| 61. |
- Holmström, Mats, et al.
(författare)
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The interaction between the Moon and the solar wind
- 2012
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Ingår i: Earth Planets and Space. - : Springer Science and Business Media LLC. - 1343-8832 .- 1880-5981. ; 64:2, s. 237-245
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Tidskriftsartikel (refereegranskat)abstract
- We study the interaction between the Moon and the solar wind using a three-dimensional hybrid plasma solver. The proton fluxes and electromagnetical fields are presented for typical solar wind conditions with different magnetic field directions. We find two different wake structures for an interplanetary magnetic field that is perpendicular to the solar wind flow, and for one that is parallell to the flow. The wake for intermediate magnetic field directions will be a mix of these two extreme conditions. Several features are consistent with a fluid interaction, e.g., the presence of a rarefaction cone, and an increased magnetic field in the wake. There are however several kinetic features of the interaction. We find kinks in the magnetic field at the wake boundary. There are also density and magnetic field variations in the far wake, maybe from an ion beam instability related to the wake refill. The results are compared to observations by the WIND spacecraft during a wake crossing. The model magnetic field and ion velocities are in agreement with the measurements. The density and the electron temperature in the central wake are not as well captured by the model, probably from the lack of electron physics in the hybrid model.
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| 62. |
- Holmström, Mats
(författare)
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The use of objective measures in selecting patients for septal surgery
- 2010
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 48:4, s. 387-393
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Forskningsöversikt (refereegranskat)abstract
- To improve results in septal surgery, patient selection is the mainstay of a successful outcome. Patient history is the basis as well as clinical examination but both are subjective and must be considered towards a background with a high frequency of septal deviation in the population and a lack of good correlation between function and status. Rhinomanometry and acoustic rhinometry as well as nasal peak inspiratory flow are tests of different nasal parameters as resistance to breathing, nasal dimensions and flow. This article illuminates the use of these more objective tests in selection of patients for septoplasty. Objective tests have in several studies shown to predict postoperative satisfaction while normal values can be a marker for a poor surgical outcome. Pros and cons with objective tests are discussed and the conclusion is: operate when there is a good correlation between the patient's status, history and the results of rhinometry!
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| 63. |
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| 64. |
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| 65. |
- Häggström, Marie, PhD, 1967-, et al.
(författare)
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Establishing Patient Safety in Intensive Care -A Grounded Theory. : Building Trust-Important for Patient Safety
- 2017
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 07:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.
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| 66. |
- Jonsjö, Martin A., et al.
(författare)
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Patients with ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) and chronic pain report similar level of sickness behavior as individuals injected with bacterial endotoxin at peak inflammation
- 2020
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Ingår i: Brain, Behavior, & Immunity - Health. - : Elsevier BV. - 2666-3546. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic sickness behavior is implicated in ME/CFS (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome) and chronic pain but the level of subjective sickness behavior in these conditions has not been investigated or compared to other clinical and non-clinical samples, or to the level in experimental inflammation. Furthermore, the relationship between sickness behavior and self-rated health and functioning is not known in patients with ME/CFS and chronic pain. The aim of the present study was to investigate how sickness behavior in patients with chronic conditions differs from that in individuals with experimental acute sickness, primary care patients, the general population and healthy subjects. In addition, we wanted to explore how sickness behavior is related to self-rated health and health-related functioning.Methods: Sickness behavior was quantified using the sickness questionnaire (SicknessQ). Self-ratings were collected at one time-point in 6 different samples. Levels of sickness behavior in patients with ME/CFS (n = 38) and patients with chronic pain (n = 190) were compared to healthy subjects with lipopolysaccharide(LPS)-induced inflammation (n = 29), primary care patients (n = 163), individuals from the general population (n = 155) and healthy subjects (n = 48), using linear regression. Correlations and moderated regression analyses were used to investigate associations between sickness behavior and self-rated health and health-related functioning in ME/CFS, chronic pain and the general population.Results: LPS-injected individuals (M = 16.3), patients with ME/CFS (M = 16.1), chronic pain (M = 16.1) and primary care patients (M = 10.7) reported significantly higher SicknessQ scores than individuals from the general population (M = 5.4) and healthy subjects (M = 3.6) all p’s < 0.001). In turn, LPS-injected individuals, patients with ME/CFS and chronic pain reported significantly higher SicknessQ scores than primary care patients (p’s < 0.01). Higher levels of sickness behavior were associated with poorer self-rated health and health-related functioning (p’s < 0.01), but less so in patients with ME/CFS and chronic pain than in individuals from the general population.Conclusions: Patients with ME/CFS and chronic pain report similar high levels of sickness behavior; higher than primary care patients, and comparable to levels in experimental inflammation. Further study of sickness behavior in ME/CFS and chronic pain populations is warranted as immune-to-brain interactions and sickness behavior may be of importance for functioning as well as in core pathophysiological processes in subsets of patients.
