| 1. |
- Axelsson, Christer, et al.
(författare)
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The Early Chain of Care in Patients with Bacteraemia with the Emphasis on the Prehospital Setting
- 2016
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Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press. - 1049-023X .- 1945-1938. ; 31:3, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about the early phase of severe infection. This report describes the early chain of care in bacteraemia as follows: (a) compare patients who were and were not transported by the Emergency Medical Services (EMS); (b) describe various aspects of the EMS chain; and (c) describe factors of importance for the delay to the start of intravenous antibiotics. It was hypothesized that, for patients with suspected sepsis judged by the EMS clinician, the delay until the onset of antibiotic treatment would be shorter.All patients in the Municipality of Gothenburg (Sweden) with a positive blood culture, when assessed at the Laboratory of Bacteriology in the Municipality of Gothenburg, from February 1 through April 30, 2012 took part in the survey.In all, 696 patients fulfilled the inclusion criteria. Their mean age was 76 years and 52% were men. Of all patients, 308 (44%) had been in contact with the EMS and/or the emergency department (ED). Of these 308 patients, 232 (75%) were transported by the EMS and 188 (61%) had “true pathogens” in blood cultures. Patients who were transported by the EMS were older, included more men, and suffered from more severe symptoms and signs.The EMS nurse suspected sepsis in only six percent of the cases. These patients had a delay from arrival at hospital until the start of antibiotics of one hour and 19 minutes versus three hours and 21 minutes among the remaining patients (P =.0006). The corresponding figures for cases with “true pathogens” were one hour and 19 minutes versus three hours and 15 minutes (P =.009).Among patients with bacteraemia, 75% used the EMS, and these patients were older, included more men, and suffered from more severe symptoms and signs. The EMS nurse suspected sepsis in six percent of cases. Regardless of whether or not patients with true pathogens were isolated, a suspicion of sepsis by the EMS clinician at the scene was associated with a shorter delay to the start of antibiotic treatment.
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| 2. |
- Bridel, Claire, et al.
(författare)
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Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology : A Systematic Review and Meta-analysis
- 2019
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 76:9, s. 1035-1048
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Forskningsöversikt (refereegranskat)abstract
- Importance Neurofilament light protein (NfL) is elevated in cerebrospinal fluid (CSF) of a number of neurological conditions compared with healthy controls (HC) and is a candidate biomarker for neuroaxonal damage. The influence of age and sex is largely unknown, and levels across neurological disorders have not been compared systematically to date.Objectives To assess the associations of age, sex, and diagnosis with NfL in CSF (cNfL) and to evaluate its potential in discriminating clinically similar conditions.Data Sources PubMed was searched for studies published between January 1, 2006, and January 1, 2016, reporting cNfL levels (using the search terms neurofilament light and cerebrospinal fluid) in neurological or psychiatric conditions and/or in HC.Study Selection Studies reporting NfL levels measured in lumbar CSF using a commercially available immunoassay, as well as age and sex.Data Extraction and Synthesis Individual-level data were requested from study authors. Generalized linear mixed-effects models were used to estimate the fixed effects of age, sex, and diagnosis on log-transformed NfL levels, with cohort of origin modeled as a random intercept.Main Outcome and Measure The cNfL levels adjusted for age and sex across diagnoses.Results Data were collected for 10 059 individuals (mean [SD] age, 59.7 [18.8] years; 54.1% female). Thirty-five diagnoses were identified, including inflammatory diseases of the central nervous system (n = 2795), dementias and predementia stages (n = 4284), parkinsonian disorders (n = 984), and HC (n = 1332). The cNfL was elevated compared with HC in a majority of neurological conditions studied. Highest levels were observed in cognitively impaired HIV-positive individuals (iHIV), amyotrophic lateral sclerosis, frontotemporal dementia (FTD), and Huntington disease. In 33.3% of diagnoses, including HC, multiple sclerosis, Alzheimer disease (AD), and Parkinson disease (PD), cNfL was higher in men than women. The cNfL increased with age in HC and a majority of neurological conditions, although the association was strongest in HC. The cNfL overlapped in most clinically similar diagnoses except for FTD and iHIV, which segregated from other dementias, and PD, which segregated from atypical parkinsonian syndromes.Conclusions and Relevance These data support the use of cNfL as a biomarker of neuroaxonal damage and indicate that age-specific and sex-specific (and in some cases disease-specific) reference values may be needed. The cNfL has potential to assist the differentiation of FTD from AD and PD from atypical parkinsonian syndromes.
