| 1. |
- Carlsson, Gunilla, et al.
(författare)
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Patients longing for authentic personal care: A phenomenological study of violent encounters in psychiatric settings
- 2006
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Ingår i: Issues in Mental Health Nursing. - : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 27:3, s. 287-305
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on patients' violence against caregivers. Several studies show that violence and threats within the health care setting are an increasing problem. Encounters that become violent have been the issue of many debates but the phenomenon is still not fully understood. It is important to understand the course of events in violent encounters, both for the sake of the patients and the caregivers' well-being. The aim of this study was to describe the essence of violent encounters, as experienced by nine patients within psychiatric care. Guided by a phenomenological method, data were analyzed within a reflective lifeworld approach. The findings explicate violent encounters characterized by a tension between "authentic personal" and "detached impersonal" caring. "Authentic personal" patients are encountered in an undisguised, straightforward, and open way, and they sense unrestricted respect that caregivers would show another human being. In these encounters violence does not develop well. However, in caring that is "detached impersonal," the encounters are experienced by the patients as uncontrolled and insecure. These encounters are full of risks and potential violence. Copyright © Taylor & Francis Group, LLC.
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| 2. |
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| 3. |
- Celma, Alberto, et al.
(författare)
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Analysis of polycyclic aromatic hydrocarbons (PAHs) and their derivatives in biochar treated stormwater
- 2023
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Ingår i: MethodsX. - 2215-0161. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Polycyclic aromatic hydrocarbons (PAHs), oxygenated PAHs (oxy-PAHs) and nitrogen heterocyclic polycyclic aromatic compounds (N-PACs) are persistent and semi-volatile organic compounds primarily formed due to incomplete combustion of organic material or, in the case of the derivatives, through transformation reactions of PAHs. Their presence in the environment is ubiquitous and many of them have been proven carcinogenic, teratogenic, and mutagenic. These toxic pollutants can therefore pose a threat to both ecosystem and human health and urges for remediation strategies for PAHs and derivatives from water bodies. Biochar is a carbon-rich material resulting from the pyrolysis of biomass resulting in a very porous matter with high surface area for an enhanced interaction with chemicals. This makes biochar a promising alternative for filtering micropollutants from contaminated aquatic bodies. In this work, a previously developed and validated methodology for the analysis of PAHs, oxy-PAHs and N-PACs in surface water samples was adapted for its utilization in biochar treated stormwater with special emphasis on scaling down the solid-phase extraction as well as including an additional filtering step for the removal of particulate matter in the media. & BULL; Optimized extraction method for PAHs, oxy-PAHs and N-PACs from stormwater treated with biochar. & BULL; Biochar strongly impacts the stormwater matrix and, therefore, additional steps are required in the extraction methodology. & BULL; Solid-phase extraction combined with GC-MS have been used to analyse PAHs, oxy-PAHs and N-PACs in stormwater treated with biochar.
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| 4. |
- Dahlberg, Anna-Karin, et al.
(författare)
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Capping fiberbank sediments to reduce persistent organic pollutants (POPs) fluxes : A large-scale laboratory column experiment
- 2023
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Ingår i: Environmental Pollution. - : Elsevier BV. - 0269-7491 .- 1873-6424. ; 333
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Tidskriftsartikel (refereegranskat)abstract
- Deposits of contaminated wood fiber waste (fiberbanks), originating from sawmills and pulp and paper industries, have been found in the aquatic environment in boreal countries. In-situ isolation capping has been proposed as a remediation solution because it has the potential to prevent dispersal of persistent organic pollutants (POPs) from this type of sediment. However, knowledge about the performance of such caps when placed on very soft (un-consolidated), gaseous organic rich sediment is scarce. We investigated the effectiveness of conventional in-situ capping to limit POPs fluxes to the water column from contaminated fibrous sediments that produce gas. A controlled, large-scale laboratory column (40 cm diameter, 2 m height) experiment was performed over 8 months to study changes in sediment-to-water fluxes of POPs and particle resuspension before and after capping the sediment with crushed stones (& GE;4 mm grain size). Two different cap thicknesses were tested (20 and 45 cm) on two types of fiberbank sediment with different fiber type composition. Results showed that capping fiberbank sediment with a 45 cm gravel cap reduced the sediment-to-water flux by 91-95% for p,p'-DDD, o,p'-DDD, by 39-82% for CB-101, CB-118, CB-138, CB-153, CB-180 and by 12-18% for HCB, whereas for less hydrophobic PCBs, capping was largely ineffective (i.e. CB-28 and CB-52). Although cap application caused particle resus-pension, the long-term effect of the cap was reduced particle resuspension. On the other hand, substantial sediment consolidation released large volumes of contaminated pore water into the overlying water body. Importantly, both sediment types produced large amount of gas, observed as gas voids forming inside the sediment and gas ebullition events, which increased pore water advection and affected the structural integrity of the cap. This may limit the practical applicability of this method on fiberbank sediments.
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| 5. |
- Dahlberg, Anna-Karin, et al.
