| 1. |
- Alfredsson, Joakim, 1962-, et al.
(författare)
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Randomized comparison of early supplemental oxygen versus ambient air in patients with confirmed myocardial infarction : Sex-related outcomes from DETO2X-AMI
- 2021
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Ingår i: American Heart Journal. - : Mosby Inc.. - 0002-8703 .- 1097-6744. ; 237, s. 13-24
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose of this study is to investigate the impact of oxygen therapy on cardiovascular outcomes in relation to sex in patients with confirmed myocardial infarction (MI).Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction trial randomized 6,629 patients to oxygen at 6 L/min for 6-12 hours or ambient air. In the present subgroup analysis including 5,010 patients (1,388 women and 3,622 men) with confirmed MI, we report the effect of supplemental oxygen on the composite of all-cause death, rehospitalization with MI, or heart failure at long-term follow-up, stratified according to sex.Results: Event rate for the composite endpoint was 18.1% in women allocated to oxygen, compared to 21.4% in women allocated to ambient air (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.65-1.05). In men, the incidence was 13.6% in patients allocated to oxygen compared to 13.3% in patients allocated to ambient air (HR 1.03, 95% CI 0.86-1.23). No significant interaction in relation to sex was found (P=.16). Irrespective of allocated treatment, the composite endpoint occurred more often in women compared to men (19.7 vs 13.4%, HR 1.51; 95% CI, 1.30-1.75). After adjustment for age alone, there was no difference between the sexes (HR 1.06, 95% CI 0.91-1.24), which remained consistent after multivariate adjustment.Conclusion: Oxygen therapy in normoxemic MI patients did not significantly affect all-cause mortality or rehospitalization for MI or heart failure in women or men. The observed worse outcome in women was explained by differences in baseline characteristics, especially age
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| 2. |
- Andersson, Henrik, et al.
(författare)
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Ethics education to support ethical competence learning in healthcare : an integrative systematic review
- 2022
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Ingår i: BMC Medical Ethics. - : BioMed Central. - 1472-6939. ; 23
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Forskningsöversikt (refereegranskat)abstract
- Background: Ethical problems in everyday healthcare work emerge for many reasons and constitute threats to ethi- cal values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.Methods: In this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 arti- cles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.Results: The review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previ- ously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.Conclusions: The review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations.
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| 3. |
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| 4. |
- Hagberg, Katarina, et al.
(författare)
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The reading practices of people with neuropsychiatric disabilities : A review of library and information science literature
- 2024
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Ingår i: Information Research. - : Högskolan i Borås. - 1368-1613. ; 29:2, s. 341-361
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Forskningsöversikt (refereegranskat)abstract
- Introduction. The ability to read and interpret different types of text can be significantly impacted by neuropsychiatric disabilities, which affect cognitive abilities. This paper explores and reviews previous studies within library and information science on neuropsychiatric disabilities in relation to reading practices. Method. Searches were performed in LISA and LISTA to identify research on readers with neuropsychiatric disabilities. Results were screened and 14 peer reviewed articles were chosen for inclusion. Utilising content analysis, the examined articles were deductively and inductively categorised according to the following themes: impairment, user group and context, research design, assistive technologies for reading, reading for information seeking, reading for evaluation, and reading, self-efficacy and identity.Findings. Most articles address dyslexia. The majority of studies have been conducted in educational settings and have an experimental research design. Six studies address assistive technologies for reading, the remaining eight concern reading in relation to information practices.Conclusion. There is an imbalance in the types of impairments that have been addressed in previous research. Few studies concern everyday reading practices and more research outside of educational contexts is needed. Furthermore, there is a lack of research that delves deeper into the experiences of readers with neuropsychiatric disabilities.
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| 5. |
- Haider, Jutta, et al.
(författare)
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Transformation or Continuity? The Impact of Social Media on Information : Implications for Theory and Practice
- 2012
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Ingår i: Proceedings of the 75th ASIS&T Annual Meeting: Information, Interaction, Innovation, vol. 49. - Silver Springs, MD : American Society for Information Science and Technology. ; 49:1
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Konferensbidrag (refereegranskat)abstract
- This panel debates whether the ways in which social media are changing the nature, creation, seeking, use and sharing of information constitute a transformation or are primarily marked by continuity. Ubiquitous and everyday access to social media (for some) seems to be bringing about changes in social practice, including of information-related activities, such that conceptualisations of information itself are potentially reshaped. Discussants draw inspiration from the pervasive impact on information activities of the everyday adoption of social media. At a theoretical level they also draw inspiration from the analytic resources of contemporary practice theory and its emphasis on materiality and embodiment, routine and change, social expectations and social identity, and knowledge as a process. All the participants of the panel have conducted new empirical research on social media use with a focus on its deep as well as broad impact. The audience members are invited to discuss with the panelists questions such as how social media relate to routinised daily practices and institutionalised practices and hierarchies, how their use refashions social relationships, how they turn information seekers and users into information managers, producers and creators and shape perceptions of information authority and trustworthiness, and how a new theorisation can help librarians, information professionals and researchers understand change and assume a proactive role in it.
