<p><strong>Background:</strong> Postnatal growth of preterm infants does not match recommended intrauterine growth, due to the initial weight loss that accompanies healthy body composition rearrangements after birth. Thus, optimal postnatal growth for preterm infants is currently unknown.</p> <p><strong>Objectives: </strong>(1)<strong> </strong>Collect longitudinal postnatal growth data of 30–36 week GA preterm infants with unimpaired postnatal adaptation; (2) Develop regressions that predict the growth trajectory such an infant will adjust to by days of life 7/14/21; (3) Extrapolate and validate the regressions downwards to 25 weeks.</p> <p><strong>Methods:</strong> Infants of 30–36 week GA, born/admitted to 1/5 participating centres between 2008–2012, who met pre-specified criteria for unimpaired postnatal adaptation and who had at minimum 14 days of data were included. Day-specific anthropometric data from birth to discharge were abstracted retrospectively. Z-score regressions for days 7/14/21 were developed. Regressions were then extrapolated to 25 weeks and validated using an independent study population.</p> <p><strong>Results:</strong> Of 6203 infants, 665 met the screening criteria. By day 14, infants adjusted to stable growth trajectories that were 84±13% of the recommended weight-for-age. Using the following predictors: GA, z-score at birth and hospital-centre, regressions accurately predicted z-scores at days 7, 14 (n=665; R²=0.939, 0.889) and 21 (n=333; R²=0.841). Validation using 25-29 week GA infants (n=173) suggested models were also accurate within this age-range.</p> <p><strong>Conclusion: </strong>These results provide robust estimates of a hypothesis of healthy postnatal growth for preterm infants. Future steps include assessing long-term outcomes in a randomized control trial and assessing the quality of growth using body composition analyses.</p> / Master of Science in Medical Sciences (MSMS)

No description available.

With a longer-living population and an increase in cancer incidence the health care’s workload has increased over the past decade. The treatment process of a cancer patient is dependant on clinical information collected and communicated from the pathology department. With a standardised and structured pathology report the information communicated can become easier to interpret and will fa- cilitate the search for important parameters. This master thesis aims to develop a template prototype to replace four static free-text templates used in the area of breast cancer pathology at the pathology department at Region Östergötland. The end product was intends to store docu- mented information in a structured manner through structured data, in order to obtain semantic interoperability. Semantic interoperability means that different systems are able to communicate with each other in such a way that the information is handled and interpreted equally by the systems. By using certain standards such as openEHR archetypes and SNOMED CT concepts, the data becomes uniform and unambiguous. When that is achieved, information can be sent more easily between systems such as patient health data if an individual moves between different cities where the hos- pitals have different medical records systems. The result of the master thesis is a single template that incorporates all the parts from the four static templates currently used at Region Östergötland. To avoid a large and cumbersome template for the end-user the template is built with con- ditions that changed the appearance of the template while it is being filled in, making it dynamic.

No description available.

Bakgrund: Var tredje kvinna och var femte man drabbas någon gång i livet av ångestsyndrom. Ångest är en upplevelse av rädsla, upprördhet, spänningar, olust samt starkt obehag. Orsakerna till ångest utgår ifrån olika faktorer, det finns fyra olika orsaksfaktorer: de genetiska, kroppsliga, psykologiska och sociokulturella. Det är inte många som söker vård för sin ångest utan oftast för bröstsmärtor, hjärtklappningar och magsmärtor. Vid utvärdering av en patient för misstänkt ångestsyndrom är det viktigt att sjuksköterskan undantar medicinska åtgärderna och istället lägger fram egenvårdsråd till den drabbade. Syfte: Syftet med studien var att belysa vuxna personers upplevelser av att leva med ångestsyndrom. Metod: Det är en kvalitativ litteraturstudie baserad på tre patografier skrivna på svenska. Dessa analyserades enligt Graneheim och Lundmans tydningar av innehållsanalys. Resultat: Innehållsanalysen gav resultat på sex kategorier; ”Att begränsas i vardagen”, ”Rädslor som vuxit fram tillsammans med ångesten”, ”Svårt att kontrollera oönskade känslor och tankar”, ”Att ångesten ger fysiska symtom”, ”Känna skam som bedrivs av ångesten” och ”Behov av att fly från ångesten”. Slutsats: Personernas vardag präglades av ångesten på så sätt att de upplevde isolering från omvärlden samt fick ångest inför att göra något obehagligt, något som resterande personer inte hade upplevt lika obehagligt. Även de fysiska symtomen förekom under ångestperioden. I studien framkom det fler och djupare upplevelser och förekomna fysiska symtom än vad som hittats i tidigare forskning.

