| 1. |
- Paulin, Dan, 1971, et al.
(författare)
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Technology-assisted sharing of knowledge in industrialization processes
- 2017
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- During the industrialization phase of an R&D process, securing inter- and intra-organ- izational knowledge sharing between functions and units is vital. In this contribution, we present facilitating, inhibiting and obstructing factors influencing technology-assisted knowledge sharing between manufacturing engineering and assembly. Examples from automotive and aerospace companies are presented.
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| 2. |
- Algurén, Beatrix, et al.
(författare)
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A scoping review and mapping exercise comparing the content of patient-reported outcome measures (PROMs) across heart disease-specific scales
- 2020
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Ingår i: Journal of Patient-Reported Outcomes. - : Springer. - 2509-8020. ; 4:1
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Forskningsöversikt (refereegranskat)abstract
- BACKGROUND: Over the past decade, the importance of person-centered care has led to increased interest in patient-reported outcome measures (PROMs). In cardiovascular care, selecting an appropriate PROM for clinical use or research is challenging because multimorbidity is often common in patients. The aim was therefore to provide an overview of heart-disease specific PROMs and to compare the content of those outcomes using a bio-psycho-social framework of health.METHODS: A scoping review of heart disease-specific PROMs, including arrhythmia/atrial fibrillation, congenital heart disease, heart failure, ischemic heart disease, and valve diseases was conducted in PubMed (January 2018). All items contained in the disease-specific PROMs were mapped to WHO's International Classification of Functioning, Disability and Health (ICF) according to standardized linking rules.RESULTS: A total of 34 PROMs (heart diseases in general n = 5; cardiac arrhythmia n = 6; heart failure n = 14; ischemic heart disease n = 9) and 147 ICF categories were identified. ICF categories covered Body functions (n = 61), Activities & Participation (n = 69), and Environmental factors (n = 17). Most items were about experienced problems of Body functions and less often about patients' daily activities, and most PROMs were specifically developed for heart failure and no PROM were identified for valve disease or congenital heart disease.CONCLUSIONS: Our results motivate and provide information to develop comprehensive PROMs that consider activity and participation by patients with various types of heart disease.
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| 3. |
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| 4. |
- Arenhall, Eva, 1974-, et al.
(författare)
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The male partners' experiences of the intimate relationships after a first myocardial infarction
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:2, s. 108-114
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Tidskriftsartikel (refereegranskat)abstract
- Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
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| 5. |
- Bergman, Eva, et al.
(författare)
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Does one's sense of coherence change after an acute myocardial infarction?: A two-year longitudinal study in Sweden.
- 2011
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Ingår i: Nursing and Health Sciences. - : Blackwell Publishing Asia Pty Ltd. - 1441-0745 .- 1442-2018. ; 13:2, s. 156-163
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess changes in the sense of coherence of patients who had suffered their first myocardial infarction. Out of 100 patients at the start of the study, these changes were evaluated in 66 men and 18 women aged 36–70 years. Generally, the sense of coherence was found to be stable among the whole group, but there were significant individual variations in its development in some of the participants over the following years. Even the individuals with an initally high sense of coherence could experience a decrease in its level. The changes that were found in the men can be explained by their marital status, level of treatment satisfaction, disease perception/quality of life, physical limitation, and alcohol intake and/or tobacco use at the baseline. An unexpected finding was that the single men with an initially high sense of coherence experienced a decreased level over time. In order to maintain or increase patients' sense of coherence, it is important for nurses to help them identify their risk factors and to provide conditions for individualized cardiac rehabilitation in order to avoid another myocardial infarction.
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| 6. |
- Bergman, Eva, et al.
(författare)
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Longitudinal study of patients after myocardial infarction : Sense of coherence, quality of life, and symptoms
- 2009
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 38:2, s. 129-140
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Myocardial infarction has pronounced effects on an individual that demand changes in lifestyle. Health is influenced by whether the individual experiences the world as comprehensible, meaningful, and manageable, that is, has a sense of coherence (SOC). High SOC scores indicate that the individual probably manages the situation by understanding the context and connections: action and effect. OBJECTIVE: The study objective was to identify the SOC, assess the quality of life (Short Form-12 Health Survey Questionnaire), assess the symptoms using the Seattle Angina Questionnaire, and create health curves from a baseline for patients with a first myocardial infarction. METHODS: A longitudinal and predictive Study of 100 participants in the heart care unit of a county hospital in southern Sweden was performed. RESULTS: Women score lower on SOC than men. Persons with high SOC scores have fewer angina attacks, are more physically active, drink more alcohol, are more satisfied with their treatments, and have better disease perception. CONCLUSION: By following SOC scores, a trend emerges that Suggests it may be a useful tool for identifying those who will need extra support.
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| 7. |
- Bergman, Eva, et al.
(författare)
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Meaningfulness is not the most important component for changes in sense of coherence
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 11:3, s. 331-338
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Tidskriftsartikel (refereegranskat)abstract
- Background Sense of coherence is a theoretical construct which is used to measure the degree to which a person finds the world comprehensible, manageable and meaningful.Aim The main aim of the present study was to assess the hypothesis of Antonovsky that meaningfulness is the most crucial component in sense of coherence. The second aim was to explore the importance of its components and factors at baseline on sense of coherence changes and if the findings can be used in cardiac rehabilitation.Methods One hundred patients, who suffered a primary myocardial infarction were followed during two years. The instruments used were; sense of coherence questionnaire-13, 12-item short-form health survey questionnaire, the Seattle Angina Questionnaire and Health Curve.Results Thirty-nine percent of the participants fulfilled Antonovsky's hypothesis. Comprehensibility and the baseline factors of smoking, alcohol use, marital status and disease perception proved to be of importance for sense of coherence changes over time.Conclusion The hypothesis that meaningfulness is the most crucial component in sense of coherence is rejected for patients with primary myocardial infarction. Comprehensibility is more important than meaningfulness for changes in sense of coherence. Nurses therefore have an important task to increase comprehensibility and sense of coherence by providing information and knowledge about myocardial infarction and lifestyle changes at an early stage. The information should be given in an individualized and easily understandable way from a salutogenic perspective, which means to identify and work with factors that can contribute to preserving and promoting health.
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| 8. |
- Bergman, Eva, et al.
