| 1. |
- Hellgren, Mikko, 1972-, et al.
(författare)
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Hypertension management in primary health care : a survey in eight regions of Sweden
- 2023
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Ingår i: Scandinavian Journal of Primary Health Care. - : Taylor & Francis. - 0281-3432 .- 1502-7724. ; 41:3, s. 343-350
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To explore hypertension management in primary healthcare (PHC).Design: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.Setting: Seventy-six PHCCs in eight regions of Sweden.Main outcome measures: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.Results: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in & GE;96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients.Conclusions: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.
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| 2. |
- Höök+, Angelica, 1972, et al.
(författare)
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Content validity of the electronic faces thermometer scale for pain in children: is a picture worth more than a thousand words?
- 2024
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Ingår i: Frontiers in pain research (Lausanne, Switzerland). - : Frontiers Media S.A.. - 2673-561X. ; 5
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Tidskriftsartikel (refereegranskat)abstract
- Early recognition of pain in children is crucial, and their self-report is the primary source of information. However, communication about pain in healthcare settings can be challenging. For non-verbal communication regarding different symptoms, children prefer digital tools. The electronic Faces Thermometer Scale (eFTS) utilizes a universal design with colors, face emojis, and numbers on an 11-point scale (0-10) for pain assessment. The aim of this study was to establish content validity of the eFTS for pain assessments in children.A mixed methods design was used. The study took place at a university hospital in eastern Sweden, involving 102 children aged 8-17 years who visited outpatient clinics. Participants were presented with 17 pictures representing varying pain levels and asked to assess hypothetical pain using the eFTS. A think-aloud approach was employed, prompting children to verbalize their thoughts about assessments and the eFTS. Quantitative data were analyzed using descriptive and comparative statistics, together with a qualitative approach for analysis of think-aloud conversations.A total of 1,734 assessments of hypothetical pain using the eFTS were conducted. The eFTS differentiated between no pain (level 0-1) and pain (level 2-10). However, no clear agreement was found in the differentiation between hypothetical pain intensity levels (level 2-10). The analysis revealed that children utilized the entire scale, ranging from no pain to high pain, incorporating numbers, colors, and face emojis in their assessments.The variability in assessments was influenced by prior experiences, which had an impact on the statistical outcome in our study. However, employing the think-aloud method enhances our understanding of how children utilize the scale and perceive its design, including the incorporation of emotion-laden anchors. Children express a preference for using the eFTS to assess their pain during hospital visits.
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| 3. |
- Nilsson, Stefan, 1972, et al.
(författare)
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School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.
- 2009
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Ingår i: Paediatric anaesthesia. - : Wiley. - 1460-9592 .- 1155-5645. ; 19:12, s. 1184-90
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. BACKGROUND: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure) in children after minor surgery. METHODS: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. RESULTS: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' CONCLUSIONS: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.
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| 4. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
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Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 40:18, s. 2152-2162
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Forskningsöversikt (refereegranskat)abstract
- © 2017 Informa UK Limited, trading as Taylor & Francis Group Background: Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings. Method: Participants’ statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model. Results: Findings indicated that pain management focused more on children’s attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain. Conclusion: Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children’s pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to “hands-on” pain management when needed.Implications for rehabilitation•When providing support, hands-on interventions should be supplemented by structured preventive programs and routines for parent collaboration (action-and-reaction approach).•When regulating support, Sweden and South Africa can learn from each other;○In Sweden, the implementation of a prevention program has been successful.○In South Africa, the possibilities giving support directly when pain in children is observed have been beneficial.
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| 5. |
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| 6. |
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| 7. |
- Baron, Sue, et al.
(författare)
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Dimensions of clinical leadership among pre-registration nursing students: A cross-sectional study between two countries.
- 2024
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Ingår i: Nurse education in practice. - 1873-5223. ; 79
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Tidskriftsartikel (refereegranskat)abstract
- To explore a) pre-registration students' self-perceptions of clinical leadership behaviours and b) differences in students' self-perceptions of leadership behaviours between two countries (UK and Israel).Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that teaching leadership in nursing education is essential if students are to develop competencies in this area. Worldwide, there is limited research on nursing students' perception of clinical leadership behaviours as well as on the development of leadership behaviours during the study years.A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in the two participating universities. In total 656 students were invited to participate and the response rates were 28.1% (Israel) and 17.9% (England).Overall, 140 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions "Emotional Intelligence" and "Impact and Influence" (p < .05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with higher scores reported in the 3rd and 4th year students compared with the 1st and 2nd Year students in the referred dimensions (p < .05).Differences in students' clinical leadership perception exist between the two cohorts examined. Nurse educators should expand international research on this subject to identify possible antecedents in developing clinical leadership behaviours. At the same time, there is a need to continue efforts to enhance the development of clinical leadership behaviours during all study years through curriculum updating to prepare future nurses better to provide quality, safe and person-centered care.
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| 8. |
- Benjaminsson, Merja Vantaa, et al.
(författare)
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Using Picture and Text Schedules to Inform Children: Effects on Distress and Pain during Needle-Related Procedures in Nitrous Oxide Sedation
- 2015
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Ingår i: Pain Research & Treatment. - : Hindawi Limited. - 2090-1542 .- 2090-1550. ; 2015:2015
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Tidskriftsartikel (refereegranskat)abstract
- During hospital visits, children often undergo examinations and treatments that may involve an experience of pain and distress that is also connected to the staff’s treatment. The United Nation’s Convention on the Rights of Persons with Disability advocates the use of Universal Design. One way of implementing this idea within paediatric nursing is to increase the use of pictorial supports, and the few studies that have been published show promising results. The aim of this study was to do a comparison between two groups of children in regard to the pre- and postconditions of implementing an intervention including staff instruction and the use of pictorial support. The support consisted of a visual schedule with pictures and text, used both preparatory to and during the hospital visit. One hundred children aged 5–15 (50 children during the preinterventional data collection and 50 children postinterventionally) reported pain intensity and distress during needle-related procedures in nitrous oxide sedation. The results showed that the intervention had a positive effect in significantly lowering the level of preprocedural distress. The results showed that the pain intensity was also lowered however not reaching statistical significance. This confirms other positive research results on the use of visual supports within paediatric care, a topic that has to be further studied.
