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Stefan Johansson

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Blog Entries posted by Stefan Johansson

  1. Work with me!

    · Stefan Johansson · 11/30/2011 11:09 AM

    I work at a Karolinska unit located at Danderyd Hospital, with 10.000 deliveries per year, the largest delivery unit in Sweden.

    In fact, almost 10% of ALL Swedish babies are born here (110.000 Swedes are born/year)!

    We have several vacant positions for qualified neonatologists.

    Work with me!

    Applicants must speak Swedish or other Scandinavian languages. PM me for more info or email the head of the unit bjorn.westrup@karolinska.se

    Click here for more info in Swedish, and here for more info in English.
  5. Ten days have passed since the conference Evidence-based Neonatology closed, and all speakers and delegates travelled back to their 35 countries. We have not yet received the results from the course evaluation, but I believe the conference was a great success! At least, many delegates and speakers told us that it was!

    I hope we will not disappoint the many delegates who asked for the 2nd EBNEO conference...
    (click here to subscribe to email updates from www.ebneo.org)

    I am very happy we managed to make EBNEO happen. Our original plan was to house the conference at a venue in the archipelago. However, in March when we had to make the definite booking, the number of delegates was far from enough to make the event possible. And, I hereby admit... it was close that we cancelled the whole thing... but we decided to move meeting to Karolinska university hospital. "The rest is history"

    Personal impressions and reflections from these days:
    (if you feel uncertain about what I mean, see the conference at http://webbtv.nu/ebneo2011)


    Textbooks are out, Internet is the new cool
    Diagnostic tests for sepsis - there is no Holy grail. (but a combo of CRP, IL-8, and six other markers might do part of the trick)
    Catheter-related infections CAN be prevented.
    Hyperbilirubinemia is difficult to pronounce many times in a row, but it is important to have clear instructions how to handle it.
    CPAP is good for preterm infants. And surfactant too.
    Individual patient data meta-analysis, sounds boring but is a really cool tool!
    Hypothermia is safe and prevents brain injuries in some, but 50% of cooled babies still have an adverse outcome.
    Better drugs for treatment of neonatal seizures are needed.
    Inotropes starting on D are commonly used, but maybe we should use these drugs in alphabetical order instead. (adrenalin...)
    PDA treatment: there is no jury out. Yet.
    Oxygenation - don't use to much (term infant), AND don't use too little (preterm infants).
    Prevent BPD - and you don't need to treat it.
    iNO in preterm infants: so much effort into the EUNO study for... nada.
    Want to reduce NEC - travel to Japan!
    Prevent pain. If this is not possible, treat it well!
    ROP? www.winrop.com
    Does family-centered care make dads sad?
    Questionnaire on priorities - it is important to know what the parents are thinking.
    Neonatal research idea? Think big! Think together!

  6. You can now view photos from EBNEO on flickr.com and also see the lectures on the web, open for all!

    The link to flickr is http://www.flickr.com/photos/ebneo, and the EBNEO web cast is online at http://www.webbtv.nu/ebneo2011. The web cast will be online during one year, till 1 June 2012. The web cast is available free of charge, but viewers need to submit their email address to see it.

    Please feel free to share the links to the photos and the web cast to your neonatal friends!


    BTW, in case you missed all tweets from the conference: http://twitter.com/ebneo



  8. Sometimes, taking a new direction make the unexpected happen.

    When we started 99nicu in May 2006, I did not think much about the long-term perspective. I just came up with "a brilliant idea" and convinced a few colleagues that we should start something good and useful. For the world. Ever since I was a medical student, working with international student exchange, I had believed in collaboration outside-the-local-box. When we meet, we get friends. And, friends help each other.

    During these five years, I have seen 99nicu develop into... something more than just a good and useful web site! We created a highly niched community, with a friendly athmosphere.

    Many people have asked for advice, but even more people have shared from their expertise. Geographical boundaries or time zones have not been limiting factors.

    For myself, 99nicu has changed my life. I have met new friends. I have learned about how neonatal medicine is practised around the world. And... I have been reading emails...

    Former and current 99nicu Team fellows, myself included, have spent many hours house-keeping the forums. But, as a community is made up of its members (I realize this sounds like some kind of communism, but it's true), 99nicu has thrived only thanks to you. Therefore, I want to salute you.
  10. In case you have missed this...

    Researchers at the Charité university hospital in Berlin, Germany, had (convinced?) a pregnant woman to deliver her baby in an MRI camera!

    Spectacular experiment! Creating buzz and headlines!

