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Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between Sudan and Sweden.

https://arctichealth.org/en/permalink/ahliterature287360
Source
J Rheumatol. 2016 Oct;43(10):1777-1786
Publication Type
Article
Date
Oct-2016
Author
Amir I Elshafie
Abdalla D Elkhalifa
Sahwa Elbagir
Mawahib I E Aledrissy
Elnour M Elagib
Musa A M Nur
Tomas Weitoft
Johan Rönnelid
Source
J Rheumatol. 2016 Oct;43(10):1777-1786
Date
Oct-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Aged, 80 and over
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - blood - diagnosis - drug therapy
Biological Products - therapeutic use
Blood Sedimentation
Drug Therapy, Combination
Female
Humans
Male
Methotrexate - therapeutic use
Middle Aged
Prednisolone - therapeutic use
Rheumatoid Factor - blood
Severity of Illness Index
Sudan
Sulfasalazine - therapeutic use
Sweden
Symptom Assessment
Young Adult
Abstract
To compare clinical characteristics and treatment between simultaneously investigated Sudanese and Swedish outpatients with rheumatoid arthritis (RA).
Outpatients with RA from Sudan (n = 281) and Sweden (n = 542) diagnosed according to the 1987 American College of Rheumatology criteria were recruited between December 2008 and September 2010 and compared concerning clinical presentation, treatment, and laboratory findings, including immunoglobulin M with rheumatoid factor (IgM-RF).
Sudanese patients had lower inclusion age (median 49 vs 68 yrs), disease duration (48 vs 107 mos), and disease onset age (43 vs 56 yrs) as compared with Swedish patients (p
PubMed ID
27481904 View in PubMed
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Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research.

https://arctichealth.org/en/permalink/ahliterature106604
Source
Lancet Neurol. 2013 Dec;12(12):1200-10
Publication Type
Article
Date
Dec-2013
Author
Andrew I R Maas
Gordon D Murray
Bob Roozenbeek
Hester F Lingsma
Isabella Butcher
Gillian S McHugh
James Weir
Juan Lu
Ewout W Steyerberg
Author Affiliation
Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. Electronic address: andrew.maas@uza.be.
Source
Lancet Neurol. 2013 Dec;12(12):1200-10
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adult
Blood pressure
Brain Injuries - epidemiology - therapy
Canada
Data Collection - standards
Disease Management
Europe
Forecasting
Glasgow Coma Scale
Humans
International Cooperation
Middle Aged
Models, Neurological
Multicenter Studies as Topic - methods - standards
National Institute of Neurological Disorders and Stroke
National Institutes of Health (U.S.)
Prognosis
Randomized Controlled Trials as Topic - methods - standards
Research Design
Symptom Assessment - standards
Trauma Severity Indices
Treatment Outcome
United States
Abstract
Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI.
Notes
Comment In: Lancet Neurol. 2013 Dec;12(12):1132-324139679
PubMed ID
24139680 View in PubMed
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AmbuFlex: tele-patient-reported outcomes (telePRO) as the basis for follow-up in chronic and malignant diseases.

https://arctichealth.org/en/permalink/ahliterature276984
Source
Qual Life Res. 2016 Mar;25(3):525-34
Publication Type
Article
Date
Mar-2016
Author
Liv Marit Valen Schougaard
Louise Pape Larsen
Anne Jessen
Per Sidenius
Liv Dorflinger
Annette de Thurah
Niels Henrik Hjollund
Source
Qual Life Res. 2016 Mar;25(3):525-34
Date
Mar-2016
Language
English
Publication Type
Article
Keywords
Ambulatory Care - methods
Chronic Disease
Denmark
Follow-Up Studies
Health Status Indicators
Humans
Neoplasms
Patient Outcome Assessment
Quality of Life
Surveys and Questionnaires
Symptom Assessment
Telemedicine - methods
Abstract
A tele-patient-reported outcome (telePRO) model includes outpatients' reports of symptoms and health status from home before or instead of visiting the outpatient clinic. In the generic PRO system, AmbuFlex, telePRO is used to decide whether a patient needs an outpatient visit and is thus a tool for better symptom assessment, more patient-centred care, and more efficient use of resources. Specific PROs are developed for each patient group. In this paper we describe our experiences with large-scale implementations of telePRO as the basis for follow-up in chronic and malignant diseases using the generic PRO system AmbuFlex.
The AmbuFlex concept consists of three generic elements: PRO data collection, PRO-based automated decision algorithm, and PRO-based graphical overview for clinical decision support. Experiences were described with respect to these elements.
By December 2015, AmbuFlex was implemented in nine diagnostic groups in Denmark. A total of 13,135 outpatients from 15 clinics have been individually referred. From epilepsy clinics, about 70 % of all their outpatients were referred. The response rates for the initial questionnaire were 81-98 %. Of 8256 telePRO-based contacts from epilepsy outpatients, up to 48 % were handled without other contact than the PRO assessment. Clinicians as well as patients reported high satisfaction with the system.
The results indicate that telePRO is feasible and may be recommended as the platform for follow-up in several patient groups with chronic and malignant diseases and with many consecutive outpatient contacts.
Notes
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PubMed ID
26790427 View in PubMed
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Assessing non-conveyed patients in the ambulance service: a phenomenological interview study with Swedish ambulance clinicians.

