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- Hedman, Christel, et al.
(författare)
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Sedation in specialized palliative care : A cross-sectional study
- 2022
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 17:7, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Palliative sedation is used to relieve refractory symptoms and is part of clinical practice in Sweden. Yet we do not know how frequently this practice occurs, how decision-making takes place, or even which medications are preferentially used.OBJECTIVES: To understand the current practice of palliative sedation in Sweden.METHODS: We conducted a retrospective cross-sectional medical record-based study. For 690 consecutive deceased patients from 11 of 12 specialized palliative care units in the southernmost region of Sweden who underwent palliative sedation during 2016, we collected data on whether the patient died during sedation and, for sedated patients, the decision-making process, medication used, and depth of sedation.RESULTS: Eight percent of patients were sedated. Almost all (94%) were given midazolam, sometimes in combination with propofol. The proportions of sedation were similar in the patient groups with and without cancer. The largest proportion of the sedated patients died in inpatient care, but 23% died at home, with specialized palliative home care. Among the patients with a decision to sedate, 42% died deeply unconscious, while for those without such a decision the corresponding figure was 16%. In only one case was there more than one physician involved in the decision to use palliative sedation.CONCLUSION: 8% of patients in specialized palliative care received palliative sedation, which is lower than international measures but much increased compared to an earlier Swedish assessment. The level of consciousness achieved often did not correspond to the planned level; this, together with indications of a scattered decision process, shows a need for clear guidelines.
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| 2. |
- Holm, Ann-Charlotte
(författare)
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Membrane transport of triiodothyronine : With particular reference to erythrocytes in health and disease
- 1992
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Cellular T3 uptake was studied in three human cell systems, i.e. cultured lymphocytes, erythrocytes and erythrocyte membrane vesicles.The basic experimental procedure included 1) incubation of cells or membranes with T3 tracer and increasing concentrations of unlabelled T3, 2) separation of unbound hormone from hormone bound to cells or membranes, 3) counting of radioactivity, and 4) calculation of saturable uptake and uptake constants. Variations on this basic experimental theme included a) addition of ATP or metabolic inhibitors, b) competition by T4 analogues, c) changes of vesicular volume and permeability, and d) changes of membrane temperature. Finally, the T3 concentration in the erythrocytes was measured.The uptake of T3 proved to be carrier-mediated. In lymphocytes it seemed to be energy dependent, but not in erythrocytes, although erythrocyte membrane vesicles had the potential to respond with accelerated uptake to increased energy supply from ATP. The mean Vmax was increased in hyperthyroidism and decreased in hypothyroidism (both p<0.01), and one patient with thyroid hormone resistance had a V max value similar to those of hyperthyroid patients. In patients with low serum free T3 from non-thyroidal causes V max was not altered. The mean Km for T3 uptake in erythrocytes was similar in controls and the patient groups examined.Binding of T3 to the membrane sites occurred only in membranes exposed to 25 °C and subsequently to 0 °C. The mean Bmax thus measured was reduced in hypothyroidism (p<0.05).The mean erythrocyte T3 concentration was 220 pM in healthy subjects, !50 pM in pregnancy, approximately 190 pM in non-thyroidal illnesses and 60 pM in hypothyroidism (all p<0.01).The results show that I) human erythrocytes and lymphocytes take up T3 by carrier-mediated transport, 2) the rate of T3 uptake changes in thyroid diesease but not in pregnancy or nonthyroidal illness, and 3) the erythrocyte T3 concentration is reduced in pregnancy and nonthyroidalillness, as in hypothyroidism.
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| 3. |
- Nordén, Anna, et al.
(författare)
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Vem äger företagen? : En kartläggning av kvinnors ägande av svenska företag
- 2023
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Från inledningen: I den här rapporten tar vi ett unikt grepp kring kvinnors och mäns ägande av företag i Sverige. Att äga ett företag ger ägaren makt över företaget. Det skapar förutsättningar att ta beslut som är anpassade till dem själva. Att äga ett företag ger också en möjlighet att ta ut inkomst för näringsverksamhet eller utdelning. Vilket innebär skattemässiga fördelar.Den genomsnittliga kvinnan som kan och vill äga företag ska ha samma förutsättningar att göra det som den genomsnittliga mannen. Så är det inte idag. De ojämlikheter som finns i ägandet tyder på strukturella hinder som kan kopplas till flera faktorer som uppväxt, utbildning, nätverk, diskriminering och tillgångtill kapital.Sett från ett bredare perspektiv handlar ägande om att skapa förutsättningar för ett bättre samhälle. Ett diversifierat ägande av företag gör det enklare att skapa produkter och tjänster för alla. Det handlar om att öka förmågan att lösa komplexa problem och att skapa nya innovationer.I denna rapport studerar vi ägande av företag och jämför framförallt kvinnor och män. Vi utökar analysen för att försöka fånga en del av den heterogenitet som finns inom dessa grupper och tittar på ålder samt om företagsägaren eller hens föräldrar är födda i Sverige eller inte.
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| 4. |
- Nordén, Charlotte, et al.
(författare)
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Ambulance nurses’ experiences of nursing critically ill and injured children : a difficult aspect of ambulance nursing care
- 2014
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X .- 1878-013X. ; 22, s. 75-80
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAmbulance nurses work daily in both emergency and non-emergency situations that can be demanding. One emotionally demanding situation for ambulance nurses is to nurse children who are ill.AimThe aim of this study was to describe ambulance nurses’ experiences of nursing critically ill or injured children.MethodEight specialist ambulance nurses were interviewed and the interviews were analyzed using qualitative content analysis.FindingsThe analysis resulted in one theme, a difficult aspect of ambulance nursing care, with five categories. The security of both child and parents was considered to be paramount. Ambulance nurses felt relieved when they handed over the responsibility and the child to the receiving unit. The ambulance nurses felt that more training, education and follow-up was desirable in order to increase their security when nursing children.ConclusionAmbulance nurses are subject to stressful feelings while nursing children. As providing reassurance to the child and its parents is a cornerstone of the treatment, it is important for the ambulance nurses to take the time to build up a trusting relationship in such an encounter. Skill development in the area might lead to increased security and reduce the mental burden resulting from negative stress
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