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  • 151.
    Erfatpour, Shela
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Fettsyraamidhydrolas enzymaktivitet efter fruktosintag2014Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 152.
    Ericsson, Mica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Läkares sekretess: Mäns våld mot kvinnor i nära relationer2014Student paper other, 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I detta PM kommer läkares sekretess angående mäns våld mot kvinnor i nära relationer att behandlas. Inledningsvis kommer en kort bakgrund till ämnet ”Mäns våld mot kvinnor i nära relationer” att ges. Sedan kommer en förklaring göras av vad en läkares sekretess generellt innebär, undantagen därifrån och när läkare har rätt att bryta sekretessen. PM:et avslutas med en diskussion och en slutsats där jag kommer se ämnet ur ett kvinnorättsperspektiv, ge en förklaring till vad perspektivet innebär och vad det skulle kunna innebära att använda det valda perspektivet på ämnet i fråga.

     

    Lagrum om sekretess som kommer att behandlas i detta PM gäller alla sjukvårdspersonal men då jag har lagt fokus på läkare som personalgrupp inom sjukvården är det endast läkares sekretess jag kommer att behandla och förklara. Ha i bakhuvudet när du läser vidare att det jag skriver om läkare också kan tillämpas på annan sjukvårdspersonal.

     

  • 153.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Asfyksi - kvaelning2004In: Nordisk Laerebog i Retsmedicin / [ed] Jørgen L. Thomsen, Copenhagen: FADL , 2004, 1, p. 125-144Chapter in book (Other (popular science, discussion, etc.))
  • 154.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Asfyksi - kvaelning2013In: Retsmedicin / [ed] Thomsen JL, FADL's Forlag a/s, 2013, 3, p. 120-135Chapter in book (Refereed)
  • 155.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Asfyksi - kvaelning2008In: Retsmedicin: nordisk laerebog / [ed] Jørgen Lange Thomsen, Köbenhavn: Foreningen af Danske Laegestuderendes Forlag Aktieselskab , 2008, 2, p. 131-147Chapter in book (Other (popular science, discussion, etc.))
  • 156.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Den svenska identifieringsverksamheten - ett exempel från Thailand 20052006In: Rättsmedicin / [ed] Thomsen Jørgen, Liber , 2006, p. 65-67Chapter in book (Other (popular science, discussion, etc.))
  • 157.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Anatomy. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Intermediate-sized (skeletin) filaments of heart Purkinje fibres: an investigation into their morphology, composition and function1979Doctoral thesis, comprehensive summary (Other academic)
  • 158.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Specialist training strategies, assessment and evaluation2012In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 18, p. 20-21Article in journal (Other academic)
  • 159.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Vad är handledning? Kan en bofink se ut hur som helst?2012In: Moderna läkare, ISSN 1403-5502, Vol. 72, no 2, p. 14-14Article in journal (Refereed)
  • 160.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Druid, Henrik
    Giebe, Birkhild
    Krantz, Peter
    Thiblin, Ingemar
    Vetenskapligt arbete under ST: en integrerad del - inte en udda fågel2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 110, no 32-33, p. 1415-1416Article in journal (Refereed)
  • 161.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Ekman, Jonn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Deaths in custody in Sweden2015In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 21, no 1, p. 1-1Article in journal (Other academic)
  • 162.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Georén, Bengt
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Öström, Mats
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Work-place homicide by bow and arrow.2000In: Journal of forensic sciences, ISSN 0022-1198, Vol. 45, no 4, p. 911-6Article in journal (Other academic)
    Abstract [en]

    Arrow wounds represent an unusual class of wounds rarely seen by most forensic pathologists. In this paper we present a case of homicide by bow and arrow and the characteristics of such injuries. The essential characteristics of the lesions obtained from conically-tapered field points and from hunting broadhead tips are described and discussed in relation to injuries caused by firearm bullets. In the present case, three arrows struck the victim, and the order in which the injuries were sustained are analyzed. We also discuss the possibilities of localizing the shooter relative to the victim by analysis of the trajectories.

  • 163.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Gustafsson, T
    Hultcrantz, M
    Höistad, M
    Jacobson, S
    Persson, A
    Postmortem imaging: a systematic review2015In: Scandinavian Journal of Forensic Science, ISSN 1503-9552, Vol. 21, no 1, p. 47-47Article in journal (Other academic)
  • 164.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Loisel, Johanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Thid, Michael
    Rättsmedicin2012In: Jourhandboken / [ed] Andersson S, Hovelius B, Lund: Studentlitteratur, 2012, p. 928-941Chapter in book (Other academic)
  • 165.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Sprogoe-Jakobsen, Susan
    The identification of tsunami victims - A Swedish experience2005In: Scandinavian Journal of Forensic Medicine, ISSN 1503-9552, Vol. 11, no 2, p. 51-53Article in journal (Other (popular science, discussion, etc.))
  • 166.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Thid, Micael
    Saukko, Petter
    Rognum, T
    Rättsmedicin i Sverige: Organisering av rettsmedisin i de nordiske land2010In: Lærebok i rettsmedisin, Oslo: Gyldendal Akademisk, 2010, p. 413-415Chapter in book (Other academic)
  • 167.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Öström, Mats
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Traffic fatalities2009In: Wiley Encyclopedia of Forensic Science, Chichester,: John Wiley & Sons Ltd , 2009Chapter in book (Other (popular science, discussion, etc.))
    Abstract [en]

