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  • 901. Ahlberg, M
    et al.
    Bäckman, Carl
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Jones, C
    Walther, Sten
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Gastroentorology.
    Group communication confirm feelings among partners of former intensive care patients2014Conference paper (Other academic)
  • 902.
    Ahlberg, Mona
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Bäckman, Carl
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Jones, Christina
    Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
    Walther, Sten
    Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center.
    Moving on in life after intensive care - partners' experience of group communication2015In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, no 5, p. 256-263Article in journal (Refereed)
    Abstract [en]

    Background:Partners have a burdensome time during and after their partners’ intensive care period. They may appear to be coping welloutwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited.

    Aim:The aim of this study was to describe the experience of participating in group communication with other partners of former intensivecare patients.

    Design:The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive careunit (ICU) patients was evaluated.

    Methods:A strategic selection was made of adult partners to former adult intensive care patients (n=15), 5 men and 10 women, aged37–89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote,in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six ofthe partners were interviewed. Content analysis was used to analyse the notebooks and the interviews.

    Findings:Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2)Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participatein group communication.

    Conclusion:Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategiesto ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is oneway for partners to be able to move forward in life.

    Relevance to clinical practice:Group communication with other patients’ partners eases the process of going through the burden ofbeing a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus andevidence for the best practice.

  • 903.
    Ahlberg, Mona
    et al.
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping. Linköping University, Department of Medical and Health Sciences, Division of Nursing Science.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Ågren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Family Health Conversations create awareness of family functioning.2019In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The whole family is affected if one family member is critically ill. The Family Health Conversation Intervention may give the family tools that support healthier family functioning.

    AIMS AND OBJECTIVES: The aim of this study was to identify which components of family function are affected when families participate in Family Health Conversations.

    DESIGN: A secondary analysis was performed of existing qualitative interviews. The Family Health Conversation is an intervention where nurses ask the family reflective questions, and reflection is made possible in three conversation sessions.

    METHODS: This study included transcribed data from 13 follow-up interviews from seven families attending Family Health Conversations after three and 12 months. Data were analysed with narrative analysis, focusing on family function.

    RESULTS: Three themes were identified. The families' family functioning had been supported with: improved understanding of each other-there was an understanding of being in the same situation but still having totally different experiences; more concern for each other-they talked about their different experiences and felt they had become closer to each other; and a process of working through-they had experienced working through various experiences, standing by and supporting, and then being able to move on.

    CONCLUSIONS: The Family Health Conversation Intervention is provided to families, accompanied by nurses. The families in this study gained an awareness of their family function that brought the family closer because of improved understanding of each other and the situation. The families experienced openness, and the family members spoke more freely with each other, which facilitated the progress of working through the experience of critical illness and helped to maintain healthy family functioning.

    RELEVANCE TO CLINICAL PRACTICE: It is important to have an overall perspective and to recognize the patient and the family as equally important within the family for awareness of family function.

  • 904.
    Ahlberg, Sven
    Linköping University, Department of Electrical Engineering. Linköping University, The Institute of Technology.
    Evaluation of Different Radio-Based Indoor Positioning Methods2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Today, positioning with GPS and the advantages this entails are almost infinitive, which means that the technology can be utilized in a variety of applications. Unfortunately, there exists a lot of limitations in conjunction with the signals from the GPS can’t reach inside e.g. buildings or underground. This means that an alternative solution that works indoors needs to be developed.

    The report presents the four most common radio-based technologies, Bluetooth,Wi-Fi, UWB and RFID, which can be used to determine a position. These all have different advantages in cost, accuracy and latency, which means that there exist a number of different applications.

    The radio-based methods use the measurement techniques, RSSI, TOA, TDOA, Cell-ID, PD or AOA to gather data. The choice of measurement technique is mainly dependent of which radio-based method being used, since their accuracy depends on the quality of the measurements and the size of the detection area, which means that all measurement techniques have different advantages and disadvantages.

    The measurement data is processed with one of the positioning methods, LS, NLS, ML, Cell-ID, WC or FP, to estimate a position. The choice of positioning method also depends on the quality of the measurements in combination with the size of the detection area.

    To evaluate the different radio-based methods together with measurement techniques and positioning methods, accuracy, latency and cost are being compared. This is used as the basis for the choice of positioning method, since a general solution can get summarized by finding the least expensive approach which can estimate an unknown position with sufficiently high accuracy.

  • 905.
    Ahlberg, Zandra
    Linköping University, Department of Educational Science (IUV).
    Simon -en tracheotomerad pojkes annorlunda vardag2000Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    Jag har valt att fokusera på hur en annorlunda elevs vardag ser ut. Jag har intervjuat diverse centrala personer i Si-mons liv inklusive honom själv. Genom observation av Simon i skolan tillsammans med intervjuerna har jag försökt skapa mig en bild av hur det är att leva med ett funktionshinder. Riskerar man att bli mobbad för att man är annor-lunda? I litteraturdelen behandlas funktionshindrade människors situation och rättigheter förr och nu. Handikappbegrep-pets betydelse och hur det används belyses också. I slutdiskussionen jämförs litteratur med empiri och det visar sig att mycket av litteraturen överensstämmer med den verkliga situationen.

  • 906.
    Ahlbert, Gabriella
    Linköping University, Department of Management and Engineering, Solid Mechanics. Linköping University, The Institute of Technology.
    Method Evaluation of Global-Local Finite Element Analysis2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    When doing finite element analysis upon the structure of Saab’s aeroplanes a coarse global model of mainly shell elements is used to determine the load distribution for sizing the structure. At some parts of the aeroplane it is however desirable to implement a more detailed analysis. These areas are usually modelled with solid elements; the problem of connecting the fine local solid elements to the coarse global model will shell elements then arises.

     

    This master thesis is preformed to investigate possible Global-Local methods to use for the structural analysis on Gripen. First a literature study of current methods on the market is made, thereafter a few methods are implemented on a generic test structure and later on also tested on a real detail of Gripen VU. The methods tested in this thesis are Mesh refinement in HyperWorks, RBE3 in HyperWorks, Glue in MSC Patran/Nastran and DMIG in MSC Nastran. The software is however not evaluated in this thesis, and a further investigation is recommended to find the most fitting software for this purpose. All analysis are performed with linear assumptions.

     

    Mesh refinement is an integrated technique where the elements are gradually decreasing in size. Per definition, this technique cannot handle gaps, but it has almost identical results to the fine reference model.

     

    RBE3 is a type of rigid body elements with zero stiffness, and is used as an interface element. RBE3 is possible to use to connect both Shell-To-Shell and Shell-To-Solid, and can handle offsets and gaps in the boundary between the global and local model.

     

    Glue is a contact definition and is also available in other software under other names. The global respectively the local model is defined as contact bodies and a contact table is used to control the coupling. Glue works for both Shell-To-Shell and Shell-To-Solid couplings, but has problem dealing with offsets and gaps in the boundary between the global and local model.

     

    DMIG is a superelement technique where the global model is divided into smaller sub-models which are mathematically connected. DMIG is only possible to use when the nodes on the boundary on the local model have the same position as the nodes at the boundary of the global model. Thus, it is not possible to only use DMIG as a Global-Local method, but can advantageously be combined with other methods.

     

    The results indicate that the preferable method to use for Global-Local analysis is RBE3. To decrease the size of the files and demand of computational power, RBE3 can be combined with a superelement technique, for example DMIG.

     

    Finally, it is important to consider the size of the local model. There will inevitably be boundary effect when performing a Global-Local analysis of the suggested type, and it is therefore important to make the local model big enough so that the boundary effects have faded before reaching the area of interest.

  • 907.
    Ahlden, M.
    et al.
    Orthocenter IFK-kliniken, Sahlgrenska akademin, Göteborgs universitetGöteborg, Sweden.
    Kvist, Joanna
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.
    Samuelsson, K.
    Ortopedkliniken, Sahlgrenska universitetssjuk huset.
    Eriksson, K.O.
    Sahlgrenska akademin, Göteborgs universitet, Sweden; Sahlgrenska akademin, Göteborgs universitet, Sweden.
    Karlsson, J.
    Ortopedkliniken, Institutionen för klinisk forskning och utbildning, Södersjukhuset, Karolinska institutetStockholm, Sweden.
    Individualiserad terapi viktigt vid främre korsbandsskada2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 111, no 36, p. 1440-Article in journal (Refereed)
    Abstract [en]

    Anterior cruciate ligament (ACL) injury is a common injury and is often associated with concomitant injuries to the menisci and cartilage and, in the long term, osteoarthritis. Preventive training programs have shown to be highly effective in terms of reducing the risk for ACL injury in sports. ACL reconstruction is indicated when the patient experiences symtoms of instability (»giving way«) despite rehabilitation with a physiotherapist aiming to gain neuromuscular control of the knee. Early ACL reconstruction may be indicated, for example when the patient desires to return to pivoting contact-sports at high level. Modern surgical technique for ACL reconstruction has evolved rapidly and includes »anatomic reconstruction« and individualized treatment, where each patient’s unique anatomy, injury and requests on knee function are taken into consideration. In Sweden, more than 90% of all ACL reconstructions performed are included into the Swedish National ACL Register.

  • 908.
    Ahldén, Ingegerd
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Alehagen, Siw
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Dahlgren, Lars Owe
    Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Parents' Expectations About Participating in Antenatal Parenthood Education Classes2012In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 1, p. 11-17Article in journal (Refereed)
    Abstract [en]

    Our objective was to assess parents' expectations about participating in antenatal parenthood education classes and to determine whether their expectations might be related to gender, age, and educational level. Data from 1,117 women and 1,019 partners residing in three cities in Sweden were collected with a questionnaire in a cross-sectional study. Participants believed that antenatal education classes would help them to feel more secure as parents and to be better oriented toward childbirth. Men had more positive expectations about the childbirth than the women. The participants mostly wanted help in preparing for parenthood and in learning infant care skills, followed by help in preparing for childbirth. The participants' expectations were affected by gender, age, and educational level. The expectant parents appeared to want more focus on preparation for parenthood than on childbirth.

  • 909.
    Ahldén, Ingegerd
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Göransson, Anne
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Josefsson, Ann
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Alehagen, Siw
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Parenthood education in Swedish antenatal care: perceptions of midwives and obstetricians in charge.2008In: The Journal of perinatal education : an ASPO/Lamaze publication, ISSN 1058-1243, Vol. 17, no 2, p. 21-27Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe perceptions of parenthood education among midwives and obstetricians in charge of antenatal care in Sweden. Focus group interviews of 25 obstetricians and midwives were conducted. Data were analyzed with a phenomenographic approach. Five main categories emerged: aim of the parenthood education, content and expectations, implementation, support to group leaders, and strategies for the future. There is a strong belief in parenthood education, and the overall aim was considered to be support in the transition to parenthood. Contents should focus on awareness of the expected child, confidence in the biological processes, and the changes of roles. Pedagogies training, cost effectiveness, development, and the need to reach target groups were emphasized.

  • 910.
    Ahldén, Maria KC
    et al.
    Oslo University, Norway.
    Helén, Rönning
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Jönköping University.
    Agren, Susanna
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure2014In: Clinical Nursing Studies, ISSN 2324-7940, Vol. 2, no 2, p. 74-83Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.

    Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.

    Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.

    Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.

    Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.

  • 911.
    Ahle, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Necrotising Enterocolitis: epidemiology and imaging2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Necrotising enterocolitis (NEC) is a potentially devastating intestinal inflammation of multifactorial aetiology in premature or otherwise vulnerable neonates. Because of the broad spectrum of presentations, diagnosis and timing of surgical intervention may be challenging, and imaging needs to be an integrated part of management.

    The first four studies included in this thesis used routinely collected, nationwide register data to describe the incidence of NEC in Sweden 1987‒2009, its variation with time, seasonality, space-time clustering, and associations with maternal, gestational, and perinatal factors, and the risk of intestinal failure in the aftermath of the disease.

    Early infant survival increased dramatically during the study period. The incidence rate of NEC was 0.34 per 1,000 live births, rising from 0.26 per 1,000 live births in the first six years of the study period to 0.57 in the last five. The incidence rates in the lowest birth weights were 100‒160 times those of the entire birth cohort. Seasonal variation was found, as well as space-time clustering in association with delivery hospitals but not with maternal residential municipalities.

    Comparing NEC cases with matched controls, some factors, positively associated with NEC, were isoimmunisation, fetal distress, caesarean section, persistent ductus arteriosus, cardiac and gastrointestinal malformations, and chromosomal abnormalities. Negative associations included maternal pre-eclampsia, maternal urinary infection, and premature rupture of the membranes. Intestinal failure occurred in 6% of NEC cases and 0.4% of controls, with the highest incidence towards the end of the study period.

