Årsbok 2016 : Socialhögskolan, Lunds universitet

Denna årsbok presenterar Socialhögskolans verksamhet för 2016och in mot 2017

Respiratory function and mechanics in pinnipeds and cetaceans

Author Posting. © Company of Biologists, 2017. This article is posted here by permission of Company of Biologists for personal use, not for redistribution. The definitive version was published in Journal of Experimental Biology 220 (2017): 1761-1773, doi:10.1242/jeb.126870.In this Review, we focus on the functional properties of the respiratory system of pinnipeds and cetaceans, and briefly summarize the underlying anatomy; in doing so, we provide an overview of what is currently known about their respiratory physiology and mechanics. While exposure to high pressure is a common challenge among breath-hold divers, there is a large variation in respiratory anatomy, function and capacity between species – how are these traits adapted to allow the animals to withstand the physiological challenges faced during dives? The ultra-deep diving feats of some marine mammals defy our current understanding of respiratory physiology and lung mechanics. These animals cope daily with lung compression, alveolar collapse, transient hyperoxia and extreme hypoxia. By improving our understanding of respiratory physiology under these conditions, we will be better able to define the physiological constraints imposed on these animals, and how these limitations may affect the survival of marine mammals in a changing environment. Many of the respiratory traits to survive exposure to an extreme environment may inspire novel treatments for a variety of respiratory problems in humans.Funding for this project was provided by the Office of Naval Research (ONR YIP Award no. N000141410563).2018-05-1

3go : en sparkcykel för äldre

Jag kom i kontakt med en 87 årig uppfinnerska genom mitt arbete på tekniska museet förra sommaren. Hon hade utvecklat och patenterat en trehjulig sparkcykel som går att fälla ihop. Jag valde att prova att formge och utveckla denna dels för att det är en målgrupp som ligger långt ifrån mig själv och dels för att det var en utmaning att bygga en fullskalemodell.Examensarbete Industridesign kandidatexamensarbet

Vad vill Du att jag skall känna till? : om möten mellan anhöriga och personal i gruppboende för funktionshindrade

The aim of this essay was to examine, from the relative's angle, which actions and behaviour that had an effect on how the relatives valued the encounters with the personnel at so called group housing for persons with cognitive disabilities. The constructional frame of the investi-gation originated from two presumptions. Firstly that the encounter between people is af-fected both by the persons who meet and by the context in which they meet. Secondly that the encounter between the professional and the relative is not an equal one, since the professional stands in some kind of power position. Central questions at issue were for example: How do relatives describe a good attitude? Which elements have an impact on how people experience the attitude? The investigation consisted of eight qualitative interviews. To achieve a positive development of the interaction, three phases were distinguished from the analysis; namely the phases of Listening, Trust and Change. These were characterised by different actions and behaviour. The phase of Listening was characterised by the fact that the information given by the relatives about the resident was given a great amount of space and that the professional showed interest in the information. The phase of Trust that information from the professional about the resident increased. Security and trust were created and the relatives started to let go some parts of the care of the resident. The phase of change was characterised by putting the knowledge of the professional more in the centre. The relatives let go more of the responsibility of the care, which for them was an important goal for the future

Hypoxic syncope in a competitive breath-hold diver with elevation of the brain damage marker S100B.

INTRODUCTION: Competitive breath-hold divers can accomplish previously unbelievable performances; e.g., the current world record for apnea during rest ("static apnea") is 11 min 35 s. However, whether such performances are associated with a risk for hypoxic brain damage has not been established. CASE REPORT: A breath-hold diver's competitive performance resulted in a loss of consciousness, after which he was subjected to a medical examination by the event physician. Blood samples were collected for analysis of the brain damage marker S100B in serum. The S100B in serum was 0.100 microg x L(-1) in the blood sample collected 15 min after the loss of consciousness. At 1 and 5 d after the incident it was 0.097 microg x L(-1) and 0.045 microg x L(-1) respectively. DISCUSSION: The elevated level of S100B, close to the upper reference limit (0.105 microg x L(-1)) indicates that the incident affected the integrity of the central nervous system. Even though this case does not establish that hypoxic brain damage is an inherent risk with loss of consciousness in competitive breathhold diving, the observation raises concerns. We suggest that it should be considered that repetitive exposures to prolonged apneas leading to severe hypoxia may be associated with negative long-term effects

