Angered Hospital

Investigate the prevalence of persistent regulatory problems (RPs) in children aged 3-18 months from an immigrant, low-resource population, and assess how these develop and may coexist with other early neurodevelopmental and medical conditions in toddlers. Health service-detected prevalence was estimated using retrospective medical records. The target population followed up within child health services, included 884 children aged 3-18 months. In total, 37 of 884 children, 4.2%, were identified with persistent RPs at 3-18 months. Combined forms of RPs were most common, with typical onset between 6 and 12 months of age. Thirteen of 37 children were diagnosed with neurodevelopmental disorders at 2.5 years. Nine of them had autism confirmed, and four had language disorders. All 13 children had early autism signs and/or other neurodevelopmental symptoms at 18 months of age. In 19 out of 37 children, co-existing medical conditions were diagnosed. Improved knowledge within child health services and methods for identifying and assessing RPs can strengthen opportunities for early interventions for coexisting conditions, where persistent RPs may be the first signs.

The recent and significant change in the architecture, engineering, and construction (AEC) industry is the increasing use of building information management (BIM) tools in design and how the generated digital data are consumed. Although designers have primarily published blueprints and model files, multiple parties are now involved in producing different aspects of the data and may be consuming data produced by others. This evolution has created new challenges in sharing and synchronizing information across organizational boundaries. Linked building data is a community effort identified as a potential means of overcoming the barriers to data interoperability. In this paper, we present how the industry can be strengthened using a peer-to-peer network based on the InterPlanetary File System (IPFS) framework to address the typical availability problems of web-based data. The paper particularly presents how Linked Data serialization of the Industry Foundation Classes (IFC) standard can be used in the context of IPFS and benchmarks the performance for the publication of models between IPFS versus HTTP protocol. We show that linked building data—in particular, IFC models converted into Resource Description Format (RDF) graphs according to the ifcOWL ontology—can be implemented using the framework, with initial indications of significant benefits of a peer-to-peer network in terms of performance, offline access, and immutable version history. Two use cases in distributed collaborative environments in the AEC/facility management (FM) sector using evolving multidomain models are used to evaluate the work.

Ziel dieser Studie war die Evaluation von Patienten, die eine transfemorale oder eine transapikale TAVI erhalten haben, in Bezug auf ihre Mortalitätsprädiktoren und ihre Langzeit-Mortalität. Methoden Untersucht wurden Patienten mit einer minimalen FU-Zeit von sechs Jahren, welche im Zeitraum von 2006 – 2014 eine TAVI im Herzkatheterlabor des Universitätsklinikums in Frankfurt erhalten haben. Das Patientenkollektiv wurde basierend auf dem Zugangsweg (transfemoral oder transapikal) analysiert. Ergebnisse Insgesamt wurden 679 Patienten in die Studie eingeschlossen. 408 Patienten (59,82 %) bekamen eine transfemorale TAVI und 271 Patienten (39,74 %) bekamen eine transapikale TAVI. Der durchschnittliche STS-Score betrug in der transfemoralen Gruppe 4,21 ± 2,4 % und in der transapikalen Gruppe 4,19 ± 2,7 %. Die Mortalität war nach 30 Tagen (15,8 % transapikal versus 8,2 % transfemoral, p = 0,00) sowie im Langzeit-FU (79,5 % transapikal versus 68,3 % transfemoral, p = 0,00) signifikant höher in der transapikalen Gruppe. Viele postinterventionelle Komplikationen waren häufiger in der transfemoralen Gruppe. Postinterventionelle Schrittmacherimplantationen (15,7 % versus 4,1 %, p = 0,00), große und kleine vaskuläre Komplikationen (5,1 % versus 1,1 %, p = 0,01) sowie große und kleine zerebrovaskuläre Insulte (31,8 % versus 9,1 %, p = 0,00) kamen in der transfemoralen Gruppe signifikant häufiger vor. Allerdings war der transfemorale Zugangsweg mit einer besseren Überlebensrate assoziiert (Log Rank Test p = 0,01 und HR 1,33 (1,04 – 1,71), p = 0,03). Patienten mit einem hohen STS-Score (HR 1,09 (1,03 – 1,15), p = 0,00), einem vorbestehenden Diabetes Mellitus (HR 0,75 (0,58 – 0,97), p = 0,03) sowie großen Gefäßkomplikationen (HR 0,60 (0,37 – 0,99), p = 0,04) korrelieren mit einem schlechteren Langzeit-Überleben. Zusammenfassung Für den kathetergestützten Aortenklappenersatz weisen beide Zugangswege spezifische Risiken auf, daher sollte die individuell beste Variante für jeden Patienten ausgewählt werden.

