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  • 301.
    Kirsebom, Marie
    Uppsala University.
    Mind the gap: organizational factors related to transfers of older people between nursing homes and hospital care2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the present thesis was to study factors related to transfers of older people between nursing homes, emergency department and hospital care.

    The thesis was based on four studies and used three methods: focus group discussions, structured review of electronic healthcare records, semi-structured interviews with registered nurses and general practitioners.

    Study I: nursing home nurses found it difficult to decide whether older residents should be referred to hospital from the nursing home. Hospital registered nurses reported often trying to stop premature discharges or having to carry out the discharge although it had not been fully prepared. Study II: transfer rate to ED was 594 over 9 months among a total of 431 residents (M 1.37 each). 25% were caused by falls and/or injuries, 63% resulted in hospitalization (M 7.12 days). The transfer rate was 0.00-1.03 transfers/bed; it was higher for private for-profit providers than for public/private non-profit providers. Study III: nursing homes with high transfer rates had fewer updated advance care plans than did nursing homes with lower transfer rates. More nurses from nursing homes with low transfer rates had a specialist education and training in dementia care and had worked longer in eldercare. Study IV: general practitioners perceived registered nurses’ continuity, competence and collaboration with family members as important to quality of care in nursing homes; inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety.

    The findings indicate that organizational factors could explain differences in transfer rates between nursing homes. The studies highlight the importance of advance care planning together with residents and family members in facilitating future medical decisions. Registered nurses’ continuity and competence are perceived as crucial to quality of care. To meet increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care several changes should be made: Nursing homes should be equipped with suitable medical equipment and registered nurse staff should be matched accordingly; importantly, registered nurses and general practitioners should be able to access each other’s healthcare record systems.

  • 302.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Pöder, Ulrika
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Transfer of nursing home residents to emergency departments: organizational differences between nursing homes with high vs. low transfer rates2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 1, p. 41-48Article in journal (Refereed)
    Abstract [en]

    Aim: To explore possible factors in the organization of nursing homes that could be related to differences in the rate of transfer of residents from nursing homes to emergency department.

    Design: Explorative.

    Method: In a single municipality, qualitative and quantitative data were collected from documents and through semi-structured interviews with 11 RNs from five nursing homes identified as having the highest vs. six identified as having the lowest transfer rates to emergency department. Data were analysed by non-parametric tests and basic content analysis.

    Results: All nursing homes in the highest transfer rate group and one in the lowest transfer rate group were run by private for-profit providers. Compared with the low group, the high group had fewer updated advance care plans and the RNs interviewed had less work experience in care of older people and less training in care of persons with dementia. There was no difference in nursing home size or staff/resident ratio. The RNs described similar possibilities to provide palliative care, medical equipment and perceived medical support from GPs.

  • 303.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Pöder, Ulrika
    Uppsala University.
    The frequency of and reasons for acute hospital transfers of older nursing home residents2013In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 58, no 1, p. 115-120Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to examine the frequency of and reason for transfer from nursing homes to the emergency department (ED), whether these transfers led to admission to a hospital ward, and whether the transfer rate differs as a function of type of nursing home provider and to identify the frequency of avoidable hospitalizations as defined by the Swedish Association of Local Authorities and Regions (SALAR). The design was retrospective, descriptive. Data were collected in a Swedish municipality where 30,000 inhabitants are 65 years or older. Structured reviews of the electronic healthcare records were performed. Included were residents living in a nursing home age 65+, with healthcare records including documented transfers to the ED during a 9-month period in 2010. The transfer rate to the ED was 594 among a total of 431 residents (M = 1.37 each). 63% resulted in hospitalization (M = 7.12 days). Nursing home's transfer rate differed between 0.00 and 1.03 transfers/ bed and was higher for the private for-profit providers than for public/private non-profit providers. One- fourth of the transfers were caused by falls and/or injuries, including fractures. The frequency of avoidable hospitalizations was 16% among the 375 hospitalizations. The proportion of transfers to the ED ranged widely between nursing homes. The reasons for this finding ought to be explored.

     

  • 304.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 4, p. 886-895Article in journal (Refereed)
    Abstract [en]

    Aim:

    To investigate registered hospital and nursing home nurses' experiencesof coordination and communication within and between care settings when olderpersons are transferred from nursing homes to hospital and vice versa.

    Background:

    It has previously been reported that transfers to hospital from nursing homes and discharge of patients from hospital are surrounded by communication difficulties. However, studies focusing on both hospital and nursing home registered nurses' experiences of communication and coordination within and between nursing homes and hospitals are uncommon.

    Design:

    A descriptive study design with a qualitative approach was used.

    Methods:

    In 2008, three focus group discussions were conducted with registered nurses from hospitals and nursing homes (n=20). Data were analysed using content analysis.

    Results:

    Nursing home registered nurses found it difficult to decide whether the older person should be referred to hospital from the nursing home. Hospitalregistered nurses reported often trying to stop premature discharges or having to carry out the discharge although it had not been fully prepared. Both hospital and nursinghome registered nurses suggested increased collaboration to understand each other's work situation better.

    Conclusion:

    Communication and coordination among hospital andnursing home registered nurses need to be furthered improved. Registered nurses'coordination and planning in the nursing home are extremely important to future elder care. We recommend that the medical care plan be regularly updated and meticulously followed, the aim being to reduce the risk of inappropriate medical treatment and nursingcare and unnecessary transfer and admission to hospital.

  • 305.
    Kivipelto, Miia
    et al.
    Karolinska Institutet ; Karolinska University Hospital ; University of Eastern Finland, Finland.
    Håkansson, Krister
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Karolinska Institutet.
    A Rare Success against Alzheimer's2017In: Scientific American, ISSN 0036-8733, E-ISSN 1946-7087, Vol. 316, no 4, p. 32-37Article in journal (Other academic)
    Abstract [en]
    • Two hundred experimental drugs intended to treat Alzheimer's disease have failed in the past 30 years. Without new therapies, the number of patients worldwide will increase dramatically by 2050.
    • A ray of hope has come recently from a clinical trial that showed that dementia's cognitive impairment might be prevented by paying close attention to various health factors.
    • Participants in the study who followed a regimen of health-related steps registered improvements on cognitive measures such as memory and mental-processing speed.
    • Results of this research suffice for health care professionals to begin making a series of recommendations to patients on diet, exercise and levels of social engagement that may help prevent dementia.
  • 306.
    Kivipelto, Miia
    et al.
    Karolinska Institutet.
    Solomon, Alina
    Karolinska Institutet.
    Håkansson, Krister
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology. Karolinska Institutet.
    Till Klarhet med Alzheimer2013In: Äldre i Centrum. Tidskrift för aktuell äldreforskning., ISSN 1653-3585, Vol. 27, no 4, p. 13-15Article, review/survey (Other academic)
  • 307.
    Klapper, Yvonne
    et al.
    Uppsala University.
    Hamad, Osama A.
    Uppsala University.
    Teramura, Yuji
    Uppsala University.
    Leneweit, Gero
    Assoc Promot Canc Therapy, Germany.
    Nienhaus, G. Ulrich
    Karlsruhe Inst Technol KIT, Germany.
    Ricklin, Daniel
    Univ Penn, USA.
    Lambris, John D.
    Univ Penn, USA.
    Nilsson Ekdahl, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences. Uppsala University.
    Nilsson, Bo
    Uppsala University.
    Mediation of a non-proteolytic activation of complement component C3 by phospholipid vesicles2014In: Biomaterials, ISSN 0142-9612, E-ISSN 1878-5905, Vol. 35, no 11, p. 3688-3696Article in journal (Refereed)
    Abstract [en]

    Liposomes are becoming increasingly important as drug delivery systems, to target a drug to specific cells and tissues and thereby protecting the recipient from toxic effects of the contained drug. Liposome preparations have been described to activate complement. In this study, we have investigated complement activation triggered by neutral dimyristoyl-phosphocholine (DMPC) liposomes in human plasma and whole-blood systems. Incubation in plasma led to the generation of complement activation products (C3a and sC5b-9). Unexpectedly, investigations of surface-bound C3 revealed contact activated, conformationally changed C3 molecules on the liposomes. These changes were characterized by Western blotting with C3 monoclonal antibodies, and by incubating liposomes with purified native C3 and factors I and H. Quartz crystal microbalance analysis confirmed binding of C3 to planar DMPC surfaces. In addition, we demonstrated that DMPC liposomes bound to or were phagocytized by granulocytes in a complement-dependent manner, as evidenced by the use of complement inhibitors. In summary, we have shown that C3 is activated both by convertase-dependent cleavage, preferentially in the fluid phase, by mechanisms which are not well elucidated, and also by contact activation into C3(H2O) on the DMPC surface. In particular, this contact activation has implications for the therapeutic regulation of complement activation during liposome treatment. (C) 2013 Elsevier Ltd. All rights reserved.

