| 1. |
- Suleman Khan, Muhammad, et al.
(författare)
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Pharmacogenetics, Plasma Concentrations, Clinical Signs and EEG During Propofol Treatment
- 2014
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Ingår i: Basic & Clinical Pharmacology & Toxicology. - : Wiley. - 1742-7835 .- 1742-7843. ; 115:6, s. 565-570
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Tidskriftsartikel (refereegranskat)abstract
- A variety of techniques have been developed to monitor the depth of anaesthesia. Propofols pharmacokinetics and response vary greatly, which might be explained by genetic polymorphisms. We investigated the impact of genetic variations on dosage, anaesthetic depth and recovery after total intravenous anaesthesia with propofol. A total of 101 patients were enrolled in the study. The plasma concentration of propofol during anaesthesia was measured using high-performance liquid chromatography. EEG was monitored during the surgical procedure as a measure of anaesthetic depth. Pyrosequencing was used to determine genetic polymorphisms in CYP2B6, CYP2C9, the UGTIA9-promotor and the GABRE gene. The correlation between genotype and to plasma concentration at the time of loss of consciousness (LOC), the total induction dose, the time to anaesthesia, eye opening and clearance were investigated. EEG monitoring showed that the majority of the patients had not reached a sufficient level of anaesthetic depth (subdelta) at the time of loss of consciousness despite a high induction dose of propofol. Patients with UGT1A9-331C/T had a higher propofol clearance than those without (p=0.03) and required a higher induction dose (p=0.03). The patients with UGT1A9-1818T/C required a longer time to LOC (p=0.03). The patients with CYP2C9*2 had a higher concentration of propofol at the time of LOC (p=0.02). The polymorphisms in the metabolizing enzymes and the receptor could not explain the large variation seen in the pharmacokinetics of propofol and the clinical response seen. At LOC, the patients showed a large difference in EEG pattern.
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| 2. |
- Brorsson, Anna Lena, 1964-, et al.
(författare)
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A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion : a study protocol
- 2013
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Ingår i: BMC Pediatrics. - : BioMed Central. - 1471-2431. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background. Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. Omitting bolus insulin doses using CSII may cause reduced glycaemic control among adolescents. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment.Methods. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used to evaluate perceived health and QoL: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment.Results and discussion. In this study, we will assess the effect of starting an insulin pump together with the model of Guided Self-Determination to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family.Trial registration: Current controlled trials: ISRCTN22444034
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| 3. |
- Eriksson, Siw, et al.
(författare)
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Three-dimensional multilayer fabric structures for interactive textiles
- 2011
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Ingår i: 3rd World Conference on 3D Fabrics and Their Applications; Wuhan; China; 20 April 2011 through 21 April 2011. - 9781846260490 ; , s. 63-67
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Konferensbidrag (refereegranskat)abstract
- Abstract. The integration of performances in interactive textile fabric system has so far been rather complicated since they are based on multilayer or three-dimensional principles. These structures are today mainly put together by means of several processes, which is laborious and time consuming. In this interdisciplinary study we have combined the principle of a three-dimensional multilayer weaving process and interactive textiles structures in order to enable the manufacturing of interactive textile structure in one process. The process is investigated using a manual reconstructed loom and the approach has been to use the 3D structures in order to integrate and organize conductive and compressive spacer layers as a textile capacitive structure. Measurements on such a structure was done by construction a first order passive high pass filter and using the fabric sample as the capacitor and a 1MΩ resistor. The behavior of the measurement of the capacitive sensor is quite close to the theoretical calculation and already at this stage the structure might be used to indicate the presence of a pressure. In this project we have shown that a three-dimensional structure enables the development of interactive textiles in one process. Further the concept of using a rebuilt manual loom has shown great potential in early research stages. It is considerable saving time and resources since, in this case, it is easy to reconstruct the loom design compared to performing similar reconstruction on a machine. Future research will focus on developing other types of interactive structures. Another issue will be to scale down the size of the structures in order to get thinner and more flexible qualities.
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| 4. |
- Eriksson, Siw, et al.
