| 1. |
- Lindberg, Helena, et al.
(författare)
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Performance of the 2023 Duke-ISCVID diagnostic criteria for infective endocarditis in relation to the modified Duke criteria and to clinical management- reanalysis of retrospective bacteremia cohorts
- 2024
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Ingår i: Clinical Infectious Diseases. - 1537-6591. ; 78:4, s. 956-963
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRevised diagnostic criteria for infective endocarditis (IE), the 2023 Duke-ISCVID criteria, were recently presented and need validation. Here, we compare the 2000 modified Duke criteria for IE with Duke-ISCVID among patients with bacteremia and relate the diagnostic classification to IE-treatment.MethodsWe reanalyzed patient cohorts with Stapylococcus aureus, Staphylococcus lugdunensis, non-beta-hemolytic streptococci, Streptococcus-like bacteria, Streptococcus dysgalactiae, Enterococcus faecalis and HACEK bacteremia. Episodes were classified as definite, possible or rejected IE with the modified Duke and Duke-ISCVID criteria. Reclassification included the microbiology criteria, PET-CT and cardiac implanted elect-ronical devices. To calculate sensitivity, patients treated as IE were considered as having IE.ResultsIn 4050 episodes of bacteremia, the modified Duke criteria criteria assigned 307episodes (7.6%) as definite IE, 1190 episodes (29%) as possible IE and 2553 episodes (63%) as rejected IE. Using the Duke-ISCVID criteria, 13 episodes (0.3%) were reclassified from possible to definite IE and 475 episodes (12%) were reclassified from rejected to possible IE. With the modified Duke criteria, 79 episodes that were treated as IE were classified as possible IE and eleven of these episodes were reclassified to definite IE with Duke-ISCVID. Applying the decision to treat for IE as reference standard, the sensitivity of the Duke-ISCVID criteria was 80%. None of the 475 episodes reclassified to possible IE were treated as IE.ConclusionsThe Duke-ISCVID criteria reclassified a small proportion of episodes to definite IE at the expense of more episodes of possible IE. Future criteria should minimize the possible group while keeping or improving sensitivity.
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| 2. |
- Lindberg, Helena, et al.
(författare)
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Treating the disease and meeting the person with the illness-patient perspectives of needs during infective endocarditis, a qualitative study
- 2024
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Ingår i: PLOS ONE. - San Francisco, CA : Public Library of Science (PLoS). - 1932-6203. ; 19:8
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundInfective endocarditis (IE) is a rare but severe infectious disease. Patients with IE are treated for weeks in the hospital and have profound impairments to their health. New treatment modalities increase options for outpatient care. Little is known about how patients perceive their disease and hospitalisation. We aimed to explore the needs of patients with IE during hospitalisation and the first few months after discharge.MethodsIn this qualitative study, 20 patients (45-86 years of age) hospitalised due to IE in Swedish hospitals were interviewed a median of 112 (67-221) days after hospitalisation. Data were analysed with qualitative content analysis, identifying eight subcategories, two categories, and an overall theme.ResultsThe overall theme illuminated a spectrum of needs of patients suffering from IE, between treating the disease and meeting the person with the illness. The needs encompassed eight axes with dual focus on both medical excellence and person-centred care. Medical excellence was needed to optimally treat, supervise, and offer follow-up on this rare and severe disease; patients longed to come home, and there were issues of reliability in the healthcare system. Person-centred care was requested, including individualised information leading to knowledge, reorientation, the beginning of health restoration, and being met as a unique person. Symptoms of fatigue, wasting, and cognitive and mental distress were often neglected by the caregiver.ConclusionsThis explorative study shows the patient's needs as important areas in a spectrum between medical excellence and person-centred care. Care in specialised units secure quality. Early discharge is requested by patients. Multiprofessional individualizing outpatient care needs to develop with preserved safety and medical excellence. The disease trajectory after discharge progresses slowly, and the possibility of mitigating its progress is still unclear. Person- centred care, screening for delayed restoration and rehabilitation after endocarditis are important fields for future studies. © 2024 Lindberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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| 3. |
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| 4. |
- Lindberg, Helena, et al.
