| 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. |
- Abbafati, Cristiana, et al.
(författare)
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- 2020
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Tidskriftsartikel (refereegranskat)
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| 3. |
- Affognon, Hippolyte, et al.
(författare)
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Ethnic groups' knowledge, attitude and practices and Rift Valley fever exposure in Isiolo County of Kenya
- 2017
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Ingår i: PLoS Neglected Tropical Diseases. - : Public Library of Science (PLoS). - 1935-2727 .- 1935-2735. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- Rift Valley fever (RVF) is an emerging mosquito-borne viral hemorrhagic fever in Africa and the Arabian Peninsula, affecting humans and livestock. For spread of infectious diseases, including RVF, knowledge, attitude and practices play an important role, and the understanding of the influence of behavior is crucial to improve prevention and control efforts. The objective of the study was to assess RVF exposure, in a multiethnic region in Kenya known to experience RVF outbreaks, from the behavior perspective. We investigated how communities in Isiolo County, Kenya were affected, in relation to their knowledge, attitude and practices, by the RVF outbreak of 2006/2007. A cross-sectional study was conducted involving 698 households selected randomly from three different ethnic communities. Data were collected using a structured questionnaire regarding knowledge, attitudes and practices that could affect the spread of RVF. In addition, information was collected from the communities regarding the number of humans and livestock affected during the RVF outbreak. This study found that better knowledge about a specific disease does not always translate to better practices to avoid exposure to the disease. However, the high knowledge, attitude and practice score measured as a single index of the Maasai community may explain why they were less affected, compared to other investigated communities (Borana and Turkana), by RVF during the 2006/2007 outbreak. We conclude that RVF exposure in Isiolo County, Kenya during the outbreak was likely determined by the behavioral differences of different resident community groups. We then recommend that strategies to combat RVF should take into consideration behavioral differences among communities.
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| 4. |
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| 5. |
- Ahmed Hassan Ahmed, Osama, 1972-
(författare)
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Rift Valley fever : challenges and new insights for prevention and control using the “One Health” approach
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Rift Valley fever (RVF) is an emerging viral zoonosis that causes frequent outbreaks in east Africa and on the Arabian Peninsula. The likelihood of RVF global expansion due to climate change and human anthropogenic factors is an important issue. The causative agent, RVF virus, is an arbovirus that is transmitted by several mosquito species and is able to infect a wide range of livestock as well as people. The infection leads to mass abortions and death in livestock and a potentially deadly hemorrhagic fever in humans. RVF has severe socio-economic consequences such as animal trade bans between countries, disruption of food security, and economic disaster for farmers and pastoralists as well as for countries. Human behavior such as direct contact with infected animals or their fluids and exposure to mosquito bites increases the risk for contracting the disease.To better understand the challenges associated with RVF outbreaks and to explore prevention and control strategies, we used the One Health approach. The local community had to be involved to understand the interaction between the environment, animals, and humans. We focused on Sudan, Saudi Arabia, and Kenya. First, we systematically reviewed the literature and then we performed cross sectional community-based studies using a special One Health questionnaire. Climatic and remote sensing data were used in combination with statistics to develop a sub-region predictive model for RVF.For both Saudi Arabia and Sudan, the ecology and environment of the affected areas were similar. These areas included irrigation canals and excessive rains that provide an attractive habitat for mosquito vectors to multiply. The surveillance systems were unable to detect the virus in livestock before it spread to humans. Ideally, livestock should serve as sentinels to prevent loss of human lives, but the situation here was reversed. Differences between countries regarding further spread of RVF was mainly determined by better economic and infrastructure resources.In Sudan, there was a lack of knowledge and appropriate practices at the studied community regarding RVF disease symptoms and risk factors for both animals and humans. The community was hesitant in notifying the authorities about RVF suspicion in livestock due to the lack of a compensation system. The perceived role of the community in controlling RVF was fragmented, increasing the probability of RVF transmission and disease.In Kenya, our study found that better knowledge about RVF does not always translate to more appropriate practices that avoid exposure to the disease. However, the combination of good knowledge, attitudes, and practices may explain why certain communities were less affected. Strategies to combat RVF should consider socio-cultural and behavioral differences among communities. We also noticed that RVF outbreaks in Kenya occurred in regions with high livestock density exposed to heavy rains and wet soil fluxes, which could be measured by evapotranspiration and vegetation seasonality variables. We developed a RVF risk map on a sub-regional scale. Future outbreaks could be better managed if such relevant RVF variables are integrated into early warning systems.To confront RVF outbreaks, a policy is needed that better incorporates ecological factors and human interactions with livestock and environment that help the RVF pathogen spread. Early detection and notification of RVF is essential because a delay will threaten the core of International Health Regulations (IHR), which emphasizes the share of information during a transboundary disease outbreak to avoid unnecessary geographical expansion.
