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| 5. |
- Bastholm Rahmner, Pia, et al.
(författare)
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Physicians perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system
- 2004
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Ingår i: International journal of health care quality assurance incorporating leadership in helath services. - : Emerald. - 1366-0756 .- 2051-3135. ; 17:4, s. 173-179
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Tidskriftsartikel (refereegranskat)abstract
- Seeks to identify physicians' perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system. Details a descriptive, qualitative study, with semi-structured individual interviews of 21 physicians in the Accident and Emergency Department of South Stockholm General Hospital. Identifies four descriptive categories for possibilities and obstacles. Concludes that gaining access to patient drug history enables physicians to carry out work in a professional way – a need the computerised prescription support system was not developed for and thus cannot fulfil. Alerts and producer-independent drug information are valuable in reducing workload. However, technical prerequisites form the base for a successful implementation. Time must be given to adapt to new ways of working.
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| 6. |
- Schillings, Audrey, et al.
(författare)
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Distribution and Occurrence Frequency of dB/dt Spikes During Magnetic Storms 1980–2020
- 2022
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Ingår i: Space Weather. - : John Wiley & Sons. - 1542-7390. ; 20:5
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Tidskriftsartikel (refereegranskat)abstract
- The physical magnetospheric cause for geomagnetically induced currents (GICs) are rapid time-varying magnetic fields (dB/dt), which occur mainly during magnetic substorms and storms. When, where and why exactly such rapid dB/dt may occur is insufficiently understood. We investigated all storms since 1980 and analyzed the negative and positive dB/dt spikes (>|500| nT/min) in the north and east component using a worldwide coverage (SuperMAG). Our analysis confirmed the existence of two dB/dt spikes "hotspots" located in the pre-midnight and in the morning magnetic local time sector, independently of the geographic location of the stations. The associated physical phenomena are probably substorm current wedge onsets and westward traveling surges (WTS) in the evening sector, and wave- or vortex-like current flows in the morning sector known as Omega bands. We observed a spatiotemporal evolution of the negative northern dB/dt spikes. The spikes initially occur in the pre-midnight sector, and then develop in time toward the morning sector. This spatiotemporal sequence is correlated with bursts in the AE index, and can be repeated several times throughout a storm. Finally, we investigated the peak value of Dst and AE during the storm period in comparison with the dB/dt spike occurrence frequency, we did not find any correlation. This result implies that a moderate storm with many spikes can be as (or more) dangerous for ground-based infrastructures than a major storm with fewer dB/dt spikes. Our findings regarding the physical causes and characteristics of dB/dt spikes may help to improve the GIC forecast for the affected regions.
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| 7. |
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| 10. |
- Friedlein, Rainer, et al.
(författare)
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Electronic structure of conjugated polymers and interfaces in polymer-based electronics
- 2003
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Ingår i: Synthetic Metals (Proceedings of the International Conference on Science and Technology of Synthetic Metals). - 0379-6779. ; 135:1-3, s. 275-277
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Konferensbidrag (refereegranskat)abstract
- The electronic structure of conjugated polymers and interfaces in polymer-based electronics were analyzed. Fine structure were observed in the region of the first resonance with pi-final state symmetry, between 284.1 eV and 285.8 eV. The electronic transitions from the non-dispersed C(1s) level to specific parts of the unoccupied band structure were generated. It was found that for a dispersing valence band, in the presence of a core-hole, a given photon energy corresponded to an excitation into a state with a distinct wave vectors.
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| 11. |
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| 12. |
- Garpenstrand, H, et al.
