptoms are present, is a complex and delicate challenge in clinical practice. More nuanced information about what to expect as well as the addition of motivational support and skillful guidance during the course should be given in accordance with the participants' experiences and needs.

    TRIAL REGISTRATION: The trial was retrospectively registered in clinicaltrials.gov (registration number: NCT03340948 ).

  • 83.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Abrams, Harvey
    Univ S Florida, FL USA.
    Bailey, Abram
    Hearing Tracker Inc, TX USA.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken. Karolinska Inst, Sweden.
    Negative Side Effects Associated with Hearing Aid Use in Adults with Hearing Loss2019Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 30, nr 6, s. 472-481Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    The low uptake of hearing aids in the United States has been attributed to a number of reasons, including low perceived hearing disability, limited perceived benefit and cost. Another possible reason may be related to negative side effects associated with hearing aid use.

    Purpose:

    The present study was aimed at determining and classifying the negative side effects associated with hearing aid use in adults with hearing loss.

    Research Design:

    The study used a cross-sectional survey design.

    Study Sample:

    Five hundred and twelve participants completed an electronic survey.

    Data Collection and Analysis:

    The data was collected using the negative side effects of hearing aids (NSE-HAs) questionnaire. Data were analyzed using Chi square analysis, principal components analysis, and calculation of Cronbach’s alpha.

    Results:

    Some individuals reported negative side effects for all 32 items. However, careful examination of results suggests that, as a whole, reported negative side effects tend to be mild with mean scores falling close to the lower quartile of the total scores. Chi square test results suggest that the variables of age, gender, duration of hearing loss, self-reported hearing disability, and duration of hearing aid use seem to be significantly associated with the reported negative side effects. The NSE-HAs questionnaire was found to have a complex structure as indicated by the principal components analysis. However, good internal consistency was found in both the full scale and subscales.

    Conclusions:

    The present study suggests that, although a large number of adults with hearing loss who use hearing aids experience some degree of negative side effects, those effects tend to be mild.

  • 84.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Beukes, Eldre W.
    Anglia Ruskin Univ, England.
    Granberg, Sarah
    Orebro Univ, Sweden; Orebro Univ Hosp, Sweden.
    Durisala, Naresh
    GN Hearing Pte Ltd, Singapore.
    Baguley, David M.
    Anglia Ruskin Univ, England; Univ Nottingham, England; Univ Nottingham, England.
    Allen, Peter M.
    Anglia Ruskin Univ, England; Anglia Ruskin Univ, England.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken. Karolinska Inst, Sweden.
    Problems and Life Effects Experienced by Tinnitus Research Study Volunteers: An Exploratory Study Using the ICF Classification2018Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 29, nr 10, s. 936-947Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Tinnitus is one of the most distressing hearing-related symptoms. It is often associated with a range of physiological and psychological complications, such as depression, anxiety, and insomnia. Hence, approaching tinnitus from a biopsychological perspective may be more appropriate than from purely a biomedical model. Objective: The present study was aimed at determining the relationship between tinnitus and the problems and life effects experienced by UK-based tinnitus research study volunteers. Open-ended questions were used. Responses were classified using the International Classification of Functioning, Disability and Health (ICF) framework to understand the impact of tinnitus in a multidimensional manner using a biopsychosocial perspective. Research Design: A cross-sectional survey design was used. Study Sample: Study sample included a sample of 240 adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus. Data Collection and Analysis: The data were collated using two open-ended questions. The first focused on problems related to having tinnitus and the second to life effects as a result of tinnitus. Responses were analyzed using a simplified content analysis approach to link concepts to ICF categories in accordance with established linking rules. A Wilcoxon signed-rank test was performed to compare the number of responses between the two questions. Results: There were 764 responses related to problems identified, 797 responses associated with life effects due to tinnitus, and 37 responses that did not fit into any ICF category. No significant differences were observed in the number of responses between the two questions. In addition, no significant association between the number of responses reported and demographic variables was found. Most of the problems and life effects experienced by tinnitus sufferers were related to body function, followed by activity limitations, and participation restrictions. Only a few responses were related to environmental and personal factors. The most frequent responses related to body function involved "emotional functions" (b152), "sleep functions" (b134), "hearing functions" (b230), "sustaining attention" (b1400), and "energy level" (b1300). For activity limitations and participation restrictions they were "communicating with-receiving-spoken messages" (d310), "socialization" (d9205), "handling stress and other psychological demands" (d240), and "recreation and leisure" (d920). The most frequently occurring responses related to environmental factors were "sound intensity" (e2500), "sound quality" (e2501), and "general products and technology for communication" (e1250). "Coping styles" was the most frequently occurring personal factor. Conclusions: The study highlights the use of open-ended questions in gathering useful information about the impact of tinnitus. The responses coded to ICF show that tinnitus impacts many domains, not only particularly body function, but also activity limitations and participation restrictions. The results demonstrate the heterogeneous nature of the impact of tinnitus on people affected.

