| 1. |
- Thomas, HS, et al.
(author)
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- 2019
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swepub:Mat__t
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| 7. |
- Ademuyiwa, Adesoji O., et al.
(author)
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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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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)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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| 8. |
- Courteille, O., et al.
(author)
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Mixed Virtual Reality Simulation -Taking Endoscopic Simulation One Step Further
- 2011
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In: Medicine Meets Virtual Reality 18. - : IOS Press. - 9781607507062 - 9781607507055 ; 163, s. 144-6
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Conference paper (peer-reviewed)abstract
- This pilot study aimed to assess medical students' appraisals of a "mixed" virtual reality simulation for endoscopic surgery (with a virtual patient case in addition to a virtual colonoscopy) as well as the impact of this simulation set-up on students' performance. Findings indicate that virtual patients can enhance contextualization of simulated endoscopy and thus facilitate an authentic learning environment, which is important in order to increase motivation.
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- Fiorillo, A., et al.
(author)
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How to improve clinical practice on involuntary hospital admissions of psychiatric patients : suggestions from the EUNOMIA study
- 2011
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 26:4, s. 201-207
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Journal article (peer-reviewed)abstract
- Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.
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| 23. |
- Sjöberg, R.L., et al.
(author)
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Accuracy of self-reports of stressful emotional events in real world settings
- 2009
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In: 21st Annual Convention of the Association for Psychological Science, San Francisco, 2009. ; , s. 256-256
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Conference paper (other academic/artistic)abstract
- In this review the empirical and theoretical literature on children’s autobiographical statements about child sexual abuse and other forms of maltreatment is discussed. It is concluded that experiences of child sexual abuse seems to be associated with a number of negative psychosocial outcomes. It is further concluded that even though children may remember experiences from the first and second years of life there is no reliable way by which details of childhood experiences can be reconstructed on the basis of preverbal memories. The literature on the suggestibility of preschool children suggests that children are capable of providing reliable testimonies about highly salient personal experiences such as sexual abuse, though a substantial proportion of children may choose not to when asked by professionals. However, suggestive interviewing practises, particularly when used with younger children will increase the risk of false allegations.
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| 26. |
- Strom, P., et al.
(author)
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Validation and learning in the Procedicus KSA virtual reality surgical simulator : Implementing a new safety culture in medical school
- 2003
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In: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 17:2, s. 227-231
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Journal article (peer-reviewed)abstract
- Background: Advanced simulator training within medicine is a rapidly growing field. Virtual reality simulators are being introduced as cost-saving educational tools, which also lead to increased patient safety. Methods: Fifteen medical students were included in the study. For 10 medical students performance was monitored, before and after 1 h of training, in two endoscopic simulators (the Procedicus KSA with haptic feedback and anatomical graphics and the established MIST simulator without this haptic feedback and graphics). Five medical students performed 50 tests in the Procedicus KSA in order to analyze learning curves. One of these five medical students performed multiple training sessions during 2 weeks and performed more than 300 tests. Results: There was a significant improvement after 1 h of training regarding time, movement economy, and total score. The results in the two simulators were highly correlated. Conclusion: Our results show that the use of surgical simulators as a pedagogical tool in medical student training is encouraging. It shows rapid learning curves and our suggestion is to introduce endoscopic simulator training in undergraduate medical education during the course in surgery when motivation is high and before the development of "negative stereotypes" and incorrect practices.
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| 27. |
- Andersson, Mats, 1954, et al.
(author)
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Characteristics of timed barium esophagogram in newly diagnosed idiopathic achalasia: clinical and manometric correlates
- 2007
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In: Acta Radiol. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 48:1, s. 2-9
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Journal article (peer-reviewed)abstract
- PURPOSE: To describe timed barium esophagogram (TBE) characteristics in patients with newly diagnosed idiopathic achalasia, and to correlate these with clinical and manometric variables. MATERIAL AND METHODS: Forty-six consecutive patients with newly diagnosed achalasia were examined with TBE. Esophageal emptying was assessed using the height, area, and volume of the barium column. Subjective evaluation was performed according to a standardized protocol in all patients. Objective diagnostic evaluation included manometry. RESULTS: At the 1-min time point after contrast ingestion, the static parameters median height, maximum, and mean width of the barium column were 16.0, 4.4, and 3.3 cm, respectively. Emptying, expressed as volume of barium, showed significant inverse correlation with the resting and the maximal relaxing pressure of the lower esophageal sphincter (LES) (R = -0.34 and R = -0.54, respectively). There was also an inverse correlation between emptied volume at TBE and the duration of symptoms (R = -0.36), and between barium column width and postprandial chest pain (R = -0.44). CONCLUSION: All patients with newly diagnosed achalasia presented with delayed emptying of barium the esophagus at TBE. The estimated emptied volume of barium (related to the ingested volume) correlated inversely with the basal tone and the relaxation pressure of the LES. Including estimation of the volume of emptied barium at TBE resulted in closer correlation with manometric values of LES tone than using the parameters traditionally recorded.
