| 1. |
- Alftberg, Åsa, et al.
(författare)
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Conversations about Death and Dying with Older People : An Ethnographic Study in Nursing Homes
- 2018
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- Nursing homes are often places where older persons “come to die.” Despite this, death and dying are seldom articulated or talked about. The aim of this study was to explore assistant nurses’ experiences of conversations about death and dying with nursing home residents. This study is part of an implementation project through a knowledge-based educational intervention based on palliative care principles. An ethnographic study design was applied in seven nursing homes, where eight assistant nurses were interviewed and followed in their daily assignments through participant observations. The assistant nurses stated that they had the knowledge and tools to conduct such conversations, even though they lacked the time and felt that emotional strain could be a hinder for conversations about death and dying. The assistant nurses used the strategies of distracting, comforting, and disregarding either when they perceived that residents’ reflections on death and dying were part of their illness and disease or when there was a lack of alignment between the residents’ contemplations and the concept of dying well. They indicated that ambivalence and ambiguity toward conversations about death and dying should be taken into consideration in future implementations of knowledge-based palliative care that take place in nursing homes after this project is finalized.
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| 2. |
- Bjarnegård, Niclas, et al.
(författare)
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Age affects proximal brachial artery stiffness : differential behaviour within the length of the brachial artery?
- 2003
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Ingår i: Ultrasound in Medicine and Biology. - 0301-5629. ; 29:8, s. 1115-1121
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Tidskriftsartikel (refereegranskat)abstract
- With increasing age, the diameter of central elastic arteries increases, whereas their distensibility decreases. The purpose of this study was to investigate the mechanical properties of the proximal brachial artery in relation to age and gender. Distensibility coefficient (DC), stiffness and compliance coefficient (CC) were calculated in 136 healthy males and females (range 9-82 y) using echo-tracking sonography. CC decreased with age in both genders, but CC was higher in males. Stiffness increased and DC decreased with age in an exponential manner, without any differences between genders. In conclusion, as in central elastic arteries, the distensibility of the proximal brachial artery decreases with age, in contrast to earlier reports on the muscular distal brachial artery. This may imply that the transition between elastic and muscular artery behavior is within the length of the brachial artery. In future studies using the brachial artery, the examination site needs to be defined.
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| 3. |
- De Basso, Rachel, et al.
(författare)
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Increased cardiovascular risk without generalized arterial dilating diathesis in persons who do not have abdominal aortic aneurysm but who are first-degree relatives of abdominal aortic aneurysm patients
- 2015
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Ingår i: Clinical and Experimental Pharmacology and Physiology. - : Wiley. - 1440-1681 .- 0305-1870. ; 42:6, s. 576-581
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Tidskriftsartikel (refereegranskat)abstract
- There is a strong genetic predisposition towards abdominal aortic aneurysm (AAA), but it is unknown whether persons without AAA but with first-degree relatives who are AAA patients have a generalized dilating diathesis, defect arterial wall mechanics, or increased cardiovascular risk. The aim of the study was to investigate arterial diameters and wall mechanics at multiple arterial sites in these subjects and compare them with controls without a family history of AAA. This study included 118 first-degree relatives of patients with AAA and 66 controls (age: 40-80years). The abdominal aorta, common carotid artery, common femoral artery, and popliteal artery were investigated by echo-tracking ultrasound. The relatives had no arterial dilatation, but they did tend to have smaller diameters than controls. Relatives had a higher heart rate, diastolic blood pressure, and mean arterial pressure than controls. The distensibility coefficient and the compliance coefficient were decreased in all arteries in male relatives, adjusted for age and smoking; these coefficients were normalized after adjustment for mean arterial pressure and heart rate. Female relatives had a lower compliance coefficient in the abdominal aorta, adjusted for age and smoking. After adjustment for mean arterial pressure and heart rate, the difference disappeared. No general arterial dilatation in relatives without AAA was found, supporting the hypothesis that the dilating diathesis is linked to the aneurysmal manifestation in the abdominal aorta. Although the threat of aneurysmal dilatation and rupture seems to be lacking in these subjects, heart rate, blood pressure, and arterial wall stiffness were all increased, which may indicate a higher risk of developing cardiovascular morbidity and mortality.
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| 4. |
- De Basso, Rachel, et al.
(författare)
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Low wall stress in popliteal artery – other mechanisms responsible for the predilection of aneurysmal dilatation?
