| 1. |
- Aad, G., et al.
(författare)
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The ATLAS Experiment at the CERN Large Hadron Collider
- 2008
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Ingår i: Journal of Instrumentation. - 1748-0221. ; 3:S08003
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Forskningsöversikt (refereegranskat)abstract
- The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
- Berglund, Svante, et al.
(författare)
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The ATLAS Tile Calorimeter Digitizer
- 1999
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Ingår i: 1999 IEEE Nuclear Science Symposium. ; 2, s. 760-764, s. 255-259
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 6. |
- Berglund, Svante, et al.
(författare)
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The ATLAS Tile Calorimeter Digitizer
- 2008
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Ingår i: Journal of Instrumentation. - 1748-0221. ; :3, s. P01004-
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Tidskriftsartikel (refereegranskat)
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| 7. |
- Bergström, Göran, 1964, et al.
(författare)
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Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS.
- 2023
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Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 373, s. 46-54
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Tidskriftsartikel (refereegranskat)abstract
- Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p<0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.
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| 8. |
- Bergström, Göran, 1964, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - Philadelphia : American Heart Association. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 9. |
- Bergström, Göran, et al.
(författare)
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Prevalence of Subclinical Coronary Artery Atherosclerosis in the General Population
- 2021
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Ingår i: Circulation. - : Wolters Kluwer. - 0009-7322 .- 1524-4539. ; 144:12, s. 916-929
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early detection of coronary atherosclerosis using coronary computed tomography angiography (CCTA), in addition to coronary artery calcification (CAC) scoring, may help inform prevention strategies. We used CCTA to determine the prevalence, severity, and characteristics of coronary atherosclerosis and its association with CAC scores in a general population.Methods: We recruited 30 154 randomly invited individuals age 50 to 64 years to SCAPIS (the Swedish Cardiopulmonary Bioimage Study). The study includes individuals without known coronary heart disease (ie, no previous myocardial infarctions or cardiac procedures) and with high-quality results from CCTA and CAC imaging performed using dedicated dual-source CT scanners. Noncontrast images were scored for CAC. CCTA images were visually read and scored for coronary atherosclerosis per segment (defined as no atherosclerosis, 1% to 49% stenosis, or ≥50% stenosis). External validity of prevalence estimates was evaluated using inverse probability for participation weighting and Swedish register data.Results: In total, 25 182 individuals without known coronary heart disease were included (50.6% women). Any CCTA-detected atherosclerosis was found in 42.1%; any significant stenosis (≥50%) in 5.2%; left main, proximal left anterior descending artery, or 3-vessel disease in 1.9%; and any noncalcified plaques in 8.3% of this population. Onset of atherosclerosis was delayed on average by 10 years in women. Atherosclerosis was more prevalent in older individuals and predominantly found in the proximal left anterior descending artery. Prevalence of CCTA-detected atherosclerosis increased with increasing CAC scores. Among those with a CAC score >400, all had atherosclerosis and 45.7% had significant stenosis. In those with 0 CAC, 5.5% had atherosclerosis and 0.4% had significant stenosis. In participants with 0 CAC and intermediate 10-year risk of atherosclerotic cardiovascular disease according to the pooled cohort equation, 9.2% had CCTA-verified atherosclerosis. Prevalence estimates had excellent external validity and changed marginally when adjusted to the age-matched Swedish background population.Conclusions: Using CCTA in a large, random sample of the general population without established disease, we showed that silent coronary atherosclerosis is common in this population. High CAC scores convey a significant probability of substantial stenosis, and 0 CAC does not exclude atherosclerosis, particularly in those at higher baseline risk.
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| 10. |
- Blomquist, Bo, 1958, et al.
(författare)
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Utvärdering av Volvo Lastvagnars monteringsfabrik för hyttillverkning i Umeå
- 2005
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Consumer report (“avnämarrapport” in Swedish) for the company in question which is financed by the company (through the Swedish Metall Workers Union, Metall) and partly also by a research foundation. It is a matter of combined data collection (collections of company data, interviews, questionnaire surveys, video-registration, etc.). In this case, was e.g. two so-called total surveys of all blue-collar employees dealing with assembly work. The problem area (or research question) was focused on a conversion back to assembly line work. Before was an early sort of, less sociotechnically advanced, parallel workgroups practiced) not the far more sociotechnically advanced alternatives to assembly line work that was at hand at the defunct Volvo Automobile AB:s plant located in Uddevalla or the so-called assembly docks located in the Volvo Truck AB:s plant in Tuve (i.e. the sole two real-life assembly system of this very calibre). This was actually wage owner consultant initiative performed with Logistic and Transportation as the sole base (no private consulting). It was a matter of combined data collection (collections of company data, interviews, questionnaire surveys, video-registration, etc. among other this thereby prospection many of our scientific methods developed during several decades. For example, involving two so-called total surveys of all blue-collar employees dealing with assembly work. The authors and their other colleagues were thus, in many respects, using a wide repertoire of scientific methods.