    This A to Z encyclopedia provides a comprehensive, definitive, and up-to-date reference of the main areas of specialist and expert knowledge and skills used by those involved in all aspects of the forensic process, including, but not limited to, forensic scientists, doctors, practicing and academic lawyers, paralegals, police, crime scene investigators, analytical chemists, behavioral scientists and toxicologists.

    This five-volume set covers all topics which, either as part of an established forensic discipline or as a potentially useful emerging discipline, are of interest to those involved in the forensic process. This includes both the scientific methodology and the admissibility of evidence. The encyclopedia also provides case studies of landmark cases in the definition and practice of forensic science.

    Wiley Encyclopedia of Forensic Science presents all material on a level and in a style that makes it accessible to a wide range of readers. In particular, lawyers needing to better understand the key aspects of the science, and scientists who require a deeper insight into legal issues will find the encyclopedia an important resource, as will physical, biological and behavioral scientists who require background information on the most important aspects of each other’s areas of expertise.

     

  • 168.
    Eriksson, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Öström, Mats
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Spigset, Olav
    Thorson, Jan
    Fatal intoxications with selective serotonin reuptake inhibition: Do the different drugs differ in toxicity?1999In: 15th Triennial Meeting International Association of Forensic Sciences, 1999, p. 270-Conference paper (Other (popular science, discussion, etc.))
  • 169.
    Eriksson, Emma
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    SSRI – Framtiden vid rehabilitering av stroke?: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 170.
    Eriksson, Irene
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Fagerström, Lisbeth
    Högskolan i Buskerud, Norge.
    Older women's experiences of suffering from urinary tract infections2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1385-1394Article in journal (Other academic)
    Abstract [en]

    Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs).

    Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women.

    Design: A qualitative descriptive design.

    Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67–96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis.

    Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care.

    Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care.

    Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care.

  • 171.
    Eriksson, Johnny
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Dissolution rate of poorly soluble drugs: Potential influence on dissolution rate using calcium sulfate as carrier in drug formulations2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 172.
    Eriksson, Josefin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Utlämnande av patientuppgifter till rättsvårdande myndigheter: Om sekretessbrytande bestämmelser och undantag i sekretess och tystnadsplikt inom hälso- och sjukvård vid myndigheters brottspreventiva och brottsutredande verksamhet2014Student paper other, 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Utlämnande av uppgifter om patienters hälsotillstånd från hälso- och sjukvården kan vara av intresse för de rättsvårdande myndigheternas verksamhet. I den här uppsatsen ska främst domstolsverkets, åklagarmyndighetens samt polisens rätt att ta del av dessa uppgifter att undersökas och sättas i relation till patientens behov av integritet och förtroende för vårdinrättningen där patienten vårdas eller har vårdats. De rättsvårdande myndigheterna behöver normalt uppgifterna för att kunna förhindra och utreda brott. 

  • 173.
    Eriksson-Strand, Johanna
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Öström, Mats
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Forensic Medicine.
    Snowmobilie fatalities in Sweden, 1999-20062007In: Proceedings of the 6th International congress of the baltic medico-legal association: New technologies in forensic medicine, 2007, p. S13-Conference paper (Other academic)
  • 174.
    Escher, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sandström, Herbert
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    [Substantial blood glucose control differences at Swedish surgery departments. Common guidelines required]2006In: Lakartidningen, ISSN 0023-7205, Vol. 103, no 48, p. 3811-4Article in journal (Refereed)
  • 175.
    Esmael, Mariam
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Djupanalyser med kunder om hur kundkommunikationen på apotek kan förstärkas: - En intervjustudie på svenska apotek ur ett kundperspektiv2018Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 176.
    Fakhimi, Tatiana
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Pharmacology.
    Sekundära metaboliters antibakteriella effekt mot Pseudomonas aeruginosa2018Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 177.
    Falck, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Norlander, Jenny
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    "Man tittar liksom med deras ögon": - Erfarenheter av föräldragruppsbehandlingen Perspektiv2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Föräldrars mentaliseringsförmåga är avgörande för ett barns psykiska hälsa och utveckling.

