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Search Results: 1 - 10 of 465389 matches for " Bj?rn A Moum "
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Epidemiology and clinical course of Crohn's disease: Results from observational studies
?istein Hovde,Bjrn A Moum
World Journal of Gastroenterology , 2012, DOI: 10.3748/wjg.v18.i15.1723
Abstract: The authors review the clinical outcome in patients with Crohn’s disease (CD) based on studies describing the natural course of the disease. Population-based studies have demonstrated that the incidence rates and prevalence rates for CD have increased since the mid-1970s. The authors search for English language articles from 1980 until 2011. Geographical variations, incidence, prevalence, smoking habits, sex, mortality and medications are investigated. An increasing incidence and prevalence of CD have been found over the last three decades. The disease seems to be most common in northern Europe and North America, but is probably increasing also in Asia and Africa. Smoking is associated with an increased risk of developing CD. Age < 40 at diagnosis, penetrating/stricturing complications, need for systemic steroids, and disease location in terminal ileum are factors associated with higher relapse rates. A slight predominance of women diagnosed with CD has been found. Ileocecal resection is the most commonly performed surgical procedure, and within the first five years after the diagnosis about one third of the patients have had intestinal surgery. Smoking is associated with a worse clinical course and with increased risk of flare-ups. In most studies the overall mortality is comparable to the background population. To date, the most effective treatment options in acute flares are glucocorticosteroids and tumor necrosis factor (TNF)-α- blockers. Azathioprine/methotrexate and TNF-α-blockers are effective in maintaining remission.
Spatial Competition between Health Care Providers: Effects of Standardization  [PDF]
Bjrn A. Kuchinke, Jürgen Zerth
Theoretical Economics Letters (TEL) , 2015, DOI: 10.4236/tel.2015.53043
Abstract: In the international health care literature the impacts of competition in health care markets are discussed widely. But aspects of standardization in regional health care markets with no price competition received comparatively little attention. We use a typical Hotelling framework to analyze a regional health care market with two health care providers competing in (vertical) quality after the scope of medical treatment has been set (horizontal quality). We conclude that in the basic model both health care providers will use vertical quality to separate from each other. In the next step we introduce a standard in vertical quality of which one health care providerthe standard profiteer—could better cope with. In the standardization case a more homogeneous supply can be expected and there is a higher possibility that the standard follower has to leave the regional health care market. Therefore standardization of health care quality could strengthen monopolistic tendencies.
Worries and Concerns among Inflammatory Bowel Disease Patients Followed Prospectively over One Year
Lars-Petter Jelsness-J?rgensen,Bjrn Moum,Tomm Bernklev
Gastroenterology Research and Practice , 2011, DOI: 10.1155/2011/492034
Abstract: Disease-related worries are frequently reported in inflammatory bowel disease (IBD), but longitudinal assessments of these worries are scarce. In the present study, patients completed the rating form of IBD patient concerns (RFIPC) at three occasions during one year. One-way analysis of variance (ANO VA), t-tests, bivariate correlation, and linear regression analyses were used to analyse data. The validity and reliability of the Norwegian RFIPC was tested. A total of 140 patients were included (V1), ulcerative colitis (UC) n = 92, Crohn's disease (CD) n = 48, mean age 46.9 and 40.0-year old, respectively. The highest rated worries included having an ostomy bag, loss of bowel control, and reduced energy levels. Symptoms were positively associated with more worries. A pattern of IBD-related worries was consistent over a period of one year. Worries about undergoing surgery or having an ostomy bag seemed to persist even when symptoms improved. The Norwegian RFIPC is valid and reliable. 1. Introduction In inflammatory bowel disease (IBD), comprising Crohn’s disease (CD) and ulcerative colitis (UC), the measurement of health-related quality of life (HRQOL) has become important, both as a primary and secondary endpoint [1–4]. In IBD, the decrease in HRQOL scores is well documented in a vast amount of studies [2–4]. Subjective health measurements in patient research may reveal important issues for the patient, but not apparent for the healthcare worker [1]. In accordance with observations made in clinical practice and with intention to help clinicians quantify information about IBD- related worries, Drossman et al. [5] developed the rating form of IBD patient concerns (RFIPC). Various studies have made use of the RFIPC in clinical trials [5–10]. These studies do, however, have a cross-sectional design, which only provide a snapshot at a given point of time. Since worries most often is future directed, they may potentially change in time and space. Our knowledge of IBD-related worries in a longitudinal perspective is limited. Only one study addresses these issues prospectively in CD, but not in UC [11]. Results of a longitudinal assessment of IBD-related worries may facilitate patient-physician communication and consequently be clinically impactful [1]. Different studies have found the RFIPC to be valid and reliable [5–10]. However, the RFIPC needs to be translated and tested psychometrically in the Norwegian language to overcome conceptual, semantic, and linguistic differences across cultures and languages [1, 12]. The primary aim of this study was to assess
