A definition of flare in low back pain (LBP): A multiphase process involving perspectives of individuals with LBP and expert consensus

Low back pain (LBP) varies over time. Consumers, clinicians and researchers use various terms to describe fluctuations of LBP symptoms. Although "flare" is commonly used to describe symptom fluctuation, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 involved derivation of a preliminary candidate flare definition based on thematic analysis of consumers' views in consultation with an expert consumer writer. In Step 2, a workshop was conducted to incorporate perspectives of LBP experts into the preliminary flare definition, which resulted in two alternative LBP flare definitions. Step 3 refined the definition using a two-round Delphi consensus process with experts in musculoskeletal conditions. The definition favoured by experts was further tested with individuals with LBP in Step 4, using the definition in three scenarios. This multiphase study produced a LBP flare definition that distinguishes it from other LBP fluctuations, represents views of consumers, involves expert consensus, and is understandable by consumers in clinical and research contexts: "A flare-up is a worsening of your condition that lasts from hours to weeks that is difficult to tolerate and generally impacts your usual activities and/or emotions". Perspective: A multiphase processes produced a low back pain (LBP) flare definition that distinguishes it from other LBP fluctuations, involves expert consensus and represents consumers' views

Detection of small RNAs in Bordetella pertussis and identification of a novel repeated genetic element

Background: Small bacterial RNAs (sRNAs) have been shown to participate in the regulation of gene expression and have been identified in numerous prokaryotic species. Some of them are involved in the regulation of virulence in pathogenic bacteria. So far, little is known about sRNAs in Bordetella, and only very few sRNAs have been identified in the genome of Bordetella pertussis, the causative agent of whooping cough. Results: An in silico approach was used to predict sRNAs genes in intergenic regions of the B. pertussis genome. The genome sequences of B. pertussis, Bordetella parapertussis, Bordetella bronchiseptica and Bordetella avium were compared using a Blast, and significant hits were analyzed using RNAz. Twenty-three candidate regions were obtained, including regions encoding the already documented 6S RNA, and the GCVT and FMN riboswitches. The existence of sRNAs was verified by Northern blot analyses, and transcripts were detected for 13 out of the 20 additional candidates. These new sRNAs were named Bordetella pertussis RNAs, bpr. The expression of 4 of them differed between the early, exponential and late growth phases, and one of them, bprJ2, was found to be under the control of BvgA/BvgS two-component regulatory system of Bordetella virulence. A phylogenetic study of the bprJ sequence revealed a novel, so far undocumented repeat of ~90 bp, found in numerous copies in the Bordetella genomes and in that of other Betaproteobacteria. This repeat exhibits certain features of mobil

Ljudstörningar i lätta bjälklag vid låga frekvenser. Mätmetod och riktlinjer

Mätningar har utförts på åtta olika bjälklag inklusive homogen betong som använts som jämförelse

Challenges in IT governance within a Swedish healthcare organization : A qualitative study on the challenges in management of digitization

Svensk sjukvård har som ambition att ligga långt fram i den digitala utvecklingen samtidigt som man idag har problem med en stor mängd mindre system och integrationen mellan dessa. Det beror mycket på den styrning som man använt sig av. Detta arbete avser att besvara frågan kring hur svenska sjukvårdsorganisationer arbetar med styrning av digitalisering och vilka utmaningar som finns där. För att besvara detta har 6 st personer inom olika regioner med betydande roller inom förändringsarbete intervjuats. Resultatet från materialet visar på att digitaliseringsarbetet utgår från behov för att minimera risker samt att den digitala mognaden är svårdefinierad inom organisationen vilket leder till bristande kommunikation. Diskussionen utgår från individens perspektiv och organisationens perspektiv. I mötet mellan  individen och organisationen identifieras fyra stycken utmaningar inom IT-styrningen. Sammanfattningsvis så behöver svenska sjukvårdsorganisationer ta steget ifrån den klassiska organisering och IT-styrning som råder idag och öka sin omställningsförmåga för att överkomma de identifierade utmaningarna.Swedish healthcare has the ambition to be at the forefront of digital development, while today it has problems with a large number of smaller systems and the integration between them. This depends a lot on the governance that is used within the organization. This work is intended to answer the question of how Swedish healthcare organizations work with the management of digitalisation and what challenges there are. To answer this, 6 people in different Swedish regions with significant roles in change work have been interviewed. The results from the material show that the digitization work is based on the need to minimize risks and that digital maturity is difficult to define within the organization, which leads to a lack of communication. The discussion is based on the individual's perspective and the organization's perspective. In the meeting between the individual and the organization, four challenges in IT governance are identified. In summary, Swedish healthcare organizations need to take the step away from the classic organization and IT governance that prevails today and increase their adaptability in order to overcome the identified challenges