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| 9. |
- Bergström, Gunnar, et al.
(författare)
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Direct burial of district heating pipe bends – A limited casing pipe temperature ap-proach
- 2003
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Ingår i: Euroheat & Power - English Edition.
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The direct burial of district heating pipe bends, i.e., without the use of expansionabsorbing elements, has reportedly frequently been done withoutany observed pipe-line damage. This in spite of current design principles,predicting so large stresses on a directly buried L bend that the techniqueshould be avoided. A reason for the lack of correspondence between practicalexperience and design theory is the difficulties in formulating relevantcriteria for tolerable stresses and deformations in the pipe. Conservative designlimits are traditionally used, particularly regarding allowable stresses inthe PUR foam.An alternative method for design with respect to the PUR foam may bedeveloped based on the idea that the deformation of the PUR foam, and thusalso the displacement of the steel pipe relative to the casing pipe, must belimited only to avoid overheating of the polyethylene. The factors influencingthe deformation of the PUR foam is mainly a question of the temperatureinduced steel pipe displacement versus the stiffness and strength of thebackfill material. When the loading properties of the PUR foam and thebackfill material are known, the relationship between the steel pipe displacementand the PUR foam deformation is defined. Thus also a relation betweena specified thermal motion of the steel pipe and the resulting maximumtemperature on the casing pipe is established. This makes it possible touse the maximum casing pipe temperature as a design value.The conclusion using this approach is that the laying of bends directly inthe ground should be possible with normal backfill materials and compactionconditions. Certain care must be taken, though, when bends are laid invery stiff and strong backfill, where high reaction pressures may develop. Ingeneral, the risk for pipeline damage is minimised if directly buried bendsare laid in only moderately compacted backfill.
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| 10. |
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| 11. |
- Bergström, Gunnar, et al.
(författare)
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Durability testing for 100 year lifetime for buried non-pressure plastic pipes
- 2006
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Ingår i: Plastics Pipes XIII.
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Konferensbidrag (refereegranskat)abstract
- For plastics pipes used for underground drainage and sewerage there is at present no internationally accepted method for the evaluation of durability. This makes it difficult to make an objective assessment for both new materials and new pipe designs entering the market. This paper presents a possible future structure of such a durability evaluation for nonpressure pipes. Based on an experimental study of pipes made from a filled and an unfilled PP material and one made from an HDPE material different damage mechanisms and changes in pipe characteristics were observed when the pipes were exposed to long-term deflection and long term (one-year) ageing at +95 °C. A CAED methodology is also described which was used to investigate the distribution and time dependence of pipe stresses.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
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| 16. |
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| 17. |
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| 18. |
- Bergström, Gunnar, et al.
(författare)
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The influence from pipe surface, weld beads and protective skins on long term failure times for PE butt fusion joints
- 2004
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Ingår i: Plastics Pipes XII.
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Konferensbidrag (refereegranskat)abstract
- When making creep tensile tests on butt fusion joints in PE pipes almost all failures emerge from the outside of the pipe. Results indicate an influence from the outside surface on the long term behaviour of butt fusion joints. It is a well established practice to scrape the outside surface of PE pipes when making electro-fusion joints. This study stress the question if scraping or bead removal is a positive thing also when making butt fusion joints. Using PE100 pipes butt fusion joints were made using different levels of surface scraping before the butt fusion and with and without removing the weld beads before testing. PE-pipes with an outside PP or PE-skin were also included with and without the skin. Tensile test pieces were cut parallel to the pipe axis centered over the butt fusion joint. The long term strength evaluation were made using a standard accelerated test procedure with the test pieces exposed to a 5 MPa tensile loading immersed in 80 °C water with 2 % Arkopal N100 surfactant. With outside weld beads left intact failure times 200 h to 400 h are normal. Leaving the inner beads but removing the outer beads increase failure times to 1000 h to 2000 h. Failure times for test pieces without weld beads approach 10000 h. Scraping of the pipe surface to a depth of 0.2 mm did not substantially change the failure-time above that for an unscraped surface. Removing 0.7 mm from the pipe surfaceincrease failure times to 2000 h to 3000 h. Outside weld beads and outside pipe surface clearly interact to lower the time to failure in accelerated creep tensile tests. Weld bead removal and scraping of outside pipe surface significantly increase failure times. The exact mechanism is not clear and the implication on butt fusion joint performance in service is not demonstrated but the results indicate possible ways to enhance safety margins when making butt fusion joints. The topic will be given further attention in coming studies.
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| 19. |
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| 20. |
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| 21. |
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| 23. |
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| 24. |
- Bergviken, Hanna, et al.
(författare)
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Focusing on the hospital stay or everyday life with cancer: Parents' experiences of choosing a central access device for their child with cancer.
