Introduction: Approximately 10 000 people suffer each year from out-of-hospital cardiac arrest in Sweden. At the turn of the millennia the survival rate for out-of-hospital cardiac arrest was circa three precent and in 2022 the survival rate had increased to around eleven percent. Survivors face cognitive, psychological, and motor problems post arrest which impacts their health-related quality of life (HRQoL) – ie. their perception of their own social and physical environment and health. The research regarding HRQoL following cardiac arrest is limited. With increasing survival rates comes an increasing need for extensive research mapping the HRQoL of cardiac arrest survivors. Aim: The aim of this study was to investigate patients’ perceived health-related quality of life after surviving cardiac arrest.   Method: This study was conducted as a quantitative general literature review with an inductive content analysis. This study used articles that included the SF-36 instrument to measure the HRQoL in cardiac arrest survivors. Main- and subcategories were created based on the data extracted from the included articles. Result: Cardiac arrest patients generally experience their health-related quality of life as worse compared to the general population. Physical, psychological and social factors were identified as the main components whose effect on HRQoL was found to be the greatest. Conclusion: Cardiac arrest survivors experience a reduced HRQoL compared to the general population. The HRQoL is affected in both the psychological and physical dimensions with long term consequences. These results create a foundation for the nurse in the work to improve the HRQoL for the patient.

Note:

Bakgrund: Fetma är ett allvarligt folkhälsoproblem då fetma ökar risken att drabbas av följdsjukdomar, samt att patienter med fetma visat sig ha lägre genomsnittlig hälsorelaterad livskvalitet (HRQoL) jämfört med befolkningen i allmänhet. Syfte: med denna litteraturöversikt var att beskriva hälsorelaterad livskvalitet bland personer som genomgått fetmakirurgi. Metod: Litteraturöversikt baserad på 8 kvantitativa interventionsstudier med uppföljningar mellan 9 månader - 10 år efter genomförd behandling. Litteratursökning skedde i databaserna PubMed och Cinahl. Analys av studierna skedde genom att studierna sammanställdes baserat på redovisning av frågeformulär SF-36 för index fysisk och mental hälsa och dess åtta dimensioner. Resultat: Samtliga studier indikerar att den fysiska hälsan i genomsnitt ökar efter fetmakirurgi. Samtliga utom en studie indikerar att hälsoindex för mental hälsa i genomsnitt ökar efter fetmakirurgi. Studier som sträcker sig över flera uppföljningsperioder visar att den initiala ökningen av hälsoindex minskar med tiden och effekten är som högst 1–2 år efter fetmakirurgi. Konklusion: Resultaten pekar på att fetmakirurgi initialt leder till en förbättring av fysisk och mental HRQoL med en tydlig topp efter 1–2 år. Studier med högt deltagande och uppföljning över tid är för få för att dra slutsatser kring effekten av fetmakirurgi på HRQoL på längre sikt. Utbildning av vårdpersonal och uppföljningsprogram kan bidra till ökat uppföljningsdeltagande, och minska risken för bortfall till följd av brister i vårdpersonalens bemötande. / Background: Obesity is a serious public health problem as it increases the risk of secondary diseases. Patients with obesity have been shown to have lower average health-related quality of life (HRQoL) compared to the general population. Aim: of this literature review was to describe health-related quality of life among people who have undergone bariatric surgery. Methods: Literature review of eight quantitative intervention studies with follow-ups between 9 months to 10 years. Literature search took place in the databases PuBMed and Cinahl. Analysis of the studies was done by summarizing the studies based on the reported result of the SF-36 questionnaire for physical and mental health and its eight dimensions. Results: All studies indicate that physical health increases on average after bariatric surgery. All but one study indicate that the mental health index increases, on average, after bariatric surgery. Studies that extend over several follow-up periods show that the initial increase in mental health decreases over time and the effect is highest 1–2 years after bariatric surgery. Conclusion: The results indicate that bariatric surgery initially leads to an improvement in physical and mental HRQoL with a clear peak after 1–2 years. Studies with high participation and follow-up over time are too few to draw conclusions about the effect of bariatric surgery on HRQoL in the longer term. Training of healthcare professionals and follow-up programs can contribute to increased follow-up participation, and reduce the risk of non-response.

