| 1. |
- Chioncel, Ovidiu, et al.
(författare)
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Epidemiology, pathophysiology and contemporary management of cardiogenic shock - a position statement from the Heart Failure Association of the European Society of Cardiology
- 2020
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Ingår i: European Journal of Heart Failure. - : WILEY. - 1388-9842 .- 1879-0844. ; 22:8, s. 1315-1341
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Tidskriftsartikel (refereegranskat)abstract
- Cardiogenic shock (CS) is a complex multifactorial clinical syndrome with extremely high mortality, developing as a continuum, and progressing from the initial insult (underlying cause) to the subsequent occurrence of organ failure and death. There is a large spectrum of CS presentations resulting from the interaction between an acute cardiac insult and a patients underlying cardiac and overall medical condition. Phenotyping patients with CS may have clinical impact on management because classification would support initiation of appropriate therapies. CS management should consider appropriate organization of the health care services, and therapies must be given to the appropriately selected patients, in a timely manner, whilst avoiding iatrogenic harm. Although several consensus-driven algorithms have been proposed, CS management remains challenging and substantial investments in research and development have not yielded proof of efficacy and safety for most of the therapies tested, and outcome in this condition remains poor. Future studies should consider the identification of the new pathophysiological targets, and high-quality translational research should facilitate incorporation of more targeted interventions in clinical research protocols, aimed to improve individual patient outcomes. Designing outcome clinical trials in CS remains particularly challenging in this critical and very costly scenario in cardiology, but information from these trials is imperiously needed to better inform the guidelines and clinical practice. The goal of this review is to summarize the current knowledge concerning the definition, epidemiology, underlying causes, pathophysiology and management of CS based on important lessons from clinical trials and registries, with a focus on improving in-hospital management.
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| 2. |
- Golla, Sandeep S V, et al.
(författare)
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Parametric Binding Images of the TSPO Ligand 18F-DPA-714.
- 2016
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Ingår i: Journal of Nuclear Medicine. - : Society of Nuclear Medicine. - 0161-5505 .- 1535-5667 .- 2159-662X. ; 57:10, s. 1543-1547
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Tidskriftsartikel (refereegranskat)abstract
- (18)F-labeled N,N-diethyl-2-(2-[4-(2-fluoroethoxy)phenyl]-5,7-dimethylpyrazolo[1,5-α]pyrimidine-3-yl)acetamide (DPA-714) is a radioligand for the 18-kDa translocator protein. The purpose of the present study was to identify the best method for generating quantitative parametric images of (18)F-DPA-714 binding.METHODS: Ninety-minute dynamic (18)F-DPA-714 PET scans with full arterial sampling from 6 healthy subjects and 9 Alzheimer disease (AD) patients were used. Plasma-input-based Logan graphical analysis and spectral analysis were used to generate parametric volume of distribution (VT) images. Five versions of Ichise, reference Logan, and 2 basis function implementations (receptor parametric mapping and simplified reference tissue model 2 [SRTM2]) of SRTM, all using gray matter cerebellum as the reference region, were applied to generate nondisplaceable binding potential (BPND) images.RESULTS: Plasma-input Logan analysis (r(2) = 0.99; slope, 0.88) and spectral analysis (r(2) = 0.99, slope, 0.93) generated estimates of VT that correlated well with values obtained using nonlinear regression. BPND values generated using SRTM2 (r(2) = 0.83; slope, 0.95) and reference Logan analysis (r(2) = 0.88; slope, 1.01) correlated well with nonlinear regression-based estimates.CONCLUSION: Both Logan analysis and spectral analysis can be used to obtain quantitatively accurate VT images of (18)F-DPA-714. In addition, SRTM2 and reference Logan analysis can provide accurate BPND images. These parametric images could be used for voxel-based comparisons.
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| 3. |
- Golla, Sandeep S V, et al.
