| 11. |
- Zetterling, Maria, et al.
(författare)
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Somatotropic and thyroid hormones in the acute phase of subarachnoid haemorrhage
- 2013
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Ingår i: Acta Neurochirurgica. - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 155:11, s. 2053-2062
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Tidskriftsartikel (refereegranskat)abstract
- Somatotropic and thyroid hormones are probably important for the recovery after acute brain injury. Still, the dynamics of these hormones after spontaneous subarachnoid haemorrhage (SAH) is not well described. The purpose of this study was to investigate the relation between somatotropic and thyroid hormones and clinical factors after SAH. Twenty patients with spontaneous SAH were included prospectively. Serum concentrations of TSH, fT4, T3, IGF-1 and GH were measured once a day for 7 days after SAH. Hormone patterns and serum concentrations were compared to the severity of SAH, neurological condition at admission, clinical course and outcome of the patients. During the first week after SAH, all patients showed increased GH and IGF-1 concentrations. In the whole group, concentrations of TSH increased, whereas T3 and fT4 decreased. There were no relations of serum concentrations of IGF-1 or GH to clinical condition at admission, clinical course or outcome of the patients. Half of the patients showed low T3 serum concentrations. A complicated course was associated with a deeper fall in TSH and T3 concentrations. There were negative correlations for mean concentrations of TSH and T3 versus WFNS grade and a positive correlation for T3 versus GOS after 6 months, indicating that low concentrations of TSH and T3 were connected to worse SAH grade and poor outcome. All patients showed increased GH and IGF-1 concentrations irrespective of the grade of SAH or clinical course. Patients with a complicated clinical course showed a more pronounced fall in TSH and T3 concentrations and low serum T3 concentrations were related to a more serious SAH and poor patient outcome. These results need to be studied further and they may contribute to the accumulated knowledge needed to understand the complex mechanisms influencing the unpredictable clinical course after SAH.
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| 12. |
- Abdelrazek, Fathya, et al.
(författare)
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Leadership and management skills of first-line managers of elderly care and their work environment
- 2010
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 18:6, s. 736-745
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Tidskriftsartikel (refereegranskat)abstract
- Aim To study the leadership and management skills of first-line managers (FLMs) of elderly care and their work environment in Egypt and Sweden. Background FLMs in Egypt and Sweden are directly responsible for staff and quality of care. However, FLMs in Sweden, in elderly care, have smaller units/organizations to manage than do their colleagues in Egypt. Furthermore, family care of the elderly has been the norm in Egypt, but in recent years institutional care has increased, whereas in Sweden, residential living homes have existed for a longer period. Methods A convenience sample of FLMs, 49 from Egypt and 49 from Sweden, answered a questionnaire measuring leadership and management skills, structural and psychological empowerment, job satisfaction and psychosomatic health. Results In both countries, FLMs' perceptions of their leadership and management skills and psychological empowerment were quite high, whereas scores for job satisfaction and psychosomatic health were lower. FLMs had higher values in several factors/study variables in Egypt compared with in Sweden. Conclusion and implications The work environment, both in Egypt and Sweden, needs to be improved to increase FLMs' job satisfaction and decrease stress. The cultural differences and levels of management have an effect on the differences between the two countries.
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| 13. |
- Adamsson Eryd, Samuel, et al.
(författare)
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Carotid intima-media thickness is associated with incidence of hospitalized atrial fibrillation.
- 2014
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 233:2, s. 673-678
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Tidskriftsartikel (refereegranskat)abstract
- Carotid intima-media thickness (IMT) is a measure of arterial thickening and a risk predictor for myocardial infarction and stroke. It is unclear whether IMT also predicts atrial fibrillation (AF). We explored the association between IMT and incidence of first AF hospitalization in a population-based cohort.
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| 14. |
- Ageberg, Eva, et al.
