Traffic-related microplastic particles, metals, and organic pollutants in an urban area under reconstruction

In urban environments, particularly areas under reconstruction, metals, organic pollutants (OP), and microplastics (MP), are released in large amounts due to heavy traffic. Road runoff, a major transport route for urban pollutants, contributes significantly to a deteriorated water quality in receiving waters. This study was conducted in Gothenburg, Sweden, and is unique because it simultaneously investigates the occurrence of OP, metals, and MP on roads and in stormwater from an urban area under reconstruction. Correlations between the various pollutants were also explored. The study was carried out by collecting washwater and sweepsand generated from street sweeping, road surface sampling, and flow-proportional stormwater sampling on several occasions. The liquid and solid samples were analyzed for metals, polycyclic aromatic hydrocarbons (PAH), oxy-PAH, aliphatics, aromatics, phthalates, and MP. The occurrence of OP was also analyzed with a non-target screening method of selected samples. Microplastics, i.e. plastic fragments/fibers, paint fragments, tire wear particles (TWP) and bitumen, were analyzed with a method based on density separation with sodium iodide and identification with a stereo microscope, melt-tests, and tactile identification. MP concentrations amounted to 1500 particles/L in stormwater, 51,000 particles/L in washwater, and 2.6 7 106 particles/kg dw in sweepsand. In stormwater, washwater and sweepsand, MP ≥20 μm were found to be dominated by TWP (38%, 83% and 78%, respectively). The results confirm traffic as an important source to MP, OP, and metal emissions. Concentrations exceeding water and sediment quality guidelines for metals (e.g. Cu and Zn), PAH, phthalates, and aliphatic hydrocarbons in the C16–C35 fraction were found in most samples. The results show that the street sweeper collects large amounts of polluted materials and thereby prevents further spread of the pollutants to the receiving stormwater

Associations between depressive symptoms and disease progression in older patients with chronic kidney disease: results of the EQUAL study

Background Depressive symptoms are associated with adverse clinical outcomes in patients with end-stage kidney disease; however, few small studies have examined this association in patients with earlier phases of chronic kidney disease (CKD). We studied associations between baseline depressive symptoms and clinical outcomes in older patients with advanced CKD and examined whether these associations differed depending on sex. Methods CKD patients (>= 65 years; estimated glomerular filtration rate <= 20 mL/min/1.73 m(2)) were included from a European multicentre prospective cohort between 2012 and 2019. Depressive symptoms were measured by the five-item Mental Health Inventory (cut-off <= 70; 0-100 scale). Cox proportional hazard analysis was used to study associations between depressive symptoms and time to dialysis initiation, all-cause mortality and these outcomes combined. A joint model was used to study the association between depressive symptoms and kidney function over time. Analyses were adjusted for potential baseline confounders. Results Overall kidney function decline in 1326 patients was -0.12 mL/min/1.73 m(2)/month. A total of 515 patients showed depressive symptoms. No significant association was found between depressive symptoms and kidney function over time (P = 0.08). Unlike women, men with depressive symptoms had an increased mortality rate compared with those without symptoms [adjusted hazard ratio 1.41 (95% confidence interval 1.03-1.93)]. Depressive symptoms were not significantly associated with a higher hazard of dialysis initiation, or with the combined outcome (i.e. dialysis initiation and all-cause mortality). Conclusions There was no significant association between depressive symptoms at baseline and decline in kidney function over time in older patients with advanced CKD. Depressive symptoms at baseline were associated with a higher mortality rate in men

Vårdprogram minskar postoperativt illamående : en klinisk naturalistisk interventionsstudie