(författare)
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Tredimensionell vävteknik med möjliga tillämpningar inom medicinsk teknik
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Integreringen av interaktiva egenskaper i teknisk textil har rönt stort intresse inom textil-forskningen de senaste åren. Med interaktiva textila strukturer avses textila system som interagerar med sin omgivning i någon mening. Ett sätt att åtadkomma dessa interaktiva strukturer är att foga samman lager av olika struktur eller material där varje lager tillför textilen/det textila systemet olika egenskaper. Det typiska tillvägagångssättet för att sammanfoga olika lager av textila material är att använda någon form av lamineringsteknik. Föreliggande projekt rör en ny vävteknik som möjliggör att flera textila lager med olika egenskaper vävs samman i en och samma process utan de tillsatser eller extra hantering som krävs vid laminering. Utöver de uppenbara produktionstekniska fördelarna möjliggör kombinationen av olika egenskaper i en lagerstruktur också att speciella krav på slutprodukten lättare kan tillgodoses. Det medicintekniska området förväntas ha stor nytta av textila strukturer som kan utformas i tre dimensioner eller kombinera olika egenskaper i en och samma struktur. Syftet är att demonstrera hur en nyutvecklad vävteknik för tredimensionella strukturer kan tillämpas för att tillverka interaktiva textila strukturer i en och samma tillverkningsprocess. I detta delprojekt har den tredimensionella tekniken använts för att utveckla en kapacitiv struktur utformad helt i textil. Genom mindre modifieringar av och tillägg till en 16-skaftad datorstyrd manuell prototypvävstol har två ledande och ett isolerande skikt kombinerats för att realisera en textilbaserad kondensator. I ett första test realiserades ett enkelt högpassfilter med den kapacitiva textila strukturen som kondensator. Filtrets egenskaper visade sig väl följa den förväntade filterkarakteristiken. Den nyutvecklade tredimensionella vävtekniken förväntas ha stora tillämpningsmöjligheter inom det medicintekniska området.
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| 5. |
- Hirvikoski, Tatja, et al.
(författare)
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Deficient cardiovascular stress reactivity predicts poor executive functions in adults with attention-deficit/hyperactivity disorder
- 2011
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Ingår i: Journal of Clinical and Experimental Neuropsychology. - : Informa UK Limited. - 1380-3395 .- 1744-411X. ; 33:1, s. 63-73
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Tidskriftsartikel (refereegranskat)abstract
- Associations between cardiovascular stress markers, subjective stress reactivity, and executive functions were studied in 60 adults (30 with attention-deficit/hyperactivity disorder, ADHD, and 30 controls) using the Paced Auditory Serial Addition Test (PASAT, a test of executive functions) as a cognitive stressor. Despite higher self-perceived stress, the adults with ADHD showed lower or atypical cardiovascular stress reactivity, which was associated with poorer performance on PASAT. Using cardiovascular stress markers, subjective stress, and results on PASAT as predictors in a logistic regression, 83.3% of the ADHD group and 86.9% of the controls could be classified correctly.
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| 6. |
- Lindholm, Anna, et al.
(författare)
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Utvärdering av förståelse på skriftlig tentamen
- 2011
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Konferensbidrag (refereegranskat)abstract
- I tidigare studier har det visats att examinationen i hög grad styr hur studenterna kommer att studera under en kurs. Därför är det viktigt att examinationen inte bara testar ytliga kunskaper och beräkningsförmåga, utan även förståelse. I denna artikel diskuteras olika sätt att utvärdera studenternas förståelse genom att analysera resultaten på skriftliga tentamina. En fallstudie på Institutionen för reglerteknik vid Lunds tekniska högskola presenteras och möjliga åtgärder för att öka förståelsen hos studenterna diskuteras.
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| 7. |
- Lindholm, Lena, et al.
(författare)
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Endogenous gas formation : an in vitro study with relevance to gas microemboli during cardiopulmonary bypass
- 2012
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Ingår i: The Journal of extra-corporeal technology. - 0022-1058. ; 44:3, s. 126-133
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Tidskriftsartikel (refereegranskat)abstract
- Gas embolism is an identified problem during cardiopulmonary bypass (CPB). Our aim was to analyze the potential influence from gas solubility based on simple physical laws, here called endogenous gas embolism. Gas solubility decreases at higher temperature and gas bubbles are presumably formed at CPB warming. An experimental model to measure gas release was designed. Medium (water or blood retrieved from mediastinal drains, 14.6 mL) was incubated and equilibrated with gas (air, 100% oxygen, or 5% carbon dioxide in air) at low temperature (10 degrees C or 23 degrees C). At warming to 37 degrees C, gas release was digitally measured. Also, the effect of fluid motion was evaluated. At warming, the medium became oversaturated with dissolved gas. When fluid motion was applied, gas was released to form bubbles. This was exemplified by a gas release of .45% (.31/.54, medians and quartile range, volume percent, p = .007) and 1.26% (1.14/ 1.33, p = .003) when blood was warmed from 23 degrees C or 10 degrees C to 37 degrees C, respectively (carbon dioxide 5% in air). Consistent findings were seen for water and with the other types of gas exposure. The theory of endogenous gas embolization was confirmed with gas being released at warming. The endogenous gas formation demonstrated a dynamic pattern with oversaturation and with rapid gas released at fluid motion. The gas release at warming was substantial, in particular when the results were extrapolated to full-scale CPB conditions. The interference from endogenous gas formation should be considered in parallel to external sources of gas microemboli.
