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1. Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs

Author

Gustafsson LK, Anbacken EM, Östlund G, Bondesson A, Pettersson T, and Zander V

Subjects
integrated-care model, multi-morbidity, interprofessional care, home-based care, person-centred integrated care., Medicine (General), R5-920
Abstract

Lena-Karin Gustafsson,1 Els-Marie Anbacken,2 Gunnel Östlund,2 Anna Bondesson,1 Tina Pettersson,1 Viktoria Zander3 1Division of Caring Science, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden; 2Division of Social Work, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden; 3Division of Health and Welfare Technology, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, SwedenCorrespondence: Lena-Karin Gustafsson, Division of Caring Science, School of Health, Care and Social Welfare, Mälardalens University, Eskilstuna, Sweden, Tel +46 70 7874420, Email lena-karin.gustafsson@mdu.seAim: This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people’s homes.Materials and Method: Open-ended group interviews with personnel were carried out, three of the group interviews pre-implementations of the model, and three of the group interviews post-implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis.Results: The quality of the integrated care model was based on care-chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person-centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants’ experiences of the post-implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting.Conclusion: Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question.Plain language summary: The intention of the present study was to follow the process of working with a new model of providing care at home, thus preventing increased numbers of hospital readmissions, based on the professionals´ point of view of what quality care is for older adults with complex care needs due to multimorbidity, living in their own home. The professionals were interviewed in group settings on several occasions during the implementation.The result showed hopeful expectations expressed by the professionals before the new model was implemented, such as a hope for getting more time for high-quality care for the older adults with multimorbidity. During the teamwork, the conversation within the team members was praised as a key factor that included shared professionalism from professionals with different levels of education and focus on their work. According to the staff, unnecessary hospital stays were reduced, while the interprofessional care-chain cooperation was improved through the work of the integrated care team. For many team members, the positive difference in both work and care satisfaction was highlighted in comparison to regular home care as they were able to use their multi-disciplinary skills and support.Keywords: integrated-care model, multi-morbidity, interprofessional care, home-based care, person-centred integrated care

Published
2024

2. “Intensive-Home-Rehabilitation” Intervention for Older Persons: A Follow-Up Study of Team Members’ Perceptions

Author

Söderman M, Bondesson A, Pettersson T, and Gustafsson LK

Subjects
home-based care, intensive-home-rehabilitation, interprofessional team, older persons, reablement, recovery, rehabilitation process., Medicine (General), R5-920
Abstract

Mirkka Söderman, Anna Bondesson, Tina Pettersson, Lena-Karin Gustafsson Division of Caring Science, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, SwedenCorrespondence: Mirkka Söderman, School of Health, Care and Social Welfare, Box 325, Eskilstuna, 631 05, Sweden, Tel +46 16153433, Email mirkka.soderman@mdu.seBackground: Reablement as a concept includes a health-promoting perspective with the goal of strengthening health and the ability to perform and participate in daily activities, a broader perspective than in general home care and rehabilitation. Reablement interventions have shown to be both more effective and to a greater extent improve the function and health-related quality of life of older persons when compared to traditional home-based care. Success factors for intensive-home-rehabilitation (IHR), an intervention based on the reablement concept, have been described earlier; however, there is a lack of knowledge about why some persons do not recover despite receiving IHR.Aim: The aim was to shed light on the older persons’ conditions during IHR from the perspective of the rehabilitation team members and to describe obstacles to recovery.Methods: Qualitative analysis of health and care records of persons (65+) who received IHR (n=19) performed by an interprofessional team.Results: The analysis revealed various problematic situations, dilemmas, that occurred in the older persons’ lives during IHR, as well as their consequences and the strategies employed by the older persons as a result. IHR aspects perceived as successful by the older persons also emerged, as well as differences in experiences of the physical and mental aspects of the IHR. Analysis also revealed reasons why the IHR might be experienced as broadly successful.Conclusion: The older persons seemed to be satisfied with IHR and achieved their goals; however, some seemed to need more time to reach their goals. Background factors such as having additional diagnoses and living alone might affect the rehabilitation process.Implication for Practice: The study provides knowledge regarding the importance of IHR for the recovery process for the increasing numbers of older persons, which might also be useful in other patient groups requiring otherwise long-term rehabilitation and recovery such as after covid-19 infection.Keywords: home-based care, intensive-home-rehabilitation, interprofessional team, older persons, reablement, recovery, rehabilitation process

