| 1. |
- Angenete, Eva, 1972, et al.
(författare)
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Laparoscopic Lavage Is Feasible and Safe for the Treatment of Perforated Diverticulitis With Purulent Peritonitis The First Results From the Randomized Controlled Trial DILALA
- 2016
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Ingår i: Annals of Surgery. - : Lippincott Williams & Wilkins. - 0003-4932 .- 1528-1140. ; 263:1, s. 117-122
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Tidskriftsartikel (refereegranskat)abstract
- Objective:To evaluate short-term outcomes of a new treatment for perforated diverticulitis with purulent peritonitis in a randomized controlled trial.Background:Perforated diverticulitis with purulent peritonitis (Hinchey III) has traditionally been treated with surgery including colon resection and stoma (Hartmann procedure) with considerable postoperative morbidity and mortality. Laparoscopic lavage has been suggested as a less invasive surgical treatment.Methods:Laparoscopic lavage was compared with colon resection and stoma in a randomized controlled multicenter trial, DILALA (ISRCTN82208287). Initial diagnostic laparoscopy showing Hinchey III was followed by randomization. Clinical data was collected up to 12 weeks postoperatively.Results: Eighty-three patients were randomized, out of whom 39 patients in laparoscopic lavage and 36 patients in the Hartmann procedure groups were available for analysis. Morbidity and mortality after laparoscopic lavage did not differ when compared with the Hartmann procedure. Laparoscopic lavage resulted in shorter operating time, shorter time in the recovery unit, and shorter hospital stay.Conclusions:In this trial, laparoscopic lavage as treatment for patients with perforated diverticulitis Hinchey III was feasible and safe in the short-term.
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| 2. |
- Beijer, Elisabeth, et al.
(författare)
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Utvärderingsverkstäder i välfärdsverksamheter : studier av verkstädernas kvalitet och nytta
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Med inspiration från aktionsforskningen har olika former av förändringsinriktad och deltagarbaserad forskning och utvecklingsarbete utvecklats, under beteckningar som forsknings- eller FoU-cirklar (Socialstyrelsen, 2002), participatorisk aktionsforskning (Participatory Action Research, PAR) (Holmer & Starrin, 1993), handlingsorienterat forskningssamarbete (Co-operative Inquiry) (Reason & Heron, 1986; Hummelvoll, 2006). Dessa olika arbetssätt förenas i en gemensam syn på hur kunskap kan utvecklas, spridas och användas: gemensamt och i samarbete, och inte utifrån ett ’top-down-perspektiv’. Utvärderingsverkstäder (i fortsättningen förkortat UV), som utgår från denna tradition, arrangeras av FoU-enheter inom välfärdsområdet, och/eller av högskola/universitet. I dessa verkstäder träffas en grupp deltagare tillsammans med utvärderingskunniga ledare från FoU-enheten/högskolan. Deltagarna genomför med stöd från ledarna och de övriga deltagarna utvärderingar, eller utvecklar system för utvärdering, på uppdrag av sina respektive organisationer.Syftet med detta paper är att redovisa och diskutera tio års erfarenheter från UV vid fyra FoU-enheter och en högskola i Mellansverige, ur deltagarnas och deras organisationers, samt ledarnas och de ansvariga enheternas/högskolans perspektiv.
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| 3. |
- Beijer, Elisabeth, et al.
(författare)
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Verkstäder för utvärdering i välfärdsverksamheter : erfarenheter från några svenska FoU-enheter och högskolor
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I denna rapport beskrivs och värderas erfarenheter från utvärderingsverkstäder, som är en pedagogisk form för att simultant lära om utvärdering och att genomföra utvärderingar inom välfärdsområdet. Rapporten bygger på studier av utvärderingsverkstäder liksom på författarnas egna erfarenheter från att bedriva verkstäder. Studien har genomförts inom ramen för Nätverket för utvärderingsverkstäder (Nuv). Initiativet till Nuv togs 2008 från Mälardalens Högskola och dess utvärderingsakademi. Nätverket etablerades mellan de enheter vars medarbetare medverkar i denna rapport; FoU Välfärd Värmland (Bengt G Eriksson), FoU i Väst/GR (Elisabeth Beijer), Mälardalens Högskola och FoU i Sörmland (Kari Jess, Laila Niklasson, Ove Karlsson Vestman) och FoU Sjuhärad Välfärd (Per-Åke Karlsson). Jennifer C Greene, gästprofessor vid Mälardalens högskola, medverkade under en tid i nätverket och bidrar även i denna antologi. Tanken med Nuv är att samla och sprida erfarenheter från redan genomförda verkstäder, för att på så sätt bidra till en utveckling där flera utvärderingsverkstäder kommer till stånd och till att förbättra arbetsmodellen på basis av gjorda erfarenheter. Denna antologi är ett led i detta. Rapporten har antologins form där varje författare svarar för innehållet i respektive kapitel. Grundmaterialet för kapitlen utgörs av de studier vi genomfört gemensamt samt erfarenheter från att leda utvärderingsverkstäder. Våren 2009 genomförde vi tillsammans en enkätundersökning riktad till deltagare i utvärderingsverkstäderna. Vi vill passa på att tacka deltagarna som tog sig tid att besvara enkäten. Dessutom genomfördes något senare ett antal intervjuer med några deltagare i utvärderingsverkstäderna liksom med några av deras chefer (tillika uppdragsgivare för utvärderingsuppdragen). Även dessa vill vi tacka för att de välvilligt låtit sig intervjuas om sina erfarenheter från verkstäderna. Vår förhoppning är att antologin ska bidra till att sprida kunskap om utvärderingsverkstäder, bidra till utveckling av metodiken samt inspirera till ytterligare verkstäder.
