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Search Results: 1 - 10 of 3759 matches for " Sund Bj?rn "
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Developing an analytical tool for evaluating EMS system design changes and their impact on cardiac arrest outcomes: combining geographic information systems with register data on survival rates
Sund Bjrn
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , 2013, DOI: 10.1186/1757-7241-21-8
Abstract: Background Out-of-hospital cardiac arrest (OHCA) is a frequent and acute medical condition that requires immediate care. We estimate survival rates from OHCA in the area of Stockholm, through developing an analytical tool for evaluating Emergency Medical Services (EMS) system design changes. The study also is an attempt to validate the proposed model used to generate the outcome measures for the study. Methods and results This was done by combining a geographic information systems (GIS) simulation of driving times with register data on survival rates. The emergency resources comprised ambulance alone and ambulance plus fire services. The simulation model predicted a baseline survival rate of 3.9 per cent, and reducing the ambulance response time by one minute increased survival to 4.6 per cent. Adding the fire services as first responders (dual dispatch) increased survival to 6.2 per cent from the baseline level. The model predictions were validated using empirical data. Conclusion We have presented an analytical tool that easily can be generalized to other regions or countries. The model can be used to predict outcomes of cardiac arrest prior to investment in EMS design changes that affect the alarm process, e.g. (1) static changes such as trimming the emergency call handling time or (2) dynamic changes such as location of emergency resources or which resources should carry a defibrillator.
Genetic Control of the Variable Innate Immune Response to Asymptomatic Bacteriuria
Jenny Gr?nberg Hernández, Fredrik Sundén, John Connolly, Catharina Svanborg, Bjrn Wullt
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0028289
Abstract: The severity of urinary tract infection (UTI) reflects the quality and magnitude of the host response. While strong local and systemic innate immune activation occurs in patients with acute pyelonephritis, the response to asymptomatic bacteriuria (ABU) is low. The immune response repertoire in ABU has not been characterized, due to the inherent problem to distinguish bacterial differences from host-determined variation. In this study, we investigated the host response to ABU and genetic variants affecting innate immune signaling and UTI susceptibility. Patients were subjected to therapeutic urinary tract inoculation with E. coli 83972 to ensure that they were exposed to the same E. coli strain. The innate immune response repertoire was characterized in urine samples, collected from each patient before and after inoculation with bacteria or PBS, if during the placebo arm of the study. Long-term E. coli 83972 ABU was established in 23 participants, who were followed for up to twelve months and the innate immune response was quantified in 233 urine samples. Neutrophil numbers increased in all but two patients and in an extended urine cytokine/chemokine analysis (31 proteins), the chemoattractants IL-8 and GRO-α, RANTES, Eotaxin-1 and MCP-1, the T cell chemoattractant and antibacterial peptide IP-10, inflammatory regulators IL-1-α and sIL-1RA and the T lymphocyte/dendritic cell product sIL-2Rα were detected and variably increased, compared to sterile samples. IL-6, which is associated with symptomatic UTI, remained low and numerous specific immune mediators were not detected. The patients were also genotyped for UTI-associated IRF3 and TLR4 promoter polymorphisms. Patients with ABU associated TLR4 polymorphisms had low neutrophil numbers, IL-6, IP-10, MCP-1 and sIL-2Rα concentrations. Patients with the ABU-associated IRF3 genotype had lower neutrophils, IL-6 and MCP-1 responses than the remaining group. The results suggest that the host-specific, low immune response to ABU mainly includes innate immune mediators and that host genetics directly influence the magnitude of this response.
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
Abstract:

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.
Limited Focus on the Use of Health Care by Elderly Migrants—A Literature Review  [PDF]
Katarina Hjelm, Bjrn Albin
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.46049
Abstract:

Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.