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| 67. |
- Järnberg, Ulf, et al.
(författare)
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Retrospektiva studier av perfluoralkylsulfonsyror i den svenska miljön - Andra och avslutande året av screeningundersökningen : Slutrapport
- 2003
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Högfluorerade organiska ämnen har på senare tid uppmärksammats internationellt som potentiellt miljöstörande ämnen. Deras kemiska och biologiska persistens medför att de är mycket långlivade i miljön. Perfluoralkylsulfonsyror och perfluoralkylkarboxylsyror innefattar ett flertal isomera föreningar med mellan 4 och 12 kol i strukturen. De förekommer dels som rena ämnen i produkter, men även som delstrukturer i derivat och polymera produkter. Några ämnen, perfluorooktansyra (PFOA) och perfluoroktansulfonsyra (PFOS) har också visats innebära toxikologiska risker genom deras leverskadande och reproduktionsstörande egenskaper. Ämnena bioackumulerar och biomagnifierar och återfinns i kraftigt förhöjda koncentrationer hos toppkonsumenter som t.ex. säl och rovfågel, samt i blod från människa. Sammantaget med deras produktionsvolymer och spridda användningsområden har detta gett anledning att undersöka spridningen av dessa ämnen i den svenska urbana miljön. På grund av det mångsidiga användningsområdet av perfluoralkylsyror som derivat och i polymer form är användningen svår att kartlägga. Några användningsområden som identifierats i Sverige är ytbehandling, industriell textil- och läderbehandling, skumsläckningsmedel samt konsumentprodukter för textil och lädervård. Användningen av PFOS-baserade produkter har troligen minskat kraftigt sedan 2002 efter att den största tillverkaren 3M frivilligt dragit ned produktionen. ITM påbörjade 2001 ett undersökningsprogram på uppdrag av Naturvårdsverket för att kartlägga användning och spridning av PFOS och PFOA i Sverige. Det har visat sig att PFOS finns spritt i måttliga koncentrationer i den urbana miljön, men även återfinns i låga halter i biota i prover från opåverkade miljöer. PFOA däremot kunde ej påvisas i mätbara halter i något biologiskt prov. Som en följd av dessa resultat beslutade Naturvårdsverket om en fortsatt studie av tidsutvecklingen av dessa typer av ämnen i den svenska miljön. Denna rapport beskriver resultaten av den andra delen av screeningprojektet och innefattar data på biologisk spridning för PFOS i gädda, abborre och sillgrissleägg och en tidstrend för PFOS i sillgrissleägg. Undersökningen ger ett underlag för vidare monitorering av halter av PFOS och liknande substanser i Sverige.
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| 68. |
- Kanstrup, Marie, et al.
