Mediedebatter och policyförslag - diskursanalys av mediedebatten om surrogatmoderskap och Statens medicinsk-etiska råds policyförslag

The aim of this study was to elucidate and analyse the debate on surrogate motherhood that has been held in Sweden for the last ten years (2003-2013) and furthermore to see how and to what extent the arguments that were used in the debate, also were found on a national policy level. The method that was used for this was discourse analysis. The empirical data were based on debate articles and editorials from the most prominent Swedish newspapers, from which two dominating discourses could be distinguished with different contents and patterns. Whether these two discourses have had an impact on national policy level or not was investigated by analysing a report dealing with the topic, Assisted reproduction – ethical aspects (2013:1), published by the Swedish National Council on Medical Ethics, “Smer”. The study had a social constructivistic starting point and also applied Carol Bacchi’s theory on policy analysis, What’s the problem represented to be? (WPR). The study showed that the discourses from the debate in Swedish media have gotten a big impact in Smer’s report both in terms of it being characterized by a for - and against-distinction (dichotomy), and in terms of the use of arguments

Analisis Teknis dan Produktivitas Alat Tangkap Bubu Lipat di Kelurahan Pasar Bengkulu Kecamatan Sungai Serut Kota Bengkulu

The Bengkulu City area with a large capture fishery activity is in the Sungai Serut District, precisely in the Pasar Bengkulu Village. Bubu Lipat is a fishing gear that is categorized into traps that are operated passively using bait. This research aims to analyze the technical and productivity of fishing gear used by fishermen in Pasar Bengkulu. It is expected to provide information, descriptions, and explanations about the development of traps to the government and related stakeholders for trap management in Pasar Bengkulu. The scope of the research data includes primary and secondary data, fishing gear construction, and catch productivity. Data collection was carried out through field observations, interviews, and documentation. The researchers conclude that the productivity of a trap per year is 1500 kilograms, and the productivity per trip is 30 kilograms. The catch of trap consists of two types, Keong Macan (Babylonia spirata) and Rajungan (Portunus pelagicus), and fishing vessels used by trap fishermen at the Pasar Bengkulu have two sizes, 1 and 2 GT with respective endurance of 10.5 PK and 26 PK. It is necessary to research the effectiveness of catching traps in Pasar Bengkulu to obtain more information regarding managing fishing gear in Pasar Bengkulu.

The Modified Chimney Technique With a Thoracic Aortic Stent Graft to Preserve the Blood Flow of the Left Common Carotid Artery for Treating Descending Thoracic Aortic Aneurysm and Dissection

While thoracic endovascular aortic repair is an effective treatment option for descending thoracic aorta pathology, it does have limitations. The main limitation is related to the anatomical difficulties when disease involves the aortic arch. A fenestrated, branched aortic stent graft and hybrid operation has been introduced to overcome this limitation, but it is a custom-made device and is time consuming to manufacture. Furthermore, these devices cannot be used in an emergency setting. We report two patients with massive descending thoracic aortic aneurysm and ruptured aortic dissection very near the aortic arch who underwent a procedure which we named the modified chimney technique. The modified chimney technique can be used as a treatment option in such an emergency situation or as a rescue procedure when aortic pathology is involved near the supra-aortic vessels

Endovascular repair versus open surgery in patients with ruptured abdominal aortic aneurysms: Clinical outcomes with 1-year follow-up