  • 85.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar University, TX 77710 USA; Audiol India, India.
    Dockens, Ashley L.
    Lamar University, TX 77710 USA.
    Bellon-Harn, Monica
    Lamar University, TX 77710 USA.
    Burns, Erin S.
    Lamar University, TX 77710 USA.
    Noncongruence between Audiologist and Patient Preferences for Patient-Centeredness2017Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 28, nr 7, s. 636-643Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Trends in preferences of both healthcare providers and patients to patient-centeredness have been emphasized in research. However, an understanding of the nature of preferences to patient-centeredness within the context of the audiologist patient relationship is needed. Purpose: The purpose of this study is to explore the congruence between audiologist and patient preferences for patient-centeredness. Research Design: A cross-sectional survey design was used to gather data from audiologists and patients with hearing loss. Study Sample: Participants included 75 audiologists and 105 consecutive patients with hearing loss. Data Collection and Analysis: Participants completed the modified Patient Practitioner Orientation Scale (PPOS) and provided selected demographic information. Data were analyzed using an independent sample t test to evaluate the differences between audiologist and patient congruence. Regression analysis was performed to evaluate factors contributing to preferences for patient-centeredness. Results: Patients had significantly lower scores in PPOS full scale when compared to the audiologists [t((170)) = 0.78; p amp;lt;= 0.001] with a very large effect size (Cohens d = 1.43). Patients also had significantly lower scores when compared to the audiologists on both the sharing [t((170)) = 1.01; p amp;lt;= 0.001] and caring [tom) = 0.56; p amp;lt;= 0.001] subscales. Statistically significant lower scores were noted for patients when compared to audiologists on 12 items on the PPOS. No relationship between any demographic factors and preferences for patient-centeredness were found. Conclusions: The current study results indicated noncongruence in preferences for patient-centeredness among audiologists and patients with hearing loss. Results point toward the need for more research considering the nature and impact of patient-centered audiology practice.

  • 86.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Dockens, Ashley L.
    Lamar Univ, TX 77710 USA.
    Flagge, Ashley
    Lamar Univ, TX 77710 USA.
    Bellon-Harn, Monica
    Lamar Univ, TX 77710 USA.
    Azios, Jamie Hartwell
    Lamar Univ, TX 77710 USA.
    Kelly-Campbell, Rebecca J.
    Univ Canterbury, New Zealand.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken. Karolinska Inst, Sweden.
    Quality and Readability of English-Language Internet Information for Tinnitus2019Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 30, nr 1, s. 31-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Because of the wealth of information available on the internet and increasing numbers of individuals relying on websites as a primary source of information for health-related questions, it is important that the readability of their content is within the comprehension level of most readers.

    Objective:

    The study evaluated the quality and readability of English-language Internet information for tinnitus.

    Research Design:

    Analysis of Internet websites on tinnitus.

    Study Sample:

    A total of 134 websites with tinnitus information.

    Data Collection and Analysis:

    Three key words (i.e., tinnitus, ringing in the ear, and buzzing in the ear) were entered in five country-specific versions of the most commonly used internet search engine in August 2016. For each of the 15 searches, the first 20 relevant websites were examined. After removing duplicates, a total of 134 websites were assessed. Their origin (commercial, nonprofit organization, government, personal, or university), quality (Health On the Net [HON] certification and DISCERN scores), and readability (Flesch Reading Ease score, Flesch-Kincaid Reading Grade Level Formula, and Simple Measure of Gobbledygook) were assessed.

    Results:

    Most websites were of commercial (49.3%) or nonprofit organization (38.8%) origin. Their quality and readability was highly variable. Only 13.5% of websites had HON certification. χ2 analysis showed that there was significant association between website origin and HON certification [χ2(4) = 132.9, p < 0.0001]. The mean DISCERN scores were 2.39. No association between DISCERN scores and website origin was found. Readability measures showed that on average, only people with at least 10‐12 yr of education could read and understand the internet information for tinnitus in websites. Almost all the websites exceeded the most stringent reading level recommended for health information.

