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  • 1.
    Larsson, Lina
    Linköping University, Department of Science and Technology. Linköping University, The Institute of Technology.
    Kliniskt datainsamlingssystem med beslutsstöd - Användarutredning och gränssnitt för Sahlgrenskas akutintag2005Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

     Extra high requirements are made on all systems in health care that they are functional and usable,´something, however, that is not always the case. At Emergency Admissions at Sahlgrenska University´Hospital many systems are in use at the same time and it happens that much overhead is caused by having to fill in the same information in different places. In addition, data that is gathered is to a large extent saved in free text format, which means that it cannot be used in a larger context such as research, quality control or for decision support. Data is saved in the patient file only for the treatment process of the individual patient.

    A data collecting system with decision support functionality could be a first step towards reducing Emergency Admissions’ costs and patients’ waiting times by providing a structured method of data collection. It is also possible that it could contribute to safer care for patients as the system could warn the staff on occasions where there may be a risk of a patient suffering from a serious, acute illness that might be difficult to diagnose.

    An analysis has been performed at Emergency Admissions at Sahlgrenska to distinguish possible users of a new system for collecting data with decision support. The results showed that the nurses in reception were the most suitable target group.

    A prototype of a user interface for gathering initial patient data at reception has been made at Emergency Admissions at Sahlgrenska. This prototype has decision support functionality for ranking the most probable diagnoses as well as providing advice on suitable tests and examinations to perform. The focus has been on usability and on adapting the system to the needs of the users.

    It is highly important that future users, the staff at Emergency Admissions, continue to participate in the future further development of the data gathering system so that their needs and requirements are not overshadowed by the new technology.

  • 2.
    Weström, Sarah
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Örneholm, Isabelle
    Linköping University, Department of Clinical and Experimental Medicine, Speech and Language Pathology. Linköping University, Faculty of Health Sciences.
    Interaktion och intervention: En undersökning av kommunikativa behov hos personer med afasi och dysartri i vardagliga och kliniska samtal2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    In speech and language intervention, the ability to interact is seldom evaluated; rather intervention is evaluated in terms of improved testresults.  If goal-setting in intervention also is based on everyday communicative needs, the relevance of the treatment may be increased and intervention outcome may be implemented in the patient’s natural environment.

    The present study, as part of a research-project, is based on analyses of interaction and interviews to examine everyday conversations and speech and language intervention. The aim was to explore if there is a relation between everyday communication needs and goal-setting in speech and language intervention for people with aphasia. A further aim was to investigate if there are everyday communicative needs that may form goals for speech and language intervention.

    Two individuals with aphasia and one individual with both dysarhtria and aphasia participated in the study. Three speech and language pathologists and two relatives also participated in the study. Everyday interaction and intervention sessions were recorded and transcribed according to Conversation Analysis principles and analysed from an interactional perspective. Interviews regarding intervention and everyday communication were carried out with all participants. Recordings were presented and discussed with all participants, in so called retrospections.

    Four phenomena that illustrate communication needs of the participating patients were identified: repair, alternative and augmentative communication, co-construction and feedback. Analysis, interviews and retrospections have revealed that communication needs can form the basis of goal-setting in speech and language intervention. It is also demonstrated that intervention mainly is based on the everyday communication needs of the patient. Retrospections were also shown to be useful in order to observe communication needs in everyday life and in order to evaluate speech and language intervention. The retrospections were found to be beneficial to an open dialogue between speech and language pathologist, patient and relatives regarding the content and aim of the intervention.

     

  • 3.
    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.

  • 4.
    Ståhl, Sally
    Linköping University, Department of Computer and Information Science. Linköping University, The Institute of Technology.
    Strokekedjan från början till slut: En etnografisk studie om farlighet och tid i en akut vårdkedja2012Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    30 000 people in Sweden get a stroke every year. This leads to large personal adaptions as well as high costs for the society. The most efficient treatment, thrombolysis, must be given as soon as possible to have a good effect. At the same time it is very important to find out if the patient has any differential diagnosis that can make the treatment hazardous.

    This study investigates how the course ov events around acute stroke patients take place and important factors for the decision making. The studiy is based on ethnographic field studys on four swedish hospitals. The material is analysed with methods from joint cognitive systems and goal-oriented design. The results show that in spite of different organisation of the course  of events around acute stroke patients are the processes and direct communication most successful for effective spread of information between the processes. The neurologist on call is an important roll who, as well as the rest of the participants in the course of events, balances the decision making between efficiency and thoroughness. The combination of analysis gives results on both system- and individual levels. Possibilites for improvents are given in three categories: logistic, technological and organizational.

  • 5.
    Andersen Söderbergh, Kim
    Linköping University, Department of Management and Engineering, Carl Malmsten - furniture studies. Linköping University, The Institute of Technology.
    Blästring av trä: Ett materialbibliotek av blästrade och ytbehandladeträytor2012Independent thesis Basic level (degree of Bachelor), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [en]

    In my thesis I have sand blasted different type of woods - ring-porous and diffuseporous deciduous tree species and conifers - to show different results depending on the species, the direction of the grain and the effects of surface treatment of a blasted surface.

    The results of my tests were sometimes unexpected, such as that the sand from blasting almost completely disappeared, that all wood surfaces after blasting exhibited a much lighter or paler surface than before and that the diffuse-porous tree species showed differences in hardness between the beginning and end of annual rings.

    By creating a library of different kinds of wood and sandblasted surface treatment, I have created a reference bank that I will be able to use me in the manufacturing of interiors, furniture and other objects.

  • 6.
    Ronquist, Gunnar
    et al.
    Avdelningen för klinisk kemi, institutionen för medicinska vetenskaper, Uppsala universitet, Uppsala, Sverige.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet, Göteborg, Sverige.
    Gabrielsson, Susanne
    Enheten för translationell immunologi, medicinkliniken, Karolinska universitetssjukhuset; Karolinska institutet, Stockholm, Sverige.
    Mincheva-Nilsson, Lucia
    Avdelningen för klinisk immunologi, institutionen för klinisk mikrobiologi, Umeå universitet, Umeå, Sverige.
    Svanvik, Joar
    Transplantationscentrum Sahlgrenska universitetssjukhuset, Göteborg, Sverige.
    Telemo, Esbjörn
    Avdelningen för reumatologi och inflammationsforskning, Göteborgs universitet, Göteborg, Sverige.
    Waldenström, Anders
    Institutionen för folkhälsa och klinisk medicin, Umeå universitet, Umeå, Sverige.
    Exosomen – intercellulär signalbärare med framtids­potential [Exosomes - intercellular signal carriers with a future potential]: Kan ge nya diagnostiska och terapeutiska möjligheter [May provide new diagnostic and therapeutic opportunities]2013In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 46, no 110, 2050-2052 p.Article in journal (Other academic)
    Abstract [en]

    Small vesicles were first described in prostatic and seminal fluids more than 30 years ago [5]. They were called prostasomes and are members of the same family now called exosomes. All cells in the body can release extracellular vesicles that function as intercellular messengers. The smallest of these, exosomes, are produced by almost all types of cells in the body and exist in all body fluids. Exosomal signalling takes place in two different ways: either with a cargo of functional proteins and/or by transfection of functional RNA molecules from one cell to the cytoplasm of another, or by ligand-receptor mediated interactions between molecules of the exosome membrane and the cellular membrane of the target cell. The importance of exosomes both in health and disease is rapidly acknowledged and clinical applications in diagnosticts and therapy are under development. The content of proteins and nucleic acids of exosomes will soon be used as bio markers for different diseases such as cancer and cardiac disease. Clinical tests are ongoing where exosomes are used as natural vectors for cancer specific peptides in the treatment of cancer. Exosomes will most probably soon be used in therapy by using them as natural vectors for new  RNA based therapies and also for follow up of therapy.

  • 7.
    Pettersson, Olivia
    et al.
    Linköping University, Department of Medical and Health Sciences.
    Wennfalk, Martina
    Linköping University, Department of Medical and Health Sciences.
    Patient education and adherence to tuberculosis treatment: - Indonesian nurses share their experiences2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this qualitative study was to explore Indonesian nurses’ experiences of patient education and patients’ adherence to TB treatment.

    Background

    Tuberculosis (TB) is an infectious disease that 9.6 million people in the world suffer from. Indonesia is one of the world’s 22 high-burden countries with over 320.000 cases of TB in 2014. The UN’s (United Nation) goal is to have ended the TB epidemics by the year 2030. Nurses play a central role in accomplishing adherence to treatment and prevention of TB.

    Method

    To fulfil the aim a qualitative method using semi-structured interviews was used. The interviews were recorded and transcribed. The transcribed data was analysed by using a qualitative content analysis with a manifest approach.

    Findings

    The findings, based on the result of nine interviews, showed four themes: “Strategies for patient education”, “Factors affecting patient education and adherence to treatment”, ”Outcomes of patient education” and ”Feelings and opinions about patient education”.

    Conclusion

    This study showed that the nurses use different strategies when practicing patient education. It was also shown that the nurses are well aware about patient-related factors and how they affect patient education and adherence to TB treatment.

    Keywords

    Tuberculosis, nursing care, patient education, adherence 

  • 8.
    Neggers, Sebastian J C M M
    et al.
    Department of Endocrinology Erasmus Medical Center, Rotterdam, Netherlands et al .
    Pronin, Vyacheslav
    1Department of Endocrinology, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
    Balcere, Inga
    Department of Endocrinology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
    Lee, Moon-Kyu
    Division of Endocrinology and Metabolism, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
    Rozhinskaya, Liudmila
    Department of Neuroendocrinology and Bone Diseases, National Endocrinology Research Centre, Moscow, Russian Federation.
    Bronstein, Marcello D
    Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.
    Gadelha, Mônica R
    Endocrine Section, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
    Maisonobe, Pascal
    Boulogne-Billancourt, Ipsen, Boulogne-Billancourt, France.
    Sert, Caroline
    Boulogne-Billancourt, Ipsen, Boulogne-Billancourt, France.
    van der Lely, Aart Jan
    Department of Endocrinology, Erasmus Medical Center, Rotterdam, Netherlands.
    Lanreotide Autogel 120 mg at extended dosing intervals in patients with acromegaly biochemically controlled with octreotide LAR: the LEAD study2015In: European Journal of Endocrinology, ISSN 0804-4643, E-ISSN 1479-683X, Vol. 173, no 3Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate extended dosing intervals (EDIs) with lanreotide Autogel 120 mg in patients with acromegaly previously biochemically controlled with octreotide LAR 10 or 20 mg.