Kraven på hälso- och sjukvårdspersonalens kompetens och insatser ökar. De bör ha ett vetenskapligt förhållningssätt och arbeta utifrån evidensbaserad omvårdnad för att ge en god och säker vård. Vårdpersonalen på en kirurgavdelning upplevde att ett stort antal patienter var illamående postoperativt. Syftet: var att utvärdera effekterna av införandet av ett vårdprogram för postoperativt illamående för patienter som genomgått planerad operation inom mage/tarm. Metod: Studien har haft en kvantitativ, deskriptiv, jämförande pre- och postinterventions design. Metoden som har använts var enkät med strukturerade frågor. Enkäten har använts vid två tillfällen, före (kontrollgrupp) och efter (interventionsgrupp) införandet av vårdprogram för postoperativt illamående.   Resultat: Signifikanta skillnader förelåg så tillsvida att interventionsgruppen hade lägre förekomst av postoperativt illamående, kväljningar och kräkningar postoperativt jämfört med kontrollgruppen.   Slutsats: Vårdprogram för patienter med mag- och/eller tarmoperation är effektivt för att minska postoperativt illamående. Den här använda metodiken för framtagande, implementering och utvärdering av vårdprogram kan med fördel användas för andra vårdområden. Sannolikt kan vårdprogrammet med fördel användas till andra patienter där postoperativt illamående är en riskfaktor.The demands on the healthcare staffs’ competence and performance are increasing. Evidence based nursing should be carried out with a scientific knowledge and approach in order to secure patients safety. The staff at a surgical clinic noticed that a great number of their patients suffered from nausea post operatively.     *        Objectives: to evaluate the effects of the implementation of a programme for post surgical nausea, for patients that had elective surgery in the abdominal and intestinal areas.   Method: The study had a quantitative, descriptive, pre- and post comparative design. A questionnaire was used at two occasions, before (the control-group) and after (the intervention-group) the implementation of a programme for post surgical nausea.   Results: Significant differences were observed in that the intervention-group experienced fewer problems with nausea and vomiting post operatively in comparison to the control-group.   Conclusions: The programme for post surgical nausea for patients with elective surgery in the abdominal and intestinal areas is effective in preventing post surgical nausea. This method for designing, implementing and evaluating a care programme can be used in other clinical settings. The programme for post surgical nausea can be used for other patients for whom post surgical nausea is a risk factor

Structural requirements for the intracellular subunit polymerization of the complement inhibitor C4b-binding protein.

C4b-binding protein (C4BP), an important inhibitor of complement activation, has a unique spider-like shape. It is composed of six to seven identical alpha-chains with or without a single beta-chain, the chains being linked by disulfide bridges in their C-terminal parts. To elucidate the structural requirements for the assembly of the alpha-chains, recombinant C4BP was expressed in HEK 293 cells. The expressed C4BP was found to contain six disulfide-linked alpha-chains. Pulse-chase analysis demonstrated that the recombinant C4BP was rapidly synthesized in the cells and the polymerized C4BP appeared in the medium after 40 min. The alpha-chains were polymerized in the endoplasmic reticulum (ER) already after 5 min chase. The polymerization process was unaffected by blockage of the transport from the ER to the Golgi mediated by brefeldin A or low temperature (10 degrees C). The C-terminal part of the alpha-chain (57 amino acids), containing 2 cysteine residues and an amphiphatic alpha-helix region, was required for the polymerization. We constructed and expressed several mutants of C4BP that lacked the cysteine residues and/or were truncated at various positions in the C-terminal region. Gel filtration analysis of these variants demonstrated the whole alpha-helix region to be required for the formation of stable polymers of C4BP, which were further stabilized by the formation of disulfide bonds

Realist evaluation for practice in Sweden, Finland and Britain

This article outlines the new, emerging realist paradigm in evaluation research and applies it to social work practice in three countries. This paradigm has the potential for a "white box" evaluation that not only systematically tracks outcomes but also the mechanisms that produce the outcomes, the contexts in which these mechanisms are triggered, and the content of the interventions. Human service programs introduce interventions that interact with the other causal mechanisms in the contexts of service users to produce outcomes. The purpose of realist evaluation is to investigate what works, for whom, and in what contexts. Practice examples are provided from Britain, Sweden, and Finland