Search

Objective: To analyze definitions and related requirements, processes, and operationalization of person-centered goal-setting in the physiotherapy research literature; to discuss those findings in relation to underlying principles of person-centeredness; and to provide an initial framework for how person-centered goal-setting could be conceptualized and operationalized in physiotherapy. Methods: A literature search was conducted in the databases: CINAHL, PubMed, PEDro, PsycINFO, REHABdata and Scopus. A content analysis was performed on how person-centered goal-setting was described. Results: A total of 21 articles were included in the content analysis. Five categories were identified: 1) Understanding goals that are meaningful to the patients; 2) Setting goals in collaboration; 3) Facing challenges with person-centered goal-setting; 4) Developing skills by experiences and education; and 5) Changing interaction and reflective practice. These categories were abstracted into two higher-ordered interlaced themes: 1) To seek mutual understanding of what is meaningful to the patient; and 2) To refine physiotherapy interaction skills, which we suggest would be useful for further conceptualization. Conclusion: In this analysis, we interpreted person-centered goal-setting in physiotherapy as a process of interaction toward a mutual understanding of what is meaningful to the patient. Future research may explore how to integrate mindful listening, embodied interaction and continuous ethical reflection with different assessments and treatment methods. more...

BACKGROUND AND PURPOSE: Early supported discharge (ESD) has been shown to be efficient and safe as part of the stroke care pathway. The best results have been seen with a multidisciplinary team and after mild to moderate stroke. However, how very early supported discharge (VESD) works has not been studied. The aim of this study was to investigate whether VESD for stroke patients in need of ongoing individualized rehabilitation affects the level of anxiety and overall disability for the patient compared with ordinary discharge routine. METHODS: A randomized controlled trial was performed with intention to treat analyses comparing VESD and ordinary discharge from hospital. All patients admitted at the stroke care unit at Sahlgrenska University Hospital of Gothenburg between August 2011 and April 2016 were screened. Inclusion occurred on day 4 using a block randomization of 20 and with a blinded assessor. Assessments were made 5 days post-stroke and 3 and 12 months post-stroke. Patients in the VESD group underwent continued rehabilitation in their homes with a multidisciplinary team from the stroke care unit for a maximum of 1 month. The patients in the control group had support as usual after discharge when needed such as home care service and outpatient rehabilitation. The primary outcome was anxiety as assessed by the Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A). The secondary outcome was the patients' degree of overall disability, measured by the modified Rankin Scale (mRS). RESULTS: No significant differences were found between the groups regarding anxiety at three or 12 months post-stroke (p = 0.811). The overall disability was significantly lower in the VESD group 3 months post-stroke (p = 0.004), compared to the control group. However, there was no significant difference between the groups 1 year post-stroke. CONCLUSIONS: The VESD does not affects the level of anxiety compared to ordinary rehabilitation. The VESD leads to a faster improvement more...

Within the traditional real estate business today there’s a growing trend focusing on increased customer value at office workplaces. Facilitating innovation requires transfer of different kinds of knowledge, which means that the knowledge-bearing actors must meet and interact. The customer is therefore no longer passive but deemed as an important active actor in the development of new and changed business models. In a case study, this paper seeks to improve our understanding of how network structure affects innovation outcomes in real estate innovation networks by analyzing network structure in terms of network size, density and in terms of actor centrality or position. This study shows that it was primarily the customer who was behind the innovative development of the workplace while the real estate company had a more network coordinating role. more...

Implementing and complying with standards and certification often increases costs for supply chain actors. These increased costs are caused by upgrading production, logistics and marketing needed to achieve compliance, and can lead to the exclusion of actors from the supply chain. In particular, the exclusion of small-scale growers in developing countries as the result of the expansion and proliferation of private voluntary standards (PVS) used by large procurers has been extensively reported. Costs of PVS are per certification and the unit is usually the individual farm, regardless of its size. In much of the developing world smallholder production dominates domestic food production, and these small farms face proportionately higher costs per unit area for certification and compliance. Benefits of PVS are per production unit, giving benefits to larger farms. Developing world smallholder production tends to be on less than one hectare, giving relatively small production. Compared with the costs per farm, there is an inherent bias in many standards and certification towards larger farms. Standards in export horticulture can, potentially, incentivize a more active role for the private sector in investing in small-scale growers in ways that are mutually beneficial for growers and exporters. Such co-investment is a feature of trading relationships and business models that are inclusive of small-scale growers. In Kenyan horticulture, donors, exporters and smallholders have in some cases managed to leverage PVS requirements into profitable local agricultural developments. In this paper, we use resource-based strategic alliance theory to explain the patterns that have evolved. We propose greater use of cooperation theory to help make more efficient economic development interventions which are complementary with private-sector investments. We explore how standards might be used to accelerate development initiatives., Agriculture in African countries - information and market power more...

