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Search Results: 1 - 10 of 7855 matches for " Hans Husum "
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Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq
Mudhafar K Murad, Stig Larsen, Hans Husum
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2012, DOI: 10.1186/1757-7241-20-13
Abstract: In the study period from 1997 to 2006, 2,788 patients injured by land mines, war, and traffic accidents were managed by a chain-of-survival trauma system where non-graduate paramedics were the key care providers. The study was conducted with a time-period cohort design.37% of the study patients had serious injuries with Injury Severity Score ≥ 9. The mean prehospital transport time was 2.5 hours (95% CI 1.9 - 3.2). During the ten-year study period trauma mortality was reduced from 17% (95% CI 15 -19) to 4% (95% CI 3.5 - 5), survival especially improving in major trauma victims. In most patients with airway problems, in chest injured, and in patients with external hemorrhage, simple life support measures were sufficient to improve physiological severity indicators.In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.The epidemic of trauma is accelerating. Injury is now the fourth leading cause of global deaths, and up to 2030 WHO estimates a further 40% increase in trauma fatalities. Almost 90% of injury deaths occur in low- and middle-income countries [1]. Who is to manage this heavy load of trauma - in disastrous events as well as chronic emergencies like the land mine epidemic? Studies of Western trauma scenarios consistently report that reduced prehospital transport times and level I trauma centers and are the essential components of a good trauma system [2]. However, helicopter evacuations and high-cost surgical centers are not feasible in low-income societies and in countries where the social fabric is broken by war. In our time, local wars and natural disasters especially hit low-resource communities and here the "scoop-and run-for-the hospital" strategy hardly fits. There is thus an urgent need to develop trauma system
A cross-sectional prospective study of seclusion, restraint and involuntary medication in acute psychiatric wards: patient, staff and ward characteristics
Tonje Husum, Johan Bj?rngaard, Arnstein Finset, Torleif Ruud
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-89
Abstract: Multilevel logistic regression using Stata was applied with data from 1016 involuntary admitted patients that were linked to data about wards. The sample comprised two hierarchical levels (patients and wards) and the dependent variables had two values (0 = no use and 1 = use). Coercive measures were defined as use of seclusion, restraint and involuntary depot medication during hospitalization.The total number of involuntary admitted patients was 1214 (35% of total sample). The percentage of patients who were exposed to coercive measures ranged from 0-88% across wards. Of the involuntary admitted patients, 424 (35%) had been secluded, 117 (10%) had been restrained and 113 (9%) had received involuntary depot medication at discharge. Data from 1016 patients could be linked in the multilevel analysis. There was a substantial between-ward variance in the use of coercive measures; however, this was influenced to some extent by compositional differences across wards, especially for the use of restraint.The substantial between-ward variance, even when adjusting for patients' individual psychopathology, indicates that ward factors influence the use of seclusion, restraint and involuntary medication and that some wards have the potential for quality improvement. Hence, interventions to reduce the use of seclusion, restraint and involuntary medication should take into account organizational and environmental factors.Use of coercion in treatment is controversial [1-5], and reducing use of coercion in psychiatric services is a priority health political issue in Western countries [6-8]. Too much use of coercion in mental health care may be a threat to the quality of care, as well as to patients' human rights. It is of crucial importance to develop a better understanding of the processes and factors involved to reduce the use of coercion. There is evidence of considerable variation in the extent to which coercive measures are used. This is shown in international comparative studie
Northward advection of Atlantic water in the eastern Nordic Seas over the last 3000 yr: a coccolith investigation of volume transport and surface water changes
C. V. Dylmer,J. Giraudeau,F. Eynaud,K. Husum
Climate of the Past Discussions , 2013, DOI: 10.5194/cpd-9-1259-2013
