| 1. |
- Björling, Gunilla, Docent, et al.
(författare)
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Tracheostomy inner cannula care : a randomized crossover study of two decontamination procedures
- 2007
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 35:9, s. 600-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Today several methods for decontaminating inner cannulae exist. These methods are not based on scientific data, but often on local clinical tradition. This study compares two different decontamination methods. The aim was to find a practical and safe decontamination method. It is a randomized, single-blinded, comparative crossover study. METHODS: Fifty outpatients with long-term tracheostomy with an inner cannula were consecutively included and randomly allocated to begin with one of two different treatment sequences: detergent and chlorhexidine-alcohol (A) or detergent (B). Samples for bacterial culture were taken before and after decontamination, and the number of bacteria colonies was counted. RESULTS: Before decontamination, the inner cannulae grew high numbers of bacteria, which were parts of the normal flora of the upper respiratory tract and did not differ significantly between the two sequences (AB; BA). The primary variable was the culture count value after chlorhexidine-alcohol/detergent (A) and detergent (B). The effects of both methods were larger than expected, and the results showed a nearly total elimination of organisms. The equivalence criterion, ratio of mean colony counts (A/B) >0.8, was met at a significance level of P<0.001. CONCLUSIONS: Cleaning the tracheostomy inner cannula with detergent and water is sufficient to achieve decontamination.
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| 2. |
- Bryce, Elizabeth, et al.
(författare)
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Impact of a mandated provincial hand hygiene program: Messages from the field.
- 2014
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 1527-3296 .- 0196-6553. ; 42:7, s. 708-712
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Tidskriftsartikel (refereegranskat)abstract
- The British Columbia Provincial Hand Hygiene Working Group was formed in September 2010 and tasked with the development and implementation of a provincial hand hygiene (HH) program for health care.
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| 3. |
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| 4. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Patients' experiences of acquiring a deep surgical site infection : An interview study
- 2010
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Ingår i: American Journal of Infection Control. - : Mosby, Inc.. - 0196-6553 .- 1527-3296. ; 38:9, s. 711-717
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Tidskriftsartikel (refereegranskat)abstract
- Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients’ experiences of SSI, the aim of the present study was to describe patients’ experiences of acquiring a deep SSI. Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.
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| 5. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Traffic flow in the operating room : An explorative and descriptive study on air quality during orthopedic trauma implant surgery
- 2012
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 40:8, s. 750-755
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Tidskriftsartikel (refereegranskat)abstract
- Background:Understanding the protective potential of operating room (OR) ventilation under different conditions is crucial to optimizing the surgical environment. This study investigated the air quality, expressed as colony-forming units (CFU)/m³, during orthopedic trauma surgery in a displacementventilated OR; explored how traffic flow and the number of persons present in the OR affects the air contamination rate in the vicinity of surgical wounds; and identified reasons for door openings in the OR.Methods:Data collection, consisting of active air sampling and observations, was performed during 30 orthopedic procedures.Results:In 52 of the 91 air samples collected (57%), the CFU/m³ values exceeded the recommended level of <10 CFU/m³. In addition, the data showed a strongly positive correlation between the total CFU/m³ per operation and total traffic flow per operation (r=0.74;P=.001; n=24), after controlling for duration of surgery. A weaker, yet still positive correlation between CFU/m³ and the number of persons present in the OR (r=0.22;P=.04; n=82) was also found. Traffic flow, number of persons present, and duration of surgery explained 68% of the variance in total CFU/m³ (P=.001).Conclusions:Traffic flow has a strong negative impact on the OR environment. The results of this study support interventions aimed at preventing surgical site infections by reducing traffic flow in the OR.
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| 6. |
- Granqvist, Karin, 1974, et al.
