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Article ; Online: Symptoms, care consumption, and healthcare costs in hospitalized patients during the first wave of the COVID-19 pandemic.

Ashman Kröönström, Linda / Lundgren-Nilsson, Åsa / Kjellby-Wendt, Gunilla / Stibrant Sunnerhagen, Katharina

2023 Volume 18, Issue 9, Page(s) e0291548

Abstract: Background: We aimed to assess symptomatology post discharge from the hospital in patients with COVID-19 treated during the first wave of the COVID-19 pandemic, and to follow care consumption and healthcare costs six months post discharge.: Methods: ... ...

Abstract	Background: We aimed to assess symptomatology post discharge from the hospital in patients with COVID-19 treated during the first wave of the COVID-19 pandemic, and to follow care consumption and healthcare costs six months post discharge. Methods: This study was a descriptive observational study over time. Data were retrieved from the Sahlgrenska University (SU) hospital registry for patients admitted to an SU hospital during March 2020 to August 2020. Of these, 1014 received a questionnaire approximately six weeks post discharge regarding symptoms. Data regarding care consumption were retrieved from the registry in the Region Västra Götaland for 529 (52.2%) patients who completed the questionnaire. Of these, 466 patients were included in the analysis of care consumption. Results: There was a reported decrease in mobility from admission to discharge in both men (p = 0.02) and women (p = 0.01). The costs of inpatient care amounted to a total of 9 601 459.20 Euro (EUR). Symptoms were reported in 436 (93.6%) patients post discharge, of which weight loss during COVID-19 was most common in both men (n = 220, 77.5%) and women (n = 107, 58.8%). During six-month follow-up, 409 (87%) patients consumed care. Of the registered visits, 868 (27.1%) were related to a COVID-19 diagnosis. The total sum of outpatient care (i.e. visits with a registered COVID-19 diagnosis) was 77 311.30 EUR. Conclusions: At discharge from the hospital, there was a decrease in mobility. Most patients had remaining sequelae post discharge. At six months post discharge, nearly 90% of patients had consumed care, with approximately 20% related to COVID-19. This indicates a persisting need for rehabilitation post discharge from hospital in patients treated for COVID-19.
MeSH term(s)	Male ; Humans ; Female ; Aftercare ; COVID-19 Testing ; Pandemics ; COVID-19/epidemiology ; Patient Discharge ; Health Care Costs ; Hospitals, University
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0291548
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Article ; Online: Renal disease as a potential compounding factor in carcinogenesis experiments with Cd151-null mice.

Ashman, L K

Oncogene

2013 Volume 32, Issue 37, Page(s) 4457

MeSH term(s)	Animals ; Carcinoma, Squamous Cell/pathology ; Cell Transformation, Neoplastic/pathology ; Humans ; Integrin alpha6beta4/metabolism ; Skin Neoplasms/pathology ; Tetraspanin 24/metabolism ; Tetraspanin 24/physiology
Chemical Substances	Integrin alpha6beta4 ; Tetraspanin 24
Language	English
Publishing date	2013-09-12
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	639046-8
ISSN	1476-5594 ; 0950-9232
ISSN (online)	1476-5594
ISSN	0950-9232
DOI	10.1038/onc.2013.73
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Article ; Online: Use of low-dose naltrexone in the management of chronic pain conditions: A systematic review.

Hatfield, Elizabeth / Phillips, Kristine / Swidan, Sahar / Ashman, Lawrence

Journal of the American Dental Association (1939)

2020 Volume 151, Issue 12, Page(s) 891–902.e1

Abstract: Background: The authors aimed to evaluate the efficacy of low-dose naltrexone in the management of chronic pain conditions and determine its potential use in orofacial pain management.: Methods: A comprehensive literature review was completed in the ... ...

