Huvudsyftet med denna studie är att undersöka om medelstora till stora företag inom svensk industri känner till begreppet Ansvarsfull Forskning & Innovation och om dessa företag använder detta verktyg eller något liknande verktyg i sina innovationsprocesser med koppling till hållbarhet.  Samt undersöka potentialen för standardisering av RRI. Denna uppsats använder en kvalitativ metod med intervjuer som är semistrukturerade för att samla in data. Efter att ha analyserat insamlade data och teoretiska referensramverk som resulterat i slutsatsen att det finns goda förutsättningar för standardisering av RRI i svensk industri finns det också faktorer som försvårar implementeringen. När det gäller ”CSR vs RRI” visar denna studie att CSR får mer status i svenska industrier än RRI. För framtida arbete med denna fråga rekommenderar denna studie att identifiera orsaken till den osäkerhet som cirkulerar implementeringen av RRI-verktyg, och även att undersöka om denna osäkerhet finns inom företagets ramar eller om det är själva verktyget som är ofullständigt.

Arbetet ger en översikt av litteratur kring kunskapsuttnyttjande, forskning och skolutveckling samt kring handledning, profession, tidsbrist och bemötande. Vi har intervjuat blivande specialpedagoger. Med hjälp av svaren har vi fått reda på vilka önskemål om skolutveckling de har, nu och i framtiden och vilka hinder och svårigheter de har sett i sin verksamhet. Vi har inriktat frågorna på forskning och kunskapsuttnyttjande.

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Bakgrund: Osteoartrit (OA), även kallat artros, är en av de vanligaste ledsjukdomarna i världen. Sjukdomen innebär för individen inskränkt rörlighet, smärta och stelhet till följd av en förlust och degeneration av lednära strukturer. Artrosskolan tillhandahåller grundbehandling för sjukdomen vilket innebär patientutbildning och träning med stark evidens gällande effekter på smärta och funktion. Egenvård är den hantering av sjukdomsförloppet som sker dag till dag av individen, detta är en viktig del för patientgruppen då sjukdomen är kronisk och livslång. Svenska artrosregistret för statistik på patienterna från artrosskolan och jämför de med Socialstyrelsens kliniska riktlinjer och de personcentrerade och sammanhållna vårdförloppens uppsatta mål för patientgruppen. Utöver enkätformulär från artrosskolan finns det ingen studie i Sverige som ger en nyanserad bild av patienters erfarenheter av egenvård flera månader efter deltagande i artrosskolan. Syfte: Syftet med studien var att beskriva upplevelser och erfarenheter av egenvård hos patienter med osteoartrit 9 månader efter deltagande i artrosskola. Metod: Åtta patienter med OA rekryterades från en rehabenhet i region Östergötland där de tidigare genomgått artrosskolan. Informanterna intervjuades individuellt med en semistrukturerad intervjuguide och innehållsanalys med induktiv ansats användes som analysmetod. Resultat: Informanternas svar delades in 16 subkategorier och följande 5 huvudkategorier: erfarenheter som främjar egenvård, föreställningar om effekter av egenvård, negativa upplevelser av egenvård, egna strategier för egenvård i vardagen samt tankar och upplevelser av artrosskolan. Konklusion: En ökad förståelse för sjukdom och behandling, en personlig och social motivation, samt egna strategier i vardagen men även negativa upplevelser som hindrande faktorer eller dålig behandlingseffekt var erfarenheter av egenvård vid OA som informanterna beskrev.

<p>The purpose of this work was to: a) Determine whether the amount of colour in a power Doppler image is dependent on the angle between the examined vessel and the soundbeam and/or on the velocity of the flow within the vessel; b) Investigate if a dependency on flow velocity could be used for the detection of volume flow differences and c) Define clinical applications utilising the improved sensitivity to low flow of PD.</p><p>In the experimental studies (study I and II) a silicon tube in a water bath was insonated, the insonation angle and the volume flow changed and the resulting images stored, transferred to a personal computer and analysed with regard to the amount of colour present in the image.</p><p>In study III and IV the ability of power Doppler to depict low flow was used to produce a map of the perfusion in well perfused organs, lack of colour in all or part of an organ taken as a sign of decreased perfusion. 150 patients with a renal transplant (study III) and 15 patients with abdominal trauma (study IV) were examined; the detected areas of decreased perfusion were correlated to other imaging modalities, laboratory and clinical records in order to determine the underlying pathology.</p><p>In study V the power Doppler sensitivity was used to look for and describe small portosystemic shunts in 141 patients with liver cirrhoses and suspected portal hypertension.</p><p>The colour representation in a power Doppler image was found to be dependent both on the insonation angle and the flow velocity. Computer analysis of the images could detect differences in volume flow down to a change of 10 ml/min.</p><p>Of the 150 renal transplants, areas of decreased perfusion were found in 12, all of which could be given a plausible explanation (2 focal infections, 4 AV fistulae, 1 kinked segmental artery and 5 with problems related to an accessory artery).</p><p>Of the 20 organs (7 livers and 13 spleens) examined in the 15 trauma patients, 5 were found to have areas without colour, corresponding to localised haematomas. Using computed tomography as gold standard, ultrasound showed neither false positive nor false negative findings.</p><p>Of the 141 patients with cirrhosis, 40 had Doppler ultrasound findings of a shunt, consistent with a portal hypertension. 7 of these 40 shunts showed a typical “ball ” or “corkscrew ” pattern.</p><p>Conclusion: The colour in a power Doppler image is dependent not only on reflector concentration (as it should be in theory) but also on the insonation angle and the velocity of the flow. This can be used to detect relative changes in volume flow. Clinical applications of power Doppler include mapping of organ perfusion and the detection of small vessels. These applications are based on the high sensitivity of power Doppler.</p>