- 2019
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Ingår i: Journal for specialists in pediatric nursing : JSPN. - : Wiley. - 1744-6155 .- 1539-0136. ; 24:3
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to gain insights into the experiences of parents of children with cancer in conjunction with their decisions on the type of central access device that their child would have.The qualitative study design was chosen to maximize the likelihood of capturing the full range of the phenomenon, that is the parents' experiences from decision-making. Open interviews were conducted between December 2015 and January 2016 with 17 parents of children who had been diagnosed with cancer in 2014-2015. The interviews were analyzed using inductive qualitative content analysis.The analysis of the decision-making process data yielded four subcategories: (a) Feeling overwhelmed owing to limited information and alienation within the healthcare system, (b) the burden of making a quick medical decision without having the big picture, (c) receiving conflicting views and approaches from the healthcare professionals, and (d) including the child's perspective. Those four subcategories were condensed into the following main category: focusing on the hospital stay and treatment or on everyday life with cancer.Healthcare professionals need to be aware that they may influence the parents' decision, and they should consider that parents are often naïve in their situation. To optimize the decision, its timing should be carefully chosen. Parents often take the child's perspective and interpret the child's reactions as reflecting a wish to avoid needle jabs or to live an unhindered everyday life. Healthcare professionals informing families about central access devices need to address both hospital stays and everyday life with cancer, and they need to adopt a child-centered approach.
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| 25. |
- Bjursten, Henrik, et al.
(författare)
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Calcium Load in the Aortic Valve, Aortic Root, and Left Ventricular Outflow Tract and the Risk for a Periprocedural Stroke
- 2022
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Ingår i: Structural Heart-the Journal of the Heart Team. - : Elsevier BV. - 2474-8706 .- 2474-8714. ; 6:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Periprocedural stroke during transcatheter aortic valve implantation is a rare but devastating complication. The calcified aortic valve is the most likely source of the emboli in a periprocedural stroke. The total load and distribution of calcium in the leaflets, aortic root, and left ventricular outflow tract varies from patient to patient. Consequently, there could be patterns of calcification that are associated with a higher risk of stroke. This study aimed to explore whether the pattern of calcification in the left ventricular outflow tract, annulus, aortic valve, and ascending aorta can be used to predict a periprocedural stroke. Methods: Among the 3282 consecutive patients who received a transcatheter aortic valve implantation in the native valve in Sweden from 2014 to 2018, we identified 52 who had a periprocedural stroke. From the same cohort, a control group of 52 patients was constructed by propensity score matching. Both groups had one missing cardiac computed tomography, and 51 stroke and 51 control patients were blindly reviewed by an experienced radiologist. Results: The groups were well balanced in terms of demographics and procedural data. Of the 39 metrics created to describe calcium pattern, only one differed between the groups. The length of calcium protruding above the annulus was 10.6 mm (interquartile range 7-13.6) for patients without stroke and 8 mm (interquartile range 3-10) for stroke patients. Conclusions: This study could not find any pattern of calcification that predisposes for a periprocedural stroke.
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| 26. |
- Björkman, Berit, et al.
(författare)
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Children's and parents' perceptions of care during the peri-radiographic process when the child is seen for a suspected fracture
- 2016
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Ingår i: Radiography. - : Elsevier BV. - 1078-8174 .- 1532-2831. ; 22:1, s. 71-76
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Tidskriftsartikel (refereegranskat)abstract
- Background Visiting a Radiology department may elicit both positive and negative feelings for children and parents alike. This study investigated children's and parents' perceptions of care during the peri-radiographic process and whether these perceptions correlated with the child's perceptions of pain and distress. Methods This study utilized a quantitative descriptive design. Its data was collected in five Radiology departments, two where examinations are performed exclusively on children and three that treat both children and adults. Data collection contained questionnaires from children (n = 110) and their parent (n = 110) as well as children's self-reports of pain and distress. Results The findings illustrated that the children and their parent were satisfied with the care provided throughout the peri-radiographic process, unrelated to the child's self-reported levels of pain and distress or examination setting (i.e. children's department or general department). The highest scores of satisfaction were ascribed to “the radiographer's kindness and ability to help in a sufficient way,” whereas “available time to ask questions and to meet the child's emotional needs” received the lowest scores. Conclusions Parents and children alike perceived the radiographers as skilled and sensitive throughout the examination, while radiographers' time allocated to interacting with the child was not perceived be sufficiently covered.
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| 27. |
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| 28. |
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| 29. |
- Bray, Lucy, et al.
(författare)
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"People play it down and tell me it can't kill people, but I know people are dying each day". Children's health literacy relating to a global pandemic (COVID-19); an international cross sectional study.
- 2021
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 16:2
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine aspects of children's health literacy; the information sources they were accessing, their information preferences, their perceived understanding of and their reported information needs in relation to COVID-19. An online survey for children aged 7-12 years of age and parent/caregivers from the UK, Sweden, Brazil, Spain, Canada and Australia was conducted between 6th of April and the 1st of June 2020. The surveys included demographic questions and both closed and open questions focussing on access to and understanding of COVID-19 information. Descriptive statistics and qualitative content analysis procedures were conducted. The findings show that parents are the main source of information for children during the pandemic in most countries (89%, n = 347), except in Sweden where school was the main source of information. However, in many cases parents chose to shield, filter or adapt their child's access to information about COVID-19, especially in relation to the death rates within each country. Despite this, children in this study reported knowing that COVID-19 was deadly and spreads quickly. This paper argues for a community rather than individual approach to addressing children's health literacy needs during a pandemic.
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| 30. |
- Brännholm Syrjälä, Maria, et al.
