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  • 101.
    Byrman, Gunilla
    et al.
    Linnaeus University, Faculty of Arts and Humanities, Department of Swedish Language. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Stevenson-Ågren, Jean
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Faculty of Arts and Humanities, Department of Languages. Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bitar, Dima
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Ericsson, Stina
    Linnaeus University, Faculty of Arts and Humanities, Department of Swedish Language. University of Gothenburg, Sweden.
    Oscarsson, Marie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Skoglund, Astrid
    Linnaeus University, Faculty of Arts and Humanities, Department of Swedish Language.
    Sadima: Vänta barn på arabiska, engelska och svenska! Effektiv och integrerande design för interaktiv mödrahälsovård2020Other (Refereed)
    Abstract [en]

    Målet har varit att göra ett effektivt, integrerande och interaktivt dialogstöd (https://sadima.lnu.se/). Stödet är avsett att användas i mödravårdssam­tal mellan kvinnor med begränsade kunskaper i svenska och svensktalande barnmorskor och är ett komplement till tolk. Samtalsstödet finns på arabiska, engelska, svenska och är fritt tillgängligt på internet.  Vi vill uppnå förbättrad och effek­­tiviserad kommu­ni­ka­tion mellan barnmorskor och kvinnor. Samtalsstödet ska leda till ökad patientsäkerhet med färre komplika­tioner och minskad sjuklighet och dödlighet bland kvinnorna och deras barn, och därigenom öka vårdkvaliteten och effektivisera bru­ket av sam­hälleliga resurser. Avsikten är att sprida och nyttiggöra sam­talsstödet till ansvariga i Sveriges Kom­muner och Regioner (SKR) och samordnings­barn­morskor i Sverige. Stödet består av en del där information kan inhämtas och en del där information kan ges om gravidi­tet, förloss­ning och preventiv­medel. Genom webbsidan ska mödra­hälso­­­vården göras mer jämlik och kom­munikativ, med ökad patientsäkerhet och egenmakt för kvinnor i mödravården.

    Vi har analyserat material med språkliga, normkritiska och vård­vetenskapliga metoder. I projektet har appen Sadima utvecklats i två versioner, en första testversion och sedan en andra version som ut­for­mats som en webbsida. För ut­veck­lan­det av den första versionen av appen fick vi medel av Vinnova (2016–2019). Vi arbetade med barnmorskor och skapade en testapp som sedan revide­ra­des och förbättrades suc­ces­sivt genom forskning om kvinnornas och barnmorskornas er­faren­het av att använda samtalsstödet. Det befintliga stödets innehåll är patientsäkrat av läkare och barnmorskor i Region Kalmar. 

    Vi har mätt funktiona­liteten i samtalsstödet genom iterativa tester, en­käter och fokusgrupper med barnmorskor och arabisktalande kvinnor, där stödets information har pro­ble­ma­tiserats; det har gällt etnicitet (språk och kultur), klass (utbildning) och jämlikhet mellan kvinnor. Mät­ningarna har granskats och utvärde­rats av referensgruppen för bedömning av funktiona­liteten hos samtalsstödet. Grup­pen har bedömt att samtalsstödet bidragit till bättre förståelse, ökad patient­säkerhet och effektivare vård. 

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  • 102.
    Calling, Susanna
    et al.
    Lund University, Sweden.
    Thulesius, Hans
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Lund University, Sweden;Region Kronoberg, Sweden.
    Randomised control trials using short messaging services (SMS) in hypertension treatment - convenient telemedicine interventions2022In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 40, no 4, p. 415-416Article in journal (Other academic)
  • 103.
    Caporuscio, Mauro
    et al.
    Linnaeus University, Faculty of Technology, Department of computer science and media technology (CM), Department of Computer Science.
    Weyns, Danny
    Linnaeus University, Faculty of Technology, Department of computer science and media technology (CM), Department of Computer Science. Katholieke Univ Leuven, Belgium.
    Andersson, Jesper
    Linnaeus University, Faculty of Technology, Department of computer science and media technology (CM), Department of Computer Science.
    Axelsson, Clara
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    IoT-enabled Physical Telerehabilitation Platform2017In: Proccedings of the International Workshop on Engineering IoT Systems: Architectures, Services, Applications, and Platforms, IEEE, 2017, p. 112-119Conference paper (Refereed)
    Abstract [en]

    Physical telerehabilitation services over the Internet allow physiotherapists to engage in remote consultation with patients at their homes, improving the quality of care and reducing costs. Traditional visual approaches, such as webcams and videophones, are limited in terms of precision of assessment and support for assistance with exercises. In this paper, we present a Physical Telerehabilitation System (PTS) that enhances video interaction with IoT technology to monitor the position of the body of patients in space and provide smart data to physiotherapists and users. We give an overview of the architecture of the PTS and evaluate (i) its usability based on a number of interviews and focus groups with stakeholders, and (ii) its technical efficiency based on a series of measurements. From this evaluation, we derive a number of challenges for further improvement of the PTS and outline a possible solution based on a microservices architecture.

  • 104.
    Carlbom, Frida
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Påverkar linsbärande graden av CVS hos den Svenska befolkningen2021Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 105.
    Carlgren, Linnéa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Den toriska kontaktlinsens rotation på ögat: Prismaballast vs. Accelerated stabilization design2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att jämföra stabiliseringsmetoderna prismaballast och ”accelerated stabilization design” på mjuka toriska korttidslinser. Detta genom att observera om någon av metoderna hade en stabilare inklination när huvudet lutades i 45 samt 90 grader.

    Metod: I studien deltog 22 personer i åldern 13-34 år. Mätningarna genomfördes på 18 högerögon och 15 vänsterögon med astigmatism mellan -0,75 D och -2,50 D. Kontaktlinserna som testades var månadslinsen Biofinity® Toric (prismaballast) och tvåveckorslinsen Acuvue® Oasys® for Astigmatism (”accelerated stabilization design”). Ett biomikroskop användes för att mäta inklinationen på linserna i upprätt läge samt huvudlutning 45 och 90 grader.

    Resultat: Resultatet av denna studie visar att det inte fanns någon statistisk signifikant skillnad i linsrotation mellan stabiliseringsmetoderna prismaballast och ”accelerated stabilization design”, i huvudlutning 45 grader (p = 0,49) eller i 90 grader (p = 0,07) på höger öga. Inte heller på vänster öga fanns någon signifikant skillnad i 45 grader (p = 0,59) eller i 90 grader (p = 0,57). Däremot fanns det en signifikant skillnad för den enskilda linsssortens inklination mellan 0 och 90 graders huvudlutning för båda linssorterna på höger samt vänster öga (p < 0,05). Mellan 0 och 45 graders huvudlutning sågs endast en signifikant skillnad i inklination för Acuvue Oasys for Astigmatism på höger öga och vänster öga (p < 0,05). Biofinity Toric var inte signifikant mellan 0 och 45 graders huvudlutning på något öga (p = 0,13).

    Slutsats: Det fanns ingen skillnad i linsrotation mellan stabiliseringsmetoderna prismaballast och ”accelerated stabilization design”. Däremot sågs en skillnad i linsinklination vid 90 graders huvudlutning, jämfört med upprätt position, för båda enskilda linssorter. Detta visar att när en individ lutar huvudet vrider sig linsen.

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  • 106.
    Carlsson, Elina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jämförelse av tre instrument för topografiska mätningar på cornea2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att jämföra mätvärden från tre instrument som används för topografiska mätningar på två olika patientgrupper: en med friska ögon och en med corneala tillstånd. Instrumenten som användes var Javal Schiøtz keratometer, Topcon CA-200 topograf och Bon Sirius Scheimpflugkamera.

    Material och metod: Tre mätningar med respektive topograf och en mätning med keratometern utfördes på samtliga 27 patienter som deltog i studien och sammanlagt 54 ögon mättes av. Medelåldern på deltagarna med friska ögon (Grupp 1) var 25 år (21-44 år) och på de med corneala tillstånd (Grupp 2) var medelåldern 34,4 år (22-58 år). Krökningsradie, styrka och gradtal på de två huvudmeridianerna mättes med keratometern. Vid mätning med topograferna noterade värden från Sim-k och för 3, 5 och 7mm; dessa värden jämfördes sedan med varandra. Keratometern jämfördes med topografernas Sim-k värden.

    Resultat: Resultatet av studien visar ingen signifikant skillnad mellan de tre instrumenten (p=0,48 1-vägs ANOVA för upprepade mätningar) varken för Grupp 1 eller Grupp 2. Sim-k värden som visar astigmatism var lägst enligt Topcon för samtliga mätområden (Sim-k, 3, 5 och 7mm). Bon Sirius visade högre grader av uppmätt astigmatism än Topcon, men lägre än de uppmätta med keratometern. Korrelationen mellan instrumenten var bra för 5mm-zonen och visade signifikant skillnad för Grupp 2 (p=0,03). Jämförelse mellan Javal keratometer och Sirius visade också signifikant skillnad för Grupp 2 (p=0,02). Javal keratometer visade högst standardavvikelse av samtliga instrument.

    Slutsats: Det fanns ingen signifikant skillnad mellan de olika instrumenten, med undantag för jämförelse mellan Sim-k-värden för Javal keratometer och Bon Sirius topograf, samt för 5mm-zonen mellan Topcon CA-200 och Bon Sirius i gruppen med corneala dystrofier. Detta visar att instrumenten är jämförbara när ögonen inte lider av extrema, onormala formförändringar.

