| 1. |
- Heath, Christian, et al.
(författare)
-
Video and qualitative research : analysing medical practice and interaction
- 2007
-
Ingår i: Medical education. - : Blackwell Publishing. - 1365-2923. ; 41:1, s. 109-116
-
Tidskriftsartikel (refereegranskat)abstract
- There has been a longstanding recognition that video provides an important resource within medical education particularly, perhaps, for training in primary health care. As a resource for research, and more specifically within qualitative social science studies of medical practice, video has proved less pervasive despite its obvious advantages. In this paper, we sketch an approach for using video to inform the analysis of medical practice and the ways in which health care is accomplished through social interaction and collaboration. Drawing on our own research we discuss two brief examples; one the use of computing technology in primary health care and secondly informal instruction during surgical operations. The examples illustrate the multimodal character of medical work, how activities are accomplished through the interplay of talk, the visual and the use of material artefacts. They also illustrate the ways in which video provides access to the complex forms of social interaction and collaboration that underpin health care. We reflect upon the research opportunities afforded by video and the ways in which video based studies of interaction can contribute to the practice and practicalities of medicine.
|
|
| 2. |
- Persson, Marie, et al.
(författare)
-
Operational strategies to manage non-elective orthopaedic surgical flows : A simulation modelling study
- 2017
-
Ingår i: BMJ Open. - London : BMJ Publishing Group. - 2044-6055. ; 7:4
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the value of simulation modelling in evaluating the effects of strategies to plan and schedule operating room (OR) resources aimed at reducing time to surgery for non-elective orthopaedic inpatients at a Swedish hospital. Methods We applied discrete-event simulation modelling. The model was populated with real world data from a university hospital with a strong focus on reducing waiting time to surgery for patients with hip fracture. The system modelled concerned two patient groups that share the same OR resources: hip-fracture and other non-elective orthopaedic patients in need of surgical treatment. We simulated three scenarios based on the literature and interaction with staff and managers: (1) baseline; (2) reduced turnover time between surgeries by 20â €..min and (3) one extra OR during the day, Monday to Friday. The outcome variables were waiting time to surgery and the percentage of patients who waited longer than 24â €..hours for surgery. Results The mean waiting time in hours was significantly reduced from 16.2â €..hours in scenario 1 (baseline) to 13.3â €..hours in scenario 2 and 13.6â €..hours in scenario 3 for hip-fracture surgery and from 26.0â €..hours in baseline to 18.9â €..hours in scenario 2 and 18.5â €..hours in scenario 3 for other non-elective patients. The percentage of patients who were treated within 24â €..hours significantly increased from 86.4% (baseline) to 96.1% (scenario 2) and 95.1% (scenario 3) for hip-fracture patients and from 60.2% (baseline) to 79.8% (scenario 2) and 79.8% (scenario 3) for patients with other non-elective patients. Conclusions Healthcare managers who strive to improve the timelines of non-elective orthopaedic surgeries may benefit from using simulation modelling to analyse different strategies to support their decisions. In this specific case, the simulation results showed that the reduction of surgery turnover times could yield the same results as an extra OR. © 2017 Published by the BMJ Publishing Group Limited.
|
|
| 3. |
- Romare, Charlotte, 1979-, et al.
(författare)
-
Nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care : A qualitative study
- 2021
-
Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:4 April
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose To describe nurse anesthetists’ experiences using smart glasses to monitor patients’ vital signs during anesthesia care. Methods Data was collected through individual semi-structured interviews with seven nurse anesthetists who had used smart glasses, with a customized application for monitoring vital signs, during clinical anesthesia care. Data was analyzed using thematic content analysis. Results An overarching theme became evident during analysis; Facing and embracing responsibility. Being a nurse anesthetist entails a great responsibility, and the participants demonstrated that they shouldered this responsibility with pride. The theme was divided in two sub-themes. The first of these, A new way of working, comprised the categories Adoption and Utility. This involved incorporating smart glasses into existing routines in order to provide safe anesthesia care. The second sub-theme, Encountering side effects, consisted of the categories Obstacles and Personal affect. This sub-theme concerned the possibility to use smart glasses as intended, as well as the affect on nurse anesthetists as users. Conclusion Smart glasses improved access to vital signs and enabled continuous monitoring regardless of location. Continued development and improvement, both in terms of the application software and the hardware, are necessary for smart glasses to meet nurse anesthetists’ needs in clinical practice. Copyright:
|
|
| 4. |
- Olsson, Anki, et al.
