| 1. |
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| 2. |
- Beijer, Elisabeth, et al.
(författare)
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Utvärderingsverkstäder i välfärdsverksamheter : studier av verkstädernas kvalitet och nytta
- 2011
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Med inspiration från aktionsforskningen har olika former av förändringsinriktad och deltagarbaserad forskning och utvecklingsarbete utvecklats, under beteckningar som forsknings- eller FoU-cirklar (Socialstyrelsen, 2002), participatorisk aktionsforskning (Participatory Action Research, PAR) (Holmer & Starrin, 1993), handlingsorienterat forskningssamarbete (Co-operative Inquiry) (Reason & Heron, 1986; Hummelvoll, 2006). Dessa olika arbetssätt förenas i en gemensam syn på hur kunskap kan utvecklas, spridas och användas: gemensamt och i samarbete, och inte utifrån ett ’top-down-perspektiv’. Utvärderingsverkstäder (i fortsättningen förkortat UV), som utgår från denna tradition, arrangeras av FoU-enheter inom välfärdsområdet, och/eller av högskola/universitet. I dessa verkstäder träffas en grupp deltagare tillsammans med utvärderingskunniga ledare från FoU-enheten/högskolan. Deltagarna genomför med stöd från ledarna och de övriga deltagarna utvärderingar, eller utvecklar system för utvärdering, på uppdrag av sina respektive organisationer.Syftet med detta paper är att redovisa och diskutera tio års erfarenheter från UV vid fyra FoU-enheter och en högskola i Mellansverige, ur deltagarnas och deras organisationers, samt ledarnas och de ansvariga enheternas/högskolans perspektiv.
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| 3. |
- Beijer, Elisabeth, et al.
(författare)
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Verkstäder för utvärdering i välfärdsverksamheter : erfarenheter från några svenska FoU-enheter och högskolor
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I denna rapport beskrivs och värderas erfarenheter från utvärderingsverkstäder, som är en pedagogisk form för att simultant lära om utvärdering och att genomföra utvärderingar inom välfärdsområdet. Rapporten bygger på studier av utvärderingsverkstäder liksom på författarnas egna erfarenheter från att bedriva verkstäder. Studien har genomförts inom ramen för Nätverket för utvärderingsverkstäder (Nuv). Initiativet till Nuv togs 2008 från Mälardalens Högskola och dess utvärderingsakademi. Nätverket etablerades mellan de enheter vars medarbetare medverkar i denna rapport; FoU Välfärd Värmland (Bengt G Eriksson), FoU i Väst/GR (Elisabeth Beijer), Mälardalens Högskola och FoU i Sörmland (Kari Jess, Laila Niklasson, Ove Karlsson Vestman) och FoU Sjuhärad Välfärd (Per-Åke Karlsson). Jennifer C Greene, gästprofessor vid Mälardalens högskola, medverkade under en tid i nätverket och bidrar även i denna antologi. Tanken med Nuv är att samla och sprida erfarenheter från redan genomförda verkstäder, för att på så sätt bidra till en utveckling där flera utvärderingsverkstäder kommer till stånd och till att förbättra arbetsmodellen på basis av gjorda erfarenheter. Denna antologi är ett led i detta. Rapporten har antologins form där varje författare svarar för innehållet i respektive kapitel. Grundmaterialet för kapitlen utgörs av de studier vi genomfört gemensamt samt erfarenheter från att leda utvärderingsverkstäder. Våren 2009 genomförde vi tillsammans en enkätundersökning riktad till deltagare i utvärderingsverkstäderna. Vi vill passa på att tacka deltagarna som tog sig tid att besvara enkäten. Dessutom genomfördes något senare ett antal intervjuer med några deltagare i utvärderingsverkstäderna liksom med några av deras chefer (tillika uppdragsgivare för utvärderingsuppdragen). Även dessa vill vi tacka för att de välvilligt låtit sig intervjuas om sina erfarenheter från verkstäderna. Vår förhoppning är att antologin ska bidra till att sprida kunskap om utvärderingsverkstäder, bidra till utveckling av metodiken samt inspirera till ytterligare verkstäder.
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| 4. |
- Karlsson, Kristin C., et al.
(författare)
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A population pharmacokinetic model of gabapentin developed in nonparametric adaptive grid and nonlinear mixed effects modeling
- 2009
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Ingår i: Therapeutic Drug Monitoring. - 0163-4356 .- 1536-3694. ; 31:1, s. 86-94
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Tidskriftsartikel (refereegranskat)abstract
- Gabapentin is used in analgesic treatment of neuropathic pain, and large interindividual variation has been observed in the pharmacokinetics (PK) of the drug. The aim of this study was to develop a population PK model for gabapentin appropriate for monitoring patients with neuropathic pain and for individualizing their dose regimens. Steady-state serum concentrations of gabapentin, distributed over a dosage interval, were obtained from 16 adult patients. Data were analyzed with an iterative 2-stage Bayesian and a nonparametric adaptive grid algorithm (NPAG) (USC*PACK) and with nonlinear mixed effects modeling (NONMEM). Compartmental population models for gabapentin PK were developed in NPAG and NONMEM using creatinine clearance and body weight as covariates. Bioavailability was included in the models as a function of dose by using a hyperbolic function derived from data previously reported in the literature. The mean population parameter estimates from the final NPAG model predicted individual serum concentrations reasonably well. The models developed in NONMEM provided additional information about the relevance of the various possible covariates and also allowed for further evaluation by simulation from the model. The population PK model may be utilized in the MM-USCPACK monitoring software (MM: multiple model dosage design) for predicting and achieving individually optimized steady-state serum concentrations of gabapentin.
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| 5. |
- Karlsson, Ove, et al.
(författare)
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Jaw exercise therapy for the treatment of trismus in head and neck Cancer: a prospective three-year follow-up study
- 2021
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 29, s. 3793-3800
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aims to examine effects of jaw exercise on trismus 3years following completion of a post-radiotherapy jaw exercise intervention. Methods: Prospective study including 50 patients with head-and-neck cancer receiving radiotherapy and/or chemotherapy, plus a matched control group. The intervention group underwent 10weeks of jaw exercise training. Patients were followed pre-and postintervention and 3years postintervention completion. Outcome measures were maximal interincisal opening (MIO), trismus-related symptoms, and health-related quality-of-life as measured by Gothenburg Trismus Questionnaire, EORTC QLQ-C30, and EORTC QLQ-H&N35. Results: The intervention group had a statistically significantly higher mean MIO compared with the control group (40.1mm and 33.9mm, respectively, p < 0.001), reported less trismus-related problems and had an improved health-related quality-of-life when compared with the control group at the 3-year follow-up. These differences were all statistically significant. Conclusion: Jaw exercise therapy resulted in increased MIO, less trismus-related symptoms, and improved health-related quality-of-life. Jaw exercise therapy should be initiated early, in a structured manner and continued long-term. © 2020, The Author(s).
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| 6. |
- Pousette, Anders, 1959, et al.
