Can ICU admission be predicted?

After intensive care (IC), patients report poor health-related quality of life (HRQoL). Many factors affect the patients and influence the HRQoL after discharge. One of these factors is the patient's health status before the critical care period. In a previous study we found that the IC patients have a high frequency of pre-existing diseases. However, it is unknown to what extent these pre-existing diseases affect the consumption of hospital resources (measured as days as inpatients) in the time period before admission to the ICU and during the years following it. The consumption prior to the ICU event may also be claimed to herald an increased risk for a later ICU admittance? The aim of this study was to examine the hospital care consumption of former ICU patients 3 years prior to and 3 years after the intensive care period. This was examined in relation to the pre-existing health status

How was it for you? Experiences of participatory design in the UK health service

Improving co-design methods implies that we need to understand those methods, paying attention to not only the effect of method choices on design outcomes, but also how methods affect the people involved in co-design. In this article, we explore participants' experiences from a year-long participatory health service design project to develop ‘Better Outpatient Services for Older People’. The project followed a defined method called experience-based design (EBD), which represented the state of the art in participatory service design within the UK National Health Service. A sample of participants in the project took part in semi-structured interviews reflecting on their involvement in and their feelings about the project. Our findings suggest that the EBD method that we employed was successful in establishing positive working relationships among the different groups of stakeholders (staff, patients, carers, advocates and design researchers), although conflicts remained throughout the project. Participants' experiences highlighted issues of wider relevance in such participatory design: cost versus benefit, sense of project momentum, locus of control, and assumptions about how change takes place in a complex environment. We propose tactics for dealing with these issues that inform the future development of techniques in user-centred healthcare design

The morality of attitudes toward nanotechnology: about God, techno-scientific progress, and interfering with nature

Using survey data, we examine public attitudes toward and awareness of nanotechnology in Germany (N = 750). First, it is shown that a majority of the people are still not familiar with nanotechnology. In addition, diffusion of information about nanotechnology thus far mostly seems to reach men and people with a relative higher educational background. Also, pro-science and technology views are positively related with nanotech familiarity. Results further show that a majority of the people have an indifferent, ambiguous, or non-attitude toward nanotechnology. Multinomial logit analyses further reveal that nanotech familiarity is positively related with people’s attitudes. In addition, it is shown that traditional religiosity is unrelated to attitudes and that individual religiosity is weakly related to nanotechnology attitudes. However, moral covariates other than religiosity seem of major importance. In particular, our results show that more negative views on technological and scientific progress as well as more holistic views about the relation between people and the environment increase the likelihood of having a negative attitude toward nanotechnology

Bacteria Penetrate the Inner Mucus Layer before Inflammation in the Dextran Sulfate Colitis Model

Protection of the large intestine with its enormous amount of commensal bacteria is a challenge that became easier to understand when we recently could describe that colon has an inner attached mucus layer devoid of bacteria (Johansson et al. (2008) Proc. Natl. Acad. Sci. USA 105, 15064-15069). The bacteria are thus kept at a distance from the epithelial cells and lack of this layer, as in Muc2-null mice, allow bacteria to contact the epithelium. This causes colitis and later on colon cancer, similar to the human disease Ulcerative Colitis, a disease that still lacks a pathogenetic explanation. Dextran Sulfate (DSS) in the drinking water is the most widely used animal model for experimental colitis. In this model, the inflammation is observed after 3-5 days, but early events explaining why DSS causes this has not been described.When mucus formed on top of colon explant cultures were exposed to 3% DSS, the thickness of the inner mucus layer decreased and became permeable to 2 microm fluorescent beads after 15 min. Both DSS and Dextran readily penetrated the mucus, but Dextran had no effect on thickness or permeability. When DSS was given in the drinking water to mice and the colon was stained for bacteria and the Muc2 mucin, bacteria were shown to penetrate the inner mucus layer and reach the epithelial cells already within 12 hours, long before any infiltration of inflammatory cells.DSS thus causes quick alterations in the inner colon mucus layer that makes it permeable to bacteria. The bacteria that reach the epithelial cells probably trigger an inflammatory reaction. These observations suggest that altered properties or lack of the inner colon mucus layer may be an initial event in the development of colitis

Predictors in the Swedish Counterterrorism Intervention Unit selection Process

This study examines the importance of physical and psychological predictors of work sample performance within the Swedish police Counterterrorism Intervention Assessment and Selection (CTIAS) process (N = 160). CTIAS consists of a 4-day prescreening (Phase 1) and a 10-day work sample test (Phase 2). Applicants may withdraw freely or be stopped by a CTIAS board (if they do not fulfill the CTIAS requirement criteria) at any moment throughout Phases 1 and 2. The dependent variable was applicants being approved at the end of CTIAS Phase 1. Biserial correlations were used to determine relationships between the predictors’ age, general mental ability, executive functions, personality, physical strength, coordination, running capacity and the dependent variable. Significant (p < 0.01) results in the biserial correlations were strength (r = 0.217), coordination (r = 0.223), and running capacity (r = 0.412). In conclusion, the logistic regression analysis with all predictors revealed that only running capacity (2800 meters) was significant for approval to CTIAS. Implications for the practical selection of CTIAS are discussed, and suggestions for future investigation are proposed. Public significance statement: The current study examined physical and psychological predictors in a selection process within a tactical unit in the Swedish Police Authority. Higher running capacity was the only predictor that increased the odds of approved applicants

Termination Casts: A Flexible Approach to Termination with General Recursion

This paper proposes a type-and-effect system called Teqt, which distinguishes terminating terms and total functions from possibly diverging terms and partial functions, for a lambda calculus with general recursion and equality types. The central idea is to include a primitive type-form "Terminates t", expressing that term t is terminating; and then allow terms t to be coerced from possibly diverging to total, using a proof of Terminates t. We call such coercions termination casts, and show how to implement terminating recursion using them. For the meta-theory of the system, we describe a translation from Teqt to a logical theory of termination for general recursive, simply typed functions. Every typing judgment of Teqt is translated to a theorem expressing the appropriate termination property of the computational part of the Teqt term.Comment: In Proceedings PAR 2010, arXiv:1012.455

On local linearization of control systems

We consider the problem of topological linearization of smooth (C infinity or real analytic) control systems, i.e. of their local equivalence to a linear controllable system via point-wise transformations on the state and the control (static feedback transformations) that are topological but not necessarily differentiable. We prove that local topological linearization implies local smooth linearization, at generic points. At arbitrary points, it implies local conjugation to a linear system via a homeomorphism that induces a smooth diffeomorphism on the state variables, and, except at "strongly" singular points, this homeomorphism can be chosen to be a smooth mapping (the inverse map needs not be smooth). Deciding whether the same is true at "strongly" singular points is tantamount to solve an intriguing open question in differential topology

Critical Enhancement of the In-medium Nucleon-Nucleon Cross Section at low Temperatures

The in-medium nucleon-nucleon cross section is calculated starting from the thermodynamic T-matrix at finite temperatures. The corresponding Bethe-Salpeter-equation is solved using a separable representation of the Paris nucleon-nucleon-potential. The energy-dependent in-medium N-N cross section at a given density shows a strong temperature dependence. Especially at low temperatures and low total momenta, the in-medium cross section is strongly modified by in-medium effects. In particular, with decreasing temperature an enhancement near the Fermi energy is observed. This enhancement can be discussed as a precursor of the superfluid phase transition in nuclear matter.Comment: 10 pages with 4 figures (available on request from the authors), MPG-VT-UR 34/94 accepted for publication in Phys. Rev.