(författare)
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The impact of comprehensibility and sense of coherence in the recovery of patients with myocardial infarction : a long-term follow-up study
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 11:3, s. 276-283
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Tidskriftsartikel (refereegranskat)abstract
- Background: After being through a myocardial infarction (MI), a severe recovery period ensues for the patient. Longterm follow-ups are helpful, but what this should include differs between patients. Today there is no established approach to identify needs for support after an MI. Aim: The aim was to describe sense of coherence (SOC) over time in relation to sex, as well as further SOC in relation to quality of life (QoL) and treatment satisfaction in patients with an MI. Methods. This study had an observational and longitudinal design and followed 18 women and 60 men with an acute MI for 49-67 months after the onset of MI. Instruments used were the SOC-13 and the Seattle Angina Questionnaire. Results: Women scored lower SOC than men. A main effect of time was shown for comprehensibility which increased significantly from baseline to the long-term follow-up. Women increased from a lower level to an equal level as men at the long-term follow-up. The total SOC was significantly associated with QoL and treatment satisfaction. Conclusion: High comprehensibility and high SOC give the patient a better basis to handle life after MI. Thus, healthcare professionals should keep in mind that SOC and especially comprehensibility have meaning for the patient's ability to handle her or his recovery. Healthcare professionals need to together with the patient identify and work with lifestyle factors that contribute to increased comprehensibility about the disease, which gives the patient the foundation to preserve and promote her or his health both in the short and long term.
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| 9. |
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| 10. |
- Brahm, Carl-Otto, et al.
(författare)
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Patients with head and neck cancer treated with radiotherapy : Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures
- 2021
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Ingår i: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:5, s. 894-902
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The impact of dental occlusion on the experiences of head and neck cancer patients and their oral, social and psychological functioning has been sparsely investigated. There is a lack of knowledge regarding the experience of tooth loss and dentures among patients treated for head and neck cancer. The aim of this study was to describe the experiences of head and neck cancer patients of prophylactic tooth extractions and temporary removable dentures, 6 months after radiotherapy treatment. Material and methods: An individual interview with 25 patients 6 months after radiotherapy was subjected to a qualitative content analysis. Results: Two categories, Impaired oral function and Belief in the future, and seven subcategories described the patients' experiences of temporary removable dentures during the first 6 months after prophylactic tooth extractions. The temporary removable dentures affected the patients' ability to chew, swallow and speak, caused pain, and were experienced as an enemy. Despite that, the patients were hopeful and had a wish for recovery, which gave them the energy to live. Conclusion: Prophylactic tooth extractions and temporary removable dentures 6 months after radiotherapy treatment affect head and neck cancer patients' recovery and everyday life. However, they have the will to take on these challenges, pertaining not only to themselves, but also to relatives and health professionals. At the individual level, the patient needs individualized professional support to get through the arduous procedure, from the acute situation until the end of the rehabilitation phase.
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| 11. |
- Capriata, Corrado Carlo Maria
(författare)
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Dynamics and Intrinsic Variability of Spintronic Devices
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Spintronics is a scientific domain focusing on utilizing electron spin for information processing. This is the element that distinguishes it from electronics, which only utilizes the charge of electrons. A common purpose of spintronic devices is to implement additional functionalities to state-of-the-art Complementary Metal-Oxide Semiconductor (CMOS) technology. The aim of this work was to assess the intrinsic variabilities of Nano-Constriction Spin Hall Nano-Oscillators (NC-SHNOs) and the dynamics of Perpendicular Magnetic Tunnel Junctions (pMTJs). The first part of the thesis focuses on NC-SHNO and two-dimensional arrays. They are nanometer-sized microwave oscillators, allowing for a wide frequency tuning range, and are compatible with CMOS Back End Of Line (BEOL). These devices are based on a heavy metal/ferromagnetic bilayer. Environmental conditions during processing, fabrication techniques, and temperature of operation can all create variabilities in the device's functioning. Crystallization grains naturally form during the sputtering of the metals. Atomic Force Microscope (AFM) characterization showed the grains being of different shapes, about 30 nm in size. Here, the aim was to develop a simulation technique based on importing the measured grain structure into micromagnetic simulations. Their results match the device-to-device variability and multi-modal behavior found in microwave measurements. Moreover, the presence of grains influences the synchronization of the arrays.The second part of this work focuses on pMTJ. These non-volatile memory elements have two metastable states, parallel (P) and antiparallel (AP), separated by an energy barrier Eb. Here, the aim was to show their potential as True Random Number Generators (TRNGs). A pulse-activated measurement set-up was used to realize random bitstreams. The randomness was confirmed by the National Institute of Standards and Technology Statistical Testing Suite (NIST-STS). After one whitening Exclusive OR (XOR) stage, all tests were successfully passed.The assessment was completed with the development of a model describing both macrospin and domain wall-mediated magnetization reversals, i.e. switching between P and AP. The analysis of the reversal dynamics was carried out with micromagnetic simulations and String Method calculations. As expected, Eb is lowered by the field and by decreasing the device size. This allows for faster fluctuations, marking the device as a potential TRNG. Both the switching attempt frequency and the energy barrier were explored by finite-temperature micromagnetic simulations.This thesis shows the potential of realistic simulations combined with measurements to assess oscillators. It also shows the efficacy of spintronic devices as 10s-MHz TRNG.
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| 12. |
- Dalteg, Tomas, et al.
(författare)
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Associations of Emotional Distress and Perceived Health in Persons With Atrial Fibrillation and Their Partners Using the Actor–Partner Interdependence Model
- 2016
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Ingår i: Journal of Family Nursing. - : SAGE Publications. - 1074-8407 .- 1552-549X. ; 22:3, s. 368-391
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Tidskriftsartikel (refereegranskat)abstract
- Individual behavior affects and is affected by other people. The aim of this study was to examine if emotional distress in patients with atrial fibrillation (AF) and their spouses was associated with their own and their partner’s perceived health. Participants included 91 dyads of patients and their spouses. Emotional distress was measured using the Hospital Anxiety and Depression Scale and perceived health was measured with the Short Form 36 Health Survey. The Actor–Partner Interdependence Model was used for dyad-level analyses of associations, using structural equation modeling. Higher levels of anxiety and depression were associated with lower levels of perceived health in patients and spouses. Higher levels of depression in patients were associated with lower levels of vitality in spouses and vice versa. As AF patients and their spouses influence each other, health-care interventions should consider the dyad to address dyadic dynamics. This may benefit the health of the individual patient and of the couple.
