Resuscitative endovascular balloon occlusion of the aorta in out-of-hospital cardiac arrest - A Delphi consensus study for uniform data collection.

BACKGROUND Evolving research on resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct treatment for out-of-hospital cardiac arrest mandates uniform recording and reporting of data. A consensus on which variables need to be collected may enable comparing and merging data from different studies. We aimed to establish a standard set of variables to be collected and reported in future REBOA studies in out-of-hospital cardiac arrest. METHODS A four-round stepwise Delphi consensus process first asked experts to propose without restraint variables for future REBOA research in out-of-hospital cardiac arrest. The experts then reviewed the variables on a 5-point Likert scale and ≥75% agreement was defined as consensus. First authors of published papers on REBOA in out-of-hospital cardiac arrest over the last five years were invited to join the expert panel. RESULTS The data were collected between May 2022 and December 2022. A total of 28 experts out of 34 primarily invited completed the Delphi process, which developed a set of 31 variables that might be considered as a supplement to the Utstein style reporting of research in out-of-hospital cardiac arrest. CONCLUSIONS This Delphi consensus process suggested 31 variables that enable future uniform reporting of REBOA in out-of-hospital cardiac arrest

Диэлектрическая управляемость твердых растворов с участием сегнетоэлектриков-релаксоров

Исследование выполнено при финансовой поддержке Министерства науки и высшего образования РФ (Государственное задание в сфере научной деятельности, научный проект № 0852-2020-0032) на оборудовании Центра коллективного пользования научно-исследовательского института физики ЮФУ

Prehospital Stressors: A Cross-sectional Study of Norwegian Helicopter Emergency Medical Physicians

Objective Personnel working in helicopter emergency medical services (HEMS) and search and rescue (SAR) are exposed to environmental stressors, which may impair performance. The aim of this survey was to study the extent HEMS and SAR physicians report the influence of specific danger-based and non–danger-based stressors. Methods The study was performed as a cross-sectional, anonymous, Web-based (Questback AS, Bogstadveien 54, 0366 Oslo, Norway) survey of Norwegian HEMS and SAR physicians between December 2, 2019, and February 25, 2020. Results Of the recipients, 119 (79.3%) responded. In helicopter operations, 33.6% (n = 40) reported involvement in a minor accident and 44.5% (n = 53) a near accident. In the rapid response car, 26.1% (n = 31) reported near accidents, whereas 26.9% (32) reported this in an ambulance. Of physicians, 20.2% (n = 24) received verbal abuse or threats during the last 12 months. When on call, 50.4% (n = 60) of physicians reported sometimes or often being influenced by fatigue. Conclusion This study shows that Norwegian HEMS and SAR physicians are exposed to several stressors of both a danger-based and non–danger-based nature, especially regarding accidents, threatening patient behavior, and fatigue. Very serious incidents appear to be seldom, and job satisfaction is high.publishedVersio

Prehospital tracheal intubations by anaesthetist-staffed critical care teams: a prospective observational multicentre study

Background Prehospital tracheal intubation is a potentially lifesaving intervention, but is associated with prolonged time on-scene. Some services strongly advocate performing the procedure outside of the ambulance or aircraft, while others also perform the procedure inside the vehicle. This study was designed as a non-inferiority trial registering the rate of successful tracheal intubation and incidence of complications performed by a critical care team either inside or outside an ambulance or helicopter. Methods This observational multicentre study was performed between March 2020 and September 2021 and involved 12 anaesthetist-staffed critical care teams providing emergency medical services by helicopter in Denmark, Norway, and Sweden. The primary outcome was first-pass successful tracheal intubations. Results Of the 422 drug-assisted tracheal intubations examined, 240 (57%) took place in the cabin of the ambulance or helicopter. The rate of first-pass success was 89.2% for intubations in-cabin vs 86.3% outside. This difference of 2.9% (confidence interval −2.4% to 8.2%) (two sided 10%, including 0, but not the non-inferiority limit Δ=−4.5) fulfils our criteria for non-inferiority, but not significant superiority. These results withstand after performing a propensity score analysis. The mean on-scene time associated with the helicopter in-cabin procedures (27 min) was significantly shorter than for outside the cabin (32 min, P=0.004). Conclusions Both in-cabin and outside the cabin, prehospital tracheal intubation by anaesthetists was performed with a high success rate. The mean on-scene time was shorter in the in-cabin helicopter cohort.publishedVersio

Comparing urine samples and cervical swabs for Chlamydia testing in a female population by means of Strand Displacement Assay (SDA)