(författare)
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Dispersal of persistent organic pollutants from fiber-contaminated sediments : biotic and abiotic pathways
- 2021
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Ingår i: Journal of Soils and Sediments. - : Springer Science and Business Media LLC. - 1439-0108 .- 1614-7480. ; 21:4, s. 1852-1865
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Tidskriftsartikel (refereegranskat)abstract
- PurposeNumerous sites contaminated with fiber emissions from pulp and paper industries are found in coastal areas of the Baltic Sea, but there is limited knowledge about the magnitude of dispersal of persistent organic pollutants (POPs) from these anthropogenic, organic-rich sediments called fiberbanks. The aim of this study was to quantify and compare different POP dispersal pathways from such fiberbanks. Dispersal mechanisms studied included abiotic and biotic routes (dissolved in water, particle-bound, and bioaccumulation).Materials and methodsContaminated fibrous sediments located in Ångermanälven River estuary in north-eastern Sweden were studied in sediment types representing different fiber content (i.e., fiberbanks, fiber-rich sediments, and less fiber impacted sediments). Sediment-to-water fluxes of dissolved contaminants (polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), and dichlorodiphenyltrichloroethane (DDT)) were measured in situ using benthic flux chambers. Particle resuspension was measured by sampling bottom water, before and after disturbing the sediment surface. Benthic biota was collected to determine the body burden of contaminants and to determine biota-pore water accumulation factors (BAFPW) and biota-sediment accumulation factors (BSAFs). In addition, concentrations of dissolved POPs in the water column were measured in field using passive samplers. Instrumental analysis was performed using gas chromatography coupled to a triple quadrupole mass spectrometer (GC-MS/MS).Results and discussionThe flux of dissolved Σ20PCBs was approximately two times higher from one of the investigated fiberbanks (3.4 ng m− 2 day− 1) compared to the other. The average particle burden of PCBs was also higher at this fiberbank after artificial disturbance (15 ng g−1 particle), which indicates that larger amounts of contaminants are likely to disperse via particle resuspension from this site compared to the other fiberbank (4.8 ng g− 1 particle). The difference might be associated with a layer of recently settled minerogenic material that covers one of the fiberbanks, which probably functions as a protective barrier. The lack of benthic biota implies that contaminant release by bioturbation is negligible in the studied fiberbanks. However, benthic biota from fiber-rich sediment showed bioaccumulation and biomagnification of contaminants.ConclusionsThe importance of diffusive flux from fiberbanks under undisturbed conditions became apparent when the different dispersal pathways were quantified. However, no dispersal pathway could be judged as irrelevant, since even under undisturbed conditions, advective particle transport was significant. Additionally, the uptake by biota and trophic transfer can be considerable. Quantification of dispersal routes and understanding of the relative importance of various pathways is critical for proper risk assessment and management of contaminated sediments.
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| 6. |
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| 7. |
- Dahlberg, Anna-Karin, 1982-, et al.
(författare)
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Persistent organic pollutants in wood fiber–contaminated sediments from the Baltic Sea
- 2020
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Ingår i: Journal of Soils and Sediments. - : Springer Science and Business Media LLC. - 1439-0108 .- 1614-7480. ; 20:5, s. 2471-2483
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Tidskriftsartikel (refereegranskat)abstract
- Many coastal areas in the Baltic Sea are contaminated with wood fiber and pollutants from pulp and paper industries. These anthropogenic, organic-rich, sediments (fiberbanks) have not been characterized and knowledge about their role as secondary sources for dispersal of persistent organic pollutants (POPs) is limited. Hence, the aim of this study was to elucidate the fate of POPs and the relationships between sorption (KD and KTOC), sediment type, and compound hydrophobicity (KOW) in fiber-contaminated sediments.
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| 8. |
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| 9. |
- Dahlberg, Helena, 1980, et al.
(författare)
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Den fenomenologiska forskningens evidensanspråk
- 2019
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Ingår i: Fenomenologi i praktiken. fenomenologisk forskning i ett skandinaviskt perspektiv / Helena Dahlberg, Sidsel Ellingsen, Bente Martinsen, Susanne Rosberg (red.). - Stockholm : Liber. - 9789147113453 ; , s. 155-189
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Bokkapitel (refereegranskat)
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| 10. |
- Dahlberg, Helena, 1980, et al.
(författare)
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Ecological caring-Revisiting the original ideas of caring science
- 2016
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 11, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this empirically grounded philosophical paper is to explore the notion of holistic care with the intention to expand it into a notion of ecological care and in such a way revisit the original ideas of caring science. The philosophical analysis, driven by lifeworld theory and especially Merleau-Ponty's philosophy, is firmly rooted in contemporary clinical care. We used interview data from patients in a study at an anthroposophic clinic in Sweden, which forms part of an ecological community with, for example, ecological agriculture. The empirical study is analysed according to reflective lifeworld research. Starting from the fact that illness can be defined as a loss of homelikeness in the body and in the familiar world, our findings illustrate how ecological care helps the patient to once again find one's place in a world that is characterized by interconnectedness. The task of ecological care is thus not only to see the patient within a world of relationships but to help the patient find his/her place again, to understand himself/herself and the world anew. Ecological care is not only about fighting an illness, but also recognizes a patient from inside a world that s/he is affected by and affects, that s/he is understood and understands from. Such care tries to restore this connection by making possible the rhythmical movement as well as the space in-between activity and rest, between being cared for and actively involving oneself in one's recovery and between closing oneself off from the world and once again going out into it.
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| 11. |
- Dahlberg, Helena, 1980, et al.
(författare)
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Open and Reflective Lifeworld Research: A Third Way
- 2020
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Ingår i: Qualitative Inquiry. - : SAGE Publications. - 1077-8004 .- 1552-7565. ; 26:5, s. 458-464
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Tidskriftsartikel (refereegranskat)abstract
- With the mission in mind to articulate an approach that is scientifically competent to meet the appeals from health care, education, social work, and other disciplines, the theme of this article is to rethink the essential ideas of phenomenological and hermeneutical research approaches, by exploring their philosophical underpinnings and especially the essential ontological idea of inseparability. We examine the fissure between approaches that favor description or interpretation and explore the arguments for a third approach that has the power to close the false epistemological methodological gap.
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| 12. |
- Dahlberg, Helena, 1980, et al.
(författare)
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The question of meaning — a momentous issue for qualitative research
- 2019
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 14:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we identify some worrying problems in the contemporary practice of qualitative research, such as the confusion regarding content and meaning in content analysis, the frequent use of standardized methods that avoids philosophy, as well as the description/interpretation dichotomy in empirical research. Since they all arise from a failure to understand the concept of meaning, we return to the question of meaning as the axis that qualitative research pivots around. We examine the meaning of meaning, and how meaning differs from content, and we then ask what consequences this has for research. Even though our analysis is rooted in phenomenological philosophy, we argue that that the ideas that we present are valid for any qualitative research approach. The question of understanding and relating to meaning, we argue, is a momentous issue for qualitative research, where we either continue safeguarding the very essence of qualitative research as dealing with human phenomena, or give it up in favor of more pragmatic and clear-cut methods that seemingly does away with the question of meaning.
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| 13. |
- Dahlberg, Helena, 1980, et al.
