<p>I Sverige lider ca 50 000 personer av bensår vilket definieras som ”sår på ben och/eller fot nedom knät som ej läkt på 6 veckor”, ungefär hälften av dessa är venösa bensår. De flesta som drabbas av bensår är 65 år eller äldre. Syftet med denna studie var att beskriva patienters upplevelse av att leva med venösa bensår. Studien är baserad på en kvalitativ metod med en induktiv ansats. Data samlades in genom intervjuer från sex patienter och analyserades sedan med hjälp av innehållsanalys. Resultatet baseras på två kategorier; begränsat och bundet liv samt önskan att bli sedd. Dessa kategorier bildade temat; att vara hel men ändå inte. Utifrån denna studie kan personal som vårdar och behandlar bensårspatienter få ökad kunskap om hur patienter upplever att det är att leva med venösa bensår. Med hänsyn till detta vore det önskvärt att effektiva och välstrukturerade vårdrutiner utarbetas för att uppnå helhetssyn inom vården och behandlingen av bensårspatienter.</p> / <p>Approximately 50 000 people in Sweden are suffering from leg ulcers which is defined as "wounds on the legs and/or foot below the knee, which is not healed in 6 weeks", about half of them are venous leg ulcers. Most people who suffer from leg ulcers are 65 years or older. The purpose of this study was to describe patients' experiences of living with venous leg ulcers. The study is based on a qualitative method with an inductive approach. Data were collected through interviews from six patients and analyzed with help of content analyzing. The results are based on two different categories: limited and restricted life, and desire to be seen. These categories formed the theme; to be whole but still not. Based on this study, staff who care for and treat leg ulcer patients can increase knowledge about how patients feel it is to live with venous leg ulcers. Given this, it would be desirable that there are effective and well-structured care practices designed to achieve holistic healthcare and treatment of patients with leg ulcers.</p>

Thesis (M.A.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed Jan. 21, 2010). Includes bibliographical references (p. 47-53).

Thesis (M.A.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed Jan. 28, 2010). Includes bibliographical references (p. 23-24).

Bakgrund Venösa bensår drabbar oftast personer över 65 år. Befolkningen i Sverige lever allt längre, detta kommer antagligen leda till att fler kommer drabbas av venösa bensår. En etiologisk diagnos ställs av en läkare genom anamnes och en klinisk undersökning. Drygt hälften av alla bensår orsakas av venös insufficiens ofta beroende av försvagades kärl eller felande venklaffar. Syfte syftet med litteraturöversikten var att belysa sjuksköterskans omvårdnadsåtgärder som påverkar läkningen av venösa bensår hos äldre. Metod litteraturöversikten baserade sig på nio arbetssteg. Bedömningen av artiklarnas vetenskapliga kvalitet gjordes med hjälp av ett bedömningsprotokoll. Både kvalitativa och kvantitativa artiklar ingick i studien. Författarna använde sig av mindmapping för att visuellt klarlägga under vilken omvårdnadsåtgärd respektive nyckelord passade in. Resultat Delaktighet, information/undervisning och stöd var omvårdnadsåtgärder som hade stor betydelse för patienter med venösa bensår. Detta gynnade kontakten mellan sjuksköterska och patient, samt läkningen av de venösa bensåren. Diskussion Omvårdnadsåtgärder rörande venösa bensår hos äldre borde belysas, omvårdnadsåtgärder kan bidra till bättre livskvalitet hos dessa patienter genom att ge rätt omvårdnad. Slutsats Författarna tror att en holistisk omvårdnad, som innebär ett fokus på hela människan, främjar patientens livskvalitet och välmående och kan vara avgörande för läkningen av venösa bensår.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Abbreviations ADP – autodermoplastics. CUL – chronic ulcers of legs. CVUL – chronic venous ulcers of legs. DGP – a doctor of general practice. KMU – Kaunas Medicine University. KMUH –Kaunas Medicine University Hospital. CSVD – Clinic of Skin and Venereal diseases. 1. Introduction The pathology of chronic ulcers of legs is quite often and it makes a huge influence on the daily life of a patient. According to the literature, ulcers open to 1,5 from 1000 people who are under the age of 65, and if we take into account healed up ulcers of legs, there are 36 people from 1000 to whom ulcers of legs have ever been opened. The reason of ulcers up to 80% of all cases is chronic insufficiency of veins. In Lithuania there are about 150 000 patients suffering from the chronic insufficiency of leg vein blood circulation, and about 30 000 of which are venous ulcers of legs. As in Lithuania in some of the medical institutions the treatment and the prophylaxis of chronic venous blood circulation and ulcers is insufficient, the above mentioned numbers of patients may be even higher. All the authors have noted that the oftenest reason of CUL is the insufficiency of venous blood circulation. In this case, CUL open due to the increased pressure in leg veins. The main reason for that is the insufficiency of surface and deep veins and the perforating vein valves. The good functioning of mentioned veins and their valves is necessary so that the blood could come back to the heart during each... [to full text]

