| 1. |
- Hachinski, Vladimir, et al.
(author)
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Stroke: Working Toward a Prioritized World Agenda
- 2010
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In: Stroke: a journal of cerebral circulation. - 1524-4628. ; 41:6, s. 1084-1099
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Journal article (peer-reviewed)abstract
- Background and Purpose-The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods-Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results-Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent "silo" mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and registries. Foster Cooperation Among Stakeholders (large stroke organizations, nongovernmental organizations, governments, patient organizations and industry) to enhance stroke care. Educate and energize professionals, patients, the public and policy makers by using a "Brain Health" concept that enables promotion of preventive measures. Conclusions-To accelerate progress in stroke, we must reach beyond the current status scientifically, conceptually, and pragmatically. Advances can be made not only by doing, but ceasing to do. Significant savings in time, money, and effort could result from discontinuing practices driven by unsubstantiated opinion, unproven approaches, and financial gain. Systematic integration of knowledge into programs coupled with careful evaluation can speed the pace of progress.
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| 2. |
- Hachinski, Vladimir, et al.
(author)
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Stroke: Working toward a Prioritized World Agenda
- 2010
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In: Cerebrovascular Diseases. - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 30:2, s. 127-147
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Journal article (peer-reviewed)abstract
- Background and Purpose: The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods: Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results: Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e. g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and registries. Foster Cooperation Among Stakeholders (large stroke organizations, nongovernmental organizations, governments, patient organizations and industry) to enhance stroke care. Educate and energize professionals, patients, the public and policy makers by using a 'Brain Health' concept that enables promotion of preventive measures. Conclusions: To accelerate progress in stroke, we must reach beyond the current status scientifically, conceptually, and pragmatically. Advances can be made not only by doing, but ceasing to do. Significant savings in time, money, and effort could result from discontinuing practices driven by unsubstantiated opinion, unproven approaches, and financial gain. Systematic integration of knowledge into programs coupled with careful evaluation can speed the pace of progress. Copyright (C) 2010 American Heart Association. Inc., S. Karger AG, Basel, and John Wiley & Sons, Inc.
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| 3. |
- Hachinski, Vladimir, et al.
(author)
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Stroke: working toward a prioritized world agenda
- 2010
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In: International Journal of Stroke. - : SAGE Publications. - 1747-4949 .- 1747-4930. ; 5:4, s. 238-256
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Journal article (other academic/artistic)abstract
- Background and Purpose The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods Preliminary work was performed by seven working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and registries. Foster Cooperation Among Stakeholders (large stroke organizations, nongovernmental organizations, governments, patient organizations and industry) to enhance stroke care. Educate and energize professionals, patients, the public and policy makers by using a 'Brain Health' concept that enables promotion of preventive measures. Conclusions To accelerate progress in stroke, we must reach beyond the current status scientifically, conceptually, and pragmatically. Advances can be made not only by doing, but ceasing to do. Significant savings in time, money, and effort could result from discontinuing practices driven by unsubstantiated opinion, unproven approaches, and financial gain. Systematic integration of knowledge into programs coupled with careful evaluation can speed the pace of progress.
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| 4. |
- Cahill, Kevin E., et al.
(author)
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Does Bridge Employment Mitigate or Exacerbate Inequalities Later in Life?
- 2024
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In: Work, Aging and Retirement. - : Oxford University Press. - 2054-4642 .- 2054-4650. ; 10:2, s. 77-99
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Journal article (peer-reviewed)abstract
- Most older Americans with career employment change jobs at least once before retiring from the labor market. Much is known about the prevalence and determinants of these bridge jobs, yet relatively little is known about the implications of such job changes—compared to direct exits from a career job—upon economic disparities in later life. In this article, we use 26 years of longitudinal data from the Health and Retirement Study to document the various pathways that older Americans take when exiting the labor force, and examine how bridge employment affects nonhousing wealth and total wealth, including the present discounted value of Social Security benefits. We find that gradual retirement in the form of bridge employment neither exacerbates nor mitigates wealth inequalities among Americans who hold career jobs later in life. That said, we do find some evidence that wealth inequalities grow among the subset of older career workers who transition from career employment to bridge employment at older ages. One policy implication of our article is that it provides evidence that might allay concerns about the potential for disparate financial impacts associated with the gradual retirement process.