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| 30. |
- Goel, Suchi, et al.
(author)
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RIFINs are adhesins implicated in severe Plasmodium falciparum malaria
- 2015
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In: Nature Medicine. - : Springer Science and Business Media LLC. - 1078-8956 .- 1546-170X. ; 21:4, s. 314-317
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Journal article (peer-reviewed)abstract
- Rosetting is a virulent Plasmodium falciparum phenomenon associated with severe malaria. Here we demonstrate that P. falciparum-encoded repetitive interspersed families of polypeptides (RIFINs) are expressed on the surface of infected red blood cells (iRBCs), bind to RBCs-preferentially of blood group A-to form large rosettes and mediate microvascular binding of iRBCs. We suggest that RIFINs have a fundamental role in the development of severe malaria and thereby contribute to the varying global distribution of ABO blood groups in the human population.
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| 34. |
- Kjellin, A., et al.
(author)
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Hybrid simulation : bringing motivation to the art of teamwork training in the operating room
- 2014
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In: Scandinavian Journal of Surgery. - : SAGE Publications. - 1457-4969 .- 1799-7267. ; 103:4, s. 232-236
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Journal article (peer-reviewed)abstract
- Background and Aims: Crew resource management-based operating room team training will be an evident part of future surgical training. Hybrid simulation in the operating room enables the opportunity for trainees to perform higher fidelity training of technical and non-technical skills in a realistic context. We focus on situational motivation and self-efficacy, two important factors for optimal learning in light of a prototype course for teams of residents in surgery and anesthesiology and nurses. Material and Methods: Authentic operating room teams consisting of residents in anesthesia (n = 2), anesthesia nurses (n = 3), residents in surgery (n = 2), and scrub nurses (n = 6) were, during a one-day course, exposed to four different scenarios. Their situational motivation was self-assessed (ranging from 1 = does not correspond at all to 7 = corresponds exactly) immediately after training, and their self-efficacy (graded from 1 to 7) before and after training. Training was performed in a mock-up operating theater equipped with a hybrid patient simulator (SimMan 3G; Laerdal) and a laparoscopic simulator (Lap Mentor Express; Simbionix). The functionality of the systematic hybrid procedure simulation scenario was evaluated by an exit questionnaire (graded from 1 = disagree entirely to 5 = agree completely). Results and Conclusions: The trainees were mostly intrinsically motivated, engaged for their own sake, and had a rather great degree of self-determination toward the training situation. Self-efficacy among the team members improved significantly from 4 to 6 (median). Overall evaluation showed very good result with a median grading of 5. We conclude that hybrid simulation is feasible and has the possibility to train an authentic operating team in order to improve individual motivation and confidence.
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| 40. |
- Kjellin, Linda L., et al.
(author)
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Determination of the antimalarial drug piperaquine in small volume pediatric plasma samples by LC-MS/MS
- 2014
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In: Bioanalysis. - : Future Science Ltd. - 1757-6180 .- 1757-6199. ; 6:23, s. 3081-3089
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Journal article (peer-reviewed)abstract
- Aim: Determination of piperaquine (PQ) in pediatric plasma requires a method with a small sample volume. Results: We report a sensitive LC-MS/MS method for quantitation of PQ with only 25 mu l human plasma. Using a deuterated internal standard (PQ-d(6)), an analytical PFP column, APCI(+) as the ion source and MRM (535/288 for PQ and 541/294 for the IS) for detection, the method has a linear calibration range of 1.5-250 ng/ml with a runtime of 3.0 min per sample. The method was applied to plasma samples from children. Conclusion: The developed LC-MS/MS method is suitable for pediatric studies with small volume plasma samples collected via capillary tubes. One limitation was the performance of PFP columns varied among different brands.
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| 41. |
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| 42. |
- Kjellin, L
(author)
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Psykiatrin och dess vårdgrannar
- 1998
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In: Psykiatrireformen Rapport 5/98. - : Västerås stad och Basenhet psykiatri Västerås.
