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| 2. |
- Holmer, H., et al.
(författare)
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Evaluating the collection, comparability and findings of six global surgery indicators
- 2019
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 106:2, s. 138-150
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Tidskriftsartikel (refereegranskat)abstract
- Background: In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates. Methods: Nationally representative data were compiled for all WHO member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases. Availability, comparability and utility were assessed for each indicator: access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality, and protection against impoverishing and catastrophic expenditure. Where feasible, imputation models were developed to generate global estimates. Results: Of all WHO member states, 19 had data on the proportion of the population within 2h of a surgical facility, 154 had data on workforce density, 72 reported number of procedures, and nine had perioperative mortality data, but none could report data on catastrophic or impoverishing expenditure. Comparability and utility were variable, and largely dependent on different definitions used. There were sufficient data to estimate that worldwide, in 2015, there were 2 038 947 (i.q.r. 1 884 916–2 281 776) surgeons, obstetricians and anaesthetists, and 266·1 (95 per cent c.i. 220·1 to 344·4) million operations performed. Conclusion: Surgical and anaesthesia indicators are increasingly being adopted by the global health community, but data availability remains low. Comparability and utility for all indicators require further resolution.
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| 4. |
- Heimann, M., et al.
(författare)
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Multimedia and Literacy Learning Among Children With Various Disabilities – Lessons Since the Nineties
- 2016
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Ingår i: Technology and Media in Children's Development. Irvine, California: 27-30 October 2016. - : The Society for Research in Child Development (SRCD).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Collaborative research using variations on the same multimedia software (demo incorporated) is reviewed from studies in Sweden, Norway, Belgium, and the US. Substantial acceleration of progress is shown for deaf children in sign language and literacy, autistic children in oral language and literacy, and for motor-handicapped, dyslexic, and typically-developing children in literacy. Theoretical discussion covers top-down and bottom-up opportunities for processing. Further, the dynamic interplay of cognitive, language, attitudinal, cultural, and social-emotional processes is stressed. Suggested future innovations in software/technology and in teacher scaffolding strategies are based both in the empirical results so far and in dynamic systems theoretical discussion.
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| 5. |
- Sullivan, Richard, et al.
(författare)
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Global cancer surgery: delivering safe, affordable, and timely cancer surgery
- 2015
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Ingår i: The Lancet Oncology. - 1474-5488. ; 16:11, s. 1193-1224
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Tidskriftsartikel (refereegranskat)abstract
- Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, aff ordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and fi nancing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US$ 6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery-eg, pathology and imaging-are also inadequate. Our analysis identifi ed substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, aff ordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.
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| 6. |
- Vallurupalli, M., et al.
(författare)
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Students for global oncology: Building a movement for student education and engagement in an emerging field
- 2015
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Ingår i: Annals of Global Health. - : Ubiquity Press, Ltd.. - 2214-9996. ; 81:1, s. 56-56
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Program/Project Purpose: Increased recognition of the global cancer burden and inequalities in care and outcomes have led to the growing field of global oncology, focused on strengthening health systems to improve cancer prevention and care. Motivated students and trainees are in need of pathways to approach these challenges. In 2012, Harvard Medical students formed Students for Global Oncology (S4GO), an adjunct to the larger inter-professional organization Global Oncology. The group had three aims: 1) connect students with mentors in the field, 2) develop novel approaches in global oncology, and 3) disseminate global oncology knowledge. Structure/Method/Design: S4GO has created content and organized events to increase awareness about the global cancer burden, while promoting trainee opportunities in research and practical hands-on projects. Engagement was enhanced by mentorship from more senior students and faculty, to interface with existing global oncology projects. Outcomes & Evaluation: Since 2012, S4GO has grown from two to 68 students. Currently, new chapters at seven other institutions in the US and Canada are being developed. As of October 2014, S4GO has developed a case-based cancer care delivery curriculum with six case-based seminars, along with numerous blog entries and interviews of leading researchers in the field of global oncology, all available on the S4GO website. Students have completed projects in over nine countries and are actively involved in technological and on-the-ground efforts to develop creative solutions and collaborations aimed at easing the global cancer burden. Held in February 2014, the inaugural student-led global oncology symposium involved 200 individuals from across the world, including leaders in global health, pharmaceutical industry, public policy and cancer care. This symposium has been viewed by hundreds online and has fostered novel collaborations and projects focused on enhancing cancer care delivery. Going Forward: In the coming years, S4GO will continue efforts to build awareness and catalyze creative solutions for cancer care in resource-limited settings. These efforts will increase exposure for novel and successful student efforts as well as intra-institutional and intra-professional activity.
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| 7. |
- Carlsson, M. S., et al.
(författare)
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Effects of mussel farms on the benthic nitrogen cycle on the Swedish west coast
- 2012
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Ingår i: Aquaculture Environment Interactions. - : Inter-Research Science Center. - 1869-215X .- 1869-7534. ; 2:2, s. 177-191
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Tidskriftsartikel (refereegranskat)abstract
- The biogeochemical impact of 3 long-line mussel farms (M1, M2 and M3) in Lysekil, Sweden, was investigated from before farm establishment until 1.5 yr after operation had begun. Sedimentation, benthic N flux, total oxygen uptake (TOU) and sulfate reduction rate (SRR) were all significantly increased below the mussel lines at all 3 farms. Effects of increased sedimentation rates were revealed by sediment profile imaging and were highest at Stn M2. These effects increased significantly with time of farm operation, indicating the accumulation of organic matter within sediments over time. Furthermore, more total particulate organic N deposited at farm stations was recycled into the water column compared to at reference stations (similar to 45 versus similar to 13%), indicating an increased release of dissolved inorganic N from sediment below the mussel farms. At one station (M2) with the highest increase in sedimentation rate, denitrification seemed inhibited, while at another station (M3), with a less pronounced increase in sedimentation rate, denitrification was in fact stimulated, accounting for 13% of total sediment N removal. Calculations based on estimated values of N removal through mussel harvest and direct measurements of N input through changes in sedimentation, N regeneration from sediment to the water column through benthic fluxes and changes in denitrification showed, in all cases, a net removal of N from the system, as only 26 to 40% of the total amount of harvested N had been added to the sediments during the growth period.
