Quality of life as a predictor of work ability of employees of Sarajevo Tobacco Factory

Introduction: Our aim was to evaluate quality of life (QOL) as a predictor of work abilities of employees in a tobacco factory.Methods: The study was performed in the period between 2011 and 2012. The sample comprised of 270 workers, males and females, aged from 20-65, with different educational backgrounds. The study was performed as cross-sectional research, on a voluntary basis, using two standardized and anonymous questionnaires: The World Health Organization Quality of Life-Brief Version questionnaire (WHOQOL-BREF) and the Work Ability Index questionnaire (WAI).Results: The participants subjectively perceived high values of QOL in general, with the highest values in the area of living environment. The lowest value was in the area of social interactions. Statistically significant differences were observed in the subjective assessments of QOL, especially in three defined areas (physical health, mental health, and social interactions).  Workers age 50-65 years and workers with basic (primary) level of education exhibited a suboptimal (<70%) values in total value and the values of individually defined areas of QOL.Conclusions: Strong predictors of exemplary work ability of employees are good physical and mental health, younger age, and higher level of education. A link was observed between suboptimal work ability and dissatisfaction with profession and working environment, frequent illness, absenteeism, and exposure to health risks at the workplace.

Actors in VR storytelling

Virtual Reality (VR) storytelling enhances the immersion of users into virtual environments (VE). Its use in virtual cultural heritage presentations helps the revival of the genius loci (the spirit of the place) of cultural monuments. This paper aims to show that the use of actors in VR storytelling adds to the quality of user experience and improves the edutainment value of virtual cultural heritage applications. We will describe the Baiae dry visit application which takes us to a time travel in the city considered by the Roman elite as "Little Rome (Pusilla Roma)" and presently is only partially preserved under the sea.Comment: Pre-print versio

VR Video Storytelling for Intangible Cultural Heritage Preservation.

Interactive digital storytelling has become a popular method for virtual cultural heritage presentations. Combinations of stories and 3D virtual reconstructions are attractive for the audience and have high edutainment values. In this paper we investigate if 360◦ VR videos further contribute to user immersion in the preservation of intangible cultural heritage. It describes a case study of the Mostar bridge diving project, aimed to present and preserve the bridge diving tradition from the Old Bridge in Mostar, Bosnia and Herzegovina. It is a virtual reality application which enables the user to virtually jump off the bridge after watching 360◦ video stories about its history and the bridge diving tradition and upon successfully completing the quiz evaluation of the knowledge gained from the stories. The user experience evaluation study shows that our method was successful in preserving a form of intangible heritage and posits suggestions that can be used in developing an intangible heritage preservation framework

PANORÁMICA DE TRIANA [Material gráfico]

FORMA PARTE DE UN DÍPTICO. ADQUIRIDA POR EL COLECCIONISTA EN LAS PALMAS G.C.FOTO DE VISTA DE VEGUETA DEDE EL RISCOCopia digital. Madrid : Ministerio de Educación, Cultura y Deporte. Subdirección General de Coordinación Bibliotecaria, 201

Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs: A Randomized Clinical Trial

