| 1. |
- Eriksson, Martin, 1970, et al.
(författare)
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Triclosan changes community composition and selects for specific bacterial taxa in marine periphyton biofilms in low nanomolar concentrations
- 2020
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Ingår i: Ecotoxicology. - : Springer Science and Business Media LLC. - 0963-9292 .- 1573-3017. ; 29:7, s. 1083-1094
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Tidskriftsartikel (refereegranskat)abstract
- The antibacterial agent Triclosan (TCS) is a ubiquitous environmental contaminant due to its widespread use. Sensitivity to TCS varies substantially among eu- and pro-karyotic species and its risk for the marine environment remains to be better elucidated. In particular, the effects that TCS causes on marine microbial communities are largely unknown. In this study we therefore used 16S amplicon rDNA sequencing to investigate TCS effects on the bacterial composition in marine periphyton communities that developed under long-term exposure to different TCS concentrations. Exposure to TCS resulted in clear changes in bacterial composition already at concentrations of 1 to 3.16 nM. We conclude that TCS affects the structure of the bacterial part of periphyton communities at concentrations that actually occur in the marine environment. Sensitive taxa, whose abundance decreased significantly with increasing TCS concentrations, include the Rhodobiaceae and Rhodobacteraceae families of Alphaproteobacteria, and unidentified members of the Candidate division Parcubacteria. Tolerant taxa, whose abundance increased significantly with higher TCS concentrations, include the families Erythrobacteraceae (Alphaproteobacteria), Flavobacteriaceae (Bacteroidetes), Bdellovibrionaceae (Deltaproteobacteria), several families of Gammaproteobacteria, and members of the Candidate phylum Gracilibacteria. Our results demonstrate the variability of TCS sensitivity among bacteria, and that TCS can change marine bacterial composition at concentrations that have been detected in the marine environment.
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| 2. |
- Chatchumni, Manaporn, et al.
(författare)
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A Scoping Review of Pain Management Education Programs (PMEPs) : Do They Prepare Nurses to Deal with Patients' Postoperative Pain?
- 2020
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Ingår i: Pain Research & Management. - : Hindawi Limited. - 1203-6765 .- 1918-1523.
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Forskningsöversikt (refereegranskat)abstract
- This is a report of a scoping review undertaken to obtain an overview of studies conducted on pain management education programs (PMEPs). The aim of this review was to describe existing research publications relating to PMEP to map how pain management practice training might directly influence surgical nurses in contributing to successful pain outcomes in patients. The initial search of electronic databases identified 40 articles according to the inclusion criteria and search strategy, which applied the following terms: ("Pain management education program") AND ∗ OR ∗ ("Nurses") AND ∗ OR ∗ ("Patient outcomes") AND ∗ ("Mixed methods"). Titles, abstracts, and keywords were also searched for the term "Nurse education." After applying exclusion criteria, five relevant peer-reviewed articles were eventually selected for the final charting of the data. The search included articles published between January 2015 and March 2019. The results show that PMEPs employ a variety of computer-based simulation, web-based facilitation, and video materials based on an evidence-based approach in their syllabuses. PMEPs were shown to enhance practice by promoting improved skills in critical thinking, leadership, patient management, and health promotion. Additionally, these programs promote an ability to practice across a variety of inpatient and outpatient settings, wherein nurses' engagement in managing patients' pain increased after completing the PMEP. Research within PMEP indicates that these programs may contribute to promoting opportunities for new collaborations within multidisciplinary team projects. Additionally, further research initiatives are needed to explore various aspects of these programs to enhance the nursing skills required for effective pain management, such as computer-based simulation, web-based facilitation, and video materials. Moreover, research relating to PMEPs in low- and middle-income countries is scarce and warrants further study.
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| 3. |
- Crippa, Alessio, et al.
(författare)
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The ProBio trial : molecular biomarkers for advancing personalized treatment decision in patients with metastatic castration-resistant prostate cancer
- 2020
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Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiple therapies exist for patients with metastatic castration-resistant prostate cancer (mCRPC). However, their improvement on progression-free survival (PFS) remains modest, potentially explained by tumor molecular heterogeneity. Several prognostic molecular biomarkers have been identified for mCRPC that may have predictive potential to guide treatment selection and prolong PFS. We designed a platform trial to test this hypothesis.Methods: The Prostate-Biomarker (ProBio) study is a multi-center, outcome-adaptive, multi-arm, biomarker-driven platform trial for tailoring treatment decisions for men with mCRPC. Treatment decisions in the experimental arms are based on biomarker signatures defined as mutations in certain genes/pathways suggested in the scientific literature to be important for treatment response in mCRPC. The biomarker signatures are determined by targeted sequencing of circulating tumor and germline DNA using a panel specifically designed for mCRPC.Discussion: Patients are stratified based on the sequencing results and randomized to either current clinical practice (control), where the treating physician decides treatment, or to molecularly driven treatment selection based on the biomarker profile. Outcome-adaptive randomization is implemented to early identify promising treatments for a biomarker signature. Biomarker signature-treatment combinations graduate from the platform when they demonstrate 85% probability of improving PFS compared to the control arm. Graduated combinations are further evaluated in a seamless confirmatory trial with fixed randomization. The platform design allows for new drugs and biomarkers to be introduced in the study.Conclusions: The ProBio design allows promising treatment-biomarker combinations to quickly graduate from the platform and be confirmed for rapid implementation in clinical care.
