37 research outputs found
Impact of extreme sea levels and waves in the bay of LundÄkra - present situation and future scenarios
This report is a study of the impacts of extreme sea levels and waves on the coastal area of the bay of LundĂ„kra. The bay is characterized by shallow sea bottoms and a flat topography, particularly in the north. Analyses have been based on historical data. To expand the analyses to apply for a future scenario a change in mean sea level has been considered. Based on general recommendations from the Swedish Meteorological and Hydrological Institute (SMHI) and recent research from the Arctic Monitoring and Assessment Program (AMAP) two future scenarios have been chosen, a sea level rise of 1 m and 1.6 m respectively, for the year of 2100. The bay of LundĂ„kra is a Natura 2000 area and also contains smaller areas of nature reserves. The bay area holds many conservation values. Some of the most important ones are found in an area of coastal meadows in the northernmost part close to the SaxĂ„n estuary. This site is important to many red listed birds. This area is particularly threatened since the highway E6 runs very close to the coast here. The bay area is also of great importance for fish and other animals. Bathymetry and topography data collected by a laser scan method have been obtained from the municipality of Landskrona and KĂ€vlinge and combined with the New National Height Model (NNH) from LantmĂ€teriet. Modeled wave data (1994-2011) have been extracted for the bay from the company Denmarkâs Hydrological Institute, DHI. Sea levels (1992-2012) have been obtained from SMHI and combined with a longer series extracted from a previous study by Karlsson Green and Martinsson (2010). Return periods have been estimated for sea levels and waves by fitting the data to Weibull and Gringorten distribution functions. For the extreme event of the November storm in 2011-11-27 the waves reached 2.2 m, which has the estimated return period of 32.5 years. The sea level reached at the same time 1.47m, with the estimated return period of 27.5 years. Applying the Bruun rule to the future scenarios a risk has been estimated of a coastline retreat of several hundreds of meters along the entire bay area. The northernmost part with the important coastal meadows will likely be flooded already at a sea level rise of 0.75 m. An analysis for calculating the wave runup levels indicate that the highway may be exposed to wave runup at extreme events in the future scenario of a 1 m sea level rise. The wave runup analysis further shows some indications that some sections of the coastline will be more exposed to wave erosion than others
Generation Y- en hÄllbar generation?
Corporate Social Responsibility (CSR) har under senare Är fÄtt stor uppmÀrksamhet i media och i företags strategier. Detta faktum innebÀr att kunder i olika grad allt mer kommer i kontakt med företags samhÀllsengagemang, inte minst inom resebranschen. Vilken betydelse har dÄ denna kontakt för kundernas val av olika produkter och tjÀnster under konsumtionsprocessen? Ser kunderna en researrangörs CSR relaterade arbete som en kvalitetsskapande faktor eller vÀcker engagemanget istÀllet misstankar om manipulation? Tidigare forskning behandlar faktorer som inverkar pÄ kunders upplevda kvalité, dock saknas forskning pÄ hur ett företags CSR arbete kan integreras bland de övriga varumÀrkesvÀrderingarna i den kvalitetsskapande processen för en specifik mÄlgrupp. Intressant mÄlgrupp för denna undersökning Àr den i teorin benÀmnda Generation Y, dÄ denna generation anses komma ha en stor pÄverkan pÄ resebranschen i framtiden
Weight and body mass index in relation to irradiated volume and to overall survival in patients with oropharyngeal cancer: a retrospective cohort study
Impact of menopause and diabetes on atherogenic lipid profile: is it worth to analyse lipoprotein subfractions to assess cardiovascular risk in women?
