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  • 1.
    Adolfsson, Päivi
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Disability Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health equity and working life.
    Umb-Carlsson, Õie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Research in Disability and Habilitation.
    Ek, Pia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology.
    Significant others’ perspectives on experiences of meal-oriented support and diet counselling for adults with intellectual disabilities who live in supported housing2024In: International Journal of Developmental Disabilities, ISSN 2047-3869, Vol. 70, no 3, p. 435-443Article in journal (Refereed)
    Abstract [en]

    The quality of meal-oriented support for people with intellectual disabilities is important for their health. The aim of the present study was to explore the experiences of meal-oriented support and diet counselling for adults with intellectual disabilities living in supported housing, from the perspective of housing staff and mothers. Five focus group interviews, including nine supporting staff members and nine mothers, were conducted. The interviews were analyzed using systematic text condensation. Five themes appeared; Extensive needs of the individual, Staff skills determine the food intake, Informal caregivers make up for shortage of support, Effective collaboration with a registered dietitian is needed and Responsibility of the organization state that professionalization of staff is needed. Lacking resources, such as time and nutritional knowledge, insufficient considerations of individual needs, and high staff turnover influence the meal-orientated services negatively. This study brings to the fore, staff working practices and the complexity of providing meal-oriented support for people with intellectual disabilities. Staff need skills to perform individually tailored support. This is best accomplished through effective collaboration between housing staff and relatives underpinned by knowledge from a registered dietitian. The working practices must be structured at the organizational level of the services.

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  • 2. Aguiar, A.
    et al.
    Ahring, K.
    Almeida, M. F.
    Assoun, M.
    Belanger Quintana, A.
    Bigot, S.
    Bihet, G.
    Malmberg, Karin Blom
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food, Nutrition and Dietetics.
    Burlina, A.
    Bushueva, T.
    Caris, A.
    Chan, H.
    Clark, A.
    Clark, S.
    Cochrane, B.
    Corthouts, K.
    Dalmau, J.
    Dassy, M.
    De Meyer, A.
    Didycz, B.
    Diels, M.
    Dokupil, K.
    Dubois, S.
    Eftring, K.
    Ekengren, J.
    Ellerton, C.
    Evans, S.
    Faria, A.
    Fischer, A.
    Ford, S.
    Freisinger, P.
    Gizewska, M.
    Gokmen-Ozel, H.
    Gribben, J.
    Gunden, F.
    Heddrich-Ellerbrok, M.
    Heiber, S.
    Heidenborg, C.
    Jankowski, C.
    Janssen-Regelink, R.
    Jones, I.
    Jonkers, C.
    Joerg-Streller, M.
    Kaalund-Hansen, K.
    Kiss, E.
    Lammardo, A. M.
    Lang, K.
    Lier, D.
    Lilje, R.
    Lowry, S.
    Luyten, K.
    MacDonald, A.
    Meyer, U.
    Moor, D.
    Pal, A.
    Robert, M.
    Robertson, L.
    Rocha, J. C.
    Rohde, C.
    Ross, K.
    Saruhan, S.
    Sjoqvist, E.
    Skeath, R.
    Stoelen, L.
    Ter Horst, N. M.
    Terry, A.
    Timmer, C.
    Tuncer, N.
    Vande Kerckhove, K.
    van der Ploeg, L.
    van Rijn, M.
    van Spronsen, F. J.
    van Teeffelen-Heithoff, A.
    van Wegberg, A.
    van Wyk, K.
    Vasconcelos, C.
    Vitoria, I.
    Wildgoose, J.
    Webster, D.
    White, F. J.
    Zweers, H.
    Practices in prescribing protein substitutes for PKU in Europe: No uniformity of approach2015In: Molecular Genetics and Metabolism, ISSN 1096-7192, E-ISSN 1096-7206, Vol. 115, no 1, p. 17-22Article in journal (Refereed)
    Abstract [en]

    Background: There appears little consensus concerning protein requirements in phenylketonuria (PKU). Methods: A questionnaire completed by 63 European and Turkish IMD centres from 18 countries collected data on prescribed total protein intake (natural/intact protein and phenylalanine-free protein substitute [PS]) by age, administration frequency and method, monitoring, and type of protein substitute. Data were analysed by European region using descriptive statistics. Results: The amount of total protein (from PS and natural/intact protein) varied according to the European region. Higher median amounts of total protein were prescribed in infants and children in Northern Europe (n = 24 centres) (infants <1 year, >2-3 g/kg/day; 1-3 years of age, >2-3 g/kg/day; 4-10 years of age, >1.5-2.5 g/kg/day) and Southern Europe (n = 10 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, 2 g/kg/day; 4-10 years of age, 1.5-2 g/kg/day), than by Eastern Europe (n = 4 centres) (infants <1 year, 2.5 g/kg/day, 1-3 years of age, >2-2.5 g/kg/day; 4-10 years of age, >1.5-2 g/kg/day) and with Western Europe (n = 25 centres) giving the least (infants <1 year, >2-2.5 g/kg/day, 1-3 years of age, 1.5-2 g/kg/day; 4-10 years of age, 1-1.5 g/kg/day). Total protein prescription was similar in patients aged >10 years (1-1.5 g/kg/day) and maternal patients (1-1.5 g/kg/day). Conclusions: The amounts of total protein prescribed varied between European countries and appeared to be influenced by geographical region. In PKU, all gave higher than the recommended 2007 WHO/FAO/UNU safe levels of protein intake for the general population.

  • 3.
    Ahlstedt, Carina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Eriksson Lindvall, Carin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Business Studies.
    Holmström, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; School of Nursing, University of Adelaide, Australia.
    What makes registered nurses remain in work?: An ethnographic study2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89, p. 32-38Article in journal (Refereed)
    Abstract [en]

    Background: Registered nurses' work-related stress, dissatisfaction and burnout are some of the problems in the healthcare and that negatively affect healthcare quality and patient care. A prerequisite for sustained high quality at work is that the registered nurses are motivated. High motivation has been proved to lead to better working results. The theory of inner work life describes the dynamic interplay between a person's perceptions, emotions and motivation and the three key factors for a good working life: nourishment, progress and catalysts. Objectives: The aim of the study was to explore registered nurses' workday events in relation to inner work life theory, to better understand what influences registered nurses to remain in work. Design: A qualitative explorative study with an ethnographic approach. Methods: Participant observation over four months; in total 56 h with 479 events and 58 informal interviews during observation; all registered nurses employed at the unit (n = 10) were included. In addition, individual interviews were conducted after the observation period (n = 9). The dataset was analysed using thematic analysis and in the final step of the analysis the categories were reflected in relation to the three key factors in theory of inner work life. Results: Nourishment in a registered nurse context describes the work motivation created by the interpersonal support between colleagues. It was important to registered nurses that physicians and colleagues respected and trusted their knowledge in the daily work, and that they felt comfortable asking questions and supporting each other. Progress in the context of registered nurses' work motivation was the feeling of moving forward with a mix of small wins and the perception of solving more complex challenges in daily work. It was also fundamental to the registered nurses' development through new knowledge and learning during daily work. Catalysts, actions that directly facilitate the work, were highlighted as the possibility to work independently along with the opportunity to work together with other registered nurses. Conclusion: This study has a number of implications for future work and research on creating an attractive workplace for registered nurses. Working independently, with colleagues from the same profession, integrated with learning, visible progress, and receiving feedback from the work itself, contribute to work motivation.

  • 4.
    Al Genaby, Shams
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
    En observationsstudie om användbarheten av Janusmed njurfunktion: En kvalitativ studie2021Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: In response to the lack of consideration of patient’s kidney function when prescribing drugs, the electronic Clinical Decision Support System (CDSS), Janusmed drugs, and renal function have been developed. This system offers knowledge on prescribing drugs to patients with impaired kidney function. Studies have shown that CDSS has the potential to lower the inappropriate prescription rate for patients with impaired kidney function. However, the general problem that CDSS faces is a low implementation rate because of inadequate usability.

    Aim: The aim was to evaluate the usability of the digital interface Janusmed drugs and renal function and map ways to improve the interface.Method: Think aloud sessions and semi-structured interviews were conducted with eight medical doctors and three clinical pharmacists. Data from the think-aloud sessions were structured through an affinity diagram, also called the KJ-method, to obtain a diagram of how the interface is used and possible improvements of the system. Furthermore, Nielsen’s ten usability heuristics were used to evaluate the usability of the system.

    Results: A total of six violations were found in the system, but they scored low on severity (1-2 points). The affinity diagram obtained showed the following five main themes on ways to improve the system: interface/technical functions, patient data, renal function, self-assessment, and future development.

    Conclusion: Janusmed drugs and renal function is a well-designed and user-friendly CDSS.However, there is still room for further improvements in the design and functionality of the interface that would increase the usability of the system

  • 5.
    Al-Kaisy, Adnan
    et al.
    St Thomas Hosp, Pain Management & Neuromodulat Ctr, Westminster Bridge Rd, London SE1 7EH, England.
    Royds, Jonathan
    Guys & St Thomas NHS Fdn Trust, London, England.
    Palmisani, Stefano
    Guys & St Thomas NHS Fdn Trust, London, England.
    Pang, David
    Guys & St Thomas NHS Fdn Trust, London, England.
    Wesley, Samuel
    Guys & St Thomas NHS Fdn Trust, London, England.
    Taylor, Rod S.
    Univ Glasgow, Inst Hlth & Well Being, Glasgow, Lanark, Scotland;Univ Exeter, Inst Hlth Res, Med Sch, Exeter, Devon, England.
    Cook, Andrew
    Univ Southampton, Wessex Inst, Southampton, Hants, England;Univ Hosp Southampton NHS Fdn Trust, Southampton, Hants, England.
    Eldabe, Sam
    South Tees Hosp NHS Fdn Trust, Middlesbrough, Cleveland, England.
    McCracken, Lance
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Duarte, Rui
    Univ Liverpool, Hlth Serv Res, Liverpool Reviews & Implementat Grp, Liverpool, Merseyside, England.
    Fairbank, Jeremy
    Univ Oxford, Oxford, England.
    Multicentre, double-blind, randomised, sham-controlled trial of 10 khz high-frequency spinal cord stimulation for chronic neuropathic low back pain (MODULATE-LBP): a trial protocol2020In: Trials, E-ISSN 1745-6215, Vol. 21, article id 111Article in journal (Refereed)
    Abstract [en]

    Introduction: Chronic neuropathic low back pain (CNLBP) is a debilitating condition in which established medical treatments seldom alleviate symptoms. Evidence demonstrates that high-frequency 10 kHz spinal cord stimulation (SCS) reduces pain and improves health-related quality of life in patients with failed back surgery syndrome (FBSS), but evidence of this effect is limited in individuals with CNLBP who have not had surgery. The aim of this multicentre randomised trial is to assess the clinical and cost-effectiveness of 10 kHz SCS for this population.

    Methods: This is a multicentre, double-blind, randomised, sham-controlled trial with a parallel economic evaluation. A total of 96 patients with CNLBP who have not had spinal surgery will be implanted with an epidural lead and a sham lead outside the epidural space without a screening trial. Patients will be randomised 1:1 to 10 kHz SCS plus usual care (intervention group) or to sham 10 kHz SCS plus usual care (control group) after receiving the full implant. The SCS devices will be programmed identically using a cathodal cascade. Participants will use their handheld programmer to alter the intensity of the stimulation as per routine practice. The primary outcome will be a 7-day daily pain diary. Secondary outcomes include the Oswestry Disability Index, complications, EQ-5D-5 L, and health and social care costs. Outcomes will be assessed at baseline (pre-randomisation) and at 1 month, 3 months and 6 months after device activation. The primary analyses will compare primary and secondary outcomes between groups at 6 months, while adjusting for baseline outcome scores. Incremental cost per quality-adjusted life year (QALY) will be calculated at 6 months and over the lifetime of the patient.

    Discussion: The outcomes of this trial will inform clinical practice and healthcare policy on the role of high-frequency 10 kHz SCS for use in patients with CNLBP who have not had surgery.

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  • 6.
    Apelman, Linnea
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food Studies, Nutrition and Dietetics.
    Sandvik, Pernilla
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food Studies, Nutrition and Dietetics.
    Roos, Eva
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Food Studies, Nutrition and Dietetics.
    Olofsson, Jonas
    Stockholm University.
    New child-friendly assessments of food odor identification ability, awareness and use of odor cues2023Conference paper (Other academic)
    Abstract [en]

    Exposure to food odors has been demonstrated to increase appetite, yet little is known about the role of olfaction in picky eating. Picky eating, the unwillingness to try new foods or eat familiar foods is common among children and linked to a low intake of fruits and vegetables. 

    Objective: To develop two new child-friendly assessment tools, that will be put in use to investigate the relationships between olfaction, picky eating, and, fruit and vegetable liking among children. 

    Methods: The following assessment tools were developed: 1) a test assessing fruit and vegetable odor identification (using food-grade aromas), similar to the validated U-sniff test but also quantifying the liking of the odors 2) a self-reported questionnaire tool assessing the awareness and use of odor cues in everyday life, developed from the interview guide Children’s Olfactory Behaviors in Everyday Life (COBEL). Development and evaluation were performed by conducting cognitive interviews with 20 children (aged 5-13). As a next step, 100 Swedish children aged 9-11 years are recruited to participate in data collection (April/May 2023). Data will also be collected on 1) willingness to consume, and liking of, the corresponding fruit and vegetables in a tasting session 2) general odor identification ability, using the validated U-Sniff test 3) the degree of picky eating and, liking of fruits and vegetables, using questionnaire assessments.

