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- Brandt, P., et al.
(författare)
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Välja och Förvalta Standardsystem
- 1998
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Bok (refereegranskat)abstract
- Standardsystem börjar alltmer användas som avancerade hjälpmedel för att effektivisera affärsverksamheten inom företag och organisationer. Här avses generella system som utvecklats av en leverantör för att kunna motsvara flera användares behov av IT-lösningar. Standardsystem är som regel parameterstyrda vilket ger en ökad flesibilitet vid användning och drift. En vanlig situation är att företag behöver förvalta flera standardsystem från olika leverantörer tillsammans med ett antal egenutvecklade system. En kritisk framgångsfaktor är att användarna i verskamheten, ADB-avdelningen och leverantörer kan samarbeta på ett professionellt sätt. Vi behöver därför ett systematiskt arbetssätt för att göra rätt saker, skapa ett kreativt klimat och fatta genomtänkta beslut. VFS-metoden för att "Välja och Förvalta Standardsystem" ger sådana möjligheter. VFS ger ett metodstöd för ett integrerat arbetssätt under systemets hela livscykel:- strategi- förstudie- utveckling- förvaltningSom underlag för styrning av dessa områden presenteras en konkret modell för projektarbete. VFS-metoden tar utgångspunkt i kundens situation. "Hur ska jag arbeta med standardsysstem för att nå ett bättre verksamhetsstöd i min organisation?" Boken avslutas med att blicka framåt över vad som händer i branschen och vilka förändringar av standadsystem som kan skönjas. I boken presenteras resultaten från en leverantörsstudie med fokus på två intressanta trender på marknaden, nämligen utvecklingen mot långsiktiga affärsrelationer och så kallade komponentbaserade standardsystem
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- Hillman, J, et al.
(författare)
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Overall management outcome of ruptured posterior fossa aneurysms
- 1996
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Ingår i: Journal of neurosurgery. - : Journal of Neurosurgery Publishing Group (JNSPG). - 0022-3085. ; 85:1, s. 33-38
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Tidskriftsartikel (refereegranskat)abstract
- ✓ A study of the overall management of ruptured posterior fossa aneurysms was conducted over a 1-year period (1993) in five neurosurgical centers in Sweden, serving a population of 6.93 million people. Forty-nine cases were identified and treated. One-third of the patients were in the seventh or eighth decade of life. Good overall management outcomes at 6 months were achieved in 30 cases (61%). The overall mortality rate was 27%. Patients with Hunt and Hess Grades I and II had a good overall recovery rate of 87%. On admission, 69% of the patients were assigned Hunt and Hess Grades III to V. The impact on patient outcomes of the intraoperative difficulties encountered, especially in the basilar tip area, is stressed. The authors found that delayed operation is not warranted in most cases. Frequent devastating rebleeding was observed among patients not offered early aneurysm clipping and the operative results were not at significant variance between the early and late surgical groups. Only 50% of the patients scheduled for delayed surgery ultimately made a good recovery, whereas 72% of patients scheduled for early operation did so. The data demonstrate that overall management results with posterior fossa aneurysms, comparable to achievements with supratentorial lesions, are within the reach of modern strategies, even in centers not specializing in these problems.
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- Hunter, D J, et al.
(författare)
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Non-dietary factors as risk factors for breast cancer, and as effect modifiers of the association of fat intake and risk of breast cancer
- 1997
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 0957-5243 .- 1573-7225. ; 8:1, s. 49-56
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Tidskriftsartikel (refereegranskat)abstract
- To assess more precisely the relative risks associated with established risk factors for breast cancer, and whether the association between dietary fat and breast cancer risk varies according to levels of these risk factors, we pooled primary data from six prospective studies in North America and Western Europe in which individual estimates of dietary fat intake had been obtained by validated food-frequency questionnaires. Based on information from 322,647 women among whom 4,827 cases occurred during follow-up: the multivariate-adjusted risk of late menarche (age 15 years or more compared with under 12) was 0.72 (95 percent confidence interval [CI] = 0.62-0.82); of being postmenopausal was 0.82 (CI = 0.69-0.97); of high parity (three or more births compared with none) was 0.72 (CI = 0.61-0.86); of late age at first birth (over 30 years of age compared with 20 or under) was 1.46 (CI = 1.22-1.75); of benign breast disease was 1.53 (CI = 1.41-1.65); of maternal history of breast cancer was 1.38 (CI = 1.14-1.67); and history of a sister with breast cancer was 1.47 (CI = 1.27-1.70). Greater duration of schooling (more than high-school graduation compared with less than high-school graduation) was associated significantly with higher risk in age-adjusted analyses, but was attenuated after controlling for other risk factors. Total fat intake (adjusted for energy consumption) was not associated significantly with breast cancer risk in any strata of these non-dietary risk factors. We observed a marginally significant interaction between total fat intake and risk of breast cancer according to history of benign breast disease; with fat intake being associated nonsignificantly positively with risk among women with a previous history of benign breast disease; no other significant interactions were observed. Risks for reproductive factors were similar to those observed in case-control studies; relative risks for family history of breast cancer were lower. We found no clear evidence in any subgroups of a major relation between total energy-adjusted fat intake and breast cancer risk.
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- Nilsson, O G, et al.
(författare)
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Bedside detection of brain ischemia using intracerebral microdialysis : subarachnoid hemorrhage and delayed ischemic deterioration
- 1999
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Ingår i: Neurosurgery. - : Ovid Technologies (Wolters Kluwer Health). - 0148-396X .- 1524-4040. ; 45:5, s. 84-1176
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Intracerebral microdialysis has been demonstrated to be a useful method for detection of brain ischemia in experimental models and in patients. We have applied new mobile microdialysate analysis equipment that allows a bedside comparison of changes in neurochemistry with the neurological status of the patient. Ten patients with severe aneurysmal subarachnoid hemorrhage (that is, with a high risk of vasospasm and a high risk of subsequent ischemic deficits) were selected.METHODS: Microdialysis catheters were inserted into the temporal and subfrontal cortex at the end of aneurysm surgery. Samples, collected hourly for 4 to 11 days, were analyzed immediately at the bedside for glucose, lactate, and glycerol and later for pyruvate and glutamate. The patients' neurological status was monitored constantly, and daily recordings of blood flow velocities were performed using transcranial Doppler sonography.RESULTS: Concentrations of the measured substances varied widely. Individual analyses revealed that patients with uneventful clinical courses generally demonstrated low and stable levels of the different metabolites, and those with signs of cerebral ischemia demonstrated various patterns of neurochemical changes. Lactate and glutamate seemed to be sensitive markers of impending ischemia, and increased glycerol levels were associated with severe ischemic deficits. Obtaining the microdialysis data directly at the bedside seemed to be of great advantage when relating the values to other clinical findings.CONCLUSION: Bedside intracerebral microdialysis monitoring of patients with subarachnoid hemorrhage and signs of delayed ischemia revealed dramatic changes in extracellular concentrations of glucose, lactate, and glycerol that could be directly correlated to the clinical status of the patients. These findings emphasize the potential of microdialysis in neurosurgical intensive care patients.
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