No description available.

Background: The number of people suffering from myocardial infarction in Sweden is decreasing, despite this the prevalence is high. Being diagnosed with myocardial infarction results in medical interventions, lifestyle changes and eventual pharmacological treatment to prevent relapse. Aim: The aim of this study was to describe patients' experience of life after amyocardial infarction. Method: A literature-based study was used, based on ten qualitative articles. The articles were analyzed in a five step-model, which resulted in three main-themes and sixsub-themes. Results: The results present life after myocardial infarction as difficult to understandand manage. This could be related to their physical and mental changes, which resulted in fear and anxiety that affected their everyday lives through experienced limitations. Fatigue where also a contributing factor in the limitations of everyday life due to energyloss. This was hard to handle without support from both relatives and health care professionals. It was essential to be meet as a unique human and not reduced to a diagnosis. Life became more valuable through the survival and gave the individuals a second chance with different priorities. Some adjusted to the lifestyle changes, while others were reluctant. Returning to work where seen as an indicator for being healthy and a return to life as before. Conclusion: To establish well-being and security through nursing, a holistic approach that is the basis of person-centered care helps nurses to see the individual situation. / I Sverige minskar antalet personer som drabbas av hjärtinfarkt trots detta är förekomsten fortfarande hög och ca 5800 avlider varje år. Hjärtinfarkten medför både fysiska och psykiska förändringar hos den drabbade. Syftet med denna litteraturstudie är att belysa patienters upplevelse av livet efter en genomgången hjärtinfarkt. I studiens resultat framkom det att både män och kvinnor såg situationen och livet efter en hjärtinfarkt som svår att hantera, då både kroppen och hjärtat inte längre upplevdes pålitligt. Detta resulterade i rädsla och oro som begränsade det vardagliga livet. Personerna upplevde att det var svårt att tolka kroppsliga signaler, vilket gav en osäkerhet som resulterade i ångest och katastrof tankar om döden. Detta medförde även att de inte vågade anstränga sig fysiskt. Känslor som ilska, frustration och nedstämdhet upplevdes på grund av den mentala och fysiska utmattningen som var svår att förstå. Personerna kunde inte utföra vardagsaktiviteter i samma utsträckning som innan hjärtinfarkten, vilket resulterade i en känsla av passivitet. Det utrycktes även ett behovav stöd från anhöriga och vårdpersonal för att klara av sin situation och det vardagligalivet. Vårdpersonalens bemötande och agerande var avgörande för hur patienterna förstod informationen som gavs, deltog i rehabilitering och klarade att genomföra nödvändiga förändringar när det gäller ohälsosamma levnadsvanor. Vårdpersonalens förmåga att skapa en trygg atmosfär tillsammans med att se patienten som människa var viktigt för att uppnå välbefinnande. Anhöriga sågs som en resurs för personerna då de kunde avlasta vardagssysslorna samtidigt som de lyssnade, vilket gav trygghet och välbefinnande hemma. Patienter upplevde att familjen satt för höga krav och fick då stödet från vänner. Partnerrelationen kunde påverkas genom den minskade sexuella relationen som grundade sig i rädsla för de fysiska förändringarna och upplevdes svårt att prata om med partnern. Livet efter en hjärtinfarkt beskrevs som en ny chans till livet där nya värderingar uppstod. Personerna upplevde att arbetsgivarens attityd och förståelse för situationen var avgörande för fortsatt sjukskrivning. För att kunna möta patientens unika behov och skapa välbefinnande genom omvårdnad, är personcentrerat förhållningssätt lämpligt för att vidhålla en helhetssyn på patienten och inte bara det fysiologiska tillståndet.

