Nonlinear brain correlates of trait self-boundarylessness

Alterations of the sense of self induced by meditation include an increased sense of boundarylessness. In this study, we investigatedbehavioural and functional magnetic resonance imaging correlates of trait self-boundarylessness during resting state and the performanceof two experimental tasks. We found that boundarylessness correlated with greater self-endorsement of words related to fluidityand with longer response times in a math task. Boundarylessness also correlated negatively with brain activity in the posterior cingulatecortex/precuneus during mind-wandering compared to a task targeting a minimal sense of self. Interestingly, boundarylessnessshowed quadratic relations to several measures. Participants reporting low or high boundarylessness, as compared to those in between,showed higher functional connectivity within the default mode network during rest, less brain activity in the medial prefrontal cortexduring self-referential word processing, and less self-endorsement of words related to constancy. We relate these results to our previousfindings of a quadratic relation between boundarylessness and the sense of perspectival ownership of experience. Additionally,an instruction to direct attention to the centre of experience elicited brain activation similar to that of meditation onset, includingincreases in anterior precentral gyrus and anterior insula and decreases in default mode network areas, for both non-meditators andexperienced meditators

Manual and Electroacupuncture for Labour Pain: Study Design of a Longitudinal Randomized Controlled Trial

Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women's experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov: NCT01197950

Patients´ Experiences of Pain Following Day Surgery - At 48 Hours, Seven Days and Three Months

Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased

A neurophenomenological fMRI study of a spontaneous automatic writer and a hypnotic cohort

Purpose: To evaluate the neurophenomenology of automatic writing (AW) in a spontaneous automatic writer (NN) and four high hypnotizables (HH). Methods: During fMRI, NN and the HH were cued to perform sponta- neous (NN) or induced (HH) AW, and a comparison task of copying complex symbols, and to rate their expe- rience of control and agency. Results: Compared to copying, for all participants AW was associated with less sense of control and agency and decreased BOLD signal responses in brain regions implicated in the sense of agency (left premotor cortex and insula, right premotor cortex, and supplemental motor area), and increased BOLD signal responses in the left and right temporoparietal junctions and the occipital lobes. During AW, the HH differed from NN in widespread BOLD decreases across the brain and increases in frontal and parietal regions. Conclusions: Spontaneous and induced AW had similar effects on agency, but only partly overlapping effects on cortical activity

Knowledge and use of sterile water injections amongst midwives in the United Kingdom: A cross-sectional study

BackgroundThe use of sterile water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure is used less commonly in the United Kingdom (UK) and that a number of barriers to introducing the practice may exist.ObjectiveThe objective of this study was to explore the awareness and use of SWI amongst midwives in the UK.DesignA cross-sectional study using an internet-based questionnaire.ParticipantsMidwives with Nursing and Midwifery Council Registration and currently practicing.SettingThe questionnaire was distributed via the Royal College of Midwives Facebook page and Twitter account. Invitations to participate were also sent to Heads of Midwifery to distribute to staff.FindingsThree hundred and ninety-eight midwives completed the survey. Eighty-two percent of midwives did not use SWI in practice although 69% would consider learning the procedure. There was considerable variation in techniques amongst midwives that did provide SWI. The lack of available practice guidelines and the advice from the National Institute for Health and Care Excellence to not use SWI were cited as the main barriers.Key conclusionsSWI use is uncommon in the UK although midwives are interested in incorporating the procedure into practice.Implications for practiceNational guidance on SWI and the lack of information and training is restricting the use of the procedure in practice, despite SWI being widely used in other countries and being effective in the treatment of pain in labour

Making Europe health literate : Including older adults in sparsely populated Arctic areas

Funding Information: This work was supported by the University of Akureyri, Iceland, under Grant R1803 and R2018, The Icelandic Regional Development Institute, under Grant 102022 and the Icelandic Council on Ageing, under Grant R2019. Publisher Copyright: © 2022, The Author(s).Background Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland. Method This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M 74.2 ± SD 6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL). Results The level of HL ranged from 6–16 (M 13.25, SD ± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression (p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL. Conclusion Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.Background: Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland. Method: This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M 74.2 ± SD 6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL). Results: The level of HL ranged from 6–16 (M 13.25, SD ± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression (p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL. Conclusion: Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.Peer reviewe

Regeneration of long-distance peripheral nerve defects after delayed reconstruction in healthy and diabetic rats is supported by immunomodulatory chitosan nerve guides

