From safety to efficiency: How drivers of technology adoption changed during the COVID-19 pandemic in municipal home care.

Background: Home care underwent abrupt adaptations to handle the COVID-19 pandemic including an accelerated digitalization. While some research exists regarding the working conditions for home care personnel during the COVID-19 pandemic, few studies exist on the effect of everyday technology use in home care during the pandemic. The aim of this study was to investigate how digital technologies, introduced in Swedish municipal home care during the COVID-19 pandemic, were adopted and used by home care nurses and how well they fitted the context of use over time.

Home Care Nurses at the Heart of the Communication Web: Communication Synchronicity and Effects on the Psychosocial Work Environment.

This qualitative study explores how communication practice affects Swedish home care nurses' psychosocial work environment. Data consisted of interviews and field observations, analyzed from the perspective of Media Synchronicity Theory and the Job-Demand-Control-Support model. Individual home care nurses were found to manage an interorganizational communication web.

Unveiling the heterogeneous utilisation of the same digital patient management platform: case studies in primary healthcare in Sweden.

Background: The utilisation of digital technology in primary healthcare, particularly digital patient management platforms, has gained prominence, notably due to the global pandemic. These platforms are positioned as substitutes for face-to-face consultations and telephone triage. They are seen as a potential solution to the escalating costs associated with an aging population, increasing chronic conditions, and a shrinking healthcare workforce.

An epidemiological and clinicopathological study of type 1 vs. type 2 morphological subtypes of papillary renal cell carcinoma- results from a nation-wide study covering 50 years in Iceland.

Introduction: Papillary renal cell carcinoma (pRCC) is the second most common histology of renal cell carcinoma (RCC), accounting for 10-15% of cases. Traditionally, pRCC is divided into type 1 and type 2, although this division is currently debated as a prognostic factor of survival. Our aim was to investigate the epidemiology and survival of the pRCC subtypes in a whole nation cohort of patients during a 50-year period.

Disease-Related Knowledge and Need for Revision of Care for Patients with Atrial Fibrillation: A Cross Sectional Study.

Purpose: To evaluate the disease-related knowledge of outpatients with atrial fibrillation (AF), and the relationship with health literacy and other background variables.

Patients And Methods: In this cross-sectional survey study, conducted in Iceland, patients with AF scheduled for an electrical cardioversion or AF catheter ablation were recruited from a hospital outpatient clinic. They completed the validated Atrial Fibrillation Knowledge Scale (AFKS), a 11-item instrument (with possible score 0-10, 10 being the best knowledge) which evaluates knowledge pertaining to AF in general, AF symptom detection and AF treatment.

Home care nurses' and managers' work environment during the Covid-19 pandemic: Increased workload, competing demands, and unsustainable trade-offs.

Little research exists on how home care nursing personnel have experienced the Covid-19 pandemic. This qualitative study explores the work environment related challenges nurses and managers in home care faced during the pandemic. We discuss these challenges in relation to the Demand-Control-Support Model and reflect on how the organizational dynamics associated with them can be understood using the competing pressures model.

"More" work for nurses: the ironies of eHealth.

Background: eHealth applications are considered a technological fix that can potentially address some of the grand challenges in healthcare, including burnout among healthcare professionals, the growing burden of patients with chronic conditions, and retaining and recruiting healthcare professionals. However, as the deployment of eHealth applications in healthcare is relatively novel, there is a lack of research on how they affect the work environment of healthcare professionals. This study explores how work evolves-particularly for nurses-during the utilisation of three eHealth applications.

How Digital Systems Are Used in Swedish Home Care Nursing Practice: A Qualitative Interview Study to Identify Challenges and Opportunities.

This study investigates how digital technology is used (or not used) in home care nursing, to identify challenges and opportunities that can move the digitalization of home care nursing forward. The use of digital technology in daily practices of home care nursing was analyzed based on semistructured interviews in four Swedish home care organizations. The results correspond to the two initial stages of a design thinking process: (1) knowledge about users and the use context , presented as an up-to-date description of how digital technology has affected home care nursing practice, and (2) definition of areas for improvement , presented as challenges and opportunities.

Materiality and the mediating roles of eHealth: A qualitative study and comparison of three cases.

Against the backdrop of eHealth solutions increasingly becoming a part of healthcare professionals' ways of doing care work, this paper questions how the solutions mediate the experience of healthcare professionals when deployed. We undertook a qualitative study of three eHealth solutions, conducting qualitative interviews with a diverse sample of 102 healthcare professionals from different care settings across the south of Sweden. Materiality and postphenomenology serve as analytic tools for achieving an understanding of the mediating roles of eHealth solutions.

Teamwork in home care nursing: A scoping literature review.

Due to an increased number of complex multi- and long-term ill patients, healthcare and nursing provided in patients' homes are expected to grow. Teamwork is important in order to provide effective and safe care. As care becomes more complex, the need for teamwork in home care nursing increases.

'It increases my ability to influence my ways of working': A qualitative study on digitally mediated patient management in primary healthcare.

Background: Digitally mediated primary healthcare is increasingly influencing working conditions, raising questions about how digitally mediated patient management is experienced.

Aim: The aim of this study was to generate insights, through the lens of postphenomenology, into how digitally mediated primary healthcare affects the work and working environment, by gathering perspectives from primary healthcare professionals who regularly manage patient errands through a digital platform.