Abstract	Background: The authors aimed to evaluate the efficacy of low-dose naltrexone in the management of chronic pain conditions and determine its potential use in orofacial pain management. Methods: A comprehensive literature review was completed in the PubMed/MEDLINE, Embase, Cumulated Index to Nursing and Allied Health Literature, Dentistry and Oral Sciences Source Library databases up through June 17, 2019, using terms such as neurogenic, inflammation, naltrexone, temporomandibular, and chronic pain. The primary outcome was reduction in pain intensity and, secondarily, improvement in quality of life. Results: A total of 793 studies were obtained with the initial search and 8 articles were selected for evaluation. Of these 8 articles, 4 were case reports, 3 were clinical studies, and 1 was a randomized controlled trial. Six studies included data on fibromyalgia, 2 studies included data on chronic regional pain syndrome, and 1 examined multiple diagnoses, including fibromyalgia, interstitial cystitis, and chronic pelvic pain. The primary outcome of all of the studies was pain intensity reduction. Conclusions and practical implications: Low-dose naltrexone provides an alternative in medical management of chronic pain disorders as a novel anti-inflammatory and immunomodulator. It can offer additional management options, as orofacial pain conditions share characteristics with other chronic pain disorders. Owing to the size and heterogeneity of the studies, more large-scale studies are needed, along with additional studies assessing orofacial pain response to low-dose naltrexone.
MeSH term(s)	Chronic Pain/drug therapy ; Fibromyalgia ; Humans ; Naltrexone/therapeutic use ; Pain Management ; Quality of Life
Chemical Substances	Naltrexone (5S6W795CQM)
Language	English
Publishing date	2020-11-23
Publishing country	England
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	220622-5
ISSN	1943-4723 ; 0002-8177 ; 1048-6364
ISSN (online)	1943-4723
ISSN	0002-8177 ; 1048-6364
DOI	10.1016/j.adaj.2020.08.019
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Article ; Online: Explanation of context, mechanisms and outcomes in adult community mental health crisis care: the MH-CREST realist evidence synthesis.

Clibbens, Nicola / Baker, John / Booth, Andrew / Berzins, Kathryn / Ashman, Michael C / Sharda, Leila / Thompson, Jill / Kendal, Sarah / Weich, Scott

Health and social care delivery research

2023 Volume 11, Issue 15, Page(s) 1–161

Abstract: Background: Mental health crises cause significant disruption to individuals and families and can be life-threatening. The large number of community crisis services operating in an inter-agency landscape complicates access to help. It is unclear which ... ...

Abstract	Background: Mental health crises cause significant disruption to individuals and families and can be life-threatening. The large number of community crisis services operating in an inter-agency landscape complicates access to help. It is unclear which underpinning mechanisms of crisis care work, for whom and in which circumstances. Aim: The aim was to identify mechanisms to explain how, for whom and in what circumstances adult community crisis services work. Objectives: The objectives were to develop, test and synthesise programme theories via (1) stakeholder expertise and current evidence; (2) a context, intervention, mechanism and outcome framework; (3) consultation with experts; (4) development of pen portraits; (5) synthesis and refinement of programme theories, including mid-range theory; and (6) identification and dissemination of mechanisms needed to trigger desired context-specific crisis outcomes. Design: This study is a realist evidence synthesis, comprising (1) identification of initial programme theories; (2) prioritisation, testing and refinement of programme theories; (3) focused realist reviews of prioritised initial programme theories; and (4) synthesis to mid-range theory. Main outcome: The main outcome was to explain context, mechanisms and outcomes in adult community mental health crisis care. Data sources: Data were sourced via academic and grey literature searches, expert stakeholder group consultations and 20 individual realist interviews with experts. Review methods: A realist evidence synthesis with primary data was conducted to test and refine three initial programme theories: (1) urgent and accessible crisis care, (2) compassionate and therapeutic crisis care and (3) inter-agency working. Results: Community crisis services operate best within an inter-agency system. This requires compassionate leadership and shared values that enable staff to be supported; retain their compassion; and, in turn, facilitate compassionate interventions for people in crisis. The complex interface between agencies is best managed through greater clarity at the boundaries of services, making referral and transition seamless and timely. This would facilitate ease of access and guaranteed responses that are trusted by the communities they serve. Strengths and limitations: Strengths include the identification of mechanisms for effective inter-agency community crisis care and meaningful stakeholder consultation that grounded the theories in real-life experience. Limitations include the evidence being heavily weighted towards England and the review scope excluding full analysis of ethnic and cultural diversity. Conclusions: Multiple interpretations of crises and diverse population needs present challenges for improving the complex pathways to help in a crisis. Inter-agency working requires clear policy guidance with local commissioning. Seamless transitions between services generate trust through guaranteed responses and ease of navigation. This is best achieved where there is inter-agency affiliation that supports co-production. Compassionate leaders engender staff trust, and outcomes for people in crisis improve when staff are supported to retain their compassion. Future work: Further work might explore inter-agency models of crisis delivery, particularly in rural communities. Future work could focus on evaluating outcomes across crisis care provider agencies and include evaluation of individual, as well as service-level, outcomes. The implementation and effect of mental health triage could be explored further, including via telehealth. Barriers to access for marginalised populations warrant a specific focus in future research. Study registration: The study is registered as PROSPERO CRD42019141680. Funding: This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in
MeSH term(s)	Humans ; Adult ; Mental Health ; England ; Palliative Care
Language	English
Publishing date	2023-10-14
Publishing country	England
Document type	Journal Article
ISSN	2755-0060
ISSN (online)	2755-0060
DOI	10.3310/TWKK5110
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Article ; Online: Explaining context, mechanism and outcome in adult community mental health crisis care: A realist evidence synthesis.

