| 1. |
- Arlien-Soborg, Mai C., et al.
(författare)
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Acromegaly management in the Nordic countries: A Delphi consensus survey
- 2024
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Ingår i: Clinical Endocrinology. - : WILEY. - 0300-0664 .- 1365-2265.
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveAcromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.MethodsA Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1-7). Consensus was defined as >= 80% of panelists rating their agreement as >= 5 or <= 3 on the Likert-type scale.ResultsConsensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.ConclusionThis consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
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| 2. |
- Arlien-Søborg, Mai C., et al.
(författare)
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Acromegaly management in the nordic countries : a Delphi consensus survey
- 2024
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Ingår i: Clinical Endocrinology. - : John Wiley & Sons. - 0300-0664 .- 1365-2265.
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Acromegaly is associated with increased morbidity and mortality if left untreated. The therapeutic options include surgery, medical treatment, and radiotherapy. Several guidelines and recommendations on treatment algorithms and follow-up exist. However, not all recommendations are strictly evidence-based. To evaluate consensus on the treatment and follow-up of patients with acromegaly in the Nordic countries.Methods: A Delphi process was used to map the landscape of acromegaly management in Denmark, Sweden, Norway, Finland, and Iceland. An expert panel developed 37 statements on the treatment and follow-up of patients with acromegaly. Dedicated endocrinologists (n = 47) from the Nordic countries were invited to rate their extent of agreement with the statements, using a Likert-type scale (1−7). Consensus was defined as ≥80% of panelists rating their agreement as ≥5 or ≤3 on the Likert-type scale.Results: Consensus was reached in 41% (15/37) of the statements. Panelists agreed that pituitary surgery remains first line treatment. There was general agreement to recommend first-generation somatostatin analog (SSA) treatment after failed surgery and to consider repeat surgery. In addition, there was agreement to recommend combination therapy with first-generation SSA and pegvisomant as second- or third-line treatment. In more than 50% of the statements, consensus was not achieved. Considerable disagreement existed regarding pegvisomant monotherapy, and treatment with pasireotide and dopamine agonists.Conclusion: This consensus exploration study on the management of patients with acromegaly in the Nordic countries revealed a relatively large degree of disagreement among experts, which mirrors the complexity of the disease and the shortage of evidence-based data.
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| 3. |
- Elg, Mattias, 1968-, et al.
(författare)
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Swedish healthcare management practices and quality improvement work - development trends
- 2011
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald. - 0952-6862 .- 1758-6542. ; 24:2, s. 101-123
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – The purpose of this paper is to empirically examine developmental trends in healthcare organisation management practice and improvement work. Design/methodology/approach – Primary healthcare centre (n ¼ 1; 031) and clinical hospital department (n ¼ 1; 542) managers were surveyed in spring 2007 (response rate 46 per cent). This article compares results from this survey with a study in 2003. A theoretical framework based on organisational inner context, organisational outer context, external environment and outcomes form the analytical base. Comparisons were made using independent two-sample t-tests. Findings – A general aspect, identified empirically, is the tendency toward increased external pressure on leaders in their improvement work. Higher management decisions, patient pressure and decisions made by policymakers increasingly influence and shape the choices made by healthcare managers about where to focus improvement efforts. Three different trends are empirically identified and elaborated: take-control logic; practice-based improvement; and patient-centeredness. Research limitations/implications – Healthcare leaders should carefully design new management control systems that support healthcare micro systems. Findings support the general assumption that staff increasingly tend to focus organisational changes on management control. Originality/value – This study extends management research with a unique survey. Through two measurements made in 2003 and 2007, several important trends about how healthcare organisations are managed and developed are identified.
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| 4. |
- Lingegård, Sofia, et al.
