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| 2. |
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| 3. |
- Thompson, Paul M., et al.
(författare)
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The ENIGMA Consortium : large-scale collaborative analyses of neuroimaging and genetic data
- 2014
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Ingår i: BRAIN IMAGING BEHAV. - : Springer Science and Business Media LLC. - 1931-7557 .- 1931-7565. ; 8:2, s. 153-182
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Tidskriftsartikel (refereegranskat)abstract
- The Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium is a collaborative network of researchers working together on a range of large-scale studies that integrate data from 70 institutions worldwide. Organized into Working Groups that tackle questions in neuroscience, genetics, and medicine, ENIGMA studies have analyzed neuroimaging data from over 12,826 subjects. In addition, data from 12,171 individuals were provided by the CHARGE consortium for replication of findings, in a total of 24,997 subjects. By meta-analyzing results from many sites, ENIGMA has detected factors that affect the brain that no individual site could detect on its own, and that require larger numbers of subjects than any individual neuroimaging study has currently collected. ENIGMA's first project was a genome-wide association study identifying common variants in the genome associated with hippocampal volume or intracranial volume. Continuing work is exploring genetic associations with subcortical volumes (ENIGMA2) and white matter microstructure (ENIGMA-DTI). Working groups also focus on understanding how schizophrenia, bipolar illness, major depression and attention deficit/hyperactivity disorder (ADHD) affect the brain. We review the current progress of the ENIGMA Consortium, along with challenges and unexpected discoveries made on the way.
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| 4. |
- Ahlstrand, Christina, 1957, et al.
(författare)
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Reliabilitetstestning av Purdue Pegboard® (finmotoriktest).
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I MQ-FAS studien, vars syfte var att ändra muskelspänningsmönstret hos kvinnor med kroniska nackbesvär, ingick ett besticktorkningsmoment som en standardiserad arbetsuppgift i hemmet. För validering av denna besticktorkning har en pilotstudie genomförts, 12 personer torkade bestick vid två tillfällen. I studien, som utfördes av 2 testledare, ingick även ett finmotorikstest (Purdue Pegboard), ansträngningsskattning (Borg RPE-skalan) samt ett frågeformulär. Detta test kan med vissa justeringar troligen vara användbart som ett mått på arbetsförmåga av övre extremiteter vid utförande av arbetssyssla i hemmet, och jämföra individ med sig själv, för att mäta om funktionsnedsättning eller ökning har skett. Dock skall poängteras att detta var en pilotstudie och ytterligare studie av reliabilitet och validitet rekommenderas innan testet används i stor utsträckning för att mäta om funktionsnedsättning eller ökning har skett.
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| 7. |
- Ali, Lilas, 1981, et al.
(författare)
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Effects of person-centred care via telephone on self-efficacy in patients with chronic obstructive pulmonary disease: Subgroup analysis of a randomized controlled trial
- 2021
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 8:2, s. 927-935
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To evaluate the effects of PCC in the form of structured telephone support on self-reported cardiac self-efficacy in patients with COPD. Methods: We enrolled 105 patients, aged ≥50years, admitted to hospital and diagnosed with COPD from January 2015 to November 2016. The patients received usual care or PCC via telephone added to usual care. The Swedish Cardiac Self-Efficacy Scale comprising three dimensions (control symptoms, control illness and maintain functioning) was used as outcome measure. Data was collected at baseline, and at 3- and 6-month follow-ups. Results: At both the 3- and 6-month follow-ups, the intervention group improved significantly more than the control group in the control illness dimension (p=.012 and p=.032, respectively). No differences were found in the other two dimensions. Conclusions: PCC in the form of structured telephone support increases patients’ confidence in managing their illness and may be a feasible strategy to support patients in their homes.
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| 8. |
- Ali, Lilas, 1981, et al.
(författare)
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Need of support in people with chronic obstructive pulmonary disease
- 2018
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Ingår i: Journal of clinical nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:5-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to describe peoples' experiences and expectations of support when living with chronic obstructive pulmonary disease (COPD). METHOD: We conducted and analysed face-to-face or telephone interviews with 17 individuals (aged 44-77 years) diagnosed with COPD. The interviewer asked open-ended questions aimed at encouraging further narration, and we analysed the participants' narratives using a phenomenological hermeneutical approach. This report adheres to the COREQ guidelines. RESULTS: The overall theme suggests that people with COPD describe support as shared knowledge and experiences, based on the following subthemes; similar experiences, the need of genuine professional knowledge, self-reliance versus self-blame, and the Internet - feeling safe but uncertain. CONCLUSION: People with COPD find their strength through shared knowledge and dialogical support with others who have similar experiences and with professionals. A person-centred eHealth approach may be suitable for this group as it offers both collaboration and support. PRACTICE IMPLICATIONS: There is a demand for access to genuine professional knowledge as additional support to patients' own capabilities and needs. Patient associations were assessed as reliable sources of information and to some extent also support, but the importance of access to professional sources was also stressed. This article is protected by copyright. All rights reserved.
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| 9. |
- Ali, Lilas, 1981, et al.
(författare)
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Person-centred care by a combined digital platform and structured telephone support for people with chronic obstructive pulmonary disease and/or chronic heart failure: study protocol for the PROTECT randomised controlled trial
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A core feature of chronic obstructive pulmonary disorder (COPD) and chronic heart failure (CHF) is that symptoms may change rapidly because of illness progression. Thus, these chronic conditions are associated with high rehospitalisation rates. Person-centred care (PCC) has been shown to have several benefits for patients with COPD or CHF (or both disorders) but it has not yet been investigated through e-health services. AIM: The project aims to evaluate the effects of PCC by a combined digital platform and structured telephone support for people with COPD and/or CHF. METHODS AND ANALYSIS: A randomised controlled trial with open, parallel groups which employs a participatory design process will be used. This project will also include process and health economic evaluation of the intervention. ETHICS AND DISSEMINATION: Ethical approval has been secured from the Regional Ethical Review Board in Gothenburg, Sweden (Dnr 063-17 and T063-18). Results will be presented at conferences and to healthcare professionals, participants and patient organisations. Findings will also be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03183817.
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| 10. |
- Alsén, Sara, et al.
(författare)
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Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:9
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Mental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave. OBJECTIVE: This study aimed to explore patients' experiences of stress-related exhaustion. DESIGN: A qualitative study with interview data analysed using a phenomenological hermeneutic method. SETTING: Participants were selected from public primary healthcare centres in a larger city in western Sweden. PARTICIPANTS: Seven women and five men on sick leave from work due to stress-related exhaustion were included in the study. FINDINGS: Stress-related exhaustion was experienced as a loss of access to oneself and one's context and feelings of being trapped and lost in life. The condition had a significant impact on personal identity, raised existential issues and was interpreted as facing a blind alley. Participants described a mistaken direction in life, being forced to stop, change direction and act differently. CONCLUSION: Stress-related exhaustion is a challenging, life-changing existential experience that involves a crisis with an opportunity for new insights. Careful consideration of patients' narratives together with the expertise of healthcare professionals can be combined to improve health and optimise recovery based on individual's situation.
