| 1. |
- Aléx, Jonas, 1975-, et al.
(författare)
-
Brister i systematiskt omhändertagande på olycksplatser : en studie av traumasimuleringar inom ambulanssjukvården
- 2018
-
Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 115
-
Tidskriftsartikel (refereegranskat)abstract
- Trauma care at an accident site is of great importance for patient survival. The purpose of the study was to observe the compliance of ambulance nurses with the Prehospital Trauma Life Support (PHTLS) concept of trauma care in a simulation situation. The material consisted of video recordings in trauma simulation and an observation protocol was designed to analyze the video material. The result showed weaknesses in systematic exam and an ineffective use of time at the scene of injury. Development of observation protocols in trauma simulation can ensure the quality of ambulance nurses' compliance with established concepts. Our pilot study shows that insufficiencies in systematic care lead to an ineffective treatment for trauma patients which in turn may increase the risk of complications and mortality.
|
|
| 2. |
- Aléx, Jonas, 1975-
(författare)
-
Cold exposure and thermal comfort among patients in prehospital emergency care : innovation research in nursing
- 2015
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundPatients’ cold exposure is a neglected problem in prehospital emergency care. Cold stress increases pain and anxiety and contributes to fear and an overall sense of dissatisfaction. When left untreated, cold stress disturbs vital body functions until ultimately reaches hypothermia.AimThe overall aim was to investigate patients’ experiences of thermal comfort and reactions to cold exposure in prehospital emergency care and to evaluate the effects of an intervention using active warming from underneath.MethodStudy I:Persons (n=20) injured in a cold environment in the north of Sweden were interviewed. Active heat was given to 13 of them.Study II:In wintertime, 62 patients were observed during prehospital emergency care. The field study was based on observations, questions about thermal discomfort, vital signs, and temperature measurements.Study III:Healthy young persons (n=23) participated in two trials each. Data were collected inside and outside a cold chamber. In one trial, the participants were lying on a regular ambulance stretcher and in a second trial on a stretcher supplied with a heated mattress. Outcomes were the Cold Discomfort Scale (CDS), back, finger, and core body temperature, four statements from the State-TraitAnxiety-Inventory (STAI), vital signs, and short notes about their experiences of the two stretchers.Study IV:A quantitative intervention study was conducted in prehospital emergency care in the north of Sweden. The patients (n=30) in the intervention group were transported in an ambulance supplemented with a heated mattress on the stretcher, whereas only a regular stretcher was used in the ambulance for the patients (n=30) in the control group. Outcomes were the CDS, finger, core body, and air temperature, and questions about cold experiences.ResultsStudy I:Patients suffered more because of the cold than from the pain of their injuries. The patients were in a desperate need of heat.Study II:Patients are exposed to cold stress due to cold environments. There was a significant decrease from the first measurement in finger temperature of patients who were indoors when the ambulance arrived, compared to the measurement taken in the ambulance. In the patient compartment of the ambulance, 85% of the patients had a finger temperature below the comfort zone and almost half of them experienced the patient compartment in the ambulance to be cold. The regular mattress surface temperature at the ambulance ranged from -22.3 to 8.4 ºC.Study III:A statistical increase of the participants’ back temperature was found between those lying on the heated mattress compared to those lying on the regular mattress. The heated mattress was experienced as warm, comfortable, providing security, and easy to relax on.Study IV:Thermal comfort increased for the patients in the intervention group and decreased in the control group. A significant higher proportion of the participants rated the stretcher as cold to lie on in the control group compared to the intervention group.ConclusionThe ambulance milieu is too cold to provide thermal comfort. Heat supply from underneath increased comfort and might prevent cold stress and hypothermia
|
|
| 3. |
- Aléx, Jonas, 1975-
(författare)
-
Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in prehospital emergency care -an intervention study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients’ exposure to cold temperatures combined with a cold ambulance mattress seems to be a major factor leading to an overall sensation of discomfort. As far as we have seen, there is still little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in the prehospital emergency care.Methods:A quantitative intervention study conducted in ambulance care in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with a heated mattress on the stretcher compared to the control group (n=30) where no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), finger, ear, and air temperatures along with subjective comments on cold experiences.Results:Thermal comfort, measured by CDS, was improved during the ambulance transport to the Emergency Department (ED) in the intervention group (p= 0.001) but decreased in the control group (p=<0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down on compared to three percent in the intervention group (p<0.001). Concerning finger, ear, and compartment air temperature no significant difference between groups was found. Mean transport time was approximately 15 minutes.Conclusion:The use of active heat, from underneath, increases the patients’ thermal comfort and may prevent the negative consequences of cold stress.
|
|
| 4. |
- Aléx, Jonas, 1975-, et al.
