| 1. |
- Eilegård Wallin, Alexandra, 1975-, et al.
(author)
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Insufficient communication and anxiety in cancer-bereaved siblings : a nationwide long-term follow-up
- 2016
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In: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; October, s. 488-494
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Journal article (peer-reviewed)abstract
- Objective: The purpose of this study was to examine siblings’ long-term psychological health in relation to their perception of communication with their family, friends, and healthcare professionals during a brother or sister's last month of life.Method: A nationwide questionnaire study was conducted during 2009 in Sweden of individuals who had lost a brother or sister to cancer within the previous two to nine years. Of the 240 siblings contacted, 174 (73%), participated. The Hospital Anxiety and Depression Scale (HADS) was employed to assess psychological health (anxiety). The data are presented as proportions (%) and relative risks (RR) with a 95% confidence interval (CI 95%).Results: Siblings who were not satisfied with the amount they talked about their feelings with others during their brother or sister's last month of life were more likely to report anxiety (15/58, 26%) than those who were satisfied (13/115, 11%; RR = 2.3(1.2–4.5)). The same was true for those who had been unable to talk to their family after bereavement (RR = 2.5(1.3–4.8)). Avoiding healthcare professionals for fear of being in their way increased siblings’ risk of reporting anxiety at follow-up (RR = 2.2(1.1–4.6)), especially avoidance in the hospital setting (RR = 6.7(2.5–18.2)). No such differences were seen when the ill brother or sister was cared for at home.Significance of results: Long-term anxiety in bereaved siblings might be due to insufficient communication. Avoiding healthcare professionals, especially when the brother or sister is cared for at the hospital, may also increase the risk of anxiety.
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| 2. |
- Hart, E. C., et al.
(author)
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Recording sympathetic nerve activity in conscious humans and other mammals: guidelines and the road to standardization
- 2017
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In: American Journal of Physiology-Heart and Circulatory Physiology. - : American Physiological Society. - 0363-6135 .- 1522-1539. ; 312:5
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Journal article (peer-reviewed)abstract
- Over the past several decades, studies of the sympathetic nervous system in humans, sheep, rabbits, rats, and mice have substantially increased mechanistic understanding of cardiovascular function and dysfunction. Recently, interest in sympathetic neural mechanisms contributing to blood pressure control has grown, in part because of the development of devices or surgical procedures that treat hypertension by manipulating sympathetic outflow. Studies in animal models have provided important insights into physiological and pathophysiological mechanisms that are not accessible in human studies. Across species and among laboratories, various approaches have been developed to record, quantify, analyze, and interpret sympathetic nerve activity (SNA). In general, SNA demonstrates "bursting" behavior, where groups of action potentials are synchronized and linked to the cardiac cycle via the arterial baroreflex. In humans, it is common to quantify SNA as bursts per minute or bursts per 100 heart beats. This type of quantification can be done in other species but is only commonly reported in sheep, which have heart rates similar to humans. In rabbits, rats, and mice, SNA is often recorded relative to a maximal level elicited in the laboratory to control for differences in electrode position among animals or on different study days. SNA in humans can also be presented as total activity, where normalization to the largest burst is a common approach. The goal of the present paper is to put together a summary of "best practices" in several of the most common experimental models and to discuss opportunities and challenges relative to the optimal measurement of SNA across species.
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| 3. |
- Lövgren, Malin, et al.
(author)
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Care at end of life influences grief : A nationwide long-term follow-up among young adults who lost a brother or sister to childhood cancer
- 2018
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In: Journal of Palliative Medicine. - Larchmont, New York : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 21:2, s. 156-162
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Journal article (peer-reviewed)abstract
- BACKGROUND: A majority of cancer-bereaved siblings report long-term unresolved grief, thus it is important to identify factors that may contribute to resolving their grief.OBJECTIVE: To identify modifiable or avoidable family and care-related factors associated with unresolved grief among siblings two to nine years post loss.DESIGN: This is a nationwide Swedish postal survey.MEASUREMENTS: Study-specific questions and the standardized instrument Hospital Anxiety and Depression Scale. Primary outcome was unresolved grief, and family and care-related factors were used as predictors.SETTING/PARTICIPANTS: Cancer-bereaved sibling (N = 174) who lost a brother/sister to childhood cancer during 2000-2007 in Sweden (participation rate 73%). Seventy-three were males and 101 females. The age of the siblings at time of loss was 12-25 years and at the time of the survey between 19 and 33 years.RESULTS: Several predictors for unresolved grief were identified: siblings' perception that it was not a peaceful death [odds ratio (OR): 9.86, 95% confidence interval (CI): 2.39-40.65], limited information given to siblings the last month of life (OR: 5.96, 95% CI: 1.87-13.68), information about the impending death communicated the day before it occurred (OR: 2.73, 95% CI: 1.02-7.33), siblings' avoidance of the doctors (OR: 3.22, 95% CI: 0.75-13.76), and lack of communication with family (OR: 2.86, 95% CI: 1.01-8.04) and people outside the family about death (OR: 5.07, 95% CI: 1.64-15.70). Depressive symptoms (OR: 1.27, 95% CI: 1.12-1.45) and time since loss (two to four years: OR: 10.36, 95% CI: 2.87-37.48 and five to seven years: OR: 8.36, 95% CI: 2.36-29.57) also predicted unresolved grief. Together, these predictors explained 54% of the variance of unresolved grief.CONCLUSION: Siblings' perception that it was not a peaceful death and poor communication with family, friends, and healthcare increased the risk for unresolved grief among the siblings.
