| 1. |
- Billaud Feragen, Kristin, et al.
(författare)
-
Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 10. Parental perceptions of appearance and treatment outcomes in their 5-year-old child
- 2017
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - : TAYLOR & FRANCIS LTD. - 2000-656X .- 2000-6764. ; 51:1, s. 81-87
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Few studies have explored childrens emotional and behavioural reactions to cleft surgery and treatment-related stress. The objective was to investigate parents evaluations of appearance and treatment outcomes in their 5-year-old child with unilateral cleft lip and palate (UCLP), and their perceptions of how their child was coping with treatment, comparing this information with recorded postsurgical complications.Design: Three parallel group randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK.Methods: Three different surgical procedures for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. A total of 356 parents completed the Scandcleft Parent Questionnaire, and 346 parents completed the Cleft Evaluation Profile.Results: The results indicated that the majority of parents were satisfied with cleft-related features of their childs appearance. Further, most children coped well with treatment according to their parents. Nevertheless, 17.5% of the children showed minor or short-term reactions after treatment experiences, and 2% had major or lasting difficulties. There were no significant relationships between parent perceptions of treatment-related problems and the occurrence of post-surgical medical complications.Conclusions: Most parents reported satisfaction with their childs appearance. However, treatment-related problems were described in some children, urging cleft centres to be aware of potential negative emotional and behavioural reactions to treatment in some young children, with a view to preventing the development of more severe treatment-related anxiety.
|
|
| 2. |
- Gamble, Carrol, et al.
(författare)
-
Timing of Primary Surgery for Cleft Palate.
- 2023
-
Ingår i: The New England journal of medicine. - : Massachusetts Medical Society. - 1533-4406 .- 0028-4793. ; 389:9, s. 795-807
-
Tidskriftsartikel (refereegranskat)abstract
- Among infants with isolated cleft palate, whether primary surgery at 6 months of age is more beneficial than surgery at 12 months of age with respect to speech outcomes, hearing outcomes, dentofacial development, and safety is unknown.We randomly assigned infants with nonsyndromic isolated cleft palate, in a 1:1 ratio, to undergo standardized primary surgery at 6 months of age (6-month group) or at 12 months of age (12-month group) for closure of the cleft. Standardized assessments of quality-checked video and audio recordings at 1, 3, and 5 years of age were performed independently by speech and language therapists who were unaware of the trial-group assignments. The primary outcome was velopharyngeal insufficiency at 5 years of age, defined as a velopharyngeal composite summary score of at least 4 (scores range from 0 to 6, with higher scores indicating greater severity). Secondary outcomes included speech development, postoperative complications, hearing sensitivity, dentofacial development, and growth.We randomly assigned 558 infants at 23 centers across Europe and South America to undergo surgery at 6 months of age (281 infants) or at 12 months of age (277 infants). Speech recordings from 235 infants (83.6%) in the 6-month group and 226 (81.6%) in the 12-month group were analyzable. Insufficient velopharyngeal function at 5 years of age was observed in 21 of 235 infants (8.9%) in the 6-month group as compared with 34 of 226 (15.0%) in the 12-month group (risk ratio, 0.59; 95% confidence interval, 0.36 to 0.99; P=0.04). Postoperative complications were infrequent and similar in the 6-month and 12-month groups. Four serious adverse events were reported (three in the 6-month group and one in the 12-month group) and had resolved at follow-up.Medically fit infants who underwent primary surgery for isolated cleft palate in adequately resourced settings at 6 months of age were less likely to have velopharyngeal insufficiency at the age of 5 years than those who had surgery at 12 months of age. (Funded by the National Institute of Dental and Craniofacial Research; TOPS ClinicalTrials.gov number, NCT00993551.).