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| 8. |
- Lindholm, Lena, et al.
(författare)
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Endogenous gas formation of carbon dioxide used for wound flooding : an experimental study with implications regarding gas microembolism during cardiopulmonary bypass
- 2014
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Ingår i: Perfusion. - : SAGE Publications. - 0267-6591 .- 1477-111X. ; 29:3, s. 242-248
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gas microembolisation is an identified risk in cardiac surgery. Flooding the wound with carbon dioxide is a method proposed to reduce this problem. The high solubility of carbon dioxide is beneficial, but may also cause problems. The gas solubility diminishes at warming and endogenous bubbles are formed when cold blood saturated with carbon dioxide is returned by cardiotomy suction.METHODS: The release of endogenous gas was measured at high resolution in an experimental digital model. A medium (water or blood) was incubated and equilibrated with gas (100% carbon dioxide or air) at a low temperature (10°C or 23°C). The temperature was increased to 37°C and the gas release was measured, at rest and at fluid motion.RESULTS: The amount of carbon dioxide released at warming was substantial for both water and blood (both p=0.005). The effect was more pronounced when the temperature differential increased (p=0.005). However, blood and water differed in these terms: with water, the release of carbon-dioxide started instantly at warming; with blood, carbon dioxide remained dissolved and was released at fluid motion. When blood was warmed from 10°C to 37°C, the gas release corresponded to 44.4% (40.6/46.5) of the medium volume (median with quartile range).CONCLUSION: Gas dissolved in a medium becomes released at warming, as confirmed here. Blood exposed to carbon dioxide became heavily oversaturated at warming, with the gas instantly released at fluid motion. The amount of contained gas increased with a higher temperature differential. Our study has relevance to wound flushing, using carbon dioxide, in cardiac surgery. The clinical consequences of these findings remain to be answered.
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| 9. |
- Lindholm, Ola, 1957-
(författare)
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Ögonblick i klassrummet : Samtal och interaktion om elevers fotografier på gymnasiet
- 2014
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- En kamera fångar ögonblick av det ljus som människan kan uppfatta, eller verkligheten som det ibland kallas. Dessa ögonblick i form av fotografier, arbetar de elever och den lärare med, som Ola Lindholm har följt på gymnasiet. Läsaren kan följa hur eleverna interagerar, hur det sociala samspelet organiseras under lektioner och redovisningar, vad som görs viktigt samt hur bildteoretiska- och yrkesmässiga kunskaper framträder i interaktionen.I studien framträder ett arbetssätt som ger eleverna ansvar och möjlighet att visa vad de kan i interaktionerna och vid redovisningarna av deras fotografier. Resultatet visar hur läraren försöker få eleverna att se skillnader i fotografiets uttryck, skärpedjup, bildbeskärning etcetera. Ibland gör eleverna motstånd och förhandlar med läraren där eleverna hävdar sin kunskap och sina åsikter om sina bilder. I bildanalysen av ett elevfotografi framträder två olika intentioner med de förslag som läraren och eleven förhandlar om. Studien visar att bildteorier, bildspråket och vad bilden kan berätta, inte är lika framträdande i interaktionen som frågor om teknik och process.Ola Lindholm, är bild- och medielärare på Sundstagymnasiet i Karlstad. Licentiatavhandlingen har skrivits inom Forskarskolan i yrkesämnenas didaktik.
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| 10. |
- Martinsson, Gunilla, et al.
