| 1. |
- Persson, Lena, 1951-, et al.
(author)
-
Acute leukaemia and malignant lymphoma patients' experiences of disease, treatment and nursing care during the active treatment phase : an explorative study
- 1995
-
In: European Journal of Cancer Care. - : John Wiley & Sons Inc.. - 0961-5423 .- 1365-2354. ; 4:3, s. 133-142
-
Journal article (peer-reviewed)abstract
- Five acute leukaemia or high malignant lymphoma patients at a hospital in southern Sweden were interviewed about their daily living problems, their coping strategies and their opinions about the nursing care they received during the active phase of their treatment. In addition the EORTC QLQ-C30, the Global Life Quality and the Sense of Coherence scales were administered. The data were analysed from a hermeneutic phenomenological perspective and interpreted to indicate that the patients sensed a threat to their lives, loss of control and having to live in uncertainty stemming from the disease and the treatment. They had problems with such things as fatigue, diarrhoea, nausea and vomiting, loss of appetite, sore mouth, and high temperature. However they seemed to minimise the importance of these problems and instead focused on gaining control of the situation, developing their knowledge of the disease and relying on the support of their family. Contradictions appeared in their statements about the quality of care; the information given was said to be good but difficult to understand, though the quality of the nursing care was judged to be high it had to be asked for i.e. help was received on request. In conclusion the entire situation of the patients perspective of both from the family and the nurses, needs to be studied in further research in order to fully understand the patients´ coping strategies and how nursing care can support them.
|
|
| 2. |
- Bjurberg, Maria, et al.
(author)
-
Prediction of patient outcome with 2-deoxy-2-[(18)F]fluoro-D-glucose-positron emission tomography early during radiotherapy for locally advanced cervical cancer
- 2009
-
In: International Journal of Gynecological Cancer. - Philadelphia : Lippincott Williams & Wilkins. - 1048-891X .- 1525-1438. ; 19:9, s. 1600-1605
-
Journal article (peer-reviewed)abstract
- Introduction: It is difficult to assess the individual response of locally advanced cervical cancer to chemoradiation therapy during the course of treatment. We have investigated the predictive value of positron emission tomography (PET) with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) early during treatment in relation to progression-free survival.Methods: This prospective single-center clinical trial included women with locally advanced cervical cancer from 2004 to 2008. 2-Deoxy-2-[(18)F]fluoro-D-glucose-PET/computed tomography was performed at baseline, during the third week of treatment and, finally, 3 months after the completion of treatment. The images were evaluated visually, semiquantitatively with the maximum standardized uptake value, and by calculating the metabolic rate of FDG. Thirty-two patients were eligible for full evaluation.Results: The median follow-up time was 28 months (range, 5-53 months). Visual metabolic complete response on FDG-PET, after a mean irradiation dose of 23 Gy (range, 16-27 Gy), was found in 7 patients, none of which relapsed. Eleven of the 25 patients with remaining malignant hypermetabolism on the second FDG-PET relapsed. Neither maximum standardized uptake value nor metabolic rate of FDG could further discriminate between patients with low risk and patients with high risk of relapse. The follow-up FDG-PET performed 3 months after the completion of treatment identified a group of patients with poor prognosis.Conclusions: In conclusion, FDG-PET early during chemoradiation therapy identified a small number of patients with an excellent prognosis. However, FDG-PET at this early point in time during treatment failed to predict the outcome for most patients. Future clinical trials to determine the optimal timing of predictive FDG-PET are thus warranted.
|
|
| 3. |
- Björkwall, Susanna, et al.
(author)
-
A generalized linear model with smoothing effects for claims reserving
- 2011
-
In: Insurance, Mathematics & Economics. - : Elsevier BV. - 0167-6687 .- 1873-5959. ; 49:1, s. 27-37
-
Journal article (peer-reviewed)abstract
- In this paper, we continue the development of the ideas introduced in England and Verrall (2001) by suggesting the use of a reparameterized version of the generalized linear model (GLM) which is frequently used in stochastic claims reserving. This model enables us to smooth the origin, development and calendar year parameters in a similar way as is often done in practice, but still keep the GLM structure. Specifically, we use this model structure in order to obtain reserve estimates and to systemize the model selection procedure that arises in the smoothing process. Moreover, we provide a bootstrap procedure to achieve a full predictive distribution.
|
|
| 4. |
- Björkwall, Susanna, et al.
(author)
-
Bootstrapping the separation method in claims reserving.
