| 1. |
- Haaland, Christine, et al.
(författare)
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ECOLOGICAL DESIGN - best practice examples : a study trip to Paris 15-19 August 2022
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report presents the parks and green walls we visited on our study visit in Paris (15th-19th of August 2022). We aimed to study green spaces, which represent a good or exceptional practice of ecological design. Ecological design, in an urban landscape context, can be described as the integration of aesthetic and ecological aspects in urban green space design. Supporting ecological processes, biodiversity and providing high aesthetical and recreational values are objectives of ecological design. The visited green spaces varied in their degree and focus on how aesthetical and ecological aspects were integrated. All objects were exceptional regarding one or several aspects such as the choice of plant material, structural and vegetation complexity or the degree in which ecological processes and biodiversity were given space. For us it was very interesting to see and discuss these varying approaches and how we perceived to which degree aesthetical and ecological goals were reached.
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| 2. |
- Svensson, Anna-Karin, et al.
(författare)
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Surgery for carpal tunnel syndrome in patients with and without diabetes-Is there a difference in the frequency of surgical procedures?
- 2024
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Ingår i: PLoS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 19:5
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Tidskriftsartikel (refereegranskat)abstract
- Carpal tunnel syndrome (CTS) occurs more often among individuals with diabetes. The aim of this retrospective observational registry study was to examine whether individuals with diabetes and CTS are treated surgically to the same extent as individuals with CTS but without diabetes. Data on CTS diagnosis and surgery were collected from the Skåne Healthcare Register (SHR). A total of 35,105 individuals (age ≥ 18 years) diagnosed with CTS from 2004-2019 were included. Data were matched to the Swedish National Diabetes Register (NDR. Cox regression models were used to calculate the risk of the use of surgical treatment. Of the 35,105 included individuals with a CTS diagnosis, 17,662 (50%) were treated surgically, and 4,966 (14%) had diabetes. A higher number of individuals with diabetes were treated surgically (2,935/4,966, 59%) than individuals without diabetes (14,727/30,139, 49%). In the Cox regression model, diabetes remained a significant risk factor for surgical treatment (PR 1.14 (95% CI 1.11-1.17)). Individuals with type 1 diabetes were more frequently treated surgically (490/757, 65%) than individuals with type 2 diabetes (2,445/4,209, 58%). There was no difference between the sexes and their treatment. The duration of diabetes was also a risk factor for surgical treatment in diabetes type 2, but high HbA1c levels were not. Individuals with diabetes are more likely to be treated surgically for CTS than individuals without diabetes. Individuals with type 1 diabetes are more likely to be treated surgically for CTS than individuals with type 2 diabetes.
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| 3. |
- Svensson Malchau, Karin, et al.
(författare)
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DORIS study: domestic violence in orthopaedics, a prospective cohort study at a Swedish hospital on the annual prevalence of domestic violence in orthopaedic emergency care
- 2024
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Ingår i: BMJ OPEN. - 2044-6055. ; 14:5
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Tidskriftsartikel (refereegranskat)abstract
- Background Domestic violence (DV) is a major problem which despite many efforts persists globally. Victims of DV can present with various injuries, whereof musculoskeletal presentation is common. Objectives The DORIS study (Domestic violence in ORthopaedIcS) aimed to establish the annual prevalence of DV at an orthopaedic emergency department (ED) in Sweden. Design Female adult patients with orthopaedic injuries seeking treatment at a tertiary orthopaedic centre between September 2021 and 2022 were screened during their ED visit. Setting This is a single-centre study at a tertiary hospital in Sweden. Participants Adult female patients seeking care for acute orthopaedic injuries were eligible for the study. During the study period, 4192 female patients were provided with study forms and 1366 responded (32.5%). Primary and secondary outcome measures The primary outcome measure was to establish the annual prevalence of injuries due to DV and second, to establish the rate of current experience of any type of DV. Results One in 14 had experience of current DV (n=100, 7.5%) and 1 in 65 (n=21, 1.5%) had an injury due to DV. Conclusions The prevalence of DV found in the current study is comparable to international findings and adds to the growing body of evidence that it needs to be considered in clinical practice. It is important to raise awareness of DV, and frame strategies, as healthcare staff have a unique position to identify and offer intervention to DV victims.
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| 4. |
- Bergström, J., et al.
