Rolf Wynn | UiT The Arctic University of Norway (original) (raw)
Papers by Rolf Wynn
BACKGROUND Health authorities recommend educating diabetes patients and their families and initia... more BACKGROUND Health authorities recommend educating diabetes patients and their families and initiating measures aiming at improving self-management, promoting a positive behavior change and reducing the risk of complications. Social media could be valid channels to intervene and deliver diabetes education. However it is not well known if the use of these channels in interventions can help to improve patients’ outcomes. OBJECTIVE To review and describe the current existing evidence on the use of social media in interventions targeting people affected with diabetes. METHODS A search was conducted across four databases (Pubmed; SCOPUS; EMBASE; and Cochrane Library). The quality of the evidence of the included primary studies was graded according to the GRADE criteria, and the risk of bias of systematic reviews was assessed by drawing on the AMSTAR guidelines. The outcomes reported by these studies were extracted and analysed. RESULTS Twenty articles of moderate and high quality were included in the review; 17 primary studies and three systematic reviews. Thirteen among the sixteen publications measuring the effect on HbA1c of the intervention using social media have reported significant reductions. The five studies that measured satisfaction with the interventions using social media found positive effects. There was mixed evidence regarding the effect of interventions using social media on health related quality of life (two publications found positive effects and three found no differences); and also on diabetes knowledge or empowerment (two articles reported improvements and two reported no significant changes). CONCLUSIONS There is little evidence of good quality on the use of social media in interventions aimed at people with diabetes. However, the use of these channels is mostly linked to benefits on patients’ outcomes. Public health institutions, clinicians and other stakeholders that aim at improving the education of diabetes patients could consider the use of social media in their interventions. CLINICALTRIAL This review has been registered in PROSPERO (registration number: CRD42018088206).
International Journal of Educational Research, 2021
Abstract The study followed the re-enrolment processes of six young people in Northern Norway who... more Abstract The study followed the re-enrolment processes of six young people in Northern Norway who had dropped out of high school. Early in the re-enrolment process, the participants focused on their experiences with lack of inner motivation, lack of endurance, and confusion concerning what they wanted to do with their lives. Later in the process, participants described positive changes in their inner motivation and reduced confusion about future goals. Their feeling of ‘being stuck’ changed into a feeling of ‘moving forward’. They described experiences with re-socialization. However, a lack of endurance remained a major challenge throughout for several of the participants.
International Journal of Surgery, 2020
Journal of Diabetes Science and Technology, 2018
Background: Contents published on social media have an impact on individuals and on their decisio... more Background: Contents published on social media have an impact on individuals and on their decision making. Knowing the sentiment toward diabetes is fundamental to understanding the impact that such information could have on people affected with this health condition and their family members. The objective of this study is to analyze the sentiment expressed in messages on diabetes posted on Twitter. Method: Tweets including one of the terms “diabetes,” “t1d,” and/or “t2d” were extracted for one week using the Twitter standard API. Only the text message and the number of followers of the users were extracted. The sentiment analysis was performed by using SentiStrength. Results: A total of 67 421 tweets were automatically extracted, of those 3.7% specifically referred to T1D; and 6.8% specifically mentioned T2D. One or more emojis were included in 7.0% of the posts. Tweets specifically mentioning T2D and that did not include emojis were significantly more negative than the tweets that ...
The clinical case report is a popular genre in medical writ-ing. While authors and editors have d... more The clinical case report is a popular genre in medical writ-ing. While authors and editors have debated the justifica-tion for the clinical case report, few have attempted to examine the long history of this genre in medical literature. By reviewing selected literature and presenting and discuss-ing excerpts of clinical case reports from Egyptian antiquity to the 20th century, we illustrate the presence of the genre in medical science and how its form developed. Central features of the clinical case report in different time periods are discussed, including its main components, structure, style and author presence.
Studies in Health Technology and Informatics, 2021
Health-dedicated groups on social media provide different contents and social support to their pe... more Health-dedicated groups on social media provide different contents and social support to their peers. Our objective is to analyze users’ engagement with health education and physical activity promotion posts according to the expressed social support and social media. All health education and physical activity promotion posts on Facebook, Twitter, and Instagram during 2017–2019 by a diabetes association were extracted. We identified the type of social support within these posts; and analysed the users’ engagement with these posts according to the type of social support and social media channel. A total of 260 posts dealing with health education (n=200) and physical activity promotion (n=60) were published. Posts promoting physical activity received 54% more likes than posts on health education (p<0.05), but they were 69% less likely to receive comments and be shared (both p<0.01). Posts expressing tangible assistance received 6 times more likes (p<0.001), and the ones indica...
