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CONTEXT: Insulin resistance (IR) is a risk factor for type 2 diabetes, diabetic kidney disease, cardiovascular disease and nonalcoholic steatohepatitis. Biliopancreatic diversion (BPD) is the most effective form of bariatric surgery for improving insulin sensitivity. OBJECTIVE: To identify plasma proteins correlating with the early restoration of insulin sensitivity after BPD. DESIGN: Prospective single-center study including 20 insulin-resistant men with morbid obesity scheduled for BPD. Patient characteristics and blood samples were repeatedly collected from baseline up to 4 weeks postsurgery. IR was assessed by homeostatic model assessment for insulin resistance (HOMA-IR), Matsuda Index, and by studying metabolic profiles during meal tolerance tests. Unbiased proteomic analysis was performed to identify plasma proteins altered by BPD. Detailed plasma profiles were made on a selected set of proteins by targeted multiple reaction monitoring mass spectrometry (MRM/MS). Changes in plasma proteome were evaluated in relation to metabolic and inflammatory changes. RESULTS: BPD resulted in improved insulin sensitivity and reduced body weight. Proteomic analysis identified 29 proteins that changed following BPD. Changes in plasma levels of afamin, apolipoprotein A-IV (ApoA4), and apolipoprotein A-II (ApoA2) correlated significantly with changes in IR. CONCLUSION: Circulating levels of afamin, ApoA4, and ApoA2 were associated with and may contribute to the rapid improvement in insulin sensitivity after BPD.

© 2017 John Wiley & Sons Ltd Interprofessional collaboration involves some kind of knowledge sharing, which is essential and will be important in the future in regard to the opportunities and challenges in practices for delivering safe and effective health care. Nursing assistants are seldom mentioned as a group of health care workers that contribute to interprofessional collaboration in health care practice. The aim of this ethnographic study was to explore how the nursing assistants’ knowledge can be shared in a team on a spinal cord injury rehabilitation ward. Using a sociomaterial perspective on practice, we captured different aspects of interprofessional collaboration in health care. The findings reveal how knowledge was shared between professionals, depending on different kinds of practice architecture. These specific cultural–discursive, material–economic, and social–political arrangements enabled possibilities through which nursing assistants’ knowledge informed other practices, and others’ knowledge informed the practice of nursing assistants. By studying what health care professionals actually do and say in practice, we found that the nursing assistants could make a valuable contribution of knowledge to the team.

© 2017 John Wiley & Sons Ltd Interprofessional collaboration involves some kind of knowledge sharing, which is essential and will be important in the future in regard to the opportunities and challenges in practices for delivering safe and effective health care. Nursing assistants are seldom mentioned as a group of health care workers that contribute to interprofessional collaboration in health care practice. The aim of this ethnographic study was to explore how the nursing assistants’ knowledge can be shared in a team on a spinal cord injury rehabilitation ward. Using a sociomaterial perspective on practice, we captured different aspects of interprofessional collaboration in health care. The findings reveal how knowledge was shared between professionals, depending on different kinds of practice architecture. These specific cultural–discursive, material–economic, and social–political arrangements enabled possibilities through which nursing assistants’ knowledge informed other practices, and others’ knowledge informed the practice of nursing assistants. By studying what health care professionals actually do and say in practice, we found that the nursing assistants could make a valuable contribution of knowledge to the team.

© 2018 The Nordic Psychiatric Association. Purpose: The Conners Rating Scales are widely used in research and clinical practice for measuring attention deficit/hyperactivity disorder (ADHD) and associated problem behaviors, but country-specific norms are seldom collected. The current study presents the standardization of the Swedish Conners 3®Rating Scales. In addition, we compared the Swedish norms to those collected in the U.S. and Germany. Material and methods: The study included altogether 3496 ratings of children and adolescents aged 6–18 years from population-based samples. Results: The scores obtained for the Swedish Conners 3®showed satisfactory to excellent internal consistency for most subscales and excellent test–retest reliability. Across-informant correlations were modest. Cross-country comparisons revealed that aggression symptoms rated by teachers and ADHD symptoms rated by parents differed between Sweden, Germany and the U.S. Executive functioning deficits also varied as a function of rater and country, with German and Swedish teachers reporting increasing behavior problems with age, whereas a decrease was observed in the U.S. For some subscales, the observed cross-cultural differences were large enough for a child to be classified as being within the normal range (t-score <60) in one country and within the clinical range (t-score > 70) in another country. Conclusion: The present study shows that the Swedish adaptation of the Conners 3®provides consistent and reproducible scores. However, across-informant ratings were only modest and significant cross-cultural differences in scoring were observed. This emphasizes the need for multi-informant assessment as well as for national norms for rating instruments commonly used within child and adolescent psychiatry research and clinical settings.