Στην παρούσα διατριβή, η οποία πραγματεύεται τις θεμελιώσεις κατασκευών, πρωτίστως αναφέρονται οι προδιαγραφές που οφείλονται να τηρούνται ως προς την ασφάλεια και τη λειτουργικότητα της ανωδομής. Γίνεται αναφορά στη σπουδαιότητα της γεωτεχνικής έρευνας και στους τρόπους και τις μεθόδους με τις οποίες αυτή διεξάγεται. Στη συνέχεια ορίζονται τα κριτήρια σχεδιασμού μιας θεμελίωσης, δηλαδή το πρόβλημα αστοχίας και το πρόβλημα λειτουργικότητας. Παρατίθενται τρόποι υπολογισμού της φέρουσας ικανότητας για διάφορες εδαφικές συνθήκες για αβαθείς θεμελιώσεις, καθώς και ο υπολογισμός συντελεστών ασφαλείας με κλασικές μεθόδους καθώς και κατά τον Ευροκώδικα EC-7. Σχετικά με τις καθιζήσεις, αναφέρονται οι κατηγορίες τους και γίνεται υπολογισμός ανά περίπτωση και τύπο εδάφους, ενώ σημειώνονται και τα αποτελέσματα τους στις κατασκευές. Επίσης, συνοψίζονται τα επιτρεπόμενα όρια των καθιζήσεων. Ακολουθούν μεθοδολογίες για το σχεδιασμό των τριών τύπων αβαθών θεμελιώσεων, δηλαδή για μεμονωμένα θεμέλια, πεδιλοδοκούς και γενική κοιτόστρωση με γνώμονα να πληρούνται τα κριτήρια σχεδιασμού. Έπειτα περιγράφονται οι βαθιές θεμελιώσεις, καθώς και οι τρόποι υπολογισμού της φέρουσας ικανότητας τους και των καθιζήσεων που προκαλούν. Γίνονται εφαρμογές διάφορων μορφών θεμελιώσεων, για μια διώροφη οικοδομή, σε δύο διαφορετικές και χαρακτηριστικές περιοχές της πόλης των Πατρών με δεδομένα από δειγματοληπτικές γεωτρήσεις. Η πρώτη περιοχή αφορά το ανατολικό τμήμα της πόλης (περιοχή στρατοπέδου ΚΕΤΧ) όπου επιφανειακά συναντάται στρώμα σκληρής πολύ αμμώδους αργίλου και σχεδιάζεται επιφανειακή θεμελίωση με εναλλακτικούς τρόπους. Η δεύτερη περιοχή αφορά την παράκτια ζώνη της πόλης, όπου συναντάται επιφανειακό στρώμα μαλακών εδαφών σημαντικού πάχους και γίνεται διαστασιολόγηση για βαθειά θεμελίωση έγχυτων πασάλων τριβής. / At first, in this thesis, which deals with foundations in constructions, there is a mention for specifications required to ensure both safety and functionality of the structure. Also, there is a reference in geotechnical investigation and methods importance. Additionally, designing criteria for foundations are defined as both “failure matter” and “ functionality (settlements) matter”. Formulas and methods of calculating bearing capacity of shallow foundations for different territory types are listed. There are also methods for calculating factors of safety (classical methods, Eurocode EC-7). There is a reference in settlement categories and the way of calculating settlement value regarding their type and the soil environment. Allowable limits of settlements are summarized, as well. Thereafter, there are analyzed the ways of designing all shallow foundation types, which are individual footings, spread footings and raft foundation, so as designing criteria are met. Deep foundations are described, as well as methods of calculating their bearing capacity and settlement value. Finally, different foundation applications are presented as possible solutions, for a two storey building structure, in two different and characteristic areas in Patras. Data have been exported from sample drillings. The first area, is located in Eastern Patras, (camp of KETEX), where there is a surface soil layer of hard, very sandy clay. There, it is designed shallow foundation in variable and alternative ways. The second area, is located in the coastal zone of Patras, where there is a surface quit thick layer of soft deposits. There, the building construction is being based by designing concrete injector piles.

