The thermal response in hands provoked by cold water was investigated with infrared thermography. In 26 healthy young men, the response of hand skin temperature to cold water provocation was measured twice on consecutive days. An infrared thermographic camera was used and data were processed in real time. The software divides each hand into 18 predefined regions of interest (ROI). The average temperature in each ROI was stored every 10th second. Baseline hand skin temperature was recorded for two minutes. The bare hands were then immersed for 30 seconds in water at 10°C × 0.5°C and carefully dried. Thereafter, the cooled and final hand skin temperature was measured. The baseline showed a higher average temperature of 0.3°C on day 2 and the 95% limits of agreement (LOA) were - 5.2-5.8, the cooled average temperatures showed no significant difference between the two days (LOA: - 4.8-4.6) and the average final hand skin temperature was 0.8°C higher on day 2 (LOA: - 5.2-6.4). In conclusion, there was variability between the two measurements, small differences in the temperature response to the reaction to cold-water provocation - probably due to Day 1 stress factor.

The trend for health care and nursing care turns from hospital to health care and nursing care at home. Studies have shown that health care professionals have no access to patient records in home and nursing home settings. Technological development creates opportunities for a host of mobile technology solutions. The aim of this study was to describe the reasoning among general practitioners (GPs) about the use of mobile distance-spanning technology (MDST) in care at home and in nursing homes. Seventeen GPs were divided in five groups for a group interview. The interviews were tape-recorded and transcribed verbatim. The qualitative content analysis resulted in four areas about the MDST, MDST has an impact on GPs' work, the nurses' profession, and the patient and the family, with nine adherent categories. The findings were interpreted and formulated in the theme: MDST should be used with caution. The results show quite a few expressions about the MDST as useful and valuable in health care at home and in nursing home settings; however, in every category, there were text that we interpreted as caution when using the MDST. The MDST cannot be used in all situations and cannot replace human meetings in health care and nursing care at home and in nursing homes. The MDST should primarily be a tool for the profession, and understanding the professions' reasoning about technology use in health care at home and in nursing home settings must be the base for implementing MDST.

Background and objective The interest in bariatric surgery is growing. Morbidly obese patients have an increased risk of hypoxia and decreased blood pressure during rapid sequence induction (RSI). Alternate RSI methods that provide cardiovascular and respiratory stability are required. With this in mind, we evaluated a method for volatile RSI in morbidly obese patients. Design Observational study. Methods Thirty-four patients with mean BMI 42.4 kg m(-2) undergoing bariatric surgery (morbidly obese group) and 22 patients with mean BMI 25.6 kg m(-2) as a control group were included in the study. Anaesthesia was induced with sevoflurane, propofol, suxamethonium and alfentanil, designed to avoid respiratory and haemodynamic adverse events and to minimise depressing effect on the brain respiratory centre under ongoing RSI. Peripheral oxygen saturation (SpO(2)) and mean arterial blood pressure were registered before and after endotracheal intubation. In addition, two time periods were measured during RSI: spontaneous breathing time (SBT) and apnoea time. Results We found no significant differences between the groups. No periods of desaturation were detected. SpO(2) was 100% before and after endotracheal intubation in all patients. Mean arterial pressure was maintained at a stable level in both groups. Mean SBT and apnoea time were 65.6 and 45.8 s in the morbidly obese group, and 70.7 and 47.7 s in the control group, respectively.

Upplevelser och erfarenheter av undersökningar i hemmet med hjälp av informations- och kommunikationsteknik beskrivet ur patienters och läkares perspektiv.Projektets övergripande syfte  Syftet med projektet är att belysa upplevelser och erfarenheter av undersökningar i hemmet med hjälp av informations. och kommunikationsteknik.    Kort beskrivning av projektet   I den första studien intervjuades 9 personer som fick vård i hemmet om deras syn på den nya teknik som distriktssköterskorna använde i hemsjukvården för diagnostik och kommunikation. I intervjuerna framkom stor tilltro till denna teknik men den kan inte överlåtas till patienterna själva eller deras anhöriga att sköta.I den andra studien gjordes gruppintervjuer omfattande totalt 17 distriktsläkare med varierande erfarenhet av en ny teknik som prövades i projektform. Uppfattningen om användbarheten av den nya tekniken vid intervjutillfället och i ett framtidsperspektiv varierade stort. Samtliga framhöll vikten av det personliga mötet med patienten som aldrig kan ersättas.I båda studierna användes kvalitativ innehållsanalys för att analysera intervjutexterna.

