Pain and function in patients with chronic low back pain and leg pain after Zhineng Qigong : a quasi-experimental feasibility study

BACKGROUND: Qigong includes training for body and mind, one method is Zhineng Qigong. Scientific literature on qigong for chronic low back pain (LBP) is sparse. This study aimed to investigate feasibility including evaluation of a Zhineng Qigong intervention for pain and other lumbar spine-related symptoms, disability, and health-related quality of life in patients with chronic LBP and/or leg pain.METHODS: Prospective interventional feasibility study without control group. Fifty-two chronic pain patients (18-75 years) with LBP and/or leg pain (Visual Analogue Scale ≥ 30) were recruited from orthopaedic clinics (spinal stenosis, spondylolisthesis, or segmental pain) and primary healthcare (chronic LBP). Patients from orthopaedic clinics were 1-6 years postoperative after lumbar spine surgery or on lumbar surgery waiting list. Patients received a 12-week training intervention with European Zhineng Qigong. The intervention consisted of face-to-face group activities in non-healthcare setting (4 weekends and 2 evenings per week), and individual Zhineng Qigong training. Main health outcomes were self-reported in a 14-day pain diary, Oswestry Disability Index (ODI), Short Form 36 version 2 (SF-36v2), and EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), once directly before and once directly after the intervention.RESULTS: Recruitment rate was 11% and retention rate was 58%. Dropouts did not report higher pain (baseline), only 3 dropped out because of lumbar spine-related pain. Adherence was median 78 h group attendance (maximum 94 h) and 14 min daily individual training. Ability to collect outcomes was 100%. Thirty patients completed (mean 15 years symptom duration). Twenty-five had degenerative lumbar disorder, and 17 history of lumbar surgery. Results showed statistically significant (within-group) improvements in pain, ODI, all SF-36v2 scales, and EQ-5D-5L.CONCLUSIONS: Despite low recruitment rate, recruitment was sufficient. A multicentre randomized controlled trial is proposed, with efforts to increase recruitment and retention rate. After this Zhineng Qigong intervention patients with chronic LBP and/or leg pain, also patients with considerable remaining LBP/sciatica after lumbar surgery, had significantly improved in pain and function. Results support involvement of postoperative patients in a future study. The results are promising, and this intervention needs to be further evaluated to provide the most reliable evidence.TRIAL REGISTRATION: NCT04520334. Retrospectively registered 20/08/2020

The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation

Background and purpose The WOSI score questionnaire is a tool designed for self-assessment of shoulder function for patients with instability problems. We made a translation into Swedish and retested the score by analyzing the psychometric properties validity, reliability, and responsiveness

Bullying and social objectives : A study of prerequisites for success in Swedish schools

This thesis examines the relationship between organizations structure, culture and leadership. The specific organization that has been studied is Swedish secondary schools. The Swedish schools have a divided task, first to develop the students academic skills and secondly to develop the students socially and civically. This thesis has its interest on the schools social environment with special interest focused on questions regarding bullying and insulting behaviour. The data that has been used consists of interviews and questionnaires with students, teachers and principals in 24 Swedish schools that have been studied in a larger study. This work is a part of a project called Structure, Culture and Leadership – prerequisites for successful schools?.  The 24 schools that took part in the SCL study were divided in to four different groups depending on how well they are succeeding in reaching the social and academic objectives formulated in the steering documents. The main result show that principals that succeed to align structure and culture in relation to both the social and academic objectives are the ones that can be perceived as successful. It is these schools that have the lowest level of bullying and the highest grades. The principal takes social responsibility and takes questions in relation to bullying and insulting behaviour seriously. By doing that the principal can communicate the seriousness of the topic in order to develop awareness within the organization and a preventive work can therefore be possible. In schools that work with the students’ ability to be participative seems to develop the students both socially and academically.Structure, Culture and Leadership - Prerequisites for Successful Schools