|
|
| 3. |
- Hysing, Mari
(författare)
-
Visuella möten i klassrummet : Bilddidaktiska konstruktioner av kunskap och positioner i gymnasieskolan
- 2021
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Due to developments in visual technology, teachers and students are exposed to an increasing number of images in their everyday life, which also finds its way into the classroom. This study aims to contribute to further understanding of how knowledge and positions are constructed in visual meetings in the classroom by problematizing the discursive practice of visual art education in upper secondary school. The study investigates how art teachers construct positions when talking about their choices of images for teaching and what kind of knowledge thereby is constructed as valuable. The study also analyzes how art teachers and students construct positions in visual meetings in the classroom and what kind of knowledge thereby is constructed as valuable. The study is theoretically framed by theories and concepts in visual culture and Foucauldian discourse analysis. The concept visual meetings refers to how art teachers and students interact and make meaning when using images that the art teachers have chosen. The perspective of discourse analysis involves that classroom interactions are seen as expressions of knowledge and power in general and of prevailing views on visual art education in particular. Data production is carried out through ethnography, which involves interviews with two art teachers and observations of eleven lessons in visual art classes at two upper secondary schools. The results show that a dominating overall school discourse regulates how the art teachers and students are constructed as active/adult/experienced and passive/child/unexperienced subjects. One of the classroom practices is shown to prioritize position and knowledge constructions related to production of aesthetically pleasing images. The other classroom practice is shown to prioritize position and knowledge constructions related to image interpretation in terms of understanding cultures and contexts. Both classroom practices also show that despite the art teachers’ stated intentions in constructing independent and critically examining positions for the students, looking practices are formed in the classrooms that do not allow such positions for the students to any great extent. The study concludes that the dominating discourses in these two classroom practices reveal régimes of truth that regulate what kind of knowledge constructions that are valued within these two examples of visual art education.
|
|
| 4. |
|
|
| 5. |
- Lohmander, Anette, et al.
(författare)
-
Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 4. Speech outcomes in 5-year-olds - velopharyngeal competency and hypernasality
- 2017
-
Ingår i: Journal of Plastic Surgery and Hand Surgery. - : TAYLOR & FRANCIS LTD. - 2000-656X .- 2000-6764. ; 51:1, s. 27-37
-
Tidskriftsartikel (refereegranskat)abstract
- Background and aim: Adequate velopharyngeal function and speech are main goals in the treatment of cleft palate. The objective was to investigate if there were differences in velopharyngeal competency (VPC) and hypernasality at age 5 years in children with unilateral cleft lip and palate (UCLP) operated on with different surgical methods for primary palatal repair. A secondary aim was to estimate burden of care in terms of received additional secondary surgeries and speech therapy. Design: Three parallel group, randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical protocols for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. Speech audio and video recordings of 391 children (136 girls, 255 boys) were available and perceptually analysed. The main outcome measures were VPC and hypernasality from blinded assessments. Results: There were no statistically significant differences between the prevalences in the arms in any of the trials. VPC: Trial 1, A: 58%, B: 61%; Trial 2, A: 57%, C: 54%; Trial 3, A: 35%, D: 51%. No hypernasality: Trial 1, A: 54%, B: 44%; Trial 2, A: 47%, C: 51%; Trial 3, A: 34%, D: 49%. Conclusions: No differences were found regarding VPC and hypernasality at age 5 years after different methods for primary palatal repair. The burden of care in terms of secondary pharyngeal surgeries, number of fistulae, and speech therapy visits differed.
|
|
| 6. |
- Lohmander, Anette, et al.
(författare)
-
Validity of auditory perceptual assessment of velopharyngeal function and dysfunction - the VPC-Sum and the VPC-Rate
- 2017
-
Ingår i: Clinical Linguistics & Phonetics. - : TAYLOR & FRANCIS INC. - 0269-9206 .- 1464-5076. ; 31:7-9, s. 589-597
-
Tidskriftsartikel (refereegranskat)abstract
- Overall weighted or composite variables for perceptual auditory estimation of velopharyngeal closure or competence have been used in several studies for evaluation of velopharyngeal function during speech. The aim of the present study was to investigate the validity of a composite score (VPC-Sum) and of auditory perceptual ratings of velopharyngeal competence (VPC-Rate). Available VPC-Sum scores and judgments of associated variables (hypernasality, audible nasal air leakage, weak pressure consonants, and non-oral articulation) from 391 5-year olds with repaired cleft palate (the Scandcleft project) were used to investigate content validity, and 339 of these were compared with an overall judgment of velopharyngeal competence (VPC-Rate) on the same patients by the same listeners. Significant positive correlations were found between the VPC-Sum and each of the associated variables (Cronbachs alpha 0.55-0.87, P amp;lt; 0.001), and a moderately significant positive correlation between VPC-Sum and VPC-Rate (Rho 0.698, P amp;lt; 0.01). The latter classified cases well when VPC-Sum was dichotomized with 67% predicted velopharyngeal competence and 90% velopharyngeal incompetence. The validity of the VPC-Sum was good and the VPC-Rate a good predictor, suggesting possible use of both measures depending on the objective.