(författare)
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Vårdande mellanrum och sammanhang
- 2016
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Ingår i: Teoretiska grunder för vårdande. Maria Arman, Karin Dahlberg, Margaretha Ekebergh (red.). - : Liber. - 9789147114115 ; , s. 145-168
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Bokkapitel (refereegranskat)
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| 14. |
- Dahlberg, Josef, et al.
(författare)
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Microbiota data from low biomass milk samples is markedly affected by laboratory and reagent contamination
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Discoveries of bacterial communities in environments that previously have been described as sterile have in recent years radically challenged the view of these environments. In this study we aimed to use 16S rRNA sequencing to describe the composition and temporal stability of the bacterial microbiota in bovine milk from healthy udder quarters, an environment previously believed to be sterile. Sequencing of the 16S rRNA gene is a technique commonly used to describe bacterial composition and diversity in various environments. With the increased use of 16S rRNA gene sequencing, awareness of methodological pitfalls such as biases and contamination has increased although not in equal amount. Evaluation of the composition and temporal stability of the microbiota in 288 milk samples was largely hampered by background contamination, despite careful and aseptic sample processing. Sequencing of no template control samples, positive control samples, with defined levels of bacteria, and 288 milk samples with various levels of bacterial growth, revealed that the data was influenced by contaminating taxa, primarily Methylobacterium. We observed an increasing impact of contamination with decreasing microbial biomass where the contaminating taxa became dominant in samples with less than 10 4 bacterial cells per mL. By applying a contamination filtration on the sequence data, the amount of sequences was substantially reduced but only a minor impact on number of identified taxa and by culture known endogenous taxa was observed. This suggests that data filtration can be useful for identifying biologically relevant associations in milk microbiota data.
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| 15. |
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| 16. |
- Dahlberg, Josef, et al.
(författare)
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Microbiota of bovine milk, teat skin, and teat canal: Similarity and variation due to sampling technique and milk fraction
- 2020
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Ingår i: Journal of Dairy Science. - : American Dairy Science Association. - 0022-0302 .- 1525-3198. ; 103, s. 7322-7330
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the effect of sampling technique and milk fraction on bovine milk microbiota data and to compare the microbiota in milk to microbiota on the teat end and in the teat canal. Representative milk samples are highly important for assessment of bacteriological findings and microbiota in milk. Samples were obtained from 5 healthy lactating dairy cows at udder quarter level during 1 milking. Swab samples from the teat. end and teat canal, and milk samples collected using different techniques and in different milk fractions were included. Milk was collected by hand stripping and through a teat canal cannula before and after machine milking, through a trans-teat wall needle aspirate after milking, and from udder quarter composite milk. The microbiota of the samples was analyzed with sequencing of the V1-V3 region of the 16S rRNA gene. In addition, somatic cell counts and bacterial cultivability were analyzed in the milk samples. Microbiota data were analyzed using multivariate methods, and differences between samples were tested using analysis of similarity (ANOSIM). Differences between samples were further explored via individual studies of the 10 most abundant genera. The microbiota on the teat end, in the teat canal, and in udder quarter composite milk, collected using a milking machine, differed in composition from the microbiota in milk collected directly from the udder quarter. No differences in milk microbiota composition were detected between hand-stripped milk samples, milk samples taken through a teat canal cannula, or milk samples taken as a trans-teat wall needle aspirate before or after milking. We conclude that for aseptic milk samples collected directly from the lactating udder quarter, sampling technique or milk fraction has minor effect on the microbiota composition.
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| 17. |
- Dahlberg, Karin, et al.
(författare)
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Ensamheter
- 2015
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Bok (övrigt vetenskapligt/konstnärligt)
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| 18. |
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| 19. |
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| 20. |
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| 21. |
- Goransson, Gunnel, et al.
(författare)
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Assessing the Risk of Contaminant Dispersion From Fibrous Sediments of Industrial Origin
- 2021
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Ingår i: Frontiers in Marine Science. - : Frontiers Media S.A.. - 2296-7745. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Unregulated discharges of wastewater from pulp and paper factories resulted in the formation of relatively thick organic (cellulose) rich sediments in shallow waters along the Swedish coast. These deposits are known as fiberbanks and are contaminated by persistent organic pollutants (POPs), metals and methylmercury, which can be dispersed by diffusion and advective processes coupled to propeller wash, high river discharges, strong wind waves and submarine landslides. Based on a case study of polychlorinated biphenyls (PCBs), one group of prevalent POPs in the fiberbanks, we present a probabilistic approach to estimate the potential risk of dispersion of fiberbank contaminants. The approach allows for estimation of the dispersal pathways that dominates the risk within a given time and provides more insight about the significance of various dispersion processes. We show that it is highly likely that chemical diffusion and advection triggered by ship-induced resuspension will disperse PCBs (sum of seven congeners; sigma 7PCB) above a threshold level for environmental impact, while the likelihood of river and wind-wave generated resuspension dispersion pathways are lower (similar to 20%, respectively). We further show that there is approximately 5% likelihood that a submarine landslide will disperse sigma 7PCB above the threshold level. The study implies that the governing parameters for risk assessment specifically should include reliable data on contaminant concentration, water depth above the fiberbank, estimation of concerned fiberbank areas, time duration of erosive fluid flows and measured diffusion. The approach provides insight into the importance of various dispersion processes. We suggest that it can be applied to support risk assessment, especially when there are limited available data and/or knowledge about the system under study.
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| 22. |
- Karin, Dahlberg, et al.
(författare)
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Reflective Lifeworld Research (2nd edition)
- 2007
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- This book explicates a reflective lifeworld research approach, based on phenomenological philosophy. The emphasis is on the lifeworld, the human intentionality and its capacity for seeing meaning and for reflection. The epistemological ideas presented in the book are transformed into an empirical research approach that serves as a guiding principle for research. The approach originates from the aim of allowing the phenomenon to guide the research by which the phe-nomenon and its meanings will be illuminated, understood and explicated, and is supported by an open and "bridled" attitude to the phenomenon and the research. Based on a solid epistemological presentation and ideas about how an open and "bridled" approach can be established, some methodological principles are outlined for data gathering as well as for descriptive and interpretive data analysis, respectively. Finally, general scientific concepts such as validity, ob-jectivity and generalisation are discussed in relation to the reflective lifeworld research approach.
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| 23. |
- Sha, Bo, et al.