IMPORTANCE: Universal nasal mupirocin plus chlorhexidine gluconate (CHG) bathing in intensive care units (ICUs) prevents methicillin-resistant Staphylococcus aureus (MRSA) infections and all-cause bloodstream infections. Antibiotic resistance to mupirocin has raised questions about whether an antiseptic could be advantageous for ICU decolonization. OBJECTIVE: To compare the effectiveness of iodophor vs mupirocin for universal ICU nasal decolonization in combination with CHG bathing. DESIGN, SETTING, AND PARTICIPANTS: Two-group noninferiority, pragmatic, cluster-randomized trial conducted in US community hospitals, all of which used mupirocin-CHG for universal decolonization in ICUs at baseline. Adult ICU patients in 137 randomized hospitals during baseline (May 1, 2015-April 30, 2017) and intervention (November 1, 2017-April 30, 2019) were included. INTERVENTION: Universal decolonization involving switching to iodophor-CHG (intervention) or continuing mupirocin-CHG (baseline). MAIN OUTCOMES AND MEASURES: ICU-attributable S aureus clinical cultures (primary outcome), MRSA clinical cultures, and all-cause bloodstream infections were evaluated using proportional hazard models to assess differences from baseline to intervention periods between the strategies. Results were also compared with a 2009-2011 trial of mupirocin-CHG vs no decolonization in the same hospital network. The prespecified noninferiority margin for the primary outcome was 10%. RESULTS: Among the 801 668 admissions in 233 ICUs, the participants\u27 mean (SD) age was 63.4 (17.2) years, 46.3% were female, and the mean (SD) ICU length of stay was 4.8 (4.7) days. Hazard ratios (HRs) for S aureus clinical isolates in the intervention vs baseline periods were 1.17 for iodophor-CHG (raw rate: 5.0 vs 4.3/1000 ICU-attributable days) and 0.99 for mupirocin-CHG (raw rate: 4.1 vs 4.0/1000 ICU-attributable days) (HR difference in differences significantly lower by 18.4% [95% CI, 10.7%-26.6%] for mupirocin-CHG, P \u3c .001). For MRSA clinical cultures, HRs were 1.13 for iodophor-CHG (raw rate: 2.3 vs 2.1/1000 ICU-attributable days) and 0.99 for mupirocin-CHG (raw rate: 2.0 vs 2.0/1000 ICU-attributable days) (HR difference in differences significantly lower by 14.1% [95% CI, 3.7%-25.5%] for mupirocin-CHG, P = .007). For all-pathogen bloodstream infections, HRs were 1.00 (2.7 vs 2.7/1000) for iodophor-CHG and 1.01 (2.6 vs 2.6/1000) for mupirocin-CHG (nonsignificant HR difference in differences, -0.9% [95% CI, -9.0% to 8.0%]; P = .84). Compared with the 2009-2011 trial, the 30-day relative reduction in hazards in the mupirocin-CHG group relative to no decolonization (2009-2011 trial) were as follows: S aureus clinical cultures (current trial: 48.1% [95% CI, 35.6%-60.1%]; 2009-2011 trial: 58.8% [95% CI, 47.5%-70.7%]) and bloodstream infection rates (current trial: 70.4% [95% CI, 62.9%-77.8%]; 2009-2011 trial: 60.1% [95% CI, 49.1%-70.7%]). CONCLUSIONS AND RELEVANCE: Nasal iodophor antiseptic did not meet criteria to be considered noninferior to nasal mupirocin antibiotic for the outcome of S aureus clinical cultures in adult ICU patients in the context of daily CHG bathing. In addition, the results were consistent with nasal iodophor being inferior to nasal mupirocin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03140423

Stewardship Prompts to Improve Antibiotic Selection for Pneumonia

ImportancePneumonia is the most common infection requiring hospitalization and is a major reason for overuse of extended-spectrum antibiotics. Despite low risk of multidrug-resistant organism (MDRO) infection, clinical uncertainty often drives initial antibiotic selection. Strategies to limit empiric antibiotic overuse for patients with pneumonia are needed.ObjectiveTo evaluate whether computerized provider order entry (CPOE) prompts providing patient- and pathogen-specific MDRO infection risk estimates could reduce empiric extended-spectrum antibiotics for non-critically ill patients admitted with pneumonia.Design, setting, and participantsCluster-randomized trial in 59 US community hospitals comparing the effect of a CPOE stewardship bundle (education, feedback, and real-time MDRO risk-based CPOE prompts; n = 29 hospitals) vs routine stewardship (n = 30 hospitals) on antibiotic selection during the first 3 hospital days (empiric period) in non-critically ill adults (≥18 years) hospitalized with pneumonia. There was an 18-month baseline period from April 1, 2017, to September 30, 2018, and a 15-month intervention period from April 1, 2019, to June 30, 2020.InterventionCPOE prompts recommending standard-spectrum antibiotics in patients ordered to receive extended-spectrum antibiotics during the empiric period who have low estimated absolute risk (<10%) of MDRO pneumonia, coupled with feedback and education.Main outcomes and measuresThe primary outcome was empiric (first 3 days of hospitalization) extended-spectrum antibiotic days of therapy. Secondary outcomes included empiric vancomycin and antipseudomonal days of therapy and safety outcomes included days to intensive care unit (ICU) transfer and hospital length of stay. Outcomes compared differences between baseline and intervention periods across strategies.ResultsAmong 59 hospitals with 96 451 (51 671 in the baseline period and 44 780 in the intervention period) adult patients admitted with pneumonia, the mean (SD) age of patients was 68.1 (17.0) years, 48.1% were men, and the median (IQR) Elixhauser comorbidity count was 4 (2-6). Compared with routine stewardship, the group using CPOE prompts had a 28.4% reduction in empiric extended-spectrum days of therapy (rate ratio, 0.72 [95% CI, 0.66-0.78]; P < .001). Safety outcomes of mean days to ICU transfer (6.5 vs 7.1 days) and hospital length of stay (6.8 vs 7.1 days) did not differ significantly between the routine and CPOE intervention groups.Conclusions and relevanceEmpiric extended-spectrum antibiotic use was significantly lower among adults admitted with pneumonia to non-ICU settings in hospitals using education, feedback, and CPOE prompts recommending standard-spectrum antibiotics for patients at low risk of MDRO infection, compared with routine stewardship practices. Hospital length of stay and days to ICU transfer were unchanged.Trial registrationClinicalTrials.gov Identifier: NCT03697070

