Beskæftigelseseffekter af investeringer i vejanlæg

Staten gennemfører i disse år mange store vejprojekter og der er typisk både stor politisk og offentlig interesse for effekterne af disse. Historisk har det primære fokus været på de trafikale effekter af infrastrukturinvesteringer, men i de senere år er der også kommet stigende interesse for at kunne måle andre og bredere effekter, såsom den arbejdskraftefterspørgsel, som skabes af anlægsprojekterne. Arbejdskraftefterspørgsel kan afhjælpe lokale ledighedsproblemer, eksempelvis i situationer med lavkonjunktur. I situationer med højkonjunktur stor kan store anlægsprojekter til gengæld risikere at rammes af rekrutteringsproblemer, som både kan fordyre eller forsinke projekter eller forvride lokale arbejdsmarkeder. Derfor er det interessant for beslutningstagerne at vide, i hvilket omfang et givent projekt øger beskæftigelsen, hvornår det sker, og hvilke faggrupper der påvirkes af efterspørgslen. Med fokus på håndtering af disse problemstillinger har COWI udarbejdet en generisk analysemodel for Vejdirektoratet, som giver mulighed for fremover at inkludere en opgørelse over beskæftigelseseffekterne i analyser og beslutningsoplæg. Analysen har fokus arbejdskraftefterspørgsel til vejbyggeri, baseret på analyse af en række forskellige projekttyper og det typiske arbejdskraftinput til vejprojekterne. Analysemodellen udgøres af en større beregningsmodel for direkte, indirekte og afledte beskæftigelseseffekter, baseret på erfaringer fra planlægning, budgettering og ledelse af vejprojekter og på gængse samfundsøkonomiske modeller for multiplikatoreffekter. Analysemodellen kan levere vigtig viden for bygherrer og andre beslutningstagere, arbejdsmarkedsaktører mv. og anvendes i den eksterne kommunikation om et større påtænkt anlægsprojekt

Development of real-time PCR for detection of Mycoplasma hominis

BACKGROUND: Mycoplasma hominis is associated with pelvic inflammatory disease, bacterial vaginosis, post partum fever, sepsis and infections of the central nervous system often leading to serious conditions. Association with development of female infertility has also been suggested, but different publications present different results. We developed a sensitive and fast diagnostic real-time PCR to test clinical samples from women undergoing laparoscopic examination before fertility treatment. To develop a test for the detection and quantification of M. hominis we selected a housekeeping gene, glyceraldehyde-3-phosphate dehydrogenase (gap), as a target. RESULTS: Real-time PCR was optimized to detect 10 copies of M. hominis PG21 genomic DNA. A fluorescence signal was measured for all 20 other M. hominis isolates, and melting curves analysis showed variations in the melting temperature in agreement with sequence variation in the region of the probes. There was no amplification of other mycoplasmal DNA and human DNA. Eighty-three patient cervical swab samples from infertile women were cultured for M. hominis in the BEa medium. Two of the samples (2.4%) were positive after 48 hours of incubation. The real-time PCR detected the same two samples positive, and the DNA concentrations in the clinical specimens were calculated to 37.000 copies/ml and 88.500 copies/ml, respectively. CONCLUSION: The results demonstrate that real-time PCR may prove to be a rapid alternative to the traditional cultivation method. Information on bacterial load in genital swabs can be obtained. The assay allowed detection of M. hominis in a closed system reducing the risk of contamination by amplicon carry-over

Comprehensive analysis of high-throughput screens with HiTSeekR

High-throughput screening (HTS) is an indispensable tool for drug (target) discovery that currently lacks user-friendly software tools for the robust identification of putative hits from HTS experiments and for the interpretation of these findings in the context of systems biology. We developed HiTSeekR as a one-stop solution for chemical compound screens, siRNA knock-down and CRISPR/Cas9 knock-out screens, as well as microRNA inhibitor and -mimics screens. We chose three use cases that demonstrate the potential of HiTSeekR to fully exploit HTS screening data in quite heterogeneous contexts to generate novel hypotheses for follow-up experiments: (i) a genome-wide RNAi screen to uncover modulators of TNFα, (ii) a combined siRNA and miRNA mimics screen on vorinostat resistance and (iii) a small compound screen on KRAS synthetic lethality. HiTSeekR is publicly available at http://hitseekr.compbio.sdu.dk. It is the first approach to close the gap between raw data processing, network enrichment and wet lab target generation for various HTS screen types

Learning Analytics og udvikling af studerendes autonomi og autenticitet

Et læringsmiljø på universitetet, der i stigende grad præges af registrering, kontrol og vurdering, giver udfordringer i forhold til de studerendes autonomi. Autonomi er ikke kun et spørgsmål om privatliv, men også om den akademiske frihed, der har været et centralt mål for universitetsuddannelserne siden dannelsen af det forskningsbaserede universitet. Vi stiller spørgsmålet: Hvordan kan universitetsundervisere tilrettelægge undervisningen på måder, som samtidig bevarer de studerendes autonomi og autenticitet i studieadfærden? Med afsæt i bogen ”Freedom to learn” (Macfarlane 2017) drøfter vi, hvordan vi som undervisere kan give studerende mulighed for at udfolde autonomi og autenticitet og giver eksempler på faldgruber i design af undervisningsforløb, som anvendelsen af learning analytics, i større eller mindre skala, kan føre til. Et særligt fokus er på brugen af learning analytics til kontrol af adfærd gennem summative evalueringer

Primary care physiotherapists ability to make correct management decisions – is there room for improvement? A mixed method study

