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  • 100401.
    Öhlund, Carl
    et al.
    Central Hospital, Jönköping, Sweden.
    Fransson, Sven-Göran
    Central Hospital, Jönköping, Sweden.
    Starck, Sven-Åke
    Central Hospital, Jönköping, Sweden.
    Calf compression for prevention of thromboembolism following hip surgery1983In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 54, no 6, p. 896-899Article in journal (Refereed)
    Abstract [en]

    A prospective, randomized trial of the effect of graded compression of the calf was done in 62 patients operated on electively for hip disease. After total hip arthroplasty, compression reduced the number of positive fibrinogen uptake tests by two-thirds, significant only in males, who seem to run a higher risk of thrombosis than females.

  • 100402.
    Öhlund, Elinor
    et al.
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Wang, William
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Phung, Gullis
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Olsson, Jonas
    Lundqvist, Felix
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Hultberg, Dag
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Fixcher, Max
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Back, Hampus
    Linköping University, Department of Computer and Information Science. Linköping University, Faculty of Science & Engineering.
    Design och implementation av en e-butik med en personifierbar produkt för att uppnå nytta och effektivitet: Utveckling av e-butiken Coffe Creation2017Independent thesis Basic level (degree of Bachelor), 12 credits / 18 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study is to find factors that enhances the usability of an e-commerce with customizable products in terms of usefulness and effectiveness/efficiency. The process which has been used to reach the end product is an iteration-based user-centered design method in which the developers have had a continuous dialogue with the end users. The design choices that have been made are based on user test feedback. Five factors of importance to achieve usefulness and effectiveness/efficiency for an e-commerce website that sell customizable products have emerged from the study.  It has been shown that both usefulness and effectiveness/efficiency are affected by the presented functionality and purpose of the application. The users understanding of how a certain choice will affect a customizable product is connected with usefulness. The applications capability to inform the user of the information found on the e-shop need to have a proper structure to achieve effectiveness/efficiency. The last factor is related to the buying process, it is shown that the usefulness can be improved if there is a possibility to select products without the need to create a custom product from scratch.

  • 100403.
    Öhlund, Sten-Erik
    Linköping University, Department of Management and Engineering. Linköping University, Faculty of Arts and Sciences.
    Interoperability Capability to interoperate in a shared work practice using information infrastructures: studies in ePrescribing2017Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The ability to interoperate between systems, people, and organizations is considered an important issue within eHealth in order to deliver patient centered care. The achieving and improving of interoperability is a complex undertaking involving the evolution of an information infrastructure, sharing of knowledge and resources, governance of the interoperation between organizations, people and work practices, and handling of economic and legal matters.

    This thesis contributes with practical knowledge on improving interoperability, based on active participation in and empirical studies of improving interoperability in ePrescribing. A case study describes and analyzes the evolution of ePrescribing in Sweden since the early pioneering years in 1980s, its growth and consolidation before the reregulation of the pharmacy market in 2009. Apractical theory on ePrescribing is presented. A unique field experimental study measuring improvement of interoperability in ePrescribing, before and after a major intervention to improve the quality of ePrescriptions between 2004 and 2009 is presented.

    Furthermore, a practical theory on interoperation and interoperability is presented. Interoperability is seen as the exercised capability of organizations through their agents to interoperate in a shared work practice in an effective, efficient, and satisfactory manner based on a common ground in a mediated, prescriptive, and non-personal communicative setting using an information infrastructure for mediating interoperation.

  • 100404.
    Öhlund, Sten-Erik
    et al.
    Högskolan Kalmar.
    Goldkuhl, Göran
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Management and Engineering, VITS - Development of Informations Systems and Work Context.
    Towards a socio-pragmatic understanding of ePrescribing2008In: Intl Conference on Action in Language, Organisations and Information Systems ALOIS,2008, Uppsala: Uppsala universitet , 2008Conference paper (Refereed)
    Abstract [en]

    ePrescribing in Sweden covers over 65% of all prescriptions. ePrescribing is a highly regulated process with a high demand on availability and security in a complex communication situation with many systems and actors involved. It is an interaction between two markets, healthcare and pharmacy. The purpose of this work is to con-tribute to the development of models to analyse e-services. Three models are used to analyse ePrescribing: the Generic Exchange Model, the Generic Regulation Model and a socio-pragmatic communication framework. The conclusion of this application is that the models contributed to new essential insights and helped to focus on es-sential communication aspects. The analysis contributes to a better understanding of ePrescribing in a general, to be useful both for those who are working with developing ePrescription, taking into account the different legisla-tion and history of prescribing in their countries, and for policy makers who may want to turn the process of ePrescribing into a new direction.

  • 100405.
    Öhlund, Sten-Erik
    et al.
    Linköping University, Department of Management and Engineering, Information Systems. Linköping University, The Institute of Technology. eHealth Institute, Linnaeus University , Kalmar, Sweden.
    Åstrand, Bengt
    eHealth Institute, Linnaeus University, Kalmar, Sweden.
    Petersson, Göran
    eHealth Institute, Linnaeus University, Kalmar, Sweden.
    Improving interoperability in ePrescribing2012In: Interactive Journal of Medical Research, E-ISSN 1929-073X, Vol. 1, no 2, article id e17Article in journal (Refereed)
    Abstract [en]

    Background: The increased application of eServices in health care, in general, and ePrescribing (electronic prescribing) in particular, have brought quality and interoperability to the forefront. The application of standards has been put forward as one important factor in improving interoperability. However, less focus has been placed on other factors, such as stakeholders involvement and the measurement of interoperability. An information system (IS) can be regarded to comprise an instrument for technology-mediated work communication. In this study, interoperability refers to the interoperation in the ePrescribing process, involving people, systems, procedures and organizations. We have focused on the quality of the ePrescription message as one component of the interoperation in the ePrescribing process. Objective: The objective was to analyze how combined efforts in improving interoperability with the introduction of the new national ePrescription format (NEF) have impacted interoperability in the ePrescribing process in Sweden, with the focus on the quality of the ePrescription message. Methods: Consecutive sampling of electronic prescriptions in Sweden before and after the introduction of NEF was undertaken in April 2008 (pre-NEF) and April 2009 (post-NEF). Interoperability problems were identified and classified based on message format specifications and prescription rules. Results: The introduction of NEF improved the interoperability of ePrescriptions substantially. In the pre-NEF sample, a total of 98.6% of the prescriptions had errors. In the post-NEF sample, only 0.9% of the prescriptions had errors. The mean number of errors was fewer for the erroneous prescriptions: 4.8 in pre-NEF compared to 1.0 in post-NEF. Conclusions: We conclude that a systematic comprehensive work on interoperability, covering technical, semantical, professional, judicial and process aspects, involving the stakeholders, resulted in an improved interoperability of ePrescriptions.

  • 100406.
    Öhlén, J.
    et al.
    Göteborgs universitet.
    Carling Elofsson, L.
    Göteborgs universitet.
    Hydén, Lars-Christer
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute.
    Friberg, F.
    Göteborgs universitet.
    Exploration of communicative patterns of consultations in palliative cancer care2008In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 12, no 1, p. 44-52Article in journal (Refereed)
    Abstract [en]

    Building on the research conducted on institutional communication, and the analysis of actual communication taking place in clinical settings, this study describes and highlights features of palliative care consultations and focuses on the distribution of discursive space (i.e., share of words, lengths of turns), occurring topics and conversational frames. Six consultations between physicians, patients and significant others were videotaped and all participants took part in audio-taped interviews. The recordings were transcribed and analysed in regard to expectations of, the discursive space of, and topics addressed in the consultations. The distribution of the discursive space was unequal, the physicians had the greatest share of words and length of turns in all six consultations, and they mostly initiated discussion of medical issues connected to examinations and treatment, while only patients initiated the topic of the patient's future. During the consultations, institutional framing tended to dominate over client framing. There was found to be room for further study of the structure and content of palliative care consultations with emphasis on how the voice of the patient can manifest itself within the framework of the medical agenda of the consultation and its significance for palliative cancer team work. © 2007 Elsevier Ltd. All rights reserved.

  • 100407.
    Öhman, Andreas
    et al.
    Linköping University, Department of Electrical Engineering, Vehicular Systems.
    Jonsson, Oskar
    Linköping University, Department of Electrical Engineering, Vehicular Systems.
    Simulering och implementering av ett elektriskt motorsystem för minimering av hastighetvariationer2018Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med examensarbetet är att utse en lämplig ersättare för en motor i en av Saab Dynamics produkter. Den tidigare motorn är en synkronmotor av typen hysteresmotor och nu söks en billigare lösning med liknande prestanda. Applikationen kräver att motorn från stillastående ska kunna accelereras till 600 varv per minut på maximalt 0,5 sekunder. Efter 0,5 sekunder ska medelhastigheten per varv maximalt avvika med 0,2 promille. I utveckling av en ny lösning ingår val av motortyp, styrelektronik och givare samt design av regleralgoritmer. I rapporten beskrivs ett antal motorer som kan vara lämpliga ersättare till den tidigare motorn samt deras styrkor och svagheter. Sedan följer en undersökning och implementation av en av de lämpliga kandidaterna, en borstlös likströmsmotor. Val av givare och styrteknik för den motortypen beskrivs och motorns lämplighet undersöks i en modell skapad i Mathworks Simulinkmiljö där ett reglersystem implementeras. Simuleringar visa att den valda motorn är lämplig för en praktisk implementation. Slutligen beskrivs konstruktionen av en testuppställning som innefattar motor, givare och styrteknik implementerad i en processor som ställer ut strömmen till motorn för att uppnå önskad hastighet. Uppställningen uppfyller kravet i testkörningar och i den bästa körningen är hastighetsvariationerna 7,4 gånger mindre än det specificerade kravet.

