Introduction

BACKGROUND: National quality registries (NQRs) purportedly facilitate quality improvement, while neither the extent nor the mechanisms of such a relationship are fully known. The aim of this case study is to describe the experiences of local stakeholders to determine those elements that facilitate and hinder clinical quality improvement in relation to participation in a well-known and established NQR on stroke in Sweden. METHODS: A strategic sample was drawn of 8 hospitals in 4 county councils, representing a variety of settings and outcomes according to the NQR's criteria. Semi-structured telephone interviews were conducted with 25 managers, physicians in charge of the Riks-Stroke, and registered nurses registering local data at the hospitals. Interviews, including aspects of barriers and facilitators within the NQR and the local context, were analysed with content analysis. RESULTS: An NQR can provide vital aspects for facilitating evidence-based practice, for example, local data drawn from national guidelines which can be used for comparisons over time within the organisation or with other hospitals. Major effort is required to ensure that data entries are accurate and valid, and thus the trustworthiness of local data output competes with resources needed for everyday clinical stroke care and quality improvement initiatives. Local stakeholders with knowledge of and interest in both the medical area (in this case stroke) and quality improvement can apply the NQR data to effectively initiate, carry out, and evaluate quality improvement, if supported by managers and co-workers, a common stroke care process and an operational management system that embraces and engages with the NQR data. CONCLUSION: While quality registries are assumed to support adherence to evidence-based guidelines around the world, this study proposes that a NQR can facilitate improvement of care but neither the registry itself nor the reporting of data initiates quality improvement. Rather, the local and general evidence provided by the NQR must be considered relevant and must be applied in the local context. Further, the quality improvement process needs to be facilitated by stakeholders collaborating within and outside the context, who know how to initiate, perform, and evaluate quality improvement, and who have the resources to do so

Miljöövervakning i Mälaren 2007

Institutionen för vatten och miljö (fd miljöanalys) har på uppdrag av Mälarens vattenvårdsförbund varit utförare av miljöövervakningsprogrammet för Mälaren under 2007. Denna rapport redovisar en sammanfattning av resultaten från dessa undersökningar med fokus på fosfor, kväve och växtplankton

Enriching the Swedish Sign Language Corpus with Part of Speech Tags Using Joint Bayesian Word Alignment and Annotation Transfer

Abstract We have used a novel Bayesian model of joint word alignment and part of speech (PoS) annotation transfer to enrich the Swedish Sign Language Corpus with PoS tags. The annotations were then handcorrected in order to both improve annotation quality for the corpus, and allow the empirical evaluation presented herein

Enriching the Swedish Sign Language Corpus with Part of Speech Tags Using Joint Bayesian Word Alignment and Annotation Transfer

Abstract We have used a novel Bayesian model of joint word alignment and part of speech (PoS) annotation transfer to enrich the Swedish Sign Language Corpus with PoS tags. The annotations were then handcorrected in order to both improve annotation quality for the corpus, and allow the empirical evaluation presented herein

Asymmetric Cerebral Blood Flow in Patients with Mild Cognitive Impairment: Possible Relationship to Further Cognitive Deterioration

To explore patterns of cerebral blood flow in patients with mild cognitive impairment (MCI), who (1) eventually deteriorate into overt dementia, with no particular focus on the type of dementia, or (2) do not appear to further deteriorate in their cognitive functions

Ämnestransporter under vårflöden i Ume älv och Kalix älv

Stora mängder av olika ämnen transporteras i våra vattendrag i samband med de vattenflödestoppar som sker i anknytning till avsmältningen av snö och is under våren. I denna rapport har vattenkemidata undersökts och utvärderats från intensifierade provtagningar under vårfloderna 2008 och 2009 i de nedre delarna av Kalix och Ume älv. De båda norrländska älvarna tillhör delprogrammet Flodmynningar där målet är att ta fram dataunderlag som beskriver tillståndet i de viktigaste större vattendragen, samt beräkna hur mycket olika ämnen transporteras med dessa ut till havet. I detta arbete har belastningsberäkningar uträknade från dygnsvattenprovtagningen jämförts med beräkningar gjorda från den ordinarie månatliga vattenprovtagningen där syftet har varit att granska hur en utökad provtagningsfrekvens påverkar belastningsberäkningarnas kvalitet. – – – – – – A large quantity of different elements is transported in our water courses as the discharge reach its maximum which happen in connection to snow and ice melting in spring. In this report, water chemistry data from intensified water samplings during spring flood 2008 and 2009 in the lower parts of Kalix and Ume River is examined and interpreted. Both rivers belong to the programme - monitoring of the river mouths of large rivers, where the aim is to deliver data that describes the status of the most important large water courses, and calculate how much of different elements are reaching the seas. In this work, calculation of loads, which are calculated from daily water samplings, have been compared with loads calculated from the ordinary monthly water sampling programme. The aim was to examine how an increased sampling frequency will affect the quality of the calculation of load

How Single Is “Single” - Some Pragmatic Reflections on Single Versus Multifaceted Interventions to Facilitate Implementation Comment on “Translating Evidence Into Healthcare Policy and Practice: Single Versus Multifaceted Implementation Strategies – Is There a Simple Answer to a Complex Question?”

An earlier overview of systematic reviews and a subsequent editorial on single-component versus multifaceted interventions to promote knowledge translation (KT) highlight complex issues in implementation science. In this supplemented commentary, further aspects are in focus; we propose examples from (KT) studies probing the issue of single interventions. A main point is that defining what is a single and what is a multifaceted intervention can be ambiguous, depending on how the intervention is conceived. Further, we suggest additional perspectives in terms of strategies to facilitate implementation. More specifically, we argue for a need to depict not only what activities are done in implementation interventions, but to unpack functions in particular contexts, in order to support the progress of implementation science