(författare)
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A Clinical Pilot Study of Individual and Group Treatment for Adolescents with Chronic Pain and Their Parents : Effects of Acceptance and Commitment Therapy on Functioning
- 2016
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Ingår i: Children. - : MDPI AG. - 2227-9067. ; 3:4
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Tidskriftsartikel (refereegranskat)abstract
- Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT) have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions), including a parent support program (four sessions). Adolescents were referred to the clinic if they experienced disabling chronic pain. They were then randomized, along with their parents, to receive group (n = 12) or individual (n = 18) treatment. Adolescent pain interference, pain reactivity, depression, functional disability, pain intensity and psychological flexibility, along with parent anxiety, depression, pain reactivity and psychological flexibility were assessed using self-reported questionnaires. There were no significant differences in outcomes between individual and group treatment. Analyses illustrated significant (p < 0.01) improvements (medium to large effects) in pain interference, depression, pain reactivity and psychological flexibility post-treatment. Additionally, analyses showed significant (p < 0.01) improvements (large effects) in parent pain reactivity and psychological flexibility post-treatment. On all significant outcomes, clinically-significant changes were observed for 21%-63% of the adolescents across the different outcome measures and in 54%-76% of the parents. These results support previous findings and thus warrant the need for larger, randomized clinical trials evaluating the relative utility of individual and group treatment and the effects of parental interventions.
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| 69. |
- Karshikoff, Bianka, et al.
(författare)
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Baseline Pro-Inflammatory Cytokine Levels Moderate Psychological Inflexibility in Behavioral Treatment for Chronic Pain
- 2022
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Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 11:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: The medical and scientific communities struggle to understand chronic pain and find effective treatments. Multimodal approaches are encouraging but show significant individual differences. Methods: Seventy-eight persons (56 women) with chronic pain received Acceptance and Commitment Therapy and provided blood samples before and after treatment. The participants completed surveys with the blood sampling. Blood plasma was analyzed for IL-6 and TNF-α levels with the Olink Inflammation Panel (Olink Bioscience Uppsala, Sweden). The treatment effects and moderating effects of low-grade inflammation on changes in outcomes were analyzed using linear mixed models. Results: Pain interference (p < 0.001) and psychological inflexibility (p < 0.001) improved significantly during treatment, but pain intensity did not (p = 0.078). Cytokine levels did not change over the course of the treatment (IL-6/TNF-α p = 0.086/0.672). Mean baseline levels of IL-6 and TNF-α moderated improvement in psychological inflexibility during the course of treatment (p = 0.044), but cytokine levels did not moderate changes in pain interference (p = 0.205) or pain intensity (p = 0.536). Conclusions: Higher baseline inflammation levels were related to less improvement in psychological inflexibility. Low-grade inflammation may be one factor underlying the variability in behavioral treatment in chronic pain.
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| 70. |
- Karshikoff, Bianka, et al.
(författare)
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Inflammatory Blood Signature Related to Common Psychological Comorbidity in Chronic Pain
- 2023
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Ingår i: Biomedicines. - : MDPI. - 2227-9059. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- Chronic pain is characterized by high psychological comorbidity, and diagnoses are symptom-based due to a lack of clear pathophysiological factors and valid biomarkers. We investigate if inflammatory blood biomarker signatures are associated with pain intensity and psychological comorbidity in a mixed chronic pain population. Eighty-one patients (72% women) with chronic pain (>6 months) were included. Patient reported outcomes were collected, and blood was analyzed with the Proseek Multiplex Olink Inflammation Panel (Bioscience Uppsala, Uppsala, Sweden), resulting in 77 inflammatory markers included for multivariate data analysis. Three subgroups of chronic pain patients were identified using an unsupervised principal component analysis. No difference between the subgroups was seen in pain intensity, but differences were seen in mental health and inflammatory profiles. Ten inflammatory proteins were significantly associated with anxiety and depression (using the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9): STAMBP, SIRT2, AXIN1, CASP-8, ADA, IL-7, CD40, CXCL1, CXCL5, and CD244. No markers were related to pain intensity. Fifteen proteins could differentiate between patients with moderate/high (GAD-7/PHQ-9 > 10) or mild/no (GAD-7/PHQ-9 < 10) psychological comorbidity. This study further contributes to the increasing knowledge of the importance of inflammation in chronic pain conditions and indicates that specific inflammatory proteins may be related to psychological comorbidity.
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