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| 5. |
- Calderón-Larrañaga, Amaia, et al.
(author)
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Effectiveness of interventions to address the negative health outcomes of informal caregiving to older adults : protocol for an umbrella review
- 2021
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In: BMJ Open. - : BMJ. - 2044-6055. ; 11:11
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Research review (peer-reviewed)abstract
- Introduction Informal (unpaid) caregivers play an essential role in caring for older people, whose care needs are often not fully met by formal services. While providing informal care may be a positive experience, it can also exert a considerable strain on caregivers’ physical and mental health. How to best support the needs of informal caregivers remains largely debated. This umbrella review (review of systematic reviews) aims to evaluate (1) whether effective interventions can mitigate the negative health outcomes of informal caregiving, (2) whether certain types of interventions are more effective than others, (3) whether effectiveness of interventions depends on caregiver/receiver, context or implementation characteristics and (4) how these interventions are perceived in terms of acceptability, feasibility and added value.Methods and analysis We will include systematic reviews of primary studies focusing on the effectiveness of interventions (public or private, unifaceted or multifaceted, delivered by health or social care professionals or volunteers) aimed at reducing the impact of caregiving on caregivers’ physical or mental health. This will also include quantitative and qualitative syntheses of implementation studies. The literature search will include the following databases: Medline, CINAHL, PsycINFO and Web of Science. A key informant-guided search of grey literature will be performed. Quality appraisal will be conducted with the AMSTAR-2 checklist for quantitative reviews and with an ad hoc checklist for qualitative syntheses. Narrative and tabular summaries of extracted data will be produced, and framework synthesis will be employed for weaving together evidence from quantitative studies in effectiveness reviews with findings on implementation from qualitative studies.Ethics and dissemination This umbrella review will use data from secondary sources and will not involve interactions with study participants; it is thus exempt from ethical approval. Results will be presented at international conferences and will be published in a peer-reviewed journal.
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| 6. |
- Kirvalidze, Mariam, et al.
(author)
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Effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults : an umbrella review of systematic reviews and meta-analyses
- 2023
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:4
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Journal article (peer-reviewed)abstract
- Objectives This umbrella review aimed to evaluate whether certain interventions can mitigate the negative health consequences of caregiving, which interventions are more effective than others depending on the circumstances, and how these interventions are experienced by caregivers themselves.Design An umbrella review of systematic reviews was conducted.Data sources Quantitative (with or without meta-analyses), qualitative and mixed-methods systematic reviews were included.Eligibility criteria Reviews were considered eligible if they met the following criteria: included primary studies targeting informal (ie, unpaid) caregivers of older people or persons presenting with ageing-related diseases; focused on support interventions and assessed their effectiveness (quantitative reviews) or their implementation and/or lived experience of the target population (qualitative reviews); included physical or mental health-related outcomes of informal caregivers.Data extraction and synthesis A total of 47 reviews were included, covering 619 distinct primary studies. Each potentially eligible review underwent critical appraisal and citation overlap assessment. Data were extracted independently by two reviewers and cross-checked. Quantitative review results were synthesised narratively and presented in tabular format, while qualitative findings were compiled using the mega-aggregation framework synthesis method.Results The evidence regarding the effectiveness of interventions on physical and mental health outcomes was inconclusive. Quantitative reviews were highly discordant, whereas qualitative reviews only reported practical, emotional and relational benefits. Multicomponent and person-centred interventions seemed to yield highest effectiveness and acceptability. Heterogeneity among caregivers, care receivers and care contexts was often overlooked. Important issues related to the low quality of evidence and futile overproduction of similar reviews were identified.Conclusions Lack of robust evidence calls for better intervention research and evaluation practices. It may be warranted to avoid one-size-fits-all approaches to intervention design. Primary care and other existing resources should be leveraged to support interventions, possibly with increasing contributions from the non-profit sector.
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| 7. |
- Kirvalidze, Mariam, et al.