  • 308.
    Klementsson, Ulrika
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hafsbrandt, Cecilia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Anestesisjuksköterskors upplevelser av samvetsstress: en intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress of conscience means a stressed conscience and occurs when the nurse anaesthetist, for different reasons, does not have the ability to act according to one´s conscience. This can lead to a stress reaction which, if repeated frequently, can lead to emotional exhaustion. Aim: The aim of this study was to shed light on experiences of stress of conscience among nurse anaesthetists. Method: The study was performed by a qualitative thematic content analysis with an inductive approach. The study involved twelve informants who were interviewed regarding their experiences of stress of conscience. Results: Stress of conscience occurs among nurse anaesthetists. One theme was analyzed that describes that the nurse anaesthetist constantly manages the feeling of a stressed conscience, and at the same time strives to do what feels right. How the informants manages the feeling of stress of conscience depends on their emotional daily fitness and the current situation. Conclusions: Stress of conscience can be experienced as a heavy load, but also to be seen as a positive internal force that helps the nurse anaesthetist to act according to one´s conscience, and do things that feel right.

     

  • 309.
    Kristiansson, Håkan
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    The Effect of Optical Defocus on the Peripheral Resolution Acuity in Old Healthy Emmetropes2011Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 310.
    Kristiansson, Håkan
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Lewis, Peter
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosén, Robert
    Biomedical and X-Ray Physics.
    Unsbo, Peter
    Biomedical and X-Ray Physics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Effect of Optical Defocus on Peripheral Resolution Acuity in Old Healthy Emmetropes2011Conference paper (Refereed)
    Abstract [en]

    Background:

    A recent study by Rosén et al found peripheral low contrast resolution acuity, but not high contrast acuity, to be affected by defocus in young healthy eyes. Since aging causes considerable degradation in peripheral optics even in healthy subjects we wanted to see if, older subjects were also sensitive to defocus in low contrast acuity.

     

    Purpose:

    The aim of this study was to evaluate the effect of optical defocus on high and low contrast resolution acuity in the peripheral visual field of healthy older emmetropes.

     

    Subjects:

    High- and low-contrast resolution acuity was evaluated under spherical defocus in the 20° nasal visual field of four healthy older emmetropic subjects. The off-axis refractive error at the 20° nasal visual field was measured by a COAS-HD VR aberrometer and was corrected accordingly for each subject.

     

    Methods:

    Resolution thresholds for visual acuity (VA) were obtained using stimuli consisting of high- (100%) and low- (10%) contrast gratings that were presented on a CRT monitor situated 1.0 meter from the subject. Stimuli, 3° in diameter were presented for 300 ms using a 2AFC paradigm. Two repeated measurements, for both high and low contrast, were obtained for each point of defocus in 1.0 D steps up to ±4 D at 45mm vertex distance. The results are corrected to effective defocus at the corneal plane.

     

    Results:

    Defocus had no visible effect on high contrast VA, although there was a slight decrease in VA with higher amounts of positive defocus. However, defocus was found to have a significant effect on low contrast VA. Moreover, low contrast resolution was more sensitive to positive defocus than the negative defocus.

     

    Conclusions:

    Defocus has an impact on low contrast resolution whereas no such effect was found for high contrast resolution. These results are similar to those obtained by Rosén et al1 in young eyes. These results suggest that low contrast optotypes could possibly be used for determining subjective refraction in low vision subjects.

  • 311.
    Kroon, Martin
    et al.
    Royal Institute of Technology.
    Holzapfel, Gerhard
    Graz University of Technology, Austria.
    A model for saccular cerebral aneurysm growth by collagen fibre remodelling2007In: Journal of Theoretical Biology, ISSN 0022-5193, E-ISSN 1095-8541, Vol. 247, p. 775-787Article in journal (Refereed)
    Abstract [en]

    The first structural model for saccular cerebral aneurysm growth is proposed. It is assumed that the development of the aneurysm isaccompanied by a loss of the media, and that only collagen fibres provide load-bearing capacity to the aneurysm wall. The aneurysm ismodelled as an axisymmetric multi-layered membrane, exposed to an inflation pressure. Each layer is characterized by an orientationangle, which changes between different layers. The collagen fibres and fibroblasts within a specific layer are perfectly aligned. The growthand the morphological changes of the aneurysm are accomplished by the turnover of collagen. Fibroblasts are responsible for collagenproduction, and the related deformations are assumed to govern the collagen production rate. There are four key parameters in themodel: a normalized pressure, the number of layers in the wall, an exponent in the collagen mass production rate law, and the pre-stretchunder which the collagen is deposited. The influence of the model parameters on the aneurysmal response is investigated, and a stabilityanalysis is performed. The model is able to predict clinical observations and mechanical test results, for example, in terms of predictedaneurysm size, shape, wall stress and wall thickness.

  • 312.
    Kroon, Martin
    et al.
    Royal Institute of Technology.
    Holzapfel, Gerhard
    Royal Institute of Technology ; Graz University of Technology, Austria.
    A new constitutive model for multi-layered collagenous tissues2008In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 41, no 12, p. 2766-2771Article in journal (Refereed)
    Abstract [en]

    Collagenous tissues such as the aneurysmal wall or the aorta are multi-layered structures with the mean fibre alignments distinguishing one layer from another. A constitutive representation of the multiple collagen layers is not yet developed, and hence the aim of the present study. The proposed model is based on the constitutive theory of finite elasticity and is characterized by an anisotropic strain-energy function which takes the material structure into account. The passive tissue behaviour is modelled and the related mechanical response is assumed to be dominated by elastin and collagen. While elastin is modelled by the neo-Hookean material the constitutive response of collagen is assumed to be transversely isotropic for each individual layer and based on an exponential function. The proposed constitutive function is polyconvex which ensures material stability. The model has five independent material parameters, each of which has a clear physical interpretation: the initial stiffnesses of the collagen fabric in the two principal directions, the shear modulus pertaining to the non-collagenous matrix material, a parameter describing the level of nonlinearity of the collagen fabric, and the angle between the principal directions of the collagen fabric and the reference coordinate system. An extension-inflation test of the adventitia of a human femoral artery is simulated by means of the finite element method and an error function is minimized by adjusting the material parameters yielding a good agreement between the model and the experimental data.

  • 313.
    Kroon, Martin
    et al.
    Royal Institute of Technology.
    Holzapfel, Gerhard
    Graz University of Technology, Austria.
    Estimation of the distributions of the anisotropic, elastic properties and wall stresses of saccular cerebral aneurysms by inverse analysis2008In: Proceedings of the Royal Society. Mathematical, Physical and Engineering Sciences, ISSN 1364-5021, E-ISSN 1471-2946, Vol. 464, no 2092, p. 807-825Article in journal (Refereed)
    Abstract [en]

    A new method is proposed for estimating the elastic properties of the inhomogeneous and anisotropic structure of saccular cerebral aneurysms by inverse analysis. The aneurysm is modelled as a membrane and the constitutive response of each individual layer of the passive tissue is characterized by a transversely isotropic strain energy function of exponential type. The collagen fibres in the aneurysm wall are assumed to govern the mechanical response. Four parameters characterize the constitutive behaviour of the tissue: two initial stiffnesses of the collagen fabric in the two in-plane principal directions, one parameter describing the degree of nonlinearity that the collagen fibres exhibit and the other structural parameter, i.e. the angle which defines the orientation of the collagen fibres. The parameter describing the fibre nonlinearity is assumed to be constant, while all others are assumed to vary continuously over the aneurysm surface. Two model aneurysms, with the same initial geometry, boundary and loading conditions, constitutive behaviour and finite-element discretization, are defined: a ‘reference model’ with known distributions of material and structural properties and an ‘estimation model’ whose properties are to be estimated. An error function is defined quantifying the deviations between the deformations from the reference and the estimation models. The error function is minimized with respect to the unknown parameters in the estimation model, and in this way the reference parameter distributions are re-established. In order to achieve a robust parameter estimation, a novel element partition method is employed. The accordance between the estimated and the reference distributions is satisfactory. The deviations of the maximum stress distributions between the two models are below 1%. Consequently, the wall stresses in the cerebral aneurysm estimated by inverse analysis are accurate enough to facilitate the assessment of the risk of aneurysm rupture.