    DESIGN AND METHODS: Patients with acromegaly had received octreotide LAR 10 or 20 mg/4 weeks for ≥ 6 months and had normal IGF1 levels. Lanreotide Autogel 120 mg was administered every 6 weeks for 24 weeks (phase 1); depending on week-24 IGF1 levels, treatment was then administered every 4, 6 or 8 weeks for a further 24 weeks (phase 2). Hormone levels, patient-reported outcomes and adverse events were assessed.

    PRIMARY ENDPOINT: proportion of patients on 6- or 8-week EDIs with normal IGF1 levels at week 48 (study end).

    RESULTS: 107/124 patients completed the study (15 withdrew from phase 1 and two from phase 2). Of 124 patients enrolled, 77.4% were allocated to 6- or 8-week EDIs in phase 2 and 75.8% (95% CI: 68.3-83.3) had normal IGF1 levels at week 48 with the EDI (primary analysis). A total of 88.7% (83.1-94.3) had normal IGF1 levels after 24 weeks with 6-weekly dosing. GH levels were ≤ 2.5 μg/l in > 90% of patients after 24 and 48 weeks. Patient preferences for lanreotide Autogel 120 mg every 4, 6 or 8 weeks over octreotide LAR every 4 weeks were high.

    CONCLUSIONS: Patients with acromegaly achieving biochemical control with octreotide LAR 10 or 20 mg/4 weeks are possible candidates for lanreotide Autogel 120 mg EDIs. EDIs are effective and well received among such patients.

  • 9.
    Gheorghiade, Mihai
    et al.
    Northwestern University Feinberg School of Medicine, Chicago, USA.
    Greene, Stephen J
    Duke University Medical Center, Durham, North Carolina, USA.
    Butler, Javed
    Stony Brook University, Stony Brook, New York, USA.
    Filippatos, Gerasimos
    Athens University Hospital Attikon and Kapodistrian University of Athens, Athens, Greece.
    Lam, Carolyn S P
    National Health Center, Singapore and Duke, National University of Singapore, Singapore.
    Maggioni, Aldo P
    Associazione Nazionale Medici Cardiologi Ospedalieri Research Center, Florence, Italy.
    Ponikowski, Piotr
    Medical University, Wroclaw, Poland.
    Shah, Sanjiv J
    Northwestern University Feinberg School of Medicine, Chicago, USA.
    Solomon, Scott D
    Brigham and Women's Hospital Boston, Massachusetts, USA.
    Kraigher-Krainer, Elisabeth
    Charite University Medicine Berlin-Campus Virchow Klinikum, Berlin, Germany.
    Samano, Eliana T
    Bayer, Sao Paulo, Brazil.
    Müller, Katharina
    Bauer Pharma, Wuppertal, Germany.
    Roessig, Lothar
    Bauer Pharma, Wuppertal, Germany.
    Burkert, Pieske
    Charité University Medicine Berlin–Campus Virchow Klinikum and German Heart Center Berlin, Germany.
    Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction: The SOCRATES-REDUCED Randomized Trial.2015In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 314, no 21, 2251-2262 p.Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: Worsening chronic heart failure (HF) is a major public health problem.

    OBJECTIVE: To determine the optimal dose and tolerability of vericiguat, a soluble guanylate cyclase stimulator, in patients with worsening chronic HF and reduced left ventricular ejection fraction (LVEF).

    DESIGN, SETTING, AND PARTICIPANTS: Dose-finding phase 2 study that randomized 456 patients across Europe, North America, and Asia between November 2013 and January 2015, with follow-up ending June 2015. Patients were clinically stable with LVEF less than 45% within 4 weeks of a worsening chronic HF event, defined as worsening signs and symptoms of congestion and elevated natriuretic peptide level requiring hospitalization or outpatient intravenous diuretic.

    INTERVENTIONS: Placebo (n = 92) or 1 of 4 daily target doses of oral vericiguat (1.25 mg [n = 91], 2.5 mg [n = 91], 5 mg [n = 91], 10 mg [n = 91]) for 12 weeks.

    MAIN OUTCOMES AND MEASURES: The primary end point was change from baseline to week 12 in log-transformed level of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The primary analysis specified pooled comparison of the 3 highest-dose vericiguat groups with placebo, and secondary analysis evaluated a dose-response relationship with vericiguat and the primary end point.

    RESULTS: Overall, 351 patients (77.0%) completed treatment with the study drug with valid 12-week NT-proBNP levels and no major protocol deviation and were eligible for primary end point evaluation. In primary analysis, change in log-transformed NT-proBNP levels from baseline to week 12 was not significantly different between the pooled vericiguat group (log-transformed: baseline, 7.969; 12 weeks, 7.567; difference, -0.402; geometric means: baseline, 2890 pg/mL; 12 weeks, 1932 pg/mL) and placebo (log-transformed: baseline, 8.283; 12 weeks, 8.002; difference, -0.280; geometric means: baseline, 3955 pg/mL; 12 weeks, 2988 pg/mL) (difference of means, -0.122; 90% CI, -0.32 to 0.07; ratio of geometric means, 0.885, 90% CI, 0.73-1.08; P = .15). The exploratory secondary analysis suggested a dose-response relationship whereby higher vericiguat doses were associated with greater reductions in NT-proBNP level (P < .02). Rates of any adverse event were 77.2% and 71.4% among the placebo and 10-mg vericiguat groups, respectively.

    CONCLUSIONS AND RELEVANCE: Among patients with worsening chronic HF and reduced LVEF, compared with placebo, vericiguat did not have a statistically significant effect on change in NT-proBNP level at 12 weeks but was well-tolerated. Further clinical trials of vericiguat based on the dose-response relationship in this study are needed to determine the potential role of this drug for patients with worsening chronic HF.

    TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01951625.

  • 10.
    Galiè, Nazzareno
    et al.
    University of Bologna, Italy.
    Barberà, Joan A
    University of Barcelona and Biomedical Research Networking Center on Respiratory Diseases, Madrid, Spain.
    Frost, Adaani E
    Baylor College of Medicine, Houston, USA.
    Ghofrani, Hossein-Ardeschir
    University of Giessen and Marbury Lung Center, Giessen, Germany.
    Hoeper, Marius M
    Hanover Medical School and German Center of Lung Research, Hanover, Germany.
    McLaughlin, Vallerie V
    University of Michigan, USA.
    Peacock, Andrew J
    Regional Heart and Lung Center, Glasgow, Scotland.
    Simonneau, Gérald
    University Paris-Sud, Paris, France.
    Vachiery, Jean-Luc
    Hospital Erasme, Brussels, Belgium.
    Grünig, Ekkehard
    University Hospital Heidelberg, Heidelberg, Germany.
    Oudiz, Ronald J
    UCLA Medical Center, Torrance,USA.
    Vonk-Noordegraaf, Anton
    University Medical Center, Amsterdam, Netherlands.
    White, R James
    University of Rochester, NY, USA.
    Blair, Christiana
    Gilead Sciences, Foster City.
    Gillies, Hunter
    Gilead Sciences, Foster City.
    Miller, Karen L
    Gilead Sciences, Foster City.
    Harris, Julia H N
    GlaxoSmith Kline, Uxbridge, UK.
    Langley, Jonathan
    GlaxoSmith Kline, Uxbridge, UK.
    Rubin, Lewis J
    University of California at San Diego, USA.
    Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension2015In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 373, no 9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Data on the effect of initial combination therapy with ambrisentan and tadalafil on long-term outcomes in patients with pulmonary arterial hypertension are scarce.

    METHODS: In this event-driven, double-blind study, we randomly assigned, in a 2:1:1 ratio, participants with World Health Organization functional class II or III symptoms of pulmonary arterial hypertension who had not previously received treatment to receive initial combination therapy with 10 mg of ambrisentan plus 40 mg of tadalafil (combination-therapy group), 10 mg of ambrisentan plus placebo (ambrisentan-monotherapy group), or 40 mg of tadalafil plus placebo (tadalafil-monotherapy group), all administered once daily. The primary end point in a time-to-event analysis was the first event of clinical failure, which was defined as the first occurrence of a composite of death, hospitalization for worsening pulmonary arterial hypertension, disease progression, or unsatisfactory long-term clinical response.

    RESULTS: The primary analysis included 500 participants; 253 were assigned to the combination-therapy group, 126 to the ambrisentan-monotherapy group, and 121 to the tadalafil-monotherapy group. A primary end-point event occurred in 18%, 34%, and 28% of the participants in these groups, respectively, and in 31% of the pooled-monotherapy group (the two monotherapy groups combined). The hazard ratio for the primary end point in the combination-therapy group versus the pooled-monotherapy group was 0.50 (95% confidence interval [CI], 0.35 to 0.72; P<0.001). At week 24, the combination-therapy group had greater reductions from baseline in N-terminal pro-brain natriuretic peptide levels than did the pooled-monotherapy group (mean change, -67.2% vs. -50.4%; P<0.001), as well as a higher percentage of patients with a satisfactory clinical response (39% vs. 29%; odds ratio, 1.56 [95% CI, 1.05 to 2.32]; P=0.03) and a greater improvement in the 6-minute walk distance (median change from baseline, 48.98 m vs. 23.80 m; P<0.001). The adverse events that occurred more frequently in the combination-therapy group than in either monotherapy group included peripheral edema, headache, nasal congestion, and anemia.