(författare)
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Elevated plasma semicarbazide-sensitive amineoxidase (SSAO) activity in type 2 diabetes melitus complicated by retinopathy
- 1999
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 16:6, s. 514-521
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Tidskriftsartikel (refereegranskat)abstract
- Aims To measure plasma semicarbazide-sensitive amine oxidase (SSAO) activities and detect retinopathy in Type 2 diabetes mellitus (DM). Methods Cross-sectional, population-based study of 65 diabetes patients (61 diagnosed from the age of 30 years) with or without retinopathy as determined by fundus photography in primary care. HbA1c was analysed by ion exchange chromatography on a Mono S for HbA1c column. SSAO activities were assayed radiometrically and formaldehyde-albumin adducts by ELISA in plasma samples from patients and 136 healthy controls. Results Subjects with diabetes had higher plasma SSAO activity, measured as nmol benzylamine.ml plasma-1.h-1(mean 20.6), than controls (mean 14.3), P < 0.0001; 95% confidence interval (CI) for difference 4.9–7.7. SSAO activity was higher in patients with retinopathy (mean 23.2) than in those without (mean 18.9), P = 0.012; 95% CI for difference 1.0–7.5, and related to the HbA1c value. No statistically significant relationship between diabetes duration and SSAO activity was found. With HbA1c values and insulin treatment entered into a multiple logistic regression model, SSAO activity no longer predicted retinopathy, P increasing from 0.025 to 0.17. SSAO activity and the presence of any retinopathy were unrelated to titres of antibodies against formaldehyde-treated human serum albumin. Conclusions SSAO activity, earlier found to be elevated in Type 1 DM, is also elevated in Type 2 DM. The SSAO family of enzymes may be involved in the development of diabetic retinopathy, possibly by catalysing the formation of toxic metabolites. A potent and specific inhibitor of human SSAO might help prevent retinopathy in Type 1 and Type 2 DM.
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| 13. |
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| 14. |
- K. Wiesner, R. F. Fink, S. L. Sorensen, M. Andersson, R. Feifel, I. Hjelte, C. Miron, A. Naves de Brito, L. Rosenqvist, H. Wang, S. Svensson, O. Björneholm
(författare)
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Valence Photoionization and Resonant Core Excitation of Ozone - Experimental and Theoretical Study of the C-State of O3
- 2003
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Ingår i: Chem Phys. Lett.. ; :375, s. 76-
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Tidskriftsartikel (refereegranskat)
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| 15. |
- Lanabere, Vanina, et al.
(författare)
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Analysis of the Geoelectric Field in Sweden Over Solar Cycles 23 and 24 : Spatial and Temporal Variability During Strong GIC Events
- 2023
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Ingår i: Space Weather. - : American Geophysical Union (AGU). - 1542-7390. ; 21:12
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Tidskriftsartikel (refereegranskat)abstract
- Geomagnetic storms can produce large perturbations on the Earth magnetic field. Through complex magnetosphere-ionosphere coupling, the geoelectric field (E) and geomagnetic field (B) are highly perturbed. The E is the physical driver of geomagnetically induced currents. However, a statistical study of the E in Sweden has never been done before. We combined geomagnetic data from the International Monitor for Auroral Geomagnetic Effects network in Northern Europe with a 3-D structure of Earth's electrical conductivity in Sweden as the input of a 1-D model to compute the E between 2000 and 2018. Northwestern Sweden presents statistically larger E magnitudes due to larger |dB/dt| variations in the north than in the south of Sweden and relative lower conductivity in the west compared to central and eastern Sweden. In contrast, the 15 strongest daily maximum |E| events present more frequently a maximum magnitude in central Sweden (62.25 degrees N) and their relative strengths are not the same for all latitudes. These results highlight the different regional response to geomagnetic storms, which can be related to ground conductivity variability and the complex magnetosphere-ionosphere coupling mechanisms. Solar storms represent a major threat to Earth's technology and therefore affect society and the economy. Historically, the main effects were related to electric power grid failures leaving many people without electricity for several hours. In order to prevent this from happening again, it is necessary to understand the temporal and spatial variability of the Earth's electric field in regions where electric power grids are placed. This study combines ground measurements of the magnetic fields in Finland and Estonia and ground conductivity maps in Sweden to estimate the ground electric fields in Sweden. A statistical analysis from 2000 to 2018 shows that the probability to find stronger daily maximum electric field magnitude (|E|) is higher in northwestern Sweden. However, the 15 strongest |E| events were found in the central region of Sweden. Furthermore, 80% of the electric power grid failure reports in Sweden during the period, correspond to events where the strongest daily maximum |E| were observed at 62.25 degrees N. This implies that a better understanding of the local geoelectric field and driving processes are required. The daily maximum geoelectric field magnitude is statistically larger in northwestern Sweden than in central and southern SwedenThe 15 strongest daily maximum geoelectric field events were more frequent in central Sweden than in northern SwedenThe 15 strongest events at each latitude are different, so the geoelectric field presents an important regional variability
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| 16. |
- Landin-Olsson, M., et al.