International Journal of Surgery, 2018
BACKGROUND Diabetes patient associations and diabetes-specific patient groups around the world ar... more BACKGROUND Diabetes patient associations and diabetes-specific patient groups around the world are present on social media. Although active participation and engagement in these diabetes social media groups has been mostly linked to positive effects, very little is known about the content that is shared on these channels or the post features that engage their users the most. OBJECTIVE The objective of this study was to analyze (1) the content and features of posts shared over a 3-year period on 3 diabetes social media channels (Facebook, Twitter, and Instagram) of a diabetes association, and (2) users’ engagement with these posts (likes, comments, and shares). METHODS All social media posts published from the Norwegian Diabetes Association between January 1, 2017, and December 31, 2019, were extracted. Two independent reviewers classified the posts into 7 categories based on their content. The interrater reliability was calculated using Cohen kappa. Regression analyses were carried ...
BMC Psychology
Background Incarcerated individuals have poor mental health compared to the general population. S... more Background Incarcerated individuals have poor mental health compared to the general population. Social support has a beneficial effect on mental health. The buffering model proposes that social support facilitates coping under stressful conditions, while the main effects model suggests that belonging to social networks and having positive social interactions are beneficial for mental health. Prisons are a highly interesting context for studying social support, as imprisonment is perceived as stressful and disrupts social relationships and the availability of support. This study aims to explore incarcerated individuals' perceptions of social support from various sources in the transition from community to prison, its perceived significance for mental health, and the opportunities and barriers to accessing social support in a Norwegian prison context. Methods The experiences of eight incarcerated individuals from a prison in Northern Norway were gathered through conducting individ...
International Journal of Integrated Care
Studies in Health Technology and Informatics
Drawing on three central sources of data on the development in e-health use in Norway (studies fr... more Drawing on three central sources of data on the development in e-health use in Norway (studies from the Norwegian Centre for e-Health Research, studies from Statistics Norway, and the Tromsø 7 Study), we describe the rising importance of e-health. Originally restricted to a limited use within the health services, in recent years the use of e-health has gained momentum both in the general population and within the traditional health services, as the Internet has offered easy access to health information as well as a range of other health-related services.
International Journal of Integrated Care
Studies in Health Technology and Informatics, 2022
The doctor-patient relationship has been the cornerstone of medical practice. As e-health is comi... more The doctor-patient relationship has been the cornerstone of medical practice. As e-health is coming to play an increasingly important role, it is necessary to consider how e-health can draw on, integrate and safeguard aspects of this relationship and thereby improve services and engage patients.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Li... more This is an Open Access article distributed under the terms of the Creative Commons Attribution License
Studies in health technology and informatics, 2020
In this paper we describe the Master Study in Telemedicine and E-health at the University of Trom... more In this paper we describe the Master Study in Telemedicine and E-health at the University of Tromsø, Norway. The study enrolled its first students in 2005 and was closed in 2018. We describe and discuss the background of the programme, its development and accomplishments and why it was closed. Hopefully, this narrative will be of use to other programmes focusing on e-health.