  • 314.
    Kroon, Martin
    et al.
    Royal Institute of Technology .
    Holzapfel, Gerhard
    Royal Institute of Technology ; Graz University of Technology, Austria.
    Modelling of saccular aneurysm growth in a human middle cerebral artery2008In: Journal of Biomechanical Engineering, ISSN 0148-0731, E-ISSN 1528-8951, Vol. 130, no 5, article id 051012Article in journal (Refereed)
    Abstract [en]

    Saccular aneurysm growth in a human middle cerebral artery is modeled. The aneurysm growth model was presented in a companion paper by Kroon and Holzapfel ("A Model for Saccular Cerebral Aneurysm Growth by Collagen Fibre Remodelling," J. Theor. Biol., in press) and was assessed there for axisymmetric growth. The aneurysm growth model is now evaluated for a more realistic setting. The middle cerebral artery is modeled as a two-layered cylinder, where the layers correspond to the media and the adventitia. An instant loss of the media in a region of the artery wall initiates the growth of the saccular aneurysm. The aneurysm wall is assumed to be a development of the adventitia of the original healthy artery, and collagen is assumed to be the only load-bearing constituent in the adventitia and in the aneurysm wall. The collagen is organized in a number of distinct layers where fibers in a specific layer are perfectly aligned in a certain fiber direction. The production of new collagen is taken to depend on the stretching of the aneurysm wall, and the continuous remodeling of the collagen fibers is responsible for the aneurysm growth. The general behavior of the growth model is investigated and also the influence of the structural organization of the collagen fabric. The analysis underlines the fact that the material behavior of aneurysmal tissue cannot be expected to be isotropic. The model predictions agree well with clinical and experimental results, for example, in terms of aneurysm size and shape, wall stress levels, and wall thickness.

  • 315.
    Kroon, Martin
    et al.
    Royal Institute of Technology (KTH).
    Holzapfel, Gerhard A.
    Royal Institute of Technology (KTH) ; Graz University of Technology, Austria.
    A theoretical model for fibroblast-controlled growth of saccular cerebral aneurysms2009In: Journal of Theoretical Biology, ISSN 0022-5193, E-ISSN 1095-8541, Vol. 257, no 1, p. 73-83Article in journal (Refereed)
    Abstract [en]

    A new theoretical model for the growth of saccular cerebral aneurysms is proposed by extending the recent constitutive framework of Kroon and Holzapfel [2007a. A model for saccular cerebral aneurysm growth by collagen fibre remodelling. J. Theor. Biol. 247, 775–787]. The continuous turnover of collagen is taken to be the driving mechanism in aneurysmal growth. The collagen production rate depends on the magnitude of the cyclic deformation of fibroblasts, caused by the pulsating blood pressure during the cardiac cycle. The volume density of fibroblasts in the aneurysmal tissue is taken to be constant throughout the growth process. The growth model is assessed by considering the inflation of an axisymmetric membranous piece of aneurysmal tissue, with material characteristics representative of a cerebral aneurysm. The diastolic and systolic states of the aneurysm are computed, together with its load-free state. It turns out that the value of collagen pre-stretch, that determines growth speed and stability of the aneurysm, is of pivotal importance. The model is able to predict aneurysms with typical berry-like shapes observed clinically, and the predicted wall stresses correlate well with the experimentally obtained ultimate stresses of this type of tissue. The model predicts that aneurysms should fail when reaching a size of about 1.2–3.6 mm, which is smaller than what has been clinically observed. With some refinements, the model may, however, be used to predict future growth of diagnosed aneurysms.

  • 316.
    Kroon, Martin
    et al.
    Royal Institute of Technology (KTH).
    Holzapfel, Gerhard A.
    Royal Institute of Technology (KTH) ; Graz University of Technology, Austria.
    Elastic properties of anisotropic vascular membranes examined by inverse analysis2009In: Computer Methods in Applied Mechanics and Engineering, ISSN 0045-7825, E-ISSN 1879-2138, Vol. 198, no 45-46, p. 3622-3632Article in journal (Refereed)
    Abstract [en]

    An inverse method for estimating the distributions of the nonlinear elastic properties of inhomogeneous and anisotropic vascular membranes such as cerebral aneurysms is proposed. The material description of the membrane is based on a versatile structural model able to represent multiple collagen layers and the passive response of the vascular wall. Each individual layer is assumed to behave transversely isotropic following exponential stiffening with increasing loading. The model includes four parameters to be explainable physically: two initial stiffnesses of the collagen fabric, a parameter related to the nonlinearity of the collagen fabric, angle between the principal directions of the collagen fabric and a reference coordinate system. For this finite deformation problem a finite element framework for membranous structures considering pressure boundary loading is outlined, i.e. the principle of virtual work, its linearisation and the related spatial discretisation. The estimation procedure consists of the following three steps: (i) in vivo or in vitro approaches record the mechanical responses of membranous structures whose properties are to be determined; (ii) define a corresponding finite element model; (iii) minimise an error function (regarding the unknown parameters) that quantifies the deviation of the numerical prediction from the recorded data. To achieve a robust parameter estimation, an element partition method is employed. The outcome of the procedure is affected by the number of nodes defined on the membrane surface and the number of load steps. In a numerical example, the proposed procedure is assessed by reestablishing given reference distributions in a reference membrane. The deviations of the estimated material parameter distributions from the related reference fields are within just a few percent. In most of the investigated cases the standard deviation for the resulting maximum principal stress was even below 1%, which is accurate enough for rupture risk assessment of vascular membranes.

  • 317. Kruse, Robert
    et al.
    Säve, Susanne
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Persson, Katarina
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Adenosine Triphosphate Induced P2Y(2) Receptor Activation Induces Proinflammatory Cytokine Release in Uroepithelial Cells.2012In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 188, no 6, p. 2419-2425Article in journal (Refereed)
    Abstract [en]

    PURPOSE: We characterized and identified the uroepithelial P2 receptor responsible for adenosine triphosphate mediated release of the cytokines interleukin-8 and 6.

    MATERIALS AND METHODS: The human renal epithelial cell line A498 (ATCC™) was cultured and stimulated with different purinergic agonists with or without prior inhibition with different antagonists or signaling pathway inhibitors. Supernatant was analyzed for interleukin-8 and 6 by enzyme-linked immunosorbent assay. P2 receptor mRNA expression was assessed by real-time reverse transcriptase-polymerase chain reaction. The candidate receptor was knocked down with siRNA technology. Interleukin-8 and 6 responses were measured after purinergic stimulation of knocked down cells.

    RESULTS: ATP and ATP-γ-S (Roche Diagnostics, Mannheim, Germany) were equipotent as inducers of interleukin-8 and 6 release. Agonist profile experiments using different P2 receptor agonists indicated that P2Y(2) was the main contributor to this release, although P2Y(11) and P2X(7) activation could not be excluded. Signaling pathway experiments showed that interleukin-8 release involved phospholipase C and inositol trisphosphate mediated signaling, indicating a P2Y receptor subtype. Antagonist experiments indicated P2Y(2) as the responsible receptor. Gene expression analysis of P2 receptors showed that strong expression of P2Y(2) receptor and subsequent knockdown of P2Y(2) receptor mRNA for 72 and 96 hours abrogated interleukin-8 and 6 release after purinergic stimulation with adenosine triphosphate-γ-S.

    CONCLUSIONS: Interleukin-8 and 6 release after purinergic stimulation in uroepithelial A498 cells is mediated through P2Y(2) receptor activation.

  • 318.
    Kwet, Avril
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Socker men inte söt: upplevelser av diabetes typ 2: en kvalitativ litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes type 2 is a chronic system disease which has a huge impact on the patient’s life. The disease can lead to many sequalae and involves different types of sufferings for the patient. The treatment consists of both medical and lifestyle changes where self-care has great importance. Previous researches have made evident that life with diabetes type 2 means a great change in lifestyle that affects the patient psychologically, physically, spiritually and socially. In addition, there were many people who had difficulty making these changes. Patients experienced shame because diabetes type 2 is seen as a lifestyle disease.

    Aim: The aim of this study was to describe patient experiences of living with diabetes type 2.

    Method: A systematic qualitative literature study was conducted with an inductive approach. A manifest content analysis was conducted on 13 articles.

    Result: People with type 2 diabetes experienced negative emotions such as fear, depression, anxiety and loneliness. Living with a changed body hindered everyday life and triggered feelings of dissatisfaction and frustration. The participants experienced restrictions in travel, career and social outlooks. Furthermore, patients with type 2 diabetes blamed themselves of getting diabetes. They also felt judged and blamed by others for getting diabetes type 2 because it is seen as a lifestyle disease. The consequence of this was that many participants hid their illness from others.

    Conclusions:  Many factors must work together, for life with type 2 diabetes to workout. It is the nurse’s responsibility support and provide the patient with the information needed to cope with the management of the disease, however, it is the patient’s responsibility to implement it. Furthermore, there is a lot of stigma against type 2 diabetes and more education is needed for patients, health care professionals and relatives/ the public in order to fight it. 