(författare)
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Effect of leisure time physical activity on severe knee or hip osteoarthritis leading to total joint replacement: a population-based prospective cohort study
- 2012
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 13:73
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on leisure time physical activity as risk factor or protective factor for knee or hip osteoarthritis (OA) show divergent results. Longitudinal prospective studies are needed to clarify the association of physical activity with future OA. The aim was to explore in a prospective population-based cohort study the influence of leisure time physical activity on severe knee or hip OA, defined as knee or hip replacement due to OA. Methods: Leisure time physical activity was reported by 28320 participants (mean age 58 years (SD 7.6), 60% women) at baseline. An overall leisure time physical activity score, taking both duration and intensity of physical activities into account, was created. The most commonly reported activities were also used for analysis. The incidence of knee or hip replacement due to OA over 11 years was monitored by linkage with the Swedish hospital discharge register. Cox's proportional hazards model (crude and adjusted for potential confounding factors) was used to assess the incidence of total joint replacement, or osteotomy (knee), in separate analyses of leisure time physical activity. Results: There was no significant overall association between leisure time physical activity and risk for knee or hip replacement due to OA over the 11-year observation time. For women only, the adjusted RR (95% CI) for hip replacement was 0.66 (0.48, 0.89) (fourth vs. first quartile), indicating a lower risk of hip replacement in those with the highest compared with the lowest physical activity. The most commonly reported activities were walking, bicycling, using stairs, and gardening. Walking was associated with a lower risk of hip replacement (adjusted RR 0.76 (95% CI 0.61, 0.94), specifically for women (adjusted RR 0.75 (95% CI 0.57, 0.98)). Conclusions: In this population-based study of middle-aged men and women, leisure time physical activity showed no consistent overall relationship with incidence of severe knee or hip OA, defined as joint replacement due to OA, over 11 years. For women, higher leisure time physical activity may have a protective role for the incidence of hip replacement. Walking may have a protective role for hip replacement, specifically for women.
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| 15. |
- Al-Rubaei, Ahmed, et al.
(författare)
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Long-term hydraulic performance of stormwater infiltration systems : a field survey
- 2013
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Ingår i: NOVATECH 2013.
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Konferensbidrag (refereegranskat)abstract
- This paper examined the factors influencing the long-term hydraulic performance of some stormwater infiltration systems (swale and two types of permeable pavements) in Växjö, southern Sweden. The infiltration capacities of 9 permeable pavements and 2 swales sites, all with different ages ranging from 1 year to 14 years, were measured using replicate double ring infiltrometers. The sites were either constructed of swale (2), interlocking concrete pavers (ICP) filled with gravel (2), concrete grid pavers (CGP) filled with gravel (3), or concrete grid pavers (CGP) filled with grass (4). The results of this study showed that the long-term behaviour of the infiltration capacity relies largely on the type and age of the system and the type of joint filling (gravel and grass). Furthermore, the study showed that the 11 year old concrete grid pavers filled with grass had the highest infiltration capacity (4.80 + 2.46 mm/min), whilst the 9 and 14 year old swales had the lowest infiltration capacity (0.10 + 0.00 mm/min).
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| 16. |
- Al-Rubaei, Ahmed Mohammed, et al.
(författare)
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Long-Term Treatment Efficiency of a Constructed Stormwater Wetland: Preliminary Results
- 2014
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Konferensbidrag (refereegranskat)abstract
- Constructed stormwater wetlands (CSWs) are commonly used in Sweden and worldwide because of their high efficiency in urban stormwater management. However, questions have been raised about the long-term performance of CSWs. This study investigated the performance of a 19-year-old constructed wetland, which was designed to treat the stormwater from a 320-ha catchment located in the city of Växjö, southern Sweden. The system has not been maintained since its construction in 1994. The results of the present study were compared with results obtained from a previous study conducted by Växjö Municipality in 1997. The results showed that the CSW significantly reduced peak flows by 72%. High concentration reductions were found for Cd, Cr, Cu, Zn, Pb, TSS and TP (90, 89, 91, 90, 96, 96 and 86%, respectively). TN concentrations were reduced by 61%. The results indicated that lack of maintenance had no effect on the performance of wetland system during this long period of operation (19 years). In contrast, especially the removal of Cu and nitrogen was enhanced compared to 1997, which may be due to maturing of the system. The results show that CSWs are resilient systems, which (provided that design is sufficient) can work efficiently for at least two decades.