The Guidelines for Counselling in Infertility describe the purpose, objectives, typical issues and communication skills involved in providing psychosocial care to individuals using fertility services. The Guidelines are presented in six sections. The first section describes how infertility consultations differ from other medical consultations in obstetrics and gynaecology, whereas the second section addresses fundamental issues in counselling, such as what is counselling in infertility, who should counsel and who is likely to need counselling. Section 3 focuses on how to integrate patient-centred care and counselling into routine medical treatment and section 4 highlights some of the special situations which can provoke the need for counselling (e.g. facing the end of treatment, sexual problems). Section 5 deals exclusively with third party reproduction and the psychosocial implications of gamete donation, surrogacy and adoption for heterosexual and gay couples and single women without partners. The final section of the Guidelines is concerned with psychosocial services that can be used to supplement counselling services in fertility clinics: written psychosocial information, telephone counselling, self-help groups and professionally facilitated group work. This paper summarizes the different sections of the Guidelines and describes how to obtain the complete text of the Guidelines for Counselling in Infertility

© 2016 John Wiley & Sons Australia, Ltd Aim: Early intensive behavioural intervention (EIBI) for children with autism spectrum disorder (ASD) is often delivered using a community model. Behaviour modification experts train and supervise non-experts (e.g. preschool personnel) to teach children according to applied behaviour analysis principles in their natural environment. Several factors predict EIBI outcomes in ASD, for example, knowledge of EIBI and EIBI allegiance among trainers. The aim of the present study was to survey levels of knowledge about and allegiance towards EIBI. Methods: Formal knowledge of EIBI and EIBI allegiance was surveyed in supervised preschool staff conducting EIBI (n = 33), preschool staff not involved in EIBI (n = 26), behaviour modification experts (n = 60), school staff (n = 25) and parents of children with ASD (n = 150) [N = 294]. A 27-item (15 knowledge and 12 allegiance questions) online questionnaire was collected. Results: Supervised preschool staff conducting EIBI had more knowledge than preschool staff not using EIBI, but they were not more allegiant. Compared with behaviour modification experts, the supervised EIBI preschool staff group showed markedly less knowledge and allegiance. Conclusions: Findings indicate potential for improvement regarding formal knowledge levels of preschool staff delivering EIBI to children with ASD in real-world settings. In addition, fostering EIBI allegiance might be prioritized when teaching EIBI among non-experts. Broadly increased EIBI knowledge levels among all preschool teachers should be achieved by adding behaviour modification techniques to common university curricula in preschool education. Allegiance of preschool personnel might be accomplished by EIBI supervisors meeting skepticism in practice with conveyance of evidence-based principles and discussions of ethical issues.

© 2017, © The Author(s) 2017. Early intensive behavioral intervention (EIBI) is widely ap plied in young children with autism spectrum disorder. Little research has addressed the significance of adherence to EIBI practices for treatment outcomes. The York Measure of Quality of Intensive Behavioral Intervention (YMQI) was designed to assess EIBI quality delivery in Ontario, Canada. The objective of this study was to examine the cross-cultural validity of the YMQI in a clinical Swedish community sample of 30 boys and four girls with autism aged 2.5 to 6 years. Internal consistency was alpha =.87 for the full scale YMQI. Interrater reliability among three raters on 97 video-recorded therapy sequences was.71 (intraclass correlation coefficient [ICC]), and intrarater reliability of two raters re-scoring 15 sequences after 6 months was ICC =.87. The convergent validity of the YMQI with EIBI expert ratings was r =.49. Findings endorse the psychometric properties of the YMQI and its usability outside of Anglo-Saxon countries.

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Interprofessional training wards (IPTWs), aiming to enhance interprofessional collaboration, have been implemented in medical education and evaluated over the last decade. The Faculty of Health Sciences, Linköping University has, in collaboration with the local health provider, arranged such training wards since 1996, involving students from the medical, nursing, physiotherapy, and occupational therapy programs. Working together across professional boundaries is seen as a necessity in the future to achieve sustainable and safe healthcare. Therefore, educators need to arrange learning contexts which enhance students' interprofessional learning. This article shows aspects of how the arrangement of an IPTW can influence the students' collaboration and learning. Data from open-ended questions from a questionnaire survey, during autumn term 2010 and spring term 2011 at an IPTW, was analyzed qualitatively using a theoretical framework of practice theory. The theoretical lens gave a picture of how architectures of the IPTW create a clash between the "expected" professional responsibilities and the " unexpected" responsibilities of caring work. Also revealed was how the proximity between students opens up contexts for negotiations and boundary work. The value of using a theoretical framework of professional learning in practice within the frames of healthcare education is discussed. © 2013 Informa UK Ltd.

Interprofessional training wards (IPTWs), aiming to enhance interprofessional collaboration, have been implemented in medical education and evaluated over the last decade. The Faculty of Health Sciences, Linköping University has, in collaboration with the local health provider, arranged such training wards since 1996, involving students from the medical, nursing, physiotherapy, and occupational therapy programs. Working together across professional boundaries is seen as a necessity in the future to achieve sustainable and safe healthcare. Therefore, educators need to arrange learning contexts which enhance students' interprofessional learning. This article shows aspects of how the arrangement of an IPTW can influence the students' collaboration and learning. Data from open-ended questions from a questionnaire survey, during autumn term 2010 and spring term 2011 at an IPTW, was analyzed qualitatively using a theoretical framework of practice theory. The theoretical lens gave a picture of how architectures of the IPTW create a clash between the "expected" professional responsibilities and the " unexpected" responsibilities of caring work. Also revealed was how the proximity between students opens up contexts for negotiations and boundary work. The value of using a theoretical framework of professional learning in practice within the frames of healthcare education is discussed. © 2013 Informa UK Ltd.