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The popliteal artery (PA) is, after aorta, the most common site for aneurysm formation. Why the PA is more susceptible than other peripheral muscular arteries is unknown. We hypothesised that the wall composition, which in turn affects wall properties, as well as the circumferential wall stress imposed on the arterial wall, might differ compared to other muscular arteries. The aim was to study the circumferential wall stress of the PA in healthy subjects with the adjacent muscular common femoral artery (CFA) as a comparison.Material and Methods: Ninety-four healthy subjects were included in this study (45 males, range 10-78 years and 49 females, range 10-83 years). The lumen diameter (LD) and intima-media thickness (IMT) in the PA and CFA were investigated with a Philips P700 ultrasound device. Together with blood pressure the circumferential wall stress was defined according to the law of Laplace adjusted for IMT.Results: The diameter increased with age in both PA and CFA (P<.001), with males having larger diameter than females (P<.001). IMT increased with age in both PA and CFA (P<.001), with higher IMT values in males only in PA (P<0.001). The calculated wall stress was unchanged with age in both arteries, but lower in PA than in CFA in both male and female subjects (P<0.001).Conclusion: This study shows that the popliteal and common femoral artery wall stress is maintained during ageing, probably due to compensatory remodeling response with an increase in arterial wall thickness. However, the stress imposed on the popliteal artery wall is quite low, indicating that other mechanisms than wall stress contribute to the process of pathological arterial dilatation in the popliteal artery.
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| 5. |
- De Basso, Rachel, et al.
(författare)
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Low wall stress in the popliteal artery: Other mechanisms responsible for the predilection of aneurysmal dilatation?
- 2014
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Ingår i: Vascular Medicine. - : SAGE Publications (UK and US). - 1477-0377 .- 1358-863X. ; 19:2, s. 131-136
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Tidskriftsartikel (refereegranskat)abstract
- The popliteal artery (PA) is, after aorta, the most common site for aneurysm formation. Why the PA is more susceptible than other peripheral muscular arteries is unknown. We hypothesized that the wall composition, which in turn affects wall properties, as well as the circumferential wall stress (WS) imposed on the arterial wall, might differ compared to other muscular arteries. The aim was to study the WS of the PA in healthy subjects with the adjacent, muscular, common femoral artery (CFA) as a comparison. Ninety-four healthy subjects were included in this study (45 males, aged 10-78 years and 49 females, aged 10-83 years). The diameter and intima-media thickness (IMT) in the PA and CFA were investigated with ultrasound. Together with blood pressure the WS was defined according to the law of Laplace adjusted for IMT. The diameter increased with age in both PA and CFA (p<0.001), with males having a larger diameter than females (p<0.001). IMT increased with age in both PA and CFA (p<0.001), with higher IMT values in males only in PA (p<0.001). The calculated WS was unchanged with age in both arteries, but lower in PA than in CFA in both sexes (p<0.001). In conclusion, this study shows that the PA and CFA WS is maintained during aging, probably due to a compensatory remodelling response with an increase in arterial wall thickness. However, the stress imposed on the PA wall is quite low, indicating that mechanisms other than WS contribute to the process of pathological arterial dilatation in the PA.
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| 6. |
- Debasso, Rachel, 1978-, et al.
(författare)
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The popliteal artery, an unusual muscular artery with wall properties similar to the aorta : Implications for susceptibility to aneurysm formation?
- 2004
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 39:4, s. 836-842
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The popliteal artery is, after the aorta, the most common site for aneurysm formation. Why the popliteal artery is more susceptible than other peripheral muscular arteries is unknown. An important factor may be differences in arterial wall composition as compared with other peripheral muscular arteries, which in turn affect wall properties. These are however unknown. We studied the mechanical wall properties of the popliteal artery in healthy subjects. Material and Methods: An ultrasound echo-tracking system was used to measure pulsatile changes in popliteal diameter in 108 healthy subjects (56 female, 52 male, age range, 9-82 years). In combination with blood pressure, stiffness (β), strain, cross-sectional artery wall compliance coefficient (CC), and distensibility coefficient (DC) were calculated. Intima-media thickness (IMT) was registered with a Philips P700 ultrasound scanner. Results: The popliteal diameter increased with age, and was larger in male subjects than in female subjects (P < .001). Fractional diameter change (strain) decreased with age (P < .001), and strain values were lower in male subjects than in female subjects (P < .01). Accordingly, stiffness increased with age (P < .001), with higher stiffness values in male subjects (P < .01). DC decreased with age (P < .001), with lower DC values in male subjects (P < .01). CC decreased with age, with no difference between genders (P < .001). IMT increased with age (P < .001), with higher IMT values in male subjects (P < .001). The increase in IMT did not affect distensibility. Conclusion: The wall properties of the popliteal artery are affected by age and gender, not only with an increase in diameter, but also with an age-related decrease in distensibility, with male subjects having lower distensibility than in female subjects. This seems not to be the behavior of a true muscular artery, but of a central elastic artery, such as the aorta, and might have implications for susceptibility to arterial dilatation, as well as the association of aneurysm formation between the aorta and the popliteal artery.
