| 61. |
- Elcadi, Guilherme H., 1966-, et al.
(författare)
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Oxygenation and Hemodynamics Do Not Underlie Early Muscle Fatigue for Patients with Work-Related Muscle Pain
- 2014
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Ingår i: PLOS ONE. - : PLOS (Public library of science). - 1932-6203. ; 9:4
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Tidskriftsartikel (refereegranskat)abstract
- Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/ or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC) -sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO(2)%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P < 0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO(2)% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics.
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| 62. |
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| 63. |
- Elcadi, Guilherme H., 1966-, et al.
(författare)
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Shoulder and forearm oxygenation and myoelectric activity in patients with work related muscle pain and healthy subjects
- 2013
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Ingår i: European Journal of Applied Physiology. - New York : Springer. - 1439-6319 .- 1439-6327. ; 113:5, s. 1103-1115
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Tidskriftsartikel (refereegranskat)abstract
- We tested hypotheses of (i) reduced oxygen usage, oxygen recovery, blood flow and oxygen consumption; and (ii) increased muscle activity for patients diagnosed with work related muscle pain in comparison to healthy controls. Oxygenation was measured with near infrared spectroscopy (NIRS), and muscle activity with EMG for the extensor carpi radialis (ECR) and trapezius descendens (TD) muscles. Eighteen patients with diffuse neck-shoulder-arm pain and seventeen controls (matched in age and sex) were equipped with NIRS and EMG probes. After determining an individual’s maximum voluntary contraction (MVC) force, short term (20 sec) isometric contractions for the ECR and TD of 10%, 30%, 50% and 70% MVC generated ∆StO2% and StO2% recovery (Rslope) from NIRS, and RMS%max from EMG signals. In addition, upper arm venous (VO) and arterial (AO) occlusions generated slopes of total hemoglobin (HbTslope) and deoxyhemoglobin (HHbslope) for the resting ECR as surrogates of blood flow and oxygen consumption, respectively. Mixed Model analyses, t-tests, and Mann-Whitney test were used to assess differences between groups. There was no significant difference in MVC between groups for either muscle. Also, ∆StO2%, Rslope for either muscle, and ECR-HbTslope were not different between groups, thus our hypotheses of reduced oxygen use, recovery, and blood flow for patients were not confirmed. However, patients had a significantly lower ECR-HHbslope confirming our hypothesis of reduced consumption. Further, there was no difference in RMS%max during contractions meaning that the hypothesis of increased activity for patients was not confirmed. When taking into account the number of NIRS variables studied, differences we found between our patient group and healthy controls (i.e. in forearm oxygen consumption and shoulder oxygen saturation level) may be considered modest. Overall our findings may have been impacted by the fact that our patients and controls were similar in muscle strength, which is in contrast to previous studies.
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| 64. |
- Elcadi, Guilherme H., 1966-, et al.
(författare)
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The relationship between oxygenation and myoelectric activity in the forearm and shoulder muscles of males and females
- 2011
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Ingår i: European Journal of Applied Physiology. - : Springer. - 1439-6319 .- 1439-6327. ; 111, s. 647-658
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the relationship between oxygen saturation (StO(2)%) measured with near-infrared spectroscopy (NIRS) and myoelectric activity (root mean square, RMS) for the extensor carpi radialis (ECR) and trapezius muscles. In addition, gender differences were examined for submaximal (10-70% MVC) and sustained (10% MVC for 5 min) isometric contractions. Thirteen males and 15 females participated. Changes in StO(2)% (a dagger StO(2)%) and RMS, expressed as percentages of maximum, were calculated for each submaximal contraction. A good correlation between a dagger StO(2)% and RMS was seen for the ECR (r = -0.53) and a moderate correlation seen for the trapezius muscle (r = -0.44). The ANOVA showed a significant decrease in ECR-a dagger StO(2)% over force with females demonstrating a tendency for larger changes than males. ECR-RMS increased over force with no impact of gender. For the trapezius, a dagger StO(2)% decreased over force but was not gender dependent. Trapezius-RMS increased over force with females demonstrating a tendency for greater change than males. For the sustained contraction, ECR-StO(2)% changed over time but was not gender dependent. ECR-RMS increased over time with females showing a greater response than males. Trapezius-StO(2)% changed over time and differed between genders, i.e., males increased while females decreased. RMS increased over time similarly for both genders. In conclusion, our data show that the ECR and trapezius aerobic demands during isometric contractions are negatively correlated to electromyography (EMG) RMS. The present study also suggests some gender specificity for forearm and shoulder myoelectric activity and oxygenation for submaximal and sustained contractions.
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| 65. |
- Elväng, Annelie, et al.