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  • 107.
    Carlsson, Martin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital, Sweden.
    Brudin, Lars
    Kalmar County Hospital, Sweden;University Hospital Linköping, Sweden.
    Wanby, Pär
    Kalmar County Hospital, Sweden.
    Directly measured free 25-hydroxy vitamin D levels show no evidence of vitamin D deficiency in young Swedish women with anorexia nervosa2018In: Eating and Weight Disorders, ISSN 1124-4909, E-ISSN 1590-1262, Vol. 23, no 2, p. 247-254Article in journal (Refereed)
    Abstract [en]

    Purpose Anorexia nervosa (AN) is an eating disorder characterized by low fat mass complicated by osteoporosis. The role of circulating vitamin D in the development of bone loss in AN is unclear. Fat mass is known to be inversely associated with vitamin D levels measured as serum levels of total, protein-bound 25-hydroxyvitamin D, but the importance of directly measured, free levels of 25(OH)D has not been determined in AN. The aim of this study was to investigate vitamin D status, as assessed by serum concentrations of total and free serum 25(OH)D in patients with AN and healthy controls. Methods In female AN patients (n = 20), and healthy female controls (n = 78), total 25(OH)D was measured by LC-MS/MS, and free 25(OH)D with ELISA. In patients with AN bone mineral density (BMD) was determined with DEXA. Results There were no differences between patients and controls in total or free S-25(OH)D levels (80 +/- 31 vs 72 +/- 18 nmol/L, and 6.5 +/- 2.5 vs 5.6 +/- 1.8 pg/ml, respectively), and no association to BMD was found. In the entire group of patients and controls, both vitamin D parameters correlated with BMI, leptin, and PTH. Conclusions The current study did not demonstrate a vitamin D deficiency in patients with AN and our data does not support vitamin D deficiency as a contributing factor to bone loss in AN. Instead, we observed a trend toward higher vitamin D levels in AN subjects compared to controls. Measurement of free vitamin D levels did not contribute to additional information.

  • 108.
    Carlsson, Martin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital.
    Nilsson, Ingela
    Kalmar County Hospital.
    Brudin, Lars
    Kalmar County Hospital ; Linköping University Hospital.
    Von, Siv-Ping
    Kalmar County Hospital.
    Wanby, Pär
    Kalmar County Hospital.
    Erythrocyte fatty acid composition does not influence levels of free, bioavailable, and total 25-hydroxy vitamin D2017In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 77, no 1, p. 45-52Article in journal (Refereed)
    Abstract [en]

    In vitro, mono- and polyunsaturated fatty acids (FAs) may decrease the binding affinity of vitamin D metabolites for vitamin D-binding protein, which in turn may influence their bioavailability. FAs incorporated as phospholipids in erythrocyte (ery-) cell membranes reflect dietary intake. The purpose of this study was to investigate ery-FA composition in relation to markers for vitamin D. In healthy females (age 22.6 +/- 2.0 years) total 25(OH)D was measured by LC-MS/MS (n=78), free 25(OH)D with ELISA (n=64 of 78), and bioavailable 25(OH)D was calculated. Analysis of ery-FA composition was by gas chromatography (n=56 of 78). A strong correlation between total 25(OH)D and free 25(OH)D was seen (r=.66, p<.001), and between total-25(OH)D and bioavailable 25(OH)D (r=.68, p<.001). No correlations between 25(OH)D fractions and specific fatty acids were found, and in particular, no associations with mono- and poly-unsaturated FA compositions. All 25(OH)D fractions were correlated with leptin (total 25(OH)D (r=-.33, p<.003); bioavailable 25(OH)D (r=-.47, p<.001); free 25(OH)D (r=-.44, p<.001). Associations were found between PTH and total 25(OH)D (r=-.35, p=.002) and weaker between bioavailable 25(OH)D (r=-.35, p=.040) and free 25(OH)D (r=-.28, p=.079). All fractions of 25(OH)D appear to correlate in a similar way to PTH, BMI and body fat (leptin). No association was found between ery-FA composition and free/bioavailable 25(OH)D. It is unlikely that FAs are a strong uncoupling factor of DBP-bound 25(OH)D.

  • 109.
    Carlsson, Martin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital.
    Wanby, Pär
    Kalmar County Hospital.
    Brudin, Lars
    Linköping University;Kalmar County Hospital.
    Lexne, Erik
    Kalmar County Hospital.
    Mathold, Karin
    Kalmar County Hospital.
    Nobin, Rebecca
    Kalmar County Hospital.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Nordqvist, Ola
    Kalmar County Council.
    Petersson, Göran
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden2016In: Nutrients, E-ISSN 2072-6643, Vol. 8, no 11, article id 717Article in journal (Refereed)
    Abstract [en]

    Controversy pervades the definition of adequate and optimal vitamin D status. The Institutes of Medicine have recommended serum 25(OH) D levels above 50 nmol/L based upon evidence related to bone health, but some experts, including the Endocrine Society and International Osteoporosis Foundation, suggest a minimum serum 25(OH) D level of 75 nmol/L to reduce the risk of falls and fractures in older adults. In a cross-sectional study, we compared vitamin D status in people >= 75 years selected from four groups with a frailty phenotype, combined with a control group free from serious illness, and who considered themselves completely healthy. Only 13% of the 169 controls were vitamin D deficient (S-25(OH) D) < 50 nmol/L), in contrast with 49% of orthopedic patients with hip fractures (n = 133), 31% of stroke patients (n = 122), 39% of patients visiting the hospital's emergency department >= 4 times a year (n = 81), and 75% of homebound adult residents in long-term care nursing homes (n = 51). The mean vitamin D concentration of the healthy control group (74 nmol/L) was similar to a suggested optimal level based on physiological data and mortality studies, and much higher than that of many officially recommended cut-off levels for vitamin D deficiency (< 50 nmol/L). The present study provides a basis for planning and implementing public guidelines for the screening of vitamin D deficiency and vitamin D treatment for frail elderly patients.

  • 110.
    Carrasco, Daniel
    et al.
    Lund University, Sweden;Skåne University Hospital, Sweden.
    Thulesius, Hans
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Region Kronoberg, Sweden;Lund University, Sweden.
    Jakobsson, Ulf
    Lund University, Sweden.
    Memarian, Ensieh
    Lund University, Sweden;Skåne University Hospital, Sweden.
    Primary care physicians' knowledge and attitudes about obesity, adherence to treatment guidelines and association with confidence to treat obesity: a Swedish survey study2022In: BMC Primary Care, E-ISSN 2731-4553, Vol. 23, no 1, article id 208Article in journal (Refereed)
    Abstract [en]

    Background Obesity is a chronic disease with increasing prevalence. We aimed to explore primary care physicians' knowledge and attitudes about obesity and how knowledge and attitudes are associated with confidence and adherence to obesity guidelines and barriers to obesity treatment. Methods A questionnaire survey was sent by e-mail to 1642 primary care physicians in four regions in Sweden. The survey focused on the physicians' knowledge, attitudes towards obesity, confidence in obesity management, adherence to obesity guidelines and barriers to optimal care. We created different statistical indices for knowledge, attitudes and adherence. To analyse the correlation between these indices, we used linear regression analyses. Results Replies from 235 primary care physicians yielded a response rate of 14.3%. Most physicians answered correctly that obesity is a disease (91%), that obesity regulation sits in the hypothalamus (70%) and that obesity is due to disorders of appetite regulation (69%). However, 44% of the physicians thought that the most effective weight reduction method for severe obesity was lifestyle changes; 47% believed that obesity is due to lack of self-control, 14% mentioned lack of motivation and 22% stated laziness. Although 97% believed that physicians can help individuals with obesity and 56% suggested that obesity treatment should be prioritised, 87% of the physicians expressed that losing weight is the patients' responsibility. There was a positive association between higher knowledge and better adherence to obesity guidelines (B = 0.07, CI 0.02-0.12, p-value = 0.005) and feeling confident to suggest medication (p < 0.001) or bariatric surgery (p = 0.002). While 99% of the physicians felt confident to discuss lifestyle changes, 67% and 81% were confident to suggest medication or bariatric surgery, respectively. Respondents perceived that the greatest barrier in obesity management was lack of time (69%) and resources (49%). Conclusion There was a positive association between Swedish primary care physicians' knowledge and adherence to obesity guidelines and being more confident to suggest obesity treatment. Yet, many physicians had an ambivalent attitude towards obesity management.

  • 111.
    Cederborg, Ida
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Kan Knaves synergonomiska enkät användas för att se skillnad i ögon, muskel- och ledbesvär efter en kortare period?2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to investigate if vision ergonomics advice, could improve eye, muscles and joint symptoms.

    The participants worked at Profil Gruppen. They all worked in front of a computer part of the day. This study included 15 participants, 9 men and 6 women. The average age was 44 years. They did not need to have any glasses or lenses, the only criteria was that they worked in front of a computer.

    The participants answered Knave’s questionnaire about eye, muscles and joint symptoms, illumination at work and some general health questions. A visit was made at the participants’ workplace. During the visit the illuminance, luminance, distance to the screen, the horizontal line of sight to the screen and the size on the letters were measured. The workers were also given advice about improved ergonomics. Three weeks after the visit they answered two of the questions from the questionnaire again, to compare if the eye, muscles and joint symptoms had changed. One of the participants did not answer the questionnaire the second time and therefore is not included in the study.

    The median for eye discomfort were 1.5 before the visit and 1 after. The median for muscle and joint discomfort were 3 before and 4 after the visit.

    A Wilcoxon test were performed and it shows that there is no significant difference before and after the vision ergonomics recommendations.

    This study shows that there is no major difference in the symptoms after vision ergonomics advice have been given to the participants.

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  • 112.
    Cedergren, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Restrefraktion och visus för myoper efter LASEK (Laser-assisted epithelial keratomileusis)2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka om graden av myopi påverkar resultatet efter LASEK med avseende på restrefraktion och visus.