(författare)
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Learning to interact with new technology: Health care workers’ experiences of using a monitoring system for assessing hand hygiene – a grounded theory study
- 2022
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 50:6, s. 651-656
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently, innovative technologies for hand hygiene (HH) monitoring have been developed to improve HH adherence in health care. This study explored health care workers’ experiences of using an electronic monitoring system to assess HH adherence. Methods: An electronic monitoring system with digital feedback was installed on a surgical ward and interviews with health care workers using the system (n = 17) were conducted. The data were analyzed according to grounded theory by Strauss and Corbin. Results: Health care workers’ experiences were expressed in terms of having trust in the monitoring system, requesting system functionality and ease of use and becoming aware of one's own performance. This resulted in the core category of learning to interact with new technology, summarized as the main strategy when using an electronic monitoring system in clinical settings. The system with digital feedback improved the awareness of HH and individual feedback was preferable to group feedback. Conclusions: Being involved in using and managing a technical innovation for assessing HH adherence in health care is a process of formulating a strategy for learning to interact with new technology. The importance of inviting health care workers to participate in the co-design of technical innovations is crucial, as it creates both trust in the innovation per se and trust in the process of learning how to use it.
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| 7. |
- Hammarskjöld, Fredrik, et al.
(författare)
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Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team
- 2014
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 42:2, s. 122-128
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. Methods: We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors. Results: A total of 2,772 CVCs was used during the study period. Data on culture results and catheterization time were available for 2,045 CVCs used in 1,674 patients. The incidences of colonization, CRI, and CRBSI were 7.0, 2.2, and 0.6 per 1,000 CVC-days, respectively. Analysis of quarterly incidences revealed 1 occasion with increasing infection rates. Catheterization time was a risk factor for CRI but not for CRBSI. Other risk factors for CRI were hemodialysis and CVC use in the internal jugular vein compared with the subclavian vein. Hemodialysis was the only risk factor for CRBSI. Conclusion: We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.
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| 8. |
- Lindsjö, Cecilia, et al.
(författare)
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Surgical site infections, occurrence, and risk factors, before and after an alcohol-based handrub intervention in a general surgical department in a rural hospital in Ujjain, India
- 2015
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 43:11, s. 1184-1189
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Tidskriftsartikel (refereegranskat)abstract
- Background: This study set out to determine occurrence of and risk factors for surgical site infections (SSIs) before and after implementation of an alcohol-based handrub (ABHR) intervention in general surgery wards in a rural, tertiary care hospital in India. Methods: Patients who underwent surgery between October 2010 and August 2011 (preintervention period) or September 2011 and August 2013 (intervention period) in the department of surgery were included. ABHR was introduced in September 2011. SSI was defined as per the Centers for Disease Control and Prevention guidelines. Comparison of SSI rate between the 2 periods was performed using analysis of variance. Risk factors were determined using multiple logistic regression models. Results: Incidence of SSI was 5% (36/720) and 6.5% (103/1,581) respectively, showing nonsignificant difference (P = .5735). The risk factor common for SSI in both periods was the duration of surgery (OR = 2.6 vs OR = 1.96, pre- and intervention periods, respectively). Risk factors in the intervention period were being a woman (OR = 2.18), renal disease (OR = 3.61), diabetes (OR = 4.43), smoking (OR = 2.14), preoperative hospitalization (<3 vs >15 days; OR = 3.22), and previous hospitalization (OR = 3.5). Compared with other studies, the amount of ABHR used in our study was low. Conclusion: The amount of ABHR used might not be sufficient to interrupt the chain of contamination of microorganisms; therefore, continuation of the intervention and surveillance is recommended.
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| 9. |
- Lytsy, Birgitta, et al.
