Edited Journal Issues by Helle Johannessen
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Papers by Helle Johannessen
Chiropractic & manual therapies, 2015
Musculoskeletal diseases are the most common causes of long-term pain and disability worldwide an... more Musculoskeletal diseases are the most common causes of long-term pain and disability worldwide and a growing international public health concern. However, the everyday burden and impact of musculoskeletal conditions are not well understood, especially among people living in low- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural, organisational and clinical characteristics for the burden of living with and caring for people living with musculoskeletal conditions in rural Botswana. In this paper, we describe the community context, theoretical framework, and research methods to address the project aim with a qualitative study. This focused ethnography is based on eight months (November 2011, April 2013, October 2013-March 2014) of ...
Academic Medicine, 2010
Humanities form an integral part of undergraduate medical curricula at numerous medical schools a... more Humanities form an integral part of undergraduate medical curricula at numerous medical schools all over the world, and medical journals publish a considerable quantity of articles in this field. The aim of this study was to determine the extent to which the literature on humanities in undergraduate medical education seeks to provide evidence of a long-term impact of this integration of humanities in undergraduate medical education. Medline was searched for publications concerning the humanities in undergraduate medical education appearing from January 2000 to December 2008. All articles were manually sorted by the authors. Two hundred forty-five articles were included in the study. Following a qualitative analysis, the references included were categorized as "pleading the case," "course descriptions and evaluations," "seeking evidence of long-term impact," or "holding the horses." Two hundred twenty-four articles out of 245 either praised the (potential) effects of humanities on medical education or described existing or planned courses without offering substantial evidence of any long-term impact of these curricular activities on medical proficiency. Only 9 articles provided evidence of attempts to document long-term impacts using diverse test tools, and 10 articles presented relatively reserved attitudes toward humanities in undergraduate medical education. Evidence on the positive long-term impacts of integrating humanities into undergraduate medical education is sparse. This may pose a threat to the continued development of humanities-related activities in undergraduate medical education in the context of current demands for evidence to demonstrate educational effectiveness.
Objectives: People of rural Botswana rely on walking as their principal mode of transport over lo... more Objectives: People of rural Botswana rely on walking as their principal mode of transport over long distances and rugged geographical terrain. For those who suffer from Muscle, Bone and Joint (MuBoJo) disorders, navigating spaces and places contributes to everyday burdens that are not well represented in the literature. In this qualitative study we observed the use of walking sticks amongst villagers in rural Botswana and examined how they might support MuBoJo health. Methods: Ethnographic fieldwork over eight months included participant observation, document review, and 70 interviews with 48 participants (35 villagers and 13 healthcare providers). Analysis included constant comparative methods followed by a structured approach to identify and assemble walking stick text for interpretation. Results: Observations and discussions revealed that many walking sticks were handcrafted from natural or household objects. From a therapeutic perspective, homemade and commercial aids were impro...
BMC Complementary and Alternative Medicine, 2014
Summary
Objectives: To compare the capacity of the MYCaW questionnaire, a priority list of concer... more Summary
Objectives: To compare the capacity of the MYCaW questionnaire, a priority list of concerns covered by validated questionnaires, and semi-structured interviews to identify patients’ per- sonalized concerns and related changes. Design: In a pragmatic trial on the effectiveness of energy healing as rehabilitation after colo- rectal cancer, a sub-sample of 31 participants completed the MYCaW questionnaire and the priority list and were interviewed before, during and after the treatment period.
Setting: Treatments were provided in healers’ clinics in Denmark. Main outcome measures: For each participant convergences and divergences of the outcome measures are identified, and strengths and weaknesses of the three methods in regard to capturing personalized concerns and changes are discussed. Results: Three patterns were identified: (1) in the intervention groups concerns stated in MYCaW were adjusted after experience with the treatment, while concerns stated in interviews and the priority list remained stable throughout the study; (2) emotional concerns were reported more often in interviews than in MYCaW, physical concerns were predominant in MYCaW, and quality of life was marked as a primary concern most frequently on the priority list; (3) participants reported greater improvement in interviews than in MYCaW.
Forensic Science International: Genetics Supplement Series, 2008
In our experience the police authorities question the success rate of recovering identifiable DNA... more In our experience the police authorities question the success rate of recovering identifiable DNA profiles from zip lock poly bags (''poly bags'') in drug cases. Hence, we conducted a retrospective study including 183 swabs sampled from reclosable zip lock poly bags from drug related casework in Norway. The success rate of recovering DNA results that could be linked to an offender was estimated.
