| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Ahlborg, Liv, et al.
(författare)
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Visuospatial ability correlates with performance in simulated gynecological laparoscopy
- 2011
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Ingår i: European Journal of Obstetrics, Gynecology, and Reproductive Biology. - : Elsevier BV. - 0301-2115 .- 1872-7654. ; 157:1, s. 73-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze the relationship between visuospatial ability and simulated laparoscopy performed by consultants in obstetrics and gynecology (OBGYN). Study design: This was a prospective cohort study carried out at two community hospitals in Sweden. Thirteen consultants in obstetrics and gynecology were included. They had previously independently performed 10-100 advanced laparoscopies. Participants were tested for visuospatial ability by the Mental Rotations Test version A (MRT-A). After a familiarization session and standardized instruction, all participants subsequently conducted three consecutive virtual tubal occlusions followed by three virtual salpingectomies. Performance in the simulator was measured by Total Time, Score and Ovarian Diathermy Damage. Linear regression was used to analyze the relationship between visuospatial ability and simulated laparoscopic performance. The learning curves in the simulator were assessed in order to interpret the relationship with the visuospatial ability. Results: Visuospatial ability correlated with Total Time (r = -0.62; p = 0.03) and Score (r = 0.57; p = 0.05) in the medium level of the virtual tubal occlusion. In the technically more advanced virtual salpingectomy the visuospatial ability correlated with Total Time (r = -0.64; p = 0.02), Ovarian Diathermy Damage (r = -0.65; p = 0.02) and with overall Score (r = 0.64; p = 0.02). Conclusions: Visuospatial ability appears to be related to the performance of gynecological laparoscopic procedures in a simulator. Testing visuospatial ability might be helpful when designing individual training programs.
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| 3. |
- Andersson, Pehr, et al.
(författare)
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Working memory and virtual endoscopy simulation
- 2004
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Ingår i: Proceedings of the twenty-sixth annual conference of the cognitive science society. - Mahwah : Lawrence Erlbaum Associates. - 9780805854640 ; , s. 1519-1519
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Konferensbidrag (refereegranskat)
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| 4. |
- Arvidsson, Anna, 1973, et al.
(författare)
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Formation of calcium phosphates on titanium implants with four different bioactive surface preparations. An in vitro study
- 2007
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Ingår i: Journal of Materials Science-Materials in Medicine. - : Springer Science and Business Media LLC. - 0957-4530 .- 1573-4838. ; 18:10, s. 1945-1954
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to compare the nucleating and growing behaviour on four types of bioactive surfaces by using the simulated body fluid (SBF) model. Titanium discs were blasted and then prepared by alkali and heat treatment, anodic oxidation, fluoridation, or hydroxyapatite coating. The discs were immersed in SBF for 1, 2, 4 and 6 weeks. Calcium phosphates were found on all specimens, as analysed with scanning electron microscopy/energy dispersive X-ray analysis (SEM/EDX). After 1 and 2 weeks of SBF immersion more titanium was accessible with SEM/EDX on the blasted surfaces than the four bioactive surface types, indicating a difference in coverage by calcium phosphates. The Ca/P mean ratio of the surfaces was approximately 1.5 after 1 week, in contrast to the fluoridated specimens which displayed a Ca/P mean ratio of approximately 2. Powder X-ray diffraction (P-XRD) analyses showed the presence of hydroxyapatite on all types of surfaces after 4 and 6 weeks of immersion. The samples immersed for 6 weeks showed a higher degree of crystallinity than the samples immersed for 4 weeks. In conclusion, differences appeared at the early SBF immersion times of 1 and 2 weeks between controls and bioactive surface types, as well as between different bioactive surface types.
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| 5. |
- Barkarmo, Sargon, et al.
(författare)
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Nano-hydroxyapatite-coated PEEK implants : a pilot study in rabbit bone
- 2013
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Ingår i: Journal of Biomedical Materials Research. Part A. - : John Wiley & Sons. - 1549-3296 .- 1552-4965. ; 101A:2, s. 465-471
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Tidskriftsartikel (refereegranskat)abstract
- Osseointegration of surface-modified polyetheretherketone (PEEK) implants was studied in vivo. A total of 18 cylinder-shaped PEEK implants were inserted in the femurs of nine New Zealand rabbits; half were coated with nanocrystalline hydroxyapatite (nanoHA) and half were uncoated controls. Healing time was 6 weeks. Samples were retrieved with the implant and surrounding tissue, processed to cut and ground sections, and analyzed histomorphometrically. The implant surfaces were analyzed with optical interferometry, scanning electron microscopy (SEM), atomic force microscopy, and X-ray photoelectron spectroscopy (XPS). NanoHA-coated PEEK surfaces had lower height deviation (Sa) than controls [mean ± SD: 0.41 μm (± 0.14) vs. 0.96 μm (± 0.28)]. SEM images showed the nanoHA crystals as a thin layer on the polymer surface. XPS analysis of the coated implants showed a Ca/P ratio of 1.67. Histomorphometry indicated that the nanoHA-coated implants had more bone-to-implant contact [16% (± 4.7) vs. 13% (± 9.3)] and more bone area [52% (± 9.5) vs. 45% (± 11.9)]. We found no difference between smooth nanoHA-coated cylinder-shaped PEEK implants and uncoated controls. However, higher mean bone-to-implant contact indicated better osseointegration in the coated implants than in the uncoated controls. The large number of lost implants was interpreted as a lack of primary stability due to implant design.
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| 6. |
- Escher, Cecilia, et al.