    Utifrån detta utformades föräldragruppsbehandlingen Perspektiv med eklektisk utgångspunkt

    i framför allt Theraplay och Dialektisk beteendeterapi. Behandlingen gavs till föräldrar med

    barn mellan 0-12 år med allvarlig barnpsykiatrisk problematik med varierad symtombild och

    etiologi. En kvalitativ studie med fokusgruppsintervjuer genomfördes med syfte att undersöka

    föräldrars erfarenheter av behandlingen och eventuella upplevelser av effekt. Resultaten

    redovisas i teman som visar upplevelse av god effekt, vilket tolkas och diskuteras utifrån

    terapeutisk gruppeffekt, mentaliseringsutveckling och generalisering i vardagen vilka bygger

    på varandra i en cirkulär process. Resultaten stöder tidigare forskning som visar att

    föräldragruppsbehandling och mentaliseringsutveckling i grupp är effektivt. Studiens resultat

    motiverar fortsatt användning inom barn- och ungdomspsykiatrin och fortsatt

    metodutveckling.

  • 178.
    Fallmark, Gunneli
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Det finns evidens för lek inom barnpsykoterapi!: En systematisk litteraturstudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Barns mentala ohälsa ökar kraftigt. Barnpsykoterapi med inslag av fri lek, här kallad lekterapi, har under många år varit den traditionella behandlingen av barn i behov av psykoterapi. För att ha en möjlighet att kunna jämföras vetenskapligt med andra dokumenterade behandlingsmetoder behöver evidensen för lekterapi som behandlingsmetod undersökas, stärkas liksom spridas. 

    Syftet med föreliggande uppsats är att undersöka kunskapsläget inom lekterapi som behandlingsmetod inom barnpsykoterapi. 

    Totalt 41 studier har granskats systematiskt enligt evidensbaserad medicinsk metod. Tjugoen av dem poängbedömdes medan övriga 20 delades upp i temagrupper för att visa ett ytterligare djup och bredd av de analyserade studierna. Tretton studier av de 21 poängbedömda fick minst 80% av totalpoängen, gradering I, och sju stycken graderingen II, d. v. s. 70-80% av max poängen. Enligt internationell praxis av gradering av evidensstyrka för slutsatser, visar två studier, eller fler, med ett högt bevisvärde eller god systematisk översikt på ett starkt vetenskapligt underlag som ger god evidens. Som ett bifynd visade sig 16 av de 41 studierna även ha en direkt anknytning till affektiv neurovetenskaplig forskning. 

    Rekommendationen är att använda barnpsykoterapi med fri lek för barn som ska behandlas vid mental ohälsa.

  • 179.
    Farooqi, Nighat
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine. Umea Univ Hosp, Dept Resp Med & Allergy, SE-90185 Umea, Sweden.
    Slinde, F.
    Håglin, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sandström, Thomas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
    Assessment of energy intake in women with chronic obstructive pulmonary disease: A doubly labeled water method study2015In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 19, no 5, p. 518-524Article in journal (Refereed)
    Abstract [en]

    To maintain energy balance, reliable methods for assessing energy intake and expenditure should be used in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to validate the diet history and 7-day food diary methods of assessing energy intake (EI) using total energy expenditure (TEE) with the doubly labeled water (DLW) method (TEEDLW) as the criterion method in outpatient women with COPD. EI was assessed by diet history (EIDH) and a 7-day food diary (EIFD) in 19 women with COPD, using TEEDLW as the criterion method. The three methods were compared using intra-class correlation coefficients (ICC) and Bland-Altman analyses. The participants were classified according to their reporting status (EI/TEE) as valid-reporters 0.79-1.21, under-reporters < 0.79 or over-reporters > 1.21. Diet history underestimated reported EI by 28%, and 7-day food diary underestimated EI by approximately 20% compared with TEEDLW. The ICC analysis showed weak agreement between TEEDLW and EIDH (ICC=-0.01; 95%CI-0.10 to 0.17) and between TEEDLW and EIFD (ICC=0.11; 95%CI -0.16 to 0.44). The Bland-Altman plots revealed a slight systematic bias for both methods. For diet history, six women (32%) were identified as valid-reporters, and for the 7-day food diary, twelve women (63%) were identified as valid-reporters. The accuracy of reported EI was only related to BMI. The diet history and 7-day food diary methods underestimated energy intake in women with COPD compared with the DLW method. Individuals with higher BMIs are prone to underreporting. Seven-day food diaries should be used with caution in assessing EI in women with COPD.

  • 180.
    Fartousi, Jasmin
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Establishment and validation of a gas chromatography/mass spectrometry method for determination of D-/L-arabinitol in urine as a means of diagnosis of invasive Candida infection2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 181.
    Finnberg, A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Junuzovic, M
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Homicidal poisoning2012In: Clinical Forensic Medicine, 2012Conference paper (Other academic)
  • 182. Finnberg, Amanda
    et al.
    Junuzovic, Mensura
    Dragovic, Ljubisa
    Ortiz-Reyes, Ruben
    Hamel, Marianne
    Davis, Joseph
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Homicide by Poisoning2013In: American Journal of Forensic Medicine and Pathology, ISSN 0195-7910, E-ISSN 1533-404X, Vol. 34, no 1, p. 38-42Article in journal (Refereed)
    Abstract [en]

    By studying the number and method of homicidal poisoning in Miami-Dade County, Florida; New York City, NY; Oakland County, Michigan; and Sweden, we have confirmed that this is an infrequently established crime. Several difficulties come with the detection of homicidal poisonings. Presenting symptoms and signs are often misdiagnosed as natural disease, especially if the crime is committed in a hospital environment, suggesting that an unknown number of homicides go undetected. In the reported cases analyzed, the lethal agent of choice has changed over the years. In earlier years, traditional poisons such as arsenic, cyanide, and parathion were frequently used. Such poisonings are nowadays rare, and instead, narcotics are more commonly detected in victims of this crime.

