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- Alm, Fredrik, 1983-, et al.
(författare)
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Adherence to Swedish Guidelines for Pain Treatment in Tonsil Surgery in Pediatric Patients
- 2016
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Konferensbidrag (refereegranskat)abstract
- Objective: As shown by data from the National Tonsil Surgery Register in Sweden, tonsil surgery often causes severe pain that lasts for many days. The register data demonstrate the necessity for better evidence-based pain treatment guidelines for tonsil surgery. The guidelines, introduced in 2013, consist of both pharmacological and non-pharmacological recommendations. In the guidelines, a multimodal analgesic approach and combination of analgesics are recommended to provide effective pain treatment with limited side effects. Two national multi-professional education days on pain, pharmacology and the guidelines were offered. Web-based information about pharmacological treatment (www.tonsililloperation.se) was designed for patients and next-of-kin. The current aims were to describe adherence to the Swedish guidelines for pain treatment in tonsil surgery in pediatric patients < 18 yearsMethod: An inter-professional questionnaire was developed, including questions linked to the relevant guidelines. The questions came from a national mapping before the guidelines were designed. The items were discussed by an expert group, and content validity was evaluated using the content validity index.ENT-and anesthesia physicians and nurses from all 50 ENT clinics in Sweden were enrolled.Results: Most clinics had received the guidelines, but there was a discrepancy between the professions. More than half had perused the literature review performed before the guidelines were designed, and attended themulti-professional education day. Pre- and perioperative treatment usually included paracetamol, clonidine and betamethasone. A multimodal pain approach after discharge from hospital (tonsillectomy and tonsillotomy) was used, combining paracetamol with cox-inhibitors. Most clinics used paracetamol, with a higher dose for the first 3 days (healthy children and acceptable nutrition), and a reduced dose from day 4.In case of inadequate analgesia after tonsillectomy, oral clonidine or opioids were used. Several clinics followed the recommendation to use clonidine as first choice and secondly an opioid. No respondents prescribed codeine compared to 80% at the mapping before the guidelines were designed. The guidelines were experienced as clear, safe and sufficient. The web-based information was used by most of the clinics to improve quality of care and provide facilitating tools for patients, relatives and caregivers.Conclusion: Swedish guidelines for tonsil surgery provide practical evidence-based pain treatment recommendations. To achieve a change, multi-professional education is necessary. This needs to be repeated for a wider spread.Future research should include evaluation through pain diaries and questionnaires to next-of-kin and children. There should be matching of data from the quality registers at each clinic, with pain variables such as unplanned health care contacts due to pain, number of days with analgesics, and return to normal diet
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| 2. |
- Andréasson, Sara Näslund, et al.
(författare)
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Peritonectomy with high voltage electrocautery generates higher levels of ultrafine smoke particles
- 2008
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Ingår i: European Journal of Surgical Oncology. - : Elsevier BV. - 0748-7983 .- 1532-2157. ; 35:7, s. 780-784
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To adequately perform peritonectomy, the use of an electrocautery device at a high voltage is recommended. The aim of this study was to analyse the amount of airborne and ultrafine particles (UFP) generated during peritonectomy and to compare this with standard colon and rectal cancer surgery (CRC). METHOD: UFP was measured approximately 2-3cm from the breathing area of the surgeon (personal sampling) and 3m from where the electrocautery smoke was generated (stationary sampling) from 14 consecutive peritonectomy procedures and 11 standard CRC resections. The sampling was by P-Trak UFP counter that has the capacity to detect particle size ranging from 0.02 to 1mum. RESULTS: The cumulative level of UFP of personal sampling in the peritonectomy group was higher (9.3x10(6)particle/ml/h (pt/ml/h)) than in the control group (4.8x10(5)pt/ml/h). A higher cumulative level of UFP in stationary sampling was observed in the PC group (2.6x10(6) pt/ml/h) than in the control group (3.9x10(4)pt/ml/h). CONCLUSION: Peritonectomy procedure with high voltage electrocautery generates elevated levels of UFP than standard CRC surgery does. The level of UFP produced by a peritonectomy is comparable to cigarette smoking. More efficient smoke evacuator systems are needed in order to reduce the levels of UFP generated during electrocautery surgery.