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| 8. |
- Claybourn, Thomas M., 1989-
(författare)
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Mollusks from the upper Shackleton Limestone (Cambrian Series 2), Central Transantarctic Mountains, East Antarctica
- 2019
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Ingår i: Journal of Paleontology. - USA : Cambridge University Press. - 0022-3360 .- 1937-2337. ; 93:3, s. 437-459
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Tidskriftsartikel (refereegranskat)abstract
- An assemblage of Cambrian Series 2, Stages 3–4, conchiferan mollusks from the Shackleton Limestone, Transantarctic Mountains, East Antarctica, is formally described and illustrated. The fauna includes one bivalve, one macromollusk, and 10 micromollusks, including the first description of the species Xinjispira simplex Zhou and Xiao, 1984 outside North China. The new fauna shows some similarity to previously described micromollusks from lower Cambrian glacial erratics from the Antarctic Peninsula. The fauna, mainly composed of steinkerns, is relatively low diversity, but the presence of diagnostic taxa, including helcionelloid Davidonia rostrata (Zhou and Xiao, 1984), bivalve Pojetaia runnegari Jell, 1980, cambroclavid Cambroclavus absonus Conway Morris in Bengtson et al., 1990, and bradoriid Spinospitella coronata Skovsted et al., 2006, as well as the botsfordiid brachiopod Schizopholis yorkensis (Ushatinskaya and Holmer in Gravestock et al., 2001), in the overlying Holyoake Formation correlates the succession to the Dailyatia odyssei Zone (Cambrian Stages 3–4) in South Australia
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| 9. |
- Ghobadi Pour, M., et al.
(författare)
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Early Ordovician (Tremadocian) faunas and biostratigraphy of the Gerd-Kuh section, eastern Alborz, Iran
- 2015
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Ingår i: Stratigraphy. - 1547-139X .- 2331-656X. ; 12:2, s. 55-61
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Tidskriftsartikel (refereegranskat)abstract
- The Tremadocian of the East Alborz Region is dominated by condensed fine clasticsediments. These beds have yielded low to medium diversity trilobite associations, which belong to theolenid, nileid and raphiophorid biofacies, characteristic of an outer shelf environment. Five successivetrilobite biozones can be recognised in the Tremadocian succession of Alborz. The lower TremadocianAsaphellus inflatus–Dactylocephalus and Psilocephalina lubrica zones are characterised by mediumdiversity trilobite associations with strong links to contemporaneous faunas of South China. Three upperzones are documented in the section at Gerd-Kuh, the successive Vachikaspis insueta and Kayseraspiszones represent a low diversity interval during a time of rapid changes in the sea level changes; themedium diversity fauna of the Asaphellus fecundus–Taihungshania miqueli zone shows strong links tothe faunas of Mediterranean segment of Gondwana. Brachiopods in Gerd-Kuh are represented by themonotaxic Tarfaya Association and the low diversity Paralenorthis–Xinanorthis Association. Therecurrent oligotaxic Protambonites Association invaded the area in the late Tremadocian during shortterm regressive episodes.
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| 10. |
- Holmer, Hampus, et al.
(författare)
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The rate and perioperative mortality of caesarean section in Sierra Leone
- 2019
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Ingår i: BMJ Global Health. - : BMJ. - 2059-7908. ; 4:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Sierra Leone has the world's highest maternal mortality, partly due to low access to caesarean section. Limited data are available to guide improvement. In this study, we aimed to analyse the rate and mortality of caesarean sections in the country. Methods We conducted a retrospective study of all caesarean sections and all reported in-facility maternal deaths in Sierra Leone in 2016. All facilities performing caesarean sections were visited. Data on in-facility maternal deaths were retrieved from the Maternal Death Surveillance and Response database. Caesarean section mortality was defined as in-facility perioperative mortality. Results In 2016, there were 7357 caesarean sections in Sierra Leone. This yields a population rate of 2.9% of all live births, a 35% increase from 2012, with district rates ranging from 0.4% to 5.2%. The most common indications for surgery were obstructed labour (42%), hypertensive disorders (25%) and haemorrhage (22%). Ninety-nine deaths occurred during or after caesarean section, and the in-facility perioperative caesarean section mortality rate was 1.5% (median 0.7%, IQR 0-2.2). Haemorrhage was the leading cause of death (73%), and of those who died during or after surgery, 80% had general anaesthesia, 75% received blood transfusion and 22% had a uterine rupture diagnosed. Conclusions The caesarean section rate has increased rapidly in Sierra Leone, but the distribution remains uneven. Caesarean section mortality is high, but there is wide variation. More access to caesarean sections for maternal and neonatal complications is needed in underserved areas, and expansion should be coupled with efforts to limit late presentation, to offer assisted vaginal delivery when indicated and to ensure optimal perioperative care.
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