(författare)
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Islet cell and thyrogastric antibodies in 633 consecutive 15- to 34-yr-old patients in the diabetes incidence study in Sweden
- 1992
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Ingår i: Diabetes. - : American Diabetes Association. - 0012-1797 .- 1939-327X. ; 41:8, s. 1022-1027
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Tidskriftsartikel (refereegranskat)abstract
- The effect of age on ICA and thyrogastric antibodies at diagnosis of IDDM was evaluated in 633 consecutively diagnosed Swedish diabetic patients aged 15-34 yr and in 282 volunteers of the same age. ICAs were present in 61% (383 of 633) of the patients and in 2% (5 of 282) of control subjects. When the initial classification was considered, ICAs were detected in 69% (327 of 473) of patients with IDDM, 23% (19 of 83) of those with NIDDM, 50% (36 of 72) of those with unclassifiable diabetes, and 20% (1 of 5) of those with secondary diabetes. The frequency of ICA fell significantly (P < 0.001) with age in IDDM patients from 77% (104/135) in those 15-19 yr old to 52% (50 of 96) in 30- to 34-yr-old IDDM patients. The low frequency of ICA in 30- to 34-yr-old IDDM patients was confined to men (42%, 28 of 66). The frequency of gastric (H+, K+-ATPase) antibodies was significantly (P < 0.05) higher in IDDM patients (10%, 47 of 449) than in patients with NIDDM (3%, 3 of 80) and unclassifiable diabetes (4%, 3 of 72). In conclusion, the frequency of ICA at the diagnosis of IDDM in young adult subjects decreases with increasing age, particularly in men. The frequent finding of ICA in patients considered to have NIDDM or unclassifiable diabetes indicates that misclassification of diabetes is frequent in young adult patients recently diagnosed with diabetes.
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| 17. |
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| 18. |
- Ringh, M, et al.
(författare)
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The challenges and possibilities of public access defibrillation.
- 2018
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 283:3, s. 238-256
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Tidskriftsartikel (refereegranskat)abstract
- Out-of-hospital cardiac arrest (OHCA) is a major health problem that affects approximately four hundred and thousand patients annually in the United States alone. It is a major challenge for the emergency medical system as decreased survival rates are directly proportional to the time delay from collapse to defibrillation. Historically, defibrillation has only been performed by physicians and in-hospital. With the development of automated external defibrillators (AEDs), rapid defibrillation by nonmedical professionals and subsequently by trained or untrained lay bystanders has become possible. Much hope has been put to the concept of Public Access Defibrillation with a massive dissemination of public available AEDs throughout most Western countries. Accordingly, current guidelines recommend that AEDs should be deployed in places with a high likelihood of OHCA. Despite these efforts, AED use is in most settings anecdotal with little effect on overall OHCA survival. The major reasons for low use of public AEDs are that most OHCAs take place outside high incidence sites of cardiac arrest and that most OHCAs take place in residential settings, currently defined as not suitable for Public Access Defibrillation. However, the use of new technology for identification and recruitment of lay bystanders and nearby AEDs to the scene of the cardiac arrest as well as new methods for strategic AED placement redefines and challenges the current concept and definitions of Public Access Defibrillation. Existing evidence of Public Access Defibrillation and knowledge gaps and future directions to improve outcomes for OHCA are discussed. In addition, a new definition of the different levels of Public Access Defibrillation is offered as well as new strategies for increasing AED use in the society.
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| 19. |
- Rosenqvist, L., et al.
(författare)
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3D Modeling of Geomagnetically Induced Currents in Sweden-Validation and Extreme Event Analysis
- 2022
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Ingår i: Space Weather. - : American Geophysical Union (AGU). - 1542-7390. ; 20:3
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Tidskriftsartikel (refereegranskat)abstract
- Rosenqvist and Hall (2019), developed a proof-of-concept modeling capability that incorporates a detailed 3D structure of Earth's electrical conductivity in a geomagnetically induced current estimation procedure (GIC-SMAP). The model was verified based on GIC measurements in northern Sweden. The study showed that southern Sweden is exposed to stronger electric fields due to a combined effect of low crustal conductivity and the influence of the surrounding coast. This study aims at further verifying the model in this region. GIC measurements on a power line at the west coast of southern Sweden are utilized. The location of the transmission line was selected to include coast effects at the ocean-land interface to investigate the importance of using 3D induction modeling methods. The model is used to quantify the hazard of severe GICs in this particular transmission line by using historic recordings of strong geomagnetic disturbances. To quantify a worst-case scenario GICs are calculated from modeled magnetic disturbances by the Space Weather Modeling Framework based on estimates for an idealized extreme interplanetary coronal mass ejection. The observed and estimated GIC based on the 3D GIC-SMAP procedure in the transmission line in southern Sweden are in good agreement. In contrast, 1D methods underestimate GICs by about 50%. The estimated GICs in the studied transmission line exceed 100 A for one of 14 historical geomagnetic storm intervals. The peak GIC during the sudden impulse phase of a "perfect" storm exceeds 300 A but depends on the locality of the station as the interplanetary magnetic cloud hits Earth.
