| 11. |
- Hass, Ursula, et al.
(författare)
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Assessment of computer-aided assistive technology: analysis of outcomes and costs
- 1997
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Ingår i: Augmentative and Alternative Communication. - : Informa UK Limited. - 0743-4618 .- 1477-3848. ; 3:2, s. 125-135
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to identify and quantify outcomes related to implementation of computer-aided assistive technologies (CAAT) for individuals with communication disabilities and to analyze CAAT costs comprising the selected devices as well as the selection process. The study was designed as a pre/post, longitudinal study. Intermediate and global measures were used as outcome measures. Costs reflecting the resource consumption for the selected devices as well as the selection process were estimated. Individuals with communication disabilities who were referred to the regional CAAT centers were asked to participate in the study. Eighty-seven individuals were recruited. The study shows that usage of CAAT involves reasonable marginal costs for the selection process and equipment (on average SEK 14,800). Usage of CAAT diminishes disability and increases skills in handling computers. However, the outcomes are not entirely positive regarding handicap, health-related quality of life, and utility.Read More: http://informahealthcare.com/doi/abs/10.1080/07434619712331277928
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| 12. |
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| 13. |
- Jonsson, Dick, et al.
(författare)
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The Cost of the Swedish Handicap Service System : Implications for Technology Assessment
- 1995
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Ingår i: International Journal of Technology Assessment in Health Care. - 0266-4623 .- 1471-6348. ; 11:2, s. 269-275
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Tidskriftsartikel (refereegranskat)abstract
- The total cost of the Swedish handicap system is estimated at US $ 10.7 billion for 1989. The cost is distributed across different authorities with separate legal and financial responsibility. The concept of technology must be extended to include consideration of both the resources spent and benefits gained in the public sector and the magnitude and distribution of transfer payments from social insurance to fulfill its function in handicap policy decision making.
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| 14. |
- Larsson, Hans, et al.
(författare)
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Studies on blood pressure, pulse rate, laboratory parameters, blood and plams viscosity in 55 patients with impaired glucose tolerance (borderline diabetes)
- 1999
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Ingår i: Biorheology. - Amsterdam,The Netherlands : IOS Press. - 0006-355X .- 1878-5034. ; 36:1/2, s. 87-88
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Tidskriftsartikel (refereegranskat)abstract
- Abstract As a substudy to a broader investigation concerning clinical parameters in patients with impaired glucose tolerance blood and plasma viscosity were studied in 55 patients in ages from 39 to 81 years (mean age 62,4 years). These patients were selected from a large health study in southern Sweden where they presented with impaired glucose tolerance but without signs of vascular disease. At the time of our study these 55 patients were still not, 20 years after their first oral glucose tolerance test, classified as ouvert diabetes. Our intention was to study effects of minor disturbances of glucose tolerance on blood rheology. The patients had a laboratory profile close to that of patients with ouvert type 2 diabetes. Compared to a ontrol group of healthy individuals they had higher values for blood and plasma viscosity at all shear rates (p<0.001), higher values for b-glucose, ESR, triglycerides, s-GT (p<0.05-0.005) and lower values for s-creatinine p<0.001). It was also found that diastolic pressure, both at rest and after exercise, was positively correlated to plasma viscosity. This holds true also for systolic arm pressure. Pulse rate at rest and after exercise showed a negative correlation to blood rheology parameters. The pool of data is very large and further analyses are under way. So far our data show that even minor abnormalities of glucose metabolism are harmful and create a risk for vascular disease.
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| 15. |
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| 16. |
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| 17. |
- Persson, Jan E
(författare)
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Kundupplevd kvalitet i tjänsteverksamheter: En analys och kritik av den företagsekonomiska dialogen
- 1997
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The contemporary discussion about how to define and measure the quality of services is dominated by a subjective perspective and quality is usually grounded in the customers perception. This conceptualisation of quality (perceived service quality) is well established in business and research. In contrast, this study is an argument for an intersubjective perspective grounded in language and demonstrates how theoretical statements as well as every-day-gossip about services and service quality can be analysed as linguistic products. First, we conduct a critical analysis of the concept of perceived service quality and show how and why this concept (the customers comparison of perception to expectations along general or specific quality dimensions) is problematic and ambiguous. Second, we examine the service concept and show how services can be understood as social processes where the customers make sense of the interactions by attributing meaning to the actions of themselves and others. Third, using Kenneth Burkes Grammar of Motives and its hexad of key terms (act, agent, scene, agency, attitude and purpose) we show how different theoretical perspectives on social interactions create different conclusions about how to understand and manage quality in services. Finally, we argue that service quality can be understood as the reasons customers give when they in a dialogue with other people explain their (dis)satisfaction with a service.