    Conclusions:

    The results highlight great variability in the quality and readability of health information, specifically for tinnitus in the internet. These findings underscores the need for stakeholders (e.g., web-developers, clinicians) to be aware of this and to develop more user-friendly health information on websites to make it more accessible for people with low literacy.

  • 87.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA; Audiology India, Mysore, Karnataka, India; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India.
    Hernandez, Barbara Michiels
    Department of Health and Kinesiology, Lamar University, Beaumont, TX, USA.
    Beck, Douglas L.
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA; Oticon Inc, Somerset, New Jersey, NJ, USA; Department of Communication Disorders, State University of New York at Buffalo, USA.
    Application of Transtheoretical (Stages of Change) Model in Studying Attitudes and Behaviors of Adults with Hearing Loss: A Descriptive Review2018Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 29, nr 6, s. 548-560Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Health Behavior Change (HBC) refers to facilitating changes to habits and/or behaviors related to health. There are a number of models/theories of HBC, which provide a structured framework to better understand the HBCs of individuals. The Transtheoretical Model (TTM, aka "the Stages of Change" model) is an integrative model used to conceptualize the process of intentional behavior change and is applied to a variety of behaviors, populations, and settings. In the last few years, use of TTM by the profession of audiology has been increasing.

  • 88.
    Manchaiah, Vinaya K. C.
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar Univ, TX 77710 USA; Audiol India, India; Manipal Univ, India.
    Pyykko, Ilmari
    Univ Hosp Tampere, Finland.
    Levo, Hilla
    Univ Helsinki, Finland.
    Kentala, Erna
    Univ Helsinki, Finland.
    Impact of Menieres Disease on Significant Others Health and Lives2018Ingår i: Journal of american academy of audiology, ISSN 1050-0545, E-ISSN 2157-3107, Vol. 29, nr 1, s. 63-72Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:

    Ménière’s disease (MD) is a chronic and, in part, intermittent illness that poses multiple challenges for both the physical and psychological well-being of patients, as well as on those around them. The patients face psychosocial consequences, which include disruptions to life goals, employment, income, relationships, leisure activities, and daily living activities that also influence their family members and friends. However, there is a limited understanding of the impact of MD on significant others (SOs).

    Purpose:

    The current study was aimed at identifying how the SOs of patients with MD respond to different aspects of the impact of the disorder on health and life (i.e., psychological aspects, activities, participation, and positive aspects).

    Research Design:

    The study employed a cross-sectional survey design.

    Study Sample:

    The study sample was 186 SOs of patients with MD who were recruited through Finnish Ménière’s Federation.

    Data Collection and Analysis:

    Participants completed a 25-item structured questionnaire focusing on different aspects of the impact of the disorder on health and life, and also provided some demographic information. Data were analyzed using Kruskal‐Wallis test, Pearson’s correlation, and K-means cluster analysis techniques.

    Results:

    Examination of response patterns suggests that the disorder had, on average, a marginal effect on SOs’ psychological aspects, activities, and participation as the SOs generally focused on complaints. Interestingly, SOs reported some positive consequences as a result of their partners’ condition. The results show a limited association between SOs’ demographic variables and response patterns. The Pearson’s correlation suggested a strong association between the subscales psychological aspects, activity limitations, and participation restrictions. Also, a weak negative correlation was observed among positive aspects and participation restrictions. The cluster analysis resulted in three clusters, namely, (1) “nonengaged,” (2) “supportive,” and (3) “concerned.”

    Conclusions:

    The current study results identify that the SOs’ reaction to patients’ condition varies and this may be from coping with victimization. Although the impact of MD on SOs is limited, some of the SOs may have more severe consequences and may require rehabilitation. The information gathered about SOs’ coping and adjustment in this study can also help while developing management and/or rehabilitation plan for people with MD.

