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- Bani-Hani, Imad, et al.
(författare)
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A holistic view of value generation process in a SSBI environment : A service dominant logic perspective
- 2018
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Ingår i: Journal of Decision Systems. - : Taylor & Francis. - 1246-0125 .- 2116-7052. ; 27:S1, s. 46-55
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Tidskriftsartikel (refereegranskat)abstract
- Self-service business intelligence (SSBI) is an emerging trend in organisations allowing users to become more autonomous in data exploration. Organisations are keen to provide such services for their employees due to its potential benefits. However, there is little empirical knowledge about the process of building a SSBI service and the role of users in this process. From an exploratory single case study of a major Norwegian online marketplace and drawing on service-dominant logic as an analytical framework, we identify and explore two major phases of building a SSBI service: co-production and co-creation. Besides providing a rich description of these phases, this study also explores the way stakeholders are involved and embedded throughout the process of value generation.
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- Bertilsson, Emilie, et al.
(författare)
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Usage of do-not-attempt-to-resuscitate orders in a Swedish community hospital : patient involvement, documentation and compliance
- 2020
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Ingår i: BMC Medical Ethics. - : Springer. - 1472-6939. ; 21:1, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: To characterize patients dying in a community hospital with or without attempting cardiopulmonary resuscitation (CPR) and to describe patient involvement in, documentation of, and compliance with decisions on resuscitation (Do-not-attempt-to-resuscitate orders; DNAR).Methods: All patients who died in Kalmar County Hospital during January 1, 2016 until December 31, 2016 were included. All information from the patients’ electronic chart was analysed.Results: Of 660 patients (mean age 77.7 ± 12.1 years; range 21–101; median 79; 321 (48.6%) female), 30 (4.5%) were pronounced dead in the emergency department after out-of-hospital CPR. Of the remaining 630 patients a DNAR order had been documented in 558 patients (88.6%). Seventy had no DNAR order and 2 an explicit order to do CPR. In 43 of these 70 patients CPR was unsuccessfully attempted while the remaining 27 patients died without attempting CPR. In 2 of 558 (0.36%) patients CPR was attempted despite a DNAR order in place. In 412 patients (73.8%) the DNAR order had not been discussed with neither patient nor family/friends. Moreover, in 75 cases (13.4%) neither patient nor family/friends were even informed about the decision on code status.Conclusions: In general, a large percentage of patients in our study had a DNAR order in place (88.6%). However, 27 patients (4.3%) died without CPR attempt or DNAR order. DNAR orders had not been discussed with the patient/surrogate in almost three fourths of the patients. Further work has to be done to elucidate the barriers to discussions of CPR decisions with the patient.
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- Bremer, Anders, Docent, 1957-, et al.
(författare)
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Do-not-attempt-resuscitation orders : attitudes, perceptions and practices of Swedish physicians and nurses
- 2021
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Ingår i: BMC Medical Ethics. - : BioMed Central (BMC). - 1472-6939. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The values and attitudes of healthcare professionals influence their handling of ‘do-not-attempt- resuscitation’ (DNAR) orders. The aim of this study was a) to describe attitudes, perceptions and practices among Swedish physicians and nurses towards discussing cardiopulmonary resuscitation and DNAR orders with patients and their relatives, and b) to investigate if the physicians and nurses were familiar with the national ethical guidelines for cardiopulmonary resuscitation.Methods: This was a retrospective observational study based on a questionnaire and was conducted at 19 wards in two regional hospitals and one county hospital.Results: 210 physicians and 312 nurses (n = 522) responded to the questionnaire. Every third (35%) professional had read the guidelines with a lower proportion of physicians (29%) compared to nurses (38%). Around 40% of patients had the opportunity or ability to participate in the DNAR discussion. The DNAR decision was discussed with 38% of patients and the prognosis with 46%. Of the patients who were considered to have the ability to participate in the dis- cussion, 79% did so. The majority (81%) of physicians and nurses believed that patients should always be asked about their preferences before a DNAR decision was made.Conclusions: Swedish healthcare professionals take a patient’s autonomy into account regarding DNAR decisions. Nevertheless, as 50% of patients were considered unable to participate in the DNAR discussion, questions remain about the timing of patient participation and whether more discussions could have been conducted earlier. Given the uncertainty about timing, the majority of patients deemed competent participated in DNAR discussions.
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- Carlsson, Jörg, et al.
(författare)
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100-åringen som inte lät sig återupplivas
- 2015
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 112
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Sverige ligger efter i frågan om livstestamenten. Exemplet med 100-åringen här nedan bör även väcka tankar kring så kallade vårddirektiv. Ämnet är mycket större än fallet med 100-åringen, men vi måste börja någonstans, skriver Jörg Carlsson och Niels Lynøe.
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- Carlsson, Jörg, et al.
(författare)
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A two-peaked increase of serum myosin heavy chain-α after full distance triathlon demonstrates heart muscle cell death
- 2017
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Ingår i: Clinical Research in Cardiology. - : Springer. - 1861-0684 .- 1861-0692. ; 106:Suppl 1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is an ongoing debate about the significance of cardiac troponin T (cTnT) elevation after strenuous exercise: heart muscle cell death versus physiologic mechanism of release through an intact cell membrane. While cTnT is a small molecule (37 kDa), cardiac specific myosin heavy chain-alpha (MHC-α) is much larger (224 kDa) and an increase after exercise could hardly be explained by passage through an intact cardiac cell membrane. PURPOSE: To measure MHC-α, and other biomarkers (C-reactive protein (CRP); cTnT, creatine kinase (CK), myoglobin (MG), creatinine (C), and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) before and after a full distance Ironman in order to answer the question of heart muscle cell death versus physiologic changes. Methods: In 52 non-elite athletes (14 female, 38 male; age 41.1 ± 9.7, range 24-70 years; all completed the race) biomarkers were measured by standard laboratory methods 7 days before, directly after, and day 1, 4 and 6 after the race. MHC-α was measured with a commercially available ELISA with no cross reactivity with other myosins. Results: The course of MHC-α concentration [µg/L] was 1.33 ± 0.53 (before), 2.57 ± 0.78 (directly after), 1.51 ± 0.53 (day 1), 2.74 ± 0.55 (day 4) and 1.83 ± 0.76 (day 6). Other biomarkers showed a one-peaked increase with maximal values either directly after the race or at day 1: cTnT 76 ± 80 ng/L (12-440; reference <15), NT-proBNP 776 ± 684 ng/L (92-4700; ref. < 300), CK 68 ± 55 µkat/L (5-280; ref. < 1.9), MG 2088 ± 2350 µg/L (130-17000; ref.< 72), and creatinine 100 ± 20 µmol/L (74-161; ref. < 100), CRP 49 ± 23 mg/L (15-119; ref.< 5). There was a significant correlation between MHC-α and NT-proBNP (R=0.48; p<0.001) but neither between MHC-α and cTnT (R=0.13; p=0.36) nor MHC-α and myoglobin (R=0.18; p=0.2). Conclusion: An Ironman leads to remarkable disturbances in biomarkers as e.g. cTnT was in the range of myocardial infarction in 100% of women and 97% of men. This is to our best knowledge the first investigation of MHC-α after strenuous exercise and its two-peaked increase most likely represents first release from the cytosolic pool and later from cell necrosis including the contractile apparatus. However, many questions remain, not at least why MHC-α baseline levels are as high as 1.33 ± 0.53 µg/L.
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