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| 3. |
- Becevic, Semir
(författare)
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Klassrumsbedömning i matematik på gymnasieskolans nivå
- 2011
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Klassrumsbedömning i matematik på gymnasienivå är en licentiatstudie med en intention att närma sig, fånga upp samt förstå och tolka lärares ageranden, tankar, upplevelser och reflektioner inom och om bedömningen i matematik i gymnasiet. En annan avsikt är delvis att fylla i luckan mellan det målrelaterade kursbedömningssystemet och det praktiska fältet med en kvalitativ forskningsstudie om lärarerfarenheter från gymnasiets matematikkurser.Studien kan inte på något sätt betraktas som uttömmande. Den är selektiv till sin natur. Det finns många andra faktorer som också påverkar de deltagande lärarnas handlingar, funderingar och beslut inom bedömningsfältet av vilka endast ett fåtal berörs av studien. Det finns även så många matematiklärare utanför studien. Lägg likaså till mer eller mindre involverade och intresserade organisationer och institutioner.Intervjuer och fokusgruppsamtal med ett antal matematiklärare från diverse gymnasieskolor har spelats in och detaljerat analyserats genom transkriberingar. Den metodanalytiska och den teoretiska ansatsen från grundad teori har succesivt lett till urskiljandet av åtta typer av bedömningsstrategier: den intuitiva, den inväntande, den kontinuerliga, den likvärdiga, den målinriktade, den provinriktade, den undervisningskopplade samt självbedömningsstrategin och till en teori om hur lärare beskriver och reflekterar om bedömning i matematik på gymnasiet. Strategierna uppvisar en rikedom i lärarnas resonemang om bedömning. Teorin har avslutningsvis fört studien till ett antal begrepp och tillhörande kategoriseringar som har underättat förstaelsen av lärarnas handlingar och resonemang inom matematikbedömningen på gymnasiet.
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| 4. |
- Bennermo, Marie, et al.
(författare)
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Genetic and environmental influences on the plasma interleukin-6 concentration in patients with a recent myocardial infarction : a case-control study
- 2011
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Ingår i: Journal of Interferon and Cytokine Research. - : Mary Ann Liebert Inc. - 1079-9907 .- 1557-7465. ; 31:2, s. 259-264
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study the stimuli responsible for triggering and sustaining the plasma concentration of the inflammatory marker interleukin-6 (IL-6) in patients with a first myocardial infarction before the age of 60 and healthy control subjects matched for age and sex. The plasma IL-6 concentration, antibodies against Chlamydia pneumoniae, cytomegalovirus, Epstein-Barr virus, Helicobacter pylori, herpes simplex type 1 and 2, and genotype for the IL6-174 G>C single-nucleotide polymorphism were determined 3 months after the acute event. The results showed that patients had higher IL-6 levels than control subjects, whereas there were no differences regarding individual or total number (pathogen burden) of positive antibody tests against the different pathogens or IL6 genotype distribution. The plasma IL-6 concentration was associated with the number of positive antibody tests in patients and control subjects, whereas patients irrespective of IL6 genotype had increased IL-6. Multivariate analysis, including traditional coronary heart disease risk factors, antibodies against pathogens, and IL6 genotype, explained 17% of the variation of the plasma IL-6 concentration. Neither pathogen burden nor IL6 genotype did contribute to the variation of plasma IL-6 levels, whereas smoking, body-mass index, hypertension, case-control status, and age were determinants of the plasma IL-6 concentration.
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| 5. |
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| 6. |
- Ericsson, Claes, 1947-, et al.