(författare)
-
Preparedness of Swedish EMS Personnel for Major Incidents in Underground Mines
- 2017
-
Ingår i: Journal of Health Science. - : David Publishing Company. - 2328-7136. ; 5, s. 239-243
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to survey the EMS (emergency medical services) personnel preparedness for major incidents in the underground mining industry in Sweden. Every year, a high number of incidents, workplace accidents and fires are reported from the Swedish mining industry. Taking care of patients located in an underground mine represents a challenge to EMS personnel. Today, knowledge about EMS personnel preparedness for major incidents in the mining industry is limited. The study design was a cross-sectional survey. The questionnaires were distributed to EMS personnel working in ambulance stations geographically located near an underground mine. Thirteen ambulance stations were included and 137 of 258 personnel answered. Demographic data were analyzed using descriptive statistics. Differences among groups were analyzed with the Chi-Squared test, continuity correction and t-test. Results showed about half of the participants reported that they do not feel prepared to work in a major incident in an underground mine. The majority wished to receive educational training to enhance their preparedness. The most commonly requested type of education was practical drills on the scene, in an underground mine. The reported preparedness was significantly higher among the participants who had received some kind of education, or had authentic experience of a mission in an underground mine than those who did not. This study reveals shortcomings in the preparedness of EMS personnel. The perceived low preparedness of EMS personnel may affect their ability to work in a major incident in the mining industry. Study findings may be used in planning the future education, including practical drills, of EMS personnel.
|
|
| 5. |
|
|
| 6. |
- Feiz, Roozbeh, 1975-, et al.
(författare)
-
Biogas Potential for Improved Sustainability in Guangzhou, China : A Study Focusing on Food Waste on Xiaoguwei Island
- 2019
-
Ingår i: Sustainability. - : MDPI. - 2071-1050. ; 11:6
-
Tidskriftsartikel (refereegranskat)abstract
- As a result of rapid development in China and the growth of megacities, large amounts of organic wastes are generated within relatively small areas. Part of these wastes can be used to produce biogas, not only to reduce waste-related problems, but also to provide renewable energy, recycle nutrients, and lower greenhouse gases and air polluting emissions. This article is focused on the conditions for biogas solutions in Guangzhou. It is based on a transdisciplinary project that integrates several approaches, for example, literature studies and lab analysis of food waste to estimate the food waste potential, interviews to learn about the socio-technical context and conditions, and life-cycle assessment to investigate the performance of different waste management scenarios involving biogas production. Xiaoguwei Island, with a population of about 250,000 people, was chosen as the area of study. The results show that there are significant food waste potentials on the island, and that all studied scenarios could contribute to a net reduction of greenhouse gas emissions. Several socio-technical barriers were identified, but it is expected that the forthcoming regulatory changes help to overcome some of them.
|
|
| 7. |
- Hedberg, Hans, et al.