    The last study investigated current practices and perceptions of imaging in the management of NEC, as reported by involved specialists. There was great consensus on most issues. Areas in need of further study seem mainly related to imaging routines, the use of ultrasound, and indications for surgery.

    Developing alongside the progress of neonatal care, NEC is a complex, multifactorial disease, with shifting patterns of predisposing and precipitating causes, and potentially serious long-term complications. The findings of seasonal variation, spacetime clustering, and negative associations with antenatal exposure to infectious agents, fit into the growing understanding of the central role of bacteria and immunological processes in normal maturation of the intestinal canal as well as in the pathogenesis of NEC. Imaging in the management of NEC may be developed through future studies combining multiple diagnostic parameters in relation to clinical outcome.

    List of papers
    1. Epidemiology and Trends of Necrotizing Enterocolitis in Sweden: 1987-2009
    Open this publication in new window or tab >>Epidemiology and Trends of Necrotizing Enterocolitis in Sweden: 1987-2009
    2013 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 132, no 2, p. E443-E451Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVE: To investigate temporal, seasonal, and geographic variations in the incidence of necrotizing enterocolitis (NEC) and its relation to early infant survival in the Swedish population and in subgroups based on gestational age, birth weight, and gender. less thanbrgreater than less thanbrgreater thanMETHODS: In the Swedish birth cohort of 1987 through 2009 all children with a diagnosis of NEC were identified in the National Patient Register, the Swedish Medical Birth Register, and the National Cause of Death Register. NEC incidence, early mortality, and seasonality were analyzed with descriptive statistics, Poisson regression, and auto regression. less thanbrgreater than less thanbrgreater thanRESULTS: The overall incidence of NEC was 3.4 in 10 000 live births, higher in boys than in girls (incidence rate ratio 1.22, 95% confidence interval 1.06-1.40, P = .005), with a peak in November and a trough in May, and increased with an average of similar to 5% a year during the study period. In most subgroups, except the most immature, an initial decrease was followed by a steady increase. Seven-day mortality decreased strongly in all subgroups over the entire study period (annual incidence rate ratio 0.96, 95% confidence interval 0.95-0.96, P andlt; .001). This was especially marked in the most premature and low birth weight infants. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: After an initial decrease, the incidence of NEC has increased in Sweden during the last decades. An association with the concurrent dramatically improved early survival seems likely.

    Place, publisher, year, edition, pages
    American Academy of Pediatrics, 2013
    Keywords
    necrotizing enterocolitis, premature infants, perinatal mortality, perinatal care, epidemiology, trends, seasonal variation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-98148 (URN)10.1542/peds.2012-3847 (DOI)000322957300017 ()
    Note

    Funding Agencies|County Council of Ostergotland||Futurum||Academy of Health Care||Jonkoping County Council, Jonkoping, Sweden||Medical Research Council of Southeast Sweden||

    Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2018-03-27
    2. Population-based study showed that necrotising enterocolitis occurred in space-time clusters with a decreasing secular trend in Sweden
    Open this publication in new window or tab >>Population-based study showed that necrotising enterocolitis occurred in space-time clusters with a decreasing secular trend in Sweden
    Show others...
    2017 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 106, no 7, p. 1097-1102Article in journal (Refereed) Published
    Abstract [en]

    Aim: This study investigated space-time clustering of neonatal necrotising enterocolitis over three decades. Methods: Space-time clustering analyses objects that are grouped by a specific place and time. The Knox test and Kulldorffs scan statistic were used to analyse space-time clusters in 808 children diagnosed with necrotising enterocolitis in a national cohort of 2 389 681 children born between 1987 and 2009 in Sweden. The municipality the mother lived in and the delivery hospital defined closeness in space and the time between when the cases were born - seven, 14 and 21 days - defined closeness in time. Results: The Knox test showed no indication of space-time clustering at the residential level, but clear indications at the hospital level in all the time windows: seven days (p = 0.026), 14 days (p = 0.010) and 21 days (p = 0.004). Significant clustering at the hospital level was found during 1987-1997, but not during 1998-2009. Kulldorffs scan statistic found seven significant clusters at the hospital level. Conclusion: Space-time clustering was found at the hospital but not residential level, suggesting a contagious environmental effect after delivery, but not in the prenatal period. The decrease in clustering over time may reflect improved routines to minimise the risk of contagion between patients receiving neonatal care.

    Place, publisher, year, edition, pages
    WILEY, 2017
    Keywords
    Cluster analysis; Necrotising enterocolitis; Neonatal care; Precipitating contagion; Preterm infant
    National Category
    Pediatrics
    Identifiers
    urn:nbn:se:liu:diva-139608 (URN)10.1111/apa.13851 (DOI)000405216700022 ()28349558 (PubMedID)
    Note

    Funding Agencies|Swedish government; county councils

    Available from: 2017-08-16 Created: 2017-08-16 Last updated: 2018-03-27
    3. Maternal, fetal and perinatal factors associated with necrotizing enterocolitis in Sweden: A national case-control study
    Open this publication in new window or tab >>Maternal, fetal and perinatal factors associated with necrotizing enterocolitis in Sweden: A national case-control study
    2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, PLoS ONE, ISSN 1932-6203, Vol. 13, no 3, article id e0194352Article in journal (Refereed) Published
    Abstract [en]

    Objective

    To analyze associations of maternal, fetal, gestational, and perinatal factors with necrotizing enterocolitis in a matched case-control study based on routinely collected, nationwide register data.

    Study design

    All infants born in 1987 through 2009 with a diagnosis of necrotizing enterocolitis in any of the Swedish national health care registers were identified. For each case up to 6 controls, matched for birth year and gestational age, were selected. The resulting study population consisted of 720 cases and 3,567 controls. Information on socioeconomic data about the mother, maternal morbidity, pregnancy related diagnoses, perinatal diagnoses of the infant, and procedures in the perinatal period, was obtained for all cases and controls and analyzed with univariable and multivariable logistic regressions for the whole study population as well as for subgroups according to gestational age.

    Results

    In the study population as a whole, we found independent positive associations with necrotizing enterocolitis for isoimmunization, fetal distress, cesarean section, neonatal bacterial infection including sepsis, erythrocyte transfusion, persistent ductus arteriosus, cardiac malformation, gastrointestinal malformation, and chromosomal abnormality. Negative associations were found for maternal weight, preeclampsia, maternal urinary infection, premature rupture of the membranes, and birthweight. Different patterns of associations were seen in the subgroups of different gestational age.

    Conclusion

    With some interesting exceptions, especially in negative associations, the results of this large, population based study, are in keeping with earlier studies. Although restrained by the limitations of register data, the findings mirror conceivable pathophysiological processes and underline that NEC is a multifactorial disease.

    Place, publisher, year, edition, pages
    San Francisco, United States: Public Library of Science, 2018
    National Category
    Pediatrics
    Identifiers
    urn:nbn:se:liu:diva-146093 (URN)10.1371/journal.pone.0194352 (DOI)000428168400016 ()29570713 (PubMedID)2-s2.0-85044427061 (Scopus ID)
    Note

    Funding agencies: Region Ostergotland, Sweden [LiO-107641]; Medical Research Council of Southeast Sweden [FORSS-77481]; Futurum - the Academy of Health Care, Jonkoping County Council, Jonkoping, Sweden; Region Ostergotland [LIO-130291, LIO-204581, LIO-280451, LIO-361481, L

    Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-05-14Bibliographically approved
    4. The role of imaging in the management of necrotising enterocolitis: a multispecialist survey and a review of the literature
    Open this publication in new window or tab >>The role of imaging in the management of necrotising enterocolitis: a multispecialist survey and a review of the literature
    2018 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 28, no 9, p. 3621-3631Article in journal (Refereed) Published
    Abstract [en]

    Objectives

    To investigate current practices and perceptions of imaging in necrotising enterocolitis (NEC) according to involved specialists, put them in the context of current literature, and identify needs for further investigation.

    Methods

    Two hundred two neonatologists, paediatric surgeons, and radiologists answered a web-based questionnaire about imaging in NEC at their hospitals. The results were descriptively analysed, using proportion estimates with 95% confidence intervals.

    Results

    There was over 90% agreement on the value of imaging for confirmation of the diagnosis, surveillance, and guidance in decisions on surgery as well as on abdominal radiography as the first-choice modality and the most important radiographic signs. More variation was observed regarding some indications for surgery and the use of some ultrasonographic signs. Fifty-eight per cent stated that ultrasound was used for NEC at their hospital. Examination frequency, often once daily or more but with considerable variations, and projections used in AR were usually decided individually rather than according to fixed schedules. Predicting the need of surgery was regarded more important than formal staging.

    Conclusion

    Despite great agreement on the purposes of imaging in NEC and the most important radiographic signs of the disease, there was considerable diversity in routines, especially regarding examination frequency and the use of ultrasound. Apart from continuing validation of ultrasound, important objectives for future studies include definition of the supplementary roles of both imaging modalities in relation to other diagnostic parameters and evaluation of various imaging routines in relation to timing of surgery, complications, and mortality rate.

    Place, publisher, year, edition, pages
    Springer, 2018
    Keywords
    Enterocolitis, necrotising, Abdominal radiography, Ultrasonography, Surveys and questionnaires, Professional practice
    National Category
    Pediatrics
    Identifiers
    urn:nbn:se:liu:diva-146094 (URN)10.1007/s00330-018-5362-x (DOI)000440984300006 ()
    Available from: 2018-03-27 Created: 2018-03-27 Last updated: 2018-08-24
  • 912.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Radiology in Linköping.
    Drott, Peder
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Andersson, Roland
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Epidemiology and Trends of Necrotizing Enterocolitis in Sweden: 1987-20092013In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 132, no 2, p. E443-E451Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate temporal, seasonal, and geographic variations in the incidence of necrotizing enterocolitis (NEC) and its relation to early infant survival in the Swedish population and in subgroups based on gestational age, birth weight, and gender. less thanbrgreater than less thanbrgreater thanMETHODS: In the Swedish birth cohort of 1987 through 2009 all children with a diagnosis of NEC were identified in the National Patient Register, the Swedish Medical Birth Register, and the National Cause of Death Register. NEC incidence, early mortality, and seasonality were analyzed with descriptive statistics, Poisson regression, and auto regression. less thanbrgreater than less thanbrgreater thanRESULTS: The overall incidence of NEC was 3.4 in 10 000 live births, higher in boys than in girls (incidence rate ratio 1.22, 95% confidence interval 1.06-1.40, P = .005), with a peak in November and a trough in May, and increased with an average of similar to 5% a year during the study period. In most subgroups, except the most immature, an initial decrease was followed by a steady increase. Seven-day mortality decreased strongly in all subgroups over the entire study period (annual incidence rate ratio 0.96, 95% confidence interval 0.95-0.96, P andlt; .001). This was especially marked in the most premature and low birth weight infants. less thanbrgreater than less thanbrgreater thanCONCLUSIONS: After an initial decrease, the incidence of NEC has increased in Sweden during the last decades. An association with the concurrent dramatically improved early survival seems likely.

  • 913.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Drott, Peder
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Elfvin, Anders
    Department of Pediatrics, Institution of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Andersson, Roland E.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Department of Surgery, Ryhov County Hospital, Jönköping, Sweden .
    Maternal, fetal and perinatal factors associated with necrotizing enterocolitis in Sweden: A national case-control study2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, PLoS ONE, ISSN 1932-6203, Vol. 13, no 3, article id e0194352Article in journal (Refereed)
    Abstract [en]

    Objective

    To analyze associations of maternal, fetal, gestational, and perinatal factors with necrotizing enterocolitis in a matched case-control study based on routinely collected, nationwide register data.

    Study design

    All infants born in 1987 through 2009 with a diagnosis of necrotizing enterocolitis in any of the Swedish national health care registers were identified. For each case up to 6 controls, matched for birth year and gestational age, were selected. The resulting study population consisted of 720 cases and 3,567 controls. Information on socioeconomic data about the mother, maternal morbidity, pregnancy related diagnoses, perinatal diagnoses of the infant, and procedures in the perinatal period, was obtained for all cases and controls and analyzed with univariable and multivariable logistic regressions for the whole study population as well as for subgroups according to gestational age.

    Results

    In the study population as a whole, we found independent positive associations with necrotizing enterocolitis for isoimmunization, fetal distress, cesarean section, neonatal bacterial infection including sepsis, erythrocyte transfusion, persistent ductus arteriosus, cardiac malformation, gastrointestinal malformation, and chromosomal abnormality. Negative associations were found for maternal weight, preeclampsia, maternal urinary infection, premature rupture of the membranes, and birthweight. Different patterns of associations were seen in the subgroups of different gestational age.