La planificación del futuro en los ámbitos demográfico, económico y actuarial es crucial. La buena planificación en programas sociales, presupuestos de gobierno, reservas actuariales, costo de seguros y pensiones, etc., depende del uso de un buen método para realizar pronósticos. Sin embargo, los constantes cambios en tecnología, estilos de vida, cambio climático, migración, por mencionar algunos, hacen que predecir ciertos fenómenos no sea una tarea fácil. En particular, la mortalidad y la longevidad son eventos que impactan directamente en costos monetarios y por lo tanto necesitan una buena proyección a futuro. Ambos son indicadores del bienestar de la población, evalúan si los programas de salud y bienestar de la población son efectivos. Específicamente, en el mercado asegurador tener una alta mortalidad implica una subida de primas y, en general mías reservas para hacer frente a los siniestros. La longevidad trae consigo situaciones similares cuando se trata el tema de anualidades y p pensiones. A nivel social, alcanzar edades muy adultas implica la creación de programas de apoyo a los adultos mayores, por ejemplo, programas de dependencia, creación de albergues, lugares de ocio y campañas de salud. El principal interés de esta Tesis es presentar opciones para una buena gestión de los costes de la mortalidad y la longevidad. La introducción presenta los antecedentes, la motivación y los objetivos. En el capitulo 1 se describen los datos que han sido utilizados para realizar los diferentes análisis: n número de personas vivas y fallecimientos en México y tasas de mortalidad del sector asegurador. También se describen los cálculos necesarios para obtener la matriz con las tasas crudas de mortalidad de la población mexicana para los a años 1990 a 2010 y edades de 0 a 100, siempre diferenciadas por sexos. En el capítulo 2 se ha modelado el comportamiento de la mortalidad de la población general en México. Los modelos a justados son el modelo Lee-Carter, el modelo Renshaw-Haberman y el modelo Age-Period-Cohort. Con las tasas de mortalidad estimadas por el modelo Lee-Carter, se ha a justado un modelo relacional Brass-type para obtener nuevas tasas del mercado asegurador a partir de las existentes, p ero corregidas por la mortalidad general. En diciembre de 2013 entró en vigor en Europa una nueva directiva donde se establecía que los precios en bienes y servicios, lo que incluye las tarifas de seguros, no pueden ser diferentes para hombres y mujeres. En el capítulo 3 se ha abordado este tema conjuntándolo con el tema de la longevidad. Tomando como edad inicial la edad 65, se estimó la función de supervivencia y con esta, se estimaron los parámetros ρ y λ de la distribución Weibull siguiendo la relaci´on S(t) = exp(−ρtλ). Diferentes proporciones de hombres y mujeres fueron asumidas para este ejercicio. Con los parámetros estimados, fue posible evaluar el riesgo de longevidad, para esto se calculó el valor en riesgo (VaR, Value-at-Risk) a diferentes niveles de confianza α. La Asociación Mexicana de Instituciones de Seguros (AMIS) desde el año 2000 y cada cinco años ha calculado tasas de mortalidad diferenciadas por sexo. Al disponer de esta información, en el capítulo 4 se ha decidido realizar el modelo Brass-type suponiendo que el número de muertos en cada edad y año sigue una distribución Poisson. De nueva cuenta el riesgo de longevidad se evaluó con el cálculo del VaR α . Después de haber utilizado distribuciones paramétricas se comprobó que es difícil describir de manera correcta la variable aleatoria número de supervivientes en cada edad, por tanto el VaR puede estar estimando de manera incorrecta el riesgo de longevidad. Así, en el capítulo 5 se ha calculado la función de distribución (CDF, Cumulative Distribution Function) utilizando métodos paramétricos y noparámetricos como el estimador núcleo clásico (CKE, Classical Kernel Estimator). También se propone utilizar el método semiparamétrico estimador núcleo doble transformado (DTKE, Double Transformed Kernel Estimator) (Alemany et al., 2013). Más aún, para el ajuste de los modelos paramétricos se presenta una alternativa a la estimación máximo verosímil, que es la estimación vía minimizar el error cuadrático medio integrado (MISE, Mean Integrated Square Error), el cual también funciona como medida de bondad de ajuste y permite comparar tanto ajustes paramétricos como noparamétricos. El capítulo 6 se basa en las aportaciones que la propia autora realizó en el trabajo titulado “La igualdad una exigencia para el seguro: problemas derivados de las tablas unisex”, que aparece en el libro El seguro español ante los cambios del estado del bienestar, publicado por la Fundación de Estudios Financieros (Guillén et al., 2013). La Tesis