Reperfusion therapy for ST elevation acute myocardial infarction 2010/2011: current status in 37 ESC countries

Aims Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. Methods and results A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patients admitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. Conclusion Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encourage

Utvärdering av Stresshanteringskurs i företagshälsovård vid Feelgood, Göteborg

Idag är stress ett mycket aktuellt ämne. Faktorer som tros vara orsaken till stress är med andra ord levnadsvillkor, miljö och samverkan mellan arv och arbetsförhållanden. Dessa faktorer anses ge rimliga förklaringar om orsaker till stressjukdomar. Detta ligger till grund när man skapar adekvata behandlingar mot stress. På Feelgood behandlas stress bland annat med en stresshanteringskurs. Meningen med kursen är att öka förståelsen för hur stress påverkar oss såväl fysiskt som mentalt samt få redskap att påverka den egna stressreaktionen. Genom kursen lär sig deltagarna känna igen stressignaler, erhåller ökad förmåga att hantera stressen och till-lämpa någon form av avspänning i vardagen. På så sätt minskar de risken för stressreaktioner och får ökad förståelse om sambanden mellan stress och ohälsa samt vikten av återhämtning och sunda vanor. Syftet med detta arbete var att undersöka om den aktuella stresshanteringskursen, som ges vid Feelgood FHV Göteborg - Lilla Bommen, minskar stressrelaterade symptom. I undersökningsgruppen ingick 23 personer, varav 20 kvinnor och 3 män. Medelåldern i gruppen var 40 år. Alla personer i gruppen var högt utbildade och arbetade inom olika yrken. Två olika undersökningsblanketter besvarades av deltagarna vid två olika tillfällen, strax före kursens början samt vid avslutningen av stresshanteringskursen. Med hjälp av den ena blanketten SCI 93 fick man svar på kursdeltagarnas symptomskattning med avseende på autonom dysfunktion. Med den andra enkäten (Testa ditt stressbeteende) undersöktes patientens stressbeteende. Det fanns ingen kontrollgrupp. Resultaten från undersökningen visar att alla undersökta parametrar, det vill säga patienternas symptomskattning med avseende på autonom dysfunktion, stressbeteende och de vanligast före-kommande stressymptomen förbättras efter genomgången stresshanteringskurs på Feelgood. De lovande behandlingsresultaten visar att den stresshanteringskurs som ges av Feelgood, mins-kar stressrelaterade symptom och är därmed en effektiv metod att behandla stress. Detta öppnar stora möjligheter att inom företagshälsovården utveckla även preventiva hälsofrämjade åtgärder på organisations- och gruppnivå samt för enskilda medarbetare

A contribution to defining the term 'definition'

Knowledge is a model that enables premeditated change. Knowledge can be subdivided: the simplest element is information. Information aggregates/relations constitute a concept. Clusters of concepts make theories. Concepts and theories can be further branched into: conclusions, explanations, cognitions, etc, which together belong to a general class of Definition. Definitions are key elements of knowledge. Yet it appears that we do not sufficiently explain the nature of this concept of definition itself. There is little doubt about the importance of words and languages, however these semantic structures contain some intrinsic ambiguities. Knowledge records grow faster than its substance, and it is increasingly difficult to manipulate and communicate this voluminous structure. The interpretations of terms and knowledge can vary significantly, especially in the multidisciplinary context. Misiformation is exacerbated by vague definitions including synonyms, homonyms and acronyms. This paper attempts to contribute to defining the term ‘definition’ to alleviate the mentioned problems

A contribution to defining the term 'definition'

Knowledge is a model that enables premeditated change. Knowledge can be subdivided: the simplest element is information. Information aggregates/relations constitute a concept. Clusters of concepts make theories. Concepts and theories can be further branched into: conclusions, explanations, cognitions, etc, which together belong to a general class of Definition. Definitions are key elements of knowledge. Yet it appears that we do not sufficiently explain the nature of this concept of definition itself. There is little doubt about the importance of words and languages, however these semantic structures contain some intrinsic ambiguities. Knowledge records grow faster than its substance, and it is increasingly difficult to manipulate and communicate this voluminous structure. The interpretations of terms and knowledge can vary significantly, especially in the multidisciplinary context. Misiformation is exacerbated by vague definitions including synonyms, homonyms and acronyms. This paper attempts to contribute to defining the term ‘definition’ to alleviate the mentioned problems

