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- Brolin, S, et al.
(författare)
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COMPARISON OF EDUCATIONAL NEEDS AMONG PATIENTS WITH ANCA ASSOCIATED VASCULITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS - A PILOT STUDY USING THE EDUCATIONAL NEEDS ASSESSMENT TOOL.
- 2022
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Ingår i: ANNALS OF THE RHEUMATIC DISEASES. - : BMJ. - 0003-4967 .- 1468-2060. ; 81, s. 1106-1106
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Patients with chronic disease need to learn and adapt to symptoms, treatment, and the impact of disease. Knowledge about the specific disease is one way to empower the patients to cope. We previously reported that disease duration and sex, rather than disease characteristics associate with an increased need of educational support in ANCA associated vasculitis (AAV) (1). Data on how specific educational needs vary between different inflammatory rheumatic diseases are lacking.ObjectivesThe aim of the study was to compare educational needs among two chronic systemic inflammatory diseases, AAV and Systemic lupus erythematosus (SLE) using the Educational Needs Assessment Tool (ENAT).MethodsThis pilot study included cross-sectional data from two separate cohorts, AVV and SLE, from the Rheumatology clinic at Karolinska University Hospital in Sweden during 2009-2022. Inclusion criteria were minimum age of 18 years and literate in Swedish. Exclusion criterion was cognitive impairment interfering with literate capabilities.Educational needs were captured by patients’ answers to the questionnaire ENAT. The ENAT consists of 39 questions, presented as total ENAT and seven domains (managing pain, movement, feelings, disease process, treatment, self-management and, support systems) each containing 4-7 items (from ’not at all important’ = 0, to ‘extremely important’ = 3). The participants’ responses were presented as “mean % of the domain score”, from 0 interpreted as no educational need to 100 as highest educational need. Participants with AAV and SLE respectively were individually matched for disease duration, sex, and education. For comparisons paired samples t-test were used.ResultsTwenty-two matched pairs (86% female), mean (SD) disease duration 5.7 (8) years, were included. The mean age were 43 (14.0) years for AAV 61 and (14.7) years for SLE (p=0.001). Educational length was reported as mean 14 (3.6) years among SLE patients and 13 (2.9) years among AAV patients (p=0.111).In all patients, the mean total ENAT was 60.4% (range 23-100%) and did not differ between the two cohorts (p=0.2) (Table 1). In the pooled group the highest educational need was found in the domains ‘Disease process’ (mean 78.3%) and ‘Self-management’ (mean 75.9%). Lowest educational need was found in the domains ‘Movement’ (mean 46.7%) and ‘Managing pain’ (mean 51.6%).Table 1.Comparison of ENAT scores (mean % of max) (SD) between patient with SLE and AAVENAT domainAll n=44SLE n=22AAV n=22pManaging pain51.6 (29.8)50.8 (28.7)52.4 (32.2)0.867Movement46.7 (35.1)41.9 (34.2)49.2 (35.7)0.500Feelings63.1 (31.0)54.6 (30.6)70.4 (30.3)0.087Disease process78.3 (22.1)73.9 (23.0)83.4 (20.9)0.130Treatments60.7 (35.1)46.4 (36.0)74.2 (30.4)0.021Self-management75.9 (21.1)75.8 (18.8)76.9 (24.3)0.886Support systems54.0 (30.2)49.2 (31.4)58.7 (28.8)0.302Total ENAT60.4 (24.0)55.7 (22.8)65.0 (24.8)0.216Patients with AAV report a higher educational need in total ENAT as well as in all individual domains, compared to SLE (Table 1), but only significantly in the domain ‘Treatments’ where the educational need among AAV was mean 74.2% (30.4) and for SLE mean 46.4% (SD 36.0) (p = 0.02).ConclusionIn this pilot study with SLE and AAV, we found educational needs regarding ‘Treatments’ to be substantially increased among the participants with AAV, compared to SLE, despite that the participants were matched for disease duration and sex, two variables previously found to be indicators of increased educational needs. AAV patients with higher educational needs were older, this result needs to be further explored in a larger sample.References[1]Brolin S, Lövström B, et al. POS1476-HPR The need for information among patients with anca associated vasculitis differs between groups. Annals of the Rheumatic Diseases. 2021;80(Suppl 1):1023.AcknowledgementsWe are grateful to the participating patients, and colleagues assisting in the data collection.Disclosure of InterestsNone declared
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- Brolin, S., et al.