finaliza con conclusiones, destacando las principales aportaciones y con un capítulo dedicado a las líneas futuras de investigación. En los anexos se incluyen los programas usados en los análisis realizados en esta Tesis. Para todos los capítulos se usó R Core Team (2014) y SAS Institute Inc. (2003). / Future planning in the demographic, economic and actuarial areas is crucial. Good planning in social programs, government budgets, actuarial reserves, cost of insurance and pensions, etc., depends on the use of a good method to forecast. However, the constant changes in technology, lifestyles, climate change, migration, to name a few, make predicting certain phenomena is not an easy task. In particular, mortality and longevity are events that directly impact cash costs and therefore need a good future projection. Both are indicators of welfare, assess whether health programs and welfare are effective. Specifically, in the insurance market have a high mortality implies an increase in premiums and overall mine reserves to meet claims. Longevity brings similar situations when the topic of pension annuities is p. At the social level, attain very adulthood involves creating support programs for the elderly, for example, dependency programs, creating shelters, leisure and health campaigns. The main interest of this thesis is to present options for a good management of costs of mortality and longevity. The introduction presents the background, motivation and objectives. N number of people living in Mexico and deaths and mortality rates of the insurance industry: In chapter 1, the data have been used to make the different analyzes are described. The necessary calculations are also described for the matrix with crude mortality rates for the Mexican population in years 1990-2010 and ages 0-100 always differentiated by sex. In chapter 2 it is modeled behavior of mortality in the general population in Mexico. The models are justados Lee-Carter model, the Renshaw-Haberman model and the Age-Period-Cohort model. With mortality rates estimated by the Lee-Carter model has to justado a relational Brass-type model for new rates of the insurance market from existing, p ero corrected overall mortality. In December 2013 a new directive which stated that prices on goods and services, including insurance rates can not be different for men and women came into force in Europe. In Chapter 3 conjuntándolo it has addressed this issue with the issue of longevity. Taking as a starting age age 65, the estimated survival function and with this, the parameters ρ and λ of the Weibull distribution were estimated following the relaci'on S (t) = exp (-ρtλ). Different proportions of men and women were assumed for this exercise. With the estimated parameters, it was possible to assess the risk of longevity, so this value at risk (VaR Value-at-Risk) at different levels of confidence α was calculated. The Mexican Association of Insurance Institutions (AMIS) since 2000 and every five years calculated mortality rates differentiated by sex. Having this information in Chapter 4 it was decided to make the Brass-type model assuming that the number of deaths in each age and year follows a Poisson distribution. Again longevity risk was assessed by calculating the VaR α. After using parametric distributions it was found that it is difficult to correctly describe the random variable number of survivors at each age, so the VaR may be incorrectly estimating the risk of longevity. Thus, in chapter 5 we calculated the distribution function (CDF Cumulative Distribution Function) using parametric and nonparametric methods like the classic core (CKE, Classical Kernel Estimator) estimator. It also proposes to use the dual-core semiparametric estimator method transformed (DTKE, Double Transformed Kernel Estimator) (Alemany et al., 2013). Moreover, for adjusting the parametric models an alternative is presented to the maximum likelihood estimate, which is the estimate via minimizing the integrated mean square error (MISE, Mean Integrated Square Error), which also functions as a measure of goodness of fit and allows comparison of both parametric and nonparametric settings. Chapter 6 is based on the contributions that the author herself performed in the paper entitled "Equality a requirement for insurance: problems resulting from unisex tables," which appears in the book The Spanish insurance to changes in the welfare state, published by the Foundation for Financial Studies (Guillen et al., 2013). The thesis ends with conclusions, highlighting the main contributions and a chapter on future research. Annexes programs used in the analyzes are included in this thesis. For all chapters was used R Core Team (2014) and SAS Institute Inc. (2003).