Context: Tobacco use among medical students is of public health concern, given their role as future role models for healthy lifestyles. This study sought to determine the prevalence and determinants of tobacco use and nicotine dependence in medical students in Pretoria. In particular, this study explored the role of sense of coherence – a measure of stress-coping ability – on tobacco use patterns among medical students. Furthermore, we examined the students’ knowledge of smoking cessation approaches, their perceptions with regard to the availability and adequacy of tobacco control curricula, and their perception of their role as ”role models” for their patients. Methods: This cross-sectional analytical study, involving undergraduate medical students in their 2nd and 6th year of study at the universities of Pretoria and Limpopo (MEDUNSA), was conducted during August and September 2008. Consenting participants completed a self-administered questionnaire (N=722). Information obtained included: demographic characteristics of respondents, alcohol use, past and current use of various tobacco products, perception of availability and adequacy of training in tobacco control (TC), support for various TC legislation and perception of the role of doctors in smoking cessation. A six-item Antonovsky’s sense of coherence scale (SOC) was also included to measure respondents’ ability to cope with stress. Nicotine dependence was measured using the diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV). Data analysis included chi-square statistics, t-test and multiple logistic regression analysis. Level of significance was set at p<0.05. Results: Prevalence of cigarette smoking in medical students was 17.3%. Cigarette smoking was significantly higher among the 6th (21.5%) than among the 2nd year (14.1%) students and was also significantly higher among males (20.4%) than among females (14.4%). In a bivariate analysis, problem drinkers were more likely to be smokers (37.5%) as compared to non-problem drinkers (13%). Compared to non-smokes, smokers were more likely to have a lower SOC [Mean(sd); 26.8 (8.8) vs 28.8 (7.4); p=0.019] and were less likely to attach importance to being seen as a role model by patients. Only 21.9% felt their training curriculum contained TC issues and of these a little over half felt the TC content was inadequate. After controlling for potential confounders, the factors that were independently associated with the current smoking status were, having lower support for TC legislation (OR=0.49; 95% CI= (0.41-0.59) and attaching less importance to being seen as a role model by patients (0.62; 0.41-0.91). Other factors associated with cigarette use included: being a 6th year student (OR=2.17; 95% CI; 1.32-3.58), having a drinking problem (2.17; 1.28-3.68), reporting exposure to others smoking at home (3.29; 1.91-5.66) and having received previous formal training in cessation (0.55; 0.32-0.95). Younger age (0.86; 0.77- 0.97), lower SOC (0.94; 0.90-0.99), and lower level of support for TC legislation (0.56; 0.40-0.79) were independently associated with nicotine dependence. Conclusions: This study’s findings suggest that tobacco use is prevalent among medical students and tobacco use is strongly associated with alcohol abuse. In addition to offering tobacco cessation services to these students, these findings highlight the need to institute a curriculum on tobacco control that includes not only teaching cessation counselling skills to medical students, but that also encourages them to become advocates for TC legislation and to recognise themselves as important role models in the society. Copyright / Dissertation (MMed)--University of Pretoria, 2009. / School of Health Systems and Public Health (SHSPH) / MMed / Unrestricted

Gravity-driven membrane (GDM) filtration is one of the promising membrane bioreactor (MBR) technologies. It operates at a low pressure by gravity, requiring a minimal energy. Thus, it exhibits a great potential for a decentralized system, conducting household in developing and transition countries. Biofouling is a universal problem in almost all membrane filtration applications, leading to the decrease in flux or the increase in transmembrane pressure depending on different operation mode. Air scoring or regular membrane cleaning has been utilized for fouling mitigation, which requires increased energy consumption as well as complicated operations. Besides, repeating cleaning will trigger the deterioration of membranes and shorten their lifetime, elevating cost expenditures accordingly. In this way, GDM filtration stands out from conventional MBR technologies in a long-term operation with relative stable flux, which has been observed in many studies. The objective of this study was to monitor the biofilm development on a flat sheet membrane submerged in a GDM reactor with constant gravitational pressure. Morphology of biofilm layer in a fixed position was acquired by an in-situ and on-line OCT (optical coherence tomography) scanning at regular intervals for both visual investigation and structure analysis. The calculated thickness and roughness were compared to the variation of flux, fouling resistance and permeate quality, showing expected consistency. At the end of experiment, the morphology of entire membrane surface was scanned and recorded by OCT. Membrane autopsy was carried out for biofilm composition analysis by total organic carbon (TOC) and liquid chromatography with organic carbon detection (LC-OCD). In addition, biomass concentration was obtained by flow cytometer and adenosine tri-phosphate (ATP) method. The data of biofilm components indicated a homogeneous biofilm structure formed after a long-term running of the GDM system, based on the morphology observation by OCT images. The superiority of GDM in both flux maintaining and long-term operation with production of high quality effluent was demonstrated, as well as the suitability of OCT for biofouling monitoring was emphasized.

