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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Drake, TM, et al.
(författare)
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Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
- 2020
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Ingår i: BMJ global health. - : BMJ. - 2059-7908. ; 5:12
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Tidskriftsartikel (refereegranskat)abstract
- Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings.MethodsA multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI).ResultsOf 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI.ConclusionThe odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.
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| 4. |
- Bondesson, Elisabeth, et al.
(författare)
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Health care utilization among individuals who die by suicide as compared to the general population : a population-based register study in Sweden
- 2022
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Globally, 700 000 people die every year by suicide. Health care consultation patterns the period before suicide could be one potential way to identify people at risk for suicide. Therefore, this study examines health care patterns up to one year prior to the suicide by age, sex and prior diagnoses and specifically investigates if and how this differs from the general population of Skåne, Sweden.METHODS: This cohort study includes all individuals, aged 15 and older, that died by suicide in Region Skåne, Sweden from 2004 to 2015 (n = 1653). The individuals were identified through the Cause of death register and then linked to the Skåne healthcare register. Health care data was analyzed as proportions consulting different types of health care the month and year preceding the suicide, we also investigated the impact of age, sex and the occurrence of prior psychiatric and pain diagnoses. Additionally, we compared the proportion of consulting care among the suicide victims and the general population of Skåne.RESULTS: In the month before their death, 53% of the suicide victims had any health care consultation, compared with 20% in the general population of Skåne, a given month (p < 0.0001). The corresponding figures for the year prior to suicide was 86% among those who died by suicide, compared to 69% in the general population of Skåne, a given year (p < 0.0001). Women, and those having a documented history of psychiatric diagnosis were more likely to have health care consultations in the month and year preceding suicide (p < 0.001), compared to men and suicide victims without a history of psychiatric disease. Older adults that died by suicide, were less likely to consult psychiatric care compared to the younger suicide victims (p < 0.001).CONCLUSION: A majority of the suicide victims consulted health care in the near time before death and the proportion of seeking health care was significantly higher than in the general population of Skåne and higher among female suicide victims as compared to males. Alternative preventive screening measures should be considered for individuals consulting health care, especially for older people and individuals outside the psychiatric care.
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| 5. |
- Bordiga, Manuela, et al.
(författare)
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Microfossil evidence for trophic changes during the Eocene-Oligocene transition in the South Atlantic (ODP Site 1263, Walvis Ridge)
- 2015
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Ingår i: Climate of the Past. - : Copernicus GmbH. - 1814-9324 .- 1814-9332. ; 11:9, s. 1249-1270
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Tidskriftsartikel (refereegranskat)abstract
- The biotic response of calcareous nannoplankton to environmental and climatic changes during the Eocene-Oligocene transition was investigated at a high resolution at Ocean Drilling Program (ODP) Site 1263 (Walvis Ridge, southeast Atlantic Ocean) and compared with a lower-resolution benthic foraminiferal record. During this time interval, global climate, which had been warm under high levels of atmospheric CO2 (pCO(2)) during the Eocene, transitioned into the cooler climate of the Oligocene, at overall lower pCO(2). At Site 1263, the absolute nannofossil abundance (coccoliths per gram of sediment; N g(-1)) and the mean coccolith size decreased distinctly after the E-O boundary (EOB; 33.89 Ma), mainly due to a sharp decline in abundance of large-sized Reticulofenestra and Dictyococcites, occurring within a time span of similar to 47 kyr. Carbonate dissolution did not vary much across the EOB; thus, the decrease in abundance and size of nannofossils may reflect an overall decrease in their export production, which could have led to variations in the food availability for benthic foraminifers. The benthic foraminiferal assemblage data are consistent with a global decline in abundance of rectilinear species with complex apertures in the latest Eocene (similar to 34.5 Ma), potentially reflecting changes in the food source, i.e., phytoplankton. This was followed by a transient increased abundance of species indicative of seasonal delivery of food to the sea floor (Epistominella spp.; similar to 33.9-33.4 Ma), with a short peak in overall food delivery at the EOB (buliminid taxa; similar to 33.8 Ma). Increased abundance of Nuttallides umbonifera (at similar to 33.3 Ma) indicates the presence of more corrosive bottom waters and possibly the combined arrival of less food at the sea floor after the second step of cooling (Step 2). The most important changes in the calcareous nannofossil and benthic communities occurred similar to 120 kyr after the EOB. There was no major change in nannofossil abundance or assemblage composition at Site 1263 after Step 2 although benthic foraminifera indicate more corrosive bottom waters during this time. During the onset of latest-Eocene-earliest-Oligocene climate change, marine phytoplankton thus showed high sensitivity to fast-changing conditions as well as to a possibly enhanced, pulsed nutrient supply and to the crossing of a climatic threshold (e.g., pCO(2) decline, high-latitude cooling and changes in ocean circulation).
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