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- Burstein, R., et al.
(författare)
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Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
- 2019
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Ingår i: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 574:7778, s. 353-358
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Tidskriftsartikel (refereegranskat)abstract
- Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations. © 2019, The Author(s).
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- 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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- Fabian, ID, et al.
(författare)
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Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries
- 2021
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Ingår i: The British journal of ophthalmology. - : BMJ. - 1468-2079 .- 0007-1161. ; 105:10, s. 1435-1443
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Tidskriftsartikel (refereegranskat)abstract
- The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.MethodsA cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries.ResultsCapture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI −12.4 to −5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease.ConclusionsFewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.
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- Amoateng, P., et al.
(författare)
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Synedrella nodiflora Extract Depresses Excitatory Synaptic Transmission and Chemically-Induced In Vitro Seizures in the Rat Hippocampus
- 2021
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Extracts of the tropical Cinderella plant Synedrella nodiflora are used traditionally to manage convulsive conditions in the West African sub-region. This study sought to determine the neuronal basis of the effectiveness of these plant extracts to suppress seizure activity. Using the hippocampal slice preparation from rats, the ability of the extract to depress excitatory synaptic transmission and in vitro seizure activity were investigated. Bath perfusion of the hydro-ethanolic extract of Synedrella nodiflora (SNE) caused a concentration-dependent depression of evoked field excitatory postsynaptic potentials (fEPSPs) recorded extracellularly in the CA1 region of the hippocampus with maximal depression of about 80% and an estimated IC50 of 0.06 mg/ml. The SNE-induced fEPSP depression was accompanied by an increase in paired pulse facilitation. The fEPSP depression only recovered partially after 20 min washing out. The effect of SNE was not stimulus dependent as it was present even in the absence of synaptic stimulation. Furthermore, it did not show desensitization as repeat application after 10 min washout produced the same level of fEPSP depression as the first application. The SNE effect on fEPSPs was not via adenosine release as it was neither blocked nor reversed by 8-CPT, an adenosine A(1) receptor antagonist. In addition, SNE depressed in vitro seizures induced by zero Mg2+ and high K+ -containing artificial cerebrospinal fluid (aCSF) in a concentration-dependent manner. The results show that SNE depresses fEPSPs and spontaneous bursting activity in hippocampal neurons that may underlie its ability to abort convulsive activity in persons with epilepsy.
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- Kositanurit, B., et al.
(författare)
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An Exploration of Factors that Impact Individual Performance in an ERP Environment : An Analysis Using Multiple Analytical Techniques
- 2006
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Ingår i: European Journal of Information Systems. - Basingstoke : Palgrave Macmillan. - 0960-085X .- 1476-9344. ; 15:6, s. 556-568
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the factors that can impact individual performance when using enterprise resource planning (ERP) systems. Starting from the proposition that organizational performance depends on individuals' task accomplishments, we test a structural model of task-technology fit, ERP user satisfaction, and individual performance in ERP environments. This research utilizes a survey method to examine the perceptions of ERP users. We performed factor and reliability analyses to assess the validity of the survey instrument. Six factors were identified as having an impact on individual performance: System Quality, Documentation, Ease of use, Reliability, Authorization, and Utilization. To explore the relationships among these factors, we conducted regression and multivariate adaptive regression splines analysis, and compared the findings from these two analytical techniques. The study provides evidence that System Quality, Utilization, and Ease of Use are the most important factors bearing on individual performance in ERP environments. Our findings also provide IT managers and researchers with knowledge of how these factors can be manipulated to improve individual performance when using ERP systems.
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| 17. |
- Osei-Bryson, K-M, et al.
(författare)
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Managing Risks in Information Systems Outsourcing : An Approach to Analyzing Outsourcing Risks and Structuring Incentive Contracts
- 2006
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Ingår i: European Journal of Operational Research. - Amsterdam : Elsevier. - 0377-2217 .- 1872-6860. ; 174:1, s. 245-264
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Tidskriftsartikel (refereegranskat)abstract
- Information systems outsourcing is now almost standard practice for many companies. Outsourcing the information processing activities is a complex issue that entails considerable implications for the strategy of the firm. An important mechanism for managing the performance of outsourcing vendors is incentive contracts. But to develop an outsourcing contract the IS manager must quantify risks and benefits. However methods and tools for analyzing and quantifying outsourcing risks that IS managers have at their disposal are rudimentary. In this paper we offer a method and some mathematical models for analyzing risks and constructing incentive contracts for IS outsourcing. We are aware that most managers do not like to use mathematical models, consequently we have minimized the technical discussion and have illustrated how this model could be implemented using spreadsheet software for ease of use.
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- Adedze, Miranda, et al.
