Smärtlindring vid vaginal förlossning och dess samband med avslutad amning vid två månaders ålder

Bakgrund: Smärtlindring under förlossning och amning är två stora kompetensområden inom barnmorskans profession vilket medför att barnmorskan bör ha kunskap om eventuella samband mellan olika smärtlindringsmetoder och amning. Tidigare forskning om smärtlindringsmetoder och dess samband med amning har oftast fokuserat på enstaka smärtlindringsmetoder samt belyst sambandet med amningsinitiering efter förlossningen. Studier saknas således där hela spektrumet av smärtlindringsmetoder och dess samband med amning fram till två månaders ålder studeras. Syfte: Att undersöka förekomst av smärtlindringsmetoder under vaginal förlossning av fullgångna barn, vilka faktorer som är associerade med respektive smärtlindringsmetod samt eventuella samband mellan smärtlindringsmetod och amning vid två månaders ålder. Metod: Populationsbaserad, prospektiv kohort studie där 31 150 moder-barn par i Uppsala och Örebro län ingick. Material inhämtades från Medicinska Födelseregistret, Statistiska Centralbyrån samt Barnhälsovården. Statistiska analyser inkluderade Chi-två test, binär logistisk regressionsanalys samt multivariat logistisk regressionsanalys. Resultat: Inhalation av lustgas var den mest använda smärtlindringsmetoden. Användningen av smärtlindringsmetoder hade flest samband med län, etnicitet, paritet och moderns ålder. Risken för användning av epiduralblockad var nästan sex gånger så hög för förstföderskor. Intramuskulära injektioner med petidin/morfin eller epiduralblockad medförde en risk för avslutad amning innan två månaders ålder, men för TENS ochakupunktur fanns ett samband med fortsatt amning vid två månaders ålder. Slutsats: Det finns ett samband mellan smärtlindringsmetod och amning två månader postpartum. Barnmorskor bör ha kunskap om detta samband för att kunna stödja mödrarnas val av smärtlindringsmetod och amningsutfall.

Optical Characterization and Optimization of Display Components : Some Applications to Liquid-Crystal-Based and Electrochromics-Based Devices

This dissertation is focused on theoretical and experimental studies of optical properties of materials and multilayer structures composing liquid crystal displays (LCDs) and electrochromic (EC) devices. By applying spectroscopic ellipsometry, we have determined the optical constants of thin films of electrochromic tungsten oxide (WOx) and nickel oxide (NiOy), the films’ thickness and roughness. These films, which were obtained at spattering conditions possess high transmittance that is important for achieving good visibility and high contrast in an EC device. Another application of the general spectroscopic ellipsometry relates to the study of a photo-alignment layer of a mixture of azo-dyes SD-1 and SDA-2. We have found the optical constants of this mixture before and after illuminating it by polarized UV light. The results obtained confirm the diffusion model to explain the formation of the photo-induced order in azo-dye films. We have developed new techniques for fast characterization of twisted nematic LC cells in transmissive and reflective modes. Our techniques are based on the characteristics functions that we have introduced for determination of parameters of non-uniform birefringent media. These characteristic functions are found by simple procedures and can be utilised for simultaneous determination of retardation, its wavelength dispersion, and twist angle, as well as for solving associated optimization problems. Cholesteric LCD that possesses some unique properties, such as bistability and good selective scattering, however, has a disadvantage – relatively high driving voltage (tens of volts). The way we propose to reduce the driving voltage consists of applying a stack of thin (~1µm) LC layers. We have studied the ability of a layer of a surface stabilized ferroelectric liquid crystal coupled with several retardation plates for birefringent color generation. We have demonstrated that in order to accomplish good color characteristics and high brightness of the display, one or two retardation plates are sufficient.

Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)

Background: Tens of millions of patients worldwide suffer from avoidable disabling injuries and death every year. Measuring the safety climate in health care is an important step in improving patient safety. The most commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The aim of the present study was to establish the validity and reliability of the translated version of the SAQ. Methods: The SAQ was translated and adapted to the Swedish context. The survey was then carried out with 374 respondents in the operating room (OR) setting. Data was received from three hospitals, a total of 237 responses. Cronbach's alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument. Results: The Cronbach's alpha values for each of the factors of the SAQ ranged between 0.59 and 0.83. The CFA and its goodness-of-fit indices (SRMR 0.055, RMSEA 0.043, CFI 0.98) showed good model fit. Intercorrelations between the factors safety climate, teamwork climate, job satisfaction, perceptions of management, and working conditions showed moderate to high correlation with each other. The factor stress recognition had no significant correlation with teamwork climate, perception of management, or job satisfaction. Conclusions: Therefore, the Swedish translation and psychometric testing of the SAQ (OR version) has good construct validity. However, the reliability analysis suggested that some of the items need further refinement to establish sound internal consistency. As suggested by previous research, the SAQ is potentially a useful tool for evaluating safety climate. However, further psychometric testing is required with larger samples to establish the psychometric properties of the instrument for use in Sweden.