    CONCLUSIONS: Among participants with pulmonary arterial hypertension who had not received previous treatment, initial combination therapy with ambrisentan and tadalafil resulted in a significantly lower risk of clinical-failure events than the risk with ambrisentan or tadalafil monotherapy. (Funded by Gilead Sciences and GlaxoSmithKline; AMBITION ClinicalTrials.gov number, NCT01178073.).

  • 11.
    Haji Modiri, Shima
    Linköping University, Department of Management and Engineering, Political Science.
    Impacts of Living and Working Conditions on the Health of Immigrants: A Comparative Study on Asylum-Seekers in Germany and the Netherlands2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    During the last several decades, many people, fleeing from disasters or political threats, have applied for asylum in the European countries. Council Directive 2003/9/EC, laying down minimum standards for the reception of asylum-seekers, as well as several other directives, have been developed in the EU in order to ensure fair treatment of the asylum-seekers in all the European countries. However, there are huge differences in the national asylum laws of countries and consequently, the way they treat the asylum-seekers. In this research, the national asylum laws of Germany and the Netherlands are studied and compared, showing that though following the Council Directive, fair or equal treatment of asylum-seekers cannot be guaranteed. In the Netherlands asylum-seekers are granted with a great extent of benefits while in Germany, they are greatly discriminated against. Based on the Social Determinants of Health Model, developed by Dahlgren and Whitehead in 1991, the hypothesis is that the asylum seekers in the Netherlands enjoy better health status than the ones in Germany, because based on the Dutch asylum laws, they have better living and working conditions. In order to confirm or negate this hypothesis, a meta-study of available literature on the health status of asylum-seekers has been done. However, the hypothesis could not be confirmed/ negated due to extreme lack of availability of data in this area.

    By discussing the relationship between life conditions and health of individuals, reviewing current legal instruments regulating asylum in the EU and analyzing the available data on the health status of asylum-seekers, this paper draws the attention to the importance of data and research on these topics and the need for development of practices for collection of such information. Availability of such information can affect future decision and policy makings regarding asylum-seekers and their health and might result in comprehensive reformations in the current national or international legal instruments.

  • 12.
    Gerebäck, David
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Zetterkvist, Gustav
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Logistical challenges for the establishment of a fly ash treatment facility2015Independent thesis Basic level (degree of Bachelor), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Syftet med denna rapport är att identifiera och kvantifiera logistiska nyckelaspekter kring etablerandet av en behandlingsanläggning för flygaska, samt ge förslag på lämplig lokalisering av denna. Med hjälp av tyngdpunktsmetoden samt omfattande studier av olika typer av rapporter fastställs nutida och framtida förusättningar för denna etablering.

  • 13.
    Liljeström, Stella
    et al.
    Linköping University, Department of Management and Engineering, Economics.
    Johansson, Sandra
    Linköping University, Department of Management and Engineering, Economics.
    Den Potentiella Risken med Riskkapital - En studie av riskkapitalbolagens intåg i djursjukvården och de potentiella effekterna detta får på djurförsäkringsmarknaden2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Until 2011 the Swedish market of animal medical treatment was dominated by a few veterinary hospitals and a large number of small and medium-sized owner-managed clinics. However, a lot has changed in the past years. In 2011 and 2012 mergers of clinics and hospitals took place and as a result of the mergers two large animal health companies were formed, today these two have a combined market share of over 60 percent. The two companies, AniCura and Evidensia, are currently owned and operated by the Swedish private equity firms EQT and Nordic Capital.

    The focus of this study is to investigate the possible effects of the changed conditions on the market of animal medical treatment on the pet insurances, both at a product and market level. In order to do so the three markets were analyzed with help of relevant theories.

    The conclusion we have drawn is that the premiums on the pet insurances increased after the entry of the private equity firms, but the reason behind this increase cannot be established. Thus, there are no signs that the development of the market will take a new direction, but a continuing homogenized range of pet insurances will occur. The effect will be unchanged market shares for the insurance companies. It is reasonable to assume that the pet insurance companies’ future development will be strongly linked to the development of the major animal health companies.

  • 14.
    Åstrom, Anne N.
    et al.
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Ekback, Gunnar
    Department of Dentistry, Örebro County Council, Örebro, Sweden.
    Ordell, Sven
    Dental Commissioning Unit,Ostergotland County Council.
    Nasir, Elwalid
    Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
    Long-term routine dental attendance: influence on tooth loss and oral health-related quality of life in Swedish older adults2014In: Community Dentistry and Oral Epidemiology, ISSN 0301-5661, E-ISSN 1600-0528, Vol. 42, no 5, 460-469 p.Article in journal (Refereed)
    Abstract [en]

    ObjectivesFew studies have investigated the effect of long-term routine dental attendance on oral health between middle-aged and older adults, using a prospective cohort design. This study aimed to assess routine dental attendance (attending dentist in the previous 12months for dental checkups) from age 50 to 65years. Moreover, this study examined whether long-term routine dental attendance contributes to oral health-related quality of life, OHRQoL, and major tooth loss independent of social factors and the type of treatment sector utilized. Whether oral health impacts of long-term routine attendance varied with type of treatment sector utilized was also investigated. MethodIn 1992, a census of the 1942 cohort in two counties of Sweden participated in a longitudinal questionnaire survey conducted at age 50 and again after 5, 10, and 15years. Information was collected on a wide range of health- and oral health-related aspects. Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow-ups in 1997, 2002, and 2007. ResultsRoutine dental attendance decreased from 69.1% at age 50-64.2% at age 65. Adjusted logistic regression analyses revealed that individuals reporting long-term routine attendance (routine attendance in both 1992 and 2007) were 0.3 (95% CI 0.2-0.5) times less likely than their counterparts who were nonroutine attenders to report oral impacts. According to generalized estimating equations (GEE), individuals who reported long-term routine attendance were 0.6 (95% CI 0.4-0.7) times less likely than nonroutine attenders to have major tooth loss across the survey years. The effect of long-term routine attendance on OHRQoL was stronger in public than in private dental healthcare attenders. ConclusionRoutine attendance decreased from age 50-65years. Long-term routine attendance had positive impact on major tooth loss and OHRQoL supporting the principle of encouraging annual dental attendance for preventive checkups among older people.

  • 15.
    Hongxing, Li
    et al.
    Department of Clinical Dentistry – Prosthodontics, University of Bergen, Bergen, Norway.
    List, Thomas
    Orofacial pain and Jaw Function, Malmö University, Malmö, Sweden.
    Nilsson, Ing-Marie
    Specialist Center for Oral Rehabilitation, Norrköping, Sweden .
    Johansson, Anders
    Department of Clinical Dentistry – Prosthodontics, University of Bergen, Bergen, Norway.
    Nordrehaug Astrom, Anne
    Department of Clinical Dentistry – Community Dentistry, University of Bergen, Bergen, Norway.
    Validity and reliability of OIDP and OHIP-14: a survey of Chinese high school students2014In: BMC Oral Health, ISSN 1472-6831, Vol. 14, no 158, 1-10 p.Article in journal (Refereed)
    Abstract [en]

    Background: To determine the impact of oral diseases on everyday life, measures of oral quality of life are needed. In complementing traditional disease-based measures, they assess the need for oral care to evaluate oral health care programs and management of treatment. To assess the reliability and validity of the Oral Impact of Daily Performance (OIDP) and the short-form Oral Health Impact Profile (OHIP-14) among high school students in Xian, the capital of Shanxi province, China. Methods: Cross-sectional one-stage stratified random cluster sample using high schools as the primary sampling unit. Students completed self-administered questionnaires at school. The survey included the OHIP-14 and OIDP inventories, translated and culturally adapted for China, and global oral health and socio-behavioral measures. Results: A total of 5,608 students participated in the study, with a 93% response rate (mean age 17.2, SD 0.8, 52% females, 45.3% urban residents). The proportion experiencing at least one impact (at any frequency) during the previous six months was 62.9% for the OHIP-14 and 45.8% for the OIDP. Cronbachs alpha measured internal consistency at 0.85 for OHIP-14 and 0.75 for OIDP while Cohens kappa varied between 0.27 and 0.58 for OHIP-14 items and between 0.23 and 0.65 for OIDP items. Kappa scores for the OHIP-14 and OIDP additive scores were 0.52 and 0.66, respectively. Both measures varied systematically and in the expected direction, with global oral health measures showing criterion validity. The correlation between OIDP and OHIP-14 was r(s) + 0.65. That both measures varied systematically with socio-behavioral factors indicates construct validity. Conclusion: Both the OIDP and OHIP-14 inventories had reasonable reliability and construct validity in relation to subjective global oral health indicators among adolescents attending high schools in China and thus appear to be useful oral health -related quality of life measures in this context. Overall, the OHIP-14 and OIDP performed equally well, although OHIP-14 had superior content validity due to its sensitivity towards less severe impacts.

  • 16.
    Backlund, Lisa
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Luuk, Liisa
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    DAY: Allians, komorbiditet och kunskap i KBT-behandling bestående av fyra behandlingsträffar och tio veckors internetbehandling för depression2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    I studien utvärderades en KBT-behandling för depression bestående av fyra behandlingsträffar i kombination med ett internetprogram under tio veckor. Syftet var att undersöka om behandlingen ledde till ökad kunskap om behandlingsinnehållet samt om kunskap, allians och komorbiditet kunde predicera symptomförbättring. Kunskapsökning undersöktes med ett kunskapstest som analyserades med ANCOVA och resultatet visade på en trend mot att behandlingen ledde till ökad kunskap. När skattningar av deltagarnas säkerhet på svaren på frågorna i kunskapstestet inkluderades i analysen var resultatet signifikant bättre för behandlingsgruppen jämfört med kontrollgruppen. Huruvida kunskap, allians och komorbiditet kunde predicera förbättring i behandlingsgruppen undersöktes med Pearsons produktmomentkorrelationskoefficient. Allians och kunskap kunde inte predicera symptomförbättring. Däremot fanns ett negativt samband mellan antalet komorbida tillstånd och symptomförbättring på ett av utfallsmåtten, vilket kan indikera att formatet fungerar sämre för personer med en generellt hög symptombörda. Forskningsområdet är nytt, varför det behövs fler studier om faktorer som påverkar behandlingsresultatet när sedvanlig KBT-behandling kombineras med internetbehandling.

