Can the APO method be used for measuring soft data?: A pilot study.

Objectives. The aims were to develop auditing according to the APO (Audit Project Odense) method for measuring soft data, exemplified by a holistic view, and to test the instrument. Design. A descriptive study of the development of an APO chart and a test registration. Setting. Primary health care, Blekinge County, Sweden. Subjects. Ten general practitioners (GPs) were invited to transform categories of the concept of a holistic view obtained in an earlier study, into 30 variables on an APO registration chart. The participants chose to study different kinds of knowledge as aspects of holistic care. Main outcome measure. An APO registration chart and test of the instrument. Results. After three meetings the group had drawn up an APO registration chart supplemented with Likert scales. A pilot audit was performed. Eight doctors registered 255 consultations. In assessment of the patients' problems, factual medical knowledge was important in 83% of the cases, familiarity in 53%, and a capacity for judgement in 36%. In decision-making factual medical knowledge was used in 88% and capacity for judgement in 58%. A holistic view was necessary for the outcome in 43% and valuable in 25%. The GPs used the Likert scales in a majority of the cases. Conclusions. In this first step in developing an instrument, the results indicate that the APO method could be an alternative for studying what happens in the consultation, and the occurrence of an abstract phenomenon such as the use of different kinds of knowledge as part of a holistic view

Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy

Background: Equine Assisted Physiotherapy (EAPT) offers children with cerebral palsy (CP) opportunities for new movement experiences, and may influence movement qualities. Descriptions of how, and to what extent EAPT affects trunk control is missing. The aim of this study was to explore if, and how changes in trunk control and changes in other movement aspects were observable in children with CP during EAPT, and if potential changes in trunk control could be measured.Method: A multiple case study with a mixed methods design was completed. Two children with CP, GMFCS grade 1, were observed using video during a period of six months, and tested with Trunk Impairment Scale modified Norwegian Version. Skilled physiotherapists analyzed the videos qualitatively, and triangulated recurring changes in movement with the results from the test.Results: Riding bareback, improvements in trunk control were observed and measured. However, riding in a saddle led to reduced trunk control. Other observable movement changes were: from asymmetry to symmetry, adaptation to rhythm, mastery of riding skills, and reduced loss of postural control. Increased instances of adapting own movements in spontaneous dialogue with the horse, were observed. Instructions and feedback from the therapist influenced the dialogue with the horse both positively and negatively.Conclusion: This study describes in detail how balance and symmetry can be stimulated during EAPT in a body characterized by imbalance and asymmetry. During EAPT, the children gained the possibility to explore new movement qualities. Equipment and feedback influenced movement qualities. (C) 2020 The Authors. Published by Elsevier Ltd

Lithium-ion battery digitalization: Combining physics-based models and machine learning

Digitalization of lithium-ion batteries can significantly advance the performance improvement of lithium-ion batteries by enabling smarter controlling strategies during operation and reducing risk and expenses in the design and development phase. Accurate physics-based models play a crucial role in the digitalization of lithium-ion batteries by providing an in-depth understanding of the system. Unfortunately, the high accuracy comes at the cost of increased computational cost preventing the employment of these models in real-time applications and for parametric design. Machine learning models have emerged as powerful tools that are increasingly being used in lithium-ion battery studies. Hybrid models can be developed by integrating physics-based models and machine learning algorithms providing high accuracy as well as computational efficiency. Therefore, this paper presents a comprehensive review of the current trends in integration of physics-based models and machine learning algorithms to accelerate the digitalization of lithium-ion batteries. Firstly, the current direction in explicit modeling methods and machine learning algorithms used in battery research are reviewed. Then a thorough investigation of contemporary hybrid models is presented addressing both battery design and development as well as real-time monitoring and control. The objective of this work is to provide details of hybrid methods including the various applications, type of employed models and machine learning algorithms, the architecture of hybrid models, and the outcome of the proposed models. The challenges and research gaps are discussed aiming to provide inspiration for future works in this field

Colorectal Oncogenesis and Inflammation in a Rat Model Based on Chronic Inflammation due to Cycling DSS Treatments

Inflammation is known to be linked with development of colorectal cancer, and the aim was to assess the malignant potential and degree of inflammation in a dextran-sulphate-sodium-(DSS-) induced cyclic colonic tumour model (CTM) in rats and to compare it with the azoxymethane-(AOM-) induced CTM model. Tumours developed in both groups, although, in the DSS group, the colonic mucosa appeared edematous and the number of haemorrhagic erosions and quantity of dysplastic lesions were higher as well as the mucosal concentration of myeloperoxidase and faecal viable count of Enterobacteriaceae. The livers were affected as evaluated by steatosis, parenchymal loss, haemorrhage, and inflammatory infiltrations, and higher proportions of acetate and lower proportions of butyrate in colonic content were found. The DSS model seems to mimic the clinical situation and may be valuable for investigation of inflammation-related dysplasia and colon cancer, as well as for altered liver function by endogenous inflammatory mediators

Blueberry Husks and Probiotics Attenuate Colorectal Inflammation and Oncogenesis, and Liver Injuries in Rats Exposed to Cycling DSS-Treatment.

