| 1. |
- Olsson, Anki, Medicine doktor, et al.
(author)
-
Activated platelet aggregation is transiently impaired also by a reduced dose of protamine
- 2019
-
In: Scandinavian Cardiovascular Journal. - : TAYLOR & FRANCIS LTD. - 1401-7431 .- 1651-2006. ; 53:6, s. 355-360
-
Journal article (peer-reviewed)abstract
- Objectives: Protamine reduces platelet aggregation after cardiopulmonary bypass (CPB). We studied the inhibitory effect of a reduced protamine dose, the duration of impaired platelet function and the possible correlation to postoperative bleeding. Design: Platelet function was assessed by impedance aggregometry in 30 patients undergoing cardiac surgery with CPB at baseline, before protamine administration, after 70% and 100% of the calculated protamine dose, after 20 minutes and at arrival to the intensive care unit. Adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used as activators. Blood loss was measured during operation and three hours after surgery. Results are presented as median (25th-75th percentile). Results: Platelet aggregation decreased markedly after the initial dose of protamine (70%) with all activators; ADP 89 (71-110) to 54 (35-78), TRAP 143 (116-167) to 109 (77-136), both p < .01; AA 25 (16-49) to 17 (12-24) and COL 92 (47-103) to 60 (38-81) U, both p < .05. No further decrease was seen after 100% protamine. The effect was transient and after twenty minutes platelet aggregation had started to recover; ADP 76 (54-106), TRAP 138 (95-158), AA 20 (10-35), COL 70 (51-93) U. Blood loss during operation correlated to aggregometry measured at baseline and after protaminization. Conclusions: Protamine after CPB induces a marked decrease in platelet aggregation already at a protamine-heparin ratio of 0.7:1. The impairment seems to be transient and recovery had started after 20 minutes.
|
|
| 2. |
- Arenaz Búa, Beatriz, et al.
(author)
-
The Pharyngoesophageal Segment after Total Laryngectomy
- 2017
-
In: Annals of Otology, Rhinology and Laryngology. - : SAGE Publications. - 0003-4894 .- 1943-572X. ; 126:2, s. 138-145
-
Journal article (peer-reviewed)abstract
- Objective: The aim of the present study was to characterize the pharyngoesophageal segment in laryngectomees who rated themselves as functional tracheoesophageal speakers. Methods: Voice perceptual assessment, high-resolution videomanometry of swallowing and phonation, and high-speed camera recording during phonation provided information about the anatomy and function of the pharyngoesophageal segment. Results: Fourteen patients were included in the study. The voice assessments presented high intra/inter-listener reliability. We found a significant correlation between roughness and poor voice quality, hyperfunction and poor intelligibility, and poor voice quality, long time since the operation, and old age. High-resolution videomanometry during phonation revealed decreasing mean pressures from the distal esophagus to the pharynx and confirmed low resting pressures at the pharyngoesophageal segment and low esophageal peristaltic contraction pressures after laryngectomy in comparison to normal subjects. The neoglottis shape was mainly circular and presented a strong mucosal wave in most of the patients on the high-speed camera recording. Conclusions: Perceptual voice assessment and high-speed camera recordings provided baseline information about voice characteristics and vibration regularity of the neoglottis. Additionally, the quantitative measures obtained with high-resolution videomanometry may have clinical applicability as reference data in voice rehabilitation after total laryngectomy.
|
|
| 3. |
- Arenaz Bua, Beatriz, et al.
(author)
-
Treatment of cricopharyngeal dysfunction: a comparative pilot study.
- 2015
-
In: BMC Research Notes. - : Springer Science and Business Media LLC. - 1756-0500. ; 8
-
Journal article (peer-reviewed)abstract
- Cricopharyngeal dysfunction is a narrowing at the level of the upper oesophageal sphincter caused by failed or incomplete sphincter opening as a result of lack of pharyngoesophageal coordination or reduction in the muscular compliance of the upper oesophageal sphincter. Oropharyngeal dysphagia is a typical symptom. Videomanometry allows direct comparison of pressure readings with dynamic anatomy during swallowing.
|
|
| 4. |
- Besker, Terese, 1970, et al.
(author)
-
The Enterprise Architect profession: An empirical study
- 2015
-
In: 9th European Conference on IS Management and Evaluation – ECIME 2015. - 2048-8912. - 9781910810569 ; :38, s. 29-36
-
Conference paper (peer-reviewed)abstract
- The field of Enterprise Architecture (EA) is rapidly evolving why there is a need for increased professionalization of the discipline. Therefore, understanding the profession of the Enterprise Architects in enterprise transformation and development becomes important. However, there are very few empirically based studies which have reflected these professionals within their work domain of an every-day business. The purpose of this paper is to increase our understanding of how the Enterprise Architect’s practice their profession and in addition, to study how these professionals describe their occupation. Five different topics are of particular interest to portraying the occupation of the Enterprise Architect's profession; the role, competence, power, style of acting and main focus. The research is a descriptive study based on interviews with Enterprise Architects in ten large Swedish organizations. In conclusion, the architect is considered as a proud individualist with an entrepreneurial vein who endeavor consideration, reflection, and the guidance capability.
|
|
| 5. |
- Boström, Magnus, 1972-, et al.
