Publikationer från Linköpings universitet
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"I moved from simply being to actively living." A qualitative study on peer mentorship camps for adults with acquired brain injury
No full textPurposeThis study explored the experiences of an Active Rehabilitation peer mentorship camp on individuals with acquired brain injury (mentees) and its impact on their daily lives.MethodsThe research involved field observations and longitudinal interviews with 18 mentees attending an Active Rehabilitation camp in Norway. Data were narratively analyzed using the Self-determination theory for insight and discussion.ResultsThree themes were constructed from the analysis. The first theme, "Striking a balance between rest and activity," reflects how mentees managed post-injury fatigue and how camp experiences enhanced their understanding and coping strategies. The second theme, "Rebuilding who I am," addresses stigma, reduced self-esteem, and acceptance challenges faced by mentees, revealing positive effects from camp participation. The third theme, "Finding a new flock," describes the reduction in social circles after injury and how interactions at the camp expanded their peer networks during and after the camp.ConclusionsActive Rehabilitation camps enhance community-based rehabilitation for individuals with acquired brain injury by improving knowledge, boosting self-esteem, and broadening social networks. It is recommended that camp providers assess the impact of room-sharing and devise strategies for personalizing camp activities and effectively matching mentees and peer mentors.Funding Agencies|Sunnaas Foundation</p
Proteomic signatures for fibrosis in MASLD: a biopsy-proven dual-cohort study
No full textObjectivesPredicting disease progression in metabolic dysfunction-associated steatotic liver disease (MASLD) is challenging, and current non-invasive tests (NITs) lack the precision to replace liver biopsy. This study aimed to identify plasma biomarkers for different stages of fibrosis using affinity-based proteomics in two biopsy-proven cohorts. The primary objective was to identify biomarkers capable of distinguishing between low-to-no fibrosis (F0-1) and significant fibrosis (F2-4) in MASLD.Materials and methodsParticipants in the discovery cohort were recruited from Uppsala University Hospital and Swedish CArdioPulmonary bioImage Study (SCAPIS), while the validation cohort was included from Link & ouml;ping University Hospital. All participants diagnosed with MASLD underwent liver biopsy and were categorized by fibrosis stage (F0-1 or F2-4). A total of 276 plasma proteins were analyzed using Olink (R) panels, with biomarkers identified through ordinal logistic regression, random forest (RF) analysis and the Boruta algorithm.ResultsThe discovery cohort included 60 participants, with 60% having fibrosis stage F0-1 and 40% having F2-4. The validation cohort had 59 participants, of whom 35 had fibrosis stage F0-1 (59.3%) and 24 had stage F2-4 (40.7%). Five biomarkers were significantly associated with fibrosis stage in the discovery cohort, with four confirmed in the validation cohort. A model combining angiotensin converting enzyme-2 (ACE2), hepatocyte growth factor (HGF) and insulin-like growth factor-binding protein-7 (IGFBP-7) demonstrated strong predictive performance for significant fibrosis (c-statistics 0.82-0.83), outperforming fibrosis-4 (FIB-4) (c-statistics 0.61-0.72).ConclusionsA biomarker model including ACE2, HGF and IGFBP7 shows promise in distinguishing between low-stage and significant fibrosis.Funding Agencies|Erik, Karin and Goesta Selanders Foundation; Boehringer Ingelheim; Antaros Medical; ALF Grants, Region Ostergotland, Medical Research Council of Southeast Sweden</p
The struggle of the care team: group dynamics and conflicts in complex psychiatric cases : a qualitative interview study
No full textBakgrund: Inom psykiatrin möter vårdpersonal patienter med varierande diagnoser och utmaningar, såsom bristande sjukdomsinsikt, svåra sociala förhållanden eller komplicerade medicinska tillstånd. Patienternas komplexitet skapar ofta konflikter i vårdteamet, då hierarki, erfarenhet och olika perspektiv på bemötande och behandling bidrar till splittring. Syfte: Att beskriva gruppdynamik och konfliktsituationer inom vårdteamet vid komplexa psykiatriska patientfall. Metod: En kvalitativ intervjustudie med induktiv ansats. Data analyserades med konventionell innehållsanalys. Resultat: Tre huvudkategorier genererades: Samverkan vid komplexa patientfall där känslan av inkludering och öppenhet för olika perspektiv är viktig i vårdteam. Komplex psykiatri där arbete inom psykiatrin präglas av komplexitet och utmaningar, där unika patientbehov och krav på helhetssyn ofta leder till konflikter inom teamet och Vägen framåt där vårdteamet belyser att kommunikation och stabilt stöd är avgörande för vårdteamets funktionalitet