Clinicians' psychological empowerment to engage in management as part of their daily work

This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and noncommercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcodePurpose – The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work. Design/methodology/approach – The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis. Findings – The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians’ clinical work. Practical implications – For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses’ psychological empowerment. Originality/value – The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses’ higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians’ and nurses’ clinical work.publishedVersio

Treatment with Unlabeled mAb BR96 After Radioimmunotherapy with (177)Lu-DOTA-BR96 in a Syngeneic Rat Colon Carcinoma Model.

Metastatic disease after successful treatment of the primary tumor continues to be a therapeutic challenge. Enhancement of therapeutic effects by the administration of unlabeled monoclonal antibodies (mAbs) after radioimmunotherapy (RIT) may provide a means of preventing or delaying the development of metastatic disease. In the present study, Brown Norway rats with syngeneic grafted colon carcinomas were administered the minimal effective therapeutic dose of 400 MBq/kg lutetium-177 ((177)Lu)-DOTA-BR96. After 2 weeks, half of the animals were given 15 mg/kg unlabeled mAb BR96 as consolidation therapy. Treatment response and toxicity were monitored 100 days after the treatment with unlabeled BR96. The treatment with unlabeled mAb after RIT resulted in a complete response (CR) in 19 of 19 animals, while RIT alone resulted in a CR in 17 of 19 animals. The additional treatment did not affect the number of animals with metastatic disease or the time to clinical symptoms of metastases. RIT resulted in reversible myelotoxicity. The unlabeled mAb BR96 did not cause any additional toxicity, making it possible to repeat the consolidation therapy

Pattern of antigen expression in metastases after radioimmunotherapy of a syngeneic rat colon carcinoma utilizing the BR96 antibody.

Abstract ABSTRACT: BACKGROUND: Repeated administration of antibody-based therapies such as radioimmunotherapy depends on preserved antigen expression in tumor lesions. The purpose of this study was to evaluate whether the antigen expression in metastases observed after radioimmunotherapy differs from that of untreated primary tumors. FINDINGS: 30 of the 35 Brown Norway rats with syngeneic colon carcinoma treated with 400 MBq/kg 177Lu-DOTA-BR96 exhibited consistent complete response of the primary tumor. 13 animals developed metastases that were detected after treatment. The antigen expression was reduced in 17 of 23 metastases detected after radioimmunotherapy compared with untreated tumors. No tumors completely lacked positively stained tumor cells. CONCLUSIONS: Although it was not possible to demonstrate that the antigen reduction is triggered by the radioimmunotherapy this result stress the importance of considering the risk of reduced antigen expression in metastases after radioimmunotherapy prior to further targeted therapies

Handling uncertainties in forest information: the hierarchical forest planning process and its use of information at large forest companies

This qualitative study aimed to map what information is used in the forest planning process at large forest-owning companies, how it is used, its level of uncertainty and currently employed strategies to handle forest information uncertainty. An additional aim was to assess the status of the paradigm of the forest planning hierarchy in forestry. We used data from semi-structured interviews with representatives of six large forest-owning companies in Sweden, representing 30 per cent of the productive forest land in the country. Our results show that the forest planning process is a hierarchical system of decisions where the information used in the different planning stages is of varying quality and that the traditional hierarchical planning paradigm still plays a vital role in forestry. The most central source of information in the whole forest-planning process is the forest stand database (forest inventory). This includes uncertain information from various sources, including subjective field measurements and aerial image interpretation. However, the use of remote sensing estimates to feed the databases is increasing, which will probably improve the overall quality. Another important finding is that forest companies tend not to use decision support systems or optimization models to solve planning problems outside the scope of strategic planning; thus, most planning is done manually, e.g. in a geographic information system (GIS) environment. Apart from the hierarchical division of the planning process itself, we identified six main strategies that the companies use to control information uncertainty, namely locking the future by making a decision, utilizing a surplus of available harvests, updating information before a decision is made, replanning when the plan is found to be infeasible, planning by looking back and ignoring the uncertainty, either intentionally or unintentionally. The results from this study increase our understanding of contemporary forest-planning practices and will be helpful in the development of decision support systems and methods for information collection

Real-time imaging required for optimal echocardiographic assessment of aortic valve calcification

Introduction Aortic valve calcification (AVC), even without haemodynamic significance, may be prognostically import as an expression of generalized atherosclerosis, but techniques for echocardiographic assessment are essentially unexplored. Methods Two-dimensional (2D) echocardiographic recordings (Philips IE33) of the aortic valve in short-axis and long-axis views were performed in 185 consecutive patients within 1 week before surgery for aortic stenosis (n = 109, AS), aortic regurgitation (n = 61, AR), their combination (n = 8) or dilation of the ascending aorta (n = 7). The grey scale mean (GSMn) of the aortic valve in an end-diastolic short-axis still frame was measured. The same frame was scored visually 15 as indicating that the aortic valve was normal, thick, or had mild, moderate or severe calcification. The visual echodensity of each leaflet was determined real time applying the same 5-grade scoring system for each leaflet, and the average for the whole valve was calculated. Finally, a similar calcification score for the whole valve based on inspection and palpation by the surgeon was noted. Results Visual assessment of real-time images using the proposed scoring system showed better correlation with the surgical evaluation of the degree of valve calcification (r = 0.83, P<0.001) compared to evaluation of stop frames by visual assessment (r = 0.66, P<0.001) or the GSMn score (r = 0.64, P<0.001). High inter- and intra-observer correlations were observed for real-time visual score (both intraclass correlation coefficient = 0.93). Conclusion Real-time evaluation of the level of AVC is superior to using stop frames assessed either visually or by dedicated computer grey scale measurement software

