| 50871. |
- Löyttynen, Jenny, et al.
(författare)
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District Nurses' Experiences of Practice in Caring for People with Mental Ill-Health in Swedish Primary Care.
- 2023
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Ingår i: Issues in Mental Health Nursing. - : Taylor & Francis Group. - 0161-2840 .- 1096-4673. ; 44:5, s. 396-405
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Tidskriftsartikel (refereegranskat)abstract
- Mental ill-health is one of the greatest public health challenges in Sweden, and it is estimated that every third person seeking primary care in the country suffers from mental ill-health. Without proper treatment at an early stage, mental ill-health may lead to long-term illness and have a significant impact on functional ability. As district nurses are specialists in public health nursing, they have been pointed out as having a key role in the prevention and management of mental ill-health. The aim was to explore district nurses' practice in caring for people with mental ill-health within primary health care. Individual semi-structured interviews were conducted with district nurses (n = 18) and the transcribed text was subjected to qualitative content analysis. The result was formulated as several subthemes, eventually developed into three themes: Practicing within an organisation where traditional attitudes are impediments, Perceiving mental healthcare as not being an obvious part of district nursing, Working as fellow human beings rather than "professionals". The findings indicate that district nurses feel uncertainty in their practice in this area. Working independently with mental ill-health was not always considered socially acceptable among district nurses. Despite these challenges they tried to remain involved without becoming emotionally overwhelmed. They also strived to meet the needs of these patients with 'small things', that could be effective and a part of recovery-oriented practice, even if they might be defined as unprofessional, and their efficacy negated.
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| 50872. |
- Lööv, Anna, 1990-, et al.
(författare)
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Diagnostic accuracy for colorectal cancer of a quantitative faecal immunochemical test in symptomatic primary care patients : a study protocol
- 2022
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Ingår i: Diagnostic and prognostic research. - : BioMed Central (BMC). - 2397-7523. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is increasing evidence supporting the use of faecal immunochemical tests (FIT) in patients reporting symptoms associated with colorectal cancer (CRC), but most studies until now have focused on selected subjects already referred for investigation. We therefore set out to determine the accuracy and predictive values of FIT in a primary care population.METHOD: A prospective, multicentre, single-gated comparative diagnostic study on quantitative FIT in patients aged 40 years and above presenting in primary care with symptoms associated with CRC will be conducted. Patients representing the whole spectrum of severity of such symptoms met with in primary care will be eligible and identified by GPs. Participants will answer a short form on symptoms during the last month. They will provide two faecal samples from two separate days. Analyses will be performed within 5 days (QuikRead go®, Aidian Oy). The analytical working range is 10-200 μg Hb/g faeces. Reference test will be linked to the Swedish Colorectal Cancer Registry up to 2 years after inclusion. Accuracy, area under ROC curves, and predictive values will be calculated for one FIT compared to the highest value of two FIT and at cutoff < 10, 10-14.9, 15-19.9 and ≥ 20 μg Hb/g faeces. Subgroup analyses will be conducted for patients with anaemia and those reporting rectal bleeding. A model-based cost-effectiveness analysis based on the clinical accuracy study will be performed. Based on previous literature, we hypothesized that the sensitivity of the highest value of two FIT at cutoff 10 μg Hb/g faeces will be 95% (95% CI + / - 15%). The prevalence of CRC in the study population was estimated to be 2%, and the rate of non-responders to be 1/6. In all, 3000 patients will be invited at 30 primary care centres.DISCUSSION: This study will generate important clinical real-life structured data on accuracy and predictive values of FIT in the most critical population for work-up of CRC, i.e. patients presenting with at times ambiguous symptoms in primary care. It will help establish the role of FIT in this large group.
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| 50873. |
- M Del Campo, J, et al.