ABSTRACT CAMbrella (2010–2012), a EU-funded project on complementary and alternative medicine foc... more ABSTRACT CAMbrella (2010–2012), a EU-funded project on complementary and alternative medicine focused on, amongst other topics, EU citizens’ needs and attitudes to complementary and alternative medicine (CAM). Three important themes relating to this topic were identified: citizens’ access to CAM in European countries, particularly given the marginalized position of CAM in most European countries; citizens’ access to information regarding CAM, as a critical means of facilitating appropriate and safe CAM use; and quality of care was considered of equal importance in relation to CAM and conventional medicine. These themes were explored in a previously published review of research-based literature of citizens’ needs and attitudes regarding CAM in the EU and associated countries.In this article, we draw on theoretical considerations of public health ethics to examine some of the ethical issues which arise from pertinent findings from this previously published study. Public health ethics is concerned with social justice and equity in health, the need to respect individual autonomy, and the obligation to prevent harm. The explorations presented here draw attention to multiple dilemmas and tensions concerning the public health ethics of CAM. We argue that public health ethics pertains to CAM as it does to other forms of healthcare. Given the complexity of public health ethics, we suggest that this field should be explored further in relation to CAM.
Final Report of CAMbrella Work Package 3 (leader: Helle Johannessen)
Complementary Therapies in Medicine, 2014
Complementary and alternative medicine (CAM); Cancer; Healing; Quality of Life (QoL); Sleep quali... more Complementary and alternative medicine (CAM); Cancer; Healing; Quality of Life (QoL); Sleep quality; Depressive symptoms; Mood Summary Purpose: Our aim was to explore the effectiveness of energy healing, a commonly used complementary and alternative therapy, on well-being in cancer patients while assessing the possible influence on the results of participating in a randomized controlled trial. Methods: 247 patients treated for colorectal cancer (response rate: 31.5%) were either (a) randomized to healing (RH) or control (RC) or (b) had self selected the healing (SH) or control condition (SC), and completed questionnaires assessing well-being (QoL, depressive symptoms, mood, and sleep quality), attitude toward complementary and alternative medicine (CAM), and faith/spirituality at baseline, 1 week, and 2 months post-intervention. They also indicated, at baseline, whether they considered QoL, depressive symptoms, mood, and sleep quality as important outcomes to them.
Forschende Komplementärmedizin / Research in Complementary Medicine, 2014
The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to prov... more The CAMbrella coordination action was funded within the Framework Programme 7. Its aim is to provide a research roadmap for clinical and epidemiological research for complementary and alternative medicine (CAM) that is appropriate for the health needs of European citizens and acceptable to their national research institutes and healthcare providers in both public and private sectors. One major issue in the European research agenda is the demographic change and its impact on health care. Our vision for 2020 is that there is an evidence base that enables European citizens to make informed decisions about CAM, both positive and negative. This roadmap proposes a strategic research agenda for the field of CAM designed to address future European health care challenges. This roadmap is based on the results of CAMbrella’s several work packages, literature reviews and expert discussions including a consensus meeting. We first conducted a systematic literature review on key issues in clinical and epidemiological research in CAM to identify the general concepts, methods and the strengths and weaknesses of current CAM research. These findings were discussed in a workshop (Castellaro, Italy, September 7–9th 2011) with international CAM experts and strategic and methodological recommendations were defined in order to improve the rigor and relevance of CAM research. These recommendations provide the basis for the research roadmap, which was subsequently discussed in a consensus conference (Järna, Sweden, May 9–11th 2012) with all CAMbrella members and the CAMbrella advisory board. The roadmap was revised after this discussion in CAMbrella Work Package (WP) 7 and finally approved by CAMbrella’s scientific steering committee on September 26th 2012. Our main findings show that CAM is very heterogenous in terms of definitions and legal regulations between the European countries. In addition, citizens’ needs and attitudes towards CAM as well as the use and provision of CAM differ significantly between countries. In terms of research methodology, there was consensus that CAM researchers should make use of all the commonly accepted scientific research methods and employ those with utmost diligence combined in a mixed methods framework. We propose 6 core areas of research that should be investigated to achieve a robust knowledge base and to allow stakeholders to make informed decisions. These are: Research into the prevalence of CAM in Europe: Reviews show that we do not know enough about the circumstances in which CAM is used by Europeans. To enable a common European strategic approach, a clear picture of current use is of the utmost