| 1. |
- Ahmadi, Zainab, et al.
(författare)
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Smoking and home oxygen therapy : a review and consensus statement from a multidisciplinary Swedish taskforce
- 2024
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Ingår i: European Respiratory Review. - : European Respiratory Society. - 0905-9180 .- 1600-0617. ; 33:171
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Forskningsöversikt (refereegranskat)abstract
- Background: Home oxygen therapy (HOT) improves survival in patients with hypoxaemic chronic respiratory disease. Most patients evaluated for HOT are former or active smokers. Oxygen accelerates combustion and smoking may increase the risk of burn injuries and fire hazards; therefore, it is considered a contraindication for HOT in many countries. However, there is variability in the practices and policies regarding this matter. This multidisciplinary Swedish taskforce aimed to review the potential benefits and risks of smoking in relation to HOT, including medical, practical, legal and ethical considerations.Methods: The taskforce of the Swedish Respiratory Society comprises 15 members across respiratory medicine, nursing, medical law and ethics. HOT effectiveness and adverse risks related to smoking, as well as practical, legal and ethical considerations, were reviewed, resulting in five general questions and four PICO (population–intervention–comparator–outcome) questions. The strength of each recommendation was rated according to the GRADE (grading of recommendation assessment, development and evaluation) methodology.Results: General questions about the practical, legal and ethical aspects of HOT were discussed and summarised in the document. The PICO questions resulted in recommendations about assessment, management and follow-up of smoking when considering HOT, if HOT should be offered to people that meet the eligibility criteria but who continue to smoke, if a specific length of time of smoking cessation should be considered before assessing eligibility for HOT, and identification of areas for further research.Conclusions: Multiple factors need to be considered in the benefit/risk evaluation of HOT in active smokers. A systematic approach is suggested to guide healthcare professionals in evaluating HOT in relation to smoking.
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| 2. |
- Amouzad Mahdiraji, Saeid, et al.
(författare)
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A Framework for Constructing Discrete Event Simulation Models for Emergency Medical Service Policy Analysis
- 2022
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Ingår i: Procedia Computer Science. - : Elsevier BV. - 1877-0509. ; 210, s. 133-140
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Konferensbidrag (refereegranskat)abstract
- Constructing simulation models can be a complex and time-consuming task, in particular if the models are constructed from scratch or if a general-purpose simulation modeling tool is used. In this paper, we propose a model construction framework, which aims to simplify the process of constructing discrete event simulation models for emergency medical service (EMS) policy analysis. The main building blocks used in the framework are a set of general activities that can be used to represent different EMS care chains modeled as flowcharts. The framework allows to build models only by specifying input data, including demographic and statistical data, and providing a care chain of activities and decisions. In a case study, we evaluated the framework by using it to construct a model for the simulation of the EMS activities related to acute stroke. Our evaluation shows that the predefined activities included in the framework are sufficient to build a simulation model for the rather complex case of acute stroke.
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| 3. |
- Bazargani, Farhan, 1969-, et al.
(författare)
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Three-dimensional Analysis of Effects of Rapid Maxillary Expansion on Facial Sutures and Bones : A systematic review
- 2013
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Ingår i: Angle orthodontist. - : The EH Angle Education and Research Foundation Inc. - 0003-3219 .- 1945-7103. ; 83:6, s. 1074-1082
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Forskningsöversikt (refereegranskat)abstract
- Objective: To evaluate the evidence on three-dimensional immediate effects of rapid maxillary expansion (RME) treatment on growing patients as assessed by computed tomography/cone beam computed tomography (CT/CBCT) imaging. Materials and Methods: The published literature was searched through the PubMed, Embase, and Cochrane Library electronic databases from January 1966 to December 2012. The inclusion criteria consisted of randomized controlled trials, prospective controlled studies, and prospective case-series. Two reviewers extracted the data independently and assessed the quality of the studies. Results: The search strategy resulted in 73 abstracts or full-text articles, of which 10 met the inclusion criteria. When treating posterior crossbites with a RME device, the existing evidence points out that the midpalatal suture opening is around 20%-50% of the total screw expansion. There seems to be no consistent evidence on whether the midpalatal sutural opening is parallel or triangular. The effect on the nasal cavity dimensions after RME seems to be apparent and indicates an enlargement between 17% and 33% of the total screw expansion. Circummaxillary sutures, particularly the zygomaticomaxillary and frontomaxillary sutures and also spheno-occipital synchondrosis, appear to be affected by the maxillary expansion. Overall, however, the changes were small and the evidence not conclusive. Conclusions: CT imaging proved to be a useful tool for assessment of treatment effects in all three dimensions. The majority of the articles were judged to be of low quality, and therefore, no evidence-based conclusions could to be drawn from these studies.