  • 319.
    Lagerqvist, Bo
    et al.
    Uppsala Univ.
    Frobert, Ole
    Örebro Univ Hosp.
    Olivecrona, Göran K.
    Lund Univ.
    Gudnason, Thorarinn
    Landspitali Univ Hosp.
    Maeng, Michael
    Aarhus Univ Hosp.
    Alstrom, Patrik
    Karolinska Inst.
    Andersson, Jonas
    Umeå Univ Hosp.
    Calais, Fredrik
    Örebro Univ Hosp.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital.
    Collste, Olov
    Karolinska Inst.
    Gotberg, Matthias
    Lund Univ.
    Hardhammar, Peter
    Ioanes, Dan
    Kallryd, Anders
    Linder, Rickard
    Karolinska Inst.
    Lundin, Anders
    Odenstedt, Jacob
    Omerovic, Elmir
    Puskar, Verner
    Todt, Tim
    Zelleroth, Eva
    Ostlund, Ollie
    James, Stefan K.
    Outcomes 1 Year after Thrombus Aspiration for Myocardial Infarction2014In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 371, no 12, p. 1111-1120Article in journal (Refereed)
    Abstract [en]

    BACKGROUND Routine intracoronary thrombus aspiration before primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) has not been proved to reduce short-term mortality. We evaluated clinical outcomes at 1 year after thrombus aspiration. METHODS We randomly assigned 7244 patients with STEMI to undergo manual thrombus aspiration followed by PCI or to undergo PCI alone, in a registry-based, randomized clinical trial. The primary end point of all-cause mortality at 30 days has been reported previously. Death from any cause at 1 year was a prespecified secondary end point of the trial. RESULTS No patients were lost to follow-up. Death from any cause occurred in 5.3% of the patients (191 of 3621 patients) in the thrombus-aspiration group, as compared with 5.6% (202 of 3623) in the PCI-only group (hazard ratio, 0.94; 95% confidence interval [CI], 0.78 to 1.15; P = 0.57). Rehospitalization for myocardial infarction at 1 year occurred in 2.7% and 2.7% of the patients, respectively (hazard ratio, 0.97; 95% CI, 0.73 to 1.28; P = 0.81), and stent thrombosis in 0.7% and 0.9%, respectively (hazard ratio, 0.84; 95% CI, 0.50 to 1.40; P = 0.51). The composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis occurred in 8.0% and 8.5% of the patients, respectively (hazard ratio, 0.94; 95% CI, 0.80 to 1.11; P = 0.48). The results were consistent across all the major subgroups, including grade of thrombus burden and coronary flow before PCI. CONCLUSIONS Routine thrombus aspiration before PCI in patients with STEMI did not reduce the rate of death from any cause or the composite of death from any cause, rehospitalization for myocardial infarction, or stent thrombosis at 1 year.

  • 320.
    Lammes, Eva
    et al.
    Karolinska University Hospital.
    Rydwik, Elisabeth
    Karolinska Institutet.
    Akner, Gunnar
    Örebro University Hospital.
    Effects of nutritional intervention and physical training on energy intake, resting metabolic rate and body composition in frail elderly: a randomised controlled pilot study2012In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 16, no 2, p. 162-167Article in journal (Refereed)
    Abstract [en]

    Objectives: To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RmR) and body composition in the frail elderly.

    Design: Open, randomised, controlled pilot treatment study.

    Setting: Community-based research centre. Participants: ninety-six community-dwelling frail elderly people aged 75 and older, 40% men.

    Intervention: Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 x 45 minutes per week for 3 months, iii) combined nutritional and physical intervention and iv) control group. 

    Measurements: The outcomes were energy intake (4-day food diary); resting metabolic rate (indirect calorimetry) and body composition (anthropometry) performed at baseline, after 3 months’ intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals).

    Results: The training group showed a significantly increased RmR at 3 months. Otherwise, there were no observed differences within or between the four groups.There was no correlation over time between energy intake, RmR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study (‘responders’) had a statistically significantly lower Bmi (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the ‘non-responders.’The ‘non-responders’ showed a small but statistically significant decrease in body fat percentage at F1, and inbody weight, Bmi and FFm at 9 months (F3).

    Conclusion: individual nutrition counselling and physical exercise had no effect on energy intake, RmR or fat free mass in community-dwelling frail elderly people aged 75 and older. interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.

  • 321.
    Larson, Malin
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Visusskillnad med Air Optix® och Air Optix® for Astigmatism vid låg astigmatism2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att kontrollera om och i så fall hur mycketvisus förbättras med toriska linser jämfört med sfäriska linser vid astigmatism -0,50 D - -1,00 D.

    I studien ingick tolv försökspersoner, fördelat på nio kvinnor och tre män, medcylinder mellan -0,50 D och -1,00 D på ett eller båda ögonen korrigerades först medAir Optix® (sfärisk) beräknad på sfärisk ekvivalent och sedan med Air Optix forAstigmatism®(torisk) med styrkor baserade på refraktionen. Högkontrastvisus ochlågkontrastvisus mättes både monokulärt och binokulärt.

    I studien framkom att i både monokulärt och binokulärt finns en statistisktsignifikant förbättring med den toriska linsen jämfört med den sfäriska. Ävenlågkontrastvisus visar en förbättring både monokulärt och binokulärt med den toriskalinsen, denna skillnad är inte statistiskt signifikant. Även vid 0,50 D cylinder finnsäven här en förbättring med den toriska linsen men denna är inte heller statistisktsignifikant, varken för hög eller lågkontrastvisus. För 1,00 D cylinder är förbättringensignifikant vid högkontrast men inte vid lågkontrastS. I likhet med tidigare studier har denna studie visat att även lågastigmatism drar fördel av korrigeras med toriska linser.

  • 322.
    Larsson, Alexsandra
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Holmkvist, Melinda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sjuksköterskors erfarenhet av att arbeta inom den palliativa vården: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Litteraturöversiktens teoretiska referensram utgår från Patricia Benners teori om kompentensstadium. Detta ramverk nyttjas för att beskriva vikten av klinisk erfarenhet under sjuksköterskors professionsutveckling. Klinisk erfarenhet anses vara grundläggande för sjuksköterskors utveckling i yrkesrollen (Benner, 1993). Bakgrund: Att åldras är en naturlig del av livet. Många människor vårdas palliativt vilket resulterar i att sjuksköterskor kräver kunskap och kompetens inom området. Sjuksköterskor som arbetar inom den palliativa vården uttrycker ofta att de vill göra gott för patienten samt anhöriga. Syfte: Syftet med denna litteraturöversikt var att belysa sjuksköterskors erfarenhet av att arbeta inom den palliativa vården. Metod: Studien är en litteraturöversikt med kvalitativ forskning i form av vetenskapliga artiklar. Datasökningarna utfördes i databaserna Cinahl, MEDLINE, PsycINFO och PubMed. Artiklarna granskades med hjälp av Statens beredning för medicinsk och social utvärdering (SBU) granskningsmall. Resultat: Visade för- och nackdelar med att arbeta inom den palliativa vården. Viktiga faktorer hos sjuksköterskor var ansvar, samarbete, känslor och tid samt resurser. En god palliativ vård grundades i sjuksköterskors tillgänglighet och närhet. Slutsats: Resultatet har visat att ett utbildningsbehov framträdde vilket pekar på att grundläggande utbildning inte är tillräcklig inom den palliativa vården. God kommunikationsförmåga, utbildning samt kunskap inom området kan vara alternativ som underlättar för sjuksköterskor.

  • 323.
    Larsson Mauléon, Annika
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ekman, Sirkka-Liisa
    Instituionen för Omvårdnad Karolinska Institutet.
    Difficulties in intraoperative care2012In: Journal of Perioperative Practice, ISSN 1467-1026, Vol. 22, no 10, p. 334-337Article in journal (Refereed)
    Abstract [en]

    Difficulties in intraoperative care

    Difficult situations which occur intraoperatively have a direct impact on nurses working within the area. A study was undertaken focusing nurses’ confrontations with difficult situations where the narrations from twelve nurses were taped. A phenomenological method was used to analyse this information and revealed how difficult intraoperative situations arise and how the nurses found different ways of handling these situations.

    by Annika Larsson Mauléon and Sirkka-Liisa EkmanCorrespondence address: Annika Larsson Mauléon, School of Health and Caring Sciences, Linnæus University, S-351 95 Växjö, Sweden. Email: Annika.larsson_mauleon@lnu.se

  • 324.
    Larsson, Tobias
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Öberg, Fia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Påverkan på relationen efter flytt till HVB-hem: Upplevelser hos närstående till en familjemedlem med psykisk ohälsa 2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Psychiatric care has changed through history. A major change occurred in connection to the psychiatric reform in the 1990s. In relation to this, the relatives also felt that they were taking a more caring role and a greater responsibility for the family member with a mental illness.Previous studies have shown that close relatives to family members with a mental illness, experience a burden related to their family member. This burden is so significant that it affects the relatives own well-being and further influenced their relationship with the family member with mental illness.

    Purpose: The aim of this study was to describe relatives’ experiences of how the relationship to a family member with mental illness is affected when the family member moves to a residential care home.

    Method: The study was conducted as an interview study with a qualitative inductive approach. In the study ten respondents were interviewed and collected material were processed by the authors through a qualitative latent content analysis.Results: The present study revealed that the close relatives find that they are in a complicated situation. The role of being related to a person with mental illness can be experienced as stressful and the relationship, due to various reasons, becomes strained. The result that emerged was that the relationship is characterized by mutual influence and the residential care home can provide security and ease the relation.  