    Material och metod: Undersökningen är en retrospektiv studie som omfattar 124 ögon. Alla ögon hade myopi med sfärstyrka från -0,75 till -5,75 dioptrier (D) med en cylinderstyrka under -1,00 D. Restrefraktion och visus 12 månader efter LASEK analyserades och en jämförelse av resultaten gjordes mellan fem grupper med olika hög grad av myopi.

    Resultat: Majoriteten av ögonen (47,6%) som ingick i studien hade en absolut restrefraktion på nära ±0,00 D och hela 92,8% av ögonen hade en restrefraktion på ±0,50 D eller mindre efter behandling. Inga ögon hade en restrefraktion som var över ±1,00 D. Efter LASEK behandlingen hade 75% av ögonen fri visus på 1,0 eller bättre och 97,6% hade fri visus 0,5 eller bättre. Det var ingen signifikant skillnad i restrefraktion efter LASEK mellan de fem grupperna med olika hög grad av myopi.

    Slutsats: LASEK är en effektiv och förutsägbar metod för behandling av myoper med sfärstyrkor upp till -5,75 D med cylinderstyrkor under -1,00 D. Majoriteten fick en god visus efter behandlingen, dock skulle visus kunna förbättras ytterligare vilket visar att det finns utrymme för förfining inom tekniken. 

  • 113.
    Chakraborty, Ranjay
    et al.
    Flinders University, Australia.
    Collins, Michael J.
    Queensland University of Technology, Australia.
    Kricancic, Henry
    Queensland University of Technology, Australia.
    Davis, Brett
    Queensland University of Technology, Australia.
    Alonso-Caneiro, David
    Queensland University of Technology, Australia.
    Yi, Fan
    Queensland University of Technology, Australia.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    The effect of intrinsically photosensitive retinal ganglion cell (ipRGC) stimulation on axial length changes to imposed optical defocus in young adults2023In: Journal of Optometry, ISSN 1888-4296, Vol. 16, no 1, p. 53-63Article in journal (Refereed)
    Abstract [en]

    Purpose: The intrinsically photosensitive retinal ganglion cells (ipRGCs) regulate pupil size and circadian rhythms. Stimulation of the ipRGCs using short-wavelength blue light causes a sustained pupil constriction known as the post-illumination pupil response (PIPR). Here we examined the effects of ipRGC stimulation on axial length changes to imposed optical defocus in young adults.

    Materials and methods: Nearly emmetropic young participants were given either myopic (+3 D, n = 16) or hyperopic (-3 D, n = 17) defocus in their right eye for 2 h. Before and after defocus, a series of axial length measurements for up to 180 s were performed in the right eye using the IOL Master following exposure to 5 s red (625 nm, 3.74 × 1014 photons/cm2/s) and blue (470 nm, 3.29 × 1014 photons/cm2/s) stimuli. The pupil measurements were collected from the left eye to track the ipRGC activity. The 6 s and 30 s PIPR, early and late area under the curve (AUC), and time to return to baseline were calculated.

    Results: The PIPR with blue light was significantly stronger after 2 h of hyperopic defocus as indicated by a lower 6 and 30 s PIPR and a larger early and late AUC (all p<0.05). Short-wavelength ipRGC stimulation also significantly exaggerated the ocular response to hyperopic defocus, causing a significantly greater increase in axial length than that resulting from the hyperopic defocus alone (p = 0.017). Neither wavelength had any effect on axial length with myopic defocus.

    Conclusions: These findings suggest an interaction between myopiagenic hyperopic defocus and ipRGC signaling.

  • 114.
    Chakraborty, Ranjay
    et al.
    Flinders University, Austria.
    Collins, Michael J.
    Queensland University of Technology, Australia.
    Kricancic, Henry
    Queensland University of Technology, Australia.
    Moderiano, Daniel
    Flinders University, Austria.
    Davis, Brett
    Queensland University of Technology, Australia.
    Alonso-Caneiro, David
    Queensland University of Technology, Australia.
    Yi, Fan
    Queensland University of Technology, Australia.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    The intrinsically photosensitive retinal ganglion cell (ipRGC) mediated pupil response in young adult humans with refractive errors2022In: Journal of Optometry, ISSN 1888-4296, Vol. 15, no 2, p. 112-121Article in journal (Refereed)
    Abstract [en]

    Purpose The intrinsically photosensitive retinal ganglion cells (ipRGCs) signal environmental light, with axons projected to the midbrain that control pupil size and circadian rhythms. Post-illumination pupil response (PIPR), a sustained pupil constriction after short-wavelength light stimulation, is an indirect measure of ipRGC activity. Here, we measured the PIPR in young adults with various refractive errors using a custom-made optical system. Methods PIPR was measured on myopic (−3.50 ± 1.82 D, n = 20) and non-myopic (+0.28 ± 0.23 D, n = 19) participants (mean age, 23.36 ± 3.06 years). The right eye was dilated and presented with long-wavelength (red, 625 nm, 3.68 × 1014 photons/cm2/s) and short-wavelength (blue, 470 nm, 3.24 × 1014 photons/cm2/s) 1 s and 5 s pulses of light, and the consensual response was measured in the left eye for 60 s following light offset. The 6 s and 30 s PIPR and early and late area under the curve (AUC) for 1 and 5 s stimuli were calculated. Results For most subjects, the 6 s and 30 s PIPR were significantly lower (p < 0.001), and the early and late AUC were significantly larger for 1 s blue light compared to red light (p < 0.001), suggesting a strong ipRGC response. The 5 s blue stimulation induced a slightly stronger melanopsin response, compared to 1 s stimulation with the same wavelength. However, none of the PIPR metrics were different between myopes and non-myopes for either stimulus duration (p > 0.05). Conclusions We confirm previous research that there is no effect of refractive error on the PIPR.

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  • 115.
    Citron, Christer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Jämförelse mellan progressiva glasögonglas: Är Free-form bättre än konventionella?2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att jämföra upplevelsen av synfältsbredden och komforten i två olika progressiva glasögonglas med samma grunddesign, men som slipats enligt olika tekniker: Konventionell teknik och Free-form teknik.

    Metod: 16 personer med glasögonrefraktion inom ± 2,5 dioptrier, sfärisk ekvivalent deltog i studien. Könsfördelningen var 9 kvinnor och 7 män i åldrar från 43 till 74 år. Deltagarna fick först svara på ett antal allmänna frågor om glasögonvana mm. Därefter fick var och en testa ett par glasögon med den ena typen av progressivt glas i fem dagar, för att sen få prova den andra typen också i fem dagar. Testerna gjordes så att hälften fick börja med typ 1 och andra hälften med typ 2 utan att veta vilken man provade. Efter varje test utvärderades glasögonglasen med frågeformulär och mätning av synfältsbredden på 40 cm.

    Resultat: Det var ingen signifikant skillnad mellan synfältsbredd och komfort i progressiva glasögonglas av konventionell design ”Gamma” och Free-form design ”Gamma HD”.

    Slutsats: De flesta deltagare i den här studien upplever ingen större skillnad mellan progressiva glas med konventionell design ”Gamma” eller Free-form design ”Gamma HD” och är mycket nöjda generellt med komforten.

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  • 116.
    Cronelöv, Mathilda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förekomst av corneal och conjunctival hyperfluorescens associerad till skötselprodukter i kombination med kontaktlinsen Biofinity2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to evaluate if a greater amount of preservative-associated transient hyperfluorescence (PATH) is appearing when using a multipurpose-solution compared to using a hydrogen peroxide system as a cleaning and disinfecting scheme for contact lenses.

     

    The subjects who participated in this study were contact lens wearers and had healthy eyes. Subjects were fitted with the soft contact lens Biofinity. The cornea and conjunctiva were examined with and without the color agent fluorescein using a slit lamp. The subjects received two different contact lens care systems: Refine One Step and BioTrue. The subjects were randomly assigned which lens that would go with which care system. The subjects came back the next day after having the contact lenses in the eyes for two hours. The contact lenses were removed, and fluorescein was instilled in order to grade corneal and conjunctival staining with the slit lamp. The contact lenses were then inserted again. The subject then came back after having the contact lenses in the eyes for four hours and another grading of corneal and conjunctival staining with the slit lamp was made. Seven and fourteen days later the subjects came back for the same procedure as day two.

     

    Mean values for PATH when using both of the contact lens solutions (BioTrue and Refine One Step) were calculated and a paired t-test was used to analyze the results: BioTrue visit 1-2 (p<0.05), 3-4 (p<0.05) and 5-6 (p<0.05); Refine One Step visit 1-2 (p=1), 3-4 (p=0.42) and 5-6 (p=1). This shows a statistically significant difference between PATH and PHMB-based contact lens solutions and silicone hydrogel contact lenses; no statistically significant difference between PATH and contact lens care system containing hydrogen peroxide in combination with a silicone hydrogel contact lens.

     

    PATH is appearing when combining a silicone hydrogel contact lens together with a multipurpose solution containing the preservative agent PHMB but gave no decreased comfort. In the clinical work PATH is non-significant, the presence of PATH does not show bio incompatibility between silicone hydrogel lenses and preservative agents but is simply the fluorescein which binds to the preservative agent PHMB.

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  • 117.
    Csobod, Sylvia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förändringar av tårfilmens osmolaritet mellan morgon och kväll hos personer utan symptom på torra ögon2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this study was to determine if there is an diurnal variation in tear osmolarity among healty non dry-eye subjects.

    Method: The osmolarity of the tearfilm was measured in a total of 30 subjects twice a day; morning and evening, using the TearLabTM osmolarity system. Measurements were performed on both right and left eye in all the subjects. All subjects were asked to fill in a symptom questionnaire named TERTC-DEQ and only those with a total score of  17 points were allowed to participate in the study. Subjects below this score had therefore no symptoms of dry eye.

