| 1. |
- Gustafsson, Mats, et al.
(författare)
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Effekter av vinterdäck : en kunskapsöversikt
- 2006
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Choice of winter tyres has, from mainly being a matter of safety and economic costs for wearing of road pavements, during later years also become a matter of inhalable particles formed during pavement wear from studded tyres and their negative effects on public health. Further, the tyres' effects on environment and noise have been illustrated in several studies. The issue is also complicated by the fact that tyre choice effects on traffic safety have several components, including such diverging parameters as friction and behaviour. Finally all aspects have to be evaluated from a socioeconomic point of view for society to be able to decide which kind of distribution of tyre types that is the most profitable. This report is a summary of current knowledge in this complex research field.
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| 2. |
- Mansouri, Larry, et al.
(författare)
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Functional loss of I kappa B epsilon leads to NF-kappa B deregulation in aggressive chronic lymphocytic leukemia
- 2015
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Ingår i: Journal of Experimental Medicine. - : Rockefeller University Press. - 0022-1007 .- 1540-9538. ; 212:6, s. 833-843
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Tidskriftsartikel (refereegranskat)abstract
- NF-kappa B is constitutively activated in chronic lymphocytic leukemia (CLL); however, the implicated molecular mechanisms remain largely unknown. Thus, we performed targeted deep sequencing of 18 core complex genes within the NF-kappa B pathway in a discovery and validation CLL cohort totaling 315 cases. The most frequently mutated gene was NFKBIE (21/315 cases; 7%), which encodes I kappa B epsilon, a negative regulator of NF-kappa B in normal B cells. Strikingly, 13 of these cases carried an identical 4-bp frameshift deletion, resulting in a truncated protein. Screening of an additional 377 CLL cases revealed that NFKBIE aberrations predominated in poor-prognostic patients and were associated with inferior outcome. Minor subclones and/or clonal evolution were also observed, thus potentially linking this recurrent event to disease progression. Compared with wild-type patients, NFKBIE-deleted cases showed reduced I kappa B epsilon protein levels and decreased p65 inhibition, along with increased phosphorylation and nuclear translocation of p65. Considering the central role of B cell receptor (BcR) signaling in CLL pathobiology, it is notable that I kappa B epsilon loss was enriched in aggressive cases with distinctive stereotyped BcR, likely contributing to their poor prognosis, and leading to an altered response to BcR inhibitors. Because NFKBIE deletions were observed in several other B cell lymphomas, our findings suggest a novel common mechanism of NF-kappa B deregulation during lymphomagenesis.
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| 3. |
- Mansouri, Larry, et al.
(författare)
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Functional loss of IκBε leads to NF-κB deregulation in aggressive chronic lymphocytic leukemia.
- 2015
-
Ingår i: Journal of Experimental Medicine. - : Rockefeller University Press. - 1540-9538 .- 0022-1007. ; 212:6, s. 833-843
-
Tidskriftsartikel (refereegranskat)abstract
- NF-κB is constitutively activated in chronic lymphocytic leukemia (CLL); however, the implicated molecular mechanisms remain largely unknown. Thus, we performed targeted deep sequencing of 18 core complex genes within the NF-κB pathway in a discovery and validation CLL cohort totaling 315 cases. The most frequently mutated gene was NFKBIE (21/315 cases; 7%), which encodes IκBε, a negative regulator of NF-κB in normal B cells. Strikingly, 13 of these cases carried an identical 4-bp frameshift deletion, resulting in a truncated protein. Screening of an additional 377 CLL cases revealed that NFKBIE aberrations predominated in poor-prognostic patients and were associated with inferior outcome. Minor subclones and/or clonal evolution were also observed, thus potentially linking this recurrent event to disease progression. Compared with wild-type patients, NFKBIE-deleted cases showed reduced IκBε protein levels and decreased p65 inhibition, along with increased phosphorylation and nuclear translocation of p65. Considering the central role of B cell receptor (BcR) signaling in CLL pathobiology, it is notable that IκBε loss was enriched in aggressive cases with distinctive stereotyped BcR, likely contributing to their poor prognosis, and leading to an altered response to BcR inhibitors. Because NFKBIE deletions were observed in several other B cell lymphomas, our findings suggest a novel common mechanism of NF-κB deregulation during lymphomagenesis.
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| 4. |
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| 5. |
- Agrell, Beata, et al.
(författare)
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Ett laglöst tillstånd
- 2012
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Annan publikation (populärvet., debatt m.m.)
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| 6. |
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| 7. |
- Andersson, Mats, et al.
(författare)
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Filter Networks
- 1999
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Ingår i: Proceedings of Signal and Image Processing (SIP'99). - Nassau, Bahamas : IASTED. - 0889862672 ; , s. 213-217
-
Konferensbidrag (refereegranskat)abstract
- This paper presents a new and efficient approach for optimization and implementation of filter banks e.g. velocity channels, orientation channels and scale spaces. The multi layered structure of a filter network enable a powerful decomposition of complex filters into simple filter components and the intermediary results may contribute to several output nodes. Compared to a direct implementation a filter network uses only a fraction of the coefficients to provide the same result. The optimization procedure is recursive and all filters on each level are optimized simultaneously. The individual filters of the network, in general, contain very few non-zero coefficients, but there are are no restrictions on the spatial position of the coefficients, they may e.g. be concentrated on a line or be sparsely scattered. An efficient implementation of a quadrature filter hierarchy for generic purposes using sparse filter components is presented.
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| 8. |
- Andersson, Mats, et al.
(författare)
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Sequential Filter Trees for Efficient 2D 3D and 4D Orientation Estimation
- 1998
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- A recursive method to condense general multidimensional FIR-filters into a sequence of simple kernels with mainly one dimensional extent has been worked out. Convolver networks adopted for 2, 3 and 4D signals is presented and the performance is illustrated for spherically separable quadrature filters. The resulting filter responses are mapped to a non biased tensor representation where the local tensor constitutes a robust estimate of both the shape and the orientation (velocity) of the neighbourhood. A qualitative evaluation of this General Sequential Filter concept results in no detectable loss in accuracy when compared to conventional FIR (Finite Impulse Response) filters but the computational complexity is reduced several orders in magnitude. For the examples presented in this paper the attained speed-up is 5, 25 and 300 times for 2D, 3D and 4D data respectively The magnitude of the attained speed-up implies that complex spatio-temporal analysis can be performed using standard hardware, such as a powerful workstation, in close to real time. Due to the soft implementation of the convolver and the tree structure of the sequential filtering approach the processing is simple to reconfigure for the outer as well as the inner (vector length) dimensionality of the signal. The implementation was made in AVS (Application Visualization System) using modules written in C.