AUTHORS Jeremiah W. Acharibasam MSc Rolf Wynn PhD, Professor * CORRESPONDENCE *Prof Rolf Wynn rol... more AUTHORS Jeremiah W. Acharibasam MSc Rolf Wynn PhD, Professor * CORRESPONDENCE *Prof Rolf Wynn rolf.wynn@gmail.com AFFILIATIONS Department of Mental Health, Navrongo War Memorial Hospital, Navrongo, Kassena-Nankana District, Ghana Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway and Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway PUBLISHED 24 August 2018 Volume 18 Issue 3 HISTORY RECEIVED: 6 January 2018 REVISED: 4 July 2018 ACCEPTED: 23 July 2018 CITATION Acharibasam JW, Wynn R. The importance of cultural awareness when planning and implementing telepsychiatric services. Rural and Remote Health 2018; 18: 4724. https://doi.org/10.22605/RRH4724 ETHICS APPROVAL: Not applicable (commentary) Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 International Licence
International Journal of Surgery, 2020
International Journal of Integrated Care, 2021
BACKGROUND Health authorities recommend educating diabetes patients and their families and initia... more BACKGROUND Health authorities recommend educating diabetes patients and their families and initiating measures aiming at improving self-management, promoting a positive behavior change and reducing the risk of complications. Social media could be valid channels to intervene and deliver diabetes education. However it is not well known if the use of these channels in interventions can help to improve patients’ outcomes. OBJECTIVE To review and describe the current existing evidence on the use of social media in interventions targeting people affected with diabetes. METHODS A search was conducted across four databases (Pubmed; SCOPUS; EMBASE; and Cochrane Library). The quality of the evidence of the included primary studies was graded according to the GRADE criteria, and the risk of bias of systematic reviews was assessed by drawing on the AMSTAR guidelines. The outcomes reported by these studies were extracted and analysed. RESULTS Twenty articles of moderate and high quality were included in the review; 17 primary studies and three systematic reviews. Thirteen among the sixteen publications measuring the effect on HbA1c of the intervention using social media have reported significant reductions. The five studies that measured satisfaction with the interventions using social media found positive effects. There was mixed evidence regarding the effect of interventions using social media on health related quality of life (two publications found positive effects and three found no differences); and also on diabetes knowledge or empowerment (two articles reported improvements and two reported no significant changes). CONCLUSIONS There is little evidence of good quality on the use of social media in interventions aimed at people with diabetes. However, the use of these channels is mostly linked to benefits on patients’ outcomes. Public health institutions, clinicians and other stakeholders that aim at improving the education of diabetes patients could consider the use of social media in their interventions. CLINICALTRIAL This review has been registered in PROSPERO (registration number: CRD42018088206).
International Journal of Educational Research, 2021
Abstract The study followed the re-enrolment processes of six young people in Northern Norway who... more Abstract The study followed the re-enrolment processes of six young people in Northern Norway who had dropped out of high school. Early in the re-enrolment process, the participants focused on their experiences with lack of inner motivation, lack of endurance, and confusion concerning what they wanted to do with their lives. Later in the process, participants described positive changes in their inner motivation and reduced confusion about future goals. Their feeling of ‘being stuck’ changed into a feeling of ‘moving forward’. They described experiences with re-socialization. However, a lack of endurance remained a major challenge throughout for several of the participants.
International Journal of Surgery, 2020
Journal of Diabetes Science and Technology, 2018
Background: Contents published on social media have an impact on individuals and on their decisio... more Background: Contents published on social media have an impact on individuals and on their decision making. Knowing the sentiment toward diabetes is fundamental to understanding the impact that such information could have on people affected with this health condition and their family members. The objective of this study is to analyze the sentiment expressed in messages on diabetes posted on Twitter. Method: Tweets including one of the terms “diabetes,” “t1d,” and/or “t2d” were extracted for one week using the Twitter standard API. Only the text message and the number of followers of the users were extracted. The sentiment analysis was performed by using SentiStrength. Results: A total of 67 421 tweets were automatically extracted, of those 3.7% specifically referred to T1D; and 6.8% specifically mentioned T2D. One or more emojis were included in 7.0% of the posts. Tweets specifically mentioning T2D and that did not include emojis were significantly more negative than the tweets that ...
The clinical case report is a popular genre in medical writ-ing. While authors and editors have d... more The clinical case report is a popular genre in medical writ-ing. While authors and editors have debated the justifica-tion for the clinical case report, few have attempted to examine the long history of this genre in medical literature. By reviewing selected literature and presenting and discuss-ing excerpts of clinical case reports from Egyptian antiquity to the 20th century, we illustrate the presence of the genre in medical science and how its form developed. Central features of the clinical case report in different time periods are discussed, including its main components, structure, style and author presence.
Studies in Health Technology and Informatics, 2021
Health-dedicated groups on social media provide different contents and social support to their pe... more Health-dedicated groups on social media provide different contents and social support to their peers. Our objective is to analyze users’ engagement with health education and physical activity promotion posts according to the expressed social support and social media. All health education and physical activity promotion posts on Facebook, Twitter, and Instagram during 2017–2019 by a diabetes association were extracted. We identified the type of social support within these posts; and analysed the users’ engagement with these posts according to the type of social support and social media channel. A total of 260 posts dealing with health education (n=200) and physical activity promotion (n=60) were published. Posts promoting physical activity received 54% more likes than posts on health education (p<0.05), but they were 69% less likely to receive comments and be shared (both p<0.01). Posts expressing tangible assistance received 6 times more likes (p<0.001), and the ones indica...
