| 1. |
- Acosta, Stefan, et al.
(författare)
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Engaging patients and caregivers in establishing research priorities for aortic dissection
- 2019
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Ingår i: SAGE Open Medicine. - : Sage Publications. - 2050-3121. ; 7, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to establish the top 10 research uncertainties in aortic dissection together with the patient organization Aortic Dissection Association Scandinavia using the James Lind Alliance concept. Methods: A pilot survey aiming to identify uncertainties sent to 12 patients was found to have high content validity (scale content validity index = 0.91). An online version of the survey was thereafter sent to 30 patients in Aortic Dissection Association Scandinavia and 45 caregivers in the field of aortic dissection. Research uncertainties of aortic dissection were gathered, collated and processed. Results: Together with research priorities retrieved from five different current guidelines, 94 uncertainties were expressed. A shortlist of 24 uncertainties remained after processing for the final workshop. After the priority-setting process, using facilitated group format technique, the ranked final top 10 research uncertainties included diagnostic tests for aortic dissection; patient information and care continuity; quality of life; endovascular and medical treatment; surgical complications; rehabilitation; psychological consequences; self-care; and how to improve prognosis. Conclusion: These ranked top 10 important research priorities may be used to justify specific research in aortic dissection and to inform healthcare research funding decisions.
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| 2. |
- Ayala, Marcelo, 1965
(författare)
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No effects of mitomycin-C in primary trabeculectomies in Sweden
- 2018
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Ingår i: Sage Open Medicine. - : SAGE Publications. - 2050-3121. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To evaluate the results of a long-term follow-up after two different types of surgical techniques: trabeculectomy with or without mitomycin-C. Materials and methods: This study is a retrospective chart review of patients operated on with a primary trabeculectomy at the Eye Department of the Skaraborg Hospital, Skovde, Sweden. Complete success was defined as intraocular pressure 18mmHg (criterion 1) or intraocular pressure reduction 30% (criterion 2) without eye drops postoperatively. Qualified success was defined using the same criteria (1 and 2), but patients were treated or untreated with eye-drops. Results: A total of 167 patients were included in this retrospective study, 83 patients in the no-mitomycin-C group and 84 patients in the mitomycin-C-treated group. No significant difference was found in intraocular pressure reduction between the mitomycin-C and no-mitomycin-C group (t-test; p=0.19). Complete success using criterion 1 was 66.2% in no-mitomycin-C and 62.8% in mitomycin-C (p=0.88); success using criterion 2 was 76.6% in the no-mitomycin-C and 64.2% in the mitomycin-C group (p=0.21). Qualified success using criterion 1 was 71.4% in the no-mitomycin-C and 74.4% in the mitomycin-C group (p=0.84); success using criterion 2 was 80.0% in the no-mitomycin-C and 84.4% in the mitomycin-C group. All included patients were born in Sweden. Conclusion: Mitomycin-C seems to add no benefits to intraocular pressure reduction after primary trabeculectomies in a Swedish population.
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| 3. |
- Benkel, Inger, et al.
(författare)
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Challenging conversations with terminally ill patients and their loved ones: Strategies to improve giving information in palliative care
- 2014
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 2:2050312114532456
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to explore the skills and strategies employed by professionals when having difficult conversations to provide information to loved ones as part of palliative care. Method: A qualitative design was chosen with in-depth interviews with nurses, assistant nurses and doctors a Hospital in Sweden and were analysed using content analysis. Results: The interviews produced examples of strategies used by professionals when imparting difficult information to patient and loved ones. The results fell into three areas: ‘Who is giving information’, ‘Structuring the conversation’ and ‘Different ways to convey a difficult message’. Conclusion: Using conversational skills and strategies in combination with a carefully planned structure appeared to facilitate difficult conversations with patients and loved ones. Further research is required, related to the specific circumstances in which the conversation takes place.
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| 4. |
- Benkel, Inger, et al.
(författare)
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Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situation
- 2020
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Ingår i: Sage Open Medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Chronic diseases have an impact on and change patient's lives which means that they need to find ways to cope with the new situation. The aim was to describe how the chronic disease has influenced patients' views of their life situation. Methods: The study was quantitative in design with data collected using a semi-structured questionnaire. Descriptive statistics were used to compare similarities and differences between patients with asthma-allergy, diabetes mellitus, cancer and inflammatory rheumatoid arthritis. Results: Changes in their life were experienced as a negative outcome for the majority of participants. Support can be in the form of interpersonal support from various persons, but also from activities and beliefs/religion. Family and friends as well as healthcare professionals were identified as being most supportive. Sadness and worry were the most common emotions among the participants and their surrounding networks. Conclusion: People with a chronic disease have to live with the consequences the disease has for their life situation. They need to find strategies to cope with the negative outcome in their new life. Support from their own network and healthcare professionals can be helpful in the new life situation.
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| 5. |
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| 6. |
- Bjorvatn, Afsaneh, et al.