  • 17.
    Pettersson, Alice
    Linköping University, Department of Physics, Chemistry and Biology, Biology. Linköping University, Faculty of Science & Engineering.
    Can stress-related behavior in dogs be due to pain? A pilot study.2015Independent thesis Basic level (degree of Bachelor), 10,5 credits / 16 HE creditsStudent thesis
    Abstract [en]

    Dogs and other pets can have back pain for years that no one notices. As a result they become stressed and can e.g. develop aggressiveness or decrease their feeding. There are indications that chiropractic treatments can treat these animals but this is not commonly known by veterinarians. This study investigated stress related behaviors and average heart rate in ten dogs before and after chiropractic treatment. A control group of eight dogs was also tested but did not receive the treatment. The test consisted of three parts: 1) one part without owner interaction, 2) one part where a human approached and 3) one part were the owner commanded the dog to sit and lie down. Eight out of ten owners experienced a positive change in their dogs’ behavior one week after the treatment though the test results did rather point at more stressful behaviors. The test group showed an increase in yawning and panting from the first to the second test (after the treatment) and showed a higher heart rate after the treatment compared to the control group during part 1. Probably due to that the treatment and the tests were in the same local and the dogs became stressed by being there again. Part 3 did show a possible increase in movability and contact with the owner but more studies are needed to confirm the change that the owners experienced. Though, this study is a step in the right direction; more animals could be treated and saved from euthanizing if chiropractic and the diagnosis of this back injury are taught to veterinarians.

  • 18.
    Hemmingsson, Lovisa
    et al.
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, Faculty of Science & Engineering.
    Klasén, Johan
    Linköping University, Department of Physics, Chemistry and Biology. Linköping University, Faculty of Science & Engineering.
    In vitro studies of Thiopurine S-Methyltransferase: Ligand binding interactions and development of a new enzymatic activity assay for TPMTwt, TPMT*6 and TPMT*82015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Acute lymphoblastic leukemia, one of the most malignant cancer forms in children is commonly treated with the thiopurine 6-mercaptopurine (6-MP) in combination with a high dose of methotrexate (MTX). 6-Mercaptopurine is in the body metabolized by the enzyme thiopurine S-methyltransferase (TPMT). Polymorphic variants of TPMT express different catalytic activities, and for this reason the dosage of 6-MP needs to be individualized. In order to better optimize the treatment it is important to understand how mutations in TPMT affect its enzymatic activity.

    In this thesis we have investigated how the wild type and two variants of TPMT interact with different ligands using fluorescence and isothermal titration calorimetry. Experiments with MTX, ANS and furosemide resulted in a similar binding strength for the wild type and the variant TPMT*8, while the other variant TPMT*6 showed a slightly weaker binding. A binding affinity for polyglutamated MTX to TPMTwt was also determined which resulted in an almost twice as strong binding compared to MTX.

    Today’s methods to determine enzymatic activity are either based on radioactivity, time consuming or expensive. As an alternative the use of a spectrophotometric assay using 5-thio-2-nitrobenzoic acid (TNB) was investigated. The method showed positive results and could hopefully be adapted to plate readers in future experiments. Using 5.5’-dithiobis-(2-nitrobenzoic acid) (DTNB, also known as Ellman’s reagent) the amount of accessible thiol groups on the protein was estimated. This revealed a similar relationship between TPMTwt and TPMT*6, while the result for TPMT*8 was inconclusive.

  • 19.
    Birchwood, Aina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Hammarberg, Matilda
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Högteknologiskt samtalsstöd vid demens: En analys av samtal med och utan surfplatta med applikationen Book Creator2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The number of people who are affected by dementia is expected to increase, from 25 million in the year 2000 to approximately 63 million in the year 2030. Dementia can be described as a global disorder of intellectual functions, where the cognitive ability including communication is affected. High technological communication aids that support people with dementia in their communication are currently an underexplored area with limited evidence. The aim of the present study was to identify interactional phenomena occurring in interaction involving one person with dementia with and without a tablet with the application Book Creator. A further aim was to examine how the conversation partner experienced the communication of the person with dementia. The study was conducted in a residential care facility for people with dementia where a total of nine conversations were recorded, six conversations without the application and three conversations with the application. The material comprised 2 hours and 25 minutes and was transcribed according to Conversation Analytic principles. Five phenomena were identified: initiative, common ground, coherence, incomplete common ground and non-coherence. The frequency of occurrence of these phenomena was calculated in percentage of their occurrence in relation to total number of turns.The result in the present study indicated that the interactional phenomena involving incomplete common ground and non-coherence occurred in a reduced frequency in conversations with the application Book Creator. The person with dementia took the initiative to the same extent in interactions with and without the application. There appeared to be no differences regarding common ground and coherence between the participants in the conversation with and without the application. The analysis also revealed that the person with dementia could handle the tablet with the application Book Creator on her own with some support. The results are in accordance with research regarding communicative difficulties in people with dementia, strategies to address these difficulties and the need of increased training in communicative treatment in dementia.

  • 20.
    Netin, Rebecka
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Pehrson, Fanny
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Logopedisk gruppbehandling för barn med språkstörning2015Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The study objective was to investigate interaction in speech and language therapy groups for children with language impairment and to investigate whether treatment was implemented in the home environment. The material was collected from a speech and language therapy center in the south of Sweden and from the participants’ home environment. In total, seven video recordings were made of speech and language therapy sessions in two different groups. Five sessions were recorded in one of the groups, and the remaining two were recorded in the second group. Three SLPs, eight children and eleven parents participated in the study. Interviews with two of the participating SLPs and two of the participating parents were conducted. Video recordings from a home setting were collected from two of the participating children. All of the collected video recorded material was transcribed and analyzed according to principles of Conversation Analysis. The results show that the SLPs in therapy use imitation-based and modelling strategies to elicitate language production. Manual signs and recasts were found to be used as treatment strategies. Other phenomena in treatment were repairs, feedback and face-saving strategies. The study highlights the asymmetry in the interaction between children and SLPs, but also shows that the interaction sometimes departs from interaction of an institutional kind. The results indicate that one of the participating parents has implemented manual signs in the interaction during treatment as well as in the home environment. The study shows that two parents use recasts in the interaction with their children.  

  • 21.
    Karlsson, Linda
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Zetterlund, Martin
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Behandlas barn olika?: Smärtskattning på barn efter skoliosoperation2010Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Despite improved guidelines and treatment of children, postoperative pain is still a problem. Painassessment in children and specially children with cognitive disibilities demands knowledge in existing pain measurement tools for nurses. Then all children have the opportunity to express their pain.

    Aim: To find out if there is a difference in the frequency of assessment in postoperative pain in children after surgery for scoliosis.

    Design: A retrospective study.

    Methods: The study was performed in Linköping University hospital. Children admitted 2008-2009 for Idiopatic scoliosis or Neuromuscular scoliosis surgery, in age 0-18 years and available via the data journal were included in the study.

    Results: Children with Idiopatic scoliosis had a higher freqvence of painassessment compared with Neuromuscular scoliosis. Children who didn´t understood verbal information had less frequence of painassesment compered with those who understood verbal information. Girls were assessed for pain significant more often as compared to boys in the group who understood verbal information.

    Conclusion: There was differences between children who were able to express themselves and those who weren´t in painassessment, but also gender matters and to ensure all children’s right to similar care it´s of importance to access different pain measurement tools.

  • 22.
    Neuhaus, V.
    et al.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Bot, A.G.J.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Guitton, T.G.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Ring, D.C.
    Orthopaedic Hand Service, Yawkey Center, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, United States.
    Scapula fractures: Interobserver reliability of classification and treatment2014In: Journal of Orthopaedic Trauma, ISSN 0890-5339, E-ISSN 1531-2291, Vol. 28, no 3, 124-129 p.Article in journal (Refereed)
    Abstract [en]

    Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. Design: Web-based reliability study. Setting: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. Participants: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. Main Outcome Measurements: Fleiss kappa (κ) was used to assess the reliability of agreement between the surgeons. Results: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, κ = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, κ = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), κ = 0.79) was substantial and the agreement about a fractured body (Body (B), κ = 0.57) or process was moderate (Process (P), κ = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (κ = 0.57) with a 73% PA. Conclusions: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. Copyright © 2013 by Lippincott Williams and Wilkins.

  • 23.
    Johansson, Camilla
    et al.
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    Pettersson, Lisa
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    Microcredit Impact on Business Performance: A Minor Field Study in El Salvador2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Microcredits have become a popular way to include poor people in the financial market. Former research on the impact on business performance has provided divergent findings and its impact on the Salvadoran market is not yet investigated. This thesis takes on this problem by analysing and evaluating how the microenterprises in Usulután, El Salvador are affected by the participation in a microcredit program. By using a quantitative method the business performance of a treatment group is compared to that of a control group. The results show that participation in a microcredit program enlarged the enterprise size in terms of sales, total assets and equity, but did not have any significant impact on business profit, marginal return to capital or fixed asset. Regressions are conducted to describe what individual characteristics of the clients are the most important for the business performance. Clients with higher education and male clients over performed other clients.

  • 24.
    Jonsson, Andreas
    et al.
    Linköping University, Department of Management and Engineering, Commercial and Business Law. Linköping University, Faculty of Arts and Sciences.
    Maslyannikov, Lev
    Linköping University, Department of Management and Engineering, Commercial and Business Law. Linköping University, Faculty of Arts and Sciences.
    Arbetsrätten vid partiella företagsförvärv: Med utgångspunkt i förvärvsmetodernas skatterättsliga följder2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Corporate acquisitions often give rise to questions pertaining labour law and tax law, where many people and large amounts of money are involved. In the context of partial acquisitions, these questions come to a head, since difficult delimitations must be done when dividing a company. These delimitations are, furthermore, based upon different grounds within different fields of law. From an economical perspective, a failed transition of staff can carry considerable costs and risks of conflict. A disadvantageous outcome in the context of tax law is expensive as well. For this reason we have chosen, in this thesis, to focus on questions concerning labour law and tax law in the context of partial corporate acquisitions. These questions are treated in the following manner.