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| 4. |
- Solmi, Marco, et al.
(författare)
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Physical and mental health impact of COVID-19 on children, adolescents, and their families :
- 2022
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 299, s. 367-376
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Tidskriftsartikel (refereegranskat)abstract
- Background: The COVID-19 pandemic has altered daily routines and family functioning, led to closing schools, and dramatically limited social interactions worldwide. Measuring its impact on mental health of vulnerable children and adolescents is crucial. Methods: The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT - www. coh-fit.com) is an on-line anonymous survey, available in 30 languages, involving >230 investigators from 49 countries supported by national/international professional associations. COH-FIT has thee waves (until the pandemic is declared over by the WHO, and 6-18 months plus 24-36 months after its end). In addition to adults, COH-FIT also includes adolescents (age 14-17 years), and children (age 6-13 years), recruited via nonprobability/snowball and representative sampling and assessed via self-rating and parental rating. Nonmodifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to promote health and prevent mental and physical illness in children and adolescents will be generated by COH-FIT. Co primary outcomes are changes in well-being (WHO-5) and a composite psychopathology P-Score. Multiple behavioral, family, coping strategy and service utilization factors are also assessed, including functioning and quality of life. Results: Up to June 2021, over 13,000 children and adolescents from 59 countries have participated in the COHFIT project, with representative samples from eleven countries. Limitations: Cross-sectional and anonymous design. Conclusions: Evidence generated by COH-FIT will provide an international estimate of the COVID-19 effect on childrens, adolescents and families, mental and physical health, well-being, functioning and quality of life, informing the formulation of present and future evidence-based interventions and policies to minimize adverse effects of the present and future pandemics on youth.
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| 5. |
- Solmi, Marco, et al.
(författare)
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The collaborative outcomes study on health and functioning during infection times in adults (COH-FIT-Adults) : Design and methods of an international online survey targeting physical and mental health effects of the COVID-19 pandemic
- 2022
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Ingår i: Journal of Affective Disorders. - : Elsevier. - 0165-0327 .- 1573-2517. ; 299, s. 393-407
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Tidskriftsartikel (refereegranskat)abstract
- Background: . High-quality comprehensive data on short-/long-term physical/mental health effects of the COVID-19 pandemic are needed. Methods: . The Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) is an international, multi-language (n=30) project involving >230 investigators from 49 countries/territories/regions, endorsed by national/international professional associations. COH-FIT is a multi-wave, on-line anonymous, cross-sectional survey [wave 1: 04/2020 until the end of the pandemic, 12 months waves 2/3 starting 6/24 months threreafter] for adults, adolescents (14-17), and children (6-13), utilizing non-probability/snowball and representative sampling. COH-FIT aims to identify non-modifiable/modifiable risk factors/treatment targets to inform prevention/intervention programs to improve social/health outcomes in the general population/vulnerable subgrous during/after COVID-19. In adults, co-primary outcomes are change from pre-COVID-19 to intra-COVID-19 in well-being (WHO-5) and a composite psychopathology P-Score. Key secondary outcomes are a P-extended score, global mental and physical health. Secondary outcomes include health-service utilization/ functioning, treatment adherence, functioning, symptoms/behaviors/emotions, substance use, violence, among others. Results: . Starting 04/26/2020, up to 14/07/2021 >151,000 people from 155 countries/territories/regions and six continents have participated. Representative samples of >= 1,000 adults have been collected in 15 countries. Overall, 43.0% had prior physical disorders, 16.3% had prior mental disorders, 26.5% were health care workers, 8.2% were aged >= 65 years, 19.3% were exposed to someone infected with COVID-19, 76.1% had been in quarantine, and 2.1% had been COVID 19-positive. Limitations: . Cross-sectional survey, preponderance of non-representative participants. Conclusions: . Results from COH-FIT will comprehensively quantify the impact of COVID-19, seeking to identify high-risk groups in need for acute and long-term intervention, and inform evidence-based health policies/strategies during this/future pandemics.
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| 6. |
- Solmi, Marco, et al.