The creation of silicon based light sources has been a major research and development effort world-wide. Among various approaches to silicon based light sources reported thus far, the hybrid gain-medium approach (especially integrated with group III-V materials) seems to be the most promising one due to its higher efficiencies than any others. [1-3], QC 20130118

Methods: Twenty-nine post-menopausal women were randomized to either 8 weeks of treatment with transdermal 17 beta-oestradiol (50 mu g/day) or placebo according to a double-blind protocol. A self-estimation of pain, a set of quantitative sensory tests measuring thresholds to temperature, thermal pain, cold pain and pressure pain, and a cold pressor test were performed on three occasions: before treatment, after 8 weeks of treatment and 20 weeks after cessation of treatment. Results: Hormonal replacement treatment significantly increased serum oestradiol levels as expected (P < 0.01). However, no differences in self-estimated pain were seen between treatment and placebo groups, nor were there any differences between the two groups regarding the results of the quantitative sensory tests or the cold pressor test at any of the examined time points. Conclusion: Eight weeks of transdermal oestradiol treatment does not influence perceived pain, pain thresholds or pain tolerance as compared with placebo treatment in post-menopausal women suffering from FM.

Acreo has a long tradition of working with quantum structure based infrared (IR) detectors and arrays. This includes QWIP (quantum well infrared photodetector), QDIP (quantum dot infrared photodetector), and InAs/GaInSb based photon detectors of different structure and composition. It also covers RandD on uncooled microbolometers. The integrated thermistor material of such detectors is advantageously based on quantum structures that are optimised for high temperature coefficient and low noise. Especially the SiGe material system is preferred due to the compatibility with silicon technology. The RandD work on IR detectors is a prominent part of Acreos centre of excellence "IMAGIC" on imaging detectors and systems for non-visible wavelengths. IMAGIC is a collaboration between Acreo, several industry partners and universities like the Royal Institute of Technology (KTH) and Linkoping University.

We have investigated optical properties of Ga0.64In0.36N0.006As0.994/GaAs single quantum-well structures using photoluminescence technique. We have found that nitrogen creates potential fluctuations in the InGaNAs structures, so it is the cause of trap centres in these structures and leads to localized excitons recombination dynamics. The near-band edge PL at 2 K exhibited a blueshift with an increase in excitation intensity of a sample but there is not such a shift in the PL peak position energy of same sample at 150 K. It has been found that PL spectra have a large full width at half maximum (FWHM) value at 2 K. These results are discussed in terms of carrier localization. Additionally, our results suggest decreasing PL integrated intensity in this structure, possibly due to non-radiative recombination. It has been shown that thermal annealing reduces the local strain created by nitrogen. By annealing process, a blue shifted emission can be observed.

FTTH networks require implementing a diplexer at each user termination. According to most of the standards, this diplexer detects a download signal beam at 1.49ÎŒm and emits an upload signal beam at 1.31ÎŒm on the same single mode fibre. Both signals exhibit datarate speed below 2.5Gbps. Today, most of the diplexers are obtained by actively aligning a set of individual optoelectronic components and micro-optics. However, new manufacturing solutions satisfying very low cost and mass production capability requirements of this market would help to speed the massive spreading of this technology. In this paper, we present an original packaging design to manufacture Diplexer Optical Sub-Assembly for FTTH application. A dual photodiode is stacked over a VCSEL and detects both the download signal beam at 1.49ÎŒm passing through the laser and one part of the upload signal beam at 1.31ÎŒm for monitoring. To satisfy this approach, an innovative VCSEL has been designed to have a very high transmission at 1.49ÎŒm. All these components are mounted on a very small circuit board on glass including also integrated circuits such as transimpedance amplifier. So, the device combines advanced optoelectronic components and highly integrated Multi-Chip-Module on glass approach using collective wafer-level assembling technologies. For the single mode fibre optical coupling, active and passive alignment solutions are considered., QC 20120301

Continuous wave photoluminescence (cw PL) spectroscopy has been used to study the optical properties of a set of InGaNAs epilayers and single quantum wells with nitrogen concentration less than a few per cent at different temperatures and different excitation powers. We found that nitrogen has a critical role on the emission light of InGaNAs nanostructures and the recombination mechanism. The incorporation of a few per cent of nitrogen leads to shrinkage of the InGaNAs band gap. The physical origin of such band gap reduction has been investigated both experimentally and theoretically by using a band anticrossing model. We have found that localization of excitons that have been caused by incorporation of a few per cent of nitrogen in these structures is the main explanation of such anomalous behavior observed in the low-temperature photoluminescence spectra of these nanostructures. The localization energies of carriers have been evaluated by studying the variation of the quantum well (QW) emission versus temperature, and it was found that the localization energy increases with increasing nitrogen composition. Our data also show that, with increasing excitation intensity, the PL peak position moves to higher energies (blue shift) due to the filling of localized states and capture centers for excitons by photo-generated carriers. © IOP Publishing Ltd.

Female sex hormones have been suggested to affect the risk of low back pain. One reason is the fact that back pain is a very common symptom during pregnancy. It also seems to be a more common problem among female than male athletes, e.g. in soccer. Although there are few scientific data supporting a relationship between female sex hormones, use of oral contraceptives and low back pain, many doctors and physiotherapists advise women with low back pain to avoid oral contraceptives. The aim of this study was to evaluate whether low back pain fluctuated during the menstrual cycle and differed between women using and not using oral contraceptives. A questionnaire was sent to 12 female soccer teams; 261 players answered and 50 players (28 with back pain and 22 controls) fulfilled the prospective study. At baseline the players underwent a thorough clinical examination and then filled in a diary concerning menstrual data, back pain, training and matches during one season. A total of 296 menstrual cycles was analysed. No difference in prevalence or severity of back pain was seen between the different phases of the menstrual cycle or between users and non-users of oral contraceptives. Our data do not support the hypothesis that low back pain is influenced by hormonal fluctuations during the menstrual cycle or by use of oral contraceptives.