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| 11. |
- Borneskog, Catrin, et al.
(författare)
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Midwife Educators' perceptions of the efficacy of the Objective Structured clinical assessment of life-saving interventions - a qualitative interview study in Bangladesh
- 2023
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier. - 1877-5756 .- 1877-5764. ; 37
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Objective Structured Clinical Assessment (OSCA) is a way of evaluating students or clinicians in how they are carrying out their duties. The aim of this study was to examine how midwifery educators in Bangladesh perceived using OSCA as an assessment device in midwifery education for student performance in life-saving midwifery interventions.METHOD: Individual interviews were conducted with 47 academic midwives and clinical midwives using purposive sampling at 38 education institutions in Bangladesh. Content analysis inspired by Elo and Kyngas was used to analyze the data.RESULTS: The ability of students to perform effectively in the OSCA-evaluated simulation of life-saving skills was related to the educators' understanding of the concept of midwifery. The overarching main category of this study showed that for midwifery educators to be able to effectually teach professional, evidence-based midwifery, they need to be able to synthesize the delivery of practical and theoretical skills with pedagogical skills and knowledge. To implement the OSCA tool more effectively, midwifery educators need to understand the underpinning principles of midwifery values and philosophy including leadership, ownership, responsibility, and personal engagement.CONCLUSION: There is potential to improve the efficacy of using OSCA to deliver the teaching of life-saving skills. Team sessions with midwives and physicians aiming to practice teamwork and role divisions in life-saving interventions are recommended.
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| 12. |
- Christiansen, Iben, et al.
(författare)
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Crosscurrents of Swedish Mathematics Teacher Education
- 2021
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Ingår i: International Perspectives on Mathematics Teacher Education. - Charlotte, North Carolina : Information Age Publishin (IAP).
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Mathematics teacher education includes the mathematics content teachers need to understand, the ways that pedagogical approaches are developed, the messages about the nature of mathematics teaching and learning, and the interface between tertiary preparation and school contexts. Scholars from Sweden, France, Malawi, Singapore, New Zealand, Brazil, the USA, and Canada provide insights for the mathematics education community’s understanding of how teacher educators in different countries structure, develop, and implement their respective mathematics teacher education programs. Several themes emerged across the chapters, including: varied approaches to developing culturally responsive pedagogies and/or Indigenous perspectives to ensure equity for all students; issues and challenges in fostering partnerships and collaborations among various stakeholders, with partnerships involving connections with mathematics classroom teachers, school districts, and/or mathematicians or mathematics departments; strategies for developing mathematics knowledge for teaching, providing insights into messages about what it means to learn mathematics in terms of content and pedagogy; and preparing teachers who have flexibility and resourcefulness. This book will be of interest to those responsible for higher education, including teacher educators, researchers in mathematics teacher education, instructors of graduate courses preparing future teacher educators, as well as policy makers.
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| 13. |
- Christiansen, Iben Maj, 1964-, et al.
(författare)
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The crosscurrents of Swedish mathematics teacher education
- 2021
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Ingår i: International perspectives on mathematics teacher education. - Waxhaw, NC, USA : Information Age Publishing. - 9781648026317 - 9781648026294 - 9781648026300 ; , s. 9-48
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Bokkapitel (refereegranskat)abstract
- As with any programs in teacher education, Swedish mathematics teacher education is influenced by changing political winds, developments in Information and Communication Technology (ICT), culture, history, PISA results, research-based program designs, and a fair amount of passion. Content and outcomes are nationally determined and include the requirement of a strong research foundation, but this is often not how practcing techers work, which exerts its own pull on teacher education. The specific implementations of programs take different forms at the universities that offer mathematics teacher education. In order to provide a comprehensive yet meaningful ntroduction to both the current system and current practices, we describe the overall organization of Swedish mathematics teacher education, and then offer short cases of implemented programs. To ensure inclusivity, the various parts are written by mathematics educators from the respective institutions. In this way, both variation across mathematicas teacher education for diffrent grade levels and variation across different institutions working with the same national directives can be distinguished. Issues such as the academization of teacher education are problematized, as are other forces that constitute the crosscurrents in Swedish mathematics teacher education.
