33 research outputs found
Joint Subjective and Objective Data Capture and Analytics for Automotive Applications
In this paper we describe a novel technological framework for capture and analysis of both objective measurement data and subjective user experience data for automotive applications. We also investigate how the framework can be extended to address privacy issues by enforcing a rigorous privacy model called differential privacy. The system under development integrates a telematics system with a smartphone app service architecture and a data-driven analytics framework. The hypothesis is that the framework will improve the opportunities of conducting large scale user trials of automotive functions and services, while improving the quality of collected data. To achieve this, a number of challenges are addressed in the paper, including how to design the subjective data capture mechanisms to be both simple to use yet powerful, how to correlate subjective data with objective measurement data, and how to protect the privacy of users
Impact of antibiotic restriction on resistance levels of Escherichia coli:a controlled interrupted time series study of a hospital-wide antibiotic stewardship programme
Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species
BACKGROUND: Infective endocarditis (IE) is diagnosed in 7â8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. METHODS: In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk â30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE >â10%), TTE (IE 3â10%), or âwait & seeâ (IE <â3%). RESULTS: We included 6393 cases with streptococcal BSIs (mean age 68.1âyears [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have â„3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to âwait & seeâ strategy if they neither have a risk factor nor â„3 positive BC bottles, while a TTE is recommended if they have either â„3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor â„3 positive BC bottles, but to TTE and TOE if they have either â„3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. CONCLUSION: In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-06391-2
Quality indicators for antibiotic stewardship programs in hospitals:pharmacoepidemiological aspects
Dagvattenhantering i Salems kommun â klimatanpassning och resiliens
Detta examensarbete Ă€r en fallstudie av Salems kommuns klimatanpassning rörande dagvattenhantering. En analys av lĂ„gpunkter och rinnvĂ€gar vid nederbörd har utförts för att identifiera översvĂ€mningsrisker. Vidare har textanalys utförts pĂ„ Salems kommuns översiktsplan, dagvattenstrategi samt pĂ„ tvĂ„ detaljplaner med tillhörande dagvattenutredningar. Den insamlade empirin har analyserats med hjĂ€lp av social-ekologisk resiliensteori. Salems kommuns arbete har jĂ€mförts med grannkommunen Botkyrka samt med vĂ€gledning och riktlinjer frĂ„n bland annat Svenskt Vatten, Sveriges meteorologiska och hydrologiska institut och NaturvĂ„rdsverket. Salems kommun visar pĂ„ klimatanpassning av dagvattensystem vid planerad bebyggelse som gĂ„r vĂ€l i linje med rekommendationer samt vetenskapliga studier och som till stor del liknar Botkyrkas arbete. Salems kommun anvĂ€nder sig av naturbaserade lösningar vilket stĂ€rker deras social-ekologiska resiliens och skapar förutsĂ€ttningar för mer ekosystemtjĂ€nster. De har betydligt mindre fokus pĂ„ klimatanpassning av dagvattensystem kopplad till befintlig bebyggelse och dĂ€rför behöver arbetet kring det utvecklas.This degree project is a case study of Salemâs municipalityâs climate adaptation of its stormwater management. An analysis of topographic lows and pathways of the precipitation has been concluded to identify risks of flooding. Furthermore, a document analysis has been carried out on Salemâs municipalityâs comprehensive plan, stormwater strategy and of two detail development plans and the stormwater investigations linked to them. The collected empirical data has been analysed using social-ecological resilience theory. Salemâs municipalityâs work has been compared to its neighbouring municipality Botkyrka and to guidance and guidelines from among others Svenskt Vatten, the Swedish Meteorological and Hydrological Institute and the Swedish Environmental Protection Agency. Salemâs municipality shows climate adaptation of its stormwater management system of planned buildings that are well in line with recommendations and scientific studies and that is largely similar to the work of Botkyrka. Salemâs municipality use nature-based solutions, which strengthens their resilience and creates conditions for more ecosystem services. They have considerably less focus on climate adaptation of stormwater systems connected to existing built environment and therefore the work around it needs to be developed
Dagvattenhantering i Salems kommun â klimatanpassning och resiliens
Detta examensarbete Ă€r en fallstudie av Salems kommuns klimatanpassning rörande dagvattenhantering. En analys av lĂ„gpunkter och rinnvĂ€gar vid nederbörd har utförts för att identifiera översvĂ€mningsrisker. Vidare har textanalys utförts pĂ„ Salems kommuns översiktsplan, dagvattenstrategi samt pĂ„ tvĂ„ detaljplaner med tillhörande dagvattenutredningar. Den insamlade empirin har analyserats med hjĂ€lp av social-ekologisk resiliensteori. Salems kommuns arbete har jĂ€mförts med grannkommunen Botkyrka samt med vĂ€gledning och riktlinjer frĂ„n bland annat Svenskt Vatten, Sveriges meteorologiska och hydrologiska institut och NaturvĂ„rdsverket. Salems kommun visar pĂ„ klimatanpassning av dagvattensystem vid planerad bebyggelse som gĂ„r vĂ€l i linje med rekommendationer samt vetenskapliga studier och som till stor del liknar Botkyrkas arbete. Salems kommun anvĂ€nder sig av naturbaserade lösningar vilket stĂ€rker deras social-ekologiska resiliens och skapar förutsĂ€ttningar för mer