Impact of disease and treatment on body weight and eating in patients with head and neck cancer : experiences from a multicenter study
Background Nutritional deterioration in patients with head and neck cancer (HNC) has a multifactorial etiology mainly associated with tumor and treatment related factors. The objective of the present thesis was to investigate the impact of the disease and treatment on body weight and eating in patients with HNC treated with radiation therapy (RT) as the single modality treatment or as preoperative RT by analyzing body weight and body mass index (BMI) over time, predictive factors for weight loss and BMI, weight loss and BMI as prognostic factors for survival, and by studying the patientsâ own experience of food and eating. Methods ARTSCAN is a randomized prospective multicenter trial conducted between the years of 1998 - 2006. Data were collected during and after RT with a total follow-up time of five years. Nutritional data from the whole study cohort (n = 712), from patients with oropharyngeal cancer (n = 232) and from two of the participating treatment centers (n = 101) were retrospectively analyzed in the present thesis. In addition, interviews (n = 13) were conducted nine months after the termination of RT as part of a care development project. Results On a group level, the patients lost weight during and after RT with a nadir at five months after the termination of RT. Factors related to a higher weight loss were oropharyngeal cancer, a high BMI at the start of RT, post-treatment aspiration, no tube feeding at the start of RT, and larger treated volumes. Furthermore, a high BMI at the start of RT was shown to be significantly related to a better five-year overall survival in patients with oropharyngeal cancer, whereas weight loss was not. The patientsâ own narratives showed that all aspects of food, eating and meals were affected by the remaining sequelae, and that the patients found ways to accept and cope with the changes that had to be done to facilitate eating. Conclusions and clinical implications The disease and treatment gave persistent effects on the HNC patientsâ weight and BMI which calls for a prolonged nutritional follow-up. The predictive factors found for weight loss can be used during patient history to find patients at risk for nutritional deterioration. In oropharyngeal cancer, patients with a high BMI at the start of RT had the best survival. This finding indicates that patients with a low BMI should be encouraged to gain weight before RT start. All aspects of food, eating and meals were affected during and after RT, and therefore the nutritional treatment should be given with a holistic approach to meet the multifaceted need patients with HNC experience
Impact of disease and treatment on body weight and eating in patients with head and neck cancer : experiences from a multicenter study
Background Nutritional deterioration in patients with head and neck cancer (HNC) has a multifactorial etiology mainly associated with tumor and treatment related factors. The objective of the present thesis was to investigate the impact of the disease and treatment on body weight and eating in patients with HNC treated with radiation therapy (RT) as the single modality treatment or as preoperative RT by analyzing body weight and body mass index (BMI) over time, predictive factors for weight loss and BMI, weight loss and BMI as prognostic factors for survival, and by studying the patientsâ own experience of food and eating. Methods ARTSCAN is a randomized prospective multicenter trial conducted between the years of 1998 - 2006. Data were collected during and after RT with a total follow-up time of five years. Nutritional data from the whole study cohort (n = 712), from patients with oropharyngeal cancer (n = 232) and from two of the participating treatment centers (n = 101) were retrospectively analyzed in the present thesis. In addition, interviews (n = 13) were conducted nine months after the termination of RT as part of a care development project. Results On a group level, the patients lost weight during and after RT with a nadir at five months after the termination of RT. Factors related to a higher weight loss were oropharyngeal cancer, a high BMI at the start of RT, post-treatment aspiration, no tube feeding at the start of RT, and larger treated volumes. Furthermore, a high BMI at the start of RT was shown to be significantly related to a better five-year overall survival in patients with oropharyngeal cancer, whereas weight loss was not. The patientsâ own narratives showed that all aspects of food, eating and meals were affected by the remaining sequelae, and that the patients found ways to accept and cope with the changes that had to be done to facilitate eating. Conclusions and clinical implications The disease and treatment gave persistent effects on the HNC patientsâ weight and BMI which calls for a prolonged nutritional follow-up. The predictive factors found for weight loss can be used during patient history to find patients at risk for nutritional deterioration. In oropharyngeal cancer, patients with a high BMI at the start of RT had the best survival. This finding indicates that patients with a low BMI should be encouraged to gain weight before RT start. All aspects of food, eating and meals were affected during and after RT, and therefore the nutritional treatment should be given with a holistic approach to meet the multifaceted need patients with HNC experience
HĂ€lsosamtal i tidig graviditet : En kvalitativ intervjustudie med barnmorskor.