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| 4. |
- Bruce, Barbro, et al.
(författare)
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Interactional style, elicitation strategies and language production in professional language intervention
- 2007
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Ingår i: Child Language Teaching and Therapy. - : SAGE Publications. - 0265-6590 .- 1477-0865. ; 23:3, s. 253-266
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Tidskriftsartikel (refereegranskat)abstract
- This paper explores language intervention for children with specific language impairment in Sweden. The elicitation strategies, style of interaction and language production used by speech and language pathologists (SLPs) were analyzed in two conditions, free conversation and training of grammar. In training, the grammatical targets were used significantly more often by the SLPs, but not by the children. In the free conversations the children talked more and had significantly higher mean length of utterance in words and the SLPs linked significantly more to the child's focus. The two conditions represent different, but complementary approaches to language intervention.
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| 5. |
- Bruce, Barbro
(författare)
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Problems of language and communication in children; Identification and intervention
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis addresses identification and intervention of language and communication problems in children. The issue of identification is addressed in study I by investigating communicative ability in 18-month-old children, and in study II by exploring the prevalence of language and communication problems in children with complex problems, such as attention deficit hyperactivity disorder (ADHD). The issue of intervention is addressed in studies III and IV by analysing verbal interaction in conversations, in which one of the participants is a child with specific language impairment (SLI). Study III explores how dialogues between children with SLI and typically developing peers (TLD) representing the same age (age peers), and the same language level (language peers) respectively, differ with respect to responsiveness, assertiveness and reciprocity. Study IV investigates interactional style and elicitation strategies of speech/language pathologists (SLP) during intervention, and how these factors influence the child with SLI. The results from study I show that receptive skills and symbolic play at 18 months of age are significantly associated with language ability three years later. Study II, in which language skills in children with ADHD were explored, indicates that language ability plays an important role for all other aspects of children's development and behaviour, with the exception of motor skills. Use of language and language comprehension caused these children many more problems than structural aspects of language production. Furthermore, reading and writing problems were found to be very frequent. Study III shows that dialogues between children with SLI and TLD age peers are characterized by more responsiveness and topic coherence than dialogues between children with SLI and TLD language peers. However, the children with SLI were more assertive, i.e., introduced more topics, in dialogues with language peers. Study IV indicates that the children with SLI talked more and had a higher mean length of utterance (MLU) in the free conversational context, whereas the individually selected grammatical targets occurred more often in the training context. In the conversational context the SLPs linked, i.e., attended, more to the child's focus and gave more feedback, while in the training context the individually selected grammatical targets occurred more often and the children were more frequently asked to follow instructions. The results have important clinical implications. First; screening procedures at Child Health Care (CHC) centres should be recommended to focus on receptive language skills and play behaviour, and not only on size of vocabulary at 18 months of age. Second; language skills, in particular language comprehension, language use and literacy skills were found to cause children with ADHD problems, and should therefore be assessed. Third; it is of great value for children with SLI to be in mixed groups with peers representing different ages and language levels, and to avoid the risk of not being selected as playmates. Fourth; increased awareness of how interactional style and elicitation strategies influence the developing language skills in children with SLI can be used in intervention planning, depending on the goals of the specific intervention procedures for the individual child.
