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  • 1.
    Cano, Stefan J
    et al.
    Modus Outcomes, UK.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Barbic, Skye P
    University of British Columbia, Canada.
    Fisher Jr, William P
    University of California, USA.
    Patient-centred outcome metrology for healthcare decision-making2017Conference paper (Refereed)
    Abstract [en]

    Valid and precise quantification of clinical variables is essential for appropriate interpretation to inform healthcare decision making. The outcomes produced from different measurement procedures and instruments, purporting to quantify the same measurand, should be directly comparable. This ensures the appropriate application and widespread adoption of clinical research findings. Metrology provides a framework for the development of a common language of reference measurement systems, which have the potential to improve the accuracy and comparability of patients’ results. However, the practices, procedures and instruments used in social measurement are currently excluded from any formal metrological framework. In this paper, we build on previous arguments, and propose a new international body to bring together metrology, psychometrics, philosophy, and clinical management to support the global comparability and equivalence of measurement results in patient centred outcome measurement to improve healthcare.

  • 2.
    de Fine Licht, Karl
    RISE - Research Institutes of Sweden, Built Environment, Energy and Circular Economy.
    Justifying Antibiotic Resistance Interventions: Uncertainty, Precaution and Ethics2018In: Ethics and Drug-Resistant Infections:  Collective Responsibility for Global Public Health / [ed] Jamrozik E. och Selgelid M.J, Springer, 2018, 5Chapter in book (Other academic)
    Abstract [en]

    This chapter charts and critically analyses the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response antibiotic resistance (ABR), as well as other major public health threats. Our ambition here is to chart and briefly discuss main issues, and point to ways in which these need to be further advanced in future research. This will result in a tentative map of complications, underlying problems and possible challenges. This map illustrates that the ethical challenges in this area are much more complex and profound than is usually acknowledged, leaving no tentatively plausible intervention package free of downsides. This creates potentially overwhelming theoretical conundrums when trying to justify what to do. We therefore end by pointing out two general features of the complexity we find to be of particular importance, and a tentative suggestion for how to create a theoretical basis for further analysis.

  • 3.
    Hornborg, Sara
    et al.
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Hallström, Elinor
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Ziegler, Friederike
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Bergman, Kristina
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Troell, Max
    Beijer Institute of Ecological Economics, Sweden; Stockholm Resilience Centre, Sweden.
    Jonell, Malin
    Beijer Institute of Ecological Economics, Sweden; Stockholm Resilience Centre, Sweden.
    Rönnbäck, Patrik
    Uppsala University, Sweden.
    Henriksson, Patrik
    Beijer Institute of Ecological Economics, Sweden; Stockholm Resilience Centre, Sweden; WorldFish, Malaysia.
    Frisk med fisk utan risk?: Betydelsen av svensk konsumtion av sjömat för hälsa och miljö2019Report (Other academic)
    Abstract [en]

    Seafood is a diverse food commodity, comprising of over 2 500 species from capture fisheries and over 600 species from farming, with vast differences between production methods. Dietary advice often includes recommendations to increase consumption of seafood, based on health benefits and that seafood may be produced with less environmental impacts and resources use compared to many other animal-based foods. However, at the same time, there are frequent media alarms related to potential health risks (some species have diet restrictions) and destructive production practices from both fisheries and aquaculture. As a result, there is often confusion on which seafood to eat or not to eat.The aim of this report is primarily to collate available information on health risks and benefits of Swedish seafood consumption, and to combine this with environmental aspects (focus on carbon footprint).Around 40 seafood products consumed in Sweden were included in the analysis. Potential health risks could only be included qualitatively, since the collected data is risk-based and thus not all products are sampled. It was found that the nutritional content and carbon footprint vastly differ between species. There were also several data gaps identified, such as the need for more detailed data on performance from different production systems. The combined assessment of nutritional value and carbon footprint categorised some species as win-win in terms of nutritional content and environmental pressures (such as small pelagic fish), while others could be more categorised as having less nutritional value and with high environmental costs (such as Northern prawn) respectively.The report provides decision support for further data collection needed to enable combined assessment of nutritional risks, benefits and environmental sustainability of seafood products. Results may be used to discuss suitable level of details of dietary advice.

