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  • 251.
    Borromeo, Reenalyn
    et al.
    KTH, School of Technology and Health (STH).
    Emil, Olsson
    KTH, School of Technology and Health (STH).
    Utvärdering av kompensationsmetoder för virvelströmmar i magnetisk resonanstomografi med bSSFP2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den mest etablerade metoden för hjärtavbildning med MRI kallas bSSFP. Denna baseras på att signalen hålls i ett jämviktstillstånd genom noggrann balansering av magnetiska gradientfält. Vid avbildning av objekt i rörelse med hög temporal upplösning sker snabba skiftningar av gradienterna som inducerar virvelströmmar i magnetkamerans ledande komponenter och i patienten. Virvelströmmarna som skapas stör det homogena statiska fältet som krävs för avbildning med bSSFP och leder till artefakter vid avbildning.

    Det finns därför ett intresse i att kompensera för virvelströmmarnas påverkan vid avbildning. I detta arbete utvärderas tre befintliga kompensationsmetoder: ”Tiny Golden Angle”, ”Double Averaging” och ”Through Slice Equlibriation”. Respektive metod tillåter olika parameterval. Målet med detta arbete är att avgöra vilken, eller vilka, kombinationer av metoderna som ger bäst kompensation för virvelströmmar utan att påverka bildernas kliniska värde. Undersökningen baserades på att kombinera olika metoder samt parametervärden hos respektive metod och applicera detta vid avbildning av ett fantom. Sedan gjordes en kvantitativ analys av fantombilderna och baserat på fantomstudien skedde ett urval av kombinationer för hjärtavbildning av en frivillig testperson. En visuell bedömning gjordes sedan på hjärtbilderna.

    Resultatet tydde på att individuell applicering av metoderna kompenserade för virvelströmmar, men även att vissa kombinationer av dessa bidrog med förbättrad bildkvalitet. Samtliga bilder bedömdes vara av klinisk kvalitet och resultatet av detta arbete öppnar möjligheten för en klinisk valideringsstudie.

  • 252. Borsbo, Bjorn
    et al.
    Gerdle, Bjorn
    Peolsson, Michael
    KTH, School of Technology and Health (STH).
    Impact of the interaction between self-efficacy, symptoms and catastrophising on disability, quality of life and health in with chronic pain patients2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 17, p. 1387-1396Article in journal (Refereed)
    Abstract [en]

    Purpose. To investigate the interactions between self-efficacy - including subcomponents - and symptoms (pain, depression and anxiety), catastrophising, disability, quality of life and health in a population of patients with chronic pain. Method. The study used 433 patients with chronic pain including 47 patients with spinal cord injury-related pain, 150 patients with chronic whiplash-associated disorders and 236 patients with fibromyalgia. The participants answered a postal questionnaire that provided background data, pain intensity and duration and psychological- and health-related variables. Results. In the multivariate context, depression, anxiety, catastrophising and disability were intercorrelated. Self-efficacy correlated positively with variables of quality of life and general health. These two groups of variables were negatively correlated. The pain variables - duration of pain, pain intensity and spreading of pain - formed a third group of variables. Self-efficacy function was negatively correlated to these three pain variables. When regressing disability, quality of life and health, we found that self-efficacy had a positive impact whereas symptoms, catastrophising and pain had a negative influence on these aspects. Different patterns of influencing variables were discerned for the three different analyses, and specific patterns of the subscales of self-efficacy corresponded to specific patterns of negative factors for the outcome of disability, quality of life and health. Conclusion. There is a complex interaction of psychological factors and symptoms and their positive and negative influence on disability, quality of life and health. The results indicate that it might be important to assess and influence both enhancing and detoriating factors to ensure an effective pain management programme.

  • 253.
    Bottinga, Miriam
    et al.
    KTH, School of Technology and Health (STH).
    Wu, Carmen
    KTH, School of Technology and Health (STH).
    Framtagning av koncept för nytt förflyttningshjälpmedel inom äldreomsorg2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 254. Bramberg, Elisabeth Bjork
    et al.
    Nyman, Teresia
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics. Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Kwak, Lydia
    Alipour, Akbar
    Bergstrom, Gunnar
    Elinder, Liselotte Schafer
    Hermansson, Ulric
    Jensen, Irene
    Development of evidence-based practice in occupational health services in Sweden: a 3-year follow-up of attitudes, barriers and facilitators2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 4, p. 335-348Article in journal (Refereed)
    Abstract [en]

    The Swedish government initiated an investigation of how to secure and develop the competence of the occupational health services. The primary aim of the present study was to investigate whether the development of evidence-based practice (EBP) in the Swedish occupational health services in relation to attitudes, knowledge and use improved during the first 3 years of the government's initiative. The study has a mixed methods design combining questionnaires and interviews with data collection at baseline and at 3-year follow-up. The response rate was 66% at baseline and 63% at follow-up. The results show that practitioners' knowledge of EBP was moderate at baseline and improved at follow-up (p = 0.002; 95% CI 0.01; 0.21). Practitioners experienced lower levels of organizational and managerial support for EBP at follow-up (p < 0.001; 95% CI 0.18; 0.38). The results revealed that managers viewed responsibility for implementing EBP as a matter for individual practitioners rather than as an organizational issue. Occupational health service managers and practitioners are generally positive to EBP. However, the findings emphasize the need to educate managers in how to support EBP at the organizational level by creating an infrastructure for EBP in the OHS.

  • 255.
    Brander, Thomas
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    Dakermandji, Christian
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    En jämförelse mellan databashanterare med prestandatester och stora datamängder2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The company Nordicstation handles large amounts of data for Swedbank, where data is stored using the relational database Microsoft SQL Server 2012 (SQL Server). The existence of other databases designed for handling large amounts of data, makes it unclear if SQL Server is the best solution for this situation.  This degree project describes a comparison between databases using performance testing, with regard to the execution time of database queries.  The chosen databases were SQL Server, Cassandra and NuoDB. Cassandra is a column-oriented database designed for handling large amounts of data, NuoDB is a database that uses the main memory for data storage and is designed for scalability. The performance tests were executed in a virtual server environment with Windows Server 2012 R2 using an application written in Java. SQL Server was the database most suited for grouping, sorting and arithmetic operations. Cassandra had the shortest execution time for write operations while NuoDB performed best in read operations. This degree project concludes that minimizing disk operations leads to shorter execution times but the scalable solution, NuoDB, suffer severe performance losses when configured as a single-node. Nordicstation is recommended to upgrade to Microsoft SQL Server 2014, or later, because of the possibility to save tables in main memory.

  • 256.
    Brandt, Theodor
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    System för automatiska rekommendationer av nyheter och evenemang2015Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Technology is the key for Bonnier Business Media (BBM) to reach their goals and deliver future growth. Therefore they want to be in the very forefront when it comes to exploring new technologies that can improve their platforms and make them more up to date. BBM has among other things aimed to develop a recommendation system that is supposed to make the content of their web sites personalized and in an efficient way present this so that the different target groups will get the information that they expect. For example the visitor should be able to get suggestions on articles and events that might be of interest.

    The aim of this thesis has been to develop a prototype of a recommendation system with associated algorithms. The prototype could be used as to examine the possibility to create personalized recommendations for the readers on BBM:s website va.se (Veckans Affärer). The implementation of the recommendation system that was developed for BBM consisted of an object-based collaborative filtering algorithm using visitor behavior, publication date and popularity of articles and events to create personalized recommendations. After com- pleting tests and analyzes the results show that it is possible to create recommendations with a higher precision than a basic recommendation system, like a popularity list, can of- fer. 