    Firstly, a review of the relevant norms within labour law, tax law and corporate law is made. This is done to paint a somewhat nuanced picture of both the assessment process within labour law and the frames of tax and company law, in which the methods of acquisition are stipulated. Against this background, we have constructed three examples that illustrate how the methods can be applied to achieve different effects pertaining labour law. The examples are designed to cover the majority of the norms that were investigated in the first part of the thesis. Finally, a general evaluation of the results is made.

    The method of acquisition, by itself, erects a framework in which labour law can be applied. However, it is the desired outcome in the context of labour law that governs the choice of acquisition method and its arrangement. It is possible to achieve these desired outcomes while receiving an advantageous treatment in the context of tax law as well. The execution of a partial acquisition, with consideration for the methods within tax law and the results within labour law, can therefore amount to a successful ”cherry pick”.

  • 25.
    Wedeen, Maria
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wickenberg, Madeleine
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    När den sexuella normen möter den asexuella patienten: En diskursanalys av intervjuer med ungdomsmottagningspersonal om sexualitet, bemötande och asexualitet2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Asexualitet är en sexuell identitet som först nyligen börjat få uppmärksamhet inom forskning och i samhällsdebatten. Det finns ytterst lite forskning på hur asexuella personer bemöts i samhället och mer specifikt i vården. Denna uppsats syftar därför till att skapa ökad förståelse för hur personal på ungdomsmottagningar i Sverige pratar om sexualitet och asexualitet. Studien är en diskursanalys av intervjuer med personal på ungdomsmottagningar i Mellansverige (N=7). Utifrån detta framkommer fyra teman: Den viktiga sexualiteten, Det goda bemötandet, Asexualitet och Det normativa samhället. Under dessa teman presenteras ett antal tolkningsrepertoarer som beskriver hur deltagarna talar om respektive tema. Det främsta fyndet i denna studie är att deltagarna konstruerar sexualitet på ett sätt som inte ger utrymme för asexualitet eller för asexuella personers upplevelser och att detta i sin tur krockar med hur de konstruerar ett gott bemötande.

  • 26.
    Sundqvist, Erik
    Linköping University, Department of Computer and Information Science.
    Protection of Non-Volatile Data in IaaS-environments2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Infrastructure-as-a-Service (IaaS) cloud solutions continue to experience growth, but many enterprises and organizations are of the opinion that cloud adoption has decreased security in several aspects. This thesis addresses protection of IaaS-environment non- volatile data. A risk analysis is conducted, using the CORAS method, to identify and evaluate risks, and to propose treatments to those risks considered non-acceptable. The complex and distributed nature of an IaaS deployment is investigated to identify di↵erent approaches to data protection using encryption in combination with Trusted Computing principles. Additionally, the outcome of the risk analysis is used to decide the advantages and/or drawbacks of the di↵erent approaches; encryption on the storage host, on the compute host or inside the virtual machine. As a result of this thesis, encryption on the compute host is decided to be most beneficial due to minimal needs for trust, minimal data exposure and key management aspects. At the same time, a high grade of automation can be obtained, retaining usability for cloud consumers without any specific security knowledge. A revisited risk analysis shows that both non- acceptable and acceptable risks are mitigated and partly eliminated, but leaves virtual machine security as an important topic for further research. Along with the risk analysis and treatment proposal, this thesis provides a proof-of-concept implementation using encryption and Trusted Computing on the compute host to protect block storage data in an OpenStack environment. The implementation directly follows the Domain-Based Storage Protection (DBSP) protocol, invented by Ericsson Research and SICS, for key management and attestation of involved hosts.

  • 27. Oliynyk, Igor
    et al.
    Varelogianni, Georgia
    Roomans, Godfried M
    Johannesson, Marie
    Effect of duramycin on chloride transport and intracellular calcium concentration in cystic fibrosis and non-cystic fibrosis epithelia.2010In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 118, no 12, 982-990 p.Article in journal (Refereed)
    Abstract [en]

    The lantibiotic duramycin (Moli1901, Lancovutide) has been suggested as a drug of choice in the treatment for cystic fibrosis (CF). It has been proposed that duramycin may stimulate chloride secretion through Ca²(+) -activated Cl⁻ channels (CaCC). We investigated whether duramycin exhibited any effect on Cl⁻ efflux and intracellular Ca²(+) concentration ([Ca²(+)](i)) in CF and non-CF epithelial cells. Duramycin did stimulate Cl⁻ efflux from CF bronchial epithelial cells (CFBE) in a narrow concentration range (around 1 μM). However, 100 and 250 μM of duramycin inhibited Cl⁻ efflux from CFBE cells. An inhibitor of the CF transmembrane conductance regulator (CFTR(inh)₋₁₇₂) and a blocker of the capacitative Ca²(+) entry, gadolinium chloride, inhibited the duramycin-induced Cl⁻ efflux. No effect on Cl⁻ efflux was observed in non-CF human bronchial epithelial cells (16HBE), human airway submucosal gland cell line, human pancreatic epithelial cells, CF airway submucosal gland epithelial cells, and CF pancreatic cells. The [Ca²(+)](i) was increased by 3 μM duramycin in 16HBE cells, but decreased after 1, and 3 μM of duramycin in CFBE cells. The results suggest that the mechanism responsible for the stimulation of Cl⁻ efflux by duramycin is mainly related to unspecific changes of the cell membrane or its components rather than to effects on CaCC.

  • 28. Varelogianni, Georgia
    et al.
    Hussain, Rashida
    Strid, Hilja
    Oliynyk, Igor
    Roomans, Godfried M
    Johannesson, Marie
    The effect of ambroxol on chloride transport, CFTR and ENaC in cystic fibrosis airway epithelial cells.2013In: Cell Biology International, ISSN 1065-6995, E-ISSN 1095-8355, Vol. 37, no 11, 1149-1156 p.Article in journal (Refereed)
    Abstract [en]

    Ambroxol, a mucokinetic anti-inflammatory drug, has been used for treatment of cystic fibrosis (CF). The respiratory epithelium is covered by the airway surface liquid (ASL), the thickness and composition of which is determined by Cl(-) efflux via the cystic fibrosis transmembrane conductance regulator (CFTR) and Na(+) influx via the epithelial Na(+) channel (ENaC). In cells expressing wt-CFTR, ambroxol increased the Cl(-) conductance, but not the bicarbonate conductance of the CFTR channels. We investigated whether treatment with ambroxol enhances chloride transport and/or CFTR and ENaC expression in CF airway epithelial cells (CFBE) cells. CFBE cells were treated with 100 µM ambroxol for 2, 4 or 8 h. mRNA expression for CFTR and ENaC subunits was analysed by real-time polymerase chain reaction (RT-PCR); protein expression was measured by Western blot. The effect of ambroxol on Cl(-) transport was measured by Cl(-) efflux measurements with a fluorescent chloride probe. Ambroxol significantly stimulated Cl(-) efflux from CFBE cells (a sixfold increase after 8 h treatment), and enhanced the expression of the mRNA of CFTR and α-ENaC, and of the CFTR protein. No significant difference was observed in β-ENaC after exposure to ambroxol, whereas mRNA expression of γ-ENaC was reduced. No significant effects of ambroxol on the ENaC subunits were observed by Western blot. Ambroxol did not significantly affect the intracellular Ca(2+) concentration. Upregulation of CFTR and enhanced Cl(-) efflux after ambroxol treatment should promote transepithelial ion and water transport, which may improve hydration of the mucus, and therefore be beneficial to CF-patients.

  • 29.
    Eklund Rimsten, Anders
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Larsson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    "Det ger sig självt om man är en bra terapeut". En intervjustudie av hemuppgifter i familjeterapi.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The homework is an important part of both Functional Family Therapy (FFT) and Dialectical Behavior Therapy (DBT). The goal of this essay has been to determine if, and in what way, homework is used in the context of family therapy, that is the frame of FFT. One hypothesis at the beginning of this work was that the interactional home assignments have started to be replaced by the behavior oriented ones that are a part of DBT.

    The individuals participating in the study are all working in a psychiatric outpatient clinic (BUP) in Uppsala. They are all using either Functional Family Therapy (n=3) or Dialectical Behavior Therapy (n=2) as treatment methods.

    The purpose of the study has been to try to understand more of the homework as a therapeutic instrument, especially the relational homework that family therapists are expected to work out on the basis of a manual that is provided within FFT. Two methods have been used to examine this: a survey and focus group interview.

    The results show a relatively large width when it comes to the therapists view on and practice of homework, though the general pattern indicates that they work out both relational as well as behavior oriented assignments in their practical work. However, there is a need and a wish of the family therapists to gain more clarity on how to determine and give a family a relational oriented homework. The conclusion of this essay is that a clarification like that is not possible, unless you go to the bottom with and define what the relational function is and how to use it in what within Functional Family Therapy is called the Relational Assessment Phase.

  • 30.
    Gauthier Westergård, Veronica
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Barnets rätt att komma till tals i familjebehandling. Familjebehandlarnas röster om Barnkonventionens artikel 12 i praktiken.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the study was to investigate if the article 12 of the Convention of the Rights of the Child to be heard is applied in family treatment by making a pilot study. Family practitioners within the municipal outpatients care had to answer how they did involve the children, the manner in which children were heard and if there were times when children should not be participate in family treatment. To get answers to these questions a semi-structured survey was made. The selected theory was systems theory.  The study also included the Convention of the Rights of the Child, family treatment and BBIC. The results showed that family practitioners used various methods to get children to be heard. There was a lot of flexibility around these practices making children involved and creating the opportunity to get children to talk. There were times when children should not participate in family therapy for example when parents had their own difficulties and when it was a predominantly adult problem.

  • 31.
    Bransell, Sara
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Pappors reflektioner om hur, över tid pågående, konflikter med mamman drabbar barnet.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of the present study was to investigate the ability of fathers, who have participated in a combined therapy/self-help group, of young children to appreciate the effects of prolonged conflicts in the family on the children, e.g. their ability as fathers to assume the children's perspective on the matter.