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| 11. |
- Alsén, Sara, et al.
(författare)
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Having allies—Experiences of support in people with stress-related exhaustion: A qualitative study
- 2022
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Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background The number of people seeking care for symptoms of exhaustion and stress is a major concern in several countries. The condition is a challenging and life-changing experience, and a deeper understanding of support to help people on sick leave due to stress-related exhaustion in their early stages is needed to facilitate recovery. Objective The aim was to explore experiences of support in people with stress-related exhaustion being on sick-leave less than six months. Method A qualitative interview study was conducted with 12 participants (7 women and 5 men; aged 25–46 years) who were on sick leave that had not exceeded six months due to stress-related exhaustion. The participants were recruited from public healthcare centres in the western part of Sweden, and the intention was to reach them early in their ongoing sick leave period. The interviews were performed face-to-face and analysed using a phenomenological hermeneutical approach. Results The findings show that people affected by stress-related exhaustion struggle to maintain their dignity and define support in terms of allies who acknowledge their personhood and provide them helpful guidance. Participants expressed their needs to be taken seriously by professionals, family, and friends willing to engage in their situation. Lack of empathy and professional knowledge in the clinical encounter induced additional stress. Conclusions This study indicates that people affected by stress-related exhaustion need allies from their surrounding networks in their struggle to maintain their dignity. Our findings highlight that it is essential to acknowledge them as persons and establish an alliance to provide appropriate support based on each person’s specific situation, needs and resources. This approach can be facilitated in a partnership, as emphasized in person-centred care (PCC). PCC emphasizes the co-creation of care in partnership between the patient (often with relatives) and health care professionals which may imply a more collaborative view of health care in which patients are engaged as active partners in planning their care.
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| 12. |
- Barenfeld, Emmelie, 1981, et al.
(författare)
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Becoming more of an insider: A grounded theory study on patients' experience of a person-centred e-health intervention.
- 2020
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore the experiences of a person-centred e-health intervention, in patients diagnosed with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF).Grounded theory was applied to gather and analyse data.The study is part of a research project evaluating the effects of person-centred care (PCC) using a digital platform and structured telephone support for people with COPD or CHF recruited from nine primary care units in Sweden.Twelve patients from the intervention group were purposefully selected in accordance with the initial sampling criteria.The intervention was delivered through a digital platform and telephone support system for 6 months. The intervention relied on person-centred ethics operationalised through three core PCC components: patient narratives, partnership and shared documentation.A core category was formulated: Being welcomed through the side door when lacking the front door keys. The core category reflects how a PCC intervention delivered remotely provides access to mutual and informal meetings at times when professional contacts were desired to support patient self-management goals. According to patients' wishes, family and friends were seldom invited as care partners in the e-health context.A PCC intervention delivered remotely as a complement to standard care in a primary care setting for patients diagnosed with COPD or CHF is a viable approach to increase patients' access and involvement in preventive care. The e-health intervention seemed to facilitate PCC, strengthen patients' position in the health service system and support their self-management.
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| 13. |
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| 14. |
- Barenfeld, Emmelie, 1981, et al.
(författare)
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Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care - a mixed-method study on patient perspectives
- 2022
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Ingår i: Bmc Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients' experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients' experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use. Methods Patients (n = 86) were recruited from the RCT PROTECT intervention group. A convergent mixed-method approach was implemented. Data were collected in parallel with the ongoing RCT via a survey, including ratings and written comments on meaningful or non-meaningful use. Also, interviews were performed with twelve purposefully selected participants. Descriptive statistics, logistic regression and content analysis were employed. Data sources were integrated in the results. Results Most participants rated the overall intervention as meaningful to use, with the telephone support rated as most meaningful. Interviews and written comments showed that patient ratings on meaningful use were explained by four categories: Not in need, Communication deficiency, Benefits in everyday life and A personal boost. Meaningful use of rating symptoms on the digital platform was predicted by living alone (adjusted odds ratio [aOR] = 2.8 P = .044). A diagnosis of chronic obstructive pulmonary disease (COPD) predicted meaningful use of digital platform direct messaging (aOR = 3.5, P = .045). Moreover, having access to direct-dial telephone contact explained meaningful use among participants with low ratings of technical competence (aOR = 3.6, P = .014). Conclusions The combined digital platform and structured telephone support could be helpful in identifying preventive actions to maintain health for people diagnosed with COPD and chronic heart failure but tends to be more meaningful for those diagnosed with COPD. Overall, lower adoption of the digital platform was seen compared to telephone support. Shortcomings were noted in the digital platform's implementation that negatively influences experiences of meaningful use. When used, the intervention proved to be an easily applicable and valued tool to support preventive actions in a person-centred manner.
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| 15. |
- Bauer, Torben, et al.
(författare)
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Effects of the Different Implementation of Legislation Relating to Sewage Sludge Disposal in the EU
- 2020
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Ingår i: Detritus. - Padova : CISA Publisher. - 2611-4135. ; 10, s. 92-99
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Forskningsöversikt (refereegranskat)abstract
- The European Directive 86/278/EEC implemented in 1986 was a means adopted by the European Union to improve use of the valuables in sewage sludge by applying treated sludge on agricultural soils. To prevent an accumulation of pollutants, the Directive provided suggestions limiting concentrations of toxic elements in sewage sludge and agricultural soil. The Directive was implemented diversely throughout EU member states, with current national legislations only partly reflecting the initial intentions of the EU Directive from 30 years ago. This study demonstrates how the European Directive was implemented in three countries currently at different stages of replacing the agricultural application of sewage sludge with incineration (Netherlands, Germany and Sweden). Additionally, recent changes in the legislation with regards to the re-use and final disposal of sewage sludge in the three chosen member states are analysed. The aim was to investigate how each member state has solved the conflict between improvement of nutrient recovery from sludge and limitation of pollutants in agricultural soil. Based on this review, limit values are not necessarily reflected in application rates of sewage sludge in agriculture. Following changes in current legislation, phosphorus recovery will become a priority task. The recovery of other valuables from sewage sludge is currently not regulated in the legislation of the three member states investigated.
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| 16. |
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| 17. |
- Blanck, Elin, et al.
(författare)
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Informal carers in Sweden - striving for partnership
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden
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| 18. |
- Blanck, Elin, et al.
