| 1. |
- Johansson, Marcus, 1992, et al.
(författare)
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A fundamental model of an industrial-scale jaw crusher
- 2017
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Ingår i: Minerals Engineering. - : Elsevier BV. - 0892-6875 .- 1872-9444. ; 105, s. 69-78
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Tidskriftsartikel (refereegranskat)abstract
- In this study, an analytical perspective is used to develop a fundamental model of a jaw crusher. Previously, jaw crushers were modelled in regard to certain aspects, for example, energy consumption (Legendre and Zevenhoven, 2014) or kinematics (Oduori et al., 2015). Approaches to date have been mainly property specific. In this work a physical modelling approach has been used to derive the modules, which are based on established facts of comminution machines, from the literature. A modelling methodology mainly inspired by Evertsson has been applied (Evertsson, 2000). The modules are divided into kinematics, flow, breakage, capacity, pressure and power. Each module has been derived and tested decoupled from the other modules to provide increased transparency of the module and its behaviour. The results of the modelling are presented for a baseline case of one industrial-scale jaw crusher and compared to manufacturer data. Future work will include validation and DEM simulations.
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| 2. |
- Andersson, Elin, et al.
(författare)
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Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke.
- 2018
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Ingår i: Prehospital and Disaster Medicine. - 1049-023X .- 1945-1938. ; , s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.METHODS: The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.RESULTS: In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows: a) More frequently documented symptoms from the face, legs/arms, and speech; b) More frequently assessments of neurology, face, arms/legs, speech, and eyes; c) More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation; d) Less frequently documented symptoms of headache, vertigo, and nausea; and e) More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled. In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.CONCLUSION: Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations. Andersson E , Bohlin L , Herlitz J , Sundler AJ , Fekete Z , Andersson Hagiwara M . Prehospital identification of patients with a final hospital diagnosis of stroke.
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| 3. |
- Fager, Olof, et al.
(författare)
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Assessing Clinical Reasoning and Decision-Making in Swedish Prehospital Emergency Care: A Mixed Methods Study With an Experimental Design
- 2024
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Ingår i: Journal of Cognitive Engineering and Decision Making. - 1555-3434 .- 2169-5032.
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Tidskriftsartikel (refereegranskat)abstract
- Clinical reasoning and decision-making in prehospital contexts are complex, and patient assessments may be influenced by stress or biases, thus potentially risking patient safety. Previous research has shown mixed results regarding cognitive interventions designed to counteract biases and improve decision-making. In educational settings, there are no tools that assess clinical reasoning while also measuring important decision-making outcomes. This study employed a mixed-methods design and a novel assessment model to evaluate clinical reasoning and decision-making among Swedish prehospital nurse specialists. Additionally, the effect of the metacognitive TWED mnemonic was investigated. Thirteen participants were randomly assigned to two groups and assessed patients in simulation settings, with groups switching cases after brief training on the TWED mnemonic. The primary outcomes included point-based scoring on decision-making, grading of potential risks of patient harm, and analysis of clinical reasoning through reflections. The results showed large variation, without overall differences between groups or demographics. A complex case presentation resulted in lower scores and greater risks of potential patient harm. Qualitative analysis highlighted participants’ ability to handle conflicting data, which correlated with better outcomes. The use of the TWED mnemonic may have increased commission bias. Further research is needed to validate and understand these findings.
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| 4. |
- Glantz, Helena, et al.
(författare)
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Effect of CPAP on diastolic function in coronary artery disease patients with nonsleepy obstructive sleep apnea : A randomized controlled trial.