samt att anhörigas involvering i patientvården bör främjas. Slutsats: Studien betonar vikten av inkluderande och samarbetsorienterade vårdteam för att förbättra gruppdynamiken, minska konflikter och skapa patientcentrerade lösningar vid komplexa psykiatriska patientfall. Kommunikation, kompetens och handledning framhålls som avgörande för en harmonisk arbetsmiljö. Bristen på anhörigas involvering identifieras som en utmaning, och deras perspektiv bör prioriteras för att främja patientens återhämtning. Helhetssyn och individuellt anpassad vård förblir centrala för att möta framtidens vårdbehov. Background: In psychiatry, healthcare professionals encounter patients with varying diagnoses and challenges, such as lack of illness insight, difficult social circumstances, or complex medical conditions. The complexity of these patients often leads to conflicts within care teams, as hierarchy, experience, and differing perspectives on approaches and treatments contribute to divisions. Aim: To describe group dynamics and conflict situations within care teams handling complex psychiatric patient cases. Method: A qualitative interview study with an inductive approach. Data were analyzed using conventional content analysis. Results: Three main categories were generated: Collaboration in complex patient cases, highlighting the importance of inclusion and openness to diverse perspectives within care teams; Complex psychiatry, emphasizing the inherent complexity and challenges in psychiatric work, where unique patient needs and demands for a holistic approach often result in conflicts within teams; and The way forward, where care teams stress that communication and stable support are crucial for team functionality, and that the involvement of family members in patient care should be promoted. Conclusion: The study highlights the importance of inclusive and collaboration-oriented care teams to improve group dynamics, reduce conflicts, and develop patient-centered solutions in complex psychiatric cases. Communication, competence, and supervision are emphasized as essential for a harmonious work environment. The lack of involvement of family members is identified as a challenge, and their perspectives should be prioritized to support patient recovery. A holistic approach and individualized care remain central to addressing future healthcare needs.
AI-driven analyzes of open-ended responses to assess outcomes of internet-based cognitive behavioral therapy (ICBT) in adolescents with anxiety and depression comorbidity
No full textObjective: Although patients prefer describing their problems using words, mental health interventions are commonly evaluated using rating scales. Fortunately, recent advances in natural language processing (i.e., AI-methods) yield new opportunities to quantify people's own mental health descriptions. Our aim was to explore whether responses to open-ended questions, quantified using AI, provide additional value in measuring intervention outcomes compared to traditional rating scales. Method: Swedish adolescents (N = 44) who received Internet-based Cognitive Behavioral Therapy (ICBT) for eight weeks completed (pre/post) scales measuring anxiety and depression and three open-ended questions (related to depression, anxiety and general mental health). The language responses were quantified using a large language model and quantitative methods to predict mental health as measured by rating scales, valence (i.e., words' positive/negative affectivity), and semantic content (i.e., meaning). Results: Similar to the rating scales, language measures revealed statistically significant health improvements between pre and post measures such as reduced depression and anxiety symptoms and an increase in the use of words conveying positive emotions and different meanings (e.g., pre-intervention: "anxious", depressed; post-intervention: "happy", "the future"). Notably, the health changes identified through semantic content measures remained statistically significant even after accounting for the changes captured by the rating scales. Conclusion: Language responses analyzed using AI-methods assessed outcomes with fewer items, demonstrating effectiveness and accuracy comparable to traditional rating scales. Additionally, this approach provided valuable insights into patients' well-being beyond mere symptom reduction, thus highlighting areas of improvement that rating scales often overlook. Since patients often prefer using natural language to express their mental health, this method could complement, and address comprehension issues associated fixed-item questionnaires
Overcoming dichotomy between surface and bulk of electrode: Conducting polymers