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| 6. |
- Dimberg, Lillemor, et al.
(författare)
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The impact of malocclusion on the quality of life among children and adolescents : a systematic review of quantitative studies
- 2015
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:3, s. 238-247
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Forskningsöversikt (refereegranskat)abstract
- Background: Among child and adolescent patients, persistent but untreated malocclusions may or may not have psychological and social impacts on the individual's quality of life. Objectives: To gain knowledge of malocclusions and its impact on oral health-related quality of life (OHRQOL), we conducted a systematic review of quantitative studies for evidence regarding the influence of malocclusions on OHRQOL in children and adolescents. Materials and methods: Five databases (MEDLINE via PubMed, EMBASE, Psychinfo, CINAHL, and the Cochrane Library) were searched using specified indexing terms. The following inclusion criteria were used: child or adolescent study population; healthy study participants without syndromes such as cleft lip/palate or severe illness; no previous or ongoing orthodontic treatment among participants; a focus on malocclusions and quality of life; controlled or subgrouped according to malocclusions/no malocclusions; malocclusions and/or orthodontic treatment need assessed by professionals using standardized measures; self-assessed OHRQOL estimated using validated questionnaire instruments; full-text articles written in English or Scandinavian languages. Quality of evidence was classified according to GRADE guidelines as high, moderate, or low. Results: The search produced 1142 titles and abstracts. Based on pre-established criteria, the full-text versions of 70 articles were obtained, 22 of which satisfied the inclusion criteria. After data extraction and interpretation, six publications were deemed eligible for full inclusion. All six were of cross-sectional design, and the quality of evidence was high in four cases and moderate in the remaining two. The four studies with a high level of quality reported that anterior malocclusion had a negative impact on OHRQOL, and the two with a moderate level of quality reported that increased orthodontic treatment need had a negative impact on OHRQOL. Conclusion: The scientific evidence was considered strong since four studies with high level of quality reported that malocclusions have negative effects on OHRQOL, predominantly in the dimensions of emotional and social wellbeing.
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| 7. |
- Feldmann, Ingalill, et al.
(författare)
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Pain and Discomfort During the First Week of Rapid Maxillary Expansion (RME) Using Two Different RME Appliances : A Randomized Controlled Trial
- 2017
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Ingår i: Angle orthodontist. - : E H Angle Orthodontists Research & Education Foundation, Inc.. - 0003-3219 .- 1945-7103. ; 87:3, s. 391-396
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate and compare perceived pain intensity, discomfort, and jaw function impairment during the first week with tooth-borne or tooth-bone-borne rapid maxillary expansion (RME) appliances. Materials and Methods: Fifty-four patients (28 girls and 26 boys) with a mean age of 9.8 years (SD 1.28 years) were randomized into two groups. Group A received a conventional hyrax appliance and group B a hybrid hyrax appliance anchored on mini-implants in the anterior palate. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment on the first and fourth days after RME appliance insertion. Results: Fifty patients answered both questionnaires. Overall median pain on the first day in treatment was 13.0 (range 0-82) and 3.5 (0-78) for groups A and B, respectively, with no significant differences in pain, discomfort, analgesic consumption, or functional jaw impairment between groups. Overall median pain on the fourth day was 9.0 (0-90) and 2.0 (0-71) for groups A and B, respectively, with no significant differences between groups. There were also no significant differences in pain levels within group A, while group B scored significantly lower concerning pain from molars and incisors and tensions from the jaw on day 4 than on the first day in treatment. There was a significant positive correlation between age and pain and discomfort on the fourth day in treatment. No correlations were found between sex and pain and discomfort, analgesic consumption, and jaw function impairment. Conclusions: Both tooth-borne and tooth-bone-borne RME were generally well tolerated by the patients during the first week of treatment.
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| 8. |
- Grotle, Margreth, et al.
(författare)
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What's in the black box of arthritis rehabilitation? : A comparison of rehabilitation practice for patients with inflammatory arthritis in northern europe
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 45:5, s. 458-466
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Tidskriftsartikel (refereegranskat)abstract
- Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries. Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register European Team Intiative for Care Research (STAR-ETIC) framework. Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities. Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.