ekosystemtjĂ€nster. De har betydligt mindre fokus pĂ„ klimatanpassning av dagvattensystem kopplad till befintlig bebyggelse och dĂ€rför behöver arbetet kring det utvecklas.This degree project is a case study of Salemâs municipalityâs climate adaptation of its stormwater management. An analysis of topographic lows and pathways of the precipitation has been concluded to identify risks of flooding. Furthermore, a document analysis has been carried out on Salemâs municipalityâs comprehensive plan, stormwater strategy and of two detail development plans and the stormwater investigations linked to them. The collected empirical data has been analysed using social-ecological resilience theory. Salemâs municipalityâs work has been compared to its neighbouring municipality Botkyrka and to guidance and guidelines from among others Svenskt Vatten, the Swedish Meteorological and Hydrological Institute and the Swedish Environmental Protection Agency. Salemâs municipality shows climate adaptation of its stormwater management system of planned buildings that are well in line with recommendations and scientific studies and that is largely similar to the work of Botkyrka. Salemâs municipality use nature-based solutions, which strengthens their resilience and creates conditions for more ecosystem services. They have considerably less focus on climate adaptation of stormwater systems connected to existing built environment and therefore the work around it needs to be developed
Lived experience of persons with multiple sclerosis : A qualitative interview study.
INTRODUCTION: Multiple sclerosis (MS) is a chronic autoimmune disease with a substantial impact on quality of life and functional capability. The prognosis of MS has changed over time due to the development of increasingly effective therapies. As the knowledge and perceptions of persons living with chronic conditions increasingly have been acknowledged, it has become important to understand lived experiences with a focus on everyday events and experiences as a way of knowing and interpreting the world. Exploring context-specific lived experiences as a source of knowledge about the disease and care may contribute to more precision in designing care services. The aim of this study was to explore the lived experience of persons living with MS in a Swedish context. MATERIALS AND METHODS: A qualitative interview study was conducted with both purposeful and random sampling strategies, resulting in 10 interviews. Data were analyzed using inductive thematic content analysis. RESULTS: The analysis generated 4 overarching themes with 12 subthemes, the 4 themes were: perspectives on life and health, influence on everyday life, relations with healthcare, and shared healthcare processes. The themes are concerned with the patients' own perspectives and context as well as medical and healthcare-related perspectives. Patterns of shared experiences were found, for example, in the diagnosis confirmation, future perspectives, and planning and coordination. More diverse experiences appeared concerning relations with others, one's individual requirements, symptoms and consequences, and knowledge building. CONCLUSION: The findings suggest a need for a more diverse and coproduced development of healthcare services to meet diverse needs in the population with greater acknowledgement of the person's lived experience, including consideration of the complexity of the disease, personal integrity, and different ways of knowing. Findings from this study will be further explored together with other quantitative and qualitative data
Parentsâ socioeconomic factors related to high antibiotic prescribing in primary health care among children aged 0â6 years in the Capital Region of Denmark
Objective: To investigate the distribution of antibiotic prescriptions in primary health care among children aged 0â6 years and its association with socioeconomic factors. Design: A cross-sectional study describing antibiotic prescriptions and socioeconomic factors, using different population-based registers from Statistics Denmark. Setting: Antibiotic prescriptions in 2012 from primary health care in the Capital Region of Denmark. Subjects: The population of children aged 0â6 years (nâ=â139,398) in the Capital Region of Denmark. Main outcome measures: High use of antibiotics identified by number of antibiotic prescriptions (â„â3 prescriptions per year) and defined daily doses (DDD). A multinomial logistic regression analysis estimating the association between high antibiotic use and parentsâ education, employment status, income, childâs sex, and ethnic background. Results: Ten percent of children accounted for 25% of the total use DDD. There was a clear tendency that the risk for high antibiotic use increased as parental educational level decreased. The risk for high use was the highest among children of mothers and fathers with basic schooling â€10 years (OR 1.60, 95% CI 1.29â1.98, and OR 1.60, 95% CI 1.34â1.91, respectively). Low income and unemployment were not associated with high antibiotic use. Conclusion: Socioeconomic factors can only partially explain differences in antibiotic use. Further research is needed to clarify the unequal distribution of antibiotic prescribing and the association between high antibiotic use and low educational level. This would provide valuable information in the planning of strategies to promote rational use of antibiotics among children.KEY POINTS The Capital Region of Denmark has the highest rate of antibiotic prescribing in Denmark. Preschool children are among the age groups with the highest use. Ten percent of the children accounted for 25% of the total antibiotic use. Low parental educational level was associated with increased antibiotic use. Parentsâ income or employment status was not found to be associated with high antibiotic use