Utilitarism i en modalrealistisk kontext

David Lewis heter upphovsmannen till den kontroversiella teorin som kallas modal realism. Den modala realismens syfte är att förklara vad det innebär för en möjlig sats att vara just möjlig. Teorin säger att det måste finnas en värld vari sådana satser får sin satisfiering. Därför är alla möjligheter aktualiserade någonstans och allt som kan hända händer i någon av alla möjliga världar. Lewis menade dessutom att hans teori inte tolererar moralteorier såsom en universalistisk utilitarism, eftersom summan av gott och ont i totaliteten av alla världar med nödvändighet måste vara fixerad enligt den modala realismen. Han menade också att vi därför måste ge upp sådana moralteorier men att detta inte var något problem eftersom sådana teorier ändå bara är filosofiska uppfinningar som är lika skilda från common sense som hans modala realism. Denna uppsats tar upp problematiken med den modala realismens påstådda kollision med utilitaristiska utsagor. Meningen är att denna uppsats ska visa varför det är rimligt att hålla fast vid en universalistisk utilitarism trots att den modala realismen tycks göra den meningslös. Detta genom att peka på möjligheten att öka det goda lokalt, utan att bryta mot det universalistiska kravet, om än inte i totaliteten av alla möjliga världar

Rolling the dice in a game of trust : Organizational effects on trust, efficacy and motivation when using economic incentives as a driving force for development in Swedish schools

For a long time, the Swedish government has tried different reforms to counteract declining student results. One action was to implement a salary-lift for teachers perceived as especially skilled. However, changes within socially complex systems tend to create tensions and resistance among the staff. In this reform, a majority of teachers were excluded from the payroll raise, which led to a renegotiation of roles, rules and commitments within the faculty. In this study, the principals’ perception of the teachers’ initial reactions and responses to the implementation is the focus. The data for this study contain four narratives from principals who implemented the salary lift within their organizations. The analysis shows that the reform challenged the principals as heads of the organizations. They stated that the salary lift created conflicts and insecurities among the teachers related to their motivation, sense of trust and self-efficacy. These conflicts and insecurities seemed to fuel a spiral of mistrust within the schools in the wake of the reform

Leadership in low- and underperforming schools : two contrasting Scandinavian cases

In this paper, we investigate how professional cultures and situated, material and external contexts relate to dynamic low- and underperforming schools in Scandinavia, particularly how the leadership is constructed through the leader, the followers and the situation. The first school studied was a low-performing school in Norway called ‘Toppen’, which has shown improved student outcomes. The other school, Seaside, is a Swedish school that is considered underperforming because student outcomes are lower than expected based on the contextual prerequisites. Our results show that Toppen can be described as a turnaround school and Seaside can be described as a cruising school. Analysis reveals that, at Toppen, the principal has been developing a culture that can be described in terms of community and motivation. At Seaside, on the other hand, the culture can be described in terms of individuality and conservatism. From this analysis, we can detect how different contexts impact two low- and underperforming schools and how they are affected by different prerequisites linked to the situated, material, external and professional contexts. However, the development of a collective professional culture with a shared sense of commitment seems to be an important tool to plan and communicate organizational improvement strategies

The silent voices : Pupil participation for gender equality and diversity

Background: The international body of research on student voice concludes that active pupil participation has multiple positive effects on the work environment and learning for pupils. In a large study on gender equality and diversity work in Swedish schools, it became evident that pupils wanted to be active participants. However, pupils considered that their wishes were, to a large extent, ignored. Therefore, it is important to try to understand this further by investigating pupils’ perceptions of their experiences. Purpose: The purpose of the study was to explore how discourses of participation and power are practised, not practised, and materialised, by focusing in-depth on pupils’ representations of gender equality and diversity work within a small sample of Swedish schools. Methodology: The study is based on data from 10 focus group interviews with 43 pupils from 4 different schools, 2 compulsory schools (pupil ages 6–15) and 2 upper secondary schools (pupil ages 16–18), in Sweden. The thematic analysis utilised a gender perspective anchored in a critical policy analysis approach. Analysis and Findings: The analysis of focus group data identified three pupil representations of gender equality and diversity work: a onetime occurrence, longing for participation and the (un)fair teacher. These representations were derived from and intertwined with discourses on pupil participation and power. Three sub-discourses were found within the discourse on participation and power: normative barriers to participation, structural barriers to participation and openings in the barriers to participation. The first two sub-discourses support the maintenance of unequal power relations between adults and pupils, while the third challenges these power relations. Conclusions: Our study suggests that no substantial levels of participation or power among the pupils were represented at the schools. Instead, the analysis visualises pupils as expressing powerlessness and disengagement. However, the discourse Openings in the barriers to participation, together with pupils’ democratic abilities, has the potential to enable change and the development of pupil participation in schools

Skelett i trädgården – en grav från bronsåldern i Kiaby. : Skåne, Kristianstad kommun, Kiaby socken, fastighet Kiaby 21:8, fornlämning L2020:8015. Arkeologisk efterundersökning 2020.

