The process of occupational therapists implementing client-centred ADL intervention in clinical practice

The overall aim: The overall aim of the thesis was to identify and describe the characteristics of the implementation process and what hinders and contributes to the implementation of complex interventions when occupational therapists interact with researchers. The long-term goal of the thesis is to contribute to the development of strategies for the implementation of complex interventions in health care. Methods: The two studies in the thesis are based on occupational therapists’ (OTs) experience of implementing a client-centred ADL intervention (CADL) in collaboration with researchers within a randomized control study (RCT). In Study I, 33 OTs participated in focus group interviews two, six and 12 months after completing a workshop before implementing the CADL intervention to persons with stroke. By using a grounded theory approach, it was possible to describe the OTs’ implementation process according to their experiences of being involved in a research project. In Study II, two questionnaires with both closed- and open-ended questions were sent out one year after participating in the workshops and five years after the project was ended. Thirty-one of the 41 OTs responded to the first questionnaire and 19 of 39 responded to the second. This study was a cross-sectional study, and a convergent parallel design of mixed methods was used in order to get a broader understanding of the OTs’ attitudes and experiences of being involved in a research project. Findings: In the analysis of the interviews in Study I, one core category emerged: ‘The implementation of a client-centred intervention enabled the fusion of science and practice’ and three sub-categories followed: 1) Including in the scientific world, 2) Involving as an actor of science, and 3) Integrating in a partnership. The OTs’ attitudes towards engaging in research were changed by support from the researchers, while the OTs acquired more and more experience in using the CADL intervention. The process comprised of being an outsider to the scientific world to being included and then becoming a part of the research as an implementer of science. The findings in Study II explored the OTs’ experience after they ended the participation in the research project. Hindrances like access to clients limited the ability to feel safe in using the CADL in meeting with the client or when the OTs had to update the knowledge given in the workshop. Experience of the team’s limited support was another factor. The majority of the OTs considered support from the researchers during the time that the projected continued to be a factor that facilitated during the implementation of the intervention revealed both one year after participating in the workshop and five years after the project ended. The opportunity to discuss and reflect on the role and experience as implementers to participate in a research project contributed to changes in the meeting with the client. The OTs felt more professional with the support of the CADL. The availability of research-based knowledge, as relayed by the researchers, was a further factor when the CADL intervention became a bridge between practice and science. Conclusions: To create a context built on a collaborative partnership between practitioners and researchers enabled the fusion of practice and science. Support from the organizations and teams, a sufficient interaction with the researchers, a satisfying self-image, and an accessible context were important and sustainable factors

Sustainable Writing Support: A Campus-wide Module to Support Bachelor Thesis Writing at a University of Technology

Higher education is today characterised by increasing student groups and high pressure on teaching staff. In these circumstances, it may be difficult to provide appropriate scaffolding of activities that many students find challenging, for example, academic and discipline-specific writing. It may also be difficult to align such support with principles associated with effective learning. In this paper, we present the design of the bachelor thesis writing support for students at a university of technology. The support is delivered by a communication division and reaches approximately 900 students each year. The paper describes the principles guiding the design and use results from a student survey to illuminate the challenges and affordances of the approach. The survey results show that students appreciate the module and its focus on dialogic feedback, student engagement and student activity. Our results also show that one of the challenges for some students is to negotiate advice from multiple sources, primarily content supervisors and writing staff. Despite such challenges, the design is an example of a sustainable, large-scale writing module based on research on feedback and learning

Ursäkten hjälper ingen, åtgärden hjälper alla! - Kriskommunikation för ett återupprättat kundförtroende

Nyckelord: Skandal, ursäkt, ansvar, kundförtroende, åtgärd Syfte: Denna uppsats vill skapa en bättre förståelse för hur företag bör uttrycka sig i media efter en skandal, för att bättre möta det som konsumenterna efterfrågar av dessa uttalanden. Syftet med denna uppsats är därmed att hjälpa företag att förbättra sina uttalanden vid skandaler och därmed lyckas bättre med sin krishantering. Metod: Studien baseras på kvalitativa studier med en dokumentanalys av företags uttalanden i media, en ostrukturerad intervju samt tre stycken fokusgruppsintervjuer. Teori: Det teoretiska materialet som har använts har presenterat tidigare forskning som redogjort för hur företag bör uttala sig vid en skandal, för att återfå konsumenters förtroende. Det har även tagits upp teorier kring bland annat kriskommunikation, etik och kundlojalitet. Slutsats: Denna studie har tydliggjort när ursäkten är viktig i ett företags uttalande och vad som gör den trovärdig. Ursäktens betydelse har även ifrågasatts och det har framgått för den inte har lika stor påverkan på konsumenternas förtroende. Vikten av åtgärden, för att återfå konsumenternas förtroende har även belysts. Andra faktorer som kan påverka hur företags uttalanden mottas av konsumenterna har också framgått, som att planera uttalandet i förväg och att anpassa uttalandet efter det kundsegment företaget har. En annan faktor som har visat sig påverka hur uttalandena mottas av konsumenterna är hur pass hög moral de har, hur lojala de är samt hur känslomässigt nära de uppfattar problemet som orsakat skandalen

Selective frontal neurodegeneration of the inferior fronto-occipital fasciculus in progressive supranuclear palsy (PSP) demonstrated by diffusion tensor tractography

