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  • 1.
    Abdelakram, Hafid
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Abdullah, Saad
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Estimating Physiological Parameters in Various Age Groups: Windkessel 4 Element Model and PPG Waveform Analysis Approach2023In: IEEE 4th International Multidisciplinary Conference on Engineering Technology, IMCET 2023, IEEE, 2023, p. 194-197Conference paper (Refereed)
    Abstract [en]

    Non-invasive monitoring of cardiovascular health through photoplethysmography (PPG) waveforms has emerged as a crucial area of research. The Windkessel 4-Element (WK4) model is a mathematical approach used to estimate key physiological parameters related to cardiovascular health, including arterial compliance, peripheral resistance, inertance, and total arterial resistance. This study aimed to evaluate key physiological parameters associated with cardiovascular health using the WK4 model, leveraging real-life PPG waveform data obtained from volunteers across three distinct age groups. To achieve this, an algorithm was developed to automatically determine optimal parameter values for each volunteer. The results revealed a mean correlation coefficient of 0.96 between the automatically generated waveforms by the algorithm and the actual real-life PPG waveforms, indicating robust agreement. Notably, only the total arterial resistance parameter exhibited significant differences among the age groups, suggesting that the algorithm holds promise for detecting agerelated changes in cardiovascular health. These findings emphasize the potential for the development of a non-invasive tool to assess cardiovascular health status and enhance healthcare outcomes. Furthermore, they underscore the capability of the developed algorithm as a non-invasive means to evaluate various aspects of cardiovascular physiology. Additionally, the versatility of this algorithm opens doors for its application in educational settings, promoting knowledge advancement, empowering research endeavors, and facilitating advancements in the field.

  • 2.
    Abdullah, Saad
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Abdelakram, Hafid
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Lindén, Maria
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Folke, Mia
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Kristoffersson, Annica
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Machine Learning-Based Classification of Hypertension using CnD Features from Acceleration Photoplethysmography and Clinical Parameters2023In: Proceedings - IEEE Symposium on Computer-Based Medical Systems, Institute of Electrical and Electronics Engineers Inc. , 2023, p. 923-924Conference paper (Refereed)
    Abstract [en]

    Cardiovascular diseases (CVDs) are a leading cause of death worldwide, and hypertension is a major risk factor for acquiring CVDs. Early detection and treatment of hypertension can significantly reduce the risk of developing CVDs and related complications. In this study, a linear SVM machine learning model was used to classify subjects as normal or at different stages of hypertension. The features combined statistical parameters derived from the acceleration plethysmography waveforms and clinical parameters extracted from a publicly available dataset. The model achieved an overall accuracy of 87.50% on the validation dataset and 95.35% on the test dataset. The model's true positive rate and positive predictivity was high in all classes, indicating a high accuracy, and precision. This study represents the first attempt to classify cardiovascular conditions using a combination of acceleration photoplethysmogram (APG) features and clinical parameters The study demonstrates the potential of APG analysis as a valuable tool for early detection of hypertension.

  • 3.
    Andersson, Per
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Sjöberg, Rickard L
    Öhrvik, John
    Leppert, Jerzy
    Effects of family history and personal experience of illness on inclination to change health related behavior2009In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 17, no 1, p. 3-7Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to examine how personal experience of illness and family history of cardiovascular disease (CVD), adjusted for gender, education and nationality, affects risk behaviour. Subjects were 2054 men and women of age 50 from two countries, Sweden (n=1011) and Poland (n=1043), who were recruited from screening program in primary health care. Family history, personal experience and risk behaviours (smoking habits, exercise habits, BMI-level) were self-reported. The results show that smoking behaviour is affected by personal experience of illness but not by family history of CVD. No effects of these variables were found on the remaining risk related variables that were tested in this study.  These results suggest that individuals with a personal experience of illness may be inclined to change smoking behaviour more than the average person. Smoking prevention strategies may thus benefit from targeting this group in particular.