International Journal of Surgery, 2018
BACKGROUND Diabetes patient associations and diabetes-specific patient groups around the world ar... more BACKGROUND Diabetes patient associations and diabetes-specific patient groups around the world are present on social media. Although active participation and engagement in these diabetes social media groups has been mostly linked to positive effects, very little is known about the content that is shared on these channels or the post features that engage their users the most. OBJECTIVE The objective of this study was to analyze (1) the content and features of posts shared over a 3-year period on 3 diabetes social media channels (Facebook, Twitter, and Instagram) of a diabetes association, and (2) users’ engagement with these posts (likes, comments, and shares). METHODS All social media posts published from the Norwegian Diabetes Association between January 1, 2017, and December 31, 2019, were extracted. Two independent reviewers classified the posts into 7 categories based on their content. The interrater reliability was calculated using Cohen kappa. Regression analyses were carried ...
BMC Psychology
Background Incarcerated individuals have poor mental health compared to the general population. S... more Background Incarcerated individuals have poor mental health compared to the general population. Social support has a beneficial effect on mental health. The buffering model proposes that social support facilitates coping under stressful conditions, while the main effects model suggests that belonging to social networks and having positive social interactions are beneficial for mental health. Prisons are a highly interesting context for studying social support, as imprisonment is perceived as stressful and disrupts social relationships and the availability of support. This study aims to explore incarcerated individuals' perceptions of social support from various sources in the transition from community to prison, its perceived significance for mental health, and the opportunities and barriers to accessing social support in a Norwegian prison context. Methods The experiences of eight incarcerated individuals from a prison in Northern Norway were gathered through conducting individ...
International Journal of Integrated Care
Studies in Health Technology and Informatics
Drawing on three central sources of data on the development in e-health use in Norway (studies fr... more Drawing on three central sources of data on the development in e-health use in Norway (studies from the Norwegian Centre for e-Health Research, studies from Statistics Norway, and the Tromsø 7 Study), we describe the rising importance of e-health. Originally restricted to a limited use within the health services, in recent years the use of e-health has gained momentum both in the general population and within the traditional health services, as the Internet has offered easy access to health information as well as a range of other health-related services.
International Journal of Integrated Care
Studies in Health Technology and Informatics, 2022
The doctor-patient relationship has been the cornerstone of medical practice. As e-health is comi... more The doctor-patient relationship has been the cornerstone of medical practice. As e-health is coming to play an increasingly important role, it is necessary to consider how e-health can draw on, integrate and safeguard aspects of this relationship and thereby improve services and engage patients.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Li... more This is an Open Access article distributed under the terms of the Creative Commons Attribution License
Studies in health technology and informatics, 2020
In this paper we describe the Master Study in Telemedicine and E-health at the University of Trom... more In this paper we describe the Master Study in Telemedicine and E-health at the University of Tromsø, Norway. The study enrolled its first students in 2005 and was closed in 2018. We describe and discuss the background of the programme, its development and accomplishments and why it was closed. Hopefully, this narrative will be of use to other programmes focusing on e-health.
AUTHORS Jeremiah W. Acharibasam MSc Rolf Wynn PhD, Professor * CORRESPONDENCE *Prof Rolf Wynn rol... more AUTHORS Jeremiah W. Acharibasam MSc Rolf Wynn PhD, Professor * CORRESPONDENCE *Prof Rolf Wynn rolf.wynn@gmail.com AFFILIATIONS Department of Mental Health, Navrongo War Memorial Hospital, Navrongo, Kassena-Nankana District, Ghana Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway and Division of Mental Health and Addictions, University Hospital of North Norway, Tromsø, Norway PUBLISHED 24 August 2018 Volume 18 Issue 3 HISTORY RECEIVED: 6 January 2018 REVISED: 4 July 2018 ACCEPTED: 23 July 2018 CITATION Acharibasam JW, Wynn R. The importance of cultural awareness when planning and implementing telepsychiatric services. Rural and Remote Health 2018; 18: 4724. https://doi.org/10.22605/RRH4724 ETHICS APPROVAL: Not applicable (commentary) Except where otherwise noted, this work is licensed under a Creative Commons Attribution 4.0 International Licence
International Journal of Surgery, 2020
International Journal of Integrated Care, 2021
Psychoneuroendocrinology, 2019
Immunological abnormalities have been demonstrated in several psychiatric disorders. Predominantl... more Immunological abnormalities have been demonstrated in several psychiatric disorders. Predominantly, studies have focused on younger adults, and research on elderly psychiatric in-patients is scant. In this naturalistic study, we investigated changes in cytokine levels during the treatment of diagnostically unselected elderly psychiatric in-patients, and whether these changes could be related to clinical outcomes. Clinical variables, demographic data, lifestyle data, and blood samples, including 27 plasma cytokines representing a broad spectrum of in-flammatory mediators, were collected from 81 patients, 60 years and older, at admission and discharge. A subgroup of 49 patients also completed a self-reported clinical, psychiatric status form, indicating their level of recovery during hospitalisation. Statistical analyses demonstrated that a broad range of cytokines fell during treatment, and the fall was associated with clinical improvement, irrespective of psychiatric and somatic diagnoses. Exploiting cytokines as biomarkers of clinical traits might to be of limited use in a general population of elderly psychiatric in-patients as the field stands now.