(författare)
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Incidence and Risk Factors for Surgical Site Infection in Ankle Fractures: An Observational Study of 480 Patients in Sweden
- 2023
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Ingår i: Journal of Clinical Medicine. - 2077-0383. ; 12:20
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Surgical site infection (SSI) is a frequently reported complication after ankle fracture surgery. To our knowledge, no study has been conducted on its incidence in Sweden. The present study aimed to determine the incidence of, risk factors for, and most common causative pathogen of SSI. Methods: Patients who underwent primary surgery for an ankle fracture between 1 September 2017 and 31 August 2019 at the Sahlgrenska University Hospital were identified. Data on potential SSI risk factors and clinical outcome (infected/non-infected) were retrieved from medical records. Cox regression analysis and descriptive statistics were used. Results: Of the 480 reviewed patients, 49 developed SSI (10.2%), of which 35 (7.3%) were superficial and 14 (2.9%) were deep. Open fractures (p < 0.001) and age (p = 0.016) were statistically significant risk factors for SSI in the univariate analysis. In the multivariable analysis, only open fracture was statistically significant (HR = 3.0; 95% C.I. = 1.3-6.9, p = 0.013). Cases of Staphylococcus aureus (S. aureus) were most common (n = 12, 24.5%). Methicillin resistance was uncommon (n = 2, 4.1%). Conclusions: An incidence of 10.2% was established, which is comparable to international findings. Infection monitoring is an important part of tackling the global challenge of antibiotic resistance. Future prospective studies to further establish risk factors are warranted to decrease the incidence of SSI.
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| 5. |
- Holmgren, Helén, 1970-, et al.
(författare)
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Case i redovisning
- 2023. - 3
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Bok (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Stålfelt, Frans, 1995, et al.
(författare)
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Can particle counting replace conventional surveillance for airborne bacterial contamination assessments? A systematic review using narrative synthesis
- 2023
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Ingår i: AMERICAN JOURNAL OF INFECTION CONTROL. - : Elsevier Inc.. - 0196-6553 .- 1527-3296. ; 51:12, s. 1417-1424
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Forskningsöversikt (refereegranskat)abstract
- Background: Bacterial airborne contamination in the operating room during surgery indicates an increased risk for surgical site infection. The conventional surveillance method for bacteria in the air is by air sampling, plating, and counting of colony-forming units (CFU). Particle counting measures particles in the air, typically in sizes of 1-20 mu m, and has been suggested as an alternative to CFU measurements. The primary aim was to investigate the correlation between the number of airborne CFU and particles during surgery. The secondary aim was to explore whether different ventilation settings influence the correlation between CFU and particles. Methods: The databases Cochrane, Embase, and Medline were searched for relevant publications. Due to the heterogeneity of the data, meta-analysis was not possible and a narrative analysis was performed instead. Results: The review included 11 studies. Two of the studies (n = 2) reported strong correlation between particles and CFU (Rp = 0.76 and Rc = 0.74). The remaining studies observed moderate correlation (n = 3), low correlation (n = 3), or no correlation (n = 3). Based on the primary results from this study, ventilation attribution to distinguish the correlation between particles and CFU had no or little contribution. Conclusions: Due to the lack of convincing evidence of correlation and lack of high-quality studies performing measurements in a standardized way, the studies could not provide the necessary evidence that show that particle counting could be used as a substitution for conventional air bacterial assessment. Further studies are warranted to strengthen the conclusion.
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| 7. |
- Sundén-Cullberg, Jonas, et al.
(författare)
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Anakinra or tocilizumab in patients admitted to hospital with severe covid-19 at high risk of deterioration (IMMCoVA): A randomized, controlled, open-label trial
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anakinra and tocilizumab are used for severe Covid-19, but only one previous randomized controlled trial (RCT) has studied both. We performed a multi-center RCT comparing anakinra or tocilizumab versus usual care (UC) for adults at high risk of deterioration.Methods: The study was conducted June 2020 to March 2021. Eligibility required ≥ 5 liters/minute of Oxygen to maintain peripheral oxygen saturation at ≥ 93%, CRP > 70 mg/L, ferritin > 500 μg/L and at least two points where one point was awarded for lymphocytes < 1x 109/L; D-dimer ≥ 0.5 mg/L and; lactate dehydrogenase ≥ 8 microkatal/L. Patients were randomly assigned 1:1:1 to receive either a single dose of tocilizumab (8 mg/kg) or anakinra 100 mg IV QID for seven days or UC alone. The primary outcome was time to recovery.Results: Recruitment was ended prematurely when tocilizumab became part of usual care. Out of a planned 195 patients, 77 had been randomized, 27 to UC, 28 to anakinra and 22 to tocilizumab. Median time to recovery was 15, 15 and 11 days. Rate ratio for recovery for UC vs anakinra was 0.91, 0.47 to 1.78, 95% [CI], p = 0.8 and for UC vs tocilizumab 1.13, 0.55 to 2.30; p = 0.7. There were non-significant trends favoring tocilizumab (and to limited degree anakinra) vs UC for some secondary outcomes. Safety profiles did not differ significantly.Conclusion: Premature closure of trial precludes firm conclusions. Anakinra or tocilizumab did not significantly shorten time to clinical recovery compared to usual care. (IMMCoVA, NCT04412291, EudraCT: 2020-00174824).