    Results: There was no statistical significant difference between the subjects tear osmolarity comparing the morning and evening values (P>0,05).

    Conclusion: This study did not show any difference in the subjects tear osmolarity, comparing morning and evening measurements. None of the individuals had any symptoms of dry eye. Therefore it is believed that in subjects with no symptoms of dry eye, the tear osmolarity remains stable between morning and evening. 

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  • 118.
    Dahlgren, Rebecka
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Olofsson, Luisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Reading performance in children obtained with MNREAD acuity chart: Normative data2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 119.
    Dahlén Ölander, Linn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Vårdpersonals upplevelser inför omställning till digifysisk vård inom öppenvårdspsykiatri: En studie med kvalitativ ansats som undersöker möjligheter och hinder.2022Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background:  In Sweden, a digital transition is sought where digital and physical care, Digi-physical healthcare, are integrated into public health care. A digital transition is one approach to meet the increasing need for health services that significantly challenges the health system but also aims to achieve increased patient participation.

    The digital transformation of care and the integration of e-mental health is still in its infancy in public psychiatry. This is despite growing evidence, progress in development, and access to digital tools, a pandemic that has pushed through barriers and increased acceptance of Digi-physical healthcare. A prerequisite for the integration of Digi-physical healthcare as a routine in public psychiatry depends on the acceptance of health care professionals.

    Aim: This study aims to investigate barriers and facilitators, as perceived by health care professionals, for implementing a combination of physical and digital care in Swedish public psychiatry.  

    Methods: Participants were health care professionals active in public outpatient psychiatry in a region in Southern Sweden. A web-based questionnaire with open and closed questions was designed. Collected data was analyzed with qualitative content analysis based on a deductive approach using the Theoretical Domains Framework (TDF).

    Results: Based on the TDF framework, barriers and enablers that influence mental health care professionals to apply the distance format as a way of working were identified. The result`s high agreement with previous research, suggests that identified TDF domains can be used to strengthen the acceptance and implementation of Digi-physical healthcare within psychiatric outpatient care. 

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  • 120.
    Dalsten Hjort, Anna
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sjuksköterskors erfarenhet av strukturerad dokumentation i primärvården2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Svensk sjukvård har stora pågående förändringar som att flertalet av regionerna håller på att byta ut sina informationssystem. I bytet av informationssystem ska dokumentationen bli mer strukturerad och standardiserad för att den ska bli mer effektiv, säker och av högre kvalité. En del av astma- och KOL-sjuksköterskor arbetar redan idag med en strukturerad dokumentationsmall då en del av deras dokumentationsinformation över går över till kvalitetsregistret Luftvägsregistret. Att undersöka deras erfarenheter kan ge värdefull kunskap inför en bredare implementering. 

    Syfte: Att undersöka sjuksköterskors erfarenheter av strukturerad dokumentation i primärvården i mötet med astma- och KOL-patienter med fokus på patientsäkerhet, jämlik vård, tidssparande arbetssätt, vårdkvalitet, professioners autonomi.

    Metod: Semistrukturerade intervjuer genomfördes med nio astma-och KOL-sjuksköterskor som arbetade i primärvården och hade ett befintligt informationssystem som möjliggjorde direktöverföring till Luftvägsregistret. Deduktiv ansats användes med de bärande begreppen: patientsäkerhet, tidssparande arbetet, vårdkvalitet, jämlik vård, professioners autonomi användes när materialet bearbetades med hjälp av kvalitativ innehållsanalys.

    Resultat: Resultatet visade sammanfattningsvis att strukturerad dokumentation kan vara ett stöd för sjuksköterskorna i deras dagliga vardag då dokumentationsmallen hjälpte dem att komma ihåg vad de skulle fråga patienten om. Dokumentationsmallen upplevdes som omfattande och kunde vara tidskrävande som ny men efter ett tag var erfarenheten att den var tidssparande. Nationella riktlinjer och standardiserade dokumentationsmallar upplevdes av de flesta som stödjande att ge patienterna en god vård. Det krävs dock en yrkesprofessionalitet som yttrar sig i erfarenhet och kunskap för att veta när de kan frångå riktlinjer och hoppa över sökord i strukturerade dokumentationsmallar. 

    Slutsats: Sjuksköterskors erfarenheter av att arbeta med strukturerad dokumentation visar fördelar men också utmaningar när det gäller patientsäkerhet, jämlik vård, tidssparande arbetssätt, vårdkvalitet samt professioners autonomi. Resultatet från studien tillsammans med det teoretiska ramverket kan bidra med underlag till det kommande implementeringsarbetet.

  • 121.
    Danielsson, Emma
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Fredriksson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sambandet mellan ackommodativ respons och ametropi hos barn under en ettårsperiod2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 122.
    Danielsson, Tom
    et al.
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital, Sweden.
    ten Siethoff, Lasse
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science. The Swedish School of Sport and Health Sciences, Sweden.
    Ahnesjö, Jonas
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Bergman, Patrick
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Faculty of Social Sciences, Department of Sport Science. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Aerobic capacity predict skeletal but not cardiac muscle damage after triathlon: the Iron(WO)man study2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, p. 1-7, article id 901Article in journal (Refereed)
    Abstract [en]

    This study examines the association between aerobic capacity and biomarkers of skeletal- and cardiac muscle damage among amateur triathletes after a full distance Ironman. Men and women (N = 55) were recruited from local sport clubs. One month before an Ironman triathlon, they conducted a 20 m shuttle run test to determine aerobic capacity. Blood samples were taken immediately after finishing the triathlon, and analyzed for cardiac Troponin T (cTnT), Myosin heavy chain-a (MHC-a), N-terminal prohormone of brain natriuretic peptide (NT-proBNP), Creatin Kinas (CK), and Myoglobin. Regression models examining the association between the biomarkers and aerobic capacity expressed in both relative terms (mLO2*kg−1*min−1) and absolute terms (LO2*min−1) controlled for weight were fitted. A total of 39 subjects (26% females) had complete data and were included in the analysis. No association between aerobic capacity and cardiac muscle damage was observed. For myoglobin, adding aerobic capacity (mLO2*kg−1*min−1) increased the adjusted r2 from 0.026 to 0.210 (F: 8.927, p = 0.005) and for CK the adjusted r2 increased from -0.015 to 0.267 (F: 13.778, p = 0.001). In the models where aerobic capacity was entered in absolute terms the adjusted r2 increased from 0.07 to 0.227 (F: 10.386, p = 0.003) for myoglobin and for CK from -0.029 to 0.281 (F: 15.215, p < 0.001). A negative association between aerobic capacity and skeletal muscle damage was seen but despite the well-known cardio-protective health effect of high aerobic fitness, no such association could be observed in this study.

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  • 123.
    De Bie, Ellinor
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalensen av hyperopi och astigmatism hos barn med ospecifika läs- och skrivsvårigheter respektive barn med dyslexi.2014Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
    Abstract [sv]

    Syfte:Målet med studien var att undersöka om prevalensen av hyperopi (och inducerad hyperopi) och astigmatism skiljer sig mellan barn med dyslexi och barn med ospecifika läs- och skrivsvårigheter. Blir de hjälpta av eventuell korrektion?

    Metod:Skolpedagoger i Kalmar, Nybro och Mörbylånga lämnade ut inbjudan för synundersökning till barn med läs-och skrivsvårigheter.Synundersökninanra genomfördes på C-optik synklinik i Kalmar.Tjugofyra barn med ospecefika läs- och skrivsvårigheter och nio barn med dyslexi deltog i undersökningen . En tid efter synundersökningen kontaktades förädrar för en uppföljningsintervju.

    Resultat: Jämförelse mellan grupperna visade ingen skillnad med avseende refraktion. Alla barn som deltog förutom ett, ordinerades korrektion för hyperopi. Ett barn var myopt med inducerad hyperopi.

    Samtliga barn förutom ett ordinerades korrektion för astigmatism.

    Efter en tid gjorde ett uppföljnings samtal till föräldrarna. Alla barn förutom ett använde sina glasögon. Många av barnen hade fått minskade besvär som var relaterade till okorrigerade synfel.

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  • 124.
    Demir, Pelsin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalence of refractive errors and incidence of myopia in Swedish schoolchildren2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Purpose

    The aim of this thesis was to investigate the prevalence, incidence, and risk factors for myopia development in a cohort of Swedish schoolchildren. The specific goals were: - to recruit a cohort of children aged 8 to 16 years and to follow the cohort over a period of 24 months with regular study visits; - to investigate the predictive value of relative peripheral error and other optical parameters for the prevalence and incidence of myopia; - to determine and investigate the predictive value of genetic and environmental factors, and structural characteristics of the eye to the incidence of myopia.

    Methods

    This was a longitudinal study with a follow-up period of 2-years conducted at Linnaeus University in Kalmar. All participants underwent eye examinations and completed questionnaires at regular intervals during the follow-up period. Data analysis was performed assuming hypotheses such as: - myopia development is associated with genetic factors and environmental factors (Papers I and IV); - changes in refractive error over time are explained by multiple genetic and environmental factors (Paper IV) - instruments with different measurement principles can lead to different refraction results (Paper II); - there is a relationship between refractive error and the characteristics of the choroid (Exploratory study, not published) and the characteristics of the microvasculature of the retina (Paper III).