(författare)
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Informationssäkerhetskultur i praktiken: Populärvetenskaplig sammanfattning
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Projektet Informationssäkerhetskultur i praktiken har finansierats av MSB under åren 2019–2024 med syftet att förklara och belysa hur informationssäkerhetskulturen i organisationer kan förändras till det bättre. Fokus har varit på olika sätt att mäta och förändra kulturen. Projektet har genomförts av forskare i tre organisationer. Upplägget är tvärvetenskapligt med forskare specialiserade inom ämnen såsom fredsstudier, statsvetenskap, informatik, psykologi och cyberförsvar. Det tvärvetenskapliga angreppssättet har, förutom de resultat som presenteras i denna rapport, inneburit stort kunskapsutbyte mellan forskare i projektet och förbättrat deras förståelse för de problem och dilemman som kopplas till hantering av informationssäkerhetskulturer. Projektets forskningsplan inkluderade flera datainsamlingsinsatser och interventioner i samhällsviktiga organisationer. Eftersom kunskap om en organisations informationssäkerhet kan missbrukas av illasinnade aktörer förutsatte projektet stort förtroende och engagemang från dessa organisationer. Det krävde också förtroende och engagemang från enskilda individer inom dessa organisationer som förväntades delta i studierna. Den pandemi som drabbade världen i början av projektet innebar att många av de planer som gjorts behövde justeras och förändras. Organisationer och personer som trots detta valt att stödja studien förtjänar därför ett tack utöver det vanliga. Stort tack!
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| 7. |
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| 8. |
- Abraham-Nordling, Mirna, et al.
(författare)
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Incidence of hyperthyroidism in Sweden
- 2011
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Ingår i: European Journal of Endocrinology. - 0804-4643 .- 1479-683X. ; 165:6, s. 899-905
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The incidence of hyperthyroidism has been reported in various countries to be 23-93/100000 inhabitants per year. This extended study has evaluated the incidence for similar to 40% of the Swedish population of 9 million inhabitants. Sweden is considered to be iodine sufficient country. Methods:All patients including children, who were newly diagnosed with overt hyperthyroidism in the years 2003-2005, were prospectively registered in a multicenter study. The inclusion criteria are as follows:clinical symptoms and/or signs of hyperthyroidism with plasma TSH concentration below 0.2 mIE/l and increased plasma levels of free/total triiodothyronine and/or free/total thyroxine. Patients with relapse of hyperthyroidism or thyroiditis were not included. The diagnosis of Graves' disease (GD), toxic multinodular goiter (TMNG) and solitary toxic adenoma (STA), smoking, initial treatment, occurrence of thyroid-associated eye symptoms/signs, and demographic data were registered. Results:A total of 2916 patients were diagnosed with de novo hyperthyroidism showing the total incidence of 27.6/100 000 inhabitants per year. The incidence of GD was 21.0/100 000 and toxic nodular goiter (TNG=STA+TMNG) occurred in 692 patients, corresponding to an annual incidence of 6.5/100 000. The incidence was higher in women compared with men (4.2:1). Seventy-five percent of the patients were diagnosed with GD, in whom thyroid-associated eye symptoms/signs occurred during diagnosis in every fifth patient. Geographical differences were observed. Conclusion:The incidence of hyperthyroidism in Sweden is in a lower range compared with international reports. Seventy-five percent of patients with hyperthyroidism had GD and 20% of them had thyroid-associated eye symptoms/signs during diagnosis. The observed geographical differences require further studies.
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| 9. |
- Andersson, Anders, et al.
(författare)
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A transcriptional timetable of autumn senescence
- 2004
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Ingår i: Genome Biology. - : Springer Science and Business Media LLC. - 1465-6906 .- 1474-760X. ; 5:4, s. R24-
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Tidskriftsartikel (refereegranskat)abstract
- Background We have developed genomic tools to allow the genus Populus (aspens and cottonwoods) to be exploited as a full-featured model for investigating fundamental aspects of tree biology. We have undertaken large-scale expressed sequence tag (EST) sequencing programs and created Populus microarrays with significant gene coverage. One of the important aspects of plant biology that cannot be studied in annual plants is the gene activity involved in the induction of autumn leaf senescence. Results On the basis of 36,354 Populus ESTs, obtained from seven cDNA libraries, we have created a DNA microarray consisting of 13,490 clones, spotted in duplicate. Of these clones, 12,376 (92%) were confirmed by resequencing and all sequences were annotated and functionally classified. Here we have used the microarray to study transcript abundance in leaves of a free-growing aspen tree (Populus tremula) in northern Sweden during natural autumn senescence. Of the 13,490 spotted clones, 3,792 represented genes with significant expression in all leaf samples from the seven studied dates. Conclusions We observed a major shift in gene expression, coinciding with massive chlorophyll degradation, that reflected a shift from photosynthetic competence to energy generation by mitochondrial respiration, oxidation of fatty acids and nutrient mobilization. Autumn senescence had much in common with senescence in annual plants; for example many proteases were induced. We also found evidence for increased transcriptional activity before the appearance of visible signs of senescence, presumably preparing the leaf for degradation of its components.
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| 10. |
- Andersson, Malin E, 1978, et al.
(författare)
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Signs of neuroaxonal injury in preeclampsia-A case control study.
- 2021
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 16:2
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Tidskriftsartikel (refereegranskat)abstract
- Cerebral injury is a common cause of maternal mortality due to preeclampsia and is challenging to predict and diagnose. In addition, there are associations between previous preeclampsia and stroke, dementia and epilepsy later in life. The cerebral biomarkers S100B, neuron specific enolase, (NSE), tau protein and neurofilament light chain (NfL) have proven useful as predictors and diagnostic tools in other neurological disorders. This case-control study sought to determine whether cerebral biomarkers were increased in cerebrospinal fluid (CSF) as a marker of cerebral origin and potential cerebral injury in preeclampsia and if concentrations in CSF correlated to concentrations in plasma.CSF and blood at delivery from 15 women with preeclampsia and 15 women with normal pregnancies were analysed for the cerebral biomarkers S100B, NSE, tau protein and NfL by Simoa and ELISA based methods. MRI brain was performed after delivery and for women with preeclampsia also at six months postpartum.Women with preeclampsia demonstrated increased CSF- and plasma concentrations of NfL and these concentrations correlated to each other. CSF concentrations of NSE and tau were decreased in preeclampsia and there were no differences in plasma concentrations of NSE and tau between groups. For S100B, serum concentrations in preeclampsia were increased but there was no difference in CSF concentrations of S100B between women with preeclampsia and normal pregnancy.NfL emerges as a promising circulating cerebral biomarker in preeclampsia and increased CSF concentrations point to a neuroaxonal injury in preeclampsia, even in the absence of clinically evident neurological complications.
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| 11. |
- Andersson, Patiyan, 1978-, et al.
