| 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. |
- Asproth, Viveca, et al.
(författare)
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Rapport från GSS : Gränsöverskridande samarbete för säkerhet
- 2014
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Rapport (populärvet., debatt m.m.)abstract
- Projektet Gränsöverbryggande Samverkan för Säkerhet (GSS) har syftat till att bidra till ökad säkerhet, och därmed också ökad livskvalitet, såväl för den befolkning som stadigvarande bor i gränslandet som de besökare som tillfälligt vistas i området. I detta syfte ligger också ökade möjligheter att rädda liv och hälsa samt att begränsa skador på miljö och materiella (ekonomiska) tillgångar. GSS fokuserar på den information och kunskap, som krävs i en räddnings-och krissituation. GSS sätter förberedelsearbetet i främsta rummet.Projektets gränsöverskridande mervärde har flera dimensioner:•Det ökar förståelse, tillit och samarbete mellan säkerhetsansvariga på ömse sidor nationsgränsen.•Myndigheter med säkerhetsansvar etablerar långsiktiga institutionella samarbeten runt säkerhet och krishantering.•Gränsregionens attraktionskraft ökar tack vare ökad säkerhet och förbättrad krishanteringsförmåga.•Den ömsesidiga kunskapen och förståelsen om förhållanden på andra sidan nationsgränsen ökar hos projektdeltagarna.Projektet har genomförts i form av tre årliga cykler bestående av scenarioskapande, ledningsövning och utvärdering. Resultatet från utvärderingarna har sedan legat till grund för nästa års cykel. Parallellt med detta har ettövningssystem utvecklats. Systemet innehåller scenariobank, övningar och stöd för dessa, play-backfunktion samt utvärderingsmodul inklusive statistikfunktioner. Utvärderingarna från övningarna finns i separat bilaga. Den första övningen genomfördes som en tabletop-övning vid Gränsräddningsrådets möte 2011. De två andra övningarna genomfördes så att deltagarna satt på sina respektive arbetsplatser och kunde kommunicera med varandra, dels via traditionella kommunikationsmedel, dels med hjälp av övningssystemet. Dessa övningar diskuterades sedan vid Gränsräddningsrådets möten.I framtagande av scenarios och övningar har personer från de verksamheter som skulle öva deltagit. Erfarenheterna från projektet är att behovet av övningar av det här slaget är stort. De deltagande organisationerna uttrycket att det varit mycket lärorikt att delta och man har skaffat sig nya kontakter och/eller utvecklat de kontakter man redan haft. Det har också visat sig att man haft direkt nytta av projektet vid verkliga händelser.Projektets kostnader har upplöpt till ca 3,2 mill. SEK och knappt 2,5 mill. NOK. Kostnader har huvudsakligen bestått i arbetstid och i någon mån av resor. Resekostnaden har minskat genom att projektet frekvent använt sig av distansteknik i stället för fysiska möten.
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| 3. |
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| 4. |
- Boettcher, Johanna, et al.
(författare)
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Combining attention training with Internet-based cognitive-behavioural self-help for social anxiety : a randomised controlled trial
- 2014
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Ingår i: Cognitive Behaviour Therapy. - : Taylor & Francis Group. - 1650-6073 .- 1651-2316. ; 43:1, s. 34-48
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Tidskriftsartikel (refereegranskat)abstract
- Guided Internet-based cognitive-behavioural self-help (ICBT) has been proven to be effective for social anxiety disorder (SAD) by several independent research groups. However, as the proportion of clinical significant change has room for improvement, new treatments should be developed and investigated. A novel treatment is attention bias modification (ABM). This study aimed at evaluating the combination of ABM and ICBT. We compared two groups, one group receiving ICBT and ABM targeting attentional avoidance and the other group receiving ICBT and control training. ABM and control training tasks were both based on the dot-probe paradigm. A total of 133 participants, diagnosed with SAD, were randomised to these two groups. The attention training group (N = 66) received 2 weeks of daily attention training followed by 9 weeks of ICBT. The control group (N = 67) received 2 weeks of daily control training, also followed by 9 weeks of ICBT. Social anxiety measures as well as the attention bias were assessed at pre-assessment, at week 2, and at post-treatment. Results showed no significant differences between the attention training group and the control group. Both groups improved substantially on social anxiety symptoms from pre- to post-assessment (dwithin = 1.39–1.41), but showed no change in attention processes (dwithin = 0.10–0.17). In this trial, the attention modification training failed to induce differential change in attention bias. Results demonstrate that the applied ABM procedure with its focus on the reduction of attentional avoidance was ineffective in the Internet-based setting. The results do not suggest that adding ABM targeting attentional avoidance to ICBT results in better outcomes than ICBT alone.