(författare)
-
Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass
- 2016
-
Ingår i: Scandinavian Cardiovascular Journal. - : TAYLOR & FRANCIS LTD. - 1401-7431 .- 1651-2006. ; 50:1, s. 58-63
-
Tidskriftsartikel (refereegranskat)abstract
- Platelet dysfunction is an important cause of postoperative bleeding after cardiac surgery. Protamine is routinely used for reversal of heparin after cardiopulmonary bypass (CBP), but may affect platelet aggregation. We assessed changes in platelet function in relation to protamine administration. Design: Platelet aggregation was analyzed by impedance aggregometry before and after protamine administration in 25 adult cardiac surgery patients. Aggregation was also studied after in vitro addition of heparin and protamine. The activators adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used.Results: Platelet aggregation was reduced by approximately 50% after in vivo protamine administration; ADP 640 +/- 230 (AU*min, mean +/- SD) to 250 +/- 160, TRAP 939 +/- 293 to 472 +/- 260, AA 307 +/- 238 to 159 +/- 143 and COL 1022 +/- 350 to 506 +/- 238 (all p<0.001). Aggregation was also reduced after in vitro addition of protamine alone with activators ADP from 518 +/- 173 to 384 +/- 157 AU*min p<0.001, and AA 449 +/- 311 to 340 +/- 285 (p<0.01) and protamine combined with heparin (1:1 ratio) with activators ADP to 349 +/- 160 and AA to 308 +/- 260 (both p<0.001); and COL from 586 +/- 180 to 455 +/- 172 (p<0.05). Conclusions: Protamine given after CPB markedly reduces platelet aggregation. Protamine added in vitro also reduces platelet aggregation, by itself or in combination with heparin.
|
|
| 5. |
- Forssell, Henrik, et al.
(författare)
-
A proposed model for prediction of survival based on a follow-up study in unresectable pancreatic cancer
- 2013
-
Ingår i: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 3:12, s. 1-6
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To define an easy-to-use model for prediction of survival time in patients with unresectable pancreatic cancer in order to optimise patient' care. DESIGN: An observational retrospective study on patients with unresectable pancreatic cancer. The initial radiographs at presentation of symptoms were reviewed and the maximum diameter of the primary tumour was determined. The occurrence of liver metastases and performance status that determines initiation of chemotherapy was also used in the regression analysis to identify prognostic subgroups. SETTING: County hospital in south-east of Sweden. POPULATION: Consecutive patients with unresectable pancreatic cancer who were diagnosed between January 2003 and May 2010 (n=132). MAIN OUTCOME MEASURES: Statistical analyses were performed using Stata V.13. Survival time was assessed with Kaplan-Meier analysis, log-rank test for equality of survivor functions and Cox regression for calculation of individual hazard based on tumour diameter, presence of liver metastases and initiation of chemotherapy treatment according to patient performance status. RESULTS: The individual hazard was log h=0.357 tumour size+1.181 liver metastases-0.989 performance status/chemotherapy. Three prognostic groups could be defined: a low-risk group with a median survival time of 6.7 (IQR 9.7) months, a medium-risk group with a median survival time of 4.5 (IQR 4.5) months and a high-risk group with a median survival time of 1.2 (IQR 1.7) months. CONCLUSIONS: The maximum diameter of the primary tumour and the presence of liver metastases found at the X-ray examination of patients with pancreatic cancer, in conjunction with whether or not chemotherapy is initiated according to performance status, predict the survival time for patients who do not undergo surgical resection. The findings result in an easy-to-use model for predicting the survival time.
|
|
| 6. |
- Roos-Jansåker, Ann-Marie, et al.
(författare)
-
Long-term stability of surgical bone regenerative procedures of peri-implantitis lesions in a prospective case-control study over 3 years
- 2011
-
Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 38:6, s. 590-597
-
Tidskriftsartikel (refereegranskat)abstract
- To evaluate the extent of bone fill over 3 years following the surgical treatment of peri-implantitis with bone grafting with or without a membrane. Material and Methods In a non-submerged wound-healing mode, 15 subjects with 27 implants were treated with a bone substitute (Algipore (R)) alone and 17 subjects with 29 implants were treated with the bone substitute and a resorbable membrane (Osseoquest (R)). Implants with radiographic bone loss >= 1.8 mm following the first year in function and with bleeding and/or pus on probing were included. Following surgery, subjects were given systemic antibiotics (10 days) and rinsed with chlorhexidine. After initial healing, the subjects were enrolled in a strict maintenance programme. Results Statistical analysis failed to demonstrate changes in bone fill between 1 and 3 years both between and within procedure groups. The mean defect fill at 3 years was 1.3 +/- (SD) 1.3 mm if treated with the bone substitute alone and 1.6 +/- (SD) 1.2 mm if treated with an adjunct resorbable membrane, (p=0.40). The plaque index decreased from approximately 40-10%, remaining stable during the following 2 years. Conclusion Defect fill using a bone substitute with or without a membrane technique in the treatment of peri-implantitis can be maintained over 3 years.
|
|
| 7. |
- Roos-Jansåker, Ann-Marie, et al.