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| 9. |
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| 10. |
- Antonson, Hans, et al.
(författare)
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Crash Barriers and Driver Behavior : A Simulator Study
- 2013
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 14:8, s. 874-880
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The study examines how drivers experience a conventional W-beam guardrail (metal crash barrier) along both sides of narrow versus wider roads (single carriageway with 2 lanes) in terms of stress, feelings, and driving patterns and whether subjective experience concurs with the actual driving patterns captured by the quantitative data.Methods: The study used different methods to capture data, including the VTI Driving Simulator III (speed and lateral vehicle position) in conjunction with electrocardiogram (ECG) data on heart rate variability (HRV) and questionnaires (oral during driving and written after driving). Eighteen participants-8 men and 10 women-were recruited for the simulator study and the simulator road section was 10 km long.Results: Driving speeds increased slightly on the wider road and on the road with a crash barrier, and the lateral driving position was nearer to the road center on the narrower road and on the road with a crash barrier. The HRV data did not indicate that participants experienced greater stress due to road width or due to the presence of a crash barrier. Participant experience captured in the oral questionnaires suggested that road width did not affect driver stress or driving patterns; however, the written questionnaire results supported the simulator data, indicating that a wider road led to increased speed. None of the participants felt that crash barriers made them feel calmer.Conclusions: We believe that there is a possibility that the increased speed on roads with crash barriers may be explained by drivers’ sense of increased security. This study demonstrates that an experimental design including experience-based data captured using both a simulator and questionnaires is productive. It also demonstrates that driving simulators can be used to study road features such as crash barriers. It seems more than likely that features such as street lamps, signs, and landscape objects could be tested in this way. © 2013 Copyright Taylor and Francis Group, LLC.
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| 11. |
- Antonson, Hans, et al.
(författare)
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Landscape heritage objects' effect on driving : a combined driving simulator and questionnaire study.
- 2014
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Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 62, s. 168-77
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Tidskriftsartikel (refereegranskat)abstract
- According to the literature, landscape (panoramas, heritage objects e.g. landmarks) affects people in various ways. Data are primarily developed by asking people (interviews, photo sessions, focus groups) about their preferences, but to a lesser degree by measuring how the body reacts to such objects. Personal experience while driving a car through a landscape is even more rare.In this paper we study how different types of objects in the landscape affect drivers during their drive. A high-fidelity moving-base driving simulator was used to measure choice of speed and lateral position in combination with stress (heart rate measure) and eye tracking. The data were supplemented with questionnaires. Eighteen test drivers (8 men and 10 women) with a mean age of 37 were recruited. The test drivers were exposed to different new and old types of landscape objects such as 19th century church, wind turbine, 17th century milestone and bus stop, placed at different distances from the road driven.The findings are in some respect contradictory, but it was concluded that that 33% of the test drivers felt stressed during the drive. All test drivers said that they had felt calm at times during the drive but the reason for this was only to a minor degree connected with old and modern objects. The open landscape was experienced as conducive to acceleration. No significant differences could be observed concerning the test drivers' gaze between old or modern objects, but a significant difference was observed between the test drivers' gaze between road stretches with faraway objects and stretches without objects.
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| 12. |
- Barrdunge, Mats, 1956-
(författare)
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Upplysningens ljus i Norrland : Om fyra aktörer vid Härnösands gymnasium under 1700-talet
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this dissertation is to investigate the occurrence of Enlightenment ideas in the central Northern part of Sweden during the 18th century, focussing on a carefully chosen set of characters: one bishop and three senior lecturers at the gymnasium of Härnösand, in the province of Ångermanland. This dissertation uses a perspective of circulation of knowledge, inspired by the research field of history of knowledge. The methodological approach in this study is to use a complex thematic definition with eight different components of Enlightenment in the analysis of relevant texts and writings by selected characters, supplemented with a contextual perspective.A center for the ecclesiastical culture of learning in Norrland was Härnösand, and the gymnasium was Norrland´s only higher education institution, north of Gävle, for 200 years between 1650 and 1850. During the 18th century, three senior lecturers were employed there, each working for the dissemination of Enlightenment ideas, through both writing and practical action: Magnus Stridsberg (1696–1772), Nils Gissler (1715–1771) and Pehr Hellzén (1744–1811). At the same time as these, the diocese was governed by Bishop Olof Kiörning (1704–1778), who was also the Supervisor of the gymnasium. He was influenced by Enlightenment ideas and showed a strong interest in advanced agriculture and contributed to the church taking greater part in the social and economic development. The first lecturer, Magnus Stridsberg, created new methods in agriculture concerning soil mixing, manure production and grain nurseries, but has mainly been remembered for his threshing machine which came into general use in central Norrland during the second half of the 18th century. The next lecturer, Nils Gissler, was Norrland´s first provincial physician and introduced a scientific approach to practical medicine in the region. With the dissemination of knowledge and a great deal of personal commitment, he showed interest in mental illness and treated his patients in his own home. He laid the foundation for an infrastructure for public health care in the province. He was a member of the Swedish Academy of Sciences and wrote many scientific papers, and in modern times has received international scientific recognition for the discovery of the inverted barometer effect. The third lecturer, Pehr Hellzén, was a pre-industrial contractor in the sawmill and shipbuilding industry in central Norrland and founded the shipyard and shipping company Wifstavarf in 1798. Hellzén gave an important inaugural speech when the new gymnasium was built: Om uplysningens verkan på människors och samhällens sällhet (On the effect of Enlightenment on the happiness of people and societies), printed in Swedish 1794. He gave Härnösand a special role within the Enlightenment, described as a driving force behind the development of science, education and economic in the region.The Enlightenment that developed in Härnösand can be summarized as a Christian ‘utilism’ with clear Enlightenment traits such as reason, experience-based science, the dissemination of knowledge, humanity, social reforms, religious tolerance & religion of reason, and utility & virtue. It rested on an evangelical Lutheran foundation, it regarded the meaning of ‘utilism’ in a broader sense than just financial gain, and included central Enlightenment ideas.
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| 13. |
- Berta, M., et al.