(författare)
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A joint, multilateral approach to improve compliance with hand hygiene in 4 countries within the Baltic region using the World Health Organization's SAVE LIVES : Clean Your Hands model
- 2016
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 44:11, s. 1208-1213
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this prospective multicenter study was to explore the usefulness of a modified World Health Organization (WHO) hand hygiene program to increase compliance with hand hygiene among health care workers (HCWs) in Latvia, Lithuania, Saint Petersburg (Russia), and Sweden and to provide a basis for continuing promotion of hand hygiene in these countries. The study was carried out in 2012. Thirteen hospitals participated, including 38 wards. Methods: Outcome data were handrub consumption, compliance with hand hygiene measured with a modified WHO method, and assessment of knowledge among HCWs. Interventions were education of the nursing staff, posters and reminders in strategic places in the wards, and feedback of the results to nursing staff in ward meetings. Results: Feedback of results was an effective tool for education at the ward level. The most useful outcome measurement was handrub consumption, which increased by at least 50% in 30% of the wards. In spite of this, handrub consumption remained at a low level in many of the wards. Conclusions: There are several reasons for this, and the most important were self-reported nursing staff shortage and fear of adverse effects from using alcoholic handrub and verified skin irritation. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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| 10. |
- Mernelius, Sara, et al.
(författare)
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Compliance with hygiene guidelines : The effect of a multimodal hygiene intervention and validation of direct observations
- 2013
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 41:5, s. E45-E48
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundGood compliance with hygiene guidelines is essential to prevent bacterial transmission and health care-associated infections. However, the compliance is usually <50%.MethodsA multimodal and multidisciplinary hygiene intervention was launched once the baseline compliance was determined through direct observations in 4 departments of obstetrics and gynecology. Detailed evaluations of the compliance rates were performed at point of stability (at 80%) and follow-up (3 years after hygiene intervention). Validation of direct observations was performed using blinded double appraisal and multiappraisal.ResultsAt baseline, the compliance with barrier precautions and the dress code at the 4 departments were 39% to 47% and 79% to 98%, respectively. Point of stability was reached approximately 1 year after the hygiene intervention was launched. The compliance with barrier precautions was significantly higher at follow-up compared with baseline in 3 departments. In the validation by double appraisal, 471 of 483 components were judged identical between observers. In the multiappraisal, 95% to 100% of the observers correctly judged the 7 components.ConclusionIt is possible to improve compliance with hygiene guidelines, but, to ensure a long-lasting effect, a continuous focus on barrier precautions is required. Observation is a valid method to monitor compliance.
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| 11. |
- Mernelius, Sara, et al.
(författare)
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The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: The Swedish Hygiene Intervention and Transmission of S aureus study
- 2013
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 41:7, s. 585-590
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Tidskriftsartikel (refereegranskat)abstract
- Background: Newborn infants are often colonized with Staphylococcus aureus originating from health care workers (HCWs). We therefore use colonization with S aureus of newborn infants to determine the effect of an improved compliance with hygiene guidelines on bacterial transmission. Methods: Compliance with hygiene guidelines was monitored prior to (baseline) and after (follow-up) a multimodal hygiene intervention in 4 departments of obstetrics and gynecology. spa typing was used to elucidate transmission routes of S aureus collected from newborn infants, mothers, fathers, staff members, and environment. Results: The compliance with hygiene guidelines increased significantly from baseline to follow-up. The transmission of S aureus from HCWs to infants was however not affected. Fathers had the highest colonization rates. Persistent carriage was indicated in 18% of the HCWs. The most commonly isolated spa type was t084, which was not detected in a previous study from the same geographic area. Conclusion: It is possible to substantially improve the compliance with hygiene guidelines, by using multimodal hygiene intervention. The improved compliance did not decrease the transmission of S aureus from sources outside the own family to newborn infants. Furthermore, we show the establishment of a new spa type (t084), which now is very common in our region. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
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| 12. |
- Pathak, Ashish, 1973-, et al.
