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- Dumont, A, et al.
(författare)
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Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial
- 2020
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Ingår i: Implementation science : IS. - : Springer Science and Business Media LLC. - 1748-5908. ; 15:1, s. 72-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWhile cesarean sections (CSs) are a life-saving intervention, an increasing number are performed without medical reasons in low- and middle-income countries (LMICs). Unnecessary CS diverts scarce resources and thereby reduces access to healthcare for women in need. Argentina, Burkina Faso, Thailand, and Vietnam are committed to reducing unnecessary CS, but many individual and organizational factors in healthcare facilities obstruct this aim. Nonclinical interventions can overcome these barriers by helping providers improve their practices and supporting women’s decision-making regarding childbirth. Existing evidence has shown only a modest effect of single interventions on reducing CS rates, arguably because of the failure to design multifaceted interventions effectively tailored to the context. The aim of this study is to design, adapt, and test a multifaceted intervention for the appropriate use of CS in Argentina, Burkina Faso, Thailand, and Vietnam.MethodsWe designed an intervention (QUALIty DECision-making—QUALI-DEC) with four components: (1) opinion leaders at heathcare facilities to improve adherence to best practices among clinicians, (2) CS audits and feedback to help providers identify potentially avoidable CS, (3) a decision analysis tool to help women make an informed decision on the mode of birth, and (4) companionship to support women during labor. QUALI-DEC will be implemented and evaluated in 32 hospitals (8 sites per country) using a pragmatic hybrid effectiveness-implementation design to test our implementation strategy, and information regarding its impact on relevant maternal and perinatal outcomes will be gathered. The implementation strategy will involve the participation of women, healthcare professionals, and organizations and account for the local environment, needs, resources, and social factors in each country.DiscussionThere is urgent need for interventions and implementation strategies to optimize the use of CS while improving health outcomes and satisfaction in LMICs. This can only be achieved by engaging all stakeholders involved in the decision-making process surrounding birth and addressing their needs and concerns. The study will generate robust evidence about the effectiveness and the impact of this multifaceted intervention. It will also assess the acceptability and scalability of the intervention and the capacity for empowerment among women and providers alike.Trial registrationISRCTN67214403
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- Kalyanasundaram, M., et al.
(författare)
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Effects of improved information and volunteer support on segregation of solid waste at the household level in urban settings in Madhya Pradesh, India (I-MISS) : protocol of a cluster randomized controlled trial
- 2021
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Segregation of household waste at the source is an effective and sustainable strategy for management of municipal waste. However, household segregation levels remain insufficient as waste management approaches are mostly top down and lack local support. The realisation and recognition of effective, improved and adequate waste management may be one of the vital drivers for attaining environmental protection and improved health and well-being. The presence of a local level motivator may promote household waste segregation and ultimately pro-environmental behaviour. The present cluster randomized control trial aims to understand if volunteer based information on waste segregation (I-MISS) can effectively promote increased waste segregation practices at the household level when compared with existing routine waste segregation information in an urban Indian setting.Methods: This paper describes the protocol of an 18 month two-group parallel,cluster randomised controlled trialin the urban setting of Ujjain, Madhya Pradesh, India. Randomization will be conducted at ward level, which is the last administrative unit of the municipality. The study will recruit 425 households in intervention and control groups. Assessments will be performed at baseline (0 months), midline (6 months), end line (12 months) and post intervention (18 months). The primary outcome will be the comparison of change in proportion of households practicing waste segregation and change in proportion of mis-sorted waste across the study period between the intervention and control groups as assessed by pick analysis. Intention to treat analysis will be conducted. Written informed consent will be obtained from all participants.Discussion: The present study is designed to study whether an external motivator, a volunteer selected from the participating community and empowered with adequate training, could disseminate waste segregation information to their community, thus promoting household waste segregation and ultimately pro-environmental behaviour. The study envisages that the volunteers could link waste management service providers and the community, give a local perspective to waste management, and help to change community habits through information, constant communication and feedback.Trial registration: The study is registered prospectively with Indian Council of Medical Research- Clinical Trial Registry of India (CTRI/2020/03/024278).