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| 13. |
- Dalteg, Tomas, et al.
(författare)
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Cardiac Disease and its Consequences on the Partner Relationship : A Systematic Review
- 2011
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:3, s. 140-149
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Cardiac disease is a chronic illness that has extensive impact on patients and their partners. No previous review has been made on how the partner relationship is affected following cardiac disease. The review limited itself to the main cardiac disease of myocardial ischemia, arrhythmia and heart failure. AIM: The aim of this review was to identify how the partner relationship is affected following cardiac disease after hospital discharge.METHOD: CINAHL, PubMed and PsycINFO were searched from 1999 to 2009. Quality assessment of included articles was made using the Joanna Briggs Institute Reviewers' Manual. A total of 20 articles were included.RESULTS: Five themes identified how the partner relationship is affected following cardiac disease, namely: overprotection, communication deficiency, sexual concerns, changes in domestic roles, and adjustment to illness. Patients reported feeling overprotected by their spouses which occasionally served as a fertile ground for arguments or conflicts. Most couples experienced some implications concerning their sexual life following cardiac disease, though in various degrees. Both patients and partners seemed to experience communication deficiency concerning emotions within their relationship following the event. Most couples experienced a shift in roles and responsibilities within their partner relationship. Even though most couples experienced great distress following being afflicted with cardiac disease they reported that the disease had brought them closer together.CONCLUSION: The review found that though couples found the cardiac event distressful they conformed and adjusted their relationship to the new situation.
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| 14. |
- Dalteg, Tomas, et al.
(författare)
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Managing uncertainty in couples living with atrial fibrillation
- 2014
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 29:3, s. E1-E10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Living with a chronic disease such as atrial fibrillation (AF) not only affects the patient but also has implications for the partner. There is a lack of research on couples living with AF and, in particular, how they experience and deal with the disease.Objective: The aim of this study was to explore couples’ main concerns when one of the spouses is afflicted with AF and how they continually handle it within their partner relationship.Methods: Classical grounded theory was used throughout the study for data collection and analysis. Interviews were conducted with 12 couples (patient and partner together). There were follow-up interviews with 2 patients and 2 partners separately.Results: Couples living with AF experience uncertainty as a common main concern. This uncertainty was fundamentally rooted in not knowing the cause of AF and apprehension about AF episodes. Couples managed this uncertainty by either explicitly sharing concerns related to AF or through implicitly sharing their concerns. Explicit sharing incorporated strategies of mutual collaboration and finding resemblance, whereas implicit sharing incorporated strategies of keeping distance and tacit understanding. Time since diagnosis and time being symptom-free were factors influencing afflicted couples’ shifting between implicit and explicit sharing.Conclusions: Atrial fibrillation affects the partner relationship by bringing uncertainty into couples’ daily lives. Even though this study shares similarities with previous studies on couples living with chronic disease, it contributes to the existing knowledge by presenting a set of strategies used by couples in managing uncertainty when living with AF.
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| 15. |
- Dalteg, Tomas
(författare)
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Partner relationship in couples living with atrial fibrillation
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to describe and explore how the partner relationship of patient–partner dyads isaffected following cardiac disease and, in particular, atrial fibrillation (AF) in one of the spouses.The thesis is based on four individual studies with different designs: descriptive (I), explorative (II, IV), and cross-sectional (III). Applied methods comprised a systematic review (I) and qualitative (II, IV) and quantitative methods (III). Participants in the studies were couples in which one of the spouses was afflicted with AF. Coherent with a systemic perspective, the research focused on the dyad as the unit of analysis. To identify and describe the current research position and knowledge base, the data for the systematic review were analyzed using an integrative approach. To explore couples’ main concern, interview data (n=12 couples) in study II were analyzed using classical grounded theory. Associations between patients and partners (n=91 couples) where analyzed through the Actor–Partner Interdependence Model using structural equation modelling (III). To explore couples’ illness beliefs, interview data (n=9 couples) in study IV were analyzed using Gadamerian hermeneutics.Study I revealed five themes of how the partner relationship is affected following cardiac disease: overprotection, communication deficiency, sexual concerns, changes in domestic roles, and adjustment to illness. Study II showed that couples living with AF experienced uncertainty as the common main concern, rooted in causation of AF and apprehension about AF episodes. The theory of Managing Uncertainty revealed the strategies of explicit sharing (mutual collaboration and finding resemblance) and implicit sharing (keeping distance and tacit understanding). Patients and spouses showed significant differences in terms of self-reported physical and mental health where patients rated themselves lower than spouses did (III). Several actor effects were identified, suggesting that emotional distress affects and is associated with perceived health. Patient partner effects and spouse partner effects were observed for vitality, indicating that higher levels of symptoms of depression in patients and spouses were associated with lower vitality in their partners. In study IV, couples’ core and secondary illness beliefs were revealed. From the core illness belief that “the heart is a representation of life,” two secondary illness beliefs were derived: AF is a threat to life, and AF can and must be explained. From the core illness belief that “change is an integral part of life,” two secondary illness beliefs were derived: AF is a disruption in our lives, and AF will not interfere with our lives. Finally, from the core illness belief that “adaptation is fundamental in life,” two secondary illness beliefs were derived: AF entails adjustment in daily life, and AF entails confidence in and adherence to professional care.In conclusion, the thesis result suggests that illness, in terms of cardiac disease and AF, affected and influenced the couple on aspects such as making sense of AF, responding to AF, and mutually incorporating and dealing with AF in their daily lives. In the light of this, the thesis results suggest that clinicians working with persons with AF and their partners should employ a systemic view with consideration of couple’s reciprocity and interdependence, but also have knowledge regarding AF, in terms of pathophysiology, the nature of AF (i.e., cause, consequences, and trajectory), and treatments. A possible approach to achieve this is a clinical utilization of an FSN based framework, such as the FamHC. Even if a formalized FSN framework is not utilized, partners should not be neglected but, rather, be considered a resource and be a part of clinical caring activities. This could be met by inviting partners to take part in rounds, treatment decisions, discharge calls or follow-up visits or other clinical caring activities. Likewise, interventional studies should include the couple as a unit of analysis as well as the target of interventions.