(författare)
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Health effects of reduced occupational sedentary behaviour in type 2 diabetes using a mobile health intervention : a study protocol for a 12-month randomized controlled trial—the ROSEBUD study
- 2022
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Ingår i: Trials. - : BioMed Central. - 1745-6215. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Short-term trials conducted in adults with type 2 diabetes mellitus (T2DM) showed that reducing sedentary behaviour by performing regular short bouts of light-intensity physical activity enhances health. Moreover, support for reducing sedentary behaviour may be provided at a low cost via mobile health technology (mHealth). There are a wide range of mHealth solutions available including SMS text message reminders and activity trackers that monitor the physical activity level and notify the user of prolonged sitting periods. The aim of this study is to evaluate the effects of a mHealth intervention on sedentary behaviour and physical activity and the associated changes in health in adults with T2DM.Methods: A dual-arm, 12-month, randomized controlled trial (RCT) will be conducted within a nationwide Swedish collaboration for diabetes research in primary health care. Individuals with T2DM (n = 142) and mainly sedentary work will be recruited across primary health care centres in five regions in Sweden. Participants will be randomized (1:1) into two groups. A mHealth intervention group who will receive an activity tracker wristband (Garmin Vivofit4), regular SMS text message reminders, and counselling with a diabetes specialist nurse, or a comparator group who will receive counselling with a diabetes specialist nurse only. The primary outcomes are device-measured total sitting time and total number of steps (activPAL3). The secondary outcomes are fatigue, health-related quality of life and musculoskeletal problems (self-reported questionnaires), number of sick leave days (diaries), diabetes medications (clinical record review) and cardiometabolic biomarkers including waist circumference, mean blood pressure, HbA1c, HDL-cholesterol and triglycerides.Discussion: Successful interventions to increase physical activity among those with T2DM have been costly and long-term effectiveness remains uncertain. The use of mHealth technologies such as activity trackers and SMS text reminders may increase awareness of prolonged sedentary behaviour and encourage increase in regular physical activity. mHealth may, therefore, provide a valuable and novel tool to improve health outcomes and clinical management in those with T2DM. This 12-month RCT will evaluate longer-term effects of a mHealth intervention suitable for real-world primary health care settings.
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| 31. |
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| 32. |
- Castor, C, et al.
(författare)
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Psychometric evaluation of the electronic faces thermometer scale for pain assessment in children 8–17years old: A study protocol
- 2023
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Ingår i: Paediatric and Neonatal Pain. - : Wiley. - 2379-5824 .- 2637-3807. ; 5:4, s. 99-109
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Tidskriftsartikel (refereegranskat)abstract
- It is often a challenge for a child to communicate their pain, and their possibilities to do so should be strengthened in healthcare settings. Digital self-assessment provides a potential solution for person-centered care in pain management and promotes child participation when a child is ill. A child's perception of pain assessment differs when it is assessed using digital or analog formats. As we move into the digital era, there is an urgent need to validate digital pain assessment tools, including the newly developed electronic Faces Thermometer Scale (eFTS). This study protocol describes three studies with the overall aim to evaluate psychometric properties of the eFTS for assessing pain in children 8–17years of age. A multi-site project design combining quantitative and qualitative methods will be used for three observational studies. Study 1: 100 Swedish-speaking children will report the level of anticipated pain from vignettes describing painful situations in four levels of pain and a think-aloud method will be used for data collection. Data will be analyzed with phenomenography as well as descriptive and comparative statistics. Study 2: 600 children aged 8–17years at pediatric and dental settings in Sweden, Denmark, Iceland, and USA will be included. Children will assess their pain intensity due to medical or dental procedures, surgery, or acute pain using three different pain Scales for each time point; the eFTS, the Faces Pain Scale Revised, and the Coloured Analogue Scale. Descriptive and comparative statistics will be used, with subanalysis taking cultural context into consideration. Study 3: A subgroup of 20 children out of these 600 children will be purposely included in an interview to describe experiences of grading their own pain using the eFTS. Qualitative data will be analyzed with content analysis. Our pilot studies showed high level of adherence to the study procedure and rendered only a small revision of background questionnaires. Preliminary analysis indicated that the instruments are adequate to be used by children and that the analysis plan is feasible. A digital pain assessment tool contributes to an increase in pain assessment in pediatric care. The Medical Research Council framework for complex interventions in healthcare supports a thorough development of a new scale. By evaluating psychometric properties in several settings by both qualitative and quantitative methods, the eFTS will become a well-validated tool to strengthen the child's voice within healthcare.
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| 33. |
- de Avila, Marla Andreia Garcia, et al.
(författare)
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Anxiety among children a year after the onset of the COVID-19 pandemic: a Brazilian cross-sectional online survey
- 2024
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Ingår i: FRONTIERS IN PUBLIC HEALTH. - 2296-2565. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Aim This study seeks to build upon a prior investigation into the impact of the COVID-19 pandemic and to evaluate the prevalence of anxiety among Brazilian children, along with its associated factors, one year after the commencement of the pandemic.Design A cross-sectional study.Methods A survey was conducted from April-May 2021 in Brazil. Children aged 6-12 and their guardians from five Brazilian regions were included. The Children's Anxiety Questionnaire (CAQ; scores 4-12) and Numerical Rating Scale (NRS; scores 0-10) were used to measure anxiety.Results Of the 906 children, 53.3% were girls (average age = 8.79 +/- 2.05 years). Mothers responded for 87.1% of the children, and 70.9% were from the Southeast region. Based on a CAQ score of >= 9 and an NRS score of >= 8, the anxiety prevalence was 24.9 and 34.9%, respectively. Using logistic regression, a CAQ >= 9 score was associated with older children and children with chronic disease or disability. An NRS score of >= 8 was associated with reduced family income during the pandemic, the person caring for the children, and with children with chronic disease or disability.Conclusion These findings suggest the need to implement public health actions aimed at children with chronic diseases and disabilities and their parents to guide them regarding the warning signs and negative emotions. This study contributes to characterizing the evolution of the pandemic in Brazil and provides a basis for comparison with the literature from other countries.