(författare)
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All professions can benefit — a mixed-methods study on simulation-based teamwork training for operating room teams
- 2023
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Ingår i: Advances in Science and Technology Research Journal. - : BioMed Central (BMC). - 2364-3277 .- 2059-0628. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Operating rooms have become more technically complex due to new advanced procedures, which has increased demands on teamwork in the operating room. In response, team training has been proposed to improve team performance, workplace culture, and patient safety. We developed and delivered a simulation-based team training course for entire professional surgical teams. This type of intervention has been proposed by researchers but has not been widely published. The aims of this intervention study were to examine participants’ reactions to the course in terms of their motivation for the training and their self-efficacy in relation to their performance, as well as their views on transferring the lessons learned in the course to their workplace.Methods: In a prospective mixed-methods intervention study, operating room professionals participated in a full-day simulation-based teamwork training course. Learning objectives were nontechnical skills, specifically communication and collaboration across the team. Seventy-one staff members representing 5 operating room professions were included, and the average work experience of participants was 6 years. Quantitative data on self-efficacy and situational motivation were collected by questionnaires before and after training. Qualitative data were collected through 5 focus group interviews that took place in direct relation to the courses and included a total of 31 participants. Transcripts were coded and analyzed using thematic analysis.Results: All occupations showed a similar pattern in terms of increases in self-efficacy and intrinsic motivation after the training. Analysis of the qualitative data showed that training in one’s profession and in authentic multiprofessional teams was important factors for motivation. Participating staff described an awareness of undesirable communication barriers in surgical teams that can lead to risks for patients. Systematic training was definitely perceived as a means to reduce barriers and improve communication and collaboration.Conclusion: Simulation-based training was equally well received by all professional groups. Our results confirm the feasibility of this type of training for professional teams and promising opportunities for improving teamwork skills. The qualitative data reveal both opportunities and limitations for transferring the learning experiences to the workplace.
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| 7. |
- Escher, Cecilia, et al.
(författare)
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Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety
- 2017
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Ingår i: BMC Medical Education. - : BIOMED CENTRAL LTD. - 1472-6920. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training.Methods: In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ).Results: We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples.Conclusion: In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.
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| 8. |
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| 9. |
- Franke Stenport, Victoria, 1970, et al.
(författare)
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Precipitation of calcium phosphate in the presence of albumin on titanium implants with four different possibly bioactive surface preparations. An in vitro study
- 2008
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Ingår i: Journal of Materials Science: Materials in Medicine. - : Springer Science and Business Media LLC. - 0957-4530 .- 1573-4838. ; 19:12, s. 3497-3505
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to compare the nucleating behaviour on four types of bioactive surfaces by using the simulated body fluid (SBF) model with the presence albumin. Titanium discs were blasted (B) and then prepared by alkali and heat treatment (AH), anodic oxidation (AO), fluoridation (F), or hydroxyapatite coating (HA). The discs were immersed in SBF with 4.5 mg/ml albumin for 3 days, 1, 2, 3 and 4 weeks and analysed with scanning electron microscopy/energy dispersive X-ray analysis (SEM/EDX) and X-ray photoelectron spectroscopy (XPS). Topographic surface characterisation was performed with a contact stylus profilometer. The results demonstrated that the bioactive surfaces initiated an enhanced calcium phosphate (CaP) formation and a more rapid increase of protein content was present on the bioactive surfaces compared to the blasted control surface. The observation was present on all bioactive surfaces. The fact that there was a difference between the bioactive surfaces and the blasted control surface with respect to precipitation of CaP and protein content on the surfaces support the fact that there may be biochemical advantages in vivo by using a bioactive surface.
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| 10. |
- Göransson, Anna, 1970, et al.
(författare)
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An in vitro comparison of possibly bioactive titanium implant surfaces.
- 2009
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Ingår i: Journal of Biomedical Materials Research Part A. - : Wiley. - 1552-4965 .- 1549-3296. ; 88:4, s. 1037-1047
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to compare Ca and P formation (CaP) and subsequent bone cell response of a blasted and four different possibly bioactive commercially pure (cp) titanium surfaces; 1. Fluoride etched (Fluoride), 2. Alkali-heat treated (AH), 3. Magnesium ion incorporated anodized (TiMgO), and 4. Nano HA coated and heat treated (nano HA) in vitro. Furthermore, to evaluate the significance of the SBF formed CaP coat on bone cell response. The surfaces were characterized by Optical Interferometry, Scanning Electron Microscopy (SEM) and X-ray Photoelectron Spectroscopy (XPS). CaP formation was evaluated after 12, 24 and 72 h in simulated body fluid (SBF). Primary human mandibular osteoblast-like cells were cultured on the various surfaces subjected to SBF for 72 h. Cellular attachment, differentiation (osteocalcin) and protein production (TGF-beta(1)) was evaluated after 3 h and 10 days respectively. Despite different morphological appearances, the roughness of the differently modified surfaces was similar. The possibly bioactive surfaces gave rise to an earlier CaP formation than the blasted surface, however, after 72 h the blasted surface demonstrated increased CaP formation compared to the possibly bioactive surfaces. Subsequent bone cell attachment was correlated to neither surface roughness nor the amount of formed CaP after SBF treatment. In contrast, osteocalcin and TGF-beta(1) production were largely correlated to the amount of CaP formed on the surfaces. However, bone response (cell attachment, osteocalcin and TGF-F production) on the blasted controls were similar or increased compared to the SBF treated fluoridated, AH and TiMgO surface. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2008.
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