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- Hussain-Alkhateeb, Laith, 1977, et al.
(författare)
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Operational guide: Early Warning and Response System (EWARS) for dengue outbreaks
- 2017
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Dengue outbreaks threaten the stability of national health systems worldwide. Every year, late detection and inadequate response mechanisms compound the effects of rapid dengue transmission. Although outbreak alert indicators exist, the means to deploy them in early warning systems is often lacking. Within this context, a programme led by TDR, the Special Programme for Research and Training in Tropical Diseases, conducted multi-country research into alarm signals for outbreaks and their use within early warning systems. In line with the prevailing literature, alarm variables such as probable dengue cases, mean temperature (and, to a lesser extent, rainfall and humidity) all evidenced predictive abilities. However, it was clear that countries lacked the requisite skills and resources to deploy these alarm signals in a predictive, operational way. It was on this basis that an accessible, adaptable and user-friendly early warning system was developed. The aim of the Early Warning and Response System (EWARS) for Dengue Outbreaks: operational guide is to provide programme managers with a user friendly tool that can: (i) analyse and draw conclusions from historic dengue datasets; (ii) identify appropriate alarm indicators that can sensitively and specifically predict forthcoming outbreaks at smaller spatial scales; and (iii) use these results and analyses to predict and build an early warning system to detect dengue outbreaks in real-time. Together, these three components build technical capacity and provide a standardized methodology for predicting dengue outbreaks in countries where skills and resources are currently constrained. This guide was produced by TDR together with the World Health Organization’s Neglected Tropical Diseases (WHO/NTD) and WHO regional offices in the context of a European Union-financed research programme, the International Research Consortium on Dengue Risk Assessment, Management and Surveillance (IDAMS), to develop an evidence-based, early warning system for outbreak detection and management of dengue fever outbreaks.
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| 2. |
- Selin, Lotta, et al.
(författare)
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High Dose versus Low Dose Oxytocin for Augmentation of Delayed Labour: a randomized controlled trial
- 2016
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Ingår i: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Delay in labour due to ineffective uterine contractions is a major problem in obstetric care and a main reason for the increased rate of caesarean deliveries, particularly among nulliparous women. Infusion with synthetic oxytocin is a commonly used treatment of hypotonic uterine contractions however there is a gap of knowledge concerning which dosage of oxytocin should be used, both starting dose and increment dose of oxytocin. Aim To compare dosage of oxytocin treatment in nulliparous women with delayed labour progress in active phase of labour. The hypothesis is that augmentation by high dose of oxytocin improves labour outcomes compared with a low dose of oxytocin, without affecting neonatal or maternal outcomes including birth experiences negatively. Methods In a randomized double-blind controlled trial conducted in six labour wards in Sweden, consenting nulliparous women in active labour and with a defined delayed progress are randomized to receive a regimen of either high dose or low dose of oxytocin (33.2 respectively 16,6 microgram oxytocin in 1000 ml isotone saline solution). Randomization is computergenerated, with allocation concealment by a coding system. Primary outcome is caesarean delivery rate. Based on a sample size calculation (α=0.05, β=0.80), a minimum of 1 045 women will be included in each group in order to reduce caesarean section rate from 17.5 % to 13 %. The study is approved by the regional Ethics Board in Gothenburg (dnr: 090-12), by the Medical Products Agency –Sweden (Eudra-CTnr:2012-00035633) and registered at ClinicalTrials.gov. Identifier: NCT01587625. Results Data collection started 15th of August 2013 and data is still under collection. This presentation will describe the study protocol and the first half period of the data collection. Conclusion The study will contribute to establishment of evidence based routines regarding oxytocin treatment of delayed labour progress.
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