| 1. |
- Angelini, Eva, 1964, et al.
(författare)
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Evaluating a targeted person-centred pain management intervention programme in lumbar spine surgery - a controlled segment-specific before-and-after interventional design
- 2024
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Ingår i: BMC Health Services Research. - 1472-6963. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Postoperative pain management in lumbar spine surgery care remains a challenge. The aim of this study was to evaluate the impact of a person-centred postoperative pain management intervention programme on lumbar spine surgery patients on postoperative pain, shared decision-making, and satisfaction with postoperative pain management. Methods: The study was performed with a controlled before-and-after interventional design in an orthopaedic unit at a university hospital. Person-centred pain management for patients undergoing spine surgery was developed in co-creation by a multi-professional team and implemented throughout the care pathway. The usual care group (pre-intervention) served as a comparison to the intervention group. Pain intensity, shared decision-making in pain management, and patient satisfaction with results of pain management, served as patient-reported measures, collected using the International Pain Outcomes questionnaire and analysed using descriptive statistics. Results: The intervention showed no benefit for patients’ pain and satisfaction, while shared decision-making in pain management was significant lower in the intervention group than in the conventional group. The per-protocol analysis showed no significant differences between groups. Conclusion: The initial assumption of the study, that the implementation of a co-created structured person-centred care pathway would improve patient-reported outcomes, was not confirmed. The periodically low fidelity to the intervention due to organizational constraints (due to sub-optimal organizational conditions and managerial support) may have affected the results.
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| 2. |
- Angelini, Eva, 1964, et al.
(författare)
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The impact of implementing a person-centred pain management intervention on resistance to change and organizational culture
- 2021
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Resistance to change and organizational culture are essential factors to consider in change management in health care settings. Implementation of structural change remains a challenge. There is a lack of studies providing information on the impact of implementation processes on the organization. The aim of this study was to describe the impact of implementing a systematic change process concerning postoperative person-centred pain management on resistance to change and organizational culture in an orthopaedic spine surgery unit. Methods: The study was set in an orthopaedic spine surgery unit at a university hospital. Person-centred bundles of care for postoperative pain management of spine surgery patients were developed in co-creation by a multi-professional expert group and implemented throughout the care pathway. The intervention was underpinned by theories on organizational culture and inspired by principles of person-centred care. Quantitative data were collected using the Resistance to Change Scale and the Organizational Culture Assessment Instrument and analysed using descriptive statistics. Results: The findings showed a low resistance to change decreasing during the study. The organizational culture shifted from a result-oriented to a formalized and structured culture after the implementation. The culture preferred by the staff was team-oriented and participation-focused throughout the study. The discrepancy between the current and preferred cultures remained extensive over time. Conclusion: It is challenging to describe the influence of the development and implementation of a postoperative pain management program on organizational culture as well as in terms of resistance to change, in a complex health care setting. In the current study the unit was under organizational strain during the implementation. Albeit, the important discrepancy between the current and preferred organizational culture could imply that structural changes aren’t enough when implementing person-centred pain management structures and needs to be combined with relational aspects of change.
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| 3. |
- Janssen, Mathias, 1973, et al.
(författare)
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Life cycle assessment of lignin-based carbon fibres
- 2019
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Ingår i: 14th Conference on sustainable development of energy, water and environment systems.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Lignin-based carbon fibres may replace both glass fibres and fossil-based carbon fibres. The objective of this study was to determine the environmental impact of the production of lignin-based carbon fibres using life cycle assessment. The life cycle assessment was done from cradle to gate and followed an attributional approach. The climate impact per kg of lignin- based carbon fibres produced was 1.50 kg CO2,eq. In comparison to glass fibres, the climate impact was reduced by 32% and the climate impact of fossil-based carbon fibres was an order of magnitude higher. A prospective analysis, in which the background energy system was cleaner, showed that the environmental impact of lignin-based carbon fibres will decrease and outperform the glass fibres and fossil-based carbon fibres from a climate impact point-of-view. The constructed LCA model can be applied in further studies of products that consist of or use lignin-based carbon fibres.
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| 4. |
- Pivodic, Aldina, 1978, et al.
(författare)
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Development and validation of a new clinical decision support tool to optimize screening for retinopathy of prematurity
- 2022
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Ingår i: British Journal of Ophthalmology. - : BMJ Publishing Group Ltd. - 0007-1161 .- 1468-2079. ; 106:11, s. 1573-1580
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND/AIMS: Prematurely born infants undergo costly, stressful eye examinations to uncover the small fraction with retinopathy of prematurity (ROP) that needs treatment to prevent blindness. The aim was to develop a prediction tool (DIGIROP-Screen) with 100% sensitivity and high specificity to safely reduce screening of those infants not needing treatment. DIGIROP-Screen was compared with four other ROP models based on longitudinal weights.METHODS: Data, including infants born at 24-30 weeks of gestational age (GA), for DIGIROP-Screen development (DevGroup, N=6991) originate from the Swedish National Registry for ROP. Three international cohorts comprised the external validation groups (ValGroups, N=1241). Multivariable logistic regressions, over postnatal ages (PNAs) 6-14 weeks, were validated. Predictors were birth characteristics, status and age at first diagnosed ROP and essential interactions.RESULTS: ROP treatment was required in 287 (4.1%)/6991 infants in DevGroup and 49 (3.9%)/1241 in ValGroups. To allow 100% sensitivity in DevGroup, specificity at birth was 53.1% and cumulatively 60.5% at PNA 8 weeks. Applying the same cut-offs in ValGroups, specificities were similar (46.3% and 53.5%). One infant with severe malformations in ValGroups was incorrectly classified as not needing screening. For all other infants, at PNA 6-14 weeks, sensitivity was 100%. In other published models, sensitivity ranged from 88.5% to 100% and specificity ranged from 9.6% to 45.2%.CONCLUSIONS: DIGIROP-Screen, a clinical decision support tool using readily available birth and ROP screening data for infants born GA 24-30 weeks, in the European and North American populations tested can safely identify infants not needing ROP screening. DIGIROP-Screen had equal or higher sensitivity and specificity compared with other models. DIGIROP-Screen should be tested in any new cohort for validation and if not validated it can be modified using the same statistical approaches applied to a specific clinical setting.