    Conclusion

    With some interesting exceptions, especially in negative associations, the results of this large, population based study, are in keeping with earlier studies. Although restrained by the limitations of register data, the findings mirror conceivable pathophysiological processes and underline that NEC is a multifactorial disease.

  • 914.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Magnusson, Amanda
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Elfvin, Anders
    Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
    Andersson, Roland
    Department of Surgery, County Hospital Ryhov, Jönköping, Sweden.
    Space-time clustering of necrotizing enterocolitis supports the existence of transmissible causes.2017Conference paper (Other academic)
    Abstract [en]

    Problem Statement: Despite great efforts to prevent necrotizing enterocolitis (NEC) the incidence may in fact be increasing, and changes in the patient population over time seem to lead to changes in clinical presentation and risk factor spectrum as well. The presence of bacteria is an important prerequisite in the pathogenesis, but, rather than being caused by specific pathogens, inflammation and bacterial invasion are thought to be mediated through erroneous interaction between microbiota and innate immunity during colonization of the gut. There are, however, reports of episodic outbreaks of NEC, seasonal variation in incident rates, and clustering, suggesting a role for transmissible infectious agents or other environmental factors around the pregnant mother or newborn infant. In order to investigate evidence for such factors we have analyzed the occurrence of space-time clusters in Sweden over 23 years. Methods: A national register-based cohort of all children born between 1987 and 2009 in Sweden, diagnosed with NEC, was identified. The Knox test and Kulldorff’s scan method were used to analyze signs of space-time clusters at two geographical levels; the mother’s residential address and the delivery hospital. Time windows of seven, 14 and 21 days were used for closeness in time. Results: The Knox test showed clustering on hospital level in all studied temporal windows; seven days (p=0.022) 14 days (p=0.011) and 21 days (p=0.006), and Kulldorff’s scan method found seven significant clusters. On residential level, there was no indication of space-time interaction. When comparing two time periods, significant clustering on hospital level was found during 1987-1997, but not during 1998-2009. Conclusion: Space-time clustering was found on hospital level, but not on community level, suggesting a contagious environmental effect at and after delivery but not in the materno-fetal environment outside the hospital before birth. The decrease in clustering over time suggests that improved routines in neonatal care have minimized the risk of NEC precipitating contagions spreading between patients in the neonatal intensive care unit. The importance of such routines should not be forgotten while our efforts to bring down NEC incidence are directed towards other challenges.

  • 915.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Ringertz, Hans G.
    Department of Radiology, Stanford University Medical Center, Stanford, USA; Division of Diagnostic Radiology, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Rubesova, Erika
    Department of Radiology, Lucile Packard Children’s Hospital, Stanford University Medical Center, Stanford, USA.
    The role of imaging in the management of necrotising enterocolitis: a multispecialist survey and a review of the literature2018In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 28, no 9, p. 3621-3631Article in journal (Refereed)
    Abstract [en]

    Objectives

    To investigate current practices and perceptions of imaging in necrotising enterocolitis (NEC) according to involved specialists, put them in the context of current literature, and identify needs for further investigation.

    Methods

    Two hundred two neonatologists, paediatric surgeons, and radiologists answered a web-based questionnaire about imaging in NEC at their hospitals. The results were descriptively analysed, using proportion estimates with 95% confidence intervals.

    Results

    There was over 90% agreement on the value of imaging for confirmation of the diagnosis, surveillance, and guidance in decisions on surgery as well as on abdominal radiography as the first-choice modality and the most important radiographic signs. More variation was observed regarding some indications for surgery and the use of some ultrasonographic signs. Fifty-eight per cent stated that ultrasound was used for NEC at their hospital. Examination frequency, often once daily or more but with considerable variations, and projections used in AR were usually decided individually rather than according to fixed schedules. Predicting the need of surgery was regarded more important than formal staging.

    Conclusion

    Despite great agreement on the purposes of imaging in NEC and the most important radiographic signs of the disease, there was considerable diversity in routines, especially regarding examination frequency and the use of ultrasound. Apart from continuing validation of ultrasound, important objectives for future studies include definition of the supplementary roles of both imaging modalities in relation to other diagnostic parameters and evaluation of various imaging routines in relation to timing of surgery, complications, and mortality rate.

  • 916.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Rubesova, Erika
    Stanford university, US.
    Ringertz, Hans
    Stanford university, US.
    The significance of radiographic and ultrasonographic findings in the management of necrotising enterocolitis - results from a survey2017Conference paper (Other academic)
    Abstract [en]

    Necrotising Enterocolitis (NEC) remains a potentially devastating emergency in neonates, predominantly the premature. Ever since it was first described in the 60's, imaging has played a great role in definition, staging, and monitoring of the disease. The radiographic image can change before the clinical condition, but typical signs are often transient and may be missing even in severe NEC [1-4]. These circumstances have led to the recommendation of frequent imaging and to the insight that the clinical decisions cannot rely solely on radiological signs [5-7]. Ultrasound (US) as a possibility to enhance sensitivity and diagnostic accuracy was first described in the mid 80's [8, 9] and was included in a diagnostic algorithm suggested by in 1994 [6], but despite great effort to develop and validate the method, its role in the management of NEC has not yet been established [7, 10, 11].

    Meanwhile, in order to improve interobserver agreement and diagnostic accuracy of AR, the radiographic signs of NEC have also been systematized into the DAAS scale [12]. Imaging, as an adjunct to clinical assessment [11], is crucial in the diagnosis and management of NEC. The purpose of this survey was to investigate current views and routines, as described by involved specialists, and identify areas in need of further study and discussion.

  • 917.
    Ahle, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Radiology in Linköping.
    Rubesova, Erika
    Stanford university, US.
    Ringertz, Hans
    Stanford university, US.
    The use of imaging in necrotising enterocolitis - results from a survey2017Conference paper (Other academic)
  • 918.
    Ahlen, Elsa
    et al.
    Linköping University, Faculty of Health Sciences.
    Hills, Charlotte S.
    University of British Columbia, Canada .
    Hanif, Hashim M.
    University of British Columbia, Canada .
    Rubino, Cristina
    University of British Columbia, Canada .
    Barton, Jason J. S.
    University of British Columbia, Canada VGH Eye Care Centre, Canada .
    Learning to read upside-down: a study of perceptual expertise and its acquisition2014In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 232, no 3, p. 1025-1036Article in journal (Refereed)
    Abstract [en]

    Reading is an expert visual and ocular motor function, learned mainly in a single orientation. Characterizing the features of this expertise can be accomplished by contrasts between reading of normal and inverted text, in which perceptual but not linguistic factors are altered. Our goal was to examine this inversion effect in healthy subjects reading text, to derive behavioral and ocular motor markers of perceptual expertise in reading, and to study these parameters before and after training with inverted reading. Seven subjects engaged in a 10-week program of 30 half-hour sessions of reading inverted text. Before and after training, we assessed reading of upright and inverted single words for response time and word-length effects, as well as reading of paragraphs for time required, accuracy, and ocular motor parameters. Before training, inverted reading was characterized by long reading times and large word-length effects, with eye movements showing more and longer fixations, more and smaller forward saccades, and more regressive saccades. Training partially reversed many of these effects in single word and text reading, with the best gains occurring in reading aloud time and proportion of regressive saccades and the least change in forward saccade amplitude. We conclude that reading speed and ocular motor parameters can serve as markers of perceptual expertise during reading and that training with inverted text over 10 weeks results in significant gains of reading expertise in this unfamiliar orientation. This approach may be useful in the rehabilitation of patients with hemianopic dyslexia.

  • 919.
    Ahlen, Gustaf
    et al.
    Karolinska University Hospital Huddinge, Sweden .
    Chen, Antony
    Karolinska University Hospital Huddinge, Sweden .
    Roe, Barbara
    University of Coll Dublin, Ireland .
    Falkeborn, Tina
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Frelin, Lars
    Karolinska University Hospital Huddinge, Sweden .
    Hall, William W
    University of Coll Dublin, Ireland .
    Sallberg, Matti
    Karolinska University Hospital Huddinge, Sweden .
    Soderholm, Jonas
    Karolinska University Hospital Huddinge, Sweden University of Gothenburg, Sweden .
    Limited effect on NS3-NS4A protein cleavage after alanine substitutions within the immunodominant HLA-A2-restricted epitope of the hepatitis C virus genotype 3a non-structural 3/4A protease2012In: Journal of General Virology, ISSN 0022-1317, E-ISSN 1465-2099, Vol. 93, p. 1680-1686Article in journal (Refereed)
    Abstract [en]

    It has been well established that immunological escape mutations within the hepatitis C virus genotype (gt) la non-structural (NS) 3/4A protease are partly prevented by a reduction in viral protease fitness. Surprisingly little is known about whether similar mutations affect proteases from other genotypes. In the present study, we assessed both the HLA-A2-restricted CTL response and gt3a NS3/4A protease fitness. Similar to gt1, the 1073-1081 epitope was immunodominant within the gt3a-specific HLA-A2-restricted CTL response, despite sequence similarity of only 56% between the gt1a and gt3a genes. However, unlike the gt1a NS3/4A protease, all residues within the gt3a 1073-1081 epitope could be replaced sequentially by alanine while retaining protease activity, at least in part.

  • 920.
    Ahlen, K.
    et al.
    Åhlén, K., Dept. Med. Biochem. and Microbiol., University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden.
    Ring, P.
    Dept. Med. Biochem. and Microbiol., University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden.
    Tomasini-Johansson, B.
    Dept. Med. Biochem. and Microbiol., University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden, Department of Medicine, University of Wisconsin-Madison, 4285 MSC, 1300 University Ave, Madison, WI 53706, United States.
    Holmqvist, K.
    Dept. Med. Biochem. and Microbiol., University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden, Department of Medical Cell Biology, University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden.
    Magnusson, Karl-Eric
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Medical Microbiology .
    Rubin, K.
    Dept. Med. Biochem. and Microbiol., University of Uppsala, Biomedical Center, SE-751 23 Uppsala, Sweden.
    Platelet-derived growth factor-BB modulates membrane mobility of ß1 integrins2004In: Biochemical and Biophysical Research Communications - BBRC, ISSN 0006-291X, E-ISSN 1090-2104, Vol. 314, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    Platelet-derived growth factor (PDGF)-BB elicits a migratory response including reorganization of the actin cytoskeleton in different cell types. Here we have investigated the effects of PDGF-BB stimulation on ß 1 integrin containing focal adhesions in human diploid fibroblasts adhered to collagen type I. Stimulation with PDGF-BB dissociated focal adhesions and relocated ß1 integrins from focal adhesions to the periphery of the cells. These changes were rapid and transient in character. Relocation of ß1 integrins was prevented by inhibitors of phosphoinositide-3-kinase and protein kinase C. PDGF-BB stimulated fibroblasts exhibited an increased diffusion coefficient of cell surface ß1 integrins as determined by fluorescence recovery of photobleaching. The cell surface expression of ß1 integrins was not changed after stimulation with PDGF-BB. Our data suggest that PDGF-BB increases the dynamic properties of cell-surface ß1 integrins, which most likely are important for the migratory response elicited by PDGF-BB. © 2003 Elsevier Inc. All rights reserved.

  • 921.
    Ahlenius, Sven
    et al.
    Göteborgs universitet.
    Heimann, Mikael
    Göteborgs universitet.
    Larsson, Knut
    Göteborgs universitet.
    Prolongation of the ejaculation latency in the male rat by thioridazine and chlorimipramine.1979In: Psychopharmacology, ISSN 0033-3158, E-ISSN 1432-2072, Vol. 65, no 2, p. 137-140Article in journal (Refereed)
    Abstract [en]

    Thioridazine (3 mg/kg) and chlorimipramine (1.5–6.0 mg/kg) prolonged the ejaculation latency and increased the number of mounts but did not change the number of intromissions preceding ejaculation. Blockade of peripheral and central noradrenaline receptors by phentolamine and phenoxybenzamine respectively resulted in a suppression of all aspects of the sexual behavior with increasing doses. dl-5-HTP (25–100 mg/kg) in combination with an inhibitor of peripheral 5-HTP decarboxylase (benserazide, 25 mg/kg) produced, like chlorimipramine and thioridazine, a prolongation of ejaculation latency and an increase in the number of mounts preceding ejaculation. Selective inhibition of 5-HT reuptake however, by zimelidine (0–20 mg/kg) or alaproclate (0–20 mg/kg) did not affect the mating behavior. At higher doses of these drugs some animals failed to initiate sexual activities. There was an increase in the postejaculatory interval but no change in the ejaculatory latency.It is concluded that the prolonged ejaculation latencies observed following treatment with thioridazine or chlorimipramine is not due to a blockade of central or peripheral adrenergic -receptors.

