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  • 1.
    Adair, Brooke
    et al.
    Australian Catholic Univ, Ctr Disabil & Dev Res, Fitzroy, Vic, Australia..
    Ullenhag, Anna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Rosenbaum, Peter
    McMaster Univ, Hamilton, ON, Canada..
    Granlund, Mats
    Jonkoping Univ, CHILD, SIDR, Sch Hlth Sci, Jonkoping, Sweden..
    Keen, Deb
    Griffith Univ, Autism Ctr Excellence, Mt Gravatt, Qld, Australia..
    Imms, Christine
    Australian Catholic Univ, Ctr Disabil & Dev Res, Fitzroy, Vic, Australia..
    Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review2018Ingår i: Developmental Medicine & Child Neurology, ISSN 0012-1622, E-ISSN 1469-8749, Vol. 60, nr 11, s. 1101-1116Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    AimWe aimed to identify measures used to assess the participation of disabled children and to map the measures' content to the family of participation-related constructs (fPRC) to inform future research and practice. MethodSix databases were searched to identify measures used to assess participation in health, psychology, and education research. Included studies involved children aged 0 to 18 years with a permanent impairment or developmental disability and reported use of a quantitative measure of participation. A second search sought relevant literature about each identified measure (including published manuals) to allow a comprehensive understanding of the measure. Measurement constructs of frequently reported measures were then mapped to the fPRC. ResultsFrom an initial yield of 32 767 articles, 578 reported one or more of 118 participation measures. Of these, 51 measures were reported in more than one article (our criterion) and were therefore eligible for mapping to the fPRC. Twenty-one measures quantified aspects of participation attendance, 10 quantified aspects of involvement as discrete scales, and four quantified attendance and involvement in a manner that could not be separated. InterpretationImproved understanding of participation and its related constructs is developing rapidly; thoughtful selection of measures in research is critical to further our knowledge base.

  • 2.
    Björck, A.
    et al.
    Örebro University, Sweden.
    Matérne, M.
    Örebro University, Sweden.
    Arvidsson Lindvall, Mialinn
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Jarl, G.
    Örebro University, Sweden.
    Investigating cognitive impairment, biopsychosocial barriers, and predictors of return to daily life among older stroke survivors2024Ingår i: Frontiers in Neurology, E-ISSN 1664-2295, Vol. 15, artikel-id 1403567Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. Materials and methods: This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65–91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman’s correlation coefficient and multiple logistic regression in the analyses. Results: The average MoCA score was 21.7 points (range: 4–30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20–0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2–6.8). Conclusion: The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.

  • 3.
    Juhlin, Linnea
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Svanström, Emma
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    ATT VARA EN DEL I DEN VÅRDANDE REHABILITERINGEN EFTER STROKE: En systematisk litteraturstudie om sjuksköterskors upplevelser2021Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Background: Stroke is a collective name for a disease caused by circulatory disorders in the brain. The patients who are affected often have complications that are experienced as a major life change. The complications mean that rehabilitative care is necessary, which is based on a good caring relationship. Aim: To describe nurses' experiences of caring for patients in rehabilitation after a stroke. Method: Systematic literature study for analysis of ten qualitative studies. Results: Nurses experienced that the rehabilitative care in the stroke wards meant helping the patients find their ‘self’, by seeing the importance of the caring relationship, relatives and the patients' participation. The nurses also experienced that the rehabilitative care involved working in a team, where the nurses experienced the importance of their extensive role and the teamwork. Conclusion: The rehabilitative care after a stroke meant that the nurses help patients find their 'self'. They perceived it as important for patients to be able to achieve good health after their illness. The nurses also felt that their professional role in the team was extensive because they had a rehabilitative responsibility in addition to the general nurse duties. It was something that the nurses felt required a teamwork in the rehabilitation team.

    Keyword: Caring, nurse-perspective, rehabilitative care, stroke-care, systematic literature review.

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  • 4.
    Lagrosen, Yvonne
    et al.
    Högskolan Väst, Avd för process- och produktutveckling.
    Travis, Frederick T.
    Maharishi University of Management, Center for Brain, Consciousness and Cognition, Fairfield, IN, United States.
    Exploring the connection between quality management and brain functioning2015Ingår i: The TQM Journal, ISSN 1754-2731, E-ISSN 1754-274X, Vol. 27, nr 5, s. 565-575Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this paper is to explore possible connections between brain functioning and quality management. Design/methodology/approach: Five central principles regarding brain functioning according to neuroscience are conceptually described and related to principles and major concepts in quality management with a special emphasis on Deming’s system of profound knowledge. Findings: The principles are shown to be related in a profound way. The first principle of coherence is closely related to appreciation for a system. The principle of homeostatic feedback loops concerns events that disturb the equilibrium of a system and is related to knowledge about variation. Neural plasticity is related to a theory of knowledge. The last two principles involve emotional and cognitive contributions to decision-making. They are closely related to the element psychology and one of them could lead to a further development of Deming’s system of profound knowledge. Research limitations/implications: The paper adds to the understanding of the role brain integration has for success in quality management efforts. A limitation is that it is difficult to localise higher-order thinking in brain function. Nonetheless, the research is indicative and provocative as a window to stimulate research into the fundamental basis of quality management success. Practical implications: The findings provide a deeper understanding of profound knowledge in quality management through relating it to how the brain is functioning, which is of value for quality managers and leaders striving for excellence for their organisations. Originality/value: The connection of brain principles with Deming’s profound knowledge has not been elaborated in the literature before. © Emerald Group Publishing Limited.