  • 183.
    Fjeldvær, Fredrik
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    En massespektrometrisk studie av to lusemidler i Norsk laks: En LC/MS-MS studie av lusemidlene deltametrin og azamethiphos i Norsk laks2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
  • 184.
    Fjellskål, Hilde
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Utviklingen av perifer neuropati hos type 2 diabetikere og om trening kan lindre symptomene2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 185.
    Flink, Katarina
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Apotekssystem i nordiska länder: En jämförelse mellan apotekssystemet i Sverige och systemen i de närmaste nordiska grannländerna2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 186.
    Flodell, Amanda
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Risker vid användning av paracetamol under graviditet: Risker vid användning av paracetamol under graviditet2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 187.
    Flygare, Gunborg
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychotherapy.
    Att vara förälder vid placering av barn: Föräldrars åsikter, tankar och behov vid socialtjänstens LVU-placeringar av barn och ungdom  2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Övervägande delen av forskning kring socialtjänstens placeringar av barn och ungdom riktar sig mot barnens situation vid dessa insatser eller föräldrarnas upplevelser av skiftande familjebehandlingar. Det har heller inte påträffats forskning riktad mot föräldrars upplevelser av barn och unga placerade i HVB-hem typ behandlingshem.

     I aktuell studie delger sex föräldrar med barn, placerade enligt LVU, individuellt sina synpunkter och tankar kring samarbete med socialtjänsten och olika vårdgivare såsom familjehem och HVB - hem.

    Denna kvalitativa studie, med en tematisk analys på narrativ bas, visar att föräldrarna är i stora drag nöjda med det samarbete som pågår gällande sina barn och ungdomar placerade p.g.a. eget beteende. Föräldrarna har dock därmed inte avsagt sig föräldraskapet utan önskar fortsatt information och delaktighet beträffande sina barn. Studien tar också fäste på anknytningsteorin både ur barnet och förälderns synvinkel gällande fortsatt relation. Fokus ligger också på den förändrade föräldrarollen som informanterna önskar få hjälp att hantera. Det saknas stöd för föräldrarnas egen situation då kris samt skam- och skuldkänslor uppstår i samband med barnens placering.

    Denna studie, visar stora likheter med utfallet av den studie Allmänna Barnhuset ansvarat för, gällande föräldrars röster om hur det är att ha sina barn placerade i fosterhem. (Höijer, 2007)

  • 188.
    Fordell, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Bodin, Kenneth
    Umeå University, Faculty of Science and Technology, High Performance Computing Center North (HPC2N).
    Bucht, Gustaf
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Malm, Jan
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    A virtual reality test battery for assessment and screening of spatial neglect2011In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 123, no 3, p. 167-174Article in journal (Refereed)
    Abstract [en]

    Background – There is a need for improved screening methods for spatial neglect.

    Aim – To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.

    Method –  VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.

    Results –  Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r2 = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47–0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was ‘easy’ to use. Eighty-eight percent reported that they felt ‘focused’, ‘pleased’ or ‘alert’. No patient had adverse symptoms. The test session took 15 min.

    Conclusions –  The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.

  • 189.
    Forsberg, Rebecca
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Conditions affecting safety on the Swedish railway: Train drivers' experiences and perceptions2016In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 85, p. 53-59Article in journal (Refereed)
    Abstract [en]

    Major changes have been implemented in recent years within the rail bound sector. There is, therefore, a need to consider if and how these large alterations affect rail safety. The aim of the study was to explore train drivers' experiences and perceptions of conditions affecting safety of the Swedish railway system. Narrative semi-structured interviews were performed with ten train drivers. Qualitative content analysis was used to analyze the interviews. The results were captured in two main categories: (1) Facing structural changes includes results unclarity in responsibility assignment, deteriorated tracks and insufficient safety culture and (2) facing technology development, covered safety systems such as ATC and ERTMS which were seen as high-quality safeguards with both benefits and challenges due to new technical devices. The new challenges that have entered the arena should be offset by increased coordination and by a party responsible for safety within the industry. Finally, restrictions and regulations regarding the use of the tablets and smart phones are desirable. 

  • 190.
    Forsberg, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    One hundred years of railway disasters and recent trends2011In: Prehospital and disaster medicine, ISSN 1049-023X, Vol. 26, no 5, p. 367-373Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Globally, railway transport is increasing steadily. Despite the adoption of diverse safety systems, major railway incidents continue to occur. Higher speeds and increased passenger traffic are factors that influence the risk of mass-casualty incidents and make railway crashes a reality that merits extensive planning and training.