(författare)
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Correlation between in-line measurements of tomato ketchup shear viscosity and extensional viscosity
- 2016
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Ingår i: Journal of Food Engineering. - : Elsevier BV. - 0260-8774 .- 1873-5770. ; 173, s. 8-14
-
Tidskriftsartikel (refereegranskat)abstract
- The viscosity and shear thinning behavior are essential characteristics of tomato ketchup. A real-time monitoring of those characteristics during processing is important to obtain a good quality of the final product and to reduce production waste. This work investigates the measurement of rheological in-line flow properties of tomato ketchup, using a real-time technique that combines ultrasound velocity profiling (UVP) and pressure difference (PD) assessment. In-line data were compared to those obtained off-line using a rotational viscometer. There was a poor correlation with the Bostwick measurement, whereas the flow curves calculated from flow velocimetry data were very similar to those measured off-line. The extensional viscosity of ketchup was determined through the measurement of Hyperbolic Contraction Flow; the curve followed a trend similar to that for the shear viscosity over the deformation rate investigated.
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| 14. |
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| 15. |
- Brüde, Ulf, et al.
(författare)
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Trafiksäkerhetseffekter av åtgärder och tillståndsförändringar
- 2008
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This study has been performed by VTI by commission of the Road Traffic Inspectorate in Sweden. The objective has been to scrutinise, discuss, compile and comment on measures, changes in conditions and effects concerning both the road, the vehicle and the road user. One further objective has been to relate, as far as possible, the effects/changes to the actual development of fatalities in traffic, in the first place over the period 1996-2006. It is found that for many factors, the conditions, measures and associated effects are insufficiently known. This is especially true for changes over time. This is unsatisfactory since, at the same time, there is strong evidence that these factors have, or may have, a considerable impact and that it is a high proportion of all traffic fatalities which are affected - either positively or negatively. We do not know about changes in conditions regarding speeds, person km travelled by age and gender, alcohol in traffic, use of mobile telephones when driving, and attitudes and deliberate traffic violations. There are no data for changes concerning risk for car drivers of different ages and genders. Effects concerning fatalities are insufficiently known for changes in traffic mileage (all other factors being constant), changes in economic conditions (effects apart from impact on traffic mileage), automatic traffic safety control speed cameras, certain physical measures, the aggregate effect of more recent vehicles, measures to influence alcohol in traffic, and attitude modification. There are no data for simultaneous analysis of accidents/injuries/fatalities, as well as for exposure, speed, road, vehicle and road user.
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| 16. |
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| 17. |
- Burström, Lena, et al.
(författare)
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Improved quality and efficiency after the introduction of physician-led team triage in an emergency department.
- 2016
-
Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 121:1, s. 38-44
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Overcrowding in the emergency department (ED) may negatively affect patient outcomes, so different triage models have been introduced to improve performance. Physician-led team triage obtains better results than other triage models. We compared efficiency and quality measures before and after reorganization of the triage model in the ED at our county hospital.MATERIALS AND METHODS: We retrospectively compared two study periods with different triage models: nurse triage in 2008 (baseline) and physician-led team triage in 2012 (follow-up). Physician-led team triage was in use during day-time and early evenings on weekdays. Data were collected from electronic medical charts and the National Mortality Register.RESULTS: We included 20,073 attendances in 2008 and 23,765 in 2012. The time from registration to physician presentation decreased from 80 to 33 min (P < 0.001), and the length of stay decreased from 219 to 185 min (P < 0.001) from 2008 to 2012, respectively. All of the quality variables differed significantly between the two periods, with better results in 2012. The odds ratio for patients who left before being seen or before treatment was completed was 0.62 (95% confidence interval 0.54-0.72). The corresponding result for unscheduled returns was 0.36 (0.32-0.40), and for the mortality rates within 7 and 30 days 0.72 (0.59-0.88) and 0.84 (0.73-0.97), respectively. The admission rate was 37% at baseline and 32% at follow-up (P < 0.001).CONCLUSION: Physician-led team triage improved the efficiency and quality in EDs.
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| 18. |
- Burström, Lena, et al.
(författare)
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Physician-led team triage based on lean principles may be superior for efficiency and quality? : A comparison of three emergency departments with different triage models
- 2012
-
Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : Springer Science and Business Media LLC. - 1757-7241. ; 20:1, s. 57-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The management of emergency departments (EDs) principally involves maintaining effective patient flow and care. Different triage models are used today to achieve these two goals. The aim of this study was to compare the performance of different triage models used in three Swedish EDs. Using efficiency and quality indicators, we compared the following triage models: physician-led team triage, nurse first/emergency physician second, and nurse first/junior physician second.METHODS: All data of patients arriving at the three EDs between 08:00- and 21:00 throughout 2008 were collected and merged into a database. The following efficiency indicators were measured: length of stay (LOS) including time to physician, time from physician to discharge, and 4-hour turnover rate. The following quality indicators were measured: rate of patients left before treatment was completed, unscheduled return within 24 and 72 hours, and mortality rate within 7 and 30 days.RESULTS: Data from 160,684 patients were analysed. The median length of stay was 158 minutes for physician-led team triage, compared with 243 and 197 minutes for nurse/emergency physician and nurse/junior physician triage, respectively (p < 0.001). The rate of patients left before treatment was completed was 3.1 % for physician-led team triage, 5.3 % for nurse/emergency physician, and 9.6 % for nurse/junior physician triage (p < 0.001). Further, the rates of unscheduled return within 24 hours were significantly lower for physician-led team triage, 1.0 %, compared with 2.1 %, and 2.5 % for nurse/emergency physician, and nurse/junior physician, respectively (p < 0.001). The mortality rate within 7 days was 0.8 % for physician-led team triage and 1.0 % for the two other triage models (p < 0.001).CONCLUSIONS: Physician-led team triage seemed advantageous, both expressed as efficiency and quality indicators, compared with the two other models.
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| 19. |
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| 20. |
- Bäckström, Mikael, et al.