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 241, s. 12-18
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Obstructive sleep apnea (OSA) has been associated with worse diastolic function in patients with coronary artery disease (CAD). This analysis determined whether continuous positive airway pressure (CPAP) treatment would improve diastolic function in CAD patients with nonsleepy OSA.METHODS: Between December 2005 and November 2010, 244 revascularized CAD patients with nonsleepy OSA (apnea-hypopnea index (AHI) ≥15/h, Epworth Sleepiness Scale [ESS] score<10) were randomly assigned to CPAP or no-CPAP. Echocardiographic measurements were obtained at baseline, and after 3 and 12months.RESULTS: A total of 171 patients with preserved left ventricular ejection fraction (≥50%), no atrial fibrillation or severe valve abnormalities, and technically adequate echocardiograms at baseline and follow-up visits were included (CPAP, n=87; no-CPAP, n=84). In the intention-to-treat analysis, CPAP had no significant effect on echocardiographic parameters of mild (enlarged left atrium or decreased diastolic relaxation velocity) or worse (increased E/é filling index [presumed elevated left ventricular filling pressure]) diastolic function. Post-hoc analysis revealed a significant association between CPAP usage for ≥4h/night and an increase in diastolic relaxation velocity at 12months' follow-up (odds ratio 2.3, 95% confidence interval 1.0-4.9; p=0.039) after adjustment for age, sex, body mass index, and left atrium diameter at baseline.CONCLUSIONS: CPAP did not improve diastolic dysfunction in CAD patients with nonsleepy OSA. However, good CPAP adherence was significantly associated with an increase in diastolic relaxation velocity after one year.
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| 5. |
- Johansson, Helena, et al.
(författare)
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Reasons for bias in ambulance clinicians’ assessments of non-conveyed patients : a mixed-methods study
- 2022
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Ingår i: BMC Emergency Medicine. - : Springer Nature. - 1471-227X. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- The number of ambulance assignments and the influx of patients to the emergency departments (EDs) in Sweden have increased in recent years. This is one reason the protocol for prehospital emergency care was developed around referring patients for non-conveyance, either through the see-and-convey elsewhere approach or through the see-and-treat approach. However, this protocol has led to challenges in patient assessments.
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| 6. |
- Levinsson, Magnus, et al.
(författare)
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En samtida diskurs om betydelsen av fysisk aktivitet för undervisning och lärande : Kritisk analys av artiklar i lärarfackliga tidskrifter.
- 2022
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Ingår i: Nordic Studies in Education. - : Cappelen Damm AS - Cappelen Damm Akademisk. - 1891-5914 .- 1891-5949. ; 42:3, s. 249-271
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Tidskriftsartikel (refereegranskat)abstract
- This article explores how teacher union journals in Sweden construct (1) problems related to teaching and learning assumed to be caused by pupils’ physical inactivity, and (2) solutions regarding how and by whom these problems should be addressed. This is done through a critical discourse analysis of four strategically selected articles published in two teacher union journals where researchers, physicians, school leaders and teachers are interviewed about the potential of more physical activity in schools. The overall conclusion is that the examined teacher union journal articles connect physical activity to teaching and learning in ways that de-professionalise teachers.
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| 7. |
- Olander, Agnes, et al.
(författare)
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Assessment of patients with suspected sepsis in the ambulance services : a qualitative interview study
- 2021
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Ingår i: BMC Emergency Medicine. - : BioMed Central. - 1471-227X. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background: The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Early identification, care and treatment are vital for patients with sepsis to avoid adverse outcomes. However, knowledge about how patients with sepsis are assessed in ambulance services (AS) by AC is limited. Therefore, the aim of this study was to explore the meaning of ACs’ lived experiences in assessing patients suspected of having sepsis.Methods: A descriptive design with a qualitative approach was used. Fourteen ACs from three Swedish ambulance organizations participated in dyadic and individual semistructured interviews. A thematic analysis based on descriptive phenomenology was performed.Results: AC experiences were grouped into four themes: (1) being influenced by previous experience; (2) searching for clues to the severity of the patient’s condition; (3) feeling confident when signs and symptoms were obvious; and (4) needing health-care professionals for support and consultation.Conclusions: This study indicates that several factors are important to assessments. ACs needed to engage in an ongoing search for information, discuss the cases with colleagues and reconsider the assessment throughout the entire ambulance mission. A reflective and open stance based on professional knowledge could contribute to recognizing patients with sepsis.
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| 8. |
- Olander, Agnes, et al.
(författare)
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Lived experiences of the onset of sepsis
- 2022
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Ingår i: The 4th International NCCS & EACS Conference April 27th – 28th 2022 at Mälardalen University, Sweden.
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Konferensbidrag (refereegranskat)
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| 9. |
- Olander, Agnes, et al.
