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- Bäckman, Karin, et al.
(author)
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Vårdens alltför svåra val? : kartläggning av prioriteringsarbete och analys av riksdagens principer och riktlinjer för prioriteringar i hälso- och sjukvården
- 2007
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Reports (other academic/artistic)abstract
- PrioriteringsCentrum har på uppdrag av Socialstyrelsen genomfört en kartläggning av på vilket sätt hälso- och sjukvårdens huvudmän och andra centrala aktörer arbetar med prioriteringar och har utvärderat hur detta arbete överensstämmer med intentionerna i riksdagens beslut om prioriteringar. Vi har även analyserat innehållet i och tillämpningen av riksdagens riktlinjer för prioriteringar i hälso- och sjukvården. Det har skett genom en etisk analys och mot bakgrund av ett stort antal intervjuer i landsting och kommuner samt med representanter för statliga myndigheter och yrkesorganisationer och med ledning av vad som framkommit i tidigare uppföljningar. Vi föreslår i rapporten ett anta förändringar och förtydliganden av riktlinjerna.Vi kan konstatera att sättet att arbeta med prioriteringar i landsting och kommuner inte är helt olikt det som gällde när Prioriteringsdelegationen redovisade en motsvarande uppföljning år 2001. Fortfarande finns knappast några öppna beslut om fördelning och prioritering av resurser om man med öppenhet avser att beslutsfattaren medvetet överväger flera alternativ och att grunderna för besluten är kända för dem som önskar ta del av dem.I situationer då tillgängliga resurser inte befinner sig i paritet med önskvärda ambitioner får sjukvårdspersonalen ta det största ansvaret för att besluta om och genomföra ransonering av vården. Förutom på chefsnivå tycks dock sjukvårdpersonal fortfarande i liten utsträckning vara medveten om de etiska principer som enligt riksdagsbeslutet ska styra prioriteringar i vården. Få känner till den etiska plattformen med de tre etiska principerna. Lokala mallar eller styrdokument för prioriteringar är ovanliga. Det saknas nödvändiga förutsättningar för att tillämpa riksdagens prioriteringsbeslut och det finns inte heller några tydliga strategier för hur man vill skapa sådana förutsättningar inom landstingen.Den kommunala vård- och omsorgsverksamheten upplever sig fortfarande i ringa utsträckning berörd av den etiska plattformen och prioriteringsprinciperna. Någon gemensam prioritering mellan huvudmännen sker knappast alls.Medborgarna är i mycket liten utsträckning involverade i prioriteringsarbetet. Den ökade öppenheten gentemot brukare innebär oftast att viss information om prioriteringar sker genom traditionella kanaler som patientorganisationer, pensionärsråd och handikappråd och synpunkter inhämtas via allmänna patientenkäter medan klagomål hanteras genom patientnämnder.Vi har också funnit tydliga skillnader när det gäller hur arbetet med prioriteringar bedrivs idag jämfört med för sex år sedan. Genom Socialstyrelsen och Läkemedelsförmånsnämnden har staten tagit ledningen när det gäller att visa hur prioriteringar kan göras på ett systematiskt och öppet sätt. Detta arbete har resulterat i en tydlig metodutveckling. Idag finns det dessutom flera exempel på konkret utvecklingsarbete och samverkan mellan huvudmän kring det vidare begreppet kunskapsstyrd vård till vilket systematiska prioriteringar är starkt relaterat. Vi kan också notera olika initiativ till vertikala prioriteringar i verksamheten där det framförallt är läkarkåren som engagerat sig; men också enstaka försök med systematiska politiska prioriteringar. Det finns dessutom flera lovande utvecklingsprojekt rörande prioriteringar som initierats av och drivs av sjukvårdspersonal både lokalt och nationellt. Yrkesförbunden är också mer aktiva idag när det gäller att sprida kunskap om prioriteringar....
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| 2. |
- Einvall, Jessica, et al.
(author)
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Investigation of reforming catalyst deactivation by exposure to fly ash from biomass gasification in laboratory scale
- 2007
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In: Energy & Fuels. - : American Chemical Society (ACS). - 0887-0624 .- 1520-5029. ; 21:5, s. 2481-2488
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Journal article (peer-reviewed)abstract
- Production of synthesis gas by catalytic reforming of product gas from biomass gasification can lead to catalyst deactivation by the exposure to ash compounds present in the flue gas. The impact of fly ash from biomass gasification on reforming catalysts was studied at the laboratory scale. The investigated catalyst was Pt/Rh based, and it was exposed to generated K2SO4 aerosol particles and to aerosol particles produced from the water-soluble part of biomass fly ash, originating from a commercial biomass combustion plant. The noble metal catalyst was also compared with a commercial Ni-based catalyst, exposed to aerosol particles of the same fashion. To investigate the deactivation by aerosol particles, a flow containing submicrometer-size selected aerosol particles was led through the catalyst bed. The particle size of the poison was measured prior to the catalytic reactor system. Fresh and aerosol particle exposed catalysts were characterized using BET surface area, XRPD (X-ray powder diffraction), and H2 chemisorption. The Pt/Rh catalyst was also investigated for activity in the steam methane reforming reaction. It was found that the method to deposit generated aerosol particles on reforming catalysts could be a useful procedure to investigate the impact of different compounds possibly present in the product gas from the gasifier, acting as potential catalyst poisons. The catalytic deactivation procedure by exposure to aerosol particles is somehow similar to what happens in a real plant, when a catalyst bed is located subsequent to a biomass gasifier or a combustion boiler. Using different environments (oxidizing, reducing, steam present, etc.) in the aerosol generation adds further flexibility to the suggested aerosol deactivation method. It is essential to investigate the deactivating effect at the laboratory scale before a full-scale plant is taken into operation to avoid operational problems.