  • 89.
    Manchaiah, Vinaya
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Lamar University, TX 77710 USA; Adiol India, India.
    Tome, David
    Polytech Institute Porto, Portugal.
    Dockens, Ashley L.
    Lamar University, TX 77710 USA.
    Harn, Monica
    Lamar University, TX 77710 USA.
    Ganesan, Purushothaman
    Wall St Audiol Inc, Canada.
    Preference to Patient-Centeredness in Undergraduate Audiology Students in Portugal2016Ingår i: JOURNAL OF THE AMERICAN ACADEMY OF AUDIOLOGY, ISSN 1050-0545, Vol. 27, nr 10, s. 816-823Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In health care, the model of patient-centered care is growing; and improved outcomes have been linked to patient-centeredness. Practicing audiologists have been found to strongly prefer a patient-centered approach as years in practice increase. It is unknown whether patient-centeredness begins during education and training. Purpose: The current study was aimed at understanding the preference to patient-centeredness in undergraduate audiology students in Portugal. Research Design: The study used a cross-sectional survey design. Study Sample: One hundred and thirty-seven undergraduate audiology students completed patient practitioner orientation scale (PPOS) and provided some demographic details. Data Collection and Analysis: The data were analyzed using one-way analysis of variance and one sample t tests. Results: A significant difference was found for sharing subscale (p amp;lt;= 0.001), caring subscale (p = 0.033), and the PPOS full scale (p amp;lt;= 0.001) among different undergraduate aroups. Further, post hoc tests showed that the difference between year 1 and with years 2, 3, and 4 were significant for sharing subscale and PPOS full scale, but not for caring subscale. No significant differences were observed among the years 2, 3, and 4 for sharing subscale, caring subscale, and for PPOS full scale. When compared audiologists preferences from a previous study on audiologists with students preferences in the current study, significant difference for both subscales and full scale was found between year 1-students and audiologists (p 0.001), with higher preference to patient-centeredness was reported by qualified audiologists. Also, significant difference was found between audiologists and overall undergraduate group for caring subscale (p = 0.001). Conclusions: The current study suggests that audiology education influences preference to patientcenteredness. Within a year of undergraduate coursework, students tend to develop high preference to patient-centeredness, which stays stable during four years of undergraduate studies. These results provide useful insights to audiology education and training, particularly in the context of audiological rehabilitation.

  • 90.
    Markovic, Gabriela
    et al.
    Karolinska Institute, Sweden.
    Schult, Marie-Louise
    Karolinska Institute, Sweden.
    Bartfai, Aniko
    Karolinska Institute, Sweden.
    Elg, Mattias
    Linköpings universitet, Institutionen för ekonomisk och industriell utveckling, Logistik- och kvalitetsutveckling. Linköpings universitet, Tekniska fakulteten. Linköpings universitet, HELIX Vinn Excellence Centre.
    STATISTICAL PROCESS CONTROL: A FEASIBILITY STUDY OF THE APPLICATION OF TIME-SERIES MEASUREMENT IN EARLY NEUROREHABILITATION AFTER ACQUIRED BRAIN INJURY2017Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, nr 2, s. 128-135Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Progress in early cognitive recovery after acquired brain injury is uneven and unpredictable, and thus the evaluation of rehabilitation is complex. The use of time-series measurements is susceptible to statistical change due to process variation. Objective: To evaluate the feasibility of using a time-series method, statistical process control, in early cognitive rehabilitation. Method: Participants were 27 patients with acquired brain injury undergoing interdisciplinary rehabilitation of attention within 4 months post-injury. The outcome measure, the Paced Auditory Serial Addition Test, was analysed using statistical process control. Results: Statistical process control identifies if and when change occurs in the process according to 3 patterns: rapid, steady or stationary performers. The statistical process control method was adjusted, in terms of constructing the baseline and the total number of measurement points, in order to measure a process in change. Conclusion: Statistical process control methodology is feasible for use in early cognitive rehabilitation, since it provides information about change in a process, thus enabling adjustment of the individual treatment response. Together with the results indicating discernible subgroups that respond differently to rehabilitation, statistical process control could be a valid tool in clinical decision-making. This study is a starting-point in understanding the rehabilitation process using a real-time-measurements approach.

  • 91.
    Martínez-Costa, Catalina
    et al.
    Institute for Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria.
    Karlsson, Daniel
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Schulz, Stefan
    Institute for Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Austria.
    Ontology patterns for clinical information modelling2014Ingår i: Proceedings of the 5th International Conference on Ontology and Semantic Web Patterns-Volume 1302, ACM Digital Library, 2014, s. 61-72Konferensbidrag (Refereegranskat)
    Abstract [en]

    Motivated by our experiences of representing clinical information using OWL DL, which often resulted in highly complex expressions, we propose the use of ontology content patterns to facilitate this task. They are based on a set of formal ontologies, constrained by the concepts and relations of a top-level one, which reduces arbitrariness in ontology design. We propose their application to information encoded by electronic health records specifications and ontology-based terminologies, in order to provide semantic interoperability across heterogeneously represented data, and to guide the creation of clinical models and detect semantic inconsistencies across them. We provide examples of their application to achieve the above mentioned tasks and discuss the limitations and further research issues.

