Bakgrund: Bålstabilitet är nödvändigt för att hålla balansen och möjliggör kraftöverföring genom kroppen. Detta gör bålstabilitet viktigt i vardagliga sysslor, sportutföranden och för att minska risken för skada. En bättre förståelse över bålstabiliteten i olika sporter kan utveckla träningsprogram, inte bara för att förbättra bålstabiliteten, utan även för att förbättra den generella prestationen. Syfte: Syftet med denna studie var att undersöka skillnader i båluthållighet mellan unga kvinnliga ryttare och fotbollsspelare, och associationen med handgrepp styrka och rotationsrörlighet i ryggen. Metod:  Båluthålligheten undersöktes med McGill’s båluthållighets test, mellan kvinnliga ryttare (n = 10) och fotbollsspelare (n = 10), ålder 16 – 20. Handgreppsstyrkan undersöktes med en handdynamometer och användes som en indikation av generell styrka. Ryggrotations testet undersöktes men en Myrinmätare. Shapiro-Wilks användes för att bekräfta normalfördelning av data. Oberoende t-test användes för att jämföra båluthållighet (sek.) mellan ryttarna och fotbollsspelarna. Signifikansnivån fastställdes till <0,05. Ett styrkeförhållande räknades ut (kg/kg kroppsvikt) och Pearsons korrelationskoefficient användes sedan för att undersöka associationen med båluthållighet (sek.). Pearsons korrelationskoefficient användes också för att undersöka associationen mellan medelvärdet av ryggrotation (°) och båluthållighet (sek.). Hög korrelation fastställdes när r> (0,7), måttlig korrelation när r = (0,3 – 0,7) och låg korrelation när r <0,3.  Resultat: Resultaten visade att ryttarna hade bättre uthållighet i bålextensionen, jämfört med fotbollsspelarna (p = 0,006). Lateralflexionen av bålen visade ingen skillnad mellan ryttarna och fotbollsspelarna (p = 0,924; p = 0,423). Handgrepp styrkan visade måttlig korrelation med bålextensionen (r = 0,631; r² = 0,398) och båda sidor av lateralflexionen av bålen (r = 0,411; r² = 0,169; r = 0,615; r² = 0,378). Rotationsrörligheten i ryggen visade låg korrelation med samtliga båluthållighets tester (r >0,3). Slutsats: Resultaten indikerar få skillnader mellan ryttare och fotbollsspelare, vilket inte är tillräckligt för att fastställa någon slutsats. Korrelationen mellan handgreppsstyrkan och båluthållighet indikerar att bättre bålstabilitet associerar med mer generell styrka. / Background: Core stability is necessary to keep balance and enables force to be transmitted through the body. This makes core stability important in everyday chores, sport performance and to reduce risk of injuries. A better understanding of the core stability in different sports can develop athletes training programs, not only to improve the core stability itself, but also to improve overall performance. Aim: The aim of this study was to examine the differences in core endurance between young female horseback riders and soccer players, and the core endurance association with hand grip strength and spinal rotation mobility. Methods: The McGill’s core endurance test was used to examine the core endurance between female horseback riders (n = 10) and soccer players (n = 10), age 16-20. The hand grip strength was examined with a hand grip dynamometer and was used to get an indication of overall body strength. The spinal rotation mobility was examined with a Myrin goniometer. Shapiro-Wilks was used to confirm the normality of the data. Independent sample t-test was used to compare core endurance time (sec.) between the horseback riders and the soccer players. The significant level was set at < 0.05. A strength ratio was calculated (kg/kg body weight), and the Pearson’s correlation coefficient was used for examining the association to core endurance (sec.). Pearson’s correlation coefficient was also used to examine the association between the spinal rotation mobility (°) and core endurance (sec.). High correlations were set at r > (0.7), moderate when r = (0.3- 0.7) and low when r < (0.3). Results: The result showed that horseback riders had better endurance in the trunk extensor test than the soccer players (p = 0.006). Hand grip strength showed moderate correlation with the endurance time of the trunk extensor test (r = 0.631, r² = 0.398), and with the lateral flexor tests (r = 0.411, r² = 0.169; r = 0.615, r² = 0.378). Low correlation was shown with the trunk flexor test (r = 0.197, r² = 0.039). The spinal rotation mobility test showed low correlation with all the core endurance tests (r >0.3). Conclusion: The results indicates few differences between the horseback riders and the soccer players, which is not enough to draw a conclusion. The correlation between hand grip strength and the core endurance tests indicates that a better core stability might be associated to an increased overall body strength.