Long-term colonic inflammation promotes carcinogenesis and histological abnormalities of the liver, and colorectal tumours frequently arise in a background of dysplasia, a precursor of adenomas. Altered colonic microbiota with an increased proportion of bacteria with pro-inflammatory characteristics, have been implicated in neoplastic progression. The composition of the microbiota can be modified by dietary components such as probiotics, polyphenols and dietary fibres. In the present study, the influence of probiotics in combination with blueberry husks on colorectal carcinogenesis and subsequent liver damage was evaluated.Colorectal tumours were induced in rats by cyclic treatment with dextran sulphate sodium (DSS). Blueberry husks and a mixture of three probiotic strains (Bifidobacterium infantis DSM 15159, Lactobacillus gasseri, DSM 16737 and Lactobacillus plantarum DSM 15313) supplemented a basic diet fortified with oats. The condition of the rats was monitored using a disease activity index (DAI). A qualitative and quantitative histological judgement was performed on segments of distal colon and rectum and the caudate lobe of the liver. The formation of short-chain fatty acids, bacterial translocation, the inflammatory reaction and viable count of lactobacilli and Enterobaceriaceae were addressed.Blueberry husks with or without probiotics significantly decreased DAI, and significantly reduced the number of colonic ulcers and dysplastic lesions. With a decreased proportion of blueberry husk in the diet, the probiotic supplement was needed to achieve a significant decrease in numbers of dysplastic lesions. Probiotics decreased faecal viable count of Enterobacteriaceae and increased that of lactobacilli. Blueberry husks with or without probiotics lowered the proportion of butyric acid in distal colon, and decreased the haptoglobin levels. Probiotics mitigated hepatic injuries by decreasing parenchymal infiltration and the incidence of stasis and translocation. The results demonstrate a dietary option for use of blueberry husks and probiotics to delay colonic carcinogenesis and hepatic injuries in the rat model

Not on the edge: the syntax and pragmatics of clause-initial negation in Swedish

The possibility of topicalizing sentential negation is severely restricted in the Germanic V2-languages. In this paper, we show that negative preposing was more frequent and less restricted in earlier stages of Swedish: approx. 8 % of all occurrences of negation are clause initial in Old Swedish, compared to less than 0.5 % in present day Swedish. We propose that this change in frequency can be traced to the syntactic status of the negative element. More specifically, we argue that Old Swedish eigh 'not' may function as a syntactic head and cliticize to the finite verb in [C-0]. This possibility is not open to the XP inte 'not' in Modern Swedish. In Modern Swedish, we argue that the restrictions on negative preposing instead are related to more general pragmatic restrictions on the information expressed in [Spec,CP]: according to our hypothesis, negative preposing is licensed by contrast

The meaning of quality work from the general practitioner's perspective: an interview study

BACKGROUND: The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. METHODS: Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of the statements. RESULTS: Two fundamentally different ways to view quality work emerged from the statements: A pronounced top-down perspective with elements of control, and an intra-profession or bottom-up perspective. From the top-down perspective, quality work was described as something that infringes professional freedom. From the bottom-up perspective the statements described quality work as a self-evident duty and as a professional attitude to the medical vocation, guided by the principles of medical ethics. Follow-up with a bottom-up approach is best done in internal processes, with the profession itself designing structures and methods based on its own needs. CONCLUSIONS: The study indicates that general practitioners view internal follow-up as a professional obligation but external control as an imposition. This opposition entails a difficulty in achieving systematism in follow-up and quality work in health care. If the statutory standards for systematic quality work are to gain a real foothold, they must be packaged in such a way that general practitioners feel that both perspectives can be reconciled