  • 4. Johansson Hanse, Jan
    et al.
    Harlin, Ulrika
    RISE - Research Institutes of Sweden, Materials and Production, IVF, Arbetsmiljö.
    Jarebrant, Caroline
    RISE - Research Institutes of Sweden, Materials and Production, IVF, Arbetsmiljö.
    Winkel, Jörgen
    Leader-Member Exchange (LMX) and Psychosocial Factors at Work Among Healthcare Professionals2014In: Journal of Nursing and Care, ISSN 2167-1168 JNC, Vol. 3, no 5, p. 1-5Article in journal (Refereed)
    Abstract [en]

    Aim: The study aims to examine the associations between leader–member exchange (LMX) and psychosocial factors at work.

    Methods: A questionnaire-based cross-sectional study was undertaken at four units in two not-for-profit hospitals in southwestern Sweden. The study sample included 240 employees.

    Results: Significant correlations were found between LMX items and most of the psychosocial domains and dimensions. The strongest correlations were found between the LMX item affect and rewards/recognition, role clarity and predictability, and the LMX item loyalty and rewards/recognition. In sum, high-quality LMX was associated with good psychosocial work conditions experienced by the employees.

    Conclusions: The results support possible ways for managers and employees to strengthen their relationships and this may in turn lead to more sustainable systems in health care.

  • 5.
    Nyberg, Magda
    et al.
    Kristianstad University, Sweden.
    Olsson, Viktoria
    Kristianstad University, Sweden.
    Örtman, Gerd
    Linnaeus University, Sweden.
    Pajalic, Zada
    Linnaeus University, Sweden; Oslo and Akershus University, Norway; Kristianstad University, Sweden.
    Andersson, Håkan S
    Linnaeus University, Sweden.
    Blucher, Anna
    Linnaeus University, Sweden.
    Lindborg, Ann-Louise
    Mälardalen University, Sweden.
    Wendin, Karin
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience. Kristianstad University, Sweden; University of Copenhagen, Denmark.
    Westergren, Albert
    Kristianstad University, Sweden.
    The meal as a performance: food and meal practices beyond health and nutrition2018In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 38, no 1, p. 83-107Article in journal (Refereed)
    Abstract [en]

    The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to investigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman's concept of performance as a theoretical framework together with Bourdieu's thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi-structured interviews were conducted with 14 elderly people (aged between 67 and 87 years) and meal observations were carried out with 11 of these people. Participants were found to manage food and meal practices by continuously adjusting and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the façade and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as ‘fuel’ where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance.

  • 6.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Limits to the reliability of the Rasch psychometric model2017Conference paper (Other academic)
    Abstract [en]

    Metrological assurance of qualitative evaluations, such as made by a person acting as a Measurement Instrument (e.g. in person-centred care) seems to be possible using a generalised linear model specifically based on the Rasch psychometric approach. Traditional classical test theory and many of the usual tools of statistics cannot work reliably on ordinal or nominal scales typical of person responses, rating questionnaires or other qualitative evaluations. This talk recalls how to establish metrological references (item banks of task difficulty, for example) and uncertainty budgets for categorical data (using informational entropy). New insight will then be given into how the reliability of subjective measurement systems and the Rasch model can be evaluated with respect to measurement scale shift and scale stretching with novel tools analysing rating scores and logistic regression residuals. Examples will range from physical rehabilitation to cognitive assessment.

  • 7.
    Pendrill, Leslie
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Cano, Stefan
    Modus Outcomes, UK.
    Barbic, Skye
    University of British Columbia, Canada.
    Fisher Jr, William P
    University of California, USA.
    Patient-Centred Outcome Metrology for Healthcare Decision-Making2018In: IOP Conf. Series: Journal of Physics: Conf. Series, ISSN 1742-6596, Vol. 1044, article id 012057Article in journal (Refereed)
    Abstract [en]

    Valid and precise quantification of clinical variables is essential for appropriate interpretation to inform healthcare decision making. The outcomes produced from different measurement procedures and instruments, purporting to quantify the same measurand, should be directly comparable. This ensures the appropriate application and widespread adoption of clinical research findings. Metrology provides a framework for the development of a common language of reference measurement systems, which have the potential to improve the accuracy and comparability of patients' results.However, the practices, procedures and instruments used in social measurement are currently excluded from any formal metrological framework. In this paper, we build on previous arguments, and propose a new international body to bring together metrology, psychometrics, philosophy, and clinical management to support the global comparability and equivalence of measurement results in patient centred outcome measurement to improve healthcare.