importance. Research into differences regarding citizens’ attitudes and needs towards CAM: Citizens are the driver for CAM utilization. Their needs and views on CAM are a key priority, and their interests must be investigated and addressed in future CAM research. Research into safety of CAM: Safety is a key issue for European citizens. CAM is considered safe, but reliable data is scarce although urgently needed in order to assess the risk and cost-benefit ratio of CAM. Research into the comparative effectiveness of CAM: Everybody needs to know in what situation CAM is a reasonable choice. Therefore, we recommend a clear emphasis on concurrent evaluation of the overall effectiveness of CAM as an additional or alternative treatment strategy in real-world settings. Research into effects of context and meaning: The impact of effects of context and meaning on the outcome of CAM treatments must be investigated; it is likely that they are significant. Research into different models of CAM health care integration: There are different models of CAM being integrated into conventional medicine throughout Europe, each with their respective strengths and limitations. These models should be described and concurrently evaluated; innovative models of CAM provision in health care systems should be one focus for CAM research. We also propose a methodological framework for CAM research. We consider that a framework of mixed methodological approaches is likely to yield the most useful information. In this model, all available research strategies including comparative effectiveness research utilising quantitative and qualitative methods should be considered to enable us to secure the greatest density of knowledge possible. Stakeholders, such as citizens, patients and providers, should be involved in every stage of developing the specific and relevant research questions, study design and the assurance of real-world relevance for the research. Furthermore, structural and sufficient financial support for research into CAM is needed to strengthen CAM research capacity if we wish to understand why it remains so popular within the EU. In order to consider employing CAM as part of the solution to the health care, health creation and self-care challenges we face by 2020, it is vital to obtain a robust picture of CAM use and…
Forschende Komplementärmedizin / Research in Complementary Medicine, 2011
The status of complementary and alternative medicine (CAM) within the EU needs clarification. The... more The status of complementary and alternative medicine (CAM) within the EU needs clarification. The definition and terminology of CAM is heterogeneous. The therapies, legal status, regulations and approaches used vary from country to country but there is widespread use by EU citizens. A coordination project funded by the EU has been launched to improve the knowledge about CAM in Europe. The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to establish an EU network involving centres of research excellence for collaborative projects, to develop consensus-based terminology to describe CAM interventions, to create a knowledge base that facilitates the understanding of patient demand for CAM and its prevalence, to review the current legal status and policies governing CAM provision, and to explore the needs and attitudes of EU citizens with respect to CAM. Based on this information a roadmap will be created that will enable sustainable and prioritised future European research in CAM. CAMbrella encompasses 16 academic research groups from 12 European countries and will run for 36 months starting from January 2010. The project will be delivered in 9 work packages coordinated by a Management Board and directed by a Scientific Steering Committee with support of an Advisory Board. The outcomes generated will be disseminated through the project's website, peer review open access publications and a final conference, with emphasis on current and future EU policies, addressing different target audiences.
Forschende Komplementärmedizin / Research in Complementary Medicine, 2011
This article explores the evidence base of efficacy and effectiveness of &amp... more This article explores the evidence base of efficacy and effectiveness of 'energy healing' for cancer patients. The term 'energy healing' refers to a wide variety of therapies which are based on the premise that the healer transfers energy to the patient. Among the most researched forms of energy healing are reiki, therapeutic touch and healing touch. PubMed, AMED, JStor, Social Science Citation Index and PsycInfo databases were searched, and articles were rated according to the SIGN (Scottish Intercollegiate Guidelines Network) quality scale. Six quantitative and two qualitative studies on the efficacy and effectiveness of energy healing for cancer patients met the inclusion criteria. None of the studies are of a size or quality that allows to draw reliable conclusions. The results of the studies are, however, interesting and should be considered when developing new studies and hypotheses on working mechanisms. The existing research does not allow conclusions regarding the efficacy or effectiveness of energy healing. Future studies should adhere to existing standards of research on the efficacy and effectiveness of a treatment, and given the complex character of potential outcomes, cross-disciplinary methodologies may be relevant. To extend the scope of clinical trials, psychosocial processes should be taken into account and explored, rather than dismissed as placebo.