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| 34. |
- de Flon, Malin, et al.
(författare)
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The childhood cancer centre is coming home: Experiences of hospital-based home care
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:12
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Tidskriftsartikel (refereegranskat)abstract
- Today, there is a shift towards care being given closer to the patient, with more children receiving care in their homes. Care at home has proven to be a viable alternative to hospital care, as shown by a project for hospital-based home care conducted in West Sweden. The aim of this study was to describe how children with cancer and parents experienced receiving care at home. After purposive sampling, six children with cancer aged 6–16 and eight parents participated. Semistructured interviews were performed, and the data were analysed using qualitative content analysis. Four main categories emerged: save time and energy in the family; maintain everyday life; feel trust in the healthcare professionals; mixed feelings about getting treatment at home. This hospital-based home care project created good conditions for both children with cancer and their parents to feel secure. In addition, home care can be very child-centric, whereby the caregivers involve the children by taking their thoughts and utterances into account.
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| 35. |
- Esplana, Linda, et al.
(författare)
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'Do you feel well or unwell?' A study on children's experience of estimating their nausea using the digital tool PicPecc.
- 2022
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Ingår i: Journal of child health care : for professionals working with children in the hospital and community. - : SAGE Publications. - 1741-2889. ; 27:4, s. 654-666
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Tidskriftsartikel (refereegranskat)abstract
- Research with childhood cancer has progressed greatly in recent years, resulting in much improved treatment that is more intensive. However, with this new treatment children often experience negative symptoms, and research shows that nausea is a symptom that most affects them. Pictorial support in person-centred care for children (PicPecc) is a digital picture-based tool for children who undergo treatment due to their cancer diagnosis and helps them more effectively communicate and self-report their symptoms and emotions. The aim of the study was to investigate children's experience of (i) using mHealth in nausea management and (ii) their acceptability of using an application (App). Semi-structured interviews were conducted with eight children aged five to fifteen years. Data were analysed with qualitative content analysis. The findings were presented in three categories: 1) Communicating feelings, 2) Playfulness generated in motivation and 3) App adaptable to children's capabilities. Using an App contributed to new opportunities for the children to participate in their care. They experienced their treatment in different ways and used different strategies to manage and distract themselves from their symptoms. Using the PicPecc App can increase healthcare staff's understanding of how children experience nausea when they undergo chemotherapy.
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| 36. |
- Fors, Andreas, 1977, et al.
(författare)
-
Effects of a person-centred approach in a school setting for adolescents with chronic pain-The HOPE randomized controlled trial
- 2020
-
Ingår i: European Journal of Pain. - : Wiley. - 1090-3801 .- 1532-2149. ; 24:8, s. 1598-1608
-
Tidskriftsartikel (refereegranskat)abstract
- Background Chronic pain among adolescents is common but effective interventions applicable in a school setting are rare. Person-centred care (PCC) is a key factor in improving health by engaging persons as partners in their own care. Methods In this randomized controlled trial, a total of 98 adolescents in secondary school or upper secondary school (aged 14 - 21 years) with chronic pain were randomly assigned to a PCC intervention or standard school healthcare. In the intervention group a pain management programme, based on a PCC approach, comprising four face-to-face sessions with a school nurse over a period of 5 weeks was added to standard school healthcare. The main outcome measure was self-efficacy in daily activities (SEDA scale) and rating scales for pain intensity and pain impact were used as secondary outcome measures. Results At the follow-up, no significant differences were found between the groups in the SEDA scale (p = .608) or in the rating scales for pain intensity (p = .261) and pain impact (p= .836). In the sub-group analysis, a significant improvement in the SEDA scale was detected at the secondary school in favour of the PCC intervention group (p = .021). Conclusion In this pain management programme based on a PCC approach, we found no effect in the total sample, but the programme showed promising results to improve self-efficacy in daily activities among adolescents at secondary school. Significance This study evaluates the effects of a pain management programme based on a PCC approach in a school setting addressing adolescents at upper secondary and secondary schools with chronic pain. No overall effects were shown, but results illustrate that the intervention improved self-efficacy in adolescents at secondary school. Implementation of a PCC approach in a school setting may have the potential to improve self-efficacy in daily activities for adolescents with chronic pain at secondary school.
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| 37. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Air-gaps in pipe joints insulated with PUR half-shells
- 2004
-
Ingår i: 9th International Symposium on District Heating and Cooling.
-
Konferensbidrag (refereegranskat)abstract
- Prefabricated half-shells as thermal insulation in pipeline joints come with obvious advantages.Most importantly, the PUR insulation can be optimised in the factory, there is no need for handlingchemicals in the field and the jointing procedure is simplified. However, the technique has neverbecome very popular in Sweden. One reason for this is the risk of air-gaps between the half-shellsand the pipe ends. Air-gaps may cause an excessive radial heat flow leading to overheating andpremature ageing of the joint casing and the shrink seals. It has also been shown that voids in thejoint insulation may promote the accumulation of water in the joint when leaks are present in theshrink seals. Furthermore, air-gaps due to half-shells will expose the medium pipe to permeatingwater and the risk for corrosion.The increase in temperature on the casing pipe caused by heat flow through an air-gap is treatedanalytically based on previous laboratory experiments.The presence of air-gaps was confirmed at excavation of a pipeline after nine years of service,where air-gaps with an approximate width of 4 mm were observed between the half-shells and thepipe ends on both sides of the joints. Previous tests undertaken by joint manufacturers have shownthat air-gaps may open up as the half-shells contract along with the joint casing when this coolsdown after shrinkage. When the pipeline is heated to service temperature, the gaps may close. However,measurements on various types of district heating pipe PUR foams indicate a tendency of thefoam to shrink in the axial direction when aged in high temperatures.