Published
2023

6. Radiographers’ perception on task shifting to nurses and assistant nurses within the radiography profession

Author

Møller Christensen, Berit, Pettersson, T., Bjällmark, Anna, Møller Christensen, Berit, Pettersson, T., and Bjällmark, Anna

Abstract

Introduction: The radiography profession is challenged by greater responsibilities and shortage of educated radiographers. Implementation of task shifting is one strategy to deal with the current situation in health care. The aim of this studiy was to evaluate radiographers’ perception of assistant nurses and nurses carrying out tasks that traditionally were undertaken within the radiography profession in a Swedish context. Methods: An electronic questionnaire was distributed to radiographers at eleven hospitals in Sweden. The questionnaire included background questions and questions about radiographers’ perception about task shifting to nurses and assistant nurses. The respondents rated their agreement level regarding task shifting on a five-point Likert scale. Data was statistically evaluated in SPSS using Mann Whitney U test. Results: Sixty-five radiographers participated in the study. Most radiographers responded negatively to task shifting to nurses (72%) or assistant nurses (65%). Most radiographers disagree that nurses should perform mammography screening or work within interventional radiography, while the attitude towards nurses calculating glomerular filtration rate was more positive. A majority disagree regarding assistant nurses performing conventional radiographs, informing the patient about contrast media administration or inserting peripheral intravenous catheters, while there was a positive attitude towards assistant nurses preparing patients for examinations. The attitude towards task shifting was not influenced by age, however radiographers with less working experience were more positive to task shifting in general. Conclusion: A majority of the radiographers had a negative attitude towards task shifting to nurses and assistant nurses. The radiographers were more positive to hand over tasks related to patient care and administrative tasks than technical related tasks within the profession. Implications for practice: Knowledge about radiographers’ p

Published
2021
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30. Cost of wild boar to farmers in Sweden.

Author

Gren, I -M, Andersson, H, Mensah, J, and Pettersson, T

Subjects
WILD boar, TOBITS, FARMERS, CROP losses, COST estimates
Abstract

Wild boar are widespread mammals in the world that can cause serious economic damage to farmers. Using data from a survey of farmers in Sweden, this study provides estimates of the cost of wild boar (crop loss, machinery damage, protection) to farmers in Sweden. The results indicate that 39 per cent of respondents had experienced at least one of the three types of costs and that they report a wide range of damage values. Regression results from an instrumental variable Tobit model showed that costs are significantly increasing in wild boar abundance and landscape diversity, and decreasing in the share of grain production. [ABSTRACT FROM AUTHOR]

Published
2020
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33. Understanding the dispersive action of nanocellulose for carbon nanomaterials

Author

Hajian, A., Lindström, S. B., Pettersson, T., Hamedi, M. M., Wågberg, L., Hajian, A., Lindström, S. B., Pettersson, T., Hamedi, M. M., and Wågberg, L.

Abstract

This work aims at understanding the excellent ability of nanocelluloses to disperse carbon nanomaterials (CNs) in aqueous media to form long-term stable colloidal dispersions without the need for chemical functionalization of the CNs or the use of surfactant. These dispersions are useful for composites with high CN content when seeking water-based, efficient and green pathways for their preparation. To establish a comprehensive understanding of such dispersion mechanism, colloidal characterization of the dispersions has been combined with surface adhesion measurements using colloidal probe atomic force microscopy (AFM) in aqueous media. AFM results based on model surfaces of graphene and nanocellulose further suggest that there is an association between the nanocellulose and the CN. This association is caused by fluctuations of the counterions on the surface of the nanocellulose inducing dipoles in the sp2 carbon lattice surface of the CNs. Furthermore, the charges on the nanocellulose will induce an electrostatic stabilization of the nanocellulose–CN complexes that prevents aggregation. Based on this understanding, nanocelluloses with high surface charge density was used to disperse and stabilize carbon nanotubes (CNTs) and reduced graphene oxide in water and further increase in the dispersion limit of CNTs could be obtained. The dispersion limit reached the value of 75 wt% CNTs and resulted in high electrical conductivity (515 S/cm) and high modulus (14 GPa) of the CNT composit e nanopapers.

