”ETT ENKELT LITET TRÄD” Arbetsterapeuters upplevelser av The Tree Theme Method® som behandlingsmetod vid stressrelaterad psykisk ohälsa.

Bakgrund En grundläggande princip inom arbetsterapi är behovet av balans i aktivitetslivet för en god hälsa. Stress är en bidragande faktor till psykisk ohälsa i dagens samhälle. Det finns en tydlig koppling mellan en obalans i vardagliga aktiviteter och ökad stress. En metod som har visat sig användbar vid behandling av stressrelaterad ohälsa är kreativa aktiviteter. En arbetsterapeutisk kreativ behandlingsmetod är The Tree Theme Method (TTM) där fokus ligger på att patienten får måla träd för att symbolisera aktivitetslivet. Ett fåtal studier har genomförts gällande TTM metoden, men ingen som tidigare fokuserat på arbetsterapeuters upplevelse av metodens effekter hos personer med stressrelaterad ohälsa. Syfte Syftet med studien var att undersöka arbetsterapeuters upplevelser av TTM som behandlingsmetod för personer med stressrelaterad psykisk ohälsa. Metod Studien är utförd enligt kvalitativ metod utifrån ett hermeneutiskt synsätt. Urvalsgruppen utgjordes av legitimerade arbetsterapeuter som använder TTM metoden i sitt dagliga arbete samt hade arbetat med personer som lider av stressymptom. Urvalet utgjordes av fem arbetsterapeuter och studien genomfördes med semistrukturerade individuella intervjuer via Skype eller telefon. Datan analyserades enligt metoden för systematisk textkondensering. Resultat Resultatet delades upp i huvudkategorierna Metodens användbarhet, Effekter under behandling, Påverkan i vardagen samt Det professionella förhållningssättet. TTM metoden ansågs lämplig för att stödja personer med stressrelaterad psykisk ohälsa då den upplevdes ge arbetsterapeuten mycket information om personen. Bildskapandet sågs kunna vara lugnande och öppna upp för känslor samt leda till insikt i vad som är orsakerna till stressen utifrån personens aktivitetsliv, roller och relationer genom livet. Metoden ansågs även kunna resultera i starka känslor hos personen som arbetsterapeuten var tvungen att klara av att bemöta. I vissa fall upplevde arbetsterapeuterna att kompetensen inte räckte till för att bemöta detta och i de fallen efterfrågades stöd från andra yrkesgrupper. Slutsats Trots att TTM metoden upplevdes innebära en del negativa aspekter för personer med stressrelaterad ohälsa, såsom ökad stress och prestationskrav i skapandet, så framgick det tydligt i resultatet att arbetsterapeuterna ansåg att fördelarna övervägde nackdelarna. TTM metoden kan sägas utgöra ett relevant arbetsterapeutiskt behandlingsalternativ vid stressrelaterad psykisk ohälsa. För att bekräfta resultat krävs ytterligare studier

