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- Ferrando, Carlos, et al.
(författare)
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Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy : a randomised controlled trial
- 2020
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Ingår i: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:1, s. 110-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59-1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48-1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found.
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| 2. |
- Williams Middleton, Karen, 1975, et al.
(författare)
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The university as an entrepreneurial learning space: The role of socialized learning in developing entrepreneurial competence
- 2020
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Ingår i: International Journal of Entrepreneurial Behaviour and Research. - 1355-2554. ; 26:5, s. 887-909
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – The purpose of this paper is to explores the influence of socialization upon the constitution and integration of learning leading to the development of entrepreneurial competence while at university, from the learner perspective. Self-reported learning is analyzed to illustrate ways in which students make use of institutional and social contributions of the university context. Design/methodology/approach – The study investigates entrepreneurial journeys of 18 participants, either currently attending or recently graduated from three universities in three countries with both comparable and distinctive contextual elements. In depth analysis of individual life stories, focusing on self-identified critical incidents, is used to illustrate ways in which students, while at university, develop entrepreneurial competence for current and future practice. Findings – Formal and non-formal learning remain important foundations for entrepreneurial competence development, delivered through designed content-centric structures. Informal learning – particularly mentor supported socialised learning – centring around the learner is key to solidifying learning towards entrepreneurial competence, through know-how and access to resources. The university emerges as an entrepreneurial learning space where students constitute and integrate learning gained through different forms. Research limitations/implications – Cross-cultural analysis is limited as the paper emphasizes the individual’s learning experience relative to the immediate university context. Practical implications – Universities play a critical role as entrepreneurial learning spaces beyond formal and non-formal learning. This includes dedicating resources to orchestrate informal learning opportunities and enabling interaction with the different agents that contribute to socialised situated learning, supporting entrepreneurial competence development. Universities need to take responsibility for facilitating the entirety of learning. Originality/value – Socialised learning in combination with other forms of learning contributes to student development of entrepreneurial competence while situated in the university context.
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