| 1. |
- Nilsson, Stefan, 1972, et al.
(författare)
-
Evaluating pictorial support in person-centred care for children (PicPecc) : A protocol for a crossover design study
- 2021
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 11:5
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction This study protocol outlines the evaluation of the pictorial support in person-centred care for children (PicPecc). PicPecc is a digital tool used by children aged 5-17 years to self-report symptoms of acute lymphoblastic leukaemia, who undergo high-dose methotrexate treatments. The design of the digital platform follows the principles of universal design using pictorial support to provide accessibility for all children regardless of communication or language challenges and thus facilitating international comparison.Methods and analysis Both effect and process evaluations will be conducted. A crossover design will be used to measure the effect/outcome, and a mixed-methods design will be used to measure the process/implementation. The primary outcome in the effect evaluation will be self-reported distress. Secondary outcomes will be stress levels monitored via neuropeptides, neurosteroids and peripheral steroids indicated in plasma blood samples; frequency of in-app estimation of high levels of distress by the children; children's use of analgesic medicine and person centeredness evaluated via the questionnaire Visual CARE Measure. For the process evaluation, qualitative interviews will be carried out with children with cancer, their legal guardians and case-related healthcare professionals. These interviews will address experiences with PicPecc in terms of feasibility and frequency of use from the child's perspective and value to the caseworker. Interview transcripts will be analysed using an interpretive description methodology.Ethics and dissemination Ethical approval was obtained from the Swedish Ethical Review Authority (reference 2019-02392; 2020-02601; 2020-06226). Children, legal guardians, healthcare professionals, policymaking and research stakeholders will be involved in all stages of the research process according to Medical Research Council's guidelines. Research findings will be presented at international cancer and paediatric conferences and published in scientific journals.Trial registration ClinicalTrials.gov; NCT04433650.
|
|
| 2. |
|
|
| 3. |
- Blohm, M, et al.
(författare)
-
Reaction to a media campaign focusing on delay in acute myocardial infarction
- 1991
-
Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 20:6, s. 661-666
-
Tidskriftsartikel (refereegranskat)abstract
- A media campaign conducted to reduce delay time and to increase the use of ambulance transport in acute myocardial infarction was performed in an urban area with about half a million inhabitants during 1 year. The main message was that chest pain lasting more than 15 minutes might indicate acute myocardial infarction; dial 90,000 immediately for ambulance transport to the hospital. The target population was the general public. After 6 and 12 months 400 and 610 randomly chosen persons, respectively, were contacted by telephone to evaluate the reaction of the general public to the campaign. Of these, 60% and 71%, respectively, had heard of the campaign, and all parts of the message were spontaneously remembered by 15% and 19%, respectively. The reaction to the campaign was generally positive. Among all patients admitted to the coronary care unit of one of the two city hospitals, 65% were aware of the campaign and 31% of them were of the opinion that they came to the hospital faster because of the campaign. In conclusion, a media campaign aimed at reducing patient delay time in acute myocardial infarction was shown to reach a majority of people in the community and patients with ischemic heart disease. The reaction was positive and about one fifth of interviewed people spontaneously remembered the total message.
|
|
| 4. |
- Feuk-Lagerstedt, E, et al.
(författare)
-
Lipid raft protecome of the human neutrophil azurophil granule.
- 2007
-
Ingår i: Proteomics. - : Wiley - VCH Verlag GmbH & Co. KGaA. - 1615-9853 .- 1615-9861. ; 7:2, s. 194-205
-
Tidskriftsartikel (refereegranskat)abstract
- Detergent-resistant membrane domains (DRMs) are present in the membranes of azurophil granules in human neutrophils (Feuk-Lagerstedt et al., J. Leukoc. Biol. 2002, 72, 970). Using a proteomic approach, we have now identified 106 proteins in a DRM preparation from these granule membranes. Among these proteins were the lipid raft structural proteins flotillin-1 and -2, cytoskeletal proteins such as actin, vimentin and tubulin, and membrane fusion promoting proteins like annexins and dysferlin. Our results suggest that the azurophil granule membrane, in similarity to the plasma membrane, is an elaborate structure that takes part in intracellular signaling and functions other than the mere delivery of bactericidal effector molecules to the phagosome.
|
|
| 5. |
- Hartford, Marianne, 1944, et al.