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| 20. |
- Rosenqvist, L., et al.
(författare)
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3D Modeling of Geomagnetically Induced Currents in Sweden—Validation and Extreme Event Analysis
- 2022
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Ingår i: Space Weather. - : John Wiley & Sons. - 1542-7390. ; 20:3
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Tidskriftsartikel (refereegranskat)abstract
- Rosenqvist and Hall (2019), https://agupubs.onlinelibrary.wiley.com/doi/abs/10.1029/2018SW002084 developed a proof-of-concept modeling capability that incorporates a detailed 3D structure of Earth's electrical conductivity in a geomagnetically induced current estimation procedure (GIC-SMAP). The model was verified based on GIC measurements in northern Sweden. The study showed that southern Sweden is exposed to stronger electric fields due to a combined effect of low crustal conductivity and the influence of the surrounding coast. This study aims at further verifying the model in this region. GIC measurements on a power line at the west coast of southern Sweden are utilized. The location of the transmission line was selected to include coast effects at the ocean-land interface to investigate the importance of using 3D induction modeling methods. The model is used to quantify the hazard of severe GICs in this particular transmission line by using historic recordings of strong geomagnetic disturbances. To quantify a worst-case scenario GICs are calculated from modeled magnetic disturbances by the Space Weather Modeling Framework based on estimates for an idealized extreme interplanetary coronal mass ejection. The observed and estimated GIC based on the 3D GIC-SMAP procedure in the transmission line in southern Sweden are in good agreement. In contrast, 1D methods underestimate GICs by about 50%. The estimated GICs in the studied transmission line exceed 100 A for one of 14 historical geomagnetic storm intervals. The peak GIC during the sudden impulse phase of a “perfect” storm exceeds 300 A but depends on the locality of the station as the interplanetary magnetic cloud hits Earth.
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| 21. |
- Rosenqvist, L., et al.
(författare)
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Femtosecond dissociation of ozone studied by the Auger Doppler effect
- 2001
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Ingår i: Journal of Chemical Physics. - : AIP Publishing. - 0021-9606 .- 1089-7690. ; 115:8, s. 3614-3620
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Tidskriftsartikel (refereegranskat)abstract
- The peaks arising from the decay of the excited oxygen atom were studied. Fast dissociation of core-excited ozone was confirmed by the presence of Auger emission from atomic oxygen in the decay spectrum from the ozone OT 1s-σ*(7a1) state. No such emission was observed after excitation of the corresponding state on the central oxygen atom. An angle-dependent energy shift of the atomic lines was observed. Analysis of the energy shift revealed that the kinetic energy released in the dissociation process is approximately 3.3 ± 0.3eV. An energy release of 8.45 was found by application of a Born-Haber cycle.
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| 23. |
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| 25. |
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| 26. |
- Ågren, Karin, et al.
(författare)
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Detection of currents and associated electric fields in Titan's ionosphere from Cassini data
- 2011
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Ingår i: Journal of Geophysical Research. - 0148-0227 .- 2156-2202. ; 116:4, s. A04313-
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Tidskriftsartikel (refereegranskat)abstract
- We present observations from three Cassini flybys of Titan using data from the radio and plasma wave science, magnetometer and plasma spectrometer instruments. We combine magnetic field and cold plasma measurements with calculated conductivities and conclude that there are currents of the order of 10 to 100 nA m (2) flowing in the ionosphere of Titan. The currents below the exobase (similar to 1400 km) are principally field parallel and Hall in nature, while the Pedersen current is negligible in comparison. Associated with the currents are perpendicular electric fields ranging from 0.5 to 3 mu V m (1).
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| 27. |
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| 28. |
- Al-Khalili, F, et al.