    METHODS: Data on railway disasters were obtained from the Centre for Research on the Epidemiology of Disasters (CRED), which maintains the Emergency Events Database (EM-DAT). This descriptive study consists of 529 railway disasters (≥10 killed and/or ≥100 non- fatally injured) from 1910 through 2009.

    RESULTS: The number of railway disasters, people killed, and non-fatally injured, has increased throughout the last hundred years-particularly during the last four decades (1970-2009), when 88% of all disasters occurred. In the mid-20th century, a shift occurred, resulting in more people being non-fatally injured than fatally injured. During 1970-2009, 74% of all railway disasters occurred in Asia, Africa, and South and Central America, combined. The remaining 26% occurred in Europe, North America, and Oceania, combined. Since 1980, railway disasters have increased, especially in Asia and Africa, while Europe has had a decrease in railway disasters. The number killed per disaster (1970-2009) was highest in Africa (n = 55), followed by South and Central America (n = 47), and Asia (n = 44). The rate was lowest in North America (n = 10) and Europe (n = 29). On average, the number of non-fatal injuries per disaster was two to three times the number of fatalities, however, in the African countries (except South Africa) the relation was closer to 1:1, which correlates to the relation found in more developed countries during the mid-20th century. The total losses (non-fatally and fatally injured) per disaster has shown a slight decreasing trend.

    CONCLUSIONS: Despite extensive crash avoidance and injury reduction safety systems, railway crashes occur on all continents, indicating that this type of incident must be accounted for in disaster planning and training. Better developed safety, crashworthiness, and rescue resources in North America and Europe may be factors explaining why the number of crashes and losses has stabilized and why the average number of people killed per disaster is lowest on these continents.

  • 191.
    Forsberg, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Iglesias Vazquez, Jose Antonio
    A Case Study of the High-speed Train Crash Outside Santiago de Compostela, Galicia, Spain2016In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 31, no 2, p. 163-168Article in journal (Refereed)
    Abstract [en]

    Introduction: The worldwide use of rail transport has increased, and the train speeds are escalating. Concurrently, the number of train disasters has been amplified globally. Consequently, railway safety has become an important issue for the future. High-velocity crashes increase the risk for injuries and mortality; nevertheless, there are relatively few studies on high-speed train crashes and the influencing factors on travelers' injuries occurring in the crash phase. The aim of this study was to investigate the fatal and non-fatal injuries and the main interacting factors that contributed to the injury process in the crash phase of the 2013 high-velocity train crash that occurred at Angrois, outside Santiago de Compostela, Spain. Methods: Hospital records (n = 157) of all the injured who were admitted to the six hospitals in the region were reviewed and compiled by descriptive statistics. The instant fatalities (n = 63) were collected on site. Influencing crash factors were observed on the crash site, by carriage inspections, and by reviewing official reports concerning the approximated train speed. Results: The main interacting factors that contributed in the injury process in the crash phase were, among other things, the train speed, the design of the concrete structure of the curve, the robustness of the carriage exterior, and the interior environment of the carriages. Of the 222 people on board (218 passengers and four crew), 99% (n = 220) were fatally or non-fatally injured in the crash. Thirty-three percent (n = 72) suffered fatal injuries, of which 88% (n = 63) died at the crash site and 13% (n = 9) at the hospital. Twenty-one percent (n = 32) of those admitted to hospital suffered multi-trauma (ie, extensive, severe, and/or critical injuries). The head, face, and neck sustained 42% (n = 123) of the injuries followed by the trunk (chest, abdomen, and pelvis; n = 92; 32%). Fractures were the most frequent (n = 200; 69%) injury. Conclusion: A mass-casualty incident with an extensive amount of fatal, severe, and critical injuries is most probable with a high-velocity train; this presents prehospital challenges. This finding draws attention to the importance of more robust carriage exteriors and injury minimizing designs of both railway carriages and the surrounding environment to reduce injuries and fatalities in future high-speed crashes.

  • 192.
    Framme, Gunilla
    Umeå University, Faculty of Social Sciences, Umeå Centre for Evaluation Research (UCER).
    Utvärdering av nätverk för personer med komplexa vårdbehov på grund av psykisk störning och missbruk: Delrapport2008Report (Other academic)
  • 193.
    Franzén, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Inhämtande av rättsintyg2014Student paper other, 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Rättsintyg är definierade i lag (2005:29) om rättsintyg (nedan kallad rättsintygslagen) § 1 som ”medicinska utlåtanden av läkare som inhämtats av polismyndighet eller åklagarmyndighet i syfte att användas i en brottsutredning eller som bevis i en rättegång i anledning av brott”.

    Sedan 2006, då rättsintygslagen trädde i kraft, har Rättsmedicinalverket det huvudsakliga ansvaret för utfärdandet av sådana intyg.   