(författare)
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Phase II randomized study of trabectedin given as two different every 3 weeks dose schedules (1.5 mg/m(2) 24 h or 1.3 mg/m(2) 3 h) to patients with relapsed, platinum-sensitive, advanced ovarian cancer
- 2009
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Ingår i: ANNALS OF ONCOLOGY. - : Elsevier BV. - 0923-7534. ; 20:11, s. 1794-802
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Tidskriftsartikel (refereegranskat)abstract
- Patients and methods: Patients previously treated with less than two or two previous chemotherapy lines were randomized to receive trabectedin 1.5 mg/m(2) 24 h (arm A, n = 54) or 1.3 mg/m(2) 3 h (arm B, n = 53). Objective response rate (ORR) per RECIST was the primary efficacy end point. Toxic effects were graded according to the National Cancer Institute-Common Toxicity Criteria v. 2.0. Results: ORR was 38.9% [95% confidence interval (CI) 25.9% to 53.1%; arm A] and 35.8% (95% CI 23.1% to 50.2%; arm B) (intention-to-treat primary analysis). Median time to progression was 6.2 months (95% CI 5.3-8.6 months; arm A) and 6.8 months (95% CI 4.6-7.4 months; arm B). Frequent severe adverse events were nausea/vomiting (24%, arm A; 15%, arm B) and fatigue (15%, arm A; 10%, arm B). Common severe laboratory abnormalities were transient, noncumulative neutropenia (55%, arm A; 37%, arm B) and transaminase increases (alanine aminotransferase, 55%, arm A; 59%, arm B). Conclusions: Both every-3-weeks trabectedin regimes, 1.5 mg/m(2) 24 h and 1.3 mg/m(2) 3 h, were active and reasonably well tolerated in AOC platinum-sensitive patients. Trabectedin every-3-weeks has promising activity and deserves to be further evaluated in relapsed AOC.
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| 50874. |
- M. Gavelin, Hanna, 1982-, et al.
(författare)
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Cognitive function in clinical burnout: A systematic review and meta-analysis
- 2022
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Ingår i: Work & Stress. - : Taylor & Francis. - 0267-8373 .- 1464-5335. ; 36:1, s. 86-104
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Forskningsöversikt (refereegranskat)abstract
- Clinical burnout has been associated with impaired cognitive functioning; however, inconsistent findings have been reported regarding the pattern and magnitude of cognitive deficits. The aim of this systematic review and multivariate meta-analysis was to assess cognitive function in clinical burnout as compared to healthy controls and identify the pattern and severity of cognitive dysfunction across cognitive domains. We identified 17 studies encompassing 730 patients with clinical burnout and 649 healthy controls. Clinical burnout was associated with impaired performance in episodic memory (g = −0.36, 95% CI −0.57 to −0.15), short-term and working memory (g = −0.36, 95% CI −0.52 to −0.20), executive function (g = −0.39, 95% CI −0.55 to −0.23), attention and processing speed (g = −0.43, 95% CI −0.57 to −0.29) and fluency (g = −0.53, 95% CI −1.04 to −0.03). There were no differences between patients and controls in crystallized (k = 6 studies) and visuospatial abilities (k = 4). Our findings suggest that clinical burnout is associated with cognitive impairment across multiple cognitive domains. Cognitive dysfunction needs to be considered in the clinical and occupational health management of burnout to optimise rehabilitation and support return-to-work.
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| 50875. |
- M. Gavelin, Hanna, 1982-, et al.
(författare)
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Computerized cognitive training in Parkinson’s disease : A systematic review and meta-analysis
- 2022
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Ingår i: Ageing Research Reviews. - : Elsevier. - 1568-1637 .- 1872-9649. ; 80
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive impairment is a central non-motor symptom of Parkinson’s disease (PD), and there are no established treatments. Computerized cognitive training (CCT) is a safe and efficacious strategy but its efficacy in PD is unclear. We aimed to investigate the efficacy of CCT on cognitive, psychosocial and daily function, and assess potential effect moderators in people with PD without dementia. Randomized controlled trials of CCT were included in multivariate meta-analyses and meta-regressions. Seventeen studies (16 trials) encompassing 679 participants were included. The pooled effect of CCT relative to control was small and statistically significant for overall cognitive function (g=0.16; 95% CI 0.02–0.29). There was robust evidence for benefit on clinical measures of global cognition across 10 trials (g=0.33; 95% CI 0.19–0.48), especially in PD with mild cognitive impairment (PD-MCI), as well as on individual cognitive domains. Greater CCT dose and PD-MCI population were associated with larger effect sizes, but no statistically significant differences were found between subgroups. There was no significant difference in the efficacy of home-based compared to supervised training. Our findings suggest that CCT is associated with cognitive benefits in PD, including when delivered remotely. Larger, well-powered trials are warranted to examine what specific CCT regimens are most likely to promote cognitive and everyday functioning in the long-term.
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| 50876. |
- M. Gavelin, Hanna, 1982-, et al.