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| 7. |
- Goldsteins, Gundars, et al.
(författare)
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Characterisation of two highly amyloidogenic mutants of transthyretin
- 1997
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Ingår i: Biochemistry. - : American Chemical Society (ACS). - 0006-2960 .- 1520-4995. ; 36:18, s. 5346-5352
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Tidskriftsartikel (refereegranskat)abstract
- The plasma protein transthyretin (TTR) has the potential to form amyloid under certain conditions. More than 50 different point mutations have been associated with amyloid formation that occurs only in adults. It is not known what structural changes are introduced into the structure of this otherwise stable molecule that results in its aggregation into insoluble amyloid fibrils. On the basis of calculations of the frequency of known mutations over the polypeptide, we have constructed two mutants in the D-strand of the polypeptide. These molecules, containing either a deletion or a substitution at amino acid positions 53−55, were unstable and spontaneously formed aggregates upon storage in TBS (pH 7.6). The precipitates were shown to be amyloid by staining with thioflavin T and Congo Red. Their ultrastructure was very similar to that of amyloid fibrils deposited in the vitreous body of patients with familial amyloidotic polyneuropathy type 1 with an amino acid replacement in position 30 (TTRmet30). Like amyloid isolated from the vitreous body of the eye, the amyloid precipitates generated from the TTR mutants exposed a trypsin cleavage site between amino acid residues 48 and 49, while plasma TTRmet30 isolated from amyloidosis patients as well as wild-type TTR only showed minor trypsin sensitivity. Our data indicate that the mutants we have constructed are similar to amyloid precursors or may share structural properties with intermediates on a pathway leading to amyloid deposits of plasma TTR.
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| 8. |
- Görman, Frida, et al.
(författare)
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Klimatpåverkan från en byggnads hela livscykel: Bakgrundsrapport till anvisningar för LCA-beräkningar
- 2024
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Senast år 2045 ska Sverige enligt det nationella klimatmålet inte ha några nettoutsläpp av växthusgaser till atmosfären. För att nå detta mål måste alla sektorer bidra. Bygg- och anläggningssektorn står för ungefär en femtedel av Sveriges totala klimatpåverkan och har tagit fram en färdplan för fossilfri konkurrenskraft för att bidra till detta mål. En del av åtgärderna i färdplanen är att minska klimatpåverkan från byggnader under hela dess livscykel, det vill säga utöver byggskedet ska även användningsskedet och slutskedet ingå. Genomförandet av en klimatberäkning av en byggnads hela livscykel är däremot inte helt enkelt och kräver flera aktiva metodval och antaganden.Krav på beräkning av en byggnads hela livscykel förekommer även både i EU:s taxonomi och det uppdaterade Energy Performance of Buildings Directive (EPBD). Trots dessa krav saknas nationella riktlinjer för hur sådana beräkningar bör utföras. Detta projekt har syftat till att ta fram gemensamma anvisningar för beräkning av byggnaders hela livscykel.Gemensamma beräkningsanvisningar för bygg- och fastighetsbranschen förväntas underlätta jämförelser mellan olika beräkningar samtidigt som de bidra till konkurrensneutralitet mellan aktörer. Gemensamma beräkningsanvisningar är också en förutsättning för att kunna förhålla sig till mål och gränsvärden samt rikta klimatförbättrande åtgärder. Enskilda aktörer i Sverige, så som byggentreprenörer och fastighetsägare, ska då kunna analysera sina åtgärder mot så väl nationella som EU:s krav.I detta projekt har särskilt fokus lagts på framtagande av beräkningsanvisningar för användningsskedet och slutskedet av byggnaders livscykel. Detta beror på att beräkningsmetodik och anvisningar för byggskedet redan har utvecklats nationellt genom lagen om klimatdeklaration för byggnader, som trädde i kraft den 1 januari 2022.De framtagna beräkningsanvisningarna är avsedda att vara gemensamma, verktygsneutrala och förenkla beräkningen av klimatpåverkan från en byggnads hela livscykel. Målet är att de ska vara i linje med LCA-kraven för nya byggnader enligt EU:s taxonomi, EPBD och standarden för klimatberäkningar av byggnader, EN 15978. Det är viktigt att notera att anvisningarna kan behöva uppdateras när mer information blir tillgänglig, exempelvis genom den delegerade akten till EPBD som ska komma i december 2025.Framtagna beräkningsanvisningarna har arbetats fram tillsammans med branschen genom en workshopserie, en kompletterande workshop med påföljande remissrunda för preliminära beräkningsanvisningar. Efter den inledande workshopsserien testades olika metodval, LCA-data och scenarioantaganden i fallstudier. Resultaten från dessa fallstudier låg sedan till grund för den kompletterande workshopen. Därefter sammanfattades resultaten i preliminära beräkningsanvisningar som skickades ut på remiss till projekt- och referensgrupper.Utöver projektgrupp och referensgrupp har ytterligare aktörer bjudits in till ett informationsmöte där dessa aktörer hade möjlighet att ge synpunkter och kommentarer utifrån deras roll. På detta möte deltog cirka 40 olika organisationer. På så sätt har det som tagits fram förankrats hos sektorns olika aktörer.Utfallet från workshops, fallstudier och hearing har resulterat i en rad slutsatser och rekommendationer som presenteras i denna rapport. Ett antal frågor har också identifierats som behöver arbetas vidare med i framtida projekt. Gemensamt med denna rapport har beräkningsanvisningar tagits fram som beskriver vilka regler som beräkningarna av en byggnads livscykel ska följa.De viktigaste slutsatserna från genomförandet av projektet och vid framtagande av beräkningsanvisningar kan sammanfattas med följande punkter:• Användning av beräkning enligt framtagna beräkningsanvisningar som ensamt beslutsunderlag kan vara problematisk.