Published
2017
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37. EURObservational Research Programme:regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A. P., Dahlstrom, U., Filippatos, G., Chioncel, O., Leiro, M. C., Drozdz, J., Fruhwald, F., Gullestad, L., Logeart, D., Fabbri, G., Urso, R., Metra, M., Parissis, J., Persson, H., Ponikowski, P., Rauchhaus, M., Voors, A. A., Nielsen, O. W., Zannad, F., Tavazzi, L., Alonso, A., Ferrari, R., Komajda, M., Wood, D., Manini, M., Taylor, C., Laroche, C., Fiorucci, E., Lucci, D., Gonzini, L., Auer, J., Oberrauner, A., Schumacher, M., Ebner, C., Hallas, A., Espersen, G., Gustafsson, F., Mattsson, N., Egstrup, K., Aagaard, S., Gohr, T., Huld, K., Knudsen, A., Refsgaard, J., Charniot, J., Juillard, A., Pon-Gabrielsen, P., Douna, F., Jondeau, G., Jourdain, P., Michel, L., Hamm, C., Lehinant, S., Rieth, A., Goeing, O., Schultheiss, H. P., Von-Schlippenbach, J., Knollmann, R., Neubuser, C., Katus, H. A., Taeger, T., Zugck, C., Fink, H., Schulz, J., Held, S., Karmann, W., Kreuzer, J., Nitsche, K., Winter, K., Fahnrich, A., Bruederlein, K., Turan, C. H., Berentelg, J., Ittel, T., Rubens, C., Hanke, M., Stoerk, S., Chrysohoou, C., Kaldara, E., Karavidas, A., Margari, R., Matzaraki, V., Nanas, J., Pozios, I., Psarogiannakopoulos, P., Pyrgakis, V., Stefanadis, C., Terrovitis, J., Trikas, A., Xydonas, S., Patrianakos, A., Vardas, P., Douras, A., Nastas, J., Ntertsas, K., Tsaknakis, T., Midi, P., Pajes, G., Moretti, L., Partemi, M., Barberini, F., Branzi, A., Gallelli, I., Grigioni, F., Ionico, T., Pasquale, F., Cas, L., Delmagro, F., Tanghetti, E., Vaccari, A., Mercuro, G., Arcuri, G. M., Marinacci, L., Severini, D., Cosmi, F., Bosi, S., Di Tano, G., Pirelli, S., Fucili, A., Minneci, C., Santoro, G. M., Correale, M., Di Biase, M., Buccolieri, M., Mandorla, S., Martinelli, S., Barbiero, M., Giordano, A., Zanelli, E., Agostoni, P., Fiorentini, C., Salvioni, E., Leuzzi, C., Modena, M. G., Reggianini, L., Cobelli, F., Opasich, C., Baldini, P., Romei, M., Pulitano, G., Ruggeri, A., Bologna, F., Piovaccari, G., Brasolin, B., Fedele, F., Merlo, M., Sinagra, G., Albanese, M. C., Miani, D., Linssen, G., Rodijk, E., Pinto, Y., Van Donk, P., Dunselman, P., Lok, D., Brouwers, F., De Jong, R. M., Boen, R., Hole, T., Rasmussen, L., Christiansen, E. M., Gjertsen, E., Lyng, J., German, M., Hogalmen, G., Skardal, R., Apelland, T., Borgen, M., Forfang, E., Baak, T., Dickstein, K., Olsen, I., Stachurski, D., Juszczyk, Z., Stankala, S., Gilewski, W., Sinkiewicz, W., Kasztelowicz, P., Gabryel, J., Kardaszewicz, P., Lazorko-Piega, M., Bellwon, J., Mosakowska, K., Rynkiewicz, A., Olczyk, S., Pagorek, M., Bartlinski, R., Borej, G., Tarchalski, J., Bartkowiak, R., Sosnowska-Pasiarska, B., Wozakowska-Kaplon, B., Krzeminski, A., Bury, K., Grzegorzko, A., Mirek-Bryniarska, E., Nessler, J., Zabojszcz, M., Broncel, M., Poliwczak, A., Retwinski, A., Soska, K., Grajek, S., Straburzynska-Migaj, E., Kuzniar, J., Rzeszuto, T., Bednarczyk, G., Ruszkowski, P., Piasecka-Krysiak, E., Zambrzycki, J., Nowak, T., Szelemej, R., Balsam, P., Folga, A., Kaplon-Cieslicka, A., Kowalewski, S., Mamcarz, A., Marchel, M., Opolski, G., Welnicki, M., Jankowska, E., Nowak, J., Nowalany-Kozielska, E., Rozentryt, P., Zembala, M., Kleinrok, A., Prokop-Lewicka, G., Kudlinska, B., Radoi, M., Macarie, C., Vinereanu, D., Capalneanu, R., Giuca, A., Ionescu, D. D., Nechita, E., Datcu, M., Istrate, C., Vladoianu, M., Christodorescu, R., Salguero, R., Blanco, V. M., Lavilla, M. A., Comin-Colet, J., Cantillo, D., Bernal, J., del Prado, J. M., Pita, A., Aguero, J., Jimenez, J. F., Calvo, F., Gonzalez, R., Molina, B., Luengos, D., Lostal, C., Bonet, L., Gonzalez, P., Soriano, F., Campos, M. J., Karlstrom, P., Nyrinder, I., Olsson, B., Pettersson, T., Stenberg, A., Lindmark, K., Asserlund, B., Faculteit Medische Wetenschappen/UMCG, Cardiovascular Centre (CVC), ACS - Amsterdam Cardiovascular Sciences, Cardiology, Maggioni, Aldo P, Dahlström, Ulf, Filippatos, Gerasimo, Chioncel, Ovidiu, Leiro, Marisa Crespo, Drozdz, Jaroslaw, Fruhwald, Friedrich, Gullestad, Lar, Logeart, Damien, Fabbri, Gianna, Urso, Renato, Metra, Marco, Parissis, John, Persson, Han, Ponikowski, Piotr, Rauchhaus, Mathia, Voors, Adriaan A., Nielsen, Olav Wendelboe, Zannad, Faiez, Tavazzi, Luigi, on behalf of the Heart Failure Association of the European Society of Cardiology (HFA): [.., F. Barberini, A. Branzi, I. Gallelli, F. Grigioni, T. Ionico, F. Pasquale, and ]