    Conclusion: To increase participation and ease the burden for the close relatives, can reduce their suffer and increase their own well-being. Which, from a holistic perspective, can create conditions for a better relationship and increase the quality of life for all individuals in the system.

  • 325.
    Le Reste, Jean Yves
    et al.
    Univ Bretagne Occidentale, France.
    Nabbe, Patrice
    Univ Bretagne Occidentale, France.
    Rivet, Charles
    Univ Bretagne Occidentale, France.
    Lygidakis, Charilaos
    AIMEF, Bologna, Italy.
    Doerr, Christa
    Allgemein Med Hsch Gottingen, Germany.
    Czachowski, Slawomir
    Nicholas Copernicus Univ, Poland.
    Lingner, Heidrun
    Allgemein Med Hsch Hannover, Germany.
    Argyriadou, Stella
    Greek Assoc Gen Practitioners ELEGEIA, Greece.
    Lazic, Djurdjica
    Univ Zagreb, Croatia.
    Assenova, Radost
    Paisij Hilendarski Univ Plovdiv, Bulgaria.
    Hasaganic, Melida
    Univ Sarajevo, Bosnia-Herzegovina.
    Munoz, Miquel Angel
    IDIAP Jordi Gol, Spain.
    Thulesius, Hans
    Lund University, Sweden.
    Le Floch, Bernard
    Univ Bretagne Occidentale, France.
    Derriennic, Jeremy
    Univ Bretagne Occidentale, France.
    Sowinska, Agnieska
    Nicholas Copernicus Univ, Poland.
    Van Marwijk, Harm
    Vrije Univ Amsterdam Med Ctr, Netherlands.
    Lietard, Claire
    Univ Bretagne Occidentale, France.
    Van Royen, Paul
    Univ Antwerp, Belgium.
    The European General Practice Research Network Presents the Translations of Its Comprehensive Definition of Multimorbidity in Family Medicine in Ten European Languages2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 1, article id e0115796Article in journal (Refereed)
    Abstract [en]

    Background Multimorbidity, according to the World Health Organization, exists when there are two or more chronic conditions in one patient. This definition seems inaccurate for the holistic approach to Family Medicine (FM) and long-term care. To avoid this pitfall the European General Practitioners Research Network (EGPRN) designed a comprehensive definition of multimorbidity using a systematic literature review. Objective To translate that English definition into European languages and to validate the semantic, conceptual and cultural homogeneity of the translations for further research. Method Forward translation of the EGPRN's definition of multimorbidity followed by a Delphi consensus procedure assessment, a backward translation and a cultural check with all teamsto ensure the homogeneity of the translations in their national context. Consensus was defined as 70% of the scores being higher than 6. Delphi rounds were repeated in each country until a consensus was reached Results 229 European medical expert FPs participated in the study. Ten consensual translations of the EGPRN comprehensive definition of multimorbidity were achieved. Conclusion A comprehensive definition of multimorbidity is now available in English and ten European languages for further collaborative research in FM and long-term care.

  • 326.
    Leander, Ellinor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Artidentifiering av mögelsvamp med MALDI-TOF MS2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Rapid and accurate species identification is crucial for successful treatment of fungal infections, especially among immunosuppressed patients. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is used routinely at clinical laboratories to identify characteristic protein patterns of bacteria and yeast by the interpretation of protein spectra in a database for accurate species identification. The hard cell wall of the mold and the heterogeneous growth with varying protein expression due to maturation, complicates identification with MALDI-TOF MS. The potential benefits of this method compared to microscopy as traditional method are shortened turn-around times, safer species identification of more species that is independent on subjective morphological assessment. The purpose of the study was to investigate whether MALDI-TOF MS could be adapted and used for the identification of molds in clinical routine diagnostics. Four reference strains (Aspergillus niger, A.fumigatus, A.terreus, A.flavus) and a clinical isolate (A.terreus) were examined. The preparation methods (I) complete formic acid extraction, (II) direct application and (III) suspension in distilled water were used for analysis of spores and frontmycelium from younger and older mold cultures. Two different masspektradatabases for species identification were compared; routine database BDAL and the specialized mold database, Filamentous Fungi Library. Also the collecting technique of mold prior to analysis with MALDI-TOF MS was evaluated. Sometimes, the species identification improved after extraction of mold cultures, while in other cases direct application was sufficient. Cultures with a lot of spores tended to give slightly more species identifications in BDAL regardless of the age of cultures. Filamentous Fungi Library, in some cases, tended to improve the performance compared to BDAL for younger cultures. More studies are required to evaluate and optimize MALDI-TOF MS as a method of mold identification.

  • 327.
    Lefdal, Astrid
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Effect of the accommodative stimulus and testing distance on the gradient AC/A2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 328.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Rosen, Robert
    Royal Institute of Technology KTH.
    Lundström, Linda
    Royal Institute of Technology KTH.
    Unsbo, Peter
    Royal Institute of Technology KTH.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Objectively Determined Refraction Improves Peripheral Vision2014In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 91, no 7, p. 740-746Article in journal (Refereed)
    Abstract [en]

    Purpose. The purpose of this study was twofold: to verify a fast, clinically applicable method for determining off-axis refraction and to assess the impact of objectively obtained off-axis refractive correction on peripheral low-contrast visual acuity. Methods. We measured peripheral low-contrast resolution acuity with Gabor patches both with and without off-axis correction at 20 degrees in the nasal visual field of 10 emmetropic subjects; the correction was obtained using a commercial open-field Hartmann-Shack wavefront sensor, the COAS-HD VR aberrometer. Off-axis refractive errors were calculated for a 5-mm circular pupil inscribed within the elliptical wavefront by COAS using the instruments' inbuilt "Seidel sphere" method. Results. Most of the subjects had simple myopic astigmatism, at 20 degrees in the nasal visual field ranging from -1.00 to -2.00 DC, with axis orientations generally near 90 degrees. The mean uncorrected and corrected low-contrast resolution acuities for all subjects were 0.92 and 0.86 logMAR, respectively (an improvement of 0.06 logMAR). For subjects with a scalar power refractive error of 1.00 diopters or more, the average improvement was 0.1 logMAR. The observed changes in low-contrast resolution acuity were strongly correlated with off-axis astigmatism (Pearson r = 0.95; p < 0.0001), the J(180) cross-cylinder component (Pearson r = 0.82; p = 0.0034), and power scalar (Pearson r = -0.75; p = 0.0126). Conclusions. The results suggest that there are definite benefits in correcting even moderate amounts of off-axis refractive errors; in this study, as little as -1.50 DC of off-axis astigmatism gave improvements of up to a line in visual acuity. It may be even more pertinent for people who rely on optimal peripheral visual function, specifically those with central visual field loss; the use of open-field aberrometers could be clinically useful in rapidly determining off-axis refractive errors specifically for this patient group who are generally more challenging to refract.

  • 329.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosén, Robert
    Biomedical & X-Ray Physics.
    Unsbo, Peter
    Biomedical & X-Ray Physics.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Clinical Impact of Objectively Determined Peripheral Refractive Error Correction on Low-Contrast Resolution AcuityManuscript (preprint) (Other academic)
  • 330.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Holm, Victoria
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Dynamic Stimulus Presentation Facilitates Peripheral Resolution Acuity2013In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 54, article id e-abstract 574Article in journal (Other academic)
    Abstract [en]

    Purpose: Peripheral high-contrast resolution is sampling limited; the center to center spacing between ganglion cells ultimately limiting visual performance (Thibos et al., 1987). Although retinal image motion in the fovea has a detrimental effect on visual acuity, previous studies have suggested that retinal image motion may be advantageous in the peripheral visual field (Bex et al., 2003; Brown, 1972; Macedo et al., 2010). The aim of this study was to evaluate the effect of drift motion on peripheral resolution acuity.

    Methods: Peripheral high-contrast resolution acuity in a group of 26 subjects (age 23.5 ± 3.2 years) was initially determined using a 2-alternative forced-choice Bayesian algorithm; the threshold value defined as the spatial frequency resulting in a 75% correct response rate. The stimuli used to measure static visual acuity were stationary Gabor-patches with a visible diameter of 2° and were presented at 20° in the nasal visual field. We determined the percentage correct response rate for varying velocities using drifting Gabor patches of the same spatial frequency as determined during measurement of static visual acuity. The sine-wave gratings drifted within the Gaussian envelope at one of 10 angular velocities, varying from 0.2 to 2.0 degrees/second in 0.2 degrees/second steps.

    Results: Results showed an overall improvement in the subjects’ performance for all velocities. There was a significant difference in the percentage of correct responses between static stimulus presentation and for velocities of between 0.4 to 1.2 degrees/second (p < 0.05, One-way repeated measures ANOVA with Bonferroni post hoc tests). The average “correct response” for static stimulus presentation was 76 ± 2 %, improving to at least 85 % for velocities between 0.4 to 1.2 degrees/second. At velocities greater than 1.2 degrees/second performance was still better than for static stimulus presentation, but showed a gradual decline with increasing speed.