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| 16. |
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| 17. |
- Dalteg, Tomas, et al.
(författare)
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The heart is a representation of life : an exploration of illness beliefs in couples living with atrial fibrillation
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 16:Suppl. 1, s. S41-S41
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To explore illness beliefs in couples where one spouse has atrial fibrillation.& para;& para;Background. Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation.& para;& para;Design. A qualitative hermeneutic design.& para;& para;Methods. Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation.& para;& para;Results. The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief 'The heart is a representation of life', two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief 'Change is an integral part of life', two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief 'Adaptation is fundamental in life', two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care.& para;& para;Conclusion. Couples' interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.
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| 18. |
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| 19. |
- Ekblad, Helena, et al.
(författare)
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Patients' well-being : experience and actions in their preventing and handling of atrial fibrillation
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:2, s. 132-139
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atrial fibrillation (AF) influences the lives of patients in the form of worsened well-being. Patients’ own experience of and how to handle AF is rarely investigated. These are important aspects for healthcare services to understand in order to support the well-being of patients with AF.Aim: To explore and describe critical incidents in which patients experience how AF affects their well-being and what actions they take to prevent and handle it.Design and methods: An explorative, descriptive design based on the critical incident technique (CIT) was used. Interviews were conducted with 25 patients (16 men and 9 women) with AF in a healthcare area in southern Sweden.Results: Patients experienced discomfort and limitations in daily life. The actions they took were self-care related actions and healthcare related actions.Conclusion: AF affects well-being when it is uncomfortable and leads to pronounced limitations in daily life with the patients trying to maintain or restore well-being through adapting and developing strategies for self-care. Patients base the handling of AF on their personal experience.
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| 20. |
- Ekblad, Helena, et al.
(författare)
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The well-being of relatives of patients with atrial fibrillation: a critical incident technique analysis
- 2014
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Ingår i: Open Nursing Journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 8, s. 48-55
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The well-being of relatives of patients having chronic heart diseases (CHD) has been found to be negatively affected by the patient's condition. Studies examining relatives of patients with atrial fibrillation (AF) indicate that their well-being may be affected in a similar manner, but further research is needed.AIM: To explore and describe critical incidents in which relatives of patients experience how AF affects their well-being and what actions they take to handle these situations.DESIGN AND METHOD: An explorative, descriptive design based on the critical incident technique (CIT) was used. Interviews were conducted with 19 relatives (14 women and five men) of patients hospitalised in southern Sweden due to acute symptoms of the AF.RESULTS: The well-being of relatives was found to be affected by their worries (patient-related health), as well as the sacri-ficing of their own needs (self-related health). In handling their own well-being, these relatives adjusted to and supported the patient (practical involvement), along with adjusting their own feelings and responding to the mood of the patients (emotional involvement).CONCLUSION: The well-being of relatives of patients with AF was affected depending on the patients' well-being. In their attempt to handle their own well-being, the relatives adjusted to and supported the patients. Further research is needed in order to evaluate the effects of support to relatives and patients respectively and together.
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| 21. |
- Farahmand, Dan, et al.
(författare)
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Intracranial pressure in hydrocephalus: impact of shunt adjustments and body positions
- 2015
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Ingår i: Journal of Neurology Neurosurgery and Psychiatry. - : BMJ. - 0022-3050 .- 1468-330X. ; 86:2, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- Background The association between intracranial pressure (ICP) and different shunt valve opening pressures in relation to body positions is fundamental for understanding the physiological function of the shunt. Objective To analyse the ICP and ICP wave amplitude (AMP) at different shunt settings and body positions in patients with hydrocephalus. Methods In this prospective study 15 patients with communicating hydrocephalus were implanted with a ligated adjustable ventriculoperitoneal shunt. They also received a portable intraparenchymatous ICP-monitoring device. Postoperative ICP and AMP were recorded with the patients in three different body positions (supine, sitting and walking) and with the shunt ligated and open at high, medium and low valve settings. In each patient 12 10 min segments were coded, blinded and analysed for mean ICP and mean AMP using an automated computer algorithm. Results Mean ICP and mean AMP were lower at all three valve settings compared with the ligated shunt state (p<0.001). Overall, when compared with the supine position, mean ICP was 11.5 +/- 1.1 (mean +/- SD) mm Hg lower when sitting and 10.5 +/- 1.1 mm Hg lower when walking (p<0.001). Mean ICP was overall 1.1 mm Hg higher (p=0.042) when walking compared with sitting. The maximal adjustability difference (highest vs lowest valve setting) was 4.4 mm Hg. Conclusions Changing from a supine to an upright position reduced ICP while AMP only increased at trend level. Lowering of the shunt valve opening pressure decreased ICP and AMP but the difference in mean ICP in vivo between the highest and lowest opening pressures was less than half that previously observed in vitro.
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| 22. |
- Fransson, Eleonor I., et al.
(författare)
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The Association between Job Strain and Atrial Fibrillation : Results from the Swedish WOLF Study
- 2015
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141.
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Atrial fibrillation (AF) is a common heart rhythmdisorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF. Methods: Data from the Swedish WOLF study was used, comprising 10,121 working men and women. Job strain was measured by the demand-control model. Information on incident AF was derived from national registers. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and AF risk. Results: In total, 253 incident AF cases were identified during a total follow-up time of 132,387 person-years. Job strain was associated with AF risk in a time-dependent manner, with stronger association after 10.7 years of follow-up (HR 1.93, 95% CI 1.10-3.36 after 10.7 years, versus HR 1.11, 95% CI 0.67-1.83 before 10.7 years). The results pointed towards a dose-response relationship when taking accumulated exposure to job strain over time into account. Conclusion: This study provides support to the hypothesis that work-related stress defined as job strain is linked to an increased risk of AF.
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| 23. |
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| 24. |
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| 25. |
- Hedberg, Berith, 1951-, et al.
(författare)
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Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:5, s. 446-455
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making.AIM: The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms.METHODS: A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale-Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data.RESULTS: Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication.CONCLUSION: Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.
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| 26. |
- Hedberg, Berith, 1951-, et al.
