| 1. |
|
|
| 2. |
- Cederborg, Anna, 1976, et al.
(författare)
-
Renal function after liver transplantation: Real-world experience with basiliximab induction and delayed reduced-dose tacrolimus
- 2022
-
Ingår i: Digestive and Liver Disease. - : Elsevier BV. - 1590-8658. ; 54:8, s. 1076-1083
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Routine use of delayed reduced-dose calcineurin-inhibitor treatment with induction immunosuppression in liver transplantation to minimize post-operative kidney injury is still scarce. Aim: To evaluate real-world experience of basiliximab induction with delayed reduced-dose tacrolimus. Methods: In a retrospective cohort study, kidney function was evaluated pre- and postoperatively by measured glomerular filtration rate (mGFR). Adult patients undergoing liver transplantation between 2000 and 2017 were divided into a conventional treatment group (immediate-introduction of tacrolimus, target trough levels 10–15 ng/mL, and corticosteroids, n = 203) and a revised treatment group (basiliximab induction, reduced-dose tacrolimus, target through levels 5–8 ng/mL, delayed until day three, and mycophenolate mofetil 2000 mg/day, n = 343). Results: Mean mGFR was similar between groups at wait-listing (85.3 vs 84.1 ml/min/1.73m², p = 0.60), but higher in the revised treatment group at 3 (56.8 vs 63.4 ml/min/1.73m², p = 0.004) and 12 months post-transplant (60.9 vs 69.7 ml/min/1.73m², p<0.001); this difference remained after correcting for multiple confounders and was independent of pre-transplant mGFR. In the revised treatment group, biopsy proven acute rejection rate was lower (38% vs. 21%, p<0.001), and graft-survival better (p = 0.01). Conclusion: Basiliximab induction with delayed reduced-dose tacrolimus is associated with less kidney injury when compared to standard-dose tacrolimus, without increased risk of rejection, graft loss or death. © 2021
|
|
| 3. |
- Derwig, Mariette, et al.
(författare)
-
eHealth usage among parents to premature or surgically treated neonates: associations with eHealth literacy, healthcare satisfaction or satisfaction with an eHealth device
- 2023
-
Ingår i: BMC Pediatrics. - 1471-2431. ; 23
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundA specific eHealth device, a surf tablet, was developed for bridging between advanced in-hospital care and children’s homes. Since little is known about determinators for parental eHealth usage, the study’s aim was to explore if parents’ usage of the device was associated with their eHealth literacy, or their satisfaction with their child’s healthcare or with the specific surf tablet.MethodsIn this explorative usage and questionnaire study, parents to neonates who were discharged home after advanced in-hospital care were included. Their surf tablet usage at maximum 30 days after discharge was reported as frequency (%) of active days (usage days/days having the device) and median number of tablet activities (chat and photo) per usage day. eHealth literacy (eHealth Literacy Questionnaire; eHLQ), healthcare satisfaction (PedsQL Healthcare Satisfaction Generic Module), and satisfaction with the surf tablet were explored regarding tablet usage. Statistics were described in median (range) and (%) using non-parametric and regression models (p ResultsParents to 32 children (11 premature, 21 operated) were included. Active days with eHealth communication using the device was 39% (9.0/29.5), with 2.0 (1.0-4.2) usage occasions per active day. Activity on the tablet was higher among parents reporting to be very satisfied or satisfied with the device (n = 25) compared with neutral/dissatisfied parents (n = 7) (2.8 vs. 2.2 vs. 1.6 activities) (p = 0.030), while their frequency of active days did not differ (31.6% vs. 38.3% vs. 40%) (p = 0.963). A higher eHealth literacy was not associated with frequency of active days (0.926 (0.652–1.317); p = 0.659) or number of eHealth activities (0.973 (0.758–1.250); p = 0.825). Healthcare satisfaction was not associated with higher frequency of active days 0.996 (0.983–1.009; p = 0.519); neither was number of eHealth activities 1.001 (0.991–1.011; p = 0.883).ConclusionIn this study, eHealth usage was associated with parental satisfaction with the specific eHealth device, but not with eHealth literacy or healthcare satisfaction. To assure equal access to healthcare when using eHealth, the user-friendliness of the device seems to be crucial, and technical support needs to be in place.
|
|
| 4. |
- Hedenström, Per, et al.