https://arctichealth.org/en/permalink/ahliterature309857
Source
BMJ Open. 2019 09 24; 9(9):e030203
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-24-2019
Author
Jakob Lederman
Caroline Löfvenmark
Therese Djärv
Veronica Lindström
Carina Elmqvist
Author Affiliation
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden jakob.lederman@ki.se.
Source
BMJ Open. 2019 09 24; 9(9):e030203
Date
09-24-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Ambulances
Clinical Competence - standards
Clinical Decision-Making - methods
Emergency Medical Services - organization & administration - standards
Emergency Service, Hospital - statistics & numerical data
Female
Health services needs and demand
Humans
Male
Medical Overuse - prevention & control
Nurse Specialists - education - standards
Quality Improvement
Risk Management - organization & administration
Staff Development - standards
Sweden - epidemiology
Symptom Assessment - methods - standards
Triage - methods
Abstract
To combat overcrowding in emergency departments, ambulance clinicians (ACs) are being encouraged to make on-site assessments regarding patients' need for conveyance to hospital, and this is creating new and challenging demands for ACs. This study aimed to describe ACs' experiences of assessing non-conveyed patients.
A phenomenological interview study based on a reflective lifeworld research approach.
The target area for the study was Stockholm, Sweden, which has a population of approximately 2.3?million inhabitants. In this area, 73 ambulances perform approximately just over 200?000 ambulance assignments annually, and approximately 25?000 patients are non-conveyed each year.
11 ACs.
In-depth open-ended interviews.
ACs experience uncertainty regarding the accuracy of their assessments of non-conveyed patients. In particular, they fear conducting erroneous assessments that could harm patients. Avoiding hasty decisions is important for conducting safe patient assessments. Several challenging paradoxes were identified that complicate the non-conveyance situation, namely; responsibility, education and feedback paradoxes. The core of the responsibility paradox is that the increased responsibility associated with non-conveyance assessments is not accompanied with appropriate organisational support. Thus, frustration is experienced. The education paradox involves limited and inadequate non-conveyance education. This, in combination with limited support from non-conveyance guidelines, causes the clinical reality to be perceived as challenging and problematic. Finally, the feedback paradox relates to the obstruction of professional development as a result of an absence of learning possibilities after assessments. Additionally, ACs also described loneliness during non-conveyance situations.
This study suggests that, for ACs, performing non-conveyance assessments means experiencing a paradoxical professional existence. Despite these aggravating paradoxes, however, complex non-conveyance assessments continue to be performed and accompanied with limited organisational support. To create more favourable circumstances and, hopefully, safer assessments, further studies that focus on these paradoxes and non-conveyance are needed.
PubMed ID
31551383 View in PubMed
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Associations between psychological factors and nighttime/daytime symptomatology in insomnia.