  • 7.
    Areskoug Sandberg, Elin
    et al.
    Örebro Univ, Univ Hlth Care, Fac Med & Hlth, Res Ctr, Örebro, Sweden.;Lund Univ, Ctr Primary Hlth Care Res, Dept Clin Sci, Malmö, Sweden.
    Duberg, Anna
    Örebro Univ, Univ Hlth Care, Fac Med & Hlth, Res Ctr, Örebro, Sweden.
    Lorenzon Fagerberg, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research, County of Västmanland. Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden.
    Moerelius, Evalotte
    Edith Cowan Univ, Sch Nursing & Midwifery, Joondalup, WA, Australia.;Perth Childrens Hosp, Nedlands, WA, Australia.
    Saernblad, Stefan
    Örebro Univ, Fac Med & Hlth, Dept Pediat, Örebro, Sweden.
    Saliva Cortisol in Girls With Functional Abdominal Pain Disorders: A Randomized Controlled Dance and Yoga Intervention2022In: Frontiers in Pediatrics , E-ISSN 2296-2360, Vol. 10, article id 836406Article in journal (Refereed)
    Abstract [en]

    Introduction: Functional abdominal pain disorders (FAPDs) are common among girls and has been associated with stress. Cortisol is one of the major stress hormones. Dance and yoga have been shown to reduce abdominal pain among girls with FAPDs.

    Aim: To investigate the effect of an 8-month intervention with dance and yoga on cortisol levels in saliva among girls with FAPDs.

    Methods: A total of 121 girls aged 9-13 years with irritable bowel syndrome (IBS) or functional abdominal pain were included in the study. Participants were randomized into an intervention group and a control group. The intervention group attended a combined dance and yoga session twice a week for 8 months. Saliva samples were collected during 1 day, in the morning and evening, at baseline, and at 4 and 8 months. Subjective pain and stress were assessed as well.

    Results: No significant effects on saliva cortisol levels between groups were observed after completion of the intervention at 8 months. However, evening cortisol and evening/morning quotient were significantly reduced at 4 months in the intervention group compared to the control group (p = 0.01, p = 0.004). There was no association between cortisol quota and pain or stress.

    Conclusion: Improvements in cortisol levels were seen in the intervention group at 4 months but did not persist until the end of the study. This indicates that dance and yoga could have a stress-reducing effect during the ongoing intervention.

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  • 8.
    Arnetz, Judith E.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Hamblin, Lydia
    Ager, Joel
    Aranyos, Deanna
    Upfal, Mark J.
    Luborsky, Mark
    Russell, Jim
    Essenmacher, Lynnette
    Application and Implementation of the Hazard Risk Matrix to Identify Hospital Workplaces at Risk for Violence2014In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 57, no 11, p. 1276-1284Article in journal (Refereed)
    Abstract [en]

    BackgroundA key barrier to preventing workplace violence injury is the lack of methodology for prioritizing the allocation of limited prevention resources. The hazard risk matrix was used to categorize the probability and severity of violence in hospitals to enable prioritization of units for safety intervention. MethodsProbability of violence was based on violence incidence rates; severity was based on lost time management claims for violence-related injuries. Cells of the hazard risk matrix were populated with hospital units categorized as low, medium, or high probability and severity. Hospital stakeholders reviewed the matrix after categorization to address the possible confounding of underreporting. ResultsForty-one hospital units were categorized as medium or high on both severity and probability and were prioritized for forthcoming interventions. Probability and severity were highest in psychiatric care units. ConclusionsThis risk analysis tool may be useful for hospital administrators in prioritizing units for violence injury prevention efforts.  

  • 9.
    Arnoldsson, Sara
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Aronsson, Bente
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Logopedi.
    Femåringar berättar på svenska och engelska: Referensdata och jämförelse med 6- och 7-åringar2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Since 2009, the EU research network COST Action IS0804 has been working towards gaining more knowledge about bilingual language acquisition in typically and atypically developing children, and towards creating assessment tools which are specifically adapted to bilingual children. Within COST Action, one working group, Narrative and discourse, focuses on narratives as a way to assess children’s language. Narratives provide more naturalistic language samples than item-based tests and are less biased against bilingual children compared to other language assessments. The Narrative and discourse group developed the assessment tool MAIN (Multilingual Assessment Instrument for Narratives). MAIN examines children’s production and comprehension of narratives on a macrostructural level (i.e. overall story structure) within the framework of story grammar (SG). One current hypothesis is that macrostructure is language independent and can therefore be compared across languages. In the current study, 16 simultaneous bilingual children (ages 4:11- 5:8, mean 5:4 years) with the language combination Swedish-English were assessed with MAIN. Their results were compared with the results of bilingual 6-7 year olds with the same language combination (Härdelin & Naylor, 2012). Results showed no significant difference regarding macrostructure between the children’s two languages, neither in production(p= 0,084) nor in comprehension (p= 0,21). However, there was a significant difference between the younger and the older children, both in production (p= 0,00099) and comprehension (p= 0,0072). Non-targetlike structures due to cross-linguistic influence,e.g. transfer and code-mixing, were noticed for both age groups. Cross-linguistic influence should thus not be mistaken for language impairment, but rather be treated as a natural part of bilingual language acquisition. In conclusion, differences in macrostructure seemed to be related to age rather than to language. The results of the current study provide insight into the performance of five-year-olds on MAIN, which has not previously been studied in a Swedish context. By comparing the results with older children, the study documents the narrative development of Swedish-English bilinguals from age 5 to 7.

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  • 10.
    Arousell, Jonna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Sacred Ideals: Diversity and Equality in Swedish Reproductive Healthcare2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    To promote diversity (mångfald) and equality (jämlikhet) is a key task for a wide range of welfare institutions in Sweden. The two terms appeal to several aspects simultaneously: inclusiveness, moral goodness, awareness and willingness to facilitate a positive social change. Diversity and equality have become, as I suggest in this thesis, two sacred ideals in Swedish society today. In the context of reproductive healthcare, various forms of diversity and equality measures are thought of as solutions to, for instance, inequalities between immigrant groups and others, structural discrimination of minority groups, and difficulties faced by the Swedish healthcare system in caring for patients’ diverse needs and preferences in clinical encounters. In this thesis, diversity and equality are analysed as two important governing mechanisms in the organisation of healthcare in multicultural Sweden. The aim was to explore how these ideals contribute to shape the provision of reproductive healthcare, and its consequences.

    Paper I shows that targeted interventions towards immigrant women in contraceptive counselling risk singling out some women from standard routes of care because they are categorised as “immigrants” or “Muslims”. Paper II shows that demands upon healthcare providers to accommodate Muslim patients’ presumed needs have the potential of also creating needs that were not there from the start. Paper III shows that many religious counsellors who are affiliated with Swedish healthcare as spiritual advisers present ideas on abortion that are less progressive than what is stipulated in Swedish abortion law. Paper IV shows that imperatives to promote gender equality in contraceptive counselling were taken seriously by providers in their encounters with non-Western women, at the possible expense of respect for relationship structures that do not conform to the ideals of gender equality.

    The findings presented in this thesis show that the interventions and initiatives that sought to presumably help disadvantaged groups of people (i.e. Muslims, immigrant women) could, in fact, be obstacles to solving the problems they were meant to address. I argue that the governance of Swedish reproductive healthcare through diversity and equality ideals must be problematised and balanced with regard to their plausible consequences.

    List of papers
    1. Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception? A qualitative exploration and critique of a common argument in reproductive health research
    Open this publication in new window or tab >>Are 'low socioeconomic status' and 'religiousness' barriers to minority women's use of contraception? A qualitative exploration and critique of a common argument in reproductive health research
    2019 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 75, p. 59-65Article in journal (Refereed) Published
    Abstract [en]

    Objective: 'Low socioeconomic status' and 'religiousness' appear to have gained status as nearly universal explanatory models for why women in minority groups are less likely to use contraception than other women in the Scandinavian countries. Through interviews with pious Muslim women with immigrant background, living in Denmark and Sweden, we wanted to gain empirical insights that could inform a discussion about what 'low socioeconomic status' and 'religiousness' might mean with regard to women's reproductive decisions.

    Design: Semi-structured interviews were conducted in Denmark and Sweden between 2013 and 2016.

    Findings: We found that a low level of education and a low income were not necessarily obstacles for women's use of contraception; rather, these were strong imperatives for women to wait to have children until their life circumstances become more stable. Arguments grounded in Islamic dictates on contraception became powerful tools for women to substantiate how it is religiously appropriate to postpone having children, particularly when their financial and emotional resources were not yet established.

    Conclusion: We have shown that the dominant theory that 'low socioeconomic status' and 'religiousness' are paramount barriers to women's use of contraception must be problematized. When formulating suggestions for how to provide contraceptive counseling to women in ethnic and religious minority groups in Denmark and Sweden, one must also take into account that factors such as low financial security as well as religious convictions can be strong imperatives for women to use contraception.

    Implications for practice: This study can help inform a critical discussion about the difficulties of using broad group-categorizations for understanding individuals' health-related behavior, as well as the validity of targeted interventions towards large heterogeneous minority groups in Scandinavian contraceptive counseling.

    Keywords
    Muslim women, Immigrant women, Contraceptive use, Reproductive health, Denmark, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
    Identifiers
    urn:nbn:se:uu:diva-388751 (URN)10.1016/j.midw.2019.03.017 (DOI)000470962400011 ()31005014 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4576
    Available from: 2019-08-14 Created: 2019-08-14 Last updated: 2019-09-05Bibliographically approved
    2. Modes of Governing: A Foucaultian Perspective on Encounters between Healthcare Providers and Muslim Women in Swedish Reproductive Healthcare
    Open this publication in new window or tab >>Modes of Governing: A Foucaultian Perspective on Encounters between Healthcare Providers and Muslim Women in Swedish Reproductive Healthcare
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    There are probably few groups of patients in Sweden today that arouse as much associations and thoughts as do Muslims from the Middle East. The core dilemma in much of these discussions is whether healthcare providers should adjust the provision of care to Muslims’ divergent religious preferences, or if they would be better off to treat Muslims in the same way as other patients. These debates are often entangled with both a concern about politics of equality (i.e. ambitions to treat everyone the same) and politics of diversity (i.e. to treatpeople from ethnic and religious minority groups differently). Inspired by Foucault’s concept of governmentality, we in this study intended to explore the principles of ‘equality’ and 'diversity’ as governing tools for the shaping of healthcare providers and patients’ conduct. We found that although these governing tools are presented as non-conflicting in health policies, there seems to be an often-present trade-off between diversity and equality ideals in their practical implementation. When these policies are assigned meaning and implemented inpractice, they appear to generate unforeseeable consequences, both for healthcare providers and for the patients. It thus appears that the policies that were introduced with the intention of improving the structure of multicultural care encounters, in some cases, had an opposite effect.

    Keywords
    Muslim, reproductive healthcare, diversity, equality, politics of recognition, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Identifiers
    urn:nbn:se:uu:diva-392207 (URN)
    Available from: 2019-08-31 Created: 2019-08-31 Last updated: 2020-07-13Bibliographically approved
    3. Does Religious Counselling on Abortion Comply with Sweden’s ‘Women‑Friendly’ Abortion Policies?: A Qualitative Exploration Among Religious Counsellors
    Open this publication in new window or tab >>Does Religious Counselling on Abortion Comply with Sweden’s ‘Women‑Friendly’ Abortion Policies?: A Qualitative Exploration Among Religious Counsellors
    2019 (English)In: Sexuality & Culture, ISSN 1095-5143, E-ISSN 1936-4822, Vol. 23, no 4, p. 1230-1249Article in journal (Refereed) Published
    Abstract [en]

    The abortion discourse in Sweden is marked by historically liberal ideals about women’s inviolable right to make autonomous reproductive decisions. However, to respond to the increase in cultural and religious pluralism building up over several decades, religious organizations have been given opportunities to provide so-called spiritual care in affiliation with Swedish hospitals since the 1980s. In this study we asked: in what ways do religious counsellors, affiliated with Swedish hospitals, construct their ideas on abortion, and how well do their ideas comply with Sweden’s ‘women-friendly’ abortion policies? Through interviews with Protestant, Catho-lic, Muslim, and Buddhist religious counsellors, we wanted to empirically test the presumption underlying the decisions to grant space to religious actors in Swedish healthcare, i.e., that religious counselling serves to complement existing services. We found that it cannot be expected that religious advice on abortion will always comply with Swedish abortion law and with the women-friendly abortion policy that the Swedish state seeks to impose. When policy-makers open up possibilities for diverse norms on abortion to manifest in close affiliation with healthcare institutions, they must be aware that some religious counsellors argue that only God—and not the woman herself—can decide whether a woman can terminate a pregnancy. We argue that the findings in this study speaks to what researchers have referred to as the “diversity-equality paradox”, which highlights the tension between the promotion of religious ideas on abortion on the one hand and the promotion of liberal ideas about women’s reproductive freedom on the other.

    Keywords
    Abortion, Women’s rights, Religious counselling, Diversity promotion, The diversity–equality paradox, Healthcare, Sweden
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology Social Sciences Interdisciplinary
    Identifiers
    urn:nbn:se:uu:diva-389908 (URN)10.1007/s12119-019-09614-6 (DOI)000490290000011 ()
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2019-07-31 Created: 2019-07-31 Last updated: 2019-11-08Bibliographically approved
    4. Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling: A Discourse Analysis.
    Open this publication in new window or tab >>Unintended Consequences of Gender Equality Promotion in Swedish Multicultural Contraceptive Counseling: A Discourse Analysis.
    Show others...
    2017 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 27, no 10, p. 1518-1528Article in journal (Refereed) Published
    Abstract [en]

    In this article, we explore how reproductive health care providers in Sweden, a country often described as one of the most gender-equal countries in the world, incorporate gender equality ideals in multicultural contraceptive counseling. In the tension between gender equality promotion on one hand and respect for cultural diversity and individualized care on the other, we will demonstrate that values of gender equality were often given priority. This is not necessarily undesirable. Nevertheless, our proposal is that the gender equality ideology may inhibit providers' ability to think differently about issues at stake in contraceptive counseling, which may negatively influence women's possibilities to obtain adequate support. At the end of the article, we suggest how health care providers' reflexivity might be used as a working tool for increased awareness about the taken-for-granted cultural norms that exist in their clinical milieu.