(författare)
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Fluorotelomer alcohols (FTOHs), brominated flame retardants (BFRs), organophosphorus flame retardants (OPFRs) and cyclic volatile methylsiloxanes (cVMSs) in indoor air from occupational and home environments
- 2018
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Ingår i: Environmental Pollution. - : Elsevier BV. - 0269-7491 .- 1873-6424. ; 241, s. 319-330
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Tidskriftsartikel (refereegranskat)abstract
- Indoor air samples were collected from private homes and various occupational indoor environments using passive air sampler and analysed for fluorotelomer alcohols (FTOHs), brominated flame retardants (BFRs), organophosphorus flame retardants (OPFRs) and cyclic volatile methyl siloxanes (cVMSs). The aim was to investigate their occurrence in indoor air, factors that may affect their presence and human daily exposure dose (DED) via inhalation. In general, levels of cVMSs were 3-4 orders of magnitude greater than the other compound classes. OPFRs concentration was found significantly higher than BFRs in indoor air. The most abundant compounds in each chemical class were 8:2 FTOH, 2,4,6-TBP, TNBP and TCEP and decamethylcyclopentasiloxane (D5). Home samples contained higher level of FTOHs, BFRs and cVMSs than occupational environments, whereas concentration of OPFRs in office samples were higher. BFRs concentrations were significantly correlated with building age and with the number of electronic/ electrical devices at the sampling sites. Moreover, significantly lower levels of FTOHs and cVMSs were observed in rooms with forced-ventilation system. Estimated DED via inhalation was significantly higher at home than in office and the total DED was on average 3-5 orders of magnitude lower than the reference value. (C) 2018 Elsevier Ltd. All rights reserved.
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| 24. |
- Volchko, Yevheniya, 1979, et al.
(författare)
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Assessing costs and benefits of improved soil quality management in remediation projects : A study of an urban site contaminated with PAH and metals
- 2020
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Ingår i: Science of the Total Environment. - : Elsevier. - 0048-9697 .- 1879-1026. ; 707
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Tidskriftsartikel (refereegranskat)abstract
- Contaminants in the soil may threaten soil functions (SFs) and, in turn, hinder the delivery of ecosystem services (ES). A framework for ecological risk assessments (ERAs) within the APPLICERA - APPLICable site-specific Environmental Risk Assessment research project promotes assessments that consider other soil quality parameters than only contaminant concentrations. The developed framework is: (i) able to differentiate the effects of contamination on SFs from the effects of other soil qualities essential for soil biota; and (ii) provides a robust basis for improved soil quality management in remediation projects. This study evaluates the socio-economic consequences of remediation alternatives stemming from a Tier 1 ERA that focusses on total contaminant concentrations and soil quality standards and a detailed, site-specific Tier 3 Triad approach that is based on the APPLICERA framework. The present study demonstrates how Tier 1 and Tier 3 ERAs differ in terms of the socio-economic consequences of their remediation actions, as well as presents a novel method for the semi-quantitative assessment of on-site ES. Although the presented Tier 3 ERA is more expensive and time-consuming than the more traditional Tier 1 ERA approach, it has the potential to lower the costs of remediation actions, decrease greenhouse gas emissions, reduce other environmental impacts, and minimise socio-economic losses. Furthermore, the remediation actions stemming from the Tier 3 ERA were predicted to exert far less negative ES effects than the actions proposed based on the results of the Tier 1 ERA.
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| 25. |
- Wiberg, Karin, et al.
(författare)
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Spatial distribution of legacy pesticides in river sediment from the Republic of Moldova
- 2021
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Ingår i: Chemosphere. - : Elsevier BV. - 0045-6535 .- 1879-1298. ; 279
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Tidskriftsartikel (refereegranskat)abstract
- Historical use of organochlorine pesticides (OCPs) in the Republic of Moldova could pose a potential risk for the aquatic environment due to the persistence, bioaccumulation and toxic properties of these environmental pollutants. However, knowledge on environmental concentrations of legacy OCPs in Moldova is limited. In this study, surface sediment from the two main rivers; Dniester (8 sites, n = 15) and Prut (6 sites, n = 12), and two tributary rivers; Bic (11 sites, n = 11) and Raut (6 sites, n = 6), were collected during 2017-2018 and analyzed for hexachlorocyclohexanes (HCHs), dichlorodiphenyltrichloroethanes (DDTs) and their transformation products (DDDs and DDEs) using gas chromatography coupled to mass spectrometry (GC-MS/MS). Sediment concentrations of Sigma 6DDX (1.9-140 ng g(-1) dry weight (dw)) and Sigma(4)HCHs (n.d-2.5 ng g(-1) dw) were found. In the big rivers, the average Sigma 6DDX concentration (18 ng g(-1) dw) were 35 times higher than Sigma(4)HCHs (0.51 ng g(-1) dw). Whereas, in the small rivers the average Sigma 6DDX concentration (32 ng g(-1) dw) was approximately 41 times higher than Sigma(4)HCHs (0.77 ng g(-1) dw). Compared to previous studies from Eastern Europe, the sediment levels were generally similar as found in Moldova's neighboring countries (Romania and Ukraine). Overall, the contamination profile indicates long-term ageing of OCPs used in the past in the agricultural sector. Less than half of the sites (45%) had levels that pose a potential risk for benthic organisms. Hence, further work is needed to determine the bioaccumulation of OCPs in the aquatic food web in this region and the associated risks to ecosystems and human health.
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| 26. |
- Ahrné, Karin, et al.