Objective: To assess if transdermal or oral estrogens, acupuncture and applied relaxation decrease the number of menopausal hot flushes/24 h and improve climacteric symptoms, as assessed by the Kupperman index, more than transdermal placebo treatment. Setting: An outpatient clinic at a Swedish university hospital. Methods: A total of 102 postmenopausal women were recruited to two studies performed in parallel. In Study I, the women were randomized between transdermal placebo or estrogen treatment and, in Study II, between oral estrogens, acupuncture or applied relaxation for 12 weeks. Climacteric symptoms were measured with daily logbooks on hot flushes. Women completed the assessment questionnaire for the Kupperman index at baseline and after 12 weeks. Results: The number of flushes/24 h decreased significantly after 4 and 12 weeks in all groups except the placebo group. Both at 4 and 12 weeks, acupuncture decreased the number of flushes more (p < 0.05; p < 0.01, respectively) than placebo. At 12 weeks, applied relaxation decreased the number of flushes more (p < 0.05) than placebo. The Kupperman index score decreased in all groups except the placebo group. The decrease in score was significantly greater in all treatment groups than in the placebo group (p < 0.01). Conclusion: Acupuncture and applied relaxation both reduced the number of hot flushes significantly better than placebo and should be further evaluated as alternatives to hormone therapy in women with menopausal vasomotor complaints.

Objective To compare laparoscopic hysterectomy and abdominal total hysterectomy regarding influence on postoperative psychological wellbeing and surgical measures. Design A prospective, open, randomised multicentre trial. Setting Five hospitals in the South East of Sweden. Population Hundred and twenty-five women scheduled for hysterectomy for benign conditions were enrolled in the study, and 119 women completed the study. Fifty-six women were randomised to abdominal hysterectomy and 63 to laparoscopic hysterectomy. Methods Psychometric tests measuring general wellbeing, depression and anxiety preoperatively and 5 weeks and 6 months postoperatively. Main outcome measure Effects of operating method on the psychological wellbeing postoperatively. Analysis of data regarding operating time, peroperative and postoperative complications, blood loss, hospital stay and recovery time. Results No significant differences in the scores were observed between the two groups in any of the four psychometric tests. Both the surgical methods were associated with a significantly higher degree of psychological wellbeing 5 weeks postoperatively compared with preoperatively. The operating time was significantly longer for the laparoscopic hysterectomy group, but the duration of the stay in hospital and sick-leave were significantly shorter for laparoscopic hysterectomy group compared with the abdominal hysterectomy group. Conclusions General psychological wellbeing is equal after laparoscopic and abdominal hysterectomy within 6 months after the operation. The advantages of the laparoscopic hysterectomy are the shorter stay in hospital and shorter sick-leave, but these issues must be balanced by a longer duration of the operation.

In this work we present performance characteristics of metalorganic vapor-phase epitaxy grown GaInNAs and InGaAs quantum-well (QW) vertical-cavity lasers (VCLs) for 1.3-Όm applications. The InGaAs VCLs emit in a wavelength range from 1200 to somewhat above 1260 nm, while the GaInNAs VCLs operate from 1265 to 1303 nm. The InGaAs VCLs are based on highly strained InGaAs double QWs, with photoluminescence (PL) maximum at around 1190 nm, and extensive negative gain-cavity detuning. As a consequence, these devices are strongly temperature sensitive and the minimum threshold current is found at very high temperature (∌90-100°C). Both kind of VCLs work continuous-wave well above 100°C, and while the InGaAs VCLs reach slightly higher light output power, they show significantly larger threshold currents. In addition, the large device detuning also has profound effects on the high-frequency response. Nevertheless, for a 1260-nm device, 10 Gb/s transmission is demonstrated in a back-to-back configuration. We also show that by further optimization of the InGaAs QWs the PL peak wavelength can be extended to at least 1240 nm. The incorporation of such QWs in the present VCL structure should considerably improve the device performance, resulting in higher light output power, lower threshold current, and reduced temperature sensitivity with a shift of the minimum threshold current towards room temperature, thus approaching standard VCL tuning., References: Wilmsen, C., Temkin, H., Coldren, L.A., (1999) Vertical-Cavity Surface-Emitting Lasers: Design, Fabrication, Characterization and Applications, , Cambridge University Press, Cambridge; Electronicast (2002) VCSEL Transceiver Global Market and Technology Forecast; Steele, R., Laser Focus World (2002) Review and Forecasts of the Laser Markets, Part II: Diode Lasers, p. 61. , February; Guden, M., Piprek, J., Material parameters of quaternary III-V semiconductors for multilayer mirrors at 1.55 Όm wavelength (1996) Modelling Simul. Mater. Sci. Eng., 4, pp. 349-357; Salomonsson, F., Mogg, S., Rapp, S., Bentell, J., Sagnes, I., Raj, R., Streubel, K., Hammar, M., Temperature-dependent performance of 1.55 Όm vertical-cavity lasers with InGaAsP/InP bottom mirror (1999) International Indium Phosphide and Related Materials Conference, pp. 223-226. , IEEE, Piscataway, NJ; Rapp, S., Salomonsson, F., Bentell, J., Sagnes, I., Moussa, H., Mériadec, C., Raj, R., Hammar, M., Near room temperature continuous-wave operation of electrically pumped 1.55 Όm vertical cavity lasers with InGaAsP/InP bottom mirror (1999) Electron. Lett., 35 (1), pp. 49-50; Karim, A., Abraham, P., Lofgreen, D., Chiu, Y.-J., Piprek, J., Bowers, J., Wafer bonded 1.55 Όm vertical-cavity lasers with continuous-wave operation up to 105°C (2001) Appl. Phys. Lett., 78 (18), pp. 2632-2633; Jayaraman, V., Geske, J.C., MacDougal, M.H., Peters, F.H., Lowes, T.D., Char, T.T., Uniform threshold current, continuous-wave, singlemode 1300 nm vertical cavity lasers from 0 to 70 °C (1998) Electron. Lett., 34 (14), pp. 1405-1407; Shau, R., Ortsiefer, M., Rosskopf, J., Böhm, G., Köhler, F., Amann, M.-C., Vertical-cavity surface-emitting laser diodes at 1.55 Όm with large output power and high operation temperature (2001) Electron. Lett., 37 (21), pp. 1295-1296; Nakagawa, S., Hall, E., Almuneau, G., Kim, J.K., Buell, D.A., Kroemer, H., Coldren, L.A., 88°C, continuous-wave operation of apertured, intracavity co