Introduction: New solutions could be a challenge for both the persons in need of health care at home and the health care professions when the person's individual needs in health care at home have to be met. The mobile distances-spanning technology (MDST) could come into use to support the health care at home. Before implementing the MDST the voices of persons in need of health care at home need to be heard about the use of MDST. Methods and Materials: The aim was to describe views and experiences about the use of MDST in health care at home from the perspectives of persons in need of health care at home. The persons were living in ordinary homes and all had experiences of MDST when district nurses were caring for them at home. Persons in need of health care at home (n=9) participated in individual qualitative research interviews for data collection. Qualitative content analysis was used for data analysis. Results: Participants put health care at home in the first place and the MDST was put in the second place. The importance of human meetings was put forwards. The results indicate in different ways opportunities, possibilities and risks with using MDSTs. When the MDST was used, it was important to have established a relationship and trust to the district nurses and the general practitioners, and to know them and to be known by them. The participants expressed that the health care professionals need to see the person behind the technology. Conclusion: Human meetings can never be excluded in health care at home even when a virtual meeting for some issues is relevant. The MDST can never capture or replace the human meetings but human meetings and virtual meetings can be used as complement to each other.

Introduction: Health care at home could be a challenge for both the persons in need of health care at home and the health care professions when the person's individual needs in health care at home have to be met. There is a need for different technical solutions in order to create opportunities for persons in need of health care to stay in their own homes and get health care. The mobile distances-spanning technology (MDST) could come into use to support the health care at home for the future. Methods and Materials: The aim of this presentation is to describe the usefulness of MDST in health care at home. During a project MDST have been tested as an addition in health care at home. The district nurses used 11 different mobile equipments in home care. During the home visits they filled out a form (n=154) about which equipment they used when caring for persons in home care. Results: The district nurses did totally 184 home visits and in 154 cases they used the equipments during the test period. The most frequently used equipment was the mobile computer with access to the patient record (73%) and the access to the patient record was reported as useful at home. The district nurses noted importance to use the bladder scanner even if it was not used so often (11%). The digital camera was used (8%) and was reported as complicated but useful when documenting the healing process of wounds. When the electronic stethoscope was used (7%) some reported a disturbing sound that hampered the assessment. Conclusion: There are several equipments that could be useful and it is important to test and identify the equipments that are most suitable for use in home care.

The objective of this study was to use spray drying to prepare mucoadhesive dry powders of the antimigraine drug, zolmitriptan, in combination with the natural polymer, chitosan, for nasal administration. The effect of type, molecular weight, and proportion of chitosan on the powder and particle characteristics was also studied. Solutions containing different proportions of chitosans were prepared and spray dried. The chemical stability and content of the drug were determined by HPLC. The morphology and size range of the microparticles were also determined. Solid-state analysis was undertaken using thermal methods (DSC/MDSC and TGA), powder X-ray diffraction (PXRD), and Fourier transform infra-red spectroscopy (FT-IR). The drug release profiles were investigated and the time required to reach maximum solution concentrations (Tmax) was used for comparison. The drug was chemically stable, with a 93-105% loading in the microparticles. The microparticles were spherical with a narrow size distribution, irrespective of the formulation. Phase separation was observed for formulations containing less than 90% (w/w) chitosan, irrespective of the type. In contrast, in the formulation containing 90% (w/w) chitosan, the drug was molecularly dispersed. FT-IR studies showed that the bands corresponding to intermolecular hydrogen bonding were broader and more diffuse when zolmitriptan was amorphous. The formation of a hydrogen bond between drug and chitosans was also observed. Tmax increased as the proportion of chitosan decreased, and was proportional to the molecular weight of the chitosan in the formulation containing 90% (w/w) chitosan. Spray drying is a suitable technique for making mucoadhesive dry powders of zolmitriptan and chitosan for nasal application. The dispersion and release of the drug was affected by the properties and composition of the chitosan.

Objectives. The aim of this study was to describe how people in need of health care at home view technology.Study design. A qualitative approach was used based on qualitative interviews, followed by qualitative content analysis.Methods. District nurses (DNs) from 4 health care centres in Northern Sweden had access to different kinds of distance-spanning technology with mobile devices and who used it in their health care at home. Persons in whose home the technology was being used were asked to participate in an interview. The interviewed persons were selected consecutively. Results. The results fall into 2 categories: (1) The well-known technology at hospital is new at home, (2) the new technology opens up possibilities but it also has limitations, with seven adherent subcategories.Conclusions. The participants viewed the technology at home as something good and as something that could open up possibilities. At the same time, they placed the use of the technology in the hands of the staff which indicates some degree of dissociation from the technology. The importance of personal meetings between patient and caregiver was very clearly stressed even when distance meetings could be performed and accepted. The participants expressed immense trust in the nursing staff and considered them responsible for the new technology at home.