(författare)
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Clinical and echocardiographic characteristics of individuals aged 75/76 years old with screening-detected elevated NT-proBNP levels
- 2020
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Ingår i: Open heart. - : BMJ. - 2053-3624. ; 7:1, s. e001200-
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Tidskriftsartikel (refereegranskat)abstract
- High plasma levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) indicate increased probability of congestive heart failure (CHF) and atrial fibrillation (AF) and are associated with poor prognosis.ObjectiveWe aimed to describe the clinical and echocardiographic characteristics of a population of individuals aged 75/76 years old with NT-proBNP ≥900 ng/L without previously known CHF or AF.MethodsAll individuals aged 75/76 years in the Stockholm region were randomised to a screening study for AF. Half of them were invited to screening. Of those invited, 49.5% agreed to participate. Individuals with NT-proBNP ≥900 ng/L without known CHF were invited for further clinical evaluation.ResultsAmong 6315 participants without AF who had NT-proBNP sampled, 102 without previously known CHF had ≥900 ng/L. Of these, 93 completed further clinical investigations. In the population that was clinically investigated, 53% were female, and the median NT-proBNP was 1200 ng/L. New AF was found in 28 (30%). The NT-proBNP value in this group was not significantly different from those where AF was not detected (median 1285 vs 1178 ng/L). Patients with newly detected AF had larger left atrial volume and higher pulmonary artery pressure than those without AF. Preserved left ventricular ejection fraction (≥50%) was found in 86% of the participants, mid-range ejection fraction (40%–49%) in 3.2% and reduced ejection fraction (<40%) in 10.8%. Thirteen patients (14%) had other serious cardiac disorders that required medical attention.ConclusionElderly individuals with NT-proBNP levels ≥900 ng/L constitute a population at high cardiovascular risk even in the absence of diagnosed CHF or AF, and therefore merit further investigation.
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| 29. |
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| 30. |
- Axelsson, Christer, et al.
(författare)
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Outcome after out-of-hospital cardiac arrest witnessed by EMS : changes over time and factors of importance for outcome in Sweden.
- 2012
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Ingår i: Resuscitation. - : Elsevier Ireland Ltd. - 0300-9572 .- 1873-1570. ; 83:10, s. 1253-1258
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Tidskriftsartikel (refereegranskat)abstract
- Background Among patients who survive after out-of-hospital cardiac arrest (OHCA), a large proportion are recruited from cases witnessed by the Emergency Medical Service (EMS), since the conditions for success are most optimal in this subset. Aim To evaluate outcome after EMS-witnessed OHCA in a 20-year perspective in Sweden, with the emphasis on changes over time and factors of importance. Methods All patients included in the Swedish Cardiac Arrest Register from 1990 to 2009 were included. Results There were 48,349 patients and 13.5% of them were EMS witnessed. There was a successive increase in EMS-witnessed OHCA from 8.5% in 1992 to 16.9% in 2009 (p for trend < 0.0001). Among EMS-witnessed OHCA, the survival to one month increased from 13.9% in 1992 to 21.8% in 2009 (p for trend < 0.0001). Among EMS-witnessed OHCA, 51% were found in ventricular fibrillation, which was higher than in bystander-witnessed OHCA, despite a lower proportion with a presumed cardiac aetiology in the EMS-witnessed group. Among EMS-witnessed OHCA overall, 16.0% survived to one month, which was significantly higher than among bystander-witnessed OHCA. Independent predictors of a favourable outcome were: (1) initial rhythm ventricular fibrillation; (2) cardiac aetiology; (3) OHCA outside home and (4) decreasing age. Conclusion In Sweden, in a 20-year perspective, there was a successive increase in the proportion of EMS-witnessed OHCA. Among these patients, survival to one month increased over time. EMS-witnessed OHCA had a higher survival than bystander-witnessed OHCA. Independent predictors of an increased chance of survival were initial rhythm, aetiology, place and age.
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| 31. |
- Backlund, L.B., et al.
(författare)
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Early detection of diabetic retinopathy by mobile retinal photography service working in partnership with primary health care teams
- 1998
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Ingår i: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 15:S3, s. S32-S37
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Tidskriftsartikel (refereegranskat)abstract
- Community-wide fundus photography was organized for early detection of diabetic retinopathy (DR) by mobile teams. High-quality three-field Kodachrome fundus photography, performed according to the London Protocol through dilated pupils was offered free of charge to primary care; images were taken in the community and assessed centrally. Data are presented from the first 80 primary health care centres (PHCCs) participating, serving 990 000 (about 60 %) of inhabitants in Stockholm County. Beginning in 1990, 6863 diabetes patients were invited by PHCCs; 5490 (80 %) attended. We reached 77 % of persons with known diabetes; only 37 % had had their eyes examined during the preceding 2 years. For 97 % of patients, images were assessable. DR was present in 34 % of patients (non-proliferative DR not requiring further assessment 29 %, non-proliferative DR requiring further assessment 1.1 %, proliferative DR 0.5 % and macular involvement 3.6 %). Re-examination after 2 years was offered to 64 %; follow-up photography after 1 year to 24 %. Fluorescein angiography and/or photocoagulation treatment was performed in 3.6 %. This method of early diagnosis is feasible, acceptable, and reached twice as many patients as did the usual referral-based system of care. We now plan to extend this service to cover the whole county.