(författare)
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THE NEED FOR INFORMATION AMONG PATIENTS WITH ANCA ASSOCIATED VASCULITIS DIFFERS BETWEEN GROUPS
- 2021
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ Publishing Group Ltd. - 0003-4967 .- 1468-2060. ; 80:Suppl. 1, s. 1023-1023
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Being diagnosed with ANCA associated vasculitis (AAV) can be a frightening experience and means facing changes that involves adapting to new situations1. Patients that are provided adequate information are better equipped to make well informed decisions regarding their care and stay compliant to the treatment plan. In order to provide adequate patient-centered information at the appropriate time and to identify those who may need extra support, the information needs must be explored2. There have been several studies on the information needs of rheumatological patients, although very few studies for patients with AAV.Objectives:The aim of this study was to explore what information patients with AAV need from their rheumatological team and how it differs between groups (gender, disease duration).Methods:Men and women over 18 years were included through a consecutive sample from a Rheumatology or Nephrology Clinic at Karolinska University Hospital in Sweden during 2008-2019. Patients with all forms of AAV (GPA, MPA and EGPA), that had the Rheumatology clinic as primary contact, were included.The participants were given Educational Needs Assessment Tool (ENAT) that measures the patient’s information needs3. The initial question, ‘Do you need information right now about something that can help you with your rheumatic disease?’ is answered yes/no. ENAT then includes 7 domains (Managing pain, Movement, Feelings, Disease process, Treatments, Self-help measures and Support systems) each containing 4-7 items (4-point Likert scale, ’not at all important = 0’ to ‘extremely important = 3’). The total sum is divided by the maximum score and gives the percentage response of maximum score (0-100%), 0% meaning no information need and 100% highest information need. The responses are presented as “mean % of the domain score”. Independent-sample t-test was used to compare the mean between groups. One way ANOVA was used to compare the mean domain score between the different diagnoses and age groups.Results:178 individuals completed the questionnaire, equally divided by gender. Age ranged from 18-85, median 61. 33,7% had been diagnosed within 2 years.The mean total score was 56,8 % of the highest possible score (0-100%). The highest information need was found in the domains ‘Disease process’ (78,1%), ‘Self-help measures’ (68,5%) and ‘Treatments’ (63,6%) whereas lesser need for information was found in the domains ‘Managing pain’ (47,5%), ‘Support systems’ (46,5%) and ‘Movement’ (41,1%). The domain ‘Feelings’ was scored as moderate (55,5%).Those who acknowledge a present information need also scored significantly higher overall in all the domains. Disease duration and gender showed significantly affect the information need. Highest scores were found among women with a disease duration < 2 years with significant difference in 3/7 domains. Age, disease activity, diagnosis and social status did not affect the ENAT scores.Conclusion:Even though only 38% of participants stated a current need for information, the results indicate that there are certain areas that patients with AAV consider important to receive more information about. Special consideration needs to be taken to women with short disease duration since they were shown to have a significantly higher need for information.References:[1]Mooney, J., et al. (2013). ‘In one ear and out the other - it’s a lot to take in’: a qualitative study exploring the informational needs of patients with ANCA-associated vasculitis. Musculoskeletal Care, 11(1)[2]Ntatsaki, E., et al. (2014). BSR and BHPR guideline for the management of adults with ANCA-associated vasculitis. Rheumatology (Oxford), 53(12)[3]Hardware, B., et al. (2004). Towards the development of a tool to assess educational needs in patients with arthritis. Clinical Effectiveness in Nursing, 8(2)Disclosure of Interests:None declared
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- Eliasson, Adrian, et al.
(författare)
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Highly Ductile Cellulose-Rich Papers Obtained by Ultrasonication-Assisted Incorporation of Low Molecular Weight Plasticizers
- 2023
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Ingår i: ACS Sustainable Chemistry and Engineering. - : American Chemical Society (ACS). - 2168-0485. ; 11:24, s. 8836-8846
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Tidskriftsartikel (refereegranskat)abstract
- Ultrasonication was used as a mean toincorporate glycerolor urea, yielding paper films with a ductility of up to 35%. Fiber-based materials are attractive sustainable alternativestofossil-based plastics, however, the lack of ductility (i.e., brittleness)limits their applicability in complex shapes as are often utilizedfor plastics. In this study, we hypothesize that it is possible toenhance the ductility of a cellulose-rich material by the incorporationof low molecular weight plasticizers (glycerol, urea, citric acid,and tannic acid). However, no significant effects could be observedafter swelling in the presence of plasticizers. To enhance any potentialeffect, it was decided to employ ultrasonication to mechanically disintegratethe fiber and aid the sorption of plasticizer prior to formation ofsheets from the treated fibers. Glycerol or urea in combination withultrasonication resulted in both internal and external fibrillationof the fibers, and it could be observed that the resulting fines createa film at the surface of the fibers in the formed sheets. Tensiletesting shows that this gives rise to a 100% increase in ductilitycompared to sheets from untreated fibers. The use of citric or tannicacid has the opposite effect, reducing ductility to a third of thatof the reference sheet. This is suggested to be due to the formationof covalent cross-links in the treated fibers, which also leads todifferent internal and external fibrillation mechanisms, as observedby scanning electron microscopy. The exceptionally high improvementof the strain-at-break for sheets from the glycerol- and urea-treatedfibers suggests that low molecular weight plasticizers affect theinternal properties of the fiber wall as well as the interactionsbetween the fine material forming in-between the fibers. The findingsfrom the current study suggest that the proposed approach to obtainductile cellulose-rich materials holds promise for the future, butit is also clear that more in-depth research is required to obtaina mechanistic understanding and release the full potential.