Umar J & Von dewall S. Anhörigas upplevelser av att i hemmet vårda en familjemedlem som genomgått stroke. En litteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö universitet: Fakulteten för hälsa och samhälle, institution för vårdvetenskap, 2021.Bakgrund: Stroke är en av den största dödsorsaken i världen samt den tredje orsaken tillfunktionsnedsättning. Sjukdomen medför konsekvenser, inte bara för patientens liv utan även för anhöriga som ofta får ta rollen som vårdgivare i hemmet. Den grundutbildade sjuksköterska ska kunna bemöta anhöriga utifrån dennes behov, ge vägledning samt erbjuda stöd. Kunskap om anhörigas upplevelser är därför betydelsefullt för den grundutbildade sjuksköterskan.Syftet: Att belysa anhörigas upplevelser av att i hemmet vårda en familjemedlem som genomgått stroke.Metod: En litteraturstudie genomfördes baserad på tretton kvalitativa artiklar från Cinahl och Pubmed. Artiklarna har genomgått en kvalitetsgranskning samt analyserats utifrån innehållsanalys. Resultat: Anhörigas upplevelser beskrivs som Förändrad livssituation som innefattar hur anhöriga upplever det ibland påtvingade vårdansvaret och hur anhöriga känner sig isolerade på grund av ekonomiska och sociala begränsningar. Det beskrivs också som påverkad hälsa som tar upp både psykiska och fysiska besvär som konsekvens av att vara en anhörigvårdare. Slutligen kommer att hantera situationen som innehåller olika copingstrategier anhöriga använde sig av för att kunna hantera situationen samt det stöd anhöriga kände behov av från sjukvård och resten av omgivningen.Konklusion: Litteraturstudiens resultat visade att anhörigvårdare genomgår en livsförändring som påverkar alla delar av livet så som den egna hälsan, det sociala samt det ekonomiska. För att underlätta för anhöriga i rollen som vårdgivare i hemmet behöver anhöriga en variation av stöd, information och kunskap från närstående och sjukvården. Sjuksköterskan ska på ett personcentrerat tillvägagångssätt möta dessa behov för att på bästa sätt främja anhörigas och patientens hälsa.Nyckelord: Anhörig, Hemmet, Stroke, Upplevelser, Vårda / Umar J & Von dewall S. Relatives' experiences of caring for a family member at home who has suffered a stroke. A literature review. Degree project in nursing 15 credits points. Malmö University: Faculty of Health and Society, Department of Care Sciences, 2021.Background: Stroke is one of the leading causes of death and the third leading cause of disability in the world. The disease is a consequence, not only for the patient's life but also for relatives who often have to take on the role of caregiving at home. Registerd Nurses must be able to respond to relatives based on their needs, provide guidance and offer support. Knowledge of relatives' experiences is therefore important for the undergraduate nurse.Aim: To illuminate relatives' experiences of caring for a family member at home who has had a stroke.Method: A literature study was conducted based on thirteen qualitative articles from Cinahl and Pubmed. The articles have undergone a quality review and been analyzed based on content analysis.Result: Relatives' experiences are described as a life changing situation, which includes how relatives experience the care responsibility imposed on them and how they felt isolated due to economic and social constraints. It is also described as damaged health that addresses both mental and physical ailments as a consequence of being a caregiver. Finally, how relatives dealt with the situation that contains various coping strategies that relatives used to handle the situation as well as the support relatives felt they needed from healthcare and the rest of the environment.Conclusion: From the results of the literature review, it emerged that caregivers undergo a life change that affects all parts of life, such as their own health, the social and the financial. To make it easier for relatives in the role of caregiver at home, relatives need a variety of support, information and knowledge from other kins and healthcare. The nurse must meet these needs in a person-centered approach in order to best promote the patient's and relatives' health.Keyword: Caring, Experiences, Home, Relative, Stroke

No description available.