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| 5. |
- Wirström, Eva, 1977, et al.
(författare)
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Observational tests of interstellar methanol formation
- 2011
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Ingår i: Astronomy and Astrophysics. - : EDP Sciences. - 0004-6361 .- 1432-0746. ; 533, s. A24-
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Tidskriftsartikel (refereegranskat)abstract
- Context. It has been established that the classical gas-phase production of interstellar methanol (CH(3)OH) cannot explain observed abundances. Instead it is now generally thought that the main formation path has to be by successive hydrogenation of solid CO on interstellar grain surfaces. Aims. While theoretical models and laboratory experiments show that methanol is efficiently formed from CO on cold grains, our aim is to test this scenario by astronomical observations of gas associated with young stellar objects (YSOs). Methods. We have observed the rotational transition quartets J = 2(K) - 1(K) of (12)CH(3)OH and (13)CH(3)OH at 96.7 and 94.4 GHz, respectively, towards a sample of massive YSOs in different stages of evolution. In addition, the J = 1-0 transitions of (12)C(18)O and (13)C(18)O were observed towards some of these sources. We use the (12)C/(13)C ratio to discriminate between gas-phase and grain surface origin: If methanol is formed from CO on grains, the ratios should be similar in CH(3)OH and CO. If not, the ratio should be higher in CH(3)OH due to (13)C fractionation in cold CO gas. We also estimate the abundance ratios between the nuclear spin types of methanol (E and A). If methanol is formed on grains, this ratio is likely to have been thermalized at the low physical temperature of the grain, and therefore show a relative over-abundance of A-methanol. Results. We show that the (12)C/(13)C isotopic ratio is very similar in gas-phase CH(3)OH and C(18)O, on the spatial scale of about 40 '', towards four YSOs. For two of our sources we find an overabundance of A-methanol as compared to E-methanol, corresponding to nuclear spin temperatures of 10 and 16 K. For the remaining five sources, the methanol E/A ratio is less than unity. Conclusions. While the (12)C/(13)C ratio test is consistent with methanol formation from hydrogenation of CO on grain surfaces, the result of the E/A ratio test is inconclusive.
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| 6. |
- Wirström, Eva, 1977, et al.
(författare)
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The 12C/13C ratio as a chemistry indicator
- 2011
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Ingår i: The Molecular Universe, Posters from the proceedings of the 280th Symposium of the International Astronomical Union held in Toledo, Spain, May 30-June 3, 2011, #384. ; 280:384
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Isotopic ratios of elements are considered powerful tools, e.g. in tracing the origin of solar system body materials, or the degree of nucleosynthesis processing throughout the Galaxy. In interstellar molecules, some isotopic ratios like H/D and 12C/13C can also be used as indicators of their chemical origin. Isotope fractionation in gas-phase chemical reactions and gas-dust interaction makes observations of the ratio between 12C and 13C isotopologues suitable to distinguish between different formation scenarios. We will present observations of the 12C/13C ratio in methanol (CH3OH) and formaldehyde (CH2O) towards a sample of embedded, massive young stellar objects. In relation to this we also present results from theoretical modeling showing the usefulness of the 12C/13C ratio as a chemistry indicator.
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| 7. |
- Wolf, Anna, et al.
(författare)
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Energy-efficient pellet production in the forest industry - a study of obstacles and success factors
- 2006
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Ingår i: Biomass and Bioenergy. - : Elsevier BV. - 0961-9534 .- 1873-2909. ; 30:1, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- With an expanding market for upgraded biofuel in many countries, it is important to develop efficient production methods for upgrading wet biomass. The possibilities for heat recovery can be improved if the upgrading process is integrated with other energy-intensive processes, as for example a pulp mill or a sawmill, in a biofuel combine. This work evaluates obstacles and Success factors for forming such biofuel combines with the forest industry. Case Studies and calculations on theoretical cases have been used together with literature references to evaluate how a biofuel combine can be realised and to compile obstacles and success factors for a combine. It could be seen from the case studies that an excess of by-products and waste heat, together with an existing need for investments are important driving forces for the formation of biofuel combines in the forest industry. The market was also identified as an important factor, which can be both an obstacle and a success factor depending on the situation. It was concluded that the existence of a small-scale pellet market near the plant is important for economic feasibility when sawdust is used as raw material. The conditions for the biofuel combine are different depending on the form of ownership. When a pulp mill or sawmill owns the pellet factory, it was concluded that minimising the risk by using well-known technologies can be an important factor for the realisation of the combine.
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