(författare)
-
Effects of an advanced first aid course or real-time video communication with ambulance personnel on layperson first response for building-site severe injury events : a simulation study
- 2024
-
Ingår i: BMC Emergency Medicine. - : BioMed Central (BMC). - 1471-227X. ; 24:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The risk of high-energy trauma injuries on construction sites is relatively high. A delayed response time could affect outcomes after severe injury. This study assessed if an advanced first aid course for first aid response for laypersons (employees or apprentices) in the construction industry or real-time video communication and support with ambulance personnel, or neither, together with access to an advanced medical kit, would have an effect on immediate layperson vital responses in a severe injury scenario.Method: This was a controlled simulation study. Employees or apprentices at a construction site were recruited and randomly allocated into a group with video support or not, and advanced first aid course or not, and where one group had both. The primary outcomes were correct behavior to recognize and manage an occluded airway and correct behavior to stop life-threatening bleeding from a lower extremity injury. Secondary outcomes included head-to-toe assessment performed, placement of a pelvic sling, and application of remote vital signs monitors.Results: Ninety participants were included in 10 groups of 3 for each of 4 exposures. One group was tested first as a baseline group, and then later after having done the training course. Live video support was effective in controlling bleeding. A first aid course given beforehand did not seem to be as effective on controlling bleeding. Video support and the first aid course previously given improved the ability of bystanders to manage the airway, the combination of the two being no better than each of the interventions taken in isolation. Course exposure and video support together were not superior to the course by itself or video by itself, except regarding placing the biosensors on the injured after video support. Secondary results showed an association between video support and completing a head-to-toe assessment. Both interventions were associated with applying a pelvic sling.Conclusion: These findings show that laypersons, here construction industry employees, can be supported to achieve good performance as first responders in a major injury scenario. Prior training, but especially live video support without prior training, improves layperson performance in this setting.
|
|
| 8. |
- Kanoni, Stavroula, et al.
(författare)
-
Implicating genes, pleiotropy, and sexual dimorphism at blood lipid loci through multi-ancestry meta-analysis.
- 2022
-
Ingår i: Genome biology. - : Springer Science and Business Media LLC. - 1474-760X .- 1465-6906 .- 1474-7596. ; 23:1
-
Tidskriftsartikel (refereegranskat)abstract
- Genetic variants within nearly 1000 loci are known to contribute to modulation of blood lipid levels. However, the biological pathways underlying these associations are frequently unknown, limiting understanding of these findings and hindering downstream translational efforts such as drug target discovery.To expand our understanding of the underlying biological pathways and mechanisms controlling blood lipid levels, we leverage a large multi-ancestry meta-analysis (N=1,654,960) of blood lipids to prioritize putative causal genes for 2286 lipid associations using six gene prediction approaches. Using phenome-wide association (PheWAS) scans, we identify relationships of genetically predicted lipid levels to other diseases and conditions. We confirm known pleiotropic associations with cardiovascular phenotypes and determine novel associations, notably with cholelithiasis risk. We perform sex-stratified GWAS meta-analysis of lipid levels and show that 3-5% of autosomal lipid-associated loci demonstrate sex-biased effects. Finally, we report 21 novel lipid loci identified on the X chromosome. Many of the sex-biased autosomal and X chromosome lipid loci show pleiotropic associations with sex hormones, emphasizing the role of hormone regulation in lipid metabolism.Taken together, our findings provide insights into the biological mechanisms through which associated variants lead to altered lipid levels and potentially cardiovascular disease risk.
|
|
| 9. |
- Zetterberg, Johanna, et al.
(författare)
-
Nurses’ experiences of encountering patients with mental illness in prehospital emergency care – a qualitative interview study
- 2022
-
Ingår i: BMC Nursing. - : BioMed Central. - 1472-6955 .- 1472-6955. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Nurses working in prehospital emergency care (PEC) encounter patients with all types of health conditions. Increasingly, they are encountering patients suffering from mental illness and this trend reflects the worldwide increase in mental illness. There is very little current knowledge of encounters between nurses and patients with mental illness in ‘PEC’, especially from the nurses’ perspectives.Aim The aim of the study is to investigate nurses’ experiences of encountering patients with mental illness in ‘PEC’.Methods The participants were recruited in a region in southeast Sweden (that covers approximately 5600 km2 and has 300,000 inhabitants). In total, 17 nurses consented to participate. The participants were asked to narrate their individual experience of encountering patients with mental illness. The interviews were transcribed verbatim, then analysed with qualitative content analysis.Results The result is presented in terms of three themes and eight sub-themes. The main themes are ‘Lacking trust in the patient and one’s own abilities’, ‘Being under internal and external influences’ and ‘Moving towards a genuine nurse-patient relationship’.Conclusion The results show that nurses strive to lay the foundation for a trusting relationship. Simultaneously nurses encountering is characterized by a mistrust and it is influenced by pre-understanding and emotions when they take care for patients. The findings could be used to develop nurses’ readiness and capability to encounter patients with mental illness and to respond appropriately to the patients somatic and mental care needs.
|
|