(författare)
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Genome-wide analysis of penile cancer using high-density single nucleotide polymorphism arrays
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The availability of genome-wide high-density single nucleotide polymorphism (SNP) arrays makes it possible to in a structured manner study chromosome aberrations in penile cancer where little is known of disruptive genetic events. In this study 19 penile squamous cell carcinomas were analyzed using the 250k NspI SNP array from Affymetrix. We find major regions of frequent copy number gain in chromosome arms 3q, 5p and 8q, and slightly less frequent in 1p, 16q and 20q. The chromosomal regions of most frequent copy number losses were 3p, 4q, 11p and 13q. We identified four candidate genes residing in the major chromosomal regions of aberration. Eight tumours showed copy number gain of the PIK3CA gene located to 3q26.3. Five of the remaining tumours carried an activating mutation of the PIK3CA gene and these tumours showed very few chromosomal aberrations. Collectively, disruption of the PIK3CA gene was found in 13/19 samples, and presence of active phosphorylated AKT was confirmed immunohistochemically in these tumours indicating an active signalling pathway. We found copy number gain of the hTERT gene (5p15.33) in 7 samples and of the Myc gene (8q24.21) in 7 samples. Copy number loss of the tumoursuppressor gene FHIT (3p14.2) was observed in 8 samples, the same 8 samples that showed copy number gain of the PIK3CA gene. In total the PI3K/AKT and RAS/MAPK pathways were found to be activated through mutation or amplification in 64% of the cases, indicating the significance of these pathways in the aetiology of penile cancer.
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| 12. |
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| 13. |
- Andrén, Ove, 1963-, et al.
(författare)
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MUC-1 gene is associated with prostate cancer death : a 20-year follow-up of a population-based study in Sweden
- 2007
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Ingår i: British Journal of Cancer. - London : Harcourt Publishers. - 0007-0920 .- 1532-1827. ; 97:6, s. 730-734
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Tidskriftsartikel (refereegranskat)abstract
- Anti-adhesion mucins have proven to play an important part in the biology of several types of cancer. Therefore, we test the hypothesis that altered expression of MUC-1 is associated with prostate cancer progression. We retrieved archival tumour tissue from a population-based cohort of 195 men with localised prostate cancer (T1a-b, Nx, M0) that has been followed for up to 20 years with watchful waiting. Semi-automated, quantitative immunohistochemistry was undertaken to evaluate MUC-1 expression. We modelled prostate cancer-specific death as a function of MUC-1 levels accounting for age, Gleason grade and tumour extent, and calculated age-adjusted and multivariate adjusted hazard ratios (HR). Men that had tumours with an MUC-intensity lower or higher than normal tissue had a higher risk of dying in prostate cancer, independent of tumour extent and Gleason score (HR 5.1 and 4.5, respectively). Adjustment for Gleason grade and tumour stage did not alter the results. Men with a Gleason score >=7 and MUC-1 deviating from the normal had a 17 (RR=17.1 95% confidence interval=2.3–128) times higher risk to die in prostate cancer compared with men with Gleason score <7 and normal MUC-1 intensity. In summary, our data show that MUC-1 is an independent prognostic marker for prostate cancer death.
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| 14. |
- Bengtsson, Erik L, et al.
(författare)
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A Case Study on the Influence of Multiple Users on the Effective Channel in a Massive MIMO System
- 2019
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Ingår i: IEEE Wireless Communications Letters. - 2162-2337. ; , s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- We investigate the importance of weak clusters when modeling a wireless massive MIMO channel. We do this by studying the influence of densely spaced terminals and the number of base-station antennas for a zero-forcing precoded massive MIMO system. In particular, we focus on the influence on the correlation and imbalance between the signals at the terminal antennas, the effective channel-gain, the eigenvalue distributions and the number of clusters.The study is based on measured radio-channels from terminal prototypes with integrated antennas connected to a massive MIMO testbed.We further evaluate the advantage of using block-diagonalized zero-forcing compared to conventional zero-forcing in a massive MIMO system. Unexpectedly, terminals with low antenna envelope correlation coefficient may benefit significantly from block-diagonal zero-forcing in a massive MIMO system.The main conclusion is that weaker clusters are important when modeling multi-user scenarios.
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| 15. |
- Bengtsson, Erik L., et al.
(författare)
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A Simulation Framework for Multiple-Antenna Terminals in 5G Massive MIMO Systems
- 2017
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Ingår i: IEEE Access. - 2169-3536. ; 5, s. 26819-26831
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Tidskriftsartikel (refereegranskat)abstract
- The recent interest in massive MIMO has spurred intensive work on massive MIMO channel modeling in contemporary literature. However, current models fail to take the characteristics of terminal antennas into account. There is no massive MIMO channel model available that can be used for evaluation of the influence of different antenna characteristics at the terminal side. In this paper, we provide a simulation framework that fills this gap. We evaluate the framework with antennas integrated into Sony Xperia handsets operating at 3.7 GHz as this spectrum is identified for the 5G new radio standard by 3GPP. The simulation results are compared with measured terminal performance when communicating with the Lund University’s massive MIMO testbed under the same loading conditions. Expressions are derived for comparison of the gain obtained from different diversity schemes computed from measured far-field antenna patterns. We conclude that the simulation framework yields results close to the measured ones and that the framework can be used for antenna evaluation for terminals in a practical precoded massive MIMO system.
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| 16. |
- Bengtsson, Erik L., et al.
(författare)
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Analysis of Transmission Schemes for Dual-Antenna Terminals in Massive MIMO Systems
- 2018
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Ingår i: 2018 25th International Conference on Telecommunications, ICT 2018. - 9781538623213 ; , s. 76-82
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Konferensbidrag (refereegranskat)abstract
- The overall system performance of massive MIMO is improved by equipping user terminals with multiple antennas. In this paper, we investigate transceiver designs for the case of a single downlink stream and in particular, we study the uplink pilot design. Moreover, we study the consequences of channel estimation errors at the base-station, and to what extent a dual-antenna terminal can get access to relevant channel statistics for optimization of the pilot signal. Gain expressions for comparison of different designs are derived. We verify the analytic results based on antennas integrated into Sony-Xperia handsets measured with the Lund University massive MIMO testbed. The measurements are performed at frequencies <6GHz since this part of the spectrum is a candidate for NR standard according to 3GPP.
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| 17. |
- Bengtsson, Erik L, et al.
(författare)
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Simulation of Multiple-Antenna Terminal Performance in Massive MIMO Systems based on Indoor Measurements
- 2020
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Ingår i: IEEE Transactions on Vehicular Technology. - 0018-9545. ; 69:1, s. 418-427
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Tidskriftsartikel (refereegranskat)abstract
- In massive MIMO systems the uplink pilot signalstransmitted by a terminal define the channel seen by the basestation. This gives the terminal some degree of freedom selectingan uplink pilot transmission strategy. In this paper, we investigatethe benefit of different pilot transmission strategies when increasingthe number of antennas in the terminal. Building on previouswork on a simulation framework for Multiple-antenna terminalsin 5G massive MIMO systems, this paper presents simulatedperformance results for various transmission schemes. The resultsare calibrated to reflect a real communication situation in a largeauditorium. Emulating the measurement set-up, we show that theframework can be tuned to generate channel distributions thatmatch measured data. Under generalized conditions, we performsimulations for different terminal transmission-strategies, bothrelated to single stream and multiple streams. All evaluations arebased on terminals with four antennas integrated into real SonyXperia smartphone-chassis, tuned to 3.7 GHz. The measurementsare conducted by using the Lund University Massive MIMOtestbed with its 100 antennas. The results clearly show theadvantage of increasing the antenna-count also at the terminalside in massive MIMO systems.