(författare)
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Sequencing of a Tick-Borne Encephalitis Virus from Ixodes ricinus Reveals a Thermosensitive RNA Switch Significant for Virus Propagation in Ectothermic Arthropods
- 2011
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Ingår i: Vector Borne and Zoonotic Diseases. - : Mary Ann Liebert Inc. - 1530-3667 .- 1557-7759. ; 11:6, s. 649-658
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Tidskriftsartikel (refereegranskat)abstract
- Tick-borne encephalitis virus (TBEV) is a flavivirus with major impact on global health. The geographical TBEV distribution is expanding, thus making it pivotal to further characterize the natural virus populations. In this study, we completed the earlier partial sequencing of a TBEV pulled out of a pool of RNA extracted from 115 ticks collected on Torö in the Stockholm archipelago. The total RNA was sufficient for all sequencing of a TBEV genome (Torö-2003), without conventional enrichment procedures such as cell culturing or suckling mice amplification. To our knowledge, this is the first time that the genome of TBEV has been sequenced directly from an arthropod reservoir. The Torö-2003 sequence has been characterized and compared with other TBE viruses. In silico analyses of secondary RNA structures formed by the two untranslated regions revealed a temperature-sensitive structural shift between a closed replicative form and an open AUG accessible form, analogous to a recently described bacterial thermoswitch. Additionally, novel phylogenetic conserved structures were identified in the variable part of the 3′-untranslated region, and their sequence and structure similarity when compared with earlier identified structures suggests an enhancing function on virus replication and translation. We propose that the thermo-switch mechanism may explain the low TBEV prevalence often observed in environmentally sampled ticks. Finally, we were able to detect variations that help in the understanding of virus adaptations to varied environmental temperatures and mammalian hosts through a comparative approach that compares RNA folding dynamics between strains with different mammalian cell passage histories.
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| 66. |
- Engström, Maria, 1966-, et al.
(författare)
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Evaluation of OLD@HOME virtual health record : staff opinions of the system and satisfaction with work
- 2009
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Ingår i: Telemedicine journal and e-health. - : Mary Ann Liebert Inc. - 1530-5627 .- 1556-3669. ; 15:1, s. 53-61
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present research was to study outcomes of use of the OLD@HOME Virtual Health Record with regard to staff opinions about information, communication technology, and satisfaction with work. A quasi-experimental design was used. Staff opinions about the information and communication technology were assessed using a study-specific questionnaire at the test site (n =22) and at other settings in the municipality (n =172). Staff (n =22) job satisfaction, perceived quality of care, and psychosomatic health were assessed using the Satisfaction with Work Questionnaires before and after a 5-month period of testing the technology in an intervention and a comparison group. Staff opinions about the information and communication technology were significantly more positive at the test site compared to other settings in the municipality. For the total scale of quality of care and the factor documentation, there were significant differences in change scores between intervention and comparison groups, with improvements for the comparison group. For job satisfaction and psychosomatic health, there were no differences in change scores between the groups. Participatory design enhances staff opinions about information and communication technology. However, a 5-month test period showed no benefits regarding staff satisfaction with work when compared to a comparison group. On the contrary, the comparison group improved in documentation, and for the intervention group, there was a trend toward deterioration, which may be due to their knowing how to document, but not having time when using both paper-based and electronic systems.
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| 67. |
- Eriksson, Anders, et al.
(författare)
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Skeletal muscle morphology in power-lifters with and without anabolic steroids
- 2005
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Ingår i: Histochemistry and Cell Biology. - : Springer Science and Business Media LLC. - 0948-6143 .- 1432-119X. ; 124:2, s. 167-175
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Tidskriftsartikel (refereegranskat)abstract
- The morphological appearance of the vastus lateralis (VL) muscle from high-level power-lifters on long-term anabolic steroid supplementation (PAS) and power-lifters never taking anabolic steroids (P) was compared. The effects of long- and short-term supplementation were compared. Enzyme-immunohistochemical investigations were performed to assess muscle fiber type composition, fiber area, number of myonuclei per fiber, internal myonuclei, myonuclear domains and proportion of satellite cells. The PAS group had larger type I, IIA, IIAB and IIC fiber areas (p<0.05). The number of myonuclei/fiber and the proportion of central nuclei were significantly higher in the PAS group (p<0.05). Similar results were seen in the trapezius muscle (T) but additionally, in T the proportion of fibers expressing developmental myosin isoforms was higher in the PAS group compared to the P group. Further, in VL, the PAS group had significantly larger nuclear domains in fibers containing > or = 5 myonuclei. The results of AS on VL morphology in this study were similar to previously reported short-term effects of AS on VL. The initial effects from AS appear to be maintained for several years.
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| 68. |
- Eriksson, Henrik, et al.