(författare)
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Sports Technology Education at Mid Sweden University
- 2013
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Ingår i: 6TH ASIA-PACIFIC CONGRESS ON SPORTS TECHNOLOGY (APCST). - : Elsevier. ; , s. 214-219
-
Konferensbidrag (refereegranskat)abstract
- In present paper we would like to share some experiences of building new education in Sports Technology at MidSweden University and the results of 10 years of successfully running it in Östersund. The Sports Technologyeducation at Mid Sweden University started at Campus Östersund in 2003 as a part of the curriculum of theEngineering Department. This specialization was initially at the three-year Bachelor level, and later it was extendedto an additional two-year Master level. Aiming at the quality of Sports Technology education, three keystones areunderlying its process, representing the solid knowledge base, capacity to be flexible in problem solving and the usean innovative approaches. The Department unites researches with a background in both natural sciences andengineering disciplines, having a wide experience of working with and within the industry, equally active in researchand teaching. The unique constellation of the profiles forming the Department include not only the SportsTech®group, being “the backbone”, but also the Ecology and Eco-technology, and Quality Technology groups bringing theexcellence and extra competence needed to assure the quality of the Sports Technology education. We were the firsthigher education institution in Sweden to give this kind of education program and now some other SwedishUniversities have followed us. Our success can be measured by a number of graduates taking good jobs in theindustry. We also enjoy a steady flow of new students coming from all parts of Sweden, and Sports Technologyeducation stays among the most desirable ones in the country.
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| 21. |
- Carlsson, Arne, et al.
(författare)
-
Metod för beräkning av fördröjningar på vägavsnitt utan omkörningsmöjlighet
- 2013
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Detta VTI notat presenterar en beräkningsmetod för beräkning av förväntad kölängd och restidsfördröjning för enfältiga vägavsnitt utan omkörningsmöjligheter. Metoden utvecklades 2001 och presenterades i ett PM. Bakgrunden till modellutvecklingen var att dåvarande Vägverket (nu Trafikverket) planerade att införa så kallade 1+1-vägar, det vill säga, vägar med längre delsträckor utan omkörningsmöjlighet. Den utvecklade beräkningsmetoden har sedermera visat sig värdefull även vid framkomlighetsberäkningar för 2+1-vägar med varierande andel tvåfältsavsnitt och har använts vid framtagning av hastighetsflödessamband till Trafikverkets ”Effektsamband för vägtransportsystemet”. Metoden använder avsnittslängd, trafikflöde samt medelhastighet och standardavvikelse som indata. Metoden är uppdelad på beräkning av effekter på grund av enstaka långsamtgående fordon samt effekter vid ”normal” hastighetsfördelning. Då mätdata saknades vid modellutvecklingen jämfördes metoden med simuleringskörningar med den mikroskopiska trafiksimuleringsmodellen AIMSUN. Resultaten visar på en relativt god korrelation men generellt så ger den analytiska metoden cirka 1,2 procent lägre restidsfördröjning. En stor del av skillnaden mellan modellerna vid måttliga flöden bör kunna härledas till det stokastiska inslaget i simuleringen. Det bör även påpekas att varken den analytiska modellen eller trafiksimuleringsmodellen har kalibrerats och validerats mot verkliga data för denna typ av väg. Skillnaden mellan modellerna innebär således inte att den analytiska modellen självklart är den som avviker från verkligheten.
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| 22. |
- Carlsson, Celice, et al.
(författare)
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On the Selectivity of Radical Scavengers Used To Probe Hydroxyl Radical Formation in Heterogeneous Systems
- 2022
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Ingår i: The Journal of Physical Chemistry C. - : American Chemical Society (ACS). - 1932-7447 .- 1932-7455. ; 126:30, s. 12435-12440
-
Tidskriftsartikel (refereegranskat)abstract
- Tris and methanol have been used quite extensively as probes for surface-bound hydroxyl radicals in heterogeneous systems, such as TiO2 photocatalysis and catalytic decomposition of H2O2. Recent studies have indicated that the selectivity for surface-bound hydroxyl radicals is questionable and that the yield of the stable detectable product, formaldehyde, may be different for different reactive species. In this work, we have explored the selectivity as well as the formaldehyde yield of these two probes by experimentally studying formaldehyde formation in homogeneous (gamma radiolysis) and heterogeneous (TiO2 photocatalysis) systems, where hydroxyl radicals and Br-2.- can be formed. The latter is formed in the reaction between hydroxyl radicals and Br- at relatively high concentrations of Br-. The experiments clearly show that the formaldehyde yield is reduced by 85% when comparing hydroxyl radicals and Br2 & BULL;- in a homogeneous methanol system and increased by 50% when making the same comparison for the homogeneous Tris system. The increased yield is attributed to a change in the reaction mechanism as Br2 & BULL;- is mainly expected to produce a nitrogen-centered radical cation, while the hydroxyl radical mainly produces carbon-centered radicals. The radical cation appears to produce formaldehyde with a higher yield. In the photocatalysis system, the trends are similar but even more emphasized. The rationale for this is discussed, as well as the suitability of methanol and Tris as probes for surface-bound hydroxyl radicals in heterogeneous systems.
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| 23. |
- Carlsson-Wall, Martin, et al.
(författare)
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The role of management controls in managing heterogeneous interests during extreme situations: the Swedish migrant crisis in 2015
- 2021
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Ingår i: Qualitative Research in Accounting and Management. - : Emerald. - 1176-6093. ; 18:1, s. 1-25
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThis paper aims to explore the role of management controls in managing heterogeneous interests during extreme situations.Design/methodology/approachThrough interviews and observations, the authors analyse the Swedish Migration Agency's management controls and study routines during the peak of the European Migrant Crisis.FindingsPrior to the crisis, the strategy used by the employees was to mediate between two interests (labelled legal security and empathy) to create a workable compromise. During the crisis, however, the authors observed filtering in the form of the previous hierarchical ordering of interests was further strengthened as the employees increasingly relied on just a single interest (the interest which they previously had deemed to be the most important) at the expense of the other interest. The findings suggest that behavioural and social controls helped such filtering; social controls helped certain employees to filter the empathy interest as more important during extreme situations and behavioural controls helped other employees to filter the legal security interest as more important. This help us explain why the authors observe less mediation between the two heterogeneous interests and rather a stricter dominance of one of the interests. The authors also illustrate how especially behavioural controls may become unsupportive of the operations during extreme situations as it consisted of rule-based standards, built to cope with "normal" situations. The heterogeneous interests affected the probability of actors, at times, ignoring behavioural controls when such controls were unsupportive. Actors whose day-to-day operations were mainly guided by the legal security interest remained tightly coupled to behavioural controls even when they felt that these controls were no longer useful. On the other hand, actors who were mainly guided by the empathy interest ignored behavioural controls when they felt that they were unsupportive.Research limitations/implicationsThe authors acknowledge that bias might arise from the reliance on retrospective views of past processes and events, which the authors primarily gathered through interviews.Practical implicationsThe authors highlight an important relationship between heterogeneous interests (i.e. legal security and empathy) and management controls during the crisis and how this relationship can lead actors to fundamentally different actions.Originality/valueThe two bodies of study on the role of management controls in managing heterogeneous interests and the role of management controls during the crisis have been largely unconnected and it is in this intersection that this study contributes.