    Rättsintygslagen innebär i korthet att Rättsmedicinalverket är ansvarig myndighet för utfärdandet av rättsintyg, att rättsintyg utfärdas endast av vissa läkare, antingen rättsläkare eller så kallade kontraktsläkare och att rättsintygen är avgiftsbelagda.

    Även innan lagändringen användes rättsintyg i brottsutredningar,[1] men dessa kunde utföras av i princip vilken läkare som helst och ansvaret för rättsintygsverksamheten var således uppdelat på ett antal olika myndigheter.[2]

    Den nya lagen om rättsintyg syftade till att nå en kvalitetshöjning av utfärdade rättsintyg genom att Rättsmedicinalverket skulle utfärda fler rättsintyg, vilket i förlängningen skulle leda till ökad rättssäkerhet i brottmål.[3]

    Rättsintyget är ett verktyg av vikt för de rättsvårdande instanserna och dess betydelse i brottsutredningar är stor. Ändå förefaller användandet av rättsintyg vara litet,[4] varför det är intressant att dels fråga sig när ett rättsintyg ska inhämtas, dels fråga sig varför det sker förhållandevis sällan.

  • 194.
    Freeman, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    The role of forensic epidemiology in evidence-based forensic medical practice2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objectives This thesis is based on 4 papers that were all written with the same intent, which was to describe and demonstrate how epidemiologic concepts and data can serve as a basis for improved validity of probabilistic conclusions in forensic medicine (FM). Conclusions based on probability are common in FM, and the validity of probabilistic conclusions is dependant on their foundation, which is often no more than personal experience. Forensic epidemiology (FE) describes the use and application of epidemiologic methods and data to questions encountered in the practice of FM, as a means of providing an evidence-based foundation, and thus increased validity, for certain types of opinions. The 4 papers comprising this thesis describe 4 unique applications of FE that have the common goal of assessing probabilities associated with evidence gathered during the course of the investigation of traumatic injury and death.

     

    Materials and Methods Paper I used a case study of a fatal traffic crash in which the seat position of the surviving occupant was uncertain as an example for describing a probabilistic approach to the investigation of occupant position in a fatal crash. The methods involved the matching of the occupants’ injuries to the vehicular and crash evidence in order to assess the probability that the surviving occupant was either the driver or passenger of the vehicle at the time of the crash.

    In the second and third papers, epidemiologic data pertaining to traffic crash-related injuries from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) was used to assess the utility and strength of evidence, such as vehicle deformation and occupant injury of a particular severity and pattern, as a means of assessing the probability of an uncertain issue of interest. The issue of interest in Paper II was the seat position of the occupant at the time of a rollover crash (similar to Paper I), and the association that was investigated was the relationship between the degree of downward roof deformation and likelihood of a serious head and neck injury in the occupant. The analysis was directed at the circumstance in which a vehicle has sustained roof deformation on one side but not the other, and only one of the occupants has sustained a serious head or neck injury. In Paper III the issue of interest was whether an occupant was using a seat belt prior to being ejected from a passenger vehicle, when there was evidence that the seat belt could have unlatched during a crash, and thus it was uncertain whether the occupant was restrained and then ejected after the seat belt unlatched, or unrestrained. Of particular interest was the relative frequency of injury to the upper extremity closest to the side window (the outboard upper extremity [OUE]), as several prior authors have postulated that during ejection when the seat belt has become unlatched the retracting seat belt would invariably cinch around the OUE and cause serious injury.

    In Paper IV the focus of the analysis was the predictability of the distribution of skull and cervical spine fractures associated with fatal falls as a function of the fall circumstances. Swedish autopsy data were used as the source material for this study.

    Results In Paper I the indifferent pre-crash probability that the survivor was the driver (0.5) was modified by the evidence to arrive at a post-test odds of 19 to 1 that he was driving.

    In Paper II NASS-CDS data for 960 (unweighted) occupants of rollover crashes were included in the analysis. The association between downward roof deformation and head and neck injury severity (as represented by a composite numerical value [HNISS] ranging from 1 to 75) was as follows: for each unit increase of the HNISS there were increased odds of 4% that the occupant was exposed to >8 cm of roof crush versus <8 cm; 6% for >15 cm compared to <8 cm, and 11% for >30 cm of roof crush compared to <8 cm.

    In Paper III NASS-CDS data for 232,931 (weighted) ejected occupants were included in the analysis, with 497 coded as seat belt failures, and 232,434 coded as unbelted. Of the 7 injury types included in the analysis, only OUE and serious head injury were found to have a significant adjusted association with seat belt failure, (OR=3.87, [95% CI 1.2, 13.0] and 3.1, [95% CI 1.0, 9.7], respectively). The results were used to construct a table of post-test probabilities that combined the derived sensitivity and (1 - specificity) rates with a range of pre-crash seat belt use rates so that the results could be used in an investigation of a suspected case of belt latch failure.