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| 6. |
- Allard, Ingrid
(författare)
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Achieving building energy performance : requirements and evaluation methods for residential buildings in Sweden, Norway, and Finland
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Building energy performance has always been important in the cold climate of Sweden, Norway and Finland. To meet the goal that all new buildings should be nearly zero-energy buildings by 2020, set in the EU directive 2010/31/EU [1] on the energy performance of buildings (EPBD recast), the building sector in Europe now faces a transition towards buildings with improved energy performance. In such a transition, a discussion is needed about the objective of the improvement – why, or to what end, the building energy performance should be improved. The objective of improving building energy performance is often a political decision, but scientific research can contribute with knowledge on how the objectives can be achieved.This thesis addresses how the indicators used in the requirements used to achieve building energy performance in Sweden, Norway, and Finland, and the methods used to evaluate these requirements, reflect building energy performance. It also addresses difficulties in achieving comparable and verifiable indicators in evaluations of building energy performance. The research objective has two parts: to review, compare, and discuss (i) requirements and (ii) evaluation methods used to achieve energy performance of residential buildings in Sweden, Norway and Finland. The work in this thesis includes reviews of the requirements used in national building codes and passive house criteria to achieve building energy performance, of methods used to evaluate compliance with such requirements, and of methods used specifically to evaluate the indicator Envelope Air Tightness. The results show that different sets of indicators are used to achieve building energy performance in the studied building codes and passive house criteria. The methods used to evaluate compliance with requirements used to achieve building energy performance are also different, but calculation methods are generally more often used than measurement methods. The calculation- and measurement methods used are often simple. A methodology to analyze the deviation between predictions- and measurements of building energy performance (the performance gap) was developed, to investigate the effects of different evaluation methods on different indicators used to achieve building energy performance. The methodology was tested in a case-study. This study indicated that the choice of method affects which parts of the performance gap reflected in the indicators Supplied Energy (see Terminology), Net Energy (see Terminology), and Overall U-value. Among the reviewed methods to evaluate air tightness, the Fan/Blower Door Pressurization is well known and preferred by professionals in the field. The results in this thesis may be useful when choosing indicators and evaluation methods to achieve different objectives of improving building energy performance and in the quest towards comparable and verifiable indicators used to achieve building energy performance.
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| 7. |
- Allard, Ingrid, 1986-, et al.
(författare)
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Energy evaluation methods for residential buildings in Nordic countries
- 2012
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Ingår i: Proceeding of the Technoport Conference. - : Elsevier.
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Konferensbidrag (refereegranskat)abstract
- To meet the goals of the directive 2010/31/EU on the energy performance of buildings, the building sector in Europe now faces a transition towards more energy efficient buildings. Research and development of new energy solutions and technology will be necessary for the transition and the importance of measuring and evaluating building energy performance increases. This paper attempts to review and evaluate different methods that are commonly used to analyze energy performance in residential buildings in Nordic countries, primarily in Sweden, Norway and Finland. A short international review of regulations is also included. Some advantages and disadvantages of each method are discussed, as well as commonly used methods in the three countries. Although the three Nordic countries have similar climate conditions and building traditions, the study shows that there exist relatively large variations in defining parameters related to energy performance in residential buildings, such as energy use, heated area, and climate zones. The outcome of the regulations could be investigated by adapting the codes on a selected set of buildings. Common analyzing methods, or parts of methods, are found to be used in several countries. These aspects may be considered in further work to develop more accurate and easily comparable methods to evaluate energy performance for residential buildings in cold climate.
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| 8. |
- Allard, Ingrid, 1986-, et al.
