Hyponatremia - Early differential diagnosis, management and prognosis

Abstract Hyponatremia is the most common electrolyte imbalance. It is associated with increased morbidity and in-hospital mortality. An effective early management is dependent on knowledge of epidemiology in the current population, accurate assessment of patient volume status and efficient diagnostic investigation. I) Prevalence of hyponatremia was investigated in an unselected population presenting to the Emergency department. Four groups of hyponatremia severity were established: Group 1: P-Na 250 ng/ml. All patients in the hypovolemic group increased their stroke volume after passive leg raise. IV) The aim of this study was to examine prevalence of hyponatremia in a large community-based cohort and association with future morbidity and mortality. In total, 22 267 individuals from the Malmö Preventive Project (MPP) cohort were included. Median follow-up time 34 years. Hyponatremia (S-Na<135mM) was observed in 166 subjects (0.7%). Hyponatremia was associated with increased all-cause mortality after adjusting for cardiovascular risk factors even when comparing “borderline” hyponatremia (S-Na 135-136) with normonatremia, HR 1.332 (1.184-1.499) p<0.001. There was also an association between hyponatremia and incident coronary artery disease (CAD) both with hyponatremia and borderline hyponatremia (e.g.S-Na135-136mM), HR:1.320 (1.127-1.545), p=0.001. Conclusions: The results of the papers included in this thesis, indicate that MR-proANP, apelin and bioreactance measurement may be valuable in early management of hyponatremia, especially determination of patient volume status. Hyponatremia is a risk factor for future cardiovascular disease and all-cause mortality even at mild levelsnear the reference range

Energy and hydrology modeling for the Paraná basin

Hydropower in Brazil stands for 64.5% of all energy sources in the country. The largest number of hydropower plants are located in the Paraná basin, which together have an installed capacity of approximately 40 GW including the world’s largest producing hydropower plant, Itaipu. The wet season during Brazilian summer (January-March) is the most important for hydropower. Occasionally, extreme, such as El Niño and La Niña, which are connected to variability of the sea surface temperature in the Tropical Pacific Ocean affect climate patterns. These events could lead to drought and result in dramatic consequences for hydropower production. Rain patterns within the basin reflect the flows during different seasons so that the largest flows in the Paraná River basin occur between January and March. The rivers Paranaíba and Grande are the main tributaries of Paraná with the largest energy inflows. The objective of this project includes the adaption of the Scania-HBV model for the Paraná basin and its evaluation. Thomson Reuters Point Carbon provided the model, which uses precipitation and temperature as input data, and through simplified hydrological processes, simulates inflow to the basin in energy units. Limitations were mainly connected to measurements and calculations of input data. Thomson Reuters Point Carbon uses information about energy inflow for prediction of future hydropower production and prices on the energy market. Severe peaks in prices seem to be connected to long-term droughts in the wet season and technical problems in the hydropower system. Natural energy inflow was the target data used for calibration of the model. The Paraná basin was divided into five sub-basins: Paraná, Grande, Paranaíba, Tietê and Paranapanema. Scania-HBV model was adapted for each sub-basin and the calibration period was chosen from 2005 to 2012. Objective functions were used to find the best fit between observed and calculated energy inflow. Evaluation was done by simulating energy inflow for a validation period from 2000 to 2005. Finally the results from the five models were put together to receive information of energy inflow for the whole basin. Model results were generally satisfying. The model captured common characteristic patterns of energy inflow for each sub-basin and peak events. All sub-basins, except one, exhibited high values of the Coefficient of determination (r2); weekly r2 values of approximately 0.8 (monthly 0.9) in calibration and 0.7 (monthly 0.8) in validation. The final result was satisfying validation showed weekly r2 0.87 (monthly 0.92) for the calibration, and 0.75 (monthly 0.82) for the validation and with a relative low Accumulated difference of -2106 GWh. These objective functions, together with the evaluation of input data, give the conclusion that the model is reliable and probably useful for future predictions of hydropower production at the Paraná River basin

Environmental Performance in Customer Communications

Corporate environmental efforts are now valued higher than ever and need to be communicated to customers in a successful manner. Companies today wish to promote themselves as sustainable and use environmental performance to obtain competitive advantages. SKF is promoting themselves as an environmentally sustainable supplier and wishes to ascertain how environmental performance can be communicated to strengthen and support its products. This project is limited to evaluate environmental performance by its usability in communication towards customers and not for their effectiveness as environmental efforts as such. The analysis and recommendations are geographically limited to the Swedish market and are primarily applicable to this market. How can environmental performance be used to promote industrial components in B2B customer communications? The project uses mainly qualitative data and some quantitative. The qualitative data consists of literature review, benchmark, and interviews with key SKF personnel and customers. The quantitative data extracted from of an externally produced customer survey. Conclusions show the importance of building a comprehensive brand image by incorporating product specific environmental performance (PSEP™) and environmental efforts which enhance the sustainable supplier brand image (SSBI™) in the environmental communication. Sustainable supplier brand image can be enhanced by including the following three things in the environmental communications: (1) SKF’s commitment to continuously improving environmental performance: focus on implemented processes and should use the Beyond Zero concept and portfolio to exemplify the efforts. (2) Certifications: focus on communicating ISO 50001. (3) Third-party verification and partnership: focus on SKF WWF Climate Savers membership. While product specific environmental performance can enhance sustainable supplier brand image a reputation as a sustainable supplier is a necessity to successfully communicate the benefits of product specific environmental performance. Communication of product specific environmental performance should always clearly communicate the correlation between PSEP™ and financial savings. To achieve this, it is important to have knowledge of customers’ KPI’s and communicate PSEP™ that is connected to those. It is also important to communicate measurements customers can relate to. Recommendations for communicating PSEP™ beyond this can be divided into two parts: (1) Recommendation for environmentally aware customers: Communicate LCA on a more complex and comprehensive level by including all parameters measured in a LCA, not limiting communication of LCA results to Beyond Zero products, and using visual tools in communication of LCA. (2) Recommendation for environmental unaware customers: Communicate effective and easily comprehendible information in every customer contact by providing SKF bearing packaging with a table of fundamental environmental parameters

Library-faculty collaboration in the light of a business administration bachelor’s program: ‘The Scientific Wave’

In contemporary digital society, information literacy is increasingly important and viewed as a necessary life skill for all ages, social groups, and professional sectors, hence also affecting higher education. Universities need to develop strategies and approaches to integrate these skills into course syllabi, assignments and assessments based on close library-faculty collaboration. However, librarians and faculty members in higher education traditionally often have separate agendas and limited collaboration. This paper illustrates the background and process of constructing a successful librarian-faculty partnership, as a shared framework entitled the ‘Scientific Wave’ throughout a bachelor’s program in business administration to enhance students’ critical thinking, research skