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- Larsson, Jerry, et al.
(författare)
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Experience of participation after brain injury related to sick leave
- 2010
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Ingår i: Konferensbidrag - Poster Washington 2010.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Experience of participation after brain injury related to sick leave Larsson Jerry, Esbjörnsson Eva, Björkdahl Ann, Nilsson Michael, Sunnerhagen KS Department of Clinical Neuroscience and Rehabilitation Medicine Institute if Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Sweden Introduction: In Europe, traumatic brain injury (TBI) is one of the main causes of death and handicap. Several studies have shown problems with return to work (RTW) after a traumatic brain injury and a lower level of activity and participation in society. In Sweden, social insurance and sickness benefit are central to people's welfare after all illness. We have not so far found any studies looking at the specific sick-leave pattern prior to a TBI or activity/participation related to sick leave. The aim of this study was to explore the relation between sick leave and participation. Method The study was carried out in Sweden and data were collected from three different hospitals in the Sahlgrenska University Hospital complex in Gothenburg. The cohort was made up of all patients (129 in total) aged between 18 and 65 admitted to the emergency room during a two year period (1999-2000) with a traumatic brain injury classified as S06.2 and S06.3 (International Classification of Diseases 10). The patients were asked to reply to a questionnaire concerning participation (IPA) four years after trauma, to explore their participation in society, related to sick leave at the date for trauma and four years after. Results Of the cohort, 31% were on sick leave the day for trauma, 63% were not on sick leave. There were no differences in severity of injury between the groups measured with RLS (Reaction Level Scale) or in days at hospital after trauma Four years after trauma there was a significant difference in participation, measured with the questionnaire IPA, regarding movement, activity in the home, social contacts and work. The group who were on sick leave at the date for trauma experienced a lower level of participation in society four years after trauma than the group not on sick leave the day for trauma. When analyzing the group not on sick leave the day for trauma considering participation four years after trauma, there was a significant difference in participation if they still were on sick leave or not. The group still on sick leave experienced a significant lower level of participation in activity, leisure time, social contacts, work and helping others than the group not on sick leave. The group on sick leave four years after TBI also had a more difficult brain injury measured with RLS. Conclusions We can in our study se that other factor than the pathology and severity of TBI are predictors for less participation in society after a brain injury. This indicate the necessity to consider premorbid and social factors in rehabilitation. As often stated, the importance is not the diagnose, but who has got the diagnosis.
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| 2. |
- Larsson, Jerry, et al.
(författare)
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Sick leave after traumatic brain injury. The person or the diagnosis - Which has greater impact?
- 2010
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 38:5, s. 541-547
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to describe if and when a sample of traumatic brain injury (TBI) patients could finish their time of sick leave during a 4-year follow up and to explore which factors that influenced the time for sick leave. Materials and methods: All persons, 1999—2002, between 18 and 64 years of age (250 in total), admitted to the emergency room and diagnosed according to ICD 10 as S062 and S063, were included. Demographic data were gathered from medical charts and data concerning sick leave 1 year before trauma and 4 years after trauma, were collected from the Swedish social insurance system. To explore predictors of sick leave, two logistic regressions were performed. Results: The sample (mean age 39.68) consisted of 78% men. More than half of the accidents were due to fall. In the sample, 28 % was on sick leave on the day of trauma and 96 % of these were still on sick leave 4 years after trauma, compared with 39 % in the group not on sick leave on the day of TBI. Sick leave at the day for trauma was found to be a predictor for sick leave 4 years after trauma for the whole group (p = 0.000) together with Glasgow Coma Scale (GCS) (p = 0.002) and length of stay (p = 0.049). In the logistic regression with only the group not on sick leave, the only significant variable was GCS (p = 0.003). Conclusion: The findings support the necessity to consider premorbid and social factors in the TBI rehabilitation.
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| 3. |
- Ludvigsson, Johnny, et al.
