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- Alassaad, Anna, 1977-, et al.
(författare)
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The effects of pharmacist intervention on emergency department visits in patients 80 years and older : subgroup analyses by number of prescribed drugs and appropriate prescribing
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:11, s. e111797-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Clinical pharmacist interventions have been shown to have positive effect on occurrence of drug-related issues as well as on clinical outcomes. However, evidence about which patients benefiting most from the interventions is limited. We aimed to explore whether pharmacist intervention is equally effective in preventing emergency department (ED) visits in patients with few or many prescribed drugs and in those with different levels of inappropriate prescribing. Methods: Patient and outcome data from a randomized controlled trial exploring the clinical effects of a ward-based pharmacist intervention in patients, 80 years and older, were used. The patients were divided into subgroups according to the number of prescribed drugs (< 5 or >= 5 drugs) and the level of inappropriate prescribing [using the Screening Tool Of Older People's potentially inappropriate Prescriptions (STOPP) and the Screening Tool to Alert doctors to Right Treatment (START) with a score of >= 2 (STOPP) and >= 1 (START) as cutoff points]. The effect of the intervention on the number of times the different subgroups visited the ED was analyzed. Results: The pharmacist intervention was more effective with respect to the number of subsequent ED visits in patients taking < 5 drugs on admission than in those taking >= 5 drugs. The rate ratio (RR) for a subsequent ED visit was 0.22 [95% confidence interval (CI) 0.09-0.52] for,5 drugs and 0.70 (95% CI 0.47-1.04) for >= 5 drugs (p = 0.02 for the interaction). The effect of intervention did not differ between patients with high or low STOPP or START scores. Conclusion: In this exploratory study, the pharmacist intervention appeared to be more effective in preventing visits to the ED for patients who were taking fewer drugs before the intervention. Our analysis of STOPP and START scores indicated that the level of inappropriate prescribing on admission had no effect on the outcomes of intervention with respect to ED visits.
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- Arehag, Marie, 1952, et al.
(författare)
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Outcomes-focused evaluation of engineering programs - Inhibitor or stimulant for improvement?
- 2013
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Ingår i: Proceedings of the 9th International CDIO Conference, Cambridge, USA.
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Konferensbidrag (refereegranskat)abstract
- In Sweden, a new model for quality evaluation of higher education is being introduced. It is internationally unique. A very strong emphasis on assessing the quality of an entire education through its outcomes, defined by samples of final degree reports, is perhaps the most original feature of the model. This is claimed to enable a direct assessment of quality rather than the indirect assessment used in conventional models. The model has, however, been intensively debated during its development and first years of use. The aims of this paper are first to evaluate in what ways and to what extent the Swedish national model for evaluation of higher education contributes to the quality improvement of the evaluated programs, and second to describe and evaluate an approach for organizing the project to prepare the evaluation documentation for a large-scale education evaluation. The paper concludes that on an overall and averaged level, the project participants estimated that the model will contribute to positive effects. Specific areas are identified including ethics and focus of final degree reports. However, there is a strong variance in the data: There is a substantial fraction of participants who have not identified any improvements or weak spots, and who do not think that the evaluation preparation will positively affect education quality development. Chalmers University of Technology chose to approach the evaluation with a centrally managed project. The setup gave possibilities for rationalization through common training, supporting materials, a common document database and for information sharing across departmental boundaries. Nevertheless, the project was very time-consuming with an average of 540 hours spent for each program/degree.
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- Danielsson, Rebecca, et al.