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| 4. |
- Nilsson, Erik, 1983-, et al.
(author)
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Evaluating humidity and sea salt disturbances on CO2 flux measurements
- 2018
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In: Journal of Atmospheric and Oceanic Technology. - 0739-0572 .- 1520-0426. ; 35, s. 859-875
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Journal article (peer-reviewed)abstract
- Global oceans are an important sink of atmospheric carbon dioxide (CO2). Therefore, understanding the air-sea flux of CO2 is a vital part in describing the global carbon balance. Eddy covariance (EC) measurements are often used to study CO2 fluxes from both land and ocean. CO2 are usually measured with infrared absorption sensors, which at the same time measure water vapor. Studies have shown that presence of water vapor fluctuations in the sampling air potentially result in erroneous CO2 flux measurements due to cross-sensitivity of the sensor. Here we compare measured CO2 fluxes from both enclosed path Li-Cor 7200 sensors and open-path Li-Cor 7500 instruments from an inland measurement site and a marine site. We also introduce new quality control criteria based upon a Relative Signal Strength Indicator (RSSI). The sampling gas in one of the Li-Cor 7200 instruments was dried by means of a multi-tube diffusion dryer so that the water vapor fluxes were close to zero. With this setup we investigated the effect that cross-sensitivity of the CO2 signal to water vapor can have on the CO2 fluxes. The dryer had no significant effect on the CO2 fluxes. We tested the hypothesis that the cross-sensitivity effect is caused by hygroscopic particles such as sea salt by spraying a saline solution on the windows of the Li-Cor 7200 instruments during the inland field test. Our results confirm earlier findings that sea salt contamination can affect CO2 fluxes significantly and confirm earlier findings, that drying the sampling air for the gas analyzer is an effective method to reduce this signal contamination.
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| 5. |
- Selin, Lotta, et al.
(author)
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High Dose versus Low Dose Oxytocin for Augmentation of Delayed Labour: a randomized controlled trial
- 2016
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In: NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016. - 9789163742699
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Conference paper (other academic/artistic)abstract
- Background Delay in labour due to ineffective uterine contractions is a major problem in obstetric care and a main reason for the increased rate of caesarean deliveries, particularly among nulliparous women. Infusion with synthetic oxytocin is a commonly used treatment of hypotonic uterine contractions however there is a gap of knowledge concerning which dosage of oxytocin should be used, both starting dose and increment dose of oxytocin. Aim To compare dosage of oxytocin treatment in nulliparous women with delayed labour progress in active phase of labour. The hypothesis is that augmentation by high dose of oxytocin improves labour outcomes compared with a low dose of oxytocin, without affecting neonatal or maternal outcomes including birth experiences negatively. Methods In a randomized double-blind controlled trial conducted in six labour wards in Sweden, consenting nulliparous women in active labour and with a defined delayed progress are randomized to receive a regimen of either high dose or low dose of oxytocin (33.2 respectively 16,6 microgram oxytocin in 1000 ml isotone saline solution). Randomization is computergenerated, with allocation concealment by a coding system. Primary outcome is caesarean delivery rate. Based on a sample size calculation (α=0.05, β=0.80), a minimum of 1 045 women will be included in each group in order to reduce caesarean section rate from 17.5 % to 13 %. The study is approved by the regional Ethics Board in Gothenburg (dnr: 090-12), by the Medical Products Agency –Sweden (Eudra-CTnr:2012-00035633) and registered at ClinicalTrials.gov. Identifier: NCT01587625. Results Data collection started 15th of August 2013 and data is still under collection. This presentation will describe the study protocol and the first half period of the data collection. Conclusion The study will contribute to establishment of evidence based routines regarding oxytocin treatment of delayed labour progress.
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| 6. |
- Wallerstedt Lantz, Anna, et al.
(author)
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90-Day readmission after radical prostatectomy—a prospective comparison between robot-assisted and open surgery
- 2019
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In: Scandinavian Journal of Urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 53:1, s. 26-33
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Journal article (peer-reviewed)abstract
- Purpose: All types of surgery are associated with complications. The debate is ongoing whether robot-assisted radical prostatectomy can lower this risk compared to open surgery. The objective of the present study was to evaluate post-operative adverse events leading to readmissions, using clinical records to classify these adverse events systematically. Materials and methods: A prospective controlled trial of men who underwent robot-assisted laparoscopic (RALP) or retropubic radical prostatectomy (RRP) at 14 departments of Urology (LAPPRO) between 2008 and 2011. Data on all readmissions within 3 months of surgery were collected from the Patient registry, Swedish Board of Health and Welfare. For each readmission the highest Clavien-Dindo grade was listed. Results: A total of 4003 patients were included in the LAPPRO trial and, after applying exclusion criteria, 3706 patients remained for analyses. The results showed no statistically significant difference in the overall readmission rates (8.1 vs. 7.1%) or readmission due to major complications (Clavien-Dindo ≥3b, 1.7 vs. 1.9%) between RALP and RRP within 90 days after surgery. Patients subjected to lymph-node dissection (LND) had twice the risk for readmission as men not undergoing LND, irrespective RALP or RRP technique. Blood transfusion was significantly more frequent during and within 30 days of RRP surgery (16 vs. 4%). Abdominal symptoms were more common after RALP. Conclusions: There is a substantial risk for hospital readmission after prostate-cancer surgery, regardless of technique; although major complications are rare. Regardless of surgical technique, attention should be focused on specific types of complications.
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