    Conclusions: In line with previous studies stimulus motion has a positive effect on peripheral high-contrast resolution acuity. Presenting moving stimuli may benefit patients who rely on peripheral visual function, such as those with central visual field loss subsequent to AMD.

  • 331.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosén, Robert
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Carius, Staffan
    Linnaeus University, Faculty of Science and Engineering, School of Computer Science, Physics and Mathematics.
    Unsbo, Peter
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Dynamic Visual Acuity in the Peripheral Visual Field Using Gabor Patches2010Conference paper (Refereed)
    Abstract [en]

    Purpose:To evaluate dynamic visual acuity (DVA) in the peripheral visual field. This ability is important within the areas of sports, traffic safety, as well as for people with low vision; specifically those with central visual field loss. In this study we investigated both static- and dynamic visual acuity in the periphery of normally sighted observers using Gabor patches.

    Methods:DVA and static visual acuity (SVA) was measured on the right eye of normally sighted emmetropes. Stimuli consisted of high-contrast Gabor patches; sine wave gratings multiplied by a Gaussian hull with a diameter of 2º, with the sine gratings drifting at 1, 2, and 4 degrees per second. Stimuli were presented, using MATLAB and Psychophysics Toolbox, on one of seven CRT monitors at the following retinal eccentricities: 10, 20 and 30 degrees, nasally and temporally as well as in the fovea. Subjects were informed to maintain fixation on a central fixation object during measurements at eccentric locations. An Adaptive Bayesian algorithm was employed to determine resolution thresholds at each eccentricity.

    Results:The results show a trend towards both better static- and dynamic visual acuities for the temporal visual field at retinal eccentricities 20° and 30° compared to nasally. There appears to be a more rapid decrease in both static- and dynamic visual acuity with increasing eccentricity for the nasal visual field. In addition, we did not find any difference in DVA and SVA in the peripheral visual field for the velocities used in this study.

    Conclusions:Results of these first preliminary measurements suggest that dynamic visual acuity measured with drifting Gabor patches is greater in the temporal visual field for eccentricities 20 degrees or larger. To confirm these results more measurements need to be performed on a lager sample of subjects.

  • 332.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosén, Robert
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Unsbo, Peter
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Naso-temporal Asymmetry of Peripheral Static and Dynamic Visual Acuity2011Conference paper (Refereed)
    Abstract [en]

    Summary

    Static and dynamic visual acuity was evaluated in the peripheral visual field on normally sighted emmetropes. The results show a significant asymmetry for both static and dynamic visual acuity between the nasal and temporal visual fields.

     

    Introduction

    It is well known that visual performance thresholds decrease rapidly with increasing retinal eccentricity1. This reduction in performance can be attributed to both optical factors and reduced neural sampling2-3; the latter being the predominant limiting factor in the peripheral retina3.  Previous studies have shown that slowly moving stimuli are more easily resolved than stationary stimuli in the peripheral retina4. There is little evidence published regarding resolution thresholds for moving stimuli in more than a few limited directions in the visual field.     

    In this study, static visual acuity (SVA) and dynamic visual acuity (DVA) thresholds were measured at 10° intervals both nasally and temporally on healthy, young emmetropes. DVA was measured at angular velocities of 1 °/s and 2 °/s using drifting Gabor patches.  

     

    Discussion

    Static and dynamic visual acuity was measured on the right eye of emmetropic subjects. Results for SVA showed significantly better resolution in the temporal visual field compared with the nasal visual field at eccentricities 20° and beyond. The mean difference in acuity at 20° was approximately 0.2 LogMAR and at 30°, 0.3 LogMAR. The difference between the thresholds for DVA showed a similar naso-temporal asymmetry; the reduction in DVA paralleling the decrease in SVA for eccentricities 10° and beyond.  No significant differences were observed between averaged results of SVA and DVA for the eccentricities tested in this study.

     

    Conclusions

    The results of this study confirm previous research conducted by Frisén (1987) showing better resolution for static stimuli presented in the temporal visual field compared to the nasal visual field. We have found that this is also true for DVA.

  • 333.
    Lewis, Peter
    et al.
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Rosén, Robert
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Unsbo, Peter
    KTH, Royal Institute of Technology, Stockholm, Sweden.
    Gustafsson, Jörgen
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Resolution of static and dynamic stimuli in the peripheral visual field.2011In: Vision Research, ISSN 0042-6989, E-ISSN 1878-5646, Vol. 51, no 16, p. 1829-1834Article in journal (Refereed)
    Abstract [en]

    In a clinical setting, emphasis is given to foveal visual function, and tests generally only utilize static stimuli. In this study, we measured static (SVA) and dynamic visual acuity (DVA) in the central and peripheral visual field on healthy, young emmetropic subjects using stationary and drifting Gabor patches. There were no differences between SVA and DVA in the peripheral visual field; however, SVA was superior to DVA in the fovea for both velocities tested. In addition, there was a clear naso-temporal asymmetry for both SVA and DVA for isoeccentric locations in the visual field beyond 10° eccentricity. The lack of difference in visual acuity between static and dynamic stimuli found in this study may reflect the use of drift-motion as opposed to displacement motion used in previous studies.

  • 334.
    Lidén, Maja
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Synfältsundersökningen vid synprövning för körkort hos optiker2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att ta reda på vilken metod som är lämpligast att använda för synfältsundersökning vid ett körkortstest hos optiker samt vilken metod det är vanligast att optiker i Sverige använder idag. Dessutom var syftet att utreda varför optiker inte får använda konfrontationstest då det är den metod läkare ska använda för synfältsundersökning enligt körkortsföreskrifterna.

    Metod: En enkätundersökning med 275 deltagande optiker gjordes. De fick besvara ett fåtal frågor kring vilken metod de använder när de undersöker synfältet vid ett körkortstest samt deras kunskap och inställning till bestämmelserna kring vilken metod som skall användas utav optiker och läkare. Enkätundersökningen publicerades med web-enkätprogrammet Easy Survey.

    Resultat: Enkätundersökningen visade att endast 58,5 % av optiker i Sverige använder sig av den speciellt avsedda apparaturen. 34,9 % av deltagarna svarade att de använde sig av Donders konfrontationstest. Undersökningen visade på att många optiker i Sverige inte vet vilken metod de enligt föreskriften från 2008 ska använda. Dessutom visar resultaten att en klar majoritet av dem inte förstår varför inte optiker får använda samma metod som läkare för synfältsundersökning vid ett körkortstest.

    Slutsats: Studien visar att en majoritet av optiker i Sverige använder den av myndigheten rekommenderade metoden men att många också använder Donders. Ett konfrontationstest borde vara mer lämpligt att använda för att undersöka synfältet vid en synprövning för körkort hos optiker än en synfältsapparat. Optiker har tillräckligt stor kunskap för att klara av att använda Donders konfrontationstest och när det utförs korrekt verkar det vara mer tillförlitligt än en apparatur så som Campitestet, då det undersöker synfältet mer utförligt.

  • 335.
    Lijuan, Mei
    et al.
    Fujian University of Traditional Chinese Medicine.
    Qingyue, Chen
    Fujian University of Traditional Chinese Medicine.
    Ge, Li
    School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China.
    Guohua, Zheng
    Fujian University of Traditional Chinese Medicine.
    Jinxiu, Chen
    Fujian University of Traditional Chinese Medicine.
    Systematic Review of Chinese Traditional Exercise Baduanjin Modulating the Blood Lipid Metabolism2012In: Evidence-based Complementary and Alternative Medicine, ISSN 1741-427X, E-ISSN 1741-4288, p. Article ID 282131-Article in journal (Refereed)
    Abstract [en]

    Background. Baduanjin exercise is considered to be beneficial to modulate the blood lipid metabolism. The purpose of the systematic review was to assess the potential efficacy and safety of Baduanjin exercise. Methods. MEDLINE, EMBASE, CBM, CNKI, VIP, Chinese Important Conference Papers Database, and Chinese Dissertation Database were searched for all prospective-controlled trials of Baduanjin exercise from their inception to December 31, 2011. Results. A total of 14 studies were included. Comparing with no treatment, Baduanjin exercise significantly reduced the levels of TC, TG, LDL-C in plasma, and elevated plasma HDL-C level for healthy participants, and the pooled MD (95% confidence interval, CI) was −0.58 mmol/L (−0.86, −0.30 mmol/L), −0.22 mmol/L (−0.31, −0.13 mmol/L), −0.35 mmol/L (−0.54, −0.17 mmol/L), 0.13 mmol/L (0.06, 0.21 mmol/L), respectively. Baduanjin exercise also obviously decreased the levels of TG, LDL-C in plasma comparing with no treatment for patients, and the pooled MD (95% CI) was −0.30 mmol/L (−0.40, −0.19 mmol/L), −0.38 mmol/L (−0.63, −0.13 mmol/L), but there was not obvious to decrease plasma TC level or elevate plasma HDL-C level in patients with the pooled MD (95%CI), −0.39 mmol/L (−1.09, 0.31 mmol/L) and 0.22 mmol/L (−0.11, 0.55 mmol/L), respectively. In addition, the obvious advantage was not observed to modulate the blood lipid metabolism in comparing Baduanjin exercise with other exercises, regardless for health participants or patients. Conclusion. Studies indicated that Baduanjin exercise could significantly decrease the levels of TC, TG, LDL-C levels in plasma and elevate plasma HDL-C level for the healthy people. It also was helpful that Baduanjin exercise modulated the blood lipid metabolism for patients. Moreover, the Baduanjin exercise did not have an obvious advantage on modulating the lipid metabolism comparing with other exercises. But the evidence was uncertain because of the small sample size and low-methodological quality

  • 336.
    Liljenberg, Anna
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Antioxidanter förhindrar AMD: Sanning eller myt?2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka ifall ett ökat intag av antioxidanter via kost eller supplement kan förhindra uppkomst och progression av åldersrelaterad makuladegeneration, AMD.