  • 922.
    Ahlepil, Erik
    et al.
    Linköping University, Department of Management and Engineering, Logistics & Quality Management.
    Björck, Joel
    Linköping University, Department of Management and Engineering, Logistics & Quality Management.
    Evaluating Distribution Structures for Overseas Export of Frozen Food.2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The meat producers of the western world needs to develop their export organizations and to streamline their physical distribution in order to take new market shares on the fast growing overseas markets. HKScan is one of those meat producing companies, the group has businesses in Finland, Sweden, Denmark and the Baltic countries. A part of their sales goes frozen on overseas export by container sea freight. Lately the logistics management of HKScan has been interested in investigating the effects of centralizing the physical distribution for the overseas export from Sweden and Denmark. This leads to the purpose of this study, which is:

     “For HKScan, develop and apply a model that evaluates distribution structures for overseas export of frozen food regarding total cost, delivery service, environmental impact and regulations.”

    The case study included comparison between the current distribution structure for HKScan and three pre-determined scenarios. The current setup consists of multiple warehouses in both countries. In the first scenario the distribution structure is centralized to include one warehouse per country. In the second scenario, the total export flow of products from both Sweden and Denmark is redirected and centralized to one warehouse in Denmark. In the third scenario, the total export flow of products from both Sweden and Denmark is instead redirected and centralized to one warehouse in Sweden.

    To evaluate and compare the different distribution structures a general model was first created by combining different theoretical models and adapting them to the context of overseas distribution for frozen food. The study then included the three phases of developing the model to fit the case company, applying the model on the case company and then to finally evaluating the model.

    The resulting model, which was the outcome of the development process, can be seen below. The model illustrates the different included elements.

    By then applying the model onto the case company, HKScan, it was found that a centralization to a joint warehouse in Denmark would make total cost savings of several percents. In addition, this scenario would increase the total service level. However, the environmental impact would be increased due to long cross-border road transport distances and longer land and sea transports from the warehouse. In addition, it was not possible to fully investigate whether such a distribution would be possible from a regulatory point of view.  A centralization in each country would have minor regulatory issues, it would lead to the smallest environmental impact and have a slight increase in service levels as well as a reduction for the total cost of one percent.

    The evaluation of the model showed that it produces reasonable results with the regulatory elements being the hardest to evaluate for the different scenarios. Regarding the detail level, the veterinary element could be accounted for by the warehousing element and the sea freight element split into transport from warehouse to domestic port and sea freight from domestic port to the destination port. The box-model, containing twelve elements, can be seen as generalizable for evaluating distribution structures in similar contexts, Overseas export of frozen food. However, the calculation performed within the model do probably only apply to the specific scenarios in the study.

  • 923.
    Ahlers, Martina
    et al.
    Linköping University, Department of Management and Engineering, Business Administration. Linköping University, Faculty of Arts and Sciences.
    Wilms, Maximilian
    Linköping University, Department of Management and Engineering, Business Administration. Linköping University, Faculty of Arts and Sciences.
    Ambidextrous Leadership in Innovation: A multiple case study of innovation leaders on the alignment of opening and closing leader behaviors2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The relatively new concept of ambidextrous leadership in innovation with the opposing yet complementary opening and closing leader behaviors has been proven to be positively related to fostering explorative and exploitative behaviors respectively among subordinates. The initiators of this concept propose that leaders in innovation need a ‘temporal flexibility to switch’ between opening and closing leader behaviors, which implies a sequential alignment of these behaviors. This proposition has yet remained theoretically and empirically unexplored and is initially questioned in this thesis with respect to related theoretical concepts.

    Therefore, this thesis aims to explain how innovation leaders align the recently defined opening and closing leader behaviors throughout the innovation process. By following a qualitative and inductive research approach, a multiple case study of five innovation leaders in German manufacturing companies was conducted. The data were collected through in-depth semi-structured interviews. The empirical data reveal that the initiators’ proposition of a sequential alignment is not sufficient to explain the complex alignment of opening and closing leader behaviors. Accordingly, a model which illustrates a predominantly simultaneous alignment of the two leader behaviors was developed. However, this model also considers that urgent situations or specific project phases and times of the year require innovation leaders to sequentially demonstrate one behavior at a time.

  • 924.
    Ahlforn, Martin
    Linköping University, Department of Computer and Information Science.
    Kommunicera och rapportera: En undersökning av sjukvårdsrådgivares syn på patientsäkerhet och inflytandet på verksamhetens säkerhetskultur2010Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Sjukvårdsrådgivning via telefon har kommit att bli ett allt vanligare sätt att kontakta vården. Det är också ett smidigt sätt att i dagens mobila samhälle utnyttja tiden effektivt. Denna typ av sjukvårdsrådgivning skiljer sig från det annars traditionella sättet där sjuksköterskan fysiskt möter patienten till exempel på en vårdcentral. I anslutning till den tidigare sjukvården finns också etablerade metoder och riktlinjer för patientsäkerhet, vilket bidrar till att kontinuerligt sträva efter att upprätthålla god vårdkvalitet och trygghet för patienten. En metod är exempelvis det avvikelserapporteringssystem som sedan tidigare används inom bland annat Landstinget i Östergötland, vilket också har kommit att användas på Sjukvårdsrådgivningen i Linköping.

    Syftet med denna studie var att inom en verksamhet för sjukvårdsrådgivning via telefon undersöka vilka attityder personalen har till patientsäkerhet, samt hur de själva beskriver sina åsikter angående detta ämne. Baserat på tidigare forskning relateras resultaten till vilken påverkan de uppskattas ha på verksamhetens säkerhetskultur.

    En webbenkät användes som instrument i studiens datainsamling. Frågorna var sedan tidigare framtagna för att mäta patientsäkerhet inom traditionell sjukvård, vilka grundade sig på element från säkerhetskulturforskning. En av studiens centrala upptäckter tyder på att personalen tycker att det är svårt att hinna med att rapportera avvikelser. Det fanns också en tendens att flera sjukvårdsrådgivare berättar om avvikelser för arbetskamrater när de väl upptäcks, än antal som avvikelserapporterar på formellt vis. Vidare påträffades också att respondenterna inte är rädda för att be om hjälp när oklarheter i arbetet uppstår. En av studiens slutsatser var att sjukvårdsrådgivarna behöver mer tid till att kunna prioritera att rapportera avvikelser som upptäcks för att minimera informationsbortfall.

  • 925.
    Ahlfors, Mathias
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Educational Sciences.
    Sten, Peter
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Educational Sciences.
    Finns tiden som behövs?: Ett första steg med implementeringen av den nya läroplanen för fritidshemmet.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction

    In 2016, the National Agency for Education issued new sections in elementary school curricula. Among other things, assignments and purposes were clarified for teachers in the extended school. The amendments take an effect on the first of July of the same year. By these changes the role and status should be improved for the teachers, by giving them more time to the extended school.

    Purpose

    The purpose of this survey is to find out if teachers in the extended school consider that their daily work has changed since the new sections of the curriculum came out, to see how the implementation of the section paragraphs has worked and will continue to work, as well as to investigate how teachers in the extended school, if their status has increased or decreased compared with previous years.

    Method

    We used a quantitative method through a survey, there were 324 replies.

    Results

    What emerges from our results is that the status is perceived to increase slowly but surely. In order to strengthen the profession, more planning time, higher pay and better insight into the activities of colleagues and principals / mandator are needed. What is also evident is that teachers in the extended school have a variety of assignments during the school day, but more time would be needed for the extended school to complete the new chapter of the curriculum.

    Conclusion

    There is still not enough time for the extended school activities. We also think that the status is going in a positive direction.

  • 926. Ahlgren Andersson, E
    et al.
    Almerud Österberg, S
    Elneborg, K
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Johansson, E
    Minthon, L
    Pettersson, M
    Thulesius, H
    Wohlin, S
    Åberg, B
    Östberg, H
    Låg kognitiv hastighet före operation hade samband med postoperativ förvirring efter elektiv hjärtkirurgi2012Conference paper (Other academic)
  • 927.
    Ahlgren, Anna
    Linköping University, Department of Computer and Information Science.
    MobiAnn: androidapplikationen som underlättar lärares arbetsuppgifter2011Independent thesis Basic level (degree of Bachelor), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [sv]

    Examensarbetet diskuterar behovet av ett stödsystem för lärare vid undervisning och tar upp olika aspekter utifrån lärarnas arbetssituation. Som en del av denna diskussion finns en implementation av ett system i form av en Androidapplikation.

    Applikationen ger lärarna möjlighet till ett stödsystem med olika användningsområde som närvarokontroll, anmärkningsmöjligheter om förseningar och stök under lektionstid, verktyg för att anteckna elevarbete och motivera betyg direkt på plats.

    Stor vikt har lagts på att göra applikationen lättanvänd och användarvänlig och därför har tester med användare varit en stor del under utvecklingen.

  • 928.
    Ahlgren, Ann-Sofie
    et al.
    Linköping University, Department of Management and Economics.
    Björck, Charlotte
    Linköping University, Department of Management and Economics.
    Internetbaserade distansutbildningar2000Independent thesis Advanced level (degree of Magister)Student thesis
    Abstract [en]

    In the informational age of today, continuous learning is of greatest importance. The demand for this seems to be increasing, while at the same time people are under more pressure to carry out more tasks in shorter amounts of time. A way to solve the problem of finding time to learn could be to make use of the possibilities that Internet offers for learning at a distance. The purpose of this thesis is to, from a pedagogical perspective, contribute to the discussion concerning Internet based distance education for a target population consisting of professionals. We have found that some of the courses included in the two certification programs which we have investigated are suitable for Internet based distance education. Furthermore, we believe that such an educational format should be a complement, and not a substitute, for the target population.

  • 929. Ahlgren, AR
    et al.
    Piitulainen, E
    Sandgren, T
    Länne, Toste
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Physiology . Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
    Alfa1-antitrypsin deficiency and blood pressure regulation2003In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 21, p. S151-S151Conference paper (Other academic)
  • 930.
    Ahlgren, Britt-Louise
    Linköping University, Department of Educational Science (IUV).
    Motorik och lärande2002Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    Denna studie är ett arbete som baserar sig på en litteraturstudie och en kvalitativ undersökning i form av intervjuer, som studerar motoriken och rörelsens betydelse för lärandet. Denna kvalitativa studie bygger på intervjuer med fyra elever och deras föräldrar samt två lärare. Här ställs också frågan om hur jag som lärare kan upptäcka dessa elever och hur jag kan arbeta med dem i skolan. Slutligen ställs också frågan hur dessa barn och föräldrar som arbetar med motorisk träning beskriver detta.

    I arbetet framgår att rörelser av olika slag kan vara stimulerande för vissa delar av hjärnans utveckling, som senare kan få betydelse för lärandet. Arbetet beskriver även vilken betydelse, reflexerna, perceptionen samt de auditiva och visuella områdena, har för lärandet. Det framkommer vilka problem ett barn kan få om den exempelvis har kvar reflexrester. Det framgår vidare att det finns hjälp att få för de barn som har motoriska problem. Denna hjälp kan de få i form av olika rörelseövningar som kan sättas in av kunnig expertis. Den här typen av hjälp får dock kritik, samtidigt som intervjuerna vittnar om att det haft en positiv inverkan och lett till förbättringar.

  • 931.
    Ahlgren, Ewa
    Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medicine and Care, Anaesthesiology. Linköping University, Faculty of Health Sciences.
    Cerebral complications after cardiac surgery2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Cerebral injuty remains a major cause of morbidity and mortality after cardiac surgery. Previous studies have mainly focused on preoperative risk factors and intraoperative events but cerebral complications may also occur in the postoperative period. Cognitive impairment is common after cardiac surgery but the consequences of this complication for activities of daily life are less known. Safe driving involves a complex set of skills requiring preserved cognitive function. A substantial number of patients with heart disease are active drivers. The impact of postoperative cognitive dysfunction on driving performance, however, has not previously been investigated in this large patient group.