Patient Preference and Adherence, 2018
Background: Nowadays, rapid and accessible participatory research on diabetes can be carried out ... more Background: Nowadays, rapid and accessible participatory research on diabetes can be carried out using social media platforms. The objective of this study was to identify preferences and inter- ests of diabetic social media users regarding a health-promotion intervention targeting them. Methods: Social media followers of the Norwegian Diabetes Association were invited to participate in the creation of a health-promotion intervention on diabetes by expressing their opinions through an online questionnaire posted on Facebook, Twitter, and Instagram. The questionnaire asked participants about their demographics and preferences regarding type of health content: format, frequency, and channels to deliver content. Questions regarding the perceived quality of diabetes-related information and satisfaction with content on social media were also included.
Results: The questionnaire was answered by 346 participants: 332 (96%) of those were reached via Facebook, 66.5% of respondents (n230) identified themselves as women, 54% (n187) as individuals diagnosed with type 1 diabetes, and 71% (n235) were aged 30–64 years. The preferred type of content was “research and innovation on diabetes”, selected by 78.0% of the respondents. “Text format” was the choice for 93.4%, and 97.3% would prefer to find health- promotion content on Facebook. There was heterogeneity in the desired frequency of this content. In a scale ranging from 0 to 100, the perceived quality of diabetes-related information on social media was 62.01.2 and satisfaction with such content 61.91.3.
Conclusion: The approach used in this study was successful in reaching and involving partici- pants quickly, and could also potentially increase diabetes patients’ engagement and satisfaction with health-promotion interventions, enhance their sense of community, and thus help people attain healthier lifestyles. It is a limitation that our sample might not have been fully representa- tive, as the most interested social media users might have chosen to participate.
Keywords: community-based participatory research, diabetes, health promotion, health education, social media
International Journal of Telemedicine and Applications, 2018
Introduction. The rising incidence of mental illness and its impact on individuals, families, and... more Introduction. The rising incidence of mental illness and its impact on individuals, families, and societies is becoming a major public health concern, especially in resource-constrained countries. Consequently, there is an increasing demand for mental health services in many middle- and low-income countries (LMIC). Challenges such as inequality in access, lack of staff and hospital beds, and underfunding, often present in the LMIC, might in part be addressed by telemental health services. However, little is known about telemental health in the LMIC. Methods. A systematic review was performed, drawing on several electronic databases, including PubMed, PsycINFO, Web of Science, Springer Link, and Google Scholar. Original English language studies on the practice of telemental health in LMIC, involving patients and published between 1 January 2000 and 16 February 2017, were included. Results. Nineteen studies met the inclusion criteria. Most of the articles were recent, which may reflect an increasing focus on telemental health in the LMIC. Eight of these studies were from Asia. Eight of the studies were interventional/randomized controlled trials, and 11 examined general mental health issues. Videoconferencing was the most frequently (6) studied telemental modality. Other modalities studied were online decision support systems (3), text messaging and bibliotherapy (1), e-chatting combined with videoconferencing (1), online therapy (2), e-counseling (1), store-and-forward technology (1), telephone follow-up (1), online discussion groups (1), audiovisual therapy and bibliotherapy (1), and computerized occupational therapy (1). Although many of the studies showed that telemental services had positive outcomes, some studies reported no postintervention improvements. Conclusion. The review shows a rising trend in telemental activity in the LMIC. There is a greater need for telemental health in the LMIC, but more research is needed on empirical and theoretical aspects of telemental activity in the LMIC and on direct comparisons between telemental activity in the LMIC and the non-LMIC.