(författare)
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GAD65 antigen therapy in recently diagnosed type 1 diabetes mellitus
- 2012
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Ingår i: New England Journal of Medicine. - : Massachusetts Medical Society. - 0028-4793 .- 1533-4406. ; 366:5, s. 433-442
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The 65-kD isoform of glutamic acid decarboxylase (GAD65) is a major autoantigen in type 1 diabetes. We hypothesized that alum-formulated GAD65 (GAD-alum) can preserve beta-cell function in patients with recent-onset type 1 diabetes.METHODS: We studied 334 patients, 10 to 20 years of age, with type 1 diabetes, fasting C-peptide levels of more than 0.3 ng per milliliter (0.1 nmol per liter), and detectable serum GAD65 autoantibodies. Within 3 months after diagnosis, patients were randomly assigned to receive one of three study treatments: four doses of GAD-alum, two doses of GAD-alum followed by two doses of placebo, or four doses of placebo. The primary outcome was the change in the stimulated serum C-peptide level (after a mixed-meal tolerance test) between the baseline visit and the 15-month visit. Secondary outcomes included the glycated hemoglobin level, mean daily insulin dose, rate of hypoglycemia, and fasting and maximum stimulated C-peptide levels.RESULTS: The stimulated C-peptide level declined to a similar degree in all study groups, and the primary outcome at 15 months did not differ significantly between the combined active-drug groups and the placebo group (P=0.10). The use of GAD-alum as compared with placebo did not affect the insulin dose, glycated hemoglobin level, or hypoglycemia rate. Adverse events were infrequent and mild in the three groups, with no significant differences.CONCLUSIONS: Treatment with GAD-alum did not significantly reduce the loss of stimulated C peptide or improve clinical outcomes over a 15-month period.
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| 4. |
- Nilsson, Jerry
(författare)
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Conceptions of Crisis Management Capabilities – Municipal Officials’ Perspectives
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In the Swedish crisis management system, the municipalities have a great responsibility. One part of this responsibility concerns preparing for crises by making risk and vulnerability analyses as well as plans for how to handle extraordinary events. Such preparedness planning involves municipal officials and consequently their conceptions of their organisations’ crisis management capabilities. This makes it vital to look into these conceptions more closely and establish whether specific characteristics can be identified. This thesis aims at gaining understanding of how officials involved in preparedness planning in general and vulnerability analysis in particular explicitly conceive of their organisations’ crisis management capabilities. The thesis poses six specific research questions, pertaining to three themes: vulnerability, dependencies and learning. The results show specific characteristics in how officials conceive of their organisations’ crisis management capabilities. These characteristics appear as similarities, variations, and even disagreements. It is argued that the characteristics as well as what explains them must be considered in the development of society’s crisis management systems.
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| 8. |
- Nilsson, Jerry, et al.
(författare)
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Vad är skyddsvärt?
- 2010
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Ingår i: FRIVA - risk, sårbarhet och förmåga. - 9789163376917 ; , s. 23-35
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- riskhantering, krishantering och lärande, tekniska infrasystems sårbarhet, risk- och sårbarhetsanalys, krishanteringssystem
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| 9. |
- Nilsson, Jerry, et al.
(författare)
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What’s important? Making what is valuable and worth protecting explicit when performing risk and vulnerability analyses
- 2010
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Ingår i: International Journal of Risk Assessment and Management. - 1466-8297 .- 1741-5241. ; 13:3-4, s. 345-363
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Tidskriftsartikel (refereegranskat)abstract
- Values and opinions about what is valuable, are of centralimportance in risk and vulnerability analyses. Yet what is considered valuableis seldom explicitly established. The aim of this study is to explore what groupsof civil servants express as valuable and worth protecting when performing riskand vulnerability analyses in their organisations and to discuss the underlyingreasons for their stipulations. A theoretical framework is elaborated and appliedon the outcome of four seminars, in which participants from Swedish publicorganisations express what they consider valuable and worth protecting. Theresults show considerable variation in what is expressed as valuable and worthprotecting. Possible explanations for the variation and the usefulness of theoutcomes of the different seminars are discussed.
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| 10. |
- Nilsson, Jerry
(författare)
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What’s the problem? Local officials’ conceptions of weaknesses in their municipalities’ crisis management capabilities
- 2010
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Ingår i: Journal of Contingencies and Crisis Management. - : Wiley. - 0966-0879 .- 1468-5973. ; 18:2, s. 83-95
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Tidskriftsartikel (refereegranskat)abstract
- It is becoming increasingly common for local-government officials (civil servants and political appointees) to take part in vulnerability analyses to assess their municipality’s capacity to withstand various crises. The question of how such groups conceive of problems concerning their municipality’s crisis management capabilities is largely unexplored. The aim of this study is to analyze the conceptions that groups of civil servants and political appointees engaged in vulnerability analyses have of weaknesses in their organizations’ crisis management capabilities. The attempt is to identify themes in how problems are described, as well as to compare how often the problems may be associated with different elements that constitute an organization and the different crisis management processes an organization needs to be involved in to manage crises. Ten vulnerability analyses, conducted in seven municipalities, and in one case at a county level, are analysed. The results are discussed in terms of what they indicate concerning the understanding these officials had of the municipalities’ crisis management capabilities.
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