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| 17. |
- Alklind Taylor, Anna-Sofia, et al.
(författare)
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Spelbaserad simulering för insatsutbildning : Slutrapport
- 2012
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport är en avrapportering av projektet Spelbaserad simulering för insatsutbildning. Projektet syftar till att:Studera hur serious games kan förstärka lärandemiljön i träning och utbildningPraktiskt testa och analysera användningen av spelteknologi för att ta fram rekommendationer för konstruktion av träningssimulatorerSkapa underlag för utveckling av Räddningsverkets utbildningsmetoder genom samarbete mellan forskare och praktikerSerious games och spelbaserad simulatorträning ses som en möjlighet att vidareutveckla undervisnings- och träningsmiljön inom räddningstjänst. Begreppet serious games definieras som att använda spel och spelteknik för att uppnå syften utöver ren underhållning. För att utnyttja områdets potential i största möjliga mån krävs en kombination av att utveckla och anpassa teknik så att den passar för ändamålet, detta kan till exempel innebära att utnyttja de möjligheter som modern spelteknik ger för att logga användarbeteende och resultat. Dessutom innefattar serious games en komponent av speldesign, det vill säga att utnyttja möjligheter som spel ger för att skapa en motiverande och engagerande lärandemiljö. Detta kan till exempel innebära att skapa tävlingsmoment och poängsystem som sporrar till upprepad användning. I projektet har vi utnyttjat såväl teknik- som speldesignskomponenten.Projektets syften har uppnåtts genom att producera och utvärdera ett prototypspel för insatsträning samt en modell för hur serious games kan användas i träning och utbildning. De huvudsakliga resultaten består av en spelprototyp av ett webbaserat spel för att träna beslutsfattande på taktisk nivå samt en pedagogisk modell för spelbaserad träning. Prototypen och modellen har testats på en distanskurs för Räddningsledarutbildning i regi av Myndigheten för samhällsskydd och beredskap (MSB). Utvärderingen visar på goda resultat vad gäller systemets användbarhet. Den pedagogiska potentialen har inte kunnat utvärderas fullt ut då prototypen inte blev en tillräckligt integrerad del i kursen där den utvärderades.Projektet visar att spelbaserad träning kan vara en möjlighet för pedagogisk utveckling med avseende på både teknik och pedagogisk kontext. I detta sammanhang är det viktigt att poängtera vikten av att genomföra och utvärdera pedagogiska anpassningar i samband med spelbaserad träning. Vidare har projektet har samarbetat med olika konstellationer av lärare och kursdeltagare vid MSB. En viktig lärdom är att tydliga resurser och organisatoriskt engagemang finns på plats i den här typen av samproducerande forskningsprojekt.
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| 18. |
- Bergman, Maria, et al.
(författare)
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The experience of being awake during orthopaedic surgery under regional anaesthesia
- 2012
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier BV. - 1878-1241 .- 1878-1292. ; 16:2, s. 88-96
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Tidskriftsartikel (refereegranskat)abstract
- To undergo orthopaedic surgery and then return home the same day is becoming more common. People feel there are benefits with day surgery as it affects their daily life less than having to spend several days in hospital. The aim of this study was to describe people’s experience of being awake while undergoing orthopaedic surgery under regional anaesthesia. Ten people who had orthopaedic day surgery under regional anaesthesia participated; eight women and two men. Data were collected in personal, qualitative interviews and analysed using qualitative thematic content analysis. The analysis resulted in two themes and seven categories. The findings show that the staffs’ consideration and professionalism were significant for the participants’ wellbeing during surgery. The environment in the operating theatre ward is described as inspiring safety, calm and warmth. A good exchange of information between the person who will undergo orthopaedic surgery and the nurse does not depend primarily on how long they spend together; it is more about how they make contact with each other and how the nurse’s presence is experienced by the person.
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| 19. |
- Bergstrand, Sara, et al.