<p>Abstract</p> <p>Background</p> <p>There has been an increasing number of diagnosed cases of <it>Chlamydia trachomatis </it>in many countries, in particular among young people. The present study was based on a growing request to examine urine as a supplementary or primary specimen in screening for <it>Chlamydia trachomatis </it>in women, with the Becton Dickinson ProbeTec (BDPT) Strand Displacement Assay (SDA). Urine samples may be particularly important in screening young people who are asymptomatic.</p> <p>Methods</p> <p>A total of 603 women aged 15 and older were enrolled from the Sexually Transmitted Infection (STI) clinic at Haukeland University Hospital, Norway, in 2007. Only 31 women were older than 35 years. Cervical swabs and urine samples were tested with BDPT for all participants. In cases of discrepant test results from a given patient, both samples were retested by Cobas TaqManCT and a Polymerase Chain Reaction (PCR)-method (in-house). Prevalence of <it>C. trachomatis</it>, sensitivity, and specificity were estimated by latent class analysis using all test results available. Bootstrap BC confidence intervals (10 000 computations) were estimated for sensitivity and specificity, and their differences in cervix vs. urine tests.</p> <p>Results</p> <p>A total of 1809 specimens were collected from 603 patients. 80 women (13.4%) were positive for <it>C. trachomatis</it>. Among these, BDPT identified 72 and 73 as positive in cervix and urine samples, respectively. Of the 523 <it>C. trachomatis </it>negative women, BDPT identified 519 as negative based on cervical swabs, and 514 based on urine samples. Sensitivity for cervical swabs and urine samples with the BDPT were 89.0% (95% CI 78.8, 98.6) and 90.2% (95% CI 78.1, 95.5), respectively. The corresponding values for specificity were 99.2% (95% CI 98.3, 100) and 98.3% (95% CI 96.4, 100).</p> <p>Conclusions</p> <p>This study indicates that urine specimens are adequate for screening high-risk groups for <it>C. trachomatis </it>by the SDA method (BDPT). Such an approach may facilitate early detection and treatment of the target groups for screening, and be cost-effective for patients and the health services.</p

An explorative study of the use and implementation of new digital technologies in the management of Norwegian development cooperation projects

This thesis merges the aspects of results-based management systems and new digital technologies together and explores what characterizes the use and implementation of new digital technologies in the management of Norwegian development cooperation projects. Through three research questions the research explores how Norwegian non-government organizations (NGOs) involved in development cooperation projects: (1) Collect, aggregate, present, and use data in decision making and reporting in existing management systems. (2) View the main barriers and opportunities of new technologies and innovations in improving current management systems and tools. (3) Perceives how new digital technologies can help facilitate learning and use of results data in the organization. The analysis of this thesis is based upon fifteen in-depth semi structured interviews across ten Norwegian NGOs involved in development cooperation projects. The interviews revealed several issues in the use and implementation of new digital technologies in Norwegian development cooperation projects that would need further research and investigation. (1) There were large variations in both the kinds of digital technologies the NGOs used in current management, and large variations in the aptness of these tools to solve the management issues at hand in the organization. (2) The small and large organizations had differentiated perceived needs and discussions in their responses to barriers and opportunities of new technologies, and that the response mostly encompassed technology as a barrier or opportunity in improving reporting rather than providing data suitable for management. (3) The research suggests that one of the constraints on learning in the NGOs might be that the organization primarily gathers results data on behalf of others rather than enabling their own management needs. Based on these findings further research is suggested in several areas, such as exploring suitable new digital technologies in the management of the NGOs involved in Norwegian development cooperation projects and unveiling possibilities of using new digital technologies to learn from the results data.nhhma

Veier til hurtigere defibrillering ved hjertestans utenfor sykehus i Norge

Abstract In order to resuscitate a patient suffering from cardiac arrest, it is crucial to obtain early defibrillation. Wanting to increase the survival-rate from out-of-hospital sudden cardiac arrest, one obviously has to reduce the time from the patient is collapsing till the first shock is delivered. This can mainly be done in one of these three ways: 1, First responder groups, 2, PAD (public access defibrillators), 3, At home-defibrillation. PAD-trials have shown that the survival rate can be increased tremendously when placing PADs on locations with a high density of people. It is therefore tempting to equipe malls, airports, train-stations etc. with these PADs. But would that lead to an increased survival-rate in Norway? In this work I discuss this question by studying relevant papers on the topic. From these I conclude that due to our low density of population, it seems most appropriate to support a first-responder-strategy in order to increase the survival-rate of out-of-hospital sudden cardiac arrest in Norway. Explanation of the above used terms: 1, First responder groups = Equipping and training lay-persons (police-officers, fire-fighters etc) to use a defibrillator. 2, PAD (public access defibrillators) = Placing defibrillators at “high-risk locations”. 3, At home-defibrillation = The patient has a private external defibrillator at home

An explorative study of the use and implementation of new digital technologies in the management of Norwegian development cooperation projects

This thesis merges the aspects of results-based management systems and new digital technologies together and explores what characterizes the use and implementation of new digital technologies in the management of Norwegian development cooperation projects. Through three research questions the research explores how Norwegian non-government organizations (NGOs) involved in development cooperation projects: (1) Collect, aggregate, present, and use data in decision making and reporting in existing management systems. (2) View the main barriers and opportunities of new technologies and innovations in improving current management systems and tools. (3) Perceives how new digital technologies can help facilitate learning and use of results data in the organization. The analysis of this thesis is based upon fifteen in-depth semi structured interviews across ten Norwegian NGOs involved in development cooperation projects. The interviews revealed several issues in the use and implementation of new digital technologies in Norwegian development cooperation projects that would need further research and investigation. (1) There were large variations in both the kinds of digital technologies the NGOs used in current management, and large variations in the aptness of these tools to solve the management issues at hand in the organization. (2) The small and large organizations had differentiated perceived needs and discussions in their responses to barriers and opportunities of new technologies, and that the response mostly encompassed technology as a barrier or opportunity in improving reporting rather than providing data suitable for management. (3) The research suggests that one of the constraints on learning in the NGOs might be that the organization primarily gathers results data on behalf of others rather than enabling their own management needs. Based on these findings further research is suggested in several areas, such as exploring suitable new digital technologies in the management of the NGOs involved in Norwegian development cooperation projects and unveiling possibilities of using new digital technologies to learn from the results data