(author)
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Estimating pairwise overlap in umbrella reviews : Considerations for using the corrected covered area (CCA) index methodology
- 2023
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In: Research Synthesis Methods. - : John Wiley & Sons. - 1759-2879 .- 1759-2887. ; 14:5, s. 764-767
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Research review (peer-reviewed)abstract
- Umbrella reviews (reviews of systematic reviews) are increasingly used to synthesize findings from systematic reviews. One important challenge when pooling data from several systematic reviews is publication overlap, that is, the same primary publications being included in multiple reviews. Pieper et al. have proposed using the corrected covered area (CCA) index to quantify the degree of overlap between systematic reviews to be pooled in an umbrella review. Recently, this methodology has been integrated in Excel- or R-based tools for easier use. In this short letter, we highlight an important consideration for using the CCA methodology for pairwise overlap assessment, especially when reviews include varying numbers of primary publications, and we urge researchers to fine-tune this method and exercise caution when review exclusion decisions are based on its output.
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| 8. |
- Platts, Loretta G., et al.
(author)
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Job Quality in the Late Career in Sweden, Japan and the United States
- 2023
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In: Research on Aging. - : Sage Publications. - 0164-0275 .- 1552-7573. ; 45:3-4, s. 259-279
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Journal article (peer-reviewed)abstract
- Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health (n = 13,936–15,520), Japanese Study of Ageing and Retirement (n = 3704) and the Health and Retirement Study (n = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level.
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| 9. |
- Platts, Loretta G., et al.
(author)
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Omvärdera synen på de äldres livsvillkor under pandemin
- 2020
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In: Läkartidningen. - 0023-7205 .- 1652-7518.
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Journal article (pop. science, debate, etc.)abstract
- Rekommendationen att alla äldre personer ska hålla sig hemma är ett uttryck för negativa stereotyper som utgår ifrån att äldre är passiva, sårbara och beroende av andra. Den riskerar att ytterligare begränsa personlig frihet och förstärka den sociala, ekonomiska och politiska marginaliseringen. Åtgärder för att skydda äldre från covid-19 behöver inriktas på hur vi kan främja ett aktivt, meningsfullt och tillfredsställande liv trots pandemin. Bättre kunskap om äldres livsvillkor behövs alltså som grund för nya rekommendationer. Vi föreslår attäldre engageras (enskilt eller via pensionärsorganisationer) i diskussioner om hur man realistiskt och varaktigt kan skydda sig utan att behöva vara isoleradäldre människors olika livsvillkor och levnadsförhållanden beaktas i nya och hälsofrämjande rekommendationernya rekommendationer måste stärka de äldres egen handlingskraftnya rekommendationer ger bättre underlag för att väga riskerna för covid-19 mot ett hälsofrämjande socialt och fysiskt aktivt liv.
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| 10. |
- Sacco, Lawrence B., et al.
(author)
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Changes in Job Quality as People Work Beyond Pensionable Age in Sweden
- 2021
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In: Work, Aging and Retirement. - : Oxford University Press (OUP). - 2054-4642 .- 2054-4650. ; 8:3, s. 282-295
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Journal article (peer-reviewed)abstract
- Large numbers of people remain in paid work after pensionable age, often in bridge jobs or with reduced working hours. Remarkably, knowledge about the quality of these jobs relative to those taken prior to pension eligibility is very limited. In this paper, we examined changes in job quality among workers in their sixties in the context of contemporaneous changes in work intensity and employment characteristics. This study is based on data from the biennial Swedish Longitudinal Occupational Survey of Health (SLOSH, 2006–2018, n = 1890–3013). Job quality outcomes were physical (dangerous, strenuous or unpleasant work) and psychosocial (job strain, effort-reward imbalance, work time control) working conditions and job satisfaction. First difference estimation was used to observe within-individual wave-to-wave changes in job quality over ages 61/62–69/70. Changes in working hours, employment characteristics (shifting to a non-permanent contract, the private sector and self-employment) and health were included as covariates. The typical individual who worked beyond pensionable age experienced statistically significant improvements in job quality. Improvements in psychosocial working conditions and job satisfaction were larger for those who reduced working hours and shifted from permanent to non-permanent contracts, from the public into the private sector and from wage-and-salary to self-employment. Work beyond pensionable age is a distinctive period, characterized by employment that becomes more flexible and rewarding and less stressful. These improvements are a function of older individuals’ preferences and ability to work fewer hours and transition to new lines of work.
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