Äldre i Värmland : Om hälsa, levnadsvanor och livssituation 2006

Landstinget har i samarbete med Karlstads universitet gjort flera befolkningsundersökningar i Värmland och publicerat rapporter om både den vuxna befolkningens och barns hälsa, senast med rapporten Värmlänningarnas Liv och Hälsa 2004. Någon befolkningsstudie av de äldres hälsa och livsvillkor har dock inte gjorts tidigare. Efter tre års förarbeten och samråd mellan landstinget, Värmlands kommuner och flera institutioner vid Karlstads universitet genomfördes den föreliggande studien av de äldres hälsa under senhösten 2006, i form av en omfattande postenkät. Urvalet utgjordes av 2500 slumpmässigt uttagna kvinnor och män som var 80 år eller äldre. Svarsfrekvensen var 60 procent, vilket får betraktas som mycket bra med tanke på att cirka 15 procent i denna åldersgrupp lever i särskilda boenden. Studien avspeglar således hälsan och livsvillkoren för de äldre. Överlag visar det sig att de äldre mår bra och har stor kapacitet att fungera som aktiva samhällsmedborgare. Samtidigt är det många som har kroniska besvär, med värk, syn- och hörselnedsättning, inkontinensbesvär etc. Det föreligger också en klar social gradient, där särskilt äldre kvinnor med arbetarbakgrund har både mer sjukdom och större ekonomiska problem än de övriga.

Psychometric properties of the Iranian version of the premature ejaculation diagnostic tool

Introduction Premature ejaculation (PE) is one of the most prevalent male sexual problems. The Premature Ejaculation Diagnostic Tool (PEDT) is a suitable patient-reported outcome measure for the assessment of PE. Aim To examine the psychometric proporties of a translated and culturally adapted version of the PEDT in a sample of Iranian men suffering from PE. Methods Two independent samples were compared, one including patients with PE based on the DSM-IV-TR criteria (n = 269) and the other including healthy men without PE (n = 289). A backward–forward translation procedure was used to translate the PEDT into Persian. Both samples were asked to fill in the PEDT twice—at baseline and 4 weeks later. Main Outcome Measures Internal consistency, test–retest reliability, convergent validity, factor structure, measurement invariance across sexual health status (i.e., between men with and without PE). Results Mean ages of men without and with PE were 34.9 and 35.3 years, respectively. Cronbach's alpha coefficient for the total PEDT score was 0.89. All items and the total score were remarkably consistent between the two measurement points. All five PEDT items correlated at r = 0.40 or greater with their own scale, indicating good convergent validity. There was a high and significant correlation (r = −0.82, P  < 0.001) between the PEDT score and IELT. Healthy men reported lower scores (fewer complaints) on the PEDT compared with the PE group. A single-factor model was found to be best-fitting in the exploratory factor analysis; this was confirmed by confirmatory factor analysis. The PEDT was invariant across sexual health status and perceived similarly by men with and without PE. Conclusion The results provide evidence for good reliability and validity of the Iranian version of the PEDT. The questionnaire therefore represents a suitable tool for screening PE in Iranian men.

Measuring Latency Variation in the Internet

We analyse two complementary datasets to quantify the latency variation experienced by internet end-users: (i) a large-scale active measurement dataset (from the Measurement Lab Network Diagnostic Tool) which shed light on long-term trends and regional differences; and (ii) passive measurement data from an access aggregation link which is used to analyse the edge links closest to the user. The analysis shows that variation in latency is both common and of significant magnitude, with two thirds of samples exceeding 100\,ms of variation. The variation is seen within single connections as well as between connections to the same client. The distribution of experienced latency variation is heavy-tailed, with the most affected clients seeing an order of magnitude larger variation than the least affected. In addition, there are large differences between regions, both within and between continents. Despite consistent improvements in throughput, most regions show no reduction in latency variation over time, and in one region it even increases. We examine load-induced queueing latency as a possible cause for the variation in latency and find that both datasets readily exhibit symptoms of queueing latency correlated with network load. Additionally, when this queueing latency does occur, it is of significant magnitude, more than 200\,ms in the median. This indicates that load-induced queueing contributes significantly to the overall latency variation.