  • 100408.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Josephsson, Staffan
    Karolinska Insitutet.
    Nygård, Louise
    Karolinska Institutet.
    Awareness through interaction in everyday occupations: experiences of people with Alzheimer's disease2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 1, p. 43-51Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe the characteristics of awareness of the consequences of having Alzheimer's disease on everyday life occupations. Six community-dwelling participants with Alzheimer's disease were interviewed on repeated occasions about their lived experiences of everyday occupations. A phenomenological method was adopted for the analysis. The findings show that the participants discovered and explored the changes in how they performed everyday occupations in the context of their social relations and through immediate reflections on their forgetfulness. They attempted to handle the changes by adapting their behaviour. Awareness of the changes in their lives was evident in their reflections, as they tried to make sense of what was happening to them. This seemed to be related to an elusive perception of change in situations that they found impossible to influence. The participants reflected on the impact their condition had on other people near them. Their reflections also involved emotional reactions to the shortcomings they experienced. In conclusion, the findings show how these people with Alzheimer's disease were able to express awareness of the consequences of their illness through their reflections on their experiences of interaction with the occupations and the social environment.Read More: http://informahealthcare.com/doi/abs/10.1080/11038120701441080

  • 100409.
    Öhman, Annika
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Medicine and Health Sciences.
    Nygård, Louise
    Karolinska Institutet.
    Meanings and motives for for engagement in self-chosen daily life occupations among individuals with Alzheimer's disease.2005In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 25, no 3, p. 89-97Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to uncover and describe the meanings and motives for engagement in self-chosen daily life occupations for elderly individuals with Alzheimer's disease dwelling in the community. Six participants with Alzheimer's disease were included. Data were collected through repeated interviews and observations focusing on their motives for their self-chosen occupational engagement and the significance of the daily occupations. The analysis used a qualitative comparative and interpretative method. The findings show that the participants' occupations supported their ordinary pattern of everyday life and provided them with an opportunity to be in a coherent context. The occupations also allowed them to experience and communicate autonomy and certain characteristics of their identity and provided them with a private sphere. The findings revealed certain crucial but double-edged environmental keys to occupation. By identifying and supporting everyday occupations with personal meaning and value, therapists and caregivers may contribute to the well-being of individuals with Alzheimer's disease living in their own homes.

  • 100410.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Karolinska Institutet.
    Nygård, Louise
    Karolinska Institutet.
    Borell, Lena
    Karolinska Institutet.
    The vocational situation in cases of memory deficits and younger-onset dementia.2001In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 15, no 1, p. 34-43Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe how persons with memory deficits or younger-onset dementia perceived and met their problems, with particular reference to their present and future vocational situation, including describing the parallel observations and attitudes of other significant persons in the vocational context. Data were collected through 16 interviews, one with each of nine subjects and seven respondents from the subjects' work-places. All interviews were analysed with a comparative method, searching for themes. In addition, subjects' IADL (instrumental activities of daily living) ability and cognition were assessed. The findings demonstrated that the subjects themselves experienced extensive difficulties before their predicament was defined. The difficulties were met by spontaneous and planned strategies on the part of the subjects and by adaptations at the workplaces, but with limited success. The situation also profoundly affected fellow workers. Overall, both the subjects and the work-place respondents had a positive attitude to continued work as long as the subjects made useful contributions. The possibility of remaining in work seemed to depend on multiple factors, including the individual's apprehension of his or her own ability and the length of the sick-leave.

  • 100411.
    Öhman, Annika
    et al.
    Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Nygård, Louise
    Karolinska Institutet.
    Kottorp, Anders
    Karolinska Institutet.
    Occupational performance and awareness of disability in mild cognitive impairment or dementia.2011In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, no 2, p. 133-142Article in journal (Refereed)
    Abstract [en]

    Limited awareness of disabilities is common in mild cognitive impairment and dementia. In order to get a broader base in planning interventions, it is important to consider a person's awareness of his/her disability encountered in performance. The aim of this study was to examine the relationship between occupational performance and awareness of disability in older adults with mild cognitive impairment or dementia. Thirty-five older adults were evaluated with the AMPS (Assessment of Motor and Process Skills) and with the AAD (Assessment of Awareness of Disability). Many-faceted Rasch models generated individual measures of ADL performance and awareness of disability. Non-parametric correlation statistics were used to analyse the relationships. The findings showed that there was an overall positive relationship between occupational performance and awareness of disability. However, individual variations in the sample implied that limitations in performance were not equivalent to a limited awareness of disability. In conclusion, awareness of disability should be individually evaluated when planning interventions together with clients and their families.Read More: http://informahealthcare.com/doi/abs/10.3109/11038121003645993

  • 100412.
    Öhman, Ann-Marie
    Linköping University, Department of Science and Technology. Linköping University, The Institute of Technology.
    Music Production; from idea to complete record2007Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This examination paper investigates how the producer assignment works focused on which musical questions that appears and how you make decisions for those. For several years I have tried to convince Kjell Öhman to make a Christmas record, and together we developed the idea of me producing one.

    I want to investigate which musical questions will arise in a music production project. Which musical decisions will be made in the process? What controls the decisions? In this report the following questions will be discussed; the genre of music, language, choice of songs, keys, arrangements, instruments and the organisation of songs.

    I have read literature about music psychology and musical processes while I have got practical experience by planning and implementing a music production. The result is a Christmas record with some Swedish jazz musicians.

    Music psychology could shortly be described as experiences related to music. Music is a living work of art and a communication process is appearing when we are involved with music. Music could be a symbol of emotion because it often symbolises feelings and affects our emotions. The structure of music is important to our emotion experience and there are many factors in music which affects our music experience.

    In January 2006 I contacted the contributory and they did all give me positive feedback. I searched for and brought song material while the arrangements were written by Kjell Öhman. We recorded in May 2006 and the musicians were all easy to co - operate with. It is important daring to make decisions when questions come up. This can be a challenge for someone who is a young and inexperienced producer but the communication between me, the sound engineer and the musicians were never a problem.

    I decided to make a Christmas record with in the genre of music called jazz, which could be identified as notes combined with improvisation – playing by ear. When deciding which musicians will be a part of the recording project, the contacts matters. Which instruments that will be used, is decided by the arrangements. The American range of Christmas songs decided the question of language and the choice of songs resulted into a mixture of known as well as unknown material. Arrangements were written to all the songs, keys are decided by the register of the instruments. An important establishment is the organisation of in which order the songs will sound on the record.

    One question is how much a producer shall let herself/himself be affected by others opinions.  There are thin lines between being sure of an answer and being open for others advice. To dare to stand up for a decision was no hard for me thanks to professional and helpful musicians. It is important to be clear in a leadership, otherwise the leader may not be taken  seriously. The most important question is how you make good and “right” decisions to people that already are professional. I have tried and this is the result, the record we have done is called “Walking in a Winter Wonderland”.

  • 100413.
    Öhman, Daniel
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Bioanalytical development for application in therapeutic drug monitoring: focus on drugs used in psychiatry2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Since the 1950s and onwards, many new psychoactive drugs have been successfully introduced in clinical practice. A common feature of these drugs is a profound metabolism before clearance from the body. Genetic and phenotypic factors among patients can be anticipated to interact with the metabolism and therefore a major variance in the drug concentration between patients upon the same dose may be found. In later years there has been an increasing awareness, that the individual drug metabolism and drug body disposition do not only refer to the parent compound and major metabolites but also to the separate enantiomers in the case of chiral drugs.

    Bioanalytical methods for determination of drug concentrations have constantly been developed to assess the large pharmacokinetic variability of these drugs. Moreover, in the psychopharmacological practice these methods are often extended into a "Therapeutic Drug Monitoring (TDM) Service". A TDM service is used to determine the patient-specific drug analytical outcome in order to assess the precision in dose prescription as well as to recommend adequate dose adjustments for a particular patient.

    Aim: The aim was to develop bioanalytical methods, utilising high performance liquid chromatography, for serum determinations in patients under chronic dosing schedules for some recently introduced drugs used in psychiatry.

    Firstly, for the antidepressant drug reboxetine by an achiral methodology (paper I) consecutively extended to an enantioselective methodology for the individual enantiomers of the drug (paper II and III). Thereafter, after the evaluation of on-line extraction as an automated alternative to manually performed solid phase extraction for sample preparation (paper IV), apply on-line extraction in combination with ion-trap mass spectrometry detection for serum determination of the novel antipsychotic drug ziprasidone (paper V).

    Results and Conclusion: The methodology described in paper I has been applied on more than 500 patient samples from the naturalistic clinical practice as well as from controlled clinical trials. The methodology has proven robust and reliable and, although manually performed, easy to handle. The kinetic outcome display a great variability in concentration outcome even within the same prescribed dose, i.e. through level samples in steady-state were found to be 660±400 nM on 8 mg/day.

    Paper II, which describes the development of three approaches for direct chiral separation of reboxetine and O-deethylreboxetine enantiomers in the reversed phase mode, is in itself new and important. It is however, after applying MS2 detection, in paper III that the methodology is extended to include patients, i.e. patients from two separate clinical trials. Trial I comprised 23 patients on monotherapy with reboxetine and trial II comprised 47 patient from a naturalistic clinical setting. The pharrnacokinetic outcome displayed a S,S- over R,R-reboxetine ratio of about 0.5 with a rather pronounced inter-individual ratio (i.e. 0.2 to 0.9). The enantiomeric ratio did not correlate to the overall reboxetine concentration and the enantiomeric ratio was about 30% higher in females than in males. Repeated samples were analysed for trial I patients displaying an inter-individual coefficient of variation (CV) of about 17% meanwhile the intra-individual CV was about 4%. Calculating the noradrenaline reuptake inhibition (NARI) -activity out of the individual enantiomeric ratios showed that females may have a higher NARI-activity than males at a given reboxetine concentration.

    Paper IV proves that online extraction offers a robust, reliable and, for the analyst, time saving alternative (above 80%) to manually performed off-line solid phase extraction for sample preparation (citalopram and its demethylated metabolites were used as model substances).

    Paper V describes the development of a TDM process for ziprasidone and its S-methylated metabolite. The sample handling as well as the analytical process was subjected to a solid and satisfactory validation. It was proved that the lack of selectivity during on-line extraction can be compensated for by a selective form of detection, i.e. mass spectrometric detection.