    Metod: Granskning och sammanställning av publicerade forskningsresultat inom området.

    Resultat: Av 7 granskade studier visade 5 på en skyddande effekt mot uppkomst eller progression av AMD vid ett ökat intag av antioxidanter. Resterande 2 studier kunde inte finna något signifikant samband. Resultatet varierar för specifika antioxidativa ämnen i olika studier.

    Slutsats: Forskningen tyder på att ett ökat intag av antioxidanter, antingen via kosten eller supplement, skulle kunna förebygga och bromsa de skador som uppkommer vid AMD. Man bör dock ytterligare utreda eventuella negativa bieffekter vid höga doser av bland annat β-karoten och E-vitamin. Det behövs fler långtidsstudier för att fullt ut förstå samspelet mellan hur olika livsmedel och specifika antioxidanter tas upp och metaboliseras och hur dessa kan påverka uppkomst och progression av AMD.

  • 337.
    Liljeroos, Maria
    et al.
    Linköping University;Uppsala University.
    Strömberg, Anna
    Linköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University;Kalmar County Council.
    Chung, Misook L.
    Univ Kentucky, USA.
    Mediation effect of depressive symptoms in the relationship between perceived control and wellbeing in patients with heart failure and their partners2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 6, p. 527-534Article in journal (Refereed)
    Abstract [en]

    Background: As treatment has improved, patients with heart failure live longer, and the care mostly takes place at home with partners providing the main assistance. Perceived control over heart failure is important in managing self-care activities to maintain health in patients and their family. Depressive symptoms are associated with impaired health status in patients with heart failure and their family. However, there is limited knowledge about how depressive symptoms affect the relationship between health status and perceived control over heart failure in patients with heart failure and their cohabiting partners. Aim: The aim of this study was to examine whether the relationship between perceived control and health status (i.e. mental and physical) was mediated by depressive symptoms in patients with heart failure and their partners. Methods: In this secondary data analysis, we included 132 heart failure patients and 132 partners who completed measures of depressive symptoms (the Beck depression inventory II), perceived control (the control attitude scale), and physical and mental health status (the short form-36) instruments. The mediation effect of depression was examined using a series of multiple regression in patients and their family caregivers separately. Results: We found a mediator effect of depressive symptoms in the relationship between perceived control and mental health status in both patients and partners. The relationship between perceived control and physical health status was mediated by depressive symptoms in the patients, not in the partners. Conclusion: Efforts to improve self-care management and maintenance by targeting perceived control may be more effective if depressive symptoms are also effectively managed.

  • 338.
    Lima Ramos, Pedro
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Univ Minho, Portugal.
    Santana, Rui
    Univ Nova Lisboa, Portugal.
    Moreno, Laura Hernandez
    Univ Minho, Portugal.
    Marques, Ana Patricia
    Univ Nova Lisboa, Portugal.
    Freitas, Cristina
    Hosp Braga, Portugal.
    Rocha-Sousa, Amandio
    Univ Porto, Portugal;Ctr Hosp Sao Joao, Portugal.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Univ Minho, Portugal.
    ., The Portuguese visual impairment study group
    Predicting participation of people with impaired vision in epidemiological studies2018In: BMC Ophthalmology, ISSN 1471-2415, E-ISSN 1471-2415, Vol. 18, article id 236Article in journal (Refereed)
    Abstract [en]

    Background

    The characteristics of the target group and the design of an epidemiologic study, in particular the recruiting methods, can influence participation. People with vision impairment have unique characteristics because those invited are often elderly and totally or partially dependent on help to complete daily activities such as travelling to study sites. Therefore, participation of people with impaired vision in studies is less predictable than predicting participation for the general population.

    Methods

    Participants were recruited in the context of a study of prevalence and costs of visual impairment in Portugal (PCVIP-study). Participants were recruited from 4 Portuguese public hospitals. Inclusion criteria were: acuity in the better eye from 0.5 decimal (0.30logMAR) or worse and/or visual field of less than 20 degrees. Recruitment involved sending invitation letters and follow-up phone calls. A multiple logistic regression model was used to assess determinants of participation. The J48 classifier, chi-square and Fisher’s exact tests were applied to investigate the possible differences between subjects in our sample.

    Results

    Individual cases were divided into 3 groups: immediate, late and non-participants. A participation rate of 20% was obtained (15% immediate, 5% late). Factors positively associated with participation included years of education, annual hospital attendance, and intermediate visual acuity. Females and greater distance to the hospital were inversely associated with participation.

    Conclusion

    In our study, a letter followed by a phone call was efficient to recruit a significant number of participants from a larger group of people with impaired vision. However, the improvement in participation observed after the phone call might not be cost-effective. People with low levels of education and women were more difficult to recruit. These findings need to be considered to avoid studies whose results are biased by gender or socio-economic inequalities of their participants. Young subjects and those at intermediate stages of vision impairment, or equivalent conditions, may need more persuasion than other profiles.

  • 339.
    Lima Ramos, Pedro
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Univ Minho, Portugal.
    Santana, Rui
    Univ Nova Lisboa, Portugal.
    Sousa, Ines
    Univ Minho, Portugal.
    Rocha-Sousa, Amandio A.
    Univ Porto, Portugal.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Univ Minho, Portugal.
    Prevalence of Visual Impairment in the Municipality of Braga -Portugal using capture-recapture methods2018In: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 59, no 9Article in journal (Other academic)
  • 340.
    Lin, Chung-Ying
    et al.
    Hong Kong Univ Sci & Technol, Peoples Republic of China.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran;Jönköping University.
    Brostrom, Anders
    Jönköping University.
    Fridlund, Bengt
    Jönköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Strömberg, Anna
    Linköping University.
    Jaarsma, Tiny
    Linköping University;ACU, Mary MacKillop Inst Hlth Res, Australia.
    Martensson, Jan
    Jönköping University.
    Psychometric Properties of the 9-item European Heart Failure Self-care Behavior Scale Using Confirmatory Factor Analysis and Rasch Analysis Among Iranian Patients2018In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 3, p. 281-288Article in journal (Refereed)
    Abstract [en]

    Background: The 9-item European Heart Failure Self-Care Behavior scale (EHFScB-9) is a self-reported questionnaire commonly used to capture the self-care behavior of people with heart failure (HF). Objective: The aim of this study was to investigate the EHFScB-9's factorial structure and categorical functioning of the response scale and differential item functioning (DIF) across subpopulations in Iran. Methods: Patients with HF (n = 380; 60.5% male; mean [SD] age, 61.7 [9.1] years) participated in this study. The median (interquartile range) of the duration of their HF was 6.0 (2.4-8.8) months. Most of the participants were in New York Heart Association classification II (NYHA II, 61.8%); few of them had left ventricular ejection fraction assessment (11.3%). All participants completed the EHFScB-9. Confirmatory factor analysis was used to test the factorial structure of the EHFScB-9; Rasch analysis was used to analyze categorical functioning and DIF items across 2 characteristics (gender and NYHA). Results: The 2-factor structure ("adherence to regimen" and "consulting behavior") of the EHFSCB-9 was confirmed, and the unidimensionality of each factor was found. Categorical functioning was supported for all items. No items displayed substantial DIF across gender (DIF contrast, -0.25-0.31). Except for item 3 ("Contact doctor or nurse if legstfeet are swollen"; DIF contrast, -0.69), no items displayed substantial DIF across NYHA classes (DIF contrast, -0.40 to 0.47). Conclusions: Despite the DIF displayed in 1 item across the NYHA classes, the EHFScB-9 demonstrated sound psychometric properties in patients with HF.