No description available.

Bakgrund: I Sverige utförs cirka 40 000 koronarangiografier årligen. I samband med koronarangiografi används intraarteriellt jodkontrastmedel. Tyreoidea (sköldkörteln) är avgörande för metabolismen och hormonproduktionen kan påverkas av jod-injicering. Skador och biverkningar på tyreoidea efter jodkontrast tillförsel är inte lika omdiskuterat som inducerade njurskador. Syfte: Syftet var att sammanställa hur tyreoidea påverkas av intraarteriellt jodkontrastmedel efter koronarangiografi.Metod:Denna studie genomfördessom en allmän litteraturstudie. Databaserna PubMed och Cinahl användes och totalt inkluderades och analyserades 10 vetenskapliga artiklar i resultatet. Resultat:Studiens resultat sammanfattades i två kategorier; Patienter med “eutyroid (frisk) tyreoidea” och patienter med “avvikande tyreoidea” före studiernas start. Resultatet för varje kategori visade hur tyreoidea påverkades efter en koronarangiografi med jodkontrastmedel. Båda kategorierna visade att det förekom patienter som utvecklade olika former av tyreoideadysfunktion. Slutsats: Rapportens resultat samstämmer med de nationella rekommendationerna för jodkontrastmedel att hänsyn ska tas till patientens tyreoideastatus före en koronarangiografi. Detta för att eventuellt kunna premedicinera riskpatienter och uppmana remittenten om uppföljning av fritt T3, fritt T4 och TSH.

Although there have been numerous investigations of laryngeal muscle activity during phonation in the chest and falsetto/head registers in trained and untrained classical singers and non-singers, no research has been conducted examining laryngeal muscle activity during phonation in the chestmix register, a register used extensively by many female commercial singers, particularly for the production of higher frequencies. The purpose of this study was to test the hypothesis that commercial singers produce chestmix by maintaining or increasing adduction of the vocal processes and by engaging the thyroarytenoid muscle to a greater degree than they would to produce a head register sound. Simultaneous recordings of thyroarytenoid and cricothyroid muscle activity, videonasendosopy, and audio were obtained from seven female commercial singers (5 trained, 2 untrained) during sustained phonation and song phrases produced in chest, chestmix, headmix, and head registers. Thryoarytenoid and cricothyroid muscle activity was normalized to a percent of mean maximum activity and compared across registers and frequencies both within subjects and across subjects. Video stills of vocal processes adduction patterns were rated for degree of vocal processes adduction and also compared across register and frequency within and across subjects. All audio samples were rated for register by two singing teachers and audio samples of sustained phonation were analyzed via Fast Fourier Transform to measure the number and energy of the harmonics present in each sample. Interjudge and intrajudge reliability tests were performed for both the vocal processes adduction rating and audio sample rating tasks. Results from the study confirmed the hypothesis and showed that thyroarytenoid activity and adduction of the vocal processes was greater for chestmix than headmix or head, particularly during production of higher frequencies, but less than for chest productions. Cricothyroid activity was similar for chestmix, headmix and head during production of lower frequencies, but greater for chestmix during production of higher frequencies.