    Results

    A total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD=2.4). Paper I: based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95=38.8-56.7), emmetropia 42.0% (CI95=33.5-51.2) and myopia 10.0%. (CI95=4.4-14.9). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. Paper II: The Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. Paper III: The sample included 86 out of the 128 participants, 51 (59%) females. The area of the foveal avascular zone (AFAZ) was correlated with central vessel density, perfusion, foveal thickness and with fovea-to-macula thickness ratio. Paper IV: The cumulative incidence of myopia during the two-years was 5.5%, incidence rate of myopia was 3.2 cases per 100 person-years. Cox regression revealed that the probability of myopic shift reduced with “age” and increased with “axial length/corneal-curvature ratio”. Myopic children at the baseline and children with two myopic parents showed a significant faster-paced SER change over time.

    Conclusion

    The prevalence and incidence of myopia in Sweden was lower than expected when compared with countries in East Asia. Genetic factors such as parental myopia remains a critical factor to consider when predicting myopia onset and progression. Children born full-term and visual acuity within the normal range can have very different retinal microvasculature at the centre of the macula that may influence refractive error development. Future studies are necessary to find out possible relationships between vasculature, structural changes and refractive error development. In addition, more studies involving children from different ethnicities and incorporating longer follow-up period are necessary to increase our understanding of the incidence of myopia in Swedish schoolchildren.

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  • 125.
    Demir, Pelsin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Theagarayan, Baskar
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Gierow, Peter
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sankaridurg, Padmaja
    Univ New South Wales, Australia.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. Univ Minho, Portugal.
    Refractive error, axial length, environmental and hereditary factors associated with myopia in Swedish children2021In: Clinical and experimental optometry, ISSN 0816-4622, E-ISSN 1444-0938, Vol. 104, no 5, p. 595-601Article in journal (Refereed)
    Abstract [en]

    Clinical relevance: Investigation of refractive errors amongst Swedish schoolchildren will help identify risk factors associated with myopia development.Background: Genetic and hereditary aspects have been linked with the development of myopia. Nevertheless, in the case of ‘school myopia’ some authors suggest that environmental factors may affect gene expression, causing school myopia to soar. Additional understanding about which environmental factors play a relevant role can be gained by studying refractive errors in countries like Sweden, where prevalence of myopia is expected to be low.Methods: Swedish schoolchildren aged 8-16 years were invited to participate. Participants underwent an eye examination, including cycloplegic refraction and axial length (AL) measurements. Predictors such as time spent in near work, outdoor activities and parental myopia were obtained using a questionnaire. Myopia was defined as spherical equivalent refraction (SER) ≤ −0.50D and hyperopia as SER ≥ +0.75D.Results: A total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD = 2.4). Based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95 = 38.8-56.7), emmetropia 42.0% (CI95 = 33.5-51.2) and myopia 10.0%. (CI95 = 4.4-14.9). The mean AL was 23.1 mm (SD = 0.86), there was a correlation between SER and AL, r = −0.65 (p < 0.001). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. The mean time spent in near work, outside of school, was 5.3 hours-per-day (SD = 3.1), and mean outdoor time reported was 2.6 hours-per-day (SD = 2.2) for all the participants. The time spent in near work and outdoor time were different for different refractive error categories.Conclusion: The prevalence of myopia amongst Swedish schoolchildren is low. Hereditary and environmental factors are associated with refractive error categories. Further studies with this sample are warranted to investigate how refractive errors and environmental factors interact over time.

  • 126.
    Demir, Pelsin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hovsepian, Nathaniel
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Pagels, Peter
    Linnaeus University, Faculty of Social Sciences, Department of Sport Science.
    Petersson, Vanja
    Region Kalmar County, Sweden.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. University of Minho, Portugal.
    All retinas are not created equal: Fovea‐to‐macula thickness ratio and foveal microvasculature in healthy young children2022In: Ophthalmic & physiological optics, ISSN 0275-5408, E-ISSN 1475-1313, Vol. 42, no 3, p. 644-652Article in journal (Refereed)
    Abstract [en]

    Purpose: Markers for the relationships between structural and microvasculature measures given by optical coherence tomography angiography are necessary to increase the diagnostic and prognostic value of this technique. The aim of this study was to investigate relationships between structural and microvasculature measures around the fovea in healthy eyes of healthy children.

    Methods: Observational cross-sectional study involving children aged 8–17 years, born at full-term, with no eye disease. The better of two 3 × 3 mm macular scans obtained with a Cirrus 5000HD-OCT was analysed. Images were corrected for lateral magnification errors. Vessel density and perfusion were measured with ImageJ/Fiji software for the superficial capillary plexus. Structural measures including foveal and macular thicknesses were performed manually.

    Results: The sample included 86 participants, 51 (59%) females. Mean age was 12.4 years (SD = 2.5); mean best-corrected acuity was −0.10 logMAR (SD = 0.09); mean refractive error was +0.59 D (SD = 1.3) and mean axial length was 23.1 mm (SD = 0.86). Mean area of the foveal avascular zone (AFAZ) was 0.20 mm2 (SD = 0.88); median fovea-to-macula thickness ratio (FMTR) was 0.63 (IQR = 0.08); mean central vessel density was 12.42 mm−1 (SD = 2.78) and mean central perfusion was 38.66% (SD = 3.83). AFAZ was correlated with central vessel density (p < 0.001), perfusion (p < 0.001), foveal thickness (p < 0.001) and FMTR (p < 0.001). Central vessel density was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.01). Central perfusion was correlated with foveal thickness (p < 0.001) and FMTR, (p = 0.003).

    Conclusion: In this study, foveal thickness, FMTR and foveal microvasculature measurements were correlated. Clinicians need to be aware that shallow foveal pits and persistent foveal microvasculature are likely to occur in optical coherence tomography angiography images. In healthy eyes from healthy children, an atypical high FMTR and a small AFAZ may be associated with incomplete foveal development. The mechanism and functional implications of this remain unknown.

  • 127.
    Demir, Pelsin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Macedo, António Filipe
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health. University of Minho, Portugal.
    Chakraborty, Ranjay
    Flinders University, Australia.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Comparison of an open view autorefractor with an open view aberrometer in determining peripheral refraction in children2023In: Journal of Optometry, ISSN 1888-4296, Vol. 16, no 1, p. 20-29Article in journal (Refereed)
    Abstract [en]

    Purpose

    The aim of this study was to compare central and peripheral refraction using an open view Shin-Nippon NVision-K 5001 autorefractor and an open view COAS-HD VR aberrometer in young children.

    Methods

    Cycloplegic central and peripheral autorefraction was measured in the right eye of 123 children aged 8 to 16 years. Three measurements each were obtained with both Shin-Nippon NVision-K 5001 autorefractor and COAS-HD VR aberrometer along the horizontal visual field up to 30° (nasal and temporal) in 10° steps. The refraction from the autorefractor was compared with aberrometer refraction for pupil analysis diameters of 2.5-mm and 5.0-mm.

    Results

    The Shin-Nippon was 0.30 D more hyperopic than COAS-HD VR at 2.5-mm pupil and 0.50 D more hyperopic than COAS-HD VR at 5-mm pupil for central refraction. For both pupil sizes, the 95% limits of agreement were approximately 0.50 D for central refraction, and limits were wider in the nasal visual field compared to the temporal visual field. The mean difference for both J0 and J45 were within 0.15 D and the 95% limits of agreement within 0.90 D across the horizontal visual field.

    Conclusion

    Defocus components were similar between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 2.5-mm pupil for most visual field angles. However, there was a significant difference in defocus component between the Shin-Nippon autorefractor and the COAS-HD VR aberrometer with a 5.0-mm pupil, wherein the autorefractor measured more hyperopia. The astigmatic components J0 and J45 were similar between instruments for both central and peripheral refraction.

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  • 128.
    Edquist, Josefine
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalens av myopi i Guatemala: En studie utförd under en resa med hjälporganisationen Vision For All2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka prevalensen av myopi i Guatemala under en resa med hjälporganisationen Vision for All samt jämföra resultaten med andra delar av världen.

    Metod: All data samlades in under en resa med Vision For All till Guatemala i mars och april 2013. Städerna som besöktes var San Bartolome Becerra, San Miguel Dueñas, San Antonio Aguas Caliente, San Lucas Toliman, Panajachel, Fraijanes, San Juan Saquetepequez och La Esperansa. Innan undersökningarna ägde rum fylldes ett journalblad i med bl.a. ålder, kön, arbete inomhus/utomhus och arbete på nära/långt håll. Undersökningarna utfördes med hjälp av en Snellen E-hakesyntavla uppsatt på fem meters avstånd. Vid mätning av visus fick patienten visa med händerna åt vilket håll E hade sin öppning. Snellen E-hake tavla användes för språkbarriären mellan undersökarna och patienterna som inte kunde någon engelska. För att få fram rätt refraktion användes flipprar i olika styrkor. Först hölls en flipper med styrkan +1,00 D framför patientens ögon. Blev det bättre provades +1,50 D flipper och så vidare. Blev det ingen förbättring provades istället -0,50 D i provbågen för att se om patienten hade en närsynthet.

    Resultat: Totalt undersöktes 1430 patienter. Av dem var 207 personer myopa, (67 män och 140 kvinnor). Myopiprevalensen var 14,8 % bland försökspersonerna. Hos männen var prevalensen 14,2 % och hos kvinnorna var 14,6 % myopa. Refraktionsfelen hos försökspersonerna varierade från -0,25 till -14,00 D med en medelrefraktion på -1,70 D.

    Slutsats: Prevalensen av myopi i Guatemala är lägre än i andra delar av världen. En anledning till det kan vara mindre närarbete. Personerna i Guatemala ägnar inte lika mycket tid åt närarbete som i västvärlden och det har visats att mycket närarbete påverkar närsynthetsutvecklingen. Hereditet påverkar också närsynthetsförekomsten då myopi till viss del är ärftligt.