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| 32. |
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| 33. |
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| 34. |
- Bastholm Rahmner, Pia, et al.
(författare)
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"Limit work to here and now" : A focus group study on how emergency physicians view their work in relation to patients' drug treatment
- 2008
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Ingår i: International Journal of Qualitative Studies on Helath and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 3:3, s. 155-164
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Tidskriftsartikel (refereegranskat)abstract
- Patients come to the emergency department (ED) with complex medication and some patients present symptoms of adverse drug effects. Drug treatment is a complex process for physicians to handle. The aim of this study was to explore how a group of ED physicians view their work in relation to patients’ drug treatment. Three semi-structured focus group discussions with 12 physicians in an ED in Sweden were conducted and analysed thematically. The core theme was ‘‘limit work to here and now’’. Three descriptive themes were identified in relation to the main theme; (1) focussing to cope with work; (2) decision making on limited patient-specific information; and (3) actively seeking learning moments. The findings show that the physicians actively seek learning moments in work. Signing their own notes in the computerized medical record is a way of getting feedback on the treatment they have initiated and it was seen as a large part of their clinical education. If we want to support the physicians with new technology for safer drug treatment, such as a computerized drug prescribing support system, the support system should be adapted to the different learning styles and needs.
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| 35. |
- Bastholm Rahmner, Pia, et al.
(författare)
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Variations in understanding the drug-prescribing process : a qualitative study among Swedish GPs
- 2009
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Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 26:2, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A majority of doctor-patient meetings result in the patient getting a prescription. This underlines the need for a high-quality prescription process. While studies have been made on single therapeutic drug groups, a complete study of the physicians' general thought process that comprises the prescription of all drugs still remains to be made. OBJECTIVE: To identify variations in ways of understanding drug prescribing among GPs. METHODS: A descriptive qualitative study was conducted with 20 Swedish physicians. Informants were recruited purposively and their understandings about prescribing were studied in semi-structured interviews. Data were analysed using a phenomenographic approach. RESULTS: Five categories were identified as follows: (A) GP prescribed safe, reliable and well-documented drugs for obvious complaints; (B) GP sought to convince the patient of the most effective drug treatment; (C) GP chose the best drug treatment taking into consideration the patient's entire life situation; (D) GP used clinical judgement and close follow-up to minimize unnecessary drug prescribing and (E) GP prescribed drugs which are cheap for society and environmentally friendly. The categories are interrelated, but have different foci: the biomedical, the patient and the society. Each GP had more than one view but none included all five. The findings also indicate that complexity increases when a drug is prescribed for primary or secondary prevention. CONCLUSIONS: GPs understand prescribing differently despite similar external circumstances. The most significant factor to influence prescribing behaviour was the physician's patient relation approach. GPs may need to reflect on difficulties they face while prescribing to enhance their understandings.
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| 36. |
- Bastholm Rahmner, Pia, et al.
(författare)
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Whose job is it anyway? : Swedish general practitioners' perception of their responsibility for the patient's drug list.
- 2010
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Ingår i: Annals of Family Medicine. - : Annals of Family Medicine. - 1544-1709 .- 1544-1717. ; 8:1, s. 40-46
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE Information about the patient's current drug list is a prerequisite for safe drug prescribing. The aim of this study was to explore general practitioners' (GPs) understandings of who is responsible for the patient's drug list so that drugs prescribed by different physicians do not interact negatively or even cause harm. The study also sought to clarify how this responsibility was managed. METHODS We conducted a descriptive qualitative study among 20 Swedish physicians. We recruited the informants purposively and captured their view on responsibility by semistructured interviews. Data were analyzed using a phenomenographic approach. RESULTS We found variation in understandings about who is responsible for the patient's drug list and, in particular, how the GPs use different strategies to manage this responsibility. Five categories emerged: (1) imposed responsibility, (2) responsible for own prescriptions, (3) responsible for all drugs, (4) different but shared responsibility, and (5) patient responsible for transferring drug information. The relation between categories is illustrated in an outcome space, which displays how the GPs reason in relation to managing drug lists. CONCLUSIONS The understanding of the GP's responsibility for the patient's drug list varied, which may be a threat to safe patient care. We propose that GPs are made aware of variations in understanding responsibility so that health care quality can be improved.