Abstract Background With increasing interest in direct access to physiotherapy, it is important to consider the physiotherapists (PTs) ability to make correct management decisions, because identification of differential diagnostic pathologies and timely referral for specialist care is vital for patient safety. The aims of the study were to investigate PTs ability to make correct management decisions in patients presenting with musculoskeletal conditions and to identify explanatory factors associated with this ability. Furthermore, we wanted to explore the PTs views on the identified factors. Methods The study was a mixed methods study with an explanatory sequential design consisting of a questionnaire survey and semi-structured interviews. The questionnaire comprised 12 clinical vignettes describing patient scenarios for musculoskeletal conditions, non-critical medical conditions and critical medical conditions. Based on this, the PTs indicated whether the patient should be managed by the PT or were in need of medical referral. Associations between correct decisions and explanatory variables was analyzed by mixed- effects logistic regression. Interviews were performed with nine PTs to explore their reactions to the results. A directed content analysis was performed. Results A total of 195 PTs participated in the questionnaire survey and 9 PTs were interviewed. Overall, PTs were more likely to make correct management decisions in the musculoskeletal conditions category, whereas wrong decisions were more often chosen for underlying medical conditions categories. Positive associations between correct management decision in the critical medical category were found for experience: odds ratio (OR) 2.73 (1.33;5.57) and passed quality audit OR 2.90 (1.50;5.58). In the interviews, PTs expressed concerns about the differential diagnostic abilities. They all noted, that experience is immensely important in the clinical reasoning process because the ability to recognise diagnostic patterns evolves over time. Furthermore, the quality audit seems to address and systematize the clinical reasoning process and workflow within the clinics. Conclusion The lack of ability to make correct management decision in critical medical categories and the uncertainties expressed by PT’s should raise concern, as direct access to physiotherapy is already well-established and the results indicate that patient safety could be at risk. The findings that experience and passed quality audit was associated with correct management decisions highlights the need for ongoing awareness and education into differential diagnostics

Primary Care Physical Therapists' Experiences when Screening for Serious Pathologies among their Patients:a Qualitative Study

OBJECTIVE: A vital part of the initial examination performed by a physical therapist is to establish whether the patient would benefit from physical therapist intervention. This process includes knowledge about contraindications for treatment and screening for serious pathologies. However, little is known about the physical therapists' views and thoughts about their own practice when screening for serious pathologies. The purpose of this study was to explore the experience gained by physical therapists when screening for serious pathologies among their patients. METHODS: This was a qualitative study based on individual semi-structured interviews with 9 primary care physical therapists. The interviews were analyzed using reflexive thematic analysis, and generated themes were explained and reported with relevant quotes. RESULTS: Three overall themes were generated: (1) the role of physical therapists in the diagnostic process; (2) responsibility from the individual to the group; and (3) the difficult task of cooperation. The physical therapists described how they relied more on their clinical suspicion than on asking red-flag questions when screening for serious pathologies. They also questioned their differential diagnostic abilities. Finally, they saw a potential to further enhance their confidence in the area by reflecting on the matter with colleagues and by receiving more feedback about their clinical reasoning regarding serious pathologies from general practitioners. CONCLUSION: These findings suggest that physical therapists primarily rely on their clinical suspicion when screening for serious pathologies but at the same time are uncertain about their differential diagnostic abilities. IMPACT: These findings can inform future interventions targeting the physical therapists' abilities to detect serious pathology

The role of hidden curriculum in teaching pharmacy students about patient safety

Objective. To examine how hidden and informal curricula shaped pharmacy students' learning about patient safety. Methods. A preliminary study exploring planned patient safety content in pharmacy curricula at 3 UK schools of pharmacy was conducted. In-depth case studies were then carried out at 2 schools of pharmacy to examine patient safety education as delivered. Results. Informal learning from teaching practitioners was assigned high levels of credibility by the students, indicating the importance of role models in practice. Students felt that the hidden lessons received in the form of voluntary work experience compensated for limited practice exposure and elements of patient safety not adequately addressed in the formal curriculum, such as learning about safe systems, errors, and professionalism. Conclusions. Patient safety is a multifaceted concept and the findings from this study highlight the importance of pharmacy students learning in a variety of settings to gain an appreciation of these different facets

Mandatory requirements for pediatric drug development in the EU and the US for novel drugs-A comparative study

Mandatory pediatric legislation has been implemented in the European Union (EU) and the United States (US) to increase research and the availability of drugs for the pediatric population. Differences in the legislative framework can cause different pediatric requirements for similar indications granted for similar drugs across jurisdictions. This cross-sectional study compares the pediatric requirements for therapeutic indications granted at the time of initial approval for novel drugs approved in the two regions from 2010 to 2018. We collected the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) decisions to grant a waiver and/or to agree on a pediatric development plan and deferrals hereof at marketing authorization (MA) from publicly available documents. An agreed pediatric development plan was required for 66% ( N = 188/285) and 63% ( N = 134/212) of the indications granted in the EU and the US at the time of approval, respectively. Almost all (EU; 98%, US; 89%) were deferred until after MA. Based on the broad scope of the EU Pediatric Regulation, an additional 36 PIPs originated from the indications granted at MA. In the subset of indications granted for drugs approved in both the EU and the US ( N = 232), significantly more indications resulted in an agreed pediatric development plan for one or more subsets of the pediatric population in the EU ( N = 185) as compared to the US ( N = 82). This was based on the exemption of orphan designated drugs in the US and the broader scope of the EU Pediatric Regulation. However, indications subject to the mandatory pediatric legislation in both regions ( N = 131) most often had similar regulatory requirements for the inclusion of the pediatric population from the EMA and the US FDA (83%, N = 109). In conclusion, when comparing mandatory pediatric requirements, more pediatric development plans were agreed upon in the EU than in the US, in line with the broader mandates of the EU Pediatric Regulation. However, authorities most often had similar regulatory requirements when an indication was subject to pediatric legislation in both regions