(author)
-
Conditions for Transformative Learning for Sustainable Development : A Theoretical Review and Approach
- 2018
-
In: Sustainability. - : MDPI. - 2071-1050. ; 10:12
-
Journal article (peer-reviewed)abstract
- Continued unsustainability and surpassed planetary boundaries require not only scientific and technological advances, but deep and enduring social and cultural changes. The purpose of this article is to contribute a theoretical approach to understand conditions and constraints for societal change towards sustainable development. In order to break with unsustainable norms, habits, practices, and structures, there is a need for learning for transformation, not only adaption. Based on a critical literature review within the field of learning for sustainable development, our approach is a development of the concept of transformative learning, by integrating three additional dimensions—Institutional Structures, Social Practices, and Conflict Perspectives. This approach acknowledges conflicts on macro, meso, and micro levels, as well as structural and cultural constraints. It contends that transformative learning is processual, interactional, long-term, and cumbersome. It takes place within existing institutions and social practices, while also transcending them. The article adopts an interdisciplinary social science perspective that acknowledges the importance of transformative learning in order for communities, organizations, and individuals to be able to deal with global sustainability problems, acknowledging the societal and personal conflicts involved in such transformation.
|
|
| 6. |
- Burmakin, Mikhail, et al.
(author)
-
Imatinib increases oxygen delivery in extracellular matrix-rich but not in matrix-poor experimental carcinoma
- 2017
-
In: Journal of Translational Medicine. - : BioMed Central. - 1479-5876 .- 1479-5876. ; 15
-
Journal article (peer-reviewed)abstract
- Background: Imatinib causes increased turnover of stromal collagen, reduces collagen fibril diameter, enhances extracellular fluid turnover and lowers interstitial fluid pressure (IFP) in the human colonic carcinoma KAT-4/HT-29 (KAT-4) xenograft model. Methods: We compared the effects of imatinib on oxygen levels, vascular morphology and IFP in three experimental tumor models differing in their content of a collagenous extracellular matrix. Results: Neither the KAT4 and CT-26 colonic carcinoma models, nor B16BB melanoma expressed PDGF beta-receptors in the malignant cells. KAT-4 tumors exhibited a well-developed ECM in contrast to the other two model systems. The collagen content was substantially higher in KAT-4 than in CT-26, while collagen was not detectable in B16BB tumors. The pO(2) was on average 5.4, 13.9 and 19.3 mmHg in KAT-4, CT-26 and B16BB tumors, respectively. Treatment with imatinib resulted in similar pO(2)-levels in all three tumor models but only in KAT-4 tumors did the increase reach statistical significance. It is likely that after imatinib treatment the increase in pO(2) in KAT-4 tumors is caused by increased blood flow due to reduced vascular resistance. This notion is supported by the significant reduction observed in IFP in KAT-4 tumors after imatinib treatment. Vessel area varied between 4.5 and 7% in the three tumor models and was not affected by imatinib treatment. Imatinib had no effect on the fraction of proliferating cells, whereas the fraction of apoptotic cells increased to a similar degree in all three tumor models. Conclusion: Our data suggest that the effects of imatinib on pO(2)-levels depend on a well-developed ECM and provide further support to the suggestion that imatinib acts by causing interstitial stroma cells to produce a less dense ECM, which would in turn allow for an increased blood flow. The potential of imatinib treatment to render solid tumors more accessible to conventional treatments would therefore depend on the degree of tumor desmoplasia.
