| 1. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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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.
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| 2. |
- Cha, Yoon-Hee, et al.
(författare)
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Motion sickness diagnostic criteria : Consensus document of the classification committee of the Bárány society
- 2021
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Ingår i: Journal of Vestibular Research: Equilibrium and Orientation. - 1878-6464. ; 31:5, s. 327-344
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Tidskriftsartikel (refereegranskat)abstract
- We present diagnostic criteria for motion sickness, visually induced motion sickness (VIMS), motion sickness disorder (MSD), and VIMS disorder (VIMSD) to be included in the International Classification of Vestibular Disorders. Motion sickness and VIMS are normal physiological responses that can be elicited in almost all people, but susceptibility and severity can be high enough for the response to be considered a disorder in some cases. This report provides guidelines for evaluating signs and symptoms caused by physical motion or visual motion and for diagnosing an individual as having a response that is severe enough to constitute a disorder.The diagnostic criteria for motion sickness and VIMS include adverse reactions elicited during exposure to physical motion or visual motion leading to observable signs or symptoms of greater than minimal severity in the following domains: nausea and/or gastrointestinal disturbance, thermoregulatory disruption, alterations in arousal, dizziness and/or vertigo, headache and/or ocular strain. These signs/symptoms occur during the motion exposure, build as the exposure is prolonged, and eventually stop after the motion ends. Motion sickness disorder and VIMSD are diagnosed when recurrent episodes of motion sickness or VIMS are reliably triggered by the same or similar stimuli, severity does not significantly decrease after repeated exposure, and signs/symptoms lead to activity modification, avoidance behavior, or aversive emotional responses. Motion sickness/MSD and VIMS/VIMSD can occur separately or together. Severity of symptoms in reaction to physical motion or visual motion stimuli varies widely and can change within an individual due to aging, adaptation, and comorbid disorders. We discuss the main methods for measuring motion sickness symptoms, the situations conducive to motion sickness and VIMS, and the individual traits associated with increased susceptibility. These additional considerations will improve diagnosis by fostering accurate measurement and understanding of the situational and personal factors associated with MSD and VIMSD.
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| 3. |
- Dahlman, Joakim, 1974-
(författare)
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Psychophysiological and Performance Aspects on Motion Sickness
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Motion sickness is not an illness, but rather a natural autonomic response to an unfamiliar or specific stimulus. The bodily responses to motion sickness are highly individual and contextually dependent, making them difficult to predict. The initial autonomic responses are similar to the ones demonstrated when under stress. When under the influence of motion sickness, motivation and ability to perform tasks or duties are limited. However, little is known about how specific cognitive functions are affected. Furthermore, standard mitigation strategies involve medications that induce fatigue or strategies that require cognitive capabilities. Both of them may result in reduced capability to perform assigned tasks or duties. Hence, there is a need for alternative mitigation strategies.The aim of the thesis was to study psychophysiological and performance aspects on motion sickness. The long-term goal is to provide strategies for mitigation and prevention of motion sickness by identifying psychophysiological responses as predictors for both wellbeing and performance. This thesis comprises four studies, in which 91 participants were exposed to two different motion sickness stimuli, either an optokinetic drum or a motion platform. Before the tests, a method for extracting fixations from eye-tracking data was developed as a prerequisite for studying fixations as a possible mitigation strategy for reducing motion sickness. During exposure to stimuli that triggers motion sickness, performance was studied by testing short-term memory and encoding and retrieval. In the final study, the effects of an artificial sound horizon were studied with respect to its potential to subconsciously function as a mitigating source.The results of the measurements of the psychophysiological responses were in accordance with previous research, confirming the ambiguity and high individuality of the responses as well as their contextual dependencies. To study fixations, a centroid mode algorithm proved to be the best way to generate fixations from eye-movement data. In the final study, the effects of the sound horizon were compared to the effects of a non-positioned sound. In the latter condition, both fixation time and the number of fixations increased over time, whereas none of them showed a significant time effect in the sound horizon condition. The fixation time slope was significantly larger in the non-positioned sound condition compared to the sound horizon condition. Number of fixations, heart rate, and skin conductance correlated positively with subjective statements that referred to motion sickness. Among participants that were susceptible to motion sickness symptoms, short-term memory performance was negatively affected. However, no effects of motion sickness on encoding and retrieval were found, regardless of susceptibility.Future studies should continue focusing on autonomic responses and psychological issues of motion sickness. Factors such as motivation, expectancies, and previous experiences play a major and yet relatively unknown role within the motion sickness phenomena.
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| 4. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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