<p>Abstract</p> <p>Background</p> <p>The clinical presentation in progressive supranuclear palsy (PSP), an atypical parkinsonian disorder, includes varying degrees of frontal dysexecutive symptoms. Using diffusion tensor imaging (DTI) and tractography (DTT), we investigated whether diffusion changes and atrophy of the inferior fronto-occipital fasciculus (IFO) occurs in PSP and if these changes correlate with disease stage and clinical phenotype. The corticospinal tract (CST), which is often involved in PSP, was investigated for comparison.</p> <p>Methods</p> <p>DTI of the whole brain was performed with a 3 T MR scanner using a single shot-EPI sequence with diffusion encoding in 48 directions. Scans were obtained in patients with PSP (n = 13) and healthy age-matched controls (n = 12). DTT of the IFO and CST was performed with the PRIDE fibre tracking tool (Philips Medical System). Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were calculated and correlated with disease stage and clinical phenotype.</p> <p>Results</p> <p>In patients with PSP, significantly decreased FA and increased ADC was found in the frontal part of IFO compared with the medial and occipital parts of IFO, as well as compared to controls. Four of the thirteen patients with PSP showed a marked decrease in the number of tracked voxels in the frontal part of IFO. These findings were most pronounced in patients with severe frontal cognitive symptoms, such as dysexecutive problems, apathy and personality change. There was a strong correlation (r²= -0.84; p < 0,001) between disease stage and FA and ADC values in the CST.</p> <p>Conclusions</p> <p>DTT for identification of neuronal tracts with subsequent measurement of FA and ADC is a useful diagnostic tool for demonstrating patterns of neuronal tract involvement in neurodegenerative disease. In selected tracts, FA and ADC values might act as surrogate markers for disease stage.</p

Quantification and economic assessment of surplus bread in Italian small-scale bakeries: An explorative study

The generation of bread waste at suppliers and retailers is often linked to the production of surplus bread. This study reports the results of the first direct quantification and economic assessment of surplus bread conducted in Italy, involving a panel of 12 bakeries and their branches located in the Lazio region, which compiled a daily diary for 5 months. They are small-scale bakeries which reflect the typical structure of the Italian businesses in the bakery sector, producing fresh bread and selling it directly to consumers. The surplus bread measured during the study consists of 6,694 kg in total, with an average quantity of 4.83 kg/day per bakery. Studying the three main products (common bread, focaccia bread and bread rolls), the average rate of surplus is respectively 5.88 %, 3.99 % and 5.28 % of the production. The corresponding economic loss represents, on average, 5.44 % of the daily turnover. A set of factors seems to exert highest influence on the generation of surplus, as the range of production, location and number of customers. When surplus bread occurs, in 63 % of the cases it is managed on alternative routes to avoid disposal. Even if detected surplus bread does not necessarily become waste, it indeed represents a big loss for bakeries

Of goats and spines : a feeding experiment

This is the postprint version of the article.Spines in plants have evolved to reduce mammalian herbivory, and their main function may be to protect twigs more than photosynthetic tissue. Type and frequency of spines vary in different scales. We hypothesised that different types of spines affect animal foraging through different mechanisms. We studied feeding behaviour by twig browsing goats in relation to two types of spines of Acacia tortilis using experimental manipulation of the occurrence of spines. Feeding time, number of biting actions, number and diameter of bites on trees (post-trial) and total intake were recorded. The removal of either long straight spines or short hooked spines resulted in no feeding responses by goats. The removal of both types of spines tended to increase feeding time resulting in more and larger bites with larger bite diameters and in increased total intake and utilisation compared to control branches. The removal of spines gave no effects on feeding rate, expressed as biting actions/minute, number of twigs bitten/minute or intake rate (g/minute). Both types of spines reduced total intake and utilisation of browse, but the functional mechanisms were different with the long straight spines mainly influencing bite size and short hooked spines mainly affecting number of bites

Placenta Growth Factor-1 antagonizes VEGF-induced angiogenesis and tumor growth by the formation of functionally inactive PlGF-1/VEGF heterodimers

AbstractTumor growth and metastasis require concomitant growth of new blood vessels, which are stimulated by angiogenic factors, including vascular endothelial growth factor (VEGF), secreted by most tumors. Whereas the angiogenic property and molecular mechanisms of VEGF have been well studied, the biological function of its related homolog, placenta growth factor (PlGF), is poorly understood. Here we demonstrate that PlGF-1, an alternatively spliced isoform of the PlGF gene, antagonizes VEGF-induced angiogenesis when both factors are coexpressed in murine fibrosarcoma cells. Overexpression of PlGF-1 in VEGF-producing tumor cells results in the formation of PlGF-1/VEGF heterodimers and depletion of the majority of mouse VEGF homodimers. The heterodimeric form of PlGF-1/VEGF lacks the ability to induce angiogenesis in vitro and in vivo. Similarly, PlGF-1/VEGF fails to activate the VEGFR-2-mediated signaling pathways. Further, PlGF-1 inhibits the growth of a murine fibrosarcoma by approximately 90% when PlGF-1-expressing tumor cells are implanted in syngeneic mice. In contrast, overexpression of human VEGF in murine tumor cells causes accelerated and exponential growth of primary fibrosarcomas and early hepatic metastases. Our data demonstrate that PlGF-1, a member of the VEGF family, acts as a natural antagonist of VEGF when both factors are synthesized in the same population of cells. The underlying mechanism is due to the formation of functionally inactive heterodimers