| 1. |
- Andersson Djurfeldt, Agnes, et al.
(författare)
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Assets, Gender and Rural Livelihoods
- 2018
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Ingår i: Agriculture, Diversification and Gender in Rural Africa : Longitudinal perspectives from six countries - Longitudinal perspectives from six countries. - : Oxford University Press. ; , s. 54-54
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Bokkapitel (refereegranskat)abstract
- In this chapter, cross-sectional data are used to assess changes in key assets and how this varies by sex of head of household using a regional perspective. Gender-based asset gaps vary regionally and also shift over time. Agricultural assets were generally biased against female farm managers. Changes in land size had a negative effect on female-managed farms (FMFs) when compared with male-managed farms. Gender biases with respect to land lie primarily in the size of cultivated areas, which is related to labour. The share of male labour is lower on FMFs. This is connected to smaller land sizes and lower use of particular irrigation techniques. Housing standard, consumer durables, and savings are less gender biased. Female farm managers in general command less male labour, and the land that they cultivate appears to be adjusted to their labour resources. Incomes generated by these households are invested in housing, consumer durables, and savings.
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| 2. |
- Andersson Djurfeldt, Agnes, et al.
(författare)
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Gender and Rural Livelihoods: Agricultural Commercialization and Farm/Non-Farm Diversification
- 2018
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Ingår i: Agriculture, Diversification and Gender in Rural Africa. - : Oxford University Press. - 9780198799290
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Bokkapitel (refereegranskat)abstract
- This chapter examines possible discrimination against female farm managers with respect to prices or market segmentation. Patterns of commercialization are fluid. Particular countries stand out with respect to certain crops, however: for maize, a growing bias against female farm managers can be noted in Zambia. Mozambique, Malawi, and to a lesser extent Tanzania stand out in terms of non-grain food crops, where market participation by male farm managers had increased relative to female-headed households. Poorer commercial possibilities are tied strongly to production factors, where lack of labour and land prevent the generation of a marketable surplus. An important distinction is that between women who manage their own farms and women who live in households headed by men: for the former the lack of access to agrarian resources prevents generation of a marketable surplus for the latter the outcomes from sales are controlled by their husbands.
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| 3. |
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| 4. |
- Andersson Lundell, Anna-Carin, 1976, et al.
(författare)
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Development of gut-homing receptors on circulating B cells during infancy.
- 2011
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Ingår i: Clinical immunology. - : Elsevier BV. - 1521-7035 .- 1521-6616. ; 138:1, s. 97-106
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Tidskriftsartikel (refereegranskat)abstract
- B cell gut-homing is mainly mediated by α4β7, CCR9 and CCR10. We here studied the expression of these receptors on B cells from cord blood and from peripheral blood at 1, 4, 18 and 36months of age in a prospective cohort of Swedish infants. The proportion of all B cells expressing α4β7 as well as the fraction of CCR10+ B cells expressing α4β7 was highest in early infancy. Nearly all naïve B cells in all age groups expressed α4β7, whereas the expression on class-switched B cells decreased with age. Moreover, the proportion of both IgA+ and IgG+ B cells expressing α4β7, CCR9 and CCR10 were higher during the first months when compared to adults. In conclusion, the high fraction of circulating IgA+ and IgG+ B cells expressing CCR9 and CCR10 in the first months of life indicates activation of naïve B cells in the gut, coinciding with bacterial colonization.
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| 5. |
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| 6. |
- Olander, Agnes, et al.
(författare)
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Assessment of patients with suspected sepsis in the ambulance services : a qualitative interview study
- 2021
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Ingår i: BMC Emergency Medicine. - : BioMed Central. - 1471-227X .- 1471-227X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background: The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Early identification, care and treatment are vital for patients with sepsis to avoid adverse outcomes. However, knowledge about how patients with sepsis are assessed in ambulance services (AS) by AC is limited. Therefore, the aim of this study was to explore the meaning of ACs’ lived experiences in assessing patients suspected of having sepsis.Methods: A descriptive design with a qualitative approach was used. Fourteen ACs from three Swedish ambulance organizations participated in dyadic and individual semistructured interviews. A thematic analysis based on descriptive phenomenology was performed.Results: AC experiences were grouped into four themes: (1) being influenced by previous experience; (2) searching for clues to the severity of the patient’s condition; (3) feeling confident when signs and symptoms were obvious; and (4) needing health-care professionals for support and consultation.Conclusions: This study indicates that several factors are important to assessments. ACs needed to engage in an ongoing search for information, discuss the cases with colleagues and reconsider the assessment throughout the entire ambulance mission. A reflective and open stance based on professional knowledge could contribute to recognizing patients with sepsis.
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| 7. |
- Olander, Agnes, et al.
(författare)
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Lived experiences of the onset of sepsis
- 2022
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Ingår i: The 4th International NCCS & EACS Conference April 27th – 28th 2022 at Mälardalen University, Sweden.
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Konferensbidrag (refereegranskat)
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| 8. |
- Olander, Agnes, et al.
(författare)
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Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services : A Prospective Study
- 2023
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Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 38:2, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Introduction:The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. Study Objective:The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. Methods:A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. Results:A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. Conclusions:As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
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| 9. |
- Olander, Agnes, et al.
(författare)
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Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
- 2023
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Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press (CUP). - 1049-023X .- 1945-1938. ; 38:2, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
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| 10. |
- Olander, Agnes, et al.
(författare)
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Prehospital characteristics among patients with sepsis: a comparison between patients with or without adverse outcome
- 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 The prehospital care of patients with sepsis are commonly performed by the emergency medical services. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients with sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse prognosis. Therefore, early identification of patients with sepsis is important, and more information about the prehospital characteristics that can be used to identify these patients is needed. Based on this lack of information, the objectives of this study were to investigate the prehospital characteristics that are identified while patients with sepsis are being transported to the hospital by the emergency medical services, and to compare these values to those of the patients with and without adverse outcomes during their hospital stays. Methods This was a retrospective observational study. The patients' electronic health records were reviewed and selected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an emergency department by the emergency medical services. Data were collected on demographics, prehospital characteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit, and analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital characteristics for predicting or development of adverse outcome were analysed. Results In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing patients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care were found to be associated with an adverse outcome. Conclusions The findings suggests that patients having a decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient prognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with sepsis early and improve their long-term outcomes. However further research is required to predict limit values of saturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients with sepsis.
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