    List of papers
    1. Bioanalysis of racemic reboxetine and its desethylated metabolite in a therapeutic drug monitoring setting using solid phase extraction and HPLC
    Open this publication in new window or tab >>Bioanalysis of racemic reboxetine and its desethylated metabolite in a therapeutic drug monitoring setting using solid phase extraction and HPLC
    2001 (English)In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 23, no 1, p. 27-34Article in journal (Refereed) Published
    Abstract [en]

    Reboxetine isa new antidepressant drug acting as a potent and selective noradrenaline reuptake inhibitor on the noradrenergic neuronal system. Because of an expected interindividual variability in drug metabolism in the clinical practice the need for therapeutic drug monitoring routines in psychiatry is always a prominent feature. In this application, the preferred bioanalytic methodology was solid phase extraction combined with reversed-Phase high-Performance liquid chromatography and ultraviolet detection at 210 nm. The technique proved reliable, with interday and intraday variation of less than 5% and a quantification limit for reboxetine and one of its main metabolites O-Desethylreboxetine (O-Reboxetine) at 5 and 30 nmol/L, respectively. The method was applied on serum samples from 38 patients treated chronically with reboxetine. These samples were drawn as trough levels in steady state with a dosage range of 2-16 mg/day. They evidenced a mean reboxetine concentration that was fairly linear and dose proportional, although the variance in concentration was large between patients, even those taking the same dosage. O-Reboxetine was detected in quantifiable amounts in only 1 of the 38 patients (<3%). In conclusion, these results suggest that a routine reboxetine therapeutic drug monitoring service that is robust enough to produce reliable and reproducible results may be introduced into everyday clinical practice.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27057 (URN)10.1097/00007691-200102000-00006 (DOI)11206039 (PubMedID)11703 (Local ID)11703 (Archive number)11703 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Simultaneous determination of reboxetine and O-desethylreboxetine enantiomers using enantioselective reversed-phase high-performance liquid chromatography
    Open this publication in new window or tab >>Simultaneous determination of reboxetine and O-desethylreboxetine enantiomers using enantioselective reversed-phase high-performance liquid chromatography
    2002 (English)In: Journal of Chromatography A, ISSN 0021-9673, E-ISSN 1873-3778, Vol. 947, no 2, p. 247-254Article in journal (Refereed) Published
    Abstract [en]

    Current knowledge of stereoselective pharmacokinetics and different potencies of drug enantiomers requires the performance of stereoselective analysis during therapeutic drug monitoring in clinical practice. However, in the case of the new antidepressant drug reboxetine, no effort has been made so far to find a such a suitable system. Therefore, as a step towards developing an enantioselective bioanalytical method for reboxetine and the O-desethylreboxetine metabolite, three stereoselective chromatographic approaches have been investigated. Several chiral columns were tested, among them Chiral-AGP, ChiraGrom 2 and Chiral-CBH, which were able to simultaneously separate the two compounds into enantiomers in total running times of 28, 18 and 12 min, respectively.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27058 (URN)10.1016/S0021-9673(02)00012-2 (DOI)11704 (Local ID)11704 (Archive number)11704 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Determination of serum reboxetine enantiomers in patients on chronic medication with racemic reboxetine
    Open this publication in new window or tab >>Determination of serum reboxetine enantiomers in patients on chronic medication with racemic reboxetine
    2003 (English)In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 25, no 2, p. 174-182Article in journal (Refereed) Published
    Abstract [en]

    The chiral compound reboxetine is used as a selective noradrenaline re-uptake inhibitor (NARI) for the treatment of major depressive disorders. The pharmacokinetic variability of the enantiomers of the drug (S,S- and R,R-reboxetine) was studied using stereoselective high-performance liquid chromatography with mass spectrometric detection in a controlled clinical monotherapy situation (trial I) and a naturalistic clinical setting (trial II). Trial I included patients receiving racemic reboxetine as 6-month monotherapy for treatment of major depressive disorder. Trough level serum samples in steady state were analyzed for the concentration of the reboxetine enantiomers in study weeks 4, 12, and 24. In a therapeutic drug monitoring setting (trial II), 47 patients on doses ranging from 4 to 16 mg daily, including much polypharmacy, trough level steady-state serum samples were analyzed by the same bioanalytical method. Data from trials I and II were assessed to determine the inter- and intraindividual pharmacokinetic outcomes. The results showed that the median S,S/R,R ratio in steady state was 0.5 and ranged from 0.22 to 0.88. It was also shown that women have an approximately 30% higher S,S/R,R ratio than men. The S,S/R,R ratios of reboxetine were not found to correlate with reboxetine concentrations. To investigate the NARI activity of a circulating serum reboxetine concentration, a recalculation of the determined enantiomeric concentrations to previously demonstrated experimental NARI potencies of the drug enantiomers was performed. This partly novel concept of estimating pharmacodynamic activity showed that the serum NARI activity in women tended to be higher than in men at a given reboxetine concentration. In conclusion, the variability in the NARI activity per nmol/L reboxetine and the variability in the concentration outcome of the reboxetine enantiomers may justify the use of enantioselective drug monitoring in the clinic. The gender aspects of the drug have to be further assessed.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26798 (URN)10.1097/00007691-200304000-00006 (DOI)11406 (Local ID)11406 (Archive number)11406 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. On-line extraction using an alkyl-diol silica precolumn for racemic citalopram and its metabolites in plasma: results compared with solid-phase extraction methodology
    Open this publication in new window or tab >>On-line extraction using an alkyl-diol silica precolumn for racemic citalopram and its metabolites in plasma: results compared with solid-phase extraction methodology
    2001 (English)In: Journal of Chromatography B: Biomedical Sciences and Applications, ISSN 1387-2273, E-ISSN 1878-5603, Vol. 753, no 2, p. 365-373Article in journal (Refereed) Published
    Abstract [en]

    Sample preparation is usually the most critical and time consuming step when using HPLC for drug analysis in biological matrixes. Sample extracts have to be clean considering both chromatographic interferences and column maintenance. To meet some of these criteria a fully automated on-line extraction (OLE) analysis method was developed for the antidepressant drug citalopram and its two demethylated metabolites, using an RP-C4-ADS extraction column. A comparison between the new OLE method and an off-line solid-phase extraction method showed that the two methodologies were equal in analytical precision but that the OLE method was faster and therefore superior in sample capacity per day.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26834 (URN)10.1016/S0378-4347(00)00579-X (DOI)11449 (Local ID)11449 (Archive number)11449 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Biolanalysis of ziprasidone and its S-methylated metabolite in serum using on-line extraction and liquid chromatography-masspectrometry
    Open this publication in new window or tab >>Biolanalysis of ziprasidone and its S-methylated metabolite in serum using on-line extraction and liquid chromatography-masspectrometry
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    The novel antipsychotic agent Ziprasidone, (Zip) was introduced for clinical prescription in Sweden in the early spring of 2001. As of yet, no bioanalytical procedure suitable for a Therapeutic Drug Monitoring (TDM)-service of the drug has been presented. Therefore a bioanalytical methodology utilising online extraction on RP-C4-ADS columns combined with ion-trap masspectrometric detection for determination of Zip and its S-methylated metabolite (Smd-Zip) was developed. The stability of the analytes in serum was determined for establishing a correct sample handling procedure.

    The calibration model for Zip and Smd-Zip had a linear response function in the concentration range 20 to 500 and 15 to 300 nM, respectively. The intra- and inter-day coefficient of variance was below 10% for all calibrator levels for both Zip and Smd-Zip. Validation of the sample handling procedure showed that samples are stable in room temperature or refrigerator for 3 days. Repeated freeze/thaw cycles, for five times did not affect the Zip or Smd-Zip concentration. In essence these findings state the importance of a correct sampling procedure for a functional ID M-procedure.

    The TDM-procedure was applied on 10 patient serum samples obtained from a naturalistic clinical setting. The obtained concentrations, ranging from 66 to 432 nM for Zip and 42 to 220 nM for Smd-Zip were within the dynamic range of the present methodology. Thus, a future utility for this newly developed method in a TDM-setting seems evident.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84595 (URN)
    Available from: 2012-10-15 Created: 2012-10-15 Last updated: 2012-10-15Bibliographically approved
  • 100414.
    Öhman, Daniel
    et al.
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Björkman, Helena
    Department of Analytical Chemistry, Stockholm University, Stockholm, Sweden.
    Bengtsson, Finn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Biolanalysis of ziprasidone and its S-methylated metabolite in serum using on-line extraction and liquid chromatography-masspectrometryManuscript (preprint) (Other academic)
    Abstract [en]

    The novel antipsychotic agent Ziprasidone, (Zip) was introduced for clinical prescription in Sweden in the early spring of 2001. As of yet, no bioanalytical procedure suitable for a Therapeutic Drug Monitoring (TDM)-service of the drug has been presented. Therefore a bioanalytical methodology utilising online extraction on RP-C4-ADS columns combined with ion-trap masspectrometric detection for determination of Zip and its S-methylated metabolite (Smd-Zip) was developed. The stability of the analytes in serum was determined for establishing a correct sample handling procedure.

    The calibration model for Zip and Smd-Zip had a linear response function in the concentration range 20 to 500 and 15 to 300 nM, respectively. The intra- and inter-day coefficient of variance was below 10% for all calibrator levels for both Zip and Smd-Zip. Validation of the sample handling procedure showed that samples are stable in room temperature or refrigerator for 3 days. Repeated freeze/thaw cycles, for five times did not affect the Zip or Smd-Zip concentration. In essence these findings state the importance of a correct sampling procedure for a functional ID M-procedure.

    The TDM-procedure was applied on 10 patient serum samples obtained from a naturalistic clinical setting. The obtained concentrations, ranging from 66 to 432 nM for Zip and 42 to 220 nM for Smd-Zip were within the dynamic range of the present methodology. Thus, a future utility for this newly developed method in a TDM-setting seems evident.

  • 100415.
    Öhman, Daniel
    et al.
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Cherma Yeste, Maria Dolores
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Norlander, Björn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Bengtsson, Finn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Determination of serum reboxetine enantiomers in patients on chronic medication with racemic reboxetine2003In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 25, no 2, p. 174-182Article in journal (Refereed)
    Abstract [en]

    The chiral compound reboxetine is used as a selective noradrenaline re-uptake inhibitor (NARI) for the treatment of major depressive disorders. The pharmacokinetic variability of the enantiomers of the drug (S,S- and R,R-reboxetine) was studied using stereoselective high-performance liquid chromatography with mass spectrometric detection in a controlled clinical monotherapy situation (trial I) and a naturalistic clinical setting (trial II). Trial I included patients receiving racemic reboxetine as 6-month monotherapy for treatment of major depressive disorder. Trough level serum samples in steady state were analyzed for the concentration of the reboxetine enantiomers in study weeks 4, 12, and 24. In a therapeutic drug monitoring setting (trial II), 47 patients on doses ranging from 4 to 16 mg daily, including much polypharmacy, trough level steady-state serum samples were analyzed by the same bioanalytical method. Data from trials I and II were assessed to determine the inter- and intraindividual pharmacokinetic outcomes. The results showed that the median S,S/R,R ratio in steady state was 0.5 and ranged from 0.22 to 0.88. It was also shown that women have an approximately 30% higher S,S/R,R ratio than men. The S,S/R,R ratios of reboxetine were not found to correlate with reboxetine concentrations. To investigate the NARI activity of a circulating serum reboxetine concentration, a recalculation of the determined enantiomeric concentrations to previously demonstrated experimental NARI potencies of the drug enantiomers was performed. This partly novel concept of estimating pharmacodynamic activity showed that the serum NARI activity in women tended to be higher than in men at a given reboxetine concentration. In conclusion, the variability in the NARI activity per nmol/L reboxetine and the variability in the concentration outcome of the reboxetine enantiomers may justify the use of enantioselective drug monitoring in the clinic. The gender aspects of the drug have to be further assessed.