     

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  • 4.
    Andreae, Christina
    Linköpings universitet, Medicinska fakulteten, Sweden.
    Appetite in patients with heart failure: Assessment, prevalence and related factors2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Appetite is an important component in nutrition for maintaining the food intake needed by the body. Decreased appetite is a common clinical problem in patients with heart failure. It has a negative impact on food intake and possibly on malnutrition and health outcomes. There is a lack of evidence on how to assess appetite in heart failure. Furthermore, there are knowledge gaps about factors associated with appetite and which role appetite plays for health status in heart failure.   Aim: The overall aim of the thesis was to investigate appetite in patients with heart failure. Four studies were conducted with the goal to evaluate the psychometric properties of the Council on Nutrition Appetite Questionnaire (CNAQ) (I) and to explore the prevalence of decreased appetite and related factors associated with appetite in patients with heart failure (II-IV).   Methods: A multicenter study was conducted in three outpatient heart failure clinics in the center of Sweden during 2009-2012. Data were collected through a baseline measurement (I-IV) and an 18-month follow-up (IV). The first study was a psychometric evaluation study (I), while the other studies had an observational cross-sectional design (II-III) and an observational prospective design (IV). One hundred and eighty-six patients diagnosed with heart failure and experiencing heart failure symptoms participated at baseline. At the 18-month follow-up study (IV), one hundred and sixteen participants from the baseline participated. Data were collected from medical records (pharmacological treatment, comorbidity, left ventricle ejection fraction, time of diagnosis), self-reported questionnaires (demographic background data, appetite, symptoms of depression, health status, sleep, self-reported physical activity), objective measurements (anthropometric assessment of body size, blood samples, six minutes’ walk test, and physical activity measured with an actigraph) and clinical assessment (New York Heart Association (NYHA) functional classification, and cognitive assessment). The main outcome variables included appetite (I, II and IV) and health status (III). Descriptive and inferential statistics were used in the studies (I-IV).   Results: The majority of the participants had moderate heart failure symptoms, i.e., NYHA class II (n=114, 61%). Most of the participants were men (n=130, 70%). Mean age was 70,7 years, (SD=11,0), and mean BMI was 28.7 (SD=5.3). The CNAQ showed acceptable psychometric properties for assessing appetite in patients with heart failure (I). This thesis shows that 38% of the participants experienced an appetite level that put them at risk of weight loss (I). It was shown that factors such as biological, medical, psychological (II) and physical activity/exercise capacity (IV) are associated with appetite. Also, appetite was associated with impaired health status. However, this association was found to be moderated by symptoms of depression (III). Neither appetite nor physical activity changed during the 18-month follow-up (IV).   Conclusion: Decreased appetite is a serious phenomenon that needs attention in the care of patients with heart failure. Health care professionals can now use a validated and simple appetite instrument to assess appetite in heart failure. In addition, attention should be paid to elderly patients and those who have symptoms of depression, sleep problems, impaired cognitive function and impaired physical activity, as well as to patients on suboptimal medical treatment. Higher appetite was shown to contribute to a better health status, but this was only evident in patients without symptoms of depression. Therefore, special attention should be paid to symptoms of depression, as this risk factor affected the association between appetite and health status. This thesis enhances the understanding of the magnitude of the problem with decreased appetite in heart failure both in numbers and factors. New priorities in nutrition care and new ideas can be established, both in practice and in research, in order to improve a nutrition care that is vital for patients with heart failure.  

  • 5.
    Borg, S.
    et al.
    Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, 581 83, Sweden.
    Öberg, B.
    Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, 581 83, Sweden.
    Nilsson, L.
    Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Sciences, Linköping University, Linköping, Sweden.
    Alfredsson, J.
    Department of Cardiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bäck, M.
    Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, Linköping, 581 83, Sweden.
    Effectiveness of a behavioral medicine intervention in physical therapy on secondary psychological outcomes and health-related quality of life in exercise-based cardiac rehabilitation: a randomized, controlled trial2023In: BMC Sports Science, Medicine and Rehabilitation, ISSN 2052-1847, Vol. 15, no 1, article id 42Article in journal (Refereed)
    Abstract [en]

