| 1. |
- Astermark, Jan, et al.
(författare)
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New Inhibitors in the Ageing Population : A Retrospective, Observational, Cohort Study of New Inhibitors in Older People with Hemophilia
- 2022
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Ingår i: Thrombosis and Haemostasis. - : Georg Thieme Verlag KG. - 0340-6245 .- 2567-689X. ; 122:6, s. 905-912
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Tidskriftsartikel (refereegranskat)abstract
- Introduction A second peak of inhibitors has been reported in patients with severe hemophilia A (HA) aged >50 years in the United Kingdom. The reason for this suggested breakdown of tolerance in the aging population is unclear, as is the potential impact of regular exposure to the deficient factor by prophylaxis at higher age. No data on hemophilia B (HB) have ever been reported. Aim The ADVANCE Working Group investigated the incidence of late-onset inhibitors and the use of prophylaxis in patients with HA and HB aged ≥40 years. Methods A retrospective, observational, cohort, survey-based study of all patients aged ≥40 years with HA or HB treated at an ADVANCE hemophilia treatment center. Results Information on 3,095 people aged ≥40 years with HA or HB was collected. Of the 2,562 patients with severe HA, the majority (73% across all age groups) received prophylaxis. In patients with severe HA, the inhibitor incidence per 1,000 treatment years was 2.37 (age 40-49), 1.25 (age 50-59), and 1.45 (age 60 +). Overall, the inhibitor incidence was greatest in those with moderate HA (5.77 [age 40-49], 6.59 [age 50-59], and 4.69 [age 60 + ]) and the majority of inhibitor cases were preceded by a potential immune system challenge. No inhibitors in patients with HB were reported. Conclusion Our data do not identify a second peak of inhibitor development in older patients with hemophilia. Prophylaxis may be beneficial in older patients with severe, and possibly moderate HA, to retain a tolerant state at a higher age.
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| 2. |
- Björkman, Ingeborg, 1957-
(författare)
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Towards Improved Medication Use : Increasing Understanding of Professional Efforts
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Professionals and researchers have developed a number of strategies aimed at improving the quality and safety of medication use. However, studies continue to demonstrate persistent problems. For instance, the first paper in this thesis reveals the prevalence of potentially harmful drug combinations among elderly people in Europe. The following four papers focus on two professional groups and how they have approached safety and quality issues related to medication use: 1) the Swedish drug and therapeutics committees (DTCs) and 2) pharmacist involved in pharmaceutical care, an international movement. Qualitative research approaches were applied.Papers II and III focus on the DTCs: analyses indicate a development of the perception of the DTC role over time. The focus of the activities was broadened – from targeting prescribing physicians to incorporating decision-makers and patients. However, a clear patient-centered perspective was generally lacking. Moreover, the findings indicate a shift in focus from cost aspects of medication use to an increased focus on quality and safety aspects. In the studies addressing pharmaceutical care (Papers IV and V), the findings propose that different classification systems for drug-related problems had different characteristics which reflected differences in goals in the pharmaceutical care process. It was also found that the concept of pharmaceutical care was understood in different ways and that the perceptions were based on at least two different understandings of health and illness. First, a patient-centered perspective characterized by a holistic understanding of health and illness, and, second, an “EBM perspective” primarily based on a biomedical understanding of health and illness. This thesis has disclosed new aspects of how two groups of professionals perceive their work towards improved quality and safety of medication use. A patient-centered perspective among healthcare collectives is not obvious; therefore, efforts and comprehensive strategies supporting change are necessary. Strategies should focus on challenging the traditional thought patterns and care approaches among professionals and students.
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| 3. |
- Egerod, Ingrid, et al.
(författare)
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ICU-recovery in Scandinavia : a comparative study of intensive care follow-up in Denmark, Norway and Sweden
- 2013
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 1532-4036 .- 0964-3397. ; 29:2, s. 11-103
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of our study was to describe and compare models of intensive care follow-up in Denmark, Norway and Sweden to help inform clinicians regarding the establishment and continuation of ICU aftercare programmes.METHODS: Our study had a multi-centre comparative qualitative design with triangulation of sources, methods and investigators. We combined prospective data from semi-structured key-informant telephone interviews and unreported data from a precursory investigation.RESULTS: Four basic models of follow-up were identified representing nurse-led or multidisciplinary programmes with or without the provision of patient diaries. A conceptual model was constructed including a catalogue of interventions related to the illness trajectory. We identified three temporal areas for follow-up directed towards the past, present or future.CONCLUSIONS: ICU follow-up programmes in the Scandinavian countries have evolved as bottom-up initiatives conducted on a semi-voluntary basis. We suggest reframing follow-up as an integral part of patient therapy. The Scandinavian programmes focus on the human experience of critical illness, with more attention to understanding the past than looking towards the future. We recommend harmonization of programmes with clear goals enabling programme assessment, while moving towards a paradigm of empowerment, enabling patient and family to take an active role in their recovery and wellbeing.