No full textThe surface of the solid-state electrodes constructed from atomic crystals is inherently uncertain due to its chemical unsaturation as its atoms lack the surrounding by the atoms of the same type as in the bulk and its exposure to a different phase. This complicates the evaluation of properties for the high surface area electrodes achieved by porosity. Conducting polymers (CP) are intrinsically conductive molecular solids built from polymeric conjugated molecules without covalent bounds between them. The molecular character of CP implies the translation of identical state from the bulk to the surface of the film without additional surface-induced defects. The absence of covalent bonds between backbones enables the access of external electrolyte to individual chain of CP forming the electrical double layer at the molecular scale. Here we discuss the combination of molecular porosity of CP with its inherent selectivity of ion transport as a special case of porous electrode. We also discuss how the Gibbs phase rule can help in understanding CP electrochemistry.Funding Agencies|Knut and Alice Wallenberg foundation; VINNOVA [308634, 308635]; Swedish Energy Agency [52023-1]; Vetenskapradet [2019e05577]</p
Caught in the crossfire: Bullying of those in managerial positions
No full textResearch on workplace bullying often considers those in managerial positions as perpetrators or resources in the process. There is a lack of studies focusing on them as targets, with most existing research centred on upward bullying. The aim of this study was to investigate all forms of bullying, comparing first-line managers with those higher up in the hierarchy and with workers, and examining how perceived social support and laissez-faire leadership affect exposure. Using a probability sample of the Swedish workforce, the results showed that managers are generally as exposed to bullying as workers. For first-line managers, exposure depended on the perception of laissez-faire leadership from their immediate superior. Social support was beneficial for all but did not have a differential effect. Organizational efforts to mitigate bullying must ensure that anti-bullying measures explicitly include all hierarchical levels, with extra focus on first-line managers.Funding Agencies|Swedish Research Council for Health, Working life and Welfare [2023-00262]</p
Development and validation of an anastomotic risk score for use in a randomized clinical trial on defunctioning stoma use in low anterior resection for rectal cancer
No full textAim The selective use of defunctioning stomas in anterior resection for rectal cancer hinges on accurately predicting anastomotic leakage. The aim of this study was to develop a prediction model for use in a prospective randomized clinical trial. Method Colorectal Cancer Database (CRCBaSe) Sweden was used to identify patients who underwent low anterior resection for rectal cancer 2007-2021. Eligibility criteria mirrored the forthcoming SELective defunctioning Stoma Approach in low anterior resection for rectal cancer (SELSA) trial, including patients &lt;80 years of age and with American Society of Anaesthesiologists' (ASA) physical status grade of &lt;III; further, patients without a defunctioning stoma were excluded. The outcome comprised anastomotic leakage within 30 days or in-hospital. Candidate predictors included age, sex, ASA grade, cardiovascular disease, diabetes, body mass index (BMI), tumour stage, tumour height, and neoadjuvant therapy. Seven models were developed and internally validated using bootstrapping. A threshold of a predicted leakage risk of &lt;= 10% was chosen for trial implementation. Validation was conducted using chart-reviewed data from a nested cohort. Results Of the 2727 eligible patients, 199 (7.3%) were registered with an anastomotic leakage. All models demonstrated similar performance, with prediction instability observed for risks exceeding 12.5%. The preferred model included three significant predictors: male sex (OR 2.00; 95% CI: 1.45-2.75), BMI &gt;30 kg/m(2) (OR 1.82; 95% CI: 1.21-2.74), and radiotherapy (OR 1.90; 95% CI: 1.35-2.69). The bootstrapped area under the curve (AUC) was 0.64 (95% CI: 0.62-0.65), with a negative predictive value of 94.6% (95% CI: 93.7%-95.6%). For the validation cohort, the corresponding estimates were 0.66 (95% CI: 0.59-0.74) and 89.5% (95% CI: 86.2%-92.5%). Conclusion Accuracy of anastomotic leakage prediction using registry-based data is moderate; however, the model's ability to rule out a &gt;10% risk is considered appropriate for trial use.Funding Agencies|Vetenskapsrdet [CRCBaSe]</p
Internationella Medicinska Programmet – ”En unik verksamhet”? : En Foucauldiansk diskursanalys av diskurser och makt relaterat till en verksamhet under Region Östergötland
