| 1. |
- Andersson Hagiwara, Magnus, et al.
(författare)
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Adverse events in prehospital emergency care: A trigger tool study
- 2019
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Ingår i: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prehospital emergency care has developed rapidly during the past decades. The care is given in a complex context which makes prehospital care a potential high-risk activity when it comes to patient safety. Patient safety in the prehospital setting has been only sparsely investigated. The aims of the present study were 1) To investigate the incidence of adverse events (AEs) in prehospital care and 2) To investigate the factors contributing to AEs in prehospital care. Methods: We used a retrospective study design where 30 randomly selected prehospital medical records were screened for AEs each month in three prehospital organizations in Sweden during a period of one year. A total of 1080 prehospital medical records were included. The record review was based on the use of 11 screening criteria. Results: The reviewers identified 46 AEs in 46 of 1080 (4.3%) prehospital medical records. Of the 46 AEs, 43 were classified as potential for harm (AE1) (4.0, 95% CI = 2.9-5.4) and three as harm identified (AE2) (0.3, 95% CI = 0.1-0.9). However, among patients with a life-threatening condition (priority 1), the risk of AE was higher (16.5%). The most common factors contributing to AEs were deviations from standard of care and missing, incomplete, or unclear documentation. The most common cause of AEs was the result of action(s) or inaction(s) by the emergency medical service (EMS) crew. Conclusions: There were 4.3 AEs per 100 ambulance missions in Swedish prehospital care. The majority of AEs originated from deviations from standard of care and incomplete documentation. There was an increase in the risk of AE among patients who the EMS team assessed as having a life-threatening condition. Most AEs were possible to avoid. © 2019 The Author(s).
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| 2. |
- Andersson Hagiwara, Magnus, et al.
(författare)
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Patient safety and patient assessment in pre-hospital care: a study protocol
- 2016
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 24:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient safety issues in pre-hospital care are poorly investigated. The aim of the planned study is tosurvey patient safety problems in pre-hospital care in Sweden.Methods/Design: The study is a retro-perspective structured medical record review based on the use of 11 screeningcriteria. Two instruments for structured medical record review are used: a trigger tool instrument designed forpre-hospital care and a newly development instrument designed to compare the pre-hospital assessment withthe final hospital assessment. Three different ambulance organisations are participating in the study. Every month,one rater in each organisation randomly collects 30 medical records for review. With guidance from the reviewinstrument, he/she independently reviews the record. Every month, the review team meet for a discussion ofproblematic reviews. The results will be analysed with descriptive statistics and logistic regression.Discussion: The findings will make an important contribution to knowledge about patient safety issues in prehospitalcare.
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| 3. |
- Comasco, Erika, et al.
(författare)
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Adolescent alcohol consumption : Biomarkers PEth and FAEE in relation to interview and questionnaire data
- 2009
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Ingår i: Journal of Studies on Alcohol and Drugs. - : ALCOHOL RES DOCUMENTATION INC CENT ALCOHOL STUD RUTGERS UNIV. - 1937-1888 .- 1938-4114. ; 70:5, s. 797-804
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE The aim of this study was to investigate the congruence of biomarkers, questionnaires, and interviews as instruments to assess adolescent alcohol consumption. METHOD The methodology used was a cross-sectional study with a randomized sample. Four different methods were used to estimate high adolescent alcohol consumption. The concordance of the results was investigated. Surveys were performed, and biological specimens were collected at all schools in the county of Västmanland, Sweden, in 2001. Eighty-one boys and 119 girls from a population of 16- and 19-year-old adolescents were randomly selected from quartiles of volunteers representing various degrees of psychosocial risk behaviors. Using a questionnaire (for a 1-hour session) and in-depth interviews, subjects were assessed regarding their alcohol-use habits. Blood and hair samples were analyzed for phosphatidylethanol (PEth) and fatty acid ethyl esters (FAEEs), respectively. RESULTS High alcohol consumption was underreported in the questionnaire compared with the interviews. PEth and FAEE analyses weakly confirmed the self-reports, and the results of the two biochemical tests did not overlap. The PEth blood test was the most specific but the least sensitive, whereas the FAEE hair test revealed low specificity and an overrepresentation of positive results in girls. CONCLUSIONS The expected higher self-report of high alcohol consumption by interview rather than by questionnaire was confirmed partly because of the influence of a bogus pipeline procedure. The absence of overlap between PEth and FAEE results and their poor agreement with self-reports suggested that biomarkers are unsuitable as screening tools for alcohol consumption in adolescents.
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| 4. |
- Nilsson, Emma, et al.
(författare)
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Vehicle Driver Monitoring : sleepiness and cognitive load
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- To prevent road crashes, it is important to understand driver related contributing factors. The overall aim of the Vehicle Driver Monitoring project was to advance the understanding of two such factors; sleepiness and cognitive distraction. The project aimed at finding methods to measure the two states, with focus on physiological measures, and to study their effect on driver behaviour. The data collection was done in several laboratory and driving simulator experiments. Much new knowledge and insights were gained in the project. Significant effects of cognitive load as well as of sleepiness were found in several physiological measures. The results also showed that context, including individual and environmental factors, has a great impact on driver behaviours, measures and driver experiences.
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| 5. |
- Nilsson, K, et al.
(författare)
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Demonstration of intracellular microorganisms (Rickettsia spp., Chlamydia pneumoniae, Bartonella spp.) in
- 2005
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Ingår i: Journal of Infection. - : Elsevier BV. - 0163-4453 .- 1532-2742. ; 50:(1):, s. 46-52.
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Rickettsiae, which causes vasculitis, has not been linked to atherosclerotic cardiovascular disease in contrast to Chlamydia pneumoniae whose association with coronary artery disease and with sclerotic heart valves in patients undergoing aortic valve replacement is well established, even if causality is yet to unproven. In the search for any of these infectious agents, 84 pathological and 15 normal aortic heart valves of patients undergoing forensic autopsy were analysed by PCR and DNA-sequencing. Methods. Two to four pieces of all valves were examined by semi-nested PCR, with primers specific for 16S rDNA, citrate synthase (gltA) and 17 kDa outer membrane protein (OMP) genes. Results. Genetic material from Rickettsia spp. and C. pneumoniae was found in 17 (20.2%) and 22 (26.2%), respectively, of the 84 pathological aortic valves. In 35 (41.7%) of these 84 valves either C. pneumoniae or Rickettsia spp. were detected by PCR and in six cases (7.1%) these two organisms co-existed. In one case with Lambl's excrescences, previously considered as aseptic, presence of rickettsia-like organisms also was demonstrated by light microscopy, immunohistochemistry and sequencing of the amplified PCR product showing 100% homology with the published sequence for R. helvetica. In three of the 15 control valves, genetic material from only C. pneumoniae was detected compared to Rickettsia spp. that was significantly detected only in the pathological valves (Fisher's Exact test, 1-sided p = 0.046). Conclusions. The findings suggest that Rickettsia spp. also have a rote in the pathogenesis of aortic valve disease.
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