Developing community based rehabilitation for cancer survivors: organizing for coordination and coherence in practice

Abstract Background Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts. Methods Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups. A Grounded Theory approach was used to analyze the data. Results A lack of shared cultures among health care providers and systems of delivery was a primary barrier to collaboration which was essential for establishing coordination of care. Formal multidisciplinary steering committees, team-based organization, and informal relationships were fundamental for developing coordination and coherence. Conclusions Coordination and coherence in community-based rehabilitation relies on increased collaboration, which may best be optimized by use of shared frameworks within and across systems. Results highlight the challenges faced in practical implementation of community rehabilitation and point to possible strategies for its enhancement

Uddeling af sølvbægere.

Uddeling af sølvbægere

Lack of systematicity in research prioritisation processes - a scoping review of evidence syntheses

BACKGROUND: A systematically and transparently prepared research priority-setting process within a specific scientific area is essential in order to develop a comprehensive and progressive evidence-based approach that will have a substantial societal impact on the site of interest. On the basis of two consensus workshops, the authors suggest the following methods for all such processes: use of experts, stakeholder involvement, literature review, and ranking. OBJECTIVES: The identification, categorisation, and discussion of methods for preparing a research prioritisation process. METHODS: Eligibility criteria: Evidence synthesis includes original studies presenting a research prioritisation process and which listed the methods used to create a research prioritisation process. Only evidence syntheses related to health research were included. Data sources: We searched the following electronic databases, without limiting by date or language: MEDLINE Ovid, Embase Ovid, Epistemonikos, and CINAHL EBSCO. Charting methods: The methods used were mapped and broken down into different elements, and the use of the elements was determined. To support the mapping, (A) all of the elements were collapsed into unique categories, and (B) four essential categories were selected as crucial to a successful research prioritisation process. RESULTS: Twelve evidence syntheses were identified, including 416 original studies. The identification and categorisation of methods used resulted in 13 unique categories of methods used to prepare a research agenda. CONCLUSION: None of the identified categories was used in all of the original studies. Surprisingly, all four of the essential categories were used in only one of the 416 original studies identified. There is seemingly no international consensus on which methods to use when preparing a research prioritisation process. PROTOCOL REGISTRATION: The protocol was registered in Open Science Framework (https://osf.io/dygz8/). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13643-022-02149-2

Sustaining international partnerships : the European master of science programme in occupational therapy, a case study

International partnerships are a mechanism for supporting the academic development of occupational therapy and promoting cultural competence. This case study describes the factors that have helped to sustain a post-qualifying programme implemented by five higher education institutions in Denmark, the Netherlands, Sweden, Switzerland and the UK since 1999. Data collection methods were documentary analysis and the reflections of a purposive sample of six key informants. Cohort and outcome data, from 193 students from 31 countries who enrolled between 1999 and 2011, are reported. Each cohort comprises students from an average of eight countries to optimize inter-cultural dialogue. Four factors support sustainability. These are 1) supportive professional European networks; 2) timeliness and alignment with European higher education policy; 3) partnership structures and processes that emphasize joint decision making and accountability; and 4) the stimulus and satisfaction associated with internationalization. The main limitations are considering the OT-EuroMaster as an intrinsic case study and using opportunistic data collection that undermines the rigor and transferability of the findings. Future opportunities include doctoral networks, transnational research and sharing our curricula design with other Regions to spread the collaborative, capacity building endeavours more widely

Enhancing CHO cell productivity through a novel dual selection system using Aspg and Gs in glutamine free medium

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Genome-wide CRISPR-Cas9 screen identifies hyperosmotic stress responsive genes in Chinese hamster ovary cells

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Activities as resources when living with advanced cancer

The overall aim of this thesis was to increase knowledge about how people with advanced cancer experience their engagement in activities and how such activities may be useful when living with life-threatening illness. This is explored with regard to creative activities in palliative occupational therapy and to self-chosen activities in everyday life. Given that improved treatment allows people with advanced cancer to live increasingly longer periods of time, it becomes important to support them in such circumstances. Gaining insight into the potential and the challenges of engagement in activities from the perspective of people with life-threatening illness may generate knowledge that can complement theoretical and practical foundations for the use of activities in therapeutic intervention and everyday life. The thesis includes four studies. In Study I the aim was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness from the perspective of clients and therapists (n = 15). This study was based on qualitative interviews analyzed using a constant comparative method. Study II aimed to investigate the meanings that people with advanced cancer ascribed to engaging in creative activity in palliative occupational therapy (n = 8). The data from qualitative interviews were analyzed using a phenomenological method. In Study III the aim was to describe and explore the daily activities of people with advanced cancer in relation to time, location, social interaction and experience (n = 45). The data were collected using semistructured diaries and qualitative interviews according to the Time Geographical Method. These data were analyzed using a constant comparative method. Study IV aimed to explore and understand how people with advanced cancer create meaning and handle everyday life through activity (n = 7). The data collection was based on a combination of qualitative interviews and participant observation. In this study an interpretive narrative approach was used for the analysis. The findings in Study I identified how clients and therapists contributed jointly in constructing a generous environment supporting engagement in activities. The findings suggested that engagement in creative activity enabled clients to create connections of past experiences with their present situation and connections reaching into a possible future. In Study II engagement in creative activities was found to ease living in proximity to death and to provide opportunities for creating new ways of living. This entailed ongoing processes for the participants, which involved confronting the consequences of advanced cancer, experimenting with ways to handle current challenges and acknowledging personal resources. Study III identified that the participants with advanced cancer spent most of their time at home. Their daily lives consisted primarily of self-care and leisure activities with limited social engagement. Establishing and maintaining rhythms of routine and change was found to be significant for the participants sense of satisfaction with daily life. The results of Study IV showed how the participants fashioned stories through daily activity that were useful to them in handling everyday life with advanced cancer. These narratives illustrated the challenges faced by the participants in creating desired stories in negotiation with their socio-cultural environment. Activities were identified as an arena for exploring contrasting feelings of health and severe illness and, in addition, for providing a familiar framework stimulating agency and life-confirming experiences. Taken together the findings identified various ways in which engagement in activities may provide opportunities to explore and work through consequences of advanced cancer. Engagement in activity was identified as stimulating the discovery of individual and sociocultural resources that the affected person could draw upon in daily life by taking agency, transcending grief and experiencing enrichment and completion in the face of impending death. These studies may contribute to the development of palliative care and to the support of people with advanced cancer as they explore ways to engage and use activities in the remainder of their lives