• Klimatförbättringsscenario baserat på beslutade åtgärder ska användas för delar av livscykeln, för att avspegla en mer realistisk minskad klimatpåverkan över tid.• Ursprungsgarantier (gröna avtal) och liknande ska inte användas eftersom det inte speglar den faktiska påverkan från använd energi.• Svensk elmix ska användas, nordisk elmix rekommenderas som tillägg.• Lokala värden för fjärrvärme rekommenderas men svenskt medelvärde kan användas.• EPD:er med marknadsbaserad energimix bör undvikas om möjligt.• Egna scenarion och antaganden ska inte användas då de är svåra att verifiera och jämförbarhet mellan beräkningarna minskar.• Nuvarande standard belyser inte potentiell nytta med flexibla och demonterbara byggnader, varför särskilda indikatorer för detta bör tas fram.• Scenariobaserade data (modul A4 till D) från EPD:er för byggmaterial ska inte användas.
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| 9. |
- Persson, Åsa, 1966-
(författare)
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De politiska partiernas rättspolitik
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Political parties act in law and politics and have opinions that can be aligned along a law-politics dimension. The purpose of this thesis is to problematize and analyze the conceptualization of law and politics as distinctly separate phenomena by studying the law and politics dimension in Swedish party politics. Specifically, it is a study of political parties´views and arguments as regards core elements of the relationship between the individual and the state. The research problematizes knowledge about law and politics in the borderland between legal scholarship and political science. To identify political parties´views and arguments as regards law and politics the study contains their views and arguments as regards state use of concealed and coercive measures, legal aid and legislation for the protection of and support to victims of crime. In order to capture possible shifts in party positions the study covers the twentieth century. These cases are of central importance of the field and are closely connected to the principles of protection and accessibility of the law as expressions of the principle of rule of law. From the 1970s the material revealed increasing concern for legal principles or values such as privacy, equality before the law, accessibility of the law, and the right of the individual to be secure from crime. These arguments was most forcefully made by the Liberal and the Left parties. The Social Democratic Party, has had a noticeably unprincipled attitude as regards law and politics and seems to be navigating without any compass other than the finances of the state. As regards the Conservative Party, the analysis leads to almost the same conclusion. The most consistent parties on the law-politics dimension are the Liberal Party and even more the Left Party. The relationship between law and politics cannot be described in terms of separation or boundaries. On the contrary, there is an essential interaction and mutual relationship. The political parties have in recent years drawn up programmes in the field of law and politics. In spite of that, it is hardly an overstatement to assert that legal issues as matters of principle do not occur frequently in preparatory documents preceding legislation. Yet the motives laid out in such documents have a significant influence on how legislation is interpreted.
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| 10. |
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| 11. |
- Rydén Ahlgren, Åsa, et al.
(författare)
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Dynamic behaviour of the common femoral artery: age and gender of minor importance
- 2001
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Ingår i: Ultrasound in Medicine and Biology. - 0301-5629 .- 1879-291X. ; 27:2, s. 181-188
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Tidskriftsartikel (refereegranskat)abstract
- The distensibility of elastic arteries has been extensively studied, while studies of muscular arteries are sparse. The influences of age and gender on the mechanical properties of the common femoral artery (CFA) were studied. The pulsatile diameter changes of the CFA were noninvasively measured using echo-tracking sonography in 173 healthy volunteers (95 females, 78 males, range 7-81 years). In combination with blood pressure measurements, stiffness (beta) and pressure strain elastic modulus (Ep) were calculated. Neither beta nor Ep was related to age or gender and a considerable interindividual variation was present. The CFA diameter increased with age. In conclusion, the distensibility of this muscular artery is not clearly affected by age or gender, although the diameter increases with age. This indicates remodelling of the arterial wall and an impact of vascular smooth muscles on long-term wall mechanics. Thus, there appear to be fundamental differences in the dynamic behaviour of the common femoral artery when compared to elastic arteries, such as the aorta and the common carotid artery.
