Quality of life development during initial hemodialysis therapy and association with loss of residual renal function

Introduction: Health related quality of life (HRQOL) is markedly reduced in hemodialysis patients compared to the general population. We investigated the course of self‐reported HRQOL over time and the association with selected factors, focusing on changes in glomerular filtration rate (GFR). Methods: Eighty‐two newly started hemodialysis patients from the SAFIR cohort filled out the Kidney Disease Quality of Life Short Form Version 1.3 (KDQOL‐SF^TM) questionnaire at baseline, 6 and 12 months. The SAFIR study was a randomized, placebo‐controlled, double‐blind intervention study, examining the effects of the angiotensin II receptor blocker irbesartan. HRQOL was a secondary outcome measure. Main inclusion criteria: Dialysis vintage <1 year, left ventricular ejection fraction >30% and urinary output >300 mL/day. GFR was measured with mean creatinine and urea clearance from 24‐hour urine collections at baseline, 6 and 12 months. Findings: Irbesartan treatment did not affect HRQOL. Patients were pooled into one group for further analyses. Decline in GFR correlated significantly with decreasing HRQOL over time. HRQOL was stable over time, with a slight nonsignificant tendency toward improved HRQOL. The largest HRQOL‐differences (positive values equal improved HRQOL) observed during the 12 month study period were (mean[95% confidence interval]): Burden of kidney disease:6.4[?2.2;15.0], Role limitations‐physical:12.7[?2.1;27.5], and Role limitations‐emotional:9.7[?5.2;24.6]. Comorbidity, especially diabetes, hospital admissions, female gender, and age were strongly associated with lower HRQOL in cross sectional analysis. Discussion: Preservation of residual renal function seems to be important for HRQOL. In newly started HD patients, HRQOL showed little change after 12 months. HRQOL was negatively affected by comorbidity, especially diabetes, hospital admissions, female gender, and age.     

The genome of Treponema pallidum: new light on the agent of syphilis

Covert brain activity related to task-free, spontaneous (i.e. unrequested), emotional evaluation of human face images was analysed in 27-channel averaged event-related potential (ERP) map series recorded from 18 healthy subjects while observing random sequences of face images without further instructions. After recording, subjects self-rated each face image on a scale from "liked" to "disliked". These ratings were used to dichotomize the face images into the affective evaluation categories of "liked" and "disliked" for each subject and the subjects into the affective attitudes of "philanthropists" and "misanthropists" (depending on their mean rating across images). Event-related map series were averaged for "liked" and "disliked" face images and for "philanthropists" and "misanthropists". The spatial configuration (landscape) of the electric field maps was assessed numerically by the electric gravity center, a conservative estimate of the mean location of all intracerebral, active, electric sources. Differences in electric gravity center location indicate activity of different neuronal populations. The electric gravity center locations of all event-related maps were averaged over the entire stimulus-on time (450 ms). The mean electric gravity center for disliked faces was located (significant across subjects) more to the right and somewhat more posterior than for liked faces. Similar differences were found between the mean electric gravity centers of misanthropists (more right and posterior) and philanthropists. Our neurophysiological findings are in line with neuropsychological findings, revealing visual emotional processing to depend on affective evaluation category and affective attitude, and extending the conclusions to a paradigm without directed task.     

Socio-technical IS design science research: developing design theory for IS integration management

Design science research is an essential part of IS research since the field should not only try to understand how the world is, but also how to change it. We argue that the aim of IS design science research should be to develop practical knowledge not only for the design of novel information technology (IT), but also for IS governance and management. Whereas at least some methodological support exists for researchers engaged in IT-centric design science research, limited support is available for researchers who want to develop design knowledge and theory for IS governance and management. To overcome this shortcoming, we suggest a socio-technical IS design science research approach. The approach has four main activities: (1) identifying problem situations and desired outcomes, (2) reviewing extant theories, knowledge and data, (3) proposing/refining design theory and knowledge, and (4) testing design theory and knowledge. The applicability and usefulness of the proposed approach is shown by means of a design science research project concerning IS integration management in the context of mergers and acquisitions.     

Institutional pressures and mindful IT management: The case of a container terminal in China

Although it has been only ten years in operations, Yantian International Container Terminals Limited (YICT) has evolved as a world-class container terminal and become the first Chinese port to receive the Best Global Container Port of the Year award for 2005–2006, as well as being designated China's best container terminal in terms of operational efficiency for 2008. A success factor of YICT is its extensive use of IT in managing and enhancing the productivity and services of the port operations. Premised upon Institutional Theory and the organizational mindfulness perspectives (preoccupation with failure and success, reluctance to simplify interpretations, sensitivity to operations, commitment to resilience, and reliance on expertise over formal authority) and using case study methodology, we examined the institutional pressures faced by YICT in its IT management (ITM), and determined how YICT coped with its institutional pressures during its IT development.     

A Glance into Social and Evolutionary Aspects of an Artifact Ecology for Collaborative Learning through the Lens of Distributed Cognition

There is steadily growing interest in the design and evaluation of digitally enhanced spaces in the real-world where users use, combine, and appropriate different physical and digital tools based on the task at hand. Under the notion of “ubiquitous computing,” researchers have explored tools and theories to analyze, understand, and model users in complex socio-technical systems. Yet, even though theoretical approaches play a significant role in the work of practitioners, there is a general difficulty in applying them, pushing researchers to explore methodological frameworks with clearer guidelines. Using the distributed cognition for teamwork (DiCoT) framework, we study collaboration and communication patterns, physical movement, and social structures of two groups of learners working on a design problem as they evolve over a 3-month period. Through an in-depth investigation, we present detailed accounts of the social and evolutionary models of DiCoT for each group. Our analysis enriches the DiCoT framework by identifying five new principles: social emersion and social circles of privacy for the social model, and continuity, mutual adaptation, and semantics of body for the evolutionary model. This article contributes to HCI research by refining and extending the existing DiCoT framework and elaborating on two dimensions that have previously been under-developed in the literature.     

An intervention method for occupational safety in farming -- evaluation of the effect and process

In order to increase safety in Swedish farming an intervention methodology to influence attitudes and behaviour was tested. Eighty eight farmers and farm workers in nine groups gathered on seven occasions during 1 year. The basic concept was to create socially supportive networks and encourage discussions and reflection, focusing on risk manageability. Six of the groups made structured incident/accident analyses. Three of the latter groups also received information on risks and accident consequences. Effects were evaluated in a pre-post questionnaire using six-graded scales. A significant increase in safety activity and significant reduction in stress and risk acceptance was observed in the total sample. Risk perception and perceived risk manageability did not change. Analysing incidents/accidents, but not receiving information, showed a more positive outcome. Qualitative data indicated good feasibility and that the long duration of the intervention was perceived as necessary. The socially supportive network was reported as beneficial for the change process.     

Bicycle messengers: energy expenditure and exposure to air pollution

The purpose of the study was to determine the level of energy expenditure and exposure to air pollution for bicycle messengers. Relationships between heart rate (HR) and oxygen uptake, and between HR and pulmonary ventilation (VE) for each participant were established in laboratory tests. Air pollution and HR were measured during one working day. The total oxygen uptake was then described as the total energy expenditure in Joule (J) and in multiples of the energy expenditure at rest (MET). The mean energy expenditure during a working day (8 h) was 12 MJ, (4.8 MET). The level of air pollution exposure when cycling seemed to be comparable with the levels of exposure when sitting inside a vehicle. The VE during cycling was four times higher than resting value. Increased VE led to increased exposure to air pollution.