(författare)
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Pressure-induced vasodilation and reactive hyperemia at different depths in sacral tissue under clinically relevant conditions
- 2014
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Ingår i: Microcirculation. - : John Wiley & Sons. - 1073-9688 .- 1549-8719. ; 21:8, s. 761-771
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To characterize pressure-induced vasodilatation and reactive hyperemia at different sacral tissue depths in different populations under clinically relevant pressure exposure.METHODS: Forty-two subjects (< 65 years), 38 subjects (≥ 65 years), and 35 patients (≥ 65 years) participated. Interface pressure, skin temperature, and blood flow at tissue depths of 1 mm, 2 mm, and 10 mm (using laser Doppler flowmetry and photoplethysmography) were measured in the sacral tissue before, during, and after load in a supine position.RESULTS: pressure-induced vasodilatation and reactive hyperemia were observed at three tissue depths. At 10 mm depth, the proportion of subjects with a lack of pressure-induced vasodilatation was higher compared to superficial depths. The patients had higher interface pressure during load than the healthy individuals, but there were no significant differences in blood flow. Twenty-nine subjects in all three study groups were identified with a lack of pressure-induced vasodilatation and reactive hyperemia.CONCLUSIONS: pressure-induced vasodilatation and reactive hyperemia can be measured at different tissue depths. A lack of these responses was found in healthy individuals as well as in patients indicating an innate susceptibility in some individuals, and are potential important factors to evaluate in order to better understand the etiology of pressure ulcers.
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| 20. |
- Bergstrand, Sara, 1978-
(författare)
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Preventing pressure ulcers by assessment of the microcirculation in tissue exposed to pressure
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to combine optical methods into a system with the ability to simultaneously measure blood flow changes at different tissue depths. The goal of such a system was to reveal vascular mechanisms relevant to pressure ulcer etiology under clinically relevant conditions and in relation to the evaluation of pressure-redistribution support surfaces.This thesis consists of four quantitative, cross-sectional studies measuring blood flow responses before, during, and after pressure exposure of the sacral tissue. Two optical methods – photoplethysmography and laser Doppler flowmetry – were combined in a newly developed system that has the ability to discriminate blood flows at different tissue depths. Studies I and II explored blood flow responses at different depths in 17 individuals. In Study I the blood flow was related to tissue thickness and tissue compression during pressure exposure of ≥ 220 mmHg. In Study II, the sacral tissue was loaded with 37.5 mmHg and 50.0 mmHg, and the variation in blood flow was measured. Studies III and IV included 42 healthy individuals < 65 years, 38 healthy individuals ≥ 65 years, and 35 patients ≥ 65 years. Study III included between-subject comparisons of blood flow and pressure between individuals in the three study groups lying in supine positions on a standard hospital mattress. Study IV added within-subject comparisons while the individual was lying on four different types of mattress. The studies explored the vascular phenomena pressure-induced vasodilation (PIV) and reactive hyperemia (RH).The most common blood flow response to tissue exposure in this thesis was PIV, although a decrease in blood flow (a lack of PIV) was observed in some individuals. The patients tended to have higher interface pressure during pressure exposure than the healthy groups but no differences in blood flow responses were seen. Our results showed that pressure levels that are normally considered to be harmless could have a significant effect on the microcirculation in different tissue structures. Differences in individual blood flow responses in terms of PIV and RH were seen, and a larger proportion of individuals lacked these responses in the deeper tissue structures compared to more superficial tissue structures.This thesis identified PIV and RH that are important vascular mechanisms for pressure ulcer development and revealed for the first time that PIV and RH are present at different depths under clinically relevant conditions. The thesis also identified a population of individuals not previously identified who lack both PIV and RH and seem to be particularly vulnerable to pressure exposure. Further, this thesis has added a new perspective to the microcirculation in pressure ulcer etiology in terms of blood flow regulation and endothelial function that are anchored in clinically relevant studies. Finally, the evaluation of pressureredistribution support surfaces in terms of mean blood flow during and after tissue exposure was shown to be unfeasible, but the assessment of PIV and RH could provide a new possibility for measuring individual physiological responses that are known to be related to pressure ulcer development.
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