| 1. |
- Ahlman, Håkan, 1947, et al.
(författare)
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Cytotoxic treatment of adrenocortical carcinoma.
- 2001
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Ingår i: World journal of surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 25:7, s. 927-33
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Tidskriftsartikel (refereegranskat)abstract
- Adrenocortical carcinoma (ACC) is a rare, aggressive tumor that is often detected in an advanced stage. Medical treatment with the adrenotoxic drug mitotane has been used for decades, but critical prospective trials on its role in residual disease or as an adjuvant agent after surgical resection are still lacking. The concept of a critical threshold plasma level of the drug must be confirmed in controlled studies. Because individual responsiveness cannot be predicted, the use mitotane is still advised for nonresectable disease. In case of cortisol or other steroid overproduction, several drugs (e.g., ketoconazole or aminoglutethimide) may be used. Chemotherapy with single agents (e.g., doxorubicin or cisplatin) have been disappointing, with low response rates (< 30%) and a short response duration. Part of this refractoriness may be explained by the fact that ACC tumors express the multidrug-resistance gene MDR-1. Chemotherapy with multiple agents has been tested in smaller series and has resulted in significant side effects. The best results were achieved by the combination of etoposide, doxorubicin, and cisplatin associated with mitotane, achieving a response rate of 54%, including individual complete responses. To be able to make progress in treating advanced ACC disease, adjuvant multicenter trials must be encouraged. When mitotane-based therapies are used, monitored drug levels are mandatory.
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| 2. |
- Al-Wathinani, Ahmed M, et al.
(författare)
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A Cross-Sectional Study on the Flood Emergency Preparedness among Healthcare Providers in Saudi Arabia.
- 2021
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Ingår i: International journal of environmental research and public health. - : MDPI AG. - 1660-4601. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- This study used a descriptive cross-sectional methodology to measure healthcare workers' knowledge, attitudes, perceptions, and willingness to respond to a flood scenario in Saudi Arabia. A validated survey was distributed to collect data using a convenience sampling technique through multiple social media platforms. A total of 227 participants were included in this study: 52% of them were aged between 26 to 34 years, 74% were residents from Riyadh, and 52.4% worked in nursing divisions. A significant number of respondents (73.2%) had positive perceptions towards their hospitals' ability to provide an effective response to a flood, 89% were willing to report to work following a flood, and 90% of participants reported the need to develop both guidelines and training for flood disaster preparedness. Preparation and successful flood mitigation in the hospital setting requires staff that have both knowledge and training in emergency management. One way to obtain such readiness is through competency-based training, including both table-top and full-scale live exercises. Although the willingness to respond to such a flooding emergency was high among staff, the development of guidelines and educational programs is needed in order to develop the competencies and skills sets to improve disaster preparedness response and preparedness efforts.
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| 3. |
- Al-Wathinani, A. M., et al.
(författare)
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Raising Awareness of Hearing and Communication Disorders Among Emergency Medical Services Students: Are Knowledge Translation Workshops Useful?
- 2022
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Ingår i: Disaster Medicine and Public Health Preparedness. - : Cambridge University Press (CUP). - 1935-7893 .- 1938-744X. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In numerous countries, emergency medical services (EMS) students receive curriculum training in effective patient-provider communication, but most of this training assumes patients have intact communication capabilities, leading to a lack of preparedness to interact with patients, who have communication disorders. In such cases, first responders could end up delivering suboptimal care or possibly wrong procedures that could harm the disabled person. Method: A quasi-experimental design (pretest-posttest) was used to assess the knowledge of EMS students both before and after a translation workshop on how to deal with patients who have hearing and communication disorders during emergencies. Comparisons between pretest and posttest scores were examined using the Wilcoxon signed rank test. The level of knowledge scores was compared before and after the workshop. Results: The results indicated that EMS students' scores improved after the workshop. There was a 0.763 increase in the average score of knowledge level. The results of this study show that knowledge translation workshops are a useful intervention to enhance the level of knowledge among EMS students when interacting with hearing and communication patients. Conclusions: Our results show that such training workshops lead to better performance. Communication is a vital element in a medical encounter between health care providers and patients at all levels of health care but specifically in the prehospital arena. Insufficient or lack of communication with a vulnerable population, who may suffer from various disabilities, has a significant impact on the outcome of treatment or emergency management.
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| 4. |
- Allwood, Jens, 1947, et al.
(författare)
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"Vänta och se versus låtsas inte förstå om du inte gör det!" Om svensk sjukvårdspersonals erfarenheter av kommunikation med utländska läkare.
- 2005
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Ingår i: Aktuellt om Migration. - 1652-7119. ; 2:(finns på internet)
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Tidskriftsartikel (refereegranskat)abstract
- Det är knappt att de hörs, steg av fötter i vita fotriktiga inomhussandaler, mjuka och tassande. Ljusa korridorer, väggar med scheman, plastblommor vid fönster och fina neutrala ”institutionsgardiner.” Dämpade röster, deltagande leenden, automatiska dörrar, breda nog för en sjukhussäng. På akuten – en samling människor med väntande och uppgivna ansiktsuttryck. Nuläget: Långa väntetider, tajta och utmattande scheman för personalen med ett ökat antal sjukskrivningar som följd. Ständiga påminnelser om anstående neddragningar och sjukvårdens brister som förstasidesnyheter. Önskas: Tid och pengar, arbetskraft som orkar, kan och vill, som ser möjligheterna och inte problemen. Något som ökar vår återspegling av det nya mångkulturella samhället i vården och som även passar in i våra personalvisioner och måldokument.