Challenges in IT governance within a Swedish healthcare organization : A qualitative study on the challenges in management of digitization

Svensk sjukvård har som ambition att ligga långt fram i den digitala utvecklingen samtidigt som man idag har problem med en stor mängd mindre system och integrationen mellan dessa. Det beror mycket på den styrning som man använt sig av. Detta arbete avser att besvara frågan kring hur svenska sjukvårdsorganisationer arbetar med styrning av digitalisering och vilka utmaningar som finns där. För att besvara detta har 6 st personer inom olika regioner med betydande roller inom förändringsarbete intervjuats. Resultatet från materialet visar på att digitaliseringsarbetet utgår från behov för att minimera risker samt att den digitala mognaden är svårdefinierad inom organisationen vilket leder till bristande kommunikation. Diskussionen utgår från individens perspektiv och organisationens perspektiv. I mötet mellan  individen och organisationen identifieras fyra stycken utmaningar inom IT-styrningen. Sammanfattningsvis så behöver svenska sjukvårdsorganisationer ta steget ifrån den klassiska organisering och IT-styrning som råder idag och öka sin omställningsförmåga för att överkomma de identifierade utmaningarna.Swedish healthcare has the ambition to be at the forefront of digital development, while today it has problems with a large number of smaller systems and the integration between them. This depends a lot on the governance that is used within the organization. This work is intended to answer the question of how Swedish healthcare organizations work with the management of digitalisation and what challenges there are. To answer this, 6 people in different Swedish regions with significant roles in change work have been interviewed. The results from the material show that the digitization work is based on the need to minimize risks and that digital maturity is difficult to define within the organization, which leads to a lack of communication. The discussion is based on the individual's perspective and the organization's perspective. In the meeting between the individual and the organization, four challenges in IT governance are identified. In summary, Swedish healthcare organizations need to take the step away from the classic organization and IT governance that prevails today and increase their adaptability in order to overcome the identified challenges

The physical activity health paradox and risk factors for cardiovascular disease:A cross-sectional compositional data analysis in the Copenhagen City Heart Study

BACKGROUND: Studies indicate that physical activity during leisure and work have opposite associations with cardiovascular disease (CVD) risk factors, referred to as the physical activity health paradox. We investigated how sedentary behaviour and physical activity types during leisure and work are associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) in an adult general population sample using compositional data analysis. METHODS: Participants wore accelerometers for 7 days (right thigh and iliac crest; 24 h/day) and had their SBP, WC, and LDL-C measured. Accelerometer data was analysed using the software Acti4 to derive daily time spent in sedentary behaviour and physical activity types. The measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) high-intensity physical activity (HIPA; sum of climbing stairs, running, cycling, and rowing), during both domains. RESULTS: In total, 652 participants were included in the analyses (median wear time: 6 days, 23.8 h/day). During leisure, the results indicated that less sedentary behaviour and more walking or more HIPA was associated with lower SBP, while during work, the findings indicated an association with higher SBP. During both domains, the findings indicated that less sedentary behaviour and more HIPA was associated with a smaller WC and lower LDL-C. However, the findings indicated less sedentary behaviour and more walking to be associated with a larger WC and higher LDL-C, regardless of domain. CONCLUSIONS: During leisure, less sedentary behaviour and more walking or HIPA seems to be associated with a lower SBP, but, during work, it seems to be associated with a higher SBP. No consistent differences between domains were observed for WC and LDL-C. These findings highlight the importance of considering the physical activity health paradox, at least for some risk factors for CVD