Ur olika synvinklar - Om att använda Viewpoints i utveckling av system för digitala vårdmöten

Inom sjukvården är misslyckade IT-projekt ett problem. Orsakerna står ofta att finna i att systemet inte fungerar som användare och intressenter förväntar sig. Samtidigt finns det omfattande forskning inom Requirement Management som syftar till att skapa metoder och modeller för att undvika sådana problem. I denna studie testas en metod på ett case inom sjukvården i syfte att se om bilden av intressenter och krav i kravanalysfasen av systemutvecklingsprocessen kan fördjupas. Detta skulle kunna vara en pusselbit för att i framtiden undvika fler misslyckade IT-projekt i sjukvården. Resultatet av testet var kluvet. Metoden bidrog till att generera en tämligen omfattande bild av möjliga intressenter, och ett antal väsentliga krav identifierades, men hur användbara dessa resultat är i en konkret utvecklingsprocess är fortfarande en öppen fråga

Detection of mouth alcohol during breath alcohol analysis.

The presence of mouth alcohol (MA) during alcohol breath test for law enforcement is the most common cause of falsely high breath alcohol concentrations (BrAC). A fast and reliable test for detection of MA roadside at the scene of the act would facilitate the police efforts for proper prosecution. A tentative technique to use orally exhaled water vapour as a reference gas to position the origin of alcohol was validated. BrAC and water vapour concentration (WVC) were simultaneously measured as a known MA component was added to subjects with existing blood alcohol. In the absence of MA, water always precedes alcohol in a volumetric expirogram. In the presence of MA this relationship reversed. A scatterplot of WVC versus BrAC from similar fractional exhaled volumes illustrates how their relative positions change by MA. A deviation area (DA) between the scatterplot curve and a fictitious linear relationship was defined as a measurement of MA. The accuracy and cut-off level of the DA to detect MA were determined with receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) was 0.95 (95% CI 0.90-1.0), indicating excellent discriminatory ability. The optimal cut-off for DA to discriminate between MA ≥0.010mg/L (1μg/100ml, 0.002g/210L) or lack of MA was -0.35, with a sensitivity of 0.91 and specificity of 0.95. Analysis of BrAC in relation to WVC is a practical method to detect and confirm MA contamination with high reliability

Isolation and characterization of a tumor necrosis factor binding protein from urine

Tumor necrosis factor (TNF)/cachectin can produce both beneficial and harmful manifestations. Mechanisms may operate to counteract potentially harmful effects such as shock and cachexia. The TNF binding protein (TNF-BP), which is found at increased levels in serum and urine of patients with chronic renal failure, may play such a role. TNF-BP was purified 1,000,000-fold to homogeneity from urine of patients with chronic renal failure by use of ion exchange chromatography, affinity chromatography on TNF-Sepharose and reverse phase chromatography. The purified protein contained only one chain with an apparent Mr on sodium dodecyl sulfate-polyacrylamide gel electrophoresis of 30,000. The aminoterminal amino acid sequence D-S-V-X-P-Q-G-K-Y-I-H-P-Q-V-N-S-I-X-K-T revealed no significant homologies with previously described protein sequences. TNF-BP may act as a regulator of the bioactivities of TNF/cachectin