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| 5. |
- Alruwaili, Abdullah, et al.
(författare)
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Supporting the Frontlines: A Scoping Review Addressing the Health Challenges of Military Personnel and Veterans
- 2023
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Ingår i: Healthcare (Switzerland). - 2227-9032. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Military personnel and veterans meet unique health challenges that stem from the complex interplay of their service experiences, the nature of warfare, and their interactions with both military and civilian healthcare systems. This study aims to examine the myriad of injuries and medical conditions specific to this population, encompassing physical and psychological traumas. (2) Methods: A scoping review (systematic search and non-systematic review) was performed to evaluate the current landscape of military healthcare. (3) Results: A significant change in the injury profile over time is identified, linked to shifts in combat strategies and the integration of advanced technologies in warfare. Environmental exposures to diverse chemical or natural agents further complicate the health of service members. Additionally, the stressors they face, ranging from routine stress to traumatic experiences, lead to various mental health challenges. A major concern is the gap in healthcare accessibility and quality, worsened by challenges in the civilian healthcare system’s capacity to address these unique needs and the military healthcare system’s limitations. (4) Conclusions: This review underscores the need for holistic, integrated approaches to care, rigorous research, and targeted interventions to better serve the health needs of military personnel and veterans.
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| 6. |
- Alruwaili, Abdullah, et al.
(författare)
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The Use of Prehospital Intensive Care Units in Emergencies—A Scoping Review
- 2023
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Ingår i: Healthcare (Switzerland). - 2227-9032. ; 11:21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing patient safety. Nevertheless, the feasibility of such an initiative becomes murky when considered globally. This review delves into the intricacies of prehospital intensive care units’ deployment for trauma care, scrutinizing their configurations, operational practices, and the inherent challenges and research priorities. Methods: A scoping review was performed for eligible studies. The result was uploaded to the RAYYAN research platform, facilitating simultaneous evaluation of the studies by all researchers. Results: A total of 42 studies were initially selected. Four studies were duplicates, and 25 studies were unanimously removed as irrelevant. The remaining studies (n = 13) were included in the review, and the outcomes were categorized into diverse subgroups. Conclusions: A country’s emergency medical services must achieve specific milestones in education, competency, resource availability, and performance to effectively harness the potential of a prehospital intensive care unit. While certain nations are equipped, others lag, highlighting a global disparity in readiness for such advanced care modalities.
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| 7. |
- Berbyuk, Nataliya, 1978, et al.
(författare)
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How do Non-Swedish Physicians Communicate with their Swedish Patients and Colleagues?
- 2006
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Ingår i: Dahl, Ø., Jensen, I., Nynäs, P. (ed.). Bridges of Understanding.. - Oslo : Unipub, Oslo Academic Press. - 8274772695 ; , s. 155-170
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Berner, Andreas, et al.
(författare)
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STREET: Swedish Tool for Risk/Resource Estimation at EvenTs. Part one, risk assessment – face validity and inter–rater reliability
- 2015
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Ingår i: Journal of Acute Disease. - 2221-6189. ; 4:1, s. 37-43
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Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized high reliability organizations collaborative tool in order to conduct common assessments and information sharing of potential risks during mass-gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.37 and a mean accuracy of 62% of the tool. Conclusions The collaboration tool, “STREET”, showed acceptable reliability and validity to be used as a foundation for high reliability organization collaboration in a simulated environment. However, the lack of reliability in one of the cases highlights the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but need, on the other hand, an already developed tool.
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| 9. |
- Berner, A, et al.
(författare)
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STREET: Swedish tool for risk /resource estimation at events. Part two, resource assessment -face validity and inter-rater reliability.
- 2015
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Ingår i: Journal of acute disease. - 2221-6189. ; 4:2, s. 112-116
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Tidskriftsartikel (refereegranskat)abstract
- Objective To develop a validated and generalized collaborative tool to be utilized by high reliability organizations in order to conduct common resource assessment before major events and mass gatherings. Methods The Swedish resource and risk estimation guide was used as foundation for the development of the generalized collaborative tool, by three different expert groups, and then analyzed. Analysis of inter-rater reliability was conducted through simulated cases that showed weighted and unweight κ-statistics. Results The results revealed a mean of unweight κ-value from the three cases of 0.44 and a mean accuracy of 61% of the tool. Conclusions A better collaboration ability and more accurate resource assessment with acceptable reliability and validity were shown in this study to be used as a foundation for resource assessment before major events/mass-gathering in a simulated environment. However, the result also indicates the challenges of creating measurable values from simulated cases. A study on real events can provide higher reliability but needs, on the other hand, an already developed tool.
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| 10. |
- Borowska-Stefanska, M., et al.
(författare)
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Emergency management of self-evacuation from flood hazard areas in Poland
- 2022
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Ingår i: Transportation Research Part D-Transport and Environment. - : Elsevier BV. - 1361-9209. ; 107
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Tidskriftsartikel (refereegranskat)abstract
- This paper analyses the effectiveness of self-evacuation activities of population by private vehicle transport from flood hazard areas, aimed at minimising the negative effects of flooding.. The paper relies on a four-step traffic model which is based, inter alia, on the results of questionnaire studies. Moreover, the model takes into account the entirety of national traffic, which allows the methodological problems related to the border effect to be overcome. As shown in the study, the shortest or the fastest routes achievable in the pre-flood period are not always most optimal when the flood has already occurred. In such a case, evacuation planning will increase the efficiency of the process. Thus, inadequate designation of evacuation routes may adversely affect the process of relocating people to places of safety. Therefore, it is important to create plans that provide information on evacuation zones, routes and destinations.
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