Poetry and Psychiatry

In this volume, Professor Ljunggren introduces the Symbolists and their feverish expectations in detail. Theirs was a time when for a brief moment everything seemed possible. Then came the rude awakening, best described in Bely’s powerful prose masterpiece Petersburg, which serves as the connective thread and recurrent point of reference throughout this collection. Written in the early 1910s, just before the world war that was to culminate in the so-called October Revolution, Bely’s novel portrays the collective experience of the Symbolists as an attempted political parricide. Many of the essays included in this volume are appearing in English for the first time

Analysing future solid waste generation - Soft linking a model of waste management with a CGE-model for Sweden

Parallel to the efforts of the EU to achieve a significant and overall reduction of waste quantities within the EU, the Swedish parliament enacted an environmental quality objective stating that ‘the total quantity of waste must not increase …’ i.e. an eventual absolute decoupling of waste generation from GDP. The decoupling issue is ad-dressed, in the present paper, by assessing future waste quantities, for a number of economic scenarios of the Swedish economy to 2030 with alternative assumptions about key factors affecting waste generation and waste management costs. We use an integrated top-down/bottom-up approach by linking a CGE-model of the Swedish economy with a systems engineering model of the Swedish waste management system. In this way, we can in more detail consider the interaction between waste generation and waste management costs (waste disposal prices) when assessing future waste quantities. A relative decoupling of waste generation takes place in all scenarios, i.e. total waste quantities increase at a lower rate than GDP. Absolute decoupling, which re-quire total waste quantities to stabilize or to reduce, does not take place in any of the scenarios. This means that the present Swedish Environmental quality objective of stabilizing waste quantities is not met in any of the scenarios with total waste genera-tion levels of 110 per cent up to nearly 200 per cent of that in 2006. The overall impression from our analysis is that costs are high for reducing waste generation irrespective of the type of waste reduced. In other words, the waste treat-ment costs are low compared to the costs for reducing waste. This situation also means that the use of policy instruments, which induce substitution by increasing the price of waste disposal services, will have very small reducing effects on the generation of all types of waste unless the price increase brings about an introduction of waste preventing techniques and affect households in the direction of a less waste intensive behaviour. For example, the policy instruments used must affect the pattern of household consumption pattern more directly, as a differentiation of the value added tax, rather than to be directed towards the waste management sector. Economic policy instruments introduced in the waste management sector are more likely to affect the choice of waste management solutions than prevent waste generation. Linking a macroeconomic and a systems engineering model for waste manage-ment, gives us a tool useful also for capturing the macroeconomic effects, such as GDP growth and structural changes, when designing policy instruments intended to prevent waste generation or take waste management in a more sustainable direction.general equilibrium model; systems engineering; solid waste; waste management; waste generation; decoupling; EMEC; NatWaste; top-down/bottom-up; waste policy instruments

Mapping the content and fates of scarce metals in discarded cars

A great variety of current products make use of components or materials (e.g. electronics, steel and aluminium alloys) that utilise increasing amounts of ‘critical’ or scarce metals (SM). For example, design trends for cars point at increasing SM utilisation in order for regulatory, business and consumer requirements on environmental performance, safety, costs, comfort and infotainment to be met. Modern cars now hold SM in substantial amounts, i.e. the circa one billion cars in use worldwide today, constitute a significant near-term secondary SM resource. However, current end-of-life vehicle (ELV) recycling is mainly aimed at isolating hazardous contents, dismantling spare parts and recycling bulk metals. There is thus a clear risk that ELV SM are not functionally recycled and thus lost for further use. Assessments of the opportunities for increased functional recycling require estimates of SM content of discarded cars and individual waste flows in ELV recycling. However, information on both is limited. Data related to cars is sparse, and challenged by the large range and age span of discarded car brands and models. Measurements of SM in waste flows are few and cover a limited range of SM. Consequently, available data does not allow us to quantify with precision the SM contents of discarded cars reaching the ELV recycling system, or map individual metal flows within it. Instead, our approach relies on mapping 25 ELV SM to main types of applications within three newly produced car models using automotive industry data (International Material Data System, IMDS), and letting these models represent the ELV fleet so that the annual input magnitudes of SM to ELV management can be estimated. Subsequently, we employ material flow analysis of ELV waste streams as basis for identifying potential pathways of these main applications, and the extent to which contained metals may reach processes capable of functional recycling. The approach allows us to qualitatively distinguish subsets of systems flows holding groups of SM, and discuss the potential for functional recycling. Using Swedish ELV management as a case, we conclude that only platinum may be functionally recycled in its main application. Cobalt, gold, manganese, molybdenum, palladium, rhodium and silver may be functionally recycled depending on application and pathways taken. For remaining 17 metals, functional recycling is lacking. Consequently, there is considerable risk of losing SM with current ELV procedures. Given differences in the application of metals and identified pathways, strategies for improving recycling and resource security are considered. Moreover, our case illustrates the considerable challenge, posed by the complexity and range of car configurations and the sparsity of information on SM, to closer assess recycling strategies and advance secondary SM resource utilisation

Challenges of recycling multiple scarce metals: The case of Swedish ELV and WEEE recycling

Cars and electronic products are characterised by high metal complexity. Meanwhile, recycling industries are not fully aligned with this complexity, leading to losses of unique scarce metal resources. By utilising the technological innovation system framework we identify, and discuss implications of, factors that impact on recycling of some precious (gold, palladium, silver) and minor metals (gallium, tantalum) in printed circuit boards (PCBs) present in Swedish end-of-life cars (ELVs) and waste electrical and electronic equipment (WEEE). We conclude that while precious metals from WEEE PCBs are currently recycled, recycling precious metals from ELV PCBs will likely remain a challenge in the near-term due to recycling being blocked by the material composition of ELV waste, design of waste legislation, and by accumulated capabilities and business models in current recycling industries. However, some of these blocking factors are open to direct influence from national policymakers or industry actors and may thus be alleviated more easily. In contrast, recycling minor metals from ELV or WEEE PCBs will likely remain challenging also in the long-term due to a larger set of blocking factors. Alleviating these may require a substantial portfolio of metal-specific policies at national and supra national levels supporting the build-up of entirely new recycling value chains