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| 24. |
- Coronel, Ernesto, 1973-
(författare)
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Solving Problems in Surface Engineering and Tribology by Means of Analytical Electron Microscopy
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- It is well known that thin coatings can provide increased lifetime and reduced energy consumption for tools and components. During use, e.g. in sliding contact, mechanical and chemical reactions often lead to the formation of new surface layers, tribofilms, possessing different properties compared to the original surface, hence affecting the overall performance. In this work, analytical electron microscopy was applied to investigate the structure and composition of tribofilms.Concerning coatings, deposition parameter dependencies, stability and tribology were investigated. The carbon content of hydrogen-free TiCx coatings was shown to significantly influence the morphology. Low carbon content resulted in columnar grains with a strong texture while high carbon content led to the formation of randomly ordered TiCx crystals. The application of positive bias to the substrate as opposed to the normally used negative bias gave a fibrous structure of sputtered TiB2 and low residual stress with maintained hardness. Further, oxidation stability was examined on a (Ta,Al)C:C coating where oxidation led to partial oxidation and formation of AlTaO4 with an 8 nm interface.A focused ion beam instrument was used to extract samples from certain areas of worn specimens. Tribological contact was observed to result in phase changes and intermixing of materials present in the contact. Sliding contact involving a Co-alloy led to a phase change from fcc to hcp. A 30 nm Co-rich tribofilm was observed with basal planes parallel to the surface. Fully formulated oil was found to inflict considerable wear to a metal doped carbon film through chemical reaction with the metal dopant. WC/Co cemented carbide used for rock drilling exhibited intermixing of rock and Co binder phase after field tests. Chemical vapour deposited diamond worn in nitrogen and argon showed formation of wear debris with amorphous structure containing nitrogen and graphitic like structure, respectively.
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| 25. |
- Crespo, Ana, et al.
(författare)
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Testing morphology-based hypotheses of phylogenetic relationships in Parmeliaceae (Ascomycota) using three ribosomal markers and the nuclear RPB1 gene
- 2007
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Ingår i: Molecular Phylogenetics and Evolution. - : Elsevier BV. - 1055-7903 .- 1095-9513. ; 44:2, s. 812-824
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Tidskriftsartikel (refereegranskat)abstract
- Parmeliaceae is the largest family of lichen-forming fungi with more than 2000 species and includes taxa with different growth forms. Morphology was widely employed to distinguish groups within this large, cosmopolitan family. In this study we test these morphology-based groupings using DNA sequence data from three nuclear and one mitochondrial marker from 1.20 taxa that include 59 genera and represent the morphological and chemical diversity in this lineage. Parmeliaceae is strongly supported as monophyletic and six well-supported main clades can be distinguished within the family. The relationships among them remain unresolved. The clades largely agree with the morphology-based groupings and only the placement of four of the genera studied is rejected by molecular data, while four other genera belong to clades previously unrecognised. The classification of these previously misplaced genera, however, has already been questioned by some authors based on morphological evidence. These results support morphological characters as important for the identification of monophyletic clades within Parmeliaceae.
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| 26. |
- Ekenberg, Love, et al.
(författare)
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Att vara eller inte vara
- 2007
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Ingår i: DN. - 1101-2447. ; :August 29
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Tidskriftsartikel (refereegranskat)
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| 27. |
- Ekenberg, Love, et al.
(författare)
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Att vara eller inte vara?
- 2007
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Ingår i: Dagens nyheter. - 0896-1441. ; :2007-08-29
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Datorspelen och gränssnittet mellan verklighet och virtuell verklighet.
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| 28. |
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| 29. |
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| 30. |
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| 31. |
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| 32. |
- Eriksson, Jenny, 1975-, et al.
(författare)
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New ways of collecting individual travel information : Evaluation of data collection and recruitment methods
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The overall purpose of the project is to conduct a demonstration study that shows how two data collection methods that have been developed to collect travel survey data perform in the field, and how they perform compared with traditional TS (i.e., postal questionnaires and/or telephone interviews). The project is also intended to provide a better understanding of the ways in which different recruitment methods of respondents can be used so that future TS can be more cost effective.The two collection methods tested consist of a mobile app and an online questionnaire with a map to assist the respondents to identify travel destinations. Three recruitment methods were used, i.e., recruitment via random sampling, a web panel, and crowdsourcing. The portion of the random sample that received an online questionnaire was divided into two groups. Half the group was given no incentive, while the other half received a gift card worth SEK 100 after answering the questioner. Those who were recruited via a web panel and were to use the mobile app were rewarded in the form of a gift card worth SEK 100 if, at minimum, they made corrections to trips made on one day registered in the mobile app. A nonresponse analysis was performed of the random sample for both the online questionnaire and the mobile app. Cost estimates for each collection method and recruitment method were also performed, as were uncertainty estimates.Overall, the study shows that the mobile app registered significantly more trips per respondent than did the online questionnaire, while the distances travelled were comparable. There are several possible interpretations of this. One is that people who responded to the online questionnaire either forget about and/or combined short trips (particularly trips made for the purposes of leisure or shopping, and using the travel modes walking and car). One presumable explanation for this is that it is easier to confirm/correct the trips that the mobile app suggests than it is to recall and enter all trips in an online questionnaire. Another possible interpretation is that people responding to different data collection methods have different travel patterns. Yet another explanation is connected to technique issues regarding the different data collection methods.
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| 33. |
- Eriksson, Jenny, 1975-, et al.
(författare)
-
Nya sätt att samla in individuell resvaneinformation : Utvärdering av insamlings- och rekryteringsmetoder
- 2018
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Inom samverkansprogrammet Nästa generations resor och transporter, som Trafikanalys är huvudansvarig för, har man identifierat ett behov av att finna och utveckla nya lösningar för resvaneundersökningar (RVU:er). Bakgrunden till detta är bland annat sjunkande svarsfrekvenser med dagens metoder, vilket skulle kunna ge problem med representativiteten. Det anses som mycket angeläget att utveckla nya metoder för datainsamling för framtidens RVU:er, både på kort och lång sikt.Det övergripande syftet med projektet är att göra en demonstrationsstudie som visar hur två datainsamlingsmetoder som har utvecklats för att samla in resevaneundersökningsdata presterar i fält, samt hur de presterar jämfört med ”traditionell” RVU (postal enkät och/eller telefonintervjuer). Projektet syftar också till att få bättre förståelse för hur olika rekryteringsmetoder kan användas för att framtida RVU:er ska kunna bli mer kostnadseffektiva. De två insamlingsmetoder som testats är webbenkät med karta och mobilapp. Tre rekryteringsmetoder har använts och dessa är rekrytering via slumpmässigt urval, webbpanel och crowdsourcing.
