| 1. |
- Choulagai, Bishnu P., et al.
(författare)
-
A cluster-randomized evaluation of an intervention to increase skilled birth attendant utilization in mid- and far-western Nepal
- 2017
-
Ingår i: Health Policy and Planning. - : Oxford University Press. - 0268-1080 .- 1460-2237. ; 32:8, s. 1092-1101
-
Tidskriftsartikel (refereegranskat)abstract
- Skilled birth attendant (SBA) utilization is low in remote and rural areas of Nepal. We designed and implemented an evaluation to assess the effectiveness of a five-component intervention that addressed previously identified barriers to SBA services in mid- and far-western Nepal. We randomly and equally allocated 36 village development committees with low SBA utilization among 1-year intervention and control groups. The eligible participants for the survey were women that had delivered a baby within the past 12 months preceding the survey. Implementation was administered by trained health volunteers, youth groups, mothers' groups and health facility management committee members. Post-intervention, we used difference-in-differences and mixed-effects regression models to assess and analyse any increase in the utilization of skilled birth care and antenatal care (ANC) services. All analyses were done by intention to treat. Our trial registration number was ISRCTN78892490 (http://www.isrctn.com/ISRCTN78892490). Interviewees included 1746 and 2098 eligible women in the intervention and control groups, respectively. The 1-year intervention was effective in increasing the use of skilled birth care services (OR = 1.57; CI 1.19-2.08); however, the intervention had no effect on the utilization of ANC services. Expanding the intervention with modifications, e.g. mobilizing more active and stable community groups, ensuring adequate human resources and improving quality of services as well as longer or repeated interventions will help achieve greater effect in increasing the utilization of SBA.
|
|
| 2. |
- Behrns, Ingrid, 1961, et al.
(författare)
-
Aphasia and Computerised Writing Aid Supported Treatment
- 2009
-
Ingår i: Aphasiology. - London : Psychology Press. - 0268-7038 .- 1464-5041. ; 23:10, s. 1276-1294
-
Tidskriftsartikel (refereegranskat)abstract
- Background:Individuals with aphasia often experience difficulties in writing. Word processors with a spell checker and a grammar checker can compensate for some of the writing difficulties associated with aphasia.Aims:To determine if writing difficulties associated with aphasia may be reduced by the use of a computerised writing aid when training patients.Methods & Procedures:The writing aids used in this study were originally designed specifically for persons with developmental reading and writing difficulties and are based on statistics of frequent misspellings and phonotactic rules. Three participants with aphasia selected one of two offered writing aids. Written production during treatment and evaluation was recorded and analysed by keystroke logging. The study had a single-subject ABA design replicated across three participants. The baseline (A) was established by measuring four dependent variables. During a 9-week intervention phase (B) the dependent variables were measured once a week. A follow-up (A) was done 10 months after the training was finished. The dependent variables were: total number of words in a writing task; proportion of correctly written words; words per minute; proportion of successful edits. The results were analysed both visually and by statistical calculations. Outcomes & Results:All participants experienced a positive improvement in their writing ability. Results showed individual differences; after completed training the first participant made more successful edits, the second wrote more words, had a larger proportion of correctly written words, and made more successful edits. The third participant's results did not show any improvement that could be statistically supported.Conclusions:This study showed that the computerised training facilitated the generating process and made the revision process more efficient for the participants. The results are important in that they indicate possible ways of designing writing treatment. However, they also show the need for careful analyses when evaluating different treatment strategies and in discussing what improved writing ability may be.
|
|
| 3. |
- Erixon Arreman, Inger, 1954-, et al.