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| 9. |
- Gummesson, Christina, et al.
(författare)
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Entrustable professional activities (EPAs) for undergraduate medical education : development and exploration of social validity
- 2023
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Ingår i: BMC Medical Education. - : BioMed Central (BMC). - 1472-6920. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The development of entrustable professional activities (EPAs) as a framework for work-based training and assessment in undergraduate medical education has become popular. EPAs are defined as units of a professional activity requiring adequate knowledge, skills, and attitudes, with a recognized output of professional labor, independently executable within a time frame, observable and measurable in its process and outcome, and reflecting one or more competencies. Before a new framework is implemented in a specific context, it is valuable to explore social validity, that is, the acceptability by relevant stakeholders.Aim: The aim of our work was to define Core EPAs for undergraduate medical education and further explore the social validity of the constructs.Method and material: In a nationwide collaboration, EPAs were developed using a modified Delphi procedure and validated according to EQual by a group consisting of teachers nominated from each of the seven Swedish medical schools, two student representatives, and an educational developer (n = 16). In the next step, social validity was explored in a nationwide survey. The survey introduced the suggested EPAs. For each EPA, the importance of the EPA was rated, as was the rater’s perception of the present graduates’ required level of supervision when performing the activity. Free-text comments were also included and analyzed.Results: Ten Core EPAs were defined and validated. The validation scores for EQual ranged from 4.1 to 4.9. The nationwide survey had 473 responders. All activities were rated as “important” by most responders, ranging from 54 to 96%. When asked how independent current graduates were in performing the ten activities, 6 to 35% reported “independent”. The three themes of the free text comments were: ‘relevant target areas and content’; ‘definition of the activities’; and ‘clinical practice and learning’.Conclusion: Ten Core EPAs were defined and assessed as relevant for Swedish undergraduate medical education. There was a consistent gap between the perceived importance and the certainty that the students could perform these professional activities independently at the time of graduation. These results indicate that the ten EPAs may have a role in undergraduate education by creating clarity for all stakeholders.
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| 10. |
- Häggman Henrikson, Birgitta, et al.
(författare)
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Temporomandibular Disorder Pain After Whiplash Trauma: A Systematic Review
- 2013
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Ingår i: Journal of Orofacial Pain. - : Quintessence. - 1064-6655 .- 1945-3396. ; 27:3, s. 217-226
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Forskningsöversikt (refereegranskat)abstract
- Aims: To assess, by systematic review of the literature, (1) the prevalence and incidence of temporomandibular disorder (TMD) pain after whiplash trauma, and (2) whether treatment modalities commonly used for TMD are equally effective in patients with solely TMD pain and those with TMD/whiplash-associated disorders (WAD) pain. Methods: A systematic literature search of the PubMed, Cochrane Library, and Bandolier databases was conducted from January 1966 through October 2012. The systematic search identified 125 articles. After an initial screening of abstracts, 45 articles were reviewed in full text. Two investigators evaluated the methodological quality of each identified study. Results: Eight studies on prevalence/incidence of TMD pain in WAD and four studies on interventions in TMD pain and WAD met the inclusion criteria. The reported median prevalence of TMD pain after whiplash trauma was 23% (range 2.4% to 52%) and the incidence ranged from 4% to 34%. For healthy controls, the reported median prevalence was 3% (range 2.5% to 8%) and the incidence ranged from 4.7% to 7%. For patients with a combination of TMD pain and WAD, treatment modalities conventionally used for TMD, such as jaw exercises and occlusal splints, had less of an effect (median improvement rate of 48%, range 13% to 68%) compared to TMD patients without a whiplash injury (75%, range 51% to 91%). Conclusion: There is some evidence that prevalence and incidence of TMD pain is increased after whiplash trauma. The poorer treatment outcome suggests that TMD pain after whiplash trauma has a different pathophysiology compared to TMD pain localized to the facial region.
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