Patient self-management of oral anticoagulation with vitamin k antagonists in everyday practice: efficacy and safety in a nationwide long-term prospective cohort study.

Patient self-management (PSM) of oral anticoagulation is under discussion, because evidence from real-life settings is missing. Using data from a nationwide, prospective cohort study in Switzerland, we assessed overall long-term efficacy and safety of PSM and examined subgroups. Data of 1140 patients (5818.9 patient-years) were analysed and no patient were lost to follow-up. Median follow-up was 4.3 years (range 0.2-12.8 years). Median age at the time of training was 54.2 years (range 18.2-85.2) and 34.6% were women. All-cause mortality was 1.4 per 100 patient-years (95% CI 1.1-1.7) with a higher rate in patients with atrial fibrillation (2.5; 1.6-3.7; p<0.001), patients>50 years of age (2.0; 1.6-2.6; p<0.001), and men (1.6; 1.2-2.1; p = 0.036). The rate of thromboembolic events was 0.4 (0.2-0.6) and independent from indications, sex and age. Major bleeding were observed in 1.1 (0.9-1.5) per 100 patient-years. Efficacy was comparable to standard care and new oral anticoagulants in a network meta-analysis. PSM of properly trained patients is effective and safe in a long-term real-life setting and robust across clinical subgroups. Adoption in various clinical settings, including those with limited access to medical care or rural areas is warranted.

Handing Down and Adaption: The Construction of the Material World of Health Care Technology in Spain (1855-1955)

This historical study uses qualitative methods to analyze and describe the components of the material world of nursing care in Spain between 1855 and 1955 based on the analysis of eight nurse training manuals. A total of 360 objects and 45 procedures were recorded. Manual analysis was carried out concurrently with data collection based on the Grounded Theory approach. Findings show that the material world of health care was composed of objects that were handed down by the medical profession to health care professionals and adapted objects, improvised mainly out of everyday household items. While the handing down of medical tools and instruments could be said to be a theoretical and technical achievement, it is not clear whether it was also a scientific accomplishment. The improvisation of objects out of everyday household items promoted by the manuals highlights the artisan-like and ingenious nature of nursing practice, which should be explored further in future studies to provide a greater understanding and promote the recognition of these objects as a health care technology.

Offshoring of Information-intensive Services: Structural Breaks in Industry Life Cycles. ACES Working Papers, August 2010

The emergence of widespread offshoring of information-intensive services is arguably one of the more impactful phenomena to transform business in the last ten years. A growing body of research has examined the firm-level drivers andlocation factors (i.e., the why's and where's) of services offshoring. However, little empirical research has examined the maturation sequencing (or when's) of services offshoring. Adopting industry life cycle theory as a framework, the key research questions examined in the paper are: when do different categories of offshoring services provision change from being emergent sectors to more mature ones, and how does the timing of this sequence relate to the type of service offshored. Using a database of 1420 offshore services FDI projects, we find that the value-add as well as the information sensitivity of the service category are related to when the service categories progress through the industry life cycle. Implications for future waves of service offshoring are discussed.

Father, Mother, Child? Eight Trends in Family Life for Policymakers to Keep in Mind. Summary

The family is the first context for a child’s development, and the most important. This is where children begin to develop their own identities and first experience a sense of closeness, community and security. Family is a domain where learning takes place – for all generations. In their daily interactions, children, mothers and fathers learn from and with one another. They develop empathy and a sense of responsibility, and learn to deal with conflict. Values, beliefs and norms, passed on from parents to children, evolve in the course of everyday life. Thus parents exert an enormous influence on their children’s educational opportunities and overall life chances – as research in Germany and other countries has clearly shown.

Enduring Uncertainty : Deportation, Punishment and Everyday Life /

This volume provides fascinating insights into the deportation process as it is felt and understood by those subjected to it. The author presents a rich and innovative ethnography of deportation and deportability experienced by migrants convicted of criminal offenses in England and Wales. This title was made Open Access by libraries from around the world through Knowledge Unlatched.