  • 257. Braniste, Viorica
    et al.
    Al-Asmakh, Maha
    Kowal, Czeslawa
    Anuar, Farhana
    Abbaspour, Afrouz
    Toth, Miklos
    Korecka, Agata
    Bakocevic, Nadja
    Guan, Ng Lai
    Kundu, Parag
    Gulyas, Balazs
    Halldin, Christer
    Hultenby, Kjell
    Nilsson, Harriet
    KTH, School of Technology and Health (STH), Basic Science and Biomedicine, Structural Biotechnology.
    Hebert, Hans
    KTH, School of Technology and Health (STH), Basic Science and Biomedicine, Structural Biotechnology.
    Volpe, Bruce T.
    Diamond, Betty
    Pettersson, Sven
    The gut microbiota influences blood-brain barrier permeability in mice2014In: Science Translational Medicine, ISSN 1946-6234, E-ISSN 1946-6242, Vol. 6, no 263, p. 263ra158-Article in journal (Refereed)
    Abstract [en]

    Pivotal to brain development and function is an intact blood-brain barrier (BBB), which acts as a gatekeeper to control the passage and exchange of molecules and nutrients between the circulatory system and the brain parenchyma. The BBB also ensures homeostasis of the central nervous system (CNS). We report that germ-free mice, beginning with intrauterine life, displayed increased BBB permeability compared to pathogen-free mice with a normal gut flora. The increased BBB permeability was maintained in germ-free mice after birth and during adulthood and was associated with reduced expression of the tight junction proteins occludin and claudin-5, which are known to regulate barrier function in endothelial tissues. Exposure of germ-free adult mice to a pathogen-free gut microbiota decreased BBB permeability and up-regulated the expression of tight junction proteins. Our results suggest that gut microbiota-BBB communication is initiated during gestation and propagated throughout life.

  • 258.
    Brejcha, Kevin
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering.
    Prestandaanalys av HTTP/22015Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Swedbank is one of Sweden’s biggest banks with estimated four million private customers and they are constantly trying to improve their services so they become more user-friendly and faster. To satisfy their customer’s need of fast and easy services Swedbank wants to lower the loading times on the web services to the user experience is faster and smoother, especially for the users doing their banking on a smartphone. The mission is to do a per-formance analysis of the new HTTP protocol HTTP/2 and take out the most essential parts so Swedbank knows what to take advantage of when installing the new versions on their servers to achieve optimal services.The results showed that after implementing HTTP/2’s new features, Swedbank’s website performance increased with 44% in total loading time. The tests were performed in a local experimental environment where the earlier HTTP versions was installed and the perfor-mance metrics was documented.

  • 259.
    Brenning, Magnus
    et al.
    KTH, School of Technology and Health (STH).
    Olander, Björn
    KTH, School of Technology and Health (STH).
    Orhan, Ibrahim
    KTH, School of Technology and Health (STH), Medical Engineering.
    Vennberg, Johan
    KTH, School of Technology and Health (STH).
    Lindh, Thomas
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering. 2Laboratory for communication networks, School of Electrical Engineering, KTH.
    NeTraWeb - A Web-Based Traffic Flow Performance Meter2006In: 4th Swedish National Computer Networking Workshop SNCNW 2006, 2006Conference paper (Refereed)
    Abstract [en]

    This paper presents a web-based traffic flow performance meter. The NeTraWeb tool configures and automates the measurement activities, including storage and presentation of the main performance parameters.

  • 260. Brismar, Torkel B.
    et al.
    Grishenkov, Dmitry
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Gustafsson, Björn
    Härmark, Johan
    KTH, School of Technology and Health (STH), Basic Science and Biomedicine, Structural Biotechnology.
    Barrefelt, Åsa
    Kothapalli, Satya V. V. N.
    KTH, School of Technology and Health (STH), Medical Engineering, Neuronic Engineering.
    Margheritelli, Silvia
    Oddo, Letizia
    Caidahl, Kenneth
    Hebert, Hans
    KTH, School of Technology and Health (STH), Basic Science and Biomedicine, Structural Biotechnology.
    Paradossi, Gaio
    Magnetite Nanoparticles Can Be Coupled to Microbubbles to Support Multimodal Imaging2012In: Biomacromolecules, ISSN 1525-7797, E-ISSN 1526-4602, Vol. 13, no 5, p. 1390-1399Article in journal (Refereed)
    Abstract [en]

    Microbubbles (MBs) are commonly used as injectable ultrasound contrast agent (UCA) in modern ultrasonography. Polymer-shelled UCAs present additional potentialities with respect to marketed lipid-shelled UCAs. They are more robust; that is, they have longer shelf and circulation life, and surface modifications are quite easily accomplished to obtain enhanced targeting and local drug delivery. The next generation of UCAs will be required to support not only ultrasound-based imaging methods but also other complementary diagnostic approaches such as magnetic resonance imaging or computer tomography. This work addresses the features of MBs that could function as contrast agents for both ultrasound and magnetic resonance imaging. The results indicate that the introduction of iron oxide nanoparticles (SPIONs) in the poly(vinyl alcohol) shell or on the external surface of the MBs does not greatly decrease the echogenicity of the host MBs compared with the unmodified one. The presence of SPIONs provides enough magnetic susceptibility to the MBs to accomplish good detectability both in vitro and in vivo. The distribution of SPIONs on the shell and their aggregation state seem to be key factors for the optimization of the transverse relaxation rate.

  • 261.
    Brodin, Lars-Åke
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering. Karolinska Universitetssjukhuset Huddinge, Sweden.
    Boman, K.
    Dahlström, U. L. F.
    Hagerman, I.
    Willenheimer, R.
    Ekokardiografi förfinar diagnostiken vid hjärtsvikt2007In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 104, no 34, p. 2338-2344Article in journal (Refereed)
  • 262.
    Brodin, Lars-Åke
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering.
    Elmqvist, H
    Bjällmark, Anna
    KTH, School of Technology and Health (STH), Medical Engineering.
    Larsson, Matilda
    KTH, School of Technology and Health (STH), Medical Engineering.
    Global and local detection of blood vessel elasticity2006Patent (Other (popular science, discussion, etc.))
    Abstract [en]

    The present invention is a non-invasive analysis system for detection of global and local blood vessel elasticity. The analysis system comprises two subsystems where subsystem 1 is data collecting unit and subsystem 2 is an analysis unit. The data collecting unit comprises one or many non-invasive image generating systems, or the data collecting system makes the registration possible of movement parameters that quantifies the dynamics of the blood vessel wall in longitudinal and radial directions. Subsystem 2 performs Wave Intensity Analysis which is an analysis method using co-related parts of the circulation system by measuring the intensity change (dl) of the blood vessel during a heart cycle. The intensity change is calculated as the product of the pressure derivate and the flow velocity derivate. In subsystem 2 the changes of pressure and flow are approximated by the deformation velocity or velocity of the radial and longitudinal direction, respectively. By calculating time constants and amplitudes of the intensity change graph a measure is obtained of the local and global elasticity of the blood vessel and atherosclerotic constrictions of arterial vessels may then be identified at an early stage.

  • 263.
    Brolin, Karin
    et al.
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Halldin, Peter
    KTH, School of Technology and Health (STH), Neuronic Engineering (Closed 20130701).
    Leijonhufvud, I.
    The effect of muscle activation on neck response2005In: Traffic Injury Prevention, ISSN 1538-9588, E-ISSN 1538-957X, Vol. 6, no 1, p. 67-76Article in journal (Refereed)
    Abstract [en]

    Prevention of neck injuries due to complex loading, such as occurs in traffic accidents, requires knowledge of neck injury mechanisms and tolerances. The influence of muscle activation on outcome of the injuries is not clearly understood. Numerical simulations of neck injury accidents can contribute to increase the understanding of injury tolerances. The finite element (FE) method is suitable because it gives data on stress and strain of individual tissues that can be used to predict injuries based on tissue level criteria. The aim of this study was to improve and validate an anatomically detailed FE model of the human cervical spine by implement neck musculature with passive and active material properties. Further, the effect of activation time and force on the stresses and strains in the cervical tissues were studied for dynamic loading due to frontal and lateral impacts. The FE model used includes the seven cervical vertebrae, the spinal ligaments, the facet joints with cartilage, the intervertebral disc, the skull base connected to a rigid head, and a spring element representation of the neck musculature. The passive muscle properties were defined with bilinear force-deformation curves and the active properties were defined using a material model based on the Hill equation. The FE model's responses were compared to volunteer experiments for frontal and lateral impacts of 15 and 7 g. Then, the active muscle properties where varied to study their effect on the motion of the skull, the stress level of the cortical and trabecular bone, and the strain of the ligaments. The FE model had a good correlation to the experimental motion corridors when the muscles activation was implemented. For the frontal impact a suitable peak muscle force was 40 N/cm2 whereas 20 N/cm2 was appropriate for the side impact. The stress levels in the cortical and trabecular bone were influenced by the point forces introduced by the muscle spring elements; therefore a more detailed model of muscle insertion would be preferable. The deformation of each spinal ligament was normalized with an appropriate failure deformation to predict soft tissue injury. For the frontal impact, the muscle activation turned out to mainly protect the upper cervical spine ligaments, while the musculature shielded all the ligaments disregarding spinal level for lateral impacts. It is concluded that the neck musculature does not have the same protective properties during different impacts loadings.