(författare)
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Being altruistically egoistic : Nursing aides’ experiences of caring for older persons with mental disorders
- 2011
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 6:4, s. 7530-
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders, excluding dementia disorders, constitute a vulnerable group of people. With the future international increase in the older population, mental disorders will increase as well, thus entailing new challenges for their caregivers. These older persons often remain in their own homes, and in Sweden they are cared for by nursing aides. With little previous research, an increased workload and facing new strenuous situations, it is important to make use of the knowledge the nursing aides possess and to deepen the understanding of their experiences. The study aimed at illuminating the meaning of caring for older persons with mental disorders as experienced by nursing aides in the municipal home help service. Interviews with nine female nursing aides were performed and analysed with a phenomenological hermeneutical research method inspired by the philosophy of Paul Ricoeur. Being altruistically egoistic emerged as a main theme in the nursing aides’ narratives. The nursing aides’ experiences could be interpreted as a movement between being altruistic and egoistic. The findings revealed a continuous distancing by the nursing aides and their struggle to redress the balance between their altruistic and egoistic actions. Caring for these older persons constitutes a complex situation where distancing functions as a recourse to prioritize oneself and to diminish the value of caring. The study suggests that an increased knowledge base on older persons with mental disorders, followed by continuous supervision, is necessary for the nursing aides to improve the quality of the care given
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| 11. |
- Martinsson, Gunilla, et al.
(författare)
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Mental disorders affect older persons in Sweden : a register-based study
- 2011
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 0885-6230 .- 1099-1166. ; 26:3, s. 277-283
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study aimed to estimate the prevalence of mental disorders based on pharmaceutical use among the old (age >/= 65) in Sweden for the years 2006-2008. METHODS: Data on the mental health of older persons were approximated on the basis of recommended prescriptions for pharmaceuticals, gathered from the Swedish Register on Prescribed Pharmaceuticals (SRPP). Each disorder (ICD-10, F20-F42, and F60-F61) was analyzed to identify associated recommended pharmaceuticals. Anatomical Therapeutic Chemical Classification codes were applied. The data covered 188 024 individuals who received 2 013 079 prescriptions for pharmaceuticals for mental disorders during a 3-year period. Persons with pharmaceuticals for dementia disorders were excluded from the calculations of the prevalence of mental disorders. RESULTS: The prevalence of mental disorders among the old in Sweden, measured on the basis of pharmaceutical use, was 6.6% in 2006, 2007, and 2008, respectively. Men constituted one-third of cases and women two-thirds. Prevalence was lowest in the age group 65-69 and increased subsequently with age. CONCLUSIONS: This fundamental register-based study included a great number of older persons and shows that mental disorders affect every fifteenth older person in Sweden. The prevalence of mental disorders increases with increasing age. The results highlight the extent of mental disorders among older persons, which is important to know when planning care for these patients. This study, by investigating a large population, provides a solid basis for general planning as well as for future mental disorder research.
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| 12. |
- Martinsson, Gunilla, et al.
(författare)
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Specialist prescribing of psychotropic drugs to older persons in Sweden : a register-based study of 188 024 older persons
- 2012
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Ingår i: BMC Psychiatry. - 1471-244X. ; 12:197
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe situation for older persons with mental disorders other than dementia disorders has scarcely been studied. The older population is increasing worldwide and along with this increase the prevalence of mental disorders will also rise. The treatment of older persons with mental disorders entails complex challenges, with drugs constituting the major medical treatment. Knowledge of geriatric psychiatry is essential for providing older persons with appropriate treatment and care. This study aimed to evaluate the prescription of drugs for mental disorders to older persons (>=65) in Sweden, focused on the medical specialties of the prescribing physicians.MethodsData concerning drug treatment for older persons from 2006 to 2008 was gathered from the Swedish Prescribed Drug Register. Mental disorders, defined as affective, psychotic and anxiety disorders (ICD-10 F20-42) were evaluated in order to identify associated drugs. Included was a total of 188 024 older individuals, who collectively filled 2 013 079 prescriptions for the treatment of mental disorders. Descriptive analyses were performed, including frequency distribution and 95% CI. The competence of the prescribers was analyzed by subdividing them into five groups: geriatricians, psychiatrists, general practitioners (GPs), other specialists, and physicians without specialist education.ResultsGPs represented the main prescribers, whereas geriatricians and psychiatrists rarely prescribed drugs to older persons. Benzodiazepines and tricyclic antidepressants were the most commonly prescribed drugs. Women were prescribed drugs from geriatricians and psychiatrists to a greater extent than men.ConclusionsThis study examined the prescription of psychotropic drugs to older persons. Physicians specialized in older persons' disorders and mental health were rarely the prescribers of these drugs. Contrary to clinical guidelines, benzodiazepines and tricyclic antidepressants were commonly prescribed to older persons, emphasizing the need for continuous examination of pharmaceutical treatment for older persons. The results indicate a future need of more specialists in geriatrics and psychiatry.
