| 1. |
- Andersson, Sten-Ove, et al.
(författare)
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Doctors’ and Nurses’ Perceptions of Military Pre-hospital Emergency Care
- 2014
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to identify physicians’ and nurses’ perceptions of military prehospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The aim is to identify the area of knowledge, pre-hospital care in a military environment, in terms of expressions from doctors and nurses focussing on the variation in how learning of pre-hospital care is perceived. The result of the study is a set of descriptive categories on a collective level, showing the variation in how doctors and nurses perceived the phenomenon of military pre-hospital emergency care. The results after predeployment training can be categorized as (1) to learn military medicine, (2) to take care of the casualty and (3) to have safety awareness. The results after an international mission can be categorized as (1) to collaborate with others, (2) to deliver general health care, and (3) to improve competence in military medicine. Possible implications of the results from the present study are the following; (I) better conditions for doctors and nurses to provide appropriate military medical care by clarification and better understanding of professions in the mission area (doctors, nurses, officers), since they may have different goals for their actions, (II) to pay attention to all aspects of military health care during predeployment training, including general health care in the mission area, (III) to implement new knowledge in military medicine in the predeployment training, and (IV) to train for the reality all doctors and nurses are about to meet. These results indicate that the training should be developed in order to optimize the prepare physicians and nurses for international assignments. This may result in increased safety for the provider of care, while at the same time minimizing suffering and enhancing the possibility of survival of the injured.
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| 2. |
- Andersson, Sten-Ove, et al.
(författare)
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Interaction, Action, and Reflection : How Medics Learn Medical Care in the Swedish Armed Forces
- 2013
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Ingår i: Military medicine. - : Association of Military Surgeons of the U S. - 0026-4075 .- 1930-613X. ; 178:8, s. 861-866
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study is to examine how medics within the Swedish Armed Forces perceive their learning outcome following military prehospital training. A qualitative study with a phenomenographic approach was used to investigate how learning is perceived among military medics. At meta level, the results can be viewed as an interaction, i.e., being able to collaborate in the medical platoon, including the ability to interact within the group and being able to lead; an action, i.e., being able to assess and treat casualties, including the ability to communicate with the casualty, to prioritize, and to be able to act; and a reflection, i.e., having confidence in one's own ability in first aid, including being prepared and feeling confident. interaction during the period of education is important for learning. action, being able to act in the field, is based on a drill in which the subject progresses from simple to complex procedures. reflection, learning to help others, is important for confidence, which in turn creates preparedness, thereby making the knowledge meaningful.
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| 3. |
- Björkman, Eleonora, 1981, et al.
(författare)
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In vitro assessment of epithelial electrical resistance in human esophageal and jejunal mucosae and in Caco-2 cell layers.
- 2012
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 1502-7708 .- 0036-5521. ; 47:11, s. 1321-1333
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. There is a need for a technique allowing studies of human mucosal specimens collected during different clinical conditions. This study elucidates if square wave pulse analysis discriminates between epithelial and transmural electrical resistance and if there is an association with transepithelial permeability of molecular probes. Methods. Mucosae from esophagus (surgical resections: n = 14; endoscopic biopsies: n = 15) and jejunum (n = 12) and Caco-2 cell monolayers were investigated in Ussing chambers. Transmural and epithelial electrical resistance were recorded by the use of standardized current pulses. Permeability was assessed using two fluorescein-labeled probes (weight 376 and 4000 Da). Results. Baseline epithelial electrical resistance was higher in esophageal mucosa (∼280 Ω*cm(2)), than in jejunal (∼10 Ω*cm(2)) and Caco-2 cells (∼140 Ω*cm(2)). The subepithelial contribution to the transmural resistance was higher in jejunal preparations (+88%) and Caco-2 cells (+75%), than in esophageal (+30%). During hypoxia the subepithelial resistance was unchanged, whereas the epithelial resistance decreased significantly in jejunal mucosa and Caco-2 cells. These findings coincided with increased transepithelial probe permeability and signs of disturbed morphology. Esophageal epithelia were resistant to hypoxia. However, exposure to deoxycholic acid and trypsin abolished the esophageal epithelial resistance and increased probe permeability. Endoscopic esophageal biopsies from patients with erosive reflux disease exhibited significantly lower epithelial resistance and higher current than healthy subjects. Conclusion. Square wave pulse analysis in Ussing chambers is suitable for assessment of epithelial electrical resistance that can reflect transepithelial permeability of molecular probes with known size. Moreover, the technique discriminated between healthy and reflux-diseased esophageal mucosal biopsies.
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| 4. |
- Sandström, Agneta, 1959-, et al.
(författare)
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Cognitive deficits in relation to personality type and hypothalamic-pituitary-adrenal (HPA) axis dysfunction in women with stress-related exhaustion
- 2011
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Ingår i: Scandinavian Journal of Psychology. - Oxford : Wiley-Blackwell. - 0036-5564 .- 1467-9450. ; 52:1, s. 71-82
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Tidskriftsartikel (refereegranskat)abstract
- Exhaustion caused by long-term work-related stress may cause cognitive dysfunction. We explored factors that may link chronic stress and cognitive impairment. Personality, psychiatric screening, and behavior were assessed by self-reporting measures in 20 female patients (mean age 39.3 years; range 26–53) with a preliminary diagnosis of stress-related exhaustion and in 16 healthy matched controls. Cognitive performance was investigated with a detailed neuropsychological test battery. Cortisol axis function was assessed by urinary and saliva collections of cortisol, dexamethasone suppression, Synacthen response, and corticotropin-releasing hormone (CRH) tests. Proinflammatory cytokines were measured. Hippocampal volumes were estimated by magnetic resonance imaging. Multivariate and univariate statistical methods were used to explore putative differences between groups and factors linked to cognitive impairment. Cognitive function clearly differed between groups, with decreased attention and visuospatial memory in the patient group, suggesting frontal cortex/medial temporal cortex-network dysfunction. Increased harm avoidance and persistence was present among patients, with lowered self-directedness linked to lower quality of life, increased anxious and depressive tendencies, and experiences of psychosocial stress. Attention was decreased with concomitantly impaired visuospatial memory. The pituitary (adrenocorticotropic hormone, ACTH) response to CRH was decreased in patients, with an increased cortisol/ACTH response to CRH. However, cortisol production rates, diurnal or dexamethasone-suppressed saliva cortisol levels, and the cortisol response to Synacthen were unaltered. Hippocampal volumes did not differ between groups. These findings suggest that cognitive dysfunction in stress-related exhaustion is linked to distinct personality traits, low quality of life, and a decreased ACTH response to CRH.
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