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- Herlitz, Johan, et al.
(författare)
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Suspicion and treatment of severe sepsis. An overview of the prehospital chain of care.
- 2012
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - BioMed Central Ltd.. - 1757-7241. ; 20:42
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Tidskriftsartikel (refereegranskat)abstract
- Background Sepsis is a life-threatening condition where the risk of death has been reported to be even higher than that associated with the major complications of atherosclerosis, i.e. myocardial infarction and stroke. In all three conditions, early treatment could limit organ dysfunction and thereby improve the prognosis. Aim To describe what has been published in the literature a/ with regard to the association between delay until start of treatment and outcome in sepsis with the emphasis on the pre-hospital phase and b/ to present published data and the opportunity to improve various links in the pre-hospital chain of care in sepsis. Methods A literature search was performed on the PubMed, Embase (Ovid SP) and Cochrane Library databases. Results In overall terms, we found a small number of articles (n=12 of 1,162 unique hits) which addressed the prehospital phase. For each hour of delay until the start of antibiotics, the prognosis appeared to become worse. However, there was no evidence that prehospital treatment improved the prognosis. Studies indicated that about half of the patients with severe sepsis used the emergency medical service (EMS) for transport to hospital. Patients who used the EMS experienced a shorter delay to treatment with antibiotics and the start of early goal-directed therapy (EGDT). Among EMS-transported patients, those in whom the EMS staff already suspected sepsis at the scene had a shorter delay to treatment with antibiotics and the start of EGDT. There are insufficient data on other links in the prehospital chain of care, i.e. patients, bystanders and dispatchers. Conclusion Severe sepsis is a life-threatening condition. Previous studies suggest that, with every hour of delay until the start of antibiotics, the prognosis deteriorates. About half of the patients use the EMS. We need to know more about the present situation with regard to the different links in the prehospital chain of care in sepsis.
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| 4. |
- Allwood, Carl Martin, et al.
(författare)
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Child witnesses’ metamemory realism
- 2006
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Ingår i: Scandinavian Journal of Psychology. - Blackwell Publishing. - 1467-9450 .- 0036-5564. ; 47:6, s. 461-470
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the degree of realism in the confidence judgments of 11 to 12-year-olds (41 girls and 40 boys) of their answers to questions relating to a short film clip showing a kidnapping event. Four different confidence scales were used: a numeric scale, a picture scale, a line scale and a written scale. The results demonstrated that the children showed a high level of overconfidence in their memories. However, no significant differences between the four confidence scales were found. Weak gender differences were found in that the girls were slightly, but significantly, better calibrated than the boys. In addition, although both boys and girls overestimated the total number of memory questions they had answered correctly, the boys gave higher estimates compared with the girls. In brief, the results indicate that, at least in the context investigated, 11-12 year-old children's confidence in and estimations of their own event memory show poor realism (overconfidence and overestimation). A comparison with previous research on adults indicates that 11 to 12-year-old children show noticeably poorer realism.
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| 5. |
- Allwood, Carl Martin, et al.
(författare)
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Does mood influence the realism of confidence judgments?
- 2002
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Ingår i: Scandinavian Journal of Psychology. - 0036-5564. ; 43:3, s. 253-260
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Tidskriftsartikel (refereegranskat)abstract
- In this study we investigated how mood influences the degree of realism in participants’ confidence judgments (based on an episodic memory task). Using music and film in combination, we successfully induced half of the participants into an elated mood, but failed to induce a sad mood in the other half. Contrary to our prediction, our data indicated that there was no difference in the realism of the confidence between the conditions. When relating this result to previous research our conclusion is that there is no, or very little, influence of mood of moderate intensity on the realism of confidence judgments.
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| 6. |
- Allwood, Carl-Martin, et al.
(författare)
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The Cognitive Interview and its effect on witnesses' confidence
- 2004
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Ingår i: Psychology, Crime & Law. - Taylor and Francis Ltd. - 1068-316X. ; 10:1, s. 37-52
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Tidskriftsartikel (refereegranskat)abstract
- Today there is ample evidence that the Cognitive Interview (CI) enhances witnesses' memory. However, less is known about how the CI affects eyewitnesses' confidence. To address this shortcoming we conducted a study analyzing how realism in confidence was affected by the CI. All participants (n = 79) were first shown a filmed kidnapping. After 2 weeks we interviewed one-third of the participants according to the guidelines of the CI, one-third according to a Standard Interview (SI), and one-third were not interviewed at all (Control condition). Participants in all three conditions were then asked to answer 45 forced-choice questions, and to give a confidence judgment after each choice. For the 45 questions, no differences in accuracy were found between the three conditions. Confidence was higher in the CI and SI conditions, compared with the Control condition. CI and SI did not differ in metacognitive realism but both showed lower realism compared with the Control condition, although only CI significantly so. The results indicate that the inflation in confidence is more likely to be explained in terms of a reiteration effect, than as a consequence of the particular mnemonics characterizing the CI (e.g. "mental reinstatement of context"). In sum, CI does not seem to impair (or improve) the realism in witnesses' confidence, and does not inflate confidence in erroneous recall, compared to a SI.
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| 7. |
- Allwood, Carl Martin, et al.
(författare)
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The effects of source and type of feedback on child witnesses' metamemory accuracy
- 2005
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Ingår i: Applied Cognitive Psychology. - 0888-4080. ; 19:3, s. 331-344
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated the effect of feedback on the accuracy (realism) of 12-year-old children’s metacognitive judgments of their answers to questions about a film clip. Two types of judgments were investigated: confidence judgments (on each question) and frequency judgments (i.e., estimates of overall accuracy). The source of feedback, whether it was presented as provided by a teacher or a peer child, did not influence metacognitive accuracy. Four types of feedback were given depending on whether the participant’s answer was correct and depending on whether the feedback confirmed or disconfirmed the child’s answer. The children showed large overconfidence when they received confirmatory feedback but much less so when they received disconfirmatory feedback. The children gave frequency judgments implying that they had more correct questions than they actually had. No main gender differences were found for any of the measures. The results indicate a high degree of malleability in children’s metacognitive judgments.
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| 8. |
- Fortes Lähdet, E., et al.
(författare)
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Analysis of Triage Worldwide
- 2009
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Ingår i: Emergency Nurse. - RCN Publishing Co.. - 1354-5752. ; 17:4, s. 16-19
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Tidskriftsartikel (refereegranskat)abstract
- Several triage methods have been developed and adopted around the world but none has been devised for specific patient populations such as older people or those with special needs. This literature review outlines the development of triage since the 1950s, briefly discusses some of the models in use around the world, including one that is used in the care of older people, and outlines the issues that should be taken into account when deciding which method to adopt.
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| 9. |
- Hagiwara, Magnus, et al.
(författare)
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Decision Support Tool in Prehospital Care : A systematic Review of Randomized Trials
- 2011
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Ingår i: Prehospital and Disaster Medicine. - 1049-023X. ; 26:5, s. 319-329
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient.Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials.Results: Use of the DST in prehospital care may have the possibility to decrease “time to definitive care” and improve diagnostic accuracy among prehospital personnel, but more studies are needed.Conclusions: The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care.
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