ObjectiveTo compare the clinical outcomes of treatment after endovascular repair and open surgery in patients with ruptured infrarenal abdominal aortic aneurysms (AAAs), including 1-year follow-up.MethodsAll consecutive conscious patients with ruptured infrarenal AAAs who presented to our tertiary care teaching hospital between January 1, 2001, and December 31, 2005, were included in this study (n = 55). Twenty-six patients underwent endovascular repair, and 29 patients underwent open surgery. Patients who were hemodynamically too unstable to undergo a computed tomography angiography scan were excluded. Outcomes evaluated were intraoperative mortality, 30-day mortality, systemic complications, complications necessitating surgical intervention, and mortality and complications during 1-year follow-up. The statistical tests we used were the Student t test, χ2 test, Fisher exact test, and Mann-Whitney U test (two sided; α = .05).ResultsThirty-day mortality was 8 (31%) of 26 patients who underwent endovascular repair and 9 (31%) of 29 patients who underwent open surgery (P = .98). Systemic complications and complications necessitating surgical intervention during the initial hospital stay were similar in both treatment groups (8/26 [31%] and 5/26 [19%] for endovascular repair, respectively, and 9/29 [31%] and 8/29 [28%] for open surgery, respectively; P > .40). During 1-year follow-up, two patients initially treated with endovascular repair died as a result of non–aneurysm-related causes; no death occurred in the open surgery group. Complications during 1-year follow-up were 1 (5%) of 20 for endovascular repair and 4 (16%) of 25 for open surgery (P = .36).ConclusionsOn the basis of our study with a highly selected population, the mortality and complication rates after endovascular repair may be similar compared with those after open surgery in patients treated for ruptured infrarenal AAAs

Comparing apples and oranges: assessment of the relative video quality in the presence of different types of distortions

<p>Abstract</p> <p>Video quality assessment is essential for the performance analysis of visual communication applications. Objective metrics can be used for estimating the relative quality differences, but they typically give reliable results only if the compared videos contain similar types of quality distortion. However, video compression typically produces different kinds of visual artifacts than transmission errors. In this article, we focus on a novel subjective quality assessment method that is suitable for comparing different types of quality distortions. The proposed method has been used to evaluate how well different objective quality metrics estimate the relative subjective quality levels for content with different types of quality distortions. Our conclusion is that none of the studied objective metrics works reliably for assessing the co-impact of compression artifacts and transmission errors on the subjective quality. Nevertheless, we have observed that the objective metrics' tendency to either over- or underestimate the perceived impact of transmission errors has a high correlation with the spatial and temporal activity levels of the content. Therefore, our results can be useful for improving the performance of objective metrics in the presence of both source and channel distortions.</p

The use of aortic balloon occlusion in traumatic shock : first report from the ABO trauma registry

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported. Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 +/- 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion. This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.Peer reviewe

Pre-hospital CPR and early REBOA in trauma patients-results from the ABOTrauma Registry

Publisher Copyright: © 2020 The Author(s).Background: Severely injured trauma patients suffering from traumatic cardiac arrest (TCA) and requiring cardiopulmonary resuscitation (CPR) rarely survive. The role of resuscitative endovascular balloon occlusion of the aorta (REBOA) performed early after hospital admission in patients with TCA is not well-defined. As the use of REBOA increases, there is great interest in knowing if there is a survival benefit related to the early use of REBOA after TCA. Using data from the ABOTrauma Registry, we aimed to study the role of REBOA used early after hospital admission in trauma patients who required pre-hospital CPR. Methods: Retrospective and prospective data on the use of REBOA were collected from the ABOTrauma Registry from 11 centers in seven countries globally between 2014 and 2019. In all patients with pre-hospital TCA, the predicted probability of survival, calculated with the Revised Injury Severity Classification II (RISC II), was compared with the observed survival rate. Results: Of 213 patients in the ABOTrauma Registry, 26 patients (12.2%) who had received pre-hospital CPR were identified. The median (range) Injury Severity Score (ISS) was 45.5 (25-75). Fourteen patients (54%) had been admitted to the hospital with ongoing CPR. Nine patients (35%) died within the first 24 h, while seventeen patients (65%) survived post 24 h. The survival rate to hospital discharge was 27% (n = 7). The predicted mortality using the RISC II was 0.977 (25 out of 26). The observed mortality (19 out of 26) was significantly lower than the predicted mortality (p = 0.049). Patients not responding to REBOA were more likely to die. Only one (10%) out of 10 non-responders survived. The survival rate in the 16 patients responding to REBOA was 37.5% (n = 6). REBOA with a median (range) duration of 45 (8-70) minutes significantly increases blood pressure from the median (range) 56.5 (0-147) to 90 (0-200) mmHg. Conclusions: Mortality in patients suffering from TCA and receiving REBOA early after hospital admission is significantly lower than predicted by the RISC II. REBOA may improve survival after TCA. The use of REBOA in these patients should be further investigated.Peer reviewe

Pelvic trauma : WSES classification and guidelines

Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.Peer reviewe