(författare)
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Self‐efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease
- 2023
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Ingår i: ESC Heart Failure. - 2055-5822.
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aims This study aims to explore possible associations between self‐efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person‐centred care delivered by telephone. Methods and results This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person‐centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer‐generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow‐up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person‐centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group‐based trajectory modelling was applied to identify trajectories for general self‐efficacy and direct costs. Next, associations between self‐efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self‐efficacy, of which three indicated different levels of increasing or stable self‐efficacy, while two showed a decrease over time in self‐efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self‐efficacy was associated with lower direct costs ( P = 0.0013). Conclusions The findings show that an increased or sustained self‐efficacy is associated with lower direct costs in patients with CHF or COPD. Person‐centred phone contacts used as an add‐on to usual care could result in lower direct costs for those with stable or increasing self‐efficacy.
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| 19. |
- Boström, Eva, et al.
(författare)
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Registered nurses' experiences of communication with patients when practising person-centred care over the phone: a qualitative interview study
- 2020
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Ingår i: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background To explore registered nurses' (RNs') experiences of practising person-centred care (PCC) by telephone with people diagnosed with chronic obstructive pulmonary disease and/or chronic heart failure. Methods Qualitative interview study. Four RNs were individually interviewed before, during, and after participating in an intervention practising PCC by telephone. The interviews were analysed using qualitative content analysis. Results The results reflect three categories of their experience: realize the complexity of practising PCC by distance, gain insight into what PCC communication meant to RNs and their approach, and develop the professional role by practising PCC theory and ethics. Conclusions PCC over the telephone facilitate healthcare and support patients. Through careful listening, the RNs (1) created space for the individual patients to express their thoughts and feelings and (2) emphasized each patient's capabilities and resources. The RNs also gained an understanding of PCC and what it means to patients and to themselves as practitioners. Potential implications are that it is important for RNs practising PCC by telephone to remould their role, to listen carefully, and to communicate as equals in conversations that respect both parties' knowledge and expertise. Health professionals need supervision and support to fully understand the person-centred approach and provide communications that support it.
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| 20. |
- Brem, Samuel, 1991, et al.
(författare)
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Phonon-assisted Photoluminescence from Dark Excitons in Monolayers of Transition Metal Dichalcogenides
- 2019
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The photoluminescence (PL) spectrum of transition metal dichalcogenides (TMDs) shows a multitude of emission peaks below the bright exciton line and not all of them have been explained yet. Here, we study the emission traces of phonon-assisted recombinations of momentum-dark excitons. To this end, we develop a microscopic theory describing simultaneous exciton, phonon and photon interaction and including consistent many-particle dephasing. We explain the drastically different PL below the bright exciton in tungsten- and molybdenum-based materials as result of different configurations of bright and dark states. In good agreement with experiments, we show that WSe2 exhibits clearly visible low-temperature PL signals stemming from the phonon-assisted recombination of momentum-dark excitons.
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| 21. |
- Cederberg, Matilda, et al.
(författare)
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A lowered threshold to partnerships: a mixed methods process evaluation of participants' experiences of a person-centred eHealth intervention
- 2023
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Ingår i: Bmc Health Services Research. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn order to understand pathways of complex interventions, the Medical Research Council has suggested that process evaluations should be conducted alongside randomised controlled trials (RCTs). This paper presents a mixed methods process evaluation of a complex, person-centred eHealth intervention for persons on sick leave with common mental disorders.AimThe aim of the study was to explore participants' experiences of a person-centred eHealth intervention and illuminate meaningful activities and processes.MethodsParticipants were recruited from the intervention arm of an RCT (n = 102). Questionnaires on perceived meaningfulness of the overall intervention and intervention activities were sent to participants on two occasions, after 3 and 6 months, and semi-structured interviews were conducted with a purposeful sample of 15 participants in the intervention group. Questionnaire data were analysed using descriptive statistics, and interview data were analysed using qualitative content analysis. The quantitative and qualitative data strands were integrated at interpretation.ResultsAt both follow-ups, a majority of participants reported that the intervention was fully or partly meaningful and that the most meaningful activity was the phone calls with health care professionals working in the intervention. In the qualitative analysis, three categories describing participants' experiences of the intervention were formed: Acknowledgment in a disconcerting situation, Finding ways forward and Unmet expectations. A synthesis of quantitative and qualitative findings resulted in the overarching theme of meaningfulness as constituted by a lowered threshold to partnerships: support within reach, when needed.ConclusionExperiences of meaningfulness of the intervention were constituted by a lowered threshold to forming care partnerships, in which support was within reach, when needed. If the content of the intervention was not in accordance with individuals' needs or expectations, access alone did not suffice to constitute meaningfulness.Trial registrationClinicalTrials.gov; NCT03404583; 19/01/2018.
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| 22. |
- Cederberg, Matilda, et al.
(författare)
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Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial
- 2022
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Ingår i: Jmir Mental Health. - : JMIR Publications Inc.. - 2368-7959. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. Objective: The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. Methods: A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. Results: At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. Conclusions: A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave.
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| 23. |
- Cederberg, Matilda, et al.
(författare)
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Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE)
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:9
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context. METHODS AND ANALYSIS: This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted. ETHICS AND DISSEMINATION: This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC. TRIAL REGISTRATION NUMBER: NCT03404583.
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| 24. |
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| 25. |
- Ebrahimi, Zahra, et al.
(författare)
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Integrating Health Promotion with and for Older People - eHealth (IHOPe) – Evaluating remote integrated person-centred care - Protocol of a randomised controlled trial with effectiveness, health economic, and process evaluation
- 2023
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Healthcare and welfare systems worldwide are unprepared to accommodate the growing population of older people. Simultaneously, the cost of reactive care for older people is increasing. However, healthcare systems in many countries are reforming towards integrated and person-centred care with a focus on health promotion and proactive actions. The Integrating Health Promotion with and for Older People – eHealth (IHOPe) project aims to describe and evaluate a person-centred e-support intervention that promotes a sustainable partnership between community dwelling frail older people and health and social care professionals. Methods The IHOPe project is designed as a randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care and add-on person-centred care through telephone support and a digital platform. The primary outcome measure is a composite score of changes in general self-efficacy and the need for unscheduled hospital care. The project is conducted in Gothenburg, Sweden. At least 220 participants aged ≥ 75 years will be included after being screened using a frailty instrument. The study design, intervention components, digital platform, and questionnaires were developed in close collaboration with an advisory group of inter-professional researchers, stakeholders, clinicians, and older representatives. Data will mainly be collected through questionnaires at baseline and 3, 6, and 12 months after inclusion in the study. Recruitment is ongoing and should be completed during 2023. Data will be analysed using quantitative and qualitative methods. The evaluation will include effectiveness, process, and health economics. The study was approved by the Regional Ethical Review Board in Gothenburg, Sweden (Dnr 2019–05364, Dnr 2020–03550, Dnr 2021–03255). Discussion The findings will expand our knowledge of remotely integrated person-centred care for frail older people. Thereby, the IHOPe project is expected to fill highlighted knowledge gaps on intervention evaluations including the triad of person-centred, digital, and integrated care elements, as well as economic evaluations of remote health services for frail older people. The study is ongoing, and the results are not completed but if they turn out to be positive, implementation is not limited to time or location. Trial registration ClinicalTrial.gov: NCT04416815. Registered 07/06/2021.