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| 14. |
- Engström, Eva, et al.
(författare)
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The role of maternal factors, postnatal nutrition, weight gain, and gender in regulation of serum IGF-I among preterm infants
- 2005
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Ingår i: Pediatr Res. ; 57:4, s. 605-10
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Tidskriftsartikel (refereegranskat)abstract
- IGF-I is important for somatic growth and development of the human fetus and neonate. IGF-I also plays an important role in normal vascularization of human retina, as it has been suggested that insufficient IGF-I may be a factor in the development of retinopathy of prematurity. The principal regulator of the bioavailability of IGF-I in the circulation is IGF binding protein 3 (IGFBP-3). The aim of this study was to study factors associated with postnatal serum concentrations of IGF-I and of IGFBP-3 in preterm infants from birth to an age corresponding to 40 wk postmenstruation. We conducted a prospective, longitudinal study in which we measured serum IGF-I and IGFBP-3 concentrations in 76 preterm infants from birth (postmenstrual ages 23-32 wk) until discharge from hospital around 40 wk. Information regarding nutrition, weight gain, maternal factors, and treatment with corticosteroids were collected weekly. Variables found to be associated with postnatal change over time of serum IGF-I and IGFBP-3 were postmenstrual age (p<0.001), weight gain (standard deviation score) (p<0.001), and enteral intake of protein (p<0.001). Male gender was associated with lower IGF-I levels (p<0.001). The relationship between protein intake and IGF-I (and also between protein intake and IGFBP-3) was positive, as was the relationship between weight gain and IGF-I (and between weight gain and IGFBP-3). These results indicate that the degree of prematurity, low enteral protein intake, male gender, and slow weight gain are associated with a slower postnatal increase of IGF-I in preterm infants.
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| 15. |
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| 16. |
- Engström, Gunnar, et al.
(författare)
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Pulmonary function and atherosclerosis in the general population : causal associations and clinical implications
- 2024
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Ingår i: European Journal of Epidemiology. - : Springer Nature. - 0393-2990 .- 1573-7284. ; 39:1, s. 35-49
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Tidskriftsartikel (refereegranskat)abstract
- Reduced lung function is associated with cardiovascular mortality, but the relationships with atherosclerosis are unclear. The population-based Swedish CArdioPulmonary BioImage study measured lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques and ankle-brachial index in 29,593 men and women aged 50–64 years. The results were confirmed using 2-sample Mendelian randomization. Lower lung function and emphysema were associated with more atherosclerosis, but these relationships were attenuated after adjustment for cardiovascular risk factors. Lung function was not associated with coronary atherosclerosis in 14,524 never-smokers. No potentially causal effect of lung function on atherosclerosis, or vice versa, was found in the 2-sample Mendelian randomization analysis. Here we show that reduced lung function and atherosclerosis are correlated in the population, but probably not causally related. Assessing lung function in addition to conventional cardiovascular risk factors to gauge risk of subclinical atherosclerosis is probably not meaningful, but low lung function found by chance should alert for atherosclerosis.
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| 17. |
- Engström, Kerstin, et al.
(författare)
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Assessing uncertainties in global cropland futures using a conditional probabilistic modelling framework
- 2016
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Ingår i: Earth System Dynamics. - : Copernicus GmbH. - 2190-4979 .- 2190-4987. ; 7:4, s. 893-915
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Tidskriftsartikel (refereegranskat)abstract
- We present a modelling framework to simulate probabilistic futures of global cropland areas that are conditional on the SSP (shared socio-economic pathway) scenarios. Simulations are based on the Parsimonious Land Use Model (PLUM) linked with the global dynamic vegetation model LPJ-GUESS (Lund-Potsdam-Jena General Ecosystem Simulator) using socio-economic data from the SSPs and climate data from the RCPs (representative concentration pathways). The simulated range of global cropland is 893-2380 Mha in 2100 (± 1 standard deviation), with the main uncertainties arising from differences in the socio-economic conditions prescribed by the SSP scenarios and the assumptions that underpin the translation of qualitative SSP storylines into quantitative model input parameters. Uncertainties in the assumptions for population growth, technological change and cropland degradation were found to be the most important for global cropland, while uncertainty in food consumption had less influence on the results. The uncertainties arising from climate variability and the differences between climate change scenarios do not strongly affect the range of global cropland futures. Some overlap occurred across all of the conditional probabilistic futures, except for those based on SSP3. We conclude that completely different socio-economic and climate change futures, although sharing low to medium population development, can result in very similar cropland areas on the aggregated global scale.