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| 4. |
- Danielson, Mattias, et al.
(författare)
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Neuroinflammatory markers associate with cognitive decline after major surgery: Findings of an explorative study
- 2020
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Ingår i: Annals of Neurology. - : Wiley. - 0364-5134 .- 1531-8249. ; 87:3, s. 370-382
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Tidskriftsartikel (refereegranskat)abstract
- Objective Long-term cognitive decline is an adverse outcome after major surgery associated with increased risk for mortality and morbidity. We studied the cerebrospinal fluid (CSF) and serum biochemical inflammatory response to a standardized orthopedic surgical procedure and the possible association with long-term changes in cognitive function. We hypothesized that the CSF inflammatory response pattern after surgery would differ in patients having long-term cognitive decline defined as a composite cognitive z score of >= 1.0 compared to patients without long-term cognitive decline at 3 months postsurgery. Methods Serum and CSF biomarkers of inflammation and blood-brain barrier (BBB) integrity were measured preoperatively and up to 48 hours postoperatively, and cognitive function was assessed preoperatively and at 2 to 5 days and 3 months postoperatively. Results Surgery was associated with a pronounced increase in inflammatory biomarkers in both CSF and blood throughout the 48-hour study period. A principal component (PC) analysis was performed on 52 inflammatory biomarkers. The 2 first PC (PC1 and PC2) construct outcome variables on CSF biomarkers were significantly associated with long-term cognitive decline at 3 months, but none of the PC construct serum variables showed a significant association with long-term cognitive decline at 3 months. Patients both with and patients without long-term cognitive decline showed early transient increases of the astroglial biomarkers S-100B and glial fibrillary acidic protein in CSF, and in BBB permeability (CSF/serum albumin ratio). Interpretation Surgery rapidly triggers a temporal neuroinflammatory response closely associated with long-term cognitive outcome postsurgery. The findings of this explorative study require validation in a larger surgical patient cohort.
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| 5. |
- Eriksson, Hanna, et al.
(författare)
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Acute symptomatic seizures and epilepsy after mechanical thrombectomy
- 2020
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Ingår i: Epilepsy and Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 104
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this study was to assess the incidence of acute symptomatic seizures and poststroke epilepsy (PSE) in a well-characterized cohort of patients treated with mechanical thrombectomy. In addition, we aimed to describe the dynamics of blood markers of brain injury in patients that developed PSE. Methods: Participants of the prospective AnStroke Trial of anesthesia method during mechanical thrombectomy were included and acute symptomatic seizures and PSE ascertained by medical records review. Blood markers neurofilament light (NFL), tau, glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B (S100B), and neuron-specific enolase (NSE) were assessed. Results: A total of 90 patients with acute anterior ischemic stroke were included. Median National Institutes of Health Stroke Scale (NIHSS) at admission to hospital was 18 (IQR 15–22). Recanalization was achieved in 90%. No patients had epilepsy prior to the ischemic stroke. Four patients (4.4%) had acute symptomatic seizures and four patients (4.4%) developed PSE during the follow-up time (to death or last medical records review) of 0–4.5 years (median follow-up 1070 days IQR 777–1306), resulting in a two-year estimated PSE risk of 5.3% (95%CI: 0.2–10.4%). Blood markers of brain injury (NFL, tau, GFAP, S100B, and NSE) were generally above the cohort median in patients that developed PSE. Conclusions: The incidence of PSE after mechanical thrombectomy was low in our cohort. All blood biomarkers displayed interesting sensitivity and specificity. However, the number of PSE cases was small and more studies are needed on risk factors for PSE after mechanical thrombectomy. The potential of blood markers of brain injury markers to contribute to assessment of PSE risk should be explored further. This article is part of the Special Issue "Seizures & Stroke".
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| 6. |
- Eriksson, Henrik, 1973
(författare)
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Coronakrisen fastnar i byråkratiska geggan
- 2020
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Slutsatsen av coronahanteringen är att det behövs mindre byråkrati, och fler förbättringar av dem nära patienten och brukaren. Varje system är perfekt designat för att få de resultat som systemet får. Med andra ord, det nuvarande offentliga systemet är utformat på ett sådant sätt att vi får de här resultaten av coronakrisen. Coronakommissionen behöver därför förstå hur systemet fungerar, dess grundproblemen, samt agera därefter.
