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  • 1.
    Högberg, Cecilia
    et al.
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Karling, Pontus
    Department of Public Health and Clinical Medicine, Medicine/Gastroenterology, Umeå University, Sweden .
    Rutegård, Jörgen
    Department of Surgical and Perioperative Sciences, Umeå University, Sweden .
    Lilja, Mikael
    Department of Public Health and Clinical Medicine, Unit of Clinical Research Centre - Östersund, Umeå University, Sweden.
    Ljung, Thomas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Immunochemical faecal occult blood tests in primary care and the risk of delay in the diagnosis of colorectal cancer2013In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 31, no 4, p. 209-214Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the value, risks, and shortcomings of immunochemical faecal occult blood tests (iFOBTs) in the diagnosis of colorectal cancer (CRC) and adenomas with high-grade dysplasia (HGD) in patients initially presenting to primary care. Design. A retrospective population-based study. Setting and subjects. All 495 cases of CRC and adenomas with HGD diagnosed in the county of Jamtland, Sweden from 2005 to 2009. Results. Of 495 patients 323 (65%) initially presented to primary care. IFOBTs were performed in 215 of 323 (67%) patients. The sensitivity of iFOBT for CRC and adenomas with HGD was 88% (83% when patients with a history of rectal bleeding were excluded). Of 34 patients with anaemia found en passant, 10 had negative iFOBTs. Time to diagnosis was longer for patients with negative iFOBTs (p < 0.0005). Conclusion. IFOBT might be helpful in selecting which patients to refer for colonoscopy. However, iFOBT has a limited sensitivity as a diagnostic test for CRC and adenomas with HGD. Relying only on iFOBT for colonoscopy referral could delay diagnosis, especially for patients with anaemia found en passant.

  • 2.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ljadas, Karin
    Englund, Erling
    Appelberg, Jonas
    Is tactile massage (touch massage) a treatment option for primary insomnia?2010Conference paper (Refereed)
    Abstract [en]

    The primary objective of the present trial was to study if tactile massage (TM) was equivalent to nurse led sleep counseling (SC) in the treatment of primary insomnia. In the randomized controlled design in total 30 women (aged 18-65 years) was allocated to one of three groups; TM, SC or a control group. Treatment with TM was administered twice a week for six weeks, SC once a week for six weeks. Subjective sleep quality (Karolinska sleep diary) during was assessed during baseline (week 0) until week 6.and at subsequent follow up at week 7, and 13. Objective sleep quality (Polysomnography) and parameters of subjective health (SF-36, Shirom-Melamed Burnout Questionnaire) and several physiological markers of stress (Cortisol, HbA1c, Blood Pressure) was assessed at baseline and subsequent follow up. Data analysis shall be analyzed with R-ANOVA methodology. Data collection will be completed by April 2010 and preliminary findings will be presented at ICCMR 2010. Primary insomnia a d other sleep disorders are a major public health problem worldwide. Sleep has an important role in the balance act between health and disease. Insufficient sleep and restitution is acknowledged as a factor contributing cardiovascular disease and lethal injury. Tactile stimulation stimulates the release of hormones, for example oxytocin which is important for the circadian homeostasis, and also related to the parasympathetic nervous system. Treatment of sleep disorders with Cognitive Behavioural Therapy (CBT), is so far the only long-term evidence based treatment for primary insomnia. Within regular health care there is no sustainable treatment for people with primary insomnia, hypnotic drugs only has short term effects and several side effects. CBT shows promising results but the availability of therapists are scarce. Nurse led SC or/and TM may have a role in the treatment of people with sleep disorders through its low-tech/low-cost design and an absence of side effects

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