    In Paper IV, the circumstances of 1,008 fatal falls were grouped in 3 categories of increasing fall height; falls occurring at ground level, falls from a height of <3 meters or down stairs, and falls from ≥3 meters. Logistic regression modeling revealed significantly increased odds of skull base and lower cervical fracture in the middle (<3 m) and upper (≥3 m) fall height groups, relative to ground level falls, as follows: (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). Additionally, C0-C1 dislocations were strongly related to fall height, with an OR of 8.3 for the injury in a ≥3 m fall versus ground level.

    Conclusions In this thesis 4 applications of FE methodology were described. In all of the applications epidemiologic data resulting from prior FM investigations were analyzed in order to draw probabilistic conclusions that could be reliably applied to the circumstances of a specific investigation. It is hoped that this thesis will serve to demonstrate the utility of FE in enhancing evidence-based practice in FM.

     

  • 195.
    Freeman, Michael D
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Everson, Todd M
    Kohles, Sean S
    Forensic epidemiologic and biomechanical analysis of a pelvic cavity blowour injury associated with ejection from a personal watercraft (Jet-Ski)2013In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 58, no 1, p. 237-244Article in journal (Refereed)
    Abstract [en]

    Jet-propelled personal watercraft (PWC) or jet-skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential for a unique type of injury mechanism. The most serious injuries associated with PWC falls are those that occur when the perineum passes in close proximity to the jet nozzle and the high-pressure water stream enters the vaginal or rectal orifice. We describe the forensic investigation into a case of an anovaginal "blowout" injury in a passenger who was ejected from the rear seat position of a PWC and subsequently suffered life-threatening injuries to the pelvic organs. The investigation included a biomechanical analysis of the injury mechanism, a summary of prior published reports of internal pelvic injuries resulting from PWC falls as well as other water sports and activities, and a comparison of the severity of the injuries resulting from differing mechanisms using the New Injury Severity Score (NISS). The mean (±standard deviation [SD]) NISS values for reported PWC injuries [not including the NISS of 38 in this case study] were 11.2 (±9.5), while the mean value for reported water-skiing falls was half that of the PWC group at 5.6 (±5.2). It was concluded that the analyzed injuries were unique to a PWC ejection versus other previously described non-PWC-associated water sport injuries. It is recommended that PWC manufacturers help consumers understand the potential risks to passengers with highly visible warnings and reduce injury risk with revised seat design, and/or passenger seat "deadman" switches.

  • 196.
    Freeman, Michael D
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Everson, Todd M
    Kohles, Sean S
    Forensic epidemiologic and biomechanical analysis of a pelvic cavity blowout injury associated with ejection from a personal watercraft (Jet-ski)2012In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 58, no 1, p. 237-244Article in journal (Refereed)
    Abstract [en]

    Jet-propelled personal watercraft (PWC) or jet-skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential for a unique type of injury mechanism. The most serious injuries associated with PWC falls are those that occur when the perineum passes in close proximity to the jet nozzle and the high-pressure water stream enters the vaginal or rectal orifice. We describe the forensic investigation into a case of an anovaginal "blowout" injury in a passenger who was ejected from the rear seat position of a PWC and subsequently suffered life-threatening injuries to the pelvic organs. The investigation included a biomechanical analysis of the injury mechanism, a summary of prior published reports of internal pelvic injuries resulting from PWC falls as well as other water sports and activities, and a comparison of the severity of the injuries resulting from differing mechanisms using the New Injury Severity Score (NISS). The mean (± standard deviation [SD]) NISS values for reported PWC injuries [not including the NISS of 38 in this case study] were 11.2 (± 9.5), while the mean value for reported water-skiing falls was half that of the PWC group at 5.6 (± 5.2). It was concluded that the analyzed injuries were unique to a PWC ejection versus other previously described non-PWC-associated water sport injuries. It is recommended that PWC manufacturers help consumers understand the potential risks to passengers with highly visible warnings and reduce injury risk with revised seat design, and/or passenger seat "deadman" switches.

  • 197.
    Freeman, Michael
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Dobbertin, K
    Kohles, SS
    Uhrenholt, L
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Serious head and neck injury as a predictor of occupant position in fatal rollover crashes2012In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 222, no 1-3, p. 228-233Article in journal (Refereed)
    Abstract [en]

    Serious head and neck injuries are a common finding in fatalities associated with rollover crashes. In some fatal rollover crashes, particularly when ejection occurs, the determination of which occupant was driving at the time of the crash may be uncertain. In the present investigation, we describe the analysis of rollover crash data from the National Automotive Sampling System-Crashworthiness Data System for the years 1997 through 2007 in which we examined the relationship between a serious head and neck injury in an occupant and a specified degree of roof deformation at theoccupant's seating position. We found 960 occupants who qualified for the analysis, with 142 deaths among the subjects. Using a ranked compositehead and neck injury score (the HNISS) we found a strong relationship between HNISS and the degree of roof crush. As a result of the analysis, we arrived at a predictive model, in which each additional unit increase in HNISS equated to an increased odds of roof crush as follows: for ≥8cm of roof crush compared with <8cm by 4%, for ≥15cm of roof crush compared to <8cm by 6% and for ≥30cm of roof crush compared to <8cm by 11%. We describe two hypothetical scenarios in which the model could be applied to the real world investigation of occupant position in a rollover crash-related fatality.