    In this thesis pre-, intra- and postoperative risk factors for focal cerebral complications were determined and the onset time of cerebral symptoms were evaluated in two cohorts of cardiac surgical patients, comprising 2480 and 3282 patients respectively. Data analysed were drafted from a clinical register and the surgical database of Linköping University Hospital Heart Center. Cerebral complication was delayed, i.e occurred after a free interval, in about one third of patients suggesting causes other than intraoperative events. Different risk factors were found for early and delayed cerebral complications suggesting different mechanisms of cerebral injury. Advanced age, preoperative hypertension, aortic surgery, prolonged cardiopulmonary bypass (CPB) time, intraoperative hypotension after completion of CPB, and arrhytlunia in the early postoperative period increased the risk for early cerebral complication. Female gender, diabetes, previous cerebrovascular disease, combined coronary artery bypass grafting (CABG) and valve surgery and arrhythmia on the thoracic ward increased the risk for delayed cerebral complication. Cognitive function and driving performance were evaluated in 27 patients before and 4-6 weeks after CABG. The patients underwent neuropsychological testing, an on-road driving test and a test in an advanced driving simulator. Twenty patients scheduled for percutaneous coronary intervention (PCI) served as controls. Complete data were obtained in 23 and 19 patients respectively. Furthermore cognitive function and driving performance in on-road driving of the 44 patients with complete tests before intervention were compared with controls of similar age without heart symptoms. Cognitive function and driving performance were already impaired in patients with coronary artery disease before intervention when compared with controls. After surgery 48% of the patients showed cognjtive decline compared to 10% after PCI. These patients also scored less in the on-road driving test to a greater extent than did patients without postoperative cognitive decline.

    List of papers
    1. Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms
    Open this publication in new window or tab >>Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms
    1998 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 12, no 3, p. 270-273Article in journal (Refereed) Published
    Abstract [en]

    Objectives: Cerebral complications continue to be a major cause of morbidity after cardiac surgery. Earlier studies have mainly focused on intraoperative events, but symptoms may also occur later in the postoperative period. The purpose of this study was to determine the incidence and risk factors of focal neurologic complications and timing of cerebral symptoms.

    Design: A retrospective study.

    Setting: Linköping University Hospital.

    Participants: Two thousand four hundred eighty patients who underwent cardiac surgery from 1992 to 1995.

    Interventions: Standard cardiopulmonary bypass (CPB) technique was used in all patients. Anticoagulant treatment included heparin and patients with coronary artery surgery were also administered acetylsalicylic acid and valve-surgery patients received warfarin or dicumarol.

    Measurements and Main Results: Seventy-five patients (3%) had focal neurologic deficits and/or confusion postoperatively. In 32 patients (43%), the onset was not intraoperative but occurred later in the postoperative period. The lowest incidence of cerebral complications was found in patients who underwent single-valve replacement (1.2%) and the highest incidence was found in patients who underwent combined procedures (valve and coronary artery surgery; 7.6%). Patients greater than 70 years of age had a complication rate of 4.1% compared with 2.5% in patients aged 70 years and less (p < 0.05). The incidence of diabetes mellitus was 11.4% in the entire series, but was more common (18.7%; p < 0.05) in patients with cerebral symptoms. Also, 5.9% of all patients had a history of cerebrovascular disease compared with 14.7% (p < 0.01) of patients with cerebral complications.

    Conclusion: Cerebral complications may be delayed after cardiac surgery, suggesting causes of cerebral damage other than intraoperative events. Valve-surgery patients had the lowest incidence and patients with combined procedures had the highest incidence of cerebral complications. Advanced age, diabetes mellitus, and preexisting cerebrovascular disease increased the risk.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81345 (URN)10.1016/S1053-0770(98)90004-0 (DOI)
    Available from: 2012-09-12 Created: 2012-09-12 Last updated: 2017-12-07Bibliographically approved
    2. Risk factor analysis of early and delayed cerebral complications after cardiac surgery
    Open this publication in new window or tab >>Risk factor analysis of early and delayed cerebral complications after cardiac surgery
    2002 (English)In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 16, no 3, p. 278-285Article in journal (Refereed) Published
    Abstract [en]

    Objective: To report the incidence, severity, and possible risk factors for early and delayed cerebral complications.

    Design: Retrospective study.

    Setting: Linköping University Hospital, Sweden.

    Participants: Consecutive patients who underwent cardiac surgery in the period July 1996 through June 2000 (n = 3,282).

    Interventions: A standard cardiopulmonary bypass (CPB) technique was used for most patients. Postoperative anticoagulant treatment included heparin or anti-Xa dalteparin. Patients undergoing coronary artery bypass graft surgery received acetylsalicylic acid, and patients undergoing valve surgery received warfarin.

    Measurements and Main Results: Cerebral complications occurred in 107 patients (3.3%). Of these, 60 (1.8%) were early, and 33 (1.0%) were delayed, and in 14 (0.4%) patients the onset was unknown. There were 37 variables in univariate analysis (p < 0.15) and 14 variables in multivariate analysis (p < 0.05) associated with cerebral complications. Predictors of early cerebral complications were older age, preoperative hypertension, aortic aneurysm surgery, prolonged CPB time, hypotension at CPB completion and soon after CPB, and postoperative arrhythmia and supraventricular tachyarrhythmia. Predictors of delayed cerebral complications were female gender, diabetes, previous cerebrovascular disease, combined valve surgery and coronary artery bypass graft surgery, postoperative supraventricular tachyarrhythmia, and prolonged ventilator support. Early cerebral complications seem to be more serious, with more permanent deficits and a higher overall mortality (35.0% v 18.2%).

    Conclusion: Most cerebral complications had an early onset. The results of this study suggest that aggressive antiarrhythmic treatment and blood pressure control may imfurther prove the cerebral outcome after cardiac surgery.

    Place, publisher, year, edition, pages
    Elsevier, 2002
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-29550 (URN)10.1053/jcan.2002.124133 (DOI)14921 (Local ID)14921 (Archive number)14921 (OAI)
    Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2018-05-22Bibliographically approved
    3. Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery
    Open this publication in new window or tab >>Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery
    2002 (English)In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 3, no 3, p. 205-208Article in journal (Refereed) Published
    Abstract [en]

    Cognitive ability is essential for the fitness to drive. Impaired cognitive functions are common after cardiac surgery. Little is known about driving habits and influence of postoperative cognitive decline on driving performance in these patients. The aim of this study was to investigate the extent of driving activity of patients before and after cardiac surgery. Ninety-seven cardiac surgical patients were interviewed about their driving habits before and 12 weeks after surgery. The mean age was 66. Before the operation, 78% were active car drivers. They drove several times a week including longer than 100 km distances. After the operation, 64% continued to drive and most of them (69%) had commenced driving within 6 weeks. The majority (79%) reported unchanged driving habits, while 13 patients (21%) had reduced their driving activity due to the cognitive symptoms they experienced. Patients with coronary artery disease are active car drivers both before and after heart surgery. Further evaluation of the ability of these patients to drive is required if we are to give advice and apply restrictions in the interest of traffic safety.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26733 (URN)10.1080/15389580213649 (DOI)11328 (Local ID)11328 (Archive number)11328 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    4. Neurocognitive impairment and driving performance after coronary artery bypass surgery
    Open this publication in new window or tab >>Neurocognitive impairment and driving performance after coronary artery bypass surgery
    Show others...
    2003 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 23, no 3, p. 334-340Article in journal (Refereed) Published
    Abstract [en]

    Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).

    Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.

    Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.

    Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.

    Keywords
    Cardiac surgery, Cerebral complications, Cognitive decline, Driving performance
    National Category
    Social Sciences
    Identifiers
    urn:nbn:se:liu:diva-26290 (URN)10.1016/s1010-7940(02)00807-2 (DOI)10806 (Local ID)10806 (Archive number)10806 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. Driving performance of patients with coronary artery disease
    Open this publication in new window or tab >>Driving performance of patients with coronary artery disease
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives To compare patients with coronary artery disease and healthy controls with respect to cognitive function and driving performance.

    Design and setting A controlled study conducted between April 1999 and January 2001.

    Subjects Forty-four patients with stable coronary artery disease scheduled for cardiac intervention with coronary artery bypass surgery or percutaneous coronary intervention. Forty volunteers of similar age without symptoms of coronary artery disease served as controls.

    Main outcome measures On-road driving scores in five specific test areas with a rating scale from 1 to 5. Neuropsychological test scores, including 12 tests.

    Results Compared with controls, patients with coronary artery disease had lower scores in all areas of the on-road driving test (p<0.05) and in the neuropsychological tests assessing psychomotor speed, visual and verbal memory, focused attention and simultaneous capacity (p<0.05). The difference between the groups in the on-road driving test appeared to be more pronounced among those above 65 years-of-age. Both patients and controls rated their performance significantly higher than the traffic inspector (p<0.05).

    Conclusions Cognitive function and driving performance may be impaired in patients with coronary artery disease.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81348 (URN)
    Available from: 2012-09-12 Created: 2012-09-12 Last updated: 2012-09-12Bibliographically approved
  • 932.
    Ahlgren, Ewa
    et al.
    Linköping University, Department of Medical and Health Sciences, Cardiothoracic Anaesthesia and Intensive care. Linköping University, Department of Medicine and Care, Thoracic Surgery. Linköping University, Faculty of Health Sciences.
    Arén, Claes
    Cerebral complications after coronary artery bypass and heart valve surgery: Risk factors and onset of symptoms1998In: Journal of Cardiothoracic and Vascular Anesthesia, ISSN 1053-0770, E-ISSN 1532-8422, Vol. 12, no 3, p. 270-273Article in journal (Refereed)
    Abstract [en]

    Objectives: Cerebral complications continue to be a major cause of morbidity after cardiac surgery. Earlier studies have mainly focused on intraoperative events, but symptoms may also occur later in the postoperative period. The purpose of this study was to determine the incidence and risk factors of focal neurologic complications and timing of cerebral symptoms.

    Design: A retrospective study.

    Setting: Linköping University Hospital.

    Participants: Two thousand four hundred eighty patients who underwent cardiac surgery from 1992 to 1995.

    Interventions: Standard cardiopulmonary bypass (CPB) technique was used in all patients. Anticoagulant treatment included heparin and patients with coronary artery surgery were also administered acetylsalicylic acid and valve-surgery patients received warfarin or dicumarol.

    Measurements and Main Results: Seventy-five patients (3%) had focal neurologic deficits and/or confusion postoperatively. In 32 patients (43%), the onset was not intraoperative but occurred later in the postoperative period. The lowest incidence of cerebral complications was found in patients who underwent single-valve replacement (1.2%) and the highest incidence was found in patients who underwent combined procedures (valve and coronary artery surgery; 7.6%). Patients greater than 70 years of age had a complication rate of 4.1% compared with 2.5% in patients aged 70 years and less (p < 0.05). The incidence of diabetes mellitus was 11.4% in the entire series, but was more common (18.7%; p < 0.05) in patients with cerebral symptoms. Also, 5.9% of all patients had a history of cerebrovascular disease compared with 14.7% (p < 0.01) of patients with cerebral complications.

    Conclusion: Cerebral complications may be delayed after cardiac surgery, suggesting causes of cerebral damage other than intraoperative events. Valve-surgery patients had the lowest incidence and patients with combined procedures had the highest incidence of cerebral complications. Advanced age, diabetes mellitus, and preexisting cerebrovascular disease increased the risk.

  • 933.
    Ahlgren, Ewa
    et al.
    Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Cederholm, Ingemar
    Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Gårdelöf, B
    Hübbert, Laila
    Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Josefsson, A
    Planerat kejsarsnitt på en kvinna med uttalat hypertrof obstruktiv kardiomyopati2011In: Svensk Förening för Anestesi och Intensivvård, Vol. 17, no 1, p. 40-41Article in journal (Refereed)
  • 934.
    Ahlgren, Ewa
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Lundqvist, Anna
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Arén, Claes
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Rutberg, Hans
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Heart Centre. Linköping University, Faculty of Health Sciences.
    Neurocognitive impairment and driving performance after coronary artery bypass surgery2003In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 23, no 3, p. 334-340Article in journal (Refereed)
    Abstract [en]

    Objective: Neurocognitive impairment is common after cardiac surgery but few studies have examined the relationship between postoperative neuropsychological test performance and everyday behavior. The influence of postoperative cognitive impairment on car driving has previously not been investigated. The purpose of this study was to evaluate neurocognitive function and driving performance after coronary artery bypass grafting (CABG).

    Methods: Twenty-seven patients who underwent coronary artery bypass grafting with standard cardiopulmonary bypass technique and 20 patients scheduled for percutaneous coronary intervention (PCI) under local anesthesia (control group) were enrolled in this prospective study conducted from April 1999 to September 2000. Complete data were obtained in 23 and 19 patients, respectively. The patients underwent neuropsychological examination with a test battery including 12 tests, a standardized on-road driving test and a test in an advanced driving simulator before and 4–6 weeks after intervention.