  • 92.
    McAllister, Anita
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    A comparison of studio recordings and recordings of spontaneous speech: assessments of voice quality in pre-school children2011Ingår i: Pan European Voice Conference (PEVOC9), Marseille, France / [ed] Antoine Giovanni & Nathalie Henrich, Marseille, 2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    A well controlled recording in a studio is the basis for voice rehabilitation. However, this laboratory like recording method can be questioned since voice use in a natural environment may be quite different. In children’s natural environment high background noise levels are common and an important factor contributing to voice problems. The noise exposure often occurs in day-care centers with the children themselves as the primary noise source (McAllister, Granqvist, Sjölander, Sundberg 2009). The aim of the present study was to compare perceptual evaluations of voice quality from a controlled recording to recordings of spontaneous speech in children’s natural environment in a day-care setting. Ten five-year-old children were recorded three times during a day at the day-care. The controlled speech material consisted of repeated sentences. Matching sentences were selected from the spontaneous speech. All sentences were repeated times three. The recordings were randomized and analyzed acoustically and evaluated perceptually by three expert listeners. Statistic analyses of all recordings showed that the laboratory sentences represent spontaneous speech characteristics regarding degree of hoarseness (r=.52) and to a lesser extent also for breathiness (r=. 401). For boys a correlation was found only for the parameter breathiness (r=.539) and for girls only for hoarseness (r=.648).  

     

    References

    McAllister, A., Granqvist, S. Sjölander, P. Sundberg, J. (2009). Child voice and noise: A pilot study of the effect of a day at the day-care on ten children’s voice quality according to perceptual evaluation. J Voice, Sep;23(5):587-93.

  • 93.
    McAllister, Anita
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Logopedi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Öron- näsa- och halskliniken US.
    Bergendal, Birgitta
    Kompetenscenter, Odontologiska Institutionen, Jönköping.
    Sjögreen, Lotta
    Mun-H-Center, Folktandvården, Västra Götalandsregionen.
    Applications and results using the Nordic Orofacial Test–Screening protocol2011Ingår i: / [ed] Professor Göran Koch, Jönköping, Jönköping: Swedish Dental Association and the Swedish Dental Society , 2011Konferensbidrag (Refereegranskat)
    Abstract [en]

    Aim: Orofacial function includes a multitude of actions, some of them vital, such as breathing, chewing and swallowing, and also acts as the basis for social interaction in terms of speech, emotional communication, facial expression and appearance. Impaired orofacial function is a common feature in many inherited disorders or may be acquired as a consequence of disease and trauma. The Nordic Orofacial Test–Screening (NOT-S) is a comprehensive method for screening of orofacial function developed by a Scandinavian network of dentists and speech and language pathologists. NOT-S comprises evaluation of twelwe domains of orofacial function. They are assessed from a structured interview and a clinical examination with a picture manual illustrating the different tasks in the examination. A method study of 120 individuals with chronic disease or disability compared to 60 healthy controls showed good intra- and interexaminer agreement. The aim was to present current applications and results from publications on the use of NOT-S.

    Materials and Methods: Beside the method study published in 2007 to date four studies has been published. One was a study in individuals with Parkinson´s disease (n=15), two were studies in individuals with rare disorders; Ectodermal dysplasia (n=46), and Prader-Willi Syndrome (n=45), and one was a study evaluating surgical treatment in children with tonsillar hyperthophy (n=67). In order o visualize to what degree the domains of orofacial function are affected in different conditions, connected plots were made from the mean NOT-S scores for the twelwe domains of NOT-S, here called dysfunction profiles.

    Results: The groups with different diagnoses showed specific dysfunction profiles indicating patterns of domains with impaired orofacial function. The use of NOT-S to assess orofacial function before and after surgery in children with tonsillar hypertrophy showed that the method can also be used to evaluate interventions.

    Conclusions: Screening with NOT-S proved to be a quick and reliable way of assessing orofacial function. NOT-S discriminated between groups with different diagnoses and also in evaluation of treatment. The results indicate that NOT-S has good reliability and discriminant validity.