(författare)
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Sustainable public procurement in large infrastructure projects—policy implementation for carbon emission reductions
- 2021
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Ingår i: Sustainability. - : MDPI AG. - 2071-1050. ; 13:20
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Tidskriftsartikel (refereegranskat)abstract
- The infrastructure construction sector is a significant source of carbon emissions, and more stringent procurement requirements are central to meeting reduction targets in this demand-led and project-based industry. This paper aims to analyze the implementation of international policies for reducing carbon emissions in infrastructure construction, focusing on the interaction between policy ambitions and procurement practices. Based on case studies of large projects and their contexts in five countries worldwide: Australia, the Netherlands, Sweden, the UK, and the US, a cross-country comparison is performed of how policies and practices for carbon reduction develop across multiple implementation levels. Three levels are included in the analysis: policy, industry, and project level. We identify the projects as either drivers of policy goals, frontrunners in industry-level development processes, or translators of national policy. These roles, and the associated pathways for carbon emission reduction, are context-specific and depend on the policy ambitions at the national or regional level, the maturity of the supplier market, and, often, on the strategies of individual champions at the project level. Long-term learning processes, both within and between the various levels, are essential for advancing carbon reduction.
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| 5. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 6. |
- Olsson, Jesper, 1966-
(författare)
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Alfabetets användning : Konkret poesi och poetisk artefaktion i svenskt 1960-tal
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The subject of this dissertation is the so-called concrete poetry that was written in Sweden during the 1960s and, to a small extent, in the 1950s, by Öyvind Fahlström, Jarl Hammarberg, Åke Hodell, Bengt Emil Johnson, and others. The study is focused on a discussion of the forms and the ways of writing that were explored, but it also gives an account of the aesthetic-historical context – of the expanded field of the arts in the 1960s, of the early avant-garde, of related forms of writing in earlier literature, such as pattern poetry.The readings are oriented toward different aspects of the texts, such as ’kneaded’ words, disruptive syntax, ’algorithmic’ forms and methods, visuality, and sonority. Two key concepts are ’artifice’ and ’materiality’, both of which indicate how the texts discussed complicate a view of poetry as ’pure’ expression of thought and emotion, or as representation of speech or language (in a restricted sense). These writings use the alphabet in an unorthodox way, and they transgress its territory by approaching other arts and other forms of ’writing’.If one of the aims of the study is to analyze the poetical forms and operations at stake, another one is to connect these to a modern ’media age’, and to discuss the impact of media technologies as well as new conceptions and theories of writing, information, and communication (for example, cybernetics) on poetry. This contextualization gives a specific meaning and value to the texts, and paves the way for a series of questions about reading, subjectivity, and political aspects of poetry.
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| 7. |
- Olsson, Jesper, 1966-, et al.
(författare)
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Kunskapens nya arenor : Humanistiska utbildningar i ett samhälle i förändring
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I den här rapporten fortsätter vi undersökningen av humaniorautbildningens samhällsrelevans med fokus på att utbildningsformer som kan ha liknande effekt som den liberal-arts-modell som efterfrågas redan existerar. I tvärvetenskapliga program, fortbildande distanskurser och undervisning i digital humaniora blir humaniorastudier del av olika sammanhang, även om det sker på annat sätt än genom en liberal arts-modell. Frågan är hur dessa undervisningsformerna fungerar idag och i vilka riktningar de kan utvecklas för att bli mer samhällsrelevanta.Vi vill poängtera att en utbildnings samhällsrelevans inte är detsamma som yrkesanpassning. Det kan tvärtom vara så att specifikt yrkesanpassade kurser har lägre samhällsrelevans på en arbetsmarknad i stor förändring än sådana som ger generiska färdigheter och kunskaper. Samhällsrelevans kan handla om en utbildnings användning och utveckling av ny teknologi eller om dess potential att ge de ämnesöverskridande kunskaper som behövs för att förstå dagens komplexa samhällsproblem.Vi som författar rapporten tar avstamp i egna erfarenheter från våra respektive lärosäten (Linköpings universitet, Linnéuniversitetet respektive Umeå universitet) samt enkätundersökningar och djupintervjuer med lärare, forskare och studenter. De utbildningar som undersöks ger inte en heltäckande bild av alla förändringar som gjorts inom humaniorautbildningar utan ska ses som nedslag för diskussion kring humaniorautbildning i förhållande till dagens och morgondagens samhälle.
