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Changing Categorical Work in Healthcare : the Use of Patient-Generated Health Data in Cancer Rehabilitation
(2020) Cerna, Katerina; Grisot, Miria; Islind, Anna Sigridur; Lindroth, Tomas; Lundin, Johan; Steineck, Gunnar; Department of Computer Science
Categorical work in chronic care is increasingly dependent on digital technologies for remote patient care. However, remote care takes many forms and while various types of digital technologies are currently being used, we lack a nuanced understanding of how to design such technologies for specific novel usages. In this paper, we focus on digital technologies for patient-generated health data and how their use changes categorical work in chronic care. Our aim is to understand how categorical work changes, which novel forms of categorical work emerge and what the implications are for the care relation. This paper is based on an ethnographic study of healthcare professionals’ work at a pelvic cancer rehabilitation clinic and their interactions with patients. In this setting, supportive talks between patients and nurses are central. To understand the complexities of categorical work in chronic care when patient-generated health data are introduced, we contrast the traditional supportive talks with supportive talks where the nurses had access to the patients’ patient-generated health data. We identify and analyze challenges connected to novel forms of categorical work. Specifically, we focus on categorical work and how it can undergo changes. Our empirical findings show how changes occur in the way patients’ lived experience of the chronic disease aligns with the categories from chronic care, as well as in the way the nurse works with clinical categories during the talk. These insights help us further understand the implications of patient generated-data use in supportive talks. We contribute to an improved understanding of the use of patient-generated health data in clinical practice and based on this, we identify design implications for how to make categorical work more collaborative.
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Post-meeting report of the 2022 On-site Padua Days on Muscle and Mobility Medicine, March 30 - April 3, 2022, Padua, Italy
(2022-07-08) Carraro, Ugo; Bittmann, Frank; Ivanova, Elena; Jónsson, Halldór; Kern, Helmut; Leeuwenburgh, Christiaan; Mayr, Winfried; Scalabrin, Mattia; Schaefer, Laura; Smeriglio, Piera; Zampieri, Sandra; Department of Engineering
Despite COVID-19 outbreak, the program of the 2022 Padua Days of Muscle and Mobility Medicine (PDM3) was confirmed On-site in February from March 30 to April 2, 2022 to be held at the University of Padua Aula Magna and at Conference Hall of the Hotel Petrarca of Thermae of Euganean Hills (Padua), Italy. Over 130 abstracts, including the last-minute submissionslisted below, convinced organizers to extend the program to five days. The sponsorship of the University of Florida and the willingness of attendees to meet friends after two years of virtual conferences were the keys of success, despite concerns for current events in East Europe. Only fourteen Virtual presentations were in the final program, eight due to last-minute Coronavirus infections and six for East Europe problems. The first two days of the program included scientists and clinicians of the University of Florida, USA and their invitees from Canada, France, Italy, Swiden, Swiss, UK and USA. Researchers and clinicians from Austria, Belgium, France, Germany, Iceland, Ireland, Italy, Russia, Slovakia, Slovenia, UK and USA filled the program of last three days more oriented to aging and rehabilitation. The large majority of abstracts was epublished before the meeting; here are last-minute abstracts and the final program. The program of the 2023 On-site PDM3 was informally designed during the Meeting, but will be circulated during 2022 summer. Fix the dates in your agenda from Thursday March 28 to Friday March 31. For now, please, submit Communications to the European Journal of Translational Myology, PAGEpress, Pavia, Italy and Original Articles or Reviews to the Journal Diagnostics, MDPI, Basel, Swiss. Both journals will host Special PDM3 Sections and will apply 50% discount on editorial processing fees to the first 15 accepted typescripts.