- 2010
-
In: Astin Bulletin. - 0515-0361 .- 1783-1350. ; 40:2, s. 845-869
-
Journal article (peer-reviewed)abstract
- The separation method was introduced by Verbeek (1972) in order to forecast numbers of excess claims and it was developed further by Taylor (1977) to be applicable to the average claim cost.The separation method differs from the chain-ladder in that when the chain-ladder only assumes claim proportionality between the development years, the separation method also separates the claim delay distribution from influences affecting the calendar years, e.g. inflation. Since the inflation contributes to the uncertainty in the estimate of the claims reserve it is important to consider its impact in the context of risk management, too. In this paper we present a method for assessing the prediction error distribution of the separation method. To this end we introduce a parametric framework within the separation model which enables joint resampling of claim counts and claim amounts. As a result, the variability of Taylor's predicted reserves can be assessed by extending the parametric bootstrap techniques of Björkwall et al. (2009). The performance of the bootstrapped separation method and chain-ladder is compared for a real data set.
|
|
| 5. |
- Björkwall, Susanna, 1976-, et al.
(author)
-
Non-parametric and parametric bootstrap techniques for age-to-age development factor methods in stochastic claims reserving.
- 2009
-
In: Scandinavian Actuarial Journal. - : Informa UK Limited. - 0346-1238 .- 1651-2030. ; :4, s. 306-331
-
Journal article (peer-reviewed)abstract
- In the literature, one of the main objects of stochastic claims reserving is to find models underlying the chain-ladder method in order to analyze the variability of the outstanding claims, either analytically or by bootstrapping. In bootstrapping these models are used to find a full predictive distribution of the claims reserve, even though there is a long tradition of actuaries calculating the reserve estimate according to more complex algorithms than the chain-ladder, without explicit reference to an underlying model. In this paper we investigate existing bootstrap techniques and suggest two alternative bootstrap procedures, one non-parametric and one parametric, by which the predictive distribution of the claims reserve can be found for other age-to-age development factor methods than the chain-ladder, using some rather mild model assumptions. For illustration, the procedures are applied to three different development triangles.
|
|
| 6. |
- Björkwall, Susanna, 1976-
(author)
-
Stochastic claims reserving in non-life insurance : Bootstrap and smoothing models
- 2011
-
Doctoral thesis (other academic/artistic)abstract
- In practice there is a long tradition of actuaries calculating reserve estimates according to deterministic methods without explicit reference to a stochastic model. For instance, the chain-ladder was originally a deterministic reserving method. Moreover, the actuaries often make ad hoc adjustments of the methods, for example, smoothing of the chain-ladder development factors, in order to fit the data set under analysis. However, stochastic models are needed in order to assess the variability of the claims reserve. The standard statistical approach would be to first specify a model, then find an estimate of the outstanding claims under that model, typically by maximum likelihood, and finally the model could be used to find the precision of the estimate. As a compromise between this approach and the actuary's way of working without reference to a model the object of the research area has often been to first construct a model and a method that produces the actuary's estimate and then use this model in order to assess the uncertainty of the estimate. A drawback of this approach is that the suggested models have been constructed to give a measure of the precision of the reserve estimate without the possibility of changing the estimate itself. The starting point of this thesis is the inconsistency between the deterministic approaches used in practice and the stochastic ones suggested in the literature. On one hand, the purpose of Paper I is to develop a bootstrap technique which easily enables the actuary to use other development factor methods than the pure chain-ladder relying on as few model assumptions as possible. This bootstrap technique is then extended and applied to the separation method in Paper II. On the other hand, the purpose of Paper III is to create a stochastic framework which imitates the ad hoc deterministic smoothing of chain-ladder development factors which is frequently used in practice.
|
|
| 7. |
- Bohlooly-Yeganeh, Mohammad, 1966, et al.
(author)
-
Enhanced spontaneous locomotor activity in bovine GH transgenic mice involves peripheral mechanisms
- 2001
-
In: Endocrinology. ; 142:10, s. 4560-4567
-
Journal article (peer-reviewed)abstract
- Clinical and experimental studies indicate a role for GH in mechanisms related to anhedonia/hedonia, psychic energy, and reward. Recently we showed that transgenic mice with general overexpression of bovine GH display increased spontaneous locomotor activity. In the present study, we investigated whether this behavioral change is owing to a direct action of GH in the central nervous system or to peripheral GH actions. A transgenic construct, containing the glial fibrillary acidic protein promoter directing specific expression of bovine GH to the central nervous system, was designed. The central nervous system-specific expression of bovine GH in the glial fibrillary acidic protein-bovine GH transgenic mice was confirmed, but no effect on spontaneous locomotor activity was observed. Serum bovine GH levels were increased in glial fibrillary acidic protein-bovine GH transgenic mice but clearly lower than in transgenic mice with general overexpression of bovine GH. In contrast to the transgenic mice with general overexpression of bovine GH, glial fibrillary acidic protein-bovine GH mice did not display any difference in serum IGF-I levels. The levels of free T(3) and the conversion of the free T(4) to free T(3) were only increased in transgenic mice with general overexpression of bovine GH, but serum corticosterone levels were similarly increased in both transgenic models. These results suggest that free T(3) and/or IGF-I, affecting dopamine and serotonin systems in the central nervous system, may mediate the enhanced locomotor activity observed in transgenic mice with general overexpression of bovine GH.
|
|
| 8. |
- Bondesson, Susanne, et al.
