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  • 1.
    Callerström, Emma
    KTH, School of Technology and Health (STH).
    Clinicians' demands on monitoring support in an Intensive Care Unit: A pilot study, at Capio S:t Görans Hospital2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Patients treated at intensive care units (ICUs) are failing in one or several organs and requireappropriate monitoring and treatment in order to maintain a meaningful life. Today clinicians inintensive care units (ICUs) manage a large amount of data generated from monitoring devices.The monitoring parameters can either be noted down manually on a monitoring sheet or, for some parameters, transferred automatically to storage. In both cases the information is stored withthe aim to support clinicians throughout the intensive care and be easily accessible. Patient datamanagement systems (PDMSs) facilitate ICUs to retrieve and integrate data. Before managinga new configuration of patient data system, it is required that the ICU makes careful analysis ofwhat data desired to be registered. This pilot study provides knowledge of how the monitoringis performed in an Intensive Care Unit in an emergency hospital in Stockholm.The aim of this thesis project was to collect data about what the clinicians require and whatequipment they use today for monitoring. Requirement elicitation is a technique to collectrequirements. Methods used to collect data were active observations and qualitative interviews.Patterns have been found about what the assistant nurses, nurses and physicians’ require of systems supporting the clinician’s with monitoring parameters. Assistant nurses would like tobe released from tasks of taking notes manually. They also question the need for atomized datacollection since they are present observing the patient bed-side. Nurses describe a demanding burden of care and no more activities increasing that burden of care is required. Physicians require support in order to see how an intervention leads to a certain result for individual patients.The results also show that there is information about decision support but no easy way to applythem, better than the ones used today. Clinicians state that there is a need to be able to evaluatethe clinical work with the help of monitoring parameters. The results provide knowledge about which areas the clinicians needs are not supported enough by the exciting tools.To conclude results show that depending on what profession and experience the clinicians have the demands on monitoring support di↵ers. Monitoring at the ICU is performed while observing individual patients, parameters from medical devices, results from medical tests and physical examinations. Information from all these sources is considered by the clinicians and is desired to be supported accordingly before clinicians commit to action resulting in certain treatment,diagnosis and/or care.

  • 2.
    Falck, Josefina
    KTH, School of Technology and Health (STH), Medical Engineering.
    Effect of side windows, stiffening plate and roof sheet on the stiffness of the bus body2013Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    As a bus developer, Scania focus to construct a safe vehicle for the passengers, i.e. high strength of the bus structure and good comfort, which is also profitable for the operator, i.e. high passenger capacity and low fuel consumption. The trade-off when developing a bus body structure is to get both high stiffness and low weight. The bus body including exterior panels plays together with the chassis an important role for the stiffness of the bus. By gathering knowledge about how various exterior panels affects the stiffness of the bus body, the design of the panels can be optimized with respect to high stiffness and low weight. Also from a calculation point of view is it of interest to know how important different panels are for the stiffness of the bus body, in order to make conscious simplifications in the calculation model.

    The aim with this master thesis was to investigate how the stiffening plate, side windows and roof sheet influence the strength of the bus body. How the thickness of the side windows affects the stiffness of the bus body is also investigated. The investigations were made as a relative comparison between a complete bus and comparison models.

     

    The results showed that exterior panels participate in distributing load. By distributing the load, the load uptake gets more efficient since a bigger part of the bus structure is used to take up the load. The side windows affect the stiffness for all tested load cases, with increased importance for the load case where a gravity field is applied in the longitudinal direction, for the torsion load case and when a load is applied to the power train in vertical direction. The roof sheet has a high impact on the stiffness in the torsion load case, but has negligible influence on the stiffness of the bus body for the other tested load cases. The stiffening plate has little influence on the stiffness of the bus body in general and is negligible for all tested load cases except for when a lateral load is applied as either a gravity field or locally to the power train.

     

    Thinner side windows are shown to have a positive influence on the stiffness of the bus body.