Background: The first 12 Norwegian assertive community treatment (ACT) teams were piloted from 20... more Background: The first 12 Norwegian assertive community treatment (ACT) teams were piloted from 2009 to 2011. Of the 338 patients included during the teams' first year of operation, 38% were subject to community treatment orders (CTOs). In Norway as in many other Western countries, the use of CTOs is relatively high despite lack of robust evidence for their effectiveness. The purpose of the present study was to explore how responsible clinicians reason and make decisions about the continued use of CTOs, recall to hospital and the discontinuation of CTOs within an ACT setting.
Methods: Semi-structured interviews with eight responsible clinicians combined with patient case files and observations of treatment planning meetings. The data were analysed using a modified grounded theory approach.
Results: The participants emphasized that being part of a multidisciplinary team with shared caseload responsibility that provides intensive services over long periods of time allowed for more nuanced assessments and more flexible treatment solutions on CTOs. The treatment criterion was typically used to justify the need for CTO. There was substantial variation in the responsible clinicians' legal interpretation of dangerousness, and some clinicians applied the dangerousness criterion more than others. Conclusions: According to the clinicians, many patients subject to CTOs were referred from hospitals and high security facilities, and decisions regarding the continuation of CTOs typically involved multiple and interacting risk factors. While patients' need for treatment was most often applied to justify the need for CTOs, in some cases the use of CTOs was described as a tool to contain dangerousness and prevent harm.
Background There is a paucity of studies on inflammatory markers in elderly psychiatric patients.... more Background
There is a paucity of studies on inflammatory markers in elderly psychiatric patients. Hence, our study was undertaken to investigate cytokines as biomarkers in diagnostically unselected elderly patients admitted to a psychiatric hospital.
Methods
Demographic data, clinical data and blood samples, including 27 cytokines, were collected from 98 patients above 60 years, consecutively admitted to a psychiatric hospital in Tromsø, Norway (69°N).
Results
The most common diagnosis was Recurrent depressive disorder (26.5%), the second most common was dementia in Alzheimer’s disease (20.4%). The most frequent somatic disease was cardiovascular disease (28%).No statistical association (p < 0.01) was found between cytokines and gender, age, BMI, anti-inflammatory drugs, psychotropic drugs, reason for admittance, smoking, vitamin supplements, alcohol consumption, length of stay, somatic disease (present/not-present) or psychiatric diagnoses. However, when allocating patients to two groups, depression and no depression, we found higher levels of 10 cytokines in the no depression group (FDR-p < 0.0044). Possibly, this could in part be explained by the higher prevalence of cardiovascular disease (CVD) and dementia in the no depression group, as these factors were significant predictors of patients being categorized as not depressed in a logistic regression. In addition, other unknown factors might have contributed to the association between no depression and elevated cytokines. On the other hand, the high level of psychiatric and somatic comorbidity in the study population may have led to increased levels of cytokines in general, possibly diluting the potential effect of other factors, depression included, on the cytokine levels. The size of the study, and particularly the size of the subgroups, represents a limitation of the study, as do the general heterogeneity and the lack of a control group.
Conclusions
There was no significant difference in cytokine levels between various psychiatric diagnoses in hospitalized elderly psychiatric patients. This indicates that previous findings of correlations between cytokines and various psychiatric disorders in highly selected adult cases might not be applicable to elderly psychiatric inpatients. Further immunological studies are needed on gerontopsychiatric patients in general and gerontopsychiatric patients with specific disorders, preferably with patients that are physically healthy.
Trial registration
Retrospectively registered in the ISRCTN registry study, with study ID ISRCTN71047363.
Background: The clenched fist syndrome/psycho-flexed hand, first described in the early 1980s, ha... more Background: The clenched fist syndrome/psycho-flexed hand, first described in the early 1980s, has not yet entered the major psychiatric textbooks. Curiously, the phenomenon has been illuminated mainly in journals and textbooks on hand surgery. There is a need to examine, describe, and understand this syndrome from a psychiatric perspective.