Music in everyday living and learning; ways of integrating music with other experiences, a report.

Mode of access: Internet.

Psychopathology of everyday life /

Includes bibliographical references and index.

Managing technology in oil pipelines industry

Operating oil pipelines in an optimum capacity through out its life, effective construction management and failure free operations are considered as critical success factors in oil transportation business. Operating oil pipelines in derated capacity due to deteriorating pipeline health or lack of demand, non-ability of augmenting pipeline capacity despite of demand, non-achievement of time, cost, and quality of pipeline construction projects, and many failures of pipelines despite of huge expenditure in inspection and maintenance are the common phenomena in oil pipelines industry. These not only cause business loss, but also increase stakeholders' concerns for sustainable development. This study addresses the above issues using an analytical framework through stakeholders' involvement. Copyright © 2006 Inderscience Enterprises Ltd.

A biography:fabrications in the life of an ERP package

This paper provides an account of the way Enterprise Resource Planning (ERP) systems change over time. These changes are conceptualized as a biographical accumulation that gives the specific ERP technology its present character, attributes and historicity. The paper presents empirics from the implementation of an ERP package within an Australasian organization. Changes to the ERP take place as a result of imperatives which arise during the implementation. Our research and evidence then extends to a different time and place where the new release of the ERP software was being 'sold' to client firms in the UK. We theorize our research through a lens based on ideas from actor network theory (ANT) and the concept of biography. The paper seeks to contribute an additional theorization for ANT studies that places the focus on the technological object and frees it from the ties of the implementation setting. The research illustrates the opportunistic and contested fabrication of a technological object and emphasizes the stability as well as the fluidity of its technologic. Copyright © 2007 SAGE.

Everyday use of Spanish among bilingual teachers in New York City and their attitudes toward the language

The attitudes that bilingual teachers have toward the use of foreign languages seem to have an effect on the success of bilingual education programs. In this study, our purpose is to shed light on how often bilingual teachers in New York City use Spanish in their everyday lives, and to examine their attitudes toward the use of Spanish in the U.S. Overall, results indicate only moderate frequencies of use of Spanish in everyday life among bilingual teachers. In addition, the study shows that bilingual teachers have a favorable attitude toward the use of Spanish in the U.S. However, bilingual teachers whose first language is English seem to have a more favorable attitude than those whose first language is Spanish. Among the native Spanish speakers, those born abroad show a more favorable attitude than those born in the U.S. Although no group seems to favor the use of lexical borrowings and code-switching, bilingual native Spanish-speaking teachers born in the U.S. seem to have a less favorable attitude than native Spanish-speaking teachers born abroad. In addition, native Spanish-speaking teachers born abroad seem to have a less favorable attitude toward lexical borrowings and code-switching than U.S.-born teachers whose first language is English. Recommendations for the training of bilingual teachers are discussed in the conclusions of the study.

Technology in Parkinson's disease:challenges and opportunities

The miniaturization, sophistication, proliferation, and accessibility of technologies are enabling the capture of more and previously inaccessible phenomena in Parkinson's disease (PD). However, more information has not translated into a greater understanding of disease complexity to satisfy diagnostic and therapeutic needs. Challenges include noncompatible technology platforms, the need for wide-scale and long-term deployment of sensor technology (among vulnerable elderly patients in particular), and the gap between the "big data" acquired with sensitive measurement technologies and their limited clinical application. Major opportunities could be realized if new technologies are developed as part of open-source and/or open-hardware platforms that enable multichannel data capture sensitive to the broad range of motor and nonmotor problems that characterize PD and are adaptable into self-adjusting, individualized treatment delivery systems. The International Parkinson and Movement Disorders Society Task Force on Technology is entrusted to convene engineers, clinicians, researchers, and patients to promote the development of integrated measurement and closed-loop therapeutic systems with high patient adherence that also serve to (1) encourage the adoption of clinico-pathophysiologic phenotyping and early detection of critical disease milestones, (2) enhance the tailoring of symptomatic therapy, (3) improve subgroup targeting of patients for future testing of disease-modifying treatments, and (4) identify objective biomarkers to improve the longitudinal tracking of impairments in clinical care and research. This article summarizes the work carried out by the task force toward identifying challenges and opportunities in the development of technologies with potential for improving the clinical management and the quality of life of individuals with PD. © 2016 International Parkinson and Movement Disorder Society.