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| 5. |
- Borgmästars, Emmy, et al.
(författare)
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Circulating tissue polypeptide-specific antigen in pre-diagnostic pancreatic cancer samples
- 2021
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 13:21
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Tidskriftsartikel (refereegranskat)abstract
- Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection.
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| 6. |
- Franklin, Oskar, et al.
(författare)
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Plasma micro-RNA alterations appear late in pancreatic cancer
- 2018
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Ingår i: Annals of Surgery. - 0003-4932 .- 1528-1140. ; 267:4, s. 775-781
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this research was to study whether plasma microRNAs (miRNA) can be used for early detection of pancreatic cancer (PC) by analyzing prediagnostic plasma samples collected before a PC diagnosis. Background: PC has a poor prognosis due to late presenting symptoms and early metastasis. Circulating miRNAs are altered in PC at diagnosis but have not been evaluated in a prediagnostic setting. Methods: We first performed an initial screen using a panel of 372 miRNAs in a retrospective case-control cohort that included early-stage PC patients and healthy controls. Significantly altered miRNAs at diagnosis were then measured in an early detection case-control cohort wherein plasma samples in the cases are collected before a PC diagnosis. Carbohydrate antigen 19–9 (Ca 19–9) levels were measured in all samples for comparison. Results: Our initial screen, including 23 stage I-II PC cases and 22 controls, revealed 15 candidate miRNAs that were differentially expressed in plasma samples at PC diagnosis. We combined all 15 miRNAs into a multivariate statistical model, which outperformed Ca 19–9 in receiver-operating characteristics analysis. However, none of the candidate miRNAs, individually or in combination, were significantly altered in prediagnostic plasma samples from 67 future PC patients compared with 132 matched controls. In comparison, Ca 19–9 levels were significantly higher in the cases at <5 years before diagnosis. Conclusion: Plasma miRNAs are altered in PC patients at diagnosis, but the candidate miRNAs found in this study appear late in the course of the disease and cannot be used for early detection of the disease.
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| 7. |
- Hansen, Elisabeth, et al.
(författare)
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Cultural activity participation and associations with self-perceived health, life-satisfaction and mental health : the Young HUNT Study, Norway
- 2015
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Leisure time activities and culture participation may have health effects and be important in pulic health promotion. More knowledge on how cultural activity participation may influence self-perceived health, life-satisfaction, self-esteem and mental health is needed. Methods: This article use data from the general population-based Norwegian HUNT Study, using the cross-sectional Young-HUNT3 (2006-08) Survey including 8200 adolescents. Data on cultural activity participation, self-perceived health, life-satisfaction, self-esteem, anxiety and depression were collected by self-reported questionnaires. Results: Both attending meetings or training in an organisation or club, and attending sports events were positively associated with each of the health parameters good self-percieved health, good life-satisfaction, good self-esteem, and low anxiety and depression symptoms. We found differences according to gender and age (13-15 years versus 16-19 years old) for several culture activities, where girls aged 16-19 years seemed to benefit most from being culturally active. The extent of participation seemed to matter. Those who had frequent participation in cultural activities reported better health outcomes compared to inactive adolecents. Conclusions: The results from this study indicate that participation in cultural activities may be positively associated with health, life-satisfaction and self-esteem in adolescents and thus important in public health promotion. Possible sex and age differences should be taken into account.
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| 8. |
- Hognes, Erik Skontorp, et al.