Stewardship Prompts to Improve Antibiotic Selection for Urinary Tract Infection

ImportanceUrinary tract infection (UTI) is the second most common infection leading to hospitalization and is often associated with gram-negative multidrug-resistant organisms (MDROs). Clinicians overuse extended-spectrum antibiotics although most patients are at low risk for MDRO infection. Safe strategies to limit overuse of empiric antibiotics are needed.ObjectiveTo evaluate whether computerized provider order entry (CPOE) prompts providing patient- and pathogen-specific MDRO risk estimates could reduce use of empiric extended-spectrum antibiotics for treatment of UTI.Design, setting, and participantsCluster-randomized trial in 59 US community hospitals comparing the effect of a CPOE stewardship bundle (education, feedback, and real-time and risk-based CPOE prompts; 29 hospitals) vs routine stewardship (n = 30 hospitals) on antibiotic selection during the first 3 hospital days (empiric period) in noncritically ill adults (≥18 years) hospitalized with UTI with an 18-month baseline (April 1, 2017-September 30, 2018) and 15-month intervention period (April 1, 2019-June 30, 2020).InterventionsCPOE prompts recommending empiric standard-spectrum antibiotics in patients ordered to receive extended-spectrum antibiotics who have low estimated absolute risk (<10%) of MDRO UTI, coupled with feedback and education.Main outcomes and measuresThe primary outcome was empiric (first 3 days of hospitalization) extended-spectrum antibiotic days of therapy. Secondary outcomes included empiric vancomycin and antipseudomonal days of therapy. Safety outcomes included days to intensive care unit (ICU) transfer and hospital length of stay. Outcomes were assessed using generalized linear mixed-effect models to assess differences between the baseline and intervention periods.ResultsAmong 127 403 adult patients (71 991 baseline and 55 412 intervention period) admitted with UTI in 59 hospitals, the mean (SD) age was 69.4 (17.9) years, 30.5% were male, and the median Elixhauser Comorbidity Index count was 4 (IQR, 2-5). Compared with routine stewardship, the group using CPOE prompts had a 17.4% (95% CI, 11.2%-23.2%) reduction in empiric extended-spectrum days of therapy (rate ratio, 0.83 [95% CI, 0.77-0.89]; P < .001). The safety outcomes of mean days to ICU transfer (6.6 vs 7.0 days) and hospital length of stay (6.3 vs 6.5 days) did not differ significantly between the routine and intervention groups, respectively.Conclusions and relevanceCompared with routine stewardship, CPOE prompts providing real-time recommendations for standard-spectrum antibiotics for patients with low MDRO risk coupled with feedback and education significantly reduced empiric extended-spectrum antibiotic use among noncritically ill adults admitted with UTI without changing hospital length of stay or days to ICU transfers.Trial registrationClinicalTrials.gov Identifier: NCT03697096