Pulmonary edema after competitive breath-hold diving

During an international breath-hold diving competition, 19 of the participating divers volunteered for the present study, aimed at elucidating possible symptoms and signs of pulmonary edema after deep dives. Measurements included dynamic spirometry and pulse oximetry, and chest auscultation was performed on those with the most severe symptoms. After deep dives (25-75 m), 12 of the divers had signs of pulmonary edema. None had any symptoms or signs after shallow pool dives. For the whole group of 19 divers, average reductions in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were -9 and -12%, respectively, after deep dives compared with after pool dives. In addition, the average reduction in arterial oxygen saturation (SaO2) was -4% after the deep dives. In six divers, respiratory symptoms (including dyspnea, cough, fatigue, substernal chest pain or discomfort, and hemoptysis) were associated with aggravated deteriorations in the physiological variables (FVC: -16%; FEV1: -27%; SaO2: -11%). This is the first study showing reduced spirometric performance and arterial hypoxemia as consequences of deep breath-hold diving, and we suggest that the observed changes are caused by diving-induced pulmonary edema. From the results of the present study, it must be concluded that the great depths reached by these elite apnea divers are associated with a risk of pulmonary edema

Increased serum levels of the brain damage marker S100B after apnea in trained breath-hold divers: a study including respiratory and cardiovascular observations

The concentration of the protein S100B in serum is used as a brain damage marker in various conditions. We wanted to investigate whether a voluntary, prolonged apnea in trained breath-hold divers resulted in an increase of S100B in serum. Nine trained breath-hold divers performed a protocol mimicking the procedures they use during breath-hold training and competition, including extensive preapneic hyperventilation and glossopharyngeal insufflation, in order to perform a maximum-duration apnea, i.e., "static apnea" (average: 335 s, range: 281–403 s). Arterial blood samples were collected and cardiovascular variables recorded. Arterial partial pressures of O2 and CO2 (PaO2 and PaCO2) were 128 Torr and 20 Torr, respectively, at the start of apnea. The degree of asphyxia at the end of apnea was considerable, with PaO2 and PaCO2 reaching 28 Torr and 45 Torr, respectively. The concentration of S100B in serum transiently increased from 0.066 µg/l at the start of apnea to 0.083 µg/l after the apnea (P < 0.05). The increase in S100B is attributed to the asphyxia or to other physiological responses to apnea, for example, increased blood pressure, and probably indicates a temporary opening of the blood-brain barrier. It is not possible to conclude that the observed increase in S100B levels in serum after a maximal-duration apnea reflects a serious injury to the brain, although the results raise concerns considering negative long-term effects. At the least, the results indicate that prolonged, voluntary apnea affects the integrity of the central nervous system and do not preclude cumulative effects

Asystole and increased serum myoglobin levels associated with 'packing blackout' in a competitive breath-hold diver.

Summary Many competitive breath-hold divers use 'glossopharyngeal insufflation', also called 'lung packing', to overfill their lungs above normal total lung capacity. This increases intrathoracic pressure, decreases venous return, compromises cardiac pumping, and reduces arterial blood pressure, possibly resulting in a syncope breath-hold divers call 'packing blackout'. We report a case with a breath-hold diver who inadvertently experienced a packing blackout. During the incident, an electrocardiogram (ECG) and blood pressure were recorded, and blood samples for determinations of biomarkers of cardiac muscle perturbation (creatine kinase-MB isoenzyme (CK-MB), cardiac troponin-T (TnT), and myoglobin) were collected. The ECG revealed short periods of asystole during the period of 'packing blackout', simultaneous with pronounced reductions in systolic, diastolic, and pulse pressures. Serum myoglobin concentration was elevated 40 and 150 min after the incident, whereas there were no changes in CK-MB or TnT. The ultimate cause of syncope in this diver probably was a decrease in cerebral perfusion following glossopharyngeal insufflation. The asystolic periods recorded in this diver could possibly indicate that susceptible individuals may be put at risk of a serious cardiac incident if the lungs are excessively overinflated by glossopharyngeal insufflation. This concern is further substantiated by the observed increase in serum myoglobin concentration after the event

Suspected arterial gas embolism after glossopharyngeal insufflation in a breath-hold diver.

INTRODUCTION: Many competitive breath-hold divers employ the technique of glossopharyngeal insufflation in order to increase their lung gas volume for a dive. After a maximal inspiration, using the oral and pharyngeal muscles repeatedly, air in the mouth is compressed and forced into the lungs. Such overexpansion of the lungs is associated with a high transpulmonary pressure, which could possibly cause pulmonary barotrauma. CASE REPORT: We report a case of transient neurological signs and symptoms occurring within 1 min after glossopharyngeal insufflation in a breath-hold diver. He complained of paresthesia of the right shoulder and a neurological exam revealed decreased sense of touch on the right side of the neck as compared to the left side. Motor function was normal. The course of events in this case is suggestive of arterial gas embolism. DISCUSSION: Although the diver recovered completely within a few minutes, the perspective of a more serious insult raises concerns in using the glossopharyngeal insufflation technique. In addition to a neurological insult, damage to other organs of the body has to be considered. Both acute and long-term negative health effects are conceivable