  • 198.
    Freeman, Michael
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Leith, Wendy
    Head and neck injury patterns in fatal falls: epidemiologic and biomechanical considerations2014In: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 21, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck. In the present study, we accessed data regarding head and neck fractures resulting from fatal falls from a Swedish autopsy database for the years 1992–2010, for the purposes of examining the relationships between skull and cervical spine fracture distribution and the circumstances of the fatal fall.

    Out of 102,310 medico-legal autopsies performed there were 1008 cases of falls associated with skull or cervical spine fractures. The circumstances of the falls were grouped in 3 statistically homogenous categories; falls occurring at ground level, falls from a height of <3 m or down stairs, and falls from ≥3 m. Only head and neck injuries and fractures that were associated with the fatal CNS injuries were included for study, and categorized as skull vault and skull base fractures, upper cervical injuries (C0–C1 dislocation, C1 and C2 fractures), and lower cervical fractures. Logistic regression modeling revealed increased odds of skull base and lower cervical fracture in the middle and upper fall severity groups, relative to ground level falls (lower cervical <3 m falls, OR = 2.55 [1.32, 4.92]; lower cervical ≥3 m falls, OR = 2.23 [0.98, 5.08]; skull base <3 m falls, OR = 1.82 [1.32, 2.50]; skull base ≥3 m falls, OR = 2.30 [1.55, 3.40]). C0–C1 dislocations were strongly related to fall height, with an OR of 8.3 for ≥3 m falls versus ground level. The findings of increased odds of skull base and lower cervical spine fracture in falls from a height are consistent with prior observations that the risk of such injuries is related to the degree of victim inversion at impact. The finding that C0–C1 dislocations are most common in falls from more than 3 m is unique, an indication that the injuries likely result from high energy shear forces rather than pure tension, as previously thought.

  • 199.
    Freeman, Michael
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine. Department of Public Health & Preventive Medicine, Oregon Health & Science University, Portland, OR; Department of Forensic Medicine, Aarhus University, Aarhus, Denmark.
    Eriksson, Anders
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Leith, Wendy
    Injury pattern as an indication of seat belt failure in ejected vehicle occupants2014In: Journal of Forensic Sciences, ISSN 0022-1198, E-ISSN 1556-4029, Vol. 59, no 5, p. 1271-1274Article in journal (Refereed)
    Abstract [en]

    Prior authors have suggested that when occupant ejection occurs in association with a seat belt failure, entanglement of the outboard upper extremity (OUE) with the retracting shoulder belt will invariably occur, leaving injury pattern evidence of belt use. In the present investigation, the authors assessed this theory using data accessed from the NASS-CDS for ejected front seat occupants of passenger vehicles. Logistic regression models were used to assess the associations between seat belt failure status and injuries. Injury types associated with seat belt failure were significant OUE and head injuries (OR=3.87, [95% CI 1.2, 13.0] and 3.1, [95% CI 1.0, 9.7], respectively). The two injury types were found to be a predictor of seat belt use and subsequent failure only if combined with a high (0.8) precrash probability of belt use. The injury pattern associated with a seat belt failure-related ejection has limited use in the forensic investigation of crash-related ejections.

  • 200.
    Freeman, Michael
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Hand, ML
    Rossignol, AM
    Applied forensic epidemiology: a Bayesian evaluation of forensic evidence in a vehicular homicide investigation2009In: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 16, no 2, p. 83-92Article in journal (Refereed)
    Abstract [en]

    The comparative weighting of evidence in a criminal case can be a complicated task when the relevance or meaning of the evidence is disputed. An example of this complexity in seen in vehicular homicide investigations in which the identity of the driver (and thus the guilty party) is not clear. The discipline of Forensic Epidemiology, including the appropriate application of Bayes' Theorem (Bayes' Law) provides a systematic framework to bring clarity to the evaluation of such matters. Bayes' is a useful tool for the conditioning and quantification of probabilities associated with evidence in a vehicular homicide investigation. The authors present a case study in the application of Bayes' Theorem to the facts in a vehicular homicide investigation. An initial analysis of the crash dynamics in comparison with the injury pattern and ejection status of the surviving occupant versus that of the decedent suggested that the survivor was the driver. The results of the analysis were used as tests for guilt, with estimated true and false positive rates, which then formed the basis for a Bayesian calculation of the posterior probability of the survivor's guilt given the evidence. As a result of the Bayesian analysis described herein, it was determined that the survivor was 19 times more likely to have been the driver, in comparison with the decedent. This ratio far exceeded the suggested threshold of 10:1 for establishing the guilt of the survivor beyond a reasonable doubt. When used properly, Bayes' Theorem can offer definitive insight in the investigation and prosecution of vehicular homicide cases.

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