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| 26. |
- Ekman, Andreas
(författare)
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Hypnosis monitoring during general anaesthesia : with focus on awareness
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- An objective measure of the hypnotic component of general anaesthesia has been sought for decades. The electroencephalogram (EEG) was early recognized as a possible useful intraoperative monitor when the effects of anaesthetic drugs on human EEG recordings were noted. The last few years have brought forward a number of commercialized monitor devices that by an index claim to give the anaesthetist an objective measure of hypnosis. Two diverse monitoring methods, differing in principle, have been developed: 1) passively processed EEG, and 2) stimulated and thereafter processed EEG. The Bispectral Index Scale (BIS) and the A-line ARX-Index (AAI) are two such monitors were BIS represents the first principle and AAI the second. In several studies the use of BIS and AAI has been shown to reduce the amount of anaesthetics given and expedite postoperative recovery as compared to standard practice. However a number of studies have also shown that the sensitivity and specificity for BIS and AAI are not perfect, and fears have been raised that the incidence of awareness even might increase if the anaesthetist aims at an upper threshold value. In this thesis, it is demonstrated that BIS monitoring during general anaesthesia in a noncardiac, surgical population requiring endotracheal intubation and/or a neuromuscular blocking agent (NMBA) was associated with a significantly reduced incidence of awareness as compared to a historical control population. Our results suggest that BIS better displays drug related alterations in the level of hypnosis than AAI in an already anesthetized patient, and that there is no difference between BIS and AAI in the response time to a noxious stimulus. We have further seen that profound neuromuscular block attenuate BIS and AAI responses to a standardized noxious stimulation during sevoflurane anaesthesia as compared to a partial neuromuscular block or after neostigmine induced reversal, and that the monitor responses were not due to electromyogram (EMG) contamination of the EEG. It is demonstrated that EEG responses to noxious stimulation, in terms of power and coherence in the γ-band, are affected by profound neuromuscular block during light sevoflurane anaesthesia. In conclusion we demonstrate that hypnosis monitoring can reduce the incidence of awareness, BIS is superior to AAI to display alterations in the level of hypnosis during aneasthesia and NMBAs affect the level of hypnosis during light general anaesthesia in stimulated patients.
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| 27. |
- Ekman, Andreas, et al.
(författare)
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Reduction in the incidence of awareness using BIS monitoring
- 2004
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 48, s. 20-26
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Tidskriftsartikel (refereegranskat)abstract
- Reduction in the incidence of awareness using BISmonitoringA. EKMAN1,M-L.LINDHOLM1,C.LENNMARKEN2and R. SANDIN11Department of Anaesthesia and Intensive Care, Regional hospital, Kalmar, and The Karolinska Institute, Stockholm, and2Department ofAnaesthesia and Intensive Care, University Hospital, Linko¨ping, SwedenBackground: Explicit recall (ER) is evident i n a pproximat ely0.2% of patients given general anaesthesia including musclerelaxants. This prospective study was performed to evaluate ifcerebral monitoring using BIS to guide the conduction ofanaesthesia could reduce this incidence significantly.Patients and methods: A prospective cohort of 4945 consecutivesurgical patients requiring muscle relaxants and/or intubationwere monitored with BIS and subsequently interviewed for ERon three occasions. BIS values between 40 and 60 were recom-mended. The results from the BIS-monitored group of patientswas compared with a historical group of 7826 similar cases in aprevious study when no cerebral monitoring was used.Results: Two patients in th e BIS-monitored grou p, 0 .0 4% ,hadER as c ompared with 0.18% in the control group (P < 0.038).Both BIS-monitored patients with ER were aware during intub-ation when they had high BIS values (>60) for 4 min andmore than 10 min, respectively. However, periods with high BIS ¼ 4 min were al so eviden t in other patient s with no ER .Episodes with high BIS, 4 min or more, were found in 19% ofthe monitored patients during induction, and in 8% of casesduring maintenance.Conclusions: The use of BIS monitoring during general anaes-thesia requiring endotracheal intubation and/or muscle relax-ants was associated with a significantly reduced incidence ofawareness as compared with a historical control population.
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| 28. |
- Ekman, Carl, et al.
(författare)
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Plasma concentrations of Gas6 and sAxl correlate with disease activity in systemic lupus erythematosus.
- 2011
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Ingår i: Rheumatology (Oxford, England). - : Oxford University Press (OUP). - 1462-0332 .- 1462-0324. ; 50, s. 1064-1069
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. SLE is a systemic autoimmune disease with an annual incidence of 3.8 per 100 000. Several pathogenic mechanisms are believed to be operating in SLE, including an impaired clearance of apoptotic cells, activation of the type I IFN pathway and generation of autoimmune leucocytes. Growth arrest-specific protein 6 (Gas6) and its receptor Axl are known to regulate inflammation and may be implicated in lupus pathogenesis. We have recently developed immunological methods to quantify the vitamin-K-dependent protein Gas6 and its soluble receptor sAxl in human plasma, which we have used to investigate the role of Gas6 and soluble Axl in SLE. Methods. We have investigated the relation between the plasma concentrations of Gas6 and sAxl and disease activity and specific symptoms in 96 SLE patients. Results. Gas6 and sAxl concentrations correlated with SLEDAI (r = 0.48, P < 0.001 and r = 0.39, P < 0.001, respectively). Furthermore, concentrations of Gas6 and sAxl correlated with ESR and CRP and inversely with haemoglobin levels. Gas6 and sAxl concentrations were significantly higher in patients with anti-DNA antibodies, leucopenia and GN. Conclusion. The plasma concentrations of Gas6 and sAxl vary with disease activity in SLE, in particular GN, and may have a role in lupus pathogenesis. Furthermore, Gas6 and sAxl may be of use as biomarkers of disease activity.