Sense of Coherence in Patients with Inflammatory Bowel Disease
Randi Opheim,May Solveig Fagermoen,Lars-Petter Jelsness-J?rgensen,Tomm Bernklev,Bjrn Moum
Gastroenterology Research and Practice , 2014, DOI: 10.1155/2014/989038
Abstract: Background and Aim. Sense of coherence (SOC) is a health-promoting concept reflecting a person’s view of life and response to stressful situations and may be of importance in coping with chronic illness. The aim of this study was to explore associations between SOC and sociodemographic, disease-related, and personal characteristics in a sample of patients with inflammatory bowel disease (IBD). Methods. Measures included sociodemographic and disease-related data, the Sense of Coherence Scale, General Self-Efficacy Scale (GSE), and Fatigue Severity Scale (FSS-5). Results. In total, 428 IBD patients had evaluable questionnaires (response rate 93%). The overall mean SOC total score was 66.25 (SD 11.47) and with no statistically significant difference between patients with ulcerative colitis (UC) and patients with Crohn’s disease (CD). In the multivariate analyses, higher GSE scores were significantly associated with higher SOC scores and higher FSS-5 scores were significantly associated with lower SOC scores in both UC and CD. Conclusion. GSE and FSS-5 contributed more to the variance in SOC than sociodemographic and disease-related variables. Longitudinal studies are warranted to investigate the value of SOC as a predictor of disability, medication adherence, coping behavior, and health-related quality of life. 1. Introduction The inflammatory bowel diseases (IBD), Crohn’s disease (CD), and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract of unknown etiology. The course of disease is characterized by periods of symptom flares and periods with quiescent disease. Common symptoms are diarrhea, bloody stools, fever, fatigue, and abdominal pain [1–3]. As with many chronic diseases, IBD patients’ quality of life and psychosocial function have been shown to be influenced by their disease [4–8]. Further, patients diagnosed with IBD at a young age and with a severe disease course have an increased risk for work disability [9]. Coping with a chronic illness such as IBD involves complex cognitive, physical, emotional, psychological, and behavioral processes [5]. Patients must be able to manage complex medication regimens, find meaning in and adapt to changeable life conditions, and deal with emotions associated with the fact that the disease is not curable. The unpredictable disease course also poses challenges for the patients’ daily life as well their life in general [10]. Given the complexity of living with a chronic illness, personal resources may be of importance for patients’ well-being, quality of life, and ability to
A Theoretical-Study of the Scattering of Ultrasound from Blood
Bjrn A.J. Angelsen
Modeling, Identification and Control , 1981, DOI: 10.4173/mic.1981.4.3
Abstract: A theoretical treatment of the scattering of ultrasound from blood is given, assuming that the blood behaves essentially as a continuum. The scattering then arises from fluctuations in the mass density and compressibility of the blood, which is caused by a fluctuation in the red cell concentration. An expression for the received signal in ultrasonic blood velocity measurements is given. The stochastic properties of the signal are discussed with reference the information content about the velocity field in the blood. Since the signal is Gaussian, all available information is contained in the power spectrum, which is a blurred approximation to the velocity distribution in the region of observation.
Equalization and Decoding for Multiple-Input Multiple-Output Wireless Channels
Bjerke Bjrn A,Proakis John G
EURASIP Journal on Advances in Signal Processing , 2002,
Abstract: We consider multiple-input, multiple-output (MIMO) wireless communication systems that employ multiple transmit and receive antennas to increase the data rate and achieve diversity in fading multipath channels. We begin by focusing on an uncoded system and define optimal and suboptimal receiver structures for this system in Rayleigh fading with and without intersymbol interference. Next, we consider coded MIMO systems. We view the coded system as a serially concatenated convolutional code (SCCC) in which the code and the multipath channel take on the roles of constituent codes. This enables us to analyze the performance using the same performance analysis tools as developed previously for SCCCs. Finally, we present an iterative ("turbo") MAP-based equalization and decoding scheme and evaluate its performance when applied to a system with transmit antennas and receive antennas. We show that by performing recursive precoding prior to transmission, significant interleaving gains can be realized compared to systems without precoding.
