Icke-farmakologiska smärtlindringsmetoder inom pediatriken

Smärta är både en sensorisk och en känslomässig subjektiv upplevelse. Barn har ett välutvecklat smärtsinne och är mer emotionella än vuxna. Man bör sträva efter att lindra smärta, där har sjuksköterskan en viktig roll, hon kan se till så barnet får behandling för sin smärta. Det finns många olika icke-farmakologiska smärtlindringsmetoder som hjälper barn att hantera smärtsamma upplevelser, de ska reducera stress, bearbeta rädslor och stärka barnets copingmekanismer. Syftet med denna studie var att belysa icke-farmakologiska smärtlindringsmetoder (IFSM) inom pediatriken. Metoden som användes var litteraturstudie av femton vetenskapliga studier. Kategorierna som framkom var, IFSMs effekt, sjuksköterskans attityd till användande av IFSM, barns attityd till användande av IFSM och föräldrars attityd till användande av IFSM. IFSM används som ett komplement till farmakologiska medel för att lindra smärta. IFSM används av sjuksköterskor men tidsbrist, för stor arbetsbörda och kunskapsbrist minskar användandet. Sjuksköterskorna använde sig även ofta av distraktion men också förberedande information som var viktigt för barnens copingförmåga. Barn använder nästan alltid IFSM självständigt exempel på detta kan vara ställningsbyte, tankekontroll och vila. Föräldrarnas närvaro har en smärtlindrande effekt för barnen och tros vara den viktigaste IFSM. Slutsatser som kan dras är att IFSM används men att det behövs mer utbildning och tydligare rutiner för att öka användandet av IFSM samt mer forskning för att öka kunskapen inom området.

Least Squares Approach to Inverse Problems in Musculoskeletal Biomechanics

Inverse simulations of musculoskeletal models computes the internal forces such as muscle and joint reaction forces, which are hard to measure, using the more easily measured motion and external forces as input data. Because of the difficulties of measuring muscle forces and joint reactions, simulations are hard to validate. One way of reducing errors for the simulations is to ensure that the mathematical problem is well-posed. This paper presents a study of regularity aspects for an inverse simulation method, often called forward dynamics or dynamical optimization, that takes into account both measurement errors and muscle dynamics. The simulation method is explained in detail. Regularity is examined for a test problem around the optimum using the approximated quadratic problem. The results shows improved rank by including a regularization term in the objective that handles the mechanical over-determinancy. Using the 3-element Hill muscle model the chosen regularization term is the norm of the activation. To make the problem full-rank only the excitation bounds should be included in the constraints. However, this results in small negative values of the activation which indicates that muscles are pushing and not pulling. Despite this unrealistic behavior the error maybe small enough to be accepted for specific applications. These results is a starting point start for achieving better results of inverse musculoskeletal simulations from a numerical point of view.

Mobil individanpassad realtidsinformation i kollektivtrafiken : En fallstudie på Tågkompaniet

The total traveling with different types of transportation has increased drastically since the 50´s. Despite this increase, the use of the public transportation has decreased in percentage which has its explanation in the overall increased use of cars as transportation. Many researchers believes that better traffic information in the public transport can lead to increased use. Therefore this study aims to investigate how mobile personalized real-time information can increase customer satisfaction in the public transport in order to maintain and attract more travelers. The study addresses the problem through a case study at the Swedish transit agency Tågkompaniet, where customers and staff are studied in order to map the present situation regarding information in the public transport. The case study also sets out to investigate which type of real-time information that is considered to be most important for the travelers. At last the study also investigate which types of technical solutions that is needed, and how the needs of travelers can be considered to be able to offer mobile personalized real-time information. The findings are that there is a dissatisfaction regarding the transit information among both travelers and staff, and that their needs and demands must be met to a greater extent in order to increase the customer satisfaction. Furthermore, the findings are also that information attributes regarding delays and disruptions in the public transport is considered to be most important by travelers. Functions such as subscribe to information, push notifications and information associated with the transit ticket are necessary to be able to provide travelers with mobile personalized real-time information. Lastly the study provides a tool to consider traveler needs in development and evaluation of mobile personalized information systems within the public transport.

Värdering av kriterier vid stora investeringar : En jämförelse mellan olika intressenters uppskattningar av kriterier

In what way does different stakeholders assess a decision and its consequences, and how do these assessments differ? When a company stands before a big decision, they need to consider aspects that are economic, ecologic and social. To make a good decision they need to consider the society and its different stakeholder groups. This study examined how different groups values and weights different criteria. The study has been done with the project Sundsvall logistics park as a case, with criteria related to that project. The goal of the study was to find a way to value and weight different criteria and then compare how the company and the stakeholders assesses these criteria. This has been done through interviews with relevant people that has got extra knowledge about the project Sundsvall logistics park, and through a survey that has been sent out to residents of Sundsvall. The informants and respondents got to assess values and weights to the criteria relative to an indirect alternative where the logistics park isn’t built. The data was then compiled using multi attribute utility theory as a tool to present the comparison. The result of the study suggests that the differences between the valuations and weightings of the criteria is partly due to an uncertainty in how the logistics park would affect the criteria, but that the biggest reason probably depends on what perspective the person is viewing the logistics park from. If the person is viewing the logistics park from an industrial perspective, the criteria related to industrial development is getting more important and is going to take up more room in the analysis. If the person is viewing the logistics park from an individual and social perspective, the criteria related to that is more important and takes up more room in the analysis.