    Ten fathers no longer living with the mothers, with whom they still had unresolved issues, participated in individual interviews concerning different questions that might be of importance to children exposed to family conflict. The interviews were based on two fictitious cases describing the situation of children whose parents are in dispute over custody. All of the participating fathers emphasized how difficult it was to keep the welfare of the child in focus, while having an ongoing conflict with the mother. They also expressed problems in judging what practical daily life measures would be best for the child during the conflict. Moreover, they raised the issue of not being able to focus on parenting, putting all their energy into managing their ex-partner instead. Hence, focusing on managing a conflict occurred at the expense of the relationship to their children. The participants also expressed how the fathers in the fictitious cases, and in their own situation, should be concerned with not intensifying an already difficult situation for the children as long as they don’t understand the children's perspectives.

    It can be concluded that the participants obtained an increased awareness of the importance of being more sensitive to the needs of their own children due to the support from the group treatment. They could see parenting as a lifelong task with responsibilities on them even when the relationship with mother had ended.

  • 32.
    Arbman, Helena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Familjerelationer i förändring? En studie av FFT-behandling avseende Frågor om Familjemedlemmar och Familjeklimat.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The paper is an evaluation of Functional Family Therapy (FFT). The aim was to investigate whether a FFT treatment meant a change for a youth and his parents regarding their description of family climate and dyads within the family. The target group consisted of 29 families that during 2011-2013 completed the FFT treatment at Ungdomscentrum (Youth Centre), in Uppsala community. The families had completed the self-assessment forms Issues of Family members and Family climate before and after the treatment. The results showed several significant differences that were consistent with previous research of the model, both internationally and nationally. Criticism and blame had been reduced between family members and the parents considered themselves less over-involved in their youth after the treatment. Current Family climate, it turned out that the adolescents, mothers and fathers experienced more closeness and less distance within the family in the end of treatment. The evaluation confirmed that the FFT- model provides some effect for families with a teenager with behavior problems. The strong emphasis on changing family patterns of communication to a more supportive one, is crucial for the family to complete their treatment and for the result of the treatment.

  • 33.
    Häggqvist, Jenni
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    von Salomé, Hanna
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Psychology.
    Kognitiv funktion vid insomni, depression samt komorbid insomni och depression: skiljer grupperna sig åt och spelar det någon roll för behandlingsutfall?2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Insomni och depression är psykiatriska åkommor som idag drabbar många människor. Forskning har visat att det råder en stor samsjuklighet mellan diagnoserna där många drabbade lider av samtidig insomni och depression vilket utgör en stor belastning för den enskilde individen. Patienter rapporterar ofta en negativ påverkan på kognitiva funktioner, bland annat minnessvårigheter och problem med koncentration och uppmärksamhet. Inom forskningen råder det i dagsläget en osäkerhet kring vilka kognitiva nedsättningar som karakteriserar personer med dessa diagnoser och på vilka sätt de skiljer sig åt. Det finns också ett behov av att undersöka vilken roll kognitiv förmåga spelar för människors möjlighet att tillgodogöra sig psykologisk behandling. I föreliggande studie var syftet att undersöka dessa båda områden. Resultaten visade inte på några signifikanta skillnader mellan personer med insomni, personer med depression och personer med det komorbida tillståndet avseende kognitiva funktioner, när det mättes genom test av uppmärksamhet, arbetsminne och exekutiva funktioner. Däremot framkom vissa samband mellan arbetsminne och förbättring av upplevda sömnbesvär, liksom mellan förmåga till bibehållen uppmärksamhet och förbättring av depressionssymtom. Vidare forskning med större och jämnare urvalsgrupper behövs för att undersöka stabiliteten i dessa fynd.

  • 34.
    Strömbom, Johanna
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Carlsson, Malin
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Vad underlättar respektive hindrar fysisk aktivitet hos personer med långvariga smärtor?: En kvalitativ intervjustudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: FacilitatorsandBarriers toPhysical ActivityamongPeople with Long-term Pain-A Qualitative Study.

    Authors: Malin Carlsson & Johanna Strömbom, Physiotherapy Programme, Faculty of Health Sciences, Linköping University, Sweden.

    Tutor: Britt Larsson, Docent of Occupational Medicine, Lector of Clinical Pain Research, Faculty of Health Sciences, Linköping University, Sweden.

    ABSTRACT

    Introduction: Exercise has been shown to have positive effects on long-term pain. There is, however, reported poor adherence in people with long-term pain. Previous research has demonstrated a number of facilitating and inhibiting factors to exercise for people with long-term pain but lay emphasis on the importance of further research with a broader approach to physical activity.Purpose: The aim of this study was to identify facilitating factors and barriers to physical activity as a treatment for long-term pain.Method: A qualitative study using semi-structured interviews was conducted with ten participants recruited through the Pain -and Rehabilitation Center in Linköping. Collected data was analysed based on a qualitative content analysis.Results: Facilitating factors were reported to be individually tailored, varied and enjoyable training, also support, fellowship, pain relief, motivation, progress, the desire to improve health, availability and knowledge. Pain, timing, lack of energy, difficulty initiating exercise, not having a need to exercise, lack of availability and knowledge, and furthermore embarrassment, laziness, fear, and lack of motivation were reported as being inhibitive.Conclusion: Factors that appeared in the results confirm previous research, this study presented additional factors such as difficulties initiating exercise and not having a need to exercise. Future research should apply presented factors in the design of treatment for patients with pain.Keywords: adherence, pain, physical activity, qualitative research.

  • 35.
    Lindgren, Lina
    Linköping University, The Tema Institute. Linköping University, Faculty of Arts and Sciences.
    Including Additional Land Use, Land Use Change and Forestry-activities under the Clean Development Mechanism: Discussions in the United Nations Climate Negotiations2011Report (Other academic)
    Abstract [en]

     

    Land use, land use change and forestry activities (LULUCF) can help mitigate climate change by creating a terrestrial carbon sink, removing carbon dioxide from the atmosphere, while at the same time help increasing adaptive capacity and reduce poverty. Still, carbon stored in biomass or soils are only stored temporary since natural or human induced disturbances can cause a total or partial loss of stored carbon.

    LULUCF-activities under the clean development mechanism (CDM),  one of the flexible mechanisms under the Kyoto protocol, have been limited to afforestation and reforestation (A/R) projects under the first commitment period. Joint implementation projects and national accounting  of  greenhouse  gas  reduction  can  in  addition  to  A/R-project  also  include deforestation,  revegetation,  forest  management,  cropland  management  and  grazing  land management. The exclusion of these types of activities from CDM has been questioned and debated recently.

    This briefing tracks the United Nations (UN) climate negotiations in regards to the possibility of including additional LULUCF-activities under CDM, mainly the negotiations occurring after the adoption of the Bali Road map.

    LULUCF under CDM has been discussed mainly in the Ad Hoc Working Group on Further Commitments for Annex I Parties under the Kyoto Protocol (AWG-KP). There are diverging ideas on whether a more holistic approach should be applied to the treatment of LULUCF under CDM or whether current structure should be kept. Costa Rica, Colombia, Mexico, Panama, El Salvador, New Zealand, Norway, Canada, Australia and several of the Least Developed Countries have been positive towards including additional LULUCF-activities. Some of the arguments brought up are that the LULUCF-sector holds a large potential to mitigate climate change that is lost with the current structure and that a broader inclusion of LULUCF-activities would lead to an inclusion of all parts of the world in the benefits from CDM. China, Brazil and  Alliance of Small  Island States  have, on the other hand, been sceptical towards including additional activities arguing that there are too large uncertainties and that it creates an offset allowing developed nations to delay emission reduction in other sectors. The EU supports the current structure and rules but is open to discuss alternatives.

    The  AWG-KP  has  been  negotiating  a  new  LULUCF-decision,  which  has  not  yet  been adopted. In the draft LULUCF-decision from the Conference of Parties in Copenhagen 2009, the possibility of expanding LULUCF under CDM was however opened. In the draft decision the Subsidiary Body for Scientific and Technological Advice (SBSTA) is requested to initiate a work programme on additional LULUCF-activities. Since the LULUCF-decision is not yet adopted, SBSTA cannot initiate this work programme and whether they will be able to do so is dependent upon the outcome of the negotiations on the LULUCF-decision. LULUCF- activities under CDM have so far received little negotiation time.

    LULUCF and CDM have also been discussed outside the formal UN climate negotiations. Several  side events,  for  example,  have treated these questions,  both  for and  against  the inclusion of additional activities.

  • 36.
    Salgado Willner, Helen
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Huvudhalscancer och livskvalitet: Patientens skattning av livskvalitet innan och efter strålbehandling2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Each year 1200-1300 patients are diagnosed with head neck cancer. Treatment that involves radiotherapy can cause severe side effects for example trismus that affects quality of life.

    Purpose: To study health-related quality of life in patients who have undergone radiation treatment for head and neck cancer and participated in a intervention group who received training intended to prevent trismus or in a control group who received standard treatment.

    Method: This is a prospective study in which data is collected from 66 patients participating in a randomized study aiming to evaluate a training program to prevent trismus. Thirty three participated in the intervention group and thirty three in the control group. Both patient groups assessed health related quality of life (HRQOL) with EORTC QLQ C30 and QLQ-H&N35, at start and end of the radiation treatment, and at 3 and 6-months after completing radiation treatment.

    Results: There is no difference between the intervention and control groups regarding symptoms, functional status and global health, except for intake of nutritional supplements.  For both groups almost all scales measuring HRQOL deteriorated under the radiation treatment. However, 3 and 6 months after end of radiotherapy HRQOL had improved and had returned to the baseline values. The only exceptions were dry mouth, sticky saliva, problems with social eating, senses and physical ability.

    Conclusion: Radiation therapy for head and neck cancer affects patients HRQOL both in the short and long term. Medical staff needs strategies to manage patients ' functional and symptomatic deterioration throughout the treatment period and try to prevent or relieve the symptoms that may still remain several months after radiotherapy.

