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  • 501.
    Ahl, Helene
    et al.
    Jönköping University, School of Education and Communication, HLK, Lifelong learning/Encell.
    Tillmar, Malin
    Linköping University.
    Swedish welfare state retrenchment and the call for women’s entrepreneurship to fill the void2015Conference paper (Refereed)
    Abstract [en]

    The last two decades have seen major welfare state retrenchment in Sweden. The public sector, which used to be a large and stable employer for women, was downsized. Public schools and public health and care services were privatized. Customer choice models were introduced. The rhetoric connected to privatization stressed the unique opportunities for women formerly employed by the state to start their own businesses in this sector, now open for competition and private initiatives. In this paper we ask what the results were. We discuss the results from a feminist perspective, i.e we ask if privatization and business ownership has improved women’s situation on the labor market, or not. The paper draws together the research findings from our own empirical research (about fifteen different studies) as well as from research done by other Nordic scholars in the field.

  • 502.
    Ahlander, Britt-Marie
    et al.
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Maret, Eva
    Department of Radiology, Ryhov County Hospital, Jönköping, Sweden.
    Brudin, Lars
    Department of Clinical Physiology, Kalmar County Hospital, Kalmar, Sweden.
    Starck, Sven-Åke
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Department of Oncology, Hospital Physics, Ryhov County Hospital, Jönköping, Sweden.
    Engvall, Jan
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    An echo-planar imaging sequence is superior to a steady-state free precession sequence for visual as well as quantitative assessment of cardiac magnetic resonance stress perfusion2017In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 52-61Article in journal (Refereed)
    Abstract [en]

    Background: To assess myocardial perfusion, steady-state free precession cardiac magnetic resonance (SSFP, CMR) was compared with gradient-echo–echo-planar imaging (GRE-EPI) using myocardial perfusion scintigraphy (MPS) as reference.

    Methods: Cardiac magnetic resonance perfusion was recorded in 30 patients with SSFP and in another 30 patients with GRE-EPI. Timing and extent of inflow delay to the myocardium was visually assessed. Signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Myocardial scar was visualized with a phase-sensitive inversion recovery sequence (PSIR). All scar positive segments were considered pathologic. In MPS, stress and rest images were used as in clinical reporting. The CMR contrast wash-in slope was calculated and compared with the stress score from the MPS examination. CMR scar, CMR perfusion and MPS were assessed separately by one expert for each method who was blinded to other aspects of the study.

    Results: Visual assessment of CMR had a sensitivity for the detection of an abnormal MPS at 78% (SSFP) versus 91% (GRE-EPI) and a specificity of 58% (SSFP) versus 84% (GRE-EPI). Kappa statistics for SSFP and MPS was 0·29, for GRE-EPI and MPS 0·72. The ANOVA of CMR perfusion slopes for all segments versus MPS score (four levels based on MPS) had correlation r = 0·64 (SSFP) and r = 0·96 (GRE-EPI). SNR was for normal segments 35·63 ± 11·80 (SSFP) and 17·98 ± 8·31 (GRE-EPI), while CNR was 28·79 ± 10·43 (SSFP) and 13·06 ± 7·61 (GRE-EPI).

    Conclusion: GRE-EPI displayed higher agreement with the MPS results than SSFP despite significantly lower signal intensity, SNR and CNR.

  • 503.
    Ahlberg, Ernst
    et al.
    Predictive Compound ADME & Safety, Drug Safety & Metabolism, AstraZeneca IMED Biotech Unit, Mölndal, Sweden.
    Winiwarter, Susanne
    Predictive Compound ADME & Safety, Drug Safety & Metabolism, AstraZeneca IMED Biotech Unit, Mölndal, Sweden.
    Boström, Henrik
    Department of Computer and Systems Sciences, Stockholm University, Sweden.
    Linusson, Henrik
    Department of Information Technology, University of Borås, Sweden.
    Löfström, Tuve
    Jönköping University, School of Engineering, JTH, Computer Science and Informatics, JTH, Jönköping AI Lab (JAIL). Department of Information Technology, University of Borås, Sweden.
    Norinder, Ulf
    Swetox, Karolinska Institutet, Unit of Toxicology Sciences, Sweden.
    Johansson, Ulf
    Jönköping University, School of Engineering, JTH, Computer Science and Informatics, JTH, Jönköping AI Lab (JAIL). Department of Information Technology, University of Borås, Sweden.
    Engkvist, Ola
    External Sciences, Discovery Sciences, AstraZeneca IMED Biotech Unit, Mölndal, Sweden.
    Hammar, Oscar
    Quantitative Biology, Discovery Sciences, AstraZeneca IMED Biotech Unit, Mölndal, Sweden.
    Bendtsen, Claus
    Quantitative Biology, Discovery Sciences, AstraZeneca IMED Biotech Unit, Cambridge, UK.
    Carlsson, Lars
    Quantitative Biology, Discovery Sciences, AstraZeneca IMED Biotech Unit, Mölndal, Sweden.
    Using conformal prediction to prioritize compound synthesis in drug discovery2017In: Proceedings of Machine Learning Research: Volume 60: Conformal and Probabilistic Prediction and Applications, 13-16 June 2017, Stockholm, Sweden / [ed] Alex Gammerman, Vladimir Vovk, Zhiyuan Luo, and Harris Papadopoulos, Machine Learning Research , 2017, p. 174-184Conference paper (Refereed)
    Abstract [en]

    The choice of how much money and resources to spend to understand certain problems is of high interest in many areas. This work illustrates how computational models can be more tightly coupled with experiments to generate decision data at lower cost without reducing the quality of the decision. Several different strategies are explored to illustrate the trade off between lowering costs and quality in decisions.