Forschende Komplementärmedizin / Research in Complementary Medicine, 2012
Clinical research · Epidemiological research · Research methodology · Complementary and alternati... more Clinical research · Epidemiological research · Research methodology · Complementary and alternative medicine · Systematic review Summary Background: In the last 2 decades there has been a large increase in publications on complementary and alternative medicine (CAM). However, CAM research methodology was heterogeneous and often of low quality. The aim of this systematic review was to investigate scientific publications with regards to general issues, concepts and strategies. We also looked at research priorities and methods employed to evaluate the clinical and epidemiological research of CAM in the past to identify the basis for consensus-based research strategies. Methods: We performed a systematic literature search for papers published between 1990 and 2010 in 7 electronic databases (Medline, Web of Science, PsychArticles, Psy-cInfo, CINAHL, EMBASE and Cochrane Library) on December 16 and 17, 2010. In addition, experts were asked to nominate relevant papers. Inclusion criteria were publications dealing with research methodology, priorities or complexities in the scientific evaluation of CAM. All references were assessed in a multistage process to identify relevant papers. Results: From the 3,279 references derived from the search and 98 references contributed by CAM experts, 170 papers fulfilled the criteria and were included in the analysis. The following key issues were identified: difficulties in past CAM research (e.g., randomisation, blinding), utility of quantitative and qualitative research methods in CAM, priority setting in CAM research and specific issues regarding various CAM modalities. Conclusions: Most authors vote for the use of commonly accepted research methods to evaluate CAM. There was broad consensus that a mixed methods approach is the most suitable for gathering conclusive knowledge about CAM.
Forschende Komplementärmedizin / Research in Complementary Medicine, 2012
Background: Surveys from several European countries suggest a European-wide increase in the use o... more Background: Surveys from several European countries suggest a European-wide increase in the use of Complementary and Alternative Medicine (CAM). To safeguard citizens' rights concerning their healthcare, it is critical to gain an overview of citizens' attitudes and to understand their expectations and needs regarding CAM. Methods: A review of literature was undertaken, based on systematic searches of the following electronic databases: PubMed, Web of Science, CINHAL, AMED, PsycINFO and PsycArticles; 189 articles met inclusion criteria. Articles were analysed thematically and their reporting quality assessed. Results: Despite the limited availability of research-based knowledge about citizens' attitudes and needs concerning CAM in many European countries, some trends can be noted. Many citizens hold positive attitudes to CAM and wish for increasing access to CAM provision. Citizens call for impartial, reliable and trustworthy information to support informed decision-making, and some citizens wish for greater support and involvement of biomedical healthcare professionals in facilitating their healthcare choices. While citizens value distinct aspects of CAM practice, they are also critical consumers and support clear regulatory and educational frameworks to ensure the quality and safety of CAM provision and medicinal products. Conclusion: To gain knowledge on citizens' needs and attitudes to CAM across Europe further research is required on 3 main issues: i) how citizens across Europe obtain information about CAM and the needs they may have for trustworthy information sources, ii) the local situations for accessing CAM and iii) citizens' perspectives on the quality of care and safety of CAM provision and products. 10 Forsch Komplementmed 2012;19:9-17
European Journal of Integrative Medicine, 2014
Introduction: The problems associated with clinical trial participation have been highlighted in ... more Introduction: The problems associated with clinical trial participation have been highlighted in the literature, but few studies have examined why patients decline to participate. Aims: To describe non-participants' and participants' characteristics and examine reasons for non-participation in a pragmatic trial of energy healing for rehabilitation for colorectal cancer. Methods: Three to seven days after postal recruitment, all eligible participants (n = 783) were contacted by telephone. Reasons given for nonparticipation were recorded in 5 categories. Data were analyzed using Chi 2 . Results: More men than women declined to participate (men = 55.7%; women = 44.3%; p = 0.022). Non-participants were on average older than participants (non-participants: mean age 68.4; SD (9); participants: mean age 64; SD (8.8); p < 0.001), and had only received surgery (nonparticipants = 54.1%; participants = 40.1%; p < 0.001). The most frequent reasons for non-participation were (1) No need for rehabilitation (n = 81; 28.6%), (2) participation too burdensome (n = 67; 23.7%), and (3) no interest in energy healing (n = 57; 20.1%). If the time span between study recruitment and surgery was 0-9 months, participation was frequently considered too burdensome (p = 0.020), especially by women (n = 45; 67.2%; p = 0.001) and those aged ≥68 (n = 54; 80.6%; p = 0.013); rehabilitation was frequently considered not needed 10-17 months after surgery (p = 0.035). Conclusion: Non-participation in a trial of energy healing as rehabilitation for colorectal cancer revealed an interplay between non-participants' demographic characteristics, health experiences, everyday life priorities and the offered rehabilitation intervention. To optimize recruitment to studies of cancer rehabilitation, consideration of disease trajectories and potential participants' rehabilitation needs is suggested.