(författare)
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Cyber nursing : Health 'experts' approaches in the post-modern era of virtual encounters
- 2013
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 50:3, s. 335-344
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Tidskriftsartikel (refereegranskat)abstract
- Background. The imperative to gather information online and to become an ‘expert’ by locating effective advice for oneself and others is a fairly new support phenomenon in relation to health advice. The creation of new positions for health ‘experts’ within the space of the Internet has been addressed as a cybernursing activity. A focused analysis of communication in health forums might give insight into the new roles that are available for healthexperts in cyberspace.Aim. The aim of this study is to describe approaches to being an ‘expert’ in lifestyle health choice forums on the Internet and to elaborate on the communicative performances that take place in the forums.Method. An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online. 2640 pages of data from two health Internet forums were gathered and analyzed.Findings. The results reveal three distinctive types of experts that emerge in the forums: (1) those that build their expertise by creating a presence in the forum based on lengthy and frequent postings, (2) those who build a presence through reciprocal exchanges with individual posters with questions or concerns, and (3) those who build expertise around a “life long learning” perspective based on logic and reason.Discussion. The results suggest that experts not only co-exist in the forums, but more importantly they reinforce each others’ positions. This effect is central; alongside one another, the posts of the three types of experts we identify constitute a whole for those seeking the forum for advice and support. Users are provided with strong opinions and advice, support and Socratic reasoning, and a problem-oriented approach. The Internet is now an integral part of everyday living, not least of which among those who seek and offer support in cyberspace. As such, cyber nursing has become an important activity to monitor, and formal health care professionals and nursing researchers must stay abreast of developments.
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| 69. |
- Ernesäter, Annica, et al.
(författare)
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Incident reporting in nurse-led national telephone triage in Sweden : The reported errors reveal a pattern that needs to be broken
- 2010
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Ingår i: Journal of Telemedicine and Telecare. - : SAGE Publications. - 1357-633X .- 1758-1109. ; 16:5, s. 243-247
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Tidskriftsartikel (refereegranskat)abstract
- We conducted a retrospective study of incident reports concerning the national, nurse-led telephone triage system in Sweden. The Swedish Health Care Direct organization (SHD) is staffed by registered nurses who act as telenurses and triage the callers' need for care, using a computerized decision support system. Data were collected during 2007 from all county councils that participated in the SHD and were analysed using content analysis. Incident reports were then compared concerning differences in reported categories and who reported the errors. The 426 incident reports included 452 errors. Of the analysed incident reports, 41% concerned accessibility problems, 25% incorrect assessment, 15% routines/guidelines, 13% technical problems and 6% information and communication. The most frequent outgoing incident reports (i.e. sent from SHD to other health-care providers) concerned accessibility problems and the most frequently incoming reports (i.e. sent to SHD from other health-care providers) concerned incorrect assessment. There was a significant difference (P < 0.001) between outgoing and incoming reports regarding the main category. Telenurses have limited possibilities for referring the caller to their primary health-care provider or specialist, which may cause them to over-triage or under-triage the callers' need for care. This over-triage or under-triage may in turn cause other health-care providers to report incorrect assessment to SHD. The implications for practice are that poor accessibility is a matter that should be addressed and that the reasons for incorrect assessment should be explored.
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| 70. |
- Ernesäter, Annica, 1970-, et al.
(författare)
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Malpractice claims regarding calls to Swedish telephone advice nursing : what went wrong and why?
- 2012
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Ingår i: Journal of Telemedicine and Telecare. - London, United Kingdoms : Sage Publications. - 1357-633X .- 1758-1109. ; 18:7, s. 379-383
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Tidskriftsartikel (refereegranskat)abstract
- We analysed the characteristics of all malpractice claims arising out of telephone calls to Swedish Healthcare Direct (SHD) during 2003-2010 (n = 33). The National Board of Health and Welfare's (NBHW) investigations describing the causes of the malpractice claims and the healthcare providers' reported measures were analysed using Qualitative Content Analysis. The original telephone calls themselves, which had been recorded, were analysed using the Roter Interaction Analysis System (RIAS). Among the 33 cases, 13 patients died and 12 were admitted to intensive care. Failure to listen to the caller (n = 12) was the most common reason for malpractice claims, and work-group discussion (n = 13) was the most common measure taken to prevent future re-occurrence. Male patients (n = 19) were in the majority, and females (n = 24) were the most common callers. The most common symptoms were abdominal (n = 11) and chest pain (n = 6). Telenurses followed up on caller understanding in six calls, and mainly used closed-ended questions. Despite the severity of these malpractice claims, the measures taken mainly addressed active failure, rather than the latent conditions. Third-party communication should be regarded as a risk. When callers make repeated contacts, telenurses need to re-evaluate their need for care.
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