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Other publication (other academic/artistic)
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| 43. |
- Kjellin, P., et al.
(author)
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A nanosized zirconium phosphate coating for PEEK implants and its effect in vivo
- 2020
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In: Materialia. - : Elsevier BV. - 2589-1529. ; 10
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Journal article (peer-reviewed)abstract
- Surface treatments and coatings can be applied to polyether ether ketone (PEEK) implants to improve their ability to osseointegrate. A new coating, consisting of amorphous nanosized zirconium phosphate (ZrP) was applied to PEEK and titanium substrates. The coating was applied by using a microemulsion as a carrier for the nanoparticles. It was found that the coating formed a thin continuous porous layer on top of the substrate, with pore diameters of 10–50 nm. The thickness of the coating was estimated to <100 nm. The resistance to acidic (pH = 4) conditions and exposure to ultrasonication was investigated with XPS, which showed no loss of coating. The adherence of the coating was investigated by insertion of implants in simulated bone material, which showed a minor loss in coating. In vitro (SBF) testing showed that the coating promoted crystallization of calcium phosphates, for uncoated PEEK, no crystallization was detected. The in vivo performance of the ZrP coating was examined by coating screw shaped PEEK implants which were implanted in rabbit tibia for 6 weeks. The anchoring strength of the implants was evaluated with removal torque (RTQ) measurements. The average RTQ for the ZrP coated implants was significantly higher compared to the non-coated implants. The results show that a nanosized ZrP coating on PEEK implants can transform the surface from having a low ability to osseointegrate to a surface which stimulates bone tissue growth. This makes the ZrP coating an interesting alternative for coating PEEK implants, such as spinal fusion cages and tendon fixation screws. © 2020
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| 44. |
- Kostic, Srdjan, 1958, et al.
(author)
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Health economic evaluation of therapeutic strategies in patients with idiopathic achalasia: results of a randomized trial comparing pneumatic dilatation with laparoscopic cardiomyotomy
- 2007
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In: Surgical endoscopy. - 1432-2218 .- 0930-2794. ; 21:7, s. 1184-9
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Journal article (peer-reviewed)abstract
- BACKGROUND: We have prospectively collected information concerning the costs incurred during the management of patients allocated to either forceful dilatation or to an immediate laparoscopic operation because of newly diagnosed achalasia. METHODS: Fifty-one patients with newly diagnosed achalasia were randomized to either pneumatic dilatation to a diameter of 30-40 mm or to a laparoscopic myotomy to which was added a posterior partial fundoplication. Follow-ups were scheduled at 1, 3, 6, and 12 months after inclusion. At each follow-up visit a study nurse interviewed the patients regarding symptoms and their quality of life (QoL) and a health economic questionnaire was completed. In the latter questionnaire, patients were asked to report the presence and character of contacts with the healthcare system since the last visit. RESULTS: In the dilatation group six patients (23%), including the patient who was operated on because of perforation, were classified as failures during the first 12 months of follow-up compared to one (4%) in the myotomy group (p = 0.047). Five of those classified as failures in the dilatation group subsequently had a surgical myotomy and the sixth patient was treated with repeated dilatations. The patient classified as failure in the myotomy group was treated with endoscopic dilatation. The initial treatment cost and the total costs were significantly higher for laparoscopic myotomy compared to a pneumatic dilatation-based strategy (p = 0.0002 and p = 0.0019, respectively). When the total costs were subdivided into the different resources used, we found that the single largest cost item for pneumatic dilatation was that for hospital stay and that for laparoscopic myotomy was the actual operative treatment (operating room time). The cost-effectiveness analysis, relating to the actual treatment failures, revealed that the cost to avoid one treatment failure (incremental cost-effectiveness ratio) amounted to 9239 euros. CONCLUSION: The current prospective, controlled clinical trial shows that despite a higher level of clinical efficacy of laparoscopic myotomy to prevent treatment failure in newly diagnosed achalasia, the cost effectiveness of pneumatic dilatation is superior, at least when a reasonable time horizon is applied.
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| 46. |
- Kostic, Srdjan, 1958, et al.
