The Flow and Pressure Relationships in Different Tubes Commonly Used for Semi-occluded Vocal Tract Exercises

This experimental study investigated the back pressure (pback) versus flow (U) relationship for 10 different tubes commonly used for semi-occluded vocal tract exercises (SOVTE), i.e., 8 straws of different lengths and diameters, a resonance tube and a silicone tube similar to a Lax Vox tube. All tubes were assessed with the free end in air. The resonance tube and silicone tube were further assessed with the free end under water at the depths from 1 to 7 cm in steps of 1 cm. The results showed that relative changes in the diameter of straws affect pback considerably more compared to the same amount of relative change in length. Additionally, once tubes are submerged into water, pback needs to overcome the pressure generated by the water depth before flow can start. Under this condition, only a small increase in pback was observed as the flow was increased. Therefore, the wider tubes submerged into water produced an almost constant pback determined by the water depth, while the thinner straws in air produced relatively large changes to pback as flow was changed. These differences may be taken advantage of when customizing exercises for different users and diagnoses and optimizing the therapy outcome

P1 receptors and cytokine secretion

Evidence has accumulated in the last three decades to suggest tissue protection and regeneration by adenosine in multiple different cell types. Adenosine produced in hypoxic or inflamed environments reduces tissue injury and promotes repair by receptor-mediated mechanisms. Among other actions, regulation of cytokine production and secretion by immune cells, astrocytes and microglia (the brain immunocytes) has emerged as a main mechanism at the basis of adenosine effects in diseases characterized by a marked inflammatory component. Many recent studies have highlighted that signalling through A1 and A2A adenosine receptors can powerfully prevent the release of pro-inflammatory cytokines, thus inhibiting inflammation and reperfusion injury. However, the activation of adenosine receptors is not invariably protective of tissues, as signalling through the A2B adenosine receptor has been linked to pro-inflammatory actions which are, at least in part, mediated by increased release of pro-inflammatory cytokines from epithelial cells, astrocytes and fibroblasts. Here, we discuss the multiple actions of P1 receptors on cytokine secretion, by analyzing, in particular, the role of the various adenosine receptor subtypes, the complex reciprocal interplay between the adenosine and the cytokine systems, their pathophysiological significance and the potential of adenosine receptor ligands as new anti-inflammatory agents

ATT UNDER SIN UPPVÄXT BLIVIT UTSATT FÖR SEXUELLA ÖVERGREPP : En litteraturstudie baserad på biografier

Sexuella övergrepp på barn är något som på senare år mer och mer har uppmärksammats. Syftet med studien var att utifrån fyra biografier beskriva vuxna individers upplevelser och känslor av att under uppväxten blivit utsatta för sexuella övergrepp samt beskriva hur de upplever att det har inverkat på deras liv som vuxna. Metoden som användes var en litteraturstudie med kvalitativ ansats. Studiens resultat visade att sexuella övergrepp skapade ett oerhört livslidande hos de utsatta, de blev ”aldrig av” med minnena och händelserna. Andra vanligt förekommande upplevelser och känslor var svek, rädsla, skuld och skam. Även känslan av att vilja ha kontroll över sitt egna liv var tydligt hos informanterna. Studiens resultat kan användas för att åstadkomma en högre medvetenhet om sexuella övergrepp vilket kan vara till hjälp vid möte med en individ som under sin uppväxt varit utsatt för de här övergreppen

Hur två skolor integrerar barn som nyss kommit till Sverige

Syftet med denna studie är att undersöka hur två skolor integrerar barn som nyss kommit till Sverige. Vi gjorde en kvalitativ intervjustudie, där två skolor besöktes. På båda skolorna intervjuades en rektor och en pedagog. Dessa två skolor valdes ut på grund av deras mångfald av invandrarbarn. Den ena skolan har ett större antal barn med annan kultur än den andra skolan som har mesta dels svenska barn. Det intervjuerna resulterade var att de använder sig av en kommunal verksamhet som kallas för Landningen, som är en förberedelseklass eller mottagningsgrupp som det även kallas för. De arbetar aktivt med integration. Det resulterade även att föräldrakontakten anses vara viktig för dessa skolor

Treatment of alcohol dependence in Swedish primary care : perceptions among general practitioners

OBJECTIVE: To describe general practitioners' (GPs) attitudes to the management of patients with alcohol dependence in primary care and current treatment routines and their view on a new treatment approach; internet-based Cognitive Behavioral Therapy (iCBT). DESIGN: A qualitative interview study with ten GPs participating in a randomized controlled trial. The interviews were analyzed using qualitative content analysis. SETTING: The participating GPs were recruited via purposeful sampling from primary care clinics in Stockholm. SUBJECTS: The GPs were participants in an RCT investigating if iCBT when added to treatment as usual (TAU) was more effective than TAU only when treating alcohol dependence in primary care. RESULTS: The GPs found alcohol important to discuss in many consultations and perceived most patients open to discuss their alcohol habits. Lack of training and treatment options were expressed as limiting factors when working with alcohol dependence. According to the respondents, routines for treating alcohol dependence were rare. CONCLUSION: GPs believed that iCBT might facilitate raising questions about alcohol use and thought iCBT may serve as an attractive treatment option to some patients. The iCBT program did not require GPs to acquire skills in behavioral treatment, which could make implementation more feasible.KEY POINTSAlcohol dependence is highly prevalent, has a large treatment gap and is relevant to discuss with patients in many consultations in primary care.This study is based on interviews with 10 GPs participating in a randomized controlled trial comparing internet-based Cognitive Behavioral Therapy (iCBT) for alcohol-dependent patients to treatment as usual.GPs viewed alcohol habits as important to discuss and they perceived most patients are open to discuss this.The access to iCBT seemed to increase GPs' willingness to ask questions about alcohol and was viewed as an attractive treatment for some patients.The iCBT program did not require GPs to acquire skills in behavioral treatment, which might be timesaving and make implementation more feasible

Treating alcohol use disorders in primary care - a qualitative evaluation of a new innovation : the 15-method

OBJECTIVE: This study aims to explore how the characteristics of an innovation, the 15-method, a stepped care model for treatment of alcohol use disorders in primary care was perceived. METHODS/DESIGN/SETTING/SUBJECT: General practitioners and heads of primary care units (n = 10) that delivered the 15-method in a randomized controlled trial participated in individual interviews at two occasions in Stockholm, Sweden. Data were analyzed with theoretical thematic analysis, using Diffusion of Innovation Theory. RESULTS: The participants described that offering the 15-method met a need among their patients. Participants were positive towards the training and the manual for the method. They mentioned a previous lack of routines to work with alcohol use disorders. The 15-method was described as easy to use. It would however be more feasible to implement in a team of different professions, rather than among general practitioners only. Priorities made by regional health care managers were described as important for the implementation, as well as financial incentives. A barrier to implementation was that alcohol screening was perceived as difficult. While the 15-method was perceived as effective in reducing the patients' alcohol use and cost effective, participants expressed uncertainty about the long-term effects. CONCLUSIONS: The 15-method provides structure for treatment of alcohol use disorders and is described by general practitioners and heads as a promising approach. Being able to offer treatment for alcohol dependence may increase the uptake of alcohol interventions in primary care. KEY POINTS Little attention has been given to develop treatment models for alcohol use disorders that are adapted to primary care settings. This study describes how an innovation, the 15-method, a stepped care model for treatment of alcohol use disorders in primary care was perceived. The 15-method provides structure for treatment of alcohol use disorders in primary care and is described by general practitioners and heads as a promising approach. Being able to offer treatment for alcohol dependence may increase the uptake of alcohol interventions in primary care