  • 94.
    Milberg, Anna
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, LAH Linköping.
    Appelquist, Gudrun
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland.
    Hagelin, Eva
    Östergötlands Läns Landsting, Närsjukvården i västra Östergötland.
    Jakobsson, Maria
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Olsson, Eva-Carin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Olsson, Maria
    Northern County of Kalmar.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    "A rewarding conclusion of the relationship": staff members' perspectives on providing bereavement follow-up2011Ingår i: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 19, nr 1, s. 37-48Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    GOALS OF WORK: Staff members in palliative home care play an important role in supporting bereaved family members. The aim of this study was to explore staff members' perspectives on providing such support.

    MATERIAL AND METHODS: Staff members in six units responded (n = 120; response rate 58%) to a postal questionnaire with Likert-type and open-ended questions. The responses were analyzed using statistics and manifest content analysis.

    MAIN RESULTS: None of the respondents stated that bereavement follow-up was "most often difficult," 23% "most often rather difficult," 52.5% "most often rather easy," and 12.5% "most often easy." Apart from a tendency for age to be linked to perceived difficulty, there were no apparent patterns. Bereavement follow-up was a positive opportunity to support the family member's coping with their bereavement and to get feedback on the palliative care provided. Critical aspects concerned the question of whose needs actually were being met at bereavement follow-up, i.e., the staff members' needs for getting feedback on the care provided versus the risk of burdening the family members' by reminding them of the deceased's dying trajectory. Aspects that negatively influenced the staff members' experiences were complex and related, e.g., to the family member's dissatisfaction with the care provided, to the staff member's perceived lack of competence, and to the staff member's relationship to the family member.

    CONCLUSIONS: Bereavement follow-up was perceived as a rewarding conclusion to the relationship with the family member. The findings suggest that meaning-based coping might be an appropriate framework when understanding staff members' experiences with providing bereavement follow-up.

  • 95.
    Milberg, Anna
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, LAH Linköping. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Strang, Peter
    Karolinska Institutet, FoUU, Stockholms Sjukhem, Stockholm.
    Protection against perceptions of powerlessness and helplessness during palliative care: The family members' perspective.2011Ingår i: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 9, nr 3, s. 251-262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective:Resilience in relation to coping with stress, loss, and bereavement has recently received increased attention. The aim of the current study was to describe aspects that are experienced as a protection against powerlessness and/or helplessness during advanced palliative home care (APHC) or as a help when coping with such perceptions.Method:Both family members during ongoing APHC and family members 3-9 months after the patient's death responded (in total, N = 233; response rate 72%) to a postal questionnaire with mainly open-ended questions. The text responses were analyzed using Manifest Content Analysis.Results:Protection against powerlessness and helplessness had been facilitated by a stable patient condition, the patient coping well, a trusting relationship with the patient, practical and emotional support from family and friends, access to palliative expertise, and staff support that was both individually-focused and cooperative. Other aspects that had helped or protected family members against powerlessness and helplessness were a belief that they had their own reliable knowledge to manage the difficult situation, talking to someone, doing good for the patient, distracting activities, acceptance, meaning and hope, and an inner feeling of security.Significance of results:The findings are discussed in relation to existential psychology, the dual process model of coping with bereavement, and repressive coping. Clinical implications are suggested.

  • 96.
    Milberg, Anna
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, LAH Linköping. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Wåhlberg, Rakel
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, LAH/Linnéa-enheten.
    Jakobsson, Maria
    Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Olsson, Eva-Carin
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Olsson, Maria
    PRIVO/Palliative Consulting Team, Northern County of Kalmar, Oskarshamn.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    What is a “secure base” when death is approaching? A study applying attachment theory to adult patients’ and family members’ experiences of palliative home care2012Ingår i: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 21, nr 8, s. 886-895Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a ‘secure base’ (a central concept within the theory).

    Methods

    Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis.

    Results

    Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person.

    Conclusions

    Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice. Copyright © 2011 John Wiley & Sons, Ltd.

  • 97.
    Mohd Sulaiman, Ismat
    et al.
    Health Informatics Centre, Planning Division, Ministry of Health Malaysia, Putrajaya, Malaysia.
    Karlsson, Daniel
    Linköpings universitet, Institutionen för medicinsk teknik, Avdelningen för medicinsk teknik. Linköpings universitet, Tekniska fakulteten.
    Koch, Sabine
    Health Informatics Centre, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.
    Mapping Acute Coronary Syndrome Registries to SNOMED CT. A Comparative Study between Malaysia and Sweden.2017Ingår i: Methods of Information in Medicine, ISSN 0026-1270, Vol. 56, nr 4, s. 330-338Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Malaysia and Sweden have mapped their acute coronary syndrome registries using SNOMED CT. Since similar-purposed patient registries can be expected to collect similar data, these data should be mapped to the same SNOMED CT codes despite the different languages used. Previous studies have however shown variations in mapping between different mappers but the reasons behind these variations and the influence of different mapping approaches are still unknown.