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| 18. |
- Bengtsson, Erik L, et al.
(författare)
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Transmission schemes for Multiple Antenna Terminals in Real Massive MIMO systems
- 2016
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Ingår i: 2016 IEEE Global Communications Conference (GLOBECOM). - 9781509013289 - 9781509013296
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Konferensbidrag (refereegranskat)abstract
- In massive MIMO performance evaluations it is often assumed that the terminal has a single antenna. The combination of multiple antennas in a terminal and massive MIMO precoding at the base station side can further improve overall system performance. We present measurement results for multi antenna terminals operating in different transmission schemes and how they perform under varying loading conditions. Gain expressions are derived that enable easy comparison between the transmission schemes. The evaluation is performed on realistic antennas integrated into Sony Xperia handsets tuned to 3.7~GHz and operated together with the Lund University massive MIMO (LuMaMi) test bed. It is concluded that the approach used in today's mobile systems, where up link and down link are addressed independently, will not provide the best performance. The performance can be improved by the selection of transmission schemes optimized for massive MIMO.
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| 19. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Breastfeeding training improved healthcare professional's self-efficacy to provide evidence-based breastfeeding support : A pre-post intervention study
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 125
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe healthcare professional's (HCP's) perceived self-efficacy in their ability to provide breastfeeding support before and after a breastfeeding training program.DESIGN: Pre-post intervention study.SETTING: Antenatal care and child healthcare (CHC) centres in Sweden during 2020.PARTICIPANTS: An intervention group consisting of 39 HCPs (midwives 51.3%, child healthcare nurses 46.2%) completing a questionnaire at baseline and after intervention, and a control group of 34 HCPs (midwives 61.8%, child healthcare nurses 38.2%) completing a questionnaire at baseline.INTERVENTION: A breastfeeding training program in line with the Ten Steps to Successful Breastfeeding and WHO recommendations about breastfeeding.MEASUREMENTS AND FINDINGS: The 11-item Breastfeeding Support Confidence Scale (BSCS) measures HCP's self-efficacy regarding providing breastfeeding support in line with Ten Steps to Successful Breastfeeding and WHO recommendations. The intervention group experienced a significantly increased self-efficacy from pre-intervention to post-intervention for 8 of the 11 BSCS items, with the overall BSCS index score increasing from 36.87 to 39.56 points (p = 0.001). The index score in the intervention group at follow-up was significantly higher than the corresponding score in the control group at baseline (p = 0.025). The intervention group had significantly higher scores at follow-up than the control group at baseline on the questions: "I'm sure that I can help mothers continue to breastfeed even if the infant doesn't follow the growth curve" (p = 0.026) and "I'm sure that I can help mothers continue to breastfeed when the breastfeeding is painful" (p = 0.048).KEY CONCLUSIONS: The breastfeeding training program improved HCP' self-efficacy to provide evidence-based support to breastfeeding mothers.IMPLICATIONS FOR PRACTICE: This training program is well suited to implement in clinical practice and follows the Ten Steps to Successful Breastfeeding.TRIAL REGISTRATION: ACTRN12623000648628.
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| 20. |
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| 21. |
- Bratt, Ola, et al.
(författare)
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Satsa på MRT för diagnostik av prostatacancer.
- 2015
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 1652-7518 .- 0023-7205. ; 112:Apr 20, s. DFZ3-
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 22. |
- Carlhed, Carina, et al.
(författare)
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Vart leder kvalitetstrappan? : Utvärdering av Pysslingens Kvalitetssystem
- 2009
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- I denna rapport presenteras slutredovisningen av en utvärdering av en modell för självutvärdering, Pysslingens Kvalitetssystem. Modellen har utvecklats och används av Pysslingen Förskolor och skolor AB, ett företag som startades i slutet av 1983 och blev det första att bedriva privat barnomsorg i Sverige på 1980-talet. Idag driver företaget 76 förskolor/skolor, fördelat på 57 förskolor och 19 skolor. Utvärderingen har skett genom intervjuer med ledningen, fördjupade fallstudier av enheter, enkät riktad till samtliga enhetschefer, pedagogiska rådgivare samt pedagoger. Utvärderargruppen kommer fram till att det finns klara styrkor med modellen som t.ex. att den bidrar till en stark kultursocialisation i Pysslingkulturen och att det är ett processverktyg för ständiga förbättringar. Det finns också svagheter som diskuteras i rapporten. Ett exempel är att syftet med Kvalitetstrappan är oklart och för vem den är till för. Det omtalade ”friutrymmet” har blivit ett oklart område, där ”eventuella” jämförelser och mätningar inte har en klar måttstock. Det är viktigt i fortsättningen att på ett ännu mer genomtänkt vis arbeta igenom organisationen efter genomsyrandeprincipen som kulturmetafor – till en än mer koherent logik än idag.
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| 23. |
- Carlsson, Jessica, 1984-, et al.
(författare)
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A miRNA expression signature that separates between normal and malignant prostate tissues
- 2011
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Ingår i: Cancer Cell International. - : BioMed Central (BMC). - 1475-2867. ; :11, s. 14-
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMicroRNAs (miRNAs) constitute a class of small non-coding RNAs that post-transcriptionally regulate genes involved in several key biological processes and thus are involved in various diseases, including cancer. In this study we aimed to identify a miRNA expression signature that could be used to separate between normal and malignant prostate tissues.ResultsNine miRNAs were found to be differentially expressed (p <0.00001). With the exception of two samples, this expression signature could be used to separate between the normal and malignant tissues. A cross-validation procedure confirmed the generality of this expression signature. We also identified 16 miRNAs that possibly could be used as a complement to current methods for grading of prostate tumor tissues.ConclusionsWe found an expression signature based on nine differentially expressed miRNAs that with high accuracy (85%) could classify the normal and malignant prostate tissues in patients from the Swedish Watchful Waiting cohort. The results show that there are significant differences in miRNA expression between normal and malignant prostate tissue, indicating that these small RNA molecules might be important in the biogenesis of prostate cancer and potentially useful for clinical diagnosis of the disease.
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| 24. |
- Carlsson, Jessica, 1984-, et al.