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    Josefine Edquist
  • 129.
    Eiermann, Birgit
    et al.
    Karolinska Institutet, Sweden.
    Hammar, Tora
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Wettermark, Björn
    Uppsala University, Sweden.
    Läkemedelsinformatik2021In: Medicinsk informatik / [ed] Petersson G., Rydmark M. och Thurin A., Stockholm: Liber, 2021, p. 245-261Chapter in book (Other academic)
    Abstract [sv]

    Kapitlet ger en översikt av kunskapsläget inom läkemedelsinformatik, med fokus på Sverige.

  • 130.
    Eisenschmidt, Karolina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Katarakt - Visus och subjektiv synupplevelse2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna studie var att undersöka om det är hög- eller lågkontrastvisus som påverkar kataraktpatienters subjektiva synupplevelse mest.

    Metod: Mätningarna utfördes på Kalmar länssjukhus i samband med patienternas förundersökning inför kataraktoperation. För att utvärdera patienternas synförmåga mättes visus med logaritmiska tavlor med tre olika kontraster, 100 %, 25 % och 5 %. Patienternas upplevda synförmåga utvärderades genom ett frågeformulär, Priquest, som används rutinmässigt i Sverige i samband med kataraktoperation. Samtliga mätningar utfördes med patientens habituella korrektion och patienterna var även fullt dilaterade på grund av att mätningarna skedde efter patienterna undersökts av en ögonläkare där dilatering var nödvändig.

    Resultat: 29 patienter medverkade i studien. Nio av dessa hade kortikal katarakt, 19 hade nukleär katarakt och tre patienter var diagnosticerade med bakre subkapsulär katarakt. Regressionsanalys utfördes mellan patienternas symptom och synskärpa för de olika kontrasterna inom varje katarakttyp. Det fanns ingen korrelation mellan symptom och synskärpa mätt med de olika kontrasterna varken binokulärt eller monokulärt för den kortikala katarakten oavsett kontrastmängd. Korrelationer fanns däremot binokulärt för den nukleära katarakten där synskärpa mätt med 5 % kontrast stämde bäst överrens med patienternas upplevda synförmåga (r = 0,60; p < 0,01). För patienterna med bakre subkapsulär katarakt utfördes ingen regressionsanalys på grund av det få deltagarantalet.

    Slutsats: För patienter med kortikal katarakt finns inget samband mellan patienternas symptom och synskärpa mätt med olika kontraster. För den nukleära katarakten fanns det tydligaste sambandet mellan symptom och synskärpa mätt med 5 % kontrast. Patienterna med bakre subkapsulär katarakt var för få för att några slutsatser ska kunna dras.

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  • 131.
    Ek, Anna
    et al.
    Karolinska Institutet, Sweden.
    Alexandrou, Christina
    Linköping university, Sweden.
    Söderström, Emmie
    Linköping university, Sweden.
    Bergman, Patrick
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Delisle Nyström, Christine
    Karolinska Institutet, Sweden.
    Direito, Artur
    National University of Singapore, Singapore.
    Eriksson, Ulf
    Strömstad Academy, Sweden.
    Henriksson, Pontus
    Linköping university, Sweden.
    Maddison, Ralph
    Deakin University, Australia.
    Trolle Lagerros, Ylva
    Karolinska Institutet, Sweden;Stockholm Health Services, Sweden.
    Bendtsen, Marcus
    Linköping university, Sweden.
    Löf, Marie
    Linköping university, Sweden;Karolinska Institutet, Sweden.
    Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial.2020In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 8, no 6, p. 1-15, article id e18531Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking.

    OBJECTIVE: The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA).

    METHODS: For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months.

    RESULTS: No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day.

    CONCLUSIONS: No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-018-5658-4.

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  • 132.
    Eklöf Johansson, Julia
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Undersökning av närforier-jämförelse mellan Maddox wing, Modifierad Thorington och von Graefe2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

     

     

  • 133.
    Ekman, Elisabet
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Pharmacovigilance: spontaneous reporting in health care2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Pharmacovigilance in healthcare is essential for safe drug treatment. Spontaneous reporting is the most common source of information in the context of implementing label changes and taking a drug off the market. However, underreporting is found to be very prevalent. One way to decrease underreporting is to include different categories of healthcare professionals in such reporting and to investigate attitudes towards and incentives for reporting adverse drug reaction (ADR)s.

    As nurses form the largest group of health professionals, a sample of nurses were allowed and encouraged to report ADR during a 12 month period after they had received training in pharmacovigilance. A questionnaire posted to physicians and nurses investigated their knowledge and attitudes towards reporting. Spontaneous reports of torsade de pointes (TdP) and erectile dysfunction (ED) were scrutinized with respect to the reported drugs, risk factors and if the reaction was listed in the summary of product characteristics (SPC).

    After training, the nurses produced relevant reports and three years after the introduction of nurses in the reporting scheme, more than half of the responding nurses were aware of their role as reporters. Both nurses and physicians stated that the most important factor for reporting a suspected ADR was the severity of the ADR and an ADR arising in response to a newly approved drug. A web-based reporting system was deemed to facilitate the reporting. In spontaneous reports of TdP, citalopram was reported as a suspected drug. However, neither QT prolongations, nor TdP, were labelled in the SPC. ED was reported for all antihypertensive drugs including angiotensin II type I blockers. A positive information component (IC), assessing the disproportionality between the observed and the expected number of reports, was found indicating that ED was reported more often in association with antihypertensive drug classes, except for angiotensinconverting enzyme inhibitors.

    This thesis demonstrates the importance of pharmacoviglilance in healthcare in terms of capturing new signals. By including nurses as reporters, the overall safety of drugs might improve. Information and education are needed to secure safe treatment when applying drugs.

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  • 134.
    Ekstedt, Mirjam
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Karolinska Institutet, Sweden.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Wennerberg, Camilla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Nilsson, Lina
    Linnaeus University, Faculty of Technology, Department of Informatics. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Wannheden, Carolina
    Karolinska Institutet, Sweden.
    Hellström, Amanda
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Enhanced patient activation in cancer care transitions: protocol for a randomized controlled trial of a tailored eectronic health intervention for men with prostate cancer2019In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 8, no 3, p. 1-13, article id e11625Article in journal (Refereed)
    Abstract [en]

    Background: Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose.

    Objective: This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activation, motivation, overall well-being, and health literacy over time in and between groups.

    Methods: A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80% power, a sample of 242 men will need to be recruited.

    Results: Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020.

    Conclusions: With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals.

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  • 135.
    Eksvärd, Susanna
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hultman, Annie
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Prevalensen av synrelaterade problem vid mörkerkörning och användningen av filterglas i relation till detta2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study was to investigate how widespread visionrelated problems are with nightdriving in Sweden and how the use of filter glasses looks in relation to this.

    Methods: Participants (n=339) were asked to answer a web-based questionnaire that dealt with questions related to nightdriving and filter glasses. The responses were then analyzed in Excel and SPSS using Mann-Whitney U test, Kruskal-Wallis H test, box plot and correlation.

    Results: The survey showed statistically significant differences in the relation between glare compared to problems with driving at night. There were also significant differences with the need for filter glasses and how much these helped in relation to glare and nightdriving.  

    Conclusion: In the study, most participants reported low to moderate problems when driving at night. Participants who experienced greater problems were fewer than those who did not experience any problems, or did not experience them as strongly. This study showed that there was a clear relationship between those who experienced the need for a solution when driving at night, such as filterglasses, and those who experienced problems with nightdriving. Since the study also showed a clear connection between problems when driving at night and the experiences of how filterglasses for night driving work, it would be wise to recommend filterglasses to those who feel the need for a solution.

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  • 136.
    Eldh, Ann Catrine
    et al.
    Linköping University, Sweden;Uppsala University, Sweden.
    Sverker, Annette
    Linköping University, Sweden.
    Bendtsen, Preben
    Linköping University, Sweden.
    Nilsson, Evalill
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Digital Transformations.
    Health Care Professionals' Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care: Qualitative Study.2020In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 7, no 4, article id e21698Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.

    OBJECTIVE: The objective of our study was to describe health care staff's experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.

    METHODS: In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.

    RESULTS: While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient's voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service-at least for a while-if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.

    CONCLUSIONS: A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.

  • 137.
    Elgstrand, Linnette
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Elm, Paulin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Förändringar i det ytliga kapillära nätverket och dess samband med fovea till makulaförhållandet2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Detta var en uppföljningsstudie där syftet var att jämföra det ytliga kapillära nätverkets (YKN:s) tjocklek mätt med ett års mellanrum hos friska skolbarn, samt jämföra det ytliga kapillära nätverkets tjocklek med blodkärlsdensiteten och fovea till makulaförhållandet för att bättre förstå foveas anatomi.

  • 138.
    Eliasson, Elin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Påverkas läshastigheten och valet av färgat overlay av ljusets färgtemperatur?2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka om ljusets färgtemperatur påverkar läshastigheten och valet av ett färgat overlay.

    Metod: I studien deltog 35 personer, 26 kvinnor och 9 män. Tre deltagare uteslöts då de inte klarade normalvärdena för de kliniska tester som genomfördes. De deltagare som klarade de kliniska testerna läste ett lästest under två ljuskällor med olika färgtemperatur, en varmvit och en neutralt vit. Testet lästes i en minut med och utan färgade overlays under båda ljuskällorna och antalet lästa ord noterades. Antalet lästa ord analyserades sedan med parade t-tester i Microsoft Excel. Även valet av färgade overlays sammanställdes och analyserades.

