Rehabiliteringsmedicin : diagnostisering och behandling av kognitiv svikt vid stroke.

Abstract Background; For stroke patients and their relatives in cognitive impairment one of the most troubling problems. The assignment is aiming to describe what cognitive impairment is, how the diagnosis is set and which recommendations there are according to treatment and management. Method; A literature study, by reading up in textbooks and searching the databases Pubmed and Cohchrane as well as the Stroke journal for articles limited to later than 1998 and for key words as cognitive impairment, stroke rehabilitation and management. Result/Discussion; Cognitive impairment strikes 30% of the stroke patients. By affecting the frontal subcortical parts is executive function impaired with speed related motor and psychomotor activities. With hippocapal injury, vascularised by posterior circuits is also memory function affected. Comprehension of room and relations as well as language is coupled with temporal and parietal areas of affection. Neuropsychological testing has been used to diagnose dementia for a long time and is now applied on stroke patients. It is per today not consensus of which test to use and when to perform them and one has not agreed on definitive guidelines and treatment recommendations although is seems as the interest is increasing

Spegel, gravsten eller spjutspets? : offentlig konst och genus

Denna publikation handlar om den konst som finns utomhus i vår stadsmiljö. I fokus står frågor om konstens synliggörande av kön, om hur konsten konstruerar kvinnlighet och manlighet och hur den framställer relationer mellan kvinna och man. Konstens genusprägling kopplas till tiden och samhällsutvecklingen: Fungerar konsten som en spegel, en gravsten eller en spjutspets? Hur förhåller den sig till de förändringar i könsrelationer och tänkande om kön som skett under 1900-talet i Sverige?Sju orter i Gävleborgs län har undersökts och materialet omfattar alla konstverk som under perioden 1920–2000 placerats utomhus i den offentliga miljön. Analysen visar på mycket tydliga tendenser beträffandesynliggörandet av kön och på starka och seglivade mönster i sättet att framställa kvinna och man och relationer mellan dem.Studien behandlar även processen bakom tillkomsten av konsten: Vilka är aktörerna och deras roller? Hur kan förloppet från initiativ till verket på plats beskrivas? Vilken är uppfattningen om konstens funktion? Hur ser man på frågor om jämställdhet och genus? I jämförelse med offentlig verksamhet inom t.ex. utbildning, vård och omsorg har den konstnärliga utsmyckningen av allmänna platser sedan länge varit avsevärt mindre regelstyrd och stått under betydligt mindre demokratiskt inflytande – på gott, kanske också på ont? En kritisk reflektion över denna utsmyckning är hur som helst angelägen och politiskt relevant – det handlar nämligen om makt och inflytande över den miljö vi alla lever i.Boken är ett bidrag till forskningen om konsten i det offentliga rummet, men den riktar sig inte bara till forskarvärlden. Den vänder sig också till olika aktörer med inflytande över stadsmiljöns utformning; kommunala tjänstemän och politiker, beslutsfattare inom landsting och stat liksom, naturligtvis, konstnärer

An Integrated Care Platform System (C3-Cloud) for Care Planning, Decision Support, and Empowerment of Patients With Multimorbidity: Protocol for a Technology Trial

Background: There is an increasing need to organize the care around the patient and not the disease, while considering the complex realities of multiple physical and psychosocial conditions, and polypharmacy. Integrated patient-centered care delivery platforms have been developed for both patients and clinicians. These platforms could provide a promising way to achieve a collaborative environment that improves the provision of integrated care for patients via enhanced information and communication technology solutions for semiautomated clinical decision support. Objective: The Collaborative Care and Cure Cloud project (C3-Cloud) has developed 2 collaborative computer platforms for patients and members of the multidisciplinary team (MDT) and deployed these in 3 different European settings. The objective of this study is to pilot test the platforms and evaluate their impact on patients with 2 or more chronic conditions (diabetes mellitus type 2, heart failure, kidney failure, depression), their informal caregivers, health care professionals, and, to some extent, health care systems. Methods: This paper describes the protocol for conducting an evaluation of user experience, acceptability, and usefulness of the platforms. For this, 2 “testing and evaluation” phases have been defined, involving multiple qualitative methods (focus groups and surveys) and advanced impact modeling (predictive modeling and cost-benefit analysis). Patients and health care professionals were identified and recruited from 3 partnering regions in Spain, Sweden, and the United Kingdom via electronic health record screening. Results: The technology trial in this 4-year funded project (2016-2020) concluded in April 2020. The pilot technology trial for evaluation phases 3 and 4 was launched in November 2019 and carried out until April 2020. Data collection for these phases is completed with promising results on platform acceptance and socioeconomic impact. We believe that the phased, iterative approach taken is useful as it involves relevant stakeholders at crucial stages in the platform development and allows for a sound user acceptance assessment of the final product. Conclusions: Patients with multiple chronic conditions often experience shortcomings in the care they receive. It is hoped that personalized care plan platforms for patients and collaboration platforms for members of MDTs can help tackle the specific challenges of clinical guideline reconciliation for patients with multimorbidity and improve the management of polypharmacy. The initial evaluative phases have indicated promising results of platform usability. Results of phases 3 and 4 were methodologically useful, yet limited due to the COVID-19 pandemic