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| 6. |
- Hansson, Joacim, 1966-, et al.
(författare)
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Profession, utbildning, forskning : biblioteks- och informationsvetenskap för en stärkt bibliotekarieprofession
- 2018
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Rapport (populärvet., debatt m.m.)abstract
- Sekretariatet för nationell biblioteksstrategi vid Kungliga Biblioteket har givit de fem biblioteks- och informationsvetenskapliga utbildningarna vid Högskolan i Borås, Linnéuniversitetet, Lunds univeritet, Umeå universitet och Uppsala universitet uppdraget att utreda och formulera förslag kring utbildning och forskning för en stärkt bibliotekarieprofession. Syftet med föreliggande rapport är, att visa situationen för svensk biblioteks- och informationsvetenskap, tydliggöra relationen till bibliotekarieprofessionen och lämna strategiska förslag på hur ämnet kan förstärkas till förmån för en stärkt professionsutvecklig. En omvärldsanalys med riktning mot bibliotekssektorn görs samt en beskrivning av nuläget för biblioteks- och informationsvetenskaplig utbildning och forskning. Biblioteks- och informationsvetenskapens centrala betydelse för bibliotekarieprofessionen lyfts fram. Utbildingsprogrammen i ämnet attraherar gott om studenter och som svar på bibliotekens konstaterade behov av biblioteks- och informationsvetenskapligt utbildad personal argumenterar rapportförfattarna för möjligheten att expandera utbildningarna på kandidat- och masternivå vid samtliga fem lärosäten. Inom forskningen konstateras, att trots att ämnet idag i grunden fungerar väl finns ännu svårigheter att erhålla finansiering för professionsinriktad biblioteksforskning. Omvärldsanalysen visar upp ett behov av en tydligare struktur för kontinuerlig kompetensutveckling inom bibliotekarieprofessionen. Rapporten mynnar ut i fem strategiska förslag rörande grundutbildning, forskning och kontinuerlig kompetensutveckling:En ökning av antalet studieplatser på program på kandidat- och masternivå i biblioteks- och informationsvetenskap.Nationell forskarskola för biblioteksforskning.Inrättande av en externfinansierad professur med inriktning mot biblioteksforskning.Stärkt finansieringsstruktur för biblioteksforskning.Etablerande av en samlad nationell struktur för kontinuerlig kompetensutveckling.
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| 7. |
- Hofmann, Robin, et al.
(författare)
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Avoiding Routine Oxygen Therapy in Patients With Myocardial Infarction Saves Significant Expenditure for the Health Care System—Insights From the Randomized DETO2X-AMI Trial
- 2022
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Ingår i: Frontiers in Public Health. - Lausanne, Switzerland : Frontiers Media SA. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Myocardial infarction (MI) occurs frequently and requires considerable health care resources. It is important to ensure that the treatments which are provided are both clinically effective and economically justifiable. Based on recent new evidence, routine oxygen therapy is no longer recommended in MI patients without hypoxemia. By using data from a nationwide randomized clinical trial, we estimated oxygen therapy related cost savings in this important clinical setting. Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomized 6,629 patients from 35 hospitals across Sweden to oxygen at 6 L/min for 6–12 h or ambient air. Costs for drug and medical supplies, and labor were calculated per patient, for the whole study population, and for the total annual care episodes for MI in Sweden (N = 16,100) with 10 million inhabitants. Results: Per patient, costs were estimated to 36 USD, summing up to a total cost of 119,832 USD for the whole study population allocated to oxygen treatment. Applied to the annual care episodes for MI in Sweden, costs sum up to between 514,060 and 604,777 USD. In the trial, 62 (2%) patients assigned to oxygen and 254 (8%) patients assigned to ambient air developed hypoxemia. A threshold analysis suggested that up to a cut-off of 624 USD spent for hypoxemia treatment related costs per patient, avoiding routine oxygen therapy remains cost saving. Conclusions: Avoiding routine oxygen therapy in patients with suspected or confirmed MI without hypoxemia at baseline saves significant expenditure for the health care system both with regards to medical and human resources. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT01787110. Copyright © 2022 Hofmann, Abebe, Herlitz, James, Erlinge, Alfredsson, Jernberg, Kellerth, Ravn-Fischer, Lindahl, Langenskiöld and DETO2X-SWEDEHEART Investigators.
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| 8. |
- Hofmann, R, et al.