https://arctichealth.org/en/permalink/ahliterature125925
Source
Cogn Behav Ther. 2012;41(4):273-87
Publication Type
Article
Date
2012
Author
Markus Jansson-Fröjmark
Allison G Harvey
Annika Norell-Clarke
Steven J Linton
Author Affiliation
Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden. markus.janssonfrojmark@psychology.su.se
Source
Cogn Behav Ther. 2012;41(4):273-87
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Anxiety - complications - psychology
Arousal
Attention
Case-Control Studies
Cross-Sectional Studies
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Health status
Health Surveys - statistics & numerical data
Humans
Male
Middle Aged
Photoperiod
Psychiatric Status Rating Scales - statistics & numerical data
Sleep Disorders - complications - psychology
Sleep Initiation and Maintenance Disorders - complications - diagnosis - psychology
Sweden
Symptom Assessment - methods - psychology - statistics & numerical data
Abstract
The aim of this study was to examine psychological factors in insomnia and the association between psychological mechanisms and nighttime and daytime symptoms.
A cross-sectional examination in the general population was used. The study sample consisted of 1890 participants from the general population. The participants completed a survey on nighttime and daytime symptoms, health outcomes, and psychological factors.
Relative to poor and normal sleepers, the insomnia group had higher scores on worry, beliefs, physiologic arousal, monitoring/attentional bias, and safety behaviors than the other two groups, and the poor sleepers exhibited a similar pattern relative to the normal sleepers. High total wake time was associated with more worry, physiologic arousal, and safety behaviors (26.3% variance), low sleep restoration with more worry, unhelpful beliefs, and monitoring/attentional bias (28.2% variance), and low sleep quality with higher scores on all the psychological mechanisms (35.8% variance). Elevated daytime symptoms were related to more unhelpful beliefs and monitoring/attentional bias (44.3% variance).
The findings indicate that psychological factors are linked to nighttime and daytime symptomatology in insomnia.
PubMed ID
22439741 View in PubMed
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Capacity to work while depressed and anxious--a phenomenological study.

https://arctichealth.org/en/permalink/ahliterature117029
Source
Disabil Rehabil. 2013 Sep;35(20):1705-11
Publication Type
Article
Date
Sep-2013
Author
Monica Bertilsson
Eva-Lisa Petersson
Gunnel Ostlund
Margda Waern
Gunnel Hensing
Author Affiliation
Institute of Medicine/Social Medicine, The Sahlgrenska Academy at University of Gothenburg, University of Gothenburg , Gothenburg , Sweden .
Source
Disabil Rehabil. 2013 Sep;35(20):1705-11
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adult
Anxiety - diagnosis - rehabilitation
Depression - diagnosis - rehabilitation
Female
Focus Groups
Humans
Interpersonal Relations
Male
Middle Aged
Occupational Health
Qualitative Research
Sweden
Symptom Assessment - methods
Task Performance and Analysis
Work Capacity Evaluation
Workplace - psychology - standards
Abstract
The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work.
Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed.
The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with one's ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost "refueling" and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome.
A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individual's capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence. Implications for Rehabilitation The reduced capacity to work due to depression and anxiety is not always understandable or observable for others, therefore, the rehabilitation process would benefit from increased knowledge and understanding of the difficulties afflicted individuals experience at work. Identifying tasks that contribute to "refueling" at work might enhance the success of the rehabilitation. Rehabilitation programs could be tailored to better address the inabilities that impact on the capacity to work when depressed and anxious.
PubMed ID
23339720 View in PubMed
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Cervical facet oedema: prevalence, correlation to symptoms, and follow-up imaging.

https://arctichealth.org/en/permalink/ahliterature284227
Source
Clin Radiol. 2016 Jun;71(6):570-5
Publication Type
Article
Date
Jun-2016
Author
M T Nevalainen
P J Foran
J B Roedl
A C Zoga
W B Morrison
Source
Clin Radiol. 2016 Jun;71(6):570-5
Date
Jun-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Axis, Cervical Vertebra - diagnostic imaging
Causality
Comorbidity
Edema - diagnosis - epidemiology
Female
Finland - epidemiology
Humans
Joint Diseases
Magnetic Resonance Imaging - statistics & numerical data
Male
Middle Aged
Prevalence
Radiculopathy - diagnosis - epidemiology
Reproducibility of Results
Risk factors
Sensitivity and specificity
Spinal Diseases - diagnosis - epidemiology
Statistics as Topic
Symptom Assessment - statistics & numerical data
Zygapophyseal Joint - diagnostic imaging
Abstract
To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms.
A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire.
The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3-4, C4-5, and C2-3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p
PubMed ID
27055743 View in PubMed
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Changes in the prevalence of asthma and respiratory symptoms in western Sweden between 2008 and 2016.