(författare)
-
Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane : a 5-year follow-up
- 2014
-
Ingår i: Journal of Clinical Periodontology. - : Wiley Blackwell. - 0303-6979 .- 1600-051X. ; 41:11, s. 1108-1114
-
Tidskriftsartikel (refereegranskat)abstract
- AimTo compare two regenerative surgical treatments for peri-implantitis over 5years. Material & MethodsTwenty-five individuals with peri-implantitis remained at study endpoint. They were treated with a bone substitute and a resorbable membrane (13 individuals with 23 implants) [Group 1], or with bone substitute alone (12 individuals with 22 implants) [Group 2]. All study individuals were kept on a strict maintenance programme every third month. ResultsFive-year follow-up demonstrated clinical and radiographic improvements in both groups. No implants were lost due to progression of peri-implantitis. Probing depths were reduced by 3.02.4mm in Group 1, and 3.3 +/- 2.09mm in Group 2 (NS). In both groups, radiographic evidence of bone gain was significant (p<0.001). At year 5, the average defect fill was 1.3mm (SD +/- 1.4mm) in Group 1 and 1.1mm (SD +/- 1.2mm) in Group 2 (mean diff; 0.4 95% CI -0.3, 1.2, p=0.24). Bleeding on probing decreased in both groups. Baseline and year 5 plaque scores did not differ between groups and was reduced from 50% to 15%. ConclusionBoth procedures resulted in stable conditions. Additional use of a membrane does not improve the outcome.
|
|
| 8. |
- Aghazadeh, Ahmad, et al.
(författare)
-
Reconstructive treatment of peri-implant defects - Results after three and five years
- 2022
-
Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 33:11, s. 1114-1124
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to assess the long-term efficacy of reconstructive treatment of peri-implantitis intraosseous defects. Material and Methods Peri-implant intraosseous defects were augmented using either an autogenous bone graft (AB) or a bovine-derived xenograft (BDX) in combination with a collagen membrane. Maintenance was provided every third month. Results In the AB group, 16 patients with 25 implants remained at year five. In the BDX group, 23 patients with 38 implants remained. Between baseline and year 5, bleeding on probing (BOP) and probing pocket depth (PPD) scores were reduced in both groups (p < .001). In the AB and BDX groups, mean PPD between baseline and year five was reduced by 1.7 and 2.8 mm, respectively. The difference between groups was significant (p < .001). In the AB group, the mean bone level change at implant level between baseline and years three and five was-0,2 and -0.7 mm, respectively. In the BDX group, the mean bone level change at implant level between baseline and years three and five was 1.6 and 1.6 mm, respectively. The difference between the groups was significant (p < .001). Successful treatment (no bone loss, no probing pocket depth (PPD) > 5 mm, no suppuration, maximum one implant surface with bleeding on probing (BOP) at year five) was obtained in 9/25 implants (36%) in the AB group and in 29/37 implants (78.3%) in the BDX group. Conclusions Reconstructive surgical treatment of peri-implant defects using BDX resulted in more predictable outcomes than using autogenous bone over 5 years.
|
|
| 9. |
- Serino, Giovanni, et al.
(författare)
-
Two- and ten-year follow-up of patients responding and non-responding to the surgical treatment of peri-implantitis : A retrospective evaluation
- 2021
-
Ingår i: Clinical Oral Implants Research. - : Blackwell Munksgaard. - 0905-7161 .- 1600-0501. ; 32:4, s. 410-421
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To report a follow-up of patients following the surgical anti-infective treatment of peri-implantitis and to identify possible risk indicators for the progression of disease during supportive peri-implant therapy. Material and Methods: Following peri-implant surgery, 41 patients (213 implants) were enrolled in a supportive peri-implant therapy. At the 2-year follow-up, two groups of patients were identified, with or without residual peri-implant pockets (responding and non-responding group). Eighteen patients (85 implants) of the non-responding group were followed for further 8 years. Results: At the 2-year examination, 73 of the 117 treated implants (62.4%) presented healthy peri-implant condition, while 44 (37.6%) presented persisting peri-implantitis associated with substantial bone loss before treatment. The 10-year examination of the non-responding group revealed that 1) 84% of the implants that regained health following surgery remained healthy during the entire observation period; 2) 66% of the implants with residual pockets following surgery maintained stable peri-implant condition; and 3) 29% of all treated implants showed disease progression, and 11 of those were extracted. Presence of pockets at 3–4 sites of the implants was identified as risk indicator for progression of peri-implantitis. Conclusion: The peri-implant health achieved following therapy was maintained for most of the implants during the follow-up. Residual pockets were a frequent finding at implants with substantial bone loss before treatment. Presence of pockets around the entire circumference of the implants resulted as a risk indicator for further disease progression. The probability of progression of peri-implant disease increased with increased observation time. © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
|
|