(författare)
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Factors associated with involvement in risk communication and confidence in shared decision making among patients with atrial fibrillation.
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S74-S75
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Tidskriftsartikel (refereegranskat)abstract
- Background: Atrial fibrillation (AF) is a highly prevalent arrhythmia. Effective communication of risks (e.g., risk for stroke) and benefits to patients (e.g., treatment with oral anticoagulants) is crucial for shared decision making. Knowledge about how patients experience confidence and satisfaction in communication in relation to their health status is limited.Aim: The aim was to explore factors associated with involvement in risk communication and confidence in shared decision making among patients with AF.Method: A cross-sectional design was used and 322 patients (39 % women), mean age 67 years (SD 10.3 years) with AF were included at four hospitals in Sweden. Clinical examinations and self-rating scales for risk communication (COMRADE), uncertainty in illness (MUIS-C), depressive symptoms (HADS), mastery of daily life (MDL), as well as physical and mental health (SF-36) were used to collect data after a follow-up visit at the outpatient clinic 3 months post an AF episode.Results: Paroxysmal, persistent and permanent AF occurred among 32%, 34% and 7% of the patients, respectively. Patients whom had undergone DC-conversion (53%) and had anticoagulants (37%). Seven percent had been treated by a percutan ablation. Heart failure (15%) and ischemic heart disease (12%) were the most common co-morbidities. CHA2DS2-VASc >2 were seen among 62% of the patients. Overall, multiple regression analyses showed that uncertainty in illness and mastery of daily life were significantly associated with confidence in decisions and uncertainty in illness and hypertension were significantly associated with satisfaction in communication. Higher uncertainty in illness and poorer mastery of daily life were associated with poor confidence in decisions. Higher uncertainty in illness and occurrence of hypertension were associated with poor satisfaction in communication. Clinical AF variables (i.e.,symptom or treatment related) or depressive symptoms were not significantly associated with satisfaction in communication or confidence in decisions in the multiple regression analysis. The final models explained 29% and 30% of the variance in confidence in decision making and satisfaction in communication.Conclusion: In this cross-sectional study, including patients with AF, confidence in decision making and satisfaction in communication are associated with uncertainty in illness, mastery of daily life and hypertension.
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| 27. |
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| 28. |
- Johansson, Dan, 1964-, et al.
(författare)
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Economics Doctoral Programs Still Elide Entrepreneurship
- 2017
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Ingår i: Econ Journal Watch. - : Atlas Economic Research Foundation. - 1933-527X. ; 14:2, s. 196-217
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Tidskriftsartikel (refereegranskat)abstract
- Is entrepreneurship covered in economics doctoral programs? Updating an earlier study (Johansson 2004), we examine leading programs in the United States and Sweden by textual analysis of textbooks and assigned articles in microeconomics, macroeconomics, and industrial organization courses. We find that coverage of entrepreneurship in textbooks is scant and that theories regarding the function of the entrepreneur are hardly mentioned in assigned articles. Talk of the entrepreneur is more common in a few newer textbooks, which could indicate a renewed interest. But even textbooks that mention the entrepreneur do not define the concept or discuss the entrepreneur’s economic role in any depth; often the entrepreneur is just another optimizing agent within a model, like a borrower, manager, or investor.
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| 29. |
- Johansson, Dan, 1964-, et al.
(författare)
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Family business : A missing link in economics?
- 2020
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Ingår i: The Journal of Family Business Strategy. - : Elsevier. - 1877-8585 .- 1877-8593. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Family firms account for a substantial share of economic activity and deviate from standard economic assumptions on firmbehavior. However, little is known about how these firms are represented in economic theory. This article examines the inclusion of family business in the curricula of economics doctoral programs in the United States and Sweden as well as professors’ and textbook authors’ views and research on family business. Textbooks, articles and course offerings used in doctoral programs are considered to indicate the state of established knowledge in the field. The findings show that family business is not included in the examined curricula. Furthermore, professors and authors do not publish research on family business and generally do not see a need to incorporate it into economic theory. This article concludes that family business is excluded from ‘core’ economic theory due to a lack of paradigmatic pluralism, axiomatic incompatibility, path dependency, institutional bias and data constraints. Lastly, it is speculated that integration of family business theory into standard economic modeling is likely to occur outside prestigious universities due to path dependency in research.
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| 30. |
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| 31. |
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| 32. |
- Lin, Chung-Ying, et al.
(författare)
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Can a multifaceted intervention including motivational interviewing improve medication adherence, quality of life, and mortality rates in older patients undergoing coronary artery bypass surgery? A multicenter, randomized controlled trial with 18-month follow-up
- 2017
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Ingår i: Drugs & Aging. - : Springer. - 1170-229X .- 1179-1969. ; 34:2, s. 143-156
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients undergoing coronary artery bypass graft (CABG) surgery are required to take a complex regimen of medications for extended periods, and they may have negative outcomes because they struggle to adhere to this regimen. Designing effective interventions to promote medication adherence in this patient group is therefore important.Objective: The present study aimed to evaluate the long-term effects of a multifaceted intervention (psycho-education, motivational interviewing, and short message services) on medication adherence, quality of life (QoL), and mortality rates in older patients undergoing CABG surgery.Methods: Patients aged over 65 years from 12 centers were assigned to the intervention (EXP; n = 144) or treatment-as-usual (TAU; n = 144) groups using cluster randomization at center level. Medication adherence was evaluated using the Medication Adherence Rating Scale (MARS), pharmacy refill rate, and lipid profile; QoL was evaluated using Short Form-36. Data were collected at baseline; 3, 6, and 18 months after intervention. Survival status was followed up at 18 months. Multi-level regressions and survival analyses for hazard ratio (HR) were used for analyses.Results: Compared with patients who received TAU, the MARS, pharmacy refill rate, and lipid profile of patients in the EXP group improved 6 months after surgery (p < 0.01) and remained so 18 months after surgery (p < 0.01). QoL also increased among patients in the EXP group as compared with those who received TAU at 18 months post-surgery (physical component summary score p = 0.02; mental component summary score p = 0.04). HR in the EXP group compared with the TAU group was 0.38 (p = 0.04).Conclusion: The findings suggest that a multifaceted intervention can improve medication adherence in older patients undergoing CABG surgery, with these improvements being maintained after 18 months. QoL and survival rates increased as a function of better medication adherence. ClinicalTrials.gov NCT02109523.