Unhealthy food habits are included in the factors behind several severe health conditions. Their unequal distribution in the population has a complex background. Putting the problem “How can we make our resources more reachable?” instead of “How can we reach these groups?” changes focus from individual to organisational health literacy which opens windows of opportunity. A public health unit with commission to contribute to close health gaps identified a need to systematically develop its own health literacy. Critical examining was conducted by the quan/qual tool Health equlibrium methodology. Reflections on accessability and acceptability of resources offered by the unit were documented and used for methodolocigal development. Aims were to develop professional judgment on how to contribute to fair health outcome and to improve support for healthy habits. Data used were collected 2019-2021.What hinders people from healthier food habits? How can we adjust our practice? Documentation included organised breakfast-talks, food-talk with cultural interpreters, lectures with sports-club health ambassadors, health groups with people of different maternal language, meetings with parents at open pre-school, staff in health promotion commissions and elderly. Problems identified were high costs on healthy food and on travels to vending points, traditional large sugar-intake, marketing of unhealthy food to children, failure to understand information from Swedish Food Agency (except the Keyhole food labelling which was much appreciated). A model for shop-walks with cultural interpreters, more accessible versions of leaflet-materials and dialogue-meetings about food in different settings were developed. Reflections on the unit's communication lead to change of settings for meetings and refined ways to talk about parenthood, women's role and aspects of ethnicity. Systematic self-reflection strenghtens organisational health literacy and may contribute to fair health outcomesKey messagesOrganisational health literacy need to be developed purposedly.Scarcity is a barrier for a healthy diet also in a welfare state like Sweden.

To identify the aetiology and outcome of seizure-like events leading to hospital referrals in infants and to identify early predictors of epilepsy and delayed neurodevelopment. This Norwegian population-based study focused on all children born in Sør-Trøndelag county, who were up to one year of age in 2014-2015. They were identified by diagnostic codes for seizure-like events and electroencephalography (EEG) examinations. Hospital records were examined up to 1.5years of age. The one-year prevalence of seizure-like events was 1.5% (114/7430). Epilepsy was diagnosed in 17%, 57% had non-epileptic paroxysmal events (NEPE), 16% had febrile seizures, and 10% had other acute symptomatic epileptic seizures. Neurodevelopmental delay occurred in 21%. The cumulative incidence was 0.22% for epilepsy and 0.79% for NEPE. Abnormal brain magnetic resonance imaging, abnormal first EEGs and neonatal care increased the likelihood of epilepsy and delayed development. Identifying situation-related factors decreased the epilepsy risk. Occurrence at a younger age increased the risk of delayed development. Absence of unambiguous motor symptoms was less common in epilepsy than in NEPE. Seizure-like events were common in infants and most were not caused by epilepsy. Specific anamnestic clues, and detailed descriptions of the entire event, helped to predict adverse outcomes.

Purpose Most people with common mental disorders are working despite symptoms. This study explores individuals’ experiences of a work-directed rehabilitation, provided by occupational therapists and physiotherapists, aiming to promote work capacity in persons with common mental disorders. Methods A qualitative content analysis was used, and 11 women and 8 men with depression or anxiety disorder were interviewed. They were 25–66 years old, had different occupations and were working full or part-time. Results The participants experienced a process interpreted as Increasing belief in one’s capacity through supported reflection and practice. This theme reflects the shifting between “reflecting” and “doing” through rehabilitation and the growing hope for change. The increasing belief in one’s capacity was developed through three stages, comprised of the categories To be supported by a professional, To realise things about oneself and To try new strategies for change. Conclusions Strategies suggested by occupational therapists and physiotherapists have the potential to promote work capacity in people who are working while depressed and anxious. The results may deepen the understanding among rehabilitation professionals about the importance of a person-centred approach to people with common mental disorders, and to combine reflection and practical exercises to support the development of work-related strategies. Implications for rehabilitation Work-directed rehabilitation provided by occupational therapists and/or physiotherapists is beneficial to people with common mental disorders. Rehabilitation professionals should focus on facilitating self-efficacy among people with common mental disorders. An individualised person-centred approach seems important in order to initiate change.

Abstract HEM draws on theories for health behavior and power relations. The methodology contains a structured documentation for formative and summative purposes. Strive for a high level of participation, control and influence from individuals and community members is a foundation pillar. Systematic use of theories allows for answering the fundamental question “in what way do we anticipate the planned intervention to contribute to closing the health gap?” Social Cognitive Theory (SCT) considers social and physical environment. HEM currently involve several SCT determinants in planning and evaluation; self- efficacy, observational learning, facilitating, expectations of outcome, reciprocal determination. The qualitative procedure is described below. Numeric data are also collected. Step one (before action, e.g. a dialogue-meeting): Consider which determinant(s) may be affected by the planned action, and by what mechanisms. Step two: Carry out the action. Step three: Describe what happened, based on input from the participants and the anticipated determinants and mechanisms. Step four: Systematic self-critical review based on common grounds for discrimination. Examples: Was it difficult to engage or include participants because of language, gender, function variation, national background or other factor? In retrospect, can you identify stereotypes in the examples you used? Did anybody else at the event act to maintain prejudice or exclusion? Step five: consider implications for methodological development. Step six: Formative collective evaluation based on reflections from step four and implications from step five. Stakeholders using HEM gather regularly for workshops based on their HEM-reports, aiming at developing tools for increasing health equity. HEM is implemented in public health work of Angered Hospital and the Dental Public Health, Region Västra Götaland, and is used by 20 different stakeholders. A web-application has been developed to facilitate documentation and spread.