(författare)
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Differences in microRNA expression during tumor development in the transition and peripheral zones of the prostate
- 2013
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Ingår i: BMC Cancer. - London, United Kingdom : BioMed Central (BMC). - 1471-2407. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: The prostate is divided into three glandular zones, the peripheral zone (PZ), the transition zone (TZ), and the central zone. Most prostate tumors arise in the peripheral zone (70-75%) and in the transition zone (20-25%) while only 10% arise in the central zone. The aim of this study was to investigate if differences in miRNA expression could be a possible explanation for the difference in propensity of tumors in the zones of the prostate. Methods: Patients with prostate cancer were included in the study if they had a tumor with Gleason grade 3 in the PZ, the TZ, or both (n=16). Normal prostate tissue was collected from men undergoing cystoprostatectomy (n=20). The expression of 667 unique miRNAs was investigated using TaqMan low density arrays for miRNAs. Student's t-test was used in order to identify differentially expressed miRNAs, followed by hierarchical clustering and principal component analysis (PCA) to study the separation of the tissues. The ADtree algorithm was used to identify markers for classification of tissues and a cross-validation procedure was used to test the generality of the identified miRNA-based classifiers. Results: The t-tests revealed that the major differences in miRNA expression are found between normal and malignant tissues. Hierarchical clustering and PCA based on differentially expressed miRNAs between normal and malignant tissues showed perfect separation between samples, while the corresponding analyses based on differentially expressed miRNAs between the two zones showed several misplaced samples. A classification and cross-validation procedure confirmed these results and several potential miRNA markers were identified. Conclusions: The results of this study indicate that the major differences in the transcription program are those arising during tumor development, rather than during normal tissue development. In addition, tumors arising in the TZ have more unique differentially expressed miRNAs compared to the PZ. The results also indicate that separate miRNA expression signatures for diagnosis might be needed for tumors arising in the different zones. MicroRNA signatures that are specific for PZ and TZ tumors could also lead to more accurate prognoses, since tumors arising in the PZ tend to be more aggressive than tumors arising in the TZ.
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| 25. |
- Carlsson, Jessica, 1984-, et al.
(författare)
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Differences in microRNA expression during tumor development in the transition and peripheral zones of the prostate
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: The prostate is divided into three glandular zones, the peripheral zone (PZ), the transition zone (TZ) and the central zone. Most prostate tumors arise in the peripheral zone (70-75%) and in the transition zone (20-25%) while only 10% arise in the central zone. The aim of this study was to investigate if differences in miRNA expression could be a possible explanation to the difference in propensity of tumors in the zones of the prostate.Methods:The expression of 667 unique miRNAs was investigated in normal and malignant transition zone and peripheral zone prostate tissues using TaqMan low density arrays for miRNAs. Student’s t-test was used in order to identify differentially expressed miRNAs and hierarchical clustering and principal component analyses were used to note the separation of the tissues. A cross-validation test using the ADtree algorithm was used to test the generality of the identified miRNA signatures.Results:The Student’s t-tests revealed that the major differences in miRNA expression are found between normal and malignant tissues. Hierarchical clustering and PCA based on differentiallyexpressed miRNAs between normal and malignant tissues showed a perfect separation between samples while analyses based on differentially expressed miRNAs between the two zones showed several misplaced samples. A classification and cross-validation procedure confirmedt hese results and several potential miRNA markers were identified.Conclusions:The results of this study indicate that the major differences in the transcription programme are those arising during tumor development, rather than during normal tissue development. In conclusion, tumors arising in the TZ have more unique differentially expressed miRNAs compared to the PZ, indicating that the PZ are more prone to tumor development than the TZ. The results also indicate that separate miRNA expression signatures for diagnosis might be needed for tumors arising in the transition- or peripheral zone.
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| 26. |
- Carlsson, Jessica, et al.
(författare)
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Validation of suitable endogenous control genes for expression studies of miRNA in prostate cancer tissues
- 2010
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Ingår i: Cancer Genetics and Cytogenetics. - : Elsevier Inc.. - 0165-4608 .- 1873-4456. ; 202:2, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- When performing quantitative polymerase chain reaction analysis, there is a need for correction of technical variation between experiments. This correction is most commonly performed by using endogenous control genes, which are stably expressed across samples, as reference genes for normal expression in a specific tissue. In microRNA (miRNA) studies, two types of control genes are commonly used: small nuclear RNAs and small nucleolar RNAs. In this study, six different endogenous control genes for miRNA studies were investigated in prostate tissue material from the Swedish Watchful Waiting cohort. The stability of the controls was investigated using two different software applications, NormFinder and BestKeeper. RNU24 was the most suitable endogenous control gene for miRNA studies in prostate tissue materials.
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| 27. |
- Carlsson, Jessica, et al.
(författare)
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Validation of suitable endogenous control genes for expression studies of miRNA in prostate cancer tissues
- 2010
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Ingår i: Cancer Genetics and Cytogenetics. - : Elsevier BV. - 0165-4608 .- 1873-4456. ; 202:2, s. 71-75
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Tidskriftsartikel (refereegranskat)abstract
- When performing quantitative polymerase chain reaction analysis, there is a need for correction of technical variation between experiments. This correction is most commonly performed by using endogenous control genes, which are stably expressed across samples, as reference genes for normal expression in a specific tissue. In microRNA (miRNA) studies, two types of control genes are commonly used: small nuclear RNAs and small nucleolar RNAs. In this study, six different endogenous control genes for miRNA studies were investigated in prostate tissue material from the Swedish Watchful Waiting cohort. The stability of the controls was investigated using two different software applications, NormFinder and BestKeeper. RNU24 was the most suitable endogenous control gene for miRNA studies in prostate tissue materials. (C) 2010 Elsevier Inc. All rights reserved.
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| 28. |
- Carlsson, Mats, 1965-, et al.
(författare)
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Design and application of a terminology management system
- 1998
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Ingår i: Studies in Health Technology and Informatics, Volume 52. - Australia : IOS Press. - 9789051994070 ; , s. 207-211
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Konferensbidrag (refereegranskat)abstract
- A Swedish data model for handling terminology, Spriterm, is presented in this paper. A prototype terminology management system, using the Spriterm data model in also described. This prototype is implemented is Microsoft ACCESS. Furthermore, two other applications using this prototype as a base are introduced. One World Wide Web based application, and a data dictionary.
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| 29. |
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| 30. |
- Cox, Peter N., et al.
(författare)
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Fluorocarbons facilitate lung recruitment
- 2003
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Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 29, s. 2297-2302
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Tidskriftsartikel (refereegranskat)abstract
- Objective: "Open the lung and keep it open" is increasingly accepted as a fundamental principle for mechanical ventilation. However, it is sometimes very difficult, or impossible, to recruit the diseased lung. We questioned whether one could facilitate recruitment by using a low dose of fluorocarbon in a model previously shown to be non-recruitable by conventional sustained inflation maneuvers. Design and setting: Experimental prospective study in a university laboratory. Animals and interventions: Nine saline-lavaged rabbits subjected to prolonged large tidal volume mechanical ventilation to establish significant lung injury were randomly allocated to two groups: control [High Frequency Oscillation (HFO) alone: n=4] or 1 ml/kg fluorocarbon (FC) treated (HFO/FC: n=5) for 2+1 h (experiment 1). An additional four similarly prepared animals were treated by single-lung instillation of 0.5 ml/kg dose of fluorocarbon and underwent serial computerized tomography scans at a series of predetermined step-wise pressure increase in both lungs (experiment 2). Measurements and results: In experiment 1 there was a very significant improvement in oxygenation in HFO/FC group (PaO2 increased from 108 mmHg to 424±81 mmHg; P<0.05) while there was no significant change in the control group. In experiment 2 lung volumes were determined using three-dimensional reconstruction. The lung having fluorocarbon showed a 2.4-fold increase in lung volume at inflation pressure of 15 cmH 2O compared to the lung without fluorocarbon. Conclusions: We propose that the low equilibrium surface tension and positive spreading coefficient of fluorocarbon facilitates lung recruitment by ungluing adherent surfaces in this model of lung injury.
