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- Gutierrez-Gutierrez, Belen, et al.
(författare)
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Propensity Score and Desirability of Outcome Ranking Analysis of Ertapenem for Treatment of Nonsevere Bacteremic Urinary Tract Infections Due to Extended-Spectrum-Beta-Lactamase-Producing Enterobacterales in Kidney Transplant Recipients
- 2021
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Ingår i: Antimicrobial Agents and Chemotherapy. - : American Society for Microbiology. - 0066-4804 .- 1098-6596. ; 65:11
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Tidskriftsartikel (refereegranskat)abstract
- There are scarce data on the efficacy of ertapenem in the treatment of bacteremia due to extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-E) in kidney transplant (KT) recipients. We evaluated the association between treatment with ertapenem or meropenem and clinical cure in KT recipients with nonsevere bacteremic urinary tract infections (B-UTI) caused by ESBL-E. We performed a registered, retrospective, international (29 centers in 14 countries) cohort study (INCREMENT-SOT, NCT02852902). The association between targeted therapy with ertapenem versus meropenem and clinical cure at day 14 (the principal outcome) was studied by logistic regression. Propensity score matching and desirability of outcome ranking (DOOR) analyses were also performed. A total of 201 patients were included; only 1 patient (treated with meropenem) in the cohort died. Clinical cure at day 14 was reached in 45/100 (45%) and 51/101 (50.5%) of patients treated with ertapenem and meropenem, respectively (adjusted OR 1.29; 95% CI 0.51 to 3.22; P = 0.76); the propensity score-matched cohort included 55 pairs (adjusted OR for clinical cure at day 14, 1.18; 95% CI 0.43 to 3.29; P = 0.74). In this cohort, the proportion of cases treated with ertapenem with better DOOR than with meropenem was 49.7% (95% CI, 40.4 to 59.1%) when hospital stay was considered. It ranged from 59 to 67% in different scenarios of a modified (weights-based) DOOR sensitivity analysis when potential ecological advantage or cost was considered in addition to outcome. In conclusion, targeted therapy with ertapenem appears as effective as meropenem to treat nonsevere B-UTI due to ESBL-E in KT recipients and may have some advantages.
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| 2. |
- Perez-Nadales, Elena, et al.
(författare)
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Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales : The impact of cytomegalovirus disease and lymphopenia
- 2020
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Ingår i: American Journal of Transplantation. - : WILEY. - 1600-6135 .- 1600-6143. ; 20:6, s. 1629-1641
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Tidskriftsartikel (refereegranskat)abstract
- Treatment of carbapenemase-producing Enterobacterales bloodstream infections in solid organ transplant recipients is challenging. The objective of this study was to develop a specific score to predict mortality in solid organ transplant recipients with carbapenemase-producing Enterobacterales bloodstream infections. A multinational, retrospective (2004-2016) cohort study (INCREMENT-SOT, ClinicalTrials.gov NCT02852902) was performed. The main outcome variable was 30-day all-cause mortality. The INCREMENT-SOT-CPE score was developed using logistic regression. The global cohort included 216 patients. The final logistic regression model included the following variables: INCREMENT-CPE mortality score >= 8 (8 points), no source control (3 points), inappropriate empirical therapy (2 points), cytomegalovirus disease (7 points), lymphopenia (4 points), and the interaction between INCREMENT-CPE score >= 8 and CMV disease (minus 7 points). This score showed an area under the receiver operating characteristic curve of 0.82 (95% confidence interval [CI] 0.76-0.88) and classified patients into 3 strata: 0-7 (low mortality), 8-11 (high mortality), and 12-17 (very-high mortality). We performed a stratified analysis of the effect of monotherapy vs combination therapy among 165 patients who received appropriate therapy. Monotherapy was associated with higher mortality only in the very-high (adjusted hazard ratio [HR] 2.82, 95% CI 1.13-7.06, P = .03) and high (HR 9.93, 95% CI 2.08-47.40, P = .004) mortality risk strata. A score-based algorithm is provided for therapy guidance.
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| 6. |
- Deldén, Maria, 1963-, et al.