  • 100416.
    Öhman, Daniel
    et al.
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Norlander, Björn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Carlsson, Björn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    On-line extraction using an alkyl-diol silica precolumn for racemic citalopram and its metabolites in plasma: results compared with solid-phase extraction methodology2001In: Journal of Chromatography B: Biomedical Sciences and Applications, ISSN 1387-2273, E-ISSN 1878-5603, Vol. 753, no 2, p. 365-373Article in journal (Refereed)
    Abstract [en]

    Sample preparation is usually the most critical and time consuming step when using HPLC for drug analysis in biological matrixes. Sample extracts have to be clean considering both chromatographic interferences and column maintenance. To meet some of these criteria a fully automated on-line extraction (OLE) analysis method was developed for the antidepressant drug citalopram and its two demethylated metabolites, using an RP-C4-ADS extraction column. A comparison between the new OLE method and an off-line solid-phase extraction method showed that the two methodologies were equal in analytical precision but that the OLE method was faster and therefore superior in sample capacity per day.

  • 100417.
    Öhman, Daniel
    et al.
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Norlander, Björn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Peterson, Curt
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Bengtsson, Finn
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Bioanalysis of racemic reboxetine and its desethylated metabolite in a therapeutic drug monitoring setting using solid phase extraction and HPLC2001In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 23, no 1, p. 27-34Article in journal (Refereed)
    Abstract [en]

    Reboxetine isa new antidepressant drug acting as a potent and selective noradrenaline reuptake inhibitor on the noradrenergic neuronal system. Because of an expected interindividual variability in drug metabolism in the clinical practice the need for therapeutic drug monitoring routines in psychiatry is always a prominent feature. In this application, the preferred bioanalytic methodology was solid phase extraction combined with reversed-Phase high-Performance liquid chromatography and ultraviolet detection at 210 nm. The technique proved reliable, with interday and intraday variation of less than 5% and a quantification limit for reboxetine and one of its main metabolites O-Desethylreboxetine (O-Reboxetine) at 5 and 30 nmol/L, respectively. The method was applied on serum samples from 38 patients treated chronically with reboxetine. These samples were drawn as trough levels in steady state with a dosage range of 2-16 mg/day. They evidenced a mean reboxetine concentration that was fairly linear and dose proportional, although the variance in concentration was large between patients, even those taking the same dosage. O-Reboxetine was detected in quantifiable amounts in only 1 of the 38 patients (<3%). In conclusion, these results suggest that a routine reboxetine therapeutic drug monitoring service that is robust enough to produce reliable and reproducible results may be introduced into everyday clinical practice.

  • 100418.
    Öhman, Daniel
    et al.
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Norlander, Björn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Peterson, Curt
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Faculty of Health Sciences.
    Bengtsson, Finn
    Linköping University, Department of Medicine and Care, Clinical Pharmacology. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Simultaneous determination of reboxetine and O-desethylreboxetine enantiomers using enantioselective reversed-phase high-performance liquid chromatography2002In: Journal of Chromatography A, ISSN 0021-9673, E-ISSN 1873-3778, Vol. 947, no 2, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Current knowledge of stereoselective pharmacokinetics and different potencies of drug enantiomers requires the performance of stereoselective analysis during therapeutic drug monitoring in clinical practice. However, in the case of the new antidepressant drug reboxetine, no effort has been made so far to find a such a suitable system. Therefore, as a step towards developing an enantioselective bioanalytical method for reboxetine and the O-desethylreboxetine metabolite, three stereoselective chromatographic approaches have been investigated. Several chiral columns were tested, among them Chiral-AGP, ChiraGrom 2 and Chiral-CBH, which were able to simultaneously separate the two compounds into enantiomers in total running times of 28, 18 and 12 min, respectively.

  • 100419.
    Öhman, Daniel
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Peterson, Curt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Clinical Pharmacology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pharmacology.
    Bengtsson, Finn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Development of a TDM-Method for determination of the neuroleptic compound Ziprasidone and its S-methylated main metabolite.2001In: Pharmacol Toxicol,2001, 2001, p. 133-133Conference paper (Refereed)
  • 100420.
    Öhman, Eva
    et al.
    Karolinska Institute, Sweden; Stockholm County Council, Sweden.
    Alinaghizadeh, Hassan
    Karolinska Institute, Sweden.
    Kaila, Paivi
    Karolinska Institute, Sweden.
    Hult, Håkan
    Linköping University, Department of Behavioural Sciences and Learning, Education and Adult Learning. Linköping University, Faculty of Educational Sciences.
    Nilsson, Gunnar H.
    Karolinska Institute, Sweden.
    Salminen, Helena
    Karolinska Institute, Sweden.
    Adaptation and validation of the instrument Clinical Learning Environment and Supervision for medical students in primary health care2016In: BMC Medical Education, ISSN 1472-6920, E-ISSN 1472-6920, Vol. 16, article id 308Article in journal (Refereed)
    Abstract [en]

    Background: Clinical learning takes place in complex socio-cultural environments that are workplaces for the staff and learning places for the students. In the clinical context, the students learn by active participation and in interaction with the rest of the community at the workplace. Clinical learning occurs outside the university, therefore is it important for both the university and the student that the student is given opportunities to evaluate the clinical placements with an instrument that allows evaluation from many perspectives. The instrument Clinical Learning Environment and Supervision (CLES) was originally developed for evaluation of nursing students clinical learning environment. The aim of this study was to adapt and validate the CLES instrument to measure medical students perceptions of their learning environment in primary health care. Methods: In the adaptation process the face validity was tested by an expert panel of primary care physicians, who were also active clinical supervisors. The adapted CLES instrument with 25 items and six background questions was sent electronically to 1,256 medical students from one university. Answers from 394 students were eligible for inclusion. Exploratory factor analysis based on principal component methods followed by oblique rotation was used to confirm the adequate number of factors in the data. Construct validity was assessed by factor analysis. Confirmatory factor analysis was used to confirm the dimensions of CLES instrument. Results: The construct validity showed a clearly indicated four-factor model. The cumulative variance explanation was 0.65, and the overall Cronbachs alpha was 0.95. All items loaded similarly with the dimensions in the non-adapted CLES except for one item that loaded to another dimension. The CLES instrument in its adapted form had high construct validity and high reliability and internal consistency. Conclusion: CLES, in its adapted form, appears to be a valid instrument to evaluate medical students perceptions of their clinical learning environment in primary health care.

  • 100421.
    Öhman, Fredrik
    Linköping University, Department of Biomedical Engineering.
    Går det att mäta blodtryck med fotopletysmografi och bioakustisk sensor i kombination?2004Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    The aim of the work was to investigate the possibility to combine information from PPG and bio-acoustic technology to extract information that is related to the blood pressure. The measurements have been carried out with several different configurations. First the relation between arterial sounds and the PPG-signal was studied. After those measurements with both PPG and the bio- acoustic technique was concluded on people in different positions and after riding a bike. The goal was to vary the blood pressure. The conclusion that can be drawn in this report is that the bio-acoustic and the PPG-signal in peripheral arteries have the same source. That implies that arterial sounds are a product of turbulence when the pulse wave passes by. Further it can be assumed that it is the first heart sound that is represented in the arterial sounds. The time before and after the arterial sound in one heart cycle vary whit the blood pressure. There relationship seems also to vary with the bloodpressure but it vary differently under different conditions.

  • 100422.
    Öhman, Fredrik
    Linköping University, Department of Electrical Engineering.
    Modulgenerator för Matchade Transistorpar2005Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    Detta examensarbete syftar till att implementera en modulgenerator som automatiskt genererar ett matchat differentialpar. Detta för att enkelt kunna generera detta vanlig förekommande byggblock utan att behöva rita om allt från grunden.

    Modulgeneratorn som konstruerats klarar att skapa upp till 2x2 transistor block matchad layout med eller utan sköld. Programmet skapar med hjälp av indata från konstruktören en skräddarsydd layout som kan användas som byggblock i integrerade kretsar.

    Examensarbetet är slutfört och har genomgått omfattande testning

    The aim of this thesis is to implement a module generator that automatically generates a matched differential pair. That is, to easily create new pairs without having to draw everything from scratch.

    The module generator is able to create matched layouts with up to 2x2 transistor blocks with or without a guard-ring. The program uses a number of input parameters from the user to customize the layout. Hence, the generated blocks can be used in a large range of analog integrated circuits.

  • 100423.
    Öhman, Hans
    Linköping University, Department of Biomedicine and Surgery, Division of dermatology and venereology. Linköping University, Faculty of Health Sciences.
    Studies on the pH gradient in normal and ichthyotic human skin1998Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    In search for pathogenetic mechanisms underlying hyperkeratosis, we examined the pH gradient across the stratum corneum in normal and ichthyotic skin. Twenty students and employees, (12 men and 8 womenaged 25-69 years) served as controls. Patients with ichthyoses were recruited from the outpatient clinic (13 men aged 12-71 years). Diagnosis was made on the basis of clinical examination and serum lipid electrophoresis.

    For recording pH values, a flat glass electrode was repeatedly applied to the skin during tape stripping of volar forearm skin. Before stripping, surface pH (mean±SD) was higher in autosomal dominant ichthyosis vulgaris (IV) (5.2±0.3; n=7) than in x-linked recessive ichthyosis (XRI) (4.6±0.2; n=6) and healthy control skin (4.5±0.2; n=7). This comparision was made between men since a sex difference was observed when comparing men and women in the control group (4.5±0.2; n=7 for men and 5.3±0.5 for women).