(författare)
-
CRP, interleukin-6, secretory phospholipase A(2) group IIA, and intercellular adhesion molecule-1 during the early phase of acute coronary syndromes and long-term follow-up
- 2006
-
Ingår i: Int J Cardiol. - : Elsevier Ireland Ltd. ; 108:1, s. 55-62
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The objectives of this study were to examine the time course of the inflammatory response in acute coronary syndromes (ACS) and to assess the markers of inflammation and their relation to disease severity. METHODS: We prospectively studied 134 patients with ACS who survived for at least 30 months. The patients were divided into four groups: acute myocardial infarction (MI) with (n=54) or without (n=46) ST-segment elevation and unstable angina with (n=14) or without (n=20) increased risk. Plasma levels of C-reactive protein (CRP), interleukin-6 (IL-6), secretory phospholipase A(2) group IIA (sPLA(2)-IIA), and intercellular adhesion molecule-1 (ICAM-1) were measured on days 1 and 4 and after 3 and 30 months. RESULTS: The highest levels of CRP and sPLA(2)-IIA were seen on day 4 but for IL-6 on day 1. These three markers, but not ICAM-1, were significantly related to disease severity, CKMB, and ejection fraction. Patients in Killip class II-IV had higher levels than those in Killip class I. The individual acute-phase responses correlated with marker levels at 3 and 30 months. ICAM-1 correlated with the development of congestive heart failure. CONCLUSIONS: In ACS there seems to be an individual predisposition to inflammatory response. Plasma IL-6 is the first marker to rise, while sPLA(2)-IIA and CRP peak later. All three markers, especially CRP, may discriminate between MI and non-MI. ICAM-1 seems to reflect other aspects of the inflammatory processes than the other markers. The results emphasize the complexity of the inflammatory response in ACS and stress the need for further studies involving multiple markers.
|
|
| 6. |
- Herlitz, Johan, et al.
(författare)
-
A description of the characteristics and outcome of patients hospitalized for acute chest pain in relation to whether they were admitted to the coronary care unit or not in the thrombolytic era
- 2002
-
Ingår i: International Journal of Cardiology. - : Elsevier Ireland Ltd. - 0167-5273 .- 1874-1754. ; 82:3, s. 279-287
-
Tidskriftsartikel (refereegranskat)abstract
- bjectives: To describe the characteristics and outcome of patients hospitalized for acute chest pain in relation to whether they were admitted to the coronary care unit (CCU) or not. Design: Prospective observational study with a follow-up of 2 years. Setting: Sahlgrenska University Hospital in Göteborg, Sweden. Subjects: All patients hospitalized due to acute chest pain during 6 months. Main outcome measures: Mortality, use of medical resources, complications and previous history. Results: In all 1.592 patients were admitted to hospital for chest pain, of whom 1.136 (71%) were not directly admitted to the CCU. These patients differed from those directly admitted to the CCU, being older, including more women, having a higher prevalence of known congestive heart failure and a lower degree of initial suspicion of acute myocardial infarction (AMI). Among all patients with confirmed AMI only 58% were directly admitted to CCU. Overall, the occurrence of complications and the use of medical resources were less frequent in the patients not admitted to the CCU. The mortality during the subsequent 2 years was 16.8% for patients not admitted to the CCU and 18.5% for patients admitted to the CCU. When adjusting for various factors at baseline, patients admitted to the CCU had a relative risk of death during 2 years of follow-up being 1.23 0.87–1.73 (P=0.24) as compared with those not admitted to the CCU. Conclusion: In a Swedish university hospital, more than two thirds of patients hospitalized for acute chest pain were not directly admitted to the CCU. They differed from those admitted to the CCU in several aspects. However, their unadjusted and adjusted mortality during the subsequent 2 years did not significantly differ from those admitted to CCU.
|
|
| 7. |
- Karlson, BW, et al.