(författare)
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Methods for air tightness analysis for residential buildings in Nordic countries
- 2012
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Ingår i: Methods for air tightness analysis forresidential buildings in Nordic countries. - Southampton : WIT Press. - 9781845646141 ; , s. 311-322
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Konferensbidrag (refereegranskat)abstract
- Envelope air tightness is one factor that has impact on the energy performance ofbuildings. The goals of the directive 2010/31/EU, on energy performance ofbuildings, raise the importance of building energy performance analysis in theprocess. Measurements of air tightness can be useful both when evaluatingbuilding energy performance and developing new building techniques. The aimof this paper is to review and evaluate methods to measure air tightness in bothnew and existing residential buildings in Sweden, Norway and Finland, based onan international literature study and a survey. The methods are categorized basedon a number of criteria to determine their suitability in different situations.Advantages and disadvantages of the methods are discussed, as well ascommonly used methods in the three countries. The review shows that thestandard ISO 9972 is used for verification in all three countries, but alternativesexist that might be more suitable in certain situations. Simpler methods are usedin the building process to increase air tightness. To achieve a comparablemeasurement, both common methods and commonly defined units are needed.
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| 9. |
- Allard, Ingrid, et al.
(författare)
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Methods for energy analysis of residential buildings in Nordic countries
- 2013
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Ingår i: Renewable & sustainable energy reviews. - : Pergamon-Elsevier Science. - 1364-0321 .- 1879-0690. ; 22, s. 306-318
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Forskningsöversikt (refereegranskat)abstract
- To meet the goals of the directive 2010/31/EU on the energy performance of buildings, the building sector in Europe now faces a transition towards more energy efficient buildings. Research and development of new energy solutions and technology will be necessary for the transition and the importance of analyzing building energy performance increases. This paper aims to review and evaluate different methods that are commonly used to analyze energy performance in residential buildings in Nordic countries, primarily in Sweden, Norway and Finland. A short international review of regulations is also included. The goal is to find commonly used methods and possibilities for the future. The introduced methods are summarized, categorized and compared based on their advantages and disadvantages. Although the three Nordic countries have similar climate conditions and building traditions, the review shows relatively large variations in the definitions of energy performance for residential buildings, as well as variations in how measurements and calculations are used in the methods for energy performance analysis. In the conducted review, methods, or parts of methods, are also found to be used. The methods used to analyze energy performance are found to be more similar than the concepts of energy performance itself in the three countries. These aspects may be considered in further work to develop an international policy practice for energy performance of residential buildings in cold climate.
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| 10. |
- Bashir, Rania Salah Eldien, et al.
(författare)
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A One Health perspective to identify environmental factors that affect Rift Valley fever transmission in Gezira state, Central Sudan
- 2019
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Ingår i: Tropical Medicine and Health. - : BioMed Central. - 1348-8945 .- 1349-4147. ; 47:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rift Valley fever (RVF) is a zoonotic viral vector-borne disease that affects both animals and humans and leads to severe economic consequences. RVF outbreaks are triggered by a favorable environment and flooding, which enable mosquitoes to proliferate and spread the virus further. RVF is endemic to Africa and has spread to Saudi Arabia and Yemen. There is great concern that RVF may spread to previously unaffected geographic regions due to climate change. We aimed to better understand the spatiotemporal pattern of the 2007 RVF outbreak at the human-animal-environment interface and to determine environmental factors that may have effects on RVF occurrence in Gezira state, Sudan.Materials and methods: We compiled epidemiological, environmental, and spatiotemporal data across time and space using remote sensing and a geographical information system (GIS). The epidemiological data included 430 RVF human cases as well as human and animal population demographic data for each locality. The cases were collected from 41 locations in Gezira state. The environmental data represent classified land cover during 2007, the year of the RVF outbreak, and the average of the Normalized Difference Vegetation Index (NDVI) for 6 months of 2007 is compared with those of 2010 and 2014, when there was no RVF outbreak. To determine the effect of the environmental factors such as NDVI, soil type, and RVF case's location on the Blue Nile riverbank on RVF incidence in Gezira state, a multilevel logistic regression model was carried out.Results: We found that the outbreak in Gezira state occurred as a result of interaction among animals, humans, and the environment. The multilevel logistic regression model (F = 43,858, df = 3, p = 0.000) explained 23% of the variance in RVF incidence due to the explanatory variables. Notably, soil type (beta = 0.613, t = 11.284, p = 0.000) and NDVI (beta = - 0.165, t = - 3.254, p = 0.001) were the explanatory environmental factors that had significant effects on RVF incidence in 2007 in Gezira state, Sudan.Conclusions: Precise remote sensing and the GIS technique, which rely on environmental indices such as NDVI and soil type that are satellite-derived, can contribute to establishing an early warning system for RVF in Sudan. Future preparedness and strengthening the capacity of regional laboratories are necessary for early notification of outbreaks in animals and humans.
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