  • 264.
    Brolin, Karin
    et al.
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    Hedenstierna, Sofia
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    Halldin, Peter
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    Bass, Cameron
    Center for Applied Biomechanics, University of Virginia, Charlottesville.
    Alem, Nabih
    US Army Aeromedical Research Laboratory, Fort Rucker.
    The importance of muscle tension on the outcome of impacts with a major vertical component2008In: International Journal of Crashworthiness, ISSN 1358-8265, E-ISSN 1754-2111, Vol. 13, no 5, p. 487-498Article in journal (Refereed)
    Abstract [en]

    The hypothesis that muscle tension protects the spine from injuries in helicopter scenarios was tested using a finite-element model of the human head and neck. It was compared with cadaver crash sled experiment with good correlation. Then, simulations were performed with a sinusoidal velocity (5-22 G) applied at T1 60° to the horizontal plane. The model with relaxed muscle activation had delayed and decreased peak head rotation compared with passive properties only. Full muscle activation decreased the injury risk for the 13.5-22 G impacts. A sensitivity study of the impact angle showed a very slight variation of the resulting neck flexion, and 1° change affected all ligament injury predictions less than 4%. Finally, simulations with helmets resulted in increased ligament and disc strains with increasing helmet mass and with an anterior or inferior shift of the centre of gravity. It is concluded that the hypothesis seems to hold.

  • 265.
    Brolin, Karin
    et al.
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    Nordberg, Axel
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    von Holst, Hans
    KTH, School of Technology and Health (STH), Neuronic Engineering.
    Stability and fibre reinforced adhesive fixation of vertebral fractures in the upper cervical spine2006In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, p. 151-152Article in journal (Refereed)
  • 266.
    Broome, Michael
    KTH, School of Technology and Health (STH), Medical Engineering.
    Aplysia CorVascSim2012Other (Other academic)
  • 267.
    Broomé, Michael
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska Univ Hosp, Sweden.
    Scarce resources call for us to weigh the pros and cons of every single decision2016In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 105, no 8, p. 880-880Article in journal (Other academic)
  • 268.
    Broomé, Michael
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. Karolinska University Hospital and Karolinska Institutet, Sweden.
    Donker, D. W.
    Individualized real-time clinical decision support to monitor cardiac loading during venoarterial ECMO2016In: Journal of Translational Medicine, ISSN 1479-5876, E-ISSN 1479-5876, Vol. 14, no 1Article in journal (Refereed)
    Abstract [en]

    Veno-arterial extracoporeal membrane oxygenation (VA ECMO) is increasingly used for acute and refractory cardiogenic shock. Yet, in clinical practice, monitoring of cardiac loading conditions during VA ECMO can be cumbersome. To this end, we illustrate the validity and clinical applicability of a real-time cardiovascular computer simulation, which allows to integrate hemodynamics, cardiac dimensions and the corresponding degree of VA ECMO support and ventricular loading in individual patients over time.

  • 269.
    Broomé, Michael
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Frenckner, Björn
    Broman, Mikaeö
    Bjällmark, Anna
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Recirculation during veno-venous extra-corporeal membrane oxygenation: a simulation study2015In: International Journal of Artificial Organs, ISSN 0391-3988, E-ISSN 1724-6040, Vol. 38, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Veno-venous ECMO is indicated in reversible life-threatening respiratory failure without life-threatening circulatory failure. Recirculation of oxygenated blood in the ECMO circuit decreases efficiency of patient oxygen delivery but is difficult to measure. We seek to identify and quantify some of the factors responsible for recirculation in a simulation model and compare with clinical data.

    METHODS:

    A closed-loop real-time simulation model of the cardiovascular system has been developed. ECMO is simulated with a fixed flow pump 0 to 5 l/min with various cannulation sites - 1) right atrium to inferior vena cava, 2) inferior vena cava to right atrium, and 3) superior+inferior vena cava to right atrium. Simulations are compared to data from a retrospective cohort of 11 consecutive adult veno-venous ECMO patients in our department.

    RESULTS:

    Recirculation increases with increasing ECMO-flow, decreases with increasing cardiac output, and is highly dependent on choice of cannulation sites. A more peripheral drainage site decreases recirculation substantially.

    CONCLUSIONS:

    Simulations suggest that recirculation is a significant clinical problem in veno-venous ECMO in agreement with clinical data. Due to the difficulties in measuring recirculation and interpretation of the venous oxygen saturation in the ECMO drainage blood, flow settings and cannula positioning should rather be optimized with help of arterial oxygenation parameters. Simulation may be useful in quantification and understanding of recirculation in VV-ECMO.

  • 270.
    Broomé, Michael
    et al.
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Maksuti, Elira
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Bjällmark, Anna
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Frenckner, Björn
    Janerot-Sjöberg, Birgitta
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Closed-loop real-time simulation model of hemodynamics and oxygen transport in the cardiovascular system2013In: Biomedical engineering online, ISSN 1475-925X, E-ISSN 1475-925X, Vol. 12, no 1, p. 69-Article in journal (Refereed)
    Abstract [en]

    Background: Computer technology enables realistic simulation of cardiovascular physiology. The increasing number of clinical surgical and medical treatment options imposes a need for better understanding of patient-specific pathology and outcome prediction. Methods: A distributed lumped parameter real-time closed-loop model with 26 vascular segments, cardiac modelling with time-varying elastance functions and gradually opening and closing valves, the pericardium, intrathoracic pressure, the atrial and ventricular septum, various pathological states and including oxygen transport has been developed. Results: Model output is pressure, volume, flow and oxygen saturation from every cardiac and vascular compartment. The model produces relevant clinical output and validation of quantitative data in normal physiology and qualitative directions in simulation of pathological states show good agreement with published data. Conclusion: The results show that it is possible to build a clinically relevant real-time computer simulation model of the normal adult cardiovascular system. It is suggested that understanding qualitative interaction between physiological parameters in health and disease may be improved by using the model, although further model development and validation is needed for quantitative patient-specific outcome prediction.

  • 271. Broomé, Michael
    et al.
    Maksuti, Elira
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Waldenström, Anders
    Bjällmark, Anna
    KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
    Simulation of arterial hypertension and progressive arteriosclerosis with a 0-D multipurpose cardiovascular model2013In: CMBE13: 3rd International Conference on Computational & Mathematical Biomedical Engineering, 2013, p. 433-436Conference paper (Refereed)
    Abstract [en]

    The effects of systemic vascular resistance and progressive stiffening/arteriosclerosis inthe vascular tree on arterial blood pressure is explored in a 0D cardiovascular simulationmodel. Pulse pressure is both sensitive and specific for increases in stiffness and meanarterial pressure both sensitive and specific for changes in vascular resistance.

