Employees' use, preferences, and restorative benefits of green outdoor environments at hospitals

Work-related stress is an increasing problem among healthcare workers all over the world. The overall hypothesis of this study is that green outdoor environments (GOE) at hospitals may contribute to a less stressful working environment by offering psychological restoration. This study investigates GOE at five acute-care hospitals located in the capital region of Denmark. It aims to identify how the GOE are used by the employees and their potential for restoration. Data was collected through a survey where 183 employees completed an on-site questionnaire which included the perceived restorativeness scale (PRS). The main results indicate that the GOE are mostly used for a short while by the employees; the main activity is to have lunch, but they are also used actively to get away from the stressful working environment. The results from this study contribute to the international research on GOE at hospitals, and may be of inspiration for designers as well as for hospital staff and administrators

Використання event-маркетингу в плануванні діяльності ТОВ «Микулинецький Бровар»

Акцентується увага на необхідності створення маркетингового плану для будь-якого підприємства, незалежно від форми власності та розмірів. Розглянуто сутність event - маркетингу та запропоновано event - заходи для реалізації маркетингового плану ТОВ«Мукулинецький Бровар»Accentuates the need to create a marketing plan for any enterprise, regardless of firm size. The essence of event - and proposed marketing event - measures to implement a marketing plan Ltd. Mukulynetskyy Brova

Fusion transcript analysis reveals slower response kinetics than multiparameter flow cytometry in childhood acute myeloid leukaemia

Funding Information: We thank the employees at the Department of Clinical Chemistry at Sahlgrenska University Hospital, Haemodiagnostic Laboratory at the Aarhus University Hospital, and Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet for sample collection, processing and analyses. Publisher Copyright: © 2022 The Authors. International Journal of Laboratory Hematology published by John Wiley & Sons Ltd.Introduction: Analysis of measurable residual disease (MRD) is increasingly being implemented in the clinical care of children and adults with acute myeloid leukaemia (AML). However, MRD methodologies differ and discordances in results lead to difficulties in interpretation and clinical decision-making. The aim of this study was to compare results from reverse transcription quantitative polymerase chain reaction (RT-qPCR) and multiparameter flow cytometry (MFC) in childhood AML and describe the kinetics of residual leukaemic burden during induction treatment. Methods: In 15 children who were treated in the NOPHO-AML 2004 trial and had fusion transcripts quantified by RT-qPCR, we compared MFC with RT-qPCR for analysis of MRD during (day 15) and after induction therapy. Eight children had RUNX1::RUNX1T1, one CBFB::MYH11 and six KMT2A::MLLT3. Results: When ≥0.1% was used as cut-off for positivity, 10 of 22 samples were discordant. The majority (9/10) were MRD positive with RT-qPCR but MRD negative with MFC, and several such cases showed the presence of mature myeloid cells. Fusion transcript expression was verified in mature cells as well as in CD34 expressing cells sorted from diagnostic samples. Conclusions: Measurement with RT-qPCR suggests slower response kinetics than indicated from MFC, presumably due to the presence of mature cells expressing fusion transcript. The prognostic impact of early measurements with RT-qPCR remains to be determined.Peer reviewe

Multidisciplinary Management of Mastocytosis : Nordic Expert Group Consensus

Mastocytosis is a heterogeneous group of diseases defined by an increased number and accumulation of mast cells, and often also by signs and symptoms of mast cell activation. Disease subtypes range from indolent to rare aggressive forms. Mastocytosis affects people of all ages and has been considered rare; however, it is probably underdiagnosed with potential severe implications. Diagnosis can be challenging and symptoms may be complex and involve multiple organ-systems. In general it is advised that patients should be referred to centres with experience in the disease offering an individualized, multidisciplinary approach. We present here consensus recommendations from a Nordic expert group for the diagnosis and general management of patients with mastocytosis.Peer reviewe

Genome-wide association meta-analysis in 269,867 individuals identifies new genetic and functional links to intelligence

Intelligence is highly heritable(1) and a major determinant of human health and well-being(2). Recent genome-wide meta-analyses have identified 24 genomic loci linked to variation in intelligence3-7, but much about its genetic underpinnings remains to be discovered. Here, we present a large-scale genetic association study of intelligence (n = 269,867), identifying 205 associated genomic loci (190 new) and 1,016 genes (939 new) via positional mapping, expression quantitative trait locus (eQTL) mapping, chromatin interaction mapping, and gene-based association analysis. We find enrichment of genetic effects in conserved and coding regions and associations with 146 nonsynonymous exonic variants. Associated genes are strongly expressed in the brain, specifically in striatal medium spiny neurons and hippocampal pyramidal neurons. Gene set analyses implicate pathways related to nervous system development and synaptic structure. We confirm previous strong genetic correlations with multiple health-related outcomes, and Mendelian randomization analysis results suggest protective effects of intelligence for Alzheimer's disease and ADHD and bidirectional causation with pleiotropic effects for schizophrenia. These results are a major step forward in understanding the neurobiology of cognitive function as well as genetically related neurological and psychiatric disorders.Peer reviewe

