UTFORMNING AV GÅNG-, CYKEL- OCH MOPED-NÄT ANPASSAT FÖR ELCYKEL

Purpose: An increase in the number of pedelecs on Swedish roads is according to studies soon reality. This creates a need to adapt the bmp-grid (bike-, moped- and pedestrian-grid) to pedelecs for them to experience good security, accessibility and comfort while using it. The guidelines Swedish municipalities follow are VGU(Design of Roads and Streets) and the GCM-manual(Bike-, moped-, and pedestrian-manual) which currently do not take society’s future increase of pedelecs into account. VGU and the GCM-manual are tools that are commonly used during planning and design of roads and streets. The aim of the thesis is to use current advice and recommendations on how to adapt the bmp-grid to the pedelec and with this complete current guidelines for bmp-infrastructure. Method: The document-analysis is made on current federal documents that have an impact on bmp-design. Scetch-suggestions were then developed from the author’s personal improvement suggestions and from advice and recommendations gathered during the document-analysis and the theoretical framework. Findings: It was discovered that if the bmp-grid’s design allow bikes traveling up to 30km/h and has a good standard for bicycles according to VGU, then the infrastructure generally fulfil the needs of the pedelec. Altough there are still areas in VGU that needs complements. This need to be done on the design-guidelines so they can aid the adaption of the infrastructure to the pedelec during the planning- and design process. Necessary steps according to the result is to give clearer notifications on bmp-design, issue guidelines for choosing DTS, motivate minimal widths on roads, categories bikers and pedestrians into separate groups, give out more detailed descriptions of when separation of bikers and pedestrians should be done and also to specify different types of bike-users. When taking needs and claim of the pedelec into consideration the result shows that: adaption of the whole bmp-grid to the pedelec is not possible, to simplify priorities the bmp-grid needs to be divided into different sections, space should be taken from the car-traffic, solutions with mixed-traffic and bike-fields for pedelecs can be used in low-speed areas, larger opportunities to connect towns to increase commuting with bicycles appeared with the pedelec. Implications: After examining current guidelines regarding the design of the bmp-grid and gathering opinions on this from interviews the conclusion is that several areas in VGU needs completion. The following are recommendations on how to take the pedelec into consideration during the design-process:• Connect towns and urban-areas with bmp-grids to make use of pedelecs capacity.• Where there is not enough space for both cars and separated pedelec- and bike lanes the speed for car-traffic can be lowered to 30km/h. This creates opportunities with mixed-traffic or bike-lanes.• The width of existing roads and streets are often greater than what’s described in VGU. They can be made smaller to free space on roads for bicycle-infrastructure.• To prioritize which parts of the bmp-grid that needs design to allow pedelecs the bmp-grid can be divided into main- and local grid. The main grid should be design with consideration to the needs and claim of the pedelecs. Limitations: The limitation of the study lies in that none of the interviews where done with employees in any of the bigger municipalities in Sweden. This gives the study a general application in small- to middle-sized cities but not in bigger cities.Keywords: elcykel, ebike, pedelec, utformning, cykel, infrastruktur, infrastructure, society, planering, utformning, säkerhet, fordonstyp

The effect of a Computerised Decision Support System (CDSS) on compliance with the prehospital assessment process: results of an interrupted time-series study

BACKGROUND: Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional "scoop and run" practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). METHODS: In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. RESULTS: In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. CONCLUSIONS: The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.

The well-being of relatives of patients with atrial fibrillation: a critical incident technique analysis

BACKGROUND: The well-being of relatives of patients having chronic heart diseases (CHD) has been found to be negatively affected by the patient's condition. Studies examining relatives of patients with atrial fibrillation (AF) indicate that their well-being may be affected in a similar manner, but further research is needed. AIM: To explore and describe critical incidents in which relatives of patients experience how AF affects their well-being and what actions they take to handle these situations. DESIGN AND METHOD: An explorative, descriptive design based on the critical incident technique (CIT) was used. Interviews were conducted with 19 relatives (14 women and five men) of patients hospitalised in southern Sweden due to acute symptoms of the AF. RESULTS: The well-being of relatives was found to be affected by their worries (patient-related health), as well as the sacri-ficing of their own needs (self-related health). In handling their own well-being, these relatives adjusted to and supported the patient (practical involvement), along with adjusting their own feelings and responding to the mood of the patients (emotional involvement). CONCLUSION: The well-being of relatives of patients with AF was affected depending on the patients' well-being. In their attempt to handle their own well-being, the relatives adjusted to and supported the patients. Further research is needed in order to evaluate the effects of support to relatives and patients respectively and together.