  • 272. Brorsson, Anna
    et al.
    Ohman, Annika
    Lundberg, Stefan
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Nygard, Louise
    Being a pedestrian with dementia: A qualitative study using photo documentation and focus group interviews2016In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 15, no 5, p. 1124-1140Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to identify problematic situations in using zebra crossings. They were identified from photo documentations comprising film sequences and the perspectives of people with dementia. The aim was also to identify how they would understand, interpret and act in these problematic situations based on their previous experiences and linked to the film sequences. A qualitative grounded theory approach was used. Film sequences from five zebra crossings were analysed. The same film sequences were used as triggers in two focus group interviews with persons with dementia. Individual interviews with three informants were also performed. The core category, the hazard of meeting unfolding problematic traffic situations when only one layer at a time can be kept in focus, showed how a problematic situation as a whole consisted of different layers of problematic situations. The first category, adding layers of problematic traffic situations to each other, was characterized by the informants' creation of a problematic situation as a whole. The different layers were described in the subcategories of layout of streets and zebra crossings, weather conditions, vehicles and crowding of pedestrians. The second category, actions used to meet different layers of problematic traffic situations, was characterized by avoiding problematic situations, using traffic lights as reminders and security precautions, following the flow at the zebra crossing and being cautious pedestrians. In conclusion, as community-dwelling people with dementia commonly are pedestrians, it is important that health care professionals and caregivers take their experiences and management of problematic traffic situations into account when providing support.

  • 273.
    Brorsson, Anna
    et al.
    Karolinska Institutet.
    Öhman, Annika
    Karolinska Institutet.
    Lundberg, Stefan
    KTH, School of Technology and Health (STH), Centres, Centre for Health and Building, CHB.
    Nygård, Louise
    Karolinska Institutet.
    Accessibility in public space as perceived by people with Alzheimer´s disease2011In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, no aug 11Article in journal (Refereed)
    Abstract [en]

    Most people with dementia remain living at home as long as possible after being diagnosed, and hence their lives also include activities in the public space. The aim of this study was to illuminate experiences of accessibility in public space in people with Alzheimer’s disease. A qualitative grounded theory approach with repeated in-depth interviews was used. The core category, accessibility as a constantly changing experience, was characterized by changes in the relationship between informants and public space. Changes in the relationship took place in activities and use of place and related to familiarity and comfort, individual motives and interests, and planning and protecting. Other changes occurred in places and problematic situations related to everyday technologies, crowded places with high tempo and noise, and change of landmarks. These changes reduced feelings of accessibility and increased difficulties in carrying out activities in public space. These findings may be helpful when providing support, and supporting community living.

  • 274. Brown, Shannon
    et al.
    Ortiz-Catalan, Max
    Petersson, Joel
    Rodby, Kristian
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical Engineering, Computer and Electronic Engineering. University of Borås, Sweden.
    Intarsia-Sensorized Band and Textrodes for Real-Time Myoelectric Pattern Recognition2016In: Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS / [ed] Patton, J Barbieri, R Ji, J Jabbari, E Dokos, S Mukkamala, R Guiraud, D Jovanov, E Dhaher, Y Panescu, D Vangils, M Wheeler, B Dhawan, AP, Institute of Electrical and Electronics Engineers (IEEE), 2016, p. 6074-6077, article id 7592114Conference paper (Refereed)
    Abstract [en]

    Surface Electromyography (sEMG) has applications in prosthetics, diagnostics and neuromuscular rehabilitation. Self-adhesive Ag/AgCl are the electrodes preferentially used to capture sEMG in short-term studies, however their long-term application is limited. In this study we designed and evaluated a fully integrated smart textile band with electrical connecting tracks knitted with intarsia techniques and knitted textile electrodes. Real-time myoelectric pattern recognition for motor volition and signal-to-noise ratio (SNR) were used to compare its sensing performance versus the conventional Ag-AgCl electrodes. After a comprehending measurement and performance comparison of the sEMG recordings, no significant differences were found between the textile and the Ag-AgCl electrodes in SNR and prediction accuracy obtained from pattern recognition classifiers.

  • 275.
    Brown, Shannon
    et al.
    Högskolan i Borås.
    Ortiz-Catalan, Max
    Chalmers University of Technology.
    Petersson, Joel
    Högskolan i Borås.
    Rödby, Kristian
    Högskolan i Borås.
    Seoane, Fernando
    KTH, School of Technology and Health (STH). Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Intarsia-sensorized band and textrodes for real-time myoelectric pattern recognition2016In: Engineering in Medicine and Biology Society (EMBC), 2016 IEEE 38th Annual International Conference of the, Institute of Electrical and Electronics Engineers (IEEE), 2016, p. 6074-6077Conference paper (Refereed)
  • 276.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Implementering av Lean i medelstora företag: En lärande utvärdering om hållbarutveckling2010Report (Other academic)
    Abstract [sv]

    Denna rapport är ett av delresultaten från det interaktiva forskningsprojektet Produktionslyftet, inom HELIX VINN Excellence Centre. Projektet genomförs i samarbete med Produktionslyftet, ett nationellt program för spridande av managementkonceptet Lean produktion. Syftet med forskningsprojektet är att öka kunskapen om hur hållbart utvecklingsarbete kan bedrivas, både utifrån ett program- och företagsperspektiv.

    Rapporten beskriver två delstudier, en kvalitativ och en kvantitativ, som genomförts i samarbete med elva av företagen i Produktionslyftet, tio av dem pilotföretag för programmet. Den första delstudien genomfördes under sommaren 2008, genom en intervjustudie med programmets pilotföretag, medan den andra genomfördes under våren 2009, i formen av en enkätstudie med sju av företagen i programmet. Då en interaktiv forskningsansats har använts, så har i båda fallen den insamlade empirin från de båda delstudierna återkopplats till representanter från Produktionslyftet, samt programmets finansiärer, och en gemensam tolkning och analys av empirin har gjorts. Denna gemensamma tolkning har sedan analyserats utifrån modeller kring hållbart utvecklingsarbete och resultatet från detta arbete har sedan sammanfattats i två arbetsrapporter, som har återkopplats till programmet och dess finansiärer.

    Resultaten i delstudierna, samt den gemensamma tolkningen och analysen av empirin, fokuserar Produktionslyftets coacher, samt deras arbete med företagen. Dels spelar coacherna uppenbarligen en central roll i programmets arbete med företagen, och dels är coacherna mycket uppskattade av företagen. Coachernas arbetssätt, samt hur deras arbete påverkar möjligheten för företagen att skapa en hållbar utveckling, upptar också en central del i rapporten. Detta kan sammanfattas, som att om coacherna driver på arbetet för hårt, få finns det risk att det uppstår problem för företagen, men om coacherna inte är pådrivande så finns risken att åtminstone vissa av företagen inte tar sitt ansvar för Lean-arbetet. Med andra ord, coachernas arbete med företagen utgör en svår balansgång mellan att uppfylla företagens målsättningar med Lean-arbetet, i vägning mot Produktionslyftets mål och syfte. Men resultaten pekar också på vikten av att företagen har ett tydligt ägarskap och driv i utvecklingsarbetet.

    Slutsatsen i denna rapport blir därför att om programmets utvecklingsarbete skall bli hållbart, så hänger det troligen på dels att man har duktiga och kompetenta coacher, men också att man har en väl fungerande företagsrekryteringsprocess, där företag med ett internt driv för Lean-arbetet väljs till programmet.