Arkeologerna, Statens historiska museer i Lund har den 7–8 september 2020, på uppdrag av Länsstyrelsen Skåne, utfört en arkeologisk efterundersökning av en skelettgrav inom fastigheten Kiaby 21:8 och inom fornlämning L1990:564/Kiaby 81:1, Kiaby socken, nordöstra Skåne.Efterundersökningen föranleddes av att det i samband med trädgårdsarbete 2017 påträffats skelettdelar av människa i en planteringsgrop i en rabatt invid boningshusets östra gavel. Vid efterundersökningen dokumenterades en skelettgrav i utsträckt ryggläge, orienterad i nordväst–sydöstlig riktning med huvudet åt sydöst. Graven framkom i en tydlig färgning, gravgrop, direkt under matjorden, på ett djup av cirka 0,30–0,35 meter. Själva gravgropen var cirka 0,15 meter djup. Skallen och delar av nacken och överarmsben hade både skadats sedan tidigare och i samband med trädgårdsarbetet 2017. Dessutom visade undersökningen att båda underbenen hade kapats vid anläggandet av husgrunden. Vänster ben, som låg närmast huset, hade grävts av strax under knäet medan höger ben var bevarat ner mot vristen. Inga spår efter fot- och tåben påträffades. Inte heller några gravgåvor.En osteologisk bedömning gör gällande att den gravlagda var en ung man, cirka 162 cm lång och mellan 16 och 18 år vid sin död. Skelettet genomgick redan i samband med påträffandet 2017 en 14C-datering som visade att graven är från bronsåldern och kan dateras till 1220–990 f.Kr. (2 sigma), det vill säga övergången mellan äldre och yngre bronsålder (cirka 1100 f.Kr.).Utöver skelettgraven dokumenterades 13 anläggningar fördelade på 12 stolphål och 1 grop. Inga fynd framkom i anläggningarna. En preliminär tolkning är att anläggningarna tillhör gravkontexten, kanske som delar av en inre konstruktion i en nu utplånad hög

Cognitive workload and visual behavior in elderly drivers with hearing loss

Purpose To examine eye tracking data and compare visual behavior in individuals with normal hearing (NH) and with moderate hearing loss (HL) during two types of driving conditions: normal driving and driving while performing a secondary task. Methods 24 participants with HL and 24 with NH were exposed to normal driving and to driving with a secondary task (observation and recall of 4 visually displayed letters). Eye movement behavior was assessed during normal driving by the following performance indicators: number of glances away from the road; mean duration of glances away from the road; maximum duration of glances away from the road; and percentage of time looking at the road. During driving with the secondary task, eye movement data were assessed in terms of number of glances to the secondary task display, mean duration of glances to the secondary task display, and maximum duration of glances to the secondary task display. The secondary task performance was assessed as well, counting the number of correct letters, the number of skipped letters, and the number of correct letters ignoring order. Results While driving with the secondary task, drivers with HL looked twice as often in the rear-view mirror than during normal driving and twice as often as drivers with NH regardless of condition. During secondary task, the HL group looked away from the road more frequently but for shorter durations than the NH group. Drivers with HL had fewer correct letters and more skipped letters than drivers with NH. Conclusions Differences in visual behavior between drivers with NH and with HL are bound to the driving condition. Driving with a secondary task, drivers with HL spend as much time looking away from the road as drivers with NH, however with more frequent and shorter glances away. Secondary task performance is lower for the HL group, suggesting this group is less willing to perform this task. The results also indicate that drivers with HL use fewer but more focused glances away than drivers with NH, they also perform a visual scan of the surrounding traffic environment before looking away towards the secondary task display