Big data model: An application to design of rolling process

The current socioeconomic and climate trends imply that the sustainability of large industrial systems such as rolling industry must be urgently improved. Present design applications do not take sufficient advantage of big data accumulated in rolling mill repositories. At the same time, the nowadays information processors and analytical theories allow for performing real-time multivariate analysis and extracting important knowledge from industrial records. For this, however, there is a need to translate raw records into appropriate mathematical forms. The proposed approach to design of rolling process combines statistical analysis of rolling sequences with empirical and theoretical models of plastic flow. Deterministic models allow for creating rolling process that will function at some level of efficiency still below the possible higher level. This is evident due to the fact that the statistical analyses of production data recorded in identical mills show high dispersion. On the contrary to current methods, the proposed approach allows for diagnosing the causes for the existence of this gap, and also suggests how this gap can be decreased. An example of design of the leadeing oval groove for rolling wire rod is presented along with discussion of general mathematical aspects to demonstrate application of extracted statistics for probabilistic optimization of process parameters

Some aspects of disambiguation of multi-disciplinary knowledge

Backround: The outburst in the internet-based sharing of knowledge has opened a Pandora’s Box of the third millennium (the phrase "to open Pandora's box" means to perform an action that may seem beneficial,but that turns out to have unexpected consequences). Scientific and engineering contents are distributed by means of the high-speed internet; however, this includes dissemination of misalignedand otherwise ambiguous concepts as well. Bearing in mind the increasing trends in knowledge migration between initially disunited disciplines, there is an urgent need to mitigate misunderstandingsthat block the communication avenues. This work presents a contribution to disambiguation of multidisciplinary knowledge, by means of exposing selected examples of ambiguity and proposing thedisambiguation solutions.Purpose: Ambiguous presentations obstruct knowledge sharing, application and expansion, and hence there is a pressing need to investigate the relevant causes and roots, and to propose appropriate remedies.Design/Method: A review of scientific and engineering databases enabled detecting acute examples. Selected cases of importance in engineering are subjected to systematic scrutiny based on ontology, semantics andepistemology.Results: The ambiguities are exposed and the causes explained. Engineering educators are prompted to recognise the damaging effects of conceptual misalignments and to consider the proposed improvements.Conclusion: There is an urgent need to improve the definitions of key engineering concepts that are currently burdened by ambiguous interpretations. The examples of disciplines where the scientific taxonomy is well established (such as entomology and some branches of geology and medicine) should be followed and a systematic hierarchy of transparent definitions introduced

Defining knowledge constituents and contents

While it appears that a consensus is crystalising with regard to the hierarchy of concepts such as “knowledge”, “definition” and “information”, there is an increasing urgency for improving definitions of these terms. Strategies such as “knowledge extraction” or “data mining” rely on the increasing availability of digital (electronic) records addressing almost any aspect of socio-economic realm. Information processors are invaluable in the capacity of turning large amount of data into information. However, a new problem emerged on the surface in this new information environment: numerous concepts and terms are blurred by ambiguous definitions (including the concept of ‘definition’ itself). This triggered a need for mitigating hindrances such as homonymy and synonymy, leading further to demands on the decoding software complexity of which equals the artificial intelligence applications. Information technology presumably copes with this diversity by providing the information decoding ‘tools’. This opens a never-ending opportunity for further permutations of tasks and service abilities. The solution, however, is to address the causes rather than indulge in multiplying the superficial remedies. Clearly, the multiplicity of definitions for the same concepts, false synonyms and so forth show that there is a need for introducing definitions of sufficient dimensionality. In this article, a number of examples of important concepts are presented first to point at the ambiguities associated with them, and then to propose their disambiguation. The minimum intent is to demonstrate how these key terms can be defined to avoid ambiguities such as pleonasm, homonymy, synonymy and circularity

Defining knowledge constituents and contents

While it appears that a consensus is crystalising with regard to the hierarchy of concepts such as “knowledge”, “definition” and “information”, there is an increasing urgency for improving definitions of these terms. Strategies such as “knowledge extraction” or “data mining” rely on the increasing availability of digital (electronic) records addressing almost any aspect of socio-economic realm. Information processors are invaluable in the capacity of turning large amount of data into information. However, a new problem emerged on the surface in this new information environment: numerous concepts and terms are blurred by ambiguous definitions (including the concept of ‘definition’ itself). This triggered a need for mitigating hindrances such as homonymy and synonymy, leading further to demands on the decoding software complexity of which equals the artificial intelligence applications. Information technology presumably copes with this diversity by providing the information decoding ‘tools’. This opens a never-ending opportunity for further permutations of tasks and service abilities. The solution, however, is to address the causes rather than indulge in multiplying the superficial remedies. Clearly, the multiplicity of definitions for the same concepts, false synonyms and so forth show that there is a need for introducing definitions of sufficient dimensionality. In this article, a number of examples of important concepts are presented first to point at the ambiguities associated with them, and then to propose their disambiguation. The minimum intent is to demonstrate how these key terms can be defined to avoid ambiguities such as pleonasm, homonymy, synonymy and circularity