(författare)
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Quantification of [18F]DPA-714 binding in the human brain : initial studies in healthy controls and Alzheimer's disease patients
- 2015
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Ingår i: Journal of Cerebral Blood Flow and Metabolism. - : SAGE Publications. - 0271-678X .- 1559-7016. ; 35:5, s. 766-772
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Tidskriftsartikel (refereegranskat)abstract
- Fluorine-18 labelled N,N-diethyl-2-(2-[4-(2-fluoroethoxy)phenyl]-5,7-dimethylpyrazolo[1,5-α]pyrimidine-3-yl)acetamide ([(18)F]DPA-714) binds to the 18-kDa translocator protein (TSPO) with high affinity. The aim of this initial methodological study was to develop a plasma input tracer kinetic model for quantification of [(18)F]DPA-714 binding in healthy subjects and Alzheimer's disease (AD) patients, and to provide a preliminary assessment whether there is a disease-related signal. Ten AD patients and six healthy subjects underwent a dynamic positron emission tomography (PET) study along with arterial sampling and a scan protocol of 150 minutes after administration of 250 ± 10 MBq [(18)F]DPA-714. The model that provided the best fits to tissue time activity curves (TACs) was selected based on Akaike Information Criterion and F-test. The reversible two tissue compartment plasma input model with blood volume parameter was the preferred model for quantification of [(18)F]DPA-714 kinetics, irrespective of scan duration, volume of interest, and underlying volume of distribution (VT). Simplified reference tissue model (SRTM)-derived binding potential (BPND) using cerebellar gray matter as reference tissue correlated well with plasma input-based distribution volume ratio (DVR). These data suggest that [(18)F]DPA-714 cannot be used for separating individual AD patients from healthy subjects, but further studies including TSPO binding status are needed to substantiate these findings.
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| 4. |
- Jaldestad, Ellen
(författare)
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Job Crafting: Changing and adapting work as one piece of the puzzle for a sustainable working life
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: This thesis focuses on job crafting as one way to increase work-related well-being and enable people to extend their working lives. The studies included were conducted within two different contexts, namely the manufacturing industry and public healthcare. These two contexts struggle with, for example, challenging working environments and staff shortages, as well as enabling older workers to extend their working lives. Job crafting, an active form of job redesign, can be defined as employees actively changing the physical and cognitive boundaries of work to better suit the person’s abilities and desires. These kinds of bottom-up-driven strategies to change and adapt work have been found to increase employee well-being and productivity, as well as reduce staff turnover. According to previous research, job crafting thus has positive effects on both people at work and their organizations. Previous research also shows that organizational structures as well as individual factors can facilitate and enhance employees’ job crafting. There is, however, a lack of studies focusing on how to best promote and facilitate employee-driven job crafting in practice. Aim: This thesis aimed to explore job crafting as one part of a health-promoting and extended working life. Job crafting was analysed in relation to an extended working life among blue-collar workers in one company in the manufacturing industry, and in relation to being able to work and feel well within public healthcare and manufacturing industry. Methods: Data was collected at one global manufacturing company and different workplaces within Swedish public healthcare. In the manufacturing company, data was collected from 100 blue-collar workers as part of an age management project focusing on factors influencing employees’ retirement decisions. The respondents represented older employees in three different countries: Sweden, the Netherlands, and France. These respondents completed a questionnaire and participated in semi-structured interviews. The quantitative data was descriptively analysed and the qualitative data was analysed with content analysis. Within public healthcare, a questionnaire was first administered to 421 healthcare employees at two times (T1-T2), six to eight months apart. A response rate of 59% provided data from 250 respondents. Secondly, semi-structured interviews were conducted with 16 healthcare employees and five managers. The quantitative data from the survey was analysed with SEM analysis, whereas the qualitative data was analysed with reflexive thematic analysis. Findings: Factors that influenced blue-collar workers’ decisions about retirement and an extended working life included perceived health and economic situation, task characteristics, support from colleagues and managers, work autonomy and work setup, and national pension schemes. Job crafting strategies that were perceived as health-promoting among blue-collar workers included adapting work whenever possible, asking colleagues for help to finish work, and changing their way of thinking about work. For some, these strategies were considered as contributing to being able to extend working life. Among the healthcare employees, health-promoting job crafting strategies included asking for new assignments and opportunities for professional development, organizing work in close cooperation with others, and involving patients in the planning of daily activities. These strategies were derived from different motives, including crafting for their development, crafting for a common good, crafting for manageability, and crafting for meaningfulness in work. Working conditions such as having support from managers and colleagues, and formal autonomy in work, facilitated job crafting among the healthcare employees. The health-promoting crafting strategies were connected to increasing work-related sense of coherence through comprehensibility, manageability, and meaningfulness. Job crafting strategies and motives were said to change over time, for example in relation to work-life balance and work experience, among respondents in both contexts. Within both contexts, it was also indicated that a strong inner drive for personal development sometimes outweighed hindering structural conditions when employees crafted for their development and manageability in work. Conclusions: Factors that influenced the retirement decisions were found on different levels within the blue-collar workers’ work context. Perceived antecedents of health-promoting job crafting among the respondents within both contexts in this thesis were found in organizational structures, workplace conditions, and individual factors. Job crafting motives and strategies were also said to change over time and were influenced by both individual factors and workplace-related conditions. From the findings in this thesis, it is suggested to further explore how to facilitate job crafting on the different work-system levels, as well as to plan job crafting interventions directed to healthcare employees and older blue-collar workers within the manufacturing industry.
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