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| 29. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Celebrity politics in an age of visual connectivity : Exploring Instagram as a platform for political mass-self communication
- 2017
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Konferensbidrag (refereegranskat)abstract
- This paper explores Instagram as a platform for political mass-self communication. Drawing on theories of mediatization and celebrity politics, it analyses how various forms of symbolic connectivity are expressed and performed by 16 leading politicians in Sweden, and moreover how their social media use relate to traditional mainstream media. The study leans on a content analysis (n=800) and results show that journalism still holds a strong symbolic value, even when politicians are in charge of the political discourse. In addition, it reveals how the platform logic of Instagram contributes to the formation of digital life style politics, where symbolic connections between politicians and a variety of actors are staged through new mediatized relations. Visual political communication does inherit a democratic and interactive potential. However, according to the analyzed data, most politicians avoid public interaction. Instead, they are preoccupied with the branding of their public persona.
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| 30. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Media criticism as a propaganda strategy in political communication
- 2023
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Ingår i: Nordic Journal of Media Studies. - 2003-184X. ; 5:1, s. 115-133
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Tidskriftsartikel (refereegranskat)abstract
- Over the last decade, strategic attacks on news media institutions and journalists have become an increasingly common feature of populist political communication. The purpose of this article is to identify various strategies that politicians use to criticise the news media and illuminate how the use and circulation of these strategies vary between party types. The article builds on a content analysis of the Twitter feeds of all members of parliament with an active account during the 2018 Swedish election campaign. Results show that political media criticism in Sweden is strongly associated with political personalisation, and it is almost exclusively a right-wing phenomenon, though not restricted specifically to populist parties. Public service media rather than newspapers or commercial broadcasters constitute the prime target for political media criticism in Sweden, illustrating the need to take media systemic aspects in to account when analysing media criticism as a propaganda strategy in political communication.
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| 31. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Mediatized interdependency : Mediated interaction between journalists and politicians on Twitter
- 2014
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Ingår i: Rethinking the Mediatization of Politics.
-
Konferensbidrag (refereegranskat)abstract
- The emergence of social media raises new questions concerning the relationship between journalists and politicians and between news media and political communication. A key trajectory in the relationship between news media institutions and political institutions is related to the changing practices of media production. The interconnections between journalists and politicians have been increasingly complex after the rise of political communication on and through social media platforms. Both politicians and journalists become dependent on factors that pertain to the communicative infrastructure and practices of social media. For example, communication on Twitter is characterised by high velocity, immediacy, and the public interactivity between politicians and journalists. This paper suggest that power relations between journalists and political actors are most fruitfully explored from the perspective of mediatized interdependency, where both parties are reliant on each other in order to get their work done properly. For example, the relations between politicians and journalists on social media platforms such as Twitter and Facebook, could be understood as negotiation (Berkowitz, 2009) or as a struggle (Broersma et. al., 2013). However, the struggle is no longer so much about what ‘could’ be published, but about an on-going discursive battle that takes place in the digital public space. Political actors often make official statements through Twitter, where they ‘correct’ publications they consider problematic. When doing so, they become media producers, which, in turn, use journalism as source and vehicle for promoting their own agenda. Consequently, media logic in the digital era is not restricted to the ground principles of journalistic work, but to a much broader set of opportunities, available to political and commercial institutions in society as well as to the broader public. In order to empirically assess the concept of mediatized interdependency the paper draws on several examples of politicians- journalists interactivity on Twitter.
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| 32. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Parasitic news : Adoption and adaption of journalistic conventions in hybrid political communication
- 2024
-
Ingår i: Journalism - Theory, Practice & Criticism. - : SAGE Publications. - 1464-8849 .- 1741-3001. ; 25:2, s. 295-312
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Tidskriftsartikel (refereegranskat)abstract
- This article explores how political parties and individual politicians in Sweden communicate strategically in an online environment where the close relationship between news and journalistic institutions no longer can be taken for granted. We define the adoption and adaption of journalistic conventions in political communication as a particular communication style, conceptualized as “parasitic news”. The article presents an analytical framework that explicates the role of parasitic news across five dimensions: ideological transparency/position, alternativeness, news genres, individual vs. collective media practices, and social media affordances. An analysis of three news projects, representing right-wing populist, liberal/conservative, and left-wing/green ideological positions, reveals that parasitic news is a flexible communication style that blurs the boundaries of politics and media in online spaces. Moreover, parasitic news challenges the relevance of established terms such as alternative, hyper-partisan, and fake news, pointing to the need of a renewed conceptual vocabulary in journalism, media and political communication research.
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| 33. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Performative Intimacies and Political Celebritisation
- 2017. - 1
-
Ingår i: Selfie Citizenship. - Cham : Springer. - 9783319452692 - 9783319452708 ; , s. 65-74
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Bokkapitel (refereegranskat)abstract
- Mattias Ekman and Andreas Widholm provide fresh insights into an ongoing performative turn in political communication, arguing that the incorporation of selfies into the daily communication strategies of individual politicians entails a popularisation and celebration of political discourse. Against the background of Swedish politicians’ self-imagery on Instagram, they show that ‘performed connectivity’ has become increasingly central for political identity making online, paralleling the celebrity management of actors in the global entertainment industry. This development is problematised in terms of three performative styles that disclose strategic choices in which politicians act and interact across the increasingly blurring boundaries of the professional and the private and where symbolic connections between politicians and citizens are staged through new mediatised performances.
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| 34. |
- Ekman, Mattias, 1974-, et al.
(författare)
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Political communication as television news : Party-produced news of the Sweden Democrats during the 2022 election campaign
- 2024
-
Ingår i: Nordicom Review. - 1403-1108 .- 2001-5119. ; 45:S1, s. 66-91
-
Tidskriftsartikel (refereegranskat)abstract
- Political communication has taken new and complex forms within the contemporary hybrid media system. In this article, we examine how political campaigning that draws on television news forms utilises the increasingly blurred boundaries between news journalism and politics online. We assess the digital television news channel Riks, which during the 2022 national election was operated by the Sweden Democrats party and distributed via YouTube. Deploying a mixed-methods approach, we analysed all videos published by Riks four weeks prior to the election. Results show that Riks blends descriptive, interpretative, and outrage genres, and strategically frames the most important political issues of the election campaign in favour of the party’s policies. Hence, the study contributes to political communication scholarship by emphasising how news has become an integral part of strategic party communication, challenging established scholarly conceptualisations of alternative media and hyperpartisan news.
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| 35. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
Political communication in an age of visual connectivity : Exploring Instagram practices among Swedish politicians
- 2017
-
Ingår i: Northern Lights. - : Intellect Ltd.. - 1601-829X .- 2040-0586. ; 15:1, s. 15-32
-
Tidskriftsartikel (refereegranskat)abstract
- This article explores the specific features of Instagram as a platform for visual political communication. Drawing on theories of mediatization and celebrity politics, it analyses how various forms of symbolic connectivity are expressed and performed by sixteen leading politicians in Sweden, and moreover how their social media use relates to news media. The study leans on a content analysis (n=800) and results show that journalism still holds a strong symbolic value, even when politicians are in charge of the political discourse. In addition, it reveals how the platform logic of Instagram contributes to the formation of digital lifestyle politics, where symbolic connections between politicians and a variety of actors are staged through new mediatized relations. Visual political communication does inherit a democratic and interactive potential. However, according to the analysed data, most politicians avoid public interaction. Instead, they are preoccupied with the branding of their public persona.