  • 37.
    Lemoine, Ida
    et al.
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    Fredin, Peter
    Linköping University, Department of Management and Engineering, Economics. Linköping University, Faculty of Arts and Sciences.
    How Does Ego Depletion Affect Moral Judgments and Pro-social Decisions?2013Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Today’s societal changes, including high rate of change and increasing information flows, are increasing the demand on the individual mental capacity. It becomes increasingly difficult to analytically process all the different dilemmas and everyday decisions as individuals have a limited mental capacity available to make these decisions. Thus, it has been suggested that ego-depleted relies more heavily on intuition, which is less burdensome, when making decision. However little is known about to what extent intuitive decisions differ from analytic. Are ego-depleted individuals more or less likely to maximize outcome in moral dilemmas involving conflicting values? Do ego depleted individuals become more or less willing to cooperate? Do ego depleted individuals become more or less altruistic? Is our intuition more or less in accordance with Homo Economicus?AIM: Starting from a Dual Process perspective on decision-making the aim of this study is to examine how ego depletion affects moral judgment and pro-social decisions.METHOD: A laboratory experiment involving 115 subjects, using real monetary incentives, was conducted among students at Linköping University. Subjects were randomized into one of two treatments. Everything was identical across treatments except for the initial ego-depletion manipulation. Using a standard paradigm for ego-depletion subjects in treatment 1 were put under high cognitive load while subjects in treatment two were put under low cognitive load. Subjects faced 16 questions divided into four different decision tasks: Moral dilemmas, Public Goods game, two types of Dictator Game where the type of sacrifice subjects could make in order to contribute money to charity was varied.RESULTS: Subjects in the high cognitive load treatment made fewer consequentialists moral judgments compared to other subjects (p = 0.075). The effect is especially strong when looking only at high-conflict dilemmas such as Crying Baby. No difference between treatments was found for the public goods games. In the dictator game involving monetary sacrifice subjects donated less money to charity when put under high cognitive load. However the finding was not significant (p = 0.292). No difference was found in the dictator game involving effort as personal sacrifice since almost everyone chooses to donate to charity.CONCLUSION: According to The Dual Process perspective this essay shows that intuitive thinking does not evidently lead to that they makes decision that more or less is in accordance with Homo Economicus. The connection between ego depletion and pro-social decisions is more complex. Further research needs to investigate which different mental shortcuts that individuals uses in various types of pro-social decisions and why intuitive and analytical decision-making differ between different decisions. Further research within the area can identify potential mechanisms and policies that can support individuals’ capacity to make decisions in accordance with their own and society’s preferences.

  • 38.
    Ringdahl, Gunilla
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Familjen i cancervården - när en förälder är sjuk2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    This study describes how the whole family with its various family members are affected in different ways when a parent suffers a cancer disease. Parents ' experience includes both their vision of how parenting and relationship are affected and how they see that the children, teenagers and young adults is affected when one parent is ill, and the significance of any talks had offered.  Even the children, teenagers and young adults as dependents between the ages of 10-25 years, have given their views on how they perceive themselves and parents affected by that one parent has/had a cancerous disease and the significance of any talks had offered. This study shows, among other things, that partner describes a much higher impact for themselves and their children than parents who are patient, and that young adults are more affected by the parent's cancer than what parents think.

  • 39.
    Nelson, Anna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Samuelsson, Helene
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Barn som upplevt familjevåld. Kunskapsläge, bedömning och behandling av legitimerade familjeterapeuter på BUP2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to investigate how registered family Therapists in child and youth psychiatry (in Swedish BUP) perceives their own and their workplace knowledge of children who have experienced family violence. The aim was to look at how registered family Therapists conducts assessments and treatments on BUP when they meet a child who may have experienced or who have experienced family violence. Questions have been how registered family Therapists perceive their own respectively their workplace knowledge of children who have experienced family violence? Additional research questions have been how assessments are made and what kind of treatment that are offered by registered family Therapists on BUP? In the study, 38 registered family Therapists, have responded to a questionnaire with fixed answers. The questionnaire study has also been supplemented by 13 telephone interviews with semi-structured questions designed to make respondents share their views more freely. The results show that registered family Therapists experience their own competence to work therapeutically with the children who have experienced family violence as good. Nevertheless, there are obvious flaws in how assessments are conducted to ensure that these children get the correct diagnoses and are offered effective treatments. The result also shows that registered family Therapists, in treatment activities, put most focus on stabilization work with a focus on improving communication and interaction, but fails to assess, discuss and deal with any trauma as a result of family violence.

  • 40.
    Goovaerts, Tony
    et al.
    Cliniques Universitaires St Luc, Brussels, Belgium .
    Bagnis Isnard, Corinne
    Université Pierre et Marie Curie, Paris France.
    Crepaldi, Carlo
    Unità Operativa di Nefrologia, Dialisi e Trapianto, Ospedale San Bortolo, Vicenza, Italy.
    Dean, Jessica
    Salford Royal Hospital, Salford, UK.
    Melander, Stefan
    Mooney, Andrew
    St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
    Prieto-Velasco, Mario
    Unidad de Nefrología, Complejo Asistencial Universitario de León, León, Spain.
    Trujillo, Carmen
    Unidad clínica de Gestión de Nefrología, Hospital Regional Carlos Haya, Malaga, Spain.
    Zambon, Roberto
    Dialisi e Trapianto, Ospedale San Bortolo, Vicenza, Italy.
    Nilsson, Eva-Lena
    Skåne University Hospital .
    Continuing education: preparing patients to choose a renal replacement therapy.2015In: Journal of Renal Care, ISSN 1755-6678, E-ISSN 1755-6686, Vol. 41, no 1, 62-75 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with progressive chronic kidney disease face a series of treatment decisions that will impact the quality of life of themselves and their family. Renal replacement therapy option education (RRTOE), generally provided by nurses, is recommended by international guidelines

    OBJECTIVES: To provide nurses with advice and guidance on running RRTOE.

    DESIGN: A consensus conference.

    PARTICIPANTS: Four nurses, 5 nephrologists and 1 clinical psychologist (9 renal units; 6 European countries) from units that had extensive experience in RRTOE or were performing research in this field.

    APPROACH: Experts brainstormed and discussed quality standards for the education team, processes, content/topics, media/material/funding and quality measurements for RRTOE.

    RESULTS: Conclusions and recommendations from these discussions that are particularly pertinent to nurses are presented in this paper.

    CONCLUSIONS: Through careful planning and smooth interdisciplinary cooperation, it is possible to implement an education and support programme that helps patients choose a form of RRT that is most suited to their needs. This may result in benefits in quality of life and clinical outcomes.

    APPLICATION TO PRACTICE: There are large differences between renal units in terms of resources available and the demographics of the catchment area. Therefore, nurses should carefully consider how best to adapt the advice offered here to their own situation. Throughout this process, it is crucial to keep in mind the ultimate goal - providing patients with the knowledge and skill to make a modality choice that will enhance their quality of life to the greatest degree.

  • 41.
    Ginning, Lise-Lotte
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Familjearbete på institution förändrar relationer och minskar konflikter.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The purpose of this essay has been find out if working with a family which has its younger members placed in an institution, SiS Youthhome Folåsa, will affect the adolescents experience of anxiety and problems within their family and their mental health.

    Through an analysis of the interviews given to the adolescents upon arrival and departure to the facility and later on in the follow up interview, I have tried find the answers to the essay`s questions.

    When the adolescents themselves have to assess their experience, they find that life is better or much better in most areas that ADAD intends to explore. It shows that, one year after they have been discharged, the adolescents experience less conflicts in their families and they also worry less about family related problems. However, their apprehension of their mental health has increased somewhat compared to how they felt before the treatment.

    The majority of the adolescents consider that they got the help they needed with the problem they had and only two (2/26) of the participants in this study were placed at another institution after their stay at Folåsa.

  • 42.
    Wold, Magdalena
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Kunskapsbaserad socialtjänst. Att utvärdera behandlingsinsatser för barn, unga, och deras familjer2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Good quality is required in the Social service´s care for children, adolescents and their families. However there are few efficacy studies supporting existing treatment methods. Also there is a lack of knowledge about the method of treatment, its effect, and how to assess results.

    My purpose has been to learn more about how to evaluate treatment methods in the social service´s care for the target group using alternatives to RCT-studies. For that purpose I have used an evaluation model for treatment of parenting support, Parenting Programme evaluation tool (PPET). The treatment of parenting support is studied from three different quality aspects that have been shown in other research studies predicting positive effects for the target group. Evaluation and quality ranking with regard to quality and effectiveness is therefore possible. The three quality aspects are: defined target group, scientifically based theory, well defined education and implementation of the method.

    I have interviewed family therapists in a team for families that work with Social Service´s prevention treatment Parent support which through individual counseling or therapy is to be supportive for children, adolescents and/or their families. Furthermore I have interviewed parents receiving the treatment during year 2014.

    The PPET-model as an alternative to RCT-studies was useful in mapping out the treatment of parenting support. Together with an evaluation of the parent´s experience of the treatment PPET makes it possible to say if treatment can have expected results. The results show that the evaluation method can be used in supporting choosing and implementing methods of treatment for Social services.

     

  • 43.
    Vigren, Anna-Lena
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Palmertz, Marie
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Expressed Emotion hos föräldrar och självskadande beteende hos ungdomar.2014Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Suicide is the second most common cause of death among young people throughout the world, and self-injury has been shown to be a risk factor related to suicide attempts. The human suffering, suicide risk, societal costs, and potentially severe consequences associated with self-injury make it essential to develop effective programs of treatment for it. One such program, intensive contextual treatment (IKB), was developed and implemented in Uppsala in order to provide assistance to adolescents exhibiting self-injuring behavior and to their parents. The aims of the present quantitative study were to investigate 1) the effectiveness of IKB in reducing parental expressed emotion (EE); 2) the effectiveness of IKB in reducing self-injury in adolescents; and 3) the relationship between a high level of parental EE and self-injury. The participants in the study, 30 families in Uppsala who have undergone IKB treatment, were requested to fill in self-response forms and to be interviewed at both the beginning and completion of treatment. The results show that IKB had a positive effect upon reducing both parental EE and self-injury in adolescents.