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| 38. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Beständighet hos krympskarvar
- 2007
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det här projektet har kommit till efter en direkt önskan från Svensk Fjärrvärmes auktorisationsnämnd om att närmare studera problemen kring krymptätande skarvar. Det är känt att materialen generellt sett har blivit bättre och den primära frågan därför gäller hur de material som används i dag åldras. Projektet har genomförts dels som en sammanställning av erfarenheter hos branschrepresentanter från krympförbands- och mastixtillverkare, fjärrvärmerörstillverkare, skarventreprenörer och fjärrvärmebolag, dels som en experimentell undersökning där ett antal olika skarvalternativ studerades med avseende på täthet och hållfasthet Resultaten visar att det uppenbart går att åstadkomma ett utmärkt skarvförband även under svåra temperatur- och fuktförhållanden och att det knappast sker några dramatiska egenskapsförändringar hos materialen under åldring. Frågan glider därmed över till hur entreprenaderna upphandlas och drivs.
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| 39. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Brittle fracture in casing pipes
- 2006
-
Ingår i: 10th International Symposium on District Heating and Cooling.
-
Konferensbidrag (refereegranskat)
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| 40. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Damage to coated plastics pipes from trenchless laying techniques
- 2006
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This project aims at evaluating an external coating on plastics pipes; and its protective function against scratches and scoring damage from trenchless laying techniques. PE100 pressure pipes with four different coatings were tested in horizontal drilling and pipe bursting field trials. During the tests, the lengthwise and cross-sectional deformations of the pipe were measured along with the traction force. The pipes’ surfaces were examined with respect to scratches, and the depth of the most prominent ones were determined. Of the two laying techniques, pipe bursting was the one that caused the deepest scratches. Horizontal drilling was not significantly worse than ordinary handling during transport and preparation with respect to scratch depth. Dragging of the pipe above ground on asphalt surfaces caused severe damage to the pipe wall. The deepest scratches were seen on two pipe selections with soft coatings. Due to their thickness, however, these coatings were not penetrated and thus successfully protected the main pipe wall. The hardest coating tested, made of polypropylene, was also the thinnest one, and it was penetrated at one location during the pipe bursting test. The traction force on the pipe was significantly higher during horizontal drilling than during pipe bursting. On the other hand, ovalisation of the pipe’s cross-section was greater during pipe bursting.
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| 41. |
- Forsaeus Nilsson, Stefan, 1972
(författare)
-
Durability of District Heating Pipes
- 2002
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis is focused on mechanical loads and moisture related problems with a potential to critically harm the functionality of pre-insulated district heating pipes and pipe joints. Directly buried pipeline bends are investigated with respect to limiting deformations from a thermally induced lateral displacement. A new approach is introduced; stating that very large deformations of the insulation foam are tolerable as long as overheating of the casing pipe is avoided. A local increase in heat losses and loss of axial shear stiffness is not critical, but a too high temperature will accelerate the rate of deterioration of the polyethylene material. Measurements indicate that the earth pressures required to reach critical deformations are not likely to develop in regularly compacted backfill materials. Problems related to backfilling with reused excavated soil containing coarse-grained materials are of particular interest. The lifetime implications from large stones causing deep indentations in the casing pipe wall are studied. A conceptual framework for the force interaction between a laterally displaced pipe and a stone adjacent to it is presented, along with tests on the long-term strength of severely strained polyethylene. The risk for obtaining deep indentations depends on the compaction of the backfill, and is greatest in materials compacted to "ordinary" levels. There is an obvious temperature dependence in the expected lifetime. To avoid the combination of indentations and an elevated casing pipe temperature, compaction of backfill material containing large stones should be avoided around pipeline bends. The strength of pipe joints to axial movements through coarse-grained backfill material is studied experimentally. It is concluded that electro-fusion welded sleeves are superior to other types. But with a simple external protection, consisting of a polyethylene net, the much cheaper single-sealed non-shrinking sleeve can be used in very tough backfill materials. The consequences of a leaking joint seal are investigated experimentally and analytically. Homogeneous and defect-free PUR foam will act as a moisture barrier, protecting the medium pipe from water. Air-gaps or voids in the foam may promote an inflow of groundwater by a "breathing effect" caused by temperature variations. Hence in order to improve the performance of the joints, efforts should be made to develop the methods for foam injection to ensure a complete filling of the joint space. Vapour diffusion in plastics pipes heating systems and in cooling systems is studied analytically. In heating systems with polyethylene medium pipes, vapour will diffuse outward and possibly condensate and accumulate in the colder parts of the insulation foam. Calculations indicate that the increase in heat losses during the first 50 years of service is about 25 - 30 %. In cooling pipes, vapour passing in from saturated soil will condense in the colder insulation. Simplified calculations show that condensation of water starts almost immediately.