Subtractive and additive manufacturing technology in moulding industry

This report is a review of additive and subtractive manufacturing techniques. This approach (additive manufacturing) has resided largely in the prototyping realm, where the methods of producing complex freeform solid objects directly from a computer model without part-specific tooling or knowledge. But these technologies are evolving steadily and are beginning to encompass related systems of material addition, subtraction, assembly, and insertion of components made by other processes. Furthermore, these various additive processes are starting to evolve into rapid manufacturing techniques for mass-customized products, away from narrowly defined rapid prototyping. Taking this idea far enough down the line, and several years hence, a radical restructuring of manufacturing could take place. Manufacturing itself would move from a resource base to a knowledge base and from mass production of single use products to mass customized, high value, life cycle products, majority of research and development was focused on advanced development of existing technologies by improving processing performance, materials, modelling and simulation tools, and design tools to enable the transition from prototyping to manufacturing of end use parts.

A practical guide to photoacoustic tomography in the life sciences.

The life sciences can benefit greatly from imaging technologies that connect microscopic discoveries with macroscopic observations. One technology uniquely positioned to provide such benefits is photoacoustic tomography (PAT), a sensitive modality for imaging optical absorption contrast over a range of spatial scales at high speed. In PAT, endogenous contrast reveals a tissue's anatomical, functional, metabolic, and histologic properties, and exogenous contrast provides molecular and cellular specificity. The spatial scale of PAT covers organelles, cells, tissues, organs, and small animals. Consequently, PAT is complementary to other imaging modalities in contrast mechanism, penetration, spatial resolution, and temporal resolution. We review the fundamentals of PAT and provide practical guidelines for matching PAT systems with research needs. We also summarize the most promising biomedical applications of PAT, discuss related challenges, and envision PAT's potential to lead to further breakthroughs.

Iron status in early life and associations with developmental outcomes

Infants and young children are at particular risk of iron deficiency and its associated consequences for growth and development. The main objectives of this thesis were to quantify iron intakes, status and determinants of status in two year olds; explore determinants of neonatal iron stores; investigate associations between iron status at birth and two years with neurodevelopmental outcomes at two years and explore the influence of growth on iron status in early childhood, using data from the Cork BASELINE (Babies after SCOPE: Evaluating Longitudinal Impact using Neurological and Nutritional Endpoints) Birth Cohort Study (n=2137). Participants were followed prospectively with interviewer-led questionnaires and clinical assessments at day 2 and at 2, 6, 12 and 24 months. At two years, there was a low prevalence of iron deficiency and iron deficiency anaemia in this cohort, representing the largest study of iron status in toddlers in Europe, to date. The increased consumption of iron-fortified products and compliance with recommendations to limit unmodified cows’ milk intakes in toddlers has contributed to the observed improvements in status. Low serum ferritin concentrations at birth, which reflect neonatal iron stores, were shown to track through to two years of age; delivery by Caesarean section, being born small-for-gestational age and maternal obesity and smoking in pregnancy were all associated with significantly lower neonatal iron stores. Despite a low prevalence of iron deficiency in this cohort, both a mean corpuscular volume <74fl and ferritin concentrations <20μg/l were associated with lower neurodevelopmental outcomes at two years. An inverse association between growth in the second year of life and iron status at two years was also observed. This thesis has presented data from one of the largest, extensively-characterised cohorts of young children, to date, to explore iron and its associations with growth and development.

Anförande: Pressed for time : The digital transformation of everyday life

Sociologisk Forsknings digitala arkiv