We compare GaInNAs and highly strained InGaAs quantum-wells (QWs) for applications in metal-organic vapor-phase epitaxy (MOVPE)-grown GaAs-based 1300-nm vertical-cavity lasers (VCLs). While the peak wavelength of InGaAs QWs can be extended by a small fraction of N, the luminescence efficiency degrades strongly with wavelength. On the other hand, using highly strained InGaAs QWs in combination with a large VCL detuning it is also possible to push the emission wavelength towards 1.3 ÎŒm. The optimized MOVPE growth conditions for such QW and VCL structures are discussed in some detail. It is noted that GaInNAs and InGaAs QWs preferably are grown at low temperature, but with quite different V/III ratios and growth rates. We also point out the importance of reduced doping concentration and growth temperature of the n-doped bottom distributed Bragg reflector to minimize optical loss and for compatibility with GaInNAs QWs. InGaAs VCLs with emission wavelengths beyond 1260 nm are demonstrated. This includes mW-range output power, mA-range threshold current and 10 Gb/s data transmission., Sponsors: SPIE NR 20140805

We report on the optical and structural integrity of metal-organic vapor-phase epitaxy grown GaInNAs/GaAs single quantum wells on AlGaAs/GaAs distributed Bragg reflectors (DBRs). Surface morphology as measured by atomic force microscopy and quantum well photoluminescence were investigated for different numbers of DBR periods and different DBR-growth temperatures. Increased number of DBR periods severely degrades the surface morphology and photoluminescence. However, a significant improvement was obtained by lowering the growth temperature of the DBRs from 745 to 680°C., Sponsors: IEEE Electron Devices Society; IEEE Lasers and Electro-Optics Society NR 20140805

The growth and characterisation of high-performance 1.2-Όm highly strained InGaAs/GaAs single quantum well (SQW) laser diodes is reported. High output power in excess of 200 mW per facet was obtained from ridge-waveguide (RWG) lasers at an emission wavelength of 1230 nm. These lasers operate CW to at least 145°C and show a high characteristic temperature of 150 K. The net modal gain was measured using the method described by Hakki and Paoli., Sponsors: IEEE Electron Devices Society; IEEE Lasers and Electro-Optics Society NR 20140805

Microcavities with dimensions on the wavelength scale are being extensively investigated due to their ability to exhibit enhanced spontaneous emission, directional output and single-mode operation. Photonic crystals with single or multiple defects have emerged as the preferred way to obtain such microcavities. We have designed and fabricated a 1.55 ÎŒm electrically injected photonic crystal surface-emitting microcavity device using an ImP-based heterostructure. The emission wavelength at 1.55 ÎŒm is an important wavelength for long haul optical communication applications., Sponsors: IEEE Electron Devices Society; IEEE Lasers and Electro-Optics Society NR 20140805

Important elements in the curriculum at the Faculty of Health Sciences in Link ping are vertical integration, i.e. integration between the clinical and basic science sections of the curriculum, and horizontal integration between different subject areas. Integration throughout the whole curriculum is time-consuming for both teachers and students and hard work is required for planning, organization and execution. The aim was to assess the importance of vertical and horizontal integration in an undergraduate medical curriculum, according to opinions among students and teachers. In a questionnaire 102 faculty teachers and 106 students were asked about the importance of 14 different components of the undergraduate medical curriculum including vertical and horizontal integration. They were asked to assign between one and six points to each component (6 points = extremely important for the quality of the curriculum; 1 point = unimportant). Students as well as teachers appreciated highly both forms of integration. Students scored horizontal integration slightly but significantly higher than the teachers (median 6 vs 5 points; p=0.009, Mann-Whitney U-test), whereas teachers scored vertical integration higher than students (6 vs 5; p=0.019, Mann-Whitney U-test). Both students and teachers considered horizontal and vertical integration to be highly important components of the undergraduate medical programme. We believe both kinds of integration support problem-based learning and stimulate deep and lifelong learning and suggest that integration should always be considered deeply when a new curriculum is planned for undergraduate medical education.