  • 277.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Interaktiv forskning: Gemensamt kunskapande för allas nytta2010In: FALF2010: Arbetsliv i förändring, Malmö: FALF , 2010Conference paper (Refereed)
    Abstract [sv]

    Utvärdering är ett mycket vanligt redskap för kontroll och uppföljning inom olika verksamheter, exempelvis projekt och program. Den traditionella ”summativa” utvärderingen har dock ett flertal brister, som gjort att intresset för formativa utvärderingar ökat. Ett exempel på dessa är de s.k. lärande utvärderingarna, men också forskning i olika former kan användas för att utvärdera projekt och program. I det offentliga programmet Produktionslyftet har det förekommit ett flertal utvärderingsformer, bl.a. två summativa måluppföljelseutvärderingar och ett interaktivt forskningsprojekt. I detta paper presenteras en fallstudie kring dessa utvärderingsformer, samt vilka interna respektive externa spridningseffekter (av programmets erfarenheter), samt också vilken form av utvecklingsstöd, som dessa har möjliggjort för Produktionslyftet. Resultaten pekar på att ett summativa utvärderingsprojekt kan användas för både intern spridning av erfarenheter och för att skapa utvecklingsstöd, förutsatt att halvtidsutvärderingar används. Detta kan också ett interaktivt forskningsprojekt bidra med, samt en lärande utvärdering, men det interaktiva forskningsprojektet tycks vara överlägset när det gäller extern spridning av resultaten från programmet – även om det också är den mest resurskrävande formen av utvärdering. Uttryckt på ett annat sätt, så skapar det interaktiva forskningsprojektet underlag för gemensam diskussion, reflektion och analys för programmet, samt gör också programmet/projektet mer transparent, genom extern spridning av gjorda erfarenheter.

  • 278.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Is Lean No Longer Mean?: A Study of the Consequences for Working Conditions in Companies Implementing Lean2010In: FALF2010: Arbetsliv i förändring, Malmö: FALF , 2010Conference paper (Refereed)
    Abstract [en]

    Lean is today becoming increasingly popular in Swedish manufacturing industry, and the concept has also started to spread to other sectors, such as administration, healthcare and the municipal sector. However, previous studies have suggested that Lean can become “mean”, creating working conditions that are bad for the employees. Conversely, other studies instead suggest that this has less to do with Lean, than with the implementation of Lean. Thus, this paper aims at studying the implementation of Lean in eight medium sized companies over a two year period, using qualitative and quantitative data. First, the results from the qualitative data suggest that these companies implementation of Lean is characterized by Lean coordinators, pilot projects and improvements groups, while the Lean tools mostly used are 5S, SMED, standardization and means to improve the production flow. Second, the perceived effects on working conditions, based on the quantitative data, suggest an improvement in the working environment, an increase in the work with safety and some degree of increase in stress for the workers. Consequently, the implementation structure of these companies does not indicate a “mean” production system, although the long term effects on working conditions cannot be determined, based on these data.

  • 279.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean administration: En litteraturgenomgång av lean när konceptet implementeras i kommuner2011In: FALF2011: Det nya arbetslivet, Luleå: FALF , 2011Conference paper (Refereed)
    Abstract [sv]

    Lean blir allt vanligare i svensk offentlig förvaltning. Litteraturstudier har tidigare genomförts inom sjukvård och service. Denna litteraturgenomgång fokuserar istället på kommuner. Fokus ligger på vilka former som lean-konceptet tar, hur det implementeras, vilka effekter som uppnås, samt vilka svårigheter som man stött på. Sökningar gjordes i två omgångar i fyra olika databaser under i maj 2010. Endast empiriska artiklar i peer-reviewadetidsskrifter inkluderades; studier som inom vård- eller industriliknande kontexterexkluderades. Totalt resulterade sökningen och urvalsprocessen i fem publikationer, som beskriver lean i elva verksamheter. Slutsatserna från genomgången av dessa är de studerade lean-implementeringar i hög grad utgår från en ansats som påminner om värdeflödeskartläggningar. Fokus för lean-arbetet ligger på verktyg och system för förbättringsarbete. De upplevda problemen i lean-arbetet är framför allt associerade med implementeringsansatsen, snarare än konceptet eller kontexten. Verksamheternas arbete med lean har gett mestadels positiva verksamhetseffekter, framför allt rörande effektivitet och produktivitet. Hur kunderna, och framför allt personalen, påverkats är dock osäkrare.

  • 280.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean i kommuner och myndigheter: En översikt över existerande empirisk forskningslitteratur2012Report (Other academic)
    Abstract [sv]

    Denna litteraturgenomgång avser att studera det empiriska underlaget om lean i kommuner och myndigheter (exklusive sjukvård) utifrån den forskningslitteratur som finns. Sökningar har gjorts i sex forskningsdatabaser under oktober 2011. Relevanta frågor för studien är hur lean används i kommuner och myndigheter, varför organisationerna väljer att arbeta med lean och vilka resultat man har uppnått.

    Totalt hittades 48 publikationer, men efter sortering återstod endast 17 empiriska artiklar av relevans för den här rapporten. De studier som valdes bort var antingen för diskuterande eller redogjorde inte tydligt för hur man har samlat in sin empiri. De 17 studierna som används är av skiftande kvalitet och utformning och det empiriska underlaget är varierat. En majoritet av de inkluderade publikationerna är publicerade efter 2005. Tio av de 17 publikationerna innehåller totalt 18 fallstudier. Utifrån detta, är det rimligt att hävda att den empiriska forskningen om lean i kommuner och myndigheter är ett relativt nytt fenomen. Fallstudierna föranleder flera slutsatser, även om det bör betonas att det empiriska underlaget är tunt och studierna är av starkt varierande kvalitet och utformning. Därför bör slutsatserna endast ses som tentativa, men det innebär samtidigt att det finns flera frågor som kan vara av stort intresse för fortsatt forskning.

    För det första, när det gäller vilka former lean-arbetet tar, så tycks värdeflödeskartläggning och slöserireducering utgöra centrala inslag i kommuner och myndigheters arbete med lean. Ofta verkar det handla om punktinsatser. Lean-program som omfattar hela organisationen är relativt ovanliga. Andra lean-verktyg förekommer också, men det är mindre vanligt. För det andra, när det gäller målen med lean-arbetet, verkar det i hög grad initieras med syfte att öka produktiviteten, även om andra skäl också förekommer, som exempelvis behov av kostnadssänkningar. För det tredje, när det gäller resultat av lean-arbetet, framför allt då värdeflödeskartläggningarna, verkar ökad produktivitet vara det vanligaste resultatet. Samtidigt leder arbetet också ofta till minskade problem och störningar för de anställda, vilket ofta uppskattas. Däremot tycks effekterna för personalen vara mer varierade än verksamhetseffekterna. De lean-verktyg som emellanåt verkar ge negativa konsekvenser är bland annat standardisering, visualisering och kundkontakt. Kundeffekterna är dock svårare att uttala sig om eftersom det ofta saknas empiri om detta i studierna.

    Slutligen bör det betonas att utifrån de inkluderade studiernas utformning och metodik är det mycket svårt att uttala sig om de långsiktiga effekterna av arbetet med lean, eftersom det finns empiri i publikationerna som väcker frågetecken om hur hållbart lean-arbetet är, till exempel deltagarnas känsla av att arbetet är avklarat efter genomförda förbättringsworkshops.

  • 281.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean Working Environments: An Empirical Study of 24 CompaniesImplementing Lean2010In: NES2010: Proactive Ergonomics: Implementation of ergonomics in planning of jobs, tasks, systems and environments., Stavanger, 2010Conference paper (Refereed)
    Abstract [en]

    This paper studies the perceived effects on the working conditions in 24 medium sized manufacturing companies, approximately 1.5 year into their implementation of Lean. This is studied quantitatively based on four stakeholders’ perceptions (the workers, the managers, the production supervisors and the white-collar workers), based on three factors; changes in the working environment, work with safety for the personnel and level of stress. The results indicate that the physical work environments have improved and the workers and production supervisors report a slight increase in stress. Lastly, all groups report an increase in the work with safety for the personnel.

