Favourable cost-benefit in an early defibrillation program using dual dispatch of ambulance and fire services in out-of-hospital cardiac arrest

Aims: Out-of-hospital cardiac arrest (OHCA) is fatal without treatment and time to defibrillation is an extremely important factor in relation to survival. We performed a cost-benefit analysis of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm, Sweden. Methods and Results: A cost-benefit analysis was performed to evaluate the effects of dual dispatch defibrillation. The increased survival rates were estimated from a real world implemented intervention and the monetary value of a life (€ 2.2 million) was applied to this benefit by using results from a recent stated-preference study. The estimated costs include defibrillators (including expendables/maintenance), training, hospitalisation/health care, call-outs for the fire services, overhead resources and costs for the dispatch centre. The estimated number of additional saved lives was 16 per year, yielding a benefit-cost ratio of 36. The cost per quality-adjusted life years (QALY) was estimated to be € 13 000 and the cost per saved life was € 60 000. Conclusions: The intervention of dual dispatch defibrillation by ambulance and fire services in the County of Stockholm had positive economic effects. For the cost-benefit analysis the return on investment was high and the cost-effectiveness showed levels below the threshold value for economic efficiency used in Sweden. The cost-utility analysis categorises the cost per QALY as medium.Cost-benefit analysis; cost-utility analysis; cost-effectiveness analysis; cardiac arrest; defibrillation; ambulance; fire services

Business Rules on Trial: Exploring hindrances in validation of Natural Language Business Rules

The ability for organizations to respond to change has become ever more important in today's rapidly changing macro environment. The Business Rules Approach, a relatively new Information Systems Development methodology, promises business agility through the focus on and use of Business Rules. Business Rules are to be stated in natural language, so that they can be accessed and validated by people without technical experience. The easy validation of Business Rules by non-technical business users is a fundamental, but largely untested, claim and assumption in the Business Rules Approach. This thesis employs an experiment where eight librarian business experts were exposed to natural language Business Rules in order to find out if any problems arise when the said business experts attempted validation. The data was collected by conducting interviews in conjunction with the experiment, resulting in the conclusion that there were no major hindrances to validation of natural language Business Rules. The business experts in the study were able to go beyond validation of Business Rules by correcting erroneous Business Rules, suggesting corrections to Business Rules and in rare cases suggest structural changes to Business Rules

Perenner i kommunala planteringar

Idag vet vi att kommuner kan få ner sina skötselkostnader för sina grönytor och samtidigt skapa attraktiva utemiljöer genom att använda sig av perenner. I det här arbetet undersöks vad som är orsaken till varför det inte finns fler perennplanteringar i Sveriges kommuner och när perennplanteringar fyller sin funktion. Arbetet baseras på en undersökning där ett antal kommuner runt om i Sverige har svarat på frågor om hur de använder perenner i sina planteringar och varför. Kommunernas svar sammanställs i diagram, vars syfte är att visa eventuella mönster som i sin tur, förhoppningsvis ger en bild av hur läget ser ut generellt. Svaren ställs därefter i relation till litteraturen som sammanfattats i en studie. Av resultaten kan vi se att intresset för perenner är stort och det beror främst på att de är skötselsnåla. Det estetiska värdet spelar också en stor roll. I de kommuner som hellre använder annat växtmaterial, är klimatet ett problem. Perennerna får inte den tidiga önskvärda blomningen och har svårt att överleva vintern. För lite pengar till skötsel och brist på intresse är andra anledningar till varför vissa kommuner väljer att inte plantera perenner. För att lyckas skapa fysiskt hållbara och ekonomiskt försvarbara perennplanteringar, måste de ansvariga i respektive kommun ha kunskapen om hur växterna lever och vad de kräver för skötsel

Affordances of models and modelling: a study of four technology design projects in the Swedish secondary school

This study aims to investigate affordances of models and modelling in design projects in technology education. To learn more about affordances when working with models and modelling, four Swedish technology teachers were interviewed using a narrative approach. Despite a small number of informants data were rich, containing detailed descriptions of sequences where students used models and modelling in ways not planned by the teachers. By using a qualitative, generic inductive approach, the narrative interviews revealed seven different affordances of models and modelling in the projects: Seeing different solutions; Finding possibilities and limitations in solutions; Representing an idea, structure or function; Communicating solutions with drawings; Making problems and solutions visible; Trial and error and learning from mistakes and finally Taking inspirations from each other’s solutions. Some conclusions and implications of the study are that when the students can see and use a wide variety of materials when modelling, they are more creative in finding solutions to design problems. The use of conceptual design in schools, leading to students performing trial and error using models to solve problems, might also be connected to the importance of a variety of materials. In the study, teachers describe how their students used models, trying different solutions, representing ideas, and trying, failing and trying again. All these modelling activities are important parts of a design process and might prove that the doing itself is a process of reflection

New Micarea records from Norway and Sweden and an identification key to the M. prasina group in Europe

Micarea czarnotae and M. pseudomicrococca are reported as new to Sweden, and M. fallax is reported as new to Norway. Micarea laeta and M. melanobola are reported from Sweden for the first time since 1927 and 1892, respectively. Micarea fallax is reported from three new localities in Sweden. An updated identification key for the M. prasina group in Central and Northern Europe is provided.Peer reviewe

Cost and benefit analysis of quality requirements in competitive software product management: a case study on the QUPER model

In market-driven product development, it is important that the software product is released to the market at the right time, and offers higher quality than the competitors. In release planning, the allocation of development effort in investments into product enhancements, functions are competing with quality requirements for limited resources. In addition, it is important to find the right balance between competing quality requirements. In this paper, we present an industrial evaluation of the benefit and cost views in the QUality PERformance (QUPER) model. The results indicate that the model is relevant in the release planning process, and that the combination of the benefit and cost views provides a clear picture of the current market situation