(författare)
-
Privatisation of public education? : The emergence of independent upper secondary schools in Sweden
- 2011
-
Ingår i: Journal of education policy. - London : Routledge, Taylor & Francis Group. - 0268-0939 .- 1464-5106. ; 26:2, s. 225-243
-
Tidskriftsartikel (refereegranskat)abstract
- This article explores the upper secondary (or post-16) school market. The study on which it is based, funded by the Swedish Research Council, was entitled 'Upper-secondary education as a market'. Empirical data include official statistics, policy documents, school publications, company reports and school visits. Printed and other news media were also scrutinised to identify how the marketisation of education is represented in public discourse. A number of themes emerged from the study which included mapping the expansion of the school market, chains of ownership and influence, marketing strategies, choice and the school market and issues raised in the media. These imply that there is a new market discourse which represents a clear break with previous social democratic education policies primarily aimed at enhancing citizenship and wider democratic values within an inclusive public school. However, critiques have also emerged including a call for strengthened regulations of and control over independent schools and concern about an education market equated more with shares and profits rather than pedagogy and student citizenship. Keywords: upper secondary education; independent schools; Sweden; privatisation; marketisation; education funding; profit-maximisation; discourse
|
|
| 4. |
- Grönberg, Angelina, et al.
(författare)
-
Long-term prognosis and health-related quality of life for people with Aphasia in Sweden
- 2024
-
Ingår i: Aphasiology. - 0268-7038 .- 1464-5041.
-
Tidskriftsartikel (refereegranskat)abstract
- Background: People with aphasia (PWA) after ischemic stroke often have difficulties in communication and social participation. To individualise rehabilitation and optimise recovery, there is a need for knowledge regarding prevalence of aphasia, and language functions in relation to long-term recovery and health-related quality of life (HRQoL). In this study, we examined these issues in a Swedish setting. Methods: We screened consecutive persons with first-ever ischemic stroke admitted to Skåne University Hospital, Sweden, at baseline (median day 4 post stroke onset) for aphasia with the Language Screening Test (LAST). We then performed a detailed follow-up of PWA at 1, 3, and 12months after stroke onset with the Swedish version of the Comprehensive Aphasia Test (CAT) for evaluation of cognition and language, and with the self-reported Aphasia Impact Questionnaire (AIQ) for evaluation of HRQoL. We analysed aphasia recovery and potential associations between aphasia severity, language functions, stroke severity according to National Institutes of Health Stroke Scale (NIHSS), and HRQoL. Results: Initial aphasia was present in 27% (n=60 of 221) of stroke persons in the acute phase. At 1month after stroke onset, 74% (n=40 of 54 survivors with initial aphasia) had remaining aphasia, at 3months 67% (n=34 of 51) had aphasia and at 12months post stroke 61% (n=30 of 49) had remaining aphasia. Improvement of aphasia was greatest during the first months after onset, with significant improvement regarding naming (p=0.01), repetition (p=0.03) and comprehension of written language (p=0.01). HRQoL remained significantly associated with aphasia severity after adjusting for stroke severity and age. At 3months, 87% (n=26) of PWA reported that aphasia affected their ability to communicate with the environment, had negative consequences on level of participation (73%, n =22), and their emotional well-being (87%, n =26). There were no significant temporal changes regarding HRQoL between 3 and 12months post stroke. Conclusion: Chronic aphasia was observed in 61% of all alive persons presenting with baseline aphasia after ischemic stroke. Aphasia has negative consequences on HRQoL for PWA and aphasia severity impacts HRQoL regardless of stroke severity.
|
|
| 5. |
- Sundström, Nina, et al.