    Resultat: Det fanns ingen signifikant skillnad i läshastighet mellan ljuskällorna utan färgade overlays. Det fanns inte heller någon signifikant förbättring av läshastigheten med overlays. Det enda undantaget var att overlayet som valdes under den varmvita ljuskällan förbättrade läshastigheten under den neutralt vita ljuskällan med 2,5 %. Nio deltagare valde exakt samma overlay under båda ljuskällorna, 23 deltagare (72 %) valde overlay som skilde sig mellan ljuskällorna.

    Slutsats: Läshastigheten utan overlay påverkas inte av ljuskällans färgtemperatur. En majoritet av deltagarna valde olika färgade overlays under de båda ljuskällorna. Däremot syns ingen skillnad i läshastighet beroende på vilket färgat overlay som används till respektive ljuskälla.

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  • 139.
    Elofsson, Linn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Färgade kontaktlinsers påverkan på visus och okulära aberrationer2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of this study was to see if two different types of cosmetically tinted contact lenses affected the visual quality and higher order aberrations and if the results differed from clear lenses. Thirtyfive subjects were divided into three different groups where each group tested one type of contact lens. The lens types were tinted lenses with a clear zone of 5mm, tinted lenses with no clear zone and clear lenses with only a handling tint. Visual acuity and aberrations were measured at baseline, after 6 hours of lens wear and after removal of the lens. The measurements were made with a COAS-HD VR aberrometer and the results were analyzed by mixed model ANOVA. Visual acuity with lens wear for all the three groups reduced by 0.06 (clear lens), 0.10 (closed pupil) and 0.06 (open pupil) compared to the baseline acuity measurements without lens. After lens removal both the clear group and tinted with no clear zone group visual acuities returned to baseline values. Furthermore, visual acuity in the open pupil group after lens removal remained similar to that of lens wear and did not return to the baseline value. However, the reduction in visual acuity with lens wear was very minimal and there was no statistically significant change in visual acuity between lens wear condition and between the three groups (p>0.05). HOA RMS for clear lenses increased from 0.165 ± 0.04μm to 0.224 ± 0.05μm with lens and then decreased to 0.173 ± 0.03μm. Tinted with no clear zone group went from 0.149 ± 0.03μm to 0.240 ± 0.14μm and then decreased to 0.159 ± 0.05μm. Open pupil group started at 0.193 ± 0.05 μm increased to 0.398 ± 0.07μm and dropped to 0.203 ± 0.08μm. None of the three contact lens types used gave any significant reduction of visual acuity either when the lens was on or after it had been removed (p>0.05). The increase in the total amount of higher order aberrations was only significant when the lens was worn and we found significantly higher amount of aberrations in the open pupil design (p<0.05).

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  • 140. Elsner, Ann E.
    et al.
    Baskaran, Karthikeyan
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Gast, Thomas J.
    Muller, Matthew S.
    Litvin, Taras V.
    Ozawa, Glen Y.
    Cuadros, Jorge
    Underserved diabetic patients with refractive errors insufficient to lead to seeking eyecare2015Conference paper (Refereed)
    Abstract [en]

    Purpose: The increase in prevalence of diabetes is anticipated to increase the numbers of patients needing eye examinations. For our Phase II SBIR data, we reported that for > 2000 underserved diabetic patients in Alameda County, California, > 60% of patients reported no eye examination for at least 3 years despite that free photo diabetic retinopathy screenings were offered with follow on examination and eyecare. If eye screening for diabetic patients is not mandated, it becomes the responsibility of the patient or their primary care physician or endocrinologist to understand and act on the need for eye examinations. Methods: From the Alameda Health system of clinics, 197 diabetic patients agreed to be photoscreened for diabetic retinopathy. Our sample was enriched to have an increased probability of eye complications; thus, 26% had no apparent diabetic retinopathy; 38%, 17% and 4% had mild, moderate and severe non-proliferative diabetic retinopathy; and 13% had proliferative diabetic retinopathy. Of the 141 patients with diabetic retinopathy, 29% had bilateral CSME. Of the 132 diabetic patients (67 males and 65 females) returning for full eye exams, 52% were Hispanic, 21% African American, 14% Asian, and 8% NonHispanic Caucasian and Other, with an average age of 58.1 ± 9.4 years. Refractive errors were defined as spherical equivalent (SE) refraction, calculated as the spherical power plus one-half of the cylindrical power. Results: The overall mean spherical equivalent refraction M was −0.16 ± 1.50 D in the right eye (−6.0 D to +3.0 D) and +0.14 ± 1.35 D (−7.0 D to +4.0 D) in the left eye. Out of 132 patients, eight patients (6.1%) had visual acuity worse than 0.3 logMAR in both eyes. The right eyes of four patients and left eyes of eight patients had visual acuity worse than 0.3 logMAR, with fellow eyes having normal visual acuity. Conclusions: In a sample of largely minority, working age adults, there was very little refractive error and relatively good visual acuity when refracted, despite diabetic retinopathy or diabetic macular edema. Thus, working age diabetic patients may not regularly seek eye care for spectacle correction that would lead to the detection of diabetic retinopathy or diabetic macular edema.

  • 141.
    Emilsson, Maria
    et al.
    University West, Sweden.
    Berndtsson, Ina
    University West, Sweden.
    Gustafsson, Per A.
    Linköping University, Sweden.
    Horne, Robert
    University College London, UK.
    Marteinsdottir, Ina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Reliability and validation of Swedish translation of Beliefs about Medication Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with attention-deficit hyperactivity disorder2020In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 74, no 2, p. 89-95Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to assess the reliability and validity of Swedish translations of the Beliefs about Medicines Questionnaire-Specific (BMQ-Specific) and Brief Illness Perception Questionnaire (B-IPQ) for use in adolescents with ADHD. Methods: Forward and backward translations of the BMQ-Specific and B-IPQ scales to Swedish were conducted and reviewed by adolescents with ADHD and professionals. The validity and reliability of both questionnaires were investigated in a cross-sectional study of 101 adolescents (13?17?years) on a long-term prescription of ADHD medication recruited from two child and adolescent psychiatric outpatient clinics in Sweden. Results: Regarding the BMQ-Specific, principal component analysis (PCA) loadings confirmed the previously defined components of Specific-Necessity and Specific-Concern. The PCA for B-IPQ revealed two components, the first one, B-IPQ Consequences, captured questions regarding perceptions of the implication of having ADHD (items 1, 2, 5, 6 and 8) and the second one, B-IPQ-Control, the perceptions of the capability to manage the ADHD disorder (items 3, 4 and 7). The Cronbach alpha coefficients for BMQ-Specific-Necessity scale was ??=?0.80, for BMQ-Specific-Concern scale ??=?0.75, B-IPQ Consequences ??=?0.74 and for B-IPQ-Control ??=?0.44. Conclusions: The present results prove the Swedish translation of BMQ-Specific and B-IPQ to be valid and reliable for utilization in adolescents with ADHD. The PCA confirmed the original components for BMQ-Specific and the recent findings of two main B-IPQ components describing emotional and cognitive implications versus the capability for self-care maintenance of ADHD.

  • 142.
    Emilsson, Maria
    et al.
    University West, Sweden.
    Gustafsson, Per
    Linköping University, Sweden;Region Östergötland 3, Sweden.
    Öhnström, Gisela
    Linköping University, Sweden;Region Östergötland 3, Sweden.
    Marteinsdottir, Ina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Linnaeus University, Linnaeus Knowledge Environments, Sustainable Health.
    Impact of personality on adherence to and beliefs about ADHD medication, and perceptions of ADHD in adolescents2020In: BMC Psychiatry, E-ISSN 1471-244X, Vol. 20, no 1, p. 1-10, article id 139Article in journal (Refereed)
    Abstract [en]

    Background Adherence to attention deficit hyperactivity disorder (ADHD) medication can prevent serious consequences, possibly with lifelong effects. Numerous factors have been observed that influence adherent behaviour, but the impact of personality traits has been inadequately explored. The purpose of this study was to explore the associations between personality traits and adherence to ADHD medication, beliefs about the medication, and perceptions of ADHD. Method Adolescents (n = 99) on ADHD medication were administered: Health-Relevant Personality Traits Five-Factor Inventory, Medication Adherence Report Scale, Beliefs about Medicines Specific and Brief Illness Perceptions Questionnaires. Results The personality trait Antagonism correlated with adherence behaviour (r = - 0.198, p = 0.005) and perceived personal control of ADHD (r = - 0.269, p = 0.007). Negative Affectivity correlated with beliefs regarding necessity (r = 0.319, p = 0.001), concerns (r = 0.344, p = 0.001), and experienced side effects of medication (r = 0.495, p = 0.001), alongside perceptions regarding duration (r = 0.272, p = 0.007), identity (r = 0.388, p < 0.001), being emotionally affected (r = 0.374, p < 0.01), personal control (r = - 0.287, p = 0.004) and concerns about ADHD (r = 0.465, p < 0.001). Impulsivity correlated with perceived consequences (r = - 0.226, p = 0.0255) and personal control of ADHD (r = - 0.379, p < 0.001). Hedonic Capacity correlated with concerns about medication (r = - 0.218, p = 0.0316) and perceived identification with ADHD (r = - 0.203, p = 0.045). Conclusion Personality traits are related to adherence, beliefs about ADHD medicines and perceptions of ADHD. Antagonism is associated with adherence, especially intentional non-adherence, while Negative Affectivity correlates with numerous perceptions of ADHD and beliefs about medications. Personality assessments could be useful in the care and treatment of adolescents with ADHD.

  • 143.
    Englund, Jessica
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Bladh, Ellen
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Barriärer för att söka ögonvård i Kenya2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Bakgrund: Ögonhälsan är ett globalt problem med över 2,2 miljarder människor som lider av synnedsättning. Studier visar att endast en liten del av de som behöver ögonvård får det. Bristen på ögonvård är ett faktum i Kenya, det finns 120 ögonläkare och 307 optiker i hela landet. Tidigare studier har urskiljt kostnad, brist på kunskap och lång transportsträcka som de främsta barriärerna för att söka ögonvård.