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| 8. |
- Olsson, Jesper, 1966-, et al.
(författare)
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Kunskapens nya arenor : Humanistiska utbildningar i ett föränderligt samhälle
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I den här rapporten fortsätter vi undersökningen av humaniorautbildningens samhällsrelevans med fokus på att utbildningsformer som kan ha liknande effekt som den liberal-arts-modell som efterfrågas redan existerar. I tvärvetenskapliga program, fortbildande distanskurser och undervisning i digital humaniora blir humaniorastudier del av olika sammanhang, även om det sker på annat sätt än genom en liberal arts-modell. Frågan är hur dessa undervisningsformerna fungerar idag och i vilka riktningar de kan utvecklas för att bli mer samhällsrelevanta.Vi vill poängtera att en utbildnings samhällsrelevans inte är detsamma som yrkesanpassning. Det kan tvärtom vara så att specifikt yrkesanpassade kurser har lägre samhällsrelevans på en arbetsmarknad i stor förändring än sådana som ger generiska färdigheter och kunskaper. Samhällsrelevans kan handla om en utbildnings användning och utveckling av ny teknologi eller om dess potential att ge de ämnesöverskridande kunskaper som behövs för att förstå dagens komplexa samhällsproblem.Vi som författar rapporten tar avstamp i egna erfarenheter från våra respektive lärosäten (Linköpings universitet, Linnéuniversitetet respektive Umeå universitet) samt enkätundersökningar och djupintervjuer med lärare, forskare och studenter. De utbildningar som undersöks ger inte en heltäckande bild av alla förändringar som gjorts inom humaniorautbildningar utan ska ses som nedslag för diskussion kring humaniorautbildning i förhållande till dagens och morgondagens samhälle.
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| 9. |
- Simonsson, Bengt, et al.
(författare)
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Intensive treatment and stem cell transplantation in chronic myelogenous leukemia : long-term follow-up
- 2005
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Ingår i: Acta Haematologica. - : S. Karger AG. - 0001-5792 .- 1421-9662. ; 113:3, s. 155-162
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Tidskriftsartikel (refereegranskat)abstract
- In the present study we combined interferon (IFN) and hydroxyurea (HU) treatment, intensive chemotherapy and autologous stem cell transplantation (SCT) in newly diagnosed chronic myelogenous leukemia patients aged below 56 years, not eligible for allogeneic SCT. Patients who had an HLA-identical sibling donor and no contraindication went for an allogeneic SCT (related donor, RD). After diagnosis, patients not allotransplanted received HU and IFN to keep WBC and platelet counts low. After 6 months patients with Ph-positive cells still present in the bone marrow received 1–3 courses of intensive chemotherapy. Those who became Ph-negative after IFN + HU or after 1–3 chemotherapy courses underwent autologous SCT. Some patients with poor cytogenetic response were allotransplanted with an unrelated donor (URD). IFN + HU reduced the percentage of Ph-positive metaphases in 56% of patients, and 1 patient became Ph-negative. After one or two intensive cytotherapies 86 and 88% had a Ph reduction, and 34 and 40% became Ph-negative, respectively. In patients receiving a third intensive chemotherapy 92% achieved a Ph reduction and 8% became Ph-negative. The median survival after auto-SCT (n = 46) was 7.5 years. The chance of remaining Ph-negative for up to 10 years after autologous SCT was around 20%. The overall survival for allo-SCT RD (n = 91) and URD (n = 28) was almost the same, i.e. ≈60% at 10 years. The median survival for all 251 patients registered was 8 years (historical controls 3.5 years). The role of the treatment schedule presented in the imatinib era is discussed.
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| 10. |
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