(författare)
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Risk stratification score screening for infective endocarditis in patients with Gram-positive bacteraemia
- 2022
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Ingår i: Infectious Diseases. - : Informa UK Limited. - 2374-4235 .- 2374-4243. ; 54:7, s. 488-496
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Tidskriftsartikel (refereegranskat)abstract
- Background: A feared cause of bacteraemia with Gram-positives is infective endocarditis. Risk stratification scores can aid clinicians in determining the risk of endocarditis. Six proposed scores for the use in bacteraemia; Staphylococcus aureus (PREDICT, VIRSTA, POSITIVE), non-β-haemolytic streptococci (HANDOC) and Enterococcus faecalis (NOVA, DENOVA) were validated for predictive ability and the utilization of echocardiography was investigated. Methods: Hospitalized adult patients with Gram-positive bacteraemia during 2017–2019 were evaluated retrospectively through medical records and the Swedish Death Registry. Baseline and score-specific data, definite endocarditis and echocardiographies performed were recorded. Sensitivity, specificity, negative and positive predictive values and echocardiography utilization were determined. Results: 480 patients with bacteraemia were included and definite endocarditis was diagnosed in 20 (7.5%), 10 (6.6%), and 2 (3.2%) patients with S. aureus, non-β-haemolytic streptococci and E. faecalis, respectively. The sensitivities of the scores were 80–100% and specificities 8–77%. Negative predictive values of the six scores were 98–100%. VIRSTA, HANDOC, NOVA and DENOVA identified all, the PREDICT5 score missed 1/20 and the POSITIVE score missed 4/20 cases of endocarditis. Transoesophageal echocardiography was performed in 141 patients (29%). Thus, the risk stratification scores suggested an increase of 3–63 (7–77%) investigations with echocardiography. Conclusions: All scores had negative-predictive values over 98%, therefore it can be concluded that PREDICT5, VIRSTA, POSITIVE, HANDOC and DENOVA are reasonable screening tools for endocarditis early on in Gram-positive bacteraemia. The use of risk stratification scores will lead to more echocardiographies.
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| 5. |
- Rasmussen, Magnus, et al.
(författare)
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One Scoring System Does Not Fit All Healthcare Settings
- 2022
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Ingår i: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. - : Oxford University Press (OUP). - 1537-6591. ; 74:1, s. 166-167
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Hedvall, Johan, et al.
(författare)
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Perspectives on Challenge-Driven Engineering Education for a Sustainable Future
- 2021
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Konferensbidrag (refereegranskat)abstract
- Engineering education has changed and evolved over decades in harmony with societies challenges. Today, sustainable development is of greatest importance and one way of equipping future engineers with the competencies to tackle this challenge is through Challenge Driven Education (CDE). This study takes on an exploratory approach when studying the implementation of CDE as it is formed at two different universities, one in Sweden, and one in Tanzania. By interviewing key-actors such as teachers and stakeholders who are in one way or another engaged or are about to become involved in CDE, an investigation has been conducted in order to understand how these key-actors view CDE as a successful pedagogical approach for educating engineers of the future. First, a question was asked on which competencies for sustainability could be considered important in future engineers. Second, the participants were encouraged to tell how CDE could develop from their perspective. Results show that the depiction of key competencies for sustainability correlates well with the participants views of what is important for future engineers, although it is evident that good communication between stakeholders and students/teachers about what is expected to train during a CDE course is paramount. The study also shows the importance of stakeholders trusting each other and having a common picture of what a CDE collaboration should lead to in order to achieve the best possible results of such training.
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| 7. |
- Lindberg, Helena Gonzales, et al.
(författare)
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The power of maps in shaping visions about the Arctic
- 2021. - 1
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Ingår i: Defining and Mapping the Arctic : Sovereignties, Policies and Perceptions - Sovereignties, Policies and Perceptions. - 2298-2418. ; 2021, s. 479-491
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Bokkapitel (refereegranskat)abstract
- Maps have the ability to make abstract information visible and real to their audiences. They provide humans a way to conceptualize and understand places and issues that otherwise might seem both distant and abstract. This article argues that maps influence what issues are visible and knowable and what issues are silenced and disregarded, often giving prominence to dominant understandings. As such, maps help constitute what is considered politically possible in terms of governing problems such as climate change or pressing ahead with new policy initiatives pertaining to economic development. Specifically, this article seeks to understand the power of maps in the context of the Arctic region, where maps can be seen as central to constructing imaginaries and indirect experiences of the Arctic. I suggest that Arctic processes and possibilities are difficult to communicate to audiences, let alone imagined, without the use of maps. To illustrate the constitutive power of maps in the Arctic, I deconstruct a set of two maps depicting oil and gas potential in the Arctic coming from a fact sheet by the U. S. Geological Survey. The analysis focuses on the ways in which these maps enable and limit certain conceptualizations and visions of ’the Arctic’ and politics within that region. I contend that maps are powerful because they shape generally held assumptions about the Arctic, often serving already dominant interests and visions about the future.