    AUC is used as a performance metric and the number of objects that can be learnt from is constrained. Some of the strategies described reach AUC values over 0.9 and outperforms strategies that are more random. The strategies that use conformal predictor p-values show varying results, although some are top performing.

    The application studied is taken from the drug discovery process. In the early stages of this process compounds, that potentially could become marketed drugs, are being routinely tested in experimental assays to understand the distribution and interactions in humans.

  • 504.
    Ahldén, Maria KC
    et al.
    Oslo University Hospital.
    Rönning, Helén
    Jönköping University, School of Health Science, HHJ. ADULT.
    Ågren, Susanna
    Department of Medicine and Health Sciences, Linköping University.
    Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure2014In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 2, no 2, p. 74-83Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.

    Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.

    Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.

    Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.

    Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.

  • 505.
    Ahlgren, Jennie
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research. Jönköping University, School of Education and Communication, HLK, Learning Practices inside and outside School (LPS), Communication, Culture & Diversity @ JU (CCD@JU).
    En didaktisk analys av universitetskursen "Etik och det moderna samhället"2013In: Högskolepedagogisk reflektion och praktik: Proceedings från Humanistiska och teologiska fakulteternas pedagogiska inspirationskonferens / [ed] Mauriz, A.; Mårtensson, K., Lunds universitet , 2013Chapter in book (Other academic)
  • 506. Ahlgren, Jennie
    et al.
    Görman, Ulf
    Mathers, John C
    Grimaldi, Keith A
    Nordström, Karin
    Do we know enough?: A scientific and ethical analysis of the basis for genetic-based personalized nutrition2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, no 8, p. 373-381Article in journal (Refereed)
  • 507.
    Ahlgren, Jennie
    et al.
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Görman, Ulf
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Nordström, Karin
    Jönköping University, School of Education and Communication, HLK, Disciplinary Research.
    Ethical considerations in relation to personalised nutrition: An overview of Work Package 5, with respect to ethics2015Report (Other academic)
    Abstract [en]

    The objectives of Food4Me work package 5 included a baseline assessment of the ethical and legal aspects of personalised nutrition at the start of the project in 2011, as well as a final assessment at the end of the project (2015), taking into account results achieved in other work packages. The initial assessment made a number of ethical issues visible, most of them relating to the consumer of personalised nutrition service. The results depicted in this publication indicate that many of the questions raised in relation to these issues remain unsolved, and in some cases they seem to be neglected in relation to the services offered by internet companies.

  • 508. Ahlgren, Jennie
    et al.
    Görman, Ulf
    Nordström, Karin
    Nordgren, Anders
    Perrudin, Maud
    Ronteltap, Amber
    Savigny, Jean
    van Trijp, Hans
    Consumers on the Internet: ethical and legal aspects of commercialization of personalized nutrition2012In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, no 4, p. 349-355Article in journal (Other academic)
  • 509. Ahlgren, Jennie
    et al.
    Görman, Ulf
    Savigny, Jean
    Nordström, Karin
    Perrudin, Maud
    Nordgren, Anders
    van Trijp, Hans
    Ronteltap, Amber
    Consumers on the Internet: Ethical and legal aspects of commercialization of personalized nutrition2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499Article in journal (Refereed)
  • 510. Ahlgren, Jennie
    et al.
    Görman, Ulf
    Önning, Gunilla
    Ska generna styra vad vi äter?2008In: Miljöforskning: Formas tidning för ett uthålligt samhälle, no 3Article in journal (Other academic)
  • 511. Ahlgren, Jennie
    et al.
    Görman, Ulf
    Önning, Gunilla
    Ska generna styra vad vi äter?2005In: Miljöforskning, no 3Article in journal (Other (popular science, discussion, etc.))
  • 512.
    Ahlgren, Jennie
    et al.
    Ethics Unit, Centre for Theology and Religious Studies, Lund University, Lund, Sweden.
    Nordgren, Anders
    Centre for Applied Ethics, Linköping University, Linköping, Sweden.
    Perrudin, Maud
    Keller and Heckman LLP, Brussels, Belgium.
    Ronteltap, Amber
    LEI, Wageningen University and Research Centre, Wageningen, The Netherlands.
    Savigny, Jean
    Keller and Heckman LLP, Brussels, Belgium.
    van Trijp, Hans
    Marketing and Consumer Behaviour, Group Wageningen University and Research .
    Nordström, Karin
    Jönköping University, School of Education and Communication, HLK, School Based Research, Social Studies and Didactics.
    Görman, Ulf
    Jönköping University, School of Education and Communication.
    Consumers on the Internet: ethical and legal aspects of commercialization of personalized nutrition2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, Vol. 8, no 4, p. 349-355Article in journal (Refereed)
    Abstract [en]

    Consumers often have a positive attitude to the option of receiving personalized nutrition advice based upon genetic testing, since the prospect of enhancing or maintaining one’s health can be perceived as empowering. Current direct-to-consumer services over the Internet, however, suffer from a questionable level of truthfulness and consumer protection, in addition to an imbalance between far-reaching promises and contrasting disclaimers. Psychological and behavioral studies indicate that consumer acceptance of a new technology is primarily explained by the end user’s rational and emotional interpretation as well as moral beliefs. Results from such studies indicate that personalized nutrition must create true value for the consumer. Also, the freedom to choose is crucial for consumer acceptance. From an ethical point of view, consumer protection is crucial, and caution must be exercised when putting nutrigenomic-based tests and advice services on the market. Current Internet offerings appear to reveal a need to further guaranty legal certainty by ensuring privacy, consumer protection and safety. Personalized nutrition services are on the borderline between nutrition and medicine. Current regulation of this area is incomplete and undergoing development. This situation entails the necessity for carefully assessing and developing existing rules that safeguard fundamental rights and data protection while taking into account the sensitivity of data, the risks posed by each step in their processing, and sufficient guarantees for consumers against potential misuse.