(författare)
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Tillstånd och trender för arter och deras livsmiljöer – rödlistade arter i Sverige 2015
- 2015
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- 2015 års upplaga av den svenska rödlistan är den fjärde i ordningen. Den är baserad på IUCN:s rödlistningskriterier och revideras vart femte år. I rödlistan bedöms risken som enskilda arter av djur, växter och svampar löper att försvinna från Sverige. Bedömningen utförs av ArtDatabankens medarbetare i samverkan med över 100 externa experter, indelade i 14 expertkommittéer för olika organismgrupper. Under arbetet med 2015 års rödlista har tillstånd och trender bedömts för 21 600 arter och 1 318 lägre taxa (apomiktiska arter, underarter och varieteter), sammanlagt ca 22 900 taxa. Av de bedömda arterna klassificerades 2 029 som hotade (kategorierna CR, EN och VU) och 4 273 som rödlistade (inkluderar även kategorierna NT, RE och DD). Förhållandet mellan antalet rödlistade och antalet bedömda arter ar 19,8 %, vilket är ungefär samma värde som 2010 och 2005. I denna rapport jämförs antalet och andelen rödlistade arter mellan olika organismgrupper, biotoper, substrat och påverkansfaktorer. Texten ar indelad i en allmän del och åtta kapitel inriktade på olika landskapstyper. Landskapstyperna utgör en grov indelning av landets miljöer enligt följande kategorier: Skog, Jordbrukslandskap, Urbana miljöer, Fjäll, Våtmarker, Sötvatten, Havsstränder och Havsmiljöer. Skogen och jordbrukslandskapet är de artrikaste landskapstyperna med 1 800 respektive 1 400 arter som har en stark anknytning dit, och ytterligare flera hundra arter som förekommer där mer sporadiskt. De faktorer som påverkar flest rödlistade arter i Sverige är skogsavverkning och igenväxning, som båda utgör ett hot mot vardera ca 30 % av de rödlistade arterna. Avverkning minskar arealen av skog där naturliga strukturer och naturlig dynamik upprätthålls, och den orsakar därmed förlust av livsmiljöer. Igenväxning orsakas av ett antal faktorer, bland annat upphörande hävd (bete och slåtter), gödsling, trädplantering och brist på naturliga störningsregimer som t.ex. regelbundna översvämningar kring vattendrag och sjöar. Andra viktiga påverkansfaktorer är fiske, torrläggning av våtmarker, tillbakagång hos värdarter (främst alm och ask som drabbats av invasiva svampsjukdomar), klimatförändringar och konkurrens från invasiva arter. IUCN:s rödlisteindex beräknas för ett urval av de bedömda organismgrupperna. Rödlisteindex visar att skillnaderna mellan rödlistorna från 2000, 2005, 2010 och 2015 är små. Ett par undantag finns dock. Groddjur och stora däggdjur har fått en något förbättrad situation sedan 2000. Totalt förefaller det ändå som att trycket mot Sveriges artstock har förblivit relativt konstant under de senaste 15 åren.
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| 27. |
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| 28. |
- Anderberg, Mats, 1961-, et al.
(författare)
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Mer än varannan ungdom med alkohol- och narkotikaproblem i öppenvården har erfarenhet av utsatthet i barndomen
- 2019
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Ingår i: Socialmedicinsk Tidskrift. - Stockholm : Karolinska Institutet. - 0037-833X. ; 96:6, s. 786-799
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Tidskriftsartikel (refereegranskat)abstract
- Det finns idag få svenska studier som undersöker erfarenheter av utsattheti barndom hos ungdomar med drogproblem, särskilt inom öppenvården.Den här studien analyserade erfarenheter av försummelse och övergreppunder barndomen hos ungdomar (medelålder 18 år) som påbörjat öppenvårdsbehandlingför drogproblem. Resultaten visade att många ungdomarhade erfarenheter av försummelse och övergrepp i barndomen. Erfarenhetav utsatthet i barndomen var också relaterat till upplevda problem i uppväxtfamiljen,t.ex. ekonomiska svårigheter, missbruk, psykisk ohälsa och våld ifamiljen. Resultaten pekar på att det är angeläget att även utreda utsattheti barndomen bland ungdomar i behandling för drogproblem, särskilt då det idag finns god evidens för att psykiatrisk samsjuklighet (t.ex. traumareaktionoch drogproblem) bör behandlads samtidigt för att uppnå bäst effekt.
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| 29. |
- Anderberg, Mats, et al.
(författare)
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Mer än varannan ungdom med alkohol- och narkotikaproblem i öppenvården har erfarenhet av utsatthet i barndomen
- 2019
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 96:6, s. 786-799
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Tidskriftsartikel (refereegranskat)abstract
- Few Swedish studies investigated experiences of childhood maltreatment in adolescents with substance use problems, especially in outpatient care. This study analyzed experiences of neglect and abuse during childhood in adol- escents (mean age 18 years) who started outpatient treatment for substance use problems. The results showed that several of them had experience of child maltreatment. Child maltreatment was also related to perceived pro- blems in the upbringing family, e.g. financial difficulties, substance use pro- blems, mental illness and violence in the family. This indicate the importance to investigate experiences of child maltreatment among adolescents in tre- atment for substance use problems, especially since there is evidence to- day that psychiatric co-morbidity (e.g. trauma reaction and drug problems) should be treated simultaneously to achieve the best effect.
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| 30. |
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| 31. |
- Asp, Margareta, 1958-
(författare)
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Vila och lärande om vila. En studie på livsvärldsfenomenologisk grund
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Avhandlingsarbetets syfte var att utifrån människors levda erfarenheter av vila, utveckla en tentativ teori om vila och om lärande avseende vila. Den kunskapen har utgjort grund för att beskriva hur förutsättningar för lärande avseende vila kan skapas. En modell för lärande avseede vila har utvecklats, i vilken en ömsesidighet mellan innehåll, lärande och förutsättningar för lärande beaktas. Studien genomfördes med en livsvärldsfenomenologisk ansats och med intervju som datainsamlingsmetod. Analysen genomfördes enligt en beskivande fenomenlogisk metodologi, i syfte att beskriva fenomenets generella struktur En generell struktur av fenomenet vila, implicerar en dualitet mellan vila och icke-vila. Essensen i vila utgörs av en harmoni i vilja, känsla och handling Vilan gestaltas i och med att en inre verklighet avseende behov och längtan överensstämmer med den yttre verklighetens beskaffenhet. Till vilans essens relateras innebördselementen: vilorytm i livet, stämningar av skönhet och trevnad, bejakad utan bedömning, frihet från bekymmer och tvång, samvaro med gemensamt intresse, att dröja, lustfylld stimulans och lustfylld utmaning. Essensen i icke- vila är disharmoni i vilja, känsla och handling. Upplevelsen av disharmoni tär på krafterna och blir allt påtagligare ju längre icke-vilan pågår. Att lära sig vila innebär att bli medveten om sitt behov av att ha en livsrytm som ger utrymme för vila, att tillåta sig att leva i en sådan rytm och att finna eller skapa källor där kraft kan hämtas. Modellen för lärande avseende vila består av tre dimensioner: lärande om vila, lärande i vila och lärande genom vila. Lärande om vila kan relateras till idëer om livsvärld, levd kropp, tid och rum, cirkularitet och intentionalitet. Lärande genom vila kan relateras till hälsa och lärande i vila kan relateras till etiska och estetiska aspekter.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Bergenfelz, Anders, et al.
