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- Carlsson, Björn, et al.
(author)
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Enantioselective Analysis of Citalopram and Metabolites in Adolescents
- 2001
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In: Therapeutic drug monitoring. - : Ovid Technologies (Wolters Kluwer Health). - 0163-4356. ; 23, s. 658-
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Journal article (peer-reviewed)abstract
- Studies of the antidepressant effect and pharmacokinetics of citalopram have been performed in adults, but the effects on children and adolescents have only been studied to a minor extent despite its increasing use in these age groups. The aim of this study was to investigate a group of adolescents treated for depression, with respect to the steady-state plasma concentrations of the enantiomers of citalopram and its demethylated metabolites desmethylcitalopram and didesmethylcitalopram. Moreover, the authors studied the genotypes for the polymorphic cytochrome P450 enzymes CYP2D6 and CYP2C19 in relation to the different enantiomers. The S/R ratios of citalopram and desmethylcitalopram found in this study of 19 adolescents were similar to studies involving older patients. The concentrations of the R-(-)- and S-(+)-enantiomers of citalopram and desmethylcitalopram were also in agreement with values from earlier studies, the R-(-)-enantiomer (distomer) being the major enantiomer. The results indicate that the use of oral contraceptives may have some influence on the metabolism of citalopram. This might be because of an interaction of the contraceptive hormones with the CYP2C19 enzyme.
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- Carlsson, Gunilla
(author)
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Att ta bussen på äldre dar.
- 2003
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In: Svensk rehabilitering. - 1403-4468. ; :4, s. 32-32
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Journal article (pop. science, debate, etc.)
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- Carlsson, Gunilla
(author)
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Catching the Bus in Old Age - Methodological Aspects of Accessibility Assessments in Public Transport
- 2002
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Doctoral thesis (other academic/artistic)abstract
- Engagement in daily activities is central for people’s health and well-being. Today, our activity arenas mostly cover great geographical areas, and to reach different activities we must travel. However, people with functional limitations are sometimes restricted in their travelling. In order to investigate accessibility problems in different travel chains, the overarching objective of this thesis was to explore basic prerequisites for the development of assessments of physical accessibility in urban public transport from a travel chain perspective. The methods used were objective environmental assessment, assessment of functional limitations and dependence on mobility aids, participant observation using the critical incident technique, and focus group interview. The participants were elderly people with functional limitations used to travelling in everyday life. The exploration started in applied research, and methodological difficulties in performing objective environmental assessments of real travel chains were identified. No method for reporting functional capacity at group level in terms of profiles of functional limitations could be found, but this was explored and a method promising for further research was identified. During the analysis of accessibility problems reported by Service Route travellers, the transactional relationships between person, environment and activity were reflected upon at individual and group/societal level. As a result, the concept of usability was considered important to explore as well. The theoretical and methodological reflections made in this collaborative work between occupational therapy and traffic planning and engineering contributes to the building of a theoretical framework for accessibility applicable in research and practice, as well as for further development of accessibility assessments.
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- Carlsson, Gunilla, 1974-
(author)
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Crystallography in Four Dimensions : Methods and Applications
- 2004
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Doctoral thesis (other academic/artistic)abstract
- The four-electron reduction of dioxygen to water is the most exothermic non-photochemical reaction available to biology. A detailed molecular description of this reaction is needed to understand oxygen-based redox processes. Horseradish peroxidase (HRP) is a haem-containing redox enzyme capable of catalysing the reduction of dioxygen to water. We developed instrumentation and experimental methodology to capture and characterise by X-ray crystallography transient reaction intermediates in this reaction.An instrument was designed (“the vapour stream system”) to facilitate reaction initiation, monitoring and intermediate trapping. In combination with single crystal microspectrophotometry, it was used to obtain conditions for capturing a reactive dioxygen complex in HRP. X-ray studies on oxidised intermediates can be difficult for various reasons. Electrons re-distributed in the sample through the photoelectric effect during X-ray exposure can react with high-valency intermediates. In order to control such side reactions during data collection, we developed a new method based on an angle-resolved spreading of the X-ray dose over many identical crystals. Composite data sets built up from small chunks of data represent crystal structures which received different X-ray doses. As the number of electrons liberated in the crystal is dose dependent, this method allows us to observe and drive redox reactions electron-by-electron in the crystal, using X-rays.The methods developed here were used to obtain a three-dimensional movie on the X-ray-driven reduction of dioxygen to water in HRP. Separate experiments established high resolution crystal structures for all intermediates, showing such structures with confirmed redox states for the first time.Activity of HRP is influenced by small molecule ligands, and we also determined the structures of HRP in complex with formate, acetate and carbon monoxide.Other studies established conditions for successfully trapping the M-intermediate in crystals of mutant bacteriorhodopsin, but the poor diffraction quality of these crystals prevented high-resolution structural studies.
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- Carlsson, Gunilla
(author)
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Det våldsamma mötets fenomenologi : - om hot och våld i psykiatrisk vård
- 2004
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Doctoral thesis (other academic/artistic)abstract
- The present study focuses on the phenomenology of the violent encounter, and is to be understood as the study of the violent encounter as a phenomenon, i.e. as experienced. The overall aim is to elucidate, analyse and describe violent encounters within psychiatric care as experienced by carers and patients. Moreover, the study aims at promoting the development of a phenomenological research approach in caring science in general and elucidating tacit caring knowledge in particular.The thesis includes three empirical studies and one methodological study. The research is guided by a phenomenological and lifeworld theoretical approach. Research data consist of narratives and qualitative interviews, as well as reenactment interviews with carers and patients. Data are analysed for meaning. The analysis and synthesis of meaning are aimed at openness and meaning sensitivity through a reflective attitude characterised by the intent to bridle the process of understanding. The goal of the analysis is to describe the general structure of the phenomenon and its meaning constituents.The result shows that violence and threat do not evolve in “naked” caring, characterised by encounters where carers are able to touch their patients at the same time as being touched, speaking both literally and figuratively. It is through “naked” caring and caring touch that the carers are able to reach the patients and to give undisguised invitations to genuine presence. The possibilities of touch rely on the carers’ capacity to be authentic and to genuinely wish well. Violence is on the contrary nourished by touch without caring intention, or non-touch, i.e. caring where the reciprocity of touching and being touched is missing between patients and caregivers.In the discussion, the different meanings of the violent encounter are related to the philosophy of Merleau-Ponty and Lévinas. The philosophical dimensions of touch are investigated and it is discussed how the “naked” encounter can be understood from a phenomenological ethical standpoint. The discussion focuses on the caregivers’ vulnerability and the high demands they are subjected to. It is also argued that a foundation of caring science is needed in caring practice in order to make possible a development of a caring attitude that prevents violence.
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