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| 12. |
- Rydén Ahlgren, Åsa, et al.
(författare)
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Female gender increases stiffness of elastic but not of muscular arteries in type I diabetic patients
- 2002
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Ingår i: Clinical Physiology and Functional Imaging. - 1475-0961 .- 1475-097X. ; 22:6, s. 409-415
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Tidskriftsartikel (refereegranskat)abstract
- The reason for the particularly increased risk for cardiovascular complications in diabetic women is still unclear. We have previously found decreased distensibility of elastic arteries in type I diabetic women, indicating increased cardiac load, not seen in type I diabetic men, which might be one contributing factor. Whether the effect of gender is different in muscular arteries in type I diabetic patients has not been assessed. As estimates of arterial distensibility we measured stiffness (▀) and pressure strain elastic modulus (Ep) in the muscular common femoral artery using echotracking sonography in 30 women (mean age 34 years, range 20-61) and 26 men (mean age 38 years, range 22-56) with type I diabetes. The results were compared with those of 89 healthy individuals of corresponding age and gender and with previously published results from elastic arteries in these patients obtained at the same occasion. The internal common femoral diameter was significantly decreased in both diabetic men and women. In sharp contrast to the highly significant decreased distensibility of the elastic abdominal aorta and common carotid artery in the type I diabetic women, the distensibility of the common femoral artery did not clearly differ between patients and controls, neither for women nor for men. Thus, the gender difference in changes of arterial distensibility found in elastic arteries was absent or far less obvious in the femoral artery. In conclusion, female gender seems to affect the mechanical properties of elastic, but not of large muscular arteries in type I diabetic patients. Thus, putative gender differences in arterial changes in type I diabetes are to be sought in elastic rather than muscular arteries.
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| 13. |
- Sandelius, Åsa P, et al.
(författare)
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Cerebrospinal fluid growth-associated protein 43 in multiple sclerosis.
- 2019
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 9:1
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Tidskriftsartikel (refereegranskat)abstract
- Neurodegeneration in multiple sclerosis (MS) correlates with disease progression and reparative processes may be triggered. Growth-associated protein 43 (GAP-43) exhibits induced expression during axonal growth and reduced expression during MS progression. We aimed to evaluate if GAP-43 can serve as a biomarker of regeneration in relapsing-remitting MS (RRMS) and whether disease-modifying therapies (DMTs) influence GAP-43 concentration in cerebrospinal fluid (CSF). GAP-43 was measured using an enzyme-linked immunosorbent assay in 105 MS patients (73 RRMS, 12 primary progressive MS, 20 secondary progressive MS) and 23 healthy controls (HCs). In 35 of the patients, lumbar puncture, clinical assessment, and magnetic resonance imaging was performed before initiation of therapeutic intervention, and at follow-up. CSF GAP-43 concentration was significantly lower in progressive MS compared with HCs (p=0.004) and RRMS (p=<0.001) and correlated negatively with disability (p=0.026). However, DMTs did not alter CSF GAP-43. Interestingly, in RRMS CSF GAP-43 levels were higher in patients with signs of active inflammatory disease than in patients in remission (p=0.042). According to CSF GAP-43 concentrations, regeneration seems reduced in progressive MS, increased during disease activity in RRMS but is unaffected by treatment of highly active DMTs.
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| 14. |
- Sandgren, T., et al.