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| 18. |
- Engström, Kerstin, 1959-
(författare)
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Genus & genrer : forskningsanknutna genusdiskurser i dagspress
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- At the centre of this study lies the question of how research-related media texts contribute to the social construction of sex and gender conceptions when they use research, either as a main source, or to support or comment on specific issues and statements, from the political arena, for example. The principal aim of the study has been to analyze and problematize the ways in which different types of newspapers, genres and editorial sections reproduce, or contribute to change, in existing gender discourses.The material was collected from two Swedish newspapers during the year 2001: the national morning paper Dagens Nyheter (DN), and the national evening paper Aftonbladet.The theories of discourse, agenda-setting and -framing in this study are related to the questions: what kinds of knowledge on women and men, and biological, physiological, psychological, social and cultural perspectives on sex/gender are represented; how are they described; and how do content and form contribute to the (re)production of, or change in, gender discourses? The main analytical perspectives are those about gender discourse (re)production, genres as ideological forms, and the epistemologies of journalism.A combination of analytical strategies and methods was used: content and thematic analysis, and qualitative analysis of text and language with methodological tools from different traditions of discourse analysis.In my study, I can see an interplay between research traditions and genre conventions in the (re)production of gender discourses. Since the news sections repeatedly choose to publish research as empiric and in the form of results, and then within that, primarily findings from medicine and the social sciences, these areas are reproduced as important and relevant, and as producers of objective, true knowledge that can be presented as simple facts. Research-related texts in culture journalism, on the other hand, follow the tradition of primarily treating research within the humanities, and nowadays also gender and queer theoretical perspectives within different disciplines. Through the genre conventions of culture journalism, this research is reproduced as something that you can reflect upon, problematize, criticize, form an opinion of, and judge.The study also gives reason to argue that media logic and institutionalized genre conventions contribute to the reproduction of science and research as different worlds and cultures, in which the natural sciences and the humanities are found in different media spaces, and different forms of knowledge about sex/gender are given space on different conditions and in different forms.
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| 19. |
- Engström, Kerstin, et al.
(författare)
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Impacts of climate mitigation strategies in the energy sector on global land use and carbon balance
- 2017
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Ingår i: Earth System Dynamics. - : Copernicus GmbH. - 2190-4979 .- 2190-4987. ; 8:3, s. 773-799
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Tidskriftsartikel (refereegranskat)abstract
- Reducing greenhouse gas emissions to limit damage to the global economy climate-change-induced and secure the livelihoods of future generations requires ambitious mitigation strategies. The introduction of a global carbon tax on fossil fuels is tested here as a mitigation strategy to reduce atmospheric CO2 concentrations and radiative forcing. Taxation of fossil fuels potentially leads to changed composition of energy sources, including a larger relative contribution from bioenergy. Further, the introduction of a mitigation strategy reduces climate-change-induced damage to the global economy, and thus can indirectly affect consumption patterns and investments in agricultural technologies and yield enhancement. Here we assess the implications of changes in bioenergy demand as well as the indirectly caused changes in consumption and crop yields for global and national cropland area and terrestrial biosphere carbon balance. We apply a novel integrated assessment modelling framework, combining three previously published models (a climate-economy model, a socio-economic land use model and an ecosystem model). We develop reference and mitigation scenarios based on the narratives and key elements of the shared socio-economic pathways (SSPs). Taking emissions from the land use sector into account, we find that the introduction of a global carbon tax on the fossil fuel sector is an effective mitigation strategy only for scenarios with low population development and strong sustainability criteria (SSP1 Taking the green road). For scenarios with high population growth, low technological development and bioenergy production the high demand for cropland causes the terrestrial biosphere to switch from being a carbon sink to a source by the end of the 21st century.
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| 20. |
- Engström, Kerstin, 1959-
(författare)
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Textcoaching och kamratgranskning som en del av lärprocessen : är det något för utbildning i (journalistiskt) skrivande?