  • 8.
    Pendrill, Leslie
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Quaglia, Milena
    Laboratory of the Government Chemist Limited, UK.
    Cano, Stefan
    Modus Outcomes, UK.
    Melin, Jeanette
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Innovative measurements forimproved diagnosis and management of neurodegenerative diseases – EMPIRNeuroMet 15HLT042017Conference paper (Refereed)
    Abstract [en]

    Background: Neurodegeneration is an incurable, debilitating process which presents a growing medical and economic challenge due to our aging population. Alzheimer’s disease is one of the most common neurodegenerative diseases. Objectives: Currently, there are no minimally invasive diagnostic tools which allow for early diagnosis or monitoring of the progression of disease in patients. Methods: The European EMPIR NeuroMet 15HLT04 project (2016 – 9) is helping to address these objectives by exploring innovative techniques for early diagnosis and monitoring, based on non-invasive magnetic resonance imaging approaches, and developing improved clinical assessment protocols focused on monitoring declining cognitive functions. Results: As a case study, the person-centred measurement of cognitive ability is examined, where better analysis of correlations with brain atrophy is enabled thanks to the Rasch metrological approach. A new model of the metrology of ordinal data, including performance metrics and restitution is presented. Conclusions: An example is given of how the Rasch invariant measure theory can improve contemporary studies of possible correlations between neurodegeneration in patients suffering from Alzheimer’s disease – specifically failing cognitive ability – and brain atrophy. It is the first time to our knowledge that the known distortions - revealed by the Rasch psychometric model - of measurement scales in common clinical instruments for cognitive assessment have been corrected for in correlation studies. Possibilities of higher resolution and more reliable clinical decisions open up. Acknowledgments The European Metrology Programme for Innovation & Research (EMPIR, Horizon2020, Art. 185) is jointly funded by the EMPIR participating countries within EURAMET (www.euramet.org) and the European Union in this EMPIR 15 HLT04 NeuroMet project (coordinator: LGC (UK)). Thanks are due, particularly, to Members of the EMPIR NeuroMet consortium. PROJECT WEBSITE http://www.lgcgroup.com/our-science/national-measurement-laboratory/european-metrology-programme-for-innovation-and-re/neuromet/#.WRHEO2dYrcs

  • 9.
    Sommarlund, Petra
    et al.
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Falkvall, Frida
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Sandberg, Peter
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Andersson, Albin
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Stavenow, Bengt
    Innovation Skåne AB.
    Vidarebäck, Carolina
    Innovation Skåne AB.
    Gerward, Sofia
    Innovation Skåne AB.
    Johansson, Jimmy
    Innovation Skåne AB.
    Lindskog, Peder
    InRikta Analys AB.
    Ambjörnsson, Mårten
    InRikta Analys AB.
    Norelius, Marianne
    Apoteket AB.
    En personlig och digital vårdupplevelse - Framtidens primärvård: Full version2016Report (Other academic)
    Abstract [sv]

    Om 10 år kommer primärvården ha andra kontaktvägar och högre tillgänglighet än idag. Patientens första kontakt är digital och i många fall kan ett digitalt beslutsstödssystem, vid behov kompletterat med hemtester, vara tillräckligt för att ge patienten den vård hen behöver. De digitala möjligheterna kommer att leda till ökad kunskap och egenförmåga hos patienten att ta större ansvar för sin egen hälsa. Personanpassade tjänster där individens behov styr kommer att erbjudas både från vården och andra aktörer. Relevant hälsodata kommer att finnas tillgänglig för de aktörer som behöver den och digitala lösningar integreras i hela vårdkedjan. På så sätt frigörs vårdresurser till de personer som verkligen behöver den.

    Denna rapport illustrerar den nutida och framtida primärvården genom fem patientfall som tillsammans täcker in merparten av primärvårdens besök. Möt febrige femårige Arvid, Ahmed med risk för att utveckla livsstilsrelaterad kronisk sjukdom, deprimerade 14-åriga Sara, Erik som just haft en hjärtinfarkt och multisjuka Inga. Från nutid och 10 år framåt förväntas primärvårdens resurser förflyttas från fall av engångskaraktär som Arvid till att arbeta förebyggande med fall som Ahmed.