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| 31. |
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| 32. |
- Davidsson, Sabina, 1972-, et al.
(författare)
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Frequency and typing of Propionibacterium acnes in prostate tissue obtained from men with and without prostate cancer
- 2016
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Ingår i: Infectious Agents and Cancer. - London, United Kingdom : BioMed Central (BMC). - 1750-9378. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prostate cancer is the most common cancer among men in Western countries but the exact pathogenic mechanism of the disease is still largely unknown. An infectious etiology and infection-induced inflammation has been suggested to play a role in prostate carcinogenesis and Propionibacterium acnes has been reported as the most prevalent microorganism in prostatic tissue. We investigated the frequency and types of P. acnes isolated from prostate tissue samples from men with prostate cancer and from control patients without the disease.Methods: We included 100 cases and 50 controls in this study. Cases were men diagnosed with prostate cancer undergoing radical prostatectomy and controls were men undergoing surgery for bladder cancer without any histological findings of prostate cancer. Six biopsies taken from each patient's prostate gland at the time of surgery were used for cultivation and further characterization of P. acnes.Results: The results revealed that P. acnes was more common in men with prostate carcinoma than in controls, with the bacteria cultured in 60 % of the cases vs. 26 % of the controls (p = 0.001). In multivariable analyses, men with P. acnes had a 4-fold increase in odds of a prostate cancer diagnosis after adjustment for age, calendar year of surgery and smoking status (OR: 4.46; 95 % CI: 1.93-11.26). To further support the biologic plausibility for a P. acnes infection as a contributing factor in prostate cancer development, we subsequently conducted cell-based experiments. P. acnes- isolates were co-cultured with the prostate cell line PNT1A. An increased cell proliferation and cytokine/chemokine secretion in infected cells was observed.Conclusion: The present study provides further evidence for a role of P. acnes in prostate cancer development.
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| 33. |
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| 34. |
- Edvardsson Björnberg, Karin, et al.
(författare)
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Climate and environmental science denial : A review of the scientific literature published in 1990-2015
- 2017
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Ingår i: Journal of Cleaner Production. - : Elsevier. - 0959-6526 .- 1879-1786. ; 167, s. 229-241
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Forskningsöversikt (refereegranskat)abstract
- Denial of scientific findings is neither a new nor an unexplored phenomenon. In the area of environmental science and policy though, the research on denial has not been systematically summarized and analyzed. This article reviews 161 scientific articles on environmental and climate science denial published in peer reviewed international journals in the last 25 years and aims to both identify research gaps and enable learning on the phenomenon. Such knowledge is needed for the increasingly important task to provide effective response to science denial, in order to put an end to its influence on environmental policy making. The review, which is based on articles found in the databases Web of Science, Scopus and Philosopher's Index, shows that denial by far is most studied in relation to climate change, with a focus on Anglo-American countries, where this form of denial is most common. Other environmental issues and other geographical areas have received much less scientific attention. While the actors behind climate science denial, their various motives and the characteristics of their operations have been thoroughly described, more comparative research between issues and countries is needed in order to draw reliable conclusions about the factors explaining the peculiarities of denial. This may in turn lay the ground for developing and actually testing the effectiveness and efficiency of strategies to counter environmental science denial. Irrespective of the ambitions of environmental goals, science-based policies are always preferable. The scientific community therefore needs to increase its efforts to dismantle false claims and to disclose the schemes of denialists.
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| 35. |
- Einarsson, Sandra, 1981-, et al.
(författare)
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Mapping impact factors leading to the GLIM diagnosis of malnutrition in patients with head and neck cancer
- 2020
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Ingår i: Clinical Nutrition ESPEN. - : Elsevier BV. - 2405-4577. ; 40, s. 149-155
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims: In head and neck cancer, the combination of weight loss and elevated C-reactive protein levels means that patients have malnutrition as defined by the Global Leadership Initiative on Malnutrition (GLIM). This study aimed to identify impact factors for malnutrition as defined by the GLIM criteria among patients with head and neck cancer at the start of treatment and up to 12 months posttreatment.Methods: In a prospective, observational study, patient, tumour, treatment, and nutritional data from 229 patients with head and neck cancer were collected at the start of treatment and at three follow-ups (7 weeks after the start of treatment and at 3 and 12 months after the termination of treatment). These clinical variables were statistically analysed in relation to malnutrition at each follow-up using univariate and multivariate analyses. Malnutrition was defined according to the two GLIM criteria of >5% body weight loss during the last 6 months and C-reactive protein >5 mg/L.Results: The following factors were predictive for malnutrition in the multivariate analysis performed 7 weeks after the start of treatment: moderate or severe mucositis, chemoradiotherapy +/- surgery, and the need for nutritional support (total or partial use of tube feeding/parenteral nutrition). Advanced tumour stage (III-IV) was significant for malnutrition at the start of treatment and at the 7 week and 3 month follow-ups, but not at 12 months.Conclusions: Severe mucositis, chemoradiotherapy +/- surgery, and advanced tumour stage were found to be impact factors for the diagnosis of malnutrition using GLIM at different follow-up times from the start of treatment up to 12 months after the end of treatment. Few patients with head and neck cancer are diagnosed with malnutrition according to the GLIM criteria in a long-term perspective after the termination of treatment. Research on the validity of the GLIM criteria is needed to build a comprehensive evidence base of impact factors for malnutrition in head and neck cancer.
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| 36. |
- Ekdahl, Christer, et al.
(författare)
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A study of the usage of a decision-support system for infective endocarditis
- 2000
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Ingår i: Medical informatics and the Internet in medicine (Print). - : Informa UK Limited. - 1463-9238 .- 1464-5238. ; 25:1, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to examine a design for a World Wide Web-based decision-support system in use by clinically active physicians. A prototype implementation of the design concerned management of infective endocarditis patient cases. The design was based on an integration of hypertext and rule-based knowledge. In the study sessions, physicians in the field of internal medicine worked on managing authentic patient cases in a laboratory setting. Data was collected from interviews with the physicians using video recordings and stimulated recall technique. The qualitative data was analysed according to the constant comparative method in order to develop a model of the physicians' usage of the system. The resulting model describes perceived contributions and criteria for usefulness of the system. The ways the physicians used the system showed that it was able to provide patient-specific support for confirming clinical decisions, for higher-level patient management, and for preparing for and initiating expert consultations. Users also stated that new medical knowledge could be gained as a side effect of using the system.