    Removal of stratum corneum, which required 170-200 strippings in ichthyotic skin and 100-120 strippings in healthy control skin, dicsclosed markedly different pH variations in the two types of ichthyoses. The major abnormality in IV skin was that a neutral pH was attained already after half the total number of strippings through the hyperkeratotic stratum corneum, which may reflect a lack of acidickeratohyalin breakdown products in this condition.This in contrast to XRI where the pH gradient was less steep and eventually plateaued at pH 6.2-6.6 instead of at 6.7-7.0 as in normal skin. A likely explanation is the accumulation of cholesterol sulfate in lower stratum corneum which occurs in XRI.

    Our results suggest that the 'acid mantle' of normal skin, which penetrates deep into the stratum corneum, is the combined result of cornification-associated organic acids and back-diffusion of of acid material from the surface. Since comeocyte desquamation involves many pH dependent enzymes, abnormalities in the transcomeal pH gradient might play a role in the pathogenesis of ichthyoses.

  • 100424.
    Öhman, Hans
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of dermatology and venereology. Östergötlands Läns Landsting, Centre for Medicine, Department of Dermatology and Venerology in Östergötland.
    The pH gradient in the epidermis evaluated by serial tape stripping2006In: Handbook of non-invasive methods and the skin / [ed] Gary L. Grove ,Gregor B.E. Jemec and Jorgen Serup, Boca Raton, Florida: Taylor & Francis , 2006, 2, p. 421-427Chapter in book (Other academic)
    Abstract [en]

    Inbunden

                Handbook of Non-Invasive Methods and the Skin       

    Engelska, 2006Firmly established as the leading international reference in this field, Non-Invasive Methods and the Skin broke new ground with its comprehensive coverage of methods used in both clinical and experimental dermatology. Completely revised and updated, containing more than twice as much information, the Second Edition continues the tradition. The authors' thorough research and clear organization make this book a baseline reference for those using noninvasive biophysical methods to study the skin.  Arranged by physical modality and structured to provide educational and practical information, the second edition, like its predecessor, will prove to be of value to young researchers and senior scientists alike. The coverage of major evaluation and measurement methods share a consistent format, including scope, sources of error, application, and validity. This edition incorporates 69 revised chapters with more than 90 new chapters covering topics such as computer technique, imaging techniques, skin friction, barrier functions, and more.New chapters provide coverage of: computers, computer techniques, and image analysis imaging techniques, including clinical photography legal situations and guidelines behind instrumental use skin friction barrier functions important new techniques such as in vitro confocal microscopy, OCT, and Raman spectroscopy veterinary/animal research use of methods  The truly interdisciplinary, international panel of contributors includes experts from the specialties of dermatology, bioengineering, pathology, manufacturing engineering, medical physics, pharmacology, microbiology, neurology, surgery, obstetrics and gynecology, cardiovascular research, and pharmacy from academic institutions and hospitals in countries such as Denmark, Germany, the United Kingdom, the United States, Japan, Israel, Taiwan, and Singapore. The revision is extensive and covers a broad spectrum of methods while providing the same caliber of authoritative information that made the previous edition so popular. Application oriented, practical, and instructive, this Second Edition will meet the needs of the researchers today, and in years to come.

  • 100425. Öhman, Inger
    et al.
    Vitols, S
    Luef, Gerhard
    Söderfeldt, Birgitta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Tomson, Torbjörn
    Topiramate kinetics during delivery, lactation, and in the neonate: Preliminary observations2002In: Epilepsia, ISSN 0013-9580, E-ISSN 1528-1167, Vol. 43, no 10, p. 1157-1160Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the pharmacokinetics of topiramate (TPM) during delivery, lactation, and in the neonate. Methods: TPM concentrations in plasma and breast milk were measured with fluorescence polarization immunoassay (FPIA) in five women with epilepsy treated with TPM during pregnancy and lactation. Blood samples were obtained at delivery from mothers, from the umbilical cord, and from the newborns on three occasions (24, 48, and 72 h) after delivery. Blood and breast milk also were collected from mothers 2 weeks, and 1 and 3 months postpartum. Blood samples also were drawn from the infants during breast-feeding. Three of the mother-infant pairs were studied both at delivery and during lactation, two contributed with data from delivery only. Results: The umbilical cord plasma/maternal plasma ratios were close to unity, suggesting extensive transplacental transfer of TPM. The mean milk/maternal plasma concentration ratio was 0.86 (range, 0.67-1.1) at 2-3 weeks after delivery. The milk/maternal plasma concentration ratios at sampling 1 and 3 months after delivery were similar (0.86 and 0.69, respectively). Two to 3 weeks after delivery, two of the breast-fed infants had detectable (>0.9 ╡M) concentrations of TPM, although below the limit of quantification (2.8 ╡M), and one had an undetectable concentration. Conclusions: Our limited data suggest free passage of TPM over the placenta and an extensive transfer into breast milk. Breast-fed infants had very low TPM concentrations, and no adverse effects were observed in the infants.

  • 100426.
    Öhman, Johanna
    Linköping University, Department of Educational Science (IUV).
    Åldersblandad undervisning: ur ett lärarperspektiv2003Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    Bakgrunden till min uppsats är att man i slutet på 1970-talet började införa åldersblandade klasser med pedagogiska motiv. Det avgörande var inte som tidigare att det var för få elever för att bilda en åldershomogen klass utan tanken var att det skulle föra med sig andra fördelar.

    Syftet med min studie är att undersöka hur lärare me d erfarenhet från både åldershomogen och åldersblandad undervisning upplever utvecklingen av deras lärarroll och arbetssätt i och med att de bytt organisationsform. Jag har även försökt att i min litteraturgenomgång ge fler exempel på vad som kan påverka undervisningens utformning.

    Övergripande nämner de lärare som jag intervjuat att deras roll har gått från den traditionella lärarrollen då man undervisar inför hela klassen till att man istället är handledare till eleverna. Eftersom det i en åldersblandad klass är en större naturlig kunskapsspridning på eleverna måste även graden av individualisering öka. Det finns dock inte något enkelt svar på hur mycket av undervisningens utformning som styrs av klassens sammansättning och vad som påverkas av andra faktorer. Eftersom organisationsformen passar olika individer olika bra så blir det svårt att ge ett entydigt svar på om åldersblandade eller åldershomogena klasser är det bästa.

  • 100427.
    Öhman, K. Peter
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    The kallikrein-kinin system in primary hypertension: dynamics of circulating components of the kallikrein-kinin system in relation to the renin-angiotensin-aldosterone system1997Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Kinins are potent vasodilatory and blood pressure lowering peptides, with additional effects on renal handling of electrolytes and water. The kallikrein-kinin system consists of two separate entities, one confined to the circulation and the other to both tissues and the circulation. The role of the plasma system and the circulating part of the tissue system in circulatory homeostasis and electrolyte and metabolism is unclear, as well as the pathogenetic involvement of these systems in primary hypertension.

    The aims of the studies were to investigate the possible participation of the plasma kallikrein~ kinin system and the circulating components of the tissue kallikrein-kinin system in the regulation of blood pressure, electrolyte and water balance; possible differences between normotensive and primary hypertensive subjects with respect to these systems; relations between the kallikrein-kinin systems and the renin angiotensin-aldosterone system; evidence of regulated release of prorenin and the possible participation of the kallikrein-kinin systems in the conversion of prorenin to renin.

    Twentyseven patients with primary hypertension and 16 normotensive control subjects were given furosemide 80 mg p.a. in the first study. In the following 3 studies 15 hypertensive and 15 normotensive subjects participated. Graded i.v. infusion of angiotensin 11 during 3h, i.v. infusion of 2000ml 0.9% sodium chloride during 4h, and fludrocortisone 0.2 mg o.d. p.a. during 7 days were administered in separate protocol.

    1. Plasma prekallikrein levels did not differ between normotensive and hypertensive subjects. Furosemide increased plasma prekallikrein, angiotensin II had no effect and sodium chloride infusion and fludrocortisone administration reduced plasma prekallikrein. 2. Tissue kallikrein in plasma did not change during these experiments. 3. There were minute differences between normotensive and hypertensive subjects in the activation of both the plasma and the tissue kallikrein-systems and in their relation to blood pressure levels and renal sodium and water handling. 4. Alterations of prorenin levels in plasma evoked by changes in blood pressure, angiotensin II levels, electrolyte and water balance were parallel with those of renin and without any signs of separate specific regulatory mechanisms. 5. There were no signs that the plasma or circulating tissue kallikrein-kinin system participated in the conversion of prorenin to renin. 6. There were no clear functional relations between endogenous mineralocorticoids and circulating tissue kalikrein or plasma prekallikrein.

    In conclusion: The data demonstrate alterations in the activity of the plasma kallikrein-kinin system, related to electrolyte and volume balance; differences between normotensive and hypertensive subjects, the pathophysiological relevance of which remains to be elucidated; minor differences in the reactivity of circulating tissue kallikrein in hypertensive subjects, but no obvious participation of the circulating components of the tissue system. Hypertensives have higer renin/prorenin ratio there are no signs of specific regulation of prorenin release or participation of circulating kallikreins in the conversion of prorenin to renin. Some of these differences may have relevance to the abnormal blood pressure levels in patients with primary hypertension.

  • 100428.
    Öhman, Peter
    et al.
    Centrum för forskning om ekonomiska relationer, Mittuniversitetet i Sundsvall.
    Nilsson, Anders
    Luleå tekniska universitet.
    Tagesson, Torbjörn
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Management and Engineering, Business Administration.
    Riskbedömningar inom bank och revision relaterade till två typfel2015In: Trovärdighet och förtroende i ekonomiska relationer / [ed] Peter Öhman, Heléne Lundberg, Lund: Studentlitteratur AB, 2015, 1, p. 145-166Chapter in book (Other academic)
  • 100429.
    Öhman, Sten
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Diagnostic methods for demonstration of intrathecal synthesis of immunoglobulines within the central nervous system1994Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis is based upon studies of quantitative and qualitative determinations of immunoglobulins A, G, and M (lgA, IgG, and IgM) in cerebrospinal fluid (CSF) and in serum. Inflammatory diseases, such as multiple sclerosis and infections (e.g. meningitis) affecting the central nervous system are characterized by intrathecal synthesis of immunoglobulins, and therefore determinations of them in CSF are important diagnostic tools.