(författare)
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Arterial dimensions in the lower extremities of patients with abdominal aortic aneurysms - No indications of a generalized dilating diathesis
- 2001
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 34:6, s. 1079-1084
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study assessed whether there is a dilating diathesis in peripheral arteries of patients with abdominal aortic aneurysms (AAAs). Methods: The anteroposterior diameters of the common femoral artery (CFA) and popliteal artery (PA) were measured in 183 consecutive patients with an AAA (158 men, 25 women, age range, 57-78 years) before elective surgery on the AAA and compared with that of healthy age-matched control subjects. The diameter registrations were performed on the right leg by using a noninvasive echo-tracking ultrasound scanning technique. Results: Eight CFA aneurysms and four PA aneurysms were found in the male patients with AAAs. Of the patients with AAAs in the CFA and in the PA who were investigated, 46% and 49%, respectively, were affected by peripheral vascular occlusive disease (PVOD). The CFA diameters in the patients with AAAs were 97.8% of those in healthy control subjects (P = not significant [NS]). After exclusion of the CFA aneurysms, the diameters were 92.7% of those in healthy control subjects (P = .0003). If patients with PVOD were also excluded, the CFA diameters were 95.2% of those in healthy control subjects (P = .022). The PA diameters in the patients with AAAs were 97.8% of those in healthy control subjects (P = NS). If PA aneurysms were excluded, the diameters were 94.4% of those in healthy control subjects (P = .0003). If patients with PVOD were also excluded, the PA diameters were 96.1% of those in healthy control subjects (P = NS). Conclusion: After excluding the few patients with AAAs who had peripheral aneurysmal disease and the patients with PVOD, no dilating diathesis in CFAs and PAs was found. This supports the hypothesis that specific genetic, or other factors, not present in most AAAs are responsible for the occurrence of concomitant peripheral aneurysms. Furthermore, the generalized vascular dilating diathesis seen in some patients seems to be a specific entity that was not necessarily affiliated with AAA disease.
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| 15. |
- Sandgren, Thomas, et al.
(författare)
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Factors predicting the diameter of the popliteal artery in healthy humans
- 1998
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Ingår i: Journal of Vascular Surgery. - 1097-6809. ; 28:2, s. 284-289
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the relevance of popliteal dilatations, knowledge of the normal popliteal artery diameter is essential. This study investigates the diameter of the popliteal artery in healthy males and females. METHODS: We measured the diameter of the popliteal artery in 121 healthy volunteers (59 males and 62 females), ages 8 to 81, with echo-tracking B-mode ultrasonography. We analyzed the influence of age, sex, height, weight, body surface area (BSA) and systolic blood pressure with a multiple regression model. RESULTS: The popliteal artery increased steadily in diameter throughout life. From 25 years on, the diameter was larger in males than in females. If corrected for BSA, this difference decreased from 17% to 7%. This study found a correlation between popliteal artery diameter and BSA (r=0.47 and r=0.61, respectively, p < 0.0001). Age, followed by BSA, was the most influencing factor on popliteal diameter in both males and females (r=0.62 and r=0.66, respectively, p < 0.0001). We used age and BSA in creating a model for prediction of popliteal artery diameter. CONCLUSIONS: The diameter of the popliteal artery increases with age, initially during growth, but also in adults. This is related to age, body size and sex, with males having larger arteries than females. It is now possible to predict the normal popliteal arterial diameter, and nomograms are presented for use in the study of aneurysmal arterial disease.
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| 16. |
- Sandgren, Thomas, et al.
(författare)
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The diameter of the common femoral artery in healthy human: influence of sex, age, and body size
- 1999
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Ingår i: Journal of Vascular Surgery. - 1097-6809. ; 29:3, s. 503-510
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the relevance of dilatations of the common femoral artery (CFA), knowledge of the normal CFA diameter is essential. The diameter of the CFA in healthy male and female subjects of different ages was investigated. METHODS: The diameter of the CFA was measured in 122 healthy volunteers (59 male, 63 female; 8 to 81 years of age) with echo-tracking B-mode ultrasound scan. The influence of age, sex, height, weight, body surface area (BSA), and systolic blood pressure was analyzed by means of a multiple regression model. RESULTS: The CFA increased steadily in diameter throughout life. From 25 years onwards, the diameter was larger in men than in women. Significant correlations were found between the CFA diameter and weight (r = 0.58 and r = 0.57 in male and female subjects, respectively; P <.0001), height (r = 0.49 and r = 0.54 in male and female subjects, respectively; P <.0001), and BSA (r = 0.60 and r = 0.62 in male and female subjects, respectively; P <.0001). Age and BSA were used to create a model for prediction of the CFA diameter (r = 0.71 and r = 0.77 in male and female subjects, respectively; P <.0001). CONCLUSION: The diameter of the CFA increases with age, initially during growth but also in adults. This is related to age, body size, and sex male subjects have larger arteries than female subjects. It is now possible to predict the normal CFA diameter, and nomograms that may be used in the study of aneurysmal disease are presented.
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| 17. |
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| 18. |
- Thrysin, Åsa, et al.