Comparing the effect of hydroxyethyl starch 130/0.4 with balanced crystalloid solution on mortality and kidney failure in patients with severe sepsis (6S-Scandinavian Starch for Severe Sepsis/Septic Shock trial): Study protocol, design and rationale for a double-blinded, randomised clinical trial

Peer reviewe

Development and Validation of a Risk Score for Chronic Kidney Disease in HIV Infection Using Prospective Cohort Data from the D:A:D Study

Ristola M. on työryhmien DAD Study Grp ; Royal Free Hosp Clin Cohort ; INSIGHT Study Grp ; SMART Study Grp ; ESPRIT Study Grp jäsen.Background Chronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice. Methods and Findings A total of 17,954 HIV-positive individuals from the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study with >= 3 estimated glomerular filtration rate (eGFR) values after 1 January 2004 were included. Baseline was defined as the first eGFR > 60 ml/min/1.73 m2 after 1 January 2004; individuals with exposure to tenofovir, atazanavir, atazanavir/ritonavir, lopinavir/ritonavir, other boosted protease inhibitors before baseline were excluded. CKD was defined as confirmed (>3 mo apart) eGFR In the D:A:D study, 641 individuals developed CKD during 103,185 person-years of follow-up (PYFU; incidence 6.2/1,000 PYFU, 95% CI 5.7-6.7; median follow-up 6.1 y, range 0.3-9.1 y). Older age, intravenous drug use, hepatitis C coinfection, lower baseline eGFR, female gender, lower CD4 count nadir, hypertension, diabetes, and cardiovascular disease (CVD) predicted CKD. The adjusted incidence rate ratios of these nine categorical variables were scaled and summed to create the risk score. The median risk score at baseline was -2 (interquartile range -4 to 2). There was a 1: 393 chance of developing CKD in the next 5 y in the low risk group (risk score = 5, 505 events), respectively. Number needed to harm (NNTH) at 5 y when starting unboosted atazanavir or lopinavir/ritonavir among those with a low risk score was 1,702 (95% CI 1,166-3,367); NNTH was 202 (95% CI 159-278) and 21 (95% CI 19-23), respectively, for those with a medium and high risk score. NNTH was 739 (95% CI 506-1462), 88 (95% CI 69-121), and 9 (95% CI 8-10) for those with a low, medium, and high risk score, respectively, starting tenofovir, atazanavir/ritonavir, or another boosted protease inhibitor. The Royal Free Hospital Clinic Cohort included 2,548 individuals, of whom 94 individuals developed CKD (3.7%) during 18,376 PYFU (median follow-up 7.4 y, range 0.3-12.7 y). Of 2,013 individuals included from the SMART/ESPRIT control arms, 32 individuals developed CKD (1.6%) during 8,452 PYFU (median follow-up 4.1 y, range 0.6-8.1 y). External validation showed that the risk score predicted well in these cohorts. Limitations of this study included limited data on race and no information on proteinuria. Conclusions Both traditional and HIV-related risk factors were predictive of CKD. These factors were used to develop a risk score for CKD in HIV infection, externally validated, that has direct clinical relevance for patients and clinicians to weigh the benefits of certain antiretrovirals against the risk of CKD and to identify those at greatest risk of CKD.Peer reviewe