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| 7. |
- Eriksson, Henrik, 1973
(författare)
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Five principles of excellent organizations
- 2020
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- How do the best organizations manage to have satisfied customers, satisfied employees, and at the same time achieve fantastic results? In the book Five Principles of Excellent Organizations, these organizations are decoded through twenty years of research. A way of working and thinking appear to exist in all successful organizations, regardless of the type of organization. What are the characteristics of excellent organizations? How do the best organizations manage to have satisfied customers, satisfied employees, and at the same time achieve fantastic results? In the book Five Principles of Excellent Organizations, these organizations are decoded through twenty years of research. A way of working and thinking appear to exist in all successful organizations, regardless of the type of organization. Many organizations are not as good as they could be. But we can develop them. This book describes how that can be done. Based on a solid and unique foundation of experience and research, the book provides clear answers to what characterises excellent organizations. It is like reading Good to Great in a different context. The book gives clear examples from some of the finest companies and from several different industries. The model with the five principles shows a clear direction for the companies that set out on the journey with the aim of becoming one of the best. Dag Kroslid, CEO, NorDan It is rare to read a book that contains so many facts and so much knowledge on the subject. It is evident that Henrik Eriksson has experienced what is described in the book. This book gives concrete and clear advice on how to succeed with your development work. I myself am not particularly fond of all new management theories that are supposed to save us managers, and I get happy when it is described that it is quite clear what needs to be in place in order to succeed. I got many thoughts and ideas myself. I will read the book again. Tomas Fellbrandt, Director of Municipal Administration, Municipality of Skövde The book describes in a very accurate way both the traps that organizations often fall into, but also the big breakthroughs that can be achieved with a clear why and through continuous improvements. The book is hard to put away once you have started reading. Here is a lot of inspiration for those who want to make organizations better. Katarina Lindström, Executive Vice President & Chief Operating Officer, Hempel Simple and concrete advice to anyone who wants to work on improving their organization. The book describes in a liberating way, far from all different concepts and management theories, how concrete improvements have been successfully achieved by working to create the greatest possible value for those we exist for. The fact that it is based on a broad and thorough research as well as on the described organizations’ improvement journeys makes it practically applicable for different organizations. Finally, a book that is not about yet another new theory of improvement with new names and concepts, but instead focuses on what has worked in practice and compiled this. Ann Söderström, Director of Healthcare, Region Västra Götaland I have been convinced for a long time that companies have an important role in making the world better. We are now in the middle of a transition where the purpose of entrepreneurship goes from being driven by profit to driven by need and purpose. However, a personal conviction does not always have to be evidence-based, which is why it is exciting and gratifying to see that 20 years of research on excellent organizations shows such a strong connection. It is time to learn more and Five Principles of Excellent Organizations feels like an obvious step along the road! Stefan Krook, Co-founder, Kivra Henrik Eriksson has in a simple way described the importance of the different principles for success and the importance of working with all principles at the same time if you want to succeed. Many good examples show that the principles are useful in all industries. The book provides a good base for the fun work of creating a sustainable and constantly developing organization. All leaders should read the book! Lena Lundh, Vice President, Lean Forum Success is not a coincidence. Success is not luck. A company does not just become good. Many parts are required in order to be good in the long term. In the book Five Principles of Excellent Organizations, you can read about many experiences and advices. It is well worth reading! To familiarise yourself with successful organizations, and later daring to try and make your own experience, can create real success. Marcus Strömberg, CEO, AcadeMedia The book Five Principles of Excellent Organizations highlights, in a positive way and with concrete examples, what success factors several leading organizations have in common. With the support of a scientific foundation, good advice is given on what to think about when building the best of organizations. It can advantageously be used as a tool to analyse your own organization and get started on systematic quality work. Anki Bäck, Principal, Byle School For more than 25 years, SIQ - the Swedish Institute for Quality - has evaluated organizations and awarded fine examples of organizational development with the Swedish Quality Award. These award recipients proved suitable to study in order to understand how successful organizations work and constantly improve. In Five Principles of Excellent Organizations, the researcher and author Henrik Eriksson decodes the principles behind the success. Combined with 20 years of research experience, very simple tips and advices are given on how more organizations can be better. The book is very easy to pick up and the potential for improvement in organizations is huge, read it and start improving! Mats Deleryd, CEO, SIQ - the Swedish Institute for Quality Concrete, research-based advice for those who want to develop an organization towards a success that is not only measured in financial profit. The perfect guide to anyone who wants to lead an organization that is good for those the organization exists for. Helene Mellström, Director/CEO, Bräcke Diakoni The technological development has created new opportunities and increased competition for both customers and companies. Based on his and his colleagues’ research, Henrik Eriksson describes in Five Principles of Excellent Organizations how our most successful organizations work. The book is written with easily accessible language and is rich in examples and quotations, which together with references makes it a great source of inspiration suitable for managers and everyone else interested in modern quality management. Bengt Klefsjö, Professor Emeritus, Quality Management, Luleå University of Technology Henrik Eriksson, PhD, is a professor at Chalmers University of Technology, and consultant and lecturer at Förbättringsakademin.