No description available.

Title: Guest dimensions of health status in patients with spondylarthritis ankylopoetica using the SF-36th Objectives: The major aim of the diploma thesis was the study and the evaluation of the quality of life of patients with the spondylarthritis ankylopoetica in the Czech Republic. Methods: The own research was conducted using the survey method by means of the standardized questionnaire Short Form 36 (SF-36), which deals with the Health Related Quality of Life . The Czech version of the SF-36 survey translated by MUDr. Petr, Ph.D. (2000) was applied. In order to reach the main aim of the thesis the research was conducted in a group of patients with spondylarthritis ankylopoetica (n=101) and among the same number of the general Czech population members. The achieved results were divided into particular age categories in the both groups. The statistically significant differences between the two analysed samples were subsequently verified. Results: The mean age of the patients with spondylarthritis ankylopoetica was 51,6±14,9 years, whereas it reached 52,3±15,5 years in the sample of the general population. In the majority of the dimensions of the SF-36 questionnaire related to the physical health (physical functioning, role physical, bodily pain and general health) achieved the patients...

The standard concerning the impairment testing for goodwill is often considered to be one of the most difficult standards in IFRS to comply with, which is largely due to the subjective and complex nature of the standard. Despite, the obvious issues with the standard it has remained fairly unaltered since its implementation back in 2005. The purpose of this research was to investigate to what extent companies listed on NASDAQ OMX Stockholm comply with the disclosure requirements in IAS 36, paragraph 134. This research also intended to answer whether there is an association between the companies’ compliance level and certain company characteristics, more specifically company size, profitability, goodwill intensity and industry type. The study also considered how time affected the compliance level. We devised hypotheses for each of the company characteristics, and these were formulate with both previous research and theory in mind. The theories that were utilized in this study were the agency theory, the political cost theory and the cost-benefit theory. The hypotheses that lacked a concrete linkage to one of the theories were instead justified using the reasoning’s found in pre-existing disclosure studies. The necessary data was collected from companies’ annual reports, which we accessed from either Business Retriever or directly from the companies’ official websites. An own interpretation of IAS 36, paragraph 134 was made in order to able to assess each company on equal terms. The collected data was then transferred to a disclosure index in order to get a compliancy score for each company investigated. The empirical findings of this research showed that two out of five hypotheses were significantly associated with the companies’ compliance level. The analysis rejected hypotheses related to profitability, goodwill intensity and industry type. The findings however showed that both year and company size are associated with the compliance level. The positive association between compliance and year, implies that compliance increases as companies get more accustomed to the standard. The findings further suggest that larger companies comply better with standard because they are under more political pressure and more inclined to please their stakeholders.

Au cours de cette thèse, nous nous sommes intéressés à la différenciation normale et pathologique des cellules germinales (CGs). Dans une première partie, la différenciation normale a été étudiée chez l'amphibien urodèle Pleurodeles waltl. L'acide rétinoïque (AcR) est impliqué dans l'induction de l'entrée en méiose des cellules germinales (CGs) chez les amniotes (Bowles et al., 2006 ; Smith et al., 2008). Nous avons voulu savoir si l'AcR était aussi impliqué dans ce processus chez le pleurodèle. Nous avons montré que l'expression de PwDmc1 (marqueur de méiose), survient plus précocement dans les gonades femelles (avant la métamorphose) que dans les gonades mâles (après la métamorphose). In vitro, l'application d'AcR sur des gonades mâles et femelles en culture organotypique ainsi que l'inhibition de la dégradation de l'AcR endogène induisent l'entrée en méiose des CGs. Nous avons également montré que la balance synthèse/dégradation l'AcR endogène est modulée par les hormones stéroïdes. Les mécanismes de différenciation des CGs décrits chez les mammifères semblent donc conservés chez les urodèles. La seconde partie de la thèse s'inscrit dans le contexte de la différenciation pathologique des CGs.De nombreuses études ont montré qu'une exposition in utero à des xénobiotiques pouvait provoquer des altérations de la différenciation des CGs. Ces cellules altérées restent en dormance pendant l'enfance. A la puberté, elles prolifèrent et donnent naissance aux tumeurs testiculaires, suggérant que le développement de ces tumeurs est hormono-sensible (McIntyre et al., 2008). Nous avons étudié les effets des hormones stéroïdes sur la prolifération des cellules séminomateuses humaines TCam2. L'oestradiol et la testostérone stimulent leur prolifération ainsi que l'expression d'une isoforme tronquée du récepteur alpha des oestrogènes ER[alpha]36. Ce récepteur est induit par la voie GPER-AMPc/PKA et semble nécessaire à l'expression du récepteur à l'EGF. Il pourrait donc constituer une cible thérapeutique potentielle. / Retinoic acid (RA) is involved in germ cells meiosis onset (CGs) in amniotes (Bowles et al., 2006 ; Smith et al., 2008). The aim of the first part of our study was to determine if RA is able to induce meiosis entry in the urodele amphibian Pleurodeles waltl. Our data on PwDmc1 (meiosis marker) expression indicate an earlier meiosis onset in females compared with males depending on RA biosynthesis. In vitro, the treatment of male and female gonads with RA induces an earlier meiosis entry in both sexes. Moreover, we have shown that RA biosynthesis is regulated by steroid hormones. Therefore, the mechanisms which trigger GCs differentiation in mammals might be conserved in urodeles. Many studies indicated that in utero xenobiotic exposure is able to induce alterations in GCs differentiation. These neoplasic cells enter in a period of dormancy until after puberty where they proliferate and the testicular tumours emerge. This prepubertal dormancy suggests that the testicular cancer development is hormone sensitive (McIntyre et al., 2008). In the second part we studied the effects of steroid hormones on the proliferation of the seminoma cell line TCam2. Our results indicate that estradiol and testosterone can induce the proliferation of this cell line and the expression of ER[alpha]36, a truncated form of estrogen receptor alpha. This expression is stimulated by GPER-cAMP/PKA signalisation pathway and activates EGFR expression. ER[alpha]36 could be a potential therapeutic target.

No description available.