  • 513.
    Ahlgren, Per
    et al.
    Department of e-Resources, University Library, Stockholm University.
    Colliander, Cristian
    Jönköping University, The University Library.
    Document-document similarity approaches and science mapping: Experimental comparison of five approaches2009In: Journal of Informetrics, ISSN 1751-1577, Vol. 3, no 1, p. 49-63Article in journal (Refereed)
    Abstract [en]

    This paper treats document-document similarity approaches in the context of science mapping. Five approaches, involving nine methods, are compared experimentally. We compare text-based approaches, the citation-based bibliographic coupling approach, and approaches that combine text-based approaches and bibliographic coupling. Forty-three articles, published in the journal Information Retrieval, are used as test documents. We investigate how well the approaches agree with a ground truth subject classification of the test documents, when the complete linkage method is used, and under two types of similarities, first-order and second-order. The results show that it is possible to achieve a very good approximation of the classification by means of automatic grouping of articles. One text-only method and one combination method, under second-order similarities in both cases, give rise to cluster solutions that to a large extent agree with the classification.

  • 514.
    Ahlgren, Per
    et al.
    Department of e-Resources, University Library, Stockholm University.
    Colliander, Cristian
    Jönköping University, The University Library.
    Textual content, cited references, similarity order, and clustering: an experimental study in the context of science mapping2009In: Proceedings of the 12th International Conference on Scientometrics and Informetrics, 2009, p. 862-873Conference paper (Refereed)
    Abstract [en]

    This paper deals with document-document similarity approaches, the issue of similarity order, and clustering methods, in the context of science mapping. Using two data sets of bibliographic records, associated with the fields of information retrieval and scientometrics, we investigate how well two document-document similarity approaches, a text-based approach and bibliographic coupling, agree with ground truth classifications (obtained by subject experts), under first-order and second-order similarities, and under four different clustering methods. The clustering methods are average linkage, complete linkage, Ward’s method and consensus clustering. The performance of first-order and second-order similarities is compared within the two document-document similarity approaches, and under each clustering method. We also compare the performance of the clustering methods. The results show that the text-based approach consistently outperformed bibliographic coupling with regard to the information retrieval data set, but performed consistently worse than the latter approach regarding the scientometrics data set. For the similarity order issue, second-order similarities performed better than first-order in 12 out of 16 cases. Average linkage had the best overall performance among the clustering methods, followed by consensus clustering. The main conclusion of the study is that second-order similarities seem to be a better choice than first-order in the science mapping context.

  • 515.
    Ahlgren, Thorbjörn
    Linnéuniversitetet, Växjö.
    Institutionalisering på hemmaplan: En idés resa i den sociala barnavården2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This thesis describes and analyses in three substudies how home-based measures for children are expanding and why an open care idea are established as part of the Swedish child welfare. The first substudy describes the national increment of what today can be considered as a treatment policy – non-institutional care in child welfare. The results are analysed with Kingdon's agenda setting theory and shows that the factors of what Kingdon describes as problems-, politics- and policyflow influenced the national increment. Significant mechanisms have primarily been, the profession, the society's concerns for socially disadvantaged children, negative experiences of institutionalisation and a political position to deinstitutionalise all care. The second substudy focuses on how knowledge and research contributes to ideological, professional, and organizational change in child welfare by analysis of Research & Developments reports and articles from the professional journal Socionomen. Based on the neo-institutional concepts of organisational fields and isoformism the study's results shows that a consequence of adaptation strategies and "rationalized myths" are a number of similarities in how home-based measures are organized and which measures that are used. The third substudy, a case study, analyses how we can understand a local development of ideas in social services for children with concepts from neo institutional theory. Interviews and municipal documents are analysed and shows that the local translation of an open care idea is characterized by discretion, personal preferences and action and affects the choice of method and organization. The study also shows a political mistrust of institutional care while there is at the same time political confidence in the individual social worker's ability to find solutions that allow non-institutional measures to be an alternative to institutional care.

    An overall conclusion of the thesis is that there is now a treatment policy in social services for the children, which involves extensive efforts at home and it has led to that more children receive support from social services. One result of non-institutional care increment is that it led to increased costs for municipalities for intervention for children and young people when out-of-home care has not decreased. Another general conclusion is that translation and adaptation of ideas to local contexts is something that generally fits street-level bureaucrats need for discretion.

     

  • 516.
    Ahlgren, Thorbjörn
    Institutionen för vårdvetenskap och socialt arbete, Växjö universitet .
    Ungdomsbehandling: Hemmaplanslösning som idé och praktik2007Licentiate thesis, monograph (Other academic)
    Abstract [en]

    This dissertation is a case study in two parts, which describes how ideas about open-care treatment of youth aged 13-20 years are interpreted and concretized in a local context. The study, i.a., aims at creating deeper knowledge about target group, content of treatment, and reported results concerning a form of treatment in social care which has hitherto been sparsely researched in Sweden. The results of the interview study demonstrate that the driving forces for developing local forms of open care treatments have first and foremost been to offer better care and to improve the professionalism of the social worker. Studies of the social welfare documents of 97 young people reveal that most of these youngsters are in bad need of treatment and that they have experiences of various kinds of treatment before the present efforts. The study also demonstrates that the efforts are rarely evaluated and lack systematic documentation. Finally, the study reveals that more than 60 per cent of the youth get some sort of continuous support by the social welfare system after the open-care treatment has come to an end. The results from both parts of the study are analysed by means of neo- institutional theory. According to this theory the local open-care treatment consists of an indistinct target group, family-oriented methods, and activities that have been legitimised by strong proponents, good timing, professional development, and by representing important political values.

