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Laparoscopic Surgery and the debate on its safety during COVID-19 pandemic
2021. Michael El Boghdady, Béatrice Marianne Ewalds-Kvist. The Surgeon 19 (2), e29-e39Artikel
Introduction: The transmission of COVID-19 virus since the outbreak of viral pneumonia due to SARS-CoV-2 gave rise to protective operative measures. Aerosol generating procedures such as laparoscopic surgery are known to be associated with increased risks of viral transmission to the healthcare workers. The safety of laparoscopy during the pandemic was then debated. We aimed to systematically review the literature regarding the safe use of laparoscopy during COVID-19.
Methods: We performed a systematic search using PubMed and ScienceDirect databases from inception to 1st May, 2020. The following search terms were used: laparoscopic surgery and COVID-19''; minimally invasive surgery and COVID-19''. Search items were considered from the nature of the articles, date of publication, aims and findings in relation to use of laparoscopic surgery during COVID-19. The study protocol was registered with PROSPERO register for systematic reviews (CRD42020183432).
Results: Altogether, 174 relevant citations were identified and reviewed for this study, of which 22 articles were included. The analysis of the findings in relation to laparoscopic surgery during the pandemic were presented in tabular form. We completed the common recommendations for performing laparoscopy during the COVID-19 pandemic in forms of pre-, intra- and post-operative phases.
Conclusion: There is no scientific evidence to date for the transmission of COVID-19 by laparoscopic surgery. Laparoscopy can be used with precautions because of its benefits compared to open surgery. If safe, conservative management is the primary alternative during the pandemic. We concluded that recommended precautions should be respected while performing laparoscopy during the pandemic.
Moral Challenges When Suspecting Abuse and Neglect in School Children
2021. Maria Forsner (et al.). Child and Adolescent Social Work Journal 38, 599-610Artikel
The World Health Organization (WHO), concludes that child maltreatment is a global concern calling for a multi sectoral interdisciplinary approach. School professionals, such as social workers, teachers, and health care professionals are in positions to discover and report maltreatment enabling social workers to intervene. However, a variety of reports reveal an evident gap between incidences and frequency of number of cases reported. A review of relevant research indicates that the problem of not reporting suggests that moral conflicts are activated in the process of decision-making. The aim was to gain a deeper understanding of school professionals' experiences of reporting suspected neglect and abuse to the Social Welfare Board. In a mixed method approach 32 school professionals, such as teachers, social workers, nurses and psychologists participated in interviews and responded to questionnaires. Findings from the qualitative content analysis were compared to the quantitative analysis in a meta-analysis. Moral conflicts occur when faced with making decisions about how to best deal with a child's situation. Thoughts about the child's best interest and relationship with his/her parents as well as the informants ' own safety, were central. The comparative meta- analysis of both data sets revealed these conflicts commence with a moral sensitivity of possible negative consequences for the child. Moral sensitivity can be viewed as a good personal attribute, it paradoxically might lead to moral stress despite an open ethical climate. Based on the results of this study, further research on the interpersonal aspects of dealing with moral conflicts involved in reporting suspected child abuse is indicated.