  • 282.
    Brännmark, Mikael
    KTH, School of Technology and Health (STH), Ergonomics.
    Ökad delaktighet i programutvärdering: En metodik för ökad resultatspridning?2009In: HSS2009: Vi bygger morgondagens samhälle, Luleå, 2009, p. 1-26Conference paper (Refereed)
  • 283.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Benn, Suzanne
    University of Technology, Sydney, Australia.
    A Proposed Model for Evaluating the Sustainability of Continuous Change Programmes2012In: Journal of Change Management, ISSN 1469-7017, E-ISSN 1479-1811, Vol. 12, no 2, p. 231-245Article in journal (Refereed)
    Abstract [en]

    Many studies report that it is difficult to sustain change. This article focuses on how an organization can initiate and sustain a continuous change process. A theoretical model is proposed as a fusion of two previous models for evaluating the sustainability of a change programme; the first is based on analysing stakeholder interest balance as a prerequisite for organizational sustainability, the second on analysing the design of the implementation, indicating whether long-term effects will be achieved. It is argued that the combination of these factors provides a more comprehensive perspective, since it allows us to evaluate both the ‘form’ and the ‘direction’ of the programme. To assess stakeholder interest balance, the goal for the change programme is analysed, utilizing the broad stakeholder interest balance perspective. To assess the design of the implementation, four preconditions for long-term effects should be analysed: management's ownership of the change initiative, professional steering, competent leadership and participation. Reference is given to the management concept Lean Production, which is claimed to engage the organization in continuous change. Application of the model highlights the mismatch between narrowly focused change programmes such as Lean Production and sustainable change.

  • 284.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Eklund, Jörgen
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Leaninspirerade förändringar och personalens upplevelser2013In: Lean i arbetslivet / [ed] Sederblad, Per, Stockholm: Liber, 2013, 1, p. 103-121Chapter in book (Other academic)
    Abstract [sv]

    De anställdas upplevelser av hur de kommer att påverkas av ett förändringskoncept är en avgörande faktor för om konceptet kommer att få reellt genomslag eller inte. Det här kapitlet behandlar denna centrala aspekt av leankonceptet – hur personalen upplever leaninspirerade förändringar. Just denna fråga finns det mycket lite empirisk forskning kring, så väl internationellt som i Sverige.

    I kapitlet redovisas en studie av personalens erfarenheter från leanarbetet i medelstora svenska tillverkningsföretag som ingått i det nationella programmet Produktionslyftet. Programmet kan ses som ett exempel på en ”svensk tolkning” av lean. Produktionslyftet har fått stort genomslag i den svenska diskussionen om lean, men samtidigt har konsekvenserna av lean ur ett arbetsmiljöperspektiv inte utvärderats på ett genomgripande sätt.

  • 285.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Eklund, Jörgen
    KTH, School of Technology and Health (STH), Ergonomics.
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Ergonomics.
    Vogel, Kjerstin
    KTH, School of Technology and Health (STH), Ergonomics.
    Belastningsergonomiska studier utifrån ett produktions- och systemperspektiv: Kunskapsöversikt2012Report (Other academic)
  • 286.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Analysseminarier som samverkansform: Följeforskning för hållbart utvecklingsarbete?2011In: HSS2011: Vi bygger tillsammans, Karlstad: HSS , 2011Conference paper (Refereed)
  • 287.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Lindskog, Pernilla
    KTH, School of Technology and Health (STH), Ergonomics.
    Implementing Lean in Swedish Municipalities and Hospitals: Initial effects on the work system2011In: FALF2011:Det nya arbetslivet, Luleå: FALF , 2011Conference paper (Refereed)
    Abstract [en]

    This paper is the first preliminary product of a three year interactive research project, studying the effects of Lean when introduced in Swedish municipalities and hospitals. Focus of the paper is the implementation process (more specifically, employee participationand facilitated learning) and changes in the work system (focusing on work content, organization and work environment). The empirical data has been collected through interviews and group interviews in three municipalities and one hospital. These results, together with the discussion and analysis, shows firstly that the implementation processes of the studied units are characterized by a medium or high level of opportunities for employee participation and learning, although this is produced in different ways. Second, the changes in the work systems mostly affect the organization of the work, through reorganization and redistribution of the work tasks, rather than changes in how the work tasks are performed.This has lead to more orderly and structured work processes. Lastly, the employees’ reactions to these changes have been mostly positive, although not exclusively so. However, it is important to stress that the employee reactions are most likely as much a result of the implementation process, as of the changes in the work systems. Longitudinal studies are therefore needed to study the long term changes in the work system and the effects on employee health, which will be the next step of this research project.

  • 288.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Health Systems Engineering, Ergonomics.
    Holden, Richard J
    Departments of Medicine and Biomedical Informatics, Center for Research and Innovation in Systems Safety, Vanderbilt University School of Medicine.
    Packages of participation: Swedish employees´experience of Lean depends on how they are involved2013In: IIE Transactions on Occupational Ergonomics and Human Factors, ISSN 2157-7323, Vol. 1, no 2, p. 93-108Article in journal (Refereed)
    Abstract [en]

    Background: Lean production is a dominant approach in Swedish and global manufacturing and service industries. Studies of Lean’s employee effects are few and contradictory. Purpose: Employee effects from Lean are likely not uniform. This article investigates the effect of employees’ participation on their experiences of Lean. Method: This study investigated how different packages of employee participation in Lean affected manufacturing workers’ experiences of Lean. During 2008–2011, qualitative and quantitative data were collected from Swedish manufacturing companies participating in the national Swedish Lean production program Produktionslyftet. Data from 129 surveys (28 companies), 39 semi-structured interviews, and 30 reports were analyzed. In the main analysis, comparisons were made of the survey-reported Lean experiences of employees in three groups: temporary group employees (N = 36), who participated in Lean mostly through intermittent projects; continuous group employees (N = 69), who participated through standing improvement groups; and combined group employees (N = 24), who participated in both ways. Results: Continuous group employees had the most positive experience of Lean, followed by the combined group. Temporary group employees had the least positive experiences, being less likely than their counterparts to report that Lean improved teamwork; occupational safety; and change-related learning, decision making, and authority. Conclusions: These findings support the importance of continuous, structured opportunities for participation but raise the possibility that more participation may result in greater workload and role overload, mitigating some benefits of employee involvement. Consequently, companies should consider involving employees in change efforts but should attend to the specific design of participation activities.

  • 289.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Håkansson, Malin
    KTH, School of Technology and Health (STH), Ergonomics.
    Lean production and work-related musculoskeletal disorders: Overviews of international and Swedish studies2012In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 41, no 1, p. 2321-2328Article in journal (Refereed)
    Abstract [en]

    This paper aimed at summarizing the knowledge of the relationship between Lean and work related musculoskeletal disorders (WMSD), and WMSD risk factors, in manufacturing companies. Literature search processes identified 23 publications studying this, in scientific journals. Eight included measurements of WMSD; three were mostly negative, two showed mixed results, one showed no results and two were mostly positive. Eighteen publications included measurements of WMSD risk factors; seven showed mostly negative results, eight snowed mixed results, two showed mostly positive results and one was inconclusive. Three literature reviews were identified, which studied this question; two were mostly negative, while the third was inconclusive. Also, 12 publications of grey literature studying Lean and WMSD risk factors in Swedish organizations were identified; nine showed mixed results, two showed mostly positive results and one showed mostly negative results. Due to the varying quality and study design of the publications, together with the few identified studies, it is difficult to compare them. The context and the implementation also likely affect the results. The general conclusion was that a Lean implementation may increase the risk of WMSD and risk factors for WMSD, if it is not accompanied with an ergonomic intervention.

  • 290.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Langstrand, Jostein
    Linköping University, Division of Quality Technology and Management, Linköping, Sweden.
    Johansson, Stina
    Luleå University of Technology, Dept. of Human Work Science, Luleå, Sweden.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Abrahamsson, Lena
    Luleå University of Technology, Dept. of Human Work Science, Luleå, Sweden.
    Winkel, Jörgen
    University of Gothenburg, Dept. of Sociology and Work Science, Gothenburg, Sweden.
    Researching lean: Methodological implications of loose definitions2012In: Quality Innovation Prosperity, ISSN 1335-1745, E-ISSN 1338-984X, Vol. 16, no 2, p. 35-48Article in journal (Refereed)
    Abstract [en]

    Recently, Lean Production (Lean) has become a prevailing management concept in Sweden. However, previous research seems to show that the Lean concept and the impact of Lean vary considerably between organizations.