(författare)
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DETermination of the role of OXygen in suspected Acute Myocardial Infarction trial
- 2014
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Ingår i: American Heart Journal. - : Mosby, Inc.. - 0002-8703 .- 1097-6744. ; 167:3, s. 322-328
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The use of supplemental oxygen in the setting of suspected acute myocardial infarction (AMI) is recommended in international treatment guidelines and established in prehospital and hospital clinical routine throughout the world. However, to date there is no conclusive evidence from adequately designed and powered trials supporting this practice. Existing data are conflicting and fail to clarify the role of supplemental oxygen in AMI. METHODS: A total of 6,600 normoxemic (oxygen saturation [SpO2] ≥90%) patients with suspected AMI will be randomly assigned to either supplemental oxygen 6 L/min delivered by Oxymask (MedCore Sweden AB, Kista, Sweden) for 6 to 12 hours in the treatment group or room air in the control group. Patient inclusion and randomization will take place at first medical contact, either before hospital admission or at the emergency department. The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registry will be used for online randomization, allowing inclusion of a broad population of all-comers. Follow-up will be carried out in nationwide health registries and Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies. The primary objective is to evaluate whether oxygen reduces 1-year all-cause mortality. Secondary end points include 30-day mortality, major adverse cardiac events, and health economy. Prespecified subgroups include patients with confirmed AMI and certain risk groups. In a 3-month pilot study, the study concept was found to be safe and feasible. CONCLUSION: The need to clarify the uncertainty of the role of supplemental oxygen therapy in the setting of suspected AMI is urgent. The DETO2X-AMI trial is designed and powered to address this important issue and may have a direct impact on future recommendations.
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| 9. |
- Hofmann, Robin, et al.
(författare)
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Oxygen therapy in ST-elevation myocardial infarction.
- 2018
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 39:29, s. 2730-2739
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To determine whether supplemental oxygen in patients with ST-elevation myocardial infarction (STEMI) impacts on procedure-related and clinical outcomes.Methods and results: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial randomized patients with suspected myocardial infarction (MI) to receive oxygen at 6 L/min for 6-12 h or ambient air. In this pre-specified analysis, we included only STEMI patients who underwent percutaneous coronary intervention (PCI). In total, 2807 patients were included, 1361 assigned to receive oxygen, and 1446 assigned to ambient air. The pre-specified primary composite endpoint of all-cause death, rehospitalization with MI, cardiogenic shock, or stent thrombosis at 1 year occurred in 6.3% (86 of 1361) of patients allocated to oxygen compared to 7.5% (108 of 1446) allocated to ambient air [hazard ratio (HR) 0.85, 95% confidence interval (95% CI) 0.64-1.13; P = 0.27]. There was no difference in the rate of death from any cause (HR 0.86, 95% CI 0.61-1.22; P = 0.41), rate of rehospitalization for MI (HR 0.92, 95% CI 0.57-1.48; P = 0.73), rehospitalization for cardiogenic shock (HR 1.05, 95% CI 0.21-5.22; P = 0.95), or stent thrombosis (HR 1.27, 95% CI 0.46-3.51; P = 0.64). The primary composite endpoint was consistent across all subgroups, as well as at different time points, such as during hospital stay, at 30 days and the total duration of follow-up up to 1356 days.Conclusions: Routine use of supplemental oxygen in normoxemic patients with STEMI undergoing primary PCI did not significantly affect 1-year all-cause death, rehospitalization with MI, cardiogenic shock, or stent thrombosis.
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| 10. |
- Hofmann, Robin, et al.
(författare)
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Oxygen therapy in suspected acute myocardial infarction
- 2017
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Ingår i: New England Journal of Medicine. - : MASSACHUSETTS MEDICAL SOC. - 0028-4793 .- 1533-4406. ; 377:13, s. 1240-1249
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The clinical effect of routine oxygen therapy in patients with suspected acute myocardial infarction who do not have hypoxemia at baseline is uncertain. METHODS: In this registry-based randomized clinical trial, we used nationwide Swedish registries for patient enrollment and data collection. Patients with suspected myocardial infarction and an oxygen saturation of 90% or higher were randomly assigned to receive either supplemental oxygen (6 liters per minute for 6 to 12 hours, delivered through an open face mask) or ambient air. RESULTS: A total of 6629 patients were enrolled. The median duration of oxygen therapy was 11.6 hours, and the median oxygen saturation at the end of the treatment period was 99% among patients assigned to oxygen and 97% among patients assigned to ambient air. Hypoxemia developed in 62 patients (1.9%) in the oxygen group, as compared with 254 patients (7.7%) in the ambient-air group. The median of the highest troponin level during hospitalization was 946.5 ng per liter in the oxygen group and 983.0 ng per liter in the ambient-air group. The primary end point of death from any cause within 1 year after randomization occurred in 5.0% of patients (166 of 3311) assigned to oxygen and in 5.1% of patients (168 of 3318) assigned to ambient air (hazard ratio, 0.97; 95% confidence interval [CI], 0.79 to 1.21; P=0.80). Rehospitalization with myocardial infarction within 1 year occurred in 126 patients (3.8%) assigned to oxygen and in 111 patients (3.3%) assigned to ambient air (hazard ratio, 1.13; 95% CI, 0.88 to 1.46; P=0.33). The results were consistent across all predefined subgroups. CONCLUSIONS: Routine use of supplemental oxygen in patients with suspected myocardial infarction who did not have hypoxemia was not found to reduce 1-year all-cause mortality. (Funded by the Swedish Heart–Lung Foundation and others; DETO2X-AMI ClinicalTrials.gov number, NCT01787110.)
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