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| 36. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
Politicians as Media Producers : Current trajectories in the relation between journalists and politicians in the age of social media
- 2015
-
Ingår i: Journalism Practice. - : Routledge. - 1751-2786 .- 1751-2794. ; 9:1, s. 78-91
-
Tidskriftsartikel (refereegranskat)abstract
- The emergence of social media raises new questions concerning the relationship between journalists and politicians and between news media and politics. The increasingly complex media milieu, in which the boundaries between media producers and audiences become partly dissolved, calls for new theoretical approaches in the study of journalism. This article reassesses central theoretical arguments about the relationship between journalism, sources, politics and democracy. Drawing on a pilot study of the printed press, it explores the increased social media use among politicians in Sweden and its implications for political journalism. The article suggests that power relations between journalism and politics can be fruitfully explored from the perspective of mediatized interdependency, a perspective that acknowledges that journalists and politicians have become both actors and sources through mutual interaction in online spaces. Furthermore, it argues that social media use has expanded journalism’s interest in the private life of politicians, thereby contributing to a de-politicization of politics.
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| 37. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
Politicians as Media Producers : Current trajectories in the relation between journalists and politicians in the age of social media
- 2017
-
Ingår i: Theories of Journalism in a Digital Age. - New York : Routledge. - 9781138684072 ; , s. 191-204
-
Bokkapitel (refereegranskat)abstract
- The emergence of social media raises new questions concerning the relationship between journalists and politicians and between news media and politics. The increasingly complex media milieu, in which the boundaries between media producers and audiences become partly dissolved, calls for new theoretical approaches in study of journalism. This article reassesses central theoretical arguments about the relationship between journalism, sources, politics and democracy. Drawing on a pilot study of the printed press, it explores the increased social media use among politicians in Sweden and its implications for political journalism. The article suggests that power relations between journalism and politics can be fruitfully explored from the perspective of mediatized interdependency, a perspective that acknowledge that both journalists and politicians have become both actors and sources through mutual interaction in online spaces. Furthermore, it argues that social media use has expanded journalism’s interest in the private life politicians, thereby contributing to a de-politicization of politics.
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| 38. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
The tweeting minister : The new(s) impact of Swedish foreign minister Carl Bildt’s use of Twitter
- 2014
-
Ingår i: 5th International Conference on Democracy as Idea and Practice.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A key trajectory in the relationship between news media institutions and political institutions is related to the changing practices of media production. The interconnections between journalists and politicians have been increasingly complex after the rise of political communication on and through social media platforms. Politicians use Twitter and Facebook as communicative platforms, both in relation to private users (citizens, audiences), and in order to influence and network with news media professionals (e.g. Larsson and Moe 2012). One of the most prolific and ‘successful’ users of social media among politicians is Swedish foreign minister Carl Bildt. This paper analyses the impact of Bildt’s twitter use on Swedish news during 2013. The study is based on a content analysis of Sweden’s six highest-circulating newspapers during the first eleven month of the year, analysing the total amount of tweets originated from Bildt that made it into the print newspapers. The study scrutinises in what news contexts tweets are used as sources, what news topics the tweets are part of, to what extent tweets pertain to the professional or personal dimension of Bildt, if the tweets are framed in positive, negative or neutral terms and the schematic ‘position’ of the tweets in the news articles. The paper argues that professional Twitter practices among high-end users normalise Twitter as a platform for journalistic practices. ‘Prominent’ users such as Carl Bildt provide news producers with easily accessed comments in a time of decreasing resources for critical inquiry, fact checking and thorough news reporting. The paper also discusses if social media could be understood as an arena where political messages and identities become increasingly marketised in relation to news production (cf. Wodak 2011).
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| 39. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
Tweeting politics : Exploring the social media interrelationship between journalism and politics in Sweden
- 2013
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Ingår i: Nordmedia 2013.
-
Konferensbidrag (refereegranskat)abstract
- The mediatization of politics refers to a process by which media institutions become increasingly powerful actors in society, making political activities and policy making dependent on journalistic demands and media logic. This paper highlights the new interrelationships between politicians and journalists that have occurred in connection with the rise of political communication on social media platforms. Political actors, previously positioned outside the realm of media, have now incorporated social media use into their communication strategies, thus, journalists are now facing politicians in a multimodal communication environment. Whereas previous studies on Twitter have analysed news topics on Twitter, or news coverage of Twitter as a phenomenon, this paper maps some of the essential factors that can explain how and to which extent Twitter messages by Swedish politicians are used in journalistic content.Using content analysis, this paper scrutinizes the total amount of tweets originated from politicians that made it into the news, in four large daily newspapers. The study examines in what contexts Tweets are used as sources, what news topics political tweets are part of, the actors behind the tweets, the geographical aspects of the political issue, and to what extent tweets pertain to the political or personal dimensions. The paper include a theoretical framework for the study, reflections on the content analysis and the result of a pilot study that examines the impact of politicians’ tweets in news.
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| 40. |
- Ekman, Mattias, 1974-, et al.
(författare)
-
Twitter and the celebritisation of politics
- 2014
-
Ingår i: Celebrity Studies. - : Routledge. - 1939-2397 .- 1939-2400. ; 5:4, s. 518-520
-
Tidskriftsartikel (refereegranskat)abstract
- A distinctive feature of our time is the constant circulation of mediated images of celebrities, a process that has taken new directions after the rise of social media platforms such as Twitter, Facebook and Instagram. This article draws on the contention that contemporary politics is increasingly celebritised, both in terms of how politicians are folded into specific celebrity frames in the news media and in the way politicians ‘perform’ their own professional and private identities through frequent use of social media. Recently, Twitter has become an established platform for a more personal form of political communication, where politicians can influence and network with news media professionals as well as showcase images of their successful and glamorous lives.Drawing on examples from the prolific tweeter and Swedish minister for foreign affairs Carl Bildt we argue that the celebritisation of politics that takes place on Twitter can be conceptualised in terms of three modes of ‘performed connectivity’: public, media and celebrity connectivity respectively. As an analytical concept, performed connectivity accentuates that political communication on Twitter is increasingly performative, meaning that it exhibits the professional as well as private sides of politicians’ daily lives. The term also underlines that this performativity is intimately linked to ideas of connectivity, which create associations of status and ‘known-ness’ in the digital public space.