    Background: Interventions promoting adherence to exercise-based cardiac rehabilitation (exCR) are important to achieve positive physical and psychological outcomes, but knowledge of the added value of behavioral medicine interventions for these measures is limited. The aim of the study was to investigate the added value of a behavioral medicine intervention in physical therapy (BMIP) in routine exCR on psychological outcomes and health-related quality of life (HRQoL) versus routine exCR alone (RC). Methods: A total of 170 patients with coronary artery disease (136 men), mean age 62.3 ± 7.9 years, were randomized at a Swedish university hospital to a BMIP plus routine exCR or to RC for four months. The outcome assessments included HRQoL (SF-36, EQ-5D), anxiety and depression (HADS), patient enablement and self-efficacy and was performed at baseline, four and 12 months. Between-group differences were tested with an independent samples t-test and, for comparisons within groups, a paired t-test was used. An intention-to-treat and a per-protocol analysis were performed. Results: No significant differences in outcomes between the groups were shown between baseline and four months or between four and 12 months. Both groups improved in most SF-36 domains, EQ-VAS and HADS anxiety at the four-month follow-up and sufficient enablement remained at the 12-months follow-up. Conclusion: A BMIP added to routine exCR care had no significant effect on psychological outcomes and HRQoL compared with RC, but significant improvements in several measures were shown in both groups at the four-month follow-up. Since recruited participants showed a better psychological profile than the general coronary artery disease population, further studies on BMIP in exCR, tailored to meet individual needs in broader patient groups, are needed. Trial registration number NCT02895451, 09/09/2016, retrospectively registered.

  • 6.
    Holmberg, Mats
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Andersson, Henrik
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Winge, Karin
    Ambulance Department, South Älvsborgs Hospital, Borås, Sweden.
    Lundberg, Camilla
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Karlsson, Thomas
    Health Metrics at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Herlitz, Johan
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Wireklint Sundström, Birgitta
    PreHospen – Centre for Prehospital Research, University of Borås, Borås, Sweden.
    Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome2018In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 18, no 216Article in journal (Refereed)
    Abstract [en]

    Background: To decrease the morbidity burden of cardiovascular disease and to avoid the development of potentially preventable complications, early assessment and treatment of acute coronary syndrome (ACS) are important. The aim of this study has therefore been to explore the possible association between patients' estimated intensity of chest pain when first seen by the ambulance crew in suspected ACS, and the subsequent outcome before and after arrival in hospital. Methods: Data was collected both prospectively and retrospectively. The inclusion criteria were chest pain raising suspicion of ACS and a reported intensity of pain 4 on the visual analogue scale. Results: All in all, 1603 patients were included in the study. Increased intensity of chest pain was related to: 1) more heart-related complications before hospital admission; 2) a higher proportion of heart failure, anxiety and chest pain after hospital admission; 3) a higher proportion of acute myocardial infarction and 4) a prolonged hospitalisation. However, there was no significant association with mortality neither in 30 days nor in three years. Adjustment for possible confounders including age, a history of smoking and heart failure showed similar results. Conclusion: The estimated intensity of chest pain reported by the patients on admission by the ambulance team was associated with the risk of complications prior to hospital admission, heart failure, anxiety and chest pain after hospital admission, the final diagnosis and the number of days in hospital.

