| 1. |
|
|
| 2. |
- Bebbington, Natalie A., et al.
(författare)
-
A Nordic survey of CT doses in hybrid PET/CT and SPECT/CT examinations
- 2019
-
Ingår i: EJNMMI Physics. - : Springer Science and Business Media LLC. - 2197-7364. ; 6:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Computed tomography (CT) scans are routinely performed in positron emission tomography (PET) and single photon emission computed tomography (SPECT) examinations globally, yet few surveys have been conducted to gather national diagnostic reference level (NDRL) data for CT radiation doses in positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT). In this first Nordic-wide study of CT doses in hybrid imaging, Nordic NDRL CT doses are suggested for PET/CT and SPECT/CT examinations specific to the clinical purpose of CT, and the scope for optimisation is evaluated. Data on hybrid imaging CT exposures and clinical purpose of CT were gathered for 5 PET/CT and 8 SPECT/CT examinations via designed booklet. For each included dataset for a given facility and scanner type, the computed tomography dose index by volume (CTDIvol) and dose length product (DLP) was interpolated for a 75-kg person (referred to as CTDIvol,75kg and DLP75kg). Suggested NDRL (75th percentile) and achievable doses (50th percentile) were determined for CTDIvol,75kg and DLP75kg according to clinical purpose of CT. Differences in maximum and minimum doses (derived for a 75-kg patient) between facilities were also calculated for each examination and clinical purpose. Results: Data were processed from 83 scanners from 43 facilities. Data were sufficient to suggest Nordic NDRL CT doses for the following: PET/CT oncology (localisation/characterisation, 15 systems); infection/inflammation (localisation/characterisation, 13 systems); brain (attenuation correction (AC) only, 11 systems); cardiac PET/CT and SPECT/CT (AC only, 30 systems); SPECT/CT lung (localisation/characterisation, 12 systems); bone (localisation/characterisation, 30 systems); and parathyroid (localisation/characterisation, 13 systems). Great variations in dose were seen for all aforementioned examinations. Greatest differences in DLP75kg for each examination, specific to clinical purpose, were as follows: SPECT/CT lung AC only (27.4); PET/CT and SPECT/CT cardiac AC only (19.6); infection/inflammation AC only (18.1); PET/CT brain localisation/characterisation (16.8); SPECT/CT bone localisation/characterisation (10.0); PET/CT oncology AC only (9.0); and SPECT/CT parathyroid localisation/characterisation (7.8). Conclusions: Suggested Nordic NDRL CT doses are presented according to clinical purpose of CT for PET/CT oncology, infection/inflammation, brain, PET/CT and SPECT/CT cardiac, and SPECT/CT lung, bone, and parathyroid. The large variation in doses suggests great scope for optimisation in all 8 examinations.
|
|
| 3. |
- Bertilsson, Fredrik
(författare)
-
Frihetstida policyskapande : Uppfostringskommissionen och de akademiska konstitutionerna 1738–1766
- 2017
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Regulating education is a vital part of government. This thesis is inspired by recent changes on the political landscape of higher education. It is guided by an interest in how political objectives and concepts of ideal social relationships are transformed and expressed through government university policies and their consequences. An early stage of what is now commonly referred to as the modern state and the modern research university, rather than present or relatively recent developments, will be explored. Instead of studying trends on the European continent, the thesis inquiries into an attempt made by the Swedish government to revise the constitutions of Swedish schools and universities through the so-called Educational Commission appointed in 1745.The purpose of the thesis is to apply a modern policy perspective to the Educational Commission’s attempt at reforming the constitution of the Swedish universities. The aim is to illuminate the construction of university regulations and to place this within a larger framework of policy making during the Age of Liberty (Frihetstiden) in Sweden.The Commission was an attempt by the Swedish government to implement educational changes based on a holistic view of the realm. It was one of several contemporary initiatives with nationwide ambitions. The Commission did not, however, succeed in reaching its formal objectives, but by placing too much emphasis on what the Commission did not achieve one risks overlooking other results and consequences. It initiated new communication structures, operating procedures and accountability schemes. It changed the regulations for assessing higher education making the university transparent and accountable to the government in new ways. New administrative routines for producing university reform were introduced.The Commission also provided university actors with a legitimate channel for voicing their opinions in relation to the government. They were given a legitimate position to formulate problems, questions and solutions regarding the university. The demands of the professors for increased autonomy in seeking knowledge and providing education stood against the claims made by the government for added control and insight into academic affairs. Through the Commission, the views of the professors were put into circulation in an official political context.
|
|
| 4. |
- Kempen, Thomas, et al.
(författare)
-
Medication Reviews Bridging Healthcare (MedBridge) : Study protocol for a pragmatic cluster-randomised crossover trial
- 2017
-
Ingår i: Contemporary Clinical Trials. - : Elsevier BV. - 1551-7144 .- 1559-2030. ; 61, s. 126-132
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mismanaged prescribing and use of medication among elderly puts major pressure on current healthcare systems. Performing a medication review, a structured critical examination of a patient's medications, during hospital stay with active follow-up into primary care could optimise treatment benefit and minimise harm. However, a lack of high quality evidence inhibits widespread implementation. This manuscript describes the rationale and design of a pragmatic cluster-randomised, crossover trial to fulfil this need for evidence.AIM: To study the effects of hospital-initiated comprehensive medication reviews, including active follow-up, on elderly patients' healthcare utilisation compared to 1) usual care and 2) solely hospital based reviews.DESIGN: Multicentre, three-treatment, replicated, cluster-randomised, crossover trial.SETTING: 8 wards with a multidisciplinary team within 4 hospitals in 3 Swedish counties.PARTICIPANTS: Patients aged 65years or older, admitted to one of the study wards.EXCLUSION CRITERIA: Palliative stage; residing in other than the hospital's county; medication review within the last 30days; one-day admission.INTERVENTIONS: 1, comprehensive medication review during hospital stay; 2, same as 1 with the addition of active follow-up into primary care; 3, usual care.PRIMARY OUTCOME MEASURE: Incidence of unplanned hospital visits during a 12-month follow-up period.DATA COLLECTION AND ANALYSES: Extraction and collection from the counties' medical record system into a GCP compliant electronic data capture system. Intention-to-treat-analyses using hierarchical models.RELEVANCE: This study has a high potential to show a reduction in elderly patients' morbidity, contributing to more sustainable healthcare in the long run.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Peura, Sari, et al.
(författare)
-
Resistant Microbial Cooccurrence Patterns Inferred by Network Topology
- 2015
-
Ingår i: Applied and Environmental Microbiology. - 0099-2240 .- 1098-5336. ; 81:6, s. 2090-2097
-
Tidskriftsartikel (refereegranskat)abstract
- Although complex cooccurrence patterns have been described for microbes in natural communities, these patterns have scarcely been interpreted in the context of ecosystem functioning and stability. Here we constructed networks from species cooccurrences between pairs of microorganisms which were extracted from five individual aquatic time series, including a dystrophic and a eutrophic lake as well as an open ocean site. The resulting networks exhibited higher clustering coefficients, shorter path lengths, and higher average node degrees and levels of betweenness than those of random networks. Moreover, simulations demonstrated that taxa with a large number of cooccurrences and placement at convergence positions in the network, so-called "hubs" and "bottlenecks," confer resistance against random removal of "taxa." Accordingly, we refer to cooccurrences at convergence positions as system-relevant interdependencies, as they, like hubs and bottlenecks, determine network topology. These topology features of the cooccurrence networks point toward microbial community dynamics being resistant over time and thus could provide indicators for the state of ecosystem stability.
|
|