<p>Percutaneous nephrostomy (PCN) is a well-established intervention performed to divert urine from the collecting system in ureteric obstruction or as a prelude to interventional procedures such as stent placement or percutaneous nephrolithotripsy (PCNL). The aim of this thesis is to enhance planning for an optimal insertion of PCN, investigate complications, long-term management, follow-up and outcome in patients with PCN treatment and to increase accuracy in CT-guided punctures.</p><p>To enhance planning for an optimal insertion of PCN prior to PCNL, biomodels from CT data were performed. Eight patients with complex urinary calculi were selected. Multislice CT of the kidney was performed and the CT data were transformed into a biomodel. The biomodels visualised unique structures before surgery, which aided the planning of endourological procedures.</p><p>PCNL is an essential procedure for treating complex urinary calculi. A subcostal approach is preferred to avoid laceration to the lung and pleura. However, a supracostal approach is often preferable, as it gives a better passage to the renal pelvis. The nature and frequency of complications after supra- versus subcostal punctures were studied in 85 patients treated with PCNL. In 63 patients, a subcostal track was established. In 22, a supracostal puncture was chosen. The main difference in preoperative complications was the higher number of patients in the supracostal group complaining of respiratory correlated pain (32%). In the subcostal group, this was (5%). </p><p>401 patients were reviewed retrospectively regarding underlying disease, subsequent management and complications of PCN treatment. The number of major complications was 4%. Minor complications were recorded in 38%, urinary tract infection being the most common. 151/401patients suffered from malignancy. 84/151 of the malignant patients died with the catheter. The median survival time of the patients with malignancies was 255 days and the median catheterisation time was 62 days. </p><p>In order to increase accuracy when performing CT guided punctures, a new puncture guide was evaluated. In 15/17 patients the puncture was successful on the first attempt. The benefits of the puncture guide were the artefact from the needle guide pointing at the target indicating the puncture path and the needle support enhancing an accurate puncture.</p>

<p>The purpose of this thesis was to investigate the utility of the Ultrasmall Superparamagnetic Iron Oxide Particle (USPIO), NC100150 Injection for assessment of macro- and microvascular morphology and function using magnetic resonance imaging. The feasibility of NC100150 Injection was tested for the following applications: Coronary angiography, Thrombus detection, Cardiac function, Myocardial perfusion, Assessment of myocardial blood volume and water exchange and finally assessment of endothelial integrity of the myocardium.</p><p>The test method included computer simulations, in vitro, animal and clinical experiments. The computer simulations included propagation of longitudinal magnetization in non-steady state acquisitions. Animal models used were coronary artery stenosis in pigs, thrombus formation in the jugular vein in pigs, normal pig myocardium and transplanted hearts in rats. A human study of patients with suspected coronary artery disease was also performed.</p><p>The results showed that angiography using an USPIO is less efficient in the coronary arteries than in the peripheral arteries. Direct targeting to thrombus using an USPIO is possible but will be limited by the spatial resolution. An USPIO will enhance gradient echo imaging of cardiac function. T2-weighted myocardial perfusion imaging is feasible as well as assessment of myocardial blood volume and endothelial integrity.</p><p>Due to physiological limitations and technical development the utility of NC100150 Injection for assessment of the macrovascular morphology is limited.However for the assessment of microvascular function, especially perfusion and permeability, NC100150 Injection may contribute to a successful implementation of these methods.</p>

