| 1. |
- Asplund, Kjell, et al.
(författare)
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Diagnostic procedures, treatments, and outcomes in stroke patients admitted to different types of hospitals
- 2015
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Ingår i: Stroke. - : Lippincott Williams & Wilkins. - 0039-2499 .- 1524-4628. ; 46:3, s. 806-812
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose: In many countries, including Sweden, initiatives have been taken to reduce between-hospital differences in the quality of stroke services. We have explored to what extent hospital type (university, specialized nonuniversity, or community hospital) influences hospital performance. Methods: Riksstroke collects clinical data during hospital stay (national coverage 94%). Follow-up data at 3 months were collected using administrative registers and a questionnaire completed by surviving patients (response rate 88%). Structural data were collected from a questionnaire completed by hospital staff (response rate 100%). Multivariate analyses with adjustment for clustering were used to test differences between types of hospitals. Results: The proportion of patients admitted directly to a stroke unit was highest in community hospitals and lowest in university hospitals. Magnetic resonance, carotid imaging, and thrombectomy were more frequently performed in university hospitals, and the door-to-needle time for thrombolysis was shorter. Secondary prevention with antihypertensive drugs was used less often, and outpatient follow-up was less frequent in university hospitals. Fewer patients in community hospitals were dissatisfied with their rehabilitation. After adjusting for possible confounders, poor outcome (dead or activities of daily living dependency 3 months after stroke) was not significantly different between the 3 types of hospital. Conclusions: In a setting with national stroke guidelines, stroke units in all hospitals, and measurement of hospital performance and benchmarking, outcome (after case-mix adjustment) is similar in university, specialized nonuniversity, and community hospitals. There seems to be fewer barriers to organizing well-functioning stroke services in community hospitals compared with university hospitals.
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| 2. |
- Asplund, Kjell, et al.
(författare)
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End of life after stroke : a nationwide study of 42,502 deaths occurring within a year after stroke
- 2018
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Ingår i: European Stroke Journal. - : Sage Publications. - 2396-9873 .- 2396-9881. ; 3:1, s. 74-81
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: In the scientific literature, there is very limited empirical information on end-of-life issues after stroke in the scientific literature. The present nationwide study describes the circumstances surrounding deaths that occur within a year after a stroke. Patients and methods: Datasets from three nationwide Swedish registers (on stroke, palliative care and cause of death) were linked. Basic information was available for 42,502 unselected cases of death that occurred within a year after a stroke and more detailed information was available for 16,408 deaths. Odds ratios for characteristics of end-of-life care were calculated by logistic regression. Results: In the late phase after stroke (three months to one year), 46% of patients died in a nursing home, whereas 37% of patients died in a hospital after readmission and 10% of patients died at home. Eleven per cent of deaths were reported as being unexpected. A next of kin was present at 49% of deaths. The frequency of unattended deaths (neither next of kin nor staff were present at the time of death) ranged from 5% at home with specialised home care to 25% in hospitals. Discussion: This is, by far, the largest study published on end-of-life issues after stroke. Major differences between countries in healthcare, community services, family structure and culture may limit direct transfer of the present results to other settings. Conclusion: There is considerable discordance between presumed good death' late after stroke (dying at home surrounded by family members) and the actual circumstances at the end of life.
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| 3. |
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| 4. |
- Asplund, Kjell
(författare)
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Hur kan tandhälsans stora gap bestå?
- 2017
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Ingår i: Tandläkartidningen. - 0039-6982. ; :2, s. 37-37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 5. |
- Asplund, Kjell
(författare)
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Hur tungt får kollegialiteten väga?
- 2017
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Ingår i: Tandläkartidningen. - 0039-6982. ; :7, s. 43-43
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Asplund, Kjell
(författare)
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Kunskap, etik och tandkräm
- 2017
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Ingår i: Tandläkartidningen. - 0039-6982. ; :12, s. 37-37
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 7. |
- Asplund, Kjell
(författare)
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Oredlighet i forskning – regleras i lag från årsskiftet: lagen ökar rättssäkerheten men täcker inte alla omoraliska beteenden i forskningen : [New Swedish legislation on research misconduct from 2020]
- 2019
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Ingår i: Läkartidningen. - : Läkartidningen förlag. - 0023-7205 .- 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- This review is prompted by new Swedish legislation on research misconduct to be in effect as of January 1st, 2020. Approximately 4 out of 10 000 published articles are retracted because of misconduct. Many Asian countries top the list of proportion of articles retracted. In Sweden, more than half of all mass media reports on misconduct concern medical research. The most discussed drivers of misconduct include the incentives by universities and funders with emphasis on competiveness, journal editors' preference for novelty over veracity, and the ethical culture as to research area, country and local institution. For most of fraudsters, detection means an end of their academic career. Victims include co-workers, institutions, patients and science at large. The newly revised European Code of Conduct for Research Integrity may serve as guidance for academic and healthcare organisations that strive to prevent research misconduct.
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| 8. |
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| 9. |
- Asplund, Kjell, et al.
(författare)
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The need to revise the Helsinki Declaration
- 2017
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Ingår i: The Lancet. - : ELSEVIER SCIENCE INC. - 0140-6736 .- 1474-547X. ; 389:10075, s. 1190-1191
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Tidskriftsartikel (refereegranskat)
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| 10. |
- Asplund, Kjell
(författare)
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Vi kan ha något att lära av komplementär och alternativ vård : ger insikter om vårdmiljön, kontinuitet, patientmötet och ospecifika effekter
- 2019
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Ingår i: Läkartidningen. - : Läkartidningen förlag. - 0023-7205 .- 1652-7518. ; 116
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Tidskriftsartikel (refereegranskat)abstract
- Den komplementära och alternativa vården satsar ofta på att den fysiska miljön ska vara samstämmig med vårdens innehåll, något som är mindre vanligt i hälso- och sjukvården. Bristande kontinuitet har negativa konsekvenser för vårdens resultat. Kontinuiteten mellan vårdpersonal och vårdsökande är klart bättre i komplementär och alternativ vård än i hälso- och sjukvården. Generös tid i mötet mellan vårdsökande och behandlare bidrar till den komplementära och alternativa vårdens attraktionskraft. Inom komplementär och alternativ vård utnyttjas ospecifika effekter, t ex förväntanseffekter, mer konsekvent för att nå gynnsamma behandlingsresultat.
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