(författare)
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Empatía y resocialización : Tratamiento de personas en proceso de resocialización
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Nuestra propuesta se centra en el tratamiento para personas que se encuentran en proceso de resocialización, experimentando una transformación y buscando un cambio duradero en la forma de manejar sus pensamientos y emociones. El concepto clave es la empatía del origen, desarrollada empíricamente en el trabajo de Ajovec y respaldada teóricamente por los estudios de Deldén y Jansson, entre otros. El concepto tiene su origen en el trabajo de Liam Girmarland, basado en las experiencias durante los años de su trabajo social tanto en Colombia y como en Suecia. La resocialización implica encontrar formas de reconstruir la percepción de sí mismo de las personas, donde la percepción anterior se basaba en la comunicación violenta, cargada de vergüenza y orgullo. A través del reconocimiento auténtico de las historias personales y del trabajo con la empatía dirigida tanto hacia las posibles víctimas de las acciones de la persona como hacia la propia persona, se puede lograr la transformación. En este proceso, es fundamental la oportunidad de reintegrarse a la sociedad, como se evidencia en la labor realizada por Ajovec en su finca cafetera. Se trata de adoptar roles constructivos y saludables, rompiendo con los roles destructivos.En nuestra presentación, describimos el trasfondo práctico y teórico del concepto de empatía del origen. Lo relacionamos con un modelo de tratamiento desarrollado por Jansson y Saxonberg (2013/2023), que aborda el trabajo emocional en la práctica del trabajo social. El enfoque principal de la presentación son los procesos de transformación en el trabajo de resocialización con adultos jóvenes que se encuentran en riesgo de incurrir en la delincuencia o ya están involucrados en ella.
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| 7. |
- Deldén, Maria, 1963-
(författare)
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Historien som fiktion : gymnasieelevers erfarande av spelfilm i historieundervisningen
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The present study explores the reception of historical feature films in history education. It is concerned with how pupils experience the films as well as the significance of the feature film for their understanding and interpretation of history. The study incorporates empirical data from classroom projects in two different Swedish upper secondary schools where film was used as an educational tool. Observations of classroom activities were made and interviews with twelve pupils and their history teachers were conducted.The study applies a phenomenological approach. The lifeworld of the pupils is in focus, specifically the aspect of the lifeworld they live and experience in history class when film is used as a means of understanding the past. The phenomenon studied is thus how the pupils experience the film, and through the film, history itself. Theoretical notions from film reception studies and history didactics are used as analytic tools.The study shows how emotional and cognitive processes converge in the pupils’ meaning making of the films. The embodiment of the films’ narrative is an important factor that contributes to both the understanding of the film as well as of history. The pupils experience the films emotionally, feeling both empathy and antipathy for the various characters, physically through sight and sound as well as embodied reactions, and cognitively through an understanding of the film’s narrative. Embodied experience is fundamental for history to become materialized. The audiovisual portrayal and materialization of the past becomes embodied in the pupils so that the experience of the film and of the historical lifeworld presented therein becomes part of their lifeworld. Generally, pupils consider the films to be trustworthy, though this perceived accuracy depends on how authentically the narrative is performed and the pupils’ previous store of historical knowledge. A didactic dilemma to consider when using historical feature film in the classroom is the contradiction between the aesthetic experience of a feature film and its use as a tool for understanding the past. The captivating character of feature film evokes empathy and engagement with the films’ characters regardless of the degree of historical accuracy. This is a critical issue for teachers; there needs to be balance between respect for the pupils’ aesthetic experience of the film and the need to guide them to develop for example the skills of historical empathy, where distance is necessary for the pupils to be able to consider different perspectives.
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- Deldén, Maria, 1963-
(författare)
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¿La ficción para qué? : Literacidad de películas históricas
- 2017
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Ingår i: Caminos de la enseñanza de la historia. - Querétaro, México. - 9786075133225 ; , s. 1242-1259
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Konferensbidrag (refereegranskat)abstract
- El texto se basa en mi tesis doctoral, Elcine como herramienta didáctica. Investigo el sentidohistórico creado a partir de las películas históricas. Laspelículas históricas forman parte de la cultura histórica,como una memoria cultural. Basándome en el filósofohistórico alemán Jörn Rüsen exploro cómo podemoscrear sentido a la historia mediada por el lenguajedel cine. Utilizo entrevistas con jóvenes, como ‘sociosde un diálogo crítico’, donde los jóvenes expresan susexperiencias de películas históricas. Pongo las vocesde los jóvenes a dialogar con teorías de las didácticasde la historia y teorías del cine. Llego a la teorizacióndel concepto de la literacidad de películas históricas(historical film literacy). Una conclusión sobre la literacidadcine-historia para crear sentido a la historia esque se trata de una fusión holística entre la emocióny la cognición, donde la dialéctica entre ambas es lovital. La experiencia del cine en el espectador la nombrovaloración emocional, con el significado de que sebasa en sentimientos básicos combinados con pensamientosde carácter más abstracto, de valor o juicio.La perspectiva crítica es importante dado que el sentidohistórico también tiene que ver con la dialécticapasado - presente - futuro, y la consciencia históricadel ser humano.
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