    If you ask me, this is a great combination of great PR work and serious research. Everyone involved gets fame and cred (also the baby I hope), and the research group will be granted to take their work to new heights. We need to learn more about the birthday, probably the most hazardous day in our lifes (if we don’t consider our very last day, lethal as it is...) The actual journey to life, so often complicated (as you know), needs more researched.

    Off-topic: while browsing the Charité web I found an extraordinary webcam. These German cranes make me... happy!
  12. Two years ago, I wrote about a large project that I initiated with another colleague and a "premiee"-parent, "Small child foundation" (Swe. Lilla barnet fond). The idea was to create a nation-wide charity foundation for research about newborn babies and their future health. Similar to March of Dimes. The "Lilla barnets fond" was officially founded late 2008, and since then we have worked hard (as volunteers) with strategic issues, including fund-raising and PR.

    This is a follow-up report with royal gossip!

    Yesterday we achieved a major milestone. The Swedish Prince Carl Philip, the official patron/protector of Lilla barnets fond, handed over the first research grants to the research projects, which were top-ranked by the foundation's scientific committee. In total, the researchers recieved 260.000 SEK (about 27500 EUR / 38000 USD).

    After the meeting, I and a few other board members met up with Prince Carl Philip and informed about our future ideas. Prince Carl Philip was very interested of neonatal care issues! He even wanted to be specifically involved in a future campaign...

    Picture? Here! And here!
  13. Cognitive surplus.
    Have not heard about it? Not me either until I read this article in Wired.

    Now I am reading the book "Cognitive surplus, creativity and generosity in a connected age". Clay Shirky outlines very interesting ideas. In fact, he explains why 99nicu has happened

    The equation is:
    Educated people, some free time, a motivation to share, the social nature of man and modern tools, these factors aggregate the cognitive surplus and create communities.

    Like lolcats on ICanHasCheezburger.com. Or much more serious sites. Like 99nicu.org

    Will write a full review later, just felt I wanted to share...
  14. Friday afternooon.
    Had just come home from holiday and rang up my friend and colleague. For a chat. He was still at work. The doctor on the on-call-schedule had not showed up. Mistake, but still!

    Tempted by the "short notice bonus" for the night shift (money can drive me to do things too...), I volunteered, went to the NICU, changed clothes and was handed over the new pager.

    The new pager - a massively bulky something! (new and modern technical things tends to get smaller and smaller. Maybe this was the exception from the rule).

    A calm evening. Went to bed at midnight. The pager went off at 3 am.

    Woke up, fiddled with the pager, looking at the large NOT-backlit LCD-screen in the dark. The telephone number was shown in the upper left corner with very tiny-tiny digits. Damn large screen, why the **** are the digits displayed so small in the upper left corner ??!!

    PRESBYOPIA, here I come... 8)
  15. When 99nicu opened in 2006, we were adopters of the main idea with Internet, the power of dialogue and sharing.
    Why not use that for professionals? And, we saw lots of possibilities and the sky was the limit.

    Today, professional social networks directed to staff in health care are becoming increasingly common and popular, and some of them have grown huge! Like www.sermo.com. (If you want to read an over-view of the largest sites, read this blog post by David Isaacson, community manager at doc2doc.)

    But, what responsibilities do individuals have, when experience and opinions from clinical scenarios are shared?

    I came across a thoughtful blog post by Bryan Vartabedian, pediatrician writing the blog www.33charts.com. He wrote:


    In principal, I completely agree that medical care can, and should, develop through web communities. In fact, we should view professional networks as complementary to other channels for information (such as Pubmed, textbooks, formal education, conferences, etc-etc). But, individual patient integrity comes above all, and as medical professionals, we need to take that integrity into consideration when we interact with colleagues on-line.

    How could we do this? My top list:


    ask the parents for consent
    anonymize all information
    change clinical details (or make new up) without significance for the question asked
    ask someone else (such as a friend working on the other side of the world) to submit the question
    report back to the parents about the "outcome" of your online consultation
  16. In my real-world-job as managing editor of the Swedish Medical Journal, I got an email from a reader regarding one of my editorials. I had written about general principles in the world of sports and that the world of health care have lessons to learn. For example, that the degree of success depends on the extent of practise, preparation, team work etc.
    (btw, greetings to Spain being World Cup Champs 2010, you're worth it )

    Anyway, this reader posted a video clip about how we feel motivation and you can view it below (takes 10 min of your life). We are increasingly becoming aware of that money is not the sole drive of motivation. "Autonomy", "masterity" and "purpose" are more important factors for work satisfaction. Importantly, these factors makes people contribute to fantastic projects like Wikipedia in their free time.

    In a recent issue of Wired, there is a similar topic covered by an article about the "Great Cognitive Surplus" - there is a revolution going on how we use our free time.