Cement Bonded Particle Boards with Different Types of Natural Fibres—Using Carbon Dioxide Injection for Increased Initial Bonding  [PDF]
Bjrn Marteinsson, Edgar Gudmundsson
Open Journal of Composite Materials (OJCM) , 2018, DOI: 10.4236/ojcm.2018.81003
Abstract: The effect of CO2 injection on initial strength increase and hardening of cement-fibre mix in a cement bonded particle board (CBPB) production was evaluated. Different cement contents, formation pressure and types of fibres were considered. The initial strength increase with CO2 injection is so much faster than this caused by conventional hydration that the produced samples do not need additional curing before they can be stored. Similar strength and stiffness values as in conventional products on the market are gained with lower cement content for similar types of fibres. Visual inspection of board surfaces aged for 13 years in a harsh exterior environment as well as comparison of strength and stiffness values for these boards when new and after ageing, gives a very satisfying result. The combined effect of the above discussed gains results in markedly increased productivity at lower cost and lower environmental impacts than is possible in traditional CBPB production.
Concealed Integrity Monitoring for Wireless Sensor Networks  [PDF]
Bjrn Stelte, Thomas Bühring
Wireless Sensor Network (WSN) , 2011, DOI: 10.4236/wsn.2011.31002
Abstract: Nowadays, sensor networks are widely installed around the world. Typical sensors provide data for healthcare, energy management, environmental monitoring, etc. In the future sensors will become a part of critical infrastructures. In such a scenario the network operator has to monitor the integrity of the network devices, otherwise the trustworthiness of the whole system is questionable. The problem is that every integrity protocol needs a secure channel between the devices. Therefore, we will introduce a covert channel for hidden transportation of integrity monitoring messages. The covert channel enables us to hide integrity check messages embedded into regular traffic without giving potential attackers a hint on the used integrity protocol.
Diversity in Family Structure—Diversity in Communication between Family Members?  [PDF]
Piia M. Bjrn, Minna Kytt?l?
Psychology (PSYCH) , 2013, DOI: 10.4236/psych.2013.43A035
Abstract:

This study aims at investigating the parent-adolescent communication of Finnish families from a multi informant perspective. Thirteen- and fourteen-year-old adolescents (n = 171) and their parents were asked to complete a questionnaire examining positive and problematic communication between the two parties. Information about their family structure was collected. The results indicated an interrelationship between parental and adolescent assessments, particularly regarding negative aspects of communication. The boys assessed their communication with parents as more positive than did the girls. The results showed that the mothers still are the synchronizing hearts of communication in modern families, whereas the fathers’ roles in family communication were more modest suggesting that the stereotypical roles in Finnish families persist even today.

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.
Opposite Neurophysiological Findings Induced by Sideritis scardica and Sideritis euboa Extract in the Rat  [PDF]
Wilfried Dimpfel, Bjrn Feistel, Leonie Schombert
Journal of Behavioral and Brain Science (JBBS) , 2016, DOI: 10.4236/jbbs.2016.611041
Abstract: Psychophysiological effects of Sideritis herba extracts depend on biologically active ingredients, which might be different for several botanical types of this plant. The present investigation aimed at the characterization of extracts from Sideritis scardica and Sideritis euboa in vivo and in vitro. Construction of electropharmacograms on the base of recording of electrical field potentials from four different brain regions was used to compare the possible pharmacological effects to a database of reference drugs with known clinical indications. Whereas Sideritis scardica produced decreases of spectral power in line with stimulatory frequency patterns as observed in the presence of Ginkgo biloba extract, administration of Sideritis euboa produced opposite effects. Electrical stimulation of the Schaffer Collaterals was used to elicit a pyramidal cell response called population spike in vitro. The amplitude of this spike was determined in the presence of single as well as theta burst stimuli. Direct exposure of brain matter to Sideritis scardica extract led to concentration dependent increases of the population spike amplitude under both stimulation patterns in the range from 12.5 to 100 mg/L. On the opposite, extract from Sideritis euboa did not change the electric response up to 50 mg/L. Higher concentrations of this extract attenuated the signal amplitude. A 1:1 blend of both gave intermediate results. The in vitro results are in line with the in vivo EEG recordings, where both extracts induced opposite changes of the electric power with respect to electric frequency patterns. The results from both models suggest a stimulatory and/or memory-enhancing action for the extract from Sideritis scardica but not for Sideritis euboa extract, where a more tranquillizing effect like that observed in the presence of Humulus cone extract may be expected.
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