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| 18. |
- Persson, Jan
(författare)
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Low dose ketamine : analgesia and side-effects in patients and volunteers
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is a need for novel approaches in the pharmacological treatment of pain. In many pain states the present treatment options are insufficient. Altered processing in sensory pathways often underlies such intractable pain. There is now ample evidence from animal and human experimental pain research, as well as clinical studies, suggesting a role for ketamine as an analgesic in these situations. The clinical usefulness of ketamine is, however, not clear due to prominent side-effects, mainly of a psychotropic nature. Defining the role of ketamine in clinical pain-treatment practice requires the clarification of several issues: the concentration-effect relationships for analgesia and side-effects, the influence of adjuvant drugs, and the differences in effect profiles between the enantiomers. The present thesis investigates these issues. Study I: A case report concerning a previously healthy young girl with an intractable pain state from a persistent suppurating wound after an appendectomy. There was a mechanical allodynia and considerable aberrations in thermal sensitivity. During the dressing procedures, racemic ketamine in a bolus dose of 0.2-0.5 mg/kg BW gave a better analgesia than morphine 30 mg, with less subjective side-effects. After treatment with ketamine once or twice daily for a total of three months there was a marked reduction of the allodynia and sensory aberrations despite the unchanged character of the wound. Study II: Five healthy volunteers received S-ketamine mixed with tracer amounts of 11C S-ketamine as randomised bolus doses. The magnitude of specific binding of (S)-ketamine was measured with Positron Emission Tomography (PET). The analgesic effects were evaluated by an experimental ischaemic pain model, and by thermal pain threshold testing. S-ketamine had a marginal and inconsistent effect on heat and cold pain thresholds, but the subjects were able to withstand ischaemic pain better. Side-effects and relief of ischaemic pain were related to dose and brain concentrations. Study III: Eight patients with rest pain in the lower extremity due to arteriosclerosis obliterans were given doses of 0.15, 0.30, or 0.45 mg.kg-1 racemic ketamine and morphine 10 mg as a five minute infusion in random order. Ketamine 0. 15 mg.kg-1 gave a pain relief equivalent to morphine 10 mg. Ketamine 0.30 mg/kg gave 7/8 patients, and Ketamine 0.45 mg/kg 8/8 patients a total pain relief at the end of the five-minute infusion. Side effects, mainly disturbed cognition and perception, were pronounced and dose-dependent. Study IV: Alfentanil was infused to a target plasma concentration of 50 ng mL-1 in 8 healthy volunteers. An escalating racemic ketamine infusion (target concentration 50, 100 and 200 ng mL-1) was then added to the alfentanil infusion. The alfentanil infusion induced hypoventilation by decreasing respiratory rate while tidal volume and respiratory drive were unaffected. This hypoventilation was antagonised by ketamine in a concentration-dependent manner mainly through an increase in respiratory rate. There were no significant differences in any of the variables related to respiratory drive. The C02 response was not affected by alfentanil or ketamine. Study V: R- and S-ketamine were infused in 10 healthy volunteers, 4 of whom were poor metabolisers (2 for the CYP2D6, 2 for the CYP2C19 pathways). Arteriovenous differences in plasma concentrations were significant and caused a difference between volumes of distributions but not between clearances calculated for arterial and venous data, respectively. Clearance was smaller for R- than for S-ketamine. Subjective side-effects were mild but more pronounced for S- than for R-ketamine. Study VI: R- and S-ketamine, together with midazolam (target concentration 10 ng mL-1), were administered to nine patients with longstanding, intractable postherpetic neuralgia using computer controlled infusions. The target levels for R-ketamine (60, 120 and 240 ng mL-1), were threefold higher than for S-ketamine. There were moderate analgesic effects of ketamine in the patients as a group. Spontaneous pain and pain evoked by a vibrating mechanical brush were significantly relieved, whereas pain evoked by light stroking with a brush was not. Some patients did not respond at all, some experienced complete relief In plasma-concentration ratios of 3:1 R- and S-ketamine were equianalgesic. At these equianalgesic concentrations S-ketamine caused more inebriation and drowsiness than R-ketamine. Conclusion: There are potent analgesic effects of ketamine in clinical and experimental ischaemic pain. The effect in postherpetic neuralgia is variable, some patients receive complete pain relief, some no relief. Specific binding of S-ketamine in the brain, measured with positron emission tomography, is related to analgesia and psychotropic side effects. Ketamine antagonises the resting hypoventilation induced by alfentanil. Side-effects, mainly affecting memory imprinting, cognition and perception, are prominent at ketamine plasma-concentrations required for acute analgesia. Alfentanil and midazolam do not eliminate the side-effects.
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| 19. |
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| 20. |
- Persson, Kristina, et al.
(författare)
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Calcium binding to the first EGF-like module of human factor IX in a recombinant fragment containing residues 1-85. Mutations V46E and Q50E each manifest a negligible increase in calcium affinity
- 1998
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Ingår i: FEBS Letters. - 1873-3468. ; 421:2, s. 100-104
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Tidskriftsartikel (refereegranskat)abstract
- The first EGF-like module of human coagulation factor IX contains a single functionally important calcium ion binding site. We have now shown the dissociation constant for this site to be approximately 160 microM in a recombinant protein fragment consisting of residues 1-85 in human fIX. This represents a approximately 10-fold increase in affinity as compared with the isolated EGF module (residues 46-85). The Gla module (here with Glu instead of Gla) thus increases the affinity of the EGF module calcium ion binding site. Each of two mutations, V46E and Q50E, made to investigate whether the extra negative charge would increase the affinity of the calcium binding site manifested a negligible increase in affinity.
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