Application of Pedagogical Perspectives in the Teaching and Training of New Cataract Surgeons—A Literature-Based Essay  [PDF]
Bjrn Johansson
Open Journal of Ophthalmology (OJOph) , 2013, DOI: 10.4236/ojoph.2013.33015

Cataract is the most common cause of visual impairment that can be effectively treated by surgery and cataract surgery is the most commonly performed surgical procedure in the world. With modern cataract operation techniques, patients expect excellent results. Teaching and training of new surgeons involve both pedagogical and ethical challenges for teachers and trainees, and also may pose a potential risk to patients. This literature-based essay aims to describe how behavioristic, cognitive and conceptual learning perspectives can be recognized during the trainee surgeons progress. It also describes how teacher-pupil relationships may vary during the training process. Finally it presents the concept of situational tutorship, where the teacher adapts to the stages that the trainee passes through with increasing experience. Teaching and trainee surgeons who are aware of pedagogical concepts such as teacher-pupil relationships and tutoring strategies may use this knowledge to optimize the learning process. Further research is needed to clarify how using this knowledge may affect the training of new cataract surgeons.

Reviewing the Learning Process through Creative Puzzle Solving  [PDF]
Bjrn Petter Jelle
Creative Education (CE) , 2017, DOI: 10.4236/ce.2017.813137
Abstract: Human beings are at a continuous learning process at various levels and with different motivations during their whole lifetime. Puzzle solving may beneficially be applied to increase the motivation, enhance the mastering apprehension, promote the creative processes, expand the ability to engage and solve miscellaneous challenges from various viewpoints, and hence lead to an improved learning process and problem solving capability. That is, the application of puzzles may lead to better learning and increased knowledge in general, stimulating the reasoning process and the apprehension of the need for both creativity and hard work. Thus, teachers of both students and teachers may find it beneficial to utilize the art of puzzle solving. Typically, the puzzles are very suitable for and mostly used in mathematics and natural science classes. Nevertheless, the puzzles are in general also applicable for any type of class. The aim of this study is to examine and discuss the learning process through applying creative puzzle solving as a teaching tool. These aspects are illustrated through a review of several selected puzzle examples.
A Globally Integrated Supply Chain Delivery Quality Strategy: Transformation Insights at the Nokia Devices Unit  [PDF]
Anne-Maarit Majanoja, Michael C. Loney, Bjrn W?rlund, Linnéa Linko, Ville Lepp?nen
American Journal of Industrial and Business Management (AJIBM) , 2014, DOI: 10.4236/ajibm.2014.48050

In recent years, it has become even more critical for companies to respond efficiently and timely to customers’ expectations. Therefore, Delivery Quality (DQ) is critical in supply chain management. In this research, we focus on analyzing the impacts of the DQ strategy implementation, and the main forces of the DQ change management and DQ leadership. At Nokia, the effort to establish a new globally integrated DQ strategy to improve its trade customers’ perception visibility was successful. The globally integrated DQ strategy, which combined product, logistics, and Marine transit insurance, was developed and implemented worldwide. Nokia had a contradictory approach by requiring all stakeholders, including external subcontractors and the insurance company, to use Nokia-owned processes and IT solutions. The identified key success factors were an efficient global DQ strategy, quality and customer-centric ideology, clear and efficient governance and leadership, clarity of ownership, global DQ practices, a total control of all trade customer claims, and DQ performance monitoring. These factors improved global DQ management. The practices can be adopted by other companies to further improve their supply chain DQ operations development.

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data
Bjrn A Kuchinke, Dirk Sauerland, Ansgar Wübker
International Journal for Equity in Health , 2009, DOI: 10.1186/1475-9276-8-44
Abstract: Existing analyses of the determinants for waiting times in Germany are a) based on patient self-reports and b) do not cover the inpatient sector. This paper aims to fill both gaps by (i) generating new primary data and (ii) analyzing waiting times in German hospitals.We requested individual appointments from 485 hospitals within an experimental study design, allowing us to analyze the impact of PHI versus SHI on waiting times (Asplin et al. 2005).In German acute care hospitals patients with PHI have significantly shorter waiting times than patients with SHI.Discrimination in waiting times by insurance status does occur in the German acute hospital sector. Since there is very little transparency in treatment quality in Germany, we do not know whether discrimination in waiting times leads to discrimination in the quality of treatment. This is an important issue for future research.In Germany, one of the main issues of the 2007 Health Reform was access to medical services. The legitimate political objective of securing access to medical services [1] is now basically ensured with the legally specified insurance for all citizens [2]. However, as there are still compulsorily- and privately-insured persons in Germany even after this reform, an important remaining question is whether access also depends on insurance type. In times of rationed medical supply, hospitals could implement waiting lists to discriminate between patients by urgency of treatment needs, but also by profitability. Holders of private health insurance (PHI) often have better access to more innovative and costly treatments than holders of statutory health insurance (SHI) [3]. Thus, discriminating between PHI and SHI patients is potentially profitable for providers of medical services. Indeed, empirical results reveal that private insurees benefit from better access to medical care including shorter waiting times. Studies using US data show that Medicaid patients were shown to have higher waiting times th
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