Bakgrund: Socialstyrelsens nationella riktlinjer ger rekommendationer om metoder för att förebygga sjukdom genom att stödja mÀnniskors förÀndring av sina levnadsvanor. Alla kvinnor ska erbjudas ett tidigt hÀlsosamtal vilket Àr av stor vikt för att identifiera ohÀlsosamma levnadsvanor. I arbetet med att motivera patienten till förÀndring Àr motiverande samtal (MI) en beprövad samtalsmetod som barnmorskan kan anvÀnda i samtalet med den gravida kvinnan. Effekterna av motiverande samtal har visat sig ha en gynnsam verkan pÄ flera hÀlsorelaterade beteenden sÄsom bruk av alkohol, tobak och andra droger, kost och fysisk aktivitet. Syfte: Syftet med studien var att undersöka barnmorskors erfarenheter av och instÀllning till hÀlsosamtal i tidig graviditet. Metod: Studien var empirisk och har en kvalitativ ansats och bygger pÄ Ätta enskilda intervjuer. Datamaterialet analyserades med innehÄllsanalys enligt Graneheim och Lundman (2004). Resultat: I resultatet framkom sex kategorier som besvarade studiens syfte.  Kategorierna heter; tidig flexibel handlÀggning, intresserade och positiva till hÀlsosamtal, tidigt hÀlsosamtal Àr en vinst, barnmorskorna hade olika Äsiketer om behov av utbildning, stor variation i genomförande av hÀlsosamtal och resurstillgÄng pÄverkar hÀlsosamtalets kvalitet. Slutsats: Det som framkom av studien var att tidsbristen Àr en avgörande faktor för arbetet med hÀlsosamtal. Barnmorskorna hade delade uppfattningar om utbildningen som gavs var tillrÀcklig eller inte. En stor vinst sÄgs med tidigt hÀlsosamtal för bÄde barnmorskan och den gravida kvinnan. Mer specifika riktlinjer och utbildningar bör dÀrför finnas eftersom övervikt Àr ett vÀxande hÀlsoproblem idag.Background: The guidelines of the National Board of Health and Welfare provides recommendations on methods on how to prevent illness by supporting people to change their lifestyles. All women should be offered an early health dialogue which is of great importance to identify unhealthy habits. Motivational interviewing is a proven method that the midwife can use in the effort to motivate the pregnant woman. The effects of motivational interviewing has been shown to have a beneficial effect on several health-related behaviors such as use of alcohol, tobacco and other drugs, diet and physical activity. Objective: The aim of this study was to explore midwives' experiences of and attitudes towards health interviews in early pregnancy. Method: The study was empirical and has a qualitative approach and is based on eight single interviews. The data were analyzed by content analysis according Graneheim and Lundman (2004). Results: The results revealed six categories that answered the purpose of the study. The categories are called: early flexible handling, interested and supportive of health interviews, early health consultation is a benefit, the midwives had different opinions about the need for training, considerable variation in the implementation of health consultations and resource availability affects the quality of health discussions. Conclusion: The findings of the study was that lack of time is a crucial factor in the work of health consultations. The midwives had different views on the training given was adequate or not. A large gain was seen with early health consultations for both the midwife and the pregnant woman. More specific guidelines and training should therefore be implemented because obesity is a growing health problem today
Personalvetarstudenter, var ni verkligen redo? : En kvalitativ studie om foÌre detta personal- och arbetslivsstudenters foÌrhaÌllningssaÌtt till oÌvergaÌngen fraÌn studier till arbetsliv
Personal- och arbetslivsprogrammet aÌr en akademisk utbildning som paÌ senare tid har diskuterats som en utbildning i graÌnslandet mellan akademi och yrkesliv. Utbildningen faÌr ofta utstaÌ kritik i samhaÌllsdebatten daÌ de nyexaminerade akademikerna, trots fleraÌrig utbildning saknar praktiska arbetsrelaterade faÌrdigheter och kunskaper. Programmet finns paÌ maÌnga olika orter i Sverige, men med olika utbildningsupplaÌgg. I denna studie undersoÌks personal- och arbetslivsprogram vid tvaÌ universitet i Sverige. Syftet med studien aÌr att undersoÌka hur tidigare studenter fraÌn personal- och arbetslivsprogram upplever att utbildningen har foÌrberett dem foÌr arbetslivet. De fraÌgestaÌllningar som vi aÌmnar besvara i och med uppsatsen aÌr foÌljande: Vilka attityder finns hos informanterna gentemot utbildningen vad gaÌller de erfarenheter och kunskaper som genererats? Vilka likheter och/eller skillnader finns hos informanterna fraÌn de olika utbildningsprogrammen vad gaÌller upplevelser om i vilken maÌn utbildningen varit foÌrberedande foÌr yrkeslivet? Hur kan dessa foÌrklaras i relation till olika saÌtt att foÌrhaÌlla sig till sin utbildning generellt? FoÌr att besvara vaÌra fraÌgestaÌllningar har vi genomfoÌrt aÌtta intervjuer med foÌre detta studenter fraÌn personal- och arbetslivsprogram. Som ett komplement till detta har aÌven tvaÌ telefonintervjuer genomfoÌrts med programansvarig paÌ respektive universitet som valts ut foÌr studien. De teoretiska utgaÌngspunkter som anvaÌnts i undersoÌkningen aÌr dels Granbergs (2009) olika kunskapstyper, Olofssons (2012) teori om utbildningskontraktet, Lindbergs (2009) modell foÌr olika perspektiv paÌ utbildningar samt DimenaÌs (2012) begreppsdefinition av begreppet âbeproÌvad erfarenhetâ. VaÌrt resultat visar paÌ att de foÌre detta studenterna generellt sett aÌr noÌjda med sin utbildning, majoriteten foÌrespraÌkar dock fler inslag av praktiska moment kopplat till yrkeslivet. Informanterna upplever i dagslaÌget inte utbildningen som saÌrskilt yrkesfoÌrberedande. Det finns en skillnad i hur de tvaÌ programansvariga vid respektive universitet foÌrhaÌller sig till utbildningen. Vi finner aÌven vissa skillnader mellan de foÌre detta studenterna roÌrande i vilken maÌn utbildningen varit foÌrberedande foÌr yrkeslivet beroende paÌ vilket universitet de tillhoÌrt. Avslutningsvis lyfter vi de aspekter som hade kunnat goÌras annorlunda, samt ger ett foÌrslag till vidare forskning.