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| 41. |
- Ekman, Nina, et al.
(författare)
-
A state-of-the-art review of direct observation tools for assessing competency in person-centred care
- 2020
-
Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 109
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Direct observation is a common assessment strategy in health education and training, in which trainees are observed and assessed while undertaking authentic patient care and clinical activities. A variety of direct observation tools have been developed for assessing competency in delivering person-centred care (PCC), yet to our knowledge no review of such tools exists.OBJECTIVE: To review and evaluate direct observation tools developed to assess health professionals' competency in delivering PCC.DESIGN: State-of-the-art review DATA SOURCES: Electronic literature searches were conducted in PubMed, ERIC, CINAHL, and Web of Science for English-language articles describing the development and testing of direct observation tools for assessing PCC published until March 2017.REVIEW METHODS: Three authors independently assessed the records for eligibility. Duplicates were removed and articles were excluded that were irrelevant based on title and/or abstract. All remaining articles were read in full text. A data extraction form was developed to cover and extract information about the tools. The articles were examined for any conceptual or theoretical frameworks underlying tool development and coverage of recognized PCC dimensions was evaluated against a standard framework. The psychometric performance of the tools was obtained directly from the original articles.RESULT: 16 tools were identified: five assessed PCC holistically and 11 assessed PCC within specific skill domains. Conceptual/theoretical underpinnings of the tools were generally unclear. Coverage of PCC domains varied markedly between tools. Most tools reported assessments of inter-rater reliability, internal consistency reliability and concurrent validity; however, intra-rater reliability, content and construct validity were rarely reported. Predictive and discriminant validity were not assessed.CONCLUSION: Differences in scope, coverage and content of the tools likely reflect the complexity of PCC and lack of consensus in defining this concept. Although all may serve formative purposes, evidence supporting their use in summative evaluations is limited. Patients were not involved in the development of any tool, which seems intrinsically paradoxical given the aims of PCC. The tools may be useful for providing trainee feedback; however, rigorously tested and patient-derived tools are needed for high-stakes use.
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| 42. |
- Ekman, Nina, et al.
(författare)
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Are the content and usability of a new direct observation tool adequate for assessing competency in delivering person-centred care : a think-aloud study with patients and healthcare professionals in Sweden
- 2024
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 14:6
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate the content and usability of a new direct observation tool for assessing competency in delivering person-centred care based on the Gothenburg Centre for Person-Centred Care (gPCC) framework.Design: This is a qualitative study using think-aloud techniques and retrospective probing interviews and analyzed using deductive content analysis.Setting: Sessions were conducted remotely via Zoom with participants in their homes or offices.Participants: 11 participants with lengthy experience of receiving, delivering and/or implementing gPCC were recruited using purposeful sampling and selected to represent a broad variety of stakeholders and potential end-users.Results: Participants generally considered the content of the four main domains of the tool, that is, person-centred care activities, clinician manner, clinician skills and person-centred care goals, to be comprehensive and relevant for assessing person-centred care in general and gPCC in particular. Some participants pointed to the need to expand person-centred care activities to better reflect the emphasis on eliciting patient resources/capabilities and psychosocial needs in the gPCC framework. Think-aloud analyses revealed some usability issues primarily regarding difficulties or uncertainties in understanding several words and in using the rating scale. Probing interviews indicated that these problems could be mitigated by improving written instructions regarding response options and by replacing some words. Participants generally were satisfied with the layout and structure of the tool, but some suggested enlarging font size and text spacing to improve readability.Conclusion: The tool appears to satisfactorily cover major person-centred care activities outlined in the gPCC framework. The inclusion of content concerning clinician manner and skills was seen as a relevant embellishment of the framework and as contributing to a more comprehensive assessment of clinician performance in the delivery of person-centred care. A revised version addressing observed content and usability issues will be tested for inter-rater and intra-rater reliability and for feasibility of use in healthcare education and quality improvement efforts.
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| 43. |
- Ekman, Nina, et al.
(författare)
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Observable indicators of person-centred care: an interview study with patients, relatives and professionals
- 2022
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:4
-
Tidskriftsartikel (refereegranskat)abstract
- Objective To identify key observable indicators of person-centred care (PCC) from interviews with patients, relatives and professionals with experience of receiving or working with PCC. Design A qualitative interview study using deductive content analysis. Setting Primary and hospital care settings in Western Sweden. Participants Twelve participants with extensive experience of receiving or working with PCC were interviewed: two patients, two patients representative with long-term conditions, one relative and informal carer, three registered nurses, one physician, two occupational therapists and one social worker/researcher. Results Nine observable indicators were identified and subsumed under three predetermined categories: initiating, working and safeguarding the partnership. The first category comprised three subcategories: welcoming, interested and courteous reception; agreeing on structure and aims of the conversation; and eliciting patients' wishes for involvement of significant others. The second category comprised four subcategories: attentive, empathic and encouraging manner; promoting mutual understanding; promoting patient engagement; and encouraging and friendly body language. The last category consisted of two subcategories: collaboration and transparency in documentation and verifying that patient's and professional's views, goals and wants are correctly documented. Conclusion Our results underline the need for health professionals to actively and conscientiously convey to patients their interest in and respect for the patient as a person and their willingness to collaborate as partners in their care from the very outset of the interaction. Non-verbal behaviours were seen to play a major role in shaping patients' impressions of health professionals. Given that patients' first impressions were considered to impact the content, course and outcomes of the interaction, more research attention should be given to their implications for the effective delivery of PCC.
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| 44. |
- Ekman, Peter, et al.
(författare)
-
Tit for tat and big steps : The case of Swedish banks' internationalization 1961-2010
- 2014
-
Ingår i: International Business Review. - : Elsevier BV. - 0969-5931 .- 1873-6149. ; 23:6, s. 1049-1063
-
Tidskriftsartikel (refereegranskat)abstract
- This study examines four major Swedish banks' internationalization process patterns during the period 1961-2010. The study complements earlier studies by also considering the banks' levels of market commitment. One objective is to determine if 'Tit for tat'-behaviour seen in earlier studies of Swedish banks still prevails after the deregulation. Adding to earlier studies, this study also considers the level of market activities and commitments. A secondary purpose is to examine how the financial crisis has affected the banks with reference to the banks' internationalization patterns. The empirical study is based on archival data on the studied banks' foreign operations. The results show that the banks' behaviour follows 'Tit for tat'-behaviour but that the internationalization has accelerated after the deregulation, hence being carried out with 'big steps' rather than small steps. The analysis also shows that the mimetic behaviour is complemented by other types of internationalization behaviours. The differences in bank internationalization also mean that the effect of a financial crisis varies depending on how the banks have internationalized.