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13260号 / 論医博第2178号 / 新制||医||1037(附属図書館) / (主査)教授 溝脇 尚志, 教授 大森 孝一, 教授 富樫 かおり / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

There is an ongoing shortage and high demand for basic and specialized nurses in health care sectors in Sweden. The sick leave among healthcare workers has been remarkably increasing since 2012. Number of sick leaves has been increased among health care workers including midwives and specialized nurses regardless to their level of education. Aim of the study is to learn more about competence, competence growth and how it has impact on nurse health at their working place.Qualitative semi-structured interview method is used in this study and snowball sampling method is used to select the study participants. Interview data of all participants are analyzed using thematize analysis method. Eight nurses took part in this study and seven of them are working in hospital and one participant is working in an elderly care home. Almost all of the participations reported that competence is one of the key requirements for health care workers. The participants reported that the competence and the competence growth in working place are associated with professional experience, resources, peer support, cooperation, personal characteristics, attitude of managers and colleagues towards skills development, work environment, training towards knowledge updating and specialization and short terms courses. The study results show that most of participations have stable sense of coherence (KASAM) and the ability to associate the works with coherence is high. Five of eight participations scored high in of sense of coherence and it’s three components: comprehensibility, manageability and meaningfulness. One participant scored high in comprehensibility, manageability and whereas low in meaningfulness. Two participants scored high in comprehensibility and meaningfulness whereas low in manageability. The components of sense of coherence are often associated with good health in many studies. However, further researches to assess the relationship between the variables sense of coherence and nurses competent are required and it can be helpful for health promotional works among heath care workers.

No description available.

This master’s thesis deals with calibration of a coherence scanning interferometer Talysurf CCI Lite. Basic terms related to surface texture evaluation were described along with selected profile and areal surface texture parameters. The working principle and design of the calibrated instrument were explained. Manufacturer’s calibration procedure was analyzed in relation to the definition of calibration in the International vocabulary of metrology. Further calibration steps leading to calculation of measurement uncertainty were presented. Last but not least, measurement uncertainties of areal surface texture parameters Sq and Sz were evaluated. The procedures and results described in this thesis may contribute to wider use of non-contact surface texture measuring instruments.

Diplomová práca sa zaoberá kvantitatívnym fázovým zobrazovaním objektov umiestnených za rozptyľujúcim prostredím v koherenciou riadenom holografickom mikroskope. Tento mikroskop umožnuje zobrazovať s úplne nekoherentným osvetlením vzorky, čo vyvoláva efekt koherenčnej brány. Koherenčná brána je veľmi dôležitá vlastnosť zobrazovacieho systému umožňujúca separáciu balistických a rozptýlených fotónov, jej dôkladnému vysvetleniu je venovaná značná časť práce. Ďalej sú prezentované základy teórie zobrazenia v koherenciou riadenom holografickom mikroskope. Tie sú využité v závere práce pri interpretácii experimentálnych výsledkov. Cieľom práce je navrhnúť metódu pre pozorovanie fázových objektov v rozptyľujúcich prostrediach a experimentálne túto metódu overiť. Na základe analytických výsledkov a predchádzajúceho výskumu je navrhnutá nová metóda, ktorá je ďalej overovaná pomocou rôzne komplexných vzoriek. Je založená na zázname viacerých obrazov s rôznym posunutím referenčného poľa. Každý posun korešponduje so zobrazovaním pomocou inej skupiny fotónov. Je možné vytvoriť syntetický obraz so zlepšenou kvalitou sčítaním jednotlivých obrazov získaných z interferencie balistických alebo rozptýlených fotónov. Experimenty s rôzne komplexnými vzorkami poskytujú náhľad na obmedzenia prezentovanej metódy.

Master’s thesis contains the theory for realization of the researched software. Besides other, it describes Fourier transform, frequency response function, coherence, impulse response and group delay. Real life application of the software is discussed. Software is invented in the MatLab environment. Further, thesis provides testing of the software and shows its commented outcomes.