Diabetes mellitus typ 2 : En litteraturstudie om individens kunskap om sin sjukdom
Bakgrund: Idag finns det mer Àn 220 miljoner mÀnniskor i hela vÀrlden med Diabetes, av dessa Àr det 90 procent som har Diabetes mellitus typ 2. Denna sjukdom orsaka stora kostnader för samhÀllet pÄ grund av komplikationer, som leder till lidande för den drabbade, sjukskrivning samt behov av sjukvÄrd och omsorg. För att individen ska kunna förhindra dessa och kunna tillÀmpa egenvÄrd Àr kunskap om sjukdomen och dess behandling en avgörande faktor. Syftet: syftet med denna studie var att belysa individens kunskap om Diabetes mellitus typ 2. Metod: en litteraturstudie av kvalitativa artiklar. Resultat: resultatet av denna studie uppdelades i tre kategorier samt tio subkategorier som belyser individens kunskap om sin sjukdom. Diskussion: kunskap Àr viktig för egenbehandling av Diabetes mellitus typ 2. Det finns en bristfÀllig kunskap som visar att individen behöver fÄ bÀttre information samt stöd frÄn sjukvÄrden för att vidare kunna hantera sin sjukdom utifrÄn den kunskapen som han/hon behöver
Barnet i fokus : En allmÀn litteraturöversikt om sjuksköterskors erfarenheter av att anpassa omvÄrdnaden till barn som genomgÄr cancerbehandling inom slutenvÄrd
Bakgrund: Sjuksköterskors frĂ€msta kompetens Ă€r omvĂ„rdnad. Sjuksköterskor har det frĂ€msta ansvaret kring att anpassa omvĂ„rdnaden till varje specifikt barn. Att anpassa omvĂ„rdnaden utefter behov, Ă„lder, mognad och utveckling kan ses som en utmaning. Sjuksköterskor ansvarar för att erbjuda barnet en vĂ„rdande kommunikation samt en holistisk och personcentrerad vĂ„rd. Tidigare forskning beskriver att barn som genomgĂ„r cancerbehandling inte kĂ€nner sig delaktiga i sin egen vĂ„rd och omvĂ„rdnad. En genomgĂ„ng av de senaste Ă„rens studier av sjuksköterskors anpassning av omvĂ„rdnad till barn med cancer kan bidra med kunskap utifrĂ„n sjuksköterskors perspektiv. Syfte: Studiens syfte var att belysa sjuksköterskors erfarenheter av att anpassa omvĂ„rdnaden till barn som genomgĂ„r cancerbehandling inom slutenvĂ„rd. Metod: En allmĂ€n litteraturöversikt med en induktiv ansats dĂ€r analysmetoden utgick frĂ„n metodförfattaren Fribergs (2017) beskrivning. Ăversikten baserades pĂ„ Ă„tta utvalda vetenskapliga artiklar. Resultat: I resultatet identifierades tre huvudkategorier; egen förberedelse, delaktighet och barnens behov. OmvĂ„rdnaden anpassades till barnen genom kommunikation, lek, se barnens symtom samt att inkludera familjen i barnens vĂ„rd och omvĂ„rdnad. Slutsats: Om sjuksköterskor anpassar omvĂ„rdnaden genom egen förberedelse, delaktighet och utifrĂ„n barnens individuella behov erbjuds barnen en vĂ„rdande kommunikation samt en personcentrerad och holistisk omvĂ„rdnad med barnen i fokus