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| 34. |
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| 35. |
- Forsman, Åsa, et al.
(författare)
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Co-operation between police and social treatment services offering treatment to drink and drug drivers : experience in Sweden
- 2011
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Ingår i: Traffic Injury Prevention. - : Informa UK Limited. - 1538-9588 .- 1538-957X. ; 12:1, s. 9-17
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe and analyze a measure that has been introduced in Sweden with the objective of quickly offering treatment for the alcohol or drug problems suspected drink or drug drivers may have. The goal of the measure is that every suspected drink or drug driver shall, as soon as apprehended by the police, be offered contact with the social services or the dependency care and treatment service, which can offer a consultation and, if needed, suitable treatment.Method: Interviews and questionnaire surveys, as well as forms that describe the treatment received by each individual case.Results: About 20 percent of all those who receive the offer from the police accept contact with the social services or the care and treatment service, and approximately 40 percent of these also attend the consultation. There is a favorable fundamental attitude to the method among the participating authorities. However, some shortcomings in application are revealed. One example concerns drug drivers who are offered contact with the social services or the care and treatment service to a considerably lesser extent than drink drivers. Another neglected group are the people who are at first suspected of drink driving but are later found to have an alcohol concentration below the legal limit. Compared with those who have an alcohol concentration above the legal limit, this group is offered contact to a lesser extent and also have a lower propensity to accept the offer.Conclusions: The results indicate a strong support for the method from involved authorities, but participation could be improved by giving more attention to neglected groups.
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| 36. |
- Forsman, Åsa, et al.
(författare)
-
Förslag till förbättringar av rattfylleristatistiken i Sverige : underlag till uppdrag att förbättra beskrivningen av vägtrafikolyckornas hälsopåverkan
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- In June 2006, the Swedish Road Administration was mandated by the Government to improve the description of the health effects of road traffic accidents. Under the terms of this mandate, a proposal was to be made as to how the recording of alcohol and drug related accidents can be improved, and how sample surveys of the prevalence of drivers under the influence of alcohol and/or drugs should be performed. This note describes the data used for these parts of the mandate. One common condition for both these parts is that possible screening methods for drivers under the influence of narcotics should be studied. In order to measure the proportion of traffic mileage travelled by drink/drug drivers, the investigation should be organised as a statistical sample survey where the police check drivers at sites selected at random. As regards selection in time, it may be reasonable to use quota sampling. In the present situation, we do not consider that it is possible to carry out regular surveys of drug driving. If the regulations are amended so that routine controls can be performed, and if the police begin to use screening instruments for drug tests, regular surveys can be performed. These surveys can then be integrated with the investigations regarding alcohol, by requiring the stopped drivers to give samples for both alcohol and for drugs.
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| 37. |
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| 38. |
- Gerth, Julia, et al.
(författare)
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Evaluation of an intermittent sliding test for reproducing work material transfer in milling operations
- 2012
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Ingår i: Tribology International. - : Elsevier BV. - 0301-679X .- 1879-2464. ; 52, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- TiN coated HSS test cylinders from an intermittent sliding test were compared with TiN coated HSS milling inserts from a single insert milling test. A 20NiCrMo2 case hardening steel was used as counter material and work material in the two tests. HSS test cylinders, coated with AlCrN, TiAlN and Al2O3, were also tested in the intermittent sliding test and evaluated with regard to material adhesion. Two distinctly different tribofilms were formed on test cylinders as well as on cutting inserts. One consisting of Mn, Si, Al and O and one consisting of Fe, Mn, Cr, Si and O. The transferred material was similar in appearance and composition, both when comparing the two test methods and when comparing the different tool coatings.
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| 39. |
- Gerth, Julia, 1979-, et al.
(författare)
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On the wear of PVD-coated HSS hobs in dry gear cutting
- 2009
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Ingår i: Wear. - : Elsevier BV. - 0043-1648 .- 1873-2577. ; 266:3-4, s. 444-452
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Tidskriftsartikel (refereegranskat)abstract
- A hob is an advanced gear cutting tool usually made of homogenous high-speed steel (HSS) and coated by physical vapour deposition (PVD). It is designed for regrinding and recoating many times. However, hobs of today suffer from unpredictable wear making it difficult to schedule when they should be taken out for reconditioning. This investigation is aimed to contribute to the fundamental knowledge of the wear mechanisms and wear propagation of hobs used in dry gear cutting. Two AlCrN-coated hobs, used in actual gear cutting, were investigated by scanning electron microscopy (SEM) to study the tool topography, light optical microscopy (LOM) to study metallographic cross-sections and by X-ray photoelectron spectroscopy (XPS) for surface analyses.It is concluded that the high potential of PVD-coated HSS as tool material is not taken full advantage of. The main reason is a combination of a poor surface preparation prior to coating and excessively high compressive residual stresses, making parts of the coating detach along the edge line even on unused cutting teeth. During cutting, the high intrinsic stresses in combination with droplets and defects in the coating facilitated its fragmentation through decohesion and detachment. Simultaneously, the rake face is gradually covered by a thin oxide layer dominated by Fe, Cr and Mn in about equal amounts, and also with a significant content of Si. It is believed but not proved that this layer is beneficial.To improve service life and reliability of gear cutting hobs, precautions should be taken for the grinding–polishing preparation prior to PVD-coating to ensure a smooth substrate free from burning damage and other defects. Also, the edge radius and coating thickness has to be matched with the magnitude of compressive residual stresses in the coating.
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| 40. |
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| 41. |
- Gerth, Julia, et al.
