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- Larsson, Agneta, 1976, et al.
(författare)
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Reducing throughput time in a service organisation by introducing cross-functional teams
- 2012
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Ingår i: Production Planning and Control. - : Informa UK Limited. - 0953-7287 .- 1366-5871. ; 23:7, s. 571-580
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to investigate throughput time benefits when implementing cross-functional teams in a service organisation. The cross-functional teams, consisting of key human resources, are similarly designed to work cells within Cellular Manufacturing. Cellular manufacturing is an approach within manufacturing to achieve production flexibility and to shorten throughput time. This paper reports the results from implementing the cellular manufacturing principle at a Swedish emergency department, aiming at decreasing patient throughput time and time-to-doctor. The main approach was to introduce a team-based organisation, also involving some elimination of process steps. The quantitative evaluation of patient data shows significant reduction in mean values of up to about 40 minutes for some patient groups, combined with an increased portion of the doctors’ time together with the patients. The qualitative evaluation of the study show enhanced teamwork and communication, and also improved visibility and understanding of the work tasks of other team members.
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| 2. |
- Larsson, Agneta, 1976, et al.
(författare)
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REORGANIZING THE EMERGENCY DEPARTMENT TO REDUCE THROUGHPUT TIME BY INTRODUCING CROSS-FUNCTIONAL TEAMS
- 2008
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Ingår i: EurOMA Conference, 15-18 June 2008, Groningen, Holland.
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Konferensbidrag (refereegranskat)abstract
- This paper reports the results from a test implementation at a Swedish emergency department, aiming at decreasing patient throughput time and time-to-doctor. The main approach was to introduce a team-based organization in combination with some integration of process-steps. The quantitative evaluation of patient data shows significant reduction in mean values of up to about 50 minutes for some patient groups, combined with an increased portion of the doctors’ time together with the patients.
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| 3. |
- Neselius, Sanna, et al.
(författare)
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CSF-Biomarkers in Olympic Boxing: Diagnosis and Effects of Repetitive Head Trauma
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 7:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sports-related head trauma is common but still there is no established laboratory test used in the diagnostics of minimal or mild traumatic brain injuries. Further the effects of recurrent head trauma on brain injury markers are unknown. The purpose of this study was to investigate the relationship between Olympic (amateur) boxing and cerebrospinal fluid (CSF) brain injury biomarkers. Methods: The study was designed as a prospective cohort study. Thirty Olympic boxers with a minimum of 45 bouts and 25 non-boxing matched controls were included in the study. CSF samples were collected by lumbar puncture 1-6 days after a bout and after a rest period for at least 14 days. The controls were tested once. Biomarkers for acute and chronic brain injury were analysed. Results: NFL (mean +/- SD, 5326 +/- 553 vs 135 +/- 51 ng/L p = 0.001), GFAP (496 +/- 238 vs 247 +/- 147 ng/L pless than0.001), T-tau (58 +/- 26 vs 49 +/- 21 ng/L pless than0.025) and S-100B (0.76 +/- 0.29 vs 0.60 +/- 0.23 ng/L p = 0.03) concentrations were significantly increased after boxing compared to controls. NFL (402 +/- 434 ng/L p = 0.004) and GFAP (369 +/- 113 ng/L p = 0.001) concentrations remained elevated after the rest period. Conclusion: Increased CSF levels of T-tau, NFL, GFAP, and S-100B in greater than80% of the boxers demonstrate that both the acute and the cumulative effect of head trauma in Olympic boxing may induce CSF biomarker changes that suggest minor central nervous injuries. The lack of normalization of NFL and GFAP after the rest period in a subgroup of boxers may indicate ongoing degeneration. The recurrent head trauma in boxing may be associated with increased risk of chronic traumatic brain injury.
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| 4. |
- Neselius, Sanna
(författare)
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Diagnosis and monitoring of sport-related concussion
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Concussions are one of the most common sport-related injuries and it is known that they cause axonal and glial damage, and that there are risks for long-term effects. The aims of this thesis were to find possible methods, which may help clinicians to diagnose and monitor mild traumatic brain injury (TBI), analyse the APOEε4 allele genotype that has been associated with poor outcome after TBI and evaluate the relationship between neuropsychological assessment and brain injury biomarkers in the cerebrospinal fluid (CSF). Methods: In paper I-IV, 30 amateur boxers and 25 non-boxing matched controls were included. All study subjects underwent medical and neurological examination, neuropsychological evaluation and ApoE genotyping. Brain injury biomarkers were analysed in CSF and blood 1-6 days after a bout and after a rest period for at least 14 days. The controls were tested once. Paper V presents a knocked out boxer where CSF brain injury biomarkers were analysed at five time points upon normalization. Results: The CSF concentrations of neurofilament light (NFL), phosphorylated NFH (pNFH), glial fibrillary acidic protein (GFAP), Total-tau and S100B and plasma-tau were significantly increased 1-6 days after bout compared to controls. NFL, pNFH and GFAP remained elevated after the rest period. Possession of APOEε4 allele did not influence biomarker concentrations. The neurological assessment showed no significant differences between boxers and controls, however boxers with elevated CSF NFL by follow up performed significantly poorer on the Trailmaking A and Simple Reaction Time tests. The case report in paper V showed marked elevation of CSF NFL, with a peak at 2 weeks post trauma, not reaching below the reference limit until week 36. Conclusion: This thesis found that the subconcussive trauma in amateur boxing causes axonal and glial brain injury, even without unconsciousness or concussion symptoms. The neuropsychological evaluation without baseline testing is not as sensitive as CSF NFL in the diagnosis and monitoring of concussion. ApoE genotype was not found to influence CSF biomarker concentrations. The case report further showed that recovery from concussion, although in absence of symptoms, could take more than 4 months. The results of this thesis indicate, that NFL and other CSF biomarkers may be valuable in the management of injured athletes and in return-to-play decisions following concussion.