(författare)
-
Impact of autofluorescence for detection of parathyroid glands during thyroidectomy on postoperative parathyroid hormone levels: parallel multicentre randomized clinical trial
- 2023
-
Ingår i: The British journal of surgery. - 1365-2168 .- 0007-1323. ; 110:12, s. 1824-1833
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Techniques for autofluorescence have been introduced to visualize the parathyroid glands during surgery and to reduce hypoparathyroidism after thyroidectomy. METHODS: This parallel multicentre RCT investigated the use of Fluobeam® LX to visualize the parathyroid glands by autofluorescence during total thyroidectomy compared with no use. There was no restriction on the indication for surgery. Patients were randomized 1 : 1 and were blinded to the group allocation. The hypothesis was that autofluorescence enables identification and protection of the parathyroid glands during thyroidectomy. The primary endpoint was the rate of low parathyroid hormone (PTH) levels the day after surgery. RESULTS: Some 535 patients were randomized, and 486 patients received an intervention according to the study protocol, 246 in the Fluobeam® LX group and 240 in the control group. Some 64 patients (26.0 per cent) in the Fluobeam® LX group and 77 (32.1 per cent) in the control group had low levels of PTH after thyroidectomy (P = 0.141; relative risk (RR) 0.81, 95 per cent c.i. 0.61 to 1.07). Subanalysis of 174 patients undergoing central lymph node clearance showed that 15 of 82 (18 per cent) in the Fluobeam® LX group and 31 of 92 (33 per cent) in the control group had low levels of PTH on postoperative day 1 (P = 0.021; RR 0.54, 0.31 to 0.93). More parathyroid glands were identified during operation in patients who had surgery with Fluobeam® LX, and fewer parathyroid glands in the surgical specimen on definitive histopathology. No specific harm related to the use of Fluobeam® LX was reported. CONCLUSION: The use of autofluorescence during thyroidectomy did not reduce the rate of low PTH levels on postoperative day 1 in the whole group of patients. It did, however, reduce the rate in a subgroup of patients.
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| 37. |
- Bergius, Berit, 1949, et al.
(författare)
-
Matematiklyftet har prövats ut
- 2013
-
Ingår i: Nämnaren. - 0348-2723. ; :2013:2, s. 14-17
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- I höst startar huvudomgången av den stora satsningen "Matematiklyftet". Under läsåret 2012-2013 har modellen prövats av 316 lärare och 31 handledare på 33 grundskolor. Dessa har arbetat med modulerna inom området "Tal och tals användning". NCM har utvecklat innehållet i provomgångens moduler och har också följt arbetet på några skolor. Erfarenheterna från utprövningen är värdefulla för utvecklingen av Matematiklyftet.
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| 38. |
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| 39. |
- Björk Brämberg, Elisabeth, et al.
(författare)
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Interpreters in Cross-Cultural Interviews: A Three-Way Coconstruction of Data
- 2013
-
Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 23:2, s. 241-247
-
Tidskriftsartikel (refereegranskat)abstract
- Our focus in this article is research interviews that involve two languages. We present an epistemological and methodological analysis of the meaning of qualitative interviewing with an interpreter. The results of the analysis show that such interviewing is not simply exchanging words between two languages, but means understanding, grasping the essential meanings of the spoken words, which requires an interpreter to bridge the different horizons of understanding. Consequently, a research interview including an interpreter means a three-way coconstruction of data. We suggest that interpreters be thoroughly introduced into the research process and research interview technique, that they take part in the preparations for the interview event, and evaluate the translation process with the researcher and informant after the interview.
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| 40. |
- Björk Brämberg, Elisabeth, et al.
(författare)
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Patient participation : A qualitative study of immigrant women and their experiences
- 2010
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa Healthcare. - 1748-2623 .- 1748-2631. ; 5:1
-
Tidskriftsartikel (refereegranskat)abstract
- Patient participation in healthcare is a neglected area of interest in the rather extensive amount of research on immigrant so-called Selma patients in Swedish health care as well as worldwide. The aim is to explore the phenomenon ‘‘patient participation’’ in the context of the Swedish health care from the perspective of immigrants non-fluent in Swedish. A phenomenological lifeworld approach was chosen. Data were collected from patients within a municipal home care setting in Sweden. Eight women agreed to participate. In seven interviews, an interpreter was necessary for the translation of the interview. Five authorized interpreters were used. Data were analysed in accordance to a descriptive phenomenological method for caring research. The analysis led to an essence of the phenomenon with three constituents, ‘‘to experience participation,’’ ‘‘to refrain from participation,’’ and ‘‘to be deprived of participation.’’ Patient participation from the perspective of immigrant women means that patients are involved and active in their own health and caring processes. For these women, it is particularly important to have the opportunity to express themselves. Patient participation presupposes professional caregivers who act in a way that increases the patients’ opportunities to take part. A skilled interpreter is often necessary in order to enable the patient participation.
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| 41. |
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| 42. |
- Boson, Karin, 1984, et al.