(författare)
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Vägledning - Klimatkrav vid upphandling av byggprojekt
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bygg- och fastighetssektorn står för nästan en femtedel av Sveriges klimatpåverkan, varav hälften kommer från byggverksamheten. Projektet Klimatkrav till rimlig kostnad har därför tagit fram en vägledning för att underlätta för bostadsföretag att ställa klimatkrav för byggprojekt. Förutsättningen för att ställa klimatkrav vid upphandling är att det finns ett enhetligt sätt att beräkna klimatpåverkan så att till exempel beräkningar från olika anbudsgivare är möjliga att jämföra.Därför har projektet tagit fram anvisningar för LCA-beräkning av byggprojekt som bland annat anger att vedertagen LCA-metodik skall användas, vilka delar av byggnaden som skall inkluderas och så vidare. Anvisningarna är en tolkning av Boverkets lagförslag på klimatdeklaration samt erfarenheter från praktiska beräkningar inom detta och andra projekt.Vägledningen presenterar förslag på konkreta informations-, förbättrings-, prestanda- och tilldelningskrav vilka kan kompletterats med negativa eller positiva ekonomiska konsekvenser. Entreprenörens uppföljning mot verkligt utförande beskrivs samt hur en beställare utvärderar och granskar beräkningar.Vägledningen kan användas av både privata och offentliga beställare och den kan användas i framtagande av upphandlingsdokument, löpande arbete under ett byggprojekt och i slutskedet av ett projekt. Den är särskilt användbar för nybyggnationer, men går att anpassa till ombyggnation.
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| 19. |
- Thrysin, Åsa, et al.
(författare)
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Vägledning - Klimatkrav vid upphandling av byggprojekt. Version 2.0
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet Klimatkrav till rimlig kostnad har tagit fram en vägledning för att underlätta för fastighetsbolag att ställa klimatkrav i byggprojekt. Råd och riktlinjer baseras på aktuell forskning, samverkan mellan entreprenörer och allmännyttiga bostadsföretag i nio testpiloter samt Boverkets arbete med Klimatdeklarationslagstiftningen. Olika typer av klimatkravkrav och upphandlingstexter presenteras och råd kring anbudsutvärdering och granskning av beräkningar presenteras. I projektet Klimatkrav till rimlig kostnad ROT har sedan denna vägledning uppdaterat för att inkludera även renoverings- och ombyggnationsprojekt samt uppdatera vägledningen som helthet även för nyproduktion och klimatdeklarationslagen. Här har IVL, Sveriges Allmännytta och Kommuninvest samarbetat med åtta testpiloter bestående av fastighetsbolag, entreprenörer och konsulter.
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| 20. |
- Thrysin, Åsa, et al.
(författare)
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Vägledning - Klimatkrav vid upphandling av byggprojekt. Version 2.1
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet Klimatkrav till rimlig kostnad har tagit fram en vägledning för att underlätta för fastighetsbolag att ställa klimatkrav i byggprojekt. Råd och riktlinjer baseras på aktuell forskning, samverkan mellan entreprenörer och allmännyttiga bostadsföretag i nio testpiloter samt Boverkets arbete med Klimatdeklarationslagstiftningen. Olika typer av klimatkravkrav och upphandlingstexter presenteras och råd kring anbudsutvärdering och granskning av beräkningar presenteras. I projektet Klimatkrav till rimlig kostnad ROT har sedan denna vägledning uppdaterat för att inkludera även renoverings- och ombyggnationsprojekt samt uppdatera vägledningen som helthet även för nyproduktion och klimatdeklarationslagen. Här har IVL, Sveriges Allmännytta och Kommuninvest samarbetat med åtta testpiloter bestående av fastighetsbolag, entreprenörer och konsulter.
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| 21. |
- Wallerstedt, Birgitta, et al.
(författare)
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Striking a Balance : A Qualitative Study of Next of Kin Participation in the Care of Older Persons in Nursing Homes in Sweden
- 2018
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Ingår i: Healthcare. - : MDPI. - 2227-9032. ; 6:2
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Tidskriftsartikel (refereegranskat)abstract
- Most of the care in nursing homes is palliative in nature, as it is the oldest and the frailest people who live in nursing homes. The aim of this study was to explore next of kin’s experiences of participating in the care of older persons at nursing homes. A qualitative design was used, based on semi-structured interviews with 40 next of kin, and analyzed using qualitative content analysis. An overarching theme emerged, a balancing act consisting of three categories: (1) visiting the nursing home; (2) building and maintaining relationships; and (3) gathering and conveying information. The next of kin have to balance their own responsibility for the older person’s wellbeing by taking part in their care and their need to leave the responsibility to the staff due to critical health conditions. The next of kin wanted to participate in care meetings and conversations, not only in practical issues. The findings indicate the need to improve the next of kin’s participation in the care as an equal partner. Increased knowledge about palliative care and decision-making of limiting life-prolonging treatment may lead to a higher quality of care
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| 22. |
- Åstrand, Håkan, et al.