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- Hanson, Lars, et al.
(författare)
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Industrial path solutions - intelligently moving manikins
- 2019
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Ingår i: DHM and Posturography. - London : Academic Press. - 9780128167137 ; , s. 115-124
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- IPS IMMA (Industrial Path Solutions - Intelligently Moving Manikins) is a digital human modeling tool developed in close cooperation between academia and industry in Sweden. The academic consortium behind the software consists of expertise within applied mathematics, ergonomics, and engineering. The development of IMMA was initiated from the vehicle industries’ need of an effective, efficient, objective, and user-friendly software for verification of manufacturing ergonomics. The ‘Industrial path solutions - intelligently moving manikins’ chapter consists of two main sections: the first about the commercially available tool, and the second about current or recent research projects developing the software further. Commercial IPS IMMA is presented by describing the biomechanical model and appearance, anthropometrics module, motion prediction, instruction language, and ergonomics evaluation. The research projects focus on dynamic motions simulation, muscle modelling and application areas such as human-robot collaboration, occupant packaging, and layout planning.
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- Parenteau, Chantal S., 1969, et al.
(författare)
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Restrained Male and Female Occupants in Frontal Crashes: Are We Different?
- 2013
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Ingår i: 2013 IRCOBI Conference Proceedings. - 2235-3151.
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Konferensbidrag (refereegranskat)abstract
- The safety community is questioning the effect of gender on the performance and assessment ofoccupant protection systems. This study consists of: 1) an investigation of NASS‐CDS data with belted occupantsinvolved in frontal vehicle crashes and 2) a comparison of dummy responses in two matched frontal tests.Because of recent work on a 50th female dummy neck, focus was placed on neck responses. An assessment ofcervical facet angles was also carried out from computed tomography (CT) scans of 423 adult patients.The NASS‐CDS data showed that the relative risk of being seriously injured was higher in females than inmales for crash severities up to 65 km/h. Females had higher overall risks of serious injury in all body regionsexcept for the head and the abdomen. In 25 to 65 km/h crashes, females were more at risk of spine injuriesthan males. In the matched tests, the normalized results showed overall higher biomechanical responses in thefemale than in the male dummy, in particular in the neck region. Airbag interaction with the head/neck complexwas noted with the female dummy. The CT scan data indicated that the cervical facet angles increased with age,becoming more horizontal. The increase was greater in females than in males. The quantification of anatomicalchanges associated with gender is needed to improve physical and/or numerical tools used to assess occupantresponses and to understand differences in injury patterns.
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- Reid, Michael S., et al.
(författare)
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Dewatering of Micro- and Nanofibrillated Cellulose for Membrane Production
- 2023
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Ingår i: ACS Sustainable Chemistry and Engineering. - : American Chemical Society (ACS). - 2168-0485. ; 11:46, s. 16428-16441
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Tidskriftsartikel (refereegranskat)abstract
- Cellulose-based membranes have tremendous potential to improve the sustainability and performance of high value applications, such as filters and energy devices, particularly as fluorinated compounds are becoming more regulated. Yet, a deeper understanding of how cellulose films are formed and their structure, in both the wet and dry state, is needed to meet application specific demands and scale-up. We investigated cellulose dewatering using dead-end filtration and the effect of particle size, pressure, temperature, ionic strength, and pH were explored. Dewatering times, filtration cake resistance and compressibility of microfibrillated celluloses (MFCs) and cellulose nanofibrils (CNFs), (and a combination thereof) were measured to understand the role of fibrillation and intermolecular forces during dewatering and forming of membranes. In this fundamental work, dewatering behavior was well described by conventional filtration theory and increasing the pressure from 1 to 4 bar reduced dewatering times by one-half with no significant impact on the mechanical properties. Cake compressibility was found to be directly related to particle size and degree of fibrillation, indicating that finer grades of MFCs and CNFs could be more effectively dewatered at higher pressures. Adjusting pH and ionic strength of cellulose dispersions could similarly reduce dewatering times, yet impacted the wet and dry mechanical properties. This work serves as a basis to better understand the structure-property relationships that develop during dewatering of MFCs and CNFs.
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