(författare)
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Incidence and factors associated with surgical site infections in a teaching hospital in Ujjain, India
- 2014
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 42:1, s. E11-E15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Surgical site infections (SSI) are among the most commonly reported health care-associated infections; however, there is a paucity of data on SSI from India. This study aimed to determine the incidence of SSI and explore its associated factors at a teaching hospital in India. Methods: Direct and indirect surveillance methods, based on Centers for Disease Control and Prevention guidelines, were used to define SSI. Patients were followed up for 30 days postsurgery. Prescribing and resistance data were collected. Results: The SSI rate among the 720 patients investigated was 5%. Risk factors for SSI identified were as follows: severity of disease (P = .001), presence of drains (P = .020), history of previous hospitalization (P = .003), preoperative stay (P = .005), wound classification (P < .001), and surgical duration (P < .001). Independent risk factors identified included wound classification (odds ratio - 4.525; P <. 001) and surgical duration (odds ratio = 2.554; P = .015). Most patients (99%) were prescribed antibiotics. Metronidazole (24.5%), ciprofloxacin (11%), and amikacin (9%) were the most commonly prescribed antibiotics. Most commonly isolated bacteria were Staphylococcus aureus (n = 14), of which 34% were methicillin-resistant Staphylococcus aureus, and Pseudomonas aeruginosa (n = 6), which showed resistance to ceftazidime (70%), ciprofloxacin (63%), and gentamicin (57%). Conclusion: Incidence of SSI at the hospital was lower than reported in many low-and middle-income countries, although higher than reported in most high-income countries. Targeted implementation strategies to decrease incidence of preventable SSI are needed to further improve quality and safety of health care in this hospital and similar hospitals elsewhere.
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| 13. |
- Rahmqvist, Mikael, et al.
(författare)
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Direct health care costs and length of hospital stay related to health care-acquired infections in adult patients based on point prevalence measurements
- 2016
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Ingår i: American Journal of Infection Control. - : MOSBY-ELSEVIER. - 0196-6553 .- 1527-3296. ; 44:5, s. 500-506
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Tidskriftsartikel (refereegranskat)abstract
- Background: The incidence of health care-acquired infection (HAI) and the consequence for patients with HAI tend to vary from study to study. By including all patients, all medical specialties, and performing a follow-up analysis, this study contributes to previous findings in this research field. Methods: Data from the Swedish National Point Prevalence Surveys of HAI 2010-2012 was merged with cost per patient data from the county Health Care Register (N=6,823). Extended length of stay (LOS) and costs related to an HAI were adjusted for sex, age, intensive care unit use, and surgery. Results: Patients with HAI (n=732) had a larger proportion of readmissions compared with patients with no HAI (29.0% vs 16.5%). Of the total bed days, 9.3% was considered to be excess days attributed to the group of patients with an HAI. The excess LOS comprised 11.4% of the total costs (95% CI, 10.2-12.7). The 1-year overall mortality rate for patients with HAI in comparison to all other patients was 1.75 (95% CI, 1.45-2.11), all 5 of these differences were statistically significant (P<.001). Conclusions: Even if not all outcomes for patients with an HAI can be explained by the HAI itself, the increase in inpatient days, readmissions, associated costs, and higher mortality rates are quite notable. (C) 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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| 14. |
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| 15. |
- Stålfelt, Frans, 1995, et al.
(författare)
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Can particle counting replace conventional surveillance for airborne bacterial contamination assessments? A systematic review using narrative synthesis
- 2023
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Ingår i: AMERICAN JOURNAL OF INFECTION CONTROL. - : Elsevier Inc.. - 0196-6553 .- 1527-3296. ; 51:12, s. 1417-1424
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Forskningsöversikt (refereegranskat)abstract
- Background: Bacterial airborne contamination in the operating room during surgery indicates an increased risk for surgical site infection. The conventional surveillance method for bacteria in the air is by air sampling, plating, and counting of colony-forming units (CFU). Particle counting measures particles in the air, typically in sizes of 1-20 mu m, and has been suggested as an alternative to CFU measurements. The primary aim was to investigate the correlation between the number of airborne CFU and particles during surgery. The secondary aim was to explore whether different ventilation settings influence the correlation between CFU and particles. Methods: The databases Cochrane, Embase, and Medline were searched for relevant publications. Due to the heterogeneity of the data, meta-analysis was not possible and a narrative analysis was performed instead. Results: The review included 11 studies. Two of the studies (n = 2) reported strong correlation between particles and CFU (Rp = 0.76 and Rc = 0.74). The remaining studies observed moderate correlation (n = 3), low correlation (n = 3), or no correlation (n = 3). Based on the primary results from this study, ventilation attribution to distinguish the correlation between particles and CFU had no or little contribution. Conclusions: Due to the lack of convincing evidence of correlation and lack of high-quality studies performing measurements in a standardized way, the studies could not provide the necessary evidence that show that particle counting could be used as a substitution for conventional air bacterial assessment. Further studies are warranted to strengthen the conclusion.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
- Wiklund, Susanne, et al.