Journal Staff

Background: The polytene nuclei of the dipteran Chironomus tentans (Ch. tentans) with their Balbiani ring (BR) genes constitute an exceptional model system for studies of the expression of endogenous eukaryotic genes. Here, we report the first draft genome of Ch. tentans and characterize its gene expression machineries and genomic architecture of the BR genes. Results: The genome of Ch. tentans is approximately 200 Mb in size, and has a low GC content (31%) and a low repeat fraction (15%) compared to other Dipteran species. Phylogenetic inference revealed that Ch. tentans is a sister clade to mosquitoes, with a split 150-250 million years ago. To characterize the Ch. tentans gene expression machineries, we identified potential orthologus sequences to more than 600 Drosophila melanogaster (D. melanogaster) proteins involved in the expression of protein-coding genes. We report novel data on the organization of the BR gene loci, including a novel putative BR gene, and we present a model for the organization of chromatin bundles in the BR2 puff based on genic and intergenic in situ hybridizations. Conclusions: We show that the molecular machineries operating in gene expression are largely conserved between Ch. tentans and D. melanogaster, and we provide enhanced insight into the organization and expression of the BR genes. Our data strengthen the generality of the BR genes as a unique model system and provide essential background for in-depth studies of the biogenesis of messenger ribonucleoprotein complexes

Tailoring Charge Recombination in Photoelectrodes Using Oxide Nanostructures

Optimizing semiconductor devices for solar energy conversion requires an explicit control of the recombination of photogenerated electron hole pairs. Here we show how the recombination of charge carriers can be controlled in semiconductor thin films by surface patterning with oxide nanodisks. The control mechanism relies on the formation of dipole-like electric fields at the interface that, depending on the field direction, attract or repel minority carriers from underneath the disks. The charge recombination rate can be controlled through the choice of oxide material and the surface coverage of nanodisks. We provide proof-of-principle demonstration of this approach by patterning the surface of Fe2O3, one of the most studied semiconductors for light-driven water splitting, with TiO2 and Cu2O nanodisks. We expect this method to be generally applicable to a range of semiconductor-based solar energy conversion devices

Open source på IT-företag

Open source är idag ett vida känt begrepp och det finns numera ett open source alternativ till nästan varje mjukvara av proprietär sort. Med en växande användarbas och en kostnad som nästan alltid är obefintlig är det naturligt att företag ser open source som ett alternativ till att köpa proprietär mjukvara. Genom denna uppsats undersöker vi därför vilka egenskaper hos open source som är viktiga och mindre viktiga när beslut om att använda den typen av mjukvara tas, och om IT-företag idag över huvud taget överväger att använda open source. För att svara på detta skapas ett teoretiskt ramverk med totalt sex faktorer som baserat på tidigare forskning och litteratur är de vanligast förekommande egenskaperna hos open source. Fyra stycken intervjuer genomförs sedan med små till medelstora IT-företag där frågorna baseras på ramverkets sex faktorer

Impact of low-dose prednisolone on bone synthesis and resorption in early rheumatoid arthritis: experiences from a two-year randomized study

Introduction Patients with rheumatoid arthritis (RA) have an increased frequency of osteoporosis, mainly because of increased bone resorption. Reduction of disease activity is suggested to reduce bone remodelling. It might also be possible that prednisolone treatment could cause this effect because prednisolone has been shown to arrest the development of joint destruction in early RA. Therefore, we examined the effects of low-dose prednisolone on serum concentrations of bone remodelling markers and insulin-like growth factor-1 (IGF-1) in RA patients in relation to bone mineral density. Methods One hundred and fifty patients, 67% women, with early RA, mean disease duration of six months (95% confidence interval (CI) = three to eight months), who had participated in the BARFOT (Better Anti-Rheumatic FarmacOTherapy) low-dose prednisolone study were included. They had been randomised to either the P-group, who were treated with 7.5 mg prednisolone daily (n = 70, mean age = 51 years, 95% CI 48 to 54 years), or the NoP-group, who received no prednisolone (n = 80, mean age 58 years, 95% CI 56 to 61 years), when they started their first disease-modifying anti-rheumatic drug (DMARD). Serum samples were analysed at baseline, 3 and 12 months for procollagen type I N-terminal propeptide (P1NP), a marker of bone formation, and the C-telopeptide crosslaps of type I collagen (CTX-1) and C-terminal telopeptide of type I collagen (1CTP), markers of bone degradation. IGF-1 was analysed at baseline and after 12 months. Bone mineral density at the lumbar spine and femoral neck was assessed by dual-energy X-ray absorptiometry at baseline and after 24 months. Results Levels of P1NP decreased rapidly in the P-group (p < 0.001). Levels of CTX-1 and 1CTP decreased in both treatment groups, but significantly more in the P-group (differences between groups p < 0.019 and p < 0.001, respectively). IGF-1 increased in the P-group (p < 0.001) but remained stable in the NoP-group. Bone mineral density decreased in the spine in both groups, significantly more in postmenopausal women from the P-group. Femur bone mineral density only decreased in the NoP-group. Conclusions Low-dose prednisolone in early RA counteracts the negative impact of rheumatoid inflammation on bone tissue in the hip, a juxta-articular localisation. Thus bone mineral density was preserved in the femur in the P-group and 1CTP decreased rapidly. However, the systemic inflammatory consequences on bone could not be prevented in the lumbar spine, especially not in postmenopausal women, probably because of the combined effect of suppression of bone synthesis by prednisolone and the postmenopausal status