Background: Delayed reconstruction of transection or laceration injuries of peripheral nerves is inflicted by a reduced regeneration capacity. Diabetic conditions, more frequently encountered in clinical practice, are known to further impair regeneration in peripheral nerves. Chitosan nerve guides (CNGs) have recently been introduced as a new generation of medical devices for immediate peripheral nerve reconstruction. Here, CNGs were used for 45 days delayed reconstruction of critical length 15 mm rat sciatic nerve defects in either healthy Wistar rats or diabetic Goto-Kakizaki rats; the latter resembling type 2 diabetes. In short and long-term investigations, we comprehensively analyzed the performance of one-chambered hollow CNGs (hCNGs) and two-chambered CNGs (CFeCNGs) in which a chitosan film has been longitudinally introduced. Additionally, we investigated in vitro the immunomodulatory effect provided by the chitosan film. Results: Both types of nerve guides, i.e. hCNGs and CFeCNGs, enabled moderate morphological and functional nerve regeneration after reconstruction that was delayed for 45 days. These positive findings were detectable in generally healthy as well as in diabetic Goto-Kakizaki rats (for the latter only in short-term studies). The regenerative outcome did not reach the degree as recently demonstrated after immediate reconstruction using hCNGs and CFeCNGs. CFeCNG-treatment, however, enabled tissue regrowth in all animals (hCNGs: only in 80% of animals). CFeCNGs did further support with an increased vascularization of the regenerated tissue and an enhanced regrowth of motor axons. One mechanism by which the CFeCNGs potentially support successful regeneration is an immunomodulatory effect induced by the chitosan film itself. Our in vitro results suggest that the pro-regenerative effect of chitosan is related to the differentiation of chitosan-adherent monocytes into pro-healing M2 macrophages. Conclusions: No considerable differences appear for the delayed nerve regeneration process related to healthy and diabetic conditions. Currently available chitosan nerve grafts do not support delayed nerve regeneration to the same extent as they do after immediate nerve reconstruction. The immunomodulatory characteristics of the biomaterial may, however, be crucial for their regeneration supportive effects

Translation and cross-cultural adaptation of the European Health Literacy Survey Questionnaire, HLS-EU-Q16: The Icelandic version

BACKGROUND: Health literacy (HL) is defined as the knowledge and competences of people to meet the complex demands of health in modern society. It is an important factor in ensuring positive health outcomes, yet Iceland is one of many countries with limited knowledge of HL and no valid HL measurement. The aim of this study was to translate the European Health Literacy Survey Questionnaire- short version (HLS-EU-Q16) into Icelandic, adapt the version, explore its psychometric properties and establish preliminary norms. METHODS: The HLS-EU-Q16 translation model included three steps: 1) translation-back-translation of HLS-EU-Q16 including specialists' review (n = 6); 2) cognitive interviewing of lay people (n = 17); and 3) psychometric analysis with survey participants. The HLS-EU-Q16 includes 16 items, with scores ranges from zero (low/no HL) to 16 (high HL). Statistics included were descriptive, internal consistency measured by Cronbach's α, exploratory factor analysis, and multivariate linear regression. RESULTS: After the translation and cognitive interviewing, 11 of the HLS-EU-Q16 items were reworded to adapt the instrument to Icelandic culture while maintaining their conceptual objectives. Survey participants were 251. Internal consistency of the translated and adapted instrument was α = .88. Four factors with eigenvalues > 1.0 explained 62.6% of variance. Principal component analysis with Oblimin rotation presented four latent constructs, "Processing and Using Information from the Doctor" (4 items, α = .77), "Processing and Using Information from the Family and Media" (4 items, α = .85), "Processing Information in Connection to Healthy Lifestyle" (5 items, α = .76), and "Finding Information about Health Problems/Illnesses" (3 items, α = .73). Lower self-rated health was an independent predictor of lower HL (β = -.484, p = .008). Preliminary norms for HL ranged from five to 16 (M 13.7, SD ± 2.6) with 72.5% with sufficient HL (score 13-16), 22% with problematic HL (score 9-12) and 5.5% with inadequate HL (score 0-8). CONCLUSIONS: The Icelandic version of HLS-EU-Q16 is psychometrically sound, with reasonably clear factor structure, and comparable to the original model. This opens possibilities to study HL in Iceland and compare the results internationally. The translation model introduced might be helpful for other countries where information on HL is missing based on lack of validated tools.Háskólinn á Akureyri (IS) research fundPeer Reviewe

Quality culture at Nordic Universities

This study aimed to investigate common features and ways of understanding quality culture (QC) within higher education institutions (HEIs) in Nordic countries. While the concept of QC is commonly accepted and often used, its meaning is not always clear. This paper focuses on how Nordic universities frame QC in their internal documentation. The Nordic context was chosen due to the close cooperation on quality issues that characterise HEIs within the Nordic region. The discussion section of this paper outlines QC in relation to quality assurance (QA) among HEIs within the European and Nordic regions. Sixteen universities participated in the study by sharing documents describing their QCs. The data were analysed using qualitative content analysis and discussed from different perspectives, such as regarding how the universities use the concept of QC and how QC is created. Based on the results, a model was created that provides an overview of how QC emerges and how the concept is implemented in documentation. It is hoped that the results will both contribute useful input to the ongoing collaboration on quality issues among HEIs in the Nordic region and will also be useful in enhancing QC at universities in other regions.</p