The innate aptitude's effect on the surgical task performance
2021. Michael El Boghdady, Béatrice Marianne Ewalds-Kvist. Updates in Surgery 73, 2079-2093Artikel
Surgery is known to be a craft profession requiring individuals with specific innate aptitude for manipulative skills, and visuospatial and psychomotor abilities. The present-day selection process of surgical trainees does not include aptitude testing for the psychomotor and manual manipulative skills of candidates for required abilities. We aimed to scrutinize the significance of innate aptitudes in surgical practice and impact of training on skills by systematically reviewing their significance on the surgical task performance. A systematic review was performed in compliance with PRISMA guidelines. An initial search was carried out on PubMed/Medline for English language articles published over 20 years from January 2001 to January 2021. Search strategy and terms to be used included ‘aptitude for surgery’, ‘innate aptitude and surgical skills, ‘manipulative abilities and surgery’, and ‘psychomotor skills and surgery’. MERSQI score was applied to assess the quality of quantitatively researched citations. The results of the present searches provided a total of 1142 studies. Twenty-one studies met the inclusion criteria out of which six citations reached high quality and rejected our three null hypothesis. Consequently, the result specified that all medical students cannot reach proficiency in skills necessary for pursuing a career in surgery; moreover, playing video games and/or musical instruments does not promote skills for surgery, and finally, there may be a valid test with predictive value for novices aspiring for a surgical career. MERSQI mean score was 11.07 (SD = 0.98; range 9.25–12.75). The significant findings indicated that medical students with low innate aptitude cannot reach skills necessary for a competent career in surgery. Training does not compensate for pictorial-skill deficiency, and a skill is needed in laparoscopy. Video-gaming and musical instrument playing did not significantly promote aptitude for microsurgery. The space-relation test has predictive value for a good laparoscopic surgical virtual-reality performance. The selection process for candidates suitable for a career in surgery requests performance in a simulated surgical environment.
Iranian women's experiences of infertility
2020. Nader Aghakhani (et al.). International journal of reproductive biomedicine 18 (1), 65-72Artikel
Background: There are concerns and diverse experiences related to infertility and childlessness. The lived experience of infertile people from various cultures needs to be explored. Objective: The aim of this qualitative study was to explore Iranian women experiences of their infertility. Materials and Methods: The data comprised interviews about fertility issues in the Persian language with eighteen women, aged 17-45 yr old, who agreed to be interviewed at the Mottahari Infertility Treatment Clinic, affiliated to the Urmia University of Medical Sciences about their fertility problems. They were approached by the researchers at the time of their first visit. The verbatim transcribed interviews were analyzed using deductive conventional content analysis. Results: The experiences of the informants were conceptualized into four major themes: 1) Shock (subthemes: Disbelief and Denial); 2) Reaction (subthemes: Distress, Guilt, Loss of self-esteem and Sexual reluctance); 3) Processing (subthemes: Internal processing, Avoidance, Marriage at risk, External processing, Stigma caused by the family and Stigma caused by the community) and 4) Reorientation (subthemes: Forgetting, Marriage to saving marriage and Sexual consent). Conclusion: Infertility can be a challenging condition. Considering that infertility-related issues affect Iranian women more contextual factors is necessary. So, culturally sensitive and gender specific protocols are suggested to provide suitable and about culturally sensitive and gender-specific protocols is a necessity in order to provide suitable care to infertile women.
The influence of music on the surgical task performance
2020. Michael El Boghdady, Béatrice Ewalds-Kvist. International Journal of Surgery 73, 101-112Artikel
Introduction: Music is commonly played in operating theatres. Music was shown to diminish stress of the surgical team along with reducing the patients anxiety before surgery. On the other hand, it has been revealed that music might give rise to negative effects of divided attention causing distraction in surgical routines. Therefore, we aimed to systematically review the effect of music on the surgeon's task performance.
Methods: A systematic review was performed in compliance with the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. A literature search using PubMed/Medline, ScienceDirect and Google Scholar, was performed by means of the search terms: music and operating theatre, as well as music and surgery. The search was limited to citations in English from year 2009-2018. Search items were considered from the nature of the articles, date of publication, forum of publication, aims and main findings in relation to use of music in operating theatres. Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria were applied. Studies were included based on predetermined inclusion criteria where after the papers' quality assessments and evidence grading were completed by two independent reviewers. The protocol was registered with the PROSPERO register of systematic reviews.
Results: Out of 18 studies that formed the base for evidence evaluations, 6 studies were assessed as having high quality and 8 studies of moderate quality. Five studies, provided both strong and moderate scientific evidence for a positive effect of music on surgeon's task performance. In contrast, strong scientific evidence for a negative effect of music on surgeon's task performance also was revealed in 2 high-quality studies. Nevertheless, the positive effect of music on the surgical task performance was significantly higher when compared to its negative effect (p < 0.0001).