(författare)
-
GAPS-EUS: a new and reliable too or the assessment of basic skills and performance in EUS among endosonography trainees
- 2021
-
Ingår i: Bmj Open Gastroenterology. - : BMJ. - 2054-4774. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objective Endosonography (EUS) is a useful but complex diagnostic modality which requires advanced endoscopy training and guidance by a supervisor. Since learning curves vary among individuals, assessment of the actual competence among EUS trainees is important. Design/methods We designed a novel assessment tool entitled Global Assessment of Performance and Skills in EUS (GAPS-EUS) for assessing skills among EUS trainees. Five quality indicators were marked on a five-grade scale by the supervisor (Observer Score) and by the trainee (Trainee Score). Trainees were included in two high-volume centres (Gothenburg, Sweden, and Bologna, Italy). Outcomes were feasibility, patient safety, reliability, and validity of GAPS-EUS in trainee-performed EUS procedures. Results Twenty-two EUS-trainees were assessed in a total of 157 EUS procedures with a completion rate of 157/157 (100 %) and a patient adverse event rate of 2/157 (1.3 %; gastroenteritis n=1, fever n=1). GAPS-EUS showed a high measurement reliability (Cronbach's alpha coefficient=0.87) and a high interrater reliability comparing the supervisor and the trainee (r=0.83, r(2) =0.69, p<0.001). The construct of GAPS-EUS was verified by comparing low-level and high-level performance procedures and the content validity by recording that the EUS-FNA manoeuvre resulted in a lower score than other aspects of EUS 3.07 (95% CI 2.91 to 3.23) vs 3.51 (95% CI 3.37 to 3.65) (p<0.001). External validity was confirmed via similar findings in both centres. Conclusion GAPS-EUS is an easy-to-use and reliable tool with a recorded high validity for the assessment of competence among trainees in EUS. It can be recommended to centres involved in the education of future endosonographers.
|
|
| 5. |
- Lindau, Björn, 1961, et al.
(författare)
-
Virtual fixturing: Inspection of a non-rigid detail resting on 3-points to estimate free state and over-constrained shapes
- 2020
-
Ingår i: ASME International Mechanical Engineering Congress and Exposition, Proceedings (IMECE). ; 2B-2020
-
Konferensbidrag (refereegranskat)abstract
- When the geometry of a non-rigid part or pre-assembly is measured fully clamped (over-constrained) in a measurement fixture, the spring-back information and influence from gravity forces are usually lost in the collected data. From the 3D-measurement data, it is hard to understand built in tensions, and the detail's tendency to bend, twist and warp after release from the measurement fixture. These effects are however important to consider when analyzing each part´s contribution to geometrical deviations after assembly. In this paper a method is presented, describing how free state shape and over-constrained shape of a measured detail can be virtually estimated starting from acquired data when the part or the preassembly is resting on only 3-points. The objective is to minimize the information loss, to spare measurement resources and to allow for a wider use of the collected data, describing the geometry. Part stiffnesses, part to part contacts and gravity effects are considered in the proposed method. The method is based on 3D-scanning techniques to acquire the shape of the measured object. Necessary compensations for part stiffnesses and gravity effects are based upon Finite Element Analysis (FEA) and the Method of Influence Coefficients (MIC). The presented method is applied to an industrial case to demonstrate its potential. The results show that estimated over-constrained shapes show good resemblance with measurements acquired when part is over-constrained in its measurement fixture.
|
|
| 6. |
- Lindkvist, Rose-Marie, et al.