    This paper illustrates some key methodological issues that need to be considered when researching loosely defined management concepts such as Lean. The paperis based on a review of the literature and five comparative Swedish cases studies.

    Our study indicates that Lean has changed over time and that operationalization and interpretations of the concept vary considerably

    This study concludes that future Lean studies should include a thorough assessment of the Lean interventions, study settings, and in particular non-Lean factors mediating the outcomes of Lean-inspired change programs.

  • 291.
    Brännmark, Mikael
    et al.
    KTH, School of Technology and Health (STH), Ergonomics.
    Lindskog, Pernilla
    KTH, School of Technology and Health (STH), Ergonomics.
    Halvarsson, Agneta
    Linköpings universitet, HELIX VINN Excellence Centre.
    Patient Quality Effects from Lean Healthcare: An Empirical Investigation2012In: NES2012 Proceedings.: Ergonomics for sustainability and growth / [ed] Ann-Beth Antonsson, Göran Hägg, Stockholm: KTH Royal Institute of Technology, 2012Conference paper (Refereed)
    Abstract [en]

    The use of Lean in healthcare settings has become common in Swedish hospitals. However, the effects from Lean on patients have not been studied extensively. This paper contributes to our understanding of this question, based on 24 semi-structured interviews in three municipal care units and three units in hospitals. The results indicate that there may be a positive link between Lean activities and quality of care. However, it is plausibly a weak link, heavily modulated by non-Lean factors. Thus, we need more empirical research to understand the causal link between patient safety and quality of care from Lean Healthcare.

  • 292.
    Bu, Yi-Qin
    et al.
    KTH, School of Technology and Health (STH).
    Wang, Jieyu
    KTH, School of Technology and Health (STH).
    Overview of Care Coordination Within Specialized Home Care in Stockholm County2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    The ageing population of Sweden is expected to increase throughout the future decades. Changing life-style trends and smaller families in the modern society has decreased the population’s access to informal care. This is expected to entail an increase in the services provided by specialized home care. This thesis studies the work performed by nurses within the department of specialized home care (ASIH) in Stockholm County. The nurses represent the majority of all professions active at ASIH in Stockholm County, which puts their work in particular interest for this thesis. The thesis focuses on the ways the nurses’ work procedures may influence continuity of care and patient safety. Continuity of care is an essential component in qualitative care and is characterized by well-executed coordination and minimization of broken patient appointments. A high level of continuity of care consequently entails a high level of patient safety. Descriptions of continuity of care at ASIH in Stockholm County can therefore provide indications on current care quality and areas of improvement.

    The thesis consists of two parts – a literature review containing international research on continuity within home care and an empirical study containing a retrospective analysis based on the Functional Resonance Analysis Method (FRAM). The empirical study creates an overview of work tasks related to nursing performed at three units of ASIH in Stockholm County. The interdependencies between work tasks are identified and important chain reactions are analyzed.

    The findings from this thesis indicate that extended training programs for nurses in the initial phase of employment is likely to decrease the number of disruptions in the nurses’ work. Furthermore, well-developed routines could facilitate work task procedures which would decrease the number of delays and disruptions in the nurses’ work. It was found that these findings together with information continuity between all parties involved represent significant factors for attaining continuity of care and patient safety at ASIH in Stockholm County.

  • 293.
    Buendia, Ruben
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Improvements in Bioimpedance SpectroscopyData Analysis: Artefact Correction, ColeParameters, and Body Fluid Estimation2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The estimation of body fluids is a useful and common practice in the status assessment of diseasemechanisms and treatments. Electrical bioimpedance spectroscopy (EBIS) methods are non-invasive,inexpensive, and efficient alternatives for the estimation of body fluids. However, these methods areindirect, and their robustness and validity are unclear.Regarding the recording of measurements, a controversy developed regarding a spectrum deviationin the impedance plane, which is caused by capacitive leakage. This deviation is frequentlycompensated for by the extended Cole model, which lacks a theoretical basis; however, there is nomethod published to estimate the parameters. In this thesis, a simplified model to correct thedeviation was proposed and tested. The model consists of an equivalent capacitance in parallel withthe load.Subsequently, two other measurement artefacts were considered. Both artefacts were frequentlydisregarded with regard to total body and segmental EBIS measurements as their influence isinsignificant with suitable skin-electrode contact. However, this case is not always valid, particularlyfrom a textile-enabled measurement system perspective. In the estimation of body fluids, EBIS dataare fitted to a model to obtain resistances at low and high frequencies. These resistances can berelated to body fluid volumes. In order to minimise the influence of all three artefacts on theestimation of body fluids and improve the robustness and suitability of the model fitting the differentdomains of immittance were used and tested. The conductance in a reduced frequency spectrum wasproposed as the most robust domain against the artefacts considered.The robustness and accuracy of the method did not increase, even though resistances at low and highfrequencies can be robustly estimated against measurement artefacts. Thus, there is likely error in therelation between the resistances and volumes. Based on a theoretical analysis, state of the artmethods were reviewed and their limitations were identified. New methods were also proposed. Allmethods were tested using a clinical database of patients involved in growth hormone replacementtherapy. The results indicated EBIS are accurate methods to estimate body fluids, however they haverobustness limits. It is hypothesized that those limits in extra-cellular fluid are primarily due toanisotropy, in total body fluid they are primarily due to the uncertainty ρi, and errors in intra-cellularfluid are primarily due to the addition of errors in extracellular and total body fluid. Currently, theseerrors cannot be prevented or minimised. Thus, the limitations for robustness must be predicted priorto applying EBIS to estimate body fluids.

  • 294.
    Buendia, Ruben
    et al.
    University of Borås, Sweden.
    bogonez-franco, Paco
    Technical University of Catalonia.
    Nescolarde, Lexa
    Technical University of Catalonia.
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Influence of electrode mismatch on Cole parameter estimation from Total Right Side Electrical Bioimpedance Spectroscopy measurements2012In: Medical Engineering and Physics, ISSN 1350-4533, E-ISSN 1873-4030, Vol. 34, no 7, p. 1024-1028Article in journal (Refereed)
    Abstract [en]

    Applications based on measurements of Electrical Bioimpedance (EBI) spectroscopy analysis, like assessment of body composition, have proliferated in the past years. Currently Body Composition Assessment (BCA) based in Bioimpedance Spectroscopy (BIS) analysis relays on an accurate estimation of the Cole parameters R-0 and R-infinity. A recent study by Bogonez-Franco et al. has proposed electrode mismatch as source of remarkable artefacts in BIS measurements. Using Total Right Side BIS measurements from the aforementioned study, this work has focused on the influence of electrode mismatch on the estimation of R-0 and R-infinity using the Non-Linear Least Square curve fitting technique on the modulus of the impedance. The results show that electrode mismatch on the voltage sensing electrodes produces an overestimation of the impedance spectrum leading to a wrong estimation of the parameters R-0 and R-infinity, and consequently obtaining values around 4% larger that the values obtained from BIS without electrode mismatch. The specific key factors behind electrode mismatch or its influence on the analysis of single and spectroscopy measurements have not been investigated yet, no compensation or correction technique is available to overcome the deviation produced on the EBI measurement. Since textile-enabled EBI applications using dry textrodes, i.e. textile electrodes with dry skin-electrode interfaces and potentially large values of electrode polarization impedance are more prone to produce electrode mismatch, the lack of a correction or compensation technique might hinder the proliferation of textile-enabled EBI applications for personalized healthcare monitoring.