    Results: More patients in the coronary artery bypass grafting group (n=11, 48%) than in the percutaneous coronary intervention group (n=2, 10%) showed a cognitive decline after intervention (P=0.01). In the on-road driving test, patients who underwent coronary artery bypass grafting deteriorated after surgery in the cognitive demanding parts like traffic behavior (P=0.01) and attention (P=0.04). Patients who underwent percutaneous intervention deteriorated in maneuvering of the vehicle (P=0.04). No deterioration was detected in the simulator in any of the groups after intervention. Patients with a cognitive decline after intervention also tended to drop in the on-road driving scores to a larger extent than did patients without a cognitive decline.

    Conclusion: This study indicates that cognitive functions important for safe driving may be influenced after cardiac surgery.

  • 935.
    Ahlgren, Ewa
    et al.
    Östergötlands Läns Landsting, Heart Centre.
    Lundqvist, Anna
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Nordlund, Anders
    Linköping University, Department of Department of Health and Society. Linköping University, Faculty of Health Sciences.
    Rutberg, Hans
    Östergötlands Läns Landsting, Heart Centre.
    Driving performance of patients with coronary artery diseaseManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives To compare patients with coronary artery disease and healthy controls with respect to cognitive function and driving performance.

    Design and setting A controlled study conducted between April 1999 and January 2001.

    Subjects Forty-four patients with stable coronary artery disease scheduled for cardiac intervention with coronary artery bypass surgery or percutaneous coronary intervention. Forty volunteers of similar age without symptoms of coronary artery disease served as controls.

    Main outcome measures On-road driving scores in five specific test areas with a rating scale from 1 to 5. Neuropsychological test scores, including 12 tests.

    Results Compared with controls, patients with coronary artery disease had lower scores in all areas of the on-road driving test (p<0.05) and in the neuropsychological tests assessing psychomotor speed, visual and verbal memory, focused attention and simultaneous capacity (p<0.05). The difference between the groups in the on-road driving test appeared to be more pronounced among those above 65 years-of-age. Both patients and controls rated their performance significantly higher than the traffic inspector (p<0.05).

    Conclusions Cognitive function and driving performance may be impaired in patients with coronary artery disease.

  • 936.
    Ahlgren, Ewa
    et al.
    Östergötlands Läns Landsting, Heart Centre.
    Rutberg, Hans
    Östergötlands Läns Landsting, Heart Centre.
    Aren, Claes
    Heart and Lung Center, University Hospital, Lund, Sweden.
    Patients with Coronary Artery Disease Are Active Car Drivers Both Before and Soon After Heart Surgery2002In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 3, no 3, p. 205-208Article in journal (Refereed)
    Abstract [en]

    Cognitive ability is essential for the fitness to drive. Impaired cognitive functions are common after cardiac surgery. Little is known about driving habits and influence of postoperative cognitive decline on driving performance in these patients. The aim of this study was to investigate the extent of driving activity of patients before and after cardiac surgery. Ninety-seven cardiac surgical patients were interviewed about their driving habits before and 12 weeks after surgery. The mean age was 66. Before the operation, 78% were active car drivers. They drove several times a week including longer than 100 km distances. After the operation, 64% continued to drive and most of them (69%) had commenced driving within 6 weeks. The majority (79%) reported unchanged driving habits, while 13 patients (21%) had reduced their driving activity due to the cognitive symptoms they experienced. Patients with coronary artery disease are active car drivers both before and after heart surgery. Further evaluation of the ability of these patients to drive is required if we are to give advice and apply restrictions in the interest of traffic safety.

  • 937.
    Ahlgren, Jennie
    et al.
    Ethics Unit, Centre for Theology and Religious Studies, Lund University, Lund, Sweden .
    Nordgren, Anders
    Linköping University, Department of Culture and Communication, Centre for Applied Ethics. Linköping University, Faculty of Arts and Sciences.
    Perrudin, Maud
    Keller and Heckman LLP, Brussels, Belgium.
    Rondeltap, Amber
    LEI, Wageningen University and Research Centre, Wageningen, The Netherlands.
    Savigny, Jean
    Keller and Heckman LLP, Brussels, Belgium.
    van Trijp, Hans
    Marketing and Consumer Behaviour, Group Wageningen University and Research Centre, Wageningen, The Netherlands.
    Nordström, Karin
    School of Education and Communication, Jönköping University, Jönköping, Sweden.
    Görman, Ulf
    Ethics Unit, Centre for Theology and Religious Studies, Lund University, Lund, Sweden .
    Consumers on the Internet: ethical and legal aspects of commercialization of personalized nutrition2013In: Genes & Nutrition, ISSN 1555-8932, E-ISSN 1865-3499, Vol. 8, no 4, p. 349-355Article, review/survey (Refereed)
    Abstract [en]

    Consumers often have a positive attitude to the option of receiving personalized nutrition advice based upon genetic testing, since the prospect of enhancing or maintaining one’s health can be perceived as empowering. Current direct-to-consumer services over the Internet, however, suffer from a questionable level of truthfulness and consumer protection, in addition to an imbalance between far-reaching promises and contrasting disclaimers. Psychological and behavioral studies indicate that consumer acceptance of a new technology is primarily explained by the end user’s rational and emotional interpretation as well as moral beliefs. Results from such studies indicate that personalized nutrition must create true value for the consumer. Also, the freedom to choose is crucial for consumer acceptance. From an ethical point of view, consumer protection is crucial, and caution must be exercised when putting nutrigenomic-based tests and advice services on the market. Current Internet offerings appear to reveal a need to further guaranty legal certainty by ensuring privacy, consumer protection and safety. Personalized nutrition services are on the borderline between nutrition and medicine. Current regulation of this area is incomplete and undergoing development. This situation entails the necessity for carefully assessing and developing existing rules that safeguard fundamental rights and data protection while taking into account the sensitivity of data, the risks posed by each step in their processing, and sufficient guarantees for consumers against potential misuse.

  • 938.
    Ahlgren, Jonna
    Linköping University, Department of Educational Science (IUV).
    Projektet Alfaskolan2003Independent thesis Basic level (professional degree)Student thesis
    Abstract [sv]

    Jag har till syfte att genom mitt arbete få kunskap om Alfaskolan som projekt, dess verksamhet och syfte. Är detta en metod att använda sig av i den ordinarie skolan? Hur förhåller sig personal i den ordinarie skolan till Alfaskolan och dess metod? Jag har även valt att studera hur Alfaskolan förhåller sig gentemot integrering respektive särskiljning. För att ge en bakgrund till Alfaskolan som projekt har jag valt att beskriva huvudprojektet Barns och ungdomars bästa i vilket Alfaskolan är ett delprojekt. I min litteraturdel inleder jag med att redogöra för olika perspektiv på specialpedagogik. Vidare definierar jag begrepp som integrering, segregering och differentiering.

    För att få en bild samt en förståelse av Alfaskolan har jag valt att använda mig av fallstudien som metod med pedagogisk fältforskning som ansats. Inom ramen för min metod har jag sedan utfört samtal, observationer och intervjuer. Samtalen har till stor del förts med Birgitta Sundvall, grundaren av Alfaskolan. Intervjuerna har genomförts med två rektorer, fyra lärare, en assistent och en kurator. Mitt resultat visar bland annat att Alfaskolan är ett mycket personligt projekt ur den aspekten att det är en person, Sundvall, som står bakom idén till projektet. En stor del av metoden och arbetssättet bygger dessutom på Sundvalls egen erfarenhet. Alfaskolan har till syfte att stödja och hjälpa barn som av olika anledningar har svårt att ta till sig den traditionella skolundervisningen. Viktiga faktorer inom Alfaskolan är bland annat miljön, stämningen, konkretion, variation och stimulans av alla sinnen. Utöver detta ska även pedagoger få kunskap om barns olika inlärningsstilar och alternativa metoder. Ett samarbete Alfaskolan och den ordinarie skolan emellan är en förutsättning. Genom detta vill man nå en uppföljning, samt att barnen integreras i den ordinarie klassen. Resultatet från intervjuerna visar dock på en avsaknad av samarbete.

  • 939.
    Ahlgren, Simon
    et al.
    Linköping University, Department of Computer and Information Science, Software and Systems.
    Aini, Daniel
    Linköping University, Department of Computer and Information Science, Software and Systems.
    Conversion and Analysis of Telemetric Data from the CCSDS Standard2017Independent thesis Basic level (university diploma), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [en]

    When communicating with spacecrafts, the international standard is to use the protocols defined by CCSDS. In this study, the Space Packet Protocol from CCSDS is converted to the Digital Recording Standard used in aviation. The goal of the study is to find out in what way such a conversion can be made, as well as analyzing the efficiency of different packing methods for the Digital Recording Standard. An application is developed in order to perform the conversion, and the performance of said application is profiled using different packet sizes. In the end the results are evaluated and an optimal packet size is found in terms of runtime and memory usage. In the end we conclude that a packet size of 216 bytes is best when prioritizing speed, and a packet size of 219 bytes is best when prioritizing memory.

  • 940.
    Ahlgren, Thorbjörn
    et al.
    Luppen kunskapscentrum.
    Näslund, Johan
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Kartläggning av barn i behov av stöd år 2002: Eksjö kommun2003Report (Other academic)
    Abstract [sv]

    Följande rapport bygger på enkätsvar från olika myndigheter i Eksjö kommun som har rapporterat de barn/ungdomar i åldern 0-18 år som man i sin verksamhet kommer i kontakt med och som man känner oro för, p.g.a. en ogynnsam utveckling. Tjugo förutbestämda kriterier användes för att beskriva orsaken till myndighetens oro. Myndigheterna har också rapporterat om de insatser som görs redan idag samt om man bedömer att det kan bli aktuellt med ytterligare insatser nu eller i framtiden.

    Totalt inrapporterades 842 barn och ungdomar. Socialförvaltningen rapporterade 78 barn och ungdomar, Barnavårdscentralen 30 barn och skolan 689 barn och ungdomar. Av 45 enkätsvar framgår det inte vem som är rapportör. Vid bearbetningen av insamlat material har 10 enkätsvar uteslutits eftersom de inte var tillräckligt ifyllda. 103 enkätsvar uteslöt för att de flerrapporterade barn och/eller ungdomar och 17 enkätsvar uteslöts eftersom de rapporterade ungdomar som inte är skrivna i Eksjö kommun. Slutligen kom 712 barn och ungdomar att ingå i kartläggningen. Detta är drygt 18,8 % av alla aktuella barn och ungdomar. Av dessa är en klar majoritet pojkar (446 dvs. 62,6 %). För hela målgruppen främst tre huvudorsaker som ger anledning till oro hos berörda myndigheter. Det är;

    1. Föräldrarna brister i omsorgen, i stödet till den unge eller möjligheten att ge stimulans pågrund av sociala, mentala, fysiska eller psykiska handikapp och/eller missbruksproblem. För130 (av 712) barn och ungdomar anser man att det är huvudorsaken till oro.
    2. Barn/ungdomar som är introverta (tysta, blyga, nedstämda, mutister). För 69 av (712) barnoch ungdomar är det huvudorsaken till att man känner oro.
    3. Föräldrars separation eller ständiga konflikter påverkar den unge negativt. För 66 av (712)barn och ungdomar är det huvudorsaken till att man känner oro.

    Resultatredovisningen visar att skolan är den myndighet vars insatser dominerande är det också så att olika insatser inom skolan dominerar. Vanligast är undervisning i liten grupp och olika typer av specialundervisning. Olika typer av anpassad studiegång är också en vanlig insats att möta barn och ungdomar med olika svårigheter. Även olika psykosociala åtgärder förekommer också t.ex. stödsamtal med skolsköterska eller kurator. Vanligast av socialförvaltningens insatser är kontaktperson/familj.

    Berörda myndigheter uppmanas också att föreslå olika typer av nya insatser för de rapporterade barnen och ungdomarna. Även här dominerar olika typer av skolinriktade insatser. Vanliga förslag är undervisning i liten grupp och/eller olika typer av specialundervisning. När socialförvaltningen anses vara ansvarig myndigheter för önskade insatser föreslår rapporterande myndigheter allt från olika typer av familjestöd till direkta förslag till omhändertagande och placering på behandlingshem.

  • 941.
    Ahlgren, Thorbjörn
    et al.
    Avdelningen för beteendevetenskap och socialt arbete, Hälsohögskolan, Jönköping University.
    Näslund, Johan
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Rosander, Michael
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Ungdomars attityder och beteende när det gäller att köpa och sälja sex: en studie i Jönköpings län våren 20082009Report (Other academic)
    Abstract [sv]

    Kunskapen om i vilken omfattning ungdomar har sålt eller köpt sex är begränsad. Delvis kan det bero på svårigheten med att bestämma vad som omfattas i begreppen sälja och köpa sex. Studier visar också att det i ungdomsrelationer förekommer att gåvor ges efter sexuella aktiviteter.