  • 3.
    Fornstedt, Cecilia
    KTH, School of Technology and Health (STH), Health Systems Engineering, Human Communication Science. Välj.
    Medical Technology and eHealth for Prevention against LifestyleRelated Diseases: A survey of attitudes among health center personnel and patients prescribed with physical activity on prescription (PAP)2017Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    With an aging population that suffers from comorbidity, healthcare is facing grand challenges. In order to meet the demand, digitalization is thought to be an opportunity. Digitalization of curative care, such as diagnostics and treatment, have been initiated and is today used and appreciated. Preventative care, on the other hand, has not been included in the digital adaptions to the same extent and there are few scientific studies within the area. Nonetheless, a further proactive care that meets patients and healthcare personnel are of interest to several actors. The Swedish Government has a vision that Sweden, in 2025, will be world leading within eHealth. For that to be possible, digital preventative care have to support and complete the preventative work that is performed today.

    The present study has investigated the attitude towards Connected Medical Devices for Prevention (CMDfP) within the primary care. By a mixed-methodology including questionnaires, the opinions of 24 health center personnel and 17 patients prescribed with Physical Activity on Prescription (PAP) were collected and analyzed. The results show that health center personnel are willing to prescribe connected eHealth devices for prevention and patients are willing to use the devices prescribed. Additionally, among the respondents there is a belief that CMDfP could facilitate in order to increase the adherence to PAP without any major impact on the personnel's workload.

    By digitalizing preventative care, it is possible that people will be able to live healthier and therefore not require care to the same extent as today. Reasons to the possible results are that digital tools within curative care have been shown to generate positive outcomes to chronically ill patients that utilize home care. Additionally, studies of preventative care have generated positive outcomes to the health of the population in several countries. It is therefore likely that the combination, digital preventative care, would be rapidly relished. These thoughts align with the positive results on attitudes of this study.

    Before CMDfP could be prescribed to patients, pilot studies have to be performed and new work routines including reimbursement models, have to be established within healthcare. These are all areas of future work within medical engineering.

  • 4.
    Hagman, Anna
    KTH, School of Technology and Health (STH).
    The Knowledge- and Adoption Level of Standards for Technical Interoperability among Providers of Healthcare Information Systems2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    This thesis was one of the deliverables of StandIN. The purpose of StandIN was to propose a common framework including standards for technical interoperability. The goal of this thesis was to structure and analyze information about the knowledge- and adoption level of the standards among providers of healthcare information systems (HIS's). Moreover, it aimed to evaluate different aspect that might affect the adoption.

    The target group was providers of HIS's used in Swedish county councils and regions. The information was gathered through a survey and semi-structured interviews, and stored in an Excel database. From the database, Pivot tables and charts were created in order to show the knowledge- as well as adoption level of the different standards. The results were thereafter compared to theory about interoperability and standard adoption.

    It was clear that the knowledge level varied for the different standards. In addition, the adoption level was very low - except from CCOW and HL7 v2. Least adopted were domain-specific standards. The results also indicated a trend for only adopting parts of standards. Moreover, many providers stated that they performed specific integrations rather than followed common standards. This seemed to be due to the choice of standards being too wide, and the actual adoption not being consistent among the different providers. According to the providers, an introduction of a national framework based on uniform and consistent international standards was an awaited solution to the problem.

    A future extension of this thesis would be to perform a similar study involving the customers. The database could also be used to do clustered analyses of the adoption state in different county councils and regions. Moreover, it could be used to analyze the development of standard adoption over time.

  • 5.
    Raghavendra, Jammalamadaka
    KTH, School of Technology and Health (STH), Medical Engineering, Medical sensors, signals and systems.
    Optomyography - Detection ofmuscle surface displacement using reflective photo resistor.2014Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    A human body can carry out many physiological complex processes which can be mechanical, electrical or bio-chemical. Each mechanical activity generates a signal that describes the characteristics of the particular action in the form of pressure or temperature. Any irregularity in the process changes the usual functioning thus affecting the performance of the system. Several techniques were introduced to evaluate these muscular signals in order to get a deeper understanding of the medical abnormalities. Displacement sensors, laser optics, electrodes, accelerometers and microphones are some of the widely used devices in measuring the electrical and mechanical activities produced in the muscles.

    The aim of this thesis project was to find and implement a simple non-contact optical method to measure and monitor the displacements caused on the surface of the skin due to muscular movements. In this study, a device was developed using photo electric sensors that can record surface changes caused on the skin due to the movements forearm muscles.

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