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| 37. |
- Ericsson, Stina, 1972, et al.
(författare)
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Att analysera interaktion
- 2023
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Snart sagt alla situationer en människa befinner sig i präglas av interaktion. Människor pratar med varandra, rör sig genom ett rum, utbyter blickar, lär sig saker, arbetar, skämtar, håller i föremål ... Utmärkande för oss människor är nämligen att vi får saker och ting gjorda med vårt språk och våra kroppsliga resurser. Genom sådana handlingar påverkar vi vår omvärld och våra medmänniskor - och vi gör det tillsammans med dem. Det är studiet av denna mänskliga interaktion som boken handlar om. I första delen introduceras forskningsfältet interaktionsanalys och de arbetssätt, redskap och etiska ställningstaganden som hör till fältet. Den andra delen innehåller forskningsstudier som visar på bredden inom fältet och som pedagogiskt leder läsaren genom hela analysarbetet. Till boken hör även ett videomaterial som illustrerar några av bokens exempel, och som är tillgängligt för läsarens egna studier. Att analysera interaktion är avsedd för utbildningar inom språk vetenskap och angränsande ämnen som sociologi, utbildningsvetenskap och kommunikation.
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Glimelius, Bengt, et al.
(författare)
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U-CAN : a prospective longitudinal collection of biomaterials and clinical information from adult cancer patients in Sweden.
- 2018
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Ingår i: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 57:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- Background: Progress in cancer biomarker discovery is dependent on access to high-quality biological materials and high-resolution clinical data from the same cases. To overcome current limitations, a systematic prospective longitudinal sampling of multidisciplinary clinical data, blood and tissue from cancer patients was therefore initiated in 2010 by Uppsala and Umeå Universities and involving their corresponding University Hospitals, which are referral centers for one third of the Swedish population.Material and Methods: Patients with cancer of selected types who are treated at one of the participating hospitals are eligible for inclusion. The healthcare-integrated sampling scheme encompasses clinical data, questionnaires, blood, fresh frozen and formalin-fixed paraffin-embedded tissue specimens, diagnostic slides and radiology bioimaging data.Results: In this ongoing effort, 12,265 patients with brain tumors, breast cancers, colorectal cancers, gynecological cancers, hematological malignancies, lung cancers, neuroendocrine tumors or prostate cancers have been included until the end of 2016. From the 6914 patients included during the first five years, 98% were sampled for blood at diagnosis, 83% had paraffin-embedded and 58% had fresh frozen tissues collected. For Uppsala County, 55% of all cancer patients were included in the cohort.Conclusions: Close collaboration between participating hospitals and universities enabled prospective, longitudinal biobanking of blood and tissues and collection of multidisciplinary clinical data from cancer patients in the U-CAN cohort. Here, we summarize the first five years of operations, present U-CAN as a highly valuable cohort that will contribute to enhanced cancer research and describe the procedures to access samples and data.
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| 42. |
- Günther, Stefan, 1964-
(författare)
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Klassicismens interiörer : Inredningskonst och arkitekturprofiler från Vitruvius till Tessin
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis is to describe and analyse the design and development of the classical interior detail and its theoretical background from its Italian origins through its development into a shared European style around 1700. It mainly presents a close study of some forty chosen interiors in Italy, France and Sweden dating from antiquity to the close of the seventeenth century. A point of departure is the descriptions of the ancient architectural theoretician Vitruvius. The role of Vitruvian theory in the history of interior detail has until now received relatively little attention. By comparing the interiors and their components with local tradition as well as contemporaneous architectural theory and Vitruvius’s rules the actual impact of Vitruvius on Classical interior detailing is investigated. The thesis is divided into ten chapters. Chapter one develops a model, which can be used to describe the relationship between interior detail and the Classical room as a whole. Chapter two deals with the ancient origins of architectural profiles. Chapter three systematises the ancient proportional system that came to be used for Classical interiors. Chapter four outlines the ancient vis-à-vis the Medieval frame profile. Chapters five to nine describe the development of interior detail from 1400 to 1700 as seen in a selection of the most renowned interiors and buildings in European interior architecture. Each chapter concludes with a summary of the principles and ideals behind the proportion and design of the rooms and their parts for the period in question. Chapter ten examines the treatment of mouldings in European architectural theory from 1450 to 1990. Interior detail is described using two variables, one of which is its factual form and the other is the way it has been proportioned in relation to the structure of the room. The design of architectural detail and its ancient heredity plays an important role to form continuity in the tradition of Classical architecture. This thesis shows that small variations in the shape of architecture profiles causes new possibilities for interplay between the whole of the building and the form of the room, walls and details. This possibility has to a great extent been used to adapt Classical detail to the artistic language of different times and spirits.
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| 43. |
- Hagbom, Marie, et al.
(författare)
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Rotavirus Stimulates Release of Serotonin (5-HT) from Human Enterochromaffin Cells and Activates Brain Structures Involved in Nausea and Vomiting
- 2011
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Ingår i: PLOS PATHOGENS. - : Public Library of Science (PLoS). - 1553-7366 .- 1553-7374. ; 7:7
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Tidskriftsartikel (refereegranskat)abstract
- otavirus (RV) is the major cause of severe gastroenteritis in young children. A virus-encoded enterotoxin, NSP4 is proposed to play a major role in causing RV diarrhoea but how RV can induce emesis, a hallmark of the illness, remains unresolved. In this study we have addressed the hypothesis that RV-induced secretion of serotonin (5-hydroxytryptamine, 5-HT) by enterochromaffin (EC) cells plays a key role in the emetic reflex during RV infection resulting in activation of vagal afferent nerves connected to nucleus of the solitary tract (NTS) and area postrema in the brain stem, structures associated with nausea and vomiting. Our experiments revealed that RV can infect and replicate in human EC tumor cells ex vivo and in vitro and are localized to both EC cells and infected enterocytes in the close vicinity of EC cells in the jejunum of infected mice. Purified NSP4, but not purified virus particles, evoked release of 5-HT within 60 minutes and increased the intracellular Ca(2+) concentration in a human midgut carcinoid EC cell line (GOT1) and ex vivo in human primary carcinoid EC cells concomitant with the release of 5-HT. Furthermore, NSP4 stimulated a modest production of inositol 1,4,5-triphosphate (IP(3)), but not of cAMP. RV infection in mice induced Fos expression in the NTS, as seen in animals which vomit after administration of chemotherapeutic drugs. The demonstration that RV can stimulate EC cells leads us to propose that RV disease includes participation of 5-HT, EC cells, the enteric nervous system and activation of vagal afferent nerves to brain structures associated with nausea and vomiting. This hypothesis is supported by treating vomiting in children with acute gastroenteritis with 5-HT(3) receptor antagonists.
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| 44. |
- Hayden, Jane M., et al.