    A non-linear relationship between the CSF/serum ratios of IgG, IgA, IgM, and albumin was found in patients with damaged blood-CSF barrier, but in whom no intrathecal synthesis orimmunoglobulins was expected. On the basis of this non-linear relationship a new kind of formula, the extended indices (lgA-EI, IgG-EI, and IgM-EI), was developed to giveimproved estimates of intrathecal synthesis.

    These formulae were evaluated together with other proposed formulae and with agarose isoelectrofocusing, to determine their diagnostic sensitivities in different neurological diseases. The main advantage with the extended indices, compared to other formulae, was a lower rate offalse positive tests, without affecting the diagnostic sensitivities for intrathecal immunoglobulin synthesis.

    A method based on ultracentrifugation is presented, where the distribution of monomeric and dimeric IgA in CSF and serum can be determined quantitatively. Both total and Ilerpes simplex virus specific lgA antibodies were estimated with respect to the physical form of lgA.

    For determination of CSF-IgM the sampling should be performed with an atraumatic Sprotte needle to minimise pre-analytical errors owing to contamination with serum or interstitial fluid.

  • 100430.
    Öhman, William
    Linköping University, Department of Management and Engineering, Malmstens Linköping University.
    Ta det piano med klaveret: Åtgärdsproblematik vid konservering av hammarklaver från 1770-talet2018Independent thesis Basic level (degree of Bachelor), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [en]

    In this thesis I explore the preservation problems occurring in English square pianos from 1770. I have investigated three aspects:

    1. Which materials do the instruments normally consist of?
    2. Which are the common types of damage?
    3. What conservation ethics are widely considered among instrument conservators and restorers?

    With the information from these three questions have I formulated treatment suggestions and general aspects to be aware of when preserving early square pianos. The most important suggestion is not to make any treatment without reflection. It´s also important to be aware of problems regarding storage, humidity, emissions, materials and tuning when preserving an early square piano. I consider these aspects in formulating treatment suggestions to conserve instruments as historical documents and to restore them to playable state. The treatment suggestions can also help and guide conservators without special knowledge of instruments toward better preservation of early square pianos. This thesis aims therefore to improve the care of this fragile cultural heritage.

  • 100431.
    Öhman-Danforth, Marina
    Linköping University, Department of Behavioural Sciences and Learning.
    Slöjdundervisning och matematisk kunskap: Hur elever och lärare använder skisser och matematiska beräkningar i slöjd i grundskola och grundsärskola2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Elever i grundskolans- och grundsärskolans slöjdundervisning använder matematik som ett redskap för att föra sitt arbete framåt. I Lgr 11 står det att eleven i sin undervisning ska möta två- och tredimensionella skisser samt genomföra matematiska beräkningar kopplat till skisser, modeller, mönster och arbetsbeskrivningar. Rapporten för Nationell utvärdering i slöjd 2013, visade dock att så inte alltid är fallet. Denna kvalitativa studie är genomförd på två skolor, genom lektionsobservationer i åk 4-9 samt intervjuer med elever och ett flertal slöjdlärare i kommunen. Syftet med uppsatsen är att ta reda på elevers och lärares uppfattning om hur skisser och matematiska beräkningar används i slöjdundervisningen samt hur detta stämmer med gjorda observationer. Resultatet visar på att elever på högstadiet alltid genomför och använder tvådimensionella skisser alt. skiss med vyplacering. Det gällde dock inte för elever på mellanstadiet, inte heller att eleverna fick möta tredimensionella skisser, inte ens på högstadiet. Resultatet visar att både lärare och elever oftast använder matematiskt talspråk istället för adekvata matematiska begrepp, att slöjdlärare inte alltid har tillräcklig egen matematisk kunskap som krävs för att hjälpa elev att genomföra ett visst slöjdarbete och att många slöjdlärare inte heller förväntar sig att explicit undervisa i utförande av matematiska beräkningar. Elever utför många matematiska ickeverbala handlingar vilket förekommer naturligt för eleverna ju äldre de blir, eller ju djupare matematisk kunskap man besitter. Yngre elever visar oftare motstånd för att använda sig av matematik som redskap. Studien visar att elever, utan andra krav från lärare, använder den matematik man behärskar, vilket visar sig vara ca tre årskurser under den egna årskursen. Detta skulle kunna vara en möjlig förklaring till det motstånd som yngre elever påvisar, då de ännu inte har befäst grundläggande matematiska kunskaper.

  • 100432. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Touching voices with the tactilator1992In: Second international conference on Tactile Aids, Hearing Aids Cochlear Implants: Improving speech communication for profoundly hearing impaired children and adults.,1992, 1992Conference paper (Other academic)
  • 100433. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Touching voices with the tactilator1992In: XXI International Conference of Audiology,1992, 1992Conference paper (Other academic)
  • 100434. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Touching voices with the tactilator1992In: International Journal of Psychology, ISSN 0020-7594, E-ISSN 1464-066X, Vol. 27, p. 89-89Article in journal (Refereed)
  • 100435. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Touching voices with the tactilator (poster presentation)1992In: The XXV Internationa Congress of Psychology,1992, 1992Conference paper (Other academic)
  • 100436. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences.
    Kan taktilering tränas?(Can tactiling be trained?)1987Report (Other academic)
  • 100437. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences.
    Tactiling: A usable support system for speechreading?1989Report (Other academic)
  • 100438. Öhngren, G
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Lyxell, Björn
    Linköping University, Department of Behavioural Sciences.
    Tactiling: A Usable support sytem for speechreading?1992In: British Journal of Audiology, ISSN 0300-5364, E-ISSN 1471-2849, Vol. 26, p. 167-173Article in journal (Refereed)
  • 100439. Öhngren, G.
    et al.
    Rönnberg, Jerker
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, The Swedish Institute for Disability Research.
    Lyxell, Björn
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences, Cognitive Psychology.
    Tactiling: a trainable supportsystem for speechreading?1990In: STL-QSPR, Vol. 2-3, p. 69-77Article in journal (Refereed)
  • 100440.
    Öhr, Jonas
    et al.
    ABB, Sweden.
    Moberg, Stig
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, The Institute of Technology.
    Wernholt, Erik
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, The Institute of Technology.
    Hanssen, Sven
    ABB, Sweden.
    Pettersson, Jens
    ABB, Sweden.
    Persson, Sofie
    ABB, Sweden.
    Sander-Tavallaey, Shiva
    ABB, Sweden.
    Identification of Flexibility Parameters of 6-axis Industrial Manipulator Models2006In: Proceedings of the 2006 International Conference on Noise and Vibration Engineering, 2006, p. 3305-Conference paper (Refereed)
    Abstract [en]

    A method for identification of flexibility parameters of a 18 DOF (degrees offreedom) robot prototype model is proposed. Experiments show the strengthof the method and the results indicates that flexibilities in the bearings and thearms, taken together, are of the same order as the flexibilities in the gears.

  • 100441.
    Öhr, Jonas
    et al.
    ABB, Sweden.
    Moberg, Stig
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, The Institute of Technology.
    Wernholt, Erik
    Linköping University, Department of Electrical Engineering, Automatic Control. Linköping University, The Institute of Technology.
    Hanssen, Sven
    ABB, Sweden.
    Pettersson, Jens
    ABB, Sweden.
    Persson, Sofie
    ABB, Sweden.
    Sander-Tavallaey, Shiva
    ABB, Sweden.
    Identification of Flexibility Parameters of 6-axis Industrial Manipulator Models2006Report (Other academic)
    Abstract [en]

    A method for identification of flexibility parameters of a 18 DOF (degrees offreedom) robot prototype model is proposed. Experiments show the strengthof the method and the results indicates that flexibilities in the bearings and thearms, taken together, are of the same order as the flexibilities in the gears.

  • 100442.
    Öhrberg, Johan
    Linköping University, Department of Management and Engineering.
    Samverkan mellan kommun och näringsliv: en fallstudie av Växtkraft Kinda2007Independent thesis Advanced level (degree of Magister), 10 points / 15 hpStudent thesis
    Abstract [sv]

    Den här uppsatsen syftar till att undersöka hur kommunal samverkan med det lokala näringslivet utformas utifrån teorier kring governance, policynätverk samt public-private partnerships. Detta genomförs utifrån en fallstudie av projektet ”Växtkraft och företagarutveckling” som är en del av den ekonomiska föreningen Växtkraft Kinda. I uppsatsen undersöks faktorer som gemensamma mål, resursutbyte, ömsesidigt beroende samt förtroende och vilken betydelse dessa har för samverkan. Dessutom granskas hur kontakterna mellan aktörerna är utformade samt vilken betydelse inflytande och konkurrens har i samarbetet.

    I uppsatsen kommer jag fram till att det existerar gemensamt formulerade mål även om de till viss del varierar mellan aktörerna. De resurser som utbyts är förutom de ekonomiska även tid, kunskap, kontakter samt lokaler. Kommunens representanter menar att resursutbytet främst sker i informella miljöer medan näringslivsrepresentanterna anser att resursutbytet äger rum i formella miljöer. Tre av de fem intervjuade anser att det finns ett ömsesidigt beroende mellan kommun och näringsliv samt att det är en omständighet som verkar som en drivande- och positiv kraft i samarbetet. Samtliga intervjuade uppger att förtroende är en viktig komponent i projektet men förtroendet är något mindre bland näringslivsrepresentanterna. De intervjuade uppger även att det finns en viss konkurrens mellan aktörerna inom projektet men att samarbete dominerar. Det finns dock vissa skillnader mellan kommunens och det lokala näringslivets uppfattningar om samarbetet. Kommunens representanter beskriver samarbetet i formella termer medan näringslivsrepresentanterna anser att det skall betraktas som en formell organisation. Dessutom menar kommunen att aktörernas inflytande beror på engagemang och kompetens medan näringslivet anser att storlek och position är avgörande faktorer.

  • 100443.
    Öhrberg, Marie
    Linköping University, Department of Social and Welfare Studies.
    Inte ett leende före jul: En studie om lärares bemötande av elever2008Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vilken betydelse har det hur lärare bemöter elever i skolan? Spelar bemötandet någon roll för hur eleverna värderar sig själva och för deras motivation i skolan? Syftet med denna studie är att belysa gymnasieelevers uppfattningar om vilken betydelse lärares bemötande av dem haft under deras grundskoletid. Fokus ligger på bemötandets betydelse för självkänsla, motivation och lärande men även hur eleverna vill bli bemötta framkommer.