(författare)
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Prediction of the Risk of Sepsis by Using Analysis of Plasma Glucose and Serum Lactate in Ambulance Services: A Prospective Study
- 2023
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Ingår i: Prehospital and Disaster Medicine. - : Cambridge University Press (CUP). - 1049-023X .- 1945-1938. ; 38:2, s. 160-167
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The early recognition of patients with sepsis is difficult and the initial assessment outside of hospitals is challenging for ambulance clinicians (ACs). Indicators that ACs can use to recognize sepsis early are beneficial for patient outcomes. Research suggests that elevated point-of-care (POC) plasma glucose and serum lactate levels may help to predict sepsis in the ambulance service (AS) setting. Study Objective: The aim of this study was to test the hypothesis that the elevation of POC plasma glucose and serum lactate levels may help to predict Sepsis-3 in the AS. Methods: A prospective observational study was performed in the AS setting of Gothenburg in Sweden from the beginning of March 2018 through the end of September 2019. The criteria for sampling POC plasma glucose and serum lactate levels in the AS setting were high or intermediate risk according to the Rapid Emergency Triage and Treatment System (RETTS), as red, orange, yellow, and green if the respiratory rate was >22 breaths/minutes. Sepsis-3 were identified retrospectively. A primary and secondary analyses were carried out. The primary analysis included patients cared for in the AS and emergency department (ED) and were hospitalized. In the secondary analysis, patients who were only cared for in the AS and ED without being hospitalized were also included. To evaluate the predictive ability of these biomarkers, the area under the curve (AUC), sensitivity, specificity, and predictive values were used. Results: A total of 1,057 patients were included in the primary analysis and 1,841 patients were included in the secondary analysis. In total, 253 patients met the Sepsis-3 criteria (in both analyses). The AUC for POC plasma glucose and serum lactate levels showed low accuracy in predicting Sepsis-3 in both the primary and secondary analyses. Among all hospitalized patients, regardless of Sepsis-3, more than two-thirds had elevated plasma glucose and nearly one-half had elevated serum lactate when measured in the AS. Conclusions: As individual biomarkers, an elevated POC plasma glucose and serum lactate were not associated with an increased likelihood of Sepsis-3 when measured in the AS in this study. However, the high rate of elevation of these biomarkers before arrival in hospital highlights that their role in clinical decision making at this early stage needs further evaluation, including other endpoints than Sepsis-3.
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| 10. |
- Olander, Agnes, et al.
(författare)
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Prehospital characteristics among patients with sepsis: a comparison between patients with or without adverse outcome
- 2019
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Ingår i: Bmc Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- Background The prehospital care of patients with sepsis are commonly performed by the emergency medical services. These patients may be critically ill and have high in-hospital mortality rates. Unfortunately, few patients with sepsis are identified by the emergency medical services, which can lead to delayed treatment and a worse prognosis. Therefore, early identification of patients with sepsis is important, and more information about the prehospital characteristics that can be used to identify these patients is needed. Based on this lack of information, the objectives of this study were to investigate the prehospital characteristics that are identified while patients with sepsis are being transported to the hospital by the emergency medical services, and to compare these values to those of the patients with and without adverse outcomes during their hospital stays. Methods This was a retrospective observational study. The patients' electronic health records were reviewed and selected consecutively based on the following: retrospectively diagnosed with sepsis and transported to an emergency department by the emergency medical services. Data were collected on demographics, prehospital characteristics and adverse outcomes, defined as the in-hospital mortality or treatment in the intensive care unit, and analysed by independent sample t-test and chi-square. Sensitivity, specificity and likelihood ratio, of prehospital characteristics for predicting or development of adverse outcome were analysed. Results In total, 327 patients were included. Of these, 50 patients had adverse outcomes. When comparing patients with or without an adverse outcome, decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care were found to be associated with an adverse outcome. Conclusions The findings suggests that patients having a decreased oxygen saturation and body temperature, increased serum glucose level and altered mental status during prehospital care are at risk of a poorer patient prognosis and adverse outcome. Recognizing these prehospital characteristics may help to identify patients with sepsis early and improve their long-term outcomes. However further research is required to predict limit values of saturation and serum glucose and to validate the use of prehospital characteristics for adverse outcome in patients with sepsis.
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