|
|
| 7. |
- Nyberg, Anette, et al.
(författare)
-
Longer work experience and age associated with safety attitudes in operating room nurses : an online cross-sectional study
- 2024
-
Ingår i: BMJ open quality. - : BMJ Publishing Group Ltd. - 2399-6641. ; 13:1
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patient safety is fundamental when providing care in the operating room. Still, adverse events and errors are a challenge for patient safety worldwide. To avoid preventable patient harm, organisations need a positive safety culture, the measurable component of which is known as the safety climate. To best improve the safety climate the current attitudes to safety must first be understood.AIM: To explore operating room nurses' safety attitudes and their views on how to improve patient safety in operating rooms.ETHOD: A cross-sectional study using the Swedish-translated version of the Safety Attitudes Questionnaire, Operating Room version. Data were collected using an online survey platform.RESULTS: 358 operating room nurses completed the questionnaire. The results show that the older age group rated their working conditions and management support as better than the younger age groups. The older age group also rated their stress recognition as lower compared with the younger age groups. The same pattern was seen in terms of work experience, with more-experienced respondents showing a higher mean score for the factor working conditions and a lower mean score for the factor stress recognition as compared with their less-experienced colleagues. When comparing hospital types, county hospital employees had higher factor scores for safety climate, job satisfaction and working conditions than university hospital employees. The respondents' most recurring recommendations for improving patient safety were 'Having better and clearer communication' followed by 'Having enough time to do things the way they should be done'.CONCLUSION: More focus on safety with increasing age and experience was observed in this cohort. Need for improvements is reported for patient safety in operating rooms, mainly when it comes to communication and workload. To improve and develop patient safety in the operating room, the organisational safety climate needs to be actively managed and developed. One step in actively managing the safety climate may be efforts to retain experienced operating room nurses.
|
|
| 8. |
- Nyberg, Andre, et al.
(författare)
-
Low-load/high-repetition elastic band resistance training in patients with COPD : a randomized, controlled, multicenter trial
- 2015
-
Ingår i: Clinical Respiratory Journal. - : John Wiley & Sons. - 1752-6981 .- 1752-699X. ; 9:3, s. 278-288
-
Tidskriftsartikel (refereegranskat)abstract
- Background: High-repetitive resistance training is recommended to increase peripheral muscular endurance in healthy adults, however the effects of resistance training with this design on exercise capacity and health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD) is unknown.Objective: Investigate if low load / high repetition elastic band resistance training (RT) could improve functional capacity, muscular function, endurance cycle capacity or HRQOL in patients with COPD.Methods: A prospective, randomized controlled multicentre trial was constructed with concealed allocation, blinded outcome assessment, and intention-to-treat analysis. A total of 44 patients with moderate to very severe COPD (FEV1 44.6% predicted) were included. Patients were randomized to either the experimental group receiving eight weeks of RT (3 sessions/week) in combination with patient education (four occasions) or the control group receiving the patient education alone.Results: At post-tests, the between-group differences were in favor of the experimental group on the 6 minute walk test (mean difference (95% confidence interval)): 34 meters (14 to 54) and the 6 minute pegboard and ring test (20 rings (3 to 37). No difference between groups was found on the chronic respiratory disease questionnaire (0.1 (-0.2 to 0.4). On secondary outcomes, results were in favor of the experimental group regarding upper extremity endurance capacity, muscular function and depression but no difference was seen between groups on endurance cycle capacity and HRQOL.Conclusion: RT can increase functional capacity and muscular function but not cycle endurance capacity and HRQOL in patients with moderate to severe COPD.
|
|
| 9. |
- Nyberg, Anette, et al.