    In conclusion, the author argues that open care treatment shows signs of a beginning institutionalisation, a taken-for-granted-ness, which he thinks is risky, as we still do not know if open-care treatment is more favourable to the young people than different kinds of 24-hour care. In addition, the author holds, that the future role of the social worker should include knowledge that decreases unfounded taken-for-granted ideas. 

  • 517. Ahlqwist, M
    et al.
    Bengtsson, C
    Hakeberg, Magnus
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Oral health.
    Hägglin, C
    Dental status of women in a 24-year longitudinal and cross-sectional study: Results from a population study of women in Göteborg.1999In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 57, no 3, p. 162-167Article in journal (Refereed)
  • 518. Ahlskog, Christian
    En evig svensk idol [recension av Anders Dybelius doktorsavhandling Ett hållbart minne? Historiebruk kring Georg Carl von Döbeln 1848-2009]2013Other (Other (popular science, discussion, etc.))
  • 519.
    Ahlskog, Mats
    et al.
    Mälardalens högskola, Innovation och produktrealisering.
    Bruch, Jessica
    Mälardalens högskola, Innovation och produktrealisering.
    Jackson, Mats
    Mälardalens högskola, Innovation och produktrealisering.
    Factors affecting development of production technologies in a machining environment2014In: Tools and Methods of Competitive Engineering 2014 TMCE 2014, Tools and Methods of Competitive Engineering (TMCE) , 2014Conference paper (Refereed)
    Abstract [en]

    The purpose of this paper is to identify critical factors forcing manufacturing companies to improve the development of production technology in a machining environment. The focus in the paper is on industrial challenges within product design and production system development when introducing new products in a machining environment. Particular attention is given to the product development process and the production equipment acquisition process. A single case study is presented, consisting of interviews, observations, document studies and an analysis of a large Swedish manufacturing company. The case study company is characterized by advanced production technology, high mechanization and high automation level. In parallel with the case study a literature review was conducted in order to identify state-of-the-art methods/models for efficient design and product introduction within a production system. The paper identifies a gap in the current way of working within the case company as well as challenges regarding the development of production technology. Based on the study, the need for future research has been identified including the need of developing an improved working support for efficient production technology development when industrializing new products.

  • 520.
    Ahlskog, Mats
    et al.
    Mälardalens högskola, Innovation och produktrealisering.
    Bruch, Jessica
    Mälardalens högskola, Innovation och produktrealisering.
    Jackson, Mats
    Mälardalens högskola, Innovation och produktrealisering.
    Joint Development of a Manufacturing Technology: A Longitudinal Case Study within the Manufacturing Industry2015In: 22nd International Annual EurOMA Conference EurOMA15, 2015Conference paper (Refereed)
    Abstract [en]

    In order to compete within the manufacturing industry, there is a need to acquire and develop new manufacturing technologies to differentiate the company from others. Therefore, the purpose of this paper is to analyse factors affecting development of a manufacturing technology in a joint development project with an equipment supplier. A longitudinal case study has been conducted at a Swedish manufacturing company and the collaboration between a manufacturing company and an equipment supplier has been studied. The findings reveal that tacit knowledge and good equipment supplier relationship are highly important factors that facilitate development of a manufacturing technology.

  • 521.
    Ahlskog, Mats
    et al.
    Mälardalens högskola, Innovation och produktrealisering.
    Bruch, Jessica
    Mälardalens högskola, Innovation och produktrealisering.
    Jackson, Mats
    Mälardalens högskola, Innovation och produktrealisering.
    Managing early manufacturing technology development phases and key activities2016In: 23rd EurOMA conference EUROMA 2016, International Annual EurOMA Conference, 2016Conference paper (Refereed)
    Abstract [en]

    In order to compete within the manufacturing industry, there is a need to acquire and develop new manufacturing technologies to differentiate the company from others. This paper builds on extant operations management and innovation management literature with the focus on how to managing early manufacturing technology development. A multiple case study has been conducted at a Swedish manufacturing company in the automotive industry and our paper proposes a conceptual process for early manufacturing technology development and the key activities therein. The findings are relevant for managers working with long-term development and the paper concludes by discussing implications and research limitations.

  • 522.
    Ahlskog, Mats
    et al.
    Department of Innovation, Design and Engineering, Mälardalen University, Eskilstuna, Sweden.
    Bruch, Jessica
    Department of Innovation, Design and Engineering, Mälardalen University, Eskilstuna, Sweden.
    Jackson, Mats
    Jönköping University, School of Engineering.
    The fuzzy front end of manufacturing technology development2019In: International Journal of Manufacturing Technology and Management (IJMTM), ISSN 1368-2148, E-ISSN 1741-5195, Vol. 33, no 5, p. 285-302Article in journal (Refereed)
    Abstract [en]

    The fuzzy front end of product development has been studied extensively in previous research, while the fuzzy front end of manufacturing technology development has been largely neglected despite its importance. Only a few empirical studies that examine the fuzzy front end of manufacturing technology development can be found, which have been primarily carried out in the process industry. Therefore, the overall purpose of this paper is to explore the fuzzy front end of manufacturing technology development. Based on three case studies carried out in the manufacturing industry, the findings of the current research highlight key activities in the fuzzy front end of manufacturing technology development and suggest that the fuzzy front end has four sub-phases with overlapping development activities. 