Djur och människors hälsa

I Sverige är Animal Assisted Therapy, AAT, en ny företeelse med undantag för ridterapeutisk verksamhet som har bedrivits sedan slutet av 1950-talet. Denna har dock fört en tynande tillvaro och huvudsakligen funnits som rehabilitering för barn och vuxna med neurologiska funktionshinder. Först de senaste 10 åren har hundar och katter tillåtits inom äldreomsorgen, främst inom demensvården. Någon besöksverksamhet med djur förekommer inte i hälso- och sjukvården och terapi med djur ordineras inte. Inom kriminalvården har djurskötsel funnits som arbetsuppgift på vissa öppna anstalter och besökshundar har nyligen införts på försök. Inom socialt arbete har projekt med hästar och hundar för ungdomar i riskzonen prövats under kortare perioder de senaste 15 åren. Djur används inte systematiskt som resurs i pedagogisk verksamhet. Ett intresse för att utveckla kunskapsområdet har sedan 2000 funnits inom Sveriges lantbruksuniversitet, främst med koppling till forskningsområdena hund och etologi. Forskning om ridterapi har bedrivits inom humanmedicinska vetenskaper sedan mitten av 1990. Denna skrift är en sammanfattning av referaten från tre successiva fokusgrupper, vilka samtliga var avsedda att bilda underlag vid framtagning av ett nytt programområde inom Sveriges lantbruksuniversitet: Djur och människors hälsa, med utgångspunkt i Animal Assisted Therapy. Fokusgrupperna bestod av 1) erfarna praktiker/kliniker inom AAT, 2) utbildare inom ämnesområden som utbildar personal inom AAT, samt 3) forskare som redan bedriver forskning inom området. Samtliga fokusgrupper samlade representanter från djur- och vårdsektorn. Vid fokusgrupperna 2 och 3 var förgående fokusgruppsreferat ett skriftligt underlag inför fokusgruppssamtalet. Varje fokusgrupp inleddes med ett inspel där samtalsledaren presenterade ämnesområdet utifrån aktuell forskning och andra relevanta kunskapskällor. Samtalet dokumenterades öppet på en väggtidning. Sammanfattningen beskriver den rehabiliterande verksamhetens förutsättningar samt karakteristika för terapisituationer där djur är ”medarbetare”. Den beskriver även de specifika förutsättningarna för forskning inom området samt angelägna forskningsområden. Som bilagor finns de tre inspelen samt deltagarförteckning för de tre fokusgrupperna. Karakteristika för terapi där djur är ”medarbetare” är trepartsrelationen i terapisituationen och interaktion med en individ av en annan art, vanligtvis däggdjur. Där terapi med djur har visat sig vara framgångsrik har oftast patienten en tidigare erfarenhet av den traditionella vårdens insatser men utan positivt resultat. Det förefaller vara särskilt sårbara personer med multipla problem som i fallstudier (case studies) och anekdoter (anecdots) rapporterats få goda effekter av terapin. De erfarna klinikerna bekräftar den bilden. Det gäller vårdinsatser för individer med komplicerade symtom och diagnosbilder. Detta innebär utmaningar i forsknings- och utbildningssammanhang. Forskningsdesign och -metod måste anpassas både till kliniknära forskning och till grundforskning om de mekanismer som påverkas för att utveckla området AAT. Utbildning och vård skall vara evidensbaserad. En annan utmaning blir att kombinera utbildnings- och forskningsresurser från den gröna och den vita sektorn samt att kommunicera uppnådda resultat i respektive sektorer så att en övergripande målsättning om ett hållbart resursutnyttjande gäller i alla samhällets sektorer och för alla insatse

Det sociala sammanhanget : om Finsam MittSkånes arbete mot utanförskap

Finsam MittSkåne (där kommunerna Eslöv, Hörby och Höör ingår) har mellan åren 2012–2017 initierat och drivit ett flertal stora samverkansinsatser. I denna bok beskrivs tre av dessa insatser. Det som dessa tre insatser haft gemensamt är dels att de syftat till att öka graden av självförsörjning bland deltagarna, dels att de alla utgått från ett salutogent perspektiv. I detta perspektiv har det sociala sammanhanget och känslan av sammanhang haft särskilt stor betydelse. Malmö universitet har under flera år haft olika uppdrag för Finsam MittSkåne att studera, kartlägga och följa upp dessa insatser. Denna bok sammanfattar de erfarenheter som de olika rapporterna beskriver, men den ger även en djupare teoretisk bakgrund som inte beskrivits i rapporterna

Multi-Agent Collision Avoidance Method Using Fuzzy Risk Estimation and Information Sharing in Unknown Environments

Automated vehicles within Industry 4.0 are used as logistics units where they can move resources from one place to another safely and efficiently. The automated vehicles can be tasked to work in unknown environments where collision-free navigation is challenging due to uncertainty and lack of environmental information. Collisions can damage equipment and may even cause harm to human workers sharing the same space. In order to carry out tasks and avoid collisions in unknown environments, automated vehicles need means of self regulation and environmental awareness through sensors. This paper presents a multi-agent collision avoidance method using fuzzy risk estimation and information sharing for automated vehicles navigating unknown environments. The automated vehicles exchange information about their current state and GPS location with other automated vehicles and use fuzzy collision risk estimation based on sensor data to avoid collisions with static obstacles and each other. Additionally, the automated vehicles collectively learn about their work environment over time by creating a virtual map of the environment through shared information. To test and evaluate the method, a series of simulated tests are carried out. The results from tests show that the automated vehicles are able to avoid collisions while also accurately mapping an initially unknown work environment using the method