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| 13. |
- Martinsson, Gunilla, et al.
(författare)
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Struggling for existence : - Life situation experiences of older persons with mental disorders
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:Art. nr. 18422
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Tidskriftsartikel (refereegranskat)abstract
- Older persons with mental disorders represent a vulnerable group of people with extensive and complex needs. The older population is rapidly increasing worldwide and, as a result of deinstitutionalization in mental health care, older persons are remaining at home to a greater extent. Although they constitute a large proportion of the population, older persons with mental disorders have been neglected in research as well as in care organizations. As there is little previous knowledge concerning older persons’ experiences of their own situations, this study aimed to illuminate the meaning of the life situation as experienced by older persons with mental disorders (excluding dementia disorders). Interviews were conducted with seven older persons and the text was analyzed using a phenomenological hermeneutical research method, inspired by the philosophy of Paul Ricoeur. ‘‘Struggling for existence’’ emerged as a main theme in the older persons’ narratives, understood as a loss of dignity of identity and involving being troubled and powerless as well as yearning for respect. The older persons fought to master their existence and to be seen for who they are. The study highlights the importance for caregivers, both formal and informal, to avoid focusing on the diagnoses and rather acknowledge the older persons and their lifeworld, be present in the relation and help them rebuild their dignity of identity. This study brings a new understanding about older persons with mental disorders that may help reduce stigma and contribute to planning future mental health care
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| 14. |
- Rosenstierne, Maiken W., et al.
(författare)
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The Microbial Detection Array for Detection of Emerging Viruses in Clinical Samples - A Useful Panmicrobial Diagnostic Tool
- 2014
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 9:6, s. e0100813-
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Tidskriftsartikel (refereegranskat)abstract
- Emerging viruses are usually endemic to tropical and sub-tropical regions of the world, but increased global travel, climate change and changes in lifestyle are believed to contribute to the spread of these viruses into new regions. Many of these viruses cause similar disease symptoms as other emerging viruses or common infections, making these unexpected pathogens difficult to diagnose. Broad-spectrum pathogen detection microarrays containing probes for all sequenced viruses and bacteria can provide rapid identification of viruses, guiding decisions about treatment and appropriate case management. We report a modified Whole Transcriptome Amplification (WTA) method that increases unbiased amplification, particular of RNA viruses. Using this modified WTA method, we tested the specificity and sensitivity of the Lawrence Livermore Microbial Detection Array (LLMDA) against a wide range of emerging viruses present in both non-clinical and clinical samples using two different microarray data analysis methods.
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| 15. |
- Saarinen, Tuula, et al.
(författare)
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Insulin pump therapy is perceived as liberating, but to many it can imply a sense of the diabetes made visible
- 2014
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Ingår i: European Diabetes Nursing. - : Informa UK Limited. - 1551-7853 .- 1551-7861. ; 11:2, s. 38-42
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Tidskriftsartikel (refereegranskat)abstract
- This study describes how adults with type 1 diabetes experience the transition from multiple daily injections (MDI) to continuous subcutaneous insulin infusion (CSII or ‘insulin pump’). The study is based on interviews in focus groups, with 11 persons with type 1 diabetes who had had CSII for at least one year, which were analysed using qualitative content analysis. The analysis resulted in three categories: life and health; involvement of others; and technology dependence. Participants' experiences are summarised in the theme ‘CSII is perceived as liberating, but also implies a sense of the diabetes made visible’. The transition resulted in changed life and health with greater freedom and flexibility, particularly in meal situations. The participants felt that their blood glucose was easier to control. Those around them reacted with curiosity, but some participants felt compelled to tell others that they had diabetes since the pump could be seen or heard. The participants found that coping with CSII in daily life was easier and more comfortable than they had expected. However, having to constantly be prepared for technical failure was experienced as cumbersome. All participants indicated that they were satisfied with their treatment and recommended it to others. Transition to CSII may be experienced as liberating, but might also imply a sense of the diabetes made visible. The results can be used in clinical practice, when advising about CSII. Being aware of both positive and negative experiences with CSII can contribute to better care for those already being treated with CSII.
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