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The present study sought to determine whether a dietary and multi-element psychological treatment (DMPT) approach in combination with standard medical treatment would offer a more efficacious therapeutic package to irritable bowel syndrome (IBS) patients than would standard medical treatment (SMT) employed alone. The DMPT group (N = 19) received a stress management training package for a 2 week period consisting of relaxation training, imagery, and bowel sound biofeedback training via a stethoscope, in addition to instructions to increase their daily consumption of dietary fiber. They also were to continue the implementation of whatever standard medical treatment they were currently receiving, be it a bulking agent, or anti-anxiety, anti-cholinergic, or anti-depressant medications, etc. The SMT group (N = 19) simply received whatever conventional medical treatment they had been prescribed.

To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. Method: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM–IV] and Fifth Edition [DSM–5]), were retrieved and analyzed using random-effect modeling. Results: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitive-behavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitive-behavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short- and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. Conclusions: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care.

This thesis investigates the possibilities of increasing efficacy and general improvement of unsupervised medical treatments by implementing electronics and embedded systems (so-called smart devices) to allow the physician to monitor or track the treatment and adherence of the patient to it. The diseases in focus are respiratory: asthma and Chronic Obstructive lung [Pulmonary] Disease (COPD). This thesis will furthermore attempt to show that shortcomings in the current treatment of these diseases incur significant human costs by loss of quality of life for the patients and causes (avoidable) costs to health-care systems and societies on a macro-economic scale, both direct and indirect. It will find that the technology to create a smart-inhaler exists, and while not a panacea, it can address many of the identified issues with the current mode of treatment.This thesis was written in partnership with SHL Medical AB, and the author wishes to extend specialthanks to Plamen Balkandjiev and Mattias Myrman for their help, support, and patience. / Detta examensarbete undersöker möjligheterna att öka effektiviteten samt allmänna förbättringar av oövervakad medicinsk behandling genom implementering av elektronik och inbyggda system (så kallade smarta-apparater) för att möjliggöra för läkare att övervaka eller följa behandlingen samt huruvida patienten fullföljer den eller ej. Sjukdomarna i fokus är astma och Kronisk Obstruktiv Lungsjukdom (KOL). Vidare kommer detta arbete försöka visa att tillkortakommanden i den befintliga behandlingen av sjukdomar inte bara medför signifikanta minskningar i livskvalitet för patienten utan även orsakar (icke oundvikliga) kostnader för sjukvårdssystem och samhällen på en makro-ekonomisk skala, indirekt såsom direkt. Den kommer även visa att tekniken som krävs för att skapa en smartinhalator existerar, och medans denna inte är en panacé kan den likväl åtgärda många av de identifierade problemen med den befintliga behandlingsmetoden.Detta exmanensarbete skrevs i samarbete med SHL Medical AB och dess författare önskar utsträckaett särskilt tack till Plamen Balkandjiev och Mattias Myrman för deras hjälp, stöd och tålamod.