School dropout is related to difficult life trajectories in Western society. Developing effective... more School dropout is related to difficult life trajectories in Western society. Developing effective preventive interventions is urgent. Nevertheless, few studies have interviewed unemployed young adults in the aftermath of school dropout to understand their experiences with influential factors. We interviewed seven former students two to five years after they had dropped out and seven same-aged students in their final year at college. The participants were given qualitative semi-structured interviews focusing on questions about what kept them on track and what pushed them off track when struggling to complete school. The participants were also clinically interviewed, drawing on the Mini International Neuropsychiatric Interview. The analysis revealed that the students who had dropped out described a larger number of mental health problems and problems of a more serious nature than the college students did. The participants who had dropped out also described less access to resources and social support. The clinical interviews supported the impression given in the qualitative interviews, that those who had dropped out were more burdened by mental disorders than the college students. The college students described comprehensive social support to play a major role in their coping with school and mental health problems. The former students who were unemployed and who had dropped out described internalizing mental health problems in
Background: Participatory health approaches are increasingly drawing attention among the scientif... more Background: Participatory health approaches are increasingly drawing attention among the scientific community, and could be used for health promotion programmes on diabetes through social media. The main aim of this project is to research how to best use social media to promote healthy lifestyles with and within the Norwegian population.
Background: Patients with severe mental illness may be subjected to Community Treatment Orders (C... more Background: Patients with severe mental illness may be subjected to Community Treatment Orders (CTOs) in order to secure that the patients adhere to treatment. Few studies have investigated the use of CTOs within an Assertive Community Treatment (ACT) setting, and little is known about how the tension between the patients' autonomy and the clinicians' responsibility to act in the patients' best interest are resolved in practice. The aim of this study was to explore the service providers' experiences with CTOs within an ACT setting. Methods: The study was based on reviews of case files of 15 patients, eight individual qualitative in depth interviews and four focus group interviews with service providers involved in ACT and decisions related to CTOs. A modified grounded theory approach was used to analyze the data.
Introduction Women with bulimia nervosa and binge eating disorder often suffer for many years bef... more Introduction Women with bulimia nervosa and binge
eating disorder often suffer for many years before they
seek professional help. Evidence-based treatments
like cognitive–behavioural therapy (CBT) might be
poorly accessible, and about 50% of those who receive
CBT respond to it. Such outcome may reflect the
heterogeneous nature of eating disorders, and addressing
this heterogeneity calls for expanding the portfolio of
treatment options. In particular, it is important to explore
such options’ acceptability, tolerability and affordability
expressed through experiences with the treatment. This
protocol outlines the rationale and design of a qualitative
study. It captures experiences from patients and therapists
who were involved in a randomised controlled trial (RCT)
exploring the efficacy of a new group-based treatment
programme combining physical exercise and dietary
therapy.
Methods and analysis 15 patients with bulimia nervosa
or binge eating disorder, 10 therapists (physical trainers
and dietitians) and 6–10 patients who dropped out of the
RCT will be semistructurally interviewed. All interviews
will be analysed using a systematic text condensation
approach.
Ethics and dissemination Results will be presented
in peer-reviewed international journals, and at relevant
international conferences. Key findings will be available
to study participants as well as to patient organisations
and health authorities. The overall study meets the intent
and requirements of the Health Research Act and the
Declaration of Helsinki. It is approved by the regional
committee for medical research ethics (2013/1871).
Trial registration number NCT02079935; Pre-results.
Objectives The aim of the current study is to explore how therapists running a guided physical ex... more Objectives The aim of the current study is to explore how
therapists running a guided physical exercise and dietary
therapy programme (PED-t) experience their contribution
to the treatment of patients with bulimia nervosa and
binge eating disorder.
Methods Ten therapists running the PED-t were
semistructurally interviewed and the transcribed
interviews were analysed using a systematic text
condensation approach.
Setting The study was run within the context of a
randomised controlled trial at the Norwegian School of
Sport Sciences.
Results The therapists experienced their knowledge
about physical exercise and nutrition as important and
useful, and that they could share their knowledge with the
patients in different ways and with confidence in their own
role. They also believed that their knowledge could serve
as tools for the patients’ post-treatment recovery and
management of their daily lives. Moreover, the therapists
put much effort in adjusting their teaching to fit each
individual participant. Finally, they reported their personal
qualities as important to build trust and therapeutic
alliance.
Conclusions The terms ‘clinical confidence’ and ‘alliance’
may stand out as the overarching ‘metacategories’
covering the experiences revealed in this study. The
clinical implication is that new groups of professionals may
have an important role in the treatment of eating disorders.