Since the 1980’s horizontal drilling has been a game-changing technology as it allowed the oil and gas industry to produce from reservoirs previously considered marginal or uneconomic. However, while it is considered a mature technology, directional drilling is still done in a reactive fashion. Although many directional drillers are quite adept at predicting the directional response of the bottomhole assembly (BHA) in a given well, the ability to manage all of the drilling parameters on a foot by foot basis while accurately predicting the effects of each parameter is impossible for the human brain alone. Given current rig rates, any amount of increased slide time and its reduced ROP which occurred due to poorly predicted directional response can result in a significant economic impact. There exist many measured parameters or system inputs which have been proven to affect the directional response of a drilling system. One parameter whose effect has not been investigated is mechanical specific energy or MSE. MSE is measure of how efficient the drilling process is in relation to rate of penetration. To date, MSE has primarily been used with for vibration analysis and rate of penetration optimization. The following dissertation covers research into the effect of MSE on the overall wellbore direction change or dog-leg severity. Using published experimental data, a correlation was developed which shows a clear relationship between the dog-leg severity, rate of penetration (ROP) and MSE. The correlation requires only a few hundred feet of drilling before it is able to be tuned to match an individual well’s results. With minimal tuning throughout the drilling of a well, very good results can be obtained with regards to forecasting dog-leg severity as the wellbores were drilled ahead. The correlation was tested using data from multiple, geo-steered wells drilled in a shale reservoir. The analysis of the correlation using real-world data proved it to be a robust and accurate method of predicting the magnitude of dog-leg severity. The use of this correlation results in a smoother wellbore, drilled with a faster overall ROP with a better chance of staying within the geologic targets.

The sample included 29 healthy competitive male distance runners. Bilateral measurements were taken for selected variables of the talocalcaneal flexibility by means of a mechanical goniometer, and of the peak isokinetic knee strength on a Cybex II device. The frontal and horizontal plane motions of the lower limbs of the subjects were recorded by high speed filming and videotaping while they were running on a motor driven treadmill at their training pace under two conditions: with running shoes and barefoot. A detailed description of each runner's history was obtained and bilateral dominance characteristics were determined. Significant functional asymmetries were found for subtalar joint flexibility (eversion, inversion, and eversion/inversion ratio) and peak isokinetic knee strength (flexion, extension, total, and flexion/extension ratio). Significant kinematic asymmetries were revealed during the foot support phase in lower leg angle, rearfoot angle, mediolateral velocity of the foot, and in some temporal parameters. The two running conditions differed significantly only for the pretouchdown phase of support. Significant trends of association were identified between selected components of the lower limb functional and kinematical asymmetries which were characterized by consistent laterality patterns. Multivariate asymmetry components and running injury patterns were independent. Only asymmetries in foot pronation during barefoot running tended to significantly differentiate between runners grouped by injury incidence. The phenomenon of functional and kinematic asymmetries in runners is warranted.

The purpose of the study was to investigate the effects of fatigue on the lower extremity landing strategies of males and females. Twelve recreationally active males (n = 6) and females (n = 6) (nine used for analysis) performed repetitive drop jumps until they could no longer reach 20% of their initial drop jump height. Kinematic and kinetic variables were assessed during the impact phase of all jumps. At initial ground contact, males exhibited greater extension at the hip and knee and less plantar flexion than females. However, females performed more eccentric work during the impact phase of landing. Fatigue resulted in an increased extension at the hip, knee, and ankle for both genders, but did not have an effect on the peak VGRF. Fatigue also resulted in an increase in work performed at the ankle and an approximately equal reduction in work performed at the knee for both genders. Investigation of the peak powers revealed that as a result of fatigue, females utilized a landing strategy in which more energy was absorbed at the knee during the early part of the impact phase. The increased reliance on the knee musculature to dissipate kinetic energy during the impact phase of landing demonstrated by females may be a reason for the commonly seen gender disparities in injury rates. Furthermore, the shift towards energy absorption during the initial part of the impact phase when noncontact injuries are known to occur, exhibited by females, may indicate a greater injury risk for females. / School of Physical Education, Sport, and Exercise Science