Att reglera sin gripkraft och lyfta ett föremål kan tänkas vara enkelt och självklart. Men för personer med visa neroulogiska sjukdomar som hydrocefalus och Parkinsons sjukdom har det visat sig att deras sjukdomar kan påverka deras gripkraft. Om nu gripkraften påverkas kan det kanske användas inom vården för att kontrollera sjukdomsförloppet, om det blir bättre efter behandlingar. På Medicinsk Teknik - Forsking och Utveckling (MT-FoU) har ett mätinstrument som mäter gripstyrkan och lyftaccelerationen konstruerats. För att detta instrument skall bli mer användbart i klinisk praktik behövs ett analysprogram för att ta fram resultatet efter mätningar gjorda med utrustningen. Ett datoriserat analysprogram har potential att vara betydligt snabbare, effektivare och objektivare jämfört med den manuella analys som används idag. Syftet med detta projekt är att skapa ett analysprogram som kan ersätta arbetet av den manuella analysen och som kan ta fram resultat från mätdata. Resultatet skall inte skilja mellan en manuell analys och den automatiska analysen. Målet är att analysen ska bli snabb, effektiv och vara objektiv samt ge samma resultat som en manuell analys skulle ge. Programmet som konstruerades blev snabbare och effektivare än den manuella analysen. Mätningar på sex stycken friska, frivilliga personer användes för att jämföra de automatiska och manuella analyserna. Ingen signifikant skillnad kunde påvisas för någon av de parametrar som skulle analyseras, och detta visar att det automatiska analysprogrammmet fungerar lika bra som manuella analyser och därmed kan ersätta dessa för att analysera framtida mätningar. Dock är detta endast testat på friska personer så om de automatiska och manuella analyserna är jämförbara även för personer som har en neurologisk sjukdom bör utredas vidare innan den automatiska analysmetoden tas i bruk. / To be able to regulate your grip force and lift an object can be simple for healthy people. However, for people with disabilities of neurological diseases such as hydrocephalus and Parkinson’s disease it has been found that their diseases can affect their grip force. If the grip power is affected, it may be used in healthcare to check the course of disease, if it gets better after treatment. At the department of Biomedical Engineering - Research and developmet a measurement device for analysing grip force and acceleration when lifting an object has been developed. In order for this instrument to be more useful in clinical practice, an analysis program is required to produce the result after measurements made with the equipment. A computerized analysis program has the potential to be significantly faster, more efficient and more objective compared to the manual analysis used today. The purpose of this project was to create an analysis program that can replace the work of the manual analysis and which can generate results from measured data. The results should not be different between a manual analysis and the automatic analysis. The goal was that the analysis should be fast, efficient and objective and also provide the same results as a manual analysis would provide. The program that was designed became faster and more efficient than the manual analysis. Measurements on six healthy volunteers were used to compare the automatic and manual analyzes. No significant differences could be detected for any of the parameters that were analyzed, and this shows that the results of the automated analysis are comparable to the manual analysis and thus can replace these to analyze future measurements. However, the automatic analysis has only been tested on healthy people, so if the automatic and manual analyzes are comparable even for people with a neurological disease should be further investigated before using the automatic analysis method on patient data.

Swedish healthcare is facing major challenges both today but more critically looking at predictions for the next 20 years. Healthcare costs will increase dramatically and competent personnel to support all the needs will be lacking. E-health solutions and the possibilities they open up regarding how care can be organized and administrated are seen in Sweden as the most important tool to counter those healthcare challenges. The Swedish government see this as a prioritized area and has together with Sveriges Kommuner och Landsting (SKL) signed on a vision to become the world leader in E-health by the year 2025. Studies have shown that E-health can give substantial cost savings with up to 180 billion SEK in saving yearly. We have in this thesis investigated to what extent E-health solutions in the area of chronic diseases are used by Regions/Counties as well as the outcome from a cost saving perspective. Problem formulation and the questions that have been investigated are, which E-health solutions are the different Swedish Regions/County councils (Landsting) using for chronic diseases and what are the cost (and capacity) benefits? What challenges are seen to implement new E-health solutions? We have been using the case study method in our research with interviews and questionnaires with the Regions/County councils as our main source of information. In our contacts we have explained that answers given in the general discussion will be anonymous and not to be linked to any specific Region/County council. This approach was made to get frankly and informative answers. Key findings are that there are today not many E-health solutions for chronic diseases made available by the County councils and the ones offered are generally not reaching a large percentage of the population with those diseases. The implementation curve for E-healthsolutions has been slow, but it differs considerably between regions. We can see that in the northern regions with more rural areas focus is put on solutions to solve the challenges with geographical distance to the patient. In the southern regions with more urban areas the regions more commonly use models to facilitate care for the patient in their home environment. We see a large potential to both improve quality of life for many people as well as reducing costs for healthcare by introducing digital tools in the area of chronic diseases. Especially methods easily accessed for a large part of the population through the 1177.se portal that can be used without extensive support from healthcare staff is something we see as an important area. Those methods have a potential to reach and impact a large part of the population without using much of healthcare resources. We suggest that regions collaborate in order to evaluate and introduce those systems and in the end reach a larger part of the population