  • 523.
    Ahlskog, Mats
    et al.
    Mälardalens högskola, Innovation och produktrealisering.
    Jackson, Mats
    Mälardalens högskola, Innovation och produktrealisering.
    Bruch, Jessica
    Mälardalens högskola, Innovation och produktrealisering.
    Manufacturing Technology Readiness Assessment2015Conference paper (Other academic)
    Abstract [en]

    The purpose of this paper is to analyze and discuss how the MRL scale can support the assessment of a manufacturing technology’s maturity level. A single case study within the manufacturing industry has been conducted investigating the use of a MRL scale. An assessment of MRL 4 has been studied.

  • 524.
    Ahlstrand, Inger
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Att vara ung kvinna och långtidssjukskriven påverkar hela livssituationen2006In: Vågor på HaVet: tio texter om arbete och funktionshinder, Jönköping: Hälsohögskolan , 2006Chapter in book (Other academic)
  • 525.
    Ahlstrand, Inger
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Pain and its relation to participation in valued activities in rheumatoid arthritis2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    There has been a dramatic change over the past two decades for persons with rheumatoid arthritis (RA) not only due to early diagnosis, structured treatment, and aggressive medication but also due to an increased demand of participation in work life and society. Despite these treatment changes, RA continues to impact these individuals’ participation in valued daily activities. Participation in valued daily activities provides wellbeing and the opportunity for engagement and participation. By persons with RA pain has been highlighted as one of the most restrictive symptoms. This thesis uses the International Classification of Functioning, Disability, and Health (ICF) as a conceptual framework to describe disability and how participation is related to pain.

    Aims: The overall aim of this thesis was to explore and describe the relationship between pain and participation in valued activities, in RA. Paper I compared pain and activity limitations in women and men with contemporary treated early RA with persons who were diagnosed ten years earlier. Paper II described experiences of pain and pain’s relationship with daily activities. Paper III examined difficulties performing valued life activities in relation to pain intensity. Paper IV described personal factors, including self-efficacy and pain acceptance, and studied whether personal factors are mediators of the relationbetween pain and performance of valued life activities.

    Methods: Different methodological approaches were used to provide a comprehensive understanding of pain and participation in valued activities in persons with RA. A prospective longitudinal cohort study was used to compare women and men treated with contemporary treated RA (n=276) with their counterparts ten years earlier (n=373) (Paper I). This study was followed by a focus group study where 33 persons with RA participated in seven focus groups (Paper II). Subsequently, Papers III and IV were conducted based on data from The Swedish Rheumatology Quality Registry (SRQ) and data from a postal questionnaire that gathered data on demographics, pain, personal factors, and participation in valued life activities (n=737). In addition, these studies used descriptive and analytical statistics with multiple regression and structural equation modelling (SEM).

    Results: Pain and activity limitations were still pronounced in women and men with RA despite recent treatment advances (Paper I). The relationship between participation and pain was dynamic and is related to fatigue, stress, and mood, factors that generated difficulties finding a suitable level of activity, resulting in difficulties balancing daily activities (Paper II). Both women and men reported restrictions in participation in valued life activities. Pain was identified as having an important relationship to difficulties performing valued life activities (Paper III). Personal factors were found important as mediators for pain in relation to participation (Paper IV).

    Conclusions: This thesis found a continued need for multidisciplinary interventions despite current treatments. Pain was identified as related to participation restrictions and had an important relationship to difficulties performing valued life activities. Pain and participation in valued activities needs to be comprehensively analysed and treated in the context of the person’s perspective and needs and demands of persons with RA. The subjective experience of participation, the engagement, must be highlighted. Personal factors mediated the relationship between pain and participation and this finding supports the value of self-management interventions to enable participation in valued activities

  • 526.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. ADULT.
    Björk, Mathilda
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Linköping university.
    Thyberg, Ingrid
    Linköping university.
    Low levels of pain impact on valued life activities in women and men with Rheumatoid Arthritis2013Conference paper (Refereed)
  • 527.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Björk, Mathilda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Thyberg, Ingrid
    AIR/Rheumatology Unit, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University Hospital, Linköping, Sweden.
    Börsbo, Björn
    Rehabilitation Medicine, IKE, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Sweden.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. School of Occupational Therapy, La Trobe University, Melbourne, VIC, Australia.
    Pain and Daily Activities in Rheumatoid Arthritis2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 15, p. 1245-1253Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method. Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results. Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it.Conclusion. The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.

  • 528.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. ADULT.
    Björk, Mathilda
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Börsbo, Björn
    Linköping university.
    Falkmer, Torbjörn
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv2011Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.

  • 529.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Björk, Mathilda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis2015In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 34, no 8, p. 1353-1362Article in journal (Refereed)
    Abstract [en]

    This study aimed to examine the difficulties with performing valued life activities in relation to pain intensity in women and men with rheumatoid arthritis (RA). In total, 737 persons with RA (73 % women) from three rheumatology units in Sweden responded to a questionnaire measuring performance of 33 valued life activities and self-rated pain. The relationships between performance of valued life activities (VLAs) and pain (measured by visual analogue scale (VAS)) were analysed based on gender. Multiple linear regression analyses were conducted with the total VLA score as dependent variable. Women reported more pain and difficulties in performing valued life activities than men. Across genders, 85 % reported at least one valued life activity affected by RA. Significantly more women than men encountered difficulties in performing some activities such as cooking, gardening and meeting new people. Women reported higher pain intensity (35 mm) than men (31 mm). Almost all 33 difficulty ratings for valued life activities were higher among persons with high pain (>40 mm) than persons with lower pain. Difficulty ratings for valued life activities correlated positively with pain in persons with lower pain, but not among those with high pain. The results highlight the importance of addressing pain, especially among women with RA, as they reported pain to impact on their valued life activities. Interestingly, this was evident also in women with lower levels of pain.