    Som teoretisk utgångspunkt presenteras dels en syn på hur självkänslan utvecklas och till viss del styr hur individen lever sitt liv, dels en idé om att det är lärares förhållningssätt som styr elevers motivation.

    Metoden som använts är gruppintervju och nio gymnasieelever har intervjuats i tre grupper med tre i varje. Anledningen till att gymnasieelever valdes som informanter var att de antogs ha lite distans till sin grundskoletid och därmed lättare kunde diskutera betydelsen av lärares bemötande.

    De slutsatser som dras i studien är att elever vill att lärare med sitt bemötande ska bekräfta dem på tämligen primära vis; genom att hälsa på dem även utanför klassrummet, tilltala dem med deras namn, uppmärksamma dem och verkligen lyssna på dem. Nästan samtliga informanter föredrog lärare som har ett strängt bemötande gentemot eleverna och anledningen till det var att det ansågs leda till ordning i klassrummet och att undervisningen fungerade bättre. När det gäller bemötande som påverkar självkänslan framkom att den känsla beröm gav uppfattades som något bestående medan negativ kritik inte ansågs ha betydelse på lång sikt. Bemötanden som anses betydelsefulla för informanternas motivation och lärande är främst lärares kompetens i sitt ämne och i att lära ut den samt lärares beröm eller negativa kritik. Relationen nämns även den som främjande för lärande.

  • 100444.
    Öhrblad, Henrik
    et al.
    Linköping University, Department of Management and Engineering.
    Berglund, Henrik
    Linköping University, Department of Management and Engineering.
    Component Meshing Methodology2008Independent thesis Advanced level (degree of Magister), 20 points / 30 hpStudent thesis
    Abstract [en]

    In order to achieve results that are reliable when using the finite element method one has to use an acceptable element mesh with respect to the shape and size of the elements. As a help to produce an acceptable mesh there are quality criteria that must be fulfilled in most pre-processors.

    One objective with this thesis is to perform a sensitivity study that can be used as a basis for a Mesh guideline for chassis parts which is requested from engineers at Volvo 3P. The software used in the sensitivity study is ANSA as pre-processor, Nastran as solver and Metapost as post-processor.

    In the first part of the sensitivity study three different models are used for studying quality criteria such as aspect ratio, skewness, mid point alignment, mid point deviation and element size. Solid elements of second order, which are used in the three models, can be generated in two ways, which constitutes another part of the sensitivity study. They may either be generated from the beginning or can be converted from first order elements. This means geometrically that if second order elements where generated from the beginning the element mesh would follow the shape of the component in a better way compared to the other method.

    Recently a pre- and post-processing program called SimLab was introduced on the market. Since SimLab supports geometry import from several CAD-systems without loss of feature information, the automatic element mesh generation is supposed to be better as the mesh generator has access to more information concerning the geometry. An evaluation of SimLab is the second major objective of the thesis. More specifically, the evaluation concerns the possibility of using the software at Volvo 3P.

    Results show a surprising insensitivity regarding the criteria and that the method of generating second order elements from the beginning is to be preferred. SimLab is a new program with big potential and the conclusion is that it is possible to use it at Volvo 3P.

  • 100445.
    Öhrling, Julia
    Linköping University, Department of Thematic Studies.
    Arbetsvärdering: en möjlig väg till jämställdhet i arbetslivet? En kvalitativ studie av ett arbetsvärderingsprojekt med jämställdhetssyfte i en kommun.2002Independent thesis Advanced level (degree of Magister)Student thesis
    Abstract [sv]

    The purpose of this degree project is to study a work evaluation project in a municipality, on the basis of key participants. The municipality is the employer, per-forming the workplace project and the chief objective is to reach gender equality between the employees. Equal pay for equal work. Through work evaluation is it pos-sible to find out which of a lot of different jobs, which have equal requirements. The jobs, which have equal requirements, should have equal pay.

    According to Swedish law, all employers need to analyse and survey their salary/wage distribution, to identify and remedy sexual discrimination concerning that area. One way to do that is to do a work evaluation and to study the result. Studying the result was what the municipality was doing, when got in contact with it. My focus is to find out what the central issues, problems and hinders are, or can occur when an employer is trying to follow the law.

    This study is based on qualitative research. The empirical material (interviews and ob-servations) from key participants, who took part in the project in the municipality, is presented through excerpts. They speak about different problems and other aspects they have experienced during the work process with the result from the evaluation project. The material is then analysed in the light of different theories. The theories treat areas as gender and organisation.

    For example is not al of the involved unions of the same opinion about the project. Money is one aspect that the key persons talk about and the circumstances around how to reach the goals of the project is another subject. The result of the study has shown that it could be useful within the project to have greater concern about the system of gender and to stronger point out the gains of ex-tended gender equality. Thou a lot of money are needed if equal pay for equal work should be reached, the gain in efficiency from the employed might compensate that.

  • 100446.
    Öhrling, Magdalena
    Linköping University, Department of Culture and Communication.
    Fem svenska medeltida cisterciensklosters interaktion med omvärlden: Ett studium av medeltida brev från 1100- och 1200-talen.2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I denna uppsats har fem svenska cistercienskloster undersökts med avseende på deras samspel med det omgivande samhället. Undersökningens huvudsakliga källor utgörs av bevarade medeltida brev från 1100- och 1200-talen. Undersökningen har visat att de fem klostren interagerade med sina omgivningar på flera sätt. Enligt breven skedde det främst på så sätt att personer utanför klostrens murar genom sina testamenten donerat egendomar eller pengar till munkarna och nunnorna, ofta med önskan om att få bli begravda där. Även rikets kungar, lokala biskopar samt påvar har varit i kontakt med  klosteranläggningarna; givit dem beskydd, donerat egendomar, tillhandahållit information och givit förmaningar. Donationer till klostren kunde leda till att vissa av Cisterciensorden regler blev åsidosatta. Enstaka skillnader mellan munk- och nunnekloster med avseende på vad som beskrivs i källmaterialet har framkommit. Undersökningens resultat har diskuterats också i förhållande till den information som återfinns i litteratur om Cisterciensorden och dess klosters samspel med omgivningen.

  • 100447.
    Öhrling, Magdalena
    Linköping University, Department of Culture and Communication, Arts and Humanities. Linköping University, Faculty of Arts and Sciences.
    "Gån fördenskull ut": Fredrik och Märtha Ysander - missionärer i Sydindien 1925-19502011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Fredrik och Märtha Ysander var i Svenska Kyrkans Missions tjänst mellan år 1923 och år 1956. Större delen av denna tid tillbringade de på missionssjukhuset i Tirupattur på den sydindiska slätten. Fredrik var läkare och Märtha var under en tid föreståndare för sjukhusets blindskola. Föreliggande uppsats har som syfte att beskriva deras liv på denna plats och i denna tid med betoning på arbete och vardag, deras förhållande till den omgivande kulturen och den inhemska befolkningen samt syn på missionsuppdraget. Uppsatsen har delvis formen av en biografi. Resultaten av undersökningen visar att arbetet innebar, förutom det rent medicinska, att delta i möten och konferenser som behandlade missionens inre angelägenheter. Fredrik var också under lång tid chef för sjukhuset och ledde då det medicinska arbetet och sjukhusets utveckling. När det var alltför hett på slätten reste man till den svenska semesterkolonin i Kodaikanal, där man vilade ut och umgicks med kollegor. Fredriks och Märthas förhållande till den indiska kulturen och de människor de kom i kontakt med var inte helt okomplicerat. Till en början var det svårt framför allt för Märtha att riktigt trivas, men med tiden ändrades hennes inställning och hon kom att känna sig hemma i Tirupattur. Fredriks syn på missionsuppdraget under alla år i tjänst var i grunden detsamma. Han ansåg att läkarmissionens uppdrag var att vittna om, att bereda en väg till och att utså en längtan efter Kristus genom att utföra barmhärtiga gärningar i Hans namn. Detta är också en förkunnelse i sig. Hos Fredrik fanns redan från början en stark längtan att gå ut som missionär. Hos Märtha växte denna längtan fram under årens lopp. Det livsval de gjorde innebar bland annat att kontakten med släkt och vänner länge var hänvisad till brev. Under några år var Fredrik och Märtha också åtskilda från sina barn. De var kvar i Sverige, bland annat för att studera, då föräldrarna reste ut till Indien för en sista period.

  • 100448.
    Öhrn, Annica
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences.
    Measures of Patient Safety: Studies of Swedish Reporting Systems and Evaluation of an Intervention Aimed at Improved Patient Safety Culture2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Unsafe health care delivery results in millions of patients suffering from injuries or death worldwide. A Swedish study estimated the prevalence of preventable adverse events as high as 8.6% in hospital care, which demonstrates that patient safety is no less a problem in Sweden than elsewhere. Reporting of adverse events has become an integral part of patient safety work. The aim of reporting is to identify patient safety problems and provide background data and information for efforts to improve patient safety. However, adverse events in health care can be captured and measured using different methods and stored in disparate systems that are not fully integrated. This makes it difficult to obtain a complete coherent picture of the frequency and nature of various types of adverse events. Another difficulty is to distinguish between adverse events and accepted complications of medical care.

    The overall aim of this thesis is to generate knowledge for improved understanding of how patient safety can be measured in terms of reporting adverse events and improved by targeting patient safety culture with an intervention implemented in a Swedish county council. Three research questions have been derived from the aim: (1) To what extent can analysis of patient claims contribute to an understanding of the magnitude of the patient safety problem? (2) To what extent do data captured from different reporting systems in Sweden differ? (3) To what extent can a structured intervention that fosters learning on patient safety issues and encourages leadership commitment improve the patient safety culture in a Swedish county council from a five-year perspective?

    The research is based on studies of three national reporting systems: Lex Maria to the National Board of Health and Welfare; patient claims to the County Councils´ Mutual Insurance Company; and medical data reported to the National Swedish Spine Register (Swespine). Data have also been assembled as part of an evaluation within the Patient Safety Dialogue intervention.

    This thesis indicates that different Swedish reporting systems provide disparate views and have many discrepancies regarding data quality and coverage of adverse events. Patient claims seem to be an important source of information that can complement information from incident reporting systems and quality registries in health care to provide an understanding of the magnitude of the patient safety problem.