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| 5. |
- Neselius, Sanna, et al.
(författare)
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Increased CSF Levels of Phosphorylated Neurofilament Heavy Protein following Bout in Amateur Boxers.
- 2013
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 8:11
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Tidskriftsartikel (refereegranskat)abstract
- Diagnosis of mild TBI is hampered by the lack of imaging or biochemical measurements for identifying or quantifying mild TBI in a clinical setting. We have previously shown increased biomarker levels of protein reflecting axonal (neurofilament light protein and tau) and glial (GFAP and S-100B) damage in cerebrospinal fluid (CSF) after a boxing bout. The aims of this study were to find other biomarkers of mild TBI, which may help clinicians diagnose and monitor mild TBI, and to calculate the role of APOE ε4 allele genotype which has been associated with poor outcome after TBI.
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| 6. |
- Neselius, Sanna, et al.
(författare)
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Monitoring concussion in a knocked-out boxer by CSF biomarker analysis.
- 2015
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Ingår i: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. - : Springer Science and Business Media LLC. - 1433-7347. ; 23:9, s. 2536-2539
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Tidskriftsartikel (refereegranskat)abstract
- Concussion is common in many sports, and the incidence is increasing. The medical consequences after a sport-related concussion have received increased attention in recent years since it is known that concussions cause axonal and glial damage, which disturbs the cerebral physiology and makes the brain more vulnerable for additional concussions. This study reports on a knocked-out amateur boxer in whom cerebrospinal fluid (CSF) neurofilament light (NFL) protein, reflecting axonal damage, was used to identify and monitor brain damage. CSF NFL was markedly increased during 36weeks, suggesting that neuronal injury persists longer than expected after a concussion. CSF biomarker analysis may be valuable in the medical counselling of concussed athletes and in return-to-play considerations. Level of evidence IV.
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| 7. |
- Neselius, Sanna, et al.
(författare)
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Neurological assessment and its relationship to CSF biomarkers in amateur boxers.
- 2014
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- Mild traumatic brain injury (TBI) or concussion is common in many sports. Today, neuropsychological evaluation is recommended in the monitoring of a concussion and in return-to-play considerations. To investigate the sensitivity of neuropsychological assessment, we tested amateur boxers post bout and compared with controls. Further the relationship between neuropsychological test results and brain injury biomarkers in the cerebrospinal fluid (CSF) were investigated.
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| 8. |
- Neselius, Sanna, et al.
(författare)
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Olympic boxing is associated with elevated levels of the neuronal protein tau in plasma
- 2013
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Ingår i: Brain Injury. - : Informa Healthcare. - 0269-9052 .- 1362-301X. ; 27:4, s. 425-433
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to investigate if olympic (amateur) boxing is associated with elevation of brain injury biomarkers in peripheral blood compared to controls. less thanbrgreater than less thanbrgreater thanMaterials and methods: Thirty olympic boxers competing in at least 47 bouts were compared to 25 controls. Blood was collected from the controls at one occasion and from the boxers within 1-6 days after a bout and after a rest period of at least 14 days. Tau concentration in plasma was determined using a novel single molecule ELISA assay and S-100B, glial fibrillary acidic protein, brain-derived neurotrophic factor and amyloid beta 1-42 were determined using standard immunoassays. less thanbrgreater than less thanbrgreater thanResults: None of the boxers had been knocked-out during the bout. Plasma-tau was significantly increased in the boxers after a bout compared to controls (mean +/- SD, 2.46 +/- 5.10 vs. 0.79 +/- 0.961 ngL(-1), p = 0.038). The other brain injury markers did not differ between the groups. Plasma-tau decreased significantly in the boxers after a resting period compared to after a bout (p = 0.030). less thanbrgreater than less thanbrgreater thanConclusions: Olympic boxing is associated with elevation of tau in plasma. The repetitive minimal head injury in boxing may lead to axonal injuries that can be diagnosed with a blood test.
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