Background: It is an important objective of the psychiatric services to keep the use of involunta... more Background: It is an important objective of the psychiatric services to keep the use of involuntary procedures to a minimum, as the use of coercion involves clinical, ethical, and legal issues. It has been claimed that Norway has a relatively high rate of involuntary admissions. We reviewed the peer-reviewed literature on the use of involuntary admission in Norway, with the purpose of identifying the current state of knowledge and areas in need of further research. Methods: A systematic review following the PRISMA statement was conducted. We searched the electronic databases PsycInfo, PubMed, Web of Science, CINAHL, and Embase for studies relating to involuntary admission to Norwe-gian adult psychiatric hospitals published in the period 1 January 2001 to 8 August 2016. The database searches were supplemented with manual searches of relevant journals, reference lists, and websites. Results: Seventy-four articles were included and grouped into six categories based on their main topics: Patients' experiences, satisfaction and perceived coercion (21 articles), the Referral and admission process (11 articles), Rates of admission (8 articles), Characteristics of the patients (17 articles), Staff attitudes (9 articles), and Outcomes (8 articles). Four of the included articles described intervention studies. Fifty-seven of the articles had a quantitative design, 16 had a qualitative design, and one a mixed-method design. There was a broad range of topics that were studied and considerable variation in study designs. The findings were largely in line with the international literature, but the particularities of Norwegian legislation and the Norwegian health services were reflected in the literature. The four intervention studies explored interventions for reducing rates of involuntary admission, such as modifying referring routines, improving patient information procedures, and increasing patients' say in the admission process, and represent an important avenue for future research on involuntary admission in Norway. Conclusions: The review suggests that Norway has a relatively high rate of involuntary admissions. The identified studies represent a broad mix of topics and designs. Four intervention studies were identified. More studies with strong designs are needed to bring research on involuntary admission in Norway to a next level.
Objectives: The aim of the current study is to explore how therapists running a guided physical e... more Objectives: The aim of the current study is to explore how therapists running a guided physical exercise and dietary therapy programme (PED-t) experience their contribution to the treatment of patients with bulimia nervosa and binge eating disorder.
Methods: Ten therapists running the PED-t were semistructurally interviewed and the transcribedinterviews were analysed using a systematic text condensation approach.
Setting: The study was run within the context of a randomised controlled trial at the Norwegian School of Sport Sciences.
Results: The therapists experienced their knowledge about physical exercise and nutrition as important and useful, and that they could share their knowledge with the patients in different ways and with confidence in their own role. They also believed that their knowledge could serve as tools for the patients’ post-treatment recovery and management of their daily lives. Moreover, the therapists put much effort in adjusting their teaching to fit each individual participant. Finally, they reported their personal qualities as important to build trust and therapeutic alliance.
Conclusions: The terms ‘clinical confidence’ and ‘alliance’ may stand out as the overarching ‘metacategories’ covering the experiences revealed in this study. The clinical implication is that new groups of professionals may have an important role in the treatment of eating disorders.
Trial registration number: NCTO2079935; Results.
Introduction: Women with bulimia nervosa and binge eating disorder often suffer for many years be... more Introduction: Women with bulimia nervosa and binge eating disorder often suffer for many years before they seek professional help. Evidence-based treatments like cognitive–behavioural therapy (CBT) might be poorly accessible, and about 50% of those who receive CBT respond to it. Such outcome may reflect the heterogeneous nature of eating disorders, and addressing this heterogeneity calls for expanding the portfolio of treatment options. In particular, it is important to explore such options’ acceptability, tolerability and affordability expressed through experiences with the treatment. This protocol outlines the rationale and design of a qualitative
study. It captures experiences from patients and therapists who were involved in a randomised controlled trial (RCT) exploring the efficacy of a new group-based treatment programme combining physical exercise and dietary therapy.
Methods and analysis: 15 patients with bulimia nervosa or binge eating disorder, 10 therapists (physical trainers and dietitians) and 6–10 patients who dropped out of the RCT will be semistructurally interviewed. All interviews will be analysed using a systematic text condensation approach.
Ethics and dissemination: Results will be presented in peer-reviewed international journals, and at relevant international conferences. Key findings will be available to study participants as well as to patient organisations and health authorities. The overall study meets the intent and requirements of the Health Research Act and the Declaration of Helsinki. It is approved by the regional committee for medical research ethics (2013/1871).
Trial registration number: NCT02079935; Pre-results.