  • 530.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Bränholm, IB
    Activity performance, life satisfaction and locus of control in young women on sick leave1998In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 11, no 2, p. 131-136Article in journal (Refereed)
  • 531.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Dahlström, Ö
    Linköping University.
    Björk, Mathilda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project2015In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 4, p. 259-264Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier.

    METHOD: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years.

    RESULTS: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2.

    CONCLUSIONS: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.

  • 532.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health Science, HHJ. ADULT.
    Thyberg, Ingrid
    Linköping University.
    Falkmer, Torbjörn
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Dahlström, Örjan
    Linköping University.
    Björk, Mathilda
    Jönköping University, School of Health Science, HHJ, Dep. of Rehabilitation.
    Less pain and activity limitations in today's early RA patients compared with patients diagnosed 10 years earlier (the swedish TIRA-project)2014In: EULAR 2014: Scientific Abstracts, 2014, p. 141-142Conference paper (Refereed)
    Abstract [en]

    Background: Over the last decades the RA-treatment strategies have changed considerably. Routines for early RA diagnosis and instituted disease modifying anti rheumatic drugs (DMARDs) have been established. In the early 2000s biologic agents also became available for treatment purposes. Despite these altered and improved strategies RA patients continue to report pain and activity limitations; women more so than men.

    Objectives: To study differences regarding pain and activity limitations during the first three years after diagnosis of RA in today's patients compared with patients diagnosed 10 years earlier from a gender perspective.

    Methods: This study was based on patients recruited to the project “early interventions in RA” (TIRA). In the first cohort (TIRA-1) 320 patients were included during 1996-1998. In the second cohort (TIRA-2) 463 patients were included during 2006-2008. Disease activity score 28 joint count (DAS-28) and medication were registered. Pain intensity (VAS), bodily pain (BP) in Short Form36 (SF-36) and activity limitation (Health Assessment Questionnaire, HAQ) were reported at inclusion and at follow-ups after one, two and three years.

    Results: Disease activity did not differ between cohorts at inclusion, but was significant lower at the follow ups in the TIRA-2 cohort compared with the TIRA-1 cohort. Patients in TIRA2 were prescribed traditional DMARD:s and biologic agents more frequent than in TIRA-1. The TIRA-2 patients reported significantly higher pain intensity and activity limitations at inclusion but lower pain intensity and activity limitations at all follow-ups than TIRA-1 patients. There were no significant differences between cohorts regarding bodily pain at inclusion, but thereafter the TIRA-2 patients showed significant lower bodily pain than the TIRA-1 patients. Men reported lower activity limitation than women in TIRA-1; otherwise there were no gender differences in TIRA-1. In TIRA-2, there were no significant gender differences regarding pain at inclusion. However, men reported lower pain than women at all follow-ups. Women, in turn, reported significantly higher activity limitations at all time points in TIRA-2. Pain and activity limitations were significantly reduced from inclusion to the one year follow-up but remained stable thereafter.

    Conclusions: Both women and men in today's early RA patient cohort report lower pain and less activity limitations at the follow ups after diagnosis of RA compared to 10 years earlier. However, both activity limitations and bodily pain are still pronounced.

  • 533.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. CHILD. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Department of Rheumatology and Department of Social and Welfare Studies, Linköping University, Norrköping, Sweden.
    Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis2017In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 31, no 6, p. 824-834Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

    METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

    RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

    CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

  • 534.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Vaz, Sharmila
    School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, WA, Australia.
    Falkmer, Torbjörn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Rehabilitation Center and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Thyberg, Ingrid
    Department of Rheumatology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
    Björk, Mathilda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Self-efficacy and painacceptance in relation to pain and performance of valued life activities inwomen and men with RAArticle in journal (Other academic)
  • 535.
    Ahlstrand, Inger
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation.
    Wagman, Petra
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Hakansson, C.
    Lund Univ, Div Occupat & Environm Med, Lund, Sweden.
    Bjork, M.
    Linkoping Univ, Dept Rheumatol, Linkoping, Sweden.
    Occupational balance and its relation to performance of valued life activities in persons with rheumatoid arthritis in working age2018In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no Suppl. 2, p. 186-186Article in journal (Refereed)
    Abstract [en]

    Background Experience of balance in everyday activities where work is an essential part is important to health and well-being, as has also been observed in previous studies in people with rheumatoid arthritis (RA). The Valued life activity scale (VLA-swe) is a questionnaire in which patient’s first report if the separate activities are valued or not to perform and secondly difficulties to perform these activities. Occupational Balance Questionnaire (OBQ) focuses on satisfaction with the amount and variation of occupations.

    Objectives The objectives were to 1) describe the relationship between performance of valued activities and experienced occupational balance, and to 2) identify aspects associated with low occupational balance in persons with RA.