https://arctichealth.org/en/permalink/ahliterature310596
Source
Allergy. 2019 09; 74(9):1703-1715
Publication Type
Historical Article
Journal Article
Research Support, Non-U.S. Gov't
Date
09-2019
Author
Eivind Borna
Bright I Nwaru
Anders Bjerg
Roxana Mincheva
Madeleine Rådinger
Bo Lundbäck
Linda Ekerljung
Author Affiliation
Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Allergy. 2019 09; 74(9):1703-1715
Date
09-2019
Language
English
Publication Type
Historical Article
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Asthma - diagnosis - epidemiology - history
Cross-Sectional Studies
Demography
Female
History, 21st Century
Humans
Male
Middle Aged
Prevalence
Public Health Surveillance
Socioeconomic Factors
Surveys and Questionnaires
Sweden - epidemiology
Symptom Assessment
Young Adult
Abstract
Asthma is a common chronic inflammatory disease of the airways, with a noticeable increase in prevalence during the second half of the 20th century. Recent studies assessing the prevalence trends among adults have been inconsistent. We investigated the changes in the prevalence of asthma, respiratory symptoms, and risk factors between 2008 and 2016 in western Sweden.
The West Sweden Asthma Study (WSAS) is a population-based study which started in 2008 (WSAS I) and then repeated in 2016 (WSAS II) in western Sweden. Randomly selected individuals aged 16-75 years (N = 18 087 in 2008 and N = 24 534 in 2016) completed a questionnaire regarding obstructive lung diseases, respiratory symptoms, potential risk factors, and also questions from the GA2 LEN survey.
The prevalence of reported ever asthma, physician-diagnosed asthma, use of asthma medication, and current asthma increased significantly from 9.6% to 11%, 8.3% to 10%, 8.6% to 9.8%, and 8.1% to 9.1%, respectively, between 2008 and 2016. There were also increases in the prevalence of respiratory symptoms during the same period. The greatest increase occurred in young adults aged 16-25 years. Female gender, allergic rhinitis, obesity, and family history of asthma remained the strongest risk factors for asthma in 2016 as it was in 2008.
There were moderate increases in asthma and respiratory symptoms in adults in western Sweden between 2008 and 2016, the greatest increase occurring in younger adults. The potential risk factors for asthma remained the same during the study period.
PubMed ID
31021427 View in PubMed
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Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD.

https://arctichealth.org/en/permalink/ahliterature260872
Source
Atten Defic Hyperact Disord. 2014 Jun;6(2):87-99
Publication Type
Article
Date
Jun-2014
Author
Mats Fredriksen
Alv A Dahl
Egil W Martinsen
Ole Klungsoyr
Stephen V Faraone
Dawn E Peleikis
Source
Atten Defic Hyperact Disord. 2014 Jun;6(2):87-99
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Attention Deficit Disorder with Hyperactivity - diagnosis - epidemiology - psychology
Comorbidity
Educational Status
Employment - psychology - statistics & numerical data
Female
Humans
Male
Mental Disorders - epidemiology
Middle Aged
Norway - epidemiology
Prospective Studies
Sex Factors
Symptom Assessment
Young Adult
Abstract
Few studies have examined the impact of childhood attention deficit hyperactivity disorder (ADHD) symptoms on adult ADHD functional outcomes. To address this issue dimensionally, ADHD symptoms in childhood and adulthood and their relation to educational deficits and work disability are studied in a clinical sample of adult patients with previously untreated ADHD. About 250 adults diagnosed systematically with ADHD according to DSM-IV were prospectively recruited. Primary outcomes were high school dropout and being out of the work last year. Childhood ADHD symptoms, sex differences, comorbidities of other mental disorders, and adult ADHD symptoms were examined by historical data, clinician interviews, and questionnaires. High levels of ADHD symptom severity in childhood were related to dropping out of high school [odds ratio (OR) = 3.0], as were higher numbers of hyperactive-impulsive symptoms in childhood. Significantly, more women than men were long-term work disabled (OR = 2.0). After adjusting for age and gender, persisting high levels of ADHD inattention symptoms in adulthood (OR = 2.5), number of comorbid disorders, and particularly anxiety disorders were significantly related to long-term work disability. Childhood hyperactive-impulsive symptoms and overall severity of childhood ADHD symptoms were associated with high school dropout rates; however, persisting ADHD inattention symptoms and comorbid mental disorders in adulthood were more correlated to occupational impairment. These findings underline proposals for studies on early recognition and interventions for ADHD and psychiatric comorbidity. They further suggest that inattentive symptoms be a focus of adult ADHD treatment and that workplace interventions be considered to prevent long-term work disability.
Notes
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