- 2013
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Ingår i: Reformation, revolution, evolution. - Umeå : Universitetspedagogiskt centrum (UPC), Umeå universitet. - 9789174595710 ; , s. 165-166
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- På Institutionen för kultur- och medievetenskaper utbildar vi blivande vetenskaps- och kulturjournalister inom två kandidatprogram (tvååriga med krav på 60 hp i förkunskaper). Under programmens gemensamma första termin är ett viktigt kursmoment Journalistiskt skrivande, 6 hp, vars mål är att studenterna ska förstå grunderna i journalistisk (framför allt nyhets-)dramaturgi och kunna tillämpa dessa i sitt skrivande. En svårighet under delmomentet brukar vara att "skola om sig" från det mer formella, akademiska skrivande som många av studenterna just har lärt sig. En annan svårighet är att en alltför stor del av studenterna inte har med sig nödvändiga kunskaper från grund- och gymnasieskolan när det gäller exempelvis begreppsanvändning, meningsbyggnad, grammatik och textbindning.Inom de allt snävare ekonomiska ramar som råder i undervisningen har det blivit allt svårare att åstadkomma tillräckligt med tid och den lärartäthet som krävs för skrivövningar, träning och åter träning och massor av respons och omskrivningar, vilket är det enda sättet att lära och bli en mer medveten, reflekterande och samtidigt journalistiskt skicklig skribent.Syftet med projektet har varit att undersöka om sådana problem delvis kan lösas genom mer studentaktiva undervisningsformer, dels för studenternas självreflektion, dels för "kollegial" respons (peer review) och diskussion studenter emellan. Detta har bland annat inneburit att vi redan från första terminen har lagt in lärandemål, undervisning och examination som inbegriper att studenterna själva tränats i att tala om texter, och det på ett sätt som inbegriper medvetenhet och kunskap om just de språkliga aspekter som diskuterats ovan.Olika former av kamratgranskning har lagts in i undervisningen under terminen, bland annat textrespons och betygsättning via ett särskilt bedömningsformulär som riktats mot kvaliteter i en journalistisk text. Projektet har också inbegripit en studentenkät om kamratgranskningen, med fokus på frågor om hur den fungerat som stöd för lärandet och medvetenheten om det egna skrivandets styrkor och svagheter – både för den som fått kommentarer och den som haft rollen av granskare. I mitt paper redovisas resultaten av dels försöket med bedömningsformulär, dels studentenkäten.
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| 21. |
- Engström, Åsa, et al.
(författare)
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Experiences of ICU diaries : touching a tender wound
- 2009
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Ingår i: Nursing in Critical Care. - : Wiley. - 1362-1017 .- 1478-5153. ; 14:2, s. 61-67
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe peoples' experiences of a personal diary written when they were critically ill and receiving care in an intensive care unit (ICU). BACKGROUND: In some ICUs, diaries are written by the ICU staff and close relatives of those who are critically ill and mechanically ventilated, but there is a lack of studies that focus on the experiences of the formerly critically ill of personal diaries written when in an ICU. METHODS: Qualitative personal interviews were conducted with nine people who were formerly critically ill. The interview texts were analysed using qualitative content analysis. FINDINGS: From the analysis of the data, one theme emerged - touching a tender wound, with four categories: being afraid and being deeply touched, appreciating close relatives' notes, a feeling of unreality and gaining coherence. The participants were deeply touched when they read the diary for the first time. Parts of it were experienced as unreal, as if they were reading about someone else. The diary provided necessary knowledge about what had happened during the time when the participants were critically ill and from which they had only fragmented or no memories at all. Even though it aroused strong feelings, reading the diary was experienced as an important support for a long time after their stay in the ICU. Experiencing that one was not fully aware of what had happened and then reading about oneself being critically ill and about one's close relatives' experiences was interpreted as touching a tender wound. CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE: It is suggested that a diary may be a tool that can help formerly critically ill people to gain a sense of coherence concerning their critical illness experience, but reading it can be painful and demanding.
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| 22. |
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| 23. |
- Humble, Mats B., 1952-, et al.