(författare)
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Effects on enteric methane production and bacterial and archaeal communities by the addition of cashew nut shell extract or glycerol-An in vitro evaluation
- 2014
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Ingår i: Journal of Dairy Science. - : American Dairy Science Association. - 0022-0302 .- 1525-3198. ; 97, s. 5729-5741
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Tidskriftsartikel (refereegranskat)abstract
- The objective of the study was to evaluate the effect of cashew nut shell extract (CNSE) and glycerol (purity >99%) on enteric methane (CH4) production and microbial communities in an automated gas in vitro system. Microbial communities from the in vitro system were compared with samples from the donor cows, in vivo. Inoculated rumen fluid was mixed with a diet with a 60:40 forage:concentrate ratio and, in total, 5 different treatments were set up: 5 mg of CNSE (CNSE-L), 10 mg of CNSE (CNSE-H), 15 mmol of glycerol/L (glycerol-L), and 30 mmol of glycerol/L (glycerol-H), and a control without feed additive. Gas samples were taken at 2, 4, 8, 24, 32, and 48 h of incubation, and the CH4 concentration was measured. Samples of rumen fluid were taken for volatile fatty acid analysis and for microbial sequence analyses after 8, 24, and 48 h of incubation. In vivo rumen samples from the cows were taken 2 h after the morning feeding at 3 consecutive days to compare the in vitro system with in vivo conditions. The gas data and data from microbial sequence analysis (454 sequencing) were analyzed using a mixed model and principal components analysis. These analyses illustrated that CH4 production was reduced with the CNSE treatment, by 8 and 18%, respectively, for the L and H concentration. Glycerol instead increased CH4 production by 8 and 12%, respectively, for the L and H concentration. The inhibition with CNSE could be due to the observed shift in bacterial population, possibly resulting in decreased production of hydrogen or formate, the methanogenic substrates. Alternatively the response could be explained by a shift in the methanogenic community. In the glycerol treatments, no main differences in bacterial or archaeal population were detected compared with the in vivo control. Thus, the increase in CH4 production may be explained by the increase in substrate in the in vitro system. The reduced CH4 production in vitro with CNSE suggests that CNSE can be a promising inhibitor of CH4 formation in the rumen of dairy cows.
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- Galt, Sheila, 1956, et al.
(författare)
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Rättvis examination – Stödjande eller styrande av lärande?
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Rättvis examination – Stödjande eller styrande av lärande? RundabordssamtalSheila Galt, MC2, bidrag till KUL 2013 Sammanfattning: Vi samtalar kring de ibland motverkande målsättningarna att rättvist examinera studenters lärande och att styra deras lärande till mer förståelse och djupinlärning. Hjälpmedel vid salstentamina belyses liksom användning av anti-plagiat verktyg. Offentlighetsprincipen och lärares ibland begränsade variation av tentamensfrågor diskuteras.Alla vet att studenter styrs starkt i sitt lärande av examinationens förväntade innehåll och form. [1] För att främja lärande finns mycket kunskap om examinationsformens betydelse. Å andra sidan vet vi att examinationsformen ofta avgör hur rättvis bedömningen anses vara. I denna workshop kommer vi att ställa rättviseaspekter mot den starka styrning av lärandet och reflektera över hur Chalmers traditionella salstentamina stödjer lärandeprocessen. Vi jämför med andra exempel på examinationsformer och begrundar styrningen av lärande som anti-plagiat verktyget Urkund ger.Frågan aktualiseras när regelverk för hjälpmedel vid salstentamina kommuniseras och tolkas. Vilken sorts lärande kan man rimligen examinera på en salstentamen? Finns det lärandemål vi måste examinera på annat sätt – och hur säkerställer vi en rättvis bedömning?Offentlighetsprincipen [2] inverkar på studenters lärandetaktik då gamla tentamensteser, lärarens lösningar och studenters lösningar får varierande grad av spridning och lättillgänglighet. Lärare brottas med behovet att tidseffektivt men rättvist examinera samma lärandemål år efter år. Memorering av andras lösningar premieras ibland oavsiktligt och frestelsen att bära med sig informationen på andra lagringsmedia än hjärnceller kan ibland vara svår.Hjälpmedel vid salstentamina av ”open book” karaktär [3] används av några lärare med motivering att ingenjörens verktyg ska i begränsad omfattning vara tillgängliga när ingenjörsfärdigheter testas. Studenterna får tyvärr ofta reaktionen att en del av lärandet kan skjutas upp till själva tentamensskrivningstiden, då allt ändå går att slå upp. Några lärare har valt att begränsa medförda anteckningar till att inte innehålla lösta tal, vilket har visat sig svårt att få en rättvis kontroll genomförd av tentamensvakterna. Vi har nu även ett regelverk som stipulerar att institutionen ska kunna erbjuda studenter låneexemplar av kursböcker i vissa fall. Allt detta behöver både problematiseras och förankras.Sammanfattningsvis behövs en kollegial diskussion av hur lärandet styrs av examinationsformen med bivillkoret att examinationen måste ske på ett rättvist sätt. [4]Referenser 1. Biggs, J. “Teaching for Quality Learning at University”, 2nd Ed., Open University Press, McGraw-Hill Education, 2003 2. HSV om Offentlighetsprincipen: http://www.hsv.se/reglerochtillsyn/vanligafragorochsvar/allmannahandlingar.4.5593f6be118cbb45b1b8000134.html 3. Agarwal, P. et. al. “Examining the Testing Effect with Open- and Closed-Book Tests”, Appl. Cognit. Psychol. 22: 861–876 (2008) http://memory.wustl.edu/Pubs/2008_Agarwal.pdf 4. HSV Rapport ”Rättssäker Examination” 2008:36 R http://www.hsv.se/download/18.5dc5cfca11dd92979c480001361/0836R.pdf
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- Grubisic, Lorena M., et al.