(författare)
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Age-related increase in wall stress of the human abdominal aorta : An in vivo study
- 2005
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 42:5, s. 926-931
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Tidskriftsartikel (refereegranskat)abstract
- Background The regulation of wall stress in the abdominal aorta (AA) of humans might be of specific interest, because the AA is the most common site for aneurysm formation in which wall stress seems to be an important pathophysiological factor. We studied the age-related changes in wall stress of the AA in healthy subjects, with the common carotid artery (CCA) as a comparison. Methods A total of 111 healthy subjects were examined with B-mode ultrasonography to determine the lumen diameter and intima-media thickness (IMT) in the AA and the CCA. Results Aortic IMT was affected by age in men and by both age and lumen diameter in women. Carotid IMT was affected by age and pulse pressure in both men and women. Wall stress was higher in the AA than in the CCA (P < .001), and men had higher wall stress than women in both the AA (P < .001) and the CCA (P < .05). Furthermore, wall stress was constant during life in the CCA of men and women and in the AA of women. In the male aorta, however, wall stress increased with age (P < 0.01). Conclusions Arterial diameters increase with age, and a compensatory thickening of the arterial wall prevents the circumferential wall stress from increasing. However, this compensatory response is insufficient in the male AA and results in an increase in stress with age. These findings might explain the propensity for aneurysms to develop in the AA of men.
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| 23. |
- Åstrand, Håkan, et al.
(författare)
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Noninvasive ultrasound measurements of aortic intima-media thickness : Implications for in vivo study of aortic wall stress
- 2003
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Ingår i: Journal of Vascular Surgery. - 0741-5214 .- 1097-6809. ; 37:6, s. 1270-1276
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Tidskriftsartikel (refereegranskat)abstract
- Object: The abdominal aorta (AA) has a predilection for aneurysm formation. An etiologic factor may be underlying aortic wall stress. The purpose of this study was to examine whether the intima-media thickness (IMT) of the AA, as a surrogate to arterial wall thickness, can be measured noninvasively with satisfactory results to calculate circumferential wall stress, and to evaluate regional and gender differences in wall stress. Methods: Sixty-five middle-aged healthy subjects were examined with B-mode ultrasound to determine the diameter and IMT in the infrarenal AA, common carotid artery (CCA), common femoral artery (CFA), and popliteal artery (PA). Blood pressure was measured noninvasively in the brachial artery. Wall stress was calculated according to the law of LaPlace. Results: Intraobserver variability for the IMT in the AA showed a coefficient of variation of 11%. IMT was thickest in the AA compared with the CCA, CFA, and PA (P < .001). There was a gender difference in IMT in the CFA (P < .05) and PA (P < .01) but not in the AA. Greater wall stress was found in the AA than in the CCA (P < .001) and PA (P < .001), with men having greater wall stress in all studied arterial regions. Conclusions: Aortic IMT can be satisfactorily studied in vivo with noninvasive B-mode ultrasound. There are gender differences in IMT and wall stress, and the largest wall stress is found in the AA in men, which might be important in aneurysm development.
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| 24. |
- Åstrand, Håkan, et al.
(författare)
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Reduced aortic wall stress in diabetes mellitus
- 2007
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 33:5, s. 592-598
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Most risk factors are similar for abdominal aortic aneurysm (AAA) and atherosclerosis, e.g. smoking, male gender, age, high blood pressure, hyperlipidemia. Diabetes mellitus however, is a risk factor for atherosclerosis, but diabetic patients seldom develop AAA. The reason for this discrepancy is unknown. Increased aortic wall stress seems to be an etiologic factor in the formation, growth and rupture of AAA in man. The aim of our study was to study the wall stress in the abdominal aorta in diabetic patients compared with healthy controls. Methods: 39 patients with diabetes mellitus and 46 age – and sex matched healthy subjects were examined with B-mode ultrasound to determine the lumen diameter (LD) and intima-media thickness (IMT) in the abdominal aorta (AA) and the common carotid artery (CCA). Diastolic blood pressure (DBP) was measured non-invasively in the brachial artery. LaPlace law was used to calculate circumferential wall stress. Results: Age, DBP, and LD in the abdominal aorta were not significantly different in the diabetic patients compared to controls. IMT in the AA was larger in the diabetic patients, 0.89 ± 0.17 vs 0.73 ± 0.11 mm (p < .001). Accordingly aortic wall stress was reduced in the diabetics, 7.8 ± 1.7 × 105 vs 9.7 ± 1.9 × 105 dynes/cm2 (p < .001). Conclusions: Wall stress in the abdominal aorta is reduced in diabetes mellitus. This is mainly due to a thicker aortic wall compared to healthy controls. The reduced aortic wall stress coincides with the fact that epidemiological studies have shown a decreased risk of aneurysm development in diabetic patients.
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