  • 7.
    Mastersong, Siobhan
    et al.
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    McNally, Bryan
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Cullinan, John
    Natl Univ Ireland, JE Cairnes Sch Business & Econ, Galway H91 WN80, Ireland..
    Vellano, Kimberly
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Escutnaire, Josephine
    Univ Lille Law & Hlth, Fac Engn & Hlth Management ILLS, Lille, France..
    Fitzpatrick, David
    Stirling Univ, Scottish Ambulance Serv, NMAHP Res Unit, Unit 13 Scion House, Stirling FK9 4NF, Scotland..
    Perkins, Gavin D.
    Univ Warwick, WMS Warwick Clin Trials Unit, Out Hosp Cardiac Arrest Outcomes OHCAO Trial, Coventry CV4 7AL, W Midlands, England..
    Koster, Rudolph W.
    Acad Med Ctr, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands..
    Nakajima, Yuko
    Emory Univ, Sch Med, Dept Emergency Med, Atlanta, GA 30303 USA..
    Pemberton, Katherine
    Queensland Ambulance Serv, GPO Box 1425, Brisbane, Qld 4001, Australia..
    Quinn, Martin
    Natl Univ Ireland Galway, Natl Out Hosp Cardiac Arrest Register OHCAR Steer, Dept Publ Hlth Med, HSE, Letterkenny F92 XK84, Co Donegal, Ireland..
    Smith, Karen
    Ambulance Victoria Ctr Res & Evaluat, POB 2000, Doncaster, Vic 3108, Australia..
    Jonsson, Bergpor Steinn
    Akureyri Hosp, Eyrarlandsvegur 600, Akureyri, Iceland..
    Strömsöe, Anneli
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tandan, Meera
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    Vellinga, Akke
    Natl Univ Ireland Galway, Discipline Gen Practice, 1 Distillery Rd, Galway, Ireland..
    Out-of-hospital cardiac arrest survival in international airports2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 127, p. 58-62Article in journal (Refereed)
    Abstract [en]

    Background: The highest achievable survival rate following out-of-hospital cardiac arrest is unknown. Data from airports serving international destinations (international airports) provide the opportunity to evaluate the success of pre-hospital resuscitation in a relatively controlled but real-life environment. Methods: This retrospective cohort study included all cases of out-of-hospital cardiac arrest at international airports with resuscitation attempted between January 1st, 2013 and December 31st, 2015. Crude incidence, patient, event characteristics and survival to hospital discharge/survival to 30 days (survival) were calculated. Mixed effect logistic regression analyses were performed to identify predictors of survival. Variability in survival between airports/countries was quantified using the median odds ratio. Results: There were 800 cases identified, with an average of 40 per airport. Incidence was 0.024/100,000 passengers per year. Percentage survival for all patients was 32%, and 58% for patients with an initial shockable heart rhythm. In adjusted analyses, initial shockable heart rhythm was the strongest predictor of survival (odds ratio, 36.7; 95% confidence interval [CI], 15.5-87.0). In the bystander-witnessed subgroup, delivery of a defibrillation shock by a bystander was a strong predictor of survival (odds ratio 4.8; 95% CI, 3.0-7.8). Grouping of cases was significant at country level and survival varied between countries. Conclusions: In international airports, 32% of patients survived an out-of-hospital cardiac arrest, substantially more than in the general population. Our analysis suggested similarity between airports within countries, but differences between countries. Systematic data collection and reporting are essential to ensure international airports continually maximise activities to increase survival.

  • 8.
    Nahlen Bose, Catarina
    et al.
    Röda Korsets Högskola, Sweden.
    Björling, Gunilla
    Röda Korsets Högskola, Sweden.
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Persson, Hans
    Karolinska Institutet, Sweden.
    Saboonchi, Fredrik
    Röda Korsets Högskola, Sweden.
    Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured2015In: Cardiology Research, ISSN 1923-2829, E-ISSN 1923-2837, Vol. 6, no 2, p. 239-248Article in journal (Refereed)
    Abstract [en]

    Background: Individuals with chronic heart failure (CHF) need to cope with both the physical limitations and the psychological impacts of the disease. Since some coping strategies are beneficial and others are linked to increased mortality and worse health-related quality of life (HRQoL), it is important to have a reliable and valid instrument to detect different coping styles. Brief COPE, a self-reporting questionnaire, has been previously used in the context of CHF. There is, however, currently a lack of consensus about the theoretical or empirical foundations for grouping the multiple coping strategies assessed by Brief COPE into higher order categories of coping. The main purpose of this study was to examine the structure of Brief COPE, founded on the higher order grouping of its subscales in order to establish an assessment model supported by theoretical considerations. Furthermore, the associations between these higher order categories of coping and HRQoL were examined to establish the predictive validity of the selected model in the context of CHF.