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| 8. |
- Eriksson, Henrik, 1973
(författare)
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Högre kvalitet uppnås inte genom fler inspektioner
- 2020
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Ingår i: Dagens Medicin.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Ju längre bort man är ifrån kärnverksamheten desto mindre verkar man förstå hur kvalitet egentligen skapas. Det finns tre grundproblem som politiker samt chefer på myndigheter och offentliga verksamheter måste förstå och agera på. 1. Överarbetade analyser och utredningar är ofta ett resursslöseri. 2. Högre kvalitet uppnås inte genom fler inspektioner och kontroller. 3. Byråkrati och administration hindrar förbättringar. Coronakrisen har exponerat de problem som finns inbyggda i hur svenska myndigheter och offentliga verksamheter leds. Trots dessa underliggande problem har medarbetare i kärnverksamheterna under pågående kris utfört fantastiska insatser och levererat vård och omsorg av hög kvalitet. Fokus har legat på att lösa de svåra problemen som man har ställts inför. Nya samarbeten har skapat lärande och innovationer. Slutsatsen är att det behövs mer lokalt problemlösande och förbättringsarbete, och inte en byråkrati som hindrar medarbetare i vård och omsorg att utföra den tjänst som medborgarna vill ha.
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| 9. |
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| 10. |
- Jurkeviciute, M., et al.
(författare)
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Identifying the Value of an eHealth Intervention Aimed at Cognitive Impairments: Observational Study in Different Contexts and Service Models
- 2020
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications Inc.. - 1438-8871. ; 22:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Value is one of the central concepts in health care, but it is vague within the field of summative eHealth evaluations. Moreover, the role of context in explaining the value is underexplored, and there is no explicit framework guiding the evaluation of the value of eHealth interventions. Hence, different studies conceptualize and operationalize value in different ways, ranging from measuring outcomes such as clinical efficacy or behavior change of patients or professionals to measuring the perceptions of various stakeholders or in economic terms. Objective: The objective of our study is to identify contextual factors that determine similarities and differences in the value of an eHealth intervention between two contexts. We also aim to reflect on and contribute to the discussion about the specification, assessment, and relativity of the "value" concept in the evaluation of eHealth interventions. Methods: The study concerned a 6-month eHealth intervention targeted at elderly patients (n=107) diagnosed with cognitive impairment in Italy and Sweden. The intervention introduced a case manager role and an eHealth platform to provide remote monitoring and coaching services to the patients. A model for evaluating the value of eHealth interventions was designed as monetary and nonmonetary benefits and sacrifices, based on the value conceptualizations in eHealth and marketing literature. The data was collected using the Mini-Mental State Examination (MMSE), the clock drawing test, and the 5-level EQ-5D (EQ-5D-5L). Semistructured interviews were conducted with patients and health care professionals. Monetary data was collected from the health care and technology providers. Results: The value of an eHealth intervention applied to similar types of populations but differed in different contexts. In Sweden, patients improved cognitive performance (MMSE mean 0.85, SD 1.62, P<.001), reduced anxiety (EQ-5D-5L mean 0.16, SD 0.54, P=.046), perceived their health better (EQ-5D-5L VAS scale mean 2.6, SD 9.7, P=.035), and both patients and health care professionals were satisfied with the care. However, the Swedish service model demonstrated an increased cost, higher workload for health care professionals, and the intervention was not cost-efficient. In Italy, the patients were satisfied with the care received, and the health care professionals felt empowered and had an acceptable workload. Moreover, the intervention was cost-effective. However, clinical efficacy and quality of life improvements have not been observed. We identified 6 factors that influence the value of eHealth intervention in a particular context: (1) service delivery design of the intervention (process of delivery), (2) organizational setup of the intervention (ie, organizational structure and professionals involved), (3) cost of different treatments, (4) hourly rates of staff for delivering the intervention, (5) lifestyle habits of the population (eg, how physically active they were in their daily life and if they were living alone or with family), and (6) local preferences on the quality of patient care. Conclusions: Value in the assessments of eHealth interventions need to be considered beyond economic terms, perceptions, or behavior changes. To obtain a holistic view of the value created, it needs to be operationalized into monetary and nonmonetary outcomes, categorizing these into benefits and sacrifices.
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