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.

Women's experiences of how their recovery process is promoted after a first myocardial infarction : Implications for cardiac rehabilitation care

Background: After a myocardial infarction and discharge from the hospital a recovery process follows for the women. In order to facilitate their recovery, both a preventive and promotive perspective should be taken into consideration. Despite this, today´s healthcare focuses more on prevention and thus research into the promotion of women’s recovery process is needed. Aim: To explore how women’s recovery processes are promoted after a first myocardial infarction Methods: The study had an explorative and descriptive design based on qualitative content analysis. Findings: The women’s recovery process was promoted through using external and internal resources as well as embracing behaviour, social and psychological dimensions. The women embraced these dimensions to a varying extent and this process led to them being able to take in a new perspective on life. Conclusions: The women’s personal recovery is a multidirectional process with a desire to develop and approach a new perspective on life. It is important for cardiac rehabilitation nurses to not only focus on lifestyle changes and social support, but also on working actively with the women’s inner strength in order to promote the personal recovery of the women. Furthermore, it would be interesting to investigate men’s experiences of how their recovery process after a first Myocardial infarction is promoted.

Finite element modeling of tube deformation during cold pilgering

A three-dimensional finite element model of cold pilgering of stainless steel tubes is developed in this paper. The objective is to use the model to increase the understanding of forces and deformations in the process. The focus is on the influence of vertical displacements of the roll stand and axial displacements of the mandrel and tube. Therefore, the rigid tools and the tube are supported with elastic springs. Additionally, the influences of friction coefficients in the tube/mandrel and tube/roll interfaces are examined. A sensitivity study is performed to investigate the influences of these parameters on the strain path and the roll separation force. The results show the importance of accounting for the displacements of the tube and rigid tools on the roll separation force and the accumulative plastic strain.

Análisis de tecnologías eco eficientes para la disposición final de residuos sólidos en las empresas Coraseo S.A y Seacor S.A

Los residuos sólidos como consecuencia directa de las actividades humanas, han representado un reto desde sus inicios, de ahí se empezaron a desarrollar técnicas y prácticas para garantizar una adecuada gestión de los residuos, nuestros primeros ancestros encontraron en los botaderos a cielo abierto la solución más fácil para disponer los desechos de animales y residuos de comida en sitios cercanos a sus viviendas, por ejemplo, los griegos poseen registros de la inauguración del primer relleno municipal en la ciudad de Atenas hace más de 2000 años. La evolución de las culturas, la revolución industrial y el crecimiento poblacional acelerado han modificado no solo la composición sino también la cantidad de los residuos sólidos producidos, haciendo cada día más difícil su adecuada gestión debido a su alto grado de toxicidad, la ausencia de materiales biodegradables y su volumen, traduciendo esto en un gran impacto. El panorama no es muy alentador y los pronósticos emitidos por el Banco Mundial prevén que para el año 2025 los niveles mundiales de residuos sólidos urbanos alcanzaran 2,2 millones de toneladas por año. Basada en el interés por la adecuada gestión de los residuos y la disminución del impacto ambiental de las empresas Coraseo S.A y Seacor S.A, la presente investigación busca seleccionar la metodología y/o tecnología más apropiada teniendo en cuenta las condiciones económicas, logísticas y de infraestructura de la empresa y la comunidad involucrada. En primera instancia se estudió en profundidad el panorama empresarial y posteriormente se seleccionó un grupo de cuatro propuestas para la transformación y aprovechamiento de los residuos sólidos que fueron evaluadas a nivel económico, normativo, medio ambiental. Los datos analizados sugieren entre otras cosas, un robustecimiento del marco legal ambiental colombiano y mundial, una mayor colaboración económica de los organismos internacionales y las entidades bancarias y finalmente una reducción en los costos de las tecnologías disponibles para el aprovechamiento de los residuos sólidos, haría posible el sueño de las sociedades de gestionar efectivamente los residuos sólidos generando el menor impacto ambiental posible y en el caso del grupo empresarial Cordobés lograr innovar y emprender con un proyecto eco eficiente como el que se evaluó.