Clibbens, Nicola / Booth, Andrew / Sharda, Leila / Baker, John / Thompson, Jill / Ashman, Michael / Berzins, Kathryn / Weich, Scott / Kendal, Sarah

International journal of mental health nursing

2023 Volume 32, Issue 6, Page(s) 1636–1653

Abstract: Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, ... ...

Abstract	Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, for whom and in what circumstances community mental health crisis services for adults work to resolve crises and is reported according to RAMESES guidelines. Using realist methodology, initial programme theories were identified and then tested through iterative evidence searching across 10 electronic databases, four expert stakeholder consultations and n = 20 individual interviews. 45 relevant records informed the three initial programme theories, and 77 documents, were included in programme theory testing. 39 context, mechanism, outcome configurations were meta-synthesized into three themes: (1) The gateway to urgent support; (2) Values based crisis interventions and (3) Leadership and organizational values. Fragmented cross-agency responses exacerbated staff stress and created barriers to access. Services should focus on evaluating interagency working to improve staff role clarity and ensure boundaries between services are planned for. Organizations experienced as compassionate contributed positively to perceived accessibility but relied on compassionate leadership. Attending to the support needs of staff and the proximity of leaders to the front line of crisis care are key. Designing interventions that are easy to navigate, prioritize shared decision-making and reduce the risk of re-traumatizing people is a priority.
MeSH term(s)	Adult ; Humans ; Mental Health ; Mental Health Services ; Outcome and Process Assessment, Health Care
Language	English
Publishing date	2023-08-13
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	2076760-2
ISSN	1447-0349 ; 1445-8330
ISSN (online)	1447-0349
ISSN	1445-8330
DOI	10.1111/inm.13204
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Zs.A 5240: Show issues

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Article ; Online: The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction.

Worrell, Stephanie G / Goodman, Karyn A / Altorki, Nasser K / Ashman, Jonathan B / Crabtree, Traves D / Dorth, Jennifer / Firestone, Scott / Harpole, David H / Hofstetter, Wayne L / Hong, Theodore S / Kissoon, Kalie / Ku, Geoffrey Y / Molena, Daniela / Tepper, Joel E / Watson, Thomas J / Williams, Terence / Willett, Christopher

The Annals of thoracic surgery

2023 Volume 117, Issue 1, Page(s) 15–32

Abstract: Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have ... ...

Abstract	Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have incorporated the input of surgeons, radiation oncologists, and medical oncologists. To address the need for multidisciplinary input in the management of esophageal cancer and to meet current best practices for clinical practice guidelines, the current guidelines were created as a collaboration between The Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO). Physician representatives chose 8 key clinical questions pertinent to the care of patients with locally advanced, resectable thoracic esophageal cancer (excluding cervical location). A comprehensive literature review was performed identifying 227 articles that met the inclusion criteria covering the use of induction chemotherapy, chemotherapy vs chemoradiotherapy before surgery, optimal radiation dose, the value of esophagectomy, timing of esophagectomy, the approach and extent of lymphadenectomy, the use of minimally invasive esophagectomy, and the value of adjuvant therapy after resection. The relevant data were reviewed and voted on by the panel with 80% of the authors, with 75% agreement on class and level of evidence. These data were then complied into the guidelines document.
MeSH term(s)	Humans ; United States ; Radiation Oncology ; Combined Modality Therapy ; Esophageal Neoplasms/surgery ; Surgeons ; Esophagogastric Junction/surgery
Language	English
Publishing date	2023-11-02
Publishing country	Netherlands
Document type	Review ; Practice Guideline
ZDB-ID	211007-6
ISSN	1552-6259 ; 0003-4975
ISSN (online)	1552-6259
ISSN	0003-4975
DOI	10.1016/j.athoracsur.2023.09.021
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Article ; Online: The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction.