  • 5.
    Martin, Sylvia
    et al.
    Uppsala University, Center for research and bioethics, Uppsala, Sweden.
    Kihlbom, Ulrik
    Uppsala University, Center for research and bioethics, Uppsala, Sweden.
    Pasquini, Guido
    IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
    Gerli, Filippo
    IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
    Niccolai, Claudia
    IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
    Bella, Sara Della
    IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
    Portaccio, Emilio
    AOUC Careggi, Florence, Italy.
    Betti, Matteo
    AOUC Careggi, Florence, Italy.
    Amato, Maria Pia
    IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
    Achiron, Anat
    Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Tel-Aviv, Israel.
    Kalron, Alon
    Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Tel-Aviv, Israel.
    Aloni, Roy
    Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Tel-Aviv, Israel.
    Schölin Bywall, Karin
    Mälardalens universitet, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala University, Center for research and bioethics, Uppsala, Sweden.
    Preferences and Attitudes Regarding Early Intervention in Multiple Sclerosis: a systematic literature review2024Ingår i: Multiple Sclerosis and Related Disorders, ISSN 2211-0348, E-ISSN 2211-0356, artikel-id 106143Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: Multiple sclerosis (MS) is a chronic inflammatory disorder affecting the brain and spinal cord, characterized by immune-mediated myelin damage. Early intervention and detection programs have emerged as promising strategies to improve patient outcomes by identifying and treating MS in its earliest stages.

    Objective: This systematic literature review aims to provide an overview of the preferences, attitudes, and opinions of both patients and healthcare professionals regarding early intervention or early detection programs for MS.

    Methods: A comprehensive search strategy was employed in March 2023 across multiple databases (MEDLINE, Scopus, PsyInfo, PubMed), from 1990 to 2023. A total of 38 articles were selected for analysis based on predefined inclusion and exclusion criteria.

    Results: The majority of articles were published in recent years and represented different methods from case reports to randomized controlled trials, with fewer systematic literature reviews. Data collection approaches included patients, healthcare workers, or mixed samples with varying age ranges and gender ratios, frequently preferring women. These samples represented different preference study methods. The included studies were primarily conducted in the USA and the UK. Thematic analysis revealed several key themes : 1) differences emerged between healthcare professionals' and patients' perspectives 2) interventions for MS outside Disease-Modifying Therapies (DMTs) 3) severe side effects 4) communication, information, and knowledge 5) psychological and emotional aspects.

    Conclusions: Understanding these diverse factors and subgroups within the MS population can inform more effective, personalized approaches to MS prevention and treatment.