(författare)
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Effects of stratification depth and dissolved organic matter on brackish bacterioplankton communities
- 2012
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Ingår i: Marine Ecology Progress Series. - : Inter-Research Science Center. - 0171-8630 .- 1616-1599. ; 453, s. 37-48
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Tidskriftsartikel (refereegranskat)abstract
- Bacterioplankton growth is often directly or indirectly controlled by external energy subsidies via organic matter inputs or solar radiation. We carried out a mesocosm experiment to assess how bacterioplankton communities responded to elevated levels of dissolved organic matter (DOM) and experimentally controlled stratification depth. The month-long experiment consisted of 2500 l mesocosms subjected to 4 experimental manipulations in triplicate: the stratification depth was set to either 1.5 or 3.5 m, with or without experimental addition of ambient levels of chromophoric DOM. DOM addition had a significant effect on bacterial community composition as assessed by terminal restriction fragment length polymorphism of amplified 16S rRNA genes. In contrast, there were no effects of the DOM amendment on bacterial biomass or production. Mixing depth and the coupled effective light climate in the photic zone also had a significant effect on bacterial community composition. Furthermore, shallow mixing depth was associated with enhanced primary production, whereas DOM addition had a negative effect on phyto plankton biomass and productivity. Our results suggest that bacterial community composition is coupled to primary production under the studied coastal nutrient regime, and point to a key role of DOM quality in controlling bacterioplankton communities.
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- Nordberg, Gunnar F, et al.
(författare)
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Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers
- 2012
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Ingår i: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 2:5, s. e000973-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Exposure to trichloramine (NCl(3)) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is not known. (1) We determined lung function in volunteers before and after exposure to indoor pool environments. (2) We studied the occurrence of respiratory symptoms and asthma in a cohort of pool workers.DESIGN/METHODS/PARTICIPANTS: (1) We studied two groups of volunteers, 37 previously non-exposed healthy persons and 14 pool workers, who performed exercise for 2 h in an indoor pool environment. NCl(3) in air was measured during pool exposures and in 10 other pool environments. Filtered air exposures were used as controls. Lung function and biomarkers of pulmonary epithelial integrity were measured before and after exposure. (2) We mailed a questionnaire to 1741 persons who indicated in the Swedish census 1990 that they worked at indoor swimming-pools.RESULTS: (1) In previously non-exposed volunteers, statistically significant decreases in FEV(1) (forced expiratory volume) and FEV(%) (p=0.01 and 0.05, respectively) were found after exposure to pool air (0.23 mg/m(3) of NCl(3)). In pool workers, a statistically significant decrease in FEV(%) (p=0.003) was seen (but no significant change of FEV(1))(.) In the 10 other pool environments the median NCl(3) concentration was 0.18 mg/m(3). (2) Our nested case/control study in pool workers found an OR for asthma of 2.31 (95% CI 0.79 to 6.74) among those with the highest exposure. Exposure-related acute mucous membrane and respiratory symptoms were also found.CONCLUSIONS: This is the first study in adults showing statistically significant decreases in lung function after exposure to NCl(3). An increased OR for asthma among highly exposed pool workers did not reach statistical significance, but the combined evidence supports the notion that current workroom exposures may contribute to asthma development. Further research on sensitive groups is warranted.
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| 10. |
- Petersson, Karl-Johan, et al.
(författare)
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Two decades of selection for fat content in milk
- 2011
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Ingår i: Book of abstracts of the ... Annual Meeting of the European Federation of Animal Science. ; 17, s. 214-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)
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