Practical radiation oncology

2023 Volume 14, Issue 1, Page(s) 28–46

Abstract	Outcomes for patients with esophageal cancer have improved over the last decade with the implementation of multimodality therapy. There are currently no comprehensive guidelines addressing multidisciplinary management of esophageal cancer that have incorporated the input of surgeons, radiation oncologists, and medical oncologists. To address the need for multidisciplinary input in the management of esophageal cancer and to meet current best practices for clinical practice guidelines, the current guidelines were created as a collaboration between The Society of Thoracic Surgeons (STS), American Society for Radiation Oncology (ASTRO), and the American Society of Clinical Oncology (ASCO). Physician representatives chose 8 key clinical questions pertinent to the care of patients with locally advanced, resectable thoracic esophageal cancer (excluding cervical location). A comprehensive literature review was performed identifying 227 articles that met the inclusion criteria covering the use of induction chemotherapy, chemotherapy vs chemoradiotherapy before surgery, optimal radiation dose, the value of esophagectomy, timing of esophagectomy, the approach and extent of lymphadenectomy, the use of minimally invasive esophagectomy, and the value of adjuvant therapy after resection. The relevant data were reviewed and voted on by the panel with 80% of the authors, with 75% agreement on class and level of evidence. These data were then complied into the guidelines document.
MeSH term(s)	Humans ; United States ; Radiation Oncology ; Combined Modality Therapy ; Esophageal Neoplasms/radiotherapy ; Surgeons ; Esophagogastric Junction
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Review ; Practice Guideline
ZDB-ID	2655748-4
ISSN	1879-8519 ; 1879-8500
ISSN (online)	1879-8519
ISSN	1879-8500
DOI	10.1016/j.prro.2023.10.001
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Article ; Online: 'Dale': an interpretative phenomenological analysis of a service user's experience with a crisis resolution/home treatment team in the United Kingdom.

Nelson, L J / Miller, P K / Ashman, D

Journal of psychiatric and mental health nursing

2016 Volume 23, Issue 6-7, Page(s) 438–448

Abstract: WHAT IS KNOWN ABOUT THE SUBJECT?: This paper describes crisis resolution/home treatment (CRHT) teams, which are part of mental health services in the United Kingdom. CRHT is expected to assist individuals in building resilience and work within a recovery ...

Abstract	WHAT IS KNOWN ABOUT THE SUBJECT?: This paper describes crisis resolution/home treatment (CRHT) teams, which are part of mental health services in the United Kingdom. CRHT is expected to assist individuals in building resilience and work within a recovery approach. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper arises from an interview with one individual, Dale, as part of a larger study exploring service users' experiences of CRHT. It adds to the body of narrative knowledge in CRHT through Dale's co-authorship of this paper, reflecting on his original interview 4 years later, with co-authors providing critical interpretation of his experience, in turn supported by cognate literature. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Implications for practice are considered, themselves mediated through Dale's own descriptions of how CRHT interventions impacted upon him. These impacts are analysed with respect to three themes: Resilience, Recovery and Power. It is centrally contended that clinicians need to more clearly comprehend three core matters. First, what resilience 'is' for service users as well as the complex process through which these individuals move in developing resilience. Second, the distinction that service users might make between 'recovery' and 'functionality', and how this in turn can impact on individuals both in personal and socioeconomic sense. Finally, the mechanics of power within CRHT contexts and how these interpersonal dynamics can affect the relationship between service user and clinician in practice. Abstract: Introduction and Aim The central purpose of this paper, part of a larger study exploring the experiences of Service Users (SUs) with CRHT, is to emphasise the importance of the SU voice itself within the domain. Following an interrogation of the historical contexts of CRHT. Method This paper uses interpretative phenomological approach around detailed thematic examination of an extended, semi-structured with a single SU: Dale. Moreover, four years after the interview was originally conducted, Dale was himself invited to reflect upon, and critically re-evaluate, his initial participation as a co-author of this paper. In this way, a genuinely participant-centred narrative on experiences with CRHT could be generated. Implications for Practice This resulted in Dale describing what 'crisis' meant to him, and his personal journey within that crisis. Although framing some experiences as negative, he primarily argues that the CRHT team was very personable, affirming his personal values and beliefs, and encouraging him to use coping skills that he had utilised effectively in prior periods of crisis. Analysis highlights three major themes permeating Dale's narrative: Resilience, Recovery and Power. It is contended that this analysis begins to demonstrate implications for practice and highlight that (and how) CRHT clinicians might more clearly engage with what resilience 'is' for SUs, and also the complex process through which these individuals move in developing it. Equally, it is proposed that practitioners should be mindful of the distinction that SUs might make between 'recovery' and 'functionality', and how this in turn can impact on individuals both in personal and socio-economic sense. Finally, the mechanics of power within CRHT contexts are foregrounded, and how these interpersonal dynamics can affect the working relationship between SU and clinician.
MeSH term(s)	Adult ; Crisis Intervention/methods ; Home Care Services ; Humans ; Male ; Mental Disorders/rehabilitation ; Mental Health Services ; Personal Narratives as Topic ; Qualitative Research ; United Kingdom
Language	English
Publishing date	2016-09-03
Publishing country	England
Document type	Journal Article
ZDB-ID	1328479-4
ISSN	1365-2850 ; 1351-0126
ISSN (online)	1365-2850
ISSN	1351-0126
DOI	10.1111/jpm.12328
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Article: CD151.

