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- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 2. |
- Brusewitz, Göran, et al.
(författare)
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Exploratory study of physiological connectedness among twins in relation to attachment
- 2016
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Ingår i: 35th Annual Conference of the Society for Scientic Exploration, June 19 - 24, Boulder, Colorado, USA.
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Konferensbidrag (refereegranskat)abstract
- By applying the concept of attachment from developmental psychology, this study explores the degree of attachment between twins as a potential dependent variable relating to their apparent physiological connectedness at a distance, sometimes called telepathy. Seven pairs of twins were selected on the basis of their responses to the Exceptional Experiences Questionnaire. The twins alternated in the role of sender in which they were exposed to a surprise stimulus and in the role of receiver in which they were physiologically monitored for their electrodermal responses (EDR). Sender and receiver were placed in labs at different ends of the building separated by several doors and walls. Senders were presented with one stimulus at a random time epoch for each of five trials. Graphs from 53 useable trials were analysed for the peak EDR response close to the middle of each epoch by a researcher naïve to which one of eight possible epochs per trial the stimulus occurred. In 12 trials out of 53 (M = .23; MCE = 6.125) the naïve researchers choice matched the epoch of the actual stimulus and was significant, p = .043 (one-tailed). The results of the Experiences in Close Relationships – Revised (ECR-R) indicated that the twins having many hits in the telepathy experiment was not significantly different from those of the others, all having very low scores on attachment-related anxiety and avoidance. The data provides justification for a major study using this methodology with selected pairs of twins. Some major improvements in the design are suggested.
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