(författare)
-
Incidence and outcome of surgery for adult hydrocephalus patients in Sweden
- 2017
-
Ingår i: British Journal of Neurosurgery. - : Informa UK Limited. - 0268-8697 .- 1360-046X. ; 31:1, s. 21-27
-
Tidskriftsartikel (refereegranskat)abstract
- Object: To present population-based and age related incidence of surgery and clinical outcome for adult patients operated for hydrocephalus, registered in the Swedish Hydrocephalus Quality Registry (SHQR). Methods: All patients registered in SHQR during 2004-2011 were included. Data on age, gender, type of hydrocephalus and type of surgery were extracted as well as three months outcome for patients with idiopathic normal pressure hydrocephalus (iNPH). Results: The material consisted of 2360 patients, 1229 men and 1131 women, age 63.8 +/- 14.4 years (mean standard deviation (SD)). The mean total incidence of surgery was 5.1 +/- 0.9 surgeries/100,000/year; 4.7 +/- 0.9 shunt surgeries and 0.4 +/- 0.1 endoscopic third ventriculostomies. For iNPH, secondary communicating hydrocephalus and obstructive hydrocephalus, the incidence of surgery was 2.2 +/- 0.8, 1.9 +/- 0.3 and 0.8 +/- 0.1/100,000/year, respectively. During 2004-2011, the incidence of surgery increased in total (p = .044), especially in age groups 70-79 years and > 80 years (p = .012 and p = .031). After surgery, 253 of 652 iNPH patients (38.8%) improved at least one step on the modified Rankin scale (mRS). Number needed to treat was 3.0 for improving one patient from unfavourable (mRS 3-5) to favourable (mRS 0-2). The mean score of a modified iNPH scale increased from 54 +/- 23 preoperatively to 63 +/- 25 postoperatively (p < .0001, n = 704), and 58% improved. No significant regional differences in incidence, surgical techniques or outcome were found. Conclusions: Incidence of hydrocephalus surgery increased significantly during 2004-2011, specifically in elderly patients. Surgical treatment of INPH markedly improved functional independence, but the improvement rate was low compared to recent single- and multicentre studies. Thus, the potential for surgical improvement is likely lower than generally reported when treating patients as part of everyday clinical care.
|
|
| 6. |
- Bergquist, Magnus, 1960, et al.
(författare)
-
Practising Peer Review in Organizations: a Qualifier for Knowledge Dissemination and Legitimization
- 2001
-
Ingår i: Journal of Information Technology. - London : SAGE Publications. ; 16:2, s. 99-112
-
Tidskriftsartikel (refereegranskat)abstract
- A key issue in many organizations is how to disseminate information in an effective way and, more importantly, how to make use of this information in order to create new knowledge. One way of addressing this problem is to focus on how information is socially transformed into knowledge. This includes how knowledge is handled in practice and how the knowledge produced is quali ed as being something worth knowing and acting upon. Two well-established practices for doing this are the refereeing system and the peer review process. These are used in scienti c communities as a means of validating and legitimating knowledge, for example by reviewing journal papers before publishing or project proposals before granting funds, etc. This paper argues that peer review is a useful concept when looking at knowledge creation and legitimization in organizations. The social meaning of peer review is to legitimize new knowledge by organizationally sanctioning it and thereby creating a platform for collective sense making. This paper uses an example from a eld study in a pharmaceutical company in order to illustrate this argument. The study took place in a quality support department where the quality of health care products and processes was assessed. The organization had a need for fast and reliable updating of information that could in uence how the production process of pharmaceuticals should be carried out. In order to cope with these problems the department established an ‘evaluation loop’, which shared several characteristics with the peer review process.
|
|
| 7. |
|
|
| 8. |
- Ahlsén, Elisabeth, 1951, et al.
(författare)
-
Activity-based communication analysis - focusing on context in communication partner training
- 2018
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1145-1165
-
Tidskriftsartikel (refereegranskat)abstract
- Background: There is an increased awareness of contextual influence on communication involving persons with aphasia (PWA) and there is a need for frameworks addressing how to analyse contextual factors and address them in, for example, communication partner training (CPT). Activity-based communication analysis (ACA) is a theoretically based method providing a vocabulary and a structure for analysing the influence of context in interaction and how it relates to communication. Aims: The purpose of this paper is to present the framework of ACA as a means of stimulating further enrichment of CPT practices. Methods and Procedures: The paper provides a brief background to the ACA approach, including examples, as well as a checklist and a model for analysis and assessment of intervention addressing communication involving PWA. Outcomes and Results: This approach enables an explicit account of different contextual factors and how they relate to communication and may, thus, guide the design of CPT for particular participants and motivate behavioural change. Conclusions: ACA is a framework that addresses the influence of context on communicative interaction and provides a way of including contextual factors in a systematic way when analysing communication involving PWA. In this way, it can contribute to a richer analysis and intervention and is clearly applicable for CPT
|
|
| 9. |
- Bauer, Malin, 1990, et al.