Ashman, L K

Journal of biological regulators and homeostatic agents

2002 Volume 16, Issue 3, Page(s) 223–226

MeSH term(s)	Amino Acid Sequence ; Animals ; Antibodies, Monoclonal/chemistry ; Antigens, CD/biosynthesis ; Antigens, CD/chemistry ; Antigens, CD/physiology ; Humans ; Mice ; Mice, Knockout ; Molecular Sequence Data ; Precipitin Tests ; Sequence Homology, Amino Acid ; Tetraspanin 24 ; Tissue Distribution
Chemical Substances	Antibodies, Monoclonal ; Antigens, CD ; CD151 protein, human ; Cd151 protein, mouse ; Tetraspanin 24
Language	English
Publishing date	2002-07
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	639196-5
ISSN	1724-6083 ; 0393-974X
ISSN (online)	1724-6083
ISSN	0393-974X
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Article ; Online: Interprofessional collaboration and communication to facilitate implementation of cognitive rehabilitation in persons with brain injury.

Waldron-Perrine, Brigid / Mudar, Raksha / Mashima, Pauline / Seagly, Katharine / Sohlberg, McKay / Bechtold, Kathleen T / Paul, Diane / Milman, Lisa / Ashman, Teresa / Peña, KellyAnn / Dunn, Rose

Journal of interprofessional care

2022 Volume 36, Issue 4, Page(s) 529–537

Abstract: Cognitive rehabilitation encompasses therapeutic services directed at improving cognitive functioning and functional abilities in individuals with brain injury. The term cognitive rehabilitation, however, is often broadly defined, and interventions ... ...

Abstract	Cognitive rehabilitation encompasses therapeutic services directed at improving cognitive functioning and functional abilities in individuals with brain injury. The term cognitive rehabilitation, however, is often broadly defined, and interventions delivered by individual disciplines may vary in their conceptualizations. This paper, written by an interprofessional collaborative group of speech-language pathologists and rehabilitation psychologists/ neuropsychologists identifies challenges in interprofessional rehabilitation of cognitive problems as well as solutions for addressing those challenges. Specifically, the challenge of defining elements of cognitive rehabilitation is addressed with a recommendation for interprofessional training and development of a shared perspective; the problem of "siloed" care is addressed by recommendations for consistent and considerable efforts at interprofessional communication, use of shared language and emphasis on health literacy; and the challenge of access to collaborative care is addressed with the recommendation to increase utilization of telerehabilitation interventions. Our goal is to empower clinicians to not only turn to evidence-based practice to address patient needs, but to go further in implementing the evidence base by facilitating true collaborative interdisciplinary services via improved knowledge of best practice, and advocacy avenues within systems of care. Such an approach will maximize the ability of rehabilitation professionals to provide meaningful, person-centered interventions that will maximize patient outcomes.
MeSH term(s)	Brain Injuries/rehabilitation ; Cognition ; Communication ; Humans ; Interprofessional Relations
Language	English
Publishing date	2022-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	1099758-1
ISSN	1469-9567 ; 0884-3988 ; 1356-1820
ISSN (online)	1469-9567
ISSN	0884-3988 ; 1356-1820
DOI	10.1080/13561820.2021.1971956
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