    OBJECTIVES: To analyze similar-purposed registries and their registry-to-SNOMED CT maps, using two national acute coronary syndrome registries as examples, to understand the reasons for mapping similarities and differences as well as their implications.

    METHODS: The Malaysian National Cardiovascular Disease - Acute Coronary Syndrome (NCVD-ACS) registry was compared to the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA). The structures of NCVD-ACS and RIKS-HIA registry forms and their distributions of headings, variables and values were studied. Data items with equivalent meaning (EDIs) were paired and their mappings were categorized into match, mismatch, and non-comparable mappings. Reasons for match, mismatch and non-comparability of each paired EDI were seen as factors that contributed to the similarities and differences between the maps.

    RESULTS: The registries and their respective maps share a similar distribution pattern regarding the number of headings, variables and values. The registries shared 101 EDIs, whereof 42 % (42) were mapped to SNOMED CT. 45 % (19) of those SNOMED CT coded EDIs had matching codes. The matching EDIs occurred only in pre-coordinated SNOMED CT expressions. Mismatches occurred due to challenges arising from the mappers themselves, limitations in SNOMED CT, and complexity of the registries. Non-comparable mappings appeared due to the use of other coding systems, unmapped data items, as well as requests for new SNOMED CT concepts.

    CONCLUSIONS: To ensure reproducible and reusable maps, the following three actions are recommended: (i) develop a specific mapping guideline for patient registries; (ii) openly share maps; and (iii) establish collaboration between clinical research societies and the SNOMED CT community.

  • 98.
    Moradi, Shahram
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lidestam, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    Ng, Hoi Ning
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV). Oticon AS, Denmark.
    Danielsson, Henrik
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Rönnberg, Jerker
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Perceptual Doping: An Audiovisual Facilitation Effect on Auditory Speech Processing, From Phonetic Feature Extraction to Sentence Identification in Noise2019Ingår i: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 40, nr 2, s. 312-327Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: We have previously shown that the gain provided by prior audiovisual ( AV) speech exposure for subsequent auditory ( A) sentence identification in noise is relatively larger than that provided by prior A speech exposure. We have called this effect "perceptual doping." Specifically, prior AV speech processing dopes ( recalibrates) the phonological and lexical maps in the mental lexicon, which facilitates subsequent phonological and lexical access in the A modality, separately from other learning and priming effects. In this article, we use data from the n200 study and aim to replicate and extend the perceptual doping effect using two different A and two different AV speech tasks and a larger sample than in our previous studies. Design: The participants were 200 hearing aid users with bilateral, symmetrical, mild- to- severe sensorineural hearing loss. There were four speech tasks in the n200 study that were presented in both A and AV modalities (gated consonants, gated vowels, vowel duration discrimination, and sentence identification in noise tasks). The modality order of speech presentation was counterbalanced across participants: half of the participants completed the A modality first and the AV modality second (A1- AV2), and the other half completed the AV modality and then the A modality (AV1- A2). Based on the perceptual doping hypothesis, which assumes that the gain of prior AV exposure will be relatively larger relative to that of prior A exposure for subsequent processing of speech stimuli, we predicted that the mean A scores in the AV1- A2 modality order would be better than the mean A scores in the A1- AV2 modality order. We therefore expected a significant difference in terms of the identification of A speech stimuli between the two modality orders (A1 versus A2). As prior A exposure provides a smaller gain than AV exposure, we also predicted that the difference in AV speech scores between the two modality orders (AV1 versus AV2) may not be statistically significantly different. Results: In the gated consonant and vowel tasks and the vowel duration discrimination task, there were significant differences in A performance of speech stimuli between the two modality orders. The participants mean A performance was better in the AV1- A2 than in the A1- AV2 modality order (i.e., after AV processing). In terms of mean AV performance, no significant difference was observed between the two orders. In the sentence identification in noise task, a significant difference in the A identification of speech stimuli between the two orders was observed (A1 versus A2). In addition, a significant difference in the AV identification of speech stimuli between the two orders was also observed (AV1 versus AV2). This finding was most likely because of a procedural learning effect due to the greater complexity of the sentence materials or a combination of procedural learning and perceptual learning due to the presentation of sentential materials in noisy conditions. Conclusions: The findings of the present study support the perceptual doping hypothesis, as prior AV relative to A speech exposure resulted in a larger gain for the subsequent processing of speech stimuli. For complex speech stimuli that were presented in degraded listening conditions, a procedural learning effect (or a combination of procedural learning and perceptual learning effects) also facilitated the identification of speech stimuli, irrespective of whether the prior modality was A or AV.