|
|
| 7. |
- Gabrielsson, Sebastian
(author)
-
A moral endeavour in a demoralizing context: Psychiatric inpatient care from the perspective of professional caregivers
- 2015
-
Doctoral thesis (other academic/artistic)abstract
- Patients in psychiatric care experience a need for and expect to develop interpersonal relationships with professional caregivers and to be respected and listened to. Despite demands for care to be person-centred and recovery-oriented, patients experience that psychiatric inpatient care fails to meet their expectations. Nursing research suggest that nurses aspire to engage with and meet the needs of patients, but that the strenuous reality of inpatient care prevents them from doing so. Exploring the content and context of psychiatric inpatient care from the perspective of professional caregivers might provide valuable insights regarding what caregivers do, and more importantly it can aid in understanding why they do what they do.This thesis aimed to explore the content and context of adult psychiatric inpatient care from the perspective of professional caregivers. This was achieved by clarifying the concept of person-centred care in the context of inpatient psychiatry, describing staff members’ reasoning on their choice of action and perceptions of interprofessional collaboration in challenging situations in inpatient psychiatric care settings, and exploring nurses’ experiences of good nursing practice in the specific context of inpatient psychiatry. A systematic review of the literature identified 34 scholarly papers that were analysed using evolutionary concept analysis. Focus group interviews were conducted with 26 professional caregivers and analysed using qualitative content analysis. Individual qualitative interviews were conducted with 12 skilled, relationship-oriented nurses and analysed using an interpretive descriptive approach to qualitative analysis.Reviewing the literature on person-centred care in inpatient psychiatry clarified how person-centred care is expected to result in quality care when interpersonal relationships are used to promote recovery. Professional caregivers’ reasoning on choice of action described different concerns in caregiver-patient interaction resulting in a focus on either meeting patients’ individual needs or solving staff members’ own problems. Describing professional caregivers’ perceptions of interprofessional collaboration suggested that they are being constrained by difficulties in collaborating with each other and a lack of interaction with patients. Exploring nurses’ experiences of good nursing practice revealed how circumstances in the clinical setting affect nurses’ ability to work through relationships. It is argued that these findings describe the workings of two opposing forces in psychiatric inpatient care. The concept of caring as a process forms the basis for discussing the content of care as a moral endeavour in which nurses strive to do good. The concept of demoralizing organizational processes is used to discuss the context of care as demoralizing and allowing for immoral actions.The main conclusions to be drawn are that, from a nursing perspective, nurses in psychiatric inpatient care need to focus on patients’ experiences and needs. For this they need sufficient resources and time to be present and develop relationships with patients.Nurses in psychiatric inpatient care also need to take personal responsibility for their professional practice. Attempts to transform psychiatric care in a person-centred direction must consider all of these aspects and their interrelatedness. Further research on psychiatric inpatient care is needed to understand more about how the content of care relates to the context of care.
|
|
| 8. |
|
|
| 9. |
- Holmberg, Mats, 1958, et al.
(author)
-
Structural brain changes in hyperthyroid Graves' disease: protocol for an ongoing longitudinal, case-controlled study in Göteborg, Sweden-the CogThy project.
- 2019
-
In: BMJ open. - : BMJ. - 2044-6055. ; 9:11
-
Journal article (peer-reviewed)abstract
- Cognitive impairment and reduced well-being are common manifestations of Graves' disease (GD). These symptoms are not only prevalent during the active phase of the disease but also often prevail for a long time after hyperthyroidism is considered cured. The pathogenic mechanisms involved in these brain-derived symptoms are currently unknown. The overall aim of the CogThy study is to identify the mechanism behind cognitive impairment to be able to recognise GD patients at risk.The study is a longitudinal, single-centre, case-controlled study conducted in Göteborg, Sweden on premenopausal women with newly diagnosed GD. The subjects are examined: at referral, at inclusion and then every 3.25 months until 15 months. Examinations include: laboratory measurements; eye evaluation; neuropsychiatric and neuropsychological testing; structural MRI of the whole brain, orbits and medial temporal lobe structures; functional near-infrared spectroscopy of the cerebral prefrontal cortex and self-assessed quality of life questionnaires. The primary outcome measure is the change in medial temporal lobe structure volume. Secondary outcome measures include neuropsychological, neuropsychiatric, hormonal and autoantibody variables. The study opened for inclusion in September 2012 and close for inclusion in October 2019. It will provide novel information on the effect of GD on medial temporal lobe structures and cerebral cortex functionality as well as whether these changes are associated with cognitive and affective impairment, hormonal levels and/or autoantibody levels. It should lead to a broader understanding of the underlying pathogenesis and future treatment perspectives.The study has been reviewed and approved by the Regional Ethical Review Board in Göteborg, Sweden. The results will be actively disseminated through peer-reviewed journals, national and international conference presentations and among patient organisations after an appropriate embargo time.44321 at the public project database for research and development in Västra Götaland County, Sweden (https://www.researchweb.org/is/vgr/project/44321).
|
|
| 10. |
- Ittner, Henrik, et al.
(author)
-
Recent Swedish Studies on the Extent of Blast Damage after Excavation
- 2016
-
Conference paper (peer-reviewed)abstract
- This paper presents two recent studies on the extent of blast damage after excavation in crystalline rock. The Swedish Transport Administration and the Swedish Nuclear Fuel and Waste Management Company (SKB) are both under regulations to limit excavation damage during construction of tunnels. SKB is also required to limit the Excavation Damage Zone (EDZ), as this could be a potential flow path for radionuclides in the planned repository for spent nuclear fuel.Presented in this paper are investigations of blast damage from three tunnel sites, a road tunnel, an experimental tunnel in Äspö Hard Rock Laboratory and an underground subway depot.As expected the fractures resulting from the bottom charge are both longer and more frequent then those mapped in the column charge. The results show that the requirement to limit blast damage according to Swedish regulations was fulfilled for the column charge at the three studied sites.
|
|