    Method: One hundred eighty-three patients diagnosed with CHF were recruited at a heart failure outpatient clinic or at a cardiac ward. Self-reported questionnaires were filled in to measure coping strategies and HRQoL. Confirmatory factor analyses were performed to investigate different hierarchical structures of Brief COPE found in the literature to assess coping strategies in patients with CHF. Regression analyses explored associations of aggregated coping strategies with HRQoL.

    Results: A four factorial structure of Brief COPE displayed the most adequate psychometric properties, consisting of problem focused coping, avoidant coping, socially supported coping and emotion focused coping. Avoidant coping was associated with worse HRQoL in CHF.

    Conclusions: This study provides support for a four-factor model of coping strategies in patients with CHF. This could facilitate assessment of coping both in clinical and research settings.

  • 9.
    Nahlen Bose, Catarina
    et al.
    The Swedish Red Cross University College, Stockholm, Sweden.
    Persson, Hans
    Karolinska Institutet, Stockholm, Sweden.
    Björling, Gunilla
    The Swedish Red Cross University College, Stockholm, Sweden.
    Ljunggren, Gunnar
    Karolinska Institutet, Stockholm, Sweden.
    Elfström, Magnus
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Saboonchi, Fredrik
    The Swedish Red Cross University College, Stockholm, Sweden.
    Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure: a randomized controlled trial2016In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 537-548, article id S1-S1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).

    AIMS:

    To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.

    METHODS:

    Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).

    RESULTS:

    No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).

    CONCLUSION:

    CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.

  • 10.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Förbättrade resultat för patienter som drabbats hjärtstopp utanför sjukhus – en uppföljning från 1992 till 20112013Conference paper (Refereed)
    Abstract [sv]

    Syfte: Att beskriva patienter som drabbats av hjärtstopp utanför sjukhus och dess resultatsförändringar i behandling och överlevnad.

    Metod: Patienter (n=59 926) som drabbats av hjärtstopp utanför sjukhus i samtliga Sveriges län och som rapporterats till Svenska hjärt-lungräddningsregistret från 1992 till 2011.

    Resultat: Antalet rapporterade hjärtstopp utanför sjukhus ökade från 27 (1992) till 52 (2011) per 100 000 invånare och år. Vidare så ökade bevittnandegraden av hjärtstopp utanför sjukhus av ambulanspersonalen, en ökad förekomst av hjärtlungräddning innan ambulansen kom fram till patienten samt att tiden ökade från larm till dess att ambulansen kom fram till patienten.

    1-månads-överlevnad ökade från 4,8% (1992) till 10,7% (2011). De som framförallt överlevde 1 månad eller mer var de patienter som levde vid ankomst till sjukhus. Av de patienter som drabbats av hjärtstopp utanför sjukhus mellan 2008 till 2010, var det 41% som genomgick kylbehandling på sjukhus samt 28% som behandlades med ballongvidgning av hjärtats kranskärl. De patienter som överlevde (2008-2011), hade 94% en god eller relativ god hjärnfunktion.

    Sammanfattning: De patienter som drabbats av hjärtstopp utanför sjukhus 1992-2011, påvisar en fördubblad överlevnad. De patienter som framförallt överlever, är de som lever vid ankomst till sjukhus och som senare läggs in på vårdavdelning.   

  • 11.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Validity of reported data in the out-of-hospital cardiac arrest register in chosen parts in Sweden: [HLR-registrets tillförlitlighet]2013Conference paper (Refereed)
    Abstract [en]

    Aim: To describe differences between reported and non reported data in the out-of-hospital cardiac arrest (OHCA) register in Sweden.

    Methods: Prospective and retrospective data of treated OHCA patients in Sweden, 2008-2010 were compared in the Swedish OHCA register. Data were investigated in three Swedish counties with various recording models. Prospective data are those reported by the ambulance crew and retrospective data those missed by the ambulance crew but discovered afterwards by crosschecking with the local ambulance register.

    Result: In 2008-2010, the number of prospective reported cases was n=2, 398 and retrospective cases n=3, 198 which indicates a 25% missing rate.