(författare)
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Plasma oxytocin changes and anti-obsessive response during serotonin reuptake inhibitor treatment : a placebo controlled study
- 2013
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Ingår i: BMC Psychiatry. - 1471-244X. ; 13, s. 344-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The drug treatments of choice for obsessive-compulsive disorder (OCD) are serotonin reuptake inhibitors (SRIs). However, a correlation between the neuropeptide oxytocin in cerebrospinal fluid and the severity of OCD has previously been shown, and oxytocin and serotonin are interconnected within the brain. Few studies have investigated whether SRIs have any effect on oxytocin; thus, our aim was to explore the possibility that oxytocinergic mechanisms contribute to the anti-obsessive effect of SRIs.Method: In a randomized, double-blind trial, comparing SRIs (clomipramine and paroxetine) with placebo in 36 adults with OCD (characterized for subtypes), plasma oxytocin was measured with radioimmunoassay after plasma extraction, at baseline, after 1 week, and after 4 weeks of treatment, and related to baseline severity and clinical response after 12 weeks, as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).Results: Baseline oxytocin levels correlated positively with baseline Y-BOCS ratings, but only among the future SRI responders. Patients with early onset of OCD had higher baseline oxytocin. During treatment, plasma oxytocin did not differ between SRI and placebo treatment. In SRI responders, plasma oxytocin first decreased and then increased; in non-responders (to SRI as well as to placebo), the reverse was the case. After 4 weeks, treatment responders had attained higher oxytocin levels compared to non-responders. The intra-individual range (i.e. the variability) of plasma oxytocin between measurements was the measure that best differentiated responders from non-responders. This range was higher in responders than non-responders, and lower in patients with autistic traits.Conclusions: SRIs have highly variable effects on plasma oxytocin between individuals. The associations between baseline oxytocin and OCD severity and between oxytocin changes and treatment response support the notions that oxytocin is involved in OCD pathophysiology, and that the anti-obsessive effects of SRIs are partly exerted through oxytocinergic mechanisms.
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| 24. |
- Höstman, Staffan, et al.
(författare)
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THAM reduces CO2-associated increase in pulmonary vascular resistance : an experimental study in lung-injured piglets
- 2015
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Ingår i: Critical Care. - : Springer Science and Business Media LLC. - 1364-8535 .- 1466-609X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Low tidal volume (VT) ventilation is recommended in patients with acute respiratory distress syndrome (ARDS). This may increase arterial carbon dioxide tension (PaCO2), decrease pH, and augment pulmonary vascular resistance (PVR). We hypothesized that Tris(hydroxymethyl)aminomethane (THAM), a pure proton acceptor, would dampen these effects, preventing the increase in PVR.METHODS: A one-hit injury ARDS model was established by repeated lung lavages in 18 piglets. After ventilation with VT of 6 ml/kg to maintain normocapnia, VT was reduced to 3 ml/kg to induce hypercapnia. Six animals received THAM for 1 h, six for 3 h, and six serving as controls received no THAM. In all, the experiment continued for 6 h. The THAM dosage was calculated to normalize pH and exhibit a lasting effect. Gas exchange, pulmonary, and systemic hemodynamics were tracked. Inflammatory markers were obtained at the end of the experiment.RESULTS: In the controls, the decrease in VT from 6 to 3 ml/kg increased PaCO2 from 6.0±0.5 to 13.8±1.5 kPa and lowered pH from 7.40±0.01 to 7.12±0.06, whereas base excess (BE) remained stable at 2.7±2.3 mEq/L to 3.4±3.2 mEq/L. In the THAM groups, PaCO2 decreased and pH increased above 7.4 during the infusions. After discontinuing the infusions, PaCO2 increased above the corresponding level of the controls (15.2±1.7 kPa and 22.6±3.3 kPa for 1-h and 3-h THAM infusions, respectively). Despite a marked increase in BE (13.8±3.5 and 31.2±2.2 for 1-h and 3-h THAM infusions, respectively), pH became similar to the corresponding levels of the controls. PVR was lower in the THAM groups (at 6 h, 329±77 dyn∙s/m(5) and 255±43 dyn∙s/m(5) in the 1-h and 3-h groups, respectively, compared with 450±141 dyn∙s/m(5) in the controls), as were pulmonary arterial pressures.CONCLUSIONS: The pH in the THAM groups was similar to pH in the controls at 6 h, despite a marked increase in BE. This was due to an increase in PaCO2 after stopping the THAM infusion, possibly by intracellular release of CO2. Pulmonary arterial pressure and PVR were lower in the THAM-treated animals, indicating that THAM may be an option to reduce PVR in acute hypercapnia.
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