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| 42. |
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| 43. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Fuktmätning med pulsekometer
- 2005
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta projekt syftar till att undersöka vilka förutsättningar som finns att bygga upp ett larmsystem baserat på pulsekometermätningar där indikeringarna kan tolkas kvantitativt och därmed ger en säkrare bild av en fuktskadas omfattning. Projektarbetet har till största delen bestått av mätningar med pulsekometer för att utröna sambanden mellan ett fuktfels storlek och utslaget på mätinstrumentet. I viss utsträckning har även jämförande mätningar på samma fuktfel gjorts med olika pulsekometrar. Undersökningar har gjorts på en provledning i laboratorium på simulerade fuktfel med såväl ”rent” vatten i behållare och med porösa material uppfuktade till varierande grad. Studier har gjorts av hur mängden fukt och dess läge i förhållande till larmtråden påverkar mätresultaten. Dessutom har effekten av standardmässiga larmaktivatorer undersökts. Kompletterande mätningar har gjorts även på en verklig fjärrvärmeledning i Göteborg. Ofta används lik- eller växelströmsresistansen mellan tråd och medierör som larmindikator för när ett fuktfel föreligger. Emellertid är det inte så att fukt med automatik väsentligt sänker resistansnivån. Det finns inte heller någon entydig korrelation mellan mängden fukt och resistansnivån. Dock ökar systemets känslighet betydligt då larmfilt används. Sådana kan emellertid påverka systemets elektriska egenskaper så att goda pulsekometermätningar försvåras. Med pulsekometer kan ett fuktfel lokaliseras med god noggrannhet, men det är inte möjligt att utifrån den uppmätta pulsekokurvan dra några mera precisa slutsatser om hur långt fuktfelet sträcker sig längs ledningen. Däremot föreligger ett linjärt samband mellan mängden fukt direkt mellan larmtråd och stålrör och mätutslagets storlek, vilket i princip gör det möjligt att använda sig av pulsekometerteknik för kvantitativa mätningar. Det är dock svårt att indikera fukt som befinner sig vid sidan av larmtråden eller utanför denna, sett från stålröret. En möjlig vidareutveckling av dagens fuktövervakningssystem vore att använda sig av den diffusionsspärr av metallfolie på insidan mantelröret som flera rörtillverkare nu introducerar som ledare för spänningspulsen istället för dagens koppartråd. Det skulle göra att all fukt inuti rörkonstruktionen befann sig mellan ledaren och jordplanet och således vore synlig på pulsekokurvan. En förutsättning är dock fortfarande ett metalliskt medierör. Pulsekometrar av olika fabrikat fungerar efter samma princip men resultaten kan presenteras på olika sätt. Mätningarna ger dock samma information. Idag krävs att en erfaren operatör tolkar resultaten, men i princip torde det vara möjligt att behandla mätdata på ett sätt som gör att slutresultatet presenteras i ett standardiserat format. En överslagsmässig teoretisk analys av temperaturmätande fuktövervakningssystem visar att de är mindre känsliga än elektriska system, såtillvida att det krävs större mängder fukt innan de kan ge en säker reaktion.
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| 44. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Grund förläggning av fjärrvärmeledningar
- 2006
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Tidigare studier inom programmet Värmegles Fjärrvärme har visat på att det går att minska investeringskostnaderna genom att effektivisera markarbetena vid läggning av fjärrvärmeledningar. Föreliggande projekt har studerat förutsättningarna för att minska läggningsdjupet i typiska villagator i värmeglesa områden utan att öka risken för skador på vare sig rör eller gata. En inventering gjordes av aktuella normer och anvisningar samt lokala föreskrifter från kommuner och energibolag gällande rörschaktens geometri, läggningsdjup, kringfyllningsmaterial, packningsgrad, dränering etc. Därutöver har energibolag och tekniska förvaltningar i ett antal svenska kommuner tillfrågats om vilka regler de följer. Det är i huvudsak endast de större kommunerna som har specifika krav på läggningsdjup i gatumark. På de flesta håll följer man Svensk Fjärrvärmes läggningsanvisningar och i mindre kommuner överlåter man i hög grad åt energibolagen att sköta frågan. I några kommuner finns överenskommelser mellan den kommunala förvaltningen och energibolaget att under vissa förutsättningar tillåta grundare förläggning, till exempel i Göteborg, Jönköping och Luleå. En analys av kostnaderna som är förknippade med markarbetena visade på att dessa kan minskas med närmare 30 % genom att minska läggningsdjupet från 600 mm till 350 mm. I ett fältförsök genomfördes mätningar i och kring fyra fjärrvärmerör av typ DN 2 × 32/160 som förlades 600 mm, 380 mm, 280 mm samt 180 mm under asfaltytan på en tungt och intensivt trafikerad fabriksgata. Återschaktning och asfaltering utfördes som för en typisk villagata i enlighet med Svensk Fjärrvärmes läggningsanvisningar. Under försökets gång har mätningar gjorts av rörens deformation, spårbildning i asfaltytan samt gatans bärighetsegenskaper. Rörens deformation har visat sig vara försumbar – oavsett vilket djup de läggs på. Detta tolkas som att fyllningen, om den är väl packad, tar upp huvuddelen av krafterna från trafikbelastningen genom valvverkan. Spårbildningen i gatan är däremot tydlig men tycks direkt avspegla sättningar i den nylagda fyllningen så att djupare fyllning ger större sättningar. En grundare rörförläggning medför därför mindre spårbildning i asfaltytan. Grundare förläggning medför något ökade värmeförluster, något större temperaturrörelser i systemet och en ökad risk för knäckning av ledningen uppåt genom överfyllnaden. Sådana aspekter får bedömas från fall till fall. Slutsatsen blir därmed att det tekniskt går att lägga fjärrvärmeledningar grundare i villagator om packningen av kringfyllningen utförs på ett bra sätt och man i övrigt följer de regelverk som finns. Det tycks också finnas goda förutsättningar för energibolagen att få acceptans för detta i sina kommuner.
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| 45. |
- Forsaeus Nilsson, Stefan, 1972
(författare)
-
Lifetime of HDPE under stress relaxation at large strains
- 2004
-
Ingår i: Plastics Pipes XII.