  • 341.
    Lindberg, A Michael
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Generation of full-length single stranded cDNAs from various types of enteroviruses1994In: EUROPIC 94: VIIIth Meeting, Korpilampi, Finland, 1994Conference paper (Refereed)
  • 342.
    Lindberg, Anders Michael
    et al.
    Uppsala University, Sweden.
    Alksnis, Marianne
    Uppsala University, Sweden.
    Stålhandske, Per
    Uppsala University, Sweden.
    Pettersson, Ulf
    Uppsala University, Sweden.
    Molecular biology of coxsackievirus1987Conference paper (Refereed)
  • 343.
    Lindberg, Anders Michael
    et al.
    Uppsala University, Sweden.
    Pettersson, Ulf
    Uppsala University, Sweden.
    Correlation between amino acid conservation in the P1 region of coxsackievirus type B and a model of the three dimensional structure of coxsackievirus B31989Conference paper (Refereed)
  • 344.
    Lindberg, Josefin
    Linnaeus University, Faculty of Science and Engineering, School of Natural Sciences.
    Förändrar mjuka kontaktlinser NITBUT?2011Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Det är många som upplever att de får torra ögon vid användning av kontaktlinser. Därför är syftet med denna studie att jämföra NITBUT utan och med kontaktlinser för att undersöka om kontaktlinser påverkar tårfilmsstabiliteten.

    Metod: 30 stycken vana linsbärare deltog i studien. Två mätningar utfördes, en gång på eftermiddagen då försökspersonen varit utan kontaktlinser hela dagen och en då de använt sina habituella kontaktlinser i minst sex timmar. NITBUT mättes indirekt med hjälp av Tearscope-plus och ett fint gitter. Det gjordes tre mätningar per öga där ett medelvärde sedan räknades ut.

    Resultat: Det var ingen signifikant skillnad (p > 0,05) mellan höger och vänster ögas mätningar. Höger ögas mätningar analyserades och visade en signifikant skillnad (p < 0,05) mellan NITBUT utan och med kontaktlinser. Deltagarna delades in i två grupper ena gruppen där NITBUT < 10 sekunder och den andra > 10 sekunder utan kontaktlinser. Den nya indelningen analyserades och det visade att hos gruppen med NITBUT <10 sekunder var skillnaden mellan utan och med kontaktlinser inte statistisk signifikant (p > 0,05) medan det i den andra gruppen med NITBUT > 10 sekunder fanns en statistisk signifikans (p < 0,05) mellan utan och med kontaktlinser.

    Slutsats: Studien kom fram till att kontaktlinser påverkar tårfilmsstabiliteten negativt. När NITBUT < 10 sekunder utan kontaktlinser påverkar kontaktlinsen inte NITBUT medan när NITBUT > 10 sekunder utan kontaktlinser kommer NITBUT att sänkas dramatiskt efter sex timmars användning av kontaktlinser och till och med hamna under gränsvärdet för torra ögon (NITBUT < 10 sekunder).

  • 345.
    Lindberg, Michael
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Identifiering av mutationer i typ B3 coxsackievirusets arvsmassa, vilka förändrar virusets vävnadstropism: Av betydelse för myokarditdiagnostik?1993Conference paper (Refereed)
  • 346.
    Lindberg, Michael
    Uppsala University, Sweden.
    Molecular biology of coxsackie B virus serotype 31986Conference paper (Refereed)
  • 347.
    Lindblad, Sanna
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Schröder, Anna
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Sjuksköterskans förhållningssätt i vården till patienter som genomgår inducerad abort: En litteraturstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Theoretical framework: The Theory of Human Caring by Jean Watson was used as a theoretical framework.

    Aim: The aim of this literature review was to describe the attitude of nursing patients who go through an induced abortion, from a nurse perspective.

    Method: This literature review is based on a sample of nine qualitative and quantitative studies, collected in the databases Cinahl, PubMed and PsycInfo. The qualities of the studies were assessed through modified templates. Analysis of the results from the studies was inspired of a content analysis.

    Findings: The nurses experienced their work as meaningful since they give support to the patient. The nurses felt that their work was justified when the decision to have an abortion was well thought through and they felt respect towards the patient when they were aware of the patient’s circumstances. The nurses experienced stress and emotional impact when they faced ethical dilemmas and contradictions to abortion.

    Conclusion: Nurses experience can affect how patients experience care. Many nurses feel that they do not get enough support to handle difficult situations that they encounter in their work. Nurses who experience a high level of support in the workplace perceive tasks as less demanding what leads to better treatment.

  • 348.
    Lindquist, Jennifer
    University of Kalmar, School of Pure and Applied Natural Sciences.
    Utfall av tre olika formler för beräkning av postoperativ refraktion vid kataraktkirurgi2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Vid kataraktkirurgi är det viktigt att med stor noggrannhet kunna beräkna ögats postoperativa refraktion. För detta finns det flera olika biometriformler, varav SRK/T, Haigis och Hoffer Q har ingått i denna studie.

    Syfte: Att jämföra hur de tre formlerna presterar i genomsnitt när man jämför den beräknade postoperativa refraktionen med det verkliga utfallet, samt att se om det finns någon skillnad i utfallet i relation till ögats axiallängd.

    Metod: Data från 81 ögon erhölls från ögonkliniken i Kalmar. Alla var uppmätta med IOLMaster och hade genomgått fakoemulsifikation. Den vikbara intraokulära lins som användes var Alcons Acrysof SN60WF. Data från biometrin sattes in i var och en av de tre formlerna och beräknad postoperativ refraktion jämfördes sedan med verklig. SRK/T och Hoffer Q hade optimerade konstanter, medan Haigis tre konstanter hämtats ur publicerat material. Jämförelse gjordes även för ögon med axiallängd kortare än 22 mm och längre än 25 mm.

    Resultat: Ingen statistiskt signifikant skillnad i utfall mellan SRK/T, Haigis och Hoffer Q fanns generellt sett. I relation till axiallängden fanns en tendens att Hoffer Q påverkas något. För ögon längre än 25 mm fanns heller ingen statistiskt signifikant skillnad mellan de tre formlerna. I gruppen med ögon kortare än 22 mm fanns det en statistiskt signifikant skillnad mellan SRK/T och Hoffer Q respektive Haigis och Hoffer Q. Dock var urvalet av korta och långa ögon så litet att någon slutsats inte kunde dras av detta.

    Slutsats: Studien visar att det inte finns någon statistiskt signifikant skillnad mellan hur SRK/T, Haigis och Hoffer Q presterar i genomsnitt. Inte heller i relation till olika axiallängder kan man se någon direkt skillnad mellan formlerna.

    Det verkar sannolikt att Haigis formel kommer att kunna prestera ännu bättre när dess konstanter optimerats.

  • 349.
    Lindström, Anna
    et al.
    Uppsala universitet.
    Näslund, Shirley
    Uppsala universitet.
    Rubertsson, Christine
    Uppsala universitet.
    The interactional organization of sex assignment after childbirth2015In: Gender and Language, ISSN 1747-6321, E-ISSN 1747-633X, Vol. 9, no 2, p. 189-222Article in journal (Refereed)
    Abstract [en]

    That society divides its members into females and males is the point of departure for much research on gender and language and yet the situated accomplishment of the primordial sex categorisation of the newborn child has not attracted much scholarly attention. The present study fills this research gap by exploring the interactional organisation of sex assignment in a corpus of 67 video recordings of Swedish hospital births. We present quantitative and qualitative support for the idea that sex assignment is a prioritised activity during the first minutes after childbirth. Contrary to descriptions and assumptions in previous research, we find that sex assignment typically is sequentially accomplished in the social interaction between parents and medical staff. Our analysis reveals a normative preference that selects parents (rather than medical staff) as the ones who should discover and declare sex. We also provide tentative evidence that sex assignment may be a gendered practice that prioritises the father (rather than the mother) as the individual entitled to assign sex.

  • 350.
    Lindström, Jonathan
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    de Wijn, Astrid S.
    Norwegian University of Science and Technology, Norway.
    Friedman, Ran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Chemistry and Biomedical Sciences.
    Stochastic modelling of tyrosine kinase inhibitor rotation therapy in chronic myeloid leukaemia2019In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, p. 1-13, article id 508Article in journal (Refereed)
    Abstract [en]

    BackgroundResistance towards targeted cancer treatments caused by single nucleotide variations is a major issue in many malignancies. Currently, there are a number of available drugs for chronic myeloid leukaemia (CML), which are overcome by different sets of mutations. The main aim of this study was to explore if it can be possible to exploit this and create a treatment protocol that outperforms each drug on its own.MethodsWe present a computer program to test different treatment protocols against CML, based on available resistance mutation growth data. The evolution of a relatively stable pool of cancer stem cells is modelled as a stochastic process, with the growth of cells expressing a tumourigenic protein (here, Abl1) and any emerging mutants determined principally by the drugs used in the therapy.ResultsThere can be some benefit to Bosutinib-Ponatinib rotation therapy even if the mutation status is unknown, whereas Imatinib-Nilotinib rotation is unlikely to improve the outcomes. Furthermore, an interplay between growth inhibition and selection effects generates a non-linear relationship between drug doses and the risk of developing resistance.ConclusionsDrug rotation therapy might be able to delay the onset of resistance in CML patients without costly ongoing observation of mutation status. Moreover, the simulations give credence to the suggestion that lower drug concentrations may achieve better results following major molecular response in CML.

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