(författare)
-
Long-term morbidity in patients with acute chest pain. A comparison between a city university hospital and a county hospital.
- 2003
-
Ingår i: Acta Cardiologica. - : La Societe Belge de Cardiologie. - 0001-5385 .- 1784-973X. ; 58:5, s. 397-402
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare long-term morbidity after hospital discharge in patients admitted to the emergency department with acute chest pain in a city university hospital and a county hospital. METHODS: Patients with acute chest pain admitted to the emergency department due to acute chest pain at Sahlgrenska University Hospital in Göteborg, Sweden, and at Uddevalla County Hospital in Uddevalla, Sweden, between October 21, 1996, and April 30, 1997, were retrospectively followed for 30 months. RESULTS: The mortality during the subsequent 30 months was similar in the two cohorts (16% in the city university hospital and 15% in the county hospital, respectively). In the city university hospital 1575 patients and in the county hospital 715 patients took part in the evaluation of survivors. Coronary angiography was performed less frequently in patients in the city hospital (14% versus 20%; p = 0.002) but there was no difference with regard to development of myocardial infarction (6% versus 7%), stroke (2% in both cohorts) or requirement of percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG) after hospital discharge. The proportion of patients who were rehospitalized did not differ, but the mean number of days in hospital per patient and per hospitalized patient was higher in the county hospital (10.2 +/- 17.2 versus 6.7 +/- 13.7 (p = 0.0003) and 17.3 +/- 19.5 versus 13.2 +/- 16.8 (p = 0.003), respectively). P-values were adjusted for differences in the patient's characteristics. The proportion of patients rehospitalized due to stable angina pectoris, cardiac arrhythmias and heart investigation was higher in the county hospital. CONCLUSION: In chest pain patients admitted to a city university hospital and a county hospital morbidity differences were found after hospital discharge indicating a higher requirement of rehospitalization for various cardiac reasons and a higher use of coronary angiography in the county hospital after discharge from hospital. The mechanisms behind this observation are not clear at present.
|
|
| 8. |
- Karlson, BW, et al.
(författare)
-
Subjective symptoms and well-being 30 months after acute chest pain in a county hospital and a city university hospital in Sweden.
- 2003
-
Ingår i: Acta Cardiologica. - : La Societe Belge de Cardiologie. - 0001-5385 .- 1784-973X. ; 58:6, s. 547-553
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To compare various health-related aspects of quality of life during long-term follow-up after admission to hospital due to acute chest pain in a city university hospital and a county hospital. METHODS: This was a retrospective survey of all chest pain patients > or = 30 years of age at the Sahlgrenska University Hospital, Göteborg, covering an area with 706 inhabitants per km2 and at Uddevalla County Hospital, Uddevalla, covering an area with 34 inhabitants per km2 over a period of six months. After 30 months all patients alive were approached with a questionnaire in which they were asked about various aspects of health-related quality of life and use of medication. RESULTS: In all, 1,813 patients in the city hospital and 804 patients in the county hospital took part in the survey. The mortality and the overall proportion of patients requiring rehospitalization was similar in the two cohorts. Thirty months after onset of symptoms there was a difference between the two study populations. Patients in the county hospital smoked less frequently (p = 0.004). They tended to have less problems with chest pain at rest (p < 0.05) and dyspnoea at slight physical exercise (p = 0.01). Furthermore, they had less emotional symptoms (p = 0.003) and their state of health caused fewer problems when doing housekeeping (p = 0.008). Differences with regard to emotional symptoms and problems when doing housekeeping were particularly observed among women, whereas smoking habits differed only among men. CONCLUSION: When comparing patients admitted to hospital with acute chest pain in a city university hospital and a county hospital after 30 months some differences appeared. Patients in the county hospital appeared to suffer from less symptoms than patients in the city hospital. This was particularly observed among women. The mechanisms behind these observations are not clear.
|
|
| 9. |
- Karlson, BW, et al.