(författare)
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Carbon footprint and energy use of Norwegian fisheries and seafood products
- 2012
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Ingår i: Sustainable Maritime Transportation and Exploitation of Sea Resources - Proceedings of the 14th International Congress of the International Maritime Association of the Mediterranean, IMAM 2011. ; , s. 1031-1036
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Konferensbidrag (refereegranskat)abstract
- Fuel consumption and emission of cooling agents are important sources for climate impact from the value chain of wild caught Norwegian seafood products. For products that are exported quickly and/or over long distances transport is also an important source. Pelagic products have low carbon footprints due to energy efficient fishing, modern refrigeration systems and efficient export methods. The fuel consumption per kilo landed products varies a lot in Norwegian fisheries, both within fisheries that use the same gear or that target the same species. This variation shows that there is a high potential to reduce GHG emissions from Norwegian fisheries.
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| 9. |
- Jackson, Jennie, et al.
(författare)
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Assessing the efficacy of a job rotation for improving occupational physical and psychosocial work environment, musculoskeletal health, social equality, production quality, and resilience at a commercial laundromat: Protocol for a longitudinal case study
- 2023
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 13:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Job rotation is a work organization strategy used to reduce work‐related exposures and musculoskeletal complaints, yet evidence for the efficacy of the approach is weak. Mismatch between job rotation and company needs, lack of full implementation, lack of exposure variation in included tasks, and failure to assess variation may underlie inconclusive research findings to date. The study aims to develop a job rotation with company stakeholders, perform a process evaluation of the implementation, and determine the extent to which the intervention improves the physical and psychosocial work environment, indicators of health, gender and social equality among workers, and production quality and resilience.Methods and analysis: Approximately 60 production workers at a Swedish commercial laundromat will be recruited. Physical and psychosocial work environment conditions, health, productivity and gender and social equality will be assessed pre‐ and post‐ intervention using surveys, accelerometers, heart rate, electromyography and focus groups. A task‐based exposure matrix will be constructed, and exposure variation estimated at the level of the individual worker pre‐ and post‐ intervention. An implementation process evaluation will be conducted. Job rotation efficacy will be assessed in terms of improvement in work environment conditions, health, gender and social inequality, and production quality and resilience. This study will provide novel information on the effects of the job rotation on physical and psychosocial work environment conditions, production quality and rate, health, and gender and social inequality among blue‐collar workers in a highly multicultural workplace.Ethics and dissemination: The study received approval from the Swedish Ethical Review Authority. Results of the project will be shared directly with the employees, managers and union representatives from the participating company, other relevant labour market stakeholders, and with researchers at national and international conferences and via scientific publication.Trial registration: The study is pre‐registered with the Open Science Framework (https://osf.io/zmdc8/).
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| 10. |
- Mason, James E., et al.
(författare)
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A cross-sectional and longitudinal analysis of pre-diagnostic blood plasma biomarkers for early detection of pancreatic cancer
- 2022
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Ingår i: International Journal of Molecular Sciences. - : MDPI. - 1661-6596 .- 1422-0067. ; 23:21
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Tidskriftsartikel (refereegranskat)abstract
- Pancreatic ductal adenocarcinoma (PDAC) is a major cause of cancer death that typically presents at an advanced stage. No reliable markers for early detection presently exist. The prominent tumor stroma represents a source of circulating biomarkers for use together with cancer cell-derived biomarkers for earlier PDAC diagnosis. CA19-9 and CEA (cancer cell-derived biomarkers), together with endostatin and collagen IV (stroma-derived) were examined alone, or together, by multivariable modelling, using pre-diagnostic plasma samples (n = 259 samples) from the Northern Sweden Health and Disease Study biobank. Serial samples were available for a subgroup of future patients. Marker efficacy for future PDAC case prediction (n = 154 future cases) was examined by both cross-sectional (ROC analysis) and longitudinal analyses. CA19-9 performed well at, and within, six months to diagnosis and multivariable modelling was not superior to CA19-9 alone in cross-sectional analysis. Within six months to diagnosis, CA19-9 (AUC = 0.92) outperformed the multivariable model (AUC = 0.81) at a cross-sectional level. At diagnosis, CA19-9 (AUC = 0.995) and the model (AUC = 0.977) performed similarly. Longitudinal analysis revealed increases in CA19-9 up to two years to diagnosis which indicates a window of opportunity for early detection of PDAC.
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