(författare)
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Staff experiences of caring for patients with extended-spectrum β-lactamase–producing bacteria : A qualitative study
- 2015
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 43:12, s. 1302-1309
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients who become carriers of antibiotic-resistant bacteria are sometimes stigmatized by health professionals. Staff members' fears of becoming infected could affect their willingness to care for these patients.METHODS:The purpose of this study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria. Assistant nurses, registered nurses, and physicians from acute care settings and nursing homes were interviewed. A modified version of Grounded Theory was used for the analysis.RESULTS:The analysis resulted in the core category "to operate as an expert in a chaotic environment" in acute care settings. Despite a lack of resources, hospital staff try to provide the best possible care for patients with ESBL. The analysis of the interviews in the nursing homes resulted in the core category "the employee who, despite uncertainty, provides good care." Despite some fear, and a lack of knowledge, the study participants tried to provide the residents with good care.CONCLUSION: Staff in acute care settings and nursing homes must have adequate knowledge and reasonable working conditions to be able to provide high-quality care for patients and residents who are ESBL carriers.
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| 20. |
- Wikström, Ewa, 1967, et al.
(författare)
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The Safe Hands Study: Implementing aseptic techniques in the operating room : Facilitating mechanisms for contextual negotiation and collective action
- 2019
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 47:3, s. 251-257
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques.METHODS: This study was set in a large operating room suite in a Swedish university hospital. The theory-driven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis.RESULTS: Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process.CONCLUSIONS: The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice.
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| 21. |
- Wistrand, Camilla, 1970-, et al.
(författare)
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Important interventions in the operating room to prevent bacterial contamination and surgical site infections
- 2022
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 50:9, s. 49-1054
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to explore interventions that Swedish operating room (OR) nurses considered important for the prevention of bacterial contamination and surgical site infections (SSIs).Methods: A web-based cross-sectional survey with an open-ended question was answered by OR nurses and analyzed using summative content analysis and descriptive statistics.Results:The OR nurses (n=890) worked within 11 surgical specialties and most of them worked at university hospitals (37%) or county hospitals (53%). The nurses described twelve important interventions to prevent bacterial contamination and SSI: skin disinfection (25.9%), the OR environment (18.2%), aseptic technique (16.4%), OR clothes (13.4%), draping (9.8%), preparation (6.1%), dressing (3.6%), basic hygiene (3.4%), normothermia (2.1%), communication (0.7%), knowledge (0.3%), and work strategies (0.2%).Discussion: Skin disinfection was considered the most important intervention in order to prevent bacterial contamination and SSI. The responses indicated that many nurses believed the patients’ skin to be sterile after the skin disinfection process. This is not a certainty, but skin disinfection does significantly decrease the amount of bacterial growth.Conclusions: This study shows that many OR nurses' interventions are in line with recommendations. Although, knowledge regarding the effect of skin disinfection needs further research and continued education.
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| 22. |
- Eriksson, Darek M., et al.
(författare)
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Organization information system : extending organizational cognition through intelligent artifacts
- 1996
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 27:3, s. 235-264
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Tidskriftsartikel (refereegranskat)abstract
- The question of investigation is, What can intelligent artifacts mean to a command system? By means of a theoretical synthesis of previous works, the present work starts with an epistemological discussion focused on systems thinking. With the organization in focus, an extrospective approach is taken in which a global discussion results in some implications for the organizational system design. This system is considered as a sociotechnological system; consequently, the nature of systems (i.e., complexity) and the nature of human beings (i.e., parts of the systems and who are to be served by the artifacts) are discussed. The result argues that intelligent artifacts can extend the intelligent behavior of organizations. Examples of computer system architecture and software architecture are given.