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| 3. |
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| 4. |
- Arora-Jonsson, Stefan, 1969-, et al.
(författare)
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Att styra organisationer med konkurrens
- 2018. - 1
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Konkurrens är en viktig och vitt spridd styrform i dagens samhälle. Tillhandahållandet av allt från dagligvaror och bilar till sjukvård, skola och tv-program styrs i allt högre grad genom att utförare får konkurrera med varandra. Konkurrens har blivit en så vanlig styrform att den ofta ses som ett ”naturligt tillstånd”, som om det inte finns några alternativ.Huvudbudskapet i denna bok är att konkurrens inte är ett naturligt tillstånd. Konkurrens behöver oftast beslutas och organiseras fram, vilket innebär att saker och ting ofta behöver ändras för att det ska kunna bli konkurrens. Författarna beskriver hur konkurrens faktiskt fungerar, varför konkurrens införs, hur konkurrens skiljer sig från andra mer välkända styrformer och vilka resultat man kan vänta sig vid införandet av konkurrens som styrform. Till exempel förklaras varför konkurrens ofta leder till mer av samma i stället för ökad variation, och hur professioner som läkare och lärare påverkas av att konkurrera.Exemplen i boken kommer framför allt från offentlig sektor, men principerna fungerar lika väl för andra sektorer. Författarna menar att detta är värdefull kunskap för alla som är chefer, medarbetare eller kunder i organisationer som har konkurrensutsatts – vilket inbegriper de flesta i vårt samhälle.
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| 5. |
- Esseen, Per-Anders, et al.
(författare)
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Broad-scale distribution of epiphytic hair lichens correlates more with climate and nitrogen deposition than with forest structure
- 2016
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Ingår i: Canadian Journal of Forest Research. - : Canadian Science Publishing. - 0045-5067 .- 1208-6037. ; 46:11, s. 1348-1358
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Tidskriftsartikel (refereegranskat)abstract
- Hair lichens are strongly influenced by forest structure at local scales, but their broad-scale distributions are less understood. We compared the occurrence and length of Alectoria sarmentosa (Ach.) Ach., Bryoria spp., and Usnea spp. in the lower canopy of > 5000 Picea abies (L.) Karst. trees within the National Forest Inventory across all productive forest in Sweden. We used logistic regression to analyse how climate, nitrogen deposition, and forest variables influence lichen occurrence. Distributions overlapped, but the distribution of Bryoria was more northern and that of Usnea was more southern, with Alectoria's distribution being intermediate. Lichen length increased towards northern regions, indicating better conditions for biomass accumulation. Logistic regression models had the highest pseudo R2 value for Bryoria, followed by Alectoria. Temperature and nitrogen deposition had higher explanatory power than precipitation and forest variables. Multiple logistic regressions suggest that lichen genera respond differently to increases in several variables. Warmingdecreased the odds for Bryoria occurrence at all temperatures. Corresponding odds for Alectoria and Usnea decreased in warmer climates, but in colder climates, they increased. Nitrogen addition decreased the odds for Alectoria and Usnea occurrence under high deposition, but under low deposition, the odds increased. Our analyses suggest major shifts in the broad-scale distribution of hair lichens with changes in climate, nitrogen deposition, and forest management.
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| 6. |
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| 7. |
- Fröberg, Andreas, 1985, et al.
(författare)
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Effects of an Empowerment-Based Health-Promotion School Intervention on Physical Activity and Sedentary Time among Adolescents in a Multicultural Area
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - Basel : MDPI. - 1661-7827 .- 1660-4601. ; 15:11
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes in (a) moderate-to-vigorous PA (MVPA), (b) sedentary time (SED), (c) exercise training (ET) frequency, and (d) ET duration, among adolescents. Participants (aged 12-13 years at baseline) from one intervention school and two control schools, were recruited from a multicultural area of Sweden, characterized by low-SES. During the course of the two-year intervention, a total of 135 participants (43% boys) were included in the study. The intervention was developed and implemented as a result of cooperation and shared decision-making among the researchers and the participants. MVPA and SED were measured with accelerometers, and ET frequency and duration was self-reported at the beginning of the seventh, eighth, and ninth grade, respectively. There were no significant effects of the two-year, empowerment-based health-promotion school intervention on changes in the accelerometer-measured MVPA and SED, or the self-reported ET frequency and duration, among the adolescents. Overall, the intervention was unsuccessful at promoting PA and reducing SED. Several possible explanations for the intervention's lack of effects are discussed.