Hästen i skogsbruket – kommuners erfarenheter

Hästarna hade förr en stor betydelse i skogsbruket, då de avlastade människan när det gällde bär- och draghjälp. I början på 1900-talet fanns det cirka 600 000 hästar i Sverige som sedan kom att minska drastiskt efter andra världskriget. Den drastiska minskningen av hästar kom att bero på den mekanisering som genomfördes och år 1970 återstod cirka 42 500 arbetshästar i Sverige. Mekaniseringen innebar att maskiner utvecklades och tillverkades för att ersätta arbetshästarna. Idag bor det många människor i och runt om Sveriges tätorter där det oftast också finns skogbeklädda arealer. Skogen bör skötas om i form av att man avverkar träd med jämna mellanrum och just i tätorterna finns det kommuner som använder sig av skogshästar i stället för skogsmaskiner. När skogsmaskiner skall utföra arbetet i skogen kan motstånd uppstå från allmänheten som anser att maskinerna förstör rekreationsområden. Det kan handla om att det blir körskador i markskiktet och att det låter mycket från maskinerna under tiden som åtgärden utförs. När hästen arbetar i skogen så minimeras risken för att körskador skall uppstå, samtidigt som att åtgärden utförs med en lägre ljudnivå. Hästen stör helt enkelt inte allmänheten på samma sätt som maskiner kan göra. Studiens syfte var att undersöka i hur stor utsträckning som skogshästar används inom Katrineholms, Jönköpings och Nyköpings kommun. Därtill skulle studien också besvara hur allmänheten reagerar på skogsvårdsåtgärder som utförs med häst. Studiens genomfördes med hjälp av intervjuer under sommaren 2022 med personer som är skogligt insatta inom de tre kommunerna, och som arbetar som skogsförvaltare och underentreprenörer. Dessutom har tio privatpersoner intervjuats inom Katrineholms och Jönköpings kommun. Många respondenter var positiva till att använda hästen inom skogsbruket där det ansågs som lämpligt. Några anledningar till detta var för att det ansågs som mer skonsamt för markskiktet än om en maskin hade utfört samma jobb samt att det ansågs trevligt att se djur som utför skogsvårdsåtgärden. Flera respondenter nämnde att allmänheten ofta var och tittade på hästarna under tiden som åtgärderna utfördes, där ibland även förskoleklasser. Studien visar att vid mindre uttag av skogsråvara så kan hästen även ekonomiskt vara ett konkurrenskraftigt alternativ till en liten skogsmaskin.The horse used to have a great importance in forestry, they were man's right hand when it came to carrying and pulling. At the beginning of the 20th century, there were approximately 600 000 horses in Sweden, which then came to decrease drastically after the Second World War. The drastic reduction in horses was due to the mechanization, and in 1970 approximately 42 500 working horses remained in Sweden. Mechanization meant that machines were developed and manufactured to replace the workhorses. Today, many people live in and around Sweden's conurbations, where there usually also are forested areas. The forest should be cared for with regular intervals and there are municipalities that are using horses instead of machines to work in the urban areas. When forest machines work in the forest, opposition may arise from the public who believe that the machines are destroying recreational areas. This could mean that there is ground damage on the soil and that there is a lot of noise from the machines during the time of the logging. When the horse works in the forest, the risk of driving injuries is minimized, and the logging takes place more silently. The horse simply does not disturb the public in the same way that machines may do. The purpose of the study is to answer the extent to which forest horses are used within the municipalities of Katrineholm, Jönköping and Nyköping. In addition, the study will also answer how the public reacts to forest conservation measures carried out with horses. The study is answered with the help of interviews conducted during the summer of 2022 with people who are knowledgeable about forestry within the municipality, for example forest managers and contractors. In addition, 10 private individuals have been interviewed within the municipalities of Katrineholm and Jönköping. Many of the respondents were positive about using the horse in forestry where it was considered appropriate. Some of the reasons were that it is gentler on the soil than if a machine were to perform the same job and that people like to see animals working in the forest. Several respondents mentioned that the public often came to watch the horses while they were working, sometimes including preschool classes. The study shows that with less extraction of forest raw material, the horse can also economically be a competitive alternative to a small forest machine

Anti-neutrophil cytoplasmatic antibodies and lung disease in cystic fibrosis

AbstractBackground: Bactericidal-permeability-increasing protein (BPI) is a potent anti-microbial protein produced by neutrophil granulocytes. Anti-neutrophil cytoplasmatic antibodies (ANCA) directed against BPI have been detected in up to 91% in patients with cystic fibrosis (CF). We aimed to evaluate the prevalence of BPI-ANCA in our CF patients and to determine whether presence of BPI-ANCA is correlated with organ damage. Methods: Twenty-four patients performed respiratory function testing and pulmonary high-resolution computed tomography (HRCT). HRCT was scored by using a modified Bhalla method. Serum samples were analysed by direct binding enzyme-linked immunosorbent assay for BPI-ANCA. Results: The prevalence of anti-BPI-IgG was 71% and anti-BPI-IgA 33%. Twenty-nine percent of our patients were positive for both BPI-ANCA isotypes. Mean HRCT score was 8.0 ranging from 0 to 22, bronchiectasis presented the most common finding (79%). There was a significant correlation between BPI-ANCA and both HRCT score and FEV1 (p<0.01). High levels of BPI-ANCA were correlated to chronic Pseudomonas aeruginosa lung infection (p<0.01). Conclusions: BPI-ANCA was common in our study group. Highly significant correlations between BPI-ANCA and parameters to evaluate lung disease in CF may be a consequence of the inflammation process, or it may indicate a pathogenic role of BPI-ANCA levels in the development of lung disease. More research is needed and the clinical significance of our findings needs further evaluation

Движение газов в ротационных наклоняющихся печах

Представлены результаты исследований движения газов и процессов тепломассообмена в ротационных наклоняющихся печах (РНП) при термообработке дисперсных материалов. Исследования выполняли с помощью численного моделирования с использованием прикладных программных пакетов ANSYS CFX и Solid Works Flow Simulation. Полученные результаты были использованы при разработке РНП различной мощности и назначения и позволили повысить их технико-экономические характеристики

To what extent does surrounding landscape explain stand-level occurrence of conservation-relevant species in fragmented boreal and hemi-boreal forest?-a systematic review protocol