Assurance Aware Contract-based Design for Safety-critical Systems

Safety-critical systems are those systems whose malfunctioning can result in harm or loss of human life, or damage to property or the environment. Such systems usually need to comply with a domain-specific safety standard, which often require a safety case in form of an explained argument supported by evidence to show that the system is acceptably safe to operate in a given context. Developing safety-critical systems to comply with safety standards is a time-consuming and costly process. It can often be the case that the development of the safety case is more costly than the development of the system itself. Component-based development is a method that separates the development of the components of a system from the development of the system itself. The latter is done by composing reusable components that are developed independently of the system. Safety-critical systems require that the safety case of such components is integrated in the overall safety case of the system. For this purpose, the reusable components, together with their safety case, can be described via specifications called contracts. By checking the contracts of each component of the system against each other, it is possible to determine if the components can be composed together and still fulfil the contract specifications. Contract-based design combined with component-based development has the potential to reduce the cost and time needed to develop both the system and the accompanying safety case. Such contract-based design can then be used to facilitate reuse of parts of the system as well as verifying that the system fulfils certain requirements. While contract-based design can be used to verify that a system meets certain requirements based on its contract-specification, actually assuring that the system behaves according to the verification results require additional evidence. Hence, reuse of safety-relevant components via contract-based design is not sufficient without the reuse of the accompanying safety case artefacts, which include both the safety argument and the supporting evidence. In this thesis we focus on developing the notion of safety contracts that can be used to make a contract-based design aware of the needs of safety assurance. The goals of such assurance aware contract-based design are to promote reuse of the assurance-related artefacts such as arguments and evidence, as well as to automate creation of parts of the safety assurance case. To address this, we explore the following research goals in more detail: (1) to facilitate automated contract-driven assurance, (2) to facilitate reuse of safety-relevant components and their accompanying assurance-relevant artefacts, and (3) to align such assurance-aware contract-based design with existing failure logic analysis. To meet the first goal, we identify the additional information needed for contract-based assurance and structure it in form of argumentation patterns of reusable reasoning. Then, we define a meta-model to connect the system modelling elements related to the contracts with the safety case elements, such as evidence and arguments. Based on this meta-model, we define an algorithm for automated instantiation of the proposed argumentation patterns from system models compliant with the proposed meta-model. To facilitate reuse of the assurance-related artefacts (goal (2)), we define variability on the contract level to distinguish between contracts that are relevant for all systems and those that are system-specific. Furthermore, we align the assurance-aware contract-based design with the ISO 26262 automotive safety standard and its reuse concepts. Finally, in addressing the third goal, we connect the assurance-aware contract-based design with an existing failure logic analysis and show how such combination can be used to automate instantiation of existing argumentation patterns. In a number of real-world examples we demonstrate and evaluate the feasibility of our contributions.SYNOPSIS - Safety Analysis for Predictable Software Intensive SystemsAMASS - Architecture-driven, Multi-concern and Seamless Assurance and Certification of Cyber-Physical SystemsSafeCOP - Safe Cooperating Cyber-Physical Systems using Wireless CommunicationFiC - Future factories in the Clou

"Matematik kommer vi att ha i skolan" : Pedagogernas och barnens syn på matematik

Matematik ingår i förskolans strävansmål, och är ett av många strävansmål i förskolan. Detta innebär att pedagoger skall sträva efter dem och hitta tillfällen att lyfta fram dem med barnen. Vi har valt att undersöka hur pedagoger jobbar med matematik, hur de presenterar matematik för barnen för att underlätta barnens vidareutveckling och hur medvetna de är om strävans mål i just matematik för förskolan. Vi har även valt att undersöka barnens tankar kring matematik och dess användning i framtiden.   I förskolans vardag kan man alltid finna sätt att lära ut matematik, men tyvärr hittar få pedagoger tid att sätta sig in i det och förstå barns tänkande och kunskaper. Mycket annat skall göras och uppmärksammas vilket leder till att matematiken för de flesta pedagoger ligger i skymundan. Trots allt kan man hitta få enstaka pedagoger som anser att man tar tillvara på tillfällena, nästan varje dag i förskolans vardag.   Barnen som går i förskolorna vi besökte har ett intresse för att räkna, mäta, jämföra med mera. Men de är inte medvetna om att de jobbar med matematik. Matematik är ett för dem ett relativt okänt ord men ordets innebörd är de bekanta med. Har pedagogerna kunskap om matematik och tycker att de är intressant och roligt reflekterar det på barnen och i arbetet med barn.           Nyckelord: Förskola, barn, matematik, pedago