(författare)
-
‘A Safe Place Where I Am Welcome to Unwind When I Choose to’—Experiences of Brief Admission by Self-Referral for Adolescents Who Self-Harm at Risk for Suicide: A Qualitative Study
- 2022
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 19:1, s. 1-15
-
Tidskriftsartikel (refereegranskat)abstract
- Evidence is lacking on how to manage imminent suicidality in adolescents with self-harm. Brief Admission by Self-referral (BA) is a crisis-management intervention, developed for adults with self-harm at risk for suicide. Structured, individualized and based on responsible autonomy, BA aims to provide a respite while minimizing negative effects of hospitalization. This qualitative interview study illuminates adolescents’ experiences of BA, adapted for this target group. Nineteen adolescents aged 14 to 19 years, described BA as helpful for timely rest and recovery to save themselves from impulses to self-harm. The individual contract, which is a prerequisite for access to BA, was perceived to give access to professional support in a safe environment, also among adolescents not using their contract. Being trusted with responsibility to self-admit was also hard work with struggles of self-doubt. Challenges included experiencing distrust from staff and fear of not being able to abstain from self-harm, which BA is conditioned upon. However, this condition was also perceived to induce self-motivation and growth. BA appeared well-adapted to the target group, fulfilling needs of predictability, autonomy, and opportunity for recovery to prevent self-harm. Suggestions for improvement included continually informing staff about important features of BA. To further evaluate benefits and challenges of BA, future research may evaluate clinical and health-economic outcomes and perspectives from parents and caregivers.
|
|
| 7. |
- Lindkvist, Rose Marie, et al.
(författare)
-
“In a Way We Took the Hospital Home”—A Descriptive Mixed-Methods Study of Parents’ Usage and Experiences of eHealth for Self-Management after Hospital Discharge Due to Pediatric Surgery or Preterm Birth
- 2021
-
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:12
-
Tidskriftsartikel (refereegranskat)abstract
- The costly and complex needs for children with long-term illness are challenging. Safe eHealth communication is warranted to facilitate health improvement and care services. This mixed-methods study aimed to describe parents’ usage and experiences of communicating with professionals during hospital-to-home-transition after their child’s preterm birth or surgery for col-orectal malformations, using an eHealth device, specifically designed for communication and support via nurses at the hospital. The eHealth devices included the possibility for daily reports, video calls, text messaging, and sending images. Interviews with 25 parents were analyzed with qualitative content analysis. Usage data from eHealth devices were compiled from database entries and analyzed statistically. Parents using the eHealth device expressed reduced worry and stress during the initial period at home through effective and safe communication. Benefits described included keeping track of their child’s progress and having easy access to support whenever needed. This was corroborated by usage data indicating that contact was made throughout the day, and more among families living far away from hospital. The eHealth device potentially replaced phone calls and prevented unnecessary visits. The eHealth technique can aid safe self-treatment within child-and family-centered care in neonatal and pediatric surgery treatment. Future research may consider organization perspectives and health economics.
|
|
| 8. |
- Lindkvist, Sofia, et al.
(författare)
-
Effect of light intensity, spectrum, and uniformity on the ability of dairy cows to navigate through an obstacle course
- 2023
-
Ingår i: Journal of Dairy Science. - 0022-0302 .- 1525-3198. ; 106, s. 7698-7710
-
Tidskriftsartikel (refereegranskat)abstract
- The most suitable light intensity for cows during nighttime has not been thoroughly investigated. Recommendations on the night-time lighting regimen on dairy farms differ between countries and range from light throughout the night to darkness to allow the animals a rest from artificial light. Commercial actors recommend red light for night-time lighting in cattle barns to facilitate livestock supervision with minimum disturbance for the animals. However, little is known about how light intensity, spectrum, and uniformity affect the ability of cows to navigate their indoor environment. Thus, in a change-over study with 12 pregnant, nonlactating dairy cows, we observed how the cows walked through an obstacle course under different light treatments. Obstacles were positioned differently for every run, to present a novel challenge for each light environment. Fourteen different light treatments were tested, involving intensity ranging from <0.01 (darkness) to 4.49 mu mol m(-2) s(-1), high or low uniformity, and white or red color. Light was characterized in terms of illuminance, photon flux density, spectral composition, and uniformity. Additionally, assessment of the environmental light field was used to describe each lighting condition from a bovine and human perspective. Data were analyzed in a generalized mixed model to assess whether lighting conditions affected cow walking speed or stride rate. Pair-wise post hoc comparisons showed that the cows walked at a slower speed in nonuniform red light compared with uniform white light or uniform red light. Interestingly, darkness did not alter walking speed or stride rate. The odds of different behaviors occurring were not affected by lighting conditions. In conclusion, darkness did not affect the ability of cows to navigate through the obstacle course, but medium-intensity, nonuniform red light affected their speed. Hence, cows do not necessarily need night-time lighting to navigate, even in a test arena with obstacles blocking their way, but nonuniform light distribution may have an effect on their movements.