  • 44.
    Sporre, Pernilla
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Engslätt Jansson, Ingegerd
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Arbetsterapeuters användning av Basal Kroppskännedom TM för att stärka patienters aktivitetsutförande2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Activity as a therapeutic medium has been central to the development of the occupational therapy profession by using meaningful and purposeful activities. Occupational therapy is founded on the commitment of activity as essential for health and wellbeing. Despite this, much of the profession has led to the development of interventions that are not activity-based. Basic Body Awareness Therapy (B-BAT) and occupational therapy have several common basic assumptions. Our clinical experience shows the potential of using the B-BAT-principles in occupational therapy. We wanted to explore other occupational therapists’ perceptions of conditions and the value of working with B-BAT-principles to strengthen patients' occupational performance. Qualitative interviews were conducted with 11 informants, strategically selected. The interview material was analyzed and formed three themes: The occupational therapists’ knowledge and performance, Working with self – the human development process, and The Obstacles and Opportunities in the organization. In relation to ergonomic knowledge, informants expressed the view that B-BAT-principles provide further opportunities to see, understand and comprehend patients and use activities as a part of their treatment. Activities are broken down into stages where simple, rhythmic movements are used to catch the meaningfulness. The patient feels and experiences occupational performance in the body. The results of the study describe the use of self as an instrument as a prerequisite for being both in activity and in contact with the patient. That strengthens the possibility of developing a therapeutic alliance.

  • 45.
    Jönsson, Maria
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Persson, Hanna
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Social interaktion i afasigrupp: En samtalsanalytisk studie med inriktning mot socialt fasadarbete och gester2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Every year, 12,000 people in Sweden are diagnosed with aphasia. Many people with aphasia supplement their logopedic treatment by participating in an aphasia group. Aphasia groups provide both social and linguistic stimulation. The aim of the present thesis was to study the social interaction between participants, and between participants and leaders in aphasia groups.

    In the present study, eleven persons with aphasia and four leaders participated divided into three aphasia groups. The groups were video recorded during sessions with a total of four sessions. Two hours of social interaction were recorded. The material was transcribed and analyzed according to Conversation Analytical principles. The study focuses specifically on the use of gestures and face-work. Both phenomena could be observed in all groups. The results of the present work showed that different gestures could enhance as well as reduce intelligibility. Individuals’ gesture use was consistent with their ability of expression, i.e. the better the expressive ability, the more acceptable and understandable gestures. Face-work that was analyzed in the present study showed that face-threatening as well as face-saving strategies occur in aphasia groups.

  • 46.
    Stupp, Roger
    et al.
    Multidisciplinary Oncology Center, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
    Mason, Warren P
    van den Bent, Martin J
    Weller, Michael
    Fisher, Barbara
    Taphoorn, Martin J B
    Belanger, Karl
    Brandes, Alba A
    Marosi, Christine
    Bogdahn, Ulrich
    Curschmann, Jürgen
    Janzer, Robert C
    Ludwin, Samuel K
    Gorlia, Thierry
    Allgeier, Anouk
    Lacombe, Denis
    Cairncross, J Gregory
    Eisenhauer, Elizabeth
    Mirimanoff, René O
    Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma2005In: The New England journal of medicine, ISSN 1533-4406, Vol. 352, no 10, 987-996 p.Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety.

    METHODS: Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival.

    RESULTS: A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P<0.001 by the log-rank test). The two-year survival rate was 26.5 percent with radiotherapy plus temozolomide and 10.4 percent with radiotherapy alone. Concomitant treatment with radiotherapy plus temozolomide resulted in grade 3 or 4 hematologic toxic effects in 7 percent of patients.

    CONCLUSIONS: The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity.

  • 47.
    Frankenstein, Katri
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lundberg, Loviisa
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    LAURA: Kognitiv beteendeterapi för kvinnor med psykisk ohälsa till följd av en traumatisk förlossning: En randomiserad kontrollerad studie av internetadministrerad vägledd självhjälpsbehandling2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The purpose of this randomized controlled study was to investigate the effect of internet- administered guided self-help for women suffering from psychological problems following traumatic childbirth. The eight-week treatment program consisted of written chapters based on cognitive behavioral therapy. 56 participants were randomly assigned to a treatment group (n = 28) or a waiting list group (n = 28).The results showed that post-traumatic symptoms decreased as a result of the treatment, with large within-group effects measured by both the Traumatic Event Scale (TES) (d = 1.33) and the Impact of Event Scale-Revised (IES-R) (d = 1.3). The difference between the groups was only significant when measured by the IES-R in which case the between-group effect was large (d = 0.97). The proportion of the participants who showed clinically significant improvement was considerably greater in the treatment group than in the waiting list group. For other measured outcomes, the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and the Quality of Life Inventory (QOLI), the difference between the groups were not significant,however the treatment group showed significant improvements between pre-and post measurements on all accounts.LAURA is most likely the first study to examine the treatment of psychological problems following traumatic childbirth. The results are promising and overall show that internet-administered cognitive behavioral therapy reduces post-traumatic symptoms following a traumatic childbirth, indicating a decrease in symptoms of anxiety and depression, and an improvement in quality of life.

  • 48.
    Ottosson, Marie-Louise
    Linköping University, Faculty of Health Sciences.
    Visualisering av basalcellscancer med Tissue Viability Imaging - ett icke-invasivt diagnostiskt alternativ2014Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [en]

    Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer. It can be divided in different subtypes. The most common type is superficial and is most frequently occurring on the trunk and on the face. In severe cases it can be difficult to differentiate basal cell carcinoma from other skin tumors, therefore a skin biopsy is conclusive diagnostic method. In terms of treatment, curettage is a common non-surgical treatment of basal cell carcinoma. However, being superficial, curettage increases the risk of recurrence. Between 30-40 % of most recurrences occur within five years.

    Tissue Viability Imaging or TiVi is a diagnostic method used by the Department of Dermatology at the University Hospital in Linköping. The technology allows the investigator to see through the top layer of the skin (epidermis) and map the skin skin blood circulation in the dermal area.

    The aim of this study was to investigate whether histological features of present basal cell carcinoma, inflammation, stroma and microvessels, correlates with the presence of the tumour visualized by Tissue Viability Imaging technique.

    The hypothesis is, that by visualizing BCC recurrence at the first visit at the clinic by using TiVi technique, we can diagnose BCC and treat patients in one step, thus reducing the amount of discomfort for the patient and also reduce the cost of care.

    In this pilot-study, patient material involving two basal cell carcinomas from one patient were used. The results show that microscopic examination of the tumor and blood vessels correlate with visualizing basal cell carcinoma with TiVi, although furthermore studies of existing basal cell carcinoma and several tumours are required to ensure correlation before TiVi can be used to replace skin biopsy.

  • 49.
    Le, Jenny
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Wuotila Isaksson, Jakob
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    En samtalsanalytisk studie av interaktion under behandling i afasigrupp2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Aphasia is a language and communication impairment, which affects interaction with other individuals. The purpose of the present study is to investigate and describe interaction between people with aphasia and between the leaders and the participants in an aphasia group during treatment sessions. Three aphasia treatment groups, with a combined total of eleven aphasia group participants and four aphasia group leaders participated in the present study. Data was collected through audio and video recording. The recordings were transcribed and analyzed according to principles from Conversation Analysis. In addition to the video and audio recording, the participants with aphasia were also tested with parts of the Swedish neurolinguistic test A-ning.

    The results of the present study demonstrated that the execution of treatment tasks can change in interaction during group treatment sessions. Both aphasia group participants and aphasia group leaders were shown to have an influence on changing the characteristics of treatment tasks. Previous research has shown that interaction in intervention usually is institutional by nature. However, the interaction during group treatment in the present study was occasionally deviating from this system. The results of the present study also show that aphasia group leaders use face work more frequently in intervention, compared to the aphasia group participants. Strategies, which strengthen communication and language ability in persons with aphasia during interaction, are used by leaders as well as by participants in aphasia treatment groups. The present study has made a description of how interaction may appear in therapy in aphasia treatment groups. However, there is a continuous need to study interaction during aphasia treatment groups in order to identify strategies that may further facilitate interaction between all the participants in the group.

  • 50.
    Bednarek, Nadia
    et al.
    Linköping University, Department of Management and Engineering. Linköping University, Faculty of Arts and Sciences.
    Celik, Lave
    Linköping University, Department of Management and Engineering. Linköping University, Faculty of Arts and Sciences.
    Implementering av Likabehandlingsplanen i skolmiljön: Finns viljan, kunnandet och förståelsen?2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The main purpose of this paper is to examine how the regulatory environment of ”equality plans" are implemented at the municipal level of decision making in the school environment - in terms of both local politicians, school structures and management by teachers.

    The paper will present how the implementation theory works in practice by examining two high schools in the Municipality of Norrkoping and see what differences exist in the implementation process of "equality plans" in schools with a variety of high and relatively low immigrant background among students.

    We will present how it seems from different perspectives. Are teachers today controlled by public professional ethics or personal reasons, where those street level bureaucrats mainly act on feeling depending on the case? And how might this affect the law? Do they in fact understand, or have the knowledge and the willingness to implement?

    In our study, we are using a comparative case study method with an interview guide. A comparison between the two school´s equality plan have been analyzed where we have developed key differences and similarities that we recognized regarding the subject.

    The results of the study demonstrate that the context is very crucial to addressing these issues. By an apparent context that becomes more pronounced it forces the schools to think more strategically and behave more in a long term counterproductive way. We could also see that in the school environment where there are a higher proportion of immigrants induces an increased pressure to professionalism among teachers.

    We therefore conclude that the implementation process is likely to be more successful if it has a strong professionalization among officials. This will lead to a greater understanding, deeper knowledge and willingness to implement the law.

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