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| 8. |
- Lindberg, Helena Gonzales
(författare)
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The constitutive power of maps in the Arctic
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- As maps are widely used, circulated, and recognised, they have consequences for how people view and understand the world. They mediate political meaning-making and frame the conditions for political alternatives to emerge or to be silenced. In contrast to dominant approaches to the study of the power of maps that consider their political influence on the basis of the intentions of the map-maker, this thesis emphasises the constitutive power of maps and the visual representations prevalent within them. Moreover, it attempts to further conversations between the fields of visual politics and critical cartography by investigating the power of maps in international politics. It does so by developing three theoretical assumptions about the constitutive power effects of maps: cartographic truth-claiming, cartographic naturalisation, and cartographic materialisation. To illustrate and examine these effects, a two-step analytical framework for interpreting and deconstructing maps is presented and applied to the study of three contemporary maps: a world map using the Web Mercator projection, a map of the changes in Arctic sea ice, and a set of two maps depicting the oil and gas potentials in the Arctic. The analysis focuses on the ways in which maps limit and enable certain conceptualisations of ‘the Arctic’ and politics within the region. The thesis concludes by contending that maps perform the political by shaping generally held assumptions about the ‘reality’ of the Arctic, both in terms of its ‘challenges’ and ‘opportunities’, and therefore serving particular interests as well as giving rise to ideas and visions about the region’s future.
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| 9. |
- Höjer, Ingrid, 1953, et al.
(författare)
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Recognition of education and schooling in case files for children and young people placed in out-of-home care
- 2018
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Ingår i: Children and youth services review. - : Elsevier BV. - 0190-7409. ; 93, s. 135-142
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Tidskriftsartikel (refereegranskat)abstract
- © 2018 Elsevier Ltd The aim of the article is to describe and discuss how issues related to schooling and educational achievement are recognized and addressed in social services case files for children and young people placed in out-of-home care (OHC) in the city of Gothenburg, Sweden. Four cohorts were included in the study: children born 1967, 1977, 1987 and 1992. 40 case files were selected from each cohort (38 from the 1977 cohort), in total 158 cases. The analyses were made through a counting of rows related to schooling and education in the documents. Results were then processed in the statistical program SPSS. The results show that the level of recognition of schooling/education was low, and that it was more frequent when the child/young person had behaviour problems and/or was placed in residential care. Little attention was paid to changes of schools. On a positive note, there was an increased attention to education and schooling for the two latter cohorts (1987, 1992), and the involvement of children, young people and parents was also more visible. To conclude, the acknowledgement of schooling and education that should be present in all placements in OHC was not generally visible in the documents in the case files, although the level of attention had increased. The message for practice is that this issue need more attention on several levels: better planning for the transition between old and new school, a developed cooperation between social services, foster/residential care and schools and a pro-active approach from social services concerning education and schooling.
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| 10. |
- W. Lindberg, Helena
(författare)
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A ‘convenient truth’: the enabling power of map-representations in a changing Arctic
- 2018
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Ingår i: ; , s. 24-24
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Climate change is not only changing the Arctic environment and ecosystems: it is also opening up the idea of the region as a last frontier to be explored. Recent representations of the future for the Arctic have become closely associated with various business-friendly opportunities as the land and sea ice is melting: They often represent so-called win-win solutions to climate change, also for Arctic communities. However, many of the proposed development opportunities imagined for the Arctic region will contribute to increase the burning of carbon, whether it is more tourism, mining, shipping, agricultural activities, or oil and gas drilling. In this paper, I argue that Arctic business opportunities can be seen as discursively based on map-representations. Many conventional maps already show the Arctic ocean as an open, blue space on the top of the world, and maps from for example the US Geological Survey (USGS) portray the potentials for oil and gas that can be found ‘under the ice’. I explore how map-representations of the Arctic have emerged through and in the context of climate change. I see maps as both constituted by political discourse but also constituting political discourses. This means that the political influence that maps have in society are not coming only from the makers, commissioners, or users of maps but also in the abilities of maps to affect its socio-political context. I focus on the map by the USGS (2008) that shows estimates of undiscovered oil and gas north of the Arctic Circle. I argue that such maps enable businesses to see climate change as a ‘convenient truth’, promoting a neoliberal attitude to nature and an ecological modernization approach to the future of the Arctic region. I conclude by discussing what discourses are silenced when discourses of economic opportunities are dominating.
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