Monitoring of bed material in a biomass fluidized bed boiler using an electronic tongue

The thermal conversion of biomass fuel mixes in fluidized beds can cause agglomeration. To counteract agglomeration, bed material is gradually exchanged with virgin bed material, and this results in increased disposal of used bed material. Furthermore, the bed material exchange represents a costly option, as it involves a cost for virgin bed material, for landfill, and for unplanned downtime of the plant. This paper presents a novel method for the evaluation of bed material quality: the electronic tongue (ET). Evaluation of bed material quality can contribute toward decreasing the cost of unnecessary exchanges of bed material. The proposed method was tested on bed material sampled on an almost daily basis from a commercial fluidized bed boiler during several months of operation. A two-electrode ET was used for the evaluation of the bed material quality. The analysis relied on pulsed voltammetry measurements and multivariate data analysis with Principal Component Analysis (PCA). The results suggest that it is possible to follow bed material changes and that the ET, after further development, may be used to optimize the material flows connected to the bed material. Further research is being conducted to optimize the ET\u27s performance and its application in monitoring bed material

A new non-invasive ultrasonic method for simultaneous measurements of longitudinal and radial arterial wall movements: first in vivo trial.

During recent years, the radial movement of the arterial wall has been extensively studied, and measurements of the radial movement are now an important tool in cardiovascular research for characterizing the mechanical properties of the arterial wall. In contrast, the longitudinal movement of vessels has gained little or no attention as it has been presumed that this movement is negligible. With modern high-resolution ultrasound, it can, however, be seen that the intima-media complex of the arterial wall moves not only in the radial direction, but also in the longitudinal direction during pulse-wave propagation. This paper describes a new non-invasive ultrasonic method that is able to measure simultaneously two dimensionally arterial vessel wall movements. The method is demonstrated in a limited in vivo trial. Results from the in vivo trial show that, apart from the well-known radial movement, there is a distinct longitudinal movement in the human common carotid artery with, in this case, the intima-media complex moving substantially as compared with the region of the tunica adventitia. Two-dimensional evaluation of the vessel-wall movements, taking not only the radial movement, but also the longitudinal movement into account, may provide novel information of importance in the evaluation of vessel-wall function

Open Access vid SLU 2012-2014

Open access (OA) är ett sätt att göra forskningsresultat fritt tillgängliga över internet och har på relativt kort tid blivit en global företeelse som har förändrat hur forskare publicerar sina resultat. Syftet med detta arbete har varit att undersöka metoder för att kunna mäta Sveriges lantbruksuniversitets (SLU) OA-publicering, liksom att ta fram siffror över hur stor andel av SLU:s vetenskapliga artiklar som publiceras OA. Utöver detta syfte, så har vi även undersökt hur OA-andelen fördelar sig mellan olika typer av OA (s.k. guld, grön och hybrid), vilka tidskrifter SLU:s forskare mest frekvent publicerar i, samt hur andelen OA ser ut på SLU:s institutioner. Mätningen har begränsats till refereegranskade tidskriftsartiklar publicerade under åren 2012-2014. Publikationsdata hämtades ur publikationsdatabasen SLUpub. För artiklar som har publicerats i OA-tidskrifter (guld OA) har SLUpub-datan samkörts med data från Directory of Open Access Journals (DOAJ). För parallellpublicerade artiklar (grön OA) har vi räknat antal artiklar i Epsilon, SLU:s öppna arkiv. För OA-artiklar publicerade i prenumerationstidskrifter (hybrid OA) genomfördes en stickprovskontroll utifrån ett randomiserat urval av hela underlaget. Resultat: andelen artiklar för hela SLU under perioden 2012-2014 var 4543. Av dessa var 790 tillgängliga guld OA vilket innebär 17,3 procent av den totala publiceringen. Trenden är uppåtgående då OA-andelen för 2012 var 16,3 procent och för 2014 19,2 procent. Andelen gröna OA-artiklar som återfanns i Epsilon och som inte kunde avskrivas som guld OA uppgick till 175 st. Dessa publikationer utgör 3,8 procent av det totala antalet publicerade artiklar under perioden. Stickprovet av det randomiserade urvalet visade på en andel hybrid OA på 16,5 procent av den totala artikelpubliceringen, vilket endast ska ses som en indikation. I rapporten redovisas även de tidskrifter som SLU-forskare publicerat mest i under perioden 2012-2014, där PLoS ONE med god marginal innehar förstaplatsen. Andelen OA på institutionsnivå redovisar endast resultat för guld OA, inte grön eller hybrid OA pga. att strukturerad data för dessa är resurskrävande att få fram. I slutsatserna diskuteras att SLU publicerar en relativt låg andel grön OA och att det även finns tämligen stora skillnader mellan institutionernas OA-publicering. Rapporten ger rekommendationer för SLU-bibliotekets vidare arbete, såsom att ta fram en förnyad strategi för utformning av stöd till grön OA och till institutioner som idag generellt publicerar OA i liten utsträckning

An autocrine sphingosine-1-phosphate signaling loop enhances NF-kappaB-activation and survival

Peer reviewe