    Methods 368 persons (age 18–65 years, 77% women) with RA responded to a questionnaire measuring occupational balance (OBQ) and performance of valued life activities (VLA-swe). Other aspects of interest were activity limitations measured by Health Assessment Questionnaire (HAQ), pain (measured by VAS), continuous stress (stressed continuously for more than a month during the last 12 months), children at home, education, and living situation. The relation between OBQ and performance in VLA across genders and Workers/Non-workers were analysed using non-parametric correlation analyses. To identify the impact of different aspects on the likelihood that participants would report lower occupational balance, OBQ was analysed using workers/nonworkers, stress, gender, age, pain and difficulties performing valued activities as independent variables in logistic regressions models. The study was approved by the Regional Ethics Committee (Dnr2011/452–31).

    Results The OBQ was significantly related to difficulties to perform valued activities reported by VLA (r=-0.41, p<0.001). Having more difficulties performing valued activities was the strongest predictor of lower occupation balance and increased the risk of reporting lower occupation balance with nearly five times (OR=4.54, p 0.001). Continuous stress increased the risk of having lower occupation balance more than three times (OR=3.27, p<0.0001) than those who not reported being stressed. The other variables show no significant impact on the likelihood that the participants would report lower occupational balance.

    Conclusions The results showed support for the relationship between occupation balance and performance of valued life activities and highlights to identify what’s important for the individual and to assume that in the rehabilitation. The results also show the importance of ability to manage stress, in order to enable for retaining ability to work and achieve high occupational balance.

  • 536.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Assessment of coping and quality of life in adults with neuromuscular diseases.1998In: European Congress on Evaluation of Rehabilitation in a Lifelong Course, 1998Conference paper (Refereed)
  • 537.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Consequences of Muscular Dystrophy: Impairment, Disability, Coping and Quality of Life.1994Doctoral thesis, monograph (Other scientific)
  • 538.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Coping with Long-term Neurological illness and the Implications for Nursing.2005In: Journal of neuroscience nursing, ISSN 0888-0395, Vol. 37, no 6, p. 301-302Article in journal (Refereed)
  • 539.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Coping with Long-term Neurological Illness and the Implications for Nursing Interventions.2005In: 9th Quadrennial World Federation of Neuroscience Nurses, 2005Conference paper (Refereed)
  • 540.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science.
    Coping with Neuromuscular disease and the Implications for Interventions2008In: The First International Symposium on Psychosocial Aspects of Neuromuscular Disorders, Bilbao, June 20-21 2008: University of Deusto, Bilbao , 2008, p. 1-Conference paper (Refereed)
    Abstract [en]

    Coping with Neuromuscular disease and the Implications for Interventions

    The lecture is based on results from three theses and about 25 scientifically articles about the plight of the patient with muscular dystrophy (MD), and the patients’ ways of coping with illness-related problems from a psychosocial perspective. MD is a group of inherited disorders characterised by muscular weakness caused by muscle wasting. Three subgroups are distinguished in our research: one group with different types of proximal MD and the other two groups characterized chiefly by distal weakness. The research was to elucidate how persons with muscular dystrophy experience their everyday life over a ten years period. The research includes four data collections with qualitative and quantitative methods. The data was selected in three different county councils in Sweden.

    The persons with MD described the change from being independent to being an individual in need of assistive devices and/or personal support to manage activities of every day life. Besides muscular weakness the persons have the strain it means to have a hereditary disease. The deterioration in a decennium was mainly with regard to ambulation. The number of persons walking without assistive devices and working has almost been halved. They experienced periods of sorrow due to losses of independence, control, status and social roles and the loss of one’s identity as a healthy person. The sorrow connecting with repeated losses are in the literature designate as chronic or episodic sorrow. Also, in the lecture the patients’ illness trajectory were described by a model of Sullivan (1994) into four dimensions in order to increase the understanding of what it means to live with muscular dystrophy.

    The aim of interventions is to support the patient’s appropriate ways of coping as Problem-focused coping/Searching for a solution, Fighting spirit/Struggling, Re-appraising of life values, Maintaining hope, Social comparison, Laughing and joking  and Caring about self.

  • 541.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences of loss and chronic sorrow in person with neurological disorders.2001In: 8th World Federation of Neuroscience Nurses Congress, 2001Conference paper (Refereed)
  • 542.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences of loss and chronic sorrow in person with neurological disorders.2001In: 8th World Federation of Neuroscience Nurses Congress, 2001Conference paper (Refereed)
  • 543.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences of Loss and Chronic Sorrow in Persons with Neurological disorders.2004In: The First Affiliated Hospital of Kunming Medical College, 2004Conference paper (Refereed)
  • 544.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences of loss and chronic sorrow in persons with severe chronic illness2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 3A, p. 76-83Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. The aims of the present study were to describe losses narrated by persons afflicted with severe chronic physical illness and to identify the concomitant occurrence of chronic sorrow. Background. Reactions connected with repeated losses are referred to in the literature as chronic sorrow, which has recently been described in conjunction with chronic illness. Design. A qualitative study with an abductive approach of analysis, including both inductive and deductive interpretations. Method. The study is based on 30 persons of working age with average disease duration of 18 years. The average age was 51 years. All of the persons had personal assistance for at least three months because of considerable need for help in daily life due to physical disability. Each person was interviewed twice. There was also an independent assessment of the deductive results concerning chronic sorrow. Results. The inductive findings show that all persons had experienced repeated physical, emotional and social losses. Most common were 'Loss of bodily function', 'Loss of relationship', 'Loss of autonomous life' and 'Loss of the life imagined'. 'Loss of identity' included the loss of human worth, dignity and a changed self-image. In addition, the deductive findings suggest that chronic sorrow exists in the study population. Sixteen of 30 participating subjects were assessed by both assessors to be in a state of chronic sorrow and there was an especially high agreement with respect to one criterion of chronic sorrow 'Loss experience, ongoing or single event' (28 of 30 subjects). Conclusions. This study shows that persons with severe chronic illness often experience recurring losses. These experiences are consistent with the phenomenon of chronic sorrow. Relevance to clinical practice. Knowledge of the existence of chronic sorrow in persons with chronic illness will enable nurses to support these persons in a more sensitive and appropriate way.