Problem-based learning (PBL), combined with early patient contact, multiprofessional education and emphasis on development of communications skills, has become the basis for the medical curriculum at the Faculty of Health Sciences in Link ping (FHS), Sweden, which was started in 1986. Important elements in the curriculum are vertical integration, i.e. integration between the clinical and basic science parts of the curriculum and horizontal integration between different subject areas. This article discusses the importance of vertical integration in an undergraduate medical curriculum, according to experiences from the Faculty of Health Sciences in Link ping, and also give examples on how it has been implemented during the latest 15 years. Results and views put forward in published articles concerning vertical integration within undergraduate medical education are discussed in relation to the experiences in Link ping. Vertical integration between basic sciences and clinical medicine in a PBL setting has been found to stimulate profound rather than superficial learning, and thereby stimulates better understanding of important biomedical principles. Integration probably leads to better retention of knowledge and the ability to apply basic science principles in the appropriate clinical context. Integration throughout the whole curriculum entails a lot of time and work in respect of planning, organization and execution. The teachers have to be deeply involved and enthusiastic and have to cooperate over departmental borders, which may produce positive spin-off effects in teaching and research but also conflicts that have to be resolved. The authors believe vertical integration supports PBL and stimulates deep and lifelong learning.

GaInNAs/GaAs quantum-well (QW) lasers emitting at 1.3 ÎŒm were grown using metal-organic vapor-phase epitaxy (MOVPE) in the limit of very low growth rate and temperature. The material was characterized by photoluminescence (PL) spectroscopy as well as by implementation in broad-area (BA) edge-emitting lasers. While the PL intensity was found to decrease by more than two orders of magnitude between 1175 and 1350 nm, the corresponding BA laser threshold current showed a much more modest increase. For a 1.28-ÎŒm laser the transparency current was 0.8 kA/cm2, the slope efficiency 0.24 W/A per facet and T0=100 K. Comparison between PL emission properties and BA laser performance reveled a complex relationship. A high PL intensity does not necessarily lead to low threshold-current lasers. In these cases, the FWHM seems to be the more relevant parameter for QW optimization., Sponsors: IEEE NR 20140805

Self-assembled InP quantum dots have been grown in planar microcavities. The dots were embedded in a Ga0.52In0.48P spacer grown on top of a high reflectance epitaxial Al0.29Ga0.71As/AlAs distributed Bragg reflector (DBR) to obtain a 33λ/4 cavity. The Fabry-Perot microcavity is formed between the AlGaAs/AlAs DBR and a dielectric SiNx/SiO2 DBR deposited on top of the GaInP spacer. The quantum dot emission is centered at 1.62 eV at 7 K. The microcavity resonance is centered at 1.65 eV, with a linewidth of 2 meV. Micro-photoluminescence (PL) studies using different objectives with different numerical apertures enable the collection of transversal modes., References: Weisbuch, C., Houdre, R., Stanley, R., (1996) Phys. Scripta, T66, p. 121; Berman, P.R., (1994) Cavity Quantum Electrodynamics, , Academic Press, New York; Gerard, J.M., Sermage, B., Gayral, B., Legrand, B., Costard, E., Thierry-Mieg, V., (1998) Phys. Rev. Lett., 81, p. 1110; Graham, L.A., Huffaker, D.L., Deng, Q., Deppe, D.G., (1998) Appl. Phys. Lett., 72, p. 1670; Huffaker, D.L., Park, G., Zhou, Z., Shchekin, O.B., Deppe, D.G., (1998) Appl. Phys. Lett., 73, p. 2564; Moritz, A., Wirth, R., Hangleiter, A., Kurtenbach, A., Eberl, K., (1996) Appl. Phys. Lett., 69, p. 212; Eberl, K., Kurtenbach, A., Zundel, M., Jin-Phillipp, N.Y., Phillipp, F., Moritz, A., Wirth, R., Hangleiter, A., (1997) J. Cryst. Growth, 175-176, p. 702; Zundel, M., Jin-Phillipp, N.Y., Phillipp, F., Eberl, K., Riedl, T., Fehrenbacher, E., Hangleiter, A., (1998) Appl. Phys. Lett., 73, p. 1784; Riedl, T., Fehrenbacher, E., Hangleiter, A., Zundel, M.K., Eberl, K., (1998) Appl. Phys. Lett., 73, p. 3730; Georgson, K., Carlsson, N., Samuelson, L., Seifert, W., Wallenberg, L.R., (1995) Appl. Phys. Lett., 67, p. 2981; Hessman, D., Castrillo, P., Pistol, M.-E., Anand, S., Carlsson, N., Seifert, W., Samuelson, L., (1996) Appl. Phys. Lett., 67, p. 749; Zwiller, V., Pistol, M.-E., Hessman, D., Cederström, R., Seifert, W., Samuelson, L., (1999) Phys. Rev. B, 59, p. 5021; Carlsson, N., Seifert, W., Petersson, A., Castrillo, P., Pistol, M.-E., Samuelson, L., (1994) Appl. Phys. Lett., 65, p. 3093; Born, M., Wolf, E., (1994) Principles of Optics, , Pergamon, Oxford NR 20140805

The effect of n-type doping on the peak reflectivity of InGaAsP/InP as well as GaAs/AlAs distributed Bragg reflectors for long-wavelength vertical-cavity lasers has been investigated. A variety of mirrors with different doping levels were grown in both material systems using metal organic vapour phase epitaxy. The reflectance of the structures was measured with high accuracy employing two independent measurement techniques. While nominally undoped DBRs exhibit an expected reflectivity in excess of 99.9%, doping is found to induce significant losses resulting in up to 0.6% reduced reflectance., Sponsors: IEEE NR 20140805

Two different groups of women, 23 healthy young adults and 13 women with chronic posterior pelvic pain, were studied before and during use of oral contraceptives (OC). Collagen metabolism markers-here, the amino terminal propeptide of type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III-as well as hormones and other endocrine factors indicating the balance between androgen expression/anabolism and catabolism of the subjects (testosterone, sex-hormone binding globulin, and insulin-like growth factor I were measured. Type I procollagen, the carboxy-terminal telopeptide of type I collagen, and the amino-terminal of procollagen type III were all significantly decreased during OC use. These findings implicate OC use-induced changes in collagen type I and III turnover. A shift in the anabolic/catabolic balance was also recorded indicating a less anabolic situation during OC use.