(författare)
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Adolescents with substance use problems in outpatient treatment: a one-year prospective follow-up study focusing on mental health and gender differences
- 2022
-
Ingår i: Substance Abuse Treatment, Prevention, and Policy. - : Springer Science and Business Media LLC. - 1747-597X. ; 17:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Although several studies have found a high incidence of coexisting mental health problems among adolescents with substance use problems, follow-up studies addressing how these conditions change over time are rare. The study will describe and analyze indications of mental health problems and how various risk factors predict outcomes 1 year after initial treatment contact. In addition, gender-specific risk factors are explored. Methods A clinical sample of 455 adolescents (29% girls, median age 17 years) answered a structural interview at baseline and were followed up using official records 1 year after initiated treatment. Bivariate associations and logistic regressions were conducted to analyse the links between risk factors at the individual, social, and structural levels as well as links between various mental illness symptoms at treatment start and indications of mental health problems 1 year later were analysed. Results The results show that mental health problems among adolescents largely persisted 1 year after start of outpatient care for substance use problems. Forty-two per cent of the sample displayed indications of mental health problems at follow-up, and registrations for both outpatient treatment and psychiatric medication were more common among the girls. Girls also reported more mental illness symptoms at treatment start than boys did, especially anxiety. Depression and suicidal thoughts had predictive values regarding indications of mental health problems and small cumulative effects were found for 6-10 co-occurring risk factors. Conclusions Adolescents with depression and suicidal thoughts at treatment start should yield attention among clinicians as these general risk factors could predict indication of mental health problems at 1 year follow-up effectively. Also, patients with more than six co-occurring risk factors seem more vulnerable for continued mental health problems. Generally, girls displayed a greater mental health and psychosocial burden at treatment initiation and were more likely to show indication of mental health problems at follow-up. These results suggests that girls are more likely to get psychiatric out-treatment parallel to, or after, substance abuse treatment. We recommend further investigation of gender differences and gender-specific needs in substance use treatment.
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| 43. |
- Boström, Curt-Åke, et al.
(författare)
-
Förstudie. Minskning av kväveoxidutsläpp från massa- och pappersindustrin.
- 1987
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Kväveoxidutsläppen har på senare år uppmärksammats som ett allvarligt luftvårdsproblem. NOx-emissionerna från massa- och pappersindustrin utgör ca 5% av den totala NOx-emissionen i Sverige. I föreliggande rapport redovisas tekniker för att minska NOx-utsläppen samt diskutera vilka möjligheter det finns att utnyttja dessa inom massaindustrin. Övergången från olja till internt genererade bränslen medför att den källa som har den största potentialen för NOx-reduktion har minskat. Sodapannorna har redan så låg specifik emission att åtgärder för att minska NOx-utsläppen från dessa sannolikt blir mycket kostsamma och ger liten total effekt. Frågan om införande av NOx-begränsande åtgärder på massaindustrins förbränningsanläggningar bör dock utredas ytterligare.
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| 44. |
- Boström, Elisabeth Almer, 1983, et al.
(författare)
-
Resistin and insulin/insulin-like growth factor signaling in rheumatoid arthritis.
- 2011
-
Ingår i: Arthritis and rheumatism. - : Wiley. - 1529-0131 .- 0004-3591. ; 63:10, s. 2894-904
-
Tidskriftsartikel (refereegranskat)abstract
- Human resistin has proinflammatory properties that activate NF-κB-dependent pathways, whereas its murine counterpart is associated with insulin resistance. The aim of this study was to examine potential cross-talk between resistin and insulin/insulin-like growth factor (IGF) signaling in rheumatoid arthritis (RA).
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| 45. |
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| 46. |
- Bremer, Anders, 1957-, et al.
(författare)
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Balancing Between Closeness and Distance : Emergency medical services personnel’s experiences of caring for families at out-of-hospital cardiac arrests and deaths
- 2012
-
Ingår i: Prehospital and Disaster Medicine. - Cambridge : Cambridge University Press. - 1049-023X .- 1945-1938. ; 27:1, s. 42-52
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction: Out-of-hospital cardiac arrest (OHCA) is a lethal health problem thataffects between 236,000 and 325,000 people in the United States each year. As resuscitationattempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services(EMS) personnel often face the needs of bereaved family members.Problem: Decisions to continue or terminate resuscitation at OHCA are influenced byfactors other than patient clinical characteristics, such as EMS personnel’s knowledge,attitudes, and beliefs regarding family emotional preparedness. However, there is littleresearch exploring how EMS personnel care for bereaved family members, or how theyare affected by family dynamics and the emotional contexts. The aim of this study is toanalyze EMS personnel’s experiences of caring for families when patients suffer cardiacarrest and sudden death.Methods: The study is based on a hermeneutic lifeworld approach. Qualitative interviewswere conducted with 10 EMS personnel from an EMS agency in southern Sweden.Results: The EMS personnel interviewed felt responsible for both patient care and familycare, and sometimes failed to prioritize these responsibilities as a result of their ownperceptions, feelings and reactions. Moving from patient care to family care implied amovement from well-structured guidance to a situational response, where the personnelwere forced to balance between interpretive reasoning and a more direct emotionalresponse, at their own discretion. With such affective responses in decision-making, thepersonnel risked erroneous conclusions and care relationships with elements of dishonesty,misguided benevolence and false hopes. The ability to recognize and respond to people’sexistential questions and needs was essential. It was dependent on the EMS personnel’sbalance between closeness and distance, and on their courage in facing the emotionalexpressions of the families, as well as the personnel’s own vulnerability. The presence offamily members placed great demands on mobility (moving from patient care to familycare) in the decision-making process, invoking a need for ethical competence.Conclusion: Ethical caring competence is needed in the care of bereaved family membersto avoid additional suffering. Opportunities to reflect on these situations within a frameworkof care ethics, continuous moral education, and clinical ethics training are needed.Support in dealing with personal discomfort and clear guidelines on family support couldbenefit EMS personnel.Bremer A, Dahlberg K, Sandman
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| 47. |
- Bremer, Anders, 1957-, et al.
(författare)
-
Experiencing Out-of-Hospital Cardiac Arrest : Significant Others’ Lifeworld Perspective
- 2009
-
Ingår i: Qualitative Health Research. - : SAGE Publications. - 1049-7323 .- 1552-7557. ; 19:10, s. 1407-1420
-
Tidskriftsartikel (refereegranskat)abstract
- When patients suffer out-of-hospital cardiac arrests (OHCA), significant others find themselves with no choice about being there. Afterwards they are often left with unanswered questions about the life-threatening circumstances, or the patient’s death, the emergency treatment and future needs. When it is unclear how the care, and the event itself will affect significant others’ well being, prehospital emergency personnel face ethical decisions. This study describes the experiences of significant others present at OHCA, focusing on ethical aspects and values. Using a lifeworld phenomenological approach, seven significant others were interviewed. The essence of the phenomenon of OHCA can be stated as: Unreality in the reality; Overwhelming responsibility; Inadequacy and limitation; Hope and hopelessness; Ethical considerations; Insecurity about the future; Trembling of life. These study findings show how significant others’ sense of unreality, inadequacy, and overwhelming responsibility at OHCA can threaten values deemed important for a good life.
