| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
-
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
-
Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
|
|
| 2. |
- Ahlqvist, Victoria, et al.
(författare)
-
Supply Chain Risk Governance: Towards a Conceptual Multi-Level Framework
- 2020
-
Ingår i: Operations and Supply Chain Management: An International Journal. - : OSCM Forum. - 1979-3561 .- 2579-9363. ; 13:4, s. 382-395
-
Tidskriftsartikel (refereegranskat)abstract
- The coronavirus pandemic (COVID-19) is currently putting high pressure on most countries’ critical infrastructures (not only health care), creating huge uncertainties in supply and demand, and disrupting global supply chains. The global crisis will demonstrate the extent to which different parties (countries, public authorities, private companies etc.) can work together and take holistic decisions in such situations. A core question in supply chain management asks how independent decision-makers at many levels can work together and how this joint work can be governed. Supply chain risk management (SCRM), however, has focused mostly on how focal private companies apply SCRM processes to identify, analyse and mitigate risk related to upstream and downstream flows in their supply networks. At the same time, interorganisational collaboration to handle diverse risks is always needed. A risk that hits one organisation often affects other, interconnected organisations. This study aims to develop the term supply chain risk governance with an associated conceptual framework that embraces various types of supply chains and actors. In a cross-disciplinary literature study, we dissect, compare and combine risk governance with interorganisational aspects of SCRM and find that the mechanisms suggested in the risk governance literature coincide with many of those in SCRM. We suggest a combination of these to govern risk processes at an inter-organisational level, regardless of the type of organisation included in the supply chain. This would be suitable for critical infrastructures that often contain a mixture of private and public actors. The scope of the literature employed is limited, and some articles have played a larger role in the framework development. The paper explores new territory through this cross-disciplinary study, extends existing multi-level frameworks with inter-organisational governance mechanisms and proposes new governance mechanisms to the field. This study could support the understanding of how critical infrastructures in our society are governed so as to increase their resilience to both smaller and larger disruptions.
|
|
| 3. |
- Ahlqvist, Victoria, et al.
(författare)
-
Supply chain risk management strategies in normal and abnormal times: policymakers' role in reducing generic medicine shortages
- 2023
-
Ingår i: International Journal of Physical Distribution & Logistics Management. - 0960-0035. ; 53:2, s. 206-230
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose – This paper links supply chain risk management to medicine supply chains to explore the role ofpolicymakers in employing supply chain risk management strategies (SCRMS) to reduce generic medicineshortages.Design/methodology/approach – Using secondary data supplemented with primary data, the authors mapand compare seven countries’ SCRMS for handling shortage risks in their paracetamol supply chains beforeand during the first two waves of the COVID-19 pandemic.Findings – Consistent with recent research, the study finds that policymakers had implemented few SCRMSspecifically for responding to disruptions caused by COVID-19. However, shortages were largely avoided sincemultiple strategies for coping with business-as-usual disruptions had been implemented prior to the pandemic.The authors did find that SCRMS implemented during COVID-19 were not always aligned with thoseimplemented pre-pandemic. The authors also found that policymakers played both direct and indirect roles.Research limitations/implications – Combining longitudinal secondary data with interviews sheds lighton how, regardless of the level of preparedness during normal times, SCRMS can be leveraged to avertshortages in abnormal times. However, the problem is highly complex, which warrants further research.Practical implications – Supply chain professionals and policymakers in the healthcare sector can use thefindings when developing preparedness and response plans.Social implications – The insights developed can help policymakers improve the availability of high-volumegeneric medicines in (ab)normal times.Originality/value – The authors contribute to prior SCRM research in two ways. First, the authorsoperationalize SCRMS in the medicine supply chain context in (ab)normal times, thereby opening avenues forfuture research on SCRM in this context. Second, the authors develop insights on the role policymakers playand how they directly implement and indirectly influence the adoption of SCRMS. Based on the study findings,the authors develop a framework that captures the diverse roles of policymakers in SCRM.
|
|
| 4. |
- Flacking, Renee, et al.
(författare)
-
Closeness and separation in neonatal intensive care
- 2012
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 101:10, s. 1032-1037
-
Forskningsöversikt (refereegranskat)abstract
- In this paper, we highlight the need for acknowledging the importance and impact of both physical and emotional closeness between the preterm infant and parent in the neonatal intensive care unit. Physical closeness refers to being spatially close and emotional closeness to parental feelings of being emotionally connected to the infant (experiencing feelings of love, warmth and affection). Through consideration of the literature in this area, we outline some of the reasons why physical closeness and emotional closeness are crucial to the physical, emotional and social well-being of both the infant and the parent. These include positive effects on infant brain development, parent psychological well-being and on the parentinfant relationship. The influence of the neonatal unit environment and culture on physical and emotional closeness is also discussed.Conclusions: Culturally sensitive care practices, procedures and the physical environment need to be considered to facilitate parentinfant closeness, such as through early and prolonged skin-to-skin contact, family-centred care, increased visiting hours, family rooms and optimization of the space on the units. Further research is required to explore factors that facilitate both physical and emotional closeness to ensure that parentinfant closeness is a priority within neonatal care.
|
|
| 5. |
- Palmqvist, Carl-William, et al.
(författare)
-
How and Why Freight Trains Deviate from the Timetable : Evidence from Sweden
- 2022
-
Ingår i: IEEE Open Journal of Intelligent Transport Systems. - 2687-7813.
-
Tidskriftsartikel (refereegranskat)abstract
- European infrastructure managers (IMs) create annual timetables for trains that will run during a year. Freight trains in Sweden often deviate from this by being added, cancelled, delayed or early, resulting in increased costs for IMs and railway undertakings (RUs). We investigate the frequency of and causes for these deviations, using one year of operational data for 48,000 trains, and 15 stakeholder interviews. We find that about 20% of freight trains are added once the timetable has been created, and that cancellations occur for about 35% of freight trains, mostly at the RUs’ initiative. Delays are common: some 40% of departures, 30% of runtimes, and 20% of dwell times are delayed. Running early is even more common: 80% are ready to depart early, and 60% do so, while 40% of runtimes and 75% of dwell times are shorter than scheduled. We find links and feedback loops between the root causes for these deviations and suggest that IMs reserve more of the capacity that is needed for freight trains and instead distribute it throughout the year. This could lead to more appropriate, attractive, and reliable timetables for freight trains, whilst greatly reducing the amount of planning effort.
|
|