(författare)
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Exploring Sexual and Reproductive Health Needs and Associated Barriers of Homeless Young Adults in Urban Ghana: A Qualitative Study
- 2022
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Ingår i: Sexuality Research and Social Policy. - : Springer Science and Business Media LLC. - 1868-9884 .- 1553-6610. ; 19:3, s. 1006-1019
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Tidskriftsartikel (refereegranskat)abstract
- Background Homelessness has become a major global and public health challenge, especially in low- and middle-income countries. This phenomenon predisposes young adults to severe psychosocial and health challenges. Aim To explore the sexual and reproductive health needs and behaviours of homeless young adults and challenges in accessing these services. Methods A semi-structured interview guide was used for data collection from in-depth interviews, focus group discussions, and key informant interviews. Data were collected between 01 June and 31 July 2020 from 30 participants using in-depth interviews, two focus group discussions involving 12 participants, and one key informant interview. Thematic analysis was used to analyse transcripts from the interviews. Results The findings show that certain behavioural patterns associated with homelessness impact the lives of homeless young adults in their sexual and reproductive health (SRH) choices, beliefs, and perspectives. This group faces several challenges in accessing sexual and reproductive health services (SRHS) such as modern contraceptives and abortion care. The high cost, and undesirable and unfriendly attitude of service providers in health facilities pose as barriers to accessing SRHS by homeless young adults. Conclusion Sustainable and proactive measures must be put in place to address the identified barriers. Timely delivery of accurate information and educative materials, ensuring affordability, and setting up of accessible and friendly facilities could improve SRHS for this group. Social and Public Policy Implications This study may inform and support policy guideline development to address homelessness and SRH needs of young adults in urban Ghana.
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| 20. |
- Ampomah, Osei Y., et al.
(författare)
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Nodulation and ecological significance of indigenous legumes in Scotland and Sweden
- 2012
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Ingår i: Symbiosis. - : Springer Nature. - 0334-5114 .- 1878-7665. ; 57:3, s. 133-148
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Tidskriftsartikel (refereegranskat)abstract
- The ability of wild indigenous legumes to form root nodules capable of biological nitrogen (N 2) fixation has rarely been demonstrated for species in natural ecosystems in large parts of Europe. In order to understand and manage these ecosystems, it is important to demonstrate nodulation across a diverse range of environments, sites and climates. This study surveyed nodulation at a number of sites in Scotland and Sweden. Presence of nodules was noted and nodule structure and indicators of nitrogen fixation capacity were assessed using light and transmission electron microscopy. Soils from several sites were also sampled for carbon and nitrogen analysis. The collections comprised 24 species in Scotland, and 30 taxa in Sweden; 17 of these in common for both countries. Highest species numbers occurred in meadows, farmland margins, hedgerows, roadsides and wasteland. Coastal sites and sites in the mountainous region above the Arctic Circle hosted several rare species. All sampled species had features of N 2-fixing nodules such as pink colour (leghaemoglobin) when dissected and bacteroids. Nodule structure for a number of species is here reported for the first time and presence of the N 2-fixing enzyme nitrogenase is demonstrated in three previously not studied Swedish legume species. North European legumes may make significant contributions to the N-budgets of their ecosystems. Such species (and their symbionts) represent unique germplasm that may be adopted to empower advances in agriculture and conservation aimed at mitigation and adaptation to the effects of climate change.
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- Osei-Bryson, Kweku-Muata, et al.
(författare)
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Exploring managerial factors affecting ERP implementation : An investigation of the Klein-Sorra model using regression splines
- 2008
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Ingår i: Information Systems Journal. - Chichester : Wiley-Blackwell. - 1350-1917 .- 1365-2575. ; 18:5, s. 499-527
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Tidskriftsartikel (refereegranskat)abstract
- Predicting successful implementation of enterprise resource planning (ERP) systems is still an elusive problem. The cost of ERP implementation failures is exceedingly high in terms of quantifiable financial resources and organizational disruption. The lack of good explanatory and predictive models makes it difficult for managers to develop and plan ERP implementation projects with any assurance of success. In this paper we investigate the Klein & Sorra theoretical model of implementation effectiveness. To test this model we develop and validate a data collection instrument to capture the appropriate data, and then use multivariate adaptive regression splines to examine the assertions of the model and suggest additional significant relationships among the factors of their model. Our research offers new dimensions for studying managerial interventions in IT implementation and insights into factors that can be managed to improve the effectiveness of ERP implementation projects.
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| 23. |
- Patterson, M. S, et al.
(författare)
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Absorption-spectroscopy In Tissue-simulating Materials - A Theoretical and Experimental-study of Photon Paths
- 1995
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Ingår i: Applied Optics. - 2155-3165. ; 34:1, s. 22-30
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Tidskriftsartikel (refereegranskat)abstract
- A diffusion model of noninvasive absorption spectroscopy was used to determine how the change in signal resulting from a point absorber depends on the position of that absorber relative to the source and detector. This is equivalent to calculating the relative probability that a photon will visit a certain location in tissue before its detection. Experimental mapping of the point-target response in tissue-simulating materials confirmed the accuracy of the model. For steady-state spectroscopy a simple relation was derived between the mean depth visited by detected photons, the source-detector separation, and the optical penetration depth. It was also demonstrated theoretically that combining a pulsed source with time-gated detection provides additional control over the spatial distribution of the photon-visit probability.
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