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| 33. |
- Lindholm, Heléne, et al.
(författare)
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Genetic risk-factors for anxiety in healthy individuals: polymorphisms in genes important for the HPA axis
- 2020
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Ingår i: BMC Medical Genetics. - : Springer Science and Business Media LLC. - 1471-2350. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Two important aspects for the development of anxiety disorders are genetic predisposition and alterations in the hypothalamic-pituitary-adrenal (HPA) axis. In order to identify genetic risk-factors for anxiety, the aim of this exploratory study was to investigate possible relationships between genetic polymorphisms in genes important for the regulation and activity of the HPA axis and self-assessed anxiety in healthy individuals. Methods DNA from 72 healthy participants, 37 women and 35 men, were included in the analyses. Their DNA was extracted and analysed for the following Single Nucleotide Polymorphisms (SNP)s: rs41423247 in theNR3C1gene, rs1360780 in theFKBP5gene, rs53576 in theOXTRgene, 5-HTTLPR inSLC6A4gene and rs6295 in theHTR1Agene. Self-assessed anxiety was measured by the State and Trait Anxiety Inventory (STAI) questionnaire. Results Self-assessed measure of both STAI-S and STAI-T were significantly higher in female than in male participants (p = 0.030 andp = 0.036, respectively). For SNP rs41423247 in theNR3C1gene, there was a significant difference in females in the score for STAI-S, where carriers of the G allele had higher scores compared to the females that were homozygous for the C allele (p < 0.01). For the SNP rs53576 in theOXTRgene, there was a significant difference in males, where carriers of the A allele had higher scores in STAI-T compared to the males that were homozygous for the G allele (p < 0.01). Conclusion This study shows that SNP rs41423247 in theNR3C1gene and SNP rs53576 in theOXTRgene are associated with self-assessed anxiety in healthy individuals in a gender-specific manner. This suggests that these SNP candidates are possible genetic risk-factors for anxiety.
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| 34. |
- Malm, Arvid, 1979-, et al.
(författare)
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Family Business – A Missing Link in Economics
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Family businesses account for a substantial share of economic activity and deviate from standard economic assumptions on firm behavior. However, little is known about how these businesses are represented in economic theory. This article examines the inclusion of family business in economics doctoral programs in the United States and Sweden, as well as professors and textbook authors’ views and research on family business. Textbooks, articles and course offerings used in doctoral programs are considered to indicate the state of knowledge in the field. This article finds that family business is not a subject within the examined programs, and professors and authors do not publish research on this topic. Moreover, professors and authors generally state that family business needs not be a part of economic theory. This paper concludes that family business is excluded from ‘core’ economic theory.
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| 35. |
- Malm, Anders
(författare)
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Operational Military Violence : A Cartography of Bureaucratic Minds and Practices
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Western use of military violence is becoming increasingly centralised, partly through the use of Unmanned Aerial Vehicles (or more commonly referred to as “drones” in the literature). Drone technology allows control and command of military operations to be put under one roof, and as military organisations traditionally have a close dependence on technological developments, procedures and regulations for centralised command and control have developed in close concert with advances in drone technology. Apart from technological innovations, there are other aspects that contribute to the growing centralisation of military violence. The increasing military sensitivity about public and media criticism regarding casualties and ‘collateral damage’ underlines the need for Western military organisations to take central control of military missions and the use of violence.What are the characteristics and consequences of this centralisation and how does it affect military practitioners’ relation to violence? The literature on military violence has slowly become aware that something has happened in Western military organisations’ relations to the use of force and has made some attempts to answer these questions. The tentative (short) answer is that military violence is becoming increasingly bureaucratised in the wake of this centralisation, and its human consequences are lost in bureaucratic routines and procedures. But so far the research on the bureaucratisation of violence has been delimited to investigations of either the theoretical procedures themselves (e.g. analysis of military doctrines), or field studies of drone operators or airmen’s work of ‘dropping bombs’. A major gap in the literature exists as the main organisational function for retaining control and command over violence – the operational level and the staff work performed there – is largely left aside in the research. Of particular interest here is how the work at operational levels of military organisations contributes to a bureaucratic institutionalisation of violence.This thesis aims to fill some of this gap through ethnographic investigations of operational military work and the training of ‘targeteers’ – staff officers working with the operational governance of military violence. In addition, the thesis also sets the current bureaucratisation of violence in a modern historical perspective, where the nation of Sweden stands as an example of how political incentives for military reformations form the foundation of a bureaucratisation of violence. The results of these investigations illustrate how bureaucratisation of violence leaves death and violence aside, and offers detailed insights into how the procedures, routines and the language of bureaucracy form the main points of reference for military practitioners’ view of their work. In addition, the analysis shows how military masculinity is reshaped from traditional warrior ideals to encompass norms of ‘the rational bureaucrat’. What is salient in these results is that they open up an otherwise closed off part of military practice and facilitates for public debates about military violence. Particularly regarding the central findings that some military practitioners do not regard violence as an outcome of their work, and that the bureaucratic operational work operates to reduce and even remove the (enemy) Other as a (human) point of reference in contemporary military work.
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| 36. |
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| 37. |
- Malm, Dan, 1954-, et al.
(författare)
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Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients
- 2018
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:7, s. 589-597
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation.Methods: A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 104 persons were randomly assigned to either a CBT (n=56) or a treatment as usual (TAU) group (n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13).Results: At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group −0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence (z=2.07, P=0.04).Conclusions: A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients.