(författare)
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Mental fatigue, cognitive performance and autonomic response following sustained mental activity in clinical burnout
- 2023
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Ingår i: Biological Psychology. - : Elsevier B.V.. - 0301-0511 .- 1873-6246. ; 183
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo investigate the effects of sustained mental activity on perceptions of mental fatigue, cognitive performance, and autonomic response in patients with clinical burnout as compared to a healthy control group.MethodsPatients with clinical burnout (n = 30) and healthy control participants (n = 30) completed a 3-hour test session, in which they were administered a set of cognitive tests before and after an effortful cognitive task with concurrent sound exposure. Perceptions of mental fatigue and task demands (mental effort and concentration difficulties) were assessed repeatedly over the course of the test session. Heart rate variability was recorded to index autonomic response.ResultsIn comparison with controls, perceived mental fatigue increased earlier in the session for the clinical burnout group and did not recover following a short rest period. Throughout the session, patients rated the tasks as more demanding and showed less improvement on measures of attention and processing speed, inhibition and working memory. While autonomic responses were initially comparable, there was a unique decrease in high-frequency heart rate variability in the clinical burnout group after extended testing and exposure.ConclusionPatients with clinical burnout are affected differently than healthy controls by sustained mental activity, as reflected by ratings of perceived mental fatigue, aspects of cognitive performance and autonomic response. Further investigation into the role of autonomic regulation in relation to cognitive symptoms in clinical burnout is warranted.
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| 50877. |
- M.Haghighi, Alireza, et al.
(författare)
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Automated AISI 317L SS thin section image porosity recognition and semi-automated prioritization for predicting the yielding position by means of image processing
- 2021
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Ingår i: Acta Mechanica Malaysia. - : Zibeline International Publishing. - 2616-4302. ; 4:2, s. 34-39
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Tidskriftsartikel (refereegranskat)abstract
- Porosity is a common phenomenon in fabricated parts, which cause stress concentration and leads to yielding, brittle fraction and fatigue of structures which makes porosity recognition and analyzing very important to increase efficiency and decrease the defects of manufactured parts. Many researches have been done in order to detecting and recognizing pores of material by different numerical and experimental methods. In this paper, an algorithm is developed in order to detect the porosity of thin section images automatically and prioritize them for a semi-automatically prediction of yielding position. The algorithm results is the following parameters in a porous material: number of pores, position and size of pores, maximum and minimum distances of pores both from each other and from boundaries. The algorithm shows an accuracy of 83% in the prediction of the results for simulated finite element method (FEM) tensile tests, which makes the algorithm creditable to be used as a non-destructive testing method.
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| 50878. |
- Ma, Charlie, et al.
(författare)
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Ash Formation in Pilot-Scale Pressurized Entrained-Flow Gasification of Bark and a Bark/Peat Mixture
- 2016
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Ingår i: Energy & Fuels. - : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 30:12, s. 10543-10554
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Tidskriftsartikel (refereegranskat)abstract
- Pressurized entrained-flow gasification (PEFG) of bark and a bark/peat mixture (BPM) was carried out in a pilot-scale reactor (600 kWth, 7 bar(a)) with the objective of studying ash transformations and behaviors. The bark fuel produced a sintered but nonflowing reactor slag, while the BPM fuel produced a flowing reactor slag. Si was enriched within these slags compared to their original fuel ash compositions, especially in the bark campaign, which indicated extensive ash matter fractionation. Thermodynamically, the Si contents largely accounted for the differences in the predicted solidus/liquidus temperatures and melt formations of the reactor slags. Suspension flow viscosity estimations were in qualitative agreement with observations and highlighted potential difficulties in controlling slag flow. Quench solids from the bark campaign were mainly composed of heterogeneous particles resembling reactor fly ash particles, while those from the BPM campaign were flowing slags with likely chemical interactions with the wall refractory. Quench effluents and raw syngas particles were dominated by elevated levels of K that, along with other chemical aspects, indicated KOH(g) and/or K(g) were likely formed during PEFG. Overall, the results provide information toward development of woody biomass PEFG and indicate that detailed understanding of the ash matter fractionation behavior is essential.
