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- Östergren, Rickard, 1975-, et al.
(author)
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Learning declarative knowledge in special education treatment group
- 2018
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In: journal of education and training. - Las Vegas, NV, United States : Macrothink Institute, Inc.. - 2330-9709. ; 5:1
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Journal article (peer-reviewed)abstract
- An organizing structure that in recent years has had a major impact on how to work with students who don’t respond to regular instruction is Response to Intervention (RTI). Efforts in RTI are divided into three different tiers of instruction: primary, secondary and tertiary. In our study, we investigate the impact of intensive secondary-tier instruction on students’ knowledge of basic combinations of digits in addition. We also focus on how the students develop their use of more advanced calculations in addition during the intervention.The results showed that students became faster at performing simple addition tasks, which indicates that their fluency – declarative knowledge – developed during the intervention phase. Our results thereby strengthen suggestions that a secondary-tier intervention level should take place in a small group of students 20-40 minutes four to five times a week. Meanwhile, the students developed their ability to solve two-digit arithmetic tasks in addition and subtraction, which could be explained by the fact that students had automated simple number combinations and thus could focus on the calculation procedure.
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- Ahl, Rebecka, 1987-, et al.
(author)
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Risk factors for depression following traumatic injury : An epidemiological study from a scandinavian trauma center
- 2017
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In: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 48:5, s. 1082-1087
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Journal article (peer-reviewed)abstract
- INTRODUCTION: A significant proportion of patients suffer depression following traumatic injuries. Once manifested, major depression is challenging to overcome and its presence risks impairing the potential for physical rehabilitation and functional recovery. Risk stratification for early detection and intervention in these instances is important. This study aims to investigate patient and injury characteristics associated with an increased risk for depression.METHODS: All patients with traumatic injuries were recruited from the trauma registry of an urban university hospital between 2007 and 2012. Patient and injury characteristics as well as outcomes were collected for analysis. Patients under the age of eighteen, prescribed antidepressants within one year of admission, in-hospital deaths and deaths within 30days of trauma were excluded. Pre- and post-admission antidepressant data was requested from the national drugs registry. Post-traumatic depression was defined as the prescription of antidepressants within one year of trauma. To isolate independent risk factors for depression a multivariable forward stepwise logistic regression model was deployed.RESULTS: A total of 5981 patients met the inclusion criteria of whom 9.2% (n=551) developed post-traumatic depression. The mean age of the cohort was 42 [standard deviation (SD) 18] years and 27.1% (n=1620) were females. The mean injury severity score was 9 (SD 9) with 18.4% (n=1100) of the patients assigned a score of at least 16. Six variables were identified as independent predictors for post-traumatic depression. Factors relating to the patient were female gender and age. Injury-specific variables were penetrating trauma and GCS score of≤8 on admission. Furthermore, intensive care admission and increasing hospital length of stay were predictors of depression.CONCLUSION: Several risk factors associated with the development of post-traumatic depression were identified. A better targeted in-hospital screening and patient-centered follow up can be offered taking these risk factors into consideration.
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- Gadan, Soran, 1976-, et al.
(author)
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Does a Defunctioning Stoma Impair Anorectal Function After Low Anterior Resection of the Rectum for Cancer? : A 12-Year Follow-up of a Randomized Multicenter Trial
- 2017
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In: Diseases of the Colon & Rectum. - : Lippincott Williams & Wilkins. - 0012-3706 .- 1530-0358. ; 60:8, s. 800-806
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Journal article (peer-reviewed)abstract
- BACKGROUND: Anorectal function after low anterior resection of the rectum for cancer is often impaired, and long-term outcome has not frequently been reported.OBJECTIVE: We evaluated anorectal function 12 years after rectal resection with regard to whether patients had a defunctioning temporary stoma at the initial rectal resection.DESIGN: An exploratory cross-sectional investigation of a previously randomized study population.SETTINGS: Twenty-one Swedish hospitals performing rectal cancer surgery during a 5-year period participated in the trial.PATIENTS: Patients operated on with low anterior resection for cancer were included.INTERVENTIONS: Patients were randomly assigned to receive or not receive a temporary defunctioning stoma.MAIN OUTCOME MEASURES: We evaluated anorectal function 12 years after low anterior resection in patients who were initially randomly assigned to temporary stoma or not, by means of using the low anterior resection syndrome score questionnaire, which assesses incontinence for flatus, incontinence for liquid stools, defecation frequency, clustering, and urgency. Self-perceived health status was evaluated by the EQ-5D-3L questionnaire.RESULTS: Eighty-nine percent (87/ 98) of the patients responded to the questionnaires, including 46 with and 41 without an initial temporary stoma. Patient demography was comparable between the groups. No differences regarding major, minor, and no low anterior resection syndrome categories were found between the groups. The stoma group had increased incontinence for flatus (p = 0.03) and liquid stools (p = 0.005) and worse overall low anterior resection syndrome score (p = 0.04) but no differences regarding frequency, clustering, and urgency.LIMITATIONS: The study was limited by its sample size (n = 98) based on a previously randomized trial population (n = 234).CONCLUSIONS: After low anterior resection for cancer, the incidence of the categories major, minor, and no low anterior resection syndrome were comparable in the stoma and the no-stoma groups. Incontinence for flatus and liquid stools was more commonly reported by patients who were randomly assigned to temporary stoma, as compared with those without, which may indicate an association between temporary stoma and impaired anorectal function.