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| 48. |
- Bremer, Anders, 1957-
(författare)
-
När livet skakas om : patienters och närståendes erfarenheter av hjärtstopp utanför sjukhus
- 2008
-
Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- I Europa vårdar ambulanspersonal årligen cirka 300 000 människor med hjärtstopp. Ungefär en av tio överlever. Tidigare forskning har inte i någon större utsträckning berört hur överlevande patienter och närstående mår efteråt eller vilka etiska aspekter och problem som möter ambulanspersonal i dessa situationer. Med hjälp av en reflekterande livsvärldsansats är syftet med denna licentiatavhandling att beskriva vad det innebär att överleva hjärtstopp utanför sjukhus respektive närvara vid en nära persons hjärtstopp. Med utgångspunkt i det empiriska resultatet är syftet att belysa och diskutera etiska aspekter och problem av betydelse för ambulanspersonals vårdande ur ett normativt perspektiv.Avhandlingens empiriska resultat visar hur ogripbart det är att drabbas av hjärtstopp och hur uppvaknandet ur medvetslösheten innebär vilsenhet och kontrollförlust genom den minneslucka som tillfogats. Att överleva innebär därför ett sökande efter sammanhang så att situationen kan ges mening och förklaring till tankar, känslor och upplevelser. Känslan av sammanhang nås via andra människors berättelser tillsammans med egna minnen. I det fortsatta livet finns existentiell rädsla och otrygghet där den egna identiteten och meningen i livet omvärderas i takt med en växande insikt om hur den egna kroppen påverkats av hjärtstoppet. Ibland upplevs kroppen som begränsad vilket skapar otrygghet och rädsla. I det fortsatta livet kan det finnas skuldkänslor för det inträffade likväl som att hjärtstoppet ses som en opåverkbar händelse. Men det finns även tacksamhet och glädje över välbefinnande och trygghet i ett förändrat liv där vardagliga sysslor ger tillvaron en viss stadga. Det passerade livshotet införlivas i ett liv där mänskliga relationer blivit än viktigare värden i ett gott liv.Närvaro vid en nära persons hjärtstopp omkullkastar känslan av kontroll. Allt upplevs overkligt, tiden tycks stanna upp och samtidigt är verkligheten extremt påtaglig. Förvåning övergår snabbt till ett kaos av tankar och känslor där panik, chock och fruktan griper tag. Verkligheten innebär ett överväldigande och ensamt ansvar där närstående känner sig otillräckliga. Väntan på professionell hjälp känns lång och det är en befriande känsla då ambulanspersonal anländer och övertar ansvaret. Samtidigt väcks hopp om att patienten ska överleva. För närstående är allt kaotiskt, ångestfyllt och omtumlande då de kastas mellan hopp och misströstan för att slutligen få ett overkligt och ogripbart besked om den nära personens överlevnad eller död. Livets grundvalar skakas om och uppmärksammar livets skörhet och att inget kan tas för givet. Efter händelsen finns obesvarade frågor och oro som riskerar att leda till ensamhet i sorg eller i en oro för den överlevandes framtid. Oavsett vilket, riskerar ensamheten att leda till uppoffring av egna och viktiga behov.I ett gott beslut balanseras etiska normer att rädda liv, rätten till värdig/god död, autonomiprincipen samt att göra gott och inte skada. Den övergripande normen vid hjärtstopp är att rädda liv. Att i det akuta skedet avgöra om patienten räddas till ett acceptabelt liv är svårt. Det empiriska resultatet ger dock stöd för att återupplivning bör göras vid behandlingsbara hjärtstopp samtidigt som resultatet visar hur svårt det är att dra en gräns för vad ett acceptabelt liv är. Undantagsvis är det goda beslutet att avstå från eller avbryta återupplivning, exempelvis vid förekomst av ett giltigt förhandsdirektiv. En värdig/god död är då det primära. Ett utökat etiskt ansvar för ambulanssjuksköterskor kan vara att de ges beslutsrätt för avbrytande av återupplivning. Ett annat ansvar handlar om möjligheten att främja ett gott liv för överlevande genom att efteråt bidra med kunskap som kan skapa förlorade sammanhang. Ansvaret för närstående kan innebära att meningslös återupplivning inte görs ”för deras skull” utan att deras behov möts på bättre sätt.
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| 49. |
- Bremer, Anders, et al.
(författare)
-
To survive out-of-hospital cardiac arrest : a search for meaning and coherence
- 2009
-
Ingår i: Qualitative Health Research. - : Sage Publications. - 1049-7323 .- 1552-7557. ; 19:3, s. 323-338
-
Tidskriftsartikel (refereegranskat)abstract
- The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient's beliefs about health and well-being. In this article, we describe patients' experiences of surviving OHCA. By using a phenomenological approach, we focus on how OHCA influences patients' well-being over time. Nine survivors were interviewed. Out-of-hospital cardiac arrest is described as a sudden and elusive threat, an awakening in perplexity, and the memory gap as a loss of coherence. Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors' emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.
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| 50. |
- Bremer, Anders, 1957-, et al.
(författare)
-
To Survive Out-of-Hospital Cardiac Arrest : A Search for Meaning and Coherence
- 2009
-
Ingår i: Qualitative Health Research. - Thousand Oaks, CA : Sage Publications. - 1049-7323 .- 1552-7557. ; 19:3, s. 323-338
-
Tidskriftsartikel (refereegranskat)abstract
- The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient’s beliefs about health and well-being. In this article, we describe patients’ experiences of surviving OHCA. By using a phenomenological approach, we focus on how OHCA influences patients’ well-being over time. Nine survivors were interviewed. Out-of-hospital cardiac arrest is described as a sudden and elusive threat, an awakening in perplexity, and the memory gap as a loss of coherence. Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors’ emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.
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