Subjects
Registrie, Male, Time Factors, Peripartum cardiomyopathy, Pilot Projects, Cardiovascular Agents/therapeutic use, Acute heart failure, Chronic heart failure, Observational studies, Pharmacological treatments, Prognosis, Aged, Cardiovascular Agents, Europe, Female, Follow-Up Studies, Heart Failure, Hospital Mortality, Hospitalization, Humans, Middle Aged, Prospective Studies, Inpatients, Registries, GUIDELINES, CLINICAL CHARACTERISTICS, Medicine, Prospective cohort study, POPULATION, Hospital Mortality/trends, education.field_of_study, OUTCOMES, Ejection fraction, Mortality rate, HOSPITALIZATION, Inpatient, Cardiology and Cardiovascular Medicine, Pharmacological treatment, Human, medicine.medical_specialty, acute heart failure, chronic heart failure, observational studies, pharmacological treatments, prognosis, aged, cardiovascular agents, female, follow-up studies, heart failure, hospital mortality, hospitalization, humans, male, middle aged, pilot projects, prospective studies, time factors, inpatients, registries, cardiology and cardiovascular medicine, EUROPE, Time Factor, Prognosi, Population, DIAGNOSIS, Follow-Up Studie, Europe/epidemiology, ONE-YEAR MORTALITY, Pilot Project, education, Hospitalization/statistics & numerical data, business.industry, medicine.disease, Heart Failure/drug therapy, Observational studie, Prospective Studie, Cardiovascular Agent, Heart failure, REGISTRY, Cardiovascular agent, Emergency medicine, Physical therapy, Observational study, QUALITY-OF-CARE, business
Abstract

AIMS: The ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.METHODS: The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.CONCLUSION: The ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network.