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Mineralization in a Critical Size Bone-Gap in Sheep Tibia Improved by a Chitosan-Calcium Phosphate-Based Composite as Compared to Predicate Device
(2022-02-01) Örlygsson, Gissur; Laxdal, Elín H.; Kárason, Sigurbergur; Dagbjartsson, Atli; Gunnarsson, Eggert; Ng, Chuen How; Einarsson, Jón M.; Gíslason, Jóhannes; Jónsson, Halldór; Department of Engineering
Deacetylated chitin derivatives have been widely studied for tissue engineering purposes. This study aimed to compare the efficacy of an injectable product containing a 50% deacetylated chitin derivative (BoneReg-Inject™) and an existing product (chronOS Inject®) serving as a predicate device. A sheep model with a critical size drill hole in the tibial plateau was used. Holes of 8 mm diameter and 30 mm length were drilled bilaterally into the proximal area of the tibia and BoneReg-Inject™ or chronOS Inject® were injected into the right leg holes. Comparison of resorption and bone formation in vivo was made by X-ray micro-CT and histological evaluation after a live phase of 12 weeks. Long-term effects of BoneReg-Inject™ were studied using a 13-month live period. Significant differences were observed in (1) amount of new bone within implant (p < 0.001), higher in BoneReg-Inject™, (2) signs of cartilage tissue (p = 0.003), more pronounced in BoneReg-Inject™, and (3) signs of fibrous tissue (p < 0.001), less pronounced in BoneReg-Inject™. Mineral content at 13 months postoperative was significantly higher than at 12 weeks (p < 0.001 and p < 0.05, for implant core and rim, respectively). The data demonstrate the potential of deacetylated chitin derivatives to stimulate bone formation.
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Bone remodeling effect of a chitosan and calcium phosphate-based composite
(2019-08-01) Kjalarsdóttir, Lilja; Dýrfjörd, Arna; Dagbjartsson, Atli; Laxdal, Elín H.; Örlygsson, Gissur; Gíslason, Jóhannes; Einarsson, Jón M.; Ng, Chuen How; Jónsson, Halldór; Department of Engineering
Chitosan is a biocompatible polymer that has been widely studied for tissue engineering purposes. The aim of this research was to assess bone regenerative properties of an injectable chitosan and calcium phosphate-based composite and identify optimal degree of deacetylation (%DDA) of the chitosan polymer. Drill holes were generated on the left side of a mandible in Sprague-Dawley rats, and the hole was either left empty or filled with the implant. The animals were sacrificed at several time points after surgery (7-22 days) and bone was investigated using micro-CT and histology. No significant new bone formation was observed in the implants themselves at any time points. However, substantial new bone formation was observed in the rat mandible further away from the drill hole. Morphological changes indicating bone formation were found in specimens explanted on Day 7 in animals that received implant. Similar bone formation pattern was seen in control animals with an empty drill hole at later time points but not to the same extent. A second experiment was performed to examine if the %DDA of the chitosan polymer influenced the bone remodeling response. The results suggest that chitosan polymers with %DDA between 50 and 70% enhance the natural bone remodeling mechanism.
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Epidemiology of spinal fractures and associated spinal cord injuries in Iceland
(2018-12) Kristinsdóttir, Eyrún Arna; Knútsdóttir, Sigrún; Sigvaldason, Kristinn; Jónsson, Halldór; Ingvarsson, Páll E.; Department of Engineering
Study design: A retrospective epidemiological study. Setting: Landspítali University Hospital, Iceland. Objectives: Assessment of epidemiological data and risk factors for traumatic spinal fractures (SFs) and associated spinal cord injury (SCI). Methods: A retrospective review of hospital admissions due to traumatic SFs during a 5-year period, with analysis of epidemiological parameters and occurrence of concomitant SCI. Patients with asymptomatic SFs and non-traumatic SCI were excluded. Results: A total of 487 patients were diagnosed with a SF or 310 PMI (per million inhabitants), 42 of them (9%, 27 PMI) with an associated SCI. The mean age was 56 years, males were 57%. Falls were the leading cause of both SFs (49%) and SCIs (43%). Low falls (<1 m) caused SFs more often in elderly women (67%, mean age 77 years) and more than 96% were without SCI. Road traffic accidents (RTA) caused 31% of SFs and 26% of SCIs. Seat belts were not used in 20% of car accidents, but information was missing in 27%. Sports/leisure-related accidents caused SFs in 12% of cases, whereof horseback riding accidents were the most common (36%). Conclusions: SFs led to SCI in 9% of patients. Several risk factors were common for SFs and SCIs but two major differences were seen: SFs without SCI were most common in older women due to low falls, while the risk of a concomitant SCI increased in young patients, in males, in falls from high levels and when driving without using seat belts. Preventive efforts should therefore be directed towards these risk factors.