Incidence and time trends of second primary malignancies after non-Hodgkin lymphoma:a Swedish population-based study

Considering treatment changes and an improved prognosis of non-Hodgkin lymphoma (NHL) over time, knowledge regarding long-term health outcomes, including late effects of treatment, has become increasingly important. We report on time trends of second primary malignancies (SPMs) in Swedish NHL patients, encompassing the years before as well as after the introduction of anti-CD20 antibody therapy. We identified NHL patients in the Swedish Cancer Register 1993 to 2014 and matched comparators from the Swedish Total Population Register. The matched cohort was followed through 2017. By linking to the Swedish Lymphoma Register, subcohort analyses by NHL subtype were performed. Flexible parametric survival models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of SPM among patients and comparators. Among 32 100 NHL patients, 3619 solid tumors and 217 myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) cases were observed, corresponding to a 40% higher rate of solid tumors (HR(solid tumors) = 1.4; 95% CI, 1.4-1.5) and a 5-fold higher rate of MDS/AML (HR(MDS/AML )= 5.2; 95% CI, 4.4-6.2) than for comparators. Overall, the observed excess risks for solid tumors or MDS/AML remained stable over the study period, except for follicular lymphoma, where the excess rate of MDS/AML attenuated with time (P for trend = .012). We conclude that NHL survivors have an increased risk of both solid tumors and hematologic malignancies, in particular MDS/AML. Stable excess risks over time indicate that contemporary treatment standards are not associated with modified SPM risk. Encouragingly, decreasing rates of MDS/AML were noted among patients with follicular lymphoma, possibly due to the increasing use of nonchemotherapy-based treatments

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

A new approach for IT audit? : Testing the theory of technology debt in an IT audit setting

Background and problem: The amounts companies spend in IT investments have increased greatly the last couple of decades. To control IT the companies perform IT audits. This is a complicated and expensive procedure which lack common standards. To contribute to the research stream within IT audit this thesis’ purpose is to test the recently proposed theory of Technology Debt in the process of performing a simple IT audit. Purpose: The objective is to test the theory of Technology Debt in an IT audit setting to evaluate the usefulness of the theory. Method: To test the theory the authors did three studies: A literature study to gain a wider understanding of the subject and to create a simple IT audit process. A secondary analysis of qualitative data to test the theory and finally an interview study to further test the theory potential. Results: The literature study complemented the theory of Technology Debt and provided the authors with an easy IT audit process. In the secondary analysis the theory was useful as a tool for identification and categorization. Finally in the interview study the theory provided a valuation criterion to evaluate the IT environment. The thesis contributes to the knowledge base of IT auditing by supplying a new angle of approach and try a new area of application for Technology Debt

Digitalt entreprenörskap inom online communities En studie om kunskapsdelning

In this paper we have studied the different dimensions of knowledge that are shared regarding digital entrepreneurship. This study builds on the knowledge in the field of digital entrepreneurship and presents a tentative taxonomy of its ever changing pool of knowledge. Ventures in the digital economy require increasing amounts of knowledge to be able to compete. To get access to knowledge they need to interact with communities that engage in knowledge sharing, these communities can exist online or offline. The dimensions/structures of knowledge that the ventures can gain access to in online communities lacks studies. We ask ourselves: What subjects of knowledge does digital entrepreneurs share in online communities? The research setting was an online community governed by a Swedish non-profit organization. The community encouraged entrepreneurial activities in Sweden by organizing online innovation contests. Conventional divisions of subjects of knowledge were found to be incapable of covering the knowledge shared to digital platform ventures. In this study we have seen indications of three dimensions of knowledge; Scalability, Morphability, and Complementarity, that could not be fully explained by conventional knowledge theories. These dimensions covered sociomaterial attributes of digital platforms and as such they differed from conventional knowledge theories in entrepreneurship.I denna studie har vi undersökt de olika kunskapsdimensioner som delas gällande digitalt entreprenörskap. Studien bygger på kunskapen inom fältet digitalt entreprenörskap och presenterar en tentativ taxonomi över dess ständigt föränderliga kunskapsdomän. Företag inom den digitala ekonomin kräver allt mer kunskap för att kunna konkurrera på marknaden. För att få tillgång till denna kunskap krävs det att företagen engagerar sig i online communities som aktivt utövar kunskapsdelning, dessa communities kan existera både online och offline. Studier gällande dimensionerna och strukturen av kunskap som företag kan få tillgång till från online communities är bristfällig och vi ställer oss därför frågan: “Vilken typ av kunskap delar digitala entreprenörer inom online communities?” Denna studie genomfördes i en online community kontrollerad av en svensk ideell organisation. Communityn uppmuntrade entreprenöriella aktiviteter i Sverige genom att organisera innovationstävlingar. Traditionella kunskapsindelningar befanns vara otillräckliga för att kunna förklara all kunskap som delades till digitala plattformsföretag. I denna studie så har vi sett indikationer på tre dimensioner av kunskap; Scalability, Morphability och Complementarity, som inte kunde fullt ut förklaras av konventionella kunskapsteorier inom entreprenörskap. I dessa dimensioner diskuterades sociomateriella attribut hos digitala plattformar och därför skiljde de sig från konventionella kunskapsteorier inom entreprenörskap

Investigating the effect of lifestyle risk factors upon the number of aspirated and mature oocytes in in vitro fertilization cycles : interaction with antral follicle count

There is evidence demonstrating that certain lifestyle factors have a detrimental effect on fertility. Since such factors often coexist, possible synergistic effects merit further investigation. Thus we aimed to examine the cumulative impact of lifestyle factors on in vitro fertilization (IVF) early reproductive treatment outcomes and their interaction with measures of ovarian reserve. Materials and methods By following women who were starting their first fresh IVF cycle in 2 cohorts, the "Lifestyle study cohort" (hypothesis generating cohort, n = 242) and the "UppSTART study" (validation cohort, n = 432) in Sweden, we identified two significant risk factors acting independently, smoking and BMI, and then further assessed their cumulative effects. Results Women with both these risk factors had an Incidence Rate Ratio (IRR) of 0.75 [(95% CI 0.61-0.94)] regarding the number of aspirated oocytes compared to women without these risk factors. Concerning the proportion of mature oocytes in relation to the total number of aspirated oocytes, the interaction between BMI and Antral Follicle Count (AFC) was significant (p-value 0.045): the lower the value of AFC, the more harmful the effect of BMI with the outcome. Conclusions Data shows that there is an individual as well as a cumulative effect of smoking and BMI on the number of aspirated and mature oocytes in fresh IVF treatment cycles. AFC might modify associations between BMI and the proportion of mature oocytes in relation to the total number of aspirated oocytes. These results highlight the importance of lifestyle factors on IVF early reproductive outcomes and provide additional evidence for the importance of preconception guidance for the optimization of IVF cycle outcome.