Syfte och frågeställningar: Syftet var att genom en tvärsnittsstudie ta reda på om det fanns asymmetrier mellan dominant och icke-dominant ben hos skadefria kvinnliga fotbollsspelare gällande sagittal knälaxitet. Frågeställningar i studien var: Hur stor är den anteriora och posteriora knälaxiteten i dominant respektive icke-dominant ben uppmätt med KT-1000 vid belastningar på 20 lb, 30 lb samt vid ett manuellt maxtest i anterior riktning? Föreligger det någon sidoskillnad mellan dominant och icke-dominant ben gällande knälaxitet uppmätt med KT-1000 vid anteriora och posteriora belastningar på 20 lb, 30 lb samt vid ett manuellt maxtest i anterior riktning? Hur stor andel av deltagarna uppvisar en sidoskillnad av sagittal knälaxitet på ≥ 2 mm respektive ≥ 3 mm uppmätt med KT-1000 och hur är frekvensen fördelad mellan dominant och icke-dominant ben hos dessa? Metod: För att besvara syfte och frågeställningar genomfördes en tvärsnittsstudie där 56 kvinnliga fotbollsspelare inom division 1-2 deltog. Samtliga deltagare var ≥ 18 år, skadefria och hade spelat fotboll i minst 5 år. Mätinstrumentet KT-1000 användes för att registrera knälaxitet mellan dominant och icke-dominant ben. Alla mätningar utfördes av samma testledare och med samma mätinstrument och genomfördes i en standardiserad position inför träning. Statistiska beräkningar utfördes på belastningarna P-20/30 lb, A-20/30 lb, Total AP-20/30 lb samt ett manuellt maxtest. Data för knälaxitet registrerades och analyserades utifrån bendominans genom ett Mann Whitney U-test. Resultat: Resultatet visade på en liksidig knälaxitet av dominant och icke-dominant ben vid anteriora och posteriora mätningar. Medelvärden varierade mellan 1,91–2,91 mm i posterior riktning med en spridning på 1-4 mm. Motsvarande mätvärden i anterior riktning var 4,03–9,53 mm med en spridning på 4-19 mm. Inga signifikanta sidoskillnader framkom mellan dominant och icke-dominant ben men en ökad knälaxitet uppmättes i dominant ben vid samtliga belastningar i anterior riktning. En sidoskillnad på ≥ 2 mm visade sig hos 16,6-51,8 % av deltagarna beroende på vilken belastning som testades. Av dessa registrerades en ökad anterior knälaxitet i det dominanta benet hos 62,1-81,2 %. Slutsats: Genomförda mätningar av sagittal knälaxitet visade inga signifikanta skillnader gällande asymmetrier mellan dominant och icke-dominant ben hos kvinnliga fotbollsspelare. Vid belastningen A-MMT uppvisade drygt hälften av deltagarna en individuell sidoskillnad på ≥ 2 mm. Studien belyser vikten av ytterligare forskning för att kartlägga individuella sidoskillnader gällande sagittal knälaxitet. / Aim: The aim of the cross-sectional study was to find out if there were asymmetries between the dominant and non-dominant leg in non-injured female soccer players regarding sagittal knee laxity. The aims were: What´s the anterior and posterior knee laxity in the dominant and non-dominant leg measured with KT-1000 at loads of 20 lb, 30 lb, and a manual maximum test in anterior direction? Is there side-to-side differences in knee laxity between the dominant and non- dominant leg measured with KT-1000 at the anterior and posterior loads of 20 lb, 30 lb and with a manual maximum test in anterior direction? How many of the participants show a side-to-side difference of sagittal knee laxity of ≥ 2 mm and ≥ 3 mm measured with the KT-1000 and how is the frequency between the dominant and non-dominant leg of these distributed? Method: In order to answer the aim of the cross-sectional study 56 female soccer players from division 1-2 participated. All participants were ≥ 18 years old, no previous knee injury and had played football for at least 5 years. The KT -1000 instrument was used to measure knee laxity between the dominant and non-dominant leg. All measurements were performed by the same test leader, with the same test-instrument and in a standardized position. Statistical calculations were performed on loads P-20/30 lb, A-20/30 lb, Total AP-20/30 lb and a manual maximum test. Data for knee laxity were measured and analyzed by leg dominance through the Mann Whitney U-test. Results: The results of all participants showed an equivalent of knee laxity of dominant and non-dominant leg at the anterior and posterior measurements. Mean values ranged from 1.91 to 2.91 mm in the posterior direction (range of 1-4 mm). The corresponding measured values in the anterior direction were 4.03 to 9.53 mm (range 4-19 mm). No significant side-to-side differences were revealed between the dominant and non-dominant leg but an increased knee laxity was documented in the dominant leg at all loads in the anterior direction. Depending on the load 16.6 to 51.8 % of the participated had a side-to-side difference ≥ 2 mm. 62.1 to 81.2 % of these registered increased anterior knee laxity in the dominant leg. Conclusions: The measurements of sagittal knee laxity revealed no significant differences in the asymmetries between the dominant and non-dominant leg in non-injured female soccer players. At the A-MMT load over half of the participants revealed a side-to-side difference ≥ 2 mm. The study highlights the need for further research to identify individual side-to-side differences regarding sagittal knee laxity.