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| 38. |
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| 39. |
- Malm, Dan, 1954-
(författare)
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Health-related quality of life in patients with pacemakers. A descriptive and experimental study
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim of this thesis was to describe and evaluate the health-relatedquality of life (HRQoL) of patients with pacemakers, as well as to determine theeffects of a nurse-led intervention regarding health-related quality of life in theform of a self-care program for these patients. Descriptive designs were used todescribe (I) quality of life (n=182) as well as (II) HRQoL (n=697) of pacemakerpatients based on a nursing perspective. In order to describe the life situation ofthese patients from a deeper perspective (III) and examine the experiences ofdaily living with a pacemaker, patients (n=13) were interviewed and data wereanalyzed according to the grounded theory method, using constant comparativeanalysis. Finally (IV), 212 patients from three hospitals were allocated, using anexperimental, multi-center, randomized design, to either a control (n=115) or anexperimental group (n=97) to evaluate the effects of a nurse-led intervention, a10-month self-care program, on the HRQoL of patients with pacemakers.The total QoL for patients with pacemakers was acceptable. Through applicationof Orem s self-care theory, information, support and education can be providedin such a way that nursing care affects the entire QoL of patients withpacemakers. Measures should be taken on behalf women, those living alone, theelderly, blue-collar workers and retired persons, all of whom have a lower QoL(I, II). Experiences of daily living with a pacemaker generally indicate thatpatients with pacemakers can attain emotional stability and social participationunder the condition that there is understanding, empathetic treatment and insightconcerning the patient s new situation (III). There were no significantdifferences in HRQoL when comparisons were made between the experimentaland the control group. Two main findings for patients in the self-care program(experimental group) were: a significantly better HRQoL in terms ofexperiencing the symptoms that were the reason for pacemaker implantation ashaving decreased or disappeared, and a higher level of perceived exertion in a 11/2-minute stair test compared with patients who had standard checkups (controlgroup) (IV).In order to increase the HRQoL of patients with pacemakers it is important thathealth care professionals support the patient in a kind and professional mannerby providing clear, relevant information, and by planning a self-care programbased on a nursing assessment of the patient s needs using a comprehensiveapproach.
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| 40. |
- Malm, Dan, 1954-, et al.
(författare)
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Impact of a cognitive behavioral intervention on quality of life and psychological distress in patients with atrial fibrillation : the importance of relatives
- 2017
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S49-S50
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although there is an evidence to support the efficacy of cognitive behavioral therapy (CBT) in improving quality of life and decreasing psychological distress in patients with cardiovascular diseases but involving patient’s and relatives in the CBT and its effect on patient’s general health, has not been evaluated.Aim: The aim was to determine whether involving the relatives in CBT for patients with Atrial Fibrillation (AF) enhances treatment outcomes relative to treatment as usual group (TAU).Method: In a randomized controlled trial, 78 patients diagnosed with AF were randomly assigned to experimental (EXP) or TAU groups. In the EXP group, patients and relative participated in a 6-week program while the patient in the TAU group received standard care. Short Form 36(SF-36), Hospital Anxiety and Depression Scale (HADS),Euro-QoL 5-Dimension Self-Report Questionnaire (EQ-5D) and Sense of Coherence (SOC-13) were completed at baseline and at 12-month follow-up. Results: In all 78 patients completed the assessment at 12 months. The two groups were similar for sociodemographic and clinical variables at baseline. The EXP group reported significantly higher scores in EQ-5D (F= 6.18, p = 0.01) and SOC (F= 4.15, p = 0.04) than TAU group. Compared with TAU group, patients in EXP group reported significantly lower depression (F= 4.58, p = 0.04). Thirteen percent of Indirect effect of the intervention on improving patient’s quality of life in the EXP group was related to the SOC improvement (z = 11.83, p < .01).Conclusions: This study provides evidence that patients and their relatives’ involvement is more effective in improving quality of life and decreasing psychological distress than those who receiving standard care. Our results also indicate that interventions should initially focus on increasing patient’s sense of coherence.
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| 41. |
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| 42. |
- Malm, Dan, et al.
(författare)
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Patients’ Experiences of Daily Living with a Pacemaker : A Grounded Theory Study
- 2006
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Ingår i: Journal of Health Psychology. - London : Sage Publications. - 1359-1053 .- 1461-7277. ; 11:5, s. 787-798
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine patients’ experiences of daily living with a pacemaker. A total of 13 pacemaker patients (seven women) aged 22-82 (mean = 59.2) years were interviewed. The informants had had a pacemaker from 0.5 to 33 (mean 13.1) years. The grounded theory method was the basis for collection and analysis of the data. The results of the analysis of the semi-structured interviews showed that variations in ‘perceived social participation’ and ‘emotional state’, the two core categories, were related to four qualitatively different ways of experiencing daily living after pacemaker implantation.
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| 43. |
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| 44. |
- Malm, Dan, et al.
(författare)
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Reducing the prevalence of catheter-related infections by quality improvement : Six-year follow-up study
- 2016
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 6:2, s. 79-87
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Tidskriftsartikel (refereegranskat)abstract
- Background: Peripheral venous catheter (PVC) insertion is a crucial nursing action during life support. Several factors that increase the risk of thrombophlebitis associated with PVCs have been reported. Objective: We wish to evaluate the impact of a quality improvement regarding PVC treatment for patients with coronary heart diseases.Method: A longitudinal, quantitative observational study was carried out in 2008 and 2013 in a hospital in southern Sweden with 360 consecutive patients suffering from acute chest pain. New routines for PVC treatment were included in the hospital with daily inspection according to a checklist. A structured observation protocol was used to survey the prevalence of thrombophlebitis between 2008 and 2013. Also, we examined the relationship between the location and luminal diameters of PVCs.Results: The student’s t-test showed significant differences between 2008 and 2013 with respect to luminal diameter of PVCs (p = 0.002), prevalence of thrombophlebitis (p = 0.003) and number of days with PVC left in situ (p < 0.001).Conclusion: These findings emphasize the value of using systematic daily inspections and checklists to achieve quality and safety in patients with acute chest pain having PVC-based treatment.
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| 45. |
- Malm, Dan, et al.
(författare)
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Regaining normalcy in relatives of patients with a pacemaker
- 2014
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 4:3, s. 139-149
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Tidskriftsartikel (refereegranskat)abstract
- Patients with chronic diseases, such as those with pacemakers, have shown that they have a worsened well-being, which means an increased interest in investigating how relatives of patients with pacemakers experience their situations and how the disease affects their life situations. The aim of this study was to explore the main concerns for the relatives of patients with a pacemaker and how they resolve these issues. A classic grounded theory was used throughout the study for data collection and analysis. Interviews were conducted with ten participants. Striving for normalcy emerged as the main concern for relatives of patients with a pacemaker and was handled through a process of regaining normalcy where the relatives strive to find a way to live as normal as possible. Regaining normalcy is done through developing trust, dwindling and finally life stabilizing, in which they are either holding back or new normalizing. Distinguishing signs are constantly done during the process to quickly notice possible symptoms of the patient. Increased knowledge and understanding of how the relatives of patients with a pacemaker regain normalcy can be used as a guide in order to support and inform the patient as well as their relatives in conjunction with implantation occasions but also in connection with recurring and lifelong follow-up occasions.