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| 50879. |
- Ma, Charlie
(författare)
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Aspects of Ash Transformations in Pressurised Entrained-Flow Gasification of Woody Biomass : Pilot-scale studies
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Pressurised entrained-flow gasification (PEFG) of woody biomass has the potential to produce high purity syngas for the production of vital chemicals, e.g., biofuels. However, ash-related issues such as reactor blockages and refractory corrosion need to be addressed before this potential can be realised from a technical perspective. These undesirable consequences can be brought about by slag formation involving inorganic ash-forming elements and the chemical transformations that they undergo during fuel conversion. The objective of this study was to elucidate the ash transformations of the major ash-forming elements and the slag formation process. A pilot-scale PEFG reactor was used as the basis of the study, gasifying different woody biomass-based fuels including wood, bark, and a bark/peat mixture. Different ash fractions were collected and chemically analysed. Reactor slags had elemental distributions differing from that of the fuel ash, indicating the occurrence of fractionation of ash material during fuel conversion. Fly ash particles from a bark campaign were also heterogeneous with particles exhibiting differing compositions and physical properties; e.g., molten and crystalline formations. Si was consistently enriched in the reactor slags compared to other major ash-forming elements, while analyses of other ash fractions indicated that K was likely volatilised to a significant extent. In terms of slag behaviour, near-wall temperatures of approximately 1050-1200 °C inside the reactor were insufficient to form flowing ash slag for continuous extraction of ash material during firing the woody biomass fuels alone. However, fuel blending of a bark fuel with a silica-rich peat changed the chemical composition of the reactor slags and bulk slag flow behaviour was evident. Thermochemical equilibrium calculations supported the importance of Si in melt formation and in lowering solidus and liquidus temperatures of Ca-rich slag compositions that are typical from clean wood and bark. Viscosity estimations also showed the impact that solids have upon slag flow behaviour and corresponded qualitatively to the experimental observations. Corrosion of reactor refractory was observed. The mullite-based refractory of the reactor formed a slag with the fuel ash slag, which caused the former to flux away. Reactor blockages were also resultant because of the high viscosity of this slag near the outlet. A preliminary study into the corrosion of different refractories was also carried out, based on firing a bark/peat mixture. Alumina-rich refractories consisting of corundum, hibonite, mullite, and andalusite tended to form anorthite and exhibited varying degrees of degradation. Infiltration of slag was evident for all the samples and was a severe mode of degradation for some refractories. For fused-cast periclase and spinel-based refractories, slag infiltration was limited to voids and no extensive signs of refractory dissolution were found. This is also supported by a thermochemical equilibrium calculations mimicking slag infiltration that incorporated viscosity estimations. The findings from this thesis contribute towards the development of woody biomass PEFG by highlighting issues concerning ash fractionation, slag behaviours and ash\slash refractory interaction that should be investigated further.
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| 50880. |
- Ma, Charlie, et al.
(författare)
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Characterization of reactor ash deposits from pilot-scale pressurized entrained-flow gasification of woody biomass
- 2013
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Ingår i: Energy & Fuels. - : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 27:11, s. 6801-6814
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Tidskriftsartikel (refereegranskat)abstract
- Pressurized entrained-flow gasification of renewable forest residues has the potential to produce high-quality syngas suitable for the synthesis of transport fuels and chemicals. The ash transformation behavior during gasification is critical to the overall production process and necessitates a level of understanding to implement appropriate control measures. Toward this end, ash deposits were collected from inside the reactor of a pilot-scale O 2-blown pressurized entrained-flow gasifier firing stem wood, bark, and pulp mill debarking residue (PMDR) in separate campaigns. These deposits were characterized with environmental scanning electron microscopy equipped with energy-dispersive X-ray spectrometry and X-ray diffractometry. The stem wood deposit contained high levels of calcium and was comparatively insubstantial. The bark and PMDR fuels contained contaminant sand and feldspar particles that were subsequently evident in each respective deposit. The bark deposit consisted of lightly sintered ash aggregates comprising presumably a silicate melt that enveloped particles of quartz and, to a lesser degree, feldspars. Discontinuous layers likely to be composed of alkaline-earth metal silicates were found upon the aggregate peripheries. The PMDR deposit consisted of a continuous slag that contained quartz and feldspar particles dispersed within a silicate melt. Significant levels of alkaline-earth and alkali metals constituted the silicate melts of both the bark and PMDR deposits. Overall, the results suggest that fuel contaminants (i.e., quartz and feldspars) play a significant role in the slag formation process during pressurized entrained-flow gasification of these woody biomasses.
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