(författare)
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Survey of damage mechanisms on PVD coated HSS hobs used in Swedish gear manufacturing industry
- 2011
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Ingår i: Tribologia. - 0780-2285. ; 30:1-2, s. 37-50
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Tidskriftsartikel (refereegranskat)abstract
- Gear hobbing is widely used for production of cylindrical gears in the Swedish transmission industry. The hob, usually consisting of a homogenous HSS (High Speed Steel) body coated with a ceramic PVD (Physical Vapour Deposition) coating, is designed for regrinding and recoating several times without affecting its cutting geometries. Efficient usage of the tool, considering production costs and gear quality, requires reconditioning before wear starts to affect the gear quality negatively and certainly before tool wear renders reconditioning impossible. Hobs of today generally lack in reliability, making it difficult to judge when they have to be taken out for reconditioning. This work presents a survey of wear as observed on today’s state of the art hobs used by Swedish gear manufactures. It aims to identify damage mechanisms and the common problems in order to enable future production of more reliable hobs. The tools were temporarily borrowed from the production and the analyses were made non-destructively using optical microscopes. This was complemented by destructive cross-sectional analysis on two of the hobs. Wear was most commonly located on the rake faces and the cutting edges of the cutting teeth. It mainly propagates by discrete fractures which appear to originate at local defects in the coating or at the interface. High intrinsic stress in the coating likely promotes coating spallation and accelerates the wear of the cutting edge.
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| 42. |
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| 43. |
- Gutkin, Renaud, et al.
(författare)
-
Slutrapport för det koncernstrategiska projektet Swerea Virtual Lab
- 2016
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Simulering som verktyg för utveckling, tillverkning och provning av produkter i avancerade material är en stor och betydande del av Swereas ordinarie verksamhet. Swerea Virtual Lab är ett fokusområde inom Swerea AB. Swerea Virtual Lab är en kraftsamling för att hjälpa industrin att utöka sin virtuella produktutveckling. Swerea Virtual Lab är en unik samarbetspartner genom sin storlek, kompetens, materialbredd och förmåga att generera indata till beräkningsmodell, genomföra simuleringar och verifiera resultat i laboratorieskala. Swerea Virtual Lab är ett välkänt begrepp, en prioriterad samarbetspartner och den självklara forskningspartnern i EU projekt och i industriella utvecklingsprojekt i Europa och Sverige. Swerea Virtual Lab kännetecknas av tydlig kontaktstruktur, transparent process, hög kvalité och hög leveranssäkerhet. Swerea Virtual Lab vänder sig till alla branscher som har ett intresse av virtuell produktutveckling.
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| 44. |
- Hammarback, Staffan, et al.
(författare)
-
Navigating oneself through the eyes of the other - meanings of encountering ambulance clinicians while being in a suicidal process
- 2024
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe suicidal process contains both observable and non-observable phases, and patients have described the process as characterized by loneliness and darkness. Ambulance clinicians encounter patients in all phases of the suicidal process but little is known on what meaning this encounter has to the patients. The aim of this study was to elucidate meanings of encountering ambulance clinicians while being in a suicidal process.MethodsData were collected through fifteen individual interviews with eight participants who had lived experiences of encountering ambulance clinicians. Inductive design using phenomenological hermeneutical approach was used.FindingsPatients are impacted by the clinicians, both in how they find their value in the situation, but also in expected trajectory. Three themes; 'Being impacted by representatives of society', 'Being unsure of ones own value' and 'Regaining hope in moments of togetherness' generated the main theme Navigating oneself through the eyes of the other.ConclusionThe way ambulance clinicians communicate impacts how patients navigate themselves in the ambivalence about living or dying, and the encounter either consolidate a feeling of being a burden, or instil hope of an endurable life. Through conversation, clinicians could support the patients in taking the first steps in the journey of recovery.
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| 45. |
- Hammarbäck, Staffan, 1981-, et al.
(författare)
-
Ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process
- 2023
-
Ingår i: Nursing Ethics. - : Sage Publications. - 0969-7330 .- 1477-0989. ; 30:6, s. 857-870
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process.Aim: The aim of this study was to describe ambulance clinicians’ conceptions of responsibility when en- countering patients in a suicidal process.Research design: A qualitative inductive design using a phenomenographic approach was used. Participants and research context: Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed.Ethical considerations: The study was approved by the Swedish Ethical Review Authority.Findings: Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient’s mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient’s life story.Conclusions: An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation.
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| 46. |
- Hammarbäck, Staffan, 1981-, et al.
(författare)
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Ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process
- 2022
-
Ingår i: Presented at the 4th International Nordic College of Caring Science & the European Academy of Caring Science Conference: "Caring in a changing world", Eskilstuna, Sweden, April 27-28, 2022.
-
Konferensbidrag (refereegranskat)abstract
- Introduction: Ambulance clinicians encounter patients in both obvious and non-obvious phases of a suicidal process. Regardless of phase, ambulance clinicians could have an important role in suicide prevention. However, the main focus in ambulance care is on emergency medicine while the patient’s mental ill-health is not necessarily included in the clinician’s assessment. Aim: To describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Method: With a phenomenographic approach, semi structured interviews were conducted with twenty-seven Swedish ambulance clinicians with a variation in competence, working experience, gender and age. Results: Three categories of description were found. Conventional responsibility, in which responsibility mainly concerns emergency medical treatment and assessment. Conditional responsibility, which to a limited extent includes the patient’s mental ill-health in responsibility but only if certain conditions are met. Ethical responsibility emerges from the encounter with the patient and responsibility is understood as providing care based on the patient’s needs, regardless of physical or mental origin. These categories are found on a spectra moving from responding to the call to responding to the patient. Responding to the patient is impaired by language deficiency or tiredness. Working with a supportive colleague, training in mental health and conversations skills were perceived as facilitating responding to the patient. Conclusion: In suicide prevention, ambulance clinicians understanding of responsibility as responding to the call is unfavorable. Responding to the patient is more favorable and means to primarily appear to the patient as fellow human being. Engaging in a relationship with the patient could cause vulnerability in the clinician, however this vulnerability could be reduced with training and education. This could be vital as it is in the relationship that suicidality could be disclosed and understood.
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| 47. |
- Hammarbäck, Staffan, et al.
(författare)
-
Ambulance clinicians’ responsibility when encountering patients in a suicidal process
- 2023
-
Ingår i: Nursing Ethics. - : SAGE Publications Ltd. - 0969-7330 .- 1477-0989.
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Even though the traditional focus in emergency care is on life-threatening medical crisis, ambulance clinicians frequently encounter patients with mental illness, including suicidal ideation. A suicide is preceded by a complex process where most of the suicidal ideation is invisible to others. However, as most patients seek healthcare in the year before suicide, ambulance clinicians could have an important part to play in preventing suicide, as they encounter patients in different phases of the suicidal process. Aim: The aim of this study was to describe ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. Research design: A qualitative inductive design using a phenomenographic approach was used. Participants and research context: Twenty-seven ambulance clinicians from two regions in southern Sweden were interviewed. Ethical considerations: The study was approved by the Swedish Ethical Review Authority. Findings: Three categories of descriptions captured a movement from responding to a biological being to responding to a social being. Conventional responsibility was perceived as a primary responsibility for emergency care. In conditional responsibility, the patient’s mental illness was given only limited importance and only if certain conditions were met. Ethical responsibility was perceived to have its primary focus on the encounter with the patient and listening to the patient’s life story. Conclusions: An ethical responsibility is favourable regarding suicide prevention in ambulance care, and competence development in mental illness and conversation skills could enable ambulance clinicians to have conversations with patients about suicidal ideation.