(författare)
-
Complex oral semantic verbal fluency in non-brain-damaged adults and individuals with multiple sclerosis and subjective anomia
- 2020
-
Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:12, s. 1471-1486
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Many neurologic conditions, for example multiple sclerosis (MS), are associated with subtle communication and language difficulties. To detect such difficulties, there is a need for valid and reliable methods. While standard aphasia test batteries have been found insufficient, more complex language tasks are believed to be able to distinguish more subtle language difficulties from normal variation in communicative ability. Aims: The aim of this study was to: (1) explore the influence of demographic variables on the results of a novel complex oral semantic fluency task with multiple restrictions in non-brain-damaged (NBD) adults, (2) investigate the construct validity and reliability of the method, and (3) compare the results of NBD individuals and individuals with MS. Method and procedure: One hundred and ten NBD individuals performed the complex task and three standard fluency tasks with single restrictions. Regression analyses were run to assess the influence of demographic factors. Furthermore, 16 individuals with MS and subjective anomia performed the complex task and the results were compared with those for a matched group of NBD individuals. Outcome and results: Age and education influenced the NBD individuals’ scores on the complex task. The NBD individuals’ results on the complex task correlated with those on the three standard fluency tasks. Furthermore, the subgroup of 16 pair-matched NBD individuals produced statistically significantly more adequate responses in the complex task than the group of individuals with MS. However, on an individual level some of the participants with MS performed at level with, or even better than the pair-matched NBD individuals. Provision of scoring guidelines yielded high interrater-reliability. Conclusions: The results illustrate the challenge in attempts to provide formal measures of subtle language disorders. Still, the complex task is a promising assessment tool which may be a complement to existing standard word fluency tasks, although future studies are required to establish the validity and ability to detect subtle language difficulties in different clinical groups.
|
|
| 10. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
-
Regional estimates of cortical thickness in brain areas involved in control of surgically restored limb movement in patients with tetraplegia.
- 2020
-
Ingår i: The journal of spinal cord medicine. - : Informa UK Limited. - 2045-7723 .- 1079-0268. ; 43:4, s. 462-469
-
Tidskriftsartikel (refereegranskat)abstract
- Spinal cord injury (SCI) causes atrophy of brain regions linked to motor function. We aimed to estimate cortical thickness in brain regions that control surgically restored limb movement in individuals with tetraplegia.Cross-sectional study.Sahlgrenska University hospital, Gothenburg, Sweden.Six individuals with tetraplegia who had undergone surgical restoration of grip function by surgical transfer of one elbow flexor (brachioradialis), to the paralyzed thumb flexor (flexor pollicis longus). All subjects were males, with a SCI at the C6 or C7 level, and a mean age of 40 years (range=31-48). The average number of years elapsed since the SCI was 13 (range=6-26).We used structural magnetic resonance imaging (MRI) to estimate the thickness of selected motor cortices and compared these measurements to those of six matched control subjects. The pinch grip control area was defined in a previous functional MRI study.Compared to controls, the cortical thickness in the functionally defined pinch grip control area was not significantly reduced (P=0.591), and thickness showed a non-significant but positive correlation with years since surgery in the individuals with tetraplegia. In contrast, the anatomically defined primary motor cortex as a whole exhibited substantial atrophy (P=0.013), with a weak negative correlation with years since surgery.Individuals with tetraplegia do not seem to have reduced cortical thickness in brain regions involved in control of surgically restored limb movement. However, the studied sample is very small and further studies with larger samples are required to establish these findings.
|
|