    Keywords
    Sweden, contraceptive counseling, cultural diversity, discourse analysis, gender equality, qualitative method, reproductive health, women
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-327196 (URN)10.1177/1049732317697099 (DOI)000406057500007 ()28728532 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2017-08-07 Created: 2017-08-07 Last updated: 2020-07-13Bibliographically approved
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  • 11.
    Backman, Petra
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Tidiga tecken på sväljningssvårigheter vid ALS2019Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Approximately 80% of all patients with ALS suffer from dysphagia sooner or later during the course of the disease. It is important to find patients with dysphagia in an early stage since weight loss and malnutrition, which dysphagia contributes to, are negative prognostic factors.

    The main purpose of this study was to identify early signs of dysphagia in patients with ALS, by investigating which clinical evaluation tools that discovers dysphagia in an early stage and see how the swallowing difficulties progress over time. Another purpose of the study was to evaluate the participants’ responses in a self-evaluation questionnaire (EAT-10) and how they correlate with findings on fiberoptic endoscopic evaluation of swallowing (FEES).

    Eleven participants with ALS were examined with FEES and non-instrumental tests one to four times over the course of one year. Only five participants were examined three or more times and because of that it is not possible to draw conclusions about the progression of dysphagia. Nine of 11 participants showed signs of dysphagia at the first examination.

    Test of lip strength was the clinical evaluation tool that identified most patients with dysphagia, followed by swallow capacity test. In an exploratory analysis, both of these tests showed good correlation with results on FEES. Patient responses on EAT-10 were also strongly correlated with the results on FEES.

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  • 12.
    Bergman, Karolin
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    Eli, Karin
    Institute of Social and Cultural Anthropology, School of Anthropology and Museum Ethnography, 51/53 Banbury Road, Oxford, OX2 6PE.
    Persson Osowski, Christine
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    Lövestam, Elin
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    Nowicka, Paulina
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of food studies, nutrition and dietetics.
    Public expressions of trust and distrust in governmental dietary advice in Sweden2019In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 29, no 8, p. 1161-1173Article in journal (Refereed)
    Abstract [en]

    We examine public trust and distrust in governmental food and nutrition authorities, through analyzing 727 letters sent electronically to the Swedish National Food Agency by lay people. Using thematic analysis, four themes were developed, defining public expressions of trust and distrust in official dietary advice. Trust was expressed as (a) seeking to confirm and clarify dietary advice, or (b) seeking official arbitration between competing dietary advice. Distrust was expressed as (c) questioning and scrutinizing dietary advice, or (d) protesting and resisting dietary advice. Notably, expressions of distrust employed discursive practices that both mirrored authoritative discourses and subverted official advice, by appealing to scientific language and 'alternative' evidence. All letters positioned the agency as the ultimate authority on healthy eating; notwithstanding whether the agency’s advice was to be followed or resisted. Thus, the letters revealed how the same authoritative discourses can simultaneously be a site of public trust and distrust.

  • 13.
    Bergström, Christel A.S.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
    Avdeef, Alex
    In ADME Res, 1732 First Ave,102, New York, NY 10128 USA.
    Perspectives in solubility measurement and interpretation2019In: ADMET AND DMPK, ISSN 1848-7718, Vol. 7, no 2, p. 88-105Article, review/survey (Refereed)
    Abstract [en]

    Several key topics in solubility measurement and interpretation are briefly summarized and illustrated with case studies drawing on published solubility determinations as a function of pH. Featured are examples of ionizable molecules that exhibit solubility-pH curve distortion from that predicted by the traditionally used Henderson-Hasselbalch equation and possible interpretations for these distortions are provided. The scope is not exhaustive; rather it is focused on detailed descriptions of a few cases. Topics discussed are limitations of kinetic solubility, 'brick-dust and grease-balls,' applications of simulated and human intestinal fluids, supersaturation and the relevance of pre-nucleation clusters and sub-micellar aggregates in the formation of solids, drug-buffer/excipient complexation, hydrotropic solubilization, acid-base 'supersolubilization,' cocrystal route to supersaturation, as well as data quality assessment and solubility prediction. The goal is to highlight principles of solution equilibria - graphically more than mathematically - that could invite better assay design, to result in improved quality of measurements, and to impart a deeper understanding of the underlying solution chemistry in suspensions of drug solids. The value of solid state characterizations is stressed but not covered explicitly in this mini-review.

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  • 14.
    Bergström, Kim
    et al.
    Ord och Vetande AB.
    Köhler, LennartOrd och Vetande AB.Sonnander, Karin
    Forskning om funktionsnedsättning pågår 2022:42022Collection (editor) (Other (popular science, discussion, etc.))
    Abstract [sv]

    Frakturer bland äldre kan upptäckas med enkel röntgen s. 2Smärta kan vara en sjukdom i sig s. 3Tillgänglighet – rätten alla inte har rätt till s. 6Tillgänglighet stort problem på Göteborgs spårvagnar s. 8Rättighetsreformen som kom av sig s. 10Familjeliv har inte alltid varit självklart för personermed funktionsnedsättning s. 13 Lästips s. 13Bättre kunskaper om hur hjärnan hanterar antal kan ge bättre matematikundervisning s. 14Hallå där! s. 15Kalendern 2022 s. 16

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  • 15. Bishop, Lauren
    et al.
    Barclay, Kieron
    Uppsala University, Swedish Collegium for Advanced Study (SCAS). Department of Sociology, Stockholm University, 106 91, Stockholm, Sweden Max Planck Institute for Demographic Research, 18057, Rostock, Germany.
    Birth order and health events attributable to alcohol and narcotics in midlife: A 25-year follow-up of a national Swedish birth cohort and their siblings2022In: SSM - Population Health, ISSN 2352-8273, Vol. 19, no 101219Article in journal (Refereed)
    Abstract [en]

    Higher birth order is associated with increased risks of adverse health outcomes attributable to alcohol or narcotics in adolescence, but it remains unclear whether these observed birth order effects are also present in midlife. Drawing on a national Swedish cohort born in 1953 and their siblings, we estimate associations between birth order and alcohol- or narcotics-attributable hospitalization or death with a 25-year follow-up to assess whether birth order differences are observed during this life course period. Health events attributable to alcohol or narcotics use were identified using the Swedish National Patient and Cause of Death registers, respectively. We apply Cox proportional hazards models to estimate average birth order differences in hazards for alcohol- or narcotics-attributable hospitalization or death between ages 30 and 55. We estimate birth order differences between families, and use two fixed-effects approaches to estimate birth order differences within families and within families of the same type. Bivariate results indicate increased hazards for both outcomes with higher birth order; however, these results are no longer observed after adjustment for familial background characteristics in all models. Our results thereby show limited evidence for birth order differences in midlife. This study highlights that shared factors within the family of origin may be stronger predictors of adverse health outcomes attributable to substance use among siblings during this life course period. Future research should disentangle the contributions of the social environment within the family of origin for adverse health outcomes attributable to alcohol or narcotics among siblings.

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  • 16.
    Blease, Charlotte
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group. Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Psychiat, Digital Psychiat, Boston, MA 02115 USA..
    Worthen, Abigail
    Amer Psychiat Assoc, Washington, DC USA..
    Torous, John
    Harvard Med Sch, Beth Israel Deaconess Med Ctr, Dept Psychiat, Digital Psychiat, Boston, MA 02115 USA..
    Psychiatrists' experiences and opinions of generative artificial intelligence in mental healthcare: An online mixed methods survey2024In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 333, article id 115724Article in journal (Refereed)
    Abstract [en]

    Following the launch of ChatGPT in November 2022, interest in large language model (LLM)-powered chatbots has surged with increasing focus on the clinical potential of these tools. Missing from this discussion, however, are the perspectives of physicians. The current study aimed to explore psychiatrists' experiences and opinions on this new generation of chatbots in mental health care. An online survey including both quantitative and qualitative responses was distributed to a non-probability sample of psychiatrists affiliated with the American Psychiatric Association. Findings revealed 44 % of psychiatrists had used OpenAI's ChatGPT-3.5 and 33 % had used GPT-4.0 "to assist with answering clinical questions." Administrative tasks were cited as a major benefit of these tools: 70 % somewhat agreed/agreed "documentation will be/is more efficient". Three in four psychiatrists (75 %) somewhat agreed/agreed "the majority of their patients will consult these tools before first seeing a doctor". Nine in ten somewhat agreed/agreed that clinicians need more support/training in understanding these tools. Open-ended responses reflected these opinions but respondents also expressed divergent opinions on the value of generative AI in clinical practice, including its impact on the future of the profession.

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  • 17.
    Bockgård, Gustav
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Languages, Department of Scandinavian Languages.
    Mattsson, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health. Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health.
    Klarare, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health. Department of Health Care Sciences, Marie Cederschiöld University, Stockholm, Sweden.
    Collaborative Interpretation of Researcher-Generated Photo-Elicitation Findings: Insights From Women With Lived Experience of Homelessness2024In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 34, no 7, p. 676-690Article in journal (Refereed)
    Abstract [en]

    Interviews with individuals experiencing homelessness can be challenging for various reasons, including mental and physical health issues, substance use, and negative experiences with authority figures. Researchers have used photos to facilitate communication and empower participants during data collection. We analyzed data from a previous study to explore the use of researcher-generated photos during interviews about health with 13 women experiencing homelessness. Conversation analysis revealed clear patterns regarding the use of the photos during the interviews. The photos were referred to 118 times over the total interview length, 6 hours and 23 minutes, with the interviewer making 62% of the referrals and the women accounting for 38%. Fifty-nine percent of the referrals occurred within the first 5 minutes of the interviews. The women used the photos to trigger associations and emotions, to describe photo content, or in a minor role during the interview. Interpretations from an advisory board of six women with lived experiences of homelessness suggested that the photos did not engage participants as intended, highlighting the importance of considering participants’ perspectives when designing photo-elicitation methods. The feedback also provided valuable insights into interview locations and incentives in research that may have influenced the women’s willingness to use the photos. This study emphasizes the importance of understanding the complexity of choosing researcher-generated photos in interviews with underserved, hard-to-reach populations.

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  • 18.
    Bodin, Maja
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Department of History of Science and Ideas.
    Regretting parenthood in a family friendly, ‘gender equal’ society: accounts from Swedish online forums2023In: Journal of Family Studies, ISSN 1322-9400, E-ISSN 1839-3543, Vol. 29, no 5, p. 2195-2212Article in journal (Refereed)
    Abstract [en]

    In the past decades, parents have used online forums to discuss challenges associated with parenthood, seeking support from other parents as well as professional advice. A highly sensitive topic discussed in these forums is regret about having children. Previous studies from various contexts have highlighted how regret, as expressed online, is often connected to difficulties of living up to and identifying with ideals of parenting, and that parenthood leads to feelings of exhaustion, entrapment and a negative self-image. In this article, I analyze how regret is expressed in two major Swedish online forums, including accounts from 142 parents. Sweden is a country that is often highlighted internationally as a pioneer in gender equality, with laws that protect sexual and reproductive rights and family- friendly policies that support parents in combining family life and work life. In light of this, I focus on the different decisions related to parenthood that people regret, the challenges and disappointments that family life has brought to parents, and the consequences that parenthood has had on their lives. I show how gender-equal parenting ideals are highly present in the discussions, and how they coexist and conflict with more traditional parenting behaviours and patterns.

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  • 19. Buffart, L. M.
    et al.
    Schreurs, M. A. C.
    Abrahams, H. J. G.
    Kalter, J.
    Aaronson, N. K.
    Jacobsen, P. B.
    Newton, R. U.
    Courneya, K. S.
    Armes, J.
    Arving, Cecilia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Lifestyle and rehabilitation in long term illness.
    Braamse, A. M.
    Brandberg, Y.
    Dekker, J.
    Ferguson, R. J.
    Gielissen, M. F.
    Glimelius, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
    Goedendorp, M. M.
    Graves, K. D.
    Heiney, S. P.
    Horne, R.
    Hunter, M. S.
    Johansson, Birgitta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology.
    Northouse, L. L.
    Oldenburg, H. S.
    Prins, J. B.
    Savard, J.
    van Beurden, M.
    van den Berg, S. W.
    Brug, J.
    Knoop, H.
    Verdonck-de Leeuw, I. M.
    Effects and moderators of coping skills training on symptoms of depression and anxiety in patients with cancer: Aggregate data and individual patient data meta-analyses2020In: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 80, article id 101882Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: This study evaluated the effects of coping skills training (CST) on symptoms of depression and anxiety in cancer patients, and investigated moderators of the effects.

    METHODS: Overall effects and intervention-related moderators were studied in meta-analyses of pooled aggregate data from 38 randomized controlled trials (RCTs). Patient-related moderators were examined using linear mixed-effect models with interaction tests on pooled individual patient data (n = 1953) from 15 of the RCTs.