No full textDenna studie syftade till att undersöka relationer mellan diskurser och makt beträffande en unik verksamhet som utför internationella utbytesprojekt bestående av en kombination av utbildning och bistånd med målet att uppnå ömsesidig nytta. Tidigare forskning i angränsande områden har visat att både diskurser och makt kan influera individuell subjektivitet, exempelvis bakomliggande motivation till deltagande, självbild och intersubjektiva relationer. Genom att nyttja Foucauldiansk diskursanalys analyserades insamlat material från 16 intervjuer och tre källor av offentligt material för att utforska begrepp så som diskursiva objekt, subjektspositioner och maktformer. Studien fann att det empiriska underlaget genomsyrades av en ekonomisk, en neokolonialistisk, en individualistisk och en kollektivistisk diskurs. Dessa diskurser hade tydliga men samtidigt komplexa relationer till varandra och till suverän, disciplinär och biopolitisk makt som reproducerade subjektspositioner utefter hierarkiska dikotomier i varierande grad. Likaså fann studien en disharmoni, dels i hur diskurserna visade sig mellan intervjudeltagare och offentligt material, dels mellan olika maktformer. Sammantaget tydde detta på tydliga implikationer för individuell subjektivitet. Studiens slutsatser bidrar med värdefulla insikter till framtida forskning inom ett område som tidigare saknat vetenskapligt underlag av psykologisk och diskursiv relevans
Paternal intelligence affects school grades in children with and without ADHD - a register-based study
No full textADHD profoundly impacts educational attainment, quality of life, and health in young adults. However, certain subgroups of ADHD patients seem to do quite well, potentially due to differences in intelligence and socioeconomic status. Here we used paternal intelligence from the Swedish Defence Conscription and Assessment register, to investigate the role of genetic propensity for intelligence, on school performance in a large cohort of ADHD patients and matched controls. Patients treated for ADHD in Linköping, Sweden between 1995 and 2020 (n = 3262), sex- and age-matched controls (n = 9591) as well as their parents and siblings were identified using regional and national registers. Socioeconomic and demographic data, ADHD diagnosis and treatment and school grades at age 16 for the study population were extracted from Swedish National registers. We explored the associations between paternal intelligence and child school performance using linear mixed models and mediation analyses, taking a wide range of potential covariates into account. Results indicate that paternal intelligence was positively associated with standardized school grades in their offspring (Zadjusted=0.09, 95%CI 0.07, 0.10). This effect was present in both ADHD patients and controls, but ADHD patients had significantly lower standardized grades (Zadjusted=-1.03, 95%CI -1.08, -0.98). Child ADHD did not serve as a mediator for how paternal intelligence affected school grades. Our findings indicate that ADHD prevents children from reaching their academic potential at all levels of paternal intelligence. Increased understanding of the contributions of ADHD, intelligence, and SES to functional outcomes can help clinicians to better personalize interventions to the unique preconditions in each patient.Funding Agencies|Linkoping University</p
Träd och trä: Materialitet och diffraktion i Eva Ströms poesi
No full textEva Ström’s poetry in Utskuret ur ett större träd (2013) and Jag såg ett träd (2022) frequently includes references to trees. This article examines how Ström’s poetry negotiates the boundaries between humans, nature, materiality, and aesthetics. It also suggests that Ström’s poetic method can be seen in light of Karen Barad’s concept of diffraction, as it invites us to read phenomena of various kinds and scales through one another. Ström’s poetry collections share certain features, such as the preoccupation with trees and contemporaneous news, including disasters and extreme weather. Taken together, they also focus on the sculptural, art history, medicine, and religious rituals. The latter collection details the Covid-19 pandemic, which foregrounds interconnectivity and the difficulty of maintaining a separation between the human body and the environment, something which posthuman materialist criticism has long recognized. In addition, the emphasis on deep time brought on by the invocation of dendrology emplaces the human in a larger, geological time frame. Similar concerns likewise emerge in the previous collection. The question of where a human begins or ends is asked, which reverberates with the later collection’s preoccupation with porosity, interconnectivity, and enmeshment. With its blurring of foreground and background, Ström’s poetry emerges as a poetics of diffraction, reading events and occurrences through one another, ranging from materials to religious artefacts, current news items, art works, and the quotidian. With its emphasis on trees, sculptures, art, and religious rituals, her poetry foregrounds material and posthuman concerns, but these are always paired with—troubled by just as they themselves in turn trouble—older, humanistic understandings of what it means to be human.