    I denna studie har totalt 16 personer (1,9 %) uppgett att de i olika omfattning utfört sexuella tjänster mot ersättning och att 79 personer (9,1 %) blivit erbjudna pengar eller annan ersättning för sexuella tjänster. Det är fler killar än tjejer som säljer sex. När det gäller att ha blivit erbjuden sex mot ersättning är det flest tjejer som svarat ja. Resultatet visar också att 131 personer (15,1 %) kan tänka sig att utföra sexuella tjänster mot ersättning. I svaren kan vi också utläsa att 348 personer (40,1%), mestadels killar, accepterar att andra utför sexuella tjänster mot ersättning.

    När det gäller i vilka kretsar de som säljer sex umgås är det tydligt att ungdomarna tittar mer på porr, att det är vanligare att de visar sig i sexuella situationer och att de har mindre tolerans mot homosexuella. Samlagsdebuten var ett år tidigare än hela undersökningsgruppen. Det är vanligare att man blivit utsatt för olika sexuella handlingar mot sin vilja, men man har också utsatt andra för sexuella handlingar mot deras vilja. Sammantaget kan vi se att ungdomarna i denna studie som sålt sex lever ett påtagligt mer sexualiserat liv än vad andra ungdomar i motsvarande ålder gör.

  • 942.
    Ahlgren, Tom
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, General Practice.
    Patientnära forskning kan rädda vården - höjer kvaliten, minskar kostnaderna. Medicinsk forskningsrådet i stor kampanj.2000In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, p. 291-291Article in journal (Other (popular science, discussion, etc.))
  • 943.
    Ahlgren, Victoria
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Andersson, Erica
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Råd och planer för likabehandling: En studie av två nationella rådgivande dokument och sex gymnasieskolors likabehandlingsplaner2012Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Detta examensarbete är en studie av två nationella rådgivande dokument och sex gymnasieskolors likabehandlingsplaner. Syftet med studien är att undersöka hur sex gymnasieskolors likabehandlingsplaner förhåller sig till Skolverkets allmänna råd samt Diskrimineringsombudsmannen (DO), Barn- och elevombudet (BEO) och Skolinspektionens handledning. För att kunna göra detta undersöks hur arbetet med likabehandling beskrivs i Skolverkets allmänna råd, DO, BEO och Skolinspektionens handledning samt gymnasieskolornas likabehandlingsplaner. Metoden vi har använt oss av är kvalitativ textanalys.

    Vår huvudfrågeställning är följande:

    • Hur förhåller sig de sex gymnasieskolornas likabehandlingsplaner till Skolverkets allmänna råd samt DO, BEO och Skolinspektionens handledning?

    För att kunna ta reda på detta har vi även följande två frågeställningar:

    • Hur beskrivs arbetet med likabehandling i Skolverkets allmänna råd samt DO, BEO och Skolinspektionens handledning?
    • Hur beskrivs arbetet med likabehandling i de sex gymnasieskolornas likabehandlingsplaner?

    I denna studie har vi kommit fram till att det skiljer sig åt hur väl likabehandlingsplanerna förhåller sig till de nationella rådgivande dokumenten. Likabehandlingsplanerna för skola 1, skola 2 och skola 5 följer Skolverkets allmänna råd samt DO, BEO och Skolinspektionens handledning till stor del, medan likabehandlingsplanerna för skola 3 och skola 6 inte följer dessa rekommendationer i lika stor utsträckning. Skola 4 uppfyller råden till viss del. Det framgår av vår studie att flera av skolorna har allvarliga brister i sina likabehandlingsplaner.

  • 944.
    Ahlgren-Moritz, Charlotte
    et al.
    Malmö högskola, Sweden.
    Alm, Anna-Karin
    Malmö högskola, Sweden.
    Christersson, Cecilia
    Malmö högskola, Sweden.
    Eikelboom Sällström, Anette
    Enheten för externa relationer, Umeå universitet, Sweden.
    Esbjörnsson, Mattias
    Malmö högskola, Sweden.
    Jacobsson, Andreas
    Fakulteten för teknik och samhälle, Malmö högskola, Sweden.
    Marell, Agneta
    Samverkan och innovation, Umeå universitet, Sweden.
    Persson, Jeanette
    Innovation och utveckling, Malmö högskola, Sweden.
    Ramsten, Anna-Carin
    Linköping University, REMESO - Institute for Research on Migration, Ethnicity and Society. Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Arts and Sciences.
    Rehme, Jakob
    Linköping University, Department of Management and Engineering, Industrial Economics. Linköping University, Faculty of Science & Engineering.
    Reinhold, Mats
    Enheten för externa relationer, Umeå universitet, Sweden.
    Sjögren, Karin
    Malmö högskola, Sweden.
    Sörensson, Victoria
    Enheten för externa relationer, Umeå universitet, Sweden.
    Värbrand, Peter
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Vägen till samverkanssäkrad utbildning. [1]: Metoder och strategier2016Book (Other academic)
    Abstract [sv]

    Universitet och högskolor bidrar till samhällsutvecklingen genom att forskningsbaserad kunskap tillämpas av olika aktörer i samhället. För att möta dagens och morgondagens samhällsutmaningar utgör således kunskapsutbyte och samverkan mellan lärosäten och samhället en värdefull möjlighet. Att ha starka relationer med samhällets aktörer identifieras också som viktigt i utvecklingen av ett internationellt starkt lärosäte.

    Samverkan i högre utbildning främjar samhällets förändringsförmåga och stärker utbildningens kvalitet, men samverkan förbereder också studenterna för ett livslångt lärande och underlättar övergången mellan utbildning och arbetsliv. Ett lärosäte i nära samverkan med aktörer i samhället är ett relevant lärosäte, det vill säga ett lärosäte som är till nytta för sin omvärld och för sina medarbetare och studenter.

    Ett grundläggande problem vad gäller möjligheterna att integrera samverkan i akademisk utbildning står att finna i statens fördelning av medel till lärosätena. De statliga medlen utgår nämligen i två separata anslag, ett vardera för de båda huvuduppdragen utbildning och forskning. Samverkan kan sägas ingå i bägge uppdragen. Till skillnad från forskningssamverkan finns det för utbildningssamverkan ingen särskild uppföljning och inte heller några ekonomiska incitament. Utvärdering av forskning och utbildning bör således breddas så att kvalitetsstärkande samverkansinslag också inkluderas i resursfördelningsprinciperna. Statens bristande strukturer för fördelning och uppföljning återspeglas i hur lärosätena fördelar resurser till och följer upp samverkan: lärare ges sällan resurser (i form av särskild tid) för att på ett pedagogiskt genomtänkt sätt kunna inkludera samverkansinslag i undervisningen; samverkan är sällan meriterande eller lönegrundande; och den utbildningssamverkan som bedrivs följs sällan upp – varken på institutions-, fakultets- eller lärosätesnivå. Samma sak kan sägas gälla på nationell nivå – det samverkande lärosätet erhåller inga extra anslag och det bestraffas ej heller för försummelse av detsamma. Att göra samverkan till en integrerad del av utbildningen innebär att samverkan bör ingå i de pedagogiska modeller som lärare använder för att leda studenternas kunskapsutveckling mot de mål som finns angivna i kurs- och utbildningsplaner. Det betyder också att arbetet med samverkan bör inkluderas i processer för styrning, planering och uppföljning av utbildning och undervisning på såväl kurs- och programnivå som på institutions-, fakultets- och lärosätesnivå. Att göra samverkan till en integrerad del av utbildningen är att sträva mot att externa aktörer ska bli en självklar del i den dagliga verksamheten – för studenter såväl som för medarbetare och för de organisationer man samverkar med. För att svenska lärosäten ska ges en realistisk möjlighet att göra samverkan till en integrerad del av utbildningsverksamheten krävs det framför allt följande:

    • att politiker och departement utformar ett fördelningssystem där framgångsrika samverkansinsatser inom utbildningen leder till en förstärkning av resursbasen på lärosätena;
    • att lärosätesledningar tar tydlig ställning för samverkansfrågan i sina strategiska styrdokument och att samverkan införs i lärosätenas kvalitetssäkringssystem för utbildning, samt att lärosätena inför system för att styra och följa upp samverkan i utbildningen på lärosätesövergripande nivå;
    • att ledningen för fakulteter, institutioner eller motsvarande omsätter lärosätets strategiska åtaganden i handlingsplaner och lokala styrdokument samt utformar system för dokumentation, styrning och uppföljning av samverkan i utbildningsprogram;
    • att lärare samt kurs- och programansvariga inför samverkan i utbildningens styrande dokument (t.ex. kurs- och utbildningsplaner) samt i den ordinarie undervisningsverksamheten.

    Dessutom bör lärosätena – både gemensamt men också vart och ett för sig – införa system och karriärvägar där medarbetares insatser i det vardagliga samverkansarbetet uppmärksammas och belönas.

    Mot bakgrund av detta kan man konstatera att det är angeläget att lärosätenas strategiska arbete avseende utveckling och uppföljning av samverkan i utbildningen vidareutvecklas. Men, med vilka verktyg, var i verksamheten och på vilka sätt?

    I följande skrift samlas erfarenheter och goda exempel gjorda inom ramen för ett flerårigt lärosätesövergripande samarbetsprojekt, Samverkanssäkrade utbildningsprogram, där utgångspunkten har varit att identifiera strategier och metoder för att integrera samverkan i utbildningsprogram. Målet har varit att undersöka och beskriva hur samverkan kan vara ett medel som bidrar till att stärka utbildningens kvalitet och relevans, samt ge förslag på hur vägen till samverkanssäkrad utbildning kan se ut.

    Den centrala slutsatsen är att samverkan, när den är en integrerad del av utbildningen, bidrar till kvalitet och säkerställer att utbildningen blir till nytta för samhället. Det finns också andra vinster med att bedriva ett systematiskt samverkansarbete, till exempel att det leder till pedagogisk utveckling för undervisande personal, att det ökar förutsättningarna för ett utmaningsbaserat lärande med studenten i centrum, att det underlättar övergången från studier till arbetsliv, och att det möjliggör fördjupade relationer med den värld lärosätet finns i. Resan mot samverkanssäkrad utbildning är, med andra ord, mödan väl värd.

  • 945.
    Ahlgren-Moritz, Charlotte
    et al.
    Malmö högskola, Sweden.
    Alm, Anna-Karin
    Malmö högskola, Sweden.
    Christersson, Cecilia
    Malmö högskola, Sweden.
    Eikelboom Sällström, Anette
    Enheten för externa relationer, Umeå universitet, Sweden.
    Esbjörnsson, Mattias
    Malmö högskola, Sweden.
    Jacobsson, Andreas
    Fakulteten för teknik och samhälle, Malmö högskola, Sweden.
    Marell, Agneta
    Samverkan och innovation, Umeå universitet, Sweden.
    Persson, Jeanette
    Innovation och utveckling, Malmö högskola, Sweden.
    Ramsten, Anna-Carin
    Linköping University, REMESO - Institute for Research on Migration, Ethnicity and Society. Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Arts and Sciences.
    Rehme, Jakob
    Linköping University, Department of Management and Engineering, Industrial Economics. Linköping University, Faculty of Science & Engineering.
    Reinhold, Mats
    Enheten för externa relationer, Umeå universitet, Sweden.
    Sjögren, Karin
    Malmö högskola, Sweden.
    Sörensson, Victoria
    Enheten för externa relationer, Umeå universitet, Sweden.
    Värbrand, Peter
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, Faculty of Science & Engineering.
    Vägen till samverkanssäkrad utbildning. [2]: Möjligheter och utmaningar2016Book (Other academic)
    Abstract [sv]

    Universitet och högskolor bidrar till samhällsutvecklingen genom att forskningsbaserad kunskap tillämpas av olika aktörer i samhället. För att möta dagens och morgondagens samhällsutmaningar utgör således kunskapsutbyte och samverkan mellan lärosäten och samhället en värdefull möjlighet. Att ha starka relationer med samhällets aktörer identifieras också som viktigt i utvecklingen av ett internationellt starkt lärosäte.

    Samverkan i högre utbildning främjar samhällets förändringsförmåga och stärker utbildningens kvalitet, men samverkan förbereder också studenterna för ett livslångt lärande och underlättar övergången mellan utbildning och arbetsliv. Ett lärosäte i nära samverkan med aktörer i samhället är ett relevant lärosäte, det vill säga ett lärosäte som är till nytta för sin omvärld och för sina medarbetare och studenter.