-
Konferensbidrag (refereegranskat)abstract
- Slow Crack Growth (SCG) in HDPE under stress relaxation was studied by measuring the time to fracture of notched pipe samples subjected to constant hoop strains. Tests were made in a 2 % Arkopal N-100 tenside solution at various temperatures. The constant deformation was accomplished by pressing the pipe samples onto oversized steel cylinders with diameters giving strain levels ranging from 5 to 50 %. In addition, efforts were made to measure the stress relaxation by applying strain gauges to the steel cylinder wall. Two grades of HDPE were studied—one PE63 grade and one PE100 grade. The two materials were found to behave very differently. Somewhat surprisingly, the PE100 grade generally exhibited shorter fracture times. Furthermore, the time to fracture showed significant temperature dependence but was more or less independent of strain level above the yield point. For the PE63 material, on the other hand, the temperature effect was much less prominent, but a slight strain level dependence was seen. It is likely that the reason for this is differences in the stress relaxation behaviour. As the stress level decreases over time, so does the crack driving potential, and an elevated temperature may not necessarily lead to an overall acceleration of the crack propagation. A frequently used empirical model for the calculation of fracture times was expanded to account for a time dependent stress level. The results indicate that SCG under stress relaxation may be analytically treated in analogy with the more common creep case.
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| 46. |
- Forsaeus Nilsson, Stefan, 1972, et al.
(författare)
-
Läckagevägar för markvatten i skarvisolering
- 2005
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Att ett tätt och sprickfritt rörskum innebär en betydelsefull barriär mot utifrån inträngande vatten har påvisats i tidigare undersökningar. Men det har också uppmärksammats att skarvskummets cellstruktur i gränsskiktet mot rörskummet ofta är betydligt grövre än i skarvskummet i övrigt. Det föreliggande projektet har avsett att klarlägga om en grövre cellstruktur i gränsskiktet mot rörskummet kan utgöra en oönskad transportväg för inträngande markvatten vid ett läckage genom skarvtätningen. Resultaten visar att utförandet av skarvskumningen avgör vilken täthet gränsskiktet får. Skumning mot ett renskalat rörskum visar sig ge klart högre säkerhet mot vattenläckage än det normala förfarandet att skumma mot befintlig yta. Undersökningarna utfördes efter ett schema där olika kombinationer av rörskum, skarvskum och förbehandlingar studerades. Gränsskiktets vattengenomsläpplighet uppmättes på sju olika skarvar med inalles fjorton olika kombinationer av gränsskikt. Dessutom karaktäriserades skarvskummen genom uppmätning av densitet, cellstorlek och andelen slutna celler. Skarvutförandet varierades på flera olika sätt. Både rör med väderexponerade ändytor rör med helt eller delvis renskalade ändytor och rör med ändgavlar användes. Vidare har enkelrör i både DN 50, DN 65 och DN 300-dimension och dubbelrör DN 2×40 använts. Fyra av skarvarna skummades vid rumstemperatur, en i låg temperatur och två med hög temperatur på medieröret. Resultaten visar att samtliga gränsskikt mot renkapade ändytor var täta, vatten passerade dessa prov endast genom ångdiffusion. När det gäller gränsskikten mot lagrade ändytor visade sig endast ett av proven vara tätt, övriga läckte i olika grad. De prover som innehöll ändgavlar visade sig vara täta på skarvskumsidan men otäta på rörskumsidan. Några tydliga skillnader mellan rör av olika dimension och mellan enkel- och dubbelrör har inte framkommit. Inte heller har några påtagliga skillnader kunnat påvisas mellan skarvar skummade vid hög temperatur och skarvar skummade vid rumstemperatur. Däremot tycks gränsskikt som skummas i låg temperatur bli tätare. Vid jämförelser av läckagehastigheter tyder resultaten på att grövre cellstrukturer i gränsskikten ger snabbare läckage. Samtidigt kan konstateras att grövre cellstruktur också bildas mot renskalade ändytor utan att föranleda något läckage. Detta tyder på att stora celler i sig inte är orsaken, men påskyndar läckage i de fall det uppstår. En överslagsmässig analys baserad på perkolationsteori antyder att PUR-skum som uppfyller kraven i SS-EN 253 avseende andelen slutna celler teoretiskt inte skall kunna vara vattengenomsläppligt. Den viktigaste slutsatsen av de genomförda studierna är att de bästa skarvskumningsresultaten uppnås om ändytorna renskalas före skumning. På så vis blir vidhäftningen i gränsskiktet maximal och risken för läckage genom detsamma minimal. Därför rekommenderas att vikten av att ändytorna renskalas för skumning lyfts fram i Svensk Fjärrvärmes Läggningsanvisningar och i tillverkarnas montageanvisningar. Det är även viktigt att skarvmontörer i sin utbildning blir tydligt informerade om vikten av att ändytorna är renskalade för att bästa resultat skall uppnås.
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| 47. |
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| 48. |
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| 49. |
- Forsaeus Nilsson, Stefan, 1972
(författare)
-
New developments in pipes and related network components for district heating
- 2016
-
Ingår i: Advanced District Heating and Cooling (DHC) Systems. - 9781782423744 ; , s. 191-214
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This chapter outlines the state-of-the-art pipes, related components and installation methods for district heating (DH). It focuses on technical aspects concerning a DH pipe system’s life cycle cost, covering investment costs, heat losses and durability of materials and components. The review is based on research results from the late 1990s onwards, which are deemed not to be considered as common knowledge nor broadly put into use by the European DH industry.
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| 50. |
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