Non-Secretory Multiple Myeloma (NSMM) is characterized by typical morphological and pathological multiple myeloma (MM) characteristics and the absence of an M-protein on immunofixation electrophoresis with estimated prevalence of 3%. Among the NSMM cases there is a subset in which no cytoplasmic Immunoglobulin synthesis is detected, and this entity is called ‘’Non-Producing’’ Multiple Myeloma (NPMM). Plasma cell leukemia (PCL) is an aggressive form of MM characterized by high levels of abnormal plasma cells circulating in the peripheral blood. We present a rare case of non-producing variant of PCL. 75-year-old male was admitted due to anemia and thrombocytopenia. His CBC revealed hemoglobin of 9.0 g/dl and platelets were 9 k/ul. CMP showed creatinine of 1.34 mg/dl, total protein of 6 g/dl, albumin 3.6 g/dl and corrected calcium was normal. LDH was 204 IU/L. Peripheral smear review showed 8% circulating atypical plasmacytoid cells, normochromic normocytic anemia and thrombocytopenia. SPEP showed no monoclonal protein. IgA was normal. IgG, IgM were low 315 mg/dl and 20 mg/dl respectively. Serum beta-2 microglobulin was high (5.5, 1.1 – 2.4 mg/dl). Serum free kappa light chain was low (0.15, 0.33-1.94 mg/dl), lambda light chain and ratio was normal. Skeletal survey showed possible lytic lesions in right femur neck and subtrochanteric left femur. Bone marrow biopsy showed plasma cell myeloma involving 90-95% of bone marrow cellularity. The plasma cells show morphologic heterogeneity with prominent immature, plasmablastic and pleomorphic morphology. Flow cytometry shows a dominant abnormal CD45-dim population with expression of CD38, CD138, CD56 and CD117 (partial). The abnormal cells are negative for cytoplasmic kappa and lambda immunoglobulin light chains and negative for myeloid and lymphoid markers (by flow cytometry and immunohistochemical stains). Complex chromosomal analysis. Plasma cell FISH studies was positive for t(11;14). Based on suggested revised diagnostic criteria for PCL from outcomes of patients at mayo clinic, our patient was diagnosed with plasma cell leukemia. Given aggressive biology of this disease, he was started on VD-PACE chemotherapy. Bone marrow biopsy after cycle 1 chemotherapy showed no morphologic, immunophenotypic or flow cytometric features of a plasma cell neoplasm. Given excellent treatment response and discussion with transplant center subsequent cycle 2 was changed to Velcade, Revlimid and low-dose dexamethasone. He is scheduled for stem cell transplant later this month. Primary plasma cell leukemia (pPCL) is the most aggressive form of the plasma cell dyscrasias. The outcome of pPCL has improved with the introduction of autologous stem cell transplantation and combination approaches with novel agents, including bortezomib and immunomodulatory drugs, such as lenalidomide. This case highlights the challenges in diagnosis of non-producer primary plasma cell leukemia.

As a bus developer, Scania focus to construct a safe vehicle for the passengers, i.e. high strength of the bus structure and good comfort, which is also profitable for the operator, i.e. high passenger capacity and low fuel consumption. The trade-off when developing a bus body structure is to get both high stiffness and low weight. The bus body including exterior panels plays together with the chassis an important role for the stiffness of the bus. By gathering knowledge about how various exterior panels affects the stiffness of the bus body, the design of the panels can be optimized with respect to high stiffness and low weight. Also from a calculation point of view is it of interest to know how important different panels are for the stiffness of the bus body, in order to make conscious simplifications in the calculation model. The aim with this master thesis was to investigate how the stiffening plate, side windows and roof sheet influence the strength of the bus body. How the thickness of the side windows affects the stiffness of the bus body is also investigated. The investigations were made as a relative comparison between a complete bus and comparison models.   The results showed that exterior panels participate in distributing load. By distributing the load, the load uptake gets more efficient since a bigger part of the bus structure is used to take up the load. The side windows affect the stiffness for all tested load cases, with increased importance for the load case where a gravity field is applied in the longitudinal direction, for the torsion load case and when a load is applied to the power train in vertical direction. The roof sheet has a high impact on the stiffness in the torsion load case, but has negligible influence on the stiffness of the bus body for the other tested load cases. The stiffening plate has little influence on the stiffness of the bus body in general and is negligible for all tested load cases except for when a lateral load is applied as either a gravity field or locally to the power train.   Thinner side windows are shown to have a positive influence on the stiffness of the bus body.