Conclusion: Certain music elements affect the surgical task performance in a positive or negative way. The total and significant outcome of the present study was that the positive effect of music on surgeon's task performance, overrides its negative effect. Classic music when played with a low to medium volume can improve the surgical task performance by increasing both accuracy and speed. The distracting effect of music should also be put in consideration when playing a loud or high-beat type of music in the operating theatres.
A review of online platforms in training and surgical education
2019. Michael El Boghdady, Béatrice Marianne Ewalds-Kvist, Afshin Alijani. European surgery 51 (2), 41-48Artikel
Introduction The use of technology in surgical education has rapidly evolved. Blended learning refers to provision of online instruction platforms by international technology companies, prompting a combination of face-to-face teaching with computer-mediated tuition. This nonsystematic literature review focuses on online teaching platforms with applications for potential use in future surgical education. Methods A literature search was performed using PubMed, Embase, OVID, and Google Scholar. To identify studies on online platforms in surgical education, the following search terms were used: online platform, online learning, surgical education and online learning, and surgical education and blended learning. The search was limited to citations in English from 1998 to 2018. The first author performed the detailed literature search. The final list of the articles was included by consensus between authors. Search items were studied from the nature of the articles, country of origin, date of publication, and aims and findings in relation to use of online platforms surgical education. Results Altogether 279 relevant citations were reviewed, of which 22 articles met the inclusion criteria: 19 papers (ten original research, two review items, seven Internet articles) and three books were found to be relevant for this study. Their analysis comprised models of platforms along with their applications in surgical education. Data on the advantages and disadvantages of online platforms as well as authors' personal experience of this instruction manner in surgical education were extracted. Problems with determining, analyzing, and integrating reading matters in a nonsystematic literature review comprising different teaching methods combined with the use of online platforms in surgical education were discussed and resolved. Conclusion Online platforms were introduced by international technology companies to encourage paperless blended learning in schools. We envisaged the use of online classrooms in surgical education because of its simple format, easy access, low costs, and interaction-inspiring nature between teachers and students in professional surgical education.
Chinese Students' Satisfaction with Life Relative to Psychological Capital and Mediated by Purpose in Life
2019. Rongwei Zhang (et al.). Current Psychology 38 (1), 260-271Artikel
Altogether 700 college students aged 18 to 24years (M=20.81, SD=1.29) originating from six universities in China participated in this study. The current aim was to find out whether a student's sense of purpose in life mediated the relationship between his/her psychological capital (PsyCap) comprising hope, generalized self-efficacy, resilience, optimism (HERO; Luthans and Youssef-Morgan. Annual Review of Organizational Psychology and Organizational Behavior, 4, 339-366, 2017) and satisfaction with life. Furthermore, it was asked which factor contributes more to students' satisfaction with life, PsyCap or purpose in life? Thus, apprentices completed the Adult Dispositional Hope Scale (Snyder et al. Journal of Personality and Social Psychology, 60(4), 570-585, 1991), General Self-Efficacy Scale (Schwarzer and Jerusalem. Causal and Control Beliefs, 1, 35-37, 1995), Resilience Scale (Wagnild and Young. Journal of Nursing Measurement, 1(2), 165-17847, 1993), Life Orientation Test-Revised (Scheier et al. Journal of Personality and Social Psychology, 67(6), 1063-1078, 1994) along with the completion of the Purpose in Life Test (Crumbaugh and Maholick. Journal of Clinical Psychology, 20(2), 200-207, 1964) and Satisfaction with life scale (Diener et al. Journal of Personality Assessment, 49(1), 71-75, 1985). The results disclosed grade differences in PsyCap elements. Moreover, positive and significant correlations between any of two variables were found, thus allowing for further analysis. Structural equation modeling revealed that students' satisfaction with life was directly predicted by PsyCap per se as well as indirectly projected by means of the construct purpose in life. Based on the present assessment, PsyCap contributed more to students' satisfaction with life than their experienced purpose in life.
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