(författare)
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Law and medical practice: A comparative vignette survey of cardiologists in Norway and Denmark
- 2020
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- This article explores the implications of legal regulation for medical discretion and decision-making in Norway and Denmark. Methods: The article is based on a cross-national cross-sectional survey exploring cardiologists’ assessments of patient eligibility for specialist health care. Forty-two cardiologists in Norway and 48 in Denmark were presented with two standardized case vignettes in the form of patient referrals and were asked to assess whether the patient was eligible for treatment by a specialist, and if so, what waiting time would be assigned to the patient. Results: Primarily based on descriptive statistics, our findings indicate interesting similarities and variations. While there was only minor variation across the countries in cardiologists’ professional assessments about a patient with a more severe condition, judgements of eligibility for specialist treatment varied for a patient with a less severe medical condition. Moreover, Danish cardiologists distinguished between the more severe and less severe conditions to a much lesser extent when assessing eligibility for specialist treatment. For waiting times, there was considerable variation at the general level, from 1 week to 6 months. The assigned waiting times were on average double those for Norwegian cardiologists compared with their Danish counterparts. Denmark’s legal standardization of waiting times appears to lead to shorter waiting times than those prescribed by Norway’s legal regulations. Conclusion: For a single clear overall intention with a new policy, simpler legal regulations may be more effective than very detailed and specific requirements. If policymakers’ overall intention is for medical doctors to make complex decisions involving the prioritization of patients, then more individualized regulations seem to be a better tool.
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| 7. |
- Boman, Åse, 1957-, et al.
(författare)
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Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background
- 2017
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Ingår i: Sage Open medicine. - : SAGE Publications. - 2050-3121 .- 2050-3121. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.
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| 8. |
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| 9. |
- Chi, PC, et al.
(författare)
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The evolving role of traditional birth attendants in maternal health in post-conflict Africa: A qualitative study of Burundi and northern Uganda
- 2018
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 6, s. 2050312117753631-
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Tidskriftsartikel (refereegranskat)abstract
- Many conflict-affected countries are faced with an acute shortage of health care providers, including skilled birth attendants. As such, during conflicts traditional birth attendants have become the first point of call for many pregnant women, assisting them during pregnancy, labour and birth, and in the postpartum period. This study seeks to explore how the role of traditional birth attendants in maternal health, especially childbirth, has evolved in two post-conflict settings in sub-Saharan Africa (Burundi and northern Uganda) spanning the period of active warfare to the post-conflict era. Methods: A total of 63 individual semi-structured in-depth interviews and 8 focus group discussions were held with women of reproductive age, local health care providers and staff of non-governmental organisations working in the domain of maternal health who experienced the conflict, across urban, semi-urban and rural settings in Burundi and northern Uganda. Discussions focused on the role played by traditional birth attendants in maternal health, especially childbirth during the conflict and how the role has evolved in the post-conflict era. Transcripts from the interviews and focus group discussions were analysed by thematic analysis (framework approach). Results: Traditional birth attendants played a major role in childbirth-related activities in both Burundi and northern Uganda during the conflict, with some receiving training and delivery kits from the local health systems and non-governmental organisations to undertake deliveries. Following the end of the conflict, traditional birth attendants have been prohibited by the government from undertaking deliveries in both Burundi and northern Uganda. In Burundi, the traditional birth attendants have been integrated within the primary health care system, especially in rural areas, and re-assigned the role of ‘birth companions’. In this capacity they undertake maternal health promotion activities within their communities. In northern Uganda, on the other hand, traditional birth attendants have not been integrated within the local health system and still appear to undertake clandestine deliveries in some rural areas. Conclusion: The prominent role of traditional birth attendants in childbirth during the conflicts in Burundi and northern Uganda has been dwindling in the post-conflict era. Traditional birth attendants can still play an important role in facilitating facility and skilled attended births if appropriately integrated with the local health system.
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| 10. |
- Dang, LVP, et al.
(författare)
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Characterization of envelope sequence of HIV virus in children infected with HIV in Vietnam
- 2020
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Ingår i: SAGE open medicine. - : SAGE Publications. - 2050-3121. ; 8, s. 2050312120937198-
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Tidskriftsartikel (refereegranskat)abstract
- HIV is characterized by high levels of genetic variability, including increased numbers of heterogeneous sequences of the envelope region. Therefore, studying genetic variability of HIV in relation to viral replication might facilitate prognosis of disease progression.Methods:The study was designed as cross-sectional; data and samples of participants collected and analyzed env genes were obtained from 23 children enrolled by Vietnam National Children’s Hospital.Results:Substantial mutations in the C2 region were found in patients with high levels of viral replication while changes in the C3 region were mostly found in patients with low viral load. In the V1 region, we found profound amino acid modifications in patients with low HIV viral loads in contrast to the V2 sequence, where we identified single point mutations in patients with increased HIV viral load. The V3 region was relatively homogeneous, while profound deletions in the V4 region were detected in patients with increased viral replication.Conclusion:Our results suggest that genetic variations in different regions of the HIV envelope sequence, including both conserved C2 and C3 and variable V1/V2 and V4 regions, might be involved in increased viral infectivity and replication capacity. Such knowledge might help improve prediction of HIV progress and treatment in patients.
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