Published
2013
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40. EURObservational Research Programme: Regional differences and 1-year follow-up results of the Heart Failure Pilot Survey (ESC-HF Pilot)

Author

Maggioni, A.P. Dahlström, U. Filippatos, G. Chioncel, O. Leiro, M.C. Drozdz, J. Fruhwald, F. Gullestad, L. Logeart, D. Fabbri, G. Urso, R. Metra, M. Parissis, J. Persson, H. Ponikowski, P. Rauchhaus, M. Voors, A.A. Nielsen, O.W. Zannad, F. Tavazzi, L. Alonso, A. Ferrari, R. Komajda, M. Wood, D. Manini, M. Taylor, C. Laroche, C. Fiorucci, E. Lucci, D. Gonzini, L. Auer, J. Oberrauner, A. Schumacher, M. Ebner, C. Hallas, A. Espersen, G. Gustafsson, F. Mattsson, N. Egstrup, K. Aagaard, S. Gohr, T. Huld, K. Knudsen, A. Refsgaard, J. Charniot, J. Juillard, A. Pon-Gabrielsen, P. Douna, F. Jondeau, G. Jourdain, P. Michel, L. Hamm, C. Lehinant, S. Rieth, A. Goeing, O. Schultheiss, H.P. Von-Schlippenbach, J. Knollmann, R. Neubüser, C. Katus, H.A. Taeger, T. Zugck, C. Fink, H. Schulz, J. Held, S. Karmann, W. Kreuzer, J. Nitsche, K. Winter, K. Fahnrich, A. Bruederlein, K. Turan, C.H. Berentelg, J. Ittel, T. Rubens, C. Hanke, M. Stoerk, S. Chrysohoou, C. Kaldara, E. Karavidas, A. Margari, R. Matzaraki, V. Nanas, J. Pozios, I. Psarogiannakopoulos, P. Pyrgakis, V. Stefanadis, C. Terrovitis, J. Trikas, A. Xydonas, S. Patrianakos, A. Vardas, P. Douras, A. Nastas, J. Ntertsas, K. Tsaknakis, T. Midi, P. Pajes, G. Moretti, L. Partemi, M. Barberini, F. Branzi, A. Gallelli, I. Grigioni, F. Ionico, T. Pasquale, F. Cas, L. Delmagro, F. Tanghetti, E. Vaccari, A. Mercuro, G. Arcuri, G.M. Marinacci, L. Severini, D. Cosmi, F. Bosi, S. Di Tano, G. Pirelli, S. Ferrari, R. Fucili, A. Minneci, C. Santoro, G.M. Correale, M. Di Biase, M. Buccolieri, M. Mandorla, S. Martinelli, S. Barbiero, M. Giordano, A. Zanelli, E. Agostoni, P. Fiorentini, C. Salvioni, E. Leuzzi, C. Modena, M.G. Reggianini, L. Cobelli, F. Opasich, C. Baldini, P. Romei, M. Pulitano, G. Ruggeri, A. Bologna, F. Piovaccari, G. Brasolin, B. Fedele, F. Merlo, M. Sinagra, G. Albanese, M.C. Miani, D. Linssen, G. Rodijk, E. Pinto, Y. Van Donk, P. Dunselman, P. Lok, D. Brouwers, F. De Jong, R.M. Boen, R. Hole, T. Rasmussen, L. Christiansen, E.M. Gjertsen, E. Lyng, J. German, M. Hogalmen, G. Skardal, R. Apelland, T. Borgen, M. Forfang, E. Baak, T. Dickstein, K. Olsen, I. Stachurski, D. Juszczyk, Z. Stankala, S. Gilewski, W. Sinkiewicz, W. Kasztelowicz, P. Gabryel, J. Kardaszewicz, P. Lazorko-Piega, M. Bellwon, J. Mosakowska, K. Rynkiewicz, A. Olczyk, S. Pagorek, M. Bartlinski, R. Borej, G. Tarchalski, J. Bartkowiak, R. Sosnowska-Pasiarska, B. Wozakowska-Kaplon, B. Krzeminski, A. Bury, K. Grzegorzko, A. Mirek-Bryniarska, E. Nessler, J. Zabojszcz, M. Broncel, M. Poliwczak, A. Retwinski, A. Soska, K. Grajek, S. Straburzynska-Migaj, E. Kuzniar, J. Rzeszuto, T. Bednarczyk, G. Ruszkowski, P. Piasecka-Krysiak, E. Zambrzycki, J. Nowak, T. Szelemej, R. Balsam, P. Folga, A. Kaplon-Cieslicka, A. Kowalewski, S. Mamcarz, A. Marchel, M. Opolski, G. Welnicki, M. Jankowska, E. Nowak, J. Nowalany-Kozielska, E. Rozentryt, P. Zembala, M. Kleinrok, A. Prokop-Lewicka, G. Kudlinska, B. Radoi, M. Macarie, C. Vinereanu, D. Capalneanu, R. Giuca, A. Ionescu, D.D. Nechita, E. Datcu, M. Istrate, C. Vladoianu, M. Christodorescu, R. Salguero, R. Blanco, V.M. Lavilla, M.A. Comin-Colet, J. Cantillo, D. Bernal, J. del Prado, J.M. Pita, A. Aguero, J. Jimenez, J.F. Calvo, F. Gonzalez, R. Molina, B. Luengos, D. Lostal, C. Bonet, L. Gonzalez, P. Soriano, F. Campos, M.J. Karlstrom, P. Nyrinder, I. Olsson, B. Pettersson, T. Stenberg, A. Lindmark, K. Asserlund, B. Heart Failure Association of the European Society of Cardiology (HFA)