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| 23. |
- Hartung, Ronald, et al.
(författare)
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Knowledge representation for leadership stories
- 2007
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Ingår i: Cybernetics and systems. - : Taylor & Francis. - 0196-9722 .- 1087-6553. ; 38:5-6, s. 587-610
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Tidskriftsartikel (refereegranskat)abstract
- Leadership requires making decisions and implementing the results by influencing those being lead. The Personal Access to Leadership project, PAL, is constructing tools to assist leaders in creative ways and assisting the development of leaders. The tools are knowledge-based systems employing shallow understanding of the domain. The approaches used provide guidance, but do not generate solutions. One aspect that continues under exploration in PAL is the use of stories for training and guiding leaders. In order to make such support systems work, a representation is needed to enable locating useful stories related to the task of a leader. This article defines a model for story representation for the PAL tools, called the PAL tool IdeaLab. The IdeaLab is the tool to which stories are being added, as a help system to support and extend the user's thinking.
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| 24. |
- Håkansson, Anne, et al.
(författare)
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Using reengineering for knowledge-based systems
- 2007
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 38:8, s. 799-824
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Tidskriftsartikel (refereegranskat)abstract
- Reverse engineering, also called reengineering, is used to modify systems that have functioned for many years, but which can no longer accomplish their intended tasks and, therefore, need to be updated. Reverse engineering can support the modification and extension of the knowledge in an already existing system. However, this can be an intricate task for a large, complex and poorly documented knowledge-based system. The rules in the knowledge base must be gathered, analyzed and understood, but also checked for verification and validation. We introduce an approach that uses reverse engineering for the knowledge in knowledge-based systems. The knowledge is encapsulated in rules, facts and conclusions, and in the relationships between them. Reverse engineering also collects functionality and source code. The outcome of reverse engineering is a model of the knowledge base, the functionality and the source code connected to the rules. These models are presented in diagrams using a graphic representation similar to Unified Modeling Language and employing ontology. Ontology is applied on top of rules, facts and relationships. From the diagrams, test cases are generated during the reverse engineering process and adopted to verify and validate the system.
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| 25. |
- Ibrahim, Osama, et al.
(författare)
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SENSE4US Policy Modelling and Simulation Tool : Evaluation Use Case: Finland’s 2015 Asylum Seekers Crisis
- 2018
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Ingår i: Cybernetics and systems. - 0196-9722 .- 1087-6553.
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Tidskriftsartikel (refereegranskat)abstract
- A key challenge for policy planning and risk assessment in governmental institutions is to ensure that relevant information, expertise and knowledge are fully integrated and taken into account during the policy process. A systems thinking approach can help gathering and organizing the necessary policy intelligence and involving a diverse range of stakeholders. This study is done as part of a design-science research (DSR) project to build and evaluate a new systems tool for structuring of public policy problems and the design of policy options to be used by policy makers, analysts and researchers in governmental institutions and parliaments. The study aims at evaluation of the tool to establish its utility and efficacy for achieving its stated purpose and assess the end-user benefits. That is performed through application of the tool to analysis of a real public policy problem, Finnish government’s action in response to the rapidly growing numbers of asylum seekers entering Finland in recent years. The resulting simulation model allows designing a pathway for immigration policy that aims to mitigate the resulting problems.
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| 26. |
- Temmesfeld, M. J., et al.