  • 545.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science.
    Integrating improvement learning into health professional educational curricula2008In: International Forum on Quality Improvement in Healthcare, France, April 24 2008: International Forum on QI , 2008, p. 1-Conference paper (Refereed)
    Abstract [en]

    We all need to start where we are and also wanting to go further all the time. This is the essence in quality improvement. The leader and the teachers must own this attitude themselves in order to have the ability to be trustworthy for the students. There is evidence in the literature about the impact of education on the professional attitude and role. This means that it is important to work with better professional development for better outcomes in the faculty.

    One starting point for us in the planning of our different programs are that improvement knowledge will be a streak through the whole education in order to establish a professional attitude of daily inspiration to produce the best practise. We have applied all curricula to Boologna declaration and in this system progression in learning is a key point. We have four levels in the basic education (3-years education which lead to Bachelor degree) where we start to introduce 1) Concepts and models in health improvement. Then let our students make a 2) Personal improvement in their everyday life. Later in the education we teach about 3) Evidence practise and systematic literature reviews. Finally the students are 4) Making health improvements in collaboration with the staff during one clinical education.

    All educational programmes on basic level since 2007 include aim descriptions about quality improvement. The aim of the learning is to have the competence to initiate and participate in work about health care improvements.

    Finally, besides the mentions aspects in improvement education there are some other factors that needs for better system performance.

  • 546.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science.
    Intentional Partnerships—Creating New Partnerships: A national and international model2008In: Quality and Safety in Nursing Education: A Clinical Microsystems Approach, Chicago, USA: The Joint Comission , 2008, p. 6-Conference paper (Refereed)
    Abstract [en]

    Since one of the aims of this meeting is to create a strategy for the participants to connect and share experiences post-conference I will start by giving a very brief account of Jönköping University and the School of Health Sciences, this in order to give you a sense of the school as a possible partner for collaboration. Then I will describe how teachers work to increase knowledge with regard to health care improvement within the nursing program. Thereafter I will talk about a research project and relate this to what we can learn about interprofessional education. The basic values regarding health care improvement described by Paul Batalden and his colleagues are central to our present development. We share the theoretical assumptions concerning the Clinical Microsystem and the view of redesigning health care education in order to produce the best care for the patient and his/her family. So within our organization both teachers and students — like nurses — have two jobs, one of which is to bring about improvement. So we have started the process where the educators need to change their teaching for the sake of better patient outcomes, better system performance, and better professional development. This means communicating not only the existing evidence-based knowledge but also improvement knowledge which involves a substantial shift in our idea of the work of health care — a challenging task that can benefit from the use of a wide variety of tools and methods. A key concern for us in the planning of our different programs is that the improvement of knowledge shall permeate the education and contribute to establishing a professional attitude marked by daily inspiration to produce the best care. The basic education involves four stages. First there is an introduction to concepts and models in health care improvement. This content is in the first semester.  Second the students’ are making a personal improvement in their everyday life. The students apply PDSA-cycle for improvement of an issue, commonly their time-table for studies, time spending for eating breakfast in the morning or eating habits in general. The third stage involves evidence-based nursing and systematic literature reviews and in the fourth stage, the students make health care improvements in collaboration with the staff during a clinical training period. The nurses at the clinic formulate the area of improvement. Then the students work systematically in pairs to collect data and the results are reported to the nurses. The latter stage is a new content in nursing education but we know from occupational therapy that the staff appreciated these works and the results were in most cases used by the staff in their job.

     

    The overall aim of the research project “Bridging the gaps” is to generate evidence about the process and outcome of clinical work within the area of quality improvement. The project contributes to an advanced environment for learning and innovation, research and development in the field of health-care management and improvement. There are 14 doctoral students at the research school, who takes part in the research project. Three of them are nurses and doctoral students at the School of Health Sciences. All PhD students have to take two compulsory courses, one is named “Bridging the gaps — a multidisciplinary research field” and the other is named “Interactive Research Methodology”. The Microsystem as a theoretical model is included in the mention research course “Bridging the gaps” and in each doctoral student’s research proposal. The PhD students shall work together with health-care staff by way of an interactive research method. This means that there is an integration of research and practice. The PhD students and the health-care staff are working together throughout the project. The staff is involved at every stage, from designing the improvement work, formulating the research questions to reporting the results. Research with this methodology generates knowledge of great relevance for clinical practice.

  • 547.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Living with Neurological Disorders: Illness Experiences, Coping and Coping Resources.2004In: WENR-conference, 2004Conference paper (Refereed)
  • 548.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lära tillsammans: ett rehabiliteringsprogram för personer med avancerad multiple skleros och deras personliga assistenter.1999Report (Other academic)
  • 549.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Mänskliga resurser och empowerment vid kronisk sjukdom.2002In: Kongress Lust & Kunskap, 2002Conference paper (Refereed)
  • 550.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Nursing rehabilitation programme and its effect on patients' coping and quality of life.1997In: 7th Quadrennial Congress, 1997Conference paper (Refereed)
891011121314 501 - 550 of 20862
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