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| 48. |
- Hammarbäck, Staffan, 1981-, et al.
(författare)
-
Navigating oneself through the eyes of the other : Meanings of encountering ambulance clinicians whilst being in a suicidal process
- 2024
-
Ingår i: The 5th International NCCS & EACS Conference, University of Stavanger, Norway, Caring science – the heart of multi-professional care. ; , s. 12-12
-
Konferensbidrag (refereegranskat)abstract
- Background:Being in a suicidal process has been described as lonely and painful but there is also a longing for someone to see, listen and understand. There is an ambivalence about living or dying and while there is a wish for an endurable future, it seems to be out of reach. Ambulance clinicians describe a lack of competence and variation in conceptualized responsibility, moving between mainly emergency medicine to an ethical responsibility to engage in a caring relationship. Since little is known what meaning this encounter has to the patients, the aim of this study was to elucidate meanings of encountering ambulance clinicians whilst being in a suicidal process. Methods:A phenomenological hermeneutical approach was used, and data were collected through fifteen individual interviews with eight participants with lived experience of encountering ambulance clinicians whilst being in a suicidal process. Results:The analysis resulted in the main theme ´Navigating oneself through the eyes of the other´. In the encounter, patients navigate their position in terms of value, and direction as expectations of the future. Three subthemes; ‘Being impacted by representatives of society’, ‘Being unsure of one´s own value’ and ‘Regaining hope in moments of togetherness’ substantiated the main theme.Conclusion: It is in in the clinicians’ power to consolidate the feeling of being a burden but also to instil hope of an endurable life. Through caring conversations clinicians can support the patients’ first steps in the journey of recovery.Ethical considerations:The Swedish Ethical Review Authority approved the study.
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| 49. |
- Hammarbäck, Staffan, 1981-, et al.
(författare)
-
The encounter between ambulance clinicians and patients in a suicidal process
- 2023
-
Ingår i: Presented at the 4th Global Conference on Emergency Nursing & Trauma Care, Gothenburg, Sweden, November 9-11, 2023, 2023.
-
Konferensbidrag (refereegranskat)abstract
- Background: Most patients have contact with healthcare in the year prior to suicide and ambulance clinicians encounter these patients in all stages of the suicidal process (Rees. Traditionally, the focus in ambulance care is on emergency medicine and encountering patients with suicidal ideation can be challenging to the clinicians. Patients describe an ambivalence between living and dying and being in the process is characterized by loneliness and darkness, but there is also a longing for someone who truly see, listen and understand the situation.Aim: To illuminate the encounter between ambulance clinicians and patients in a suicidal process.Method: The presentation is founded in two qualitative interview studies. The first study has a phenomenographic approach and describes ambulance clinicians’ conceptions of responsibility when encountering patients in a suicidal process. The second study has a phenomenological hermeneutical approach and illuminates meaning of patients’ lived experience of encountering ambulance clinicians whilst being in a suicidal process.Ethical considerations: Both studies included in the presentation were approved by the Swedish Ethical Review Authority.Results: Ambulance clinicians describe lack of competence regarding suicidality. However, the competence that patients desire is compassion and humanity which impacts on the ambivalence between living and dying. Both clinicians and patients experience vulnerability in the encounter. To the clinicians, this vulnerability comes from coming forth as a person in the encounter. At the same time, it is the personal in clinicians that remind patients of human community and convey hope of a bearable life. Conclusions: The encounter with ambulance clinicians could be the start of the patients’ recovery. Not only can the clinicians offer a safe haven, but they can also support the patients in reclaiming their life stories.
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| 50. |
- Hammarbäck, Staffan, et al.
(författare)
-
The meaning of the encounter with ambulance clinicians whilst being in a suicidal process
- 2023
-
Ingår i: International Association for Suicide Prevention. - : International Association for Suicide Prevention. ; , s. 229-230
-
Konferensbidrag (refereegranskat)abstract
- Background: Patients in suicidal processes describe ambivalence about living or dying, and that there are feelings of loneliness, shame and failure, and longing for someone to truly see and understand. When encountering hospital emergency care, the experiences range from hostility to gentleness. However, a positive relationship is understood as part of recovery. It can be challenging for ambulance clinicians to encounter patients in suicidal processes, and suicidal ideation is not necessarily considered to be within the scope of their responsibility. Ambulance clinicians encounter patients in all stages of the suicidal process, and they could have responsibility in preventing future suicide. Nevertheless, there is scarce research on how patients experience this encounter and what meaning it has to them.Aim: The aim of the study was to elucidate meanings of encountering ambulance clinicians whilst being in a suicidal process.Method: A qualitative inductive design was used. Fifteen individual interviews were conducted with eight participants with experience of encountering ambulance clinicians whilst being in a suicidal process. The interviews were transcribed and the data was analysed using phenomenological hermeneutics.Ethical considerations: The study was approved by the Swedish Ethical Review Authority.Results: Preliminary findings presents three themes. Being under ambulance clinicians’ authority which means to be inferior in the power balance to the clinicians. However, the power balance is highlighted through body language, tone or focusing on diagnosis, but it could also be balanced through a personal and empathic encounter. Being unsure of one’s own value where one keeps up a façade to protect both one’s vulnerability but also to avoid putting one’s burden upon the clinicians. Being a problem to solve, and not a person in need of help, is elucidated when the clinicians use impeaching language. Regaining hope in moments of togetherness where the brief relationship with the clinicians can rise hope when one is seen as a unique person. Having an everyday conversation reminds of human community. An opportunity to share one’s story and to be supported in approaching what is distressful, arises when clinicians have an understanding attitude.Conclusions: Encountering ambulance clinicians means to be inferior. Clinicians’ communication highlights the power imbalance and can increase feelings of loneliness and being a burden. But there is also in the clinicians’ power to equalize the imbalance, to convey hope and remind of human community. Thus, the encounter could be the start of the patients’ recovery.
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