| 1. |
- Semb, G, et al.
(författare)
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Erratum
- 2017
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Ingår i: Journal of plastic surgery and hand surgery. - 2000-6764. ; 51:2, s. 158-158
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Tidskriftsartikel (refereegranskat)
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| 2. |
- Bannister, P., et al.
(författare)
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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 3. Descriptive study of postoperative nursing care following first stage cleft closure
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 21-26
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. Materials and methods: A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials. This included the age and weight at admission, the postoperative recovery setting, pain management, postoperative feeding, post-operative complications, and length of hospital stay. Results: Four hundred and three nursing forms from the first surgical procedure were returned for analysis. Differences in important aspects of care such as postoperative analgesia and postoperative feeding were evident. Postoperative care was influenced by local custom and practice, as little firm clinical evidence exists to guide optimal management. Conclusion: Postoperative recovery may play a significant role in the future selection of surgical protocols, and future trials need to consider cross-study site training to familiarise nurses, prior to any changes in surgical methods.
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| 3. |
- Bruxvoort, K. J., et al.
(författare)
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The Impact of Introducing Malaria Rapid Diagnostic Tests on Fever Case Management: A Synthesis of Ten Studies from the ACT Consortium
- 2017
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Ingår i: Am J Trop Med Hyg. - : American Society of Tropical Medicine and Hygiene. - 0002-9637 .- 1476-1645. ; 97:4, s. 1170-1179
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Tidskriftsartikel (refereegranskat)abstract
- Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type. This synthesis includes 562,368 outpatient encounters (study size range 2,400-432,513). mRDTs were associated with significantly lower ACT prescription (range 8-69% versus 20-100%). Prescribing did not always adhere to malaria test results; in several settings, ACTs were prescribed to more than 30% of test-negative patients or to fewer than 80% of test-positive patients. Either an antimalarial or an antibiotic was prescribed for more than 75% of patients across most settings; lower antimalarial prescription for malaria test-negative patients was partly offset by higher antibiotic prescription. Symptomatic management with antipyretics alone was prescribed for fewer than 25% of patients across all scenarios. In community health worker and private retailer settings, mRDTs increased referral of patients to other providers. This synthesis provides an overview of shifts in case management that may be expected with mRDT introduction and highlights areas of focus to improve design and implementation of future case management programs.
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| 4. |
- Hopkins, H., et al.
(författare)
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Impact of introduction of rapid diagnostic tests for malaria on antibiotic prescribing: analysis of observational and randomised studies in public and private healthcare settings
- 2017
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Ingår i: Bmj-British Medical Journal. - : BMJ. - 1756-1833 .- 0959-8138. ; 356
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES To examine the impact of use of rapid diagnostic tests for malaria on prescribing of antimicrobials, specifically antibiotics, for acute febrile illness in Africa and Asia. Analysis of nine preselected linked and codesigned observational and randomised studies (eight cluster or individually randomised trials and one observational study). Public and private healthcare settings, 2007-13, in Afghanistan, Cameroon, Ghana, Nigeria, Tanzania, and Uganda. Proportions of patients for whom an antibiotic was prescribed in trial groups who had undergone rapid diagnostic testing compared with controls and in patients with negative test results compared with patients with positive results. A secondary aim compared classes of antibiotics prescribed in different settings. Antibiotics were prescribed to 127 052/238 797 (53%) patients in control groups and 167 714/283 683 (59%) patients in intervention groups. Antibiotics were prescribed to 40% (35 505/89 719) of patients with a positive test result for malaria and to 69% (39 400/57 080) of those with a negative result. All but one study showed a trend toward more antibiotic prescribing in groups who underwent rapid diagnostic tests. Random effects meta-analysis of the trials showed that the overall risk of antibiotic prescription was 21% higher (95% confidence interval 7% to 36%) in intervention settings. In most intervention settings, patients with negative test results received more antibiotic prescriptions than patients with positive results for all the most commonly used classes: penicillins, trimethoprim-sulfamethoxazole (one exception), tetracyclines, and metronidazole. Introduction of rapid diagnostic tests for malaria to reduce unnecessary use of antimalarials-a beneficial public health outcome-could drive up untargeted use of antibiotics. That 69% of patients were prescribed antibiotics when test results were negative probably represents overprescription. This included antibiotics from several classes, including those like metronidazole that are seldom appropriate for febrile illness, across varied clinical, health system, and epidemiological settings. It is often assumed that better disease specific diagnostics will reduce antimicrobial overuse, but they might simply shift it from one antimicrobial class to another. Current global implementation of malaria testing might increase untargeted antibiotic use and must be examined.
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| 7. |
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| 8. |
- Bjorkman, A, et al.
(författare)
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Zanzibar: towards malaria elimination?
- 2011
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Ingår i: TROPICAL MEDICINE & INTERNATIONAL HEALTH. - 1360-2276. ; 16, s. 119-119
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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| 9. |
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| 10. |
- Elfving, Anders, 1976-
(författare)
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Near-infrared photodetectors based on Si/SiGe nanostructures
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Two types of photodetectors containing Ge/Si quantum dots have been fabricated based on materials grown by molecular beam epitaxy and characterized with several experimental techniques. The aim was to study new device architectures with the implementation of Ge nanostructures, in order to obtain high detection efficiency in the near infrared range at room temperature.Heterojunction bipolar phototransistors were fabricated with 10 Ge dot layers in the base-collector (b-c) junction. With the illumination of near infrared radiation at 1.31 to 1.55 µm, the incident light would excite the carriers. The applied field across the b-c junction caused hole transport into the base, leading to a reduced potential barrier between the emitter-base (e-b) junction. Subsequently, this resulted in enhanced injection of electrons across the base into the collector, i.e., forming an amplified photo-induced current. We have therefore obtained significantly enhanced photo-response for the Ge-dot based phototransistors, compared to corresponding quantum dot p-i-n photodiodes. Responsivity values up to 470 mA/W were measured at 1.31 µm using waveguide geometry, and ∼2.5 A/W at 850 nm, while the dark current was as low as 0.01 mA/cm2 at –2 V.Metal-oxide field-effect phototransistors were also studied. These lateral detectors were processed with three terminals for source, drain and gate contacts. The Ge quantum dot layers were sandwiched between pseudomorphically grown SiGe quantum wells. The detector devices were processed using a multi-finger comb structure with an isolated gate contact on top of each finger and patterned metal contacts on the side edges for source and drain. It was found that the photo-responsivity was increased by a factor of more than 20 when a proper gate bias was applied. With VG above threshold, the measured response was 350 and >30 mA/W at 1.31 and 1.55 µm, respectively.Properties of Si/Si1-xGex nanostructures were examined, in order to facilitate proper design of the above mentioned transistor types of photodetectors. The carrier recombination processes were characterized by photoluminescence measurements, and the results revealed a gradual change from spatially indirect to direct transitions in type II Si1-xGex islands with increased measurement temperature. Energy dispersive X-ray spectrometry of buried Ge islands produced at different temperatures indicated a gradual decrease of the Ge concentration with temperature, which was due to the enhanced intermixing of Si and Ge atoms. At a deposition temperature of 730°C the Ge concentration was as low as around 40 %.Finally, the thermal stability of the Si/SiGe(110) material system, which is a promising candidate for future CMOS technology due to its high carrier mobility, was investigated by high resolution X-ray diffraction reciprocal space mapping. Anisotropic strain relaxation was observed with maximum in-plane lattice mismatch in the [001] direction.
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