European Journal of Integrative Medicine, 2013
ABSTRACT CAMbrella (2010–2012), a EU-funded project on complementary and alternative medicine foc... more ABSTRACT CAMbrella (2010–2012), a EU-funded project on complementary and alternative medicine focused on, amongst other topics, EU citizens’ needs and attitudes to complementary and alternative medicine (CAM). Three important themes relating to this topic were identified: citizens’ access to CAM in European countries, particularly given the marginalized position of CAM in most European countries; citizens’ access to information regarding CAM, as a critical means of facilitating appropriate and safe CAM use; and quality of care was considered of equal importance in relation to CAM and conventional medicine. These themes were explored in a previously published review of research-based literature of citizens’ needs and attitudes regarding CAM in the EU and associated countries.In this article, we draw on theoretical considerations of public health ethics to examine some of the ethical issues which arise from pertinent findings from this previously published study. Public health ethics is concerned with social justice and equity in health, the need to respect individual autonomy, and the obligation to prevent harm. The explorations presented here draw attention to multiple dilemmas and tensions concerning the public health ethics of CAM. We argue that public health ethics pertains to CAM as it does to other forms of healthcare. Given the complexity of public health ethics, we suggest that this field should be explored further in relation to CAM.
BMC Complementary and Alternative Medicine, 2014
The use of complementary and alternative Medicine (CAM) has increased over the past two decades i... more The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphibased process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens' needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public's health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges.
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Edited Journal Issues by Helle Johannessen
Papers by Helle Johannessen
Objectives: To compare the capacity of the MYCaW questionnaire, a priority list of concerns covered by validated questionnaires, and semi-structured interviews to identify patients’ per- sonalized concerns and related changes. Design: In a pragmatic trial on the effectiveness of energy healing as rehabilitation after colo- rectal cancer, a sub-sample of 31 participants completed the MYCaW questionnaire and the priority list and were interviewed before, during and after the treatment period.
Setting: Treatments were provided in healers’ clinics in Denmark. Main outcome measures: For each participant convergences and divergences of the outcome measures are identified, and strengths and weaknesses of the three methods in regard to capturing personalized concerns and changes are discussed. Results: Three patterns were identified: (1) in the intervention groups concerns stated in MYCaW were adjusted after experience with the treatment, while concerns stated in interviews and the priority list remained stable throughout the study; (2) emotional concerns were reported more often in interviews than in MYCaW, physical concerns were predominant in MYCaW, and quality of life was marked as a primary concern most frequently on the priority list; (3) participants reported greater improvement in interviews than in MYCaW.
Objectives: To compare the capacity of the MYCaW questionnaire, a priority list of concerns covered by validated questionnaires, and semi-structured interviews to identify patients’ per- sonalized concerns and related changes. Design: In a pragmatic trial on the effectiveness of energy healing as rehabilitation after colo- rectal cancer, a sub-sample of 31 participants completed the MYCaW questionnaire and the priority list and were interviewed before, during and after the treatment period.
Setting: Treatments were provided in healers’ clinics in Denmark. Main outcome measures: For each participant convergences and divergences of the outcome measures are identified, and strengths and weaknesses of the three methods in regard to capturing personalized concerns and changes are discussed. Results: Three patterns were identified: (1) in the intervention groups concerns stated in MYCaW were adjusted after experience with the treatment, while concerns stated in interviews and the priority list remained stable throughout the study; (2) emotional concerns were reported more often in interviews than in MYCaW, physical concerns were predominant in MYCaW, and quality of life was marked as a primary concern most frequently on the priority list; (3) participants reported greater improvement in interviews than in MYCaW.