(author)
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Pneumatic dilatation or laparoscopic cardiomyotomy in the management of newly diagnosed idiopathic achalasia. Results of a randomized controlled trial
- 2007
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In: World journal of surgery. - : Springer Science and Business Media LLC. - 0364-2313 .- 1432-2323. ; 31:3, s. 470-8
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Journal article (peer-reviewed)abstract
- BACKGROUND: The most effective therapeutic strategy in newly diagnosed achalasia is yet to be established. Therefore we designed a study in which pneumatic dilatation was compared to laparoscopic cardiomyotomy to which was added a partial posterior fundoplication. PATIENTS AND RESULTS: A series of 51 patients (24 males, mean age 44 years) were randomly allocated to the therapeutic modalities (dilatation = 26, surgery = 25). All patients were followed for at least 12 months, and during that period the pneumatic dilatations strategy had significantly more treatment failures (P = 0.04). Only minor differences emerged between the study groups when symptoms, dysphagia scorings, and quality-of-life assessments were evaluated 12 months after initiation of therapy. CONCLUSIONS: Laparoscopic myotomy was found to be superior to an endoscopic balloon dilatation strategy in the treatment of achalasia when studied during the first 12 months after treatment.
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| 47. |
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| 48. |
- Lindquist, T., et al.
(author)
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A novel modular and dispatchable CSP Stirling system : Design, validation, and demonstration plans
- 2019
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In: AIP Conference Proceedings. - : American Institute of Physics (AIP).
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Conference paper (peer-reviewed)abstract
- This paper summarizes the preliminary results from the on-going development of a novel modular dispatchable solar power plant concept. The work encompasses techno-economic feasibility assessment, concept design, full scale sub-system tests and validation work, and ultimately plans for a fully integrated demonstration of the system. The proposed solar power plant concept consists of a heliostat field that powers a latent heat thermal energy storage (TES), fitted on a small tower. The solar receiver located underneath the TES tank, is an optical cavity with a small aperture that enables the concentrated sunlight to be emitted directly on the solar absorber surface while ensuring low convective and radiative losses. The stored thermal energy is provided to the engine, in proximity to the latent heat storage, with a pumped heat transfer fluid (HTF). The Stirling engine with a rated power of 13 kW has been modified and optimised for the operational conditions that the eutectic aluminum-silicon latent heat storage provides. For example, a new engine tubular gas heater has been developed for the HTF (i.e. sodium) and the expansion cylinder has been enlarged to improve both efficiency and power output as the temperature of the working gas is somewhat lower than in previous dish Stirling application. The choice of eutectic aluminum-silicon as TES media resulted from a thorough assessment of several phase change materials throughout the design phase of the project. Indeed, such a TES media selected would benefit from a suitable melting temperature of around 580°C, high energy density, high thermal conductivity, and low cost.
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| 49. |
- Lindstedt, Katarina, 1979-, et al.
(author)
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Adolescents with full or subthreshold anorexia nervosa in a naturalistic sample : Treatment interventions and patient satisfaction
- 2020
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In: Child and Adolescent Psychiatry and Mental Health. - : BioMed Central. - 1753-2000. ; 14:1
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Journal article (peer-reviewed)abstract
- Background: Despite major research efforts, current recommendations of treatment interventions for adolescents with anorexia nervosa are scarce, and the importance of patient satisfaction for treatment outcome is yet to be established. The overall aim of the present study was to examine treatment interventions and patient satisfaction in a naturalistic sample of adolescents with anorexia nervosa or subthreshold anorexia nervosa and possible associations to outcome defined as being in remission or not at treatment follow-up.Methods: Participants were identified through the Swedish national quality register for eating disorder treatment (SwEat). The samples consisted of 1899 patients who were follow-up registered 1 year after entering treatment and 474 patients who had completed a 1-year patient satisfaction questionnaire. A two-step cluster analysis was used for identifying subgroups of patients who received certain combinations and various amounts of treatment forms.Results: Patients who received mainly family-based treatment and/or inpatient care were most likely to achieve remission at 1-year follow-up, compared to patients in the other clusters. They were also younger, in general. Individual therapy was the most common treatment form, and was most appreciated among the adolescents. At 1-year follow-up, many patients reported improvements in eating habits, but far fewer reported improvements regarding cognitive symptoms. Overall, the patients rated the therapist relationship in a rather positive way, but they gave quite low ratings to statements associated with their own participation in treatment.Conclusions: The results indicate that young adolescents who receive mainly family-based treatment and/or inpatient care respond more rapidly to treatment compared to older adolescents who receive mainly individual therapy or mixed treatment interventions. At 1-year follow-up, the adolescents reported improvements in behavioral symptoms and seemed quite satisfied with the therapist relationship.
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