Acute pancreatitis - severity classification, complications and outcome

Acute pancreatitis, with an annual incidence of approximately 35 per 100 000 inhabitants in Sweden, is in most cases mild and self-limiting. Severe acute pancreatitis, affecting 10-15% of the cases is, however, associated with severe complications and even death. The optimal management of acute pancreatitis includes accurate early prediction of the disease severity. The aims of this thesis were to investigate early severity classification, complications and outcome in acute pancreatitis patients, with special regard to patients developing the severe form of the disease. The results of the studies were: I) Two early risk factors for death were identified: increasing age and hypotension at admission. Deaths were to a high extent related to multiple organ dysfunction. Early recurrence after biliary acute pancreatitis was common. II) A model for early prediction of severity in acute pancreatitis with artificial neural networks was developed, identifying 6 risk factors. The ROC area for the model was 0.92, and it performed significantly better than the APACHE II score. III) Patients with pancreatic pseudocysts were found to be resource demanding in regard to recurrences and repeated hospital visits. Even larger pancreatic pseudocysts could be managed successfully with conservative treatment. IV) In a national Swedish survey, the treatment of patients with pancreatic pseudocysts appeared to be heterogeneous, with different treatment options available and varying local traditions. V) In long-term follow-up after acute pancreatitis, impairment was mainly seen in the endocrine pancreatic function, and especially after severe disease. The time to rehabilitation and return to work and normal life was long, and the costs for the society high. The quality of life years after the disease was, however, as good as in the normal population. VI) A survey of patients dying in acute pancreatitis without reaching the hospital showed that this group represents a substantial part of all deaths from the disease. The dominating aetiology was alcohol. Pulmonary injury was the most common organ manifestation outside the pancreas. To reduce mortality due to acute pancreatitis it is important to target also the patients that never reach hospital

Vloga čudenja pri učencih glede pojmovanja evolucije in učenja o njej

Learning about evolution can be challenging for students, as a full understanding may require them to see the world in new ways, to master a disciplinary language and to understand complex processes. Drawing on a long line of theoretically grounded arguments of philosophers and researchers for including wonder in science teaching, we report on the results of an empirical study with the primary aim of investigating the role of wonder in students’ learning about evolution. The study was carried out through a formative intervention in which two researchers in science education collaborated with a seventh-grade teacher. Over a period of six weeks, 45 students participated in lessons and workshops aimed at eliciting a sense of wonder in relation to concepts that are known to impact the learning of evolution. We incorporated four ‘triggers’ to elicit students’ wonder in the science class: aesthetic experiences, defiance of expectations, agency and awareness of a mystery within the ordinary. Logbook entries and interviews with student pairs provided empirical material for a qualitative analysis of the role of wonder in the students’ meaning-making about, learning of and engagement in evolution. The results show that it is possible to design science teaching that triggers students’ wonder in relation to an intended learning object. The results also reveal that the participating students described their sense of wonder in qualitatively different ways and that they still struggled to make sense of the concept of evolution after six weeks of teaching. (DIPF/Orig.

CODUSA - Customize Optimal Donor Using Simulated Annealing In Heart Transplantation.

In heart transplantation, selection of an optimal recipient-donor match has been constrained by the lack of individualized prediction models. Here we developed a customized donor-matching model (CODUSA) for patients requiring heart transplantations, by combining simulated annealing and artificial neural networks. Using this approach, by analyzing 59,698 adult heart transplant patients, we found that donor age matching was the variable most strongly associated with long-term survival. Female hearts were given to 21% of the women and 0% of the men, and recipients with blood group B received identical matched blood group in only 18% of best-case match compared with 73% for the original match. By optimizing the donor profile, the survival could be improved with 33 months. These findings strongly suggest that the CODUSA model can improve the ability to select optimal match and avoid worst-case match in the clinical setting. This is an important step towards personalized medicine

Summing up - Batch 20 : Change Projects from the International Training Programme - Batch 20

Lund University has offered the Sida-financed International Training Programmeon Child Rights, Classroom and School Management since 2003. Theprogramme targets those in a position from which they can initiate processesof change in the education sector in their countries. During the programmeall participating teams initiate a change project in their respective countriesaiming at the realization of the intention of the Child Rights Convention inpolicy as well as in practice. This book contains the final reports from Batch20 with change agents from China, Colombia, DPR of Korea, Indonesia, Malawi,Mozambique, Namibia, Sri Lanka, Uganda, Viet Nam, and Zambia

Child Rights, Classroom and School Management : Change Projects from the International Training Programme Batch 13 - 2010b

In 2003 Lund University Commissioned Education was given the task, after publictender, to create and administrate a programme on “Child Rights, Classroom andSchool Management” following the provisions and principles contained in the UNConvention on the Rights of the Child (CRC), Sida’s development policy on Education and other internationally ratified instruments in the areas of child rights and education. The programme was oriented to target persons holding a position from where they could initiate processes of change in their home countries. During the years 2003-2009 the International Training Programme (ITP) on Child Rights, Classroom and School Management was arranged 11 times with 330 participants completing it. Most of them are still working for child rights in their countries and have formed national and regional networks. In 2010 Lund University Commissioned Education won the contract in a new procurement for arranging the programme twice a year 2010 - 2012 with an option for another two years. In 2010 the 12th and 13th batch started the redesigned programme and this book is one of the results of batch 13

Child Rights, Classroom and School Management : Change Projects from the International Training Programme Batch 14 - 2011a

Lund University has offered the Sida-financed International Training Programme on Child Rights, Classroom and School Management since 2003. The programme targets those in a position from which they can initiate processes of change in the education sector in their countries. During the programme all participating teams initiate a change project in their respective countries aiming at the realization of the intention of the Child Rights Convention in policy as well as in practice. This book contains the final reports from Batch 14 with change agents from Cambodia, China, Colombia, Egypt, India, Namibia, South Africa, Tanzania and Zambia