OBJECTIVES: To establish the prevalence of unsteadiness and rotatory vertigo in peri- and postmenopausal women, and whether balance disturbances are more common in women with vasomotor symptoms and without hormone replacement therapy (HRT). METHOD: A validated questionnaire was sent to all 1523 women aged 54 or 55 years in Linköping, Sweden. RESULTS: Daily or weekly unsteadiness was reported by 5%, and daily or weekly rotatory vertigo by 4% of all women. The frequency of vasomotor symptoms correlated with reported unsteadiness (rs = 0.23, p < 0.001). Fourteen per cent of women with daily vasomotor symptoms reported weekly or daily unsteadiness, compared with 3% of those without vasomotor symptoms (odds ratio (OR) 7.58, 95% confidence interval (CI) 3.72-15.45). The frequency of vasomotor symptoms correlated with rotatory vertigo (rs = 0.19, p < 0.001). Ten per cent of women with daily vasomotor symptoms reported weekly or daily rotatory vertigo, compared with 2% of women without vasomotor symptoms (OR 5.21, 95% CI 1.07-25.52). No correlation was seen between vasomotor symptoms and falls. Users of HRT had the same prevalence of balance disturbances as non-users. CONCLUSIONS: Women with frequent vasomotor symptoms seem to run a greater risk of unsteadiness and rotatory vertigo than do women without symptoms. This association may not be explained by means of a cross-sectional study, but there might exist a causal connection between vasomotor symptoms and balance disturbances.

We report on the fabrication and characterisation of a resonant cavity light-emitting diode (RCLED) operating at 1.55 Όm. As compared to conventional LEDs such devices merit from a higher emission intensity with a more narrow linewidth and are therefore promising as light sources in fibre optical communication systems. The present design is based on an InGaAsP multi-quantum well structure and utilises two InGaAsP/InP epitaxial distributed Bragg reflectors (DBRs), one 50 periods high reflectivity bottom mirror and a top out-coupling mirror with lower reflectivity. This gives the advantage of top-emission combined with the possibility of achieving very narrow linewidth. The process is fully monolithic and full wafer scale compatible., References: Purcel, E.M., (1946) Phys. Rev., 69, p. 681; Shubert, E.F., Hunt, N.E.J., Malik, R.J., Micovic, M., Miller, D.L., (1996) J. Lightwave Technol., 14, p. 1721; De Neve, H., (1995) Phot. Techn. Lett., 7, p. 287; Corbett, B., Considine, L., Walsh, S., Kelly, W.M., (1993) Phot. Techn. Lett., 5, p. 1041; Hunt, N.E.J., Shubert, E.F., Logon, E.F., Zydzik, G.J., (1992) Appl. Phys. Lett., 61, p. 2287; Depreter, B., InP microcavity LED emitting at 1.55 Όn LEOS, p. 241. , Nov 97, San Francisco, Ca, USA; Christenson, G.L., (1997) Phot. Techn. Lett., 9, p. 725; Streubel, K., (1994) J. Cryst. Growth, 143, p. 7; Lourdudoss, S., (1994) Mat. Sci. Eng., B28, p. 179; De Neve, H., (1997) Appl. Phys. Lett., 70, p. 799; Rapp, S., All Epitaxial Single-Fused 1.55 Όm Vertical Cavity Laser Based on an InP Bragg Reflector (1998) Proceedings of the 10th International Conference on Indiumphosphide and Related Materials, p. 303. , 11-15 May Tsukuba Japan; Gebretsadik, H., Kamath, K., Zhou, W.-D., Battacharya, P., (1998) Appl. Phys. Lett., 72, p. 135; Streubel, K., Helin, U., BÀcklin, E., Johansson, Å., High Brightness Visible (660 nm) Resonant-Cavity Light-Emitting Diode Photon. Techn. Lett. NR 20140805

We have investigated the properties of wafer-fused Si-doped isotype hetero-junctions between GaAs and InP. Current/voltage measurements were conducted to study the influence of the doping concentrations on each side of the interface on the electrical conductivity. An almost ohmic behavior with a very low series resistance was obtained for the highest examined doping level on the GaAs side, whereas the doping concentration on the InP side was found to be of little significance. Fusion at different temperatures showed that the conductivity degrades significantly below 500°C, although mechanically stable junctions were obtained also at temperatures as low as 305°C. Secondary ion mass spectroscopy measurements showed no redistribution of Si, but indicated the presence of small amounts of C and Fe impurities at the interface., References: Liau, Mull, D.E., (1990) Appl. Phys. Lett., 56, p. 737; Lo, (1991) Appl. Phys. Lett., 58, p. 1961; Black, A., Zhu, Z.-H., (1997) IEEE J. Sel. Top. Quantum Electron., 3, p. 927; Margalit, N.M., (1997) IEEE J. Sel. Top. Quantum Electron., 3, p. 359; Salomonsson, F., (1998) J. Appl. Phys., 83, p. 768; Hammar, M., Proceedings of the 10th International Conference on Indium Phosphide and Related Materials (IPRM) '98, p. 801. , May 11-15, Tsukuba, Japan; Wada, H., Ogawa, Y., Kamijoh, T., (1993) Appl. Phys. Lett., 62, p. 738; Dudley, J.J., (1994), PhD dissertation, University of California, Santa BarbaraFarrow, R.F.C., (1974) J. Phys. D: Appl Phys., p. 2436; Sagalowicz, L., (1997) Phil. Mag. Lett., 76, p. 445 NR 20140805