    RESULTS: CST had a statistically significant but small effect on depression (g = -0.31,95% confidence interval (CI) = -0.40;-0.22) and anxiety (g = -0.32,95%CI = -0.41;-0.24) symptoms. Effects on depression symptoms were significantly larger for interventions delivered face-to-face (p = .003), led by a psychologist (p = .02) and targeted to patients with psychological distress (p = .002). Significantly larger reductions in anxiety symptoms were found in younger patients (pinteraction < 0.025), with the largest reductions in patients <50 years (β = -0.31,95%CI = -0.44;-0.18) and no significant effects in patients ≥70 years. Effects of CST on depression (β = -0.16,95%CI = -0.25;-0.07) and anxiety (β = -0.24,95%CI = -0.33;-0.14) symptoms were significant in patients who received chemotherapy but not in patients who did not (pinteraction < 0.05).

    CONCLUSIONS: CST significantly reduced symptoms of depression and anxiety in cancer patients, and particularly when delivered face-to-face, provided by a psychologist, targeted to patients with psychological distress, and given to patients who were younger and received chemotherapy.

  • 20.
    Bärkås, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group.
    Patients’ Access to Their Mental Health Records: Understanding Policy, Access, and Patient Experiences2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    ORA is the concept of patients' access to clinical information, which has become more widespread worldwide. When patients are provided online record access (ORA) to their health records, concerns have been raised by healthcare professionals, especially when it comes to patients with mental health diagnoses. In the general population, positive aspects appear to outweigh the negative, yet limited research has so far explored the impact of ORA in mental healthcare. 

    The overall aim of this thesis was to explore how patients experience ORA in mental healthcare through four studies: 1) a literature review aimed to explore the current literature on the experiences of ORA among mental healthcare patients, care partners, and healthcare professionals, 2) a document analysis combined with key stakeholder email interviews that aimed to explore to what extent ORA in mental healthcare has been implemented in Sweden including national and local policy regulations, 3) an online patient survey study aimed to understand mental healthcare patients' experiences with ORA in Sweden, Estonia, Finland, and Norway, and 4) an online patient survey study aimed to understand if and how patients with mental health conditions experiences of ORA differs from patients in other healthcare settings. 

    More patients reported positive experiences with ORA in mental healthcare than negative experiences. Common benefits of ORA included, among others, a greater sense of control over their care, improved understanding of their mental health diagnosis, and better adherence to appointments. Despite patients' predominant positive experiences, only 17 out of 21 regions in Sweden offered ORA in mental healthcare in 2021. Additionally, many patients experienced errors and omissions and felt offended by the content of their health records. Mental healthcare patients experienced this at a higher rate than patients in other healthcare settings.

    In conclusion, mental healthcare patients have higher rates of negative experiences of ORA compared to patients in other healthcare settings. However, patients' experiences of ORA are still predominantly positive among both patient groups. Yet, in 2021, only 17 regions offered patients ORA in mental healthcare. Denying mental healthcare patients ORA to protect them from negative experiences could instead increase stigma in this patient group.

    List of papers
    1. Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review
    Open this publication in new window or tab >>Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions: Scoping Review
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    2021 (English)In: JMIR Mental Health, E-ISSN 2368-7959, Vol. 8, no 12, article id e34170Article in journal (Refereed) Published
    Abstract [en]

    Background: Electronic health records (EHRs) are increasingly implemented internationally, whereas digital sharing of EHRs with service users (SUs) is a relatively new practice. Studies of patient-accessible EHRs (PAEHRs)-often referred to as open notes-have revealed promising results within general medicine settings. However, studies carried out in mental health care (MHC) settings highlight several ethical and practical challenges that require further exploration.

    Objective: This scoping review aims to map available evidence on PAEHRs in MHC. We seek to relate findings with research from other health contexts, to compare different stakeholders' perspectives, expectations, actual experiences with PAEHRs, and identify potential research gaps.

    Methods: A systematic scoping review was performed using 6 electronic databases. Studies that focused on the digital sharing of clinical notes or EHRs with people affected by mental health conditions up to September 2021 were included. The Mixed Methods Appraisal Tool was used to assess the quality of the studies. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Extension for Scoping Reviews guided narrative synthesis and reporting of findings.

    Results: Of the 1034 papers screened, 31 were included in this review. The studies used mostly qualitative methods or surveys and were predominantly published after 2018 in the United States. PAEHRs were examined in outpatient (n=29) and inpatient settings (n=11), and a third of all research was conducted in Veterans Affairs Mental Health. Narrative synthesis allowed the integration of findings according to the different stakeholders. First, SUs reported mainly positive experiences with PAEHRs, such as increased trust in their clinician, health literacy, and empowerment. Negative experiences were related to inaccurate notes, disrespectful language use, or uncovering of undiscussed diagnoses. Second, for health care professionals, concerns outweigh the benefits of sharing EHRs, including an increased clinical burden owing to more documentation efforts and possible harm triggered by reading the notes. Third, care partners gained a better understanding of their family members' mental problems and were able to better support them when they had access to their EHR. Finally, policy stakeholders and experts addressed ethical challenges and recommended the development of guidelines and trainings to better prepare both clinicians and SUs on how to write and read notes.

    Conclusions: PAEHRs in MHC may strengthen user involvement, patients' autonomy, and shift medical treatment to a coproduced process. Acceptance issues among health care professionals align with the findings from general health settings. However, the corpus of evidence on digital sharing of EHRs with people affected by mental health conditions is limited. Above all, further research is needed to examine the clinical effectiveness, efficiency, and implementation of this sociotechnical intervention.

    Place, publisher, year, edition, pages
    JMIR Publications, 2021
    Keywords
    electronic health records, open notes, psychiatry, mental health, user involvement, patient advocacy, patient portal
    National Category
    Psychiatry Other Medical Sciences not elsewhere specified
    Research subject
    Medical Informatics; Psychology
    Identifiers
    urn:nbn:se:uu:diva-462043 (URN)10.2196/34170 (DOI)000739100300011 ()34904956 (PubMedID)
    Projects
    NORDeHEALTHBeyond Implementation of eHealth
    Funder
    NordForsk, 100477Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01229
    Available from: 2021-12-19 Created: 2021-12-19 Last updated: 2024-02-20Bibliographically approved
    2. Patients’ Access to Their Psychiatric Notes: Current Policies and Practices in Sweden
    Open this publication in new window or tab >>Patients’ Access to Their Psychiatric Notes: Current Policies and Practices in Sweden
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    2021 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 17, article id 9140Article in journal (Refereed) Published
    Abstract [en]

    Patients’ access to electronic health records (EHRs) is debated worldwide, and access to psychiatry records is even more criticized. There is a nationwide service in Sweden which offers all citizens the opportunity to read their EHR, including clinical notes. This study aims to explore Swedish national and local policy regulations regarding patients’ access to their psychiatric notes and describe to what extent patients currently are offered access to them. The rationale behind the study is that current policies and current practices may differ between the 21 self-governing regions, although there is a national regulation. We gathered web-based information from policy documents and regulations from each region’s website. We also conducted key stakeholder interviews with respondents from the regions and cross-regional private care providers, using a qualitative approach. The results show that 17 of 21 regions share psychiatric notes with patients, where forensic psychiatric care was the most excluded psychiatric care setting. All private care providers reported that they mainly follow the regions’ guidelines. Our findings show that regional differences concerning sharing psychiatric notes persist, despite Swedish regulations and a national policy that stipulates equal care for everyone. The differences, however, appear to have decreased over time, and we report evidence that the regions are moving toward increased transparency for psychiatry patients.

    Place, publisher, year, edition, pages
    MDPI, 2021
    Keywords
    mental health, psychiatry, psychiatric record, psychiatric notes, patient accessible electronic health record, PAEHR, open notes, policies
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Research subject
    Medical Informatics
    Identifiers
    urn:nbn:se:uu:diva-452386 (URN)10.3390/ijerph18179140 (DOI)000694051800001 ()34501730 (PubMedID)
    Projects
    NORDeHEALTH
    Funder
    NordForsk, 100477
    Available from: 2021-09-06 Created: 2021-09-06 Last updated: 2024-02-20Bibliographically approved
    3. Experiences from Patients in Mental Healthcare Accessing their Electronic Health Records: Results from a Cross-National Survey in Estonia, Finland, Norway, and Sweden
    Open this publication in new window or tab >>Experiences from Patients in Mental Healthcare Accessing their Electronic Health Records: Results from a Cross-National Survey in Estonia, Finland, Norway, and Sweden
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    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Research subject
    Medical Informatics
    Identifiers
    urn:nbn:se:uu:diva-522716 (URN)
    Available from: 2024-02-08 Created: 2024-02-08 Last updated: 2024-02-20
    4. Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden
    Open this publication in new window or tab >>Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients: Results from a Nationwide Survey in Sweden
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    2023 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 25, article id e47841Article in journal (Refereed) Published
    Abstract [en]

    Background: Previous research reports that patients with mental health conditions experience benefits, for example, increased empowerment and validation, from reading their patient-accessible electronic health records (PAEHRs). In mental health care (MHC), PAEHRs remain controversial, as health care professionals are concerned that patients may feel worried or offended by the content of the notes. Moreover, existing research has focused on specific mental health diagnoses, excluding the larger PAEHR userbase with experience in MHC. Objective: The objective of this study is to establish if and how the experiences of patients with and those without MHC differ in using their PAEHRs by (1) comparing patient characteristics and differences in using the national patient portal between the 2 groups and (2) establishing group differences in the prevalence of negative experiences, for example, rates of errors, omissions, and offenses between the 2 groups. Methods: Our analysis was performed on data from an online patient survey distributed through the Swedish national patient portal as part of our international research project, NORDeHEALTH. The respondents were patient users of the national patient portal 1177, aged 15 years or older, and categorized either as those with MHC experience or with any other health care experience (nonmental health care [non-MHC]). Patient characteristics such as gender, age, education, employment, and health status were gathered. Portal use characteristics included frequency of access, encouragement to read the record, and instances of positive and negative experiences. Negative experiences were further explored through rates of error, omission, and offense. The data were summarized through descriptive statistics. Group differences were analyzed through Pearson chi-square. Results: Of the total sample (N=12,334), MHC respondents (n=3131) experienced errors (1586/3131, 50.65%, and non-MHC 3311/9203, 35.98%), omissions (1089/3131, 34.78%, and non-MHC 2427/9203, 26.37%) and offenses (1183/3131, 37.78%, and non-MHC 1616/9203, 17.56%) in the electronic health record at a higher rate than non-MHC respondents (n=9203). Respondents reported that the identified error (MHC 795/3131, 50.13%, and non-MHC 1366/9203, 41.26%) and omission (MHC 622/3131, 57.12%, and non-MHC 1329/9203, 54.76%) were “very important,” but most did nothing to correct them (MHC 792/3131, 41.29%, and non-MHC 1838/9203, 42.17%). Most of the respondents identified as women in both groups. Conclusions: About 1 in 2 MHC patients identified an error in the record, and about 1 in 3 identified an omission, both at a much higher rate than in the non-MHC group. Patients with MHC also felt offended by the content of the notes more commonly (1 in 3 vs 1 in 6). These findings validate some of the worries expressed by health care professionals about providing patients with MHC with PAEHRs and highlight challenges with the documentation quality in the records.

    Place, publisher, year, edition, pages
    JMIR Publications, 2023
    Keywords
    electronic health records, EHR, mental health, mental health care, national survey, online records access, open notes, ORA, patient-accessible electronic health record, PAEHR, patients, user experiences
    National Category
    Health Care Service and Management, Health Policy and Services and Health Economy
    Research subject
    Medical Informatics
    Identifiers
    urn:nbn:se:uu:diva-515506 (URN)10.2196/47841 (DOI)001104378500001 ()37921861 (PubMedID)
    Funder
    NordForsk, 100477Forte, Swedish Research Council for Health, Working Life and Welfare
    Available from: 2023-11-03 Created: 2023-11-03 Last updated: 2024-07-02Bibliographically approved
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  • 21.
    Christiansen, Mats
    Karolinska Institutet.
    Varför har vi fetischer?2017In: Medicinsk Vetenskap, ISSN 1104-3822, Vol. 24, no 2, p. 49-49Article in journal (Other (popular science, discussion, etc.))
  • 22.
    Clausson, Amalia
    et al.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
    Jansson, Patrik
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Educational Sciences, Department of Education.
    Att vara eller att inte vara med i en idrottsföreing: - Faktorer som påverkar beslutet2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att ta reda på om ungdomar som valt ett liv inom föreningsidrotten på grund av inre eller yttre motivation och faktorer. Finns det skillnader mellan könen?  

    Vi kom fram till att det väldigt ofta var den inre motivationen som låg bakom påbörjandet eller upprätthållandet av medlemskapet i en idrottsförening. Av de personer som svarat att de valt att inte vara aktiva utövare i en idrottsförening visar det sig att drygt hälften inte är det på grund av yttre faktorer och många anser att aktiviteten är ”tråkig”. Ungdomar som är aktiva väljer att vara det för att det ”är kul” och de flesta påbörjade idrotten för att de ”ville prova på”.

    Vid en jämförelse av pojkar och flickor och upprätthållande i en föreningsidrott visade sig en skillnad där flickorna i något större andel drevs av inre motivation. När det gäller avslutande eller att inte påbörjat medlemskap visade sig yttre faktorer ha haft störst påverkan bland ungdomarna. 