  • 295.
    Buendia, Ruben
    et al.
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications.
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Cole Parameter Estimation from the Modulus of the Electrical Bioimpeadance for Assessment of Body Composition: A Full Spectroscopy Approach2011In: Journal of Electrical Bioimpedance, ISSN 1891-5469, E-ISSN 1891-5469, Vol. 2, p. 72-78Article in journal (Refereed)
    Abstract [en]

    Activities around applications of Electrical Bioimpedance Spectroscopy (EBIS) have proliferated in the past decade significantly. Most of these activities have been focused in the analysis of the EBIS measurements, which eventually might enable novel applications. In Body Composition Assessment (BCA) the most common analysis approach currently used in EBIS is based on the Cole function, which most often requires curve fitting. One of the most implemented approaches for obtaining the Cole parameters is performed in the impedance plane through the geometrical properties that the Cole function exhibit in such domain as depressed semi-circle. To fit the measured impedance data to a semi-circle in the impedance plane, obtaining the Cole parameters in an indirect and sequential manner has several drawbacks. Applying a Non-Linear Least Square (NLLS) iterative fitting on the spectroscopy measurement, obtains the Cole parameters considering the frequency information contained in the measurement. In this work, from experimental total right side EBIS measurements, the BCA parameters have been obtained to assess the amount and distribution of whole body fluids. The values for the BCA parameters have been obtained using values for the Cole parameters estimated with both approaches: circular fitting on the impedance plane and NLLS impedance-only fitting. The comparison of the values obtained for the BCA parameters with both methods confirms that the NLLS impedance-only is an effective alternative as Cole parameter estimation method in BCA from EBIS measurements. Using the modulus of the Cole function as the model for the fitting would eliminate the need for performing a phase detection in the acquisition process, simplifying the hardware specifications of the measurement instrumentation when implementing a bioimpedance spectrometer.

  • 296.
    Buendia, Ruben
    et al.
    School of Engineering, University of Borås.
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications, University of Alcala, Madrid, Spain.
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Cole parameter estimation from total right side electrical bioimpedance spectroscopy measurements: Influence of the number of frequencies and the upper limit2011In: 2011 ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY (EMBC), 2011, p. 1843-1846Conference paper (Refereed)
    Abstract [en]

    Applications based on measurements of Electrical Bioimpedance Spectroscopy (EBIS) analysis are proliferating. The most spread and known application of EBIS is the non-invasive assessment of body composition. Fitting to the Cole function to obtain the Cole parameters, R<sub>0</sub> and R<sub>&#x221E;</sub>, is the core of the EBIS analysis to obtain the body fluid distribution. An accurate estimation of the Cole parameters is essential for the Body Composition Assessment (BCA) and the estimation process depends on several factors. One of them is the upper frequency limit used for the estimation and the other is the number of measured frequencies in the measurement frequency range. Both of them impose requirements on the measurement hardware, influencing largely in the complexity of the bioimpedance spectrometer. In this work an analysis of the error obtained when estimating the Cole parameters with several frequency ranges and different number of frequencies has been performed. The study has been done on synthetic EBIS data obtained from experimental Total Right Side (TRS) measurements. The results suggest that accurate estimations of R<sub>0</sub> and R<sub>&#x221E;</sub> for BCA measurements can be achieved using much narrower frequency ranges and quite fewer frequencies than electrical bioimpedance spectrometers commercially available nowadays do.

  • 297.
    Buendia, Ruben
    et al.
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Bosacus, I.
    University of Gothenburg.
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications, University of Alcala, Madrid, Spain.
    Johannsson, G.
    Ellegård, L.
    Lindecrantz, Kaj
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Robust approach against capacitive coupling for the estimation of body fluids using clinical bioimpedance spectroscopy measurementsManuscript (preprint) (Other academic)
  • 298.
    Buendia, Ruben
    et al.
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications, University of Alcala, Madrid, Spain.
    Experimental validation of a method for removing the capacitive leakage artifact from electrical bioimpedance spectroscopy measurements2010In: Measurement science and technology, ISSN 0957-0233, E-ISSN 1361-6501, Vol. 21, no 11Article in journal (Refereed)
    Abstract [en]

    Often when performing electrical bioimpedance (EBI) spectroscopy measurements, the obtained EBI data present a hook-like deviation, which is most noticeable at high frequencies in the impedance plane. The deviation is due to a capacitive leakage effect caused by the presence of stray capacitances. In addition to the data deviation being remarkably noticeable at high frequencies in the phase and the reactance spectra, the measured EBI is also altered in the resistance and the modulus. If this EBI data deviation is not properly removed, it interferes with subsequent data analysis processes, especially with Cole model-based analyses. In other words, to perform any accurate analysis of the EBI spectroscopy data, the hook deviation must be properly removed. Td compensation is a method used to compensate the hook deviation present in EBI data; it consists of multiplying the obtained spectrum, Z meas (ω), by a complex exponential in the form of exp(–jωTd). Although the method is well known and accepted, Td compensation cannot entirely correct the hook-like deviation; moreover, it lacks solid scientific grounds. In this work, the Td compensation method is revisited, and it is shown that it should not be used to correct the effect of a capacitive leakage; furthermore, a more developed approach for correcting the hook deviation caused by the capacitive leakage is proposed. The method includes a novel correcting expression and a process for selecting the proper values of expressions that are complex and frequency dependent. The correctness of the novel method is validated with the experimental data obtained from measurements from three different EBI applications. The obtained results confirm the sufficiency and feasibility of the correcting method.

  • 299.
    Buendia, Ruben
    et al.
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS).
    Harris, Matthew
    Phillips Research.
    Caffarel, Jeniffer
    Phillips Research.
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications, University of Alcala, Madrid, Spain.
    Hook Effect correction & resistance-based Cole fitting prior Cole model-based analysis: Experimental validation2010In: Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2010, IEEE Engineering in Medicine and Biology , 2010, p. 6563-6566Conference paper (Refereed)
    Abstract [en]

    The analysis of measurements of Electrical Bioimpedance (EBI) is on the increase for performing non-invasive assessment of health status and monitoring of pathophysiological mechanisms. EBI measurements might contain measurements artefacts that must be carefully removed prior to any further analysis. Cole model-based analysis is often selected when analysing EBI data and might lead to miss-conclusion if it is applied on data contaminated with measurement artefacts. The recently proposed Correction Function to eliminate the influence of the Hook Effect from EBI data and the fitting to the real part of the Cole model to extract the Cole parameters have been validated on experimental measurements. The obtained results confirm the feasible experimental use of these promising pre-processing tools that might improve the outcome of EBI applications using Cole model-based analysis.

  • 300.
    Buendia, Ruben
    et al.
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS) (Closed 20130701). University of Alcala, Spain; Chalmers University of Technology, Sweden; University of Boras, Sweden.
    Seoane, Fernando
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS) (Closed 20130701). University of Boras, Sweden.
    Lindecrantz, Kaj
    KTH, School of Technology and Health (STH), Medical sensors, signals and systems (MSSS) (Closed 20130701). University of Boras, Sweden; Karolinska Instituet, Sweden.
    Bosacus, I.
    University of Gothenburg.
    Gil-Pita, Roberto
    Department of Theory of the Signal and Communications, University of Alcala, Madrid, Spain.
    Johannsson, G.
    Ellegård, L.
    Ward, L.
    Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods2015In: Physiological Measurement, ISSN 0967-3334, E-ISSN 1361-6579, Vol. 36, no 10Article in journal (Refereed)
    Abstract [en]

    Determination of body fluids is a useful common practice in determination of disease mechanisms and treatments. Bioimpedance spectroscopy (BIS) methods are non-invasive, inexpensive and rapid alternatives to reference methods such as tracer dilution. However, they are indirect and their robustness and validity are unclear. In this article, state of the art methods are reviewed, their drawbacks identified and new methods are proposed. All methods were tested on a clinical database of patients receiving growth hormone replacement therapy. Results indicated that most BIS methods are similarly accurate (e.g. < 0.5 +/- 3.0% mean percentage difference for total body water) for estimation of body fluids. A new model for calculation is proposed that performs equally well for all fluid compartments (total body water, extra-and intracellular water). It is suggested that the main source of error in extracellular water estimation is due to anisotropy, in total body water estimation to the uncertainty associated with intracellular resistivity and in determination of intracellular water a combination of both.

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