(författare)
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En start för tänket, en bit på väg : Analys av ett utvecklingsprojekt kring kultur och estetik i skolan
- 2007
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- En start för tänket, en bit på väg beskriver och analyserar ett utvecklingsprojekt kring kultur och estetiska lärprocesser. Några skolor i Värmland deltog under tre års tid i det så kallade pilotskoleprojektet, vars huvudsyfte var att ta fram modeller för hur en estetisk dimension skulle kunna genomsyra verksamheten i skolan. Boken har både ett teoretiskt och ett praktiskt anslag. Det teoretiska yttrar sig dels i en genomgång av forskningsläget i Sverige, dels i en diskussion av undersökningsdeltagarnas sätt att definiera en estetisk lärprocess och den kunskapsbildning som kommer till stånd i en sådan. Det praktiska yttrar sig i att de respektive skolornas konkreta arbete skildras. Förutom att boken kan betraktas som en utvärdering av arbetet och sålunda kan utgöra ett underlag för diskussion och reflektion vid de deltagande skolorna, kan den ses som en kunskapsbank för andra skolor som vill fördjupa arbetet med kultur och estetik. Den torde också med fördel kunna användas inom lärarutbildningar där dess dubbla fokus på teori och praktik svarar mot den målsättning som uttrycks i styrdokumenten. Författarna Claes Ericsson och Monica Lindgren har lång erfarenhet av såväl undervisning i estetiska uttrycksmedel i skola och lärarutbildning som av forskning kring kultur och estetik i skolan.
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| 8. |
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| 10. |
- Ericsson, Claes
(författare)
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Från guidad visning till shopping och förströdd tillägnelse: moderniserade villkor för ungdomars musikaliska lärande.
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abstract In the Swedish compulsory school system there is a trend towards increased student influence. School ideologists have for at least ten years strongly emphasised this issue. This tendency is in line with a more general direction in Western societies, which in many aspects has moved toward individualisation. Based on these developments, the main reason for undertaking the presents study was to contribute to the discussion about different aspects of learning, which have as their starting point the issue of how adolescents experience musical learning. The study moves in and between the two fields of musical learning in school and in leisure time, and the data consists of seven group conversations carried out with eighth and ninth graders in secondary school. The analysis is undertaken in three steps, each one of which represents a gradually increasing level of abstraction. The theory is grounded on two different areas which have some common aspects, namely theories of modernity and philosophy of music education. The results show that value related issues such as preference and interpretation in the greatest possible extent should be left to the students, and the teacher should instead provide help to students by giving them tools for expression, such as training skills and providing a suitable milieu for musicing. Adolescents give expression to an apprehension that an important task of the school subject music is to expose musical genres and activities, whereupon the students can then choose what suits them. This way of acquiring music does not correspond to the way in which students assimilate music in everyday contexts and highlights a contradiction between how they legitimise musical learning in school and in leisure time. In their leisure time, students acquire preferences for music in an unsystematic and random manner. Their discussions strongly emphasise a search for music “to call their own”. Furthermore, the study shows that learning often occurs in situations where it is not intentional, for example when music listening is a background activity, but still an analysis of musical parameters takes place in an unconscious matter. Some of the adolescents consider ability to collaborate as the most important knowledge that comes out of music education in school. This attitude can be seen as a move from content to form. Two main discourses were identified: the discourse music and the discourse the school subject music. The discourse music is wide and embraces music in leisure time as well as in school. It consists of listening and musicing. The discourse the school subject music is narrow and legitimised only through its position as a school subject. The study also shows that musical learning has a therapeutical dimension and can be considered as a means to strengthen the self. This function seems to be an important end in musical activities. Finally, modern aesthetical values were applied to a post modern context, which implies that the aesthetics of modernity is still alive, and occupying a new body. Music educators in schools ought to consider the above outlined modernised conditions for musical learning, and thereby reflect upon the implications they might bring for music education.
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