Background: Silviculture and land-use change has reduced the amount of natural forest worldwide and left what remains confined to isolated fragments or stands. To understand processes governing species occurrence in such stands, much attention has been given to stand-level factors such as size, structure, and deadwood amount. However, the surrounding matrix will directly impact species dispersal and persistence, and the link between the surrounding landscape configuration, composition and history, and stand-level species occurrence has received insufficient attention. Thus, to facilitate optimisation of forest management and species conservation, we propose a review addressing 'To what extent does surrounding landscape explain stand-level occurrence of conservation-relevant species in fragmented boreal and hemi-boreal forest?'.Methods: The proposed systematic review will identify and synthesise relevant articles following the CEE guidelines for evidence synthesis and the ROSES standards. A search for peer-reviewed and grey literature will be conducted using four databases, two online search engines, and 36 specialist websites. Identified articles will be screened for eligibility in a two-step process; first on title and abstract, and second on the full text. Screening will be based on predefined eligibility criteria related to a PECO-model; population being boreal and hemi-boreal forest, exposure being fragmentation, comparator being landscapes with alternative composition, configuration, or history, and outcome being occurrence (i.e., presence and/or abundance) of conservation-relevant species. All articles that pass the full-text screening will go through study validity assessment and data extraction, and be part of a narrative review. If enough studies prove comparable, quantitative meta-analyses will also be performed. The objective of the narrative review and the meta-analyses will be to address the primary question as well as six secondary questions, and to identify important knowledge gaps

Industry 4.0 readiness in manufacturing companies: challenges and enablers towards increased digitalization

Digitalization is changing the business environment and companies face challenges to make progress. A first step to support companies is to verify their digital readiness, capabilities, and developing clear plans for improvement. This paper aims to evaluate the digital readiness of seven companies through the application of a self-check tool, followed by a deeper investigation through a case study, to identify reasons, challenges/barriers and enablers towards digitalization. A workshop was conducted to evaluate the use of a self-check tool and collect other analysis. Results include the readiness level and comparison between companies, actions and practices towards increased digitalization

Priority setting in primary health care - dilemmas and opportunities: a focus group study

<p>Abstract</p> <p>Background</p> <p>Swedish health care authorities use three key criteria to produce national guidelines for local priority setting: severity of the health condition, expected patient benefit, and cost-effectiveness of medical intervention. Priority setting in primary health care (PHC) has significant implications for health costs and outcomes in the health care system. Nevertheless, these guidelines have been implemented to a very limited degree in PHC. The objective of the study was to qualitatively assess how general practitioners (GPs) and nurses perceive the application of the three key priority-setting criteria.</p> <p>Methods</p> <p>Focus groups were held with GPs and nurses at primary health care centres, where the staff had a short period of experience in using the criteria for prioritising in their daily work.</p> <p>Results</p> <p>The staff found the three key priority-setting criteria (severity, patient benefit, and cost-effectiveness) to be valuable for priority setting in PHC. However, when the criteria were applied in PHC, three additional dimensions were identified: 1) viewpoint (medical or patient's), 2) timeframe (now or later), and 3) evidence level (group or individual).</p> <p>Conclusions</p> <p>The three key priority-setting criteria were useful. Considering the three additional dimensions might enhance implementation of national guidelines in PHC and is probably a prerequisite for the criteria to be useful in priority setting for individual patients.</p

HTR1A a Novel Type 1 Diabetes Susceptibility Gene on Chromosome 5p13-q13

Background: We have previously performed a genome-wide linkage study in Scandinavian Type 1 diabetes (T1D) families. In the Swedish families, we detected suggestive linkage (LOD less than= 2.2) to the chromosome 5p13-q13 region. The aim of our study was to investigate the linked region in search for possible T1D susceptibility genes. Methodology/Principal Findings: Microsatellites were genotyped in the Scandinavian families to fine-map the previously linked region. Further, SNPs were genotyped in Swedish and Danish families as well as Swedish sporadic cases. In the Swedish families we detected genome-wide significant linkage to the 5-hydroxytryptamine receptor 1A (HTR1A) gene (LOD 3.98, pless than9.8x10(-6)). Markers tagging two separate genes; the ring finger protein 180 (RNF180) and HTR1A showed association to T1D in the Swedish and Danish families (pless than0.002, pless than0.001 respectively). The association was not confirmed in sporadic cases. Conditional analysis indicates that the primary association was to HTR1A. Quantitative PCR show that transcripts of both HTR1A and RNF180 are present in human islets of Langerhans. Moreover, immunohistochemical analysis confirmed the presence of the 5-HTR1A protein in isolated human islets of Langerhans as well as in sections of human pancreas. Conclusions: We have identified and confirmed the association of both HTR1A and RFN180, two genes in high linkage disequilibrium (LD) to T1D in two separate family materials. As both HTR1A and RFN180 were expressed at the mRNA level and HTR1A as protein in human islets of Langerhans, we suggest that HTR1A may affect T1D susceptibility by modulating the initial autoimmune attack or either islet regeneration, insulin release, or both