(författare)
-
Patient safety during joint replacement surgery : experiences of operating room nurses
- 2021
-
Ingår i: BMJ open quality. - : BMJ Publishing Group Ltd. - 2399-6641. ; 10:4
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Avoidable complications for surgical patients still occur despite efforts to improve patient safety processes in operating rooms. Analysis of experiences of operating room nurses can contribute to better understanding of perioperative processes and flow, and why avoidable complications still occur.AIM: To explore aspects of patient safety practice during joint replacement surgery through assessment of operating room nurse experiences.METHOD: A qualitative design using semistructured interviews with 21 operating room nurses currently involved in joint replacement surgery in Sweden. Inductive qualitative content analysis was used.RESULTS: The operating room nurses described experiences with patient safety hazards on an organisational, team and individual level. Uncertainties concerning a reliable plan for the procedure and functional reporting, as well as documentation practices, were identified as important. Teamwork and collaboration were described as crucial at the team level, including being respected as valuable, having shared goals and common expectations. On the individual level, professional knowledge, skills and experience were needed to make corrective steps.CONCLUSION: The conditions to support patient safety, or limit complication risk, during joint replacement surgery continue to be at times inconsistent, and require steady performance attention. Operating room nurses make adjustments to help solve problems as they arise, where there are obvious risks for patient complications. The organisational patient safety management process still seems to allow deviation from established practice standards at times, and relies on individual-based corrective measures at the 'bedside' at times for good results.
|
|
| 10. |
- Nyberg, Anette, et al.
(författare)
-
Perioperative patient safety indicators : A Delphi study
- 2024
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702.
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To identify, define and achieve consensus on perioperative patient safety indicators within a Swedish context.DesignA modified Delphi method.Methods: A purposeful sample of 22 experts, all experienced operating room nurse specialists, was recruited for this study. A questionnaire was constructed incorporating statements derived from a preceding study. The experts were asked to rate the importance of each statement concerning patient safety during the perioperative phase. The data collection occurred through an online survey platform between November 2022 and April 2023. The CREDES checklist guided the reporting of this study.Results: The three-round Delphi study resulted in consensus on 73 statements out of 103, encompassing 74% process indicators and 26% structure indicators. Key areas of consensus included the use of the Surgical Safety Checklist and optimizing the operating room environment.Conclusion: Consensus was reached on perioperative safety indicators, underscoring the intricate challenges involved in ensuring patient safety in the operating room. It emphasizes the important integration of both structure and process indicators for comprehensive safety assessment during surgical procedures. Recognizing the difficulty in measuring factors like teamwork and communication, essential for patient safety, the study offers practical guidance. It underlines a balanced approach and specific consensus areas applicable in clinical practice to enhance perioperative patient safety.Implications for the profession and patient care: This study provides concrete practice guidance and establishes a structured framework for evaluating perioperative care processes. It emphasizes the critical role of professionals having the necessary skills and being present during surgical procedures. Additionally, the study underscores the paramount importance of effective communication and teamwork within the operating room team, substantively contributing to overall patient safety enhancement.Impact: The study focused on addressing the challenge of ensuring patient safety in operating rooms, acknowledging the persistent complications related to surgery despite global efforts to eliminate avoidable harm in healthcare. Consensus was reached on 73 crucial indicators for perioperative patient safety, emphasizing a balanced approach integrating both process and structure indicators for a comprehensive assessment of safety during surgical procedures. The study has a broad impact on professionals and healthcare systems, providing concrete guidance for practice and offering a structured process for evaluating perioperative care.Reporting Method: The study is reported informed by 'Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations derived from a methodological systematic review'.Patient or Public Contribution: No patient or public contribution.
|
|