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| 8. |
- Grafström, Anton, et al.
(författare)
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Combinaison d’échantillons probabilistes indépendants
- 2019
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Ingår i: Survey Methodology. - : Statistics Canada. - 0714-0045 .- 1492-0921. ; 45:2, s. 371-387
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Tidskriftsartikel (refereegranskat)abstract
- Dans divers domaines, il est de plus en plus important de fusionner les sources d’information disponibles pouraméliorer les estimations des caractéristiques de la population. En présence de plusieurs échantillonsprobabilistes indépendants d’une population finie, nous examinons plusieurs solutions d’estimateur combiné dutotal de la population, basé soit sur une combinaison linéaire d’estimateurs distincts, soit sur une méthode paréchantillon combiné. L’estimateur en combinaison linéaire fondé sur des variances estimées est susceptible d’êtrebiaisé, car les estimateurs distincts du total de la population peuvent être fortement corrélés à leurs estimateursde la variance respectifs. Nous illustrons la possibilité d’utiliser un échantillon combiné pour estimer les variancesdes estimateurs distincts, ce qui donne des estimateurs de la variance groupés généraux. Ces estimateurs de lavariance groupés utilisent tous les renseignements disponibles et peuvent réduire considérablement le biais d’unecombinaison linéaire d’estimateurs distincts.
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| 9. |
- Grafström, Anton, et al.
(författare)
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On combining independent probability samples
- 2019
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Ingår i: Survey Methodology. - : Statistics Canada. - 0714-0045 .- 1492-0921. ; 45:2, s. 349-364
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Tidskriftsartikel (refereegranskat)abstract
- Merging available sources of information is becoming increasingly important for improving estimates of population characteristics in a variety of fields. In presence of several independent probability samples from a finite population we investigate options for a combined estimator of the population total, based on either a linear combination of the separate estimators or on the combined sample approach. A linear combination estimator based on estimated variances can be biased as the separate estimators of the population total can be highly correlated to their respective variance estimators. We illustrate the possibility to use the combined sample to estimate the variances of the separate estimators, which results in general pooled variance estimators. These pooled variance estimators use all available information and have potential to significantly reduce bias of a linear combination of separate estimators.
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| 10. |
- Haller, Henrik, 1977-, et al.
(författare)
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Application of ecological engineering within the framework for strategic sustainable development for design of appropriate soil bioremediation technologies in marginalized regions
- 2018
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Ingår i: Journal of Cleaner Production. - : Elsevier. - 0959-6526 .- 1879-1786. ; 172, s. 2415-2424
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Tidskriftsartikel (refereegranskat)abstract
- This study explores a systematic strategy to design appropriate bioremediation projects for marginalized regions that have the potential to contribute to sustainable development in that region. Ecological Engineering (EE) is of particular value for the development of appropriate bioremediation technology for such regions but a stricter planning tool than provided by EE itself, is also needed when the goal of the project goes beyond remediation targets. The Framework for Strategic Sustainable Development (FSSD) applies basic principles for sustainability and includes a stepwise strategic planning mechanism for their application. The inclusion of EE within the FSSD may steer soil bioremediation projects in rural areas in developing countries and sparsely populated regions in industrialized countries towards sustainability. The utility of the approach was tested on two cases of soil pollution in marginalized regions: the Chinandega region in Nicaragua (pesticide polluted agricultural soil) and a former filling station (diesel polluted residual area) in Gäddede, northern Sweden. The study demonstrates how the inclusion of the EE key concepts within the FSSD may increase the utility of EE for strategic sustainable development within the region. No difficulties in terms of conflicting suggestions were found in the proposed integrated approach; the two tools were found to contribute on different aspects to provide support to project management and decision making.
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