En ny svensk-rysk och rysk-svensk ordbok

Anmeldt værk:Norstedts ryska ordbok: rysk-svensk, svensk-rysk. (Rysk titel.) Projektledareoch huvudredaktör: Ulla Birgegård. Huvudredaktör: ElisabethMarklund Sharapova. Projektsamordnare på förlaget: Britt-Marie Berglund.Stockholm: Norstedts Akademiska Förlag 2006

Low Serum Levels of Dehydroepiandrosterone Sulfate Predict All-Cause and Cardiovascular Mortality in Elderly Swedish Men.

Context: The age-related decline in dehydroepiandrosterone (DHEA) levels is thought to be of importance for general and vascular aging. However, data on the association between DHEA and mortality are conflicting. Objectives: We tested the hypothesis that low serum DHEA and DHEA sulfate (DHEA-S) levels predict all-cause and cardiovascular disease (CVD) death in elderly men. Design, Setting, and Participants: We used gas/liquid chromatography-mass spectrometry to analyze baseline levels of DHEA and DHEA-S in the prospective population-based MrOS Sweden study (2644 men, aged 69-81 yr). Mortality data were obtained from central registers and analyzed using Cox proportional hazards regressions. Main Outcome Measures: All-cause and CVD mortality by serum DHEA(-S) levels. Results: During a mean 4.5-yr follow-up, 328 deaths occurred. Low levels of DHEA-S (quartile 1 vs. quartiles 2-4), predicted death from all causes [hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.21-1.96; adjusted for traditional cardiovascular risk factors], from CVD (n = 123 deaths; HR 1.61, 95% CI 1.10-2.37) and ischemic heart disease (n = 73; HR 1.67, 95% CI 1.02-2.74) but not cancer. Analyses with DHEA gave similar results. The association between low DHEA-S and CVD death remained after adjustment for C-reactive protein and circulating estradiol and testosterone levels. When stratified by the median age of 75.4 yr, the mortality prediction by low DHEA-S was more pronounced among younger (age adjusted HR for CVD death 2.64, 95% CI 1.37-5.09) than older men (HR 1.30, 95% CI 0.83-2.04). Conclusions: Low serum levels of DHEA(-S) predict death from all causes, CVD, and ischemic heart disease in older men

Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials

Background: Treatment efficacy of physical agents in osteoarthritis of the knee (OAK) pain has been largely unknown, and this systematic review was aimed at assessing their short-term efficacies for pain relief. Methods: Systematic review with meta-analysis of efficacy within 1–4 weeks and at follow up at 1–12 weeks after the end of treament. Results: 36 randomised placebo-controlled trials (RCTs) were identified with 2434 patients where 1391 patients received active treatment. 33 trials satisfied three or more out of five methodological criteria (Jadad scale). The patient sample had a mean age of 65.1 years and mean baseline pain of 62.9 mm on a 100 mm visual analogue scale (VAS). Within 4 weeks of the commencement of treatment manual acupuncture, static magnets and ultrasound therapies did not offer statistically significant short-term pain relief over placebo. Pulsed electromagnetic fields offered a small reduction in pain of 6.9 mm [95% CI: 2.2 to 11.6] (n = 487). Transcutaneous electrical nerve stimulation (TENS, including interferential currents), electro-acupuncture (EA) and low level laser therapy (LLLT) offered clinically relevant pain relieving effects of 18.8 mm [95% CI: 9.6 to 28.1] (n = 414), 21.9 mm [95% CI: 17.3 to 26.5] (n = 73) and 17.7 mm [95% CI: 8.1 to 27.3] (n = 343) on VAS respectively versus placebo control. In a subgroup analysis of trials with assumed optimal doses, short-term efficacy increased to 22.2 mm [95% CI: 18.1 to 26.3] for TENS, and 24.2 mm [95% CI: 17.3 to 31.3] for LLLT on VAS. Follow-up data up to 12 weeks were sparse, but positive effects seemed to persist for at least 4 weeks after the course of LLLT, EA and TENS treatment was stopped. Conclusion: TENS, EA and LLLT administered with optimal doses in an intensive 2–4 week treatment regimen, seem to offer clinically relevant short-term pain relief for OAK

Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs)

Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods: The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m(2). Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95% confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95% CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10) FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m(2) the HR (95% CI) for CVD death was 55% (13-111)/(1-SD) increase in log(10) FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function

Validity and reliability of Resource Utilization Groups (RUG-III) in Finnish long-term care facilities

Resource Utilization Groups, Version III (RUG-III) is a case-mix system developed in the USA for classification of long-term care residents. This paper examines the validity and reliability of an adapted 22-group version of RUG-III (RUG-III/22) for use in long-term care facilities in Finland. Finnish cost weights for RUG-III/22 groups are calculated and different methods for their computation are evaluated. The study sample (1,964 residents) was collected in 1995 - 96 from ten long-term care facilities in Finland. RUG-III/22 alone explained 38.2% of the variance of total patient-specific (nursing + auxiliary staff) per diem cost. Resource use within RUG groups was relatively homogeneous. Other predictors of resource use included age, gender and length of stay. RUG-III/22 also met the standard for good reliability (i.e. a kappa value of 0.6 or higher) for crucial classification items, such as activities of daily living and high correlation between assessments based on relative cost.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68924/2/10.1177_14034948990270030201.pd