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| 46. |
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| 47. |
- Malm, Johan, 1982-, et al.
(författare)
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Coherent structures and dominant frequencies in a turbulent three-dimensional diffuser
- 2012
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Ingår i: Journal of Fluid Mechanics. - : Cambridge University Press (CUP). - 0022-1120 .- 1469-7645. ; 699, s. 320-351
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Tidskriftsartikel (refereegranskat)abstract
- Dominant frequencies and coherent structures are investigated in a turbulent, three-dimensional and separated diffuser flow at $\mathit{Re}= 10\hspace{0.167em} 000$ (based on bulk velocity and inflow-duct height), where mean flow characteristics were first studied experimentally by Cherry, Elkins and Eaton (Intl J. Heat Fluid Flow, vol. 29, 2008, pp. 803–811) and later numerically by Ohlsson et al. (J. Fluid Mech., vol. 650, 2010, pp. 307–318). Coherent structures are educed by proper orthogonal decomposition (POD) of the flow, which together with time probes located in the flow domain are used to extract frequency information. The present study shows that the flow contains multiple phenomena, well separated in frequency space. Dominant large-scale frequencies in a narrow band $\mathit{St}\equiv fh/ {u}_{b} \in [0. 0092, 0. 014] $ (where $h$ is the inflow-duct height and ${u}_{b} $ is the bulk velocity), yielding time periods ${T}^{\ensuremath{\ast} } = T{u}_{b} / h\in [70, 110] $, are deduced from the time signal probes in the upper separated part of the diffuser. The associated structures identified by the POD are large streaks arising from a sinusoidal oscillating motion in the diffuser. Their individual contributions to the total kinetic energy, dominated by the mean flow, are, however, small. The reason for the oscillating movement in this low-frequency range is concluded to be the confinement of the flow in this particular geometric set-up in combination with the high Reynolds number and the large separated zone on the top diffuser wall. Based on this analysis, it is shown that the bulk of the streamwise root mean square (r.m.s.) value arises due to large-scale motion, which in turn can explain the appearance of two or more peaks in the streamwise r.m.s. value. The weak secondary flow present in the inflow duct is shown to survive into the diffuser, where it experiences an imbalance with respect to the upper expanding corners, thereby giving rise to the asymmetry of the mean separated region in the diffuser.
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| 48. |
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| 49. |
- Malm, Johan, 1982-
(författare)
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Spectral-element simulations of turbulent wall-bounded flows including transition and separation
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The spectral-element method (SEM) is used to study wall-bounded turbulent flowsin moderately complex geometries. The first part of the thesis is devoted to simulations of canonical flow cases, such as temporal K-type transitionand turbulent channel flow, to investigate general resolution requirements and computational efficiency of the numerical code nek5000. Large-eddy simulation (LES) is further performed of a plane asymmetric diffuser flow with an opening angle of 8.5 degrees, featuring turbulent flow separation. Good agreement with numerical studies of Herbst (2007) is obtained, and it is concluded that the use of a high-order method is advantageous for flows featuring pressure-induced separation. Moreover, it is shown, both a priori on simpler model problems and a posteriori using the full Navier--Stokes equations, that the numerical instability associated with SEM at high Reynolds numbers is cured either by employing over-integration (dealiasing) or a filter-based stabilisation, thus rendering simulations of moderate to high Reynolds number flows possible. The second part of the thesis is devoted to the first direct numerical simulation (DNS) of a truly three-dimensional, turbulent and separated diffuser flow at Re = 10 000 (based on bulk velocity and inflow-duct height), experimentally investigated by Cherry et al. (2008). The massively parallel capabilities of the spectral-element method are exploited by running the simulations on up to 32 768 processors. Very good agreement with experimental mean flow data is obtained and it is thus shown that well-resolved simulations of complex turbulent flows with high accuracy are possible at realistic Reynolds numberseven in complicated geometries. An explanation for the discovered asymmetry of the mean separated flow is provided and itis demonstrated that a large-scale quasi-periodic motion is present in the diffuser. In addition, a new diagnostic measure, based on the maximum vorticity stretching component in every spatial point, is designed and tested in a number of turbulent and transitional flows. Finally, Koopman mode decomposition is performed of a minimal channel flow and compared to classical proper orthogonal decomposition (POD).
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| 50. |
- Malm, Johan, et al.
(författare)
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Stabilization of the Spectral Element Method in Convection Dominated Flows by Recovery of Skew-Symmetry
- 2013
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Ingår i: Journal of Scientific Computing. - : Springer Science and Business Media LLC. - 0885-7474 .- 1573-7691. ; 57:2, s. 254-277
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Tidskriftsartikel (refereegranskat)abstract
- We investigate stability properties of the spectral element method for advection dominated incompressible flows. In particular, properties of the widely used convective form of the nonlinear term are studied. We remark that problems which are usually associated with the nonlinearity of the governing Navier-Stokes equations also arise in linear scalar transport problems, which implicates advection rather than nonlinearity as a source of difficulty. Thus, errors arising from insufficient quadrature of the convective term, commonly referred to as 'aliasing errors', destroy the skew-symmetric properties of the convection operator. Recovery of skew-symmetry can be efficiently achieved by the use of over-integration. Moreover, we demonstrate that the stability problems are not simply connected to underresolution. We combine theory with analysis of the linear advection-diffusion equation in 2D and simulations of the incompressible Navier-Stokes equations in 2D of thin shear layers at a very high Reynolds number and in 3D of turbulent and transitional channel flow at moderate Reynolds number. For the Navier-Stokes equations, where the divergence-free constraint needs to be enforced iteratively to a certain accuracy, small divergence errors can be detrimental to the stability of the method and it is therefore advised to use additional stabilization (e.g. so-called filter-based stabilization, spectral vanishing viscosity or entropy viscosity) in order to assure a stable spectral element method.
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