(författare)
-
Use of medical resources complications and long-term outcome in patients hospitalized with acute chest pain. A comparison between a city university hospital and a county hospital
- 2002
-
Ingår i: International Journal of Cardiology. - : Elsevier Ireland Ltd. - 0167-5273 .- 1874-1754. ; 85:2-3, s. 229-238
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: The primary aim was to test the hypothesis that there is a difference in long-term outcome after hospital discharge among patients hospitalized with acute chest pain in a university hospital and a county hospital. Secondary aims were to compare these two hospitals with regard to use of medical resources, occurrence of complications and risk indicators for death. Patients: All patients hospitalized at Sahlgrenska University Hospital in Göteborg (with a catchment population of 706 inhabitants/km2) and Uddevalla County Hospital (with a catchment population of 34 inhabitants/km2) due to symptoms of acute chest pain during a period of 6 months. Results: Complications, use of medical resources and mortality during the subsequent 2 years after discharge were compared among 1592 hospitalizations in a city hospital and 822 in a county hospital due to acute chest pain. Angina pectoris after the first event, congestive heart failure and various arrhythmias were more frequently reported in the county hospital. The use of medical resources differed. Thus, the use of betablockers, heparin, antiarrhythmics, diuretics and nipride was more frequent in the county hospital, whereas the use of nitrates, digitalis, coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) was more frequent in the city hospital. Despite these differences, the mortality 2 years after hospital discharge was similar (14.7% in the city hospital and 12.8% in the county hospital, P=0.26). Two factors, intravenous digitalis in hospital and a prescription of insulin at discharge, were significantly more associated with death in the county hospital compared with the city hospital. Conclusions: When comparing a city university hospital with a county hospital with regard to patients admitted with chest pain, major differences in terms of complications and use of medical resources were found. Thus, various complications were reported more frequently in the county hospital. The use of medical resources varied, some being used more frequently in the county hospital, whereas others were used more frequently in the university hospital. Despite these differences the mortality 2 years after hospital discharge was similar in the two cohorts.
|
|
| 10. |
- Karlson, Björn W., 1953, et al.
(författare)
-
Patients admitted to the emergency department with acute chest pain--is there a difference between patients in an urban and a rural area?
- 2000
-
Ingår i: European journal of emergency medicine : official journal of the European Society for Emergency Medicine. - : European Journal of Emergency Medicine. - 0969-9546 .- 1473-5695. ; 7:4, s. 277-86
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the characteristics and outcome for patients coming to the emergency department with acute chest pain in a city university hospital, representing an urban area, and a county hospital, representing a rural area. This was a retrospective survey of all chest pain patients at Sahlgrenska University Hospital, Göteborg, covering an area with 706 inhabitants/km2, and at Uddevalla County Hospital, Uddevalla, covering an area with 34 inhabitants/km2, over a period of 6 months. In all 2,297 patients were registered at Sahlgrenska University Hospital and 1062 at Uddevalla Hospital (per 100,000 inhabitants and year 1,502 and 1,342 patients, respectively). The patients in the urban area were more frequently sent home from the emergency department than in the rural area (30% versus 23%; p < 0.0001). Patients in the urban area had a lower prevalence of previous cardiovascular diseases. An obvious acute myocardial infarction (AMI) or a strong suspicion of AMI at initial evaluation was less frequent in the urban area whereas no suspicion of AMI was twice as common (46% versus 24%; p < 0.0001). Furthermore, there was a difference in the use of medications; various cardiovascular drugs were more frequently used in the rural area. Despite these differences at baseline the 30-day mortality was similar (3.5% in the urban area and 3.6% in the rural area; NS), as well as the 2-year mortality (14.0% and 12.7%, respectively; NS). It is concluded that the number of patients admitted to the emergency department with acute chest pain/100,000 was slightly higher in the urban than in the rural area. Patients in the urban area differed from those in the rural area having a lower prevalence of previous cardiovascular diseases, a lower initial suspicion of AMI, they were less frequently hospitalized and less frequently prescribed various cardiovascular drugs. Mortality did not differ between the two cohorts.
|
|