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| 37. |
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| 38. |
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| 39. |
- Bohm, K, et al.
(författare)
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Survival is similar after standard treatment and chest compression only in out-of-hospital bystander cardiopulmonary resuscitation.
- 2007
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Ingår i: Circulation. - : Lippincott Williams & Wilkins. - 0009-7322 .- 1524-4539. ; 116:25, s. 2908-2912
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: We sought to compare the 1-month survival rates among patients after out-of-hospital cardiac arrest who had been given bystander cardiopulmonary resuscitation (CPR) in relation to whether they had received standard CPR with chest compression plus mouth-to-mouth ventilation or chest compression only. METHODS AND RESULTS: All patients with out-of-hospital cardiac arrest who received bystander CPR and who were reported to the Swedish Cardiac Arrest Register between 1990 and 2005 were included. Crew-witnessed cases were excluded. Among 11,275 patients, 73% (n=8209) received standard CPR, and 10% (n=1145) received chest compression only. There was no significant difference in 1-month survival between patients who received standard CPR (1-month survival=7.2%) and those who received chest compression only (1-month survival=6.7%). CONCLUSIONS: Among patients with out-of-hospital cardiac arrest who received bystander CPR, there was no significant difference in 1-month survival between a standard CPR program with chest compression plus mouth-to-mouth ventilation and a simplified version of CPR with chest compression only.
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| 40. |
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| 41. |
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| 42. |
- Bäcklund, L.B., et al.
(författare)
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New Blindness in Diabetes Reduced by More Than One-Third in Stockholm County
- 1997
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Ingår i: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 14:9, s. 732-740
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Tidskriftsartikel (refereegranskat)abstract
- To monitor changes over time in the incidence of blindness among people with diabetes, referrals (mentioning diabetes) to all vision rehabilitation centres in Stockholm County (1995 population 1 725 756) during 1981-1995 were registered. A mass mailing to people with diabetes in 1989 urged them to have their eyes examined. Mobile fundus photography teams initiated early diagnosis of diabetic retinopathy in primary health care in 1990. Referrals with diabetes and blindness, defined (WHO, ICD 10) as best-corrected visual acuity (VA) of the better eye less than 3/60 (0.05), occurred for 172 persons (7.6% of those referred with diabetes). During 1981-1985, 93 were referred (95% confidence interval 75 to 114); 1986-1990, 51 (38 to 67); 1991-1995, 28 (19 to 41). Five-year average annual incidence rate of referrals with blindness was reduced by 47% from 1.2 to 0.63 to 0.33 per 100,000 population. Mean yearly reduction during 1981-1995 was 11% (8 to 15%), 11.5% (8 to 15%) if blindness was defined as in the UK (VA 3/60 or less), and 7% (4 to 9%) for legal blindness (VA 6/60 or less); test for trend p < 0.001 (Poisson regression analysis). This is the first report of reduction in a geographical region of a proxy measure for new blindness in diabetes by one-third or more, attaining one of the main targets of the St Vincent Declaration.
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| 43. |
- Carlsson, T., et al.
(författare)
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Association of cumulative early medical factors with autism and autistic symptoms in a population-based twin sample
- 2022
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Ingår i: Translational Psychiatry. - : Springer Science and Business Media LLC. - 2158-3188. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- Although highly heritable, environment also contributes to the etiology of autism spectrum disorder (ASD), with several specific environmental factors previously suggested. A registry-linked population-based twin cohort of 15,701 pairs (586 individuals with an ASD diagnosis), was established within the Child and Adolescent Twin Study in Sweden. Participants were evaluated for autistic symptoms at age 9 using the Autism-Tics, ADHD and other Comorbidities parental interview. A series of binary cut-offs indicated whether participants scored over various ASD symptom percentiles. Three early medical factors previously associated with ASD, beyond familial confounding (low birth weight, congenital malformations and perinatal hypoxia), were summed up creating an individual cumulative exposure load. A series of unconditional logistic regressions between all individuals and conditional regressions within twin pairs were performed for each outcome and exposure level. Between all individuals increasing cumulative early exposure loads were associated with increasing risk of ASD diagnosis (OR 3.33 (95%CI 1.79-6.20) for three exposures) and autistic symptoms (ranging from OR 2.12 (1.57-2.86) for three exposures at the 55th symptom percentile cut-off to OR 3.39 (2.2-5.24) at the 95th). Within twin pairs, the association between three exposures and an ASD diagnosis remained similar, but not statistically significant (OR 2.39 (0.62-9.24)). Having a higher load of early cumulative exposure was consistently associated with autistic symptoms after adjusting for familial confounding and sex (OR 3.45 (1.66-7.15) to OR 7.36 (1.99-27.18)). This study gives support to the cumulative stress hypothesis of ASD, and the dimensional model regarding environmental exposures, after adjustment for familial confounding.
