Exploring the meaning, role and experiences of a patient-led social innovation for people affected by cancer: a new collaborative care model complementing traditional cancer rehabilitation in Sweden

Objective Kraftens Hus is the first support centre in Sweden designed by and for people affected by cancer, including patients, family, friends, staff members and local community representatives (collectively \u27stakeholders\u27). The purpose of this study was to explore the meaning, role and experiences of Kraftens Hus stakeholders using a patient and public involved methodology. Methods To understand and map the experiences of visitors to Kraftens Hus, we applied concept mapping (CM), a mixed methods approach where data are collected and analysed in four structured steps designed to capture the diverse perspectives of multiple stakeholders. Qualitative interviews with relevant stakeholders supplemented the CM findings. Results The final concept map contained six clusters of ideas. Within the clusters, there was a recurring theme that cancer-affected people value accessible and long-term psychosocial support (PSS). The intended emotional, social and practical needs identified in a previous design process seem to have been addressed and appreciated by Kraftens Hus visitors. Conclusion Kraftens Hus is an example of a new patient-led social innovation based on a life-event perspective and integration of resources from different sectors in society. By focusing on life, not the disease, the care continuum expands, and long-term PSS is provided alongside cancer treatment. The evaluation confirms that PSS should focus on health and well-being in the broadest sense

Improved survival in myeloma patients–a nationwide registry study of 4,647 patients ≥75 years treated in Denmark and Sweden

The prevalence of multiple myeloma (MM) is increasing in Nordic countries and the rest of the western world. Patients aged ≥75 years at diagnosis constitute an increasing proportion of all MM patients, but are underrepresented in randomized clinical trials. There is an urgent need for studies of the characteristics, treatment and outcome in this cohort. We present data from two nationwide population-based registries of all MM patients diagnosed in Denmark from January 1, 2005 until February 18, 2020, and in Sweden from January 1, 2008 until December 31, 2019, including treatment data for patients diagnosed until 2018 (Denmark) and 2019 (Sweden). In total 4,647 patients were ≥75 years at diagnosis, compared to 7,378 younger patients. Patients ≥75 years, accounting for approximately 40% of all MM patients, are a distinct cohort with more advanced disease at diagnosis, reflected by higher International Staging System (ISS) stage, and a higher proportion have renal failure and anemia. We found a more gradual introduction of modern medications in the older cohort than in the younger, despite simultaneous changes in guidelines. Compared to the cohorts in randomized controlled trials that guide the treatment of non-transplant eligible patients, we found a higher proportion of patients ≥75 years and presenting with ISS III in the real-world populations. Nevertheless, response rates and survival are increasing, indicating that modern treatment regimens are effective and well tolerated also in elderly MM patients in real-world populations

The Effect of Low-Frequency Road Noise on Driver Sleepiness and Performance

It is a well-known fact today that driver sleepiness is a contributory factor in crashes. Factors considered as sleepiness contributor are mostly related to time of the day, hours being awake and hours slept. Factors contributing to active and passive fatigue are mostly focusing on the level of cognitive load. Less is known what role external factors, e.g. type of road, sound/noise, vibrations etc., have on the ability to stay awake both under conditions of sleepiness and under active or passive fatigue. The aim of this moving base driving simulator study with 19 drivers participating in a random order day and night time, was to evaluate the effect of low-frequency road noise on driver sleepiness and performance, including both long-term and short-term effects. The results support to some extent the hypothesis that road-induced interior vehicle sound affects driving performance and driver sleepiness. Increased low-frequency noise helps to reduce speed during both day-and night time driving, but also contributes to increase the number of lane crossings during night time.Funding Agencies|competence centre ViP (Virtual Prototyping and Assessment by Simulation); VINNOVA (the Swedish Governmental Agency for Innovation Systems) [2007-03083]; ViP; Volvo Car Cooperation</p

NORD2000 SPÅR : Beräkning av spårkorrektion från ytråhet på rälen för bullerberäkningar

Kunskapscentrum om bulle

SleepNoise

It is well known that sleepiness is an important contributor to crashes. The drivers are influenced by circadian low, hours slept or being awake. There is also reason to believe that variations in interior road noise may be a contributing factor. Up to now the road noise models in simulators are not very mature and not validated. The aim of the technical part of the SleepNoise project was to develop the road noise model for the ViP simulation infrastructure, including individual vehicle types driving on individual road types. The goal was a sound model, close enough to the original real world setting as to be approved by vehicle noise experts. The resulting modelled interior sound spectrum should not deviate more than a few decibels from the corresponding recorded sound.På omslaget: Sleep Noise</p

Nord2000 spår : Beräkning av spårkorrektion från ytråhet på rälen för bullerberäkningar

I samband med att nya emissionsdata för svenska tåg togs fram för den EU-gemensamma beräkningsmetoden Cnossos-EU och för Nord2000 skapades en korrektion för varje mätplats utifrån den uppmätta ytråheten på rälen. Detta PM beskriver en förenklad metod för att beräkna motsvarande korrektion baserad på den uppmätta ytråheten som sedan går att använda både för beräkningar med den Nordiska metoden reviderad 1996 och med Nord2000

Investigating lead time, cost and patient pathways of breast cancer care: a comparative study of four hospitals in Sweden

Introduction:This paper aims to provide support for quality improvement in breast cancer care in Sweden. Using qualityregister data from 2009-2012 with approximately 2630 patients in four hospitals, we would like to answerthree questions: (1) Is there a hospital which has the shortest lead time and/or lowest cost thus serving as arole model? (2) Is there a typical way of working, in terms of patient pathways, that leads to shorter lead timeand/or lower cost? (3) Does shorter lead time imply lower cost? The results of this research will be useful forinter-organizational learning among the hospitals for creating better breast cancer care.Methods:Descriptive statistics is used to analyze the lead times to surgery and subsequent treatments (radiation andchemotherapy) and cost per patient for each hospital. Process mining using ProM software is used forunderstanding patients’ pathways. For all hospitals, the lead time and cost are categorized into three groups,namely, short or low, moderate, and long or high. The grouping uses discretization technique in such a way thatthe low-cost or short-lead time class corresponds to set goals and the moderate group will be the majority ofthe cases. The analysis is carried out within and across hospitals. The relationship between low/high cost care,short/long lead time and patient pathways are investigated visually and cross-checked with the practitioners.Results: Results show that lead times often exceed set goals and this is especially true for time betweensurgery and radiation. Two hospitals seem to achieve a better result here, and one of these hospital alsoappear to stand out positively from the other three hospitals in terms of lead time from diagnosis to surgery.The two hospitals above also have a larger percentage of low-cost patients than the other two hospitals.Pathway mapping revealed differences in the use of personnel resources among the hospitals. Generally, thereseems to be a relationship between the unique pathways and the cost. Across hospitals, the low cost group hasa lot less unique pathways. This can imply that the deviation from the common clinical pathway may lead tohigher cost.Discussion: This work shows how quality register data can provide useful information for improving breastcancer care. Based on the evidence, areas of improvement can be mapped for each hospital and how they canlearn from each other. This work provides a starting point for a more directed investigation into understandingpatient clinical pathways and towards explaining why some care costs a lot more than the others or why somepatients have to wait for such a long time.Declaration of competing interestsWe gratefully thank Regional Cancer Centre West for the funding of this research