Methods: Two rounds of interviews were conducted with a diversified sample of primary healthcare professionals at a primary healthcare centre.

Embedding and Integrating a Digital Patient Management Platform Into Everyday Primary Care Routines: Qualitative Case Study.

Background: Traditional primary care is characterized by patient consultations via phone and physical visits. However, the current development in Swedish primary care is to blend digital solutions with traditional solutions. This paper addresses this development by examining the normalization of embedding and integrating a digital health care platform into everyday care routines in a primary care clinic.

Communicating the Implementation of Open Notes to Health Care Professionals: Mixed Methods Study.

Background: The literature on how to communicate reform in organizations has mainly focused on levels of hierarchy and has largely ignored the variety of professions that may be found within an organization. In this study, we focus on the relationship between media type and professional responses.

Objective: The objective of this study was to investigate whether and how belonging to a profession influences the choice of communication media and the perception of information when a technical innovation is implemented in a health care setting.

Peptidylarginine Deiminase (PAD) and Post-Translational Protein Deimination-Novel Insights into Alveolata Metabolism, Epigenetic Regulation and Host-Pathogen Interactions.

The alveolates (Superphylum Alveolata) comprise a group of primarily single-celled eukaryotes that have adopted extremely diverse modes of nutrition, such as predation, photoautotrophy and parasitism. The alveolates consists of several major phyla including the apicomplexans, a large group of unicellular, spore forming obligate intracellular parasites, and chromerids, which are believed to be the phototrophic ancestors of the parasitic apicomplexans. Molecular pathways involved in Alveolata host-pathogen interactions, epigenetic regulation and metabolism in parasite development remain to be fully understood.

A gene expression-based single sample predictor of lung adenocarcinoma molecular subtype and prognosis.

Disease recurrence in surgically treated lung adenocarcinoma (AC) remains high. New approaches for risk stratification beyond tumor stage are needed. Gene expression-based AC subtypes such as the Cancer Genome Atlas Network (TCGA) terminal-respiratory unit (TRU), proximal-inflammatory (PI) and proximal-proliferative (PP) subtypes have been associated with prognosis, but show methodological limitations for robust clinical use.

A Theoretical Twist on the Transparency of Open Notes: Qualitative Analysis of Health Care Professionals' Free-Text Answers.

Background: The New Public Management movement strove for transparency so that policy makers and citizens could gain insight into the work and performance of health care. As the use of the electronic health record (EHR) started to diffuse, a foundation was laid for enhanced transparency within and between health care organizations. Now we appear to be experiencing a new kind of transparency in the health care sector.

Lost in Translation? Care Coordination Across Contexts in Swedish Homecare Nursing.

The responsibilities for delivery of care in Sweden is divided between the regions and the municipalities. The regions run the hospitals and the primary care centres (PCCs) whereas the municipalities are responsible for homecare nursing and nursing homes. The homecare nurses and the doctors they need to seek advice from, thus belong to different organizations/contexts.

eHealth Services in the Near and Distant Future in Swedish Home Care Nursing.

Sweden and other developed countries are putting deliberate efforts into eHealth and digitalization of home care nursing. eHealth services have big potential in this area because they can provide mobile access to healthcare information. This study explores the eHealth services that home care nursing providers in Sweden currently use, plan to use, and have discarded.

What do doctors mean when they talk about teamwork? Possible implications for interprofessional care.

The concept of teamwork has been associated with improved patient safety, more effective care and a better work environment. However, the academic literature on teamwork is pluralistic, and there are reports on discrepancies between theory and practice. Furthermore, healthcare professionals' direct conceptualizations of teamwork are sometimes missing in the research.

Open Notes in Swedish Psychiatric Care (Part 2): Survey Among Psychiatric Care Professionals.

Background: This is the second of two papers presenting the results from a study of the implementation of patient online access to their electronic health records (here referred to as Open Notes) in adult psychiatric care in Sweden. The study contributes an important understanding of both the expectations and concerns that existed among health care professionals before the introduction of the Open Notes Service in psychiatry and the perceived impact of the technology on their own work and patient behavior after the implementation. The results from the previously published baseline survey showed that psychiatric health care professionals generally thought that Open Notes would influence both the patients and their own practice negatively.

Driving for successful change processes in healthcare by putting staff at the wheel.

Purpose The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community.

Open Notes in Swedish Psychiatric Care (Part 1): Survey Among Psychiatric Care Professionals.

Background: When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015.

Extramedullary Cavernous Hemangioma with Intradural and Extradural Growth and Clinical Symptoms of Brown-Séquard Syndrome: Case Report and Review of the Literature.

Background: Primary spinal tumors are rare. Symptoms depend on the size and location of the tumor.

Case Description: A patient presented with a rare clinical finding, Brown-Séquard syndrome.

Can physician laboratory-test requests be influenced by interventions?

Background: Laboratory tests affect healthcare costs and unnecessary test requests can thus be a concern. We studied whether it was possible to influence physician laboratory-test requests using four structured interventions: introduction of clinical guidelines, education, feedback, and reminder letters. The interventions occurred at different times at Landspítali University Hospital, Reykjavik, Iceland.