  • 99.
    Moradi, Shahram
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Wahlin, Anna
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Hällgren, Mathias
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Öron- näsa- och halskliniken US.
    Rönnberg, Jerker
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Handikappvetenskap. Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutet för handikappvetenskap (IHV).
    Lidestam, Björn
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten.
    The Efficacy of Short-term Gated Audiovisual Speech Training for Improving Auditory Sentence Identification in Noise in Elderly Hearing Aid Users2017Ingår i: Frontiers in Psychology, ISSN 1664-1078, E-ISSN 1664-1078, Vol. 8, artikel-id 368Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to examine the efficacy and maintenance of short-term (one-session) gated audiovisual speech training for improving auditory sentence identification in noise in experienced elderly hearing-aid users. Twenty-five hearing aid users (16 men and 9 women), with an average age of 70.8 years, were randomly divided into an experimental (audiovisual training, n = 14) and a control (auditory training, n = 11) group. Participants underwent gated speech identification tasks comprising Swedish consonants and words presented at 65 dB sound pressure level with a 0 dB signal-to-noise ratio (steady-state broadband noise), in audiovisual or auditory-only training conditions. The Hearing-in-Noise Test was employed to measure participants auditory sentence identification in noise before the training (pre-test), promptly after training (post-test), and 1 month after training (one-month follow-up). The results showed that audiovisual training improved auditory sentence identification in noise promptly after the training (post-test vs. pre-test scores); furthermore, this improvement was maintained 1 month after the training (one-month follow-up vs. pre-test scores). Such improvement was not observed in the control group, neither promptly after the training nor at the one-month follow-up. However, no significant between-groups difference nor an interaction between groups and session was observed. Conclusion: Audiovisual training may be considered in aural rehabilitation of hearing aid users to improve listening capabilities in noisy conditions. However, the lack of a significant between-groups effect (audiovisual vs. auditory) or an interaction between group and session calls for further research.

  • 100.
    Myleus, Anna
    et al.
    Umea Univ, Sweden.
    Stenhammar, Lars
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Norrköping.
    Högberg, Lotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Barn- och ungdomskliniken i Norrköping.
    Browaldh, Lars
    Karolinska Inst, Sweden; Soder Sjukhuset, Sweden.
    Daniels, Ing-Marie
    Uppsala Univ Hosp, Sweden.
    Fagerberg, Ulrika L.
    Vastmanland Hosp, Sweden; Karolinska Inst, Sweden.
    Gudjonsdottir, Audur H.
    Sahlgrens Univ Hosp, Sweden.
    Malmquist, Marianne
    Sahlgrens Univ Hosp, Sweden.
    Sandstrom, Olof
    Umea Univ, Sweden.
    Ivarsson, Anneli
    Umea Univ, Sweden.
    Questionnaire showed that Swedish paediatric clinics complied well with the revised European guidelines for diagnosing coeliac disease2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 6, s. 1140-1143Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim In 2012, revised criteria for diagnosing childhood coeliac disease were published by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and incorporated into the revised Swedish guidelines the same year. These made it possible, in certain cases, to diagnose coeliac disease without taking small bowel biopsies. This survey assessed the extent to which the new guidelines were implemented by Swedish paediatric clinics two years after their introduction. Methods In October 2014, we distributed a paper questionnaire including five questions on diagnostic routines to the 40 paediatric clinics in university or regional hospitals in Sweden that perform small bowel biopsies. Results All 36 (90%) clinics that responded used anti-tissue transglutaminase antibodies as the initial diagnostic test and some also used serological markers. Most clinics (81%) used endoscopy and took multiple duodenal biopsies, whereas only a few (19%) occasionally employed a suction capsule. Almost all clinics (86%) omitted taking small bowel biopsies in symptomatic children with repeatedly high coeliac serology and positive genotyping, thereby avoiding the need for invasive endoscopy under anaesthesia. Conclusion The 2012 Swedish Paediatric Coeliac Disease Diagnostic Guidelines had been widely accepted and implemented in routine health care two years after their introduction.

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