Abstract

AimsThe ESC-HF Pilot survey was aimed to describe clinical epidemiology and 1-year outcomes of outpatients and inpatients with heart failure (HF). The pilot phase was also specifically aimed at validating structure, performance, and quality of the data set for continuing the survey into a permanent Registry.MethodsThe ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 Cardiology Centres in 12 European countries selected to represent the different health systems across Europe. All outpatients with HF and patients admitted for acute HF on 1 day per week for eight consecutive months were included. From October 2009 to May 2010, 5118 patients were included: 1892 (37%) admitted for acute HF and 3226 (63%) patients with chronic HF. The all-cause mortality rate at 1 year was 17.4% in acute HF and 7.2% in chronic stable HF. One-year hospitalization rates were 43.9% and 31.9%, respectively, in hospitalized acute and chronic HF patients. Major regional differences in 1-year mortality were observed that could be explained by differences in characteristics and treatment of the patients.ConclusionThe ESC-HF Pilot survey confirmed that acute HF is still associated with a very poor medium-term prognosis, while the widespread adoption of evidence-based treatments in patients with chronic HF seems to have improved their outcome profile. Differences across countries may be due to different local medical practice as well to differences in healthcare systems. This pilot study also offered the opportunity to refine the organizational structure for a long-term extended European network. © 2013 The Author.

Published
2013

48. Evaluation of a passive sampler for the speciation of metals in urban runoff water

Author

Knutsson, J., Knutsson, P., Rauch, S., Pettersson, T., Morrison, Gregory, Knutsson, J., Knutsson, P., Rauch, S., Pettersson, T., and Morrison, Gregory

Abstract

Metals in urban runoff water need to be monitored in order to estimate fluxes and assess their impact on the aquatic environment. Passive sampling is a useful and reliable emerging tool for measuring time averaged concentrations of metals in water bodies. This paper describes the deployment of a passive sampler to measure Cu, Ni and Zn in an urban runoff water treatment facility. The concentrations derived from the passive samplers are compared to concentrations obtained from an automated water sampler which provides pooled spot water samples and to model predictions from the visualMINTEQ computer speciation code. Results show that visualMINTEQ predictions partly describe the metal speciation in non-equilibrium systems. In addition we conclude that passive samplers are useful for monitoring and characterization of metal speciation under chemodynamic conditions. © 2013 The Royal Society of Chemistry.

Published
2013

50. Replacement predictions for drinking water networks through historical data

Author

Malm, A., Ljunggren, O., Bergstedt, O., Pettersson, T., Morrison, Gregory, Malm, A., Ljunggren, O., Bergstedt, O., Pettersson, T., and Morrison, Gregory

Abstract

Lifetime distribution functions and current network age data can be combined to provide an assessment of the future replacement needs for drinking water distribution networks. Reliable lifetime predictions are limited by a lack of understanding of deterioration processes for different pipe materials under varied conditions. An alternative approach is the use of real historical data for replacement over an extended time series. In this paper, future replacement needs are predicted through historical data representing more than one hundred years of drinking water pipe replacement in Gothenburg, Sweden. The verified data fits well with commonly used lifetime distribution curves. Predictions for the future are discussed in the context of path dependence theory. © 2012 Elsevier Ltd.

Published
2012

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