(författare)
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Validation of the Collaborative Outcomes study on Health and Functioning during Infection Times (COH-FIT) questionnaire for adults
- 2023
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Ingår i: Journal of Affective Disorders. - : ELSEVIER. - 0165-0327 .- 1573-2517. ; 326, s. 249-261
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Collaborative Outcome study on Health and Functioning during Infection Times (COH-FIT; www.coh-fit.com) is an anonymous and global online survey measuring health and functioning during the COVID-19 pandemic. The aim of this study was to test concurrently the validity of COH-FIT items and the in-ternal validity of the co-primary outcome, a composite psychopathology "P-score". Methods: The COH-FIT survey has been translated into 30 languages (two blind forward-translations, consensus, one independent English back-translation, final harmonization). To measure mental health, 1-4 items ("COH-FIT items") were extracted from validated questionnaires (e.g. Patient Health Questionnaire 9). COH-FIT items measured anxiety, depressive, post-traumatic, obsessive-compulsive, bipolar and psychotic symptoms, as well as stress, sleep and concentration. COH-FIT Items which correlated r >= 0.5 with validated companion question-naires, were initially retained. A P-score factor structure was then identified from these items using exploratory factor analysis (EFA) and confirmatory factor analyses (CFA) on data split into training and validation sets. Consistency of results across languages, gender and age was assessed. Results: From >150,000 adult responses by May 6th, 2022, a subset of 22,456 completed both COH-FIT items and validated questionnaires. Concurrent validity was consistently demonstrated across different languages for COH-FIT items. CFA confirmed EFA results of five first-order factors (anxiety, depression, post-traumatic, psychotic, psychophysiologic symptoms) and revealed a single second-order factor P-score, with high internal reliability (omega = 0.95). Factor structure was consistent across age and sex. Conclusions: COH-FIT is a valid instrument to globally measure mental health during infection times. The P-score is a valid measure of multidimensional mental health.
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| 7. |
- Thornell, Anders, 1976, et al.
(författare)
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Treatment of Acute Diverticulitis Laparoscopic Lavage vs. Resection (DILALA): study protocol for a randomised controlled trial.
- 2011
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Ingår i: Trials. - : Springer Science and Business Media LLC. - 1745-6215. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Perforated diverticulitis is a condition associated with substantial morbidity. Recently published reports suggest that laparoscopic lavage has less complications and shorter hospital stay. So far no randomised study has published any results. METHODS: DILALA is a Scandinavian, randomised trial, comparing laparoscopic lavage (LL) to the traditional Hartmann's Procedure (HP). Primary endpoint is the number of re-operations within 12 months. Secondary endpoints consist of mortality, quality of life (QoL), re-admission, health economy assessment and permanent stoma. Patients are included when surgery is required. A laparoscopy is performed and if Hinchey grade III is diagnosed the patient is included and randomised 1:1, to either LL or HP. Patients undergoing LL receive >3L of saline intraperitoneally, placement of pelvic drain and continued antibiotics. Follow-up is scheduled 6-12 weeks, 6 months and 12 months. A QoL-form is filled out on discharge, 6- and 12 months. Inclusion is set to 80 patients (40+40). DISCUSSION: HP is associated with a high rate of complication. Not only does the primary operation entail complications, but also subsequent surgery is associated with a high morbidity. Thus the combined risk of treatment for the patient is high. The aim of the DILALA trial is to evaluate if laparoscopic lavage is a safe, minimally invasive method for patients with perforated diverticulitis Hinchey grade III, resulting in fewer re-operations, decreased morbidity, mortality, costs and increased quality of life. British registry (ISRCTN) for clinical trials ISRCTN82208287 http://www.controlled-trials.com/ISRCTN82208287.
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| 8. |
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| 9. |
- Wärnberg, Fredrik, et al.
(författare)
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Prognostic Risk Assessment and Prediction of Radiotherapy Benefit for Women with Ductal Carcinoma In Situ (DCIS) of the Breast, in a Randomized Clinical Trial (SweDCIS).
- 2021
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Ingår i: Cancers. - : MDPI AG. - 2072-6694. ; 13:23
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Tidskriftsartikel (refereegranskat)abstract
- Prediction of radiotherapy (RT) benefit after breast-conserving surgery (BCS) for DCIS is crucial. The aim was to validate a biosignature, DCISionRT®, in the SweDCIS randomized trial. Women were randomly assigned to RT or not after BCS, between 1987 and 2000. Tumor blocks were collected, and slides were sent to PreludeDxTM for testing. In 504 women with complete data and negative margins, DCISionRT divided 52% women into Elevated (DS > 3) and 48% in Low (DS ≤ 3) Risk groups. In the Elevated Risk group, RT significantly decreased relative 10-year ipsilateral total recurrence (TotBE) and 10-year ipsilateral invasive recurrence (InvBE) rates, HR 0.32 and HR 0.24, with absolute decreases of 15.5% and 9.3%. In the Low Risk group, there were no significant risk differences observed with radiotherapy. Using a cutoff of DS > 3.0, the test was not predictive for RT benefit (p = 0.093); however, above DS > 2.8 RT benefit was greater for InvBE (interaction p = 0.038). Recurrences at 10 years without radiotherapy increased significantly per 5 DS units (TotBE HR:1.5 and InvBE HR:1.5). Continuous DS was prognostic for TotBE risk although categorical DS did not reach significance. Absolute 10-year TotBE and InvBE risks appear sufficiently different to indicate that DCISionRT can aid physicians in selecting individualized adjuvant DCIS treatment strategies. Further analyses are planned in combined cohorts to increase statistical power.
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