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- Krakau, Karolina, 1968-, et al.
(författare)
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Energy balance and metabolism after severe traumatic brain injury : A pilot study using doubly labelled water
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To explore the course of energy balance in patients with severe traumatic brain injury, from time of injury until twelve weeks post injury. Method: This prospective desriptive study included six patients with isolated, closed severe traumatic brain injury and an expected hospital stay of ≥2-3 months. Energy balance was calculated from energy intake compared to total energy expenditure measured by continuous indirect calorimetry and doubly labelled water. Clinical and laboratory variables with possible influence on metabolism and nutritional delivery were recorded simultaneously. Intermittent indirect calorimetry measurements were used to differentiate components of the energy expended. Results: Patients were roughly in energy balance while on mechanical ventilation, but in negative energy balance from the 3rd week post injury. The total energy expenditure then increased while the daily energy intake declined. Concurrent with this period were difficulties in retaining enteral and/or parenteral nutrition delivery routes until oral feeding was satisfactory. Nitrogen balance was back to normal at about 1.5 months and the inflammatory period with increased C-reactive protein levels continued for 12 to 58 days from time of injury. During the first and second month post injury, patients lost 8-19% of their initial body weight. Conclusion: Data suggests that negative energy balance after a severe TBI could not only be explained by the elevated metabolic rate and catabolism induced by the trauma, but also by difficulties in securing alternative nutritional routes in the distressed patient.
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| 2. |
- Krakau, Karolina, 1968-, et al.
(författare)
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Prediction of energy expenditure in patients with severe traumatic brain injury : A validation study by use of continuous indirect calorimetry and doubly labelled water
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Objective: The aim was to evaluate the accuracy of methods to predict energy expenditure (EE) in patients with severe traumatic brain injury (TBI). Method: To this prospective descriptive study, a small cohort of patients (n6) with isolated, severe TBI and an expected hospital stay of ≥2-3 months were included. The EE was measured at two intervals: by continuous indirect calorimetry during mechanical ventilation and by doubly labelled water from 3rd to 5th week post injury. Different equations for prediction of EE and a portable monitor, the SenseWear Armband were compared to the measured EE. Result: The majority of methods for predicting EE agreed poorly with the measured EE during indirect calorimetry period. A good agreement was found only with the three Penn-State equations, but two were biased according to Bland Altman analysis. The Penn-State equation from 1998 was the only valid predictive method, with a mean difference per day close to zero (+22 kcal), an excellent agreement (ICC 0.82) with 72% (n54/75) accurately assessed days (±10% of the measured EE) and with all patients within clinically acceptable levels, i.e. ±15% of the measured EE. During doubly labelled water period, observations were too few for any conclusive statement. Conclusion: These data support use of the Penn-State equation from 1998 to estimate EE in patients with severe TBI while on mechanical ventilation.
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| 4. |
- Lundh, Torbjörn, 1965, et al.
(författare)
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Torque Devices
- 2018
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Torque devices for navigating a guidewire through a body lumen are disclosed. The devices have a variable speed transmission design, including at least a first transmission region along a first position of the device, and a second transmission region along a second position of the device. The first and second transmission regions have different diameters, thereby allowing rotational control of the guidewire between at least two different stroke angles.
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| 5. |
- Lundälv, Jörgen, 1966
(författare)
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Forskare: ”Förkastligt med biljakt”.
- 2015
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Ingår i: Norrländska Socialdemokraten den 11 februari 2015.
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Ekwall, Eva, 1950-, et al.
(författare)
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Women's perceptions of interactions with the health care team during treatment of the first recurrence of ovarian cancer
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Most women suffering a recurrence of ovarian cancer return to the same department where their primary cancer was treated. The aim of this study was to explore what women with the first recurrence of ovarian cancer perceived as important in their interaction with the healthcare team. Interviews were conducted with 12 women at the end of a chemotherapy treatment. The interviews were subjected to qualitative content analysis. The findings stress the importance for the healthcare team to offer each woman the opportunity to obtain support to become familiar with the disease. This theme of becoming familiar with the disease was supported by the following sub-themes: being confirmed as a person, getting help in making sense of information regarding the disease and its treatment, having the opportunity to be involved and share responsibility, and feeling confident that medical expertise is good enough.Becoming familiar with the disease was expressed as a process of understanding and assimilating the whole new situation. Optimal support from healthcare professionals was facilitated by establishing trusting relationships. Being confirmed and treated as a unique person was seen as a prerequisite to achieving familiarity with the disease. The women needed help to make sense of the information available. They stressed the importance of being able to influence their encounters with healthcare professionals in accordance with their own perspectives. Also of importance was having the opportunity to share the responsibility for their care and lives. The findings suggest that patients’ need should be identified repeatedly throughout the illness trajectory.
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| 7. |
- Bäckström, Josefin, 1977-, et al.
(författare)
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Family members’ experiences of support during care and rehabilitation of patients with severe burns
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this study was to explore family members’ experiences of support during burn care and during the rehabilitation phase after hospital discharge.Background: Family members are important in the recovery process of patients with severe burns; however, few previous studies have focused on how this group experiences and values support during care and rehabilitation.Methods: Ten semi-structured interviews with family members of patients treated at the national burn centres were recorded digitally, transcribed verbatim, and analysed using content analysis. The informants were included nationwide, most were females, and different socioeconomic groups were represented.Results: Categories related to experiences during care were: Nonsupport, Professional support, Support from family and friends, A wish for support, and That little something extra. Categories related to experiences during rehabilitation were: Nonsupport, Professional support, Support from family and friends, Support from the injured person and Religion. Support from other family members and friends was generally considered the most important source of support, and there was a wish for more proactive support from care professionals.Conclusion: The experience of support is individual, which makes supporting family members a complex task. Individualized treatment of family members and their inclusion in the care process are of central importance, as is identifying specific needs for support both during the time in hospital and during rehabilitation. It is important to be proactive and offer support.
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| 8. |
- Bäckström, Josefin, 1977-, et al.
(författare)
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Family members of patients with severe burns: Experiences during care and rehabilitation
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aim was to explore experiences of care and rehabilitation in family members of patients with burns. Ten semi-structured interviews analyzed using qualitative content analysis resulted in seven categories related to the care: Feeling distress, Receiving excellent care, Being treated in an insensitive way, Reluctance towards giving care, Being the hub of the family network, Feeling hope, and Being thankful. Six categories were related to rehabilitation: Ambiguous feelings, Difficulties after discharge, Being forced to take responsibility, Handling the situation, Gaining support and Being thankful. Although there are positive experiences during care, family members experience the time in hospital and after discharge as distressful and could benefit from being cared for in a more individualized way. Improved communication between caregivers and the family member may be important. Family members need to be included in the planning of care and support offered at discharge could ease the burden on these individuals.
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