(author)
-
Effects on blood pressure in patients with refractory angina pectoris after enhanced external counterpulsation
- 2010
-
In: Blood Pressure. - : Informa UK Limited. - 0803-7051 .- 1651-1999. ; 19:5, s. 287-294
-
Journal article (peer-reviewed)abstract
- Objective. Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to reduce the frequency and severity of angina pectoris. Little is known how EECP affects the blood pressure. Methods. 153 patients with refractory angina were treated with either EECP or retained on their pharmacological treatment (reference group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate were measured pre- and post-treatment and at 12 months follow-up. Results. EECP treatment altered the blood pressure in patients with refractory angina pectoris. A decrease in the blood pressure was more common in the EECP group compared with the reference group. In the reference group, an increase in the blood pressure was more common. A correlation between a decrease in blood pressure after EECP treatment and a higher baseline MAP, SBP and DBP was seen. No such correlation was seen in the reference group. The blood pressure response did not persist at 12 months follow-up. Conclusion. EECP treatment affects the blood pressure in patients with refractory angina pectoris. The decreased blood pressure may be a result of an improved exercise capacity, an improved endothelial function and vasoreactivity in general.
|
|
| 9. |
- Borg, Julia, et al.
(author)
-
Oesophageal dysmotility, delayed gastric emptying and gastrointestinal symptoms in patients with diabetes mellitus.
- 2007
-
In: Diabetic Medicine. - : Wiley. - 1464-5491 .- 0742-3071. ; 24:11, s. 1235-1239
-
Journal article (peer-reviewed)abstract
- Aims Gastroparesis is a common gastrointestinal complication in diabetes mellitus, whereas dysfunction in the other gastrointestinal organs has been less thoroughly investigated. Furthermore, it is not known whether there is any relationship between motility and dysmotility between these organs. The aim of this study was to examine whether diabetic patients with gastrointestinal symptoms also have motility disturbances in the oesophagus and stomach and, if so, whether there are any associations between these disturbances. Methods Thirty-one patients with diabetes mellitus who complained of gastrointestinal symptoms were asked to complete a questionnaire about their symptoms. They were further investigated with oesophageal manometry and gastric emptying scintigraphy. Results Fifty-eight per cent of the patients had abnormal oesophageal function, and 68% had delayed gastric emptying. Abdominal fullness was the only symptom that related to any dysfunction, and it was associated with delayed gastric emptying (P = 0.02). We did not find any relationship in motility or dysmotility between the oesophagus and the stomach. Conclusion Oesophageal dysmotility, as well as gastroparesis, are common in patients with diabetes who have gastrointestinal symptoms. It is important to investigate these patients further, to be able to reach an accurate diagnosis and instigate appropriate treatment. Our findings indicate that the oesophagus and the stomach function as separate organs and that pathology in one does not necessarily mean pathology in the other.
|
|
| 10. |
- Claesson, Åsa, et al.
(author)
-
lntegrated Optical Fiber Sensors in Additive Manufactured Metal Components for Smart Manufacturing Applications
- 2019
-
In: Smart Systems Integration; 13th International Conference and Exhibition on Integration Issues of Miniaturized Systems.
-
Conference paper (peer-reviewed)abstract
- This work combines fiber optic sensors with additive manufacturing to enable integration of temperature and strain sensors in metal components. In this paper, we present a fiber optic sensor network integrated in press hardening tools to monitor the contact between the tool and the metal sheet during forming operation. The tools are manufactured through metal powder bed fusion using laser melting processes (PBF-SLM), after which the tools are prepared for sensor integration. A demonstrator press hardening tool with integrated fiber optic sensors was heated using an electric heat foil and the sensor measurements was compared to a thermal simulation model. The sensor technology is based on Fiber Bragg Gratings (FBGs), integrated at several positions along the optical fiber. FBGs are in-fiber sensors that are multiplexed. lt is possible to place hundreds of FBG sensors along one single fiber, thus allowing for quasidistributed sensing of temperature or strain. The optical fiber itself can be less than 100 micrometer in diameter, allowing for sensing at several points in a minimally invasive way, when integrated in a tool or component.
|
|