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| 4. |
- Holme, Lotta, et al.
(författare)
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Handikapphistorisk forskning : En översikt
- 2001. - 1
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Ingår i: Humanistisk hälsoforskning. - Lund : Studentlitteratur. - 9144018916 - 9789144018911 ; , s. 209-242
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I tio artiklar belyses den forskning inom hälsoområdet som bedrivs av bland andra antropologer, etnologer, sociologer, historiker och filosofer i Sverige. Boken kan tjäna som utgångspunkt eller kurslitteratur för dem som vill få en överblick över vilka frågor och områden som behandlats i den humanistiska hälsoforskningen
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| 5. |
- Joel-Edgar, Sian, et al.
(författare)
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The questioning lens as research tool : the social shaping of network visualisation boundaries in the case of the UK junior doctors’ contract dispute
- 2020
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Ingår i: Information, Communication and Society. - : Routledge. - 1369-118X .- 1468-4462. ; 23:1, s. 20-37
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Tidskriftsartikel (refereegranskat)abstract
- Social media and the data it produces lend itself to being visualised as a network. Individual Twitter users can be represented as nodes and retweeted by another Twitter user, thereby forming a relationship, an edge, between users. However, an unbounded network is a sprawling mass of nodes and edges. Boundary settings are typically applied, for example, a time period, a hashtag, a keyword search or a network substructure of a phenomenon of interest. Thus, the particular visualisation created is dependent upon the boundaries applied, enabling productive visual consumption, but concealing its social shaping. To explore this question of boundary setting and its associated issues, we draw on an example from the Twitter discussions about the UK Minister for Health, Jeremy Hunt, and the media debate surrounding the contractual hours of junior doctors during 2015–2016. We discuss the role and impact differing stakeholders have in setting these boundaries. We seek to provide a set of ‘questioning lenses’ in which we ask why these boundary settings were selected, what effect they have, and what are the potential implications of these boundary setting techniques on the visualisation consumer.
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| 6. |
- Klamroth, Robert, et al.
(författare)
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Applicability of the European Society of Cardiology Guidelines on the management of acute coronary syndromes to older people with haemophilia A – A modified Delphi consensus by the ADVANCE Working Group
- 2023
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Ingår i: Haemophilia. - : Wiley. - 1351-8216 .- 1365-2516. ; 29:1, s. 21-32
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Forskningsöversikt (refereegranskat)abstract
- Introduction: As people with haemophilia (PWH) receive better treatment and live longer they are more likely to encounter cardiovascular disease (CVD) and other comorbidities. ESC guidelines for the acute management of patients presenting with acute coronary syndrome (ACS) are based on the non-haemophilia population. Aim: To review the guidelines and propose relevant adaptations for PWHA without inhibitors who are treated with prophylaxis and present with ACS. Methods: As part of the ADVANCE Group, 20 European haemophilia experts used a modified Delphi approach to develop and gain consensus on proposed adaptations of the ESC guidelines for PWHA without inhibitors. Results: Of the 32 Class I recommendations across both guidelines, adaptions were considered necessary and proposed for 15. The adaptions highlight the need to provide sufficient FVIII trough levels at the time of antithrombotic treatment in people with haemophilia A (HA) without inhibitors. Patients receiving emicizumab prophylaxis and requiring oral anticoagulation therapy or combined single antiplatelet plus oral anticoagulation therapy will require additional FVIII replacement therapy. Conclusion: In the absence of high-quality clinical evidence, the combined expert opinion used to develop these adaptions to the current ESC guidelines may help to guide clinicians in their treatment decisions when a PWHA presents with ACS.
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| 7. |
- Olsson, Ingrid, 1961-, et al.
(författare)
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Handikapphistorisk forskning : en översikt
- 2000
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Ingår i: Humanistisk hälsoforskning : en forskningsöversikt. - Linköping : Tema Hälsa och samhälle, Linköpings Universitet. - 9172197188 ; , s. 209-242
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- I tio artiklar belyses den forskning inom hälsoområdet som bedrivs av bland andra antropologer, etnologer, sociologer, historiker och filosofer i Sverige.Boken kan tjäna som utgångspunkt eller kurslitteratur för dem som vill få en överblick över vilka frågor och områden som behandlats i den humanistiska hälsoforskningen
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| 8. |
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