|
|
| 9. |
- Lindkvist, Sofia, et al.
(författare)
-
Effects of achromatic and chromatic lights on pupillary response, endocrinology, activity, and milk production in dairy cows
- 2021
-
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 16
-
Tidskriftsartikel (refereegranskat)abstract
- Artificial light can be used as a management tool to increase milk yield in dairy production. However, little is known about how cows respond to the spectral composition of light. The aim of this study was to investigate how dairy cows respond to artificial achromatic and chromatic lights. A tie-stall barn equipped with light-emitting diode (LED) light fixtures was used to create the controlled experimental light environments. Two experiments were conducted, both using dairy cows of Swedish Red and light mixtures with red, blue or white light. In experiment I, the response to light of increasing intensity on pupil size was evaluated in five pregnant non-lactating cows. In experiment II 16h of achromatic and chromatic daylight in combination with dim, achromatic night light, was tested on pregnant lactating cows during five weeks to observe long term effects on milk production, activity and circadian rhythms. Particular focus was given to possible carry over effects of blue light during the day on activity at night since this has been demonstrated in humans. Increasing intensity of white and blue light affected pupil size (P<0.001), but there was no effect on pupil size with increased intensity of red light. Milk yield was maintained throughout experiment II, and plasma melatonin was higher during dim night light than in daylight for all treatments (P<0.001). In conclusion, our results show that LED fixtures emitting red light driving the ipRGCs indirectly via ML-cones, blue light stimulating both S-cones and ipRGCs directly and a mixture of wavelengths (white light) exert similar effects on milk yield and activity in tied-up dairy cows. This suggests that the spectral composition of LED lighting in a barn is secondary to duration and intensity.
|
|
| 10. |
- McCulloch, Sofia, et al.
(författare)
-
The diagnostic value of a change in bowel habit for colorectal cancer within different age groups
- 2020
-
Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 8:2, s. 211-219
-
Tidskriftsartikel (refereegranskat)abstract
- Background Change in bowel habit as a sole alarm symptom for colorectal cancer is disputed. Objective We investigated the diagnostic value of change in bowel habit for colorectal cancer, particularly as a single symptom and within different age groups. Methods This retrospective cohort study examined colorectal cancer fast track referrals and outcomes across four Swedish hospitals (April 2016-May 2017). Entry criteria constituted one or more of three alarm features: anaemia, visible rectal bleeding, or change in bowel habit for more than 4 weeks in patients over 40 years of age. Patients were grouped as having only change in bowel habit, change in bowel habit plus anaemia/bleeding or anaemia/bleeding only. Results Of 628 patients, 22% were diagnosed with colorectal cancer. There were no cases of colorectal cancer in the only change in bowel habit group under 55 years, while this was 6% for 55-64 years, 8% for 65-74 years and 14% for 75 years and older. Among subjects under 55 years, 2% with anaemia/bleeding had colorectal cancer, this increased to 34% for 55 years and older (P < 0.0001). Change in bowel habit plus anaemia/bleeding gave a colorectal cancer prevalence of 16% in under 55 years and increased to 30% for 55 years and older (P = 0.07). Conclusion Change in bowel habit as the only alarm feature has a low diagnostic yield for colorectal cancer in patients under 55 years.
|
|