The purpose of this work was to: a) Determine whether the amount of colour in a power Doppler image is dependent on the angle between the examined vessel and the soundbeam and/or on the velocity of the flow within the vessel; b) Investigate if a dependency on flow velocity could be used for the detection of volume flow differences and c) Define clinical applications utilising the improved sensitivity to low flow of PD. In the experimental studies (study I and II) a silicon tube in a water bath was insonated, the insonation angle and the volume flow changed and the resulting images stored, transferred to a personal computer and analysed with regard to the amount of colour present in the image. In study III and IV the ability of power Doppler to depict low flow was used to produce a map of the perfusion in well perfused organs, lack of colour in all or part of an organ taken as a sign of decreased perfusion. 150 patients with a renal transplant (study III) and 15 patients with abdominal trauma (study IV) were examined; the detected areas of decreased perfusion were correlated to other imaging modalities, laboratory and clinical records in order to determine the underlying pathology. In study V the power Doppler sensitivity was used to look for and describe small portosystemic shunts in 141 patients with liver cirrhoses and suspected portal hypertension. The colour representation in a power Doppler image was found to be dependent both on the insonation angle and the flow velocity. Computer analysis of the images could detect differences in volume flow down to a change of 10 ml/min. Of the 150 renal transplants, areas of decreased perfusion were found in 12, all of which could be given a plausible explanation (2 focal infections, 4 AV fistulae, 1 kinked segmental artery and 5 with problems related to an accessory artery). Of the 20 organs (7 livers and 13 spleens) examined in the 15 trauma patients, 5 were found to have areas without colour, corresponding to localised haematomas. Using computed tomography as gold standard, ultrasound showed neither false positive nor false negative findings. Of the 141 patients with cirrhosis, 40 had Doppler ultrasound findings of a shunt, consistent with a portal hypertension. 7 of these 40 shunts showed a typical “ball ” or “corkscrew ” pattern. Conclusion: The colour in a power Doppler image is dependent not only on reflector concentration (as it should be in theory) but also on the insonation angle and the velocity of the flow. This can be used to detect relative changes in volume flow. Clinical applications of power Doppler include mapping of organ perfusion and the detection of small vessels. These applications are based on the high sensitivity of power Doppler.

Percutaneous nephrostomy (PCN) is a well-established intervention performed to divert urine from the collecting system in ureteric obstruction or as a prelude to interventional procedures such as stent placement or percutaneous nephrolithotripsy (PCNL). The aim of this thesis is to enhance planning for an optimal insertion of PCN, investigate complications, long-term management, follow-up and outcome in patients with PCN treatment and to increase accuracy in CT-guided punctures. To enhance planning for an optimal insertion of PCN prior to PCNL, biomodels from CT data were performed. Eight patients with complex urinary calculi were selected. Multislice CT of the kidney was performed and the CT data were transformed into a biomodel. The biomodels visualised unique structures before surgery, which aided the planning of endourological procedures. PCNL is an essential procedure for treating complex urinary calculi. A subcostal approach is preferred to avoid laceration to the lung and pleura. However, a supracostal approach is often preferable, as it gives a better passage to the renal pelvis. The nature and frequency of complications after supra- versus subcostal punctures were studied in 85 patients treated with PCNL. In 63 patients, a subcostal track was established. In 22, a supracostal puncture was chosen. The main difference in preoperative complications was the higher number of patients in the supracostal group complaining of respiratory correlated pain (32%). In the subcostal group, this was (5%). 401 patients were reviewed retrospectively regarding underlying disease, subsequent management and complications of PCN treatment. The number of major complications was 4%. Minor complications were recorded in 38%, urinary tract infection being the most common. 151/401patients suffered from malignancy. 84/151 of the malignant patients died with the catheter. The median survival time of the patients with malignancies was 255 days and the median catheterisation time was 62 days. In order to increase accuracy when performing CT guided punctures, a new puncture guide was evaluated. In 15/17 patients the puncture was successful on the first attempt. The benefits of the puncture guide were the artefact from the needle guide pointing at the target indicating the puncture path and the needle support enhancing an accurate puncture.

The purpose of this thesis was to investigate the utility of the Ultrasmall Superparamagnetic Iron Oxide Particle (USPIO), NC100150 Injection for assessment of macro- and microvascular morphology and function using magnetic resonance imaging. The feasibility of NC100150 Injection was tested for the following applications: Coronary angiography, Thrombus detection, Cardiac function, Myocardial perfusion, Assessment of myocardial blood volume and water exchange and finally assessment of endothelial integrity of the myocardium. The test method included computer simulations, in vitro, animal and clinical experiments. The computer simulations included propagation of longitudinal magnetization in non-steady state acquisitions. Animal models used were coronary artery stenosis in pigs, thrombus formation in the jugular vein in pigs, normal pig myocardium and transplanted hearts in rats. A human study of patients with suspected coronary artery disease was also performed. The results showed that angiography using an USPIO is less efficient in the coronary arteries than in the peripheral arteries. Direct targeting to thrombus using an USPIO is possible but will be limited by the spatial resolution. An USPIO will enhance gradient echo imaging of cardiac function. T2-weighted myocardial perfusion imaging is feasible as well as assessment of myocardial blood volume and endothelial integrity. Due to physiological limitations and technical development the utility of NC100150 Injection for assessment of the macrovascular morphology is limited.However for the assessment of microvascular function, especially perfusion and permeability, NC100150 Injection may contribute to a successful implementation of these methods.