Fundamental verdivurdering av XXL ASA

Denne masterutredningen er en fundamental verdivurdering av XXL ASA, heretter kalt XXL. Målet med oppgaven er å finne verdien av én XXL-aksje per 19.02.16, der verdivurderingen baseres på sekundærdata gjennom offentlig tilgjengelig informasjon. Siden oppstarten av selskapet i 2000 har de vokst til å bli Nordens største sportskjede med butikker i Norge, Sverige og Finland. Selskapet har en sterk posisjon i de nordiske markedene, og har ønske om å ekspandere til flere europeiske land innen få år. Etter en introduksjon av XXL og sportsbransjen gjennomføres en strategisk analyse som kartlegger selskapets interne ressurser, samt de makro- og mikroøkonomiske forhold som påvirker sportsbransjen. Analysene viser blant annet at selskapet og bransjen har flere muligheter for vekst, der en av faktorene er samfunnets fokus på helse og fysisk aktivitet. Videre analyseres XXLs historiske regnskapstall opp mot sportsbransjens, gjennom en risiko- og rentabilitetsanalyse. Analysene viser at XXLs likviditet og soliditet er noe presset i forhold til bransjens, men utviklingen for selskapet er positiv. Samtidig har XXL snudd en strategisk ulempe til en fordel i løpet av analyseperioden, og oppnådde en superrentabilitet til egenkapitalen på 8,03 % i 2015. Fordelen består hovedsakelig av en bransjefordel, og bygger opp om resultatene fra den strategiske analysen, der bransjens attraktivitet ble synliggjort. Deretter utarbeides et framtidsregnskap og -krav for perioden 2016-2027. Ved bruk av egenkapital- og selskapskapitalmetoden beregnes ett endelig fundamentalt verdiestimat på XXL-aksjen på 98,67 kroner per 19.02.16. En analyse av usikkerheten i estimatet viser at små endringer i forutsetningene for verdsettelsen kan utgjøre store endringer i verdiestimatet. Dette endrer ikke våre vurderinger, men det er viktig å være klar over graden av usikkerhet. Til slutt utføres en komparativ verdivurdering som supplement til den fundamentale verdivurderingen. Denne verdsettelsen ga et estimat på 95,64 kroner, og viser at estimatet fra den fundamentale verdsettelsen er rimelig. Begge estimatene er høyere enn børsverdien per 19.02.16 på 90,50 kroner, og det tyder på at markedet undervurderer XXLs framtidige inntjening. Vårt endelige verdiestimat forblir 98,67 kroner, og er 9 % høyere enn børskursen per 19.02.16. Basert på dette gir vi en hold-anbefaling av aksjen, men den store usikkerheten i verdiestimatet gjør anbefalingen uklar

Fundamental verdivurdering av XXL ASA

Denne masterutredningen er en fundamental verdivurdering av XXL ASA, heretter kalt XXL. Målet med oppgaven er å finne verdien av én XXL-aksje per 19.02.16, der verdivurderingen baseres på sekundærdata gjennom offentlig tilgjengelig informasjon. Siden oppstarten av selskapet i 2000 har de vokst til å bli Nordens største sportskjede med butikker i Norge, Sverige og Finland. Selskapet har en sterk posisjon i de nordiske markedene, og har ønske om å ekspandere til flere europeiske land innen få år. Etter en introduksjon av XXL og sportsbransjen gjennomføres en strategisk analyse som kartlegger selskapets interne ressurser, samt de makro- og mikroøkonomiske forhold som påvirker sportsbransjen. Analysene viser blant annet at selskapet og bransjen har flere muligheter for vekst, der en av faktorene er samfunnets fokus på helse og fysisk aktivitet. Videre analyseres XXLs historiske regnskapstall opp mot sportsbransjens, gjennom en risiko- og rentabilitetsanalyse. Analysene viser at XXLs likviditet og soliditet er noe presset i forhold til bransjens, men utviklingen for selskapet er positiv. Samtidig har XXL snudd en strategisk ulempe til en fordel i løpet av analyseperioden, og oppnådde en superrentabilitet til egenkapitalen på 8,03 % i 2015. Fordelen består hovedsakelig av en bransjefordel, og bygger opp om resultatene fra den strategiske analysen, der bransjens attraktivitet ble synliggjort. Deretter utarbeides et framtidsregnskap og -krav for perioden 2016-2027. Ved bruk av egenkapital- og selskapskapitalmetoden beregnes ett endelig fundamentalt verdiestimat på XXL-aksjen på 98,67 kroner per 19.02.16. En analyse av usikkerheten i estimatet viser at små endringer i forutsetningene for verdsettelsen kan utgjøre store endringer i verdiestimatet. Dette endrer ikke våre vurderinger, men det er viktig å være klar over graden av usikkerhet. Til slutt utføres en komparativ verdivurdering som supplement til den fundamentale verdivurderingen. Denne verdsettelsen ga et estimat på 95,64 kroner, og viser at estimatet fra den fundamentale verdsettelsen er rimelig. Begge estimatene er høyere enn børsverdien per 19.02.16 på 90,50 kroner, og det tyder på at markedet undervurderer XXLs framtidige inntjening. Vårt endelige verdiestimat forblir 98,67 kroner, og er 9 % høyere enn børskursen per 19.02.16. Basert på dette gir vi en hold-anbefaling av aksjen, men den store usikkerheten i verdiestimatet gjør anbefalingen uklar.nhhma

Competency requirements for the assessment of patients with mental illness in somatic emergency care: A modified Delphi study from the nurses’ perspective

Patients suffering from mental illness are vulnerable, and they do not always have access to proper emergency care. The aim of this study was to identify competency requirements for the assessment of patients with mental illness by soliciting the views of emergency care nurses. A modified Delphi method comprising four rounds was used. Data were collected in Sweden between October 2018 and March 2019. The data were analyzed using content analysis and descriptive statistics. The panel of experts reached the highest level of consensus regarding basic medical knowledge: the capability to listen and show respect to the patient are essential competency requirements when assessing patients with mental illness in emergency care. Awareness of these competency requirements will enhance teaching and training of emergency care nurses