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    Att vara eller att inte vara med i en idrottsförening
  • 23.
    Coumoundouros, Chelsea
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women's and children's health), Clinical Psychology in Healthcare.
    Mårtensson, Erika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women's and children's health), Clinical Psychology in Healthcare. Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research.
    Ferraris, Giulia
    Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women's and children's health), Clinical Psychology in Healthcare.
    Sanderman, Robbert
    Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Woodford, Joanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women's and children's health), Clinical Psychology in Healthcare.
    Implementation of e-mental health interventions for informal caregivers of adults with chronic diseases: a systematic review2020In: Implementation Science, E-ISSN 1748-5908, Vol. 15, p. P10-P10, article id 105Article in journal (Refereed)
    Abstract [en]

    Background:

    Many informal caregivers experience mental health difficulties. E-mental health interventions offer effective and accessible mental health support; however, these interventions are often not implemented. To explore implementation of e-mental health interventions for informal caregivers, a systematic review was conducted to (1) examine implementation barriers and facilitators, and (2) identify implementation and intervention features associated with intervention effectiveness.

    Method:

    Multiple electronic databases were searched for studies published since 2007 reporting on the implementation and/or effectiveness of e-mental health interventions for informal caregivers of adults with chronic diseases. A thematic synthesis of data related to implementation will be used to identify implementation barriers and facilitators. A qualitative comparative analysis, using data from pragmatic randomized controlled trials, will be used to determine combinations of conditions related to an intervention’s implementation or program features, sufficient for intervention effectiveness.

    Results:

    Electronic database searches yielded 9248 unique records to undergo title/abstract screening. The literature screening process is currently underway to identify full-texts eligible for inclusion in the analysis. Preliminary findings will be presented. Implementation barriers and facilitators identified in the thematic synthesis will be presented. These barriers and facilitators will be linked to initial results from the qualitative comparative analysis, as barriers and facilitators may relate to conditions important for intervention effectiveness. Practical applications of these findings will be discussed. If a qualitative comparative analysis cannot be completed prior to the conference, pragmatic trials reporting on intervention effectiveness will be descriptively summarized and analysis plans discussed.

    Conclusions:

    This review will identify key factors to consider during implementation of e-mental health interventions for informal caregivers and present potential solutions to overcome implementation barriers. These findings can be used to inform intervention design and implementation strategies to facilitate the implementation of e-mental health services for informal caregivers.

    Acknowledgements:

    This work was supported by the European Union’s Horizon 2020 research and innovation program under the Marie-Sklodowska Curie grant agreement No 814072.

  • 24.
    Coumoundouros, Chelsea
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    von Essen, Louise
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Sanderman, Robbert
    Department of Psychology, Health and Technology, University of Twente, Enschede, the Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Woodford, Joanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
    Implementation of e-mental health interventions for informal caregivers of adults with chronic diseases: a protocol for a mixed-methods systematic review with a qualitative comparative analysis2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 6, article id e035406Article, review/survey (Refereed)
    Abstract [en]

    INTRODUCTION: Informal caregivers provide the majority of care to individuals with chronic health conditions, benefiting the care recipient and reducing use of formal care services. However, providing informal care negatively impacts the mental health of many caregivers. E-mental health interventions have emerged as a way to provide accessible mental healthcare to caregivers. Much attention has been given to reviewing the effectiveness and efficacy of such interventions, however, factors related to implementation have received less consideration. Therefore, this mixed-methods systematic review will aim to examine factors associated with the effectiveness and implementation of e-mental health interventions for caregivers.

    METHODS AND ANALYSIS: Eligible studies published since 1 January 2007 will be searched for in several electronic databases (CINAHL Plus with Full Text, the Cochrane Library, EMBASE, PsycINFO, PubMed and Web of Science), clinical trial registries and OpenGrey, with all screening steps conducted by two independent reviewers. Studies will be included if they focus on the implementation or effectiveness of e-mental health interventions designed for informal adult caregivers of adults with cancer, heart disease, stroke, diabetes, dementia or chronic obstructive pulmonary disease. Pragmatic randomised controlled trials quantitatively reporting on caregiver anxiety, depression, psychological distress or stress will be used for a qualitative comparative analysis to identify combinations of conditions that result in effective interventions. Qualitative and quantitative data on implementation of e-mental health interventions for caregivers will be integrated in a thematic synthesis to identify barriers and facilitators to implementation. These results will inform future development and implementation planning of e-mental health interventions for caregivers.

    ETHICS AND DISSEMINATION: Ethical approval is not required for this study as no primary data will be collected. Results will be disseminated in the form of a scientific publication and presentations at academic conferences and plain language summaries for various stakeholders.

    PROSPERO REGISTRATION NUMBER: CRD42020155727.

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  • 25.
    Danielsson, Katarina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Sakarya, Aysegül
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
    Jansson-Fröjmark, Markus
    Department of Clinical Neuroscience, Karolinska Institute.
    The reduced Morningness–Eveningness Questionnaire: Psychometric properties and related factors in a young Swedish population2019In: Chronobiology International, ISSN 0742-0528, E-ISSN 1525-6073, Vol. 36, no 4, p. 530-540Article in journal (Refereed)
    Abstract [en]

    During puberty, there is a delay in sleep patterns and the circadian clock, and the prevalence of sleep difficulties is high among young adults. Thus, it is important to be able to measure chronotype (CT) in this group, both in the clinic and for broader epidemiological studies, to better understand the sleep difficulties observed. The reduced version of one of the most widely used questionnaire to measure CT, the Horne & Östberg Morningness–Eveningness Questionnaire (MEQ), has been developed and validated in many languages. The aim of the present study was to investigate the reliability and validity of the Swedish reduced MEQ (rMEQ) and to investigate factors correlated with rMEQ scores in a random sample of young Swedish participants. We sent the rMEQ, sleep questions, demographic questions, the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale, and the Hospital Anxiety and Depression Scale (HADS-A and HADS-D) to 1000 randomly selected individuals aged 16–26 years in Uppsala, Sweden (response rate = 68%). A parallel analysis of the rMEQ revealed a single factor solution. Inter-item correlations within the questionnaire were between 0.08 and 0.46. One of the rMEQ items displayed weak correlations with the other questions. Cronbach’s alpha of the rMEQ was 0.68. Low rMEQ scores (eveningness) were correlated with more frequent late bedtimes and difficulties getting up in the morning. Lower rMEQ scores were significantly related to male sex, no educational activity or work, nicotine use, younger age, and higher ISI and HADS-D scores. Even though the inter-item correlations of the rMEQ were very low to moderate, the rMEQ had a Cronbach’s alpha not far off from acceptable levels, and the strong correlations of the rMEQ scores with responses to the sleep questions indicated that the rMEQ had an adequate validity. To conclude, the rMEQ can be used to effectively estimate CT when a short questionnaire is required; however, caution should be taken when interpreting the results considering the reliability of the questionnaire.

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  • 26. Davoody, Nadia
    et al.
    Eghdam, Aboozar
    Koch, Sabine
    Hägglund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Evaluation of an Electronic Care and Rehabilitation Planning Tool With Stroke Survivors With Aphasia: Usability Study2023In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 10Article in journal (Refereed)
    Abstract [en]

    Background: Patients with chronic illnesses with physical and cognitive disabilities, particularly stroke survivors with aphasia, are often not involved in design and evaluation processes. As a consequence, existing eHealth services often do not meet the needs of this group of patients, which has resulted in a digital divide. Objective: The aim of this study was to examine the effectiveness and user satisfaction of an electronic care and rehabilitation planning tool from the perspective of stroke survivors with aphasia. This would help us gain knowledge on how such a tool would need to be adapted for these patients for further development. Methods: Usability tests were conducted with 9 postdischarge stroke survivors with aphasia. Effectiveness was measured using task-based tests, and user satisfaction was studied through qualitative interviews at the end of each test. All tests were audio recorded, and each test lasted approximately 1 hour. The data were analyzed using qualitative content analysis. As the tool can be used by stroke survivors either independently or with some support from their next of kin or care professionals, the research group decided to divide the participants into 2 groups. Group 1 did not receive any support during the tests, and group 2 received some minor support from the moderator. Results: The results showed that the care and rehabilitation planning tool was not effective for stroke survivors with aphasia, as many participants in group 1 did not accomplish the tasks successfully. Despite several usability problems and challenges in using the tool because of patients’ disabilities, the participants were positive toward using the tool and found it useful for their care and rehabilitation journey. Conclusions: There is a need to involve patients with chronic illnesses more in the design and evaluation processes of health information systems and eHealth services. eHealth services and health information systems designed for this group of patients should be more adaptable and flexible to provide them with appropriate functionalities and features, meet their needs, and be useful and easy to use. In addition, the design and evaluation processes should be adapted, considering the challenges of this patient group.

  • 27.
    Dorlo, Thomas P. C.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences. Univ Utrecht, Utrecht Inst Pharmaceut Sci, Div Pharmacoepidemiol & Clin Pharmacol, Utrecht, Netherlands;Uppsala Univ, Dept Pharmaceut Biosci, Uppsala, Sweden.
    Fernndez, Carmen
    Stockholm Univ, Wenner Gren Inst, Dept Mol Biosci, Stockholm, Sweden.
    Troye-Blomberg, Marita
    Stockholm Univ, Wenner Gren Inst, Dept Mol Biosci, Stockholm, Sweden.
    De Vries, Peter J.
    Tergooi Hosp, Dept Internal Med, Hilversum, Netherlands.
    Boraschi, Diana
    CNR, Inst Prot Biochem, Naples, Italy.
    Mbacham, Wilfred F.
    Univ Yaounde I, Fac Med, Dept Biochem & Physiol, Yaounde, Cameroon.
    Poverty-Related Diseases College: a virtual African-European network to build research capacity2016In: BMJ Global Health, E-ISSN 2059-7908, Vol. 1, no 1, article id UNSP e000032Article in journal (Refereed)
    Abstract [en]

    The Poverty-Related Diseases College was a virtual African-European college and network that connected young African and European biomedical scientists working on poverty-related diseases. The aim of the Poverty-Related Diseases College was to build sustainable scientific capacity and international networks in poverty-related biomedical research in the context of the development of Africa. The Poverty-Related Diseases College consisted of three elective and mandatory training modules followed by a reality check in Africa and a science exchange in either Europe or the USA. In this analysis paper, we present our experience and evaluation, discuss the strengths and encountered weaknesses of the programme, and provide recommendations to policymakers and funders.

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  • 28.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

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  • 29.
    Ekstam, Lisa
    et al.
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Dept Occupat Therapy, Stockholm, Sweden..
    Johansson, Ulla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Guidetti, Susanne
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Eriksson, Gunilla
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine. Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    Ytterberg, Charlotte
    Karolinska Inst, Div Occupat Therapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Univ Hosp, Div Neurol, Dept Clin Neurosci, Huddinge, Sweden.;Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden..
    The combined perceptions of people with stroke and their carers regarding rehabilitation needs 1 year after stroke: a mixed methods study2015In: BMJ Open, E-ISSN 2044-6055, Vol. 5, no 2, article id e006784Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to explore the associations between the dyad's (person with stroke and informal caregiver) perception of the person with stroke's rehabilitation needs and stroke severity, personal factors (gender, age, sense of coherence), the use of rehabilitation services, amount of informal care and caregiver burden. Further, the aim was to explore the personal experience of everyday life changes among persons with stroke and their caregivers and their strategies for handling these 1 year after stroke. Design: A mixed methods design was used combining quantitative and qualitative data and analyses. Setting: Data were mainly collected in the participants' homes. Outcome measures: Data were collected through established instruments and open-ended interviews. The dyad's perceptions of the person with stroke's rehabilitation needs were assessed by the persons with stroke and their informal caregivers using a questionnaire based on Ware's taxonomy. The results were combined and classified into three groups: met, discordant (ie, not in agreement) and unmet rehabilitation needs. To assess sense of coherence (SOC) in persons with stroke, the SOC-scale was used. Caregiver burden was assessed using the Caregiver Burden Scale. Data on the use of rehabilitation services were obtained from the computerised register at the Stockholm County Council. Participants: 86 persons with stroke (mean age 73 years, 38% women) and their caregivers (mean age 65 years, 40% women). Results: Fifty-two per cent of the dyads perceived that the person with stroke's need for rehabilitation was met 12 months after stroke. Met rehabilitation needs were associated with less severe stroke, more coping strategies for solving problems in everyday activities and less caregiver burden. Conclusions: Rehabilitation interventions need to focus on supporting the dyads' process of psychological and social adaptation after stroke. Future studies need to explore and evaluate the effects of using a dyadic perspective throughout rehabilitation.

  • 30.
    Ekstrand-Hammarström, Barbro
    et al.
    FOI, Umeå.
    Akfur, Christine
    FOI, Umeå.
    Andersson, Per Ola
    FOI, UMEÅ.
    Lejon, Christian
    FOI, Umeå.
    Österlund, Lars
    Uppsala University, Disciplinary Domain of Science and Technology, Technology, Department of Engineering Sciences, Solid State Physics.
    Buch, Anders
    FOI, Umeå.
    Human Primary Bronchial Epithelial Cells are more Responsive to Titanium Dioxide Nanoparticles than the Lung Epithelial Cell Lines A549 and BEAS-2B2012In: Nanotoxicology, ISSN 1743-5390, E-ISSN 1743-5404, Vol. 6, no 6, p. 623-634Article in journal (Refereed)
    Abstract [en]

    We have compared the cellular uptake and responses of fivepreparations of nanocrystalline titanium dioxide (TiO2) betweennormal human bronchial epithelial (NHBE) cells and epithelialcell lines (A549 and BEAS-2B). The P25 nanoparticles, containingboth anatase and rutile modifications, induced reactive oxygenspecies (ROS) and secretion of the neutrophil chemoattractantIL-8 in all three cell types used. Pure anatase and rutile particlesprovoked differential IL-8 response in A549 and no response inBEAS-2B cells despite similar formation of ROS. The pure TiO2modifications also provoked release of the inflammatorymediators: IL-6, G-CSF and VEGF, in NHBE cells but not in the twocell lines. We conclude that the responsiveness of lung epithelialcells is strongly dependent on both the physicochemicalproperties of TiO2 nanoparticles and the type of responder cells.The differential pro-inflammatory responsiveness of primarylung epithelial cells compared with immortalized cell linesshould be considered in the assessment of adverse reactions toinhaled nanoparticles.