BACKGROUND: Stroke is the disease with the highest costs for hospital care and also after discharge. Early supported discharge (ESD) has shown to be efficient and safe and the best results with well-organised discharge teams and patients with less severe strokes. The aim is to investigate if very early supported discharge (VESD) for stroke patients in need for on-going individualised rehabilitation at home is useful for the patient and cost effective. METHODS/DESIGN: A randomized controlled trial comparing VESD with ordinary discharge. Inclusion criteria: confirmed stroke, >18 years of age, living within 30 min from the stroke unit, on day 2 0-16 points on the National institute of health stroke scale (NIHSS) and 50-100 points on the Barthel Index (BI), with BI 100 then the patient can be included if the Montreal Cognitive Assessment is < 26. Exclusion criteria are: NIHSS >16, BI < 50, life expectancy < 1 year, inability to speak or to communicate in Swedish. The inclusion occurs on day 4 and in block randomization of 20 and with blinded assessor. Primary outcome: levels of anxiety and depression. Secondary outcomes: independence, security, level of function, quality of health, needs of support in activities of daily living and caregiver burden. Power calculation is based on the level of anxiety and with a power of 80%, p-value 0.05 (2 sided test) 44 persons per group are needed. Data is gathered on co-morbidity, re-entry to hospital, mortality and a health economic analysis. Interviews will be accomplished with a strategic sample of 15 patients in the intervention group before discharge, within two weeks after homecoming and 3 months later. Interviews are also planned with 15 relatives in the intervention group 3 months after discharge. DISCUSSION: The ESD studies in the Cochrane review present hospital stays of a length that no longer exist in Sweden. There is not yet, to our knowledge, any study of early supported discharge with present length of h more...

Franchising has been important in many industries for a long time and organized alliances are a current phenomenon in the Printing Industry, and may be all alternative way for smaller privately owned printing houses to be a part of a larger network to handle rapid changes in the market. The objective of this qualitative case study of three Swedish Organized Alliances is to investigate how companies perceive the importance of organized alliances in the Printing Industry. This study concludes that there are many different opinions about the use, impact and importance of organized alliances in the Printing Industry. However, the partner companies believe that they acquire value by being part of an organized alliance. The most important advantages are joint purchasing, access to national agreements, large scale advantages and partly access to a franchise brand. The results indicate that different kinds of organized alliances fit different companies because of the focus of the alliance and the difference in support and commitment from the central organization. Both central organizations and many partner companies deem the franchise brand as important for national recognition. Nevertheless, the combination of the franchise brand and the local company brand is a way for printing houses to strengthen both on the local and national market. The major disadvantage of being part of all organized alliance is the high costs compared to the benefits, which has given many respondents a reason to consider leaving the organized alliances., QC 20110311 more...

Even though tough competition favours formation of alliances, competition between partners is difficult to handle. This qualitative case study investigates how a fragmented industry perceives the level of competition with their cooperative partners and the influence of organized alliances. The results indicate that when cooperation between partners is strong, the competition between partners tends to be perceived as weak, which can be a result of the high initial trust needed to cooperate. Thus, printing companies strive for strong cooperation with a few close trustful partners, which makes the competitive situation between these partners weak. The competitive impact of organized alliances is diversified, since the foremost reason for cooperation is to lower and share costs. However, the use of a franchise brand, in addition to the local brand, may strengthen the company’s competitive advantages on a national basis. more...

The fast technological development and the convergence of the media industry have made competition in theprinting industry harder and not only in-industry any longer. This puts great pressure on individualcompanies, and in a climate of rapid change, companies need to respond quickly to external forces in order toremain competitive. To accomplish this many different competitive resources and competences need to bemanaged. This can be achieved either directly by ownership or indirectly by cooperation. This qualitative casestudy sets out to investigate how alliances are used in the dynamic business environment of the printingindustry, with a focus on cooperation in connection with digital printing.The primary reason, for the companies’ cooperation was gaining access to resources to enhance customersatisfaction and retain customer contact. This paper illustrates that alliances and cooperations can be used indifferent ways and being part of an alliance can be regarded as successful and something worth nurturing.Even though alliances can provide competitive advantages, this study also indicates that hypercompetitivebehavior, like being to opportunistic, clearly can have drastic negative effects on an alliance., QC 20100826 more...

The fast technological development and the convergence of the media industry have made competition in the printing industry harder and not only in-industry any longer. This puts great pressure on individual companies, and in a climate of rapid change, companies need to respond quickly to external forces in order to remain competitive. To accomplish this many different competitive resources and competences need to be managed. This can be achieved either directly by ownership or indirectly by cooperation. This qualitative case study sets out to investigate how alliances are used in the dynamic business environment of the printing industry, with a focus on cooperation in connection with digital printing.The primary reason, for the companies' cooperation was gaining access to resources to enhance customer satisfaction and retain customer contact. This paper illustrates that alliances and cooperations can be used in different ways and being part of an alliance can be regarded as successful and something worth nurturing. Even though alliances can provide competitive advantages, this study also indicates that hypercompetitive behavior, like being to opportunistic, clearly can have drastic negative effects on an alliance. more...