    Syfte: Att undersöka hur många som aldrig tidigare hade sökt ögonvård av de hjälpsökande i Kenya och varför. 

    Metod: Studien är en kvantitativ tvärsnittsstudie som genomfördes i Nairobi- och Nakuru-området bland hjälpsökande i samarbete med Vision For All. Totalt deltog 122 hjälpsökande varav 77 kvinnor och 45 män, alla från 15 år. Deltagarna fick svara på en enkät med flervalsfrågor angående deras tidigare erfarenhet av ögonvård. Där de fick välja mellan 13 olika barriärer, såsom “kostnad” och “inte medvetna om behovet av ögonvård”. 

    Resultat: Majoriteten av deltagarna, både män (64,44%) och kvinnor (54,54%), hade inte sökt ögonvård tidigare. “Kostnad” var den största barriären hos både männen (44,80%) och kvinnorna (33,30%) och det fanns ingen skillnad mellan svaren (p=0,640). I Nairobi (40,54%) och Nakuru (35,29%) var kostnad den största barriären, med ingen skillnad i svaren mellan städerna (p = 0,762). Även i åldersgrupperna var det “kostnad” som var den huvudsakliga barriären förutom ≥ 60 där det var “synnedsättning är normalt med åldrande” (33,33%) och ingen skillnad i svar (p = 0,258).  

    Slutsats: Ett betydande antal deltagare hade aldrig sökt ögonvård tidigare, med kostnaden som den främsta barriären. Denna trend är konsekvent mellan kön och städer, vilket överensstämmer med resultaten från andra globala studier. Dessutom var äldre deltagare och kvinnor mer benägna att uppfatta att “synnedsättning är normalt med åldrande”, snarare än som ett problem som kräver vård.

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    Barriärer i Kenya
  • 144.
    Englund, Lina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    eHälsointerventioners betydelse för vårdrondens utveckling – en scoping review2023Independent thesis Advanced level (degree of Master of Fine Arts (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Wardrounds are carried out daily by healtcare staff in the inpatient ward. The purpose of the wardround is to meet the patient´s needs for care and treatment and include examinations, prognosis, planning and teaching of staff. The digital development also takes place in healthcare and places new demands on care and at the same time offers new technical opportunities.

    Purpose: The purpose is to identify types of eHealth interventions that are used in the wardround in inpatient care and to study how the wardround in inpatient care has developed with the help of eHealth interventions.

    Method: To answer the study´s question a scoping review was carried out to survey literature in this field. Data were retrieved from two different databases where sixteen articles responded to the purpose of the study and met the inclusion criteria. A thematic analysis was then carried out to analyze the articles.

    Results: Four themes and eight subthemes were identified. Consultants ondistance, participation in virtual wardrounds, new technology and education. eHealthinterventions have resulted in increased patient safety, reduced the lack of specialistcompetence, reduced the distance between patient/specialist, increased the participation of relatives, reduced the spread of infection and strength enedinterprofessional cooperation in connection with the wardround.

    Conclusion: The wardround has developed through new working methodsmade possible by new technology, for example robots and virtual glasses. Geographical distances can be reduced with the help of virtual wardrounds, which also places high demands on the availability of an internet connection and staff with coordinating the new working methods. eHealth interventions have the potential to strengthen patient safety, contribute to more equal care and reduce resource shortagesin inpatient care.

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    fulltext
  • 145.
    Engqvist, Peter
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Robotprocessautomation på sjukhus: Två kvantitativa fallstudier2023Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Background: Robotic Process Automation (RPA) is an automation technology that can replace human work in IT systems. RPA is a growing field, and there are hopes that it can contribute positive effects in healthcare, particularly by freeing up employees for other tasks and increasing quality by reducing errors. There is a need for more examples of RPA in healthcare. Objective: The aim of this study was to investigate the effects of RPA in a hospital environment, specifically regarding: 1) quality in terms of reduced errors, and 2) efficiency in terms of freed-up time for employees. Method: An experimental design with a quantitative approach was used to examine two cases in a hospital: 1) RPA to reduce human errors in the medication list of the electronic health record system. The number and percentage of errors corrected by RPA were measured. 2) RPA to free up time for medical secretaries in a specific workflow. The time required to complete the manual task was measured through 14 measurements involving 4 secretaries. The number and percentage of cases handled by RPA were measured. Accumulated saved working time for the organization was measured, along with the saved Full-Time Equivalent (FTE). Results: 1) RPA corrected human errors in 68% of cases (n=3179). 2) The manual process took 27 (24.5-30.5) seconds to complete (median and interquartile range). During eight months, RPA handled 9956 cases, resulting in a time savings of 9.33 (8.47-10.54) work hours per month within the organization, equivalent to 5.3 (4.8-6.0) percent of a full-time position. Conclusion: The study demonstrated two cases that achieved desired effects, one in terms of quality and one in terms of efficiency. The cases also presented complicating factors, such as RPA being a temporary solution and the complexity of shared workspace between humans and RPA. The results can inspire other organizations and contribute to aggregated knowledge for creating guidelines and standards.

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    PeterEngqvist_Robotprocessautomation_på_sjukhus2023
  • 146.
    Engström, Ebba
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Pioch Broder, Kristin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sambandet mellan upplevd körförmåga, visus och kön hos patienter som behandlas för neovaskulär AMD2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 147.
    Enström, My
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Hur kasserar svenska linsbärare sina kontaktlinser samt kontaktlinsförpackningar?: En enkätundersökning2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 148.
    Entenza Gutierrez, Nedicto
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sjöström, Anneli
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Ögonsjuksköterskors erfarenheter av tolkanvändning i patientmötet: En fenomenografisk studie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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    fulltext
  • 149.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Sjukskrivningskoordinatorns roll: Patientens perspektiv2014Report (Other academic)
    Abstract [sv]

    Inom landstinget har funktionen sjukskrivningskoordinator införts med uppgift att bland annat samordna arbetet inom rehabiliteringsgarantin.

    I den här studien utvärderades funktionen sjukskrivningskoordinator inom primärvården i Landstinget i Kalmar län utifrån patientens perspektiv. Målet var att ta reda på patienters egen uppfattning om betydelsen av en sjukskrivningskoordinator inom deras sjukskrivningsprocess. Denna studie är en fortsättning av en tidigare studie kring effekterna av införandet av en sjukskrivningskoordinator inom Landstinget i Kalmar län då koordinatorsfunktionen utvärderades utifrån hälso- och sjukvårdspersonalens perspektiv.

    Samtliga patienter var positiva till att ha en koordinator involverad i sin sjukskrivningsprocess och de upplevde koordinatorsfunktionen som ett stöd. Koordinatorn sågs som ”spindeln i nätet” som samordnade kontakter både internt och externt. Patienterna upplevde att de hade fått ett bra bemötande och koordinatorns personlighet var en viktig faktor för hur väl de tyckte att funktionen fungerade.

    Sammanfattningsvis såg patienten koordinatorn som ett värdefullt stöd i sin sjukskrivningsprocess och för sitt välmående.

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    fulltext
  • 150.
    Ericson, Lisa
    Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry.
    Utvärdering – Sjukskrivningskoordinators roll inom Landstinget i Kalmar län2013Report (Other academic)
    Abstract [sv]

    Rehabiliteringsgarantin syftar till att stärka den enskildes ställning i sjukskrivningsprocessen och säkerställa att patienten får tillgång till medicinsk behandling och rehabilitering i form av kognitiv beteendeterapi och multimodal rehabilitering. Sjukskrivningskoordinatorns huvuduppgifter är dels att samordna detta nya arbetssätt och dels att förebygga eller minska behovet av sjukskrivning. Därutöver ska koordinatorn fungera som kontaktperson med berörda interna och externa enheter i sjukskrivnings/rehabiliteringsprocessen.

    Målet med denna utvärdering var att ta reda på hur enheterna och de berörda yrkeskategorierna, indirekt patienterna, har påverkats av införandet av funktionen sjukskrivningskoordinator inom Landstinget i Kalmar län. Utvärderingen avses vara ett underlag för beslut om koordinatorns framtida roll i landstinget om statsbidraget upphör.

    Datainsamlingen skedde både kvalitativt och kvantitativt genom semistrukturerade djupintervjuer respektive webbenkät.

    Införandet av sjukskrivningskoordinator uppfattades som mestadels positivt bland tillfrågade koordinatorer, verksamhetschefer och läkare, det fanns dock genomgående en del som var mer negativa. De tre yrkeskategorierna har olika perspektiv vilket delvis återspeglades i svaren. Koordinatorerna själva var ofta lite mer positivt inställda, och läkarna hamnade delvis i ”två läger”. Rollen/funktionen som sjukskrivningskoordinator ansågs dock vara viktig för såväl verksamheten och sjukskrivningsprocessen, som för patienten och läkaren. Koordinatorn ansågs fungera som samordnande ”spindel i nätet” med kontakter både internt och externt, och uppfattades ha lett till en effektivare sjukskrivningsprocess. Detta skiljde sig dock utifrån olika enheters behov. Ur patientens perspektiv bedömde majoriteten av de tillfrågade att det inneburit ökad trygghet och säkerhet samt snabbare vårdkedja och färre sjukvårdskontakter.

    Sammanfattningsvis verkar rollen som sjukskrivningskoordinator i stort vara en uppskattad resurs av både verksamhetschefer och läkare samt av koordinatorerna själva. Det finns dock mer att önska kring dess utformning, och kanske att funktionen borde anpassas utifrån respektive enhets enskilda behov.

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