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| 46. |
- Claesson, A., et al.
(författare)
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Unmanned aerial vehicles (drones) in out-of-hospital-cardiac-arrest
- 2016
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central (BMC). - 1757-7241. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of an automated external defibrillator (AED) prior to EMS arrival can increase 30-day survival in out-of-hospital cardiac arrest (OHCA) significantly. Drones or unmanned aerial vehicles (UAV) can fly with high velocity and potentially transport devices such as AEDs to the site of OHCAs. The aim of this explorative study was to investigate the feasibility of a drone system in decreasing response time and delivering an AED. Methods: Data of Global Positioning System (GPS) coordinates from historical OHCA in Stockholm County was used in a model using a Geographic Information System (GIS) to find suitable placements and visualize response times for the use of an AED equipped drone. Two different geographical models, urban and rural, were calculated using a multi-criteria evaluation (MCE) model. Test-flights with an AED were performed on these locations in rural areas. Results: In total, based on 3,165 retrospective OHCAs in Stockholm County between 2006-2013, twenty locations were identified for the potential placement of a drone. In a GIS-simulated model of urban OHCA, the drone arrived before EMS in 32 % of cases, and the mean amount of time saved was 1.5 min. In rural OHCA the drone arrived before EMS in 93 % of cases with a mean amount of time saved of 19 min. In these rural locations during (n = 13) test flights, latch-release of the AED from low altitude (3-4 m) or landing the drone on flat ground were the safest ways to deliver an AED to the bystander and were superior to parachute release. Discussion: The difference in response time for EMS between urban and rural areas is substantial, as is the possible amount of time saved using this UAV-system. However, yet another technical device needs to fit into the chain of survival. We know nothing of how productive or even counterproductive this system might be in clinical reality. Conclusions: To use drones in rural areas to deliver an AED in OHCA may be safe and feasible. Suitable placement of drone systems can be designed by using GIS models. The use of an AED equipped drone may have the potential to reduce time to defibrillation in OHCA.
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| 47. |
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| 50. |
- Dimmock, Andrew P., et al.
(författare)
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Modeling the Geomagnetic Response to the September 2017 Space Weather Event Over Fennoscandia Using the Space Weather Modeling Framework : Studying the Impacts of Spatial Resolution
- 2021
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Ingår i: Space Weather. - : American Geophysical Union (AGU). - 1542-7390. ; 19:5
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Tidskriftsartikel (refereegranskat)abstract
- We must be able to predict and mitigate against geomagnetically induced current (GIC) effects to minimize socio-economic impacts. This study employs the space weather modeling framework (SWMF) to model the geomagnetic response over Fennoscandia to the September 7-8, 2017 event. Of key importance to this study is the effects of spatial resolution in terms of regional forecasts and improved GIC modeling results. Therefore, we ran the model at comparatively low, medium, and high spatial resolutions. The virtual magnetometers from each model run are compared with observations from the IMAGE magnetometer network across various latitudes and over regional-scales. The virtual magnetometer data from the SWMF are coupled with a local ground conductivity model which is used to calculate the geoelectric field and estimate GICs in a Finnish natural gas pipeline. This investigation has lead to several important results in which higher resolution yielded: (1) more realistic amplitudes and timings of GICs, (2) higher amplitude geomagnetic disturbances across latitudes, and (3) increased regional variations in terms of differences between stations. Despite this, substorms remain a significant challenge to surface magnetic field prediction from global magnetohydrodynamic modeling. For example, in the presence of multiple large substorms, the associated large-amplitude depressions were not captured, which caused the largest model-data deviations. The results from this work are of key importance to both modelers and space weather operators. Particularly when the goal is to obtain improved regional forecasts of geomagnetic disturbances and/or more realistic estimates of the geoelectric field.
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