ERCP är ett komplicerat invärtes kirurgisk ingrepp som genomförs med hjälp av endoskopi. ERCP-avdelningen vid Karolinska Universitetssjukhuset tog tidigare ofta emot patienter från ERCP-avdelningen på Visby på grund av operationens förväntade svårighet. Nu har de istället sedan en tid tillbaka givit distansguidning under pågående operationen till ERCP i Visby. Distansguidningen skapar ett virtuellt team som ger nya mänskliga, tekniska och organisatoriska utmaningar. Syftet med denna studie var tvåfaldigt: det ena att fördjupa kunskapen i hur ett MTO-perspektiv tillsammans med ett tjänstedesignsverktyg kunde appliceras på det specifika fallet, det andra var att svara på hur utvalda faktorer som är kritiska för fysiskt åtskilda teams stöddes och hämmades i den valda fallstudien. En observation- och intervjustudie med hjälp av tjänstedesignsverktyget Blueprint utfördes med involverade personer för distansguidningen med efterföljande tematiskt analys av transkriberad data. Utfallet av analys belyser tekniska svårigheter och ett lärlingssystem mellan kirurgerna utanför distansguidningens av ERCP organisatoriska kontroll som är viktig för det virtuella teamets personliga relationer, tillit och kultur. En diskussion förs ur ett mänskligt, tekniskt och organisatoriskt perspektiv. Kombinationen av MTO och tjänstedesign fungerade för denna fallstudie och kan vara en kraftfull kombination. Dock anses studiens utförande kunna optimeras för att bättre integrera de två och utnyttja tjänstedesignsverktyget Blueprint ytterligare. Lärdomar i hur detta kan göras i framtida studier beskrivs.

Helgenomsekvensering genererar enorma mängder komplex data som kan vara svår att analysera. Visualisering av denna data är ett viktigt steg för att underlätta analys. Av speciellt intresse är visualisering av strukturella varianter, variationer i DNA större än 1000 baspar, som tros ligga till grund för flera genetiska sjukdomar. För detta ändamål utvecklades fyra verktyg: ett cirkeldiagram, ett täckningsdiagram, ett karyotypdiagram och en interaktionsvärmekarta. Mjukvaran skrevs i språket Python och utnyttjar ramverket Qt och tillhörande Python-bindningar för dess grafiska användargränssnitt, tillsammans med biblioteket Matplotlib för att plotta vissa grafer. Verktygen innehåller en mängd funktioner och knyter ihop dessa i ett för användaren enkelt gränssnitt, men plats för vidareutveckling finns. En rad förslag till sådan vidareutveckling diskuteras, så som att implementera fler funktioner, integrera verkygen bättre med befintlig mjukvara, och förbättra portabilitet genom nätverksfunktioner. / Whole genome sequencing generates enormous amounts of complex data that can be difficult to analyze. Visualization of this data is an important step to facilitate analysis. Of particular interest is visualization of structural variants, variations in DNA greater than 1000 base pairs, some of which are thought to be the cause of genetic disorders. For this purpose four tools were developed: a circle diagram, a coverage diagram, a karyotype diagram and an interaction heatmap. The software was written in Python and utilizes the framework Qt and associated Python-bindings for its graphical user interface, together with the library Matplotlib for some plotting functions. Although the tools feature a variety of functions and tie these together in an easy to use interface, there is still room for development. A number of suggestions for such development is discussed, such as implementing more functions, integrating the tools better with existing software, and improving portability through network functions.

<p>Examen i vårdadministration, YH-utbildning: 20 YH-poäng</p>

No description available.

Factitious disorder (FD) imposed on self is a psychiatric disorder characterized by the intentional feigning of symptoms or the self-inflicted production of symptoms in the absence of an obvious external reward. Previously known as Munchausen syndrome, this term is now reserved for severe, chronic, or dramatic cases. Multiple theories for the pathogenesis of FD have been proposed, but most studies point to the behaviors exhibited as a coping mechanism to address emotional stress and resolve unmet psychosocial needs. This case report describes a 31-year-old male who frequently presented to several Emergency Departments at hospitals within the Appalachian region with intentional ingestion of foreign objects. These scenarios ultimately required the patient to undergo approximately 32 esophagogastroduodenoscopy (EGD) and 28 gastroscopy procedures over the course of two years. The patient also had a significant history of suicide attempts by prescription medication overdose, although clinical workup and laboratory confirmation of such ingestion was varied. After two years of these frequent ED presentations, the patient was evaluated for FD upon voluntary admission to an inpatient psychiatric facility. Due to the need for anesthetic agents in the frequent EGD's performed on this patient, the possibility of drug-seeking as the motivating factor for this patient’s behavior and the possibility of a co-occurring substance use disorder were considered. Suicidality in FD and the lack of case reports and reliable research on the topic makes a challenging diagnosis and clinical course even more complex. Additionally, the clinical management of FD is unique, and no reliable studies have detailed an effective treatment plan. Thus, to add to the literature, the treatment and outcome to date for the patient presented here and the suicidal ideation and intentional overdoses complicating this case are discussed. Continued research and reporting of FD cases will help guide clinicians in the treatment and management of this challenging diagnosis.