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- Gadan, Soran, 1976-, et al.
(author)
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Reversal of defunctioning stoma following rectal cancer surgery : are we getting better? A population-based single centre experience
- 2019
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In: ANZ journal of surgery. - : Wiley-Blackwell Publishing Inc.. - 1445-1433 .- 1445-2197. ; 89:4, s. 403-407
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Journal article (peer-reviewed)abstract
- BACKGROUND: The aim was to assess factors influencing the timing of defunctioning stoma (DS) reversal following low anterior resection of rectum for cancer (LAR).METHODS: All patients operated with LAR and a primary DS during a 9-year period were included. Reversal later than 120 days after LAR was considered as delayed. A DS not reversed within 2 years was considered as permanent.RESULTS: In the present study, median age at LAR was 67 years, 45% were females, median body mass index was 25, 87% had American Society of Anesthesiologists class I or II, 64% had pre-operative radiotherapy, and 3% had cancer stage IV. A total of 79% (92/116) underwent stoma reversal, whereof 25% (23/92) were reversed within 120 days. The most common health-related reasons for delayed stoma reversal were adjuvant chemotherapy in 38%, symptomatic anastomotic leakage in 16% and other post-operative adverse events in 13%. In 35% delayed stoma reversal was because of low priority within the healthcare system. A total of 18% (20/110) never had their DS reversed (n = 11) or had their DS converted to a permanent end colostomy (n = 9). Major risk factors for permanent stoma were stage IV cancer in 55%, and symptomatic anastomotic leakage in 30%.CONCLUSION: One fourth of the patients had their defunctioning stoma reversed within 120 days. The most common identifiable medical reasons for delayed stoma reversal were adjuvant chemotherapy and symptomatic anastomotic leakage, while in one out of three patients it was because of low priority by the healthcare provider.
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- Lindgren, Erik, et al.
(author)
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Gender differences in utilization of coronary angiography and angiographic findings after out-of-hospital cardiac arrest : A registry study
- 2019
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In: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 143, s. 189-195
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Journal article (peer-reviewed)abstract
- Introduction: We investigated the impact of gender in performance and findings of early coronary angiography (CAG) and percutaneous coronary intervention (PCI), comorbidity and outcome in a large population of out-of-hospital cardiac arrest (OHCA) patients with an initially shockable rhythm.Methods: Retrospective cohort study. Data retrieved 2008-2013 from the Swedish Register for Cardio-Pulmonary Resuscitation, Swedeheart Registry and National Patient Register.Results: We identified 1498 patients of whom 78% were men. Men and women had the same pathology on the first registered electrocardiogram (ECG): 30% vs. 29% had ST-elevation and 10% vs. 9% had left bundle branch block (LBBB) (P=0.97). Proportions of performed CAG did not differ between genders. Among patients without ST-elevation/LBBB men more often had at least one significant stenosis, 78% vs. 54% (P= 0.001), more multi-vessel disease (P= 0.01), had normal coronary angiography less often, 22% vs. 46% and PCI more often, 59% vs. 42% (P= 0.03). Among patients without STelevation/LBBB on the initial ECG, more men had previously known ischaemic heart disease, 27% vs. 19% (P=0.02) and a presumed cardiac origin of the cardiac arrest, 86% vs. 72% (P< 0.001). Multivariable analysis showed no association between gender and evaluation by early CAG. In men and women, 1-year survival was 56% vs. 50% (P= 0.22) in patients with ST-elevation/LBBB and 48% vs. 51% (P= 0.50) in patients without.Conclusion: Despite no gender differences in ECG findings indicating an early CAG, men had more severe coronary artery disease while women more frequently had normal coronary angiography. However, this did not influence 1-year survival.
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- Sjöberg, Rickard L., et al.
(author)
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Blood Metabolomic Predictors of 1-Year Outcome in Subarachnoid Hemorrhage
- 2015
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In: Neurocritical Care. - : Springer. - 1541-6933 .- 1556-0961. ; 23:2, s. 225-232
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Journal article (peer-reviewed)abstract
- Delayed neurological deficit (DND) is the most important cause of morbidity and mortality in patients with subarachnoid hemorrhage (SAH) whose aneurysms have been secured. However, the methods currently used to predict the development of DND, such as trans-cranial Doppler or levels biochemical markers in blood and cerebrospinal fluid are not very accurate. Venous blood was drawn from 50 patients with SAH, admitted to the neurosurgical department UmeAyen University Hospital, at day 1-3 and day 7 after the bleed. The clinical status of the patients was followed up approximately 1 year after this episode and classified according to the Glasgow Outcome Score (GOS). Results showed considerable differences in blood metabolomic patterns between day 1-3 and 7 after the hemorrhage. Fifty-six out of 98 metabolites could be identified from our in-house library and 17 of these metabolites changed significantly from day 1-3 to 7 after the bleed. One of these, myo-inositol, was predictive of clinical outcome even after correction for multiple testing. An estimation of the diagnostic accuracy of high levels of this substance in predicting good outcome (GOS 4-5) yielded a sensitivity of .763 and a specificity of .5 at the optimal cut off point. SAH is an event with a profound effect on blood metabolomics profiles. Myo-inositol might be an interesting compound for future study to focus on in the search for metabolic markers in venous blood of delayed neurological deterioration in SAH patients.
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