    För att detta ska realiseras behöver vården säkerställa att patient- och kostnadsansvar följer individen och inte organisatoriska gränssnitt. Ett tydligt syfte med digitaliseringen och den avsedda effekten på verksamheten behöver definieras och hinder som möjliggör samlad vårdinformation som flödar mellan kommun och landsting behöver undanröjas.

  • 10.
    Sommarlund, Petra
    et al.
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Falkvall, Frida
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Sandberg, Peter
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Andersson, Albin
    RISE, SP – Sveriges Tekniska Forskningsinstitut.
    Stavenow, bengt
    Innovation Skåne AB.
    Vitabäck, carolina
    Innovation Skåne AB.
    Gerwand, Sofia
    Innovation Skåne AB.
    Lindskog, Peder
    Nordic Healhcare Group.
    Ambjörnsson, Mårten
    Nordic Healthcare Group.
    Norelius, Marianne
    Apoteket AB.
    En personlig och digital vårdupplevelse - framtidens primärvård: Kortversion2016Report (Other academic)
    Abstract [sv]

    Om 10 år kommer primärvården ha andra kontaktvägar och högre tillgänglighet än idag. Patientens första kontakt är digital och i många fall kan ett digitalt beslutsstödssystem, vid behov kompletterat med hemtester, vara tillräckligt för att ge patienten den vård hen behöver. De digitala möjligheterna kommer att leda till ökad kunskap och egenförmåga hos patienten att ta större ansvar för sin egen hälsa. Personanpassade tjänster där individens behov styr kommer att erbjudas både från vården och andra aktörer. Relevant hälsodata kommer att finnas tillgänglig för de aktörer som behöver den och digitala lösningar integreras i hela vårdkedjan. På så sätt frigörs vårdresurser till de personer som verkligen behöver den.

    Denna rapport illustrerar den nutida och framtida primärvården genom fem patientfall som tillsammans täcker in merparten av primärvårdens besök. Möt febrige femårige Arvid, Ahmed med risk för att utveckla livsstilsrelaterad kronisk sjukdom, deprimerade 14-åriga Sara, Erik som just haft en hjärtinfarkt och multisjuka Inga. Från nutid och 10 år framåt förväntas primärvårdens resurser förflyttas från fall av engångskaraktär som Arvid till att arbeta förebyggande med fall som Ahmed.

    För att detta ska realiseras behöver vården säkerställa att patient- och kostnadsansvar följer individen och inte organisatoriska gränssnitt. Ett tydligt syfte med digitaliseringen och den avsedda effekten på verksamheten behöver definieras och hinder som möjliggör samlad vårdinformation som flödar mellan kommun och landsting behöver undanröjas.

  • 11.
    Westergren, Albert
    et al.
    Kristianstad University, Sweden.
    Hagell, Peter
    Kristianstad University, Sweden.
    Wendin, Karin
    RISE, SP – Sveriges Tekniska Forskningsinstitut, SP Food and Bioscience. University of Copenhagen, Denmark; Kristianstad University, Sweden.
    Sjödahl Hammarlund, Catharina
    Kristianstad University, Sweden; Lund University, Sweden.
    Conceptual relationships between the ICF and experiences of mealtimes and related tasks among persons with Parkinson's disease2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 4, p. 201-208Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate experiences of mealtimes and related tasks among people with Parkinson’s disease (PD) and to link these conceptually to the International Classification of Functioning, Disability and Health (ICF). Data were collected by use of semi-structured interviews of 19 people with PD. Inductive content analysis resulted in five categories: 1) Managing mealtime preparations and related tasks, 2) Compromised physical control, 3) Difficulties enjoying meals, 4) Difficulties eating together with others, and 5) Strategies to maintain conventional norms and independence. Deductive content analysis linked the categories to the ICF categories: body functions (mental, sensory, neuromusculoskeletal and movement-related functions); activities (self-determination and chores); participation (interpersonal interactions and relationships); and environmental factors (conventional norms, attitudes of friends and strangers). Emotional and involuntary movement functions were represented in all five inductively derived categories. Eating difficulties may have negative consequences on participation and the emotional wellbeing of people with Parkinson’s disease.

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