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| 8. |
- Seth Caous, Josefin, et al.
(författare)
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Instrument tables equipped with local unidirectional airflow units reduce bacterial contamination during orthopedic implant surgery in an operating room with a displacement ventilation system
- 2022
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Ingår i: Infection Prevention in Practice. - : Elsevier Ltd. - 2590-0889. ; 4:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Airborne bacteria present in the operating room may be a cause of surgical site infection, either contaminating the surgical wound directly, or indirectly via e.g. surgical instruments. The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room with displacement ventilation. Methods: Local airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. A minimum of three air samples and two-three samples from instrument dummies were taken during each surgery. Samples were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR. Results: 188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above assistant table (P<0.001) and instrument table (P=0.002), as well as on the instrument dummies from the assistant table (P=0.001). Conclusions: Instrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination. © 2022 The Authors
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| 9. |
- Simonsson, Johan, et al.
(författare)
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Worse patient-reported outcomes and higher risk of reoperation and adverse events after total hip replacement in patients with opioid use in the year before surgery: a Swedish register-based study on 80,483 patients
- 2022
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 93, s. 190-197
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Recent studies indicate that preoperative use of opioids could be associated with higher rates of complications and worse patient-reported outcomes (PROs) after orthopedic surgery. We investigated the prevalence of preoperative opioid use and analyzed its influence on risk of revision, adverse events (AE), and PROs in patients with total hip replacement (THR). Patients and methods - This observational study included 80,483 patients operated on in 2008-2016 with THRs due to osteoarthritis. Data was obtained from the Swedish Hip Arthroplasty Register, Statistics Sweden's sociodemographic registers, the Swedish National Patient Register, and the Prescribed Drug Register. We focused on patients with ≥ 4 opioid prescriptions filled 1 year prior to THR. To control for confounding, we used propensity scores to weight subjects in our analyses. Logistic and linear regression was used for outcome variables with adjustments for sociodemographic variables and comorbidities. Results - Patients with ≥ 4 opioid prescriptions in the year before THR (n = 14,720 [18%]) had a higher risk of revision within 2 years (1.8% vs. 1.1% OR 1.4, 95% CI 1.3-1.6) and AE within 90 days (9.4% vs. 6.4% OR 1.2, 95% CI 1.2-1.3) compared with patients without opioid treatment in the preoperative period. Patients with ≥ 4 opioid prescriptions rated 5 points worse on a 0-100 scale of Pain Visual Analogue Scale (VAS) and 9 points worse on a general health (EQ) VAS 1 year postoperatively. Interpretation - Having ≥ 4 opioid prescriptions filled in the year before surgery is associated with a higher risk of revision, adverse events, and worse PROs after THR. Consequently, preoperative opioid treatment should be addressed in the clinical assessment of patients eligible for THR.
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| 10. |
- Svensson, Anna-Karin, lecture in special education
(författare)
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Studen's Challenges and Support Neede in Reching Academic Literacies in Higher Education : In-Depth Interviews with Swedish Students
- 2022
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Ingår i: International Journal of Educational Methodology. - : Eurasian Society of Educational Research. - 2469-9632. ; 8:4, s. 731-741
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to capture and analyse perspectives on higher education from the views of five students through in-depth interviews. The students' statements are analyzed in order to gain an understanding of their experiences of developing academic literacies in their university studies. They are regularly visiting the university study workshop for help with their exam assignments. The following questions have been formulated to fulfil the aim of the study: (a) what aspects of studies in higher education do the students express as important, favorable, or unfavorable, for their development of academic literacies? and (b) in what way do the students value the study workshops as an educational tool? The analysis reveals three themes: the importance of explicit support structures, the importance of teachers’ feedback, and the importance of using the students’ pedagogical capital. The results also show that the students highly value the study workshop when they reflect upon the one-to-one feedback, but the support seems to be insufficient both in supporting them to be more independent in their studies and in developing academic literacies from a critical and epistemological point of view.
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