(författare)
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Surgical helmets can be converted into efficient disinfectable powered air-purifying respirators
- 2022
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553. ; 50:6, s. 624-630
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Tidskriftsartikel (refereegranskat)abstract
- Background: Filtering facepiece respirators often fail to provide sufficient protection due to a poor fit. Powered air-purifying respirators (PAPRs) are not designed for healthcare personnel, and are challenging to disinfect. Surgical helmets (SH) are available in many United States hospitals but do not provide respiratory protection. Several modifications to SH have been suggested, but none are sufficiently compliant with safety and efficiency standards. The purpose of this investigation was the development of a filter adaptor, which converts SHs into efficient, safe, and disinfectable PAPRs. Methods: Four critical features were investigated close to regulatory requirements: total inward leakage of particles, CO2 concentrations, intra-helmet differential pressure, and automated disinfection. Results: The average total inward leakage in the 2 independent tests were 0.005% and 0.01%. CO2 concentrations were lower than in the original SH. The modification generates a positive differential pressure. The filter's performance was not compromised after 50 cycles in a sterilization machine. Discussion: The modified SH provides several hundred times better protection than FFP-3 masks. Conclusions: Surgical helmets can be modified into safe, efficient, and disinfectable PAPRs, suitable for HCP and the operating room in particular. They can play a role in the preparedness for upcoming events requiring efficient respiratory protection.
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| 27. |
- Triebig, Cornelia, et al.
(författare)
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Elements of a documentation framework for agent-based simulation models
- 2009
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Ingår i: Cybernetics and systems. - London : Taylor & Francis. - 0196-9722 .- 1087-6553. ; 40:5, s. 441-474
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Tidskriftsartikel (refereegranskat)abstract
- Sufficient and appropriate documentation of a simulation model forms an essential prerequisite for quality assessment as well as for activities of maintenance, reuse or reproduction of the model and its results. This is true for every simulation paradigm. However, in particular for agent-based simulations with their high degree of freedom in design, their usually complex behavior and interactions, high level of detail and heterogeneity, etc, documentation becomes indispensable, but also problematic.This paper contributes to general advancement of the methodological basis of agent-based simulations by presenting a structured way of documenting agent-based simulation models. We propose a documentation framework that consists of six different categories of model information: metadata, informal model characterization, model contents, expected simulation behavior, experimental frame and passed tests.
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| 28. |
- Verikas, Antanas, et al.
(författare)
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Image analysis and fuzzy integration applied to print quality assessment
- 2005
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Ingår i: Cybernetics and systems. - London : Taylor & Francis. - 0196-9722 .- 1087-6553. ; 36:6, s. 549-564
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Tidskriftsartikel (refereegranskat)abstract
- We present an image analysis and fuzzy integration based option for the assessment of print quality in rotogravure printing. Values of several print distortion attributes are evaluated employing image analysis procedures and then are aggregated into an overall print quality measure using fuzzy integration. The experimental investigations performed have shown that the print quality evaluations provided by the measure correlate well with the print quality rankings obtained from the expert. The developed tools are successfully used in printing shops for routine print quality control.
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| 29. |
- Xiong, Ning, et al.
(författare)
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Reactive tuning of target estimate accuracy in multisensor data fusion
- 2007
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 38:1, s. 83-103
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Tidskriftsartikel (refereegranskat)abstract
- Dealing with conflicting and target-specific requirements is an important issue in multisensor and multitarget tracking. This paper aims to allocate sensing resources among various targets in reaction to individual information requests. The proposed approach is to introduce agents for every relevant target responsible for its tracking. Such agents are expected to bargain with each other for a division of resources. A bilateral negotiation model is established for resource allocation in two-target tracking. The applications of agent negotiation to target covariance tuning are illustrated together with simulation results presented. Moreover, we suggest a way of organizing simultaneous one-to-one negotiations, making our negotiation model still applicable in scenarios of tracking more than two targets.
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| 30. |
- Xiong, Ning
(författare)
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Toward Coherent Matching in Case-Based Classification
- 2011
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 42:3, s. 198-214
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Tidskriftsartikel (refereegranskat)abstract
- Building suitable similarity models presents a key issue in developing case-based classification systems. A good similarity model should reflect the real usefulness of a previous case for solving a new problem. This article proposes a new approach to learning of similarity assessments by optimizing local compatibility functions. The goal is to achieve a set of matching functions that are coherent in the sense of most supportive evidences whereas least inconsistence when applied to the case library. The effectiveness of the presented method has been demonstrated by the evaluation results on a set of data sets in the University of California-Irvine (UCI) Machine Learning Repository.
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