(författare)
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Post-operative pain relief using local infiltration analgesia during open abdominal hysterectomy: a randomized, double-blind study
- 2017
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 61:5, s. 539-548
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd Background: Post-operative pain is common and often severe after open abdominal hysterectomy, and analgesic consumption high. This study assessed the efficacy of local infiltration analgesia (LIA) injected systematically into different tissues during surgery compared with saline on post-operative pain and analgesia. Methods: Fifty-nine patients were randomized to Group LIA (n=29) consisting of 156ml of a mixture of 0.2% ropivacaine + 30mg ketorolac + 0.5mg (5 ml) adrenaline, where the drugs were injected systematically in the operating site, around the proximal vagina, the ligaments, in the fascia and subcutaneously, or to saline and intravenous ketorolac, Group C (Control, n=28), in a double-blind study. Post-operative pain, analgesic consumption, side-effects, and home discharge were analysed. Results: Median dose of rescue morphine given 0–24h after surgery was significantly lower in group LIA (18mg, IQR 5–25mg) compared with group C (27mg, IQR 15–43mg, P=0.028). Median time to first analgesic injection was significantly longer in group LIA (40min, IQR 20–60min) compared with group C (20min, IQR 12–30min, P=0.009). NRS score was lower in the group LIA compared with group C in the direct post-operative period (0–2h). No differences were found in post-operative side-effects or home discharge between the groups. Discussion: Systematically injected local infiltration analgesia for pain management was superior to saline in the primary endpoint, resulting in significantly lower rescue morphine requirements during 0–24h, longer time to first analgesic request and lower early post-operative pain intensity.
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| 45. |
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| 46. |
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| 47. |
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| 48. |
- Jansson, Elisabeth, et al.
(författare)
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Evaluating the implementation of a county council policy in two municipalities - methodological strategies and tools.
- 2009
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Konferensbidrag (refereegranskat)abstract
- Background: In year 2004 the Stockholm County Council (CC) approved a policy to reduce overweight and obesity. The implementation at local level started in two pilot municipalities during a two years period and resulted in several subprojects. Program theory (PT) is a methodology used to understand and identify key components in complex programs. Objectives: To highlight strategies and tools applied in planning and conducting an implementation evaluation of a CC policy in two municipalities. Methods: A descriptive process analysis of identified obstacles and solutions in all phases of the evaluation. Work notes, minutes from the steering group and the evaluating group meetings where analyzed to recapture the evaluation process. Result: PT was used to get an understanding of the components of the policy, the projects and their interrelations. Three separate PT where developed, one for the CC policy and one for the project in each municipality. To get a general idea of the projects and to organise the vast amount of documentation a form was developed for the project managers to fill in. To identify stakeholders and actors, organisational charts (OC) were developed for the project’s organisations including CC representatives. The evaluation’s data collection was based on principles for triangulation (documents, survey and interviews). The PT and OC where used in the purposeful sample of respondents. The PT and OC also worked as a component when reporting the results. Conclusion: PT is a useful tool to clarify the intentions and relations between levels of implementation when evaluating complex, multilevel programs. Using multiple means for data collection is a helpful strategy to generate both general and in depth understanding of a policy’s implementation. PT and OC are useful tools to make sure everyone has the same understanding of the policy’s components and organisation when communicating with stakeholders and respondents in all phases of the evaluation process.
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| 49. |
- Jansson Timan, Terje, et al.
(författare)
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Mortality following emergency laparotomy: a Swedish cohort study
- 2021
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Ingår i: Bmc Surgery. - : Springer Science and Business Media LLC. - 1471-2482. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Emergency laparotomy (EL) is a central, high-risk procedure in emergency surgery. Patients in need of an EL present an acute pathology in the abdomen that must be operated on in order to save their lives. Usually, the underlying condition produces an affected physiology. The perioperative management of this critically ill patient group in need of high-risk surgery and anaesthesia is challenging and related to high mortality worldwide. However, outcomes in Sweden have yet to be studied. This retrospective cohort study explores the perioperative management and outcome after 710 ELs by investigating mortality, overall length of stay (LOS) in hospital, need for care at the intensive care unit (ICU), surgical complications and a general review of perioperative management. Methods Medical records after laparotomy was retrospectively analysed for a period of 38 months (2014-2017), the emergency cases were included. Children (< 18 years), aortic surgery, second look and other expected reoperations were excluded. Demographic, management and outcome data were collected after an extensive analysis of the cohort. Results A total of 710 consecutive operations, representing 663 patients, were included in the cohort (mean age 65.6 years). Mortality (30 days/1 year) after all operations was 14.2% and 26.6% respectively. The mean LOS in hospital was 12 days, while LOS in the ICU was five days. Of all operations, 23.8% patients were admitted at any time to the ICU postoperatively and the 30-day mortality seen among ICU patients was 37.9%. Mortality was strongly correlated to existing comorbidity, high ASA classification, ICU care and faecal peritonitis. The mean/median time from notification to operate until the first incision was 3:46/3:02 h and 87% of patients had their first incision within 6 h of notification. Conclusions In this present Swedish study, high mortality and morbidity were observed after emergency laparotomy, which is in agreement with other recent studies. Trial registration: The study has been registered with ClinicalTrials.gov (NCT03549624, registered 8 June 2018).
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| 50. |
- Jansson Timan, Terje, et al.
(författare)
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One-year mortality rates after standardized management for emergency laparotomy: results from the Swedish SMASH study
- 2024
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Ingår i: BJS Open. - : OXFORD UNIV PRESS. - 2474-9842. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients who require an emergency laparotomy suffer from high mortality and morbidity rates. Studies have shown that the standardization of perioperative management reduces complications in the short term. The aim of the present study was to report long-term mortality rates for the SMASH (Standardized perioperative Management of patients operated with acute Abdominal Surgery in a High-risk and emergency setting) study, as well as short- and long-term outcomes for different age groups within the SMASH study. Methods: A prospective intervention study was introduced in 2018, with the aim of investigating the introduction of a standardized protocol for emergency laparotomy. For 42 months, intervention patients were managed according to the protocol and outcomes were then compared with those of historical controls. Results: A total of 1344 unique patients were included (681 in the intervention group and 663 in the control group). The 90-day mortality rate was 14.1 per cent in the intervention group and 20.8 per cent in the control group (P = 0.002) and the 1-year mortality rate in adjusted analyses was 19.7 and 27.8 per cent respectively (P =< 0.001). An age-related subgroup analysis showed that the oldest patients (76 years and older, 260 in the intervention group and 240 in the control group) had a 1-year mortality rate of 29.6 and 43.8 per cent respectively (P = 0.004) and a mean duration of hospital stay of 9.9 and 11.6 days respectively (P = 0.027). Among older adults (61-75 years), the mean duration of hospital stay was 11.7 days in the intervention group compared with 15.1 days in the control group (P = 0.009) and the mean duration of ICU care was reduced to 4.49 days compared with 7.29 days (P = 0.046). Conclusion: The standardized protocol associated with an emergency laparotomy appears to be beneficial, even in the long term. For elderly patients, it appears to reduce mortality rates and the durations of hospital stay and ICU care.
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