Abstract: Three marine sediment cores distributed along the Norwegian (MD95-2011), Barents Sea (JM09-KA11-GC), and Svalbard (HH11-134-BC) continental margins have been investigated in order to reconstruct changes in the poleward flow of Atlantic Waters (AW) and in the nature of upper surface water masses within the eastern Nordic Seas over the last 3000 yr. These reconstructions are based on a limited set of coccolith proxies: the abundance ratio between Emiliania huxleyi and Coccolithus pelagicus, an index of Atlantic vs. Polar-Arctic surface water masses; and Gephyrocapsa muellerae, a drifted coccolith species from the temperate North Atlantic, whose abundance changes are related to variations in the volume transport of the North Atlantic Current and its northernmost extension (the West Spitsbergen Current – WSC) off western Svalbard. The entire investigated area, from 66 to 77° N, was affected by an overall increase in volume flow of AW from 3000 cal yr BP to Present. The long-term modulation of westerlies strength and location which are essentially driven by the dominant mode of the North Atlantic Oscillation (NAO), is thought to explain the observed dynamics of poleward AW flow. The same mechanism also reconciles the recorded opposite zonal shifts in the location of the Arctic Front between the area off western Norway and the Barents Sea-eastern Fram Strait region. The Little Ice Age was governed by deteriorating conditions, with Arctic/Polar waters dominating in the surface off western Svalbard and western Barents Sea, possibly associated with both severe sea-ice conditions and a strongly reduced AW volume flow. A sudden short pulse of resumed high WSC flow interrupted this cold spell in eastern Fram Strait from 330 to 410 cal yr BP, with a a magnitude only surpassed by the one which characterizes the Modern Period. Our dataset not only confirms the high amplitude warming of surface waters at the turn of the 19th century off western Svalbard, it also shows that such a warming was primarily induced by an excess volume flow of AW which stands as unprecedented over the last 3000 yr.
Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls
Rolv-Ole Lindsetmo, Roar Johnsen, Tor Jac Eide, Tore Gutteberg, Hanne Haukland Husum, Arthur Revhaug
World Journal of Gastroenterology , 2008,
Abstract: AIM: To estimate the test characteristics of Helicobacter pylori (H pylori) serology and of C14-urea breath test (C14-UBT) in two different peptic ulcer populations and in community controls. Second, the aim was to explore the association between the level of H pylori IgG antibodies and severity of inflammation as to active peptic ulceration in the same populations.METHODS: Vagotomized (n = 83), medically treated peptic ulcer patients (n = 73) and one reference group of community controls (n = 88) were gastroscoped. H pylori status was determined by histology, bacterial growth, C14-UBT and serology. Based on the updated Sydney System, cumulative scores from biopsies from the prepyloruos, incisura angularis, corpus and fundus were calculated.RESULTS: The prevalence of H pylori infection varied from 70% to 79%. The C14-UBT had high accuracy compared to the serology test. The sensitivity of the serology test was good, but the specificity was low (41%-71%). The association between H pylori IgG antibodies and scores of gastric mucosal inflammation and current or previous peptic ulcer were weak.CONCLUSION: The accuracy of C14-UBT to diagnose H pylori infection was good, and the clinical utility of a negative H pylori serology test was substantial, while the gain in clinical information of a positive test was meagre. Positive H pylori titres could not distinguish between subjects with or those without active peptic ulceration.
Network Economies for the Internet-Application Models  [PDF]
Hans Gottinger
iBusiness (IB) , 2011, DOI: 10.4236/ib.2011.34042
Abstract: We propose a decentralized model of network and server economies, where we show efficient QoS (Quality of Service) provisioning and Pareto allocation of resources (network and server resources) among agents and suppliers, which are either network routers or servers (content providers). Specifically, it is shown 1) how prices for resources are set at the suppliers based on the QoS demands from the agents and 2) how dynamic routing algorithms and admission control mechanisms based on QoS preferences emerge from the user classes for the network economy.
Fatal Complications and Early Death after Surgical Treatment of Lung Cancer in 2000 and 2010. A Population Based Study  [PDF]
Hans Rostad
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41019
Abstract:

In the year 2000 lung cancer was operated in 349 patients in Norway, in 2010 the number was 461. In the first period fatal surgical hemorrhage occurred in eight patients, in four of them peroperatively. Postoperative hemorrhage occurred in four patients in the year 2000 and in two in 2010. Ten patients died intra- or postoperatively in the two periods which is a mortality rate within 30 days after surgery of 4.3% in the first and 1.1% in the second period. Pneumonectomy was performed in 34 patients in 2000 and eight in 2010, respectively. Altogether 19 patients died within six months after surgery without having experienced surgical complications. Pneumonectomy should not be performed in elderly and debilitated persons.