  • 31.
    Eldh, Ann Catrine
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Education, Health, and Social Studies, Dalarna University, SE.
    Fredriksson, Mio
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Halford, Christina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Wallin, Lars
    School of Education, Health, and Social Studies, Dalarna University, SE.
    Dahlström, Tobias
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Vengberg, Sofie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
    Facilitators and barriers to applying a national quality registry for quality improvement in stroke care2014In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 14, p. 354-Article in journal (Refereed)
    Abstract [en]

    Background: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. Methods: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. Results: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. Conclusion: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so.

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  • 32.
    Eliasson, Kristina
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. Uppsala University.
    Ergonomists’ risk assessments: From guesstimates to strategic approaches2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Musculoskeletal disorders are among the most prevalent causes of work-related ill-health, consequently risk assessments of hazardous factors related to these disorders are important for prevention. Occupational Health Services (OHS) providers are independent experts, supporting employers regarding work environment issues and rehabilitation. Ergonomists represents one of the professions within OHS, and risk assessment regarding musculoskeletal disorders is within the scope of their work tasks. 

    The overall objective was to explore Swedish ergonomists’ practices and approaches with risk assessments, in order to contribute new knowledge about how ergonomists’ work methods can be further developed to improve prevention of work-related musculoskeletal disorders. 

    Paper I explored the process of risk assessment assignments and the ergonomists’ use of observation-based risk-assessment tools. The result showed a lack of systematic approaches regarding risk assessment assignments and limited use and knowledge of observation-based risk-assessment tools. In Paper II inter-observer and intra-observer reliability of risk assessments, without the use of an explicit observational method were assessed. The results showed a non-acceptable reliability. Paper III explored ergonomists experiences of an e-learning concept for knowledge translation in the OHS context. The e-learning concept was considered as feasible. The knowledge translation inspired increased use of risk-assessment tools, changes in the risk assessment procedures, e.g. selection of tools, and employing a participatory approach. Paper IV described the development of a process model for occupational health surveillance for workers exposed to hand-intensive work (HIW-model), and the studies that will explore the model. Paper V explored company representatives’ experiences of the HIW-model, and factors which facilitated the execution of the model. The model contributed to increased risk awareness and understanding of how individual workers’ musculoskeletal ill-health relates to exposures in work. Facilitating factors were: a joint start-up meeting in which the process was planned, clear communication, and clarity regarding the ownership of the process. 

    In conclusion, the findings showed that ergonomists’ expertise is needed in the entire risk management process and not only in the risk assessment phase. In this process, the ergonomists need to be active and take the expert role (which includes a stocked toolbox) and support the employer through the whole risk management process from initiation to evaluation of risk controlling measures.

    List of papers
    1. Factors influencing ergonomists' use of observation-based risk-assessment tools
    Open this publication in new window or tab >>Factors influencing ergonomists' use of observation-based risk-assessment tools
    2019 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 64, no 1, p. 93-106Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Several observation-based risk-assessment tools have been developed in recent decades. Studies reporting their use often focus only on the user, the ergonomist. The influence of context and the attributes of the tools may also affect the use but are factors that are seldom considered. OBJECTIVE: The aim of the present study was to explore the process of risk-assessment assignments and to identify factors influencing the use of research-based observation-based risk-assessment tools among Swedish ergonomists, with a background as reg. physiotherapists, employed in Occupational Health Services (OHS). METHODS: A web-based questionnaire (n = 70) was combined with semi-structured interviews (n = 12). RESULTS: There was limited use of several observation-based risk-assessment tools. Furthermore, the results showed that ergonomics risk-assessment assignments are most commonly initiated reactively and that interventions were seldom evaluated. Factors that influence use are related both to the ergonomist and to the attributes of the tools as well as to contextual factors assigned to authorities, and internal organisations both within occupational health service companies and client companies. CONCLUSION: There was a lack of systematic approaches in ergonomics risks assessment and low use and knowledge of risk-assessment tools. This indicates that there is a need to support OHS companies in implementing systematic tools in their practice.

    Place, publisher, year, edition, pages
    IOS PRESS, 2019
    Keywords
    Ergonomics, occupational health service, musculoskeletal disorders, observation tools, Ottawa model of research use
    National Category
    Occupational Health and Environmental Health
    Identifiers
    urn:nbn:se:uu:diva-395564 (URN)10.3233/WOR-192972 (DOI)000487235000009 ()31450532 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-1563
    Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2020-06-09Bibliographically approved
    2. Inter- and intra-observer reliability of risk assessment of repetitive work without an explicit method
    Open this publication in new window or tab >>Inter- and intra-observer reliability of risk assessment of repetitive work without an explicit method
    2017 (English)In: Applied Ergonomics, ISSN 0003-6870, E-ISSN 1872-9126, Vol. 62, p. 1-8Article in journal (Refereed) Published
    Abstract [en]

    A common way to conduct practical risk assessments is to observe a job and report the observed long term risks for musculoskeletal disorders. The aim of this study was to evaluate the inter- and intra-observer reliability of ergonomists' risk assessments without the support of an explicit risk assessment method. Twenty-one experienced ergonomists assessed the risk level (low, moderate, high risk) of eight upper body regions, as well as the global risk of 10 video recorded work tasks. Intra-observer reliability was assessed by having nine of the ergonomists repeat the procedure at least three weeks after the first assessment. The ergonomists made their risk assessment based on his/her experience and knowledge. The statistical parameters of reliability included agreement in %, kappa, linearly weighted kappa, intraclass correlation and Kendall's coefficient of concordance. The average inter-observer agreement of the global risk was 53% and the corresponding weighted kappa (K-w) was 0.32, indicating fair reliability. The intra-observer agreement was 61% and 0.41 (K-w). This study indicates that risk assessments of the upper body, without the use of an explicit observational method, have non-acceptable reliability. It is therefore recommended to use systematic risk assessment methods to a higher degree.

    Keywords
    Inter-observer reliability, Intra-observer reliability, Risk assessment, Observational methods
    National Category
    Occupational Health and Environmental Health
    Identifiers
    urn:nbn:se:uu:diva-276859 (URN)10.1016/j.apergo.2017.02.004 (DOI)000401206600001 ()28411720 (PubMedID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202
    Note

    Title in thesis list of papers: Inter- and intra-observer reliability of risk assessment of repetitive work without any specific method

    Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2020-06-09Bibliographically approved
    3. Exploring ergonomists' experiences after participation in a theoretical and practical research project in observational risk assessment tools
    Open this publication in new window or tab >>Exploring ergonomists' experiences after participation in a theoretical and practical research project in observational risk assessment tools
    2022 (English)In: International Journal of Occupational Safety and Ergonomics, ISSN 1080-3548, E-ISSN 2376-9130, Vol. 28, no 2, p. 1136-1144Article in journal (Refereed) Published
    Abstract [en]

    Objective. The aim of this qualitative study was to explore how ergonomists experienced an e-learning concept as a tool for knowledge translation; furthermore, to explore what, if any, impact the knowledge translation had regarding the ergonomists’ work with risk assessments.

    Methods. Twelve Swedish ergonomists employed in the occupational health service (OHS) participated in a research project, which included an e-learning program in risk assessment training. Focus group interviews and individual interviews were used for data collection.

    Results. The ergonomists appreciated the e-learning concept, e.g., its flexibility enabled them to decide when and where to practice. The concept was considered feasible within the context of the OHS. The ergonomists experienced an increased knowledge of different observation-based risk assessment tools, which expanded their professional toolboxes. Additionally, they began to reflect more regarding the reliability of risk assessment tools and how to enhance quality in risk assessment assignments.

    Conclusion. This study showed that e-learning may comprise an efficient knowledge translation for improved risk assessments in the OHS. The program contributed to changes in ergonomists’ risk assessment procedures, e.g., in the selection of tools, increasing the number of observers, employing a participatory approach and more often actively involving stakeholders during the risk assessment process.

    Keywords
    e-learning, knowledge translation, participatory, risk assessment procedure
    National Category
    Occupational Health and Environmental Health
    Identifiers
    urn:nbn:se:uu:diva-411940 (URN)10.1080/10803548.2020.1870836 (DOI)000614484700001 ()
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202
    Available from: 2020-06-04 Created: 2020-06-04 Last updated: 2022-07-01Bibliographically approved
    4. Protocol for a qualitative research project exploring an occupational health surveillance model for workers exposed to hand-intensive work
    Open this publication in new window or tab >>Protocol for a qualitative research project exploring an occupational health surveillance model for workers exposed to hand-intensive work
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Other Health Sciences
    Identifiers
    urn:nbn:se:uu:diva-411941 (URN)
    Available from: 2020-06-04 Created: 2020-06-04 Last updated: 2020-06-09
    5. Occupational health surveillance for workers exposed to hand-intensive work: Company representatives’ experiences of a model that interconnects exposure assessments and medical health checks
    Open this publication in new window or tab >>Occupational health surveillance for workers exposed to hand-intensive work: Company representatives’ experiences of a model that interconnects exposure assessments and medical health checks
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    Occupational Health and Environmental Health
    Identifiers
    urn:nbn:se:uu:diva-411942 (URN)
    Available from: 2020-06-04 Created: 2020-06-04 Last updated: 2020-06-09
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  • 33.
    Eliasson, Kristina
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Palm, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nordander, Catarina
    Occupational and Environmental Medicine, Lund University.
    Dahlgren, Gunilla
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
    Lewis, Charlotte
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
    Hellman, Therese
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Svartengren, Magnus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Nyman, Teresia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Protocol for a qualitative research project exploring an occupational health surveillance model for workers exposed to hand-intensive workManuscript (preprint) (Other academic)
  • 34.
    Eriksson, Mats
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Lafolie, P
    Schierbeck, M
    Hörling, M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Vem har ansvaret för hur journalgranskning får göras?: Enhetligariktlinjer för journalgranskning bör utformas för att säkerställa attpatientintegriteten värnas likadant i alla regioner.2020In: Dagens Medicin, ISSN 1402-1943, Vol. 7, article id 15Article in journal (Refereed)
  • 35. Fagerlund, Asbjørn
    et al.
    Bärkås, Annika
    Kharko, Anna
    Blease, Charlotte
    Hagström, Josefin
    Huvila, Isto
    Hörhammer, Iiris
    Kane, Bridget
    Kristiansen, Eli
    Kujala, Sari
    Moll, Jonas
    Rexhepi, Hanife
    Scandurra, Isabella
    Simola, Saija
    Soone, Hedvig
    Wang, Bo
    Åhlfeldt, Rose-Mharie
    Hägglund, Maria
    Johansen, Monika
    Experiences from Patients in Mental Healthcare Accessing their Electronic Health Records: Results from a Cross-National Survey in Estonia, Finland, Norway, and SwedenManuscript (preprint) (Other academic)
  • 36. Faggiano, Fabrizio
    et al.
    Allara, Elias
    Giannotta, Fabrizia
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Molinar, Roberta
    Sumnall, Harry
    Wiers, Reinout
    Michie, Susan
    Collins, Linda
    Conrod, Patricia
    Europe Needs a Central, Transparent, and Evidence-Based Approval Process for Behavioural Prevention Interventions2014In: PLoS Medicine, ISSN 1549-1277, E-ISSN 1549-1676, Vol. 11, no 10, p. e1001740-Article in journal (Refereed)
    Download full text (pdf)
    fulltext
  • 37.
    Fang, Jing
    et al.
    Chinese Acad Sci, Shenzhen Inst Adv Technol, Shenzhen 518055, Peoples R China.
    Wang, Tao
    Lanzhou Univ, Sch Informat Sci & Engn, Lanzhou 730000, Gansu, Peoples R China.
    Li, Cancheng
    Lanzhou Univ, Sch Informat Sci & Engn, Lanzhou 730000, Gansu, Peoples R China.
    Hu, Xiping
    Chinese Acad Sci, Shenzhen Inst Adv Technol, Shenzhen 518055, Peoples R China;Lanzhou Univ, Sch Informat Sci & Engn, Lanzhou 730000, Gansu, Peoples R China.
    Ngai, Edith
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computer Systems.
    Seet, Boon-Chong
    Auckland Univ Technol, Dept Elect & Elect Engn, Auckland 1010, New Zealand.
    Cheng, Jun
    Chinese Acad Sci, Shenzhen Inst Adv Technol, Shenzhen 518055, Peoples R China.
    Guo, Yi
    Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Dept Neurol,Clin Med Coll 2,Affiliated Hosp 1, Shenzhen 518020, Peoples R China.
    Jiang, Xin
    Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Dept Geriatr,Clin Med Coll 2,Affiliated Hosp 1, Shenzhen 518020, Peoples R China.
    Depression Prevalence in Postgraduate Students and Its Association With Gait Abnormality2019In: IEEE Access, E-ISSN 2169-3536, Vol. 7, p. 174425-174437Article in journal (Refereed)
    Abstract [en]

    In recent years, an increasing number of university students are found to be at high risk of depression. Through a large scale depression screening, this paper finds that around 6.5% of the university postgraduate students in China experience depression. We then investigate whether the gait patterns of these individuals have already changed as depression is suggested to associate with gait abnormality. Significant differences are found in several spatiotemporal, kinematic and postural gait parameters such as walking speed, stride length, head movement, vertical head posture, arm swing, and body sway, between the depressed and non-depressed groups. Applying these features to classifiers with different machine learning algorithms, we examine whether natural gait analysis may serve as a convenient and objective tool to assist in depression recognition. The results show that when using a random forest classifier, the two groups can be classified automatically with a maximum accuracy of 91.58%. Furthermore, a reasonable accuracy can already be achieved by using parameters from the upper body alone, indicating that upper body postures and movements can effectively contribute to depression analysis.