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| 3. |
- Elfstrand, Lidia, et al.
(author)
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Recrystallization of waxy maize starch during manufacturing of starch microspheres for drug delivery: Influence of excipients
- 2007
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In: Carbohydrate Polymers. - : Elsevier BV. - 0144-8617. ; 69:4, s. 732-741
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Journal article (peer-reviewed)abstract
- The formation of ordered structure, such as crystallites, in starch was studied by means of differential scanning calorimetry (DSC). The influence of time/temperature treatment and additives such as polyethylene glycol (PEG), bovine serum albumin (BSA) and a carbonate buffer on the formation was investigated. The experiments were planned with a CCC (Central Composite Circumscribed) design. For all three investigated systems it could be concluded that the incubation time at 6 °C was the decisive factor for the amount of ordered structure obtained during the incubation, while the incubation time at 37 °C was the decisive factor for the thermal stability of the crystallites as expressed by Ton, Tm and Tc. The additives seemed to mainly affect the nucleation phase of crystallization process. The additives decreased the time required in order to obtain a certain level of ordering in the incubated starch samples. The carbonate buffer decreased the amount of ordered structure in starch as judged by DSC enthalpy values, while increasing the melting temperature of these structures. The additives PEG and BSA lowered the melting temperatures of the starch in the systems but increased the enthalpy values. By optimization procedure a specific amount of ordered structure with desired thermal characteristics could be predicted.
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| 6. |
- Georgopoulos, Theofanis, et al.
(author)
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Influence of native lipids on the rheological properties of wheat flour dough and gluten
- 2006
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In: Journal of Texture Studies. - : Wiley. - 0022-4901 .- 1745-4603. ; 37:1, s. 49-62
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Journal article (peer-reviewed)abstract
- We report on the viscoelastic properties of dough and gluten (prepared by ultracentrifugation) after the flour lipids had been removed by solvents differing in polarity (chloroform, ethanol and diethylether). The extracted lipids were fractionated by thin layer chromatography. The flours differed in lipid composition after the extraction. Ethanol removed more polar lipids than the other solvents. Removal of lipids (0.6-0.9% on flour weight) altered the viscoelastic properties of dough significantly, whereas those of gluten were only marginally affected. The storage modulus (G') of dough increased with used solvent polarity. The highest value of G' was observed for the dough made with the flour where the lipids were removed by ethanol. This was consistent with a marked decrease in the frequency dependence of G' of dough when the lipids were removed.
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| 7. |
- Larsson, Ann-Charlotte, et al.
(author)
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Deactivation of SCR Catalysts by Exposure to Aerosol Particles of Potassium and Zinc Salts
- 2007
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In: Aerosol Science and Technology. - : Informa UK Limited. - 0278-6826 .- 1521-7388. ; 41:4, s. 369-379
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Journal article (peer-reviewed)abstract
- Generated aerosol particle deposition has been applied in laboratory scale to induce deactivation of commercial Selective Catalytic Reduction (SCR) catalysts Of V2O5-WO3/TiO2 monolithic type. The monolithic catalyst has been exposed to the generated submicrometer particle of inorganic salts, KCl, K2SO4, and ZnCl2 at 200 degrees C in a tubular reactor. The generated particles have been deposited on the catalytic surfaces by utilization of an electrostatic field. Physical characterization of the generated aerosol particles were conducted by Scanning Mobility Particle Sizer (SMPS) and Electric Low Pressure Impactor (ELPI) with and without catalyst in order to investigate the magnitude of the particle deposition. Particle charge distribution was also evaluated with a Tandem Differential Mobility Analyser (TDMA) set up.SCR is the most common method to commercially reduce NOx emissions from combustion processes. Catalyst lifetime is important for process economics and extending catalyst life can allow future strengthened emission legislation and diminished NOx emissions.Verification of particle deposition has been conducted through comparison with catalyst samples exposed to commercial biomass combustion condition.The reactivity of both fresh and exposed catalyst samples as well as commercially used samples was examined in SCR reaction and the methods of deposition as well as the influence of the different salts on catalytic performance have been explored.Catalyst samples have been evaluated with Scanning Electron Microscopy (SEM) with respect to surface morphology of the catalyst material. The laboratory deactivated catalyst samples showed resemblance with the commercially exposed catalyst sample with respect to salts concentration and deposition of the salts particles. The obtained influence on catalyst activity was comparable with commercially obtained catalyst activity reductions at comparable potassium concentration levels.
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| 8. |
- Larsson, Ann-Charlotte, et al.
(author)
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Physical and chemical characterisation of potassium deactivation of a SCR catalyst for biomass combustion
- 2007
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In: Topics in catalysis. - : Springer Science and Business Media LLC. - 1022-5528 .- 1572-9028. ; 45:1-4, s. 149-152
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Journal article (peer-reviewed)abstract
- The deactivation of a commercial Selective Catalytic Reduction (SCR) catalyst, of V2O5-WO3/TiO2 type, has been studied through comparisons with results from a full-scale biomass combustion plant to that with laboratory experiments. In the latter, the catalyst was exposed to KCl and K2SO4 by both wet impregnation with diluted salt solutions and deposition of generated submicrometer aerosol particles by means of an electrostatic field. The reactivity of fresh and deactivated samples was examined in the SCR reaction. Chemical and physical characterizations were focusing on internal structures and chemical composition. Deposition of submicrometer sized particles on the monolithic SCR catalyst was shown to induce deactivation with characteristics resembling those obtained in a commercial biomass combustion plant.
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