On the Foundations of Guidelines for Health Economic Assessment  [PDF]
Hans Keiding
Open Journal of Social Sciences (JSS) , 2016, DOI: 10.4236/jss.2016.45004
Abstract:

In recent years, increased attention has been given to guidelines for cost-effectiveness analysis of medical interventions, and some of these guidelines (such as NICE [1]) have become rather influential. In the paper, we present a model of retrieving and processing information to be used for the study of guidelines and their use. Our main result, which relies on a version of the theorem of Blackwell [2], shows that in cases where there are sufficiently many decisions to be made on the basis of the information obtained, there can be no other objective ranking of methods than the trivial one ranking more information is higher than less information. In our context, this means that guidelines may have administrative advantages but cannot be considered as a scientifically based approach to better decision making.

The Market for Firms: Market Signaling and Overpricing  [PDF]
Jerome Davis, Hans Keiding
Technology and Investment (TI) , 2010, DOI: 10.4236/ti.2010.13024
Abstract: In this paper, the pricing and sale of firms is approached from the owners’ point of view. It is shown that there are very strong ex ante owner incentives to set prices of firm products or services below their short- term profit maximizing levels, since low prices signal low costs and as a consequence a higher sales value of the firm. Buyers take this signaling into consideration, but irrespective of their countermoves, the equilib- rium result may be a lowering of ex ante product prices, and an ex post market overvaluation of the firm. This model is utilized to suggest possible explanations to one of the more puzzling initial public offer (IPO) phenomena: the long run underperformance of IPO equities.
Deposition of charged nano-particles in the human airways including effects from cartilaginous rings  [PDF]
Hans O. Akerstedt
Natural Science (NS) , 2011, DOI: 10.4236/ns.2011.310113
Abstract: This paper presents a numerical study of the deposition of spherical charged nano-particles caused by convection, Brownian diffusion and electrostatics in a pipe with a cartilaginous ring structure. The model describes the deposition of charged particles in the different generations of the tracheobronchial tree of the human lung. The upper airways are characterized by a certain wall structure called cartilaginous rings which modify the particle deposition when compared to an airway with a smooth wall. The problem is defined by solving Naver-Stokes equations in combination with a convective-diffusion equation and Gauss law for electrostatics. Three non- dimensional parameters describe the problem, the Peclet number Pe = 2ūa/D , the Reynolds number Re = ūa/v and an electrostatic parameter α=α2c0q2/(4ε0κT) . Here U is the mean velocity, a the pipe radius and D the diffusion coefficient due to Brownian motion given by D=κTCu/3πμd , where Cu is the Cunningham-factor Cu=1+λ/d(2.34+1.05exp(-0.39d/λ)) Here d is the particle diameter and λ the mean free path of the air molecules. Results are provided for generations G4-G16 of the human airways. The electrostatic parameter is varied to model different concentrations and charge numbers.
Using Insulation in China’s Buildings: Potential for Significant Energy Savings and Carbon Emission Reductions  [PDF]
Guoliang Liu, Hans Liu
Low Carbon Economy (LCE) , 2011, DOI: 10.4236/lce.2011.24027
Abstract: Most old residential and commercial buildings in China are not insulated or not to new standards. This is true even in regions with very cold winters or regions with very hot summers. The insulation in new buildings is very poor relative to North American standards. However, insulating the exterior walls, attic roofs, and foundation walls to new standards of buildings in China would reduce the need for heating and air conditioning, and thus would save roughly 200 million tons of coal each year. This in turn would lead to a reduction in CO2 emissions of about 510 million tons per year, which is equal to about 8.4% of China’s total carbon emissions in 2006. The use of insulation in buildings will help homeowners save money, help China save energy and help the environment all at the same time. Insulation will provide a continued payback to the homeowner, not only in dollars and cents, but also by providing a more enjoyable and comfortable living environment for many years.
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