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| 45. |
|
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| 46. |
- Enlund, Mats, et al.
(författare)
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Survival after primary breast cancer surgery following propofol or sevoflurane general anesthesia-A retrospective, multicenter, database analysis of 6305 Swedish patients
- 2020
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Ingår i: Acta Anaesthesiologica Scandinavica. - : John Wiley & Sons. - 0001-5172 .- 1399-6576. ; 64:8, s. 1048-1054
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Tidskriftsartikel (refereegranskat)abstract
- Background: Retrospective studies indicate that the choice of anesthetic can affect long-term cancer survival. Propofol seems to have an advantage over sevoflurane. However, this is questioned for breast cancer. We gathered a large cohort of breast cancer surgery patients from seven Swedish hospitals and hypothesized that general anesthesia with propofol would be superior to sevoflurane anesthesia regarding long-term breast cancer survival.Methods: We identified all patients who were anaesthetized for breast cancer surgery between 2006 and 2012. The patients were matched to the Swedish Breast Cancer Quality Register, to retrieve tumor characteristics, prognostic factors, and adjuvant treatment as well as date of death. Overall survival between patients undergoing sevoflurane and propofol anesthesia was analyzed with different statistical approaches: (a) multiple Cox regression models adjusted for demographic, oncological, and multiple control variables, (b) propensity score matching on the same variables, but also including the participating centers as a cofactor in a separate analysis.Results: The database analysis identified 6305 patients. The 5-year survival rates were 91.0% and 81.8% for the propofol and sevoflurane group, respectively, in the final model (P = .126). Depending on the statistical adjustment method used, different results were obtained, from a non-significant to a "proposed" and even a "determined" difference in survival that favored propofol, with a maximum of 9.2 percentage points higher survival rate at 5 years (hazard ratio 1.46, 95% CI 1.10-1.95).Conclusions: It seems that propofol may have a survival advantage compared with sevoflurane among breast cancer patients, but the inherent weaknesses of retrospective analyses were made apparent.
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| 47. |
- Flam, B, et al.
(författare)
-
Authors' Response
- 2015
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Ingår i: Journal of intensive care medicine. - : SAGE Publications. - 1525-1489 .- 0885-0666. ; 52:1, s. 493-4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 48. |
- Fors, Andreas, 1977, et al.
(författare)
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Effectiveness of person-centred care after acute coronary syndrome in relation to educational level: Subgroup analysis of a two-armed randomised controlled trial
- 2016
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Ingår i: International journal of cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 221, s. 957-962
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to evaluate the effects of person-centred care (PCC) after acute coronary syndrome (ACS) in relation to educational level of participants. METHOD: 199 Patients <75years with ACS were randomised to PCC plus usual care or usual care alone and followed for 6months from hospital to outpatient care and primary care. For the PCC group, patients and health care professionals co-created a PCC health plan reflecting both perspectives, which induced a continued collaboration in person-centred teams at each health care level. A composite score of changes that included general self-efficacy assessment, return to work or previous activity level, re-hospitalisation or death was used as outcome measure. RESULTS: In the group of patients without postsecondary education (n=90) the composite score showed a significant improvement in favour of the PCC intervention (n=40) vs. usual care (n=50) at six months (35.0%, n=14 vs. 16.0%, n=8; odds ratio (OR)=2.8, 95% confidence interval (CI): 1.0-7.7, P=0.041). In patients with postsecondary education (n=109), a non-significant difference in favour of the PCC intervention (n=54) vs. usual care (n=55) was observed in the composite score (13.0%, n=7 vs 3.6%, n=2; OR=3.9, 95% CI: 0.8-19.9, P=0.097). CONCLUSION: A PCC approach, which stresses the necessity of a patient-health care professional partnership, is beneficial in patients with low education after an ACS event. Because these patients have been identified as a vulnerable group in cardiac rehabilitation, we suggest that PCC can be integrated into conventional cardiac rehabilitation programmes to improve both equity in uptake and health outcomes. TRIAL REGISTRATION: Swedish registry, Researchweb.org, ID NR 65 791.
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| 49. |
- Fors, Andreas, 1977, et al.
(författare)
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Effects of a person-centred telephone-support in patients with chronic obstructive pulmonary disease and/or chronic heart failure - A randomized controlled trial
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:8
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the effects of person-centred support via telephone in two chronically ill patient groups, chronic obstructive pulmonary disease (COPD) and/or chronic heart failure (CHF). 221 patients ≥ 50 years with COPD and/or CHF were randomized to usual care vs. usual care plus a person-centred telephone-support intervention and followed for six months. Patients in the intervention group were telephoned by a registered nurse initially to co-create a person-centred health plan with the patient and subsequently to discuss and evaluate the plan. The primary outcome measure was a composite score comprising General Self-Efficacy (GSE), re-hospitalization and death. Patients were classified as deteriorated if GSE had decreased by ≥ 5 points, or if they had been re-admitted to hospital for unscheduled reasons related to COPD and/or CHF or if they had died. At six-month follow-up no difference in the composite score was found between the two study groups (57.6%, n = 68 vs. 46.6%, n = 48
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| 50. |
- Fors, Andreas, 1977, et al.
(författare)
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Effects of person-centred care after an event of acute coronary syndrome: Two-year follow-up of a randomised controlled trial
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 249, s. 42-47
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Authors. Aim: To assess the long-term effect of person-centred care (PCC) in patients with acute coronary syndrome (ACS). Method: Patients with ACS were randomly assigned to treatment as usual (control group) or an added PCC intervention for six months. The primary endpoint was a composite score of changes in general self-efficacy. ≥. five units, return to work or to a prior activity level and re-hospitalisation or death. Results: The composite score improved in the PCC intervention group (n = 94) at a two-year follow-up compared with the control group (n = 105) (18.1%, n = 17 vs. 10.5%, n = 11; P = 0.127). In the per-protocol analysis (n = 183) the improvement was significant in favour of the PCC intervention (n = 78) compared with usual care (n = 105) (21.8%, n = 17 vs. 10.5%, n = 11; P = 0.039). This effect was driven by the finding that more patients in the PCC group improved their general self-efficacy score. ≥. 5. units (32.2%, n = 19 vs. 17.3%, n = 14; P = 0.046). The composite score improvement was significantly higher in the PCC intervention group without post-secondary education (n = 33) in comparison with corresponding patients in the control group (n = 50) (30.3%, n = 10 vs. 10.0%, n = 5; P = 0.024). Conclusion: Implementation of PCC results in sustained improvements in health outcome in patients with ACS. PCC can be incorporated into conventional cardiac prevention programmes to improve equity in uptake and patient health outcomes. Trial registration: Swedish registry, Researchweb.org, ID NR 65791.
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