We report on the electrical and compositional characterization of wafer-fused isotype heterojunctions between Zn-, C- or Si-doped GaAs and Zn- or Si-doped InP. The junctions were characterized by current-voltage and secondary ion mass spectrometry (SIMS) measurements. It is demonstrated that very low-resistive junctions can be obtained in each case, but also that there is a strong influence from the detailed sample structure and processing conditions. SIMS was used to monitor the doping concentration across the interface as well as the impurity concentrations of oxygen, carbon and iron. © 1999 Publication Board, Japanese Journal of Applied Physics., References: Black, A., Hawkins, A.R., Margalit, N.M., Babic, D.I., Holmes, A.L., Chang Jr., Y.-L., Abraham, P., Hu, E.L., (1997) IEEE J. Sel. Top. Quantum Electron., 3, p. 927; Zhu, Z.-H., Ejeckham, F.E., Qian, Y., Zhang, J., Zhang, Z., Christenson, G.L., Lo, Y.H., (1997) IEEE J. Sel. Top. Quantum Electron., 3, p. 943; Qian, Y., Ahu, Z.H., Lo, Y.H., Huffaker, D.L., Dcppe, D.G., Hou, H.Q., Hammons, E.B., Tu, Y.K., (1997) Appl. Phys. Lett., 71, p. 25; Rapp, S., Salomonsson, F., Streubel, K., Mogg, S., Wennekes, F., Bentell, J., Hammar, M., (1999) Jpn. J. Appl. Phys., 38 (1 B); Margalit, N.M., Piprek, J., Zhang, S., Babic, D.I., Streubel, K., Mirin, R.P., Wesselman, J.R., Hu, E.L., (1997) IEEE J. Sel. Top. Quantum Electron., 3, p. 359; Salomonsson, F., Streubel, K., Bentell, J., Hammar, M., Keiper, D., Westphalen, R., Piprek, J., Behrend, J., (1998) J. Appl. Phys., 83, p. 768; Babic, D.I., (1995), Ph.D. dissertation, University of California, Santa BarbaranoteSagalowicz, L., Rudra, A., Syrbu, A., Behrend, J., Salomonsson, F., Streubel, K., Hammar, M., Bentell, J., (1997) Philos. Mag. Lett., 76, p. 445; Wennekes, F., (1997), Diploma Thesis, Royal Institute of TechnologyNolte, D.D., (1989) Appl. Phys. Lett., 54, p. 259; Wada, H., Ogawa, Y., Kamijoh, T., (1993) Appl. Phys. Lett., 62, p. 738; Okuno, Y., Uomi, K., Aoki, M., Tsuchiya, T., (1997) IEEE J. Quantum Electron, 33, p. 959; Dudley, J.J., (1994), Ph.D. dissertation, University of California, Santa BarbaraFarrow, R.F.C., (1974) J. Phys. D: Appl. Phys., p. 2436 NR 20140805

We report on three novel vertical cavity laser (VCL) structures for 1.55 Όm operation. Two of the VCL structures utilize an n-type GaInAsP/InP Bragg mirror combined with an Al(Ga)As/GaAs mirror using either wafer-fusion or metamorphic epitaxial growth. The third VCL employs two wafer fused AlGaAs/GaAs mirrors, in which lateral current confinement is obtained by localized fusion of the p-mirror. All three VCLs use strained GaInAsP quantum wells as active material and achieve continuous-wave (CW) operation at room-temperature or above. The single fused VCL operates up to 17 °C and 101 °C in continuous-wave and pulsed mode, respectively. The monolithic VCL-structure with a metamorphic GaAs/AlAs n-type mirror uses a reversed biased tunnel junction for current injection. This laser achieves record high output power (1mW) at room temperature and operates CW up to 45 °C. The double fused VCLs with a 10×10 Όm2 active area operate CW up to 30 °C with threshold current as low as 2.5 mA and series resistance of 30 Ohms. The emission spectra exhibit a single lasing mode polarized with 30 dB extinction ratio and a spectral linewidth of 150 MHz., Sponsors: SPIE NR 20140805

We have fabricated and evaluated a long-wavelength vertical-cavity laser (VCL) based on an epitaxially integrated InP distributed Bragg reflector (DBR) under continuous wave (CW) and pulsed conditions. We conclude that, for an InP-DBR-down configuration, the high-temperature performance is limited by the heat conductivity of the bottom mirror. The highest operating temperature for CW and pulsed condition is 17 °C and 101 °C respectively, indicating a substantial self-heating for CW. To investigate the prospect for improved performance in other mounting configurations, we have applied a two-dimensional finite element analysis to the heat transfer problem. It is suggested that for top-side-down mounting with the AlGaAs/GaAs DBR closest to the heat sink, a performance comparable to that of so called double-fused VCLs could be possible., Correspondence Address: Salomonsson, P.; Royal Inst of Technology, Kista, Sweden NR 20140805