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- Quennerstedt, M., et al.
(författare)
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What did they learn in school today? A method for exploring aspects of learning in physical education
- 2014
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Ingår i: European Physical Education Review. - : SAGE Publications. - 1356-336X .- 1741-2749. ; 20:2, s. 282-302
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Tidskriftsartikel (refereegranskat)abstract
- This paper outlines a method for exploring learning in educational practice. The suggested method combines an explicit learning theory with robust methodological steps in order to explore aspects of learning in school physical education. The design of the study is based on sociocultural learning theory, and the approach adds to previous research within the field, both in terms of the combination of methods used and the claims made in our studies. The paper describes a way of collecting and analysing the retrieved data and discusses and illustrates the results of a study using this combination of explicit learning theory and robust methodological steps.
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- Annerstedt, Claes, 1953, et al.
(författare)
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Caring as an important foundation in coaching for social sustainability: a case study of a successful Swedish coach inhigh-performance sport
- 2014
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Ingår i: Reflective Practice. - : Informa UK Limited. - 1462-3943 .- 1470-1103. ; 15:1, s. 27-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to describe and analyze the experiences and strategies of one successful coach in high-performance sports. Through case study methodology we have studied Bengt Johansson, one of the most successful coaches in Sweden ever. From the perspective of social sustainability, caring seems to have constituted an important basis for coaching the Swedish national team in handball during Bengt Johansson′s years as head coach. Caring in this sense means to respect the players, value them, involve them, have dialogue with them, listen to them and support them as human beings. Johansson has demonstrated how competitiveness, dedication and hard work coexist alongside compassion, empathy, participation and caring. © 2013 Taylor & Francis.
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- Annerstedt, M, et al.
(författare)
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Rhabdomyolysis and acute renal failure associated with influenza virus type A.
- 1999
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Ingår i: Scandinavian journal of urology and nephrology. - 0036-5599. ; 33:4, s. 260-4
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Tidskriftsartikel (refereegranskat)abstract
- Two patients with rhabdomyolysis-induced acute renal failure due to influenza A virus infection are presented. Both had influenza symptoms, with high fever and severe muscular pain leading to walking problems. In addition, they were dehydrated due to vomiting and diarrhoea. Both had evidence of an ongoing influenza infection according to serological tests. Muscle injury due to the viral infection gave rise to rhabdomyolysis with efflux of myoglobin from the muscles, causing renal failure. In conclusion, influenza A virus infection can cause rhabdomyolysis accompanied by reversible acute renal failure.
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- Codlin, AJ, et al.
(författare)
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Independent evaluation of 12 artificial intelligence solutions for the detection of tuberculosis
- 2021
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1, s. 23895-
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Tidskriftsartikel (refereegranskat)abstract
- There have been few independent evaluations of computer-aided detection (CAD) software for tuberculosis (TB) screening, despite the rapidly expanding array of available CAD solutions. We developed a test library of chest X-ray (CXR) images which was blindly re-read by two TB clinicians with different levels of experience and then processed by 12 CAD software solutions. Using Xpert MTB/RIF results as the reference standard, we compared the performance characteristics of each CAD software against both an Expert and Intermediate Reader, using cut-off thresholds which were selected to match the sensitivity of each human reader. Six CAD systems performed on par with the Expert Reader (Qure.ai, DeepTek, Delft Imaging, JF Healthcare, OXIPIT, and Lunit) and one additional software (Infervision) performed on par with the Intermediate Reader only. Qure.ai, Delft Imaging and Lunit were the only software to perform significantly better than the Intermediate Reader. The majority of these CAD software showed significantly lower performance among participants with a past history of TB. The radiography equipment used to capture the CXR image was also shown to affect performance for some CAD software. TB program implementers now have a wide selection of quality CAD software solutions to utilize in their CXR screening initiatives.
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