Suchergebnisse

The issue of the presence of patients' loved ones during their intensive care unit (ICU) stay is a frequently discussed topic among ICU staff. Today, ICU patients' loved ones are seen as important for the care of the patient. There is a gap in knowledge and research concerning the frequency and duration of visits by loved ones and the effect of such visits on patient outcome. The aim of this study was to explore the frequency and duration of loved ones' visits and whether or not such visits have an impact on patient outcome. A prospective, explorative observational study design was used. The sample included 198 ICU patients from a general ICU in Sweden. Twenty-five per cent of the patients had no visitors whatsoever. Forty-seven per cent of the patients who had visitors had visits of ≤0·5 h/day, 36% had visits of between 0·6 and 2 h/day and 17% had visits of >2 h/day. The most frequent visitors were spouses and children. Significant differences between the groups were that the patients who had no visitors were older, had a shorter ICU stay, lower nine equivalents of nursing manpower score and more often lived alone. There were no significant differences in mortality and length of hospital stay over time. We could not establish that patients who had no visitors had a poorer outcome. Most of the older patients had no visitors, which indicates that elderly people may have a poorer social network; thus, there may be a greater need for professional caring relationships and care planning.

In massive multiple-input multiple-output (MIMO), most precoders result in downlink signals that suffer from high peak-to-average ratio (PAR), independently of modulation order and whether single-carrier or orthogonal frequency-division multiplexing (OFDM) transmission is used. The high PAR lowers the power efficiency of the base-station amplifiers. To increase the power efficiency, low-PAR precoders have been proposed. In this paper, we compare different transmission methods for massive MIMO in terms of the power consumed by the amplifiers. It is found that: 1) OFDM and single-carrier transmission have the same performance over a hardened massive MIMO channel and 2) when the higher amplifier power efficiency of low-PAR precoding is taken into account, conventional and low-PAR precoders lead to approximately the same power consumption. Since downlink signals with low PAR allow for simpler and cheaper hardware, than signals with high PAR, therefore, the results suggest that low-PAR precoding with either single-carrier or OFDM transmission should be used in a massive MIMO base station. ; Funding agencies: European Union [ICT-619086]; Swedish Research Council (Vetenskapsradet); ELLIIT

AbstractHealth care is a complex system with multiprofessional staff and multiple patient care pathways. Time pressure and minimal margins for error make it challenging to implement new policies or procedures, no matter how desirable. Changes in health care also requires the participation of the staff. System dynamics (SD) simulations can lead to shared systems understanding and allows for the development and testing of new scenarios in silico before implementing solutions. However, research shows that the actual implementation rate of simulations is low. This paper presents a reanalysis of a successful change project in health care combining SD principles with basic action research (AR) premises. The analysis was done by a multidisciplinary research group using qualitative methodology and identifies that a fruitful combination of AR inquiry and SD modelling potentially can improve implementation rates.

In this paper, several algorithms for compressing the feedback of channel quality information are presented and analyzed. These algorithms are developed for a proposed adaptive modulation scheme for future multi-carrier 4G mobile systems. These strategies compress the feedback data and, used together with opportunistic scheduling, drastically reduce the feedback data rate. Thus the adaptive modulation schemes become more suitable and efficient to be implemented in future mobile systems, increasing data throughput and overall system performance. ; This work has been partly funded by the Spanish government with projects MACAWI (TEC 2005-07477-c02-02), MAMBO2 (CCG06-UC3M-TIC-0698), and European COST Action 289 and is a result of work done within this European action

INTRODUCTION: Tobacco is still one of the single most important risk factors among the lifestyle habits that cause morbidity and mortality in humans. Furthermore, tobacco has a heavy social gradient, as the consequences are even worse among disadvantaged and vulnerable groups. To reduce tobacco-related inequity in health, those most in need should be offered the most effective tobacco cessation intervention. The aim of this study is to facilitate and improve the evaluation of already implemented national tobacco cessation efforts, focusing on 10 disadvantaged and vulnerable groups of tobacco users. METHODS AND ANALYSIS: This is a prospective cohort study. Data will be collected by established tobacco cessation counsellors in Sweden. The study includes adult tobacco or e-cigarette users, including disadvantaged and vulnerable patients, receiving in-person interventions for tobacco or e-cigarette cessation (smoking, snus and/or e-cigarettes). Patient inclusion was initiated in April 2020. For data analyses patients will be sorted into vulnerable groups based on risk factors and compared with tobacco users without the risk factor in question.The primary outcome is continuous successful quitting after 6 months, measured by self-reporting. Secondary outcomes include abstinence at the end of the treatment programme, which could be from minutes over days to weeks, 14-day point prevalence after 6 months, and patient satisfaction with the intervention. Effectiveness of successful quitting will be examined by comparing vulnerable with non-vulnerable patients using a mixed-effect logistic regression model adjusting for potential prognostic factors and known confounders. ETHICS AND DISSEMINATION: The project will follow the guidelines from the Swedish Data Protection Authority and have been approved by the Swedish Ethical Review Authority before patient inclusion (Dnr: 2019-02221). Only patients providing written informed consent will be included. Both positive and negative results will be published in scientific peer-reviewed journals and presented at national and international conferences. Information will be provided through media available to the public, politicians, healthcare providers and planners as these are all important stakeholders. TRIAL REGISTRATION NUMBER: NCT04819152.