    Download full text (pdf)
    FULLTEXT01
  • 38.
    Farrand, Paul
    et al.
    University of Exeter.
    Woodford, Joanne
    University of Exeter.
    Impact of support on the effectiveness of written cognitive behavioural self-help: a systematic review and meta-analysis of randomised controlled trials2013In: Clinical Psychology Review, ISSN 0272-7358, E-ISSN 1873-7811, Vol. 33, no 1, p. 182-195Article in journal (Refereed)
    Abstract [en]

    Cognitive behavioural therapy self-help is an effective intervention for a range of common mental health difficulties. However the extent to which effectiveness may vary by type of support--guided, minimal contact, self-administered--has not been extensively considered. This review identifies the impact of support on the effectiveness of written cognitive behavioural self-help and further explores the extent to which effectiveness varies across mental health condition by type of support provided. Randomised controlled trials were identified by searching relevant bibliographic databases, clinical trials registers, conference proceedings and expert contact. 38 studies were included in the meta-analysis yielding a statistically significant overall mean effect size (Hedges' g=-0.49). Overall effect size did not significantly differ by type of support (Q=0.85, df=2, p=0.65) (guided: Hedges' g=-0.53; minimal contact: Hedges' g=-0.55; self-administered: Hedges' g=-0.42). For guided and self-administered types of support, planned comparisons revealed a trend for effect size to vary by mental health condition and for guided CBT self-help the modality of support was significant (Q=6.32, df=2, p=0.04), with the largest effect size associated with telephone delivery (Hedges' g=-0.91). Additional moderator analysis was undertaken for depression given the number of available studies. Regardless of higher baseline levels of severity the effect size for minimal contact was greater than for guided support. Greater consideration should be given to the potential that type of support may be related to the effectiveness of written cognitive behavioural self-help and that this may vary across mental health condition. Findings from this systematic review make several recommendations to inform future research.

  • 39.
    Farrand, Paul
    et al.
    University of Exeter.
    Woodford, Joanne
    University of Exeter.
    Llewellyn, David
    University of Exeter.
    Anderson, Martin
    University of Exeter.
    Venkatasubramanian, Shanker
    University of Exeter.
    Ukoumunne, Obioha C
    University of Exeter.
    Adlam, Anna
    University of Exeter.
    Dickens, Chris
    University of Exeter.
    Behavioural activation written self-help to improve mood, wellbeing and quality of life in people with dementia supported by informal carers (PROMOTE): a study protocol for a single-arm feasibility study.2016In: Pilot and feasibility studies, ISSN 2055-5784, Vol. 2, article id 42Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Increases in life expectancy have resulted in a global rise in dementia prevalence. Dementia is associated with poor wellbeing, low quality of life and increased incidence of mental health difficulties such as low mood or depression. However, currently, there is limited access to evidence-based psychological interventions for people with dementia experiencing low mood and poor wellbeing. Behavioural activation-based self-help, supported by informal carers and guided by mental health professionals, may represent an effective and acceptable solution.

    METHODS/DESIGN: The present study is a phase II (feasibility) single-arm trial informed by the Medical Research Council complex interventions research methods framework. Up to 50 dementia participant/informal carer dyads will be recruited from a variety of settings including primary care, dementia-specific health settings and community outreach. People living with dementia will receive behavioural activation-based self-help and be supported by their informal carer who has received training in the skills required to support the self-help approach. In turn, during the use of the intervention, the informal carer will be guided by mental health professionals to help them work through the materials and problem solve any difficulties. Consistent with the objectives of feasibility studies, outcomes relating to recruitment from different settings, employment of different recruitment methods, attrition, data collection procedures, clinical delivery and acceptability of the intervention will be examined. Clinical outcomes for people with dementia (symptoms of depression and quality of life) and informal carers (symptoms of depression and anxiety, carer burden and quality of life) will be measured pre-treatment and at 3 months post-treatment allocation.

    DISCUSSION: This study will examine the feasibility and acceptability of a novel behavioural activation-based self-help intervention designed to promote wellbeing and improve low mood in people living with dementia, alongside methodological and procedural uncertainties associated with research-related procedures. As determined by pre-specified progression criteria, if research procedures and the new intervention demonstrate feasibility and acceptability, results will then be used to inform the design of a pilot randomised controlled trial (RCT) to specifically examine remaining methodological uncertainties associated with recruitment into a randomised controlled design.

    TRIAL REGISTRATION: Current Controlled Trials ISRCTN42017211.

  • 40.
    Farrand, Paul
    et al.
    Clinical Education Development and Research (CEDAR), Psychology: College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
    Woodford, Joanne
    Clinical Education Development and Research (CEDAR), Psychology: College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
    Small, Faye
    Clinical Education Development and Research (CEDAR), Psychology: College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
    Mullen, Eugene
    Clinical Education Development and Research (CEDAR), Psychology: College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.
    Behavioural activation self-help to improve depression in people living with dementia: The PROMOTE treatment protocol.2017In: New Zealand Journal of Psychology, Vol. 46, no 2, p. 51-62Article in journal (Refereed)
    Abstract [en]

    There is an increasing number of people living with dementia and depression, with support for people to live well with dementia becoming a global healthcare priority and seminal to the New Zealand Framework for Dementia Care (Ministry of Health, 2013). This paper overviews the clinical protocol for the PROMOTE self-help programme to inform the delivery of a written low intensity intervention based on behavioural activation for the treatment of depression and low mood in people with dementia. The primary aim of the programme is to decrease symptoms of depression and improve quality of life in people living with dementia. Support to the person living with dementia in the use of the PROMOTE programme is provided by an informal caregiver, who themselves receive guidance over the telephone by an appropriately trained mental health professional. This model of support and guidance represents a novel feature of the intervention, and one that potentially helps to increase access within the community. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

  • 41.
    Ferraris, Giulia
    et al.
    University Medical Center Groningen, University of Groningen.
    Dang, Srishti
    University Medical Center Groningen, University of Groningen.
    Woodford, Joanne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Healthcare Sciences and e-Health.
    Hagedoorn, Mariët
    University Medical Center Groningen, University of Groningen.
    Dyadic Interdependence in Non-spousal Caregiving Dyads’ Wellbeing: A Systematic Review2022In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 13, article id 882389Article, review/survey (Refereed)
    Abstract [en]

    Caregiving dyads (i.e., an informal caregiver and a care recipient) work as an interdependent emotional system, whereby it is assumed that what happens to one member of the dyad essentially happens to the other. For example, both members of the dyad are involved in care giving and care receiving experiences and therefore major life events, such as a serious illness affect the dyad and not only the individual. Consequently, informal caregiving may be considered an example of dyadic interdependence, which is “the process by which interacting people influence one another’s experience.” This systematic review aimed to synthesize studies of dyadic interdependence, specifically in non-spousal caregiving dyads (e.g., adult children—parents, siblings, other relatives, or friends). Electronic databases (PsycINFO, Pubmed, and CINAHL) were systematically searched for dyadic studies reporting on interdependence in the emotional and relational wellbeing of non-spousal caregiving dyads. A total of 239 full-text studies were reviewed, of which 14 quantitative and qualitative studies met the inclusion criteria with a majority of dyads consisting of adult daughters caring for their older mothers. A narrative synthesis suggested mutual influences between non-spousal caregiving dyad members based on: (1) associations between intrapersonal (e.g., psychological functioning) and interpersonal (e.g., relationship processes) variables and emotional and relational wellbeing of the dyad; (2) associations between care context variables (e.g., socio-demographics and care tasks) and emotional and relational wellbeing of the dyad; and (3) patterns of covariation between caregivers’ and care recipients’ wellbeing. Evidence supporting dyadic interdependence among non-spousal caregiving dyads shed light on the ways dyad members influence each other’s wellbeing while providing and receiving care (e.g., via the exchange of support). Future studies investigating mutual influences in dyads, should differentiate subsamples of caregivers based on relationship type, and adopt dyadic and longitudinal designs.

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    fulltext
  • 42.
    Fletcher, Erika
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology.
    van Maren, Wendy
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Cordfunke, Robert
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Dinkelaar, Jasper
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Codee, Jeroen
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Marel, Gijs
    Department of Bio-organic Synthesis, Leiden Institute of Chemistry, Leiden University, Leiden.
    Melief, Cornelis
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Ossendorp, Ferry
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Drijfhout, Jan Wouter
    Department of Immunohematology & Blood Transfusion, Leiden University Medical Center, Leiden.
    Mangsbo, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Formation ofimmune-complexes by a defined linear tetanus toxin-derived B cell epitope boosts human T cell responses to long peptides: ICs boost specific-T cellsManuscript (preprint) (Other academic)
    Abstract [en]

    Enhancing T cell responses against both viral and tumor antigens requires efficient co-stimulation and directed delivery of peptide antigens into APCs. As short peptides can lead to T cell tolerance and can only be used in a specific set of patients, long peptides are considered favourable vaccine moieties from a clinical perspective as they can harbor more than one immunogenic epitope enabling a broader target population. In addition, longer peptides are not bound unselectively to MHC class I on any cell, but rather require processing and will thereby be presented to T cells in secondary lymphoid organs. However, as peptides are not actively targeted to and taken up by APCs, and the standard non-conjugated adjuvant-peptide mixtures do not ensure co-targeting of the two to the same APC. We have identified a linear tetanus-toxin derived B cell epitope that can mediate the formation of immune-complexes by the presence of circulating antibodies. Herein, we show that these complexes, improve both antigen uptake by APCs (blood monocytes and CD1c+ DCs) and thereby CD8+ T cell recall responses in a human ex-vivo blood loop system. The uptake of the peptide conjugate by blood monocytes is dependent on antibodies and the complement component C1q.  The defined linear peptide steers the immune-complex formation to a monoclonal-like complex and as a consequence we show that the number of linear tetanus sequences per T cell epitope determines the outcome of the response. We envision that this strategy can be used to facilitate active uptake of antigens into antigen-presenting cells to improve T cell responses against pathogens or cancer.

  • 43.
    Forinder, Ulla
    et al.
    Socialhögskolan, Stockholms universitet.
    Lindahl Norberg, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Psychosocial oncology and supportive care. Karolinska Institutet.
    Posttraumatic growth and support among parents whose children have survived stem cell transplantation2014In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 18, no 4, p. 326-335Article in journal (Refereed)
    Abstract [en]

    In the current study, we investigated the occurrence of posttraumatic growth (PTG) among parents whose children had had stem cell transplantation (SCT) and survived. Although SCT is well established, it remains stressful and dangerous, and SCT is only performed if there is no other choice of treatment to be considered. A questionnaire batteries including the Post-Traumatic Stress Disorder (PTSD) Check List-Civilian version and the Post-Traumatic Growth Inventory were sent out to a cross-sectional national sample of parents of children who had had SCT six months or more before the study. The response rate was 66% (n = 281). The data were analyzed in relation to parents' appraisal of the event, gender, and perceived social support. The results confirm that SCT in childhood is an event of extreme adversity for the parents. Indications of PTSD were found among an important minority of the parents. Nevertheless, a large proportion of the parents had experienced growth as a consequence of the child's illness. Appreciation of life and personal strength were the domains with the highest scores. Moreover, a higher level of PTG was correlated with a higher level of posttraumatic stress and with an experience of the trauma as more severe. In summary, the study indicates that PTG is a relevant concept for this group of parents.

  • 44.
    Fransson, Emma
    et al.
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Sarkadi, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Hjern, Anders
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden.;Karolinska Inst, Karolinska Univ Hosp, Dept Med, Clin Epidemiol, S-17176 Stockholm, Sweden..
    Bergstrom, Malin
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, S-10691 Stockholm, Sweden.;Karolinska Inst, S-10691 Stockholm, Sweden..
    Why should they live more with one of us when they are children to us both?: Parents' motives for practicing equal joint physical custody for children aged 0-42016In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 66, p. 154-160Article in journal (Refereed)
    Abstract [en]

    Joint physical custody, i.e., children spending an equal amount of time in both parents' home after a separation or divorce, is increasing in many countries. In line with the national policy to promote paternal involvement in parenting, two-thirds of Swedish preschoolers with non-cohabiting parents live in two homes. Internationally, there has been a debate regarding the benefits or risks with joint physical custody for infants and toddlers. The aim of this qualitative study was to explore the reasons given by divorced parents for sharing joint physical custody of children 0-4 years of age. Interviews were conducted with 46 parents (18 fathers and 28 mothers) and analyzed using systematic text condensation. Two themes emerged in response to the research question. In the theme Same rights and responsibilities, parents described that joint physical custody was 'a given' as both parents were seen to have equal rights to and responsibility for the children. Both men and women described involved fatherhood as an ideal goal. In the theme For the sake of the child, parents emphasized that joint physical custody was in the best interest of the child. Some parents had conflicts with their ex-spouses, but were still convinced of the benefits of joint physical custody and strove to make it work.