    When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years versus 67 years; p=0.003). There was no difference between groups with regard to sex, time of day and year of OHCA, witnessed status or initial rhythm.

    However, bystander CPR was more frequent among patients in who were reported prospectively (65% versus 60%; p= 0.023) where as survival to 1 month was higher among patients who were reported retrospectively (9,2% versus 11,9%;p=0.035)

     

    Conclusion: Among 3, 198 cases of OHCA in three regions in Sweden 800 (25%) were not reported prospectively by the ambulance crew but retrospectively when discovered as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, less frequently receiving bystander CPR but having a higher survival. Our data suggest that patients who suffer OHCA and are prospectively reported to a quality register may be influenced by selection bias.

  • 12.
    Södersved Källestedt, Marie-Louise
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Uppsala University,Sweden.
    Linden, Harald
    Dept Patient Safety Reg Sormland, Eskilstuna, Sweden..
    Bjurling-Sjoberg, Petronella
    Uppsala Univ, Caring Sci, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.;Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden..
    Rapid response systems Smartphone activated community first responders' experiences of out-of-hospital cardiac arrests alerts, a qualitative study2022In: Resuscitation Plus, E-ISSN 2666-5204, Vol. 10, article id 100246Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to illustrate how community first responders perceive out-of-hospital cardiac arrest alerts delivered via smartphone, what support they have and how they cope with potentially distressing experiences. Method: A qualitative interview study was conducted with a volunteer sample of 14 community first responders in two regions of Sweden. The interviews were transcribed and analysed using thematic analysis with a data-driven inductive approach supported by NVivo 1.3. Results: The responders' experiences were illustrated in three main themes, each including several subthemes: 1) Profound wish to help, including the sense of importance and sense of emergency; 2) Facing the situation, including essential actions performed in collaboration, confidence from training and experience, challenges posed by unforeseen situations and ethical dilemmas, and coping with emotional reactions; and 3) Potential for improvements, including technical and communication development, feedback and debriefing, training and social marketing. Conclusion: The community first responders were motivated and eager to help but simultaneously feared the mission and were not always prepared for their own reactions in the emergency when dispatched. Although cardiopulmonary resuscitation training and experience gave them skills that enabled them to act constructively, they faced situations that might be facilitated by improvements in the community first responder system and further training. The responders were proud of their efforts and were good ambassadors for the system. Appreciation of their commitment, better preparation and providing support in the aftermath of an emergency appears to be a good investment in societies' efforts to bring quick help to distressed persons.

  • 13.
    Trobec, R.
    et al.
    Department of Communication Systems, Jožef Stefan Institute, Ljubljana, Slovenia.
    Jan, M.
    Department of Cardiovascular Surgery, University Medical Centre, Ljubljana, Slovenia.
    Lindén, Maria
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Tomasic, Ivan
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Detection and Treatment of Atrial Irregular Rhythm with Body Gadgets and 35-channel ECG2019In: 2019 42nd International Convention on Information and Communication Technology, Electronics and Microelectronics, MIPRO 2019 - Proceedings, Institute of Electrical and Electronics Engineers Inc. , 2019, p. 301-308Conference paper (Refereed)
    Abstract [en]

    The atrial irregular rhythm, often reflected in atrial fibrillation, undulation or flutter, is recognized as one of the major causes of brain stroke and entails an increased risk of thromboembolic events because it increases the likelihood of blood clots formation. Its early detection is becoming an increasingly important preventive measure. The paper presents a simple methodology for the detection of atrial irregular rhythm by ECG body gadget that can perform long-term measurements, e.g. several weeks or more. Multichannel ECG, on the body surface, gives a more detailed insight into the atrial activity in comparison to standard 12-lead ECG. The information from MECG is compared with single-channel patch ECG. The obtained results suggest that the proposed methodology could be useful in treatments of atrial irregular rhythm. One can obtain a reliable information about the time and duration of fibrillation events, or determine arrhythmic focuses and conductive pathways in heart atria, or study the effects of antiarrhythmic drugs on existing arrhythmias and on an eventual development of new types of arrhythmias. 

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