    The research also shows that a structured intervention that fosters learning on patient safety issues and encourages leadership commitment can improve the culture of patient safety. However, a longer period of time and focused efforts might be required to achieve improvements across all departments within a Swedish county council.

    List of papers
    1. Reporting of Sentinel Events in Swedish Hospitals: A Comparison of Severe Adverse Events Reported by Patients and Providers
    Open this publication in new window or tab >>Reporting of Sentinel Events in Swedish Hospitals: A Comparison of Severe Adverse Events Reported by Patients and Providers
    2011 (English)In: Joint Commission Journal on Quality and Patient Safety, ISSN 1553-7250, E-ISSN 1938-131X, Vol. 37, no 11, p. 495-501Article in journal (Refereed) Published
    Abstract [en]

    Background: Mandatory and voluntary reporting of adverse events is common in health care organizations but a more accurate understanding of the extent of patient injury may be obtained if additional sources are used. Patients in Sweden may file a claim for economic compensation from the national insurance system if they believe they have sustained an injury. The extent and pattern of reporting of serious adverse events in a mandatory national reporting system was compared with the reporting of adverse events on the basis of patient claims.

    Methods: Regional sentinel event reports were compared with malpractice claims data between 1996 and 2003. A sample consisting of 113 patients with deaths or serious injuries was selected from the malpractice claims data source. The medical records of these patients were reviewed by three chief medical officers.

    Results: Of the deaths or injuries associated with the 113 patients—25 deaths, 37 with more than 30% disability, and 51 with 16%-30% disability—23 (20%) had been reported by chief medical officers to the National Board of Health and Welfare as sentinel events. Most adverse events were found in orthopedic surgery, and orthopedic injuries had more serious consequences. None of the patient injuries caused by infections were reported as sentinel events. Individual errors were more frequent in cases reported as sentinel events.

    Conclusions: Adverse events causing severe harm are underreported to a great extent in Sweden despite the existence of a mandatory reporting system; physicians often consider them to be complications. Health care organizations should consider using a portfolio of tools—including incident reporting, medical record review, and analysis of patient claims—to gain a comprehensive picture of adverse events.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72589 (URN)
    Available from: 2011-11-29 Created: 2011-11-29 Last updated: 2017-12-08Bibliographically approved
    2. What can we learn from patient claims?: Analysing of patient injuries following orthopaedic surgery
    Open this publication in new window or tab >>What can we learn from patient claims?: Analysing of patient injuries following orthopaedic surgery
    2012 (English)In: Patient Safety in Surgery, ISSN 1754-9493, Vol. 6, no 2, p. 1-6Article in journal (Refereed) Published
    Abstract [en]

    Background: Objective data on the incidence and pattern of adverse events after orthopaedic surgical procedures remain scarce, secondary to the reluctance for encompassing reporting of surgical complications. The aim of this study was to analyze the nature of adverse events after orthopaedic surgery reported to a national database for patient claims in Sweden.

    Methods: In this retrospective review data from two Swedish national databases during a 4-year period were analyzed. We used the "County Councils' Mutual Insurance Company", a national no-fault insurance system for patient claims, and the "National Patient Register at the National Board of Health and Welfare".

    Results: A total of 6,029 patient claims filed after orthopaedic surgery were assessed during the study period. Of those, 3,336 (55%) were determined to be adverse events, which received financial compensation. Hospital-acquired infections and sepsis were the most common causes of adverse events (n = 741; 22%). The surgical procedure that caused the highest rate of adverse events was "decompression of spinal cord and nerve roots" (code ABC**), with 168 adverse events of 17,507 hospitals discharges (1%). One in five (36 of 168; 21.4%) injured patient was seriously disabled or died.

    Conclusions: We conclude that patients undergoing spinal surgery run the highest risk of being severely injured and that these patients also experienced a high degree of serious disability. The most common adverse event was related to hospital acquired infections. Claims data obtained in a no-fault system have a high potential for identifying adverse events and learning from them.

    Keywords
    Insurance Claim Review, Medical Errors, Orthopaedics, Patient Safety, Patient Admission, Safety Management
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72590 (URN)10.1186/1754-9493-6-2 (DOI)
    Note

    On the day of the defence date the status of this article was "Manuscript".

    Available from: 2011-11-29 Created: 2011-11-29 Last updated: 2014-09-11Bibliographically approved
    3. Adverse events in spine surgery in Sweden: A comparison of patient claims data and national quality register (Swespine) data
    Open this publication in new window or tab >>Adverse events in spine surgery in Sweden: A comparison of patient claims data and national quality register (Swespine) data
    Show others...
    2011 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 82, no 6, p. 727-731Article in journal (Refereed) Published
    Abstract [en]

    Background and purpose: Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine).

    Methods: We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 2005. The medical records of the patients filing these claims were reviewed and compared with Swespine data for the same period.

    Results: Two-thirds (119/182, 65%) of patients who claimed economic compensation from the insurance company were registered in Swespine. Of the 210 complications associated with these 182 claims, only 74 were listed in Swespine. The most common causes of compensated injuries (n = 139) were dural lesions (n = 40) and wound infections (n = 30). Clinical outcome based on global assessment, leg pain, disability, and quality of health was worse for patients who claimed economic compensation than for the total group of Swespine patients.

    Interpretation: We found considerable under-reporting of complications in Swespine. Dural lesions and infections were not well recorded, although they were important reasons for problems and contributed to high levels of disability. By analyzing data from more than one source, we obtained a better understanding of the patterns of adverse events and outcomes after spine surgery.

    Place, publisher, year, edition, pages
    Informa, 2011
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72591 (URN)10.3109/17453674.2011.636673 (DOI)000297352700016 ()22066564 (PubMedID)
    Available from: 2011-11-29 Created: 2011-11-29 Last updated: 2017-12-08Bibliographically approved
    4. Patient safety dialogue: evaluation of an intervention aimed at achieving an improved patient safety culture
    Open this publication in new window or tab >>Patient safety dialogue: evaluation of an intervention aimed at achieving an improved patient safety culture
    2011 (English)In: Journal of patient safety, ISSN 1549-8425, Vol. 7, no 4, p. 185-92Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVES: Patient Safety Dialogue, a local intervention inspired by walk round-style approaches, was implemented in 2005 in a Swedish county council to achieve a positive patient safety culture in health care. This paper evaluates the results and changes after 5 years of the Patient Safety Dialogue in 50 departments (37 medical and 13 psychiatric) in 3 hospitals.

    METHODS: The patient safety culture maturity was rated on 5 levels that correspond with the Manchester Patient Safety Assessment Framework. The assessment was based on information supplied by the departments and discussions between clinical leaders and staff members with special patient safety assignments and representatives from a patient safety unit. Three patient safety areas were assessed: hospital-acquired infections, outcome measurements, and general patient safety. Each department was assessed 3 times: at baseline and at follow-ups at 18 and 36 months. Average scores were calculated for each of the 3 safety areas on all occasions. The departments were classified into 3 types of trajectories on the basis of the development of their scores over time.

    RESULTS: More than two-thirds of the departments attained higher scores in round 3 than in round 1. Seventy-eight percent of the departments in the general patient safety area were categorized as continuously improving or developing, compared with 68% for outcome measurement and 50% for hospital-acquired infection. Approximately one-third was categorized as nonimproving, with scores in round 3 lower than or equal to the scores in round 1. The medical departments had higher scores than the psychiatric departments in all rounds.

    CONCLUSIONS: Most of the 50 departments were evaluated to have improved their patient safety culture during the 5 years of the Patient Safety Dialogue, suggesting that the intervention is effective in supporting an improved patient safety culture. However, one-third of the departments did not improve during the 5-year study period.

    Place, publisher, year, edition, pages
    Informa, 2011
    Keywords
    Safety, culture, program evaluation, safety management
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-72593 (URN)10.1097/PTS.0b013e318230e702 (DOI)21952549 (PubMedID)
    Available from: 2011-11-29 Created: 2011-11-29 Last updated: 2013-10-25Bibliographically approved
  • 100449.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Patient Security.
    Andersson, Christer
    Östergötlands Läns Landsting, Patient Security.
    Elfström, Johan
    Östergötlands Läns Landsting, Patient Security. Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences.
    Liedgren, Christer
    Östergötlands Läns Landsting, Patient Security.
    Rutberg, Hans
    Östergötlands Läns Landsting, Patient Security.
    Framgång kräver ledningens stöd och resurser2007In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, no 4, p. 224-228Article in journal (Other academic)
  • 100450.
    Öhrn, Annica
    et al.
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Elfström, Johan
    Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences.
    Liedgren, Christer
    Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Rutberg, Hans
    Linköping University, Department of Medical and Health Sciences, Health Technology Assessment and Health Economics. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Patient Safety.
    Reporting of Sentinel Events in Swedish Hospitals: A Comparison of Severe Adverse Events Reported by Patients and Providers2011In: Joint Commission Journal on Quality and Patient Safety, ISSN 1553-7250, E-ISSN 1938-131X, Vol. 37, no 11, p. 495-501Article in journal (Refereed)
    Abstract [en]

    Background: Mandatory and voluntary reporting of adverse events is common in health care organizations but a more accurate understanding of the extent of patient injury may be obtained if additional sources are used. Patients in Sweden may file a claim for economic compensation from the national insurance system if they believe they have sustained an injury. The extent and pattern of reporting of serious adverse events in a mandatory national reporting system was compared with the reporting of adverse events on the basis of patient claims.

    Methods: Regional sentinel event reports were compared with malpractice claims data between 1996 and 2003. A sample consisting of 113 patients with deaths or serious injuries was selected from the malpractice claims data source. The medical records of these patients were reviewed by three chief medical officers.

    Results: Of the deaths or injuries associated with the 113 patients—25 deaths, 37 with more than 30% disability, and 51 with 16%-30% disability—23 (20%) had been reported by chief medical officers to the National Board of Health and Welfare as sentinel events. Most adverse events were found in orthopedic surgery, and orthopedic injuries had more serious consequences. None of the patient injuries caused by infections were reported as sentinel events. Individual errors were more frequent in cases reported as sentinel events.

    Conclusions: Adverse events causing severe harm are underreported to a great extent in Sweden despite the existence of a mandatory reporting system; physicians often consider them to be complications. Health care organizations should consider using a portfolio of tools—including incident reporting, medical record review, and analysis of patient claims—to gain a comprehensive picture of adverse events.

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