  • 6.
    Peultier, Anne-Claire
    et al.
    Erasmus Univ, Erasmus Sch Hlth Policy & Management, Bayle Bldg,Burgemeester Oudlaan 50, NL-3062 PA Rotterdam, Netherlands.
    Pandya, Ankur
    Harvard TH Chan Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USA.
    Sharma, Richa
    Yale Sch Med, Dept Neurol, New Haven, CT USA.
    Severens, Johan L.
    Erasmus Univ, Erasmus Sch Hlth Policy & Management, Bayle Bldg,Burgemeester Oudlaan 50, NL-3062 PA Rotterdam, Netherlands.
    Redekop, Kenneth W.
    Erasmus Univ, Erasmus Sch Hlth Policy & Management, Bayle Bldg,Burgemeester Oudlaan 50, NL-3062 PA Rotterdam, Netherlands; Erasmus Univ, Inst Med Technol Assessment, Rotterdam, Netherlands.
    Cost-effectiveness of Mechanical Thrombectomy More Than 6 Hours After Symptom Onset Among Patients With Acute Ischemic Stroke2020Ingår i: JAMA Network Open, E-ISSN 2574-3805, Vol. 3, nr 8, artikel-id e2012476Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Importance Two 2018 randomized controlled trials (DAWN and DEFUSE 3) demonstrated the clinical benefit of mechanical thrombectomy (MT) more than 6 hours after onset in acute ischemic stroke (AIS). Health-economic evidence is needed to determine whether the short-term health benefits of late MT translate to a cost-effective option during a lifetime in the United States. Objective To compare the cost-effectiveness of 2 strategies (MT added to standard medical care [SMC] vs SMC alone) for various subgroups of patients with AIS receiving care more than 6 hours after symptom onset. Design, Setting, and Participants This economic evaluation study used the results of the DAWN and DEFUSE 3 trials to populate a cost-effectiveness model from a US health care perspective combining a decision tree and Markov trace. The DAWN and DEFUSE 3 trials enrolled 206 international patients from 2014 to 2017 and 182 US patients from 2016 to 2017, respectively. Patients were followed until 3 months after stroke. The clinical outcome at 3 months was available for 29 subgroups of patients with AIS and anterior circulation large vessel occlusions. Data analysis was conducted from July 2018 to October 2019. Exposures MT with SMC in the extended treatment window vs SMC alone. Main Outcomes and Measures Expected costs and quality-adjusted life-years (QALYs) during lifetime were estimated. Deterministic results (incremental costs and effectiveness, incremental cost-effectiveness ratios, and net monetary benefit) were presented, and probabilistic analyses were performed for the total populations and 27 patient subgroups. Results In the DAWN study, the MT group had a mean (SD) age of 69.4 (14.1) years and 42 of 107 (39.3%) were men, and the control group had a mean (SD) age of 70.7 (13.2) years and 51 of 99 (51.5%) were men. In the DEFUSE 3 study, the MT group had a median (interquartile range) age of 70 (59-79) years, and 46 of 92 (50.0%) were men, and the control group had a median (interquartile range) age of 71 (59-80) years, and 44 of 90 (48.9%) were men. For the total trial population, incremental cost-effectiveness ratios were $662/QALY and $13877/QALY based on the DAWN and DEFUSE 3 trials, respectively. MT with SMC beyond 6 hours had a probability greater than 99.9% of being cost-effective vs SMC alone at a willingness-to-pay threshold of $100 000/QALY. Subgroup analyses showed a wide range of probabilities for MT with SMC to be cost-effective at a willingness-to-pay threshold of $50000/QALY, with the greatest uncertainty observed for patients with a National Institute of Health Stroke Scale score of at least 16 and for those aged 80 years or older. Conclusions and Relevance The results of this study suggest that late MT added to SMC is cost-effective in all subgroups evaluated in the DAWN and DEFUSE 3 trials, with most results being robust in probabilistic sensitivity analyses. Future MT evidence-gathering could focus on older patients and those with National Institute of Health Stroke Scale scores of 16 and greater.

    Question Is mechanical thrombectomy in the extended treatment window cost-effective across patient subgroups in the United States? Findings This economic evaluation study found that mechanical thrombectomy provides good value for money in all the defined subgroups the 2 randomized clinical trials evaluated. Sensitivity analyses revealed a wide range of probabilities for late mechanical thrombectomy to be cost-effective at the willingness-to-pay threshold of $50 000 per quality-adjusted life-year. Meaning The results of this study suggest that attention should be placed on increasing access to mechanical thrombectomy rather than on developing subgroup-specific guidelines unless workforce and budget constraints require prioritization.

    This economic evaluation study compares the cost-effectiveness of 2 strategies (mechanical thrombectomy with standard medical care vs standard medical care alone) for various subgroups of patients with acute ischemic stroke who were receiving care more than 6 hours after symptom onset.

  • 7.
    Renbro, Gunnar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Palpationsömhet i perifer nerv och känseltest med sporre på friska försökspersoner2010Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Smärtor i ben är vanligt förekommande och neuropati (nervskada) är en orsak som troligen är underdiagnostiserad. Bimanuell (tvåhändig/tvåsidig) nervpalpation och känseltest med sporre har visat sig vara ganska tillförlitliga och enkla test för att hitta nervskada men har inte testats på friska individer.

    Syfte: Syftet var att undersöka om bimanuell nervpalpation i fossa poplitea framkallar smärta/obehag och om det finns skillnad mellan vänster och höger sida vid bimanuell undersökning med sporre på underben hos friska försökspersoner.

    Metod: Ett bimanuellt palpationstest av nervi tibialis och peroneus i fossa poplitea och även ett bimanuellt känseltest med sporre över dermatomen L4, L5 och S1 på underben genomfördes. Urvalet var ändamålsenligt och totalt deltog 37 försökspersoner. Åldersspannet var 20 till 57 och medianålder 23.

    Resultat: Vid palpationstestet hade intensiteten av smärta/obehag en median på 1 (variationsvidd 3) på den 11 gradiga skalan. En stor del skattade olika mellan sidorna i både palpationstestet (11 av 37) och känseltestet med sporre (25 av 37). Det var inte någon större skillnad mellan könen.

    Slutsats: När man utför dessa nervtester måste man ta hänsyn till att även friska individer ofta anger en liten sidoskillnad och inte alltid skattar noll vad gäller smärta/obehag. Det behövs dock fler studier för att bekräfta dessa resultat.

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