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  • 45.
    Frigell, Sara
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Förlossningsrädsla under graviditet: Betydande bakgrundsfaktorer- Förekomst- Önskemål om förlossningssätt- Kvinnors kontakt med klinik för förlossningsrädda2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att undersöka förekomst av gravida kvinnors upplevelse av förlossningsrädsla i relation till deras sociodemografiska, psykiatriska och obstetriska bakgrund samt önskat förlossningssätt. Metod. Förstföderskor och omföderskor som skrevs in på barnmorskemottagning tillfrågades om deltagande i studien och fick besvara två frågeformulär under graviditeten. Resultat. Totalt 776 kvinnor svarade på båda frågeformulären och svarsfrekvensen för de flesta frågor som användes till studien var över 92 %. I tidig graviditet upplevdes förlossningsrädsla av 12 % av kvinnorna i studien och av 15,5 % i sen graviditet. Nästan hälften av de med tidig upplevelse av förlossningsrädsla upplevde i slutet på graviditeten ingen eller liten rädsla. Upplevd förlossningsrädsla var vanligare bland kvinnor som tidigare varit gravida, omföderskor med erfarenhet av kejsarsnitt, kvinnor födda utanför Sverige och kvinnor som tidigare haft kontakt med psykiater och kurator. Kvinnor med upplevd förlossningsrädsla var mer benägna att önska kejsarsnitt än de som upplevde ingen eller liten rädsla. Av kvinnor med upplevd förlossningsrädsla hade omkring en fjärdedel under graviditeten varit i kontakt med Klaramottagningen, en mottagning med specialisering på förlossningsrädsla och en femtedel av dessa kvinnor rapporterade mot slutet av graviditeten ingen eller liten rädsla. Kontakt med Klaramottagningen hade även kvinnor som i tidig graviditet rapporterade ingen eller liten rädsla. Av dessa kvinnor rapporterade 45,8 % att de upplevde förlossningsrädsla i slutet på graviditeten. Konklusion. Former för hur identifiering, fördelning av vårdens resurser och utformning av stödet till gravida kvinnor och framförallt till de med upplevd förlossningsrädsla bäst sker kan utvecklas ytterligare.

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  • 46.
    Gao, Lei
    et al.
    Donghua Univ, Coll Chem & Chem Engn, State Key Lab Modificat Chem Fibers & Polymer Mat, Minist Educ,Sci & Technol Ecotext, Shanghai 201620, Peoples R China.;Wuzhou Univ, Coll Food & Pharmaceut Engn, Wuzhou 543000, Peoples R China..
    Baryshnikov, Glib V.
    Linköping Univ, Dept Sci & Technol, Lab Organ Elect, SE-60174 Norrköping, Sweden.;Bohdan Khmelnytsky Natl Univ, Dept Chem & Nanomat Sci, UA-18031 Cherkassy, Ukraine..
    Ali, Amjad
    Linköping Univ, Dept Sci & Technol, Lab Organ Elect, SE-60174 Norrköping, Sweden..
    Kuklin, Artem V.
    Uppsala University, Disciplinary Domain of Science and Technology, Physics, Department of Physics and Astronomy.
    Qian, Cheng
    Donghua Univ, Coll Chem & Chem Engn, State Key Lab Modificat Chem Fibers & Polymer Mat, Minist Educ,Sci & Technol Ecotext, Shanghai 201620, Peoples R China..
    Zhang, Xianrui
    Wuzhou Univ, Coll Food & Pharmaceut Engn, Wuzhou 543000, Peoples R China..
    Chen, Fengkun
    Donghua Univ, Coll Chem & Chem Engn, State Key Lab Modificat Chem Fibers & Polymer Mat, Minist Educ,Sci & Technol Ecotext, Shanghai 201620, Peoples R China..
    Yi, Tao
    Donghua Univ, Coll Chem & Chem Engn, State Key Lab Modificat Chem Fibers & Polymer Mat, Minist Educ,Sci & Technol Ecotext, Shanghai 201620, Peoples R China..
    Wu, Hongwei
    Donghua Univ, Coll Chem & Chem Engn, State Key Lab Modificat Chem Fibers & Polymer Mat, Minist Educ,Sci & Technol Ecotext, Shanghai 201620, Peoples R China..
    Hydrophilic Cocrystals with Water Switched Luminescence2024In: Angewandte Chemie International Edition, ISSN 1433-7851, E-ISSN 1521-3773, Vol. 63, no 8Article in journal (Refereed)
    Abstract [en]

    Utilizing water molecules to regulate the luminescence properties of solid materials is highly challenging. Herein, we develop a strategy to produce water-triggered luminescence-switching cocrystals by coassembling hydrophilic donors with electron-deficient acceptors, where 1,2,4,5-Tetracyanobenzene (TCNB) was used as the electron acceptor and pyridyl benzimidazole derivatives were used as the electron donors enabling multiple hydrogen-bonds. Two cocrystals, namely 2PYTC and 4PYTC were obtained and showed heat-activated emission, and such emission could be quenched or weakened by adding water molecules. The cocrystal structure exhibited the donor molecule that can form multiple hydro bonds with water and acceptor molecules due to the many nitrogen atoms of them. The analyses of the photophysical data, powder X-ray diffraction, and other data confirmed the reversible fluorescence "on-off" effects were caused by eliminating and adding water molecules in the crystal lattice. The density functional theory calculations indicate that the vibration of the O-H bond of water molecules in the cocrystal can absorb the excitation energy and suppress fluorescence. Furthermore, the obtained cocrystals also showed temperature, humidity, and H+/NH4+ responsive emission behavior, which allows their applications as thermal and humidity sensors, and multiple information encryptions. This research paves the way for preparing intelligent hydrophilic organic cocrystal luminescent materials. Hydrophilic donors with electron-deficient acceptors were coassembled to achieve luminescence-switching cocrystals triggered by water molecules. The obtained cocrystals show a strong water absorption ability and excellent fluorescence properties. The emission of cocrystals can be reversibly switched by heating and water. Finally, the obtained cocrystals show potential applications in temperature-humidity and acid-base responses.+image

  • 47.
    Grunér, Sofia
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience.
    Effekten av talsyntesstöd på textförståelse och läshastighet hos personer med lässvårigheter2016Independent thesis Advanced level (degree of Master (Two Years)), 30 credits / 45 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att undersöka om ett modernt talsyntesprogram (TorTalk) hade en kompensatorisk effekt på textförståelse och läshastighet hos 63 svensktalande skolbarn och vuxna (i åldrarna 8 till 26 år) med lässvårigheter. I denna randomiserade studie användes en cross-over design i två faser för att jämföra två typer av textpresentation (datorstödd kontra högläsning). I Fas 1 lyssnade deltagarna antingen på en text med talsyntes samtidigt som de följde med i texten via en markering på datorskärmen (datorstödd textpresentation), eller läste texten högt för sig själva (högläsning). I Fas 2 byttes betingelserna så att även en inomgruppsanalys kunde göras. De statistiska analyserna visade att användning av talsyntesprogrammet hade en signifikant effekt på både textförståelse och läshastighet. Den största effekten sågs gällande läshastigheten där deltagarna som använde programmet höjde sin läshastighet betydligt. I inomgruppsanalysen delades deltagarna in i grupper om yngre deltagare (skolår 3 till 5) och äldre deltagare (skolår 6 till vuxen ålder). Analysen avseende de yngre deltagarna visade på en signifikant effekt av talsyntesprogrammet på både textförståelse och läshastighet medan analysen avseende de äldre deltagarna endast visade på en signifikant effekt gällande läshastighet. En explorativ analys genomfördes även avseende de individuella prestationerna. Denna visade att alla deltagare antingen höjde sin prestation avseende läshastighet eller textförståelse med hjälp talsyntesprogrammet, eller båda delarna. Vissa deltagare höjde dock sin läshastighet mot att textförståelsen sänktes, vilket inte var önskvärt. Potentiella orsaker till detta diskuteras. Dessa resultat kan ha en stor betydelse för personer med lässvårigheter då resultaten starkt indikerar att man med hjälp av ett talsyntesprogram ofta kan minska hindret som lässvårigheter medför i skolgång, vardag eller arbetsliv.

  • 48.
    Guo, Cheng
    et al.
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden..
    Tomson, Goran
    Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden.;Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Guo, Jizhi
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Li, Xiangyun
    Weifang Med Univ, Sch Management, Weifang, Peoples R China..
    Keller, Christina
    Jonkoping Univ, Int Business Sch, Jonkoping, Sweden..
    Söderqvist, Fredrik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
    Psychometric evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Chinese adolescents - a methodological study2015In: Health and Quality of Life Outcomes, E-ISSN 1477-7525, Vol. 13, article id 198Article in journal (Refereed)
    Abstract [en]

    Background: In epidemiological surveillance of mental health there is good reason to also include scales that measure the presence of well-being rather than merely symptoms of ill health. The Mental Health Continuum-Short Form (MHC-SF) is a self-reported scale to measure emotional, psychological and social well-being and conduct categorical diagnosis of positive mental health. This particular instrument includes the three core components of the World Health Organization's definition of mental health and had previously not been psychometrically evaluated on adolescents in China. Methods: In total 5,399 students (51.1 % female) from schools in the urban areas of Weifang in China were included in the study (mean age = 15.13, SD = 1.56). Participants completed a comprehensive questionnaire with several scales, among them the MHC-SF. Statistical analyses to evaluate reliability, structural validity, measurement invariance, presence of floor and ceiling effects and to some extent external validity of the MHC-SF were carried out. Results: The Cronbach's a coefficients for sub-scales as well as the total scale were all above 0.80 indicating good reliability. Confirmative factor analysis confirmed the three-dimensional structure of the Chinese version of MHC-SF and supported the configural and metric invariance across gender and age. Noteworthy ceiling effects were observed for single items and sub-scales although not for the total scale. More importantly, observed floor effects were negligible. The stronger correlation found between MHC-SF and Minneapolis-Manchester Quality of Life Instrument (as measure of positive mental health) than between MHC-SF and Hospital Anxiety Depression Scale (as measure of mental illness and distress) yielded support for external validity. Conclusion: In conclusion, the main findings of this study are in line with studies from other countries that evaluated the psychometric properties of the MHC-SF and show that this instrument, that includes the three core components of the WHO definition of mental health, is useful in assessing positive adolescent mental health also in China.

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  • 49.
    Hagström, Josefin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group.
    Åhlfeldt, Rose-Mharie
    Blease, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group.
    Cajander, Åsa
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division Vi3.
    Rexhepi, Hanife
    Moll, Jonas
    Kane, Bridget
    Scandurra, Isabella
    Hägglund, Maria
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group.
    Security and Privacy of Online Record Access: A Survey of Adolescents’ Views and Experiences in Sweden2024In: Journal of Adolescent Health, ISSN 1054-139X, E-ISSN 1879-1972Article in journal (Refereed)
    Abstract [en]

    Purpose Ensuring security of online health records and patients’ perceptions of security are concerns in adolescent healthcare. Little is known about adolescents’ perceptions about healthcare’s ability to protect online health records. This article explores adolescents’ perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information. Methods This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15–19 years. Gender and health status differences were calculated using the Kruskal-Wallis test. Results Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%). Discussion In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems.

  • 50. Hardell, Lennart
    et al.
    Carlberg, Michael
    Söderqvist, Fredrik
    Department of Oncology, University Hospital, Örebro, Sweden.
    Hansson Mild, Kjell
    Case-control study of the association between malignant brain tumours diagnosed between 2007 and 2009 and mobile and cordless phone use2013In: International Journal of Oncology, ISSN 1019-6439, E-ISSN 1791-2423, Vol. 43, no 6, p. 1833-1845Article in journal (Refereed)
    Abstract [en]

    Previous studies have shown a consistent association between long-term use of mobile and cordless phones and glioma and acoustic neuroma, but not for meningioma. When used these phones emit radiofrequency electromagnetic fields (RF-EMFs) and the brain is the main target organ for the handheld phone. The International Agency for Research on Cancer (IARC) classified in May, 2011 RF-EMF as a group 2B, i.e. a 'possible' human carcinogen. The aim of this study was to further explore the relationship between especially long-term (>10 years) use of wireless phones and the development of malignant brain tumours. We conducted a new case-control study of brain tumour cases of both genders aged 18-75 years and diagnosed during 2007-2009. One population-based control matched on gender and age (within 5 years) was used to each case. Here, we report on malignant cases including all available controls. Exposures on e.g. use of mobile phones and cordless phones were assessed by a self-administered questionnaire. Unconditional logistic regression analysis was performed, adjusting for age, gender, year of diagnosis and socio-economic index using the whole control sample. Of the cases with a malignant brain tumour, 87% (n=593) participated, and 85% (n=1,368) of controls in the whole study answered the questionnaire. The odds ratio (OR) for mobile phone use of the analogue type was 1.8, 95% confidence interval (CI)=1.04‑3.3, increasing with >25 years of latency (time since first exposure) to an OR=3.3, 95% CI=1.6-6.9. Digital 2G mobile phone use rendered an OR=1.6, 95% CI=0.996-2.7, increasing with latency >15-20 years to an OR=2.1, 95% CI=1.2-3.6. The results for cordless phone use were OR=1.7, 95% CI=1.1-2.9, and, for latency of 15-20 years, the OR=2.1, 95% CI=1.2-3.8. Few participants had used a cordless phone for >20-25 years. Digital type of wireless phones (2G and 3G mobile phones, cordless phones) gave increased risk with latency >1-5 years, then a lower risk in the following latency groups, but again increasing risk with latency >15-20 years. Ipsilateral use resulted in a higher risk than contralateral mobile and cordless phone use. Higher ORs were calculated for tumours in the temporal and overlapping lobes. Using the meningioma cases in the same study as reference entity gave somewhat higher ORs indicating that the results were unlikely to be explained by recall or observational bias. This study confirmed previous results of an association between mobile and cordless phone use and malignant brain tumours. These findings provide support for the hypothesis that RF-EMFs play a role both in the initiation and promotion stages of carcinogenesis.

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