    Having said that, I want to share a new milestone from 99nicu, that there are now more than 3000 registered members.
    I want to acknowledge all people who share their expertise here! Motivation, that's the word!



  19. Mad about Mad Men

    · Stefan Johansson · 01/29/2010 02:10 PM

    I hardly ever follow TV-series. Hospital hours are not very compatible with that. In addition, I am boring enough to spare my TV sessions for News and Sports. During the previous decade, I can only remember that I saw Sopranos.

    I got a DVD-box for Christmas from my wife. Mad Men season 1. Not having heard about this series, I was blank to what to expect. Now, we have both become Mad Men junkies...

    For those of you who don't know about this TV-series (as I did not): the story is about an advertising firm in New York City in the 1960s. How life is evolving around work and family life. How lives can crack and fall apart. How lies work. And don't work.

    View the introductionary graphics on Youtube...


    As all good things are subjected to parody... a Simpsons Mad Men version can also be seen on Youtube!
    http://www.youtube.com/watch?v=KcmM7Jh2Y3k

    PS. Due to copyright restrictions, I could not embed the clips above. You have to go to Youtube to view them.
  20. Four years ago, I got an idea to start an Internet community for neonatal staff. At that time I was a member of a Swedish Mac-computer community and had realized that web-based professional networks can become great resources. (BTW, this is pre-historical times of today's Social Media-hype.)

    I convinced a few of my friends in the NICU at Karolinska to spend MUCH time to set the whole thing up...
    The 11th of May 2006 was the official opening!

    It is hard to summarize the development during the past four years, but it is a fact that 99nicu has grown steadily. On average, 2 new member have registered every day since the start. We now count more than 200 unique visitors and more than 4000 page visits. Per day!

    But, 99nicu is more than numbers. Personally, I do not care about web statistics, when I think about what a community for neonatal staff can achieve. With the bulk of knowledge that has been shared here, for the good of the tiny babies that we all care for in NICUs over the world. I know that advice given in the virtual NICU has had major impact on the outcomes for some infants. That matters to me.

    The future... well... think about 99nicu in evolutionary terms. We all (you and me and every single member) build this community. What happens here, depends on us.

    The funding... I am doctor, not a salesman, and there has not been a crowd of investors knocking on the door. Even though I have taken a big bite of the cake myself, 99nicu has also been funded by individual members making small donations (become a supporting member here!) and by educational grants from commercial companies. These latter contributions have been essential for our maintenance costs. Thanks!

    Finally, I would like to acknowledge:


    all members who have contributed with ideas, advice and supportive words
    the original Team for believing in this crazy idea in the first place
    the current Team - without your efforts, 99nicu would not be the same. Maybe not at all!
    wife and son for understanding that 99nicu is my contribution to a better world

    Greeting to all of you!
    /Stefan

    PS. Celibrate the Four Year Anniversary in the Lounge!
  22. I don't read many blogs, but I follow The Premie Experiment (http://thepreemieexperiment.blogspot.com/)
    and Science-Based Medicine (http://www.sciencebasedmedicine.org/)

    Still, there is one neonatal blog that I certainly miss, Neonatal Doc (http://neonataldoc.blogspot.com/)
    Whoever this person is, I would like to read more!
    If this whoever person reads this, please email me personally at stefan.johansson@ki.se
    would love to hear more from you and to offer you a anonymeous blog space here at 99nicu
  23. Most of us want to become parents. But, is it a human right to reproduce?

    Some people may argue in favour, but I am not sure I would. Despite the importance of reproduction itself (for all species, incl mammalians like Homo Sapiens), nothing can be taken for granted. In neonatal medicine we know that normality is not a 100% state, sometimes the other side of the coin shows up too.

    Generally, I would argue that we regard expecting and having children in a more respectful way. At least in the Swedish language, I dislike how some couples may express their future plans. Many couples say that they will "get children" (Swe. "skaffa barn") as if infants could be picked up somewhere. I like the phrase "having a child" (Swe. "vänta/få barn") much better, this phrase has a different deeper meaning. An infant is a gift, given to you.

  25. Ipad - where are you?!

    · Stefan Johansson · 04/03/2010 08:05 AM

    I live in Sweden. That's a non-Ipad-land. Probably for a long time. (2011?)

    I just browsed several of the reviews from Over There, and even Walt Mossberg at Wall Street Journal likes it. And David Pogue at NYT wrote two reviews, one for "techies" and one for everyone else!

    Come on Jobs - get the Ipad localised in Swedish (with åäö etc) and send me one!

    Video review....


    http://www.youtube.com/watch?v=_Y7_3H5B7DQ

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