    Ett grundläggande problem vad gäller möjligheterna att integrera samverkan i akademisk utbildning står att finna i statens fördelning av medel till lärosätena. De statliga medlen utgår nämligen i två separata anslag, ett vardera för de båda huvuduppdragen utbildning och forskning. Samverkan kan sägas ingå i bägge uppdragen. Till skillnad från forskningssamverkan finns det för utbildningssamverkan ingen särskild uppföljning och inte heller några ekonomiska incitament. Utvärdering av forskning och utbildning bör således breddas så att kvalitetsstärkande samverkansinslag också inkluderas i resursfördelningsprinciperna. Statens bristande strukturer för fördelning och uppföljning återspeglas i hur lärosätena fördelar resurser till och följer upp samverkan: lärare ges sällan resurser (i form av särskild tid) för att på ett pedagogiskt genomtänkt sätt kunna inkludera samverkansinslag i undervisningen; samverkan är sällan meriterande eller lönegrundande; och den utbildningssamverkan som bedrivs följs sällan upp – varken på institutions-, fakultets- eller lärosätesnivå. Samma sak kan sägas gälla på nationell nivå – det samverkande lärosätet erhåller inga extra anslag och det bestraffas ej heller för försummelse av detsamma. Att göra samverkan till en integrerad del av utbildningen innebär att samverkan bör ingå i de pedagogiska modeller som lärare använder för att leda studenternas kunskapsutveckling mot de mål som finns angivna i kurs- och utbildningsplaner. Det betyder också att arbetet med samverkan bör inkluderas i processer för styrning, planering och uppföljning av utbildning och undervisning på såväl kurs- och programnivå som på institutions-, fakultets- och lärosätesnivå. Att göra samverkan till en integrerad del av utbildningen är att sträva mot att externa aktörer ska bli en självklar del i den dagliga verksamheten – för studenter såväl som för medarbetare och för de organisationer man samverkar med. För att svenska lärosäten ska ges en realistisk möjlighet att göra samverkan till en integrerad del av utbildningsverksamheten krävs det framför allt följande:

    • att politiker och departement utformar ett fördelningssystem där framgångsrika samverkansinsatser inom utbildningen leder till en förstärkning av resursbasen på lärosätena;
    • att lärosätesledningar tar tydlig ställning för samverkansfrågan i sina strategiska styrdokument och att samverkan införs i lärosätenas kvalitetssäkringssystem för utbildning, samt att lärosätena inför system för att styra och följa upp samverkan i utbildningen på lärosätesövergripande nivå;
    • att ledningen för fakulteter, institutioner eller motsvarande omsätter lärosätets strategiska åtaganden i handlingsplaner och lokala styrdokument samt utformar system för dokumentation, styrning och uppföljning av samverkan i utbildningsprogram;
    • att lärare samt kurs- och programansvariga inför samverkan i utbildningens styrande dokument (t.ex. kurs- och utbildningsplaner) samt i den ordinarie undervisningsverksamheten.

    Dessutom bör lärosätena – både gemensamt men också vart och ett för sig – införa system och karriärvägar där medarbetares insatser i det vardagliga samverkansarbetet uppmärksammas och belönas.

    Mot bakgrund av detta kan man konstatera att det är angeläget att lärosätenas strategiska arbete avseende utveckling och uppföljning av samverkan i utbildningen vidareutvecklas. Men, med vilka verktyg, var i verksamheten och på vilka sätt?

    I följande skrift samlas erfarenheter och goda exempel gjorda inom ramen för ett flerårigt lärosätesövergripande samarbetsprojekt, Samverkanssäkrade utbildningsprogram, där utgångspunkten har varit att identifiera strategier och metoder för att integrera samverkan i utbildningsprogram. Målet har varit att undersöka och beskriva hur samverkan kan vara ett medel som bidrar till att stärka utbildningens kvalitet och relevans, samt ge förslag på hur vägen till samverkanssäkrad utbildning kan se ut.

    Den centrala slutsatsen är att samverkan, när den är en integrerad del av utbildningen, bidrar till kvalitet och säkerställer att utbildningen blir till nytta för samhället. Det finns också andra vinster med att bedriva ett systematiskt samverkansarbete, till exempel att det leder till pedagogisk utveckling för undervisande personal, att det ökar förutsättningarna för ett utmaningsbaserat lärande med studenten i centrum, att det underlättar övergången från studier till arbetsliv, och att det möjliggör fördjupade relationer med den värld lärosätet finns i. Resan mot samverkanssäkrad utbildning är, med andra ord, mödan väl värd.

  • 946.
    Ahlin, Dennis
    et al.
    Linköping University, Department of Management and Engineering. Linköping University, Faculty of Arts and Sciences.
    Strandberg, Emma
    Linköping University, Department of Management and Engineering. Linköping University, Faculty of Arts and Sciences.
    K2 eller K3?: En studie av de väsentliga skillnaderna2011Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Accounting regulations for unlisted companies in Sweden is changing. There is a draft for new accounting rules for unlisted companies. Through the definition of a small company in the Swedish Annual Accounting Act, 97 percent of Swedish companies will have the possibility to choose between K2 and K3. The market demands a better understanding of differences between the regulations.

    Aim: Identify significant differences between K2 and K3, in order to examine which of these differences that is the most important factors for companies in their selection of rules.

    Method: A qualitative study has been conducted in which interviews and responses were used as data collection. A sampling method was used to identify distinct differences between the K2 and K3. These differences have been the basis for examining the significant differences as well.

    Analysis and conclusion: Differences between K2 and K3 that are significant in the choice of the firm have been identified in five areas. These differences will therefore affect the firms’ choice between K2 and K3. The reason is that they are a part of an assessment of the company’s overall needs of complexity in their accounting.

  • 947.
    Ahlin, Eva
    et al.
    Linköping University, Department of Behavioural Sciences and Learning.
    Tjäder, Anna
    Linköping University, Department of Behavioural Sciences and Learning.
    "Jag trivs bäst i öppna landskap...": Om naturmiljöers påverkan på oss människor2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    En kvantitativ studie med experimentell design har genomförts i syfte att jämföra natur- respektive urbanmiljöers påverkan på känslomässig och fysiologisk återhämtning efter en stressupplevelse, samt utslag på kognitiv prestation. Hypotesen var att naturstimuli genererar högre grad av känslomässig och fysiologisk återhämtning än urbanstimuli. Frågeställningen var om vi kunde se någon skillnad mellan gruppernas prestationsförmåga efter genomförd återhämtning, vad gäller riktad uppmärksamhet. Återhämtningsgrad har mätts i förändring i blodtryck, puls och självskattning av känslor.  Resultatet visade att naturmiljön genererar en högre nivå återhämtning med avseende på sänkt diastoliskt blodtryck, ökade positiva känslor samt minskad oro. Däremot visades ingen skillnad i kognitiv prestationsförmåga mellan grupperna. Slutsatsen är att känslomässig samt fysiologisk återhämtning kan underlättas i naturmiljö jämfört med urbanmiljö och att detta även kan ske med hjälp av naturbilder. Däremot är det inte är självklart att man får större kapacitet riktad uppmärksamhet efter exponering av naturbilder jämfört med stadsbilder.

  • 948.
    Ahlin, Fredrik
    et al.
    Linköping University, Faculty of Medicine and Health Sciences. Wilhelminen Hospital, Austria.
    Arfvidsson, John
    Linköping University, Faculty of Medicine and Health Sciences. Wilhelminen Hospital, Austria.
    Vargas, Kris G.
    Wilhelminen Hospital, Austria.
    Stojkovic, Stefan
    Medical University of Vienna, Austria; Ludwig Boltzmann Cluster Cardiovasc Research, Austria.
    Huber, Kurt
    Wilhelminen Hospital, Austria; Ludwig Boltzmann Cluster Cardiovasc Research, Austria; Sigmund Freud University, Austria.
    Wojta, Johann
    Medical University of Vienna, Austria; Ludwig Boltzmann Cluster Cardiovasc Research, Austria; Medical University of Vienna, Austria.
    MicroRNAs as circulating biomarkers in acute coronary syndromes: A review2016In: Vascular pharmacology, ISSN 1537-1891, E-ISSN 1879-3649, Vol. 81, p. 15-21Article, review/survey (Refereed)
    Abstract [en]

    Coronary artery disease (CAD) and its complications remain the most common cause of death worldwide. Cardiac troponins (cTn) are standard biomarkers used today for diagnosis and risk stratification of myocardial infarction (MI). Increasing efforts are made to develop additional, new biomarkers for more effective and safe rule-in and rule-out of MI patients at the emergency department. During the past decade, microRNAs (miRNAs) have emerged as new, potential diagnostic biomarkers in several diseases, including MI. In this review, we aimed to summarize some of the prominent studies in the field, and discuss the potential value of miRNAs in the diagnosis of MI. (C) 2016 Elsevier Inc. All rights reserved.

  • 949.
    Ahlin, Jesper
    Linköping University, Department of Culture and Communication. Linköping University, Faculty of Arts and Sciences.
    What is Wrong Between Us?: On the problem of circularity in Scanlon's contractualism2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    In this essay, the Scanlonian contractualist formula will be understood as follows: Within the domain of morality of what we owe to each other, an action is morally wrong if it follows principles that similarly motivated people can reasonably reject. Consequently, the concept of ‘reasonable rejection’ is the operative element in moral valuation, thus begging the question of what it is for a rejection to be reasonable. The problem of circularity in Scanlon’s contractualism builds upon a reading according to which Scanlon’s explanation of what it is to be ‘reasonably rejected’ seems to be understood as ‘when the action is morally wrong’. If this is the case, then Scanlon’s contractualism refers to its own thesis when performing moral valuations: that is wrong which can be reasonably rejected, and for an action to be reasonably rejected it must be morally wrong. The problem of circularity apparently renders Scanlon’s contractualism ‘empty’ as it cannot explain what it is for an action to be morally wrong without referring to its own thesis.

    In this essay I will try to clarify the difference between welfarist and structural charges of circularity. I will argue that the structural charges of circularity are due to a fallacious constructivist reading of What We Owe to Each Other. As I understand Scanlon, the constructivist reading places Scanlon’s theory too close to the contractualist tradition. I will also argue that critics holding Scanlon’s contractualism to be circular have failed to note that his theory only claims to cover a narrow domain of morality. Where critics hold Scanlon’s contractualism to refer to its own thesis when performing moral valuations I will argue that the theory refers to moral domains outside that of what we owe to each other. Hopefully my discussion on constructivism and circularity will shed some light on the simple brilliance and practical applicability of Scanlon’s contractualism.

    I will give a brief overview of What We Owe to Each Other before I present the critique put forth by Onora O’Neill, Mark Timmons and Joseph Raz. Then I will show how Scanlon treats the problem of circularity in his book, and how his defense targets substantial and not structural charges of circularity. I will then show that the structural critique is fallacious by analyzing the domain of morality that Scanlon’s contractualism targets. Finally I will try to apply Scanlon’s formula on personal relationships and on environmental issues. As of this point I will refer to Scanlon’s thesis as ‘contractualism’ while other theories following the contractualist tradition will be referred to as ‘contractarian’.

  • 950.
    Ahlin, Karin
    et al.
    Linköping University, Department of Management and Economics.
    Westerlund, Johanna
    Linköping University, Department of Management and Economics.
    Sinnliga produkter: estetik som konkurrensmedel2006Independent thesis Advanced level (degree of Magister), 10 points / 15 hpStudent thesis
    Abstract [en]

    Background: In today’s society consumers expect the offered products to function in accordance to what is being promised. Aspects such as functionality and quality are consequently part of most companies’ product offerings and can to a lesser extent be used as competitive advantages. A good product is not enough when it comes to creating added value; a product must also convey other intangible values, such as emotional, identity boosting or aesthetic ones. By using aesthetics to appeal to consumers’ senses, this may have a greater impact regarding choice of product, which can create a larger competitiveness than traditional marketing.

    Purpose: The purpose of this thesis is to illustrate a product’s role in marketing by understanding how aesthetic values can be used as means of competition.

    Method: The study is based on seven interviews with corporate representatives within the domestic appliance business and an organisation that deals with design.

    Conclusion: The study has shown that a product’s aesthetic expression has great importance due to consumers’ increasingly growing interest for these aspects. As more senses are affected, the possibility increases for a product to appeal to the consumer. The sensuous expression that is most prominent today is visual aesthetics even if there is certain insight regarding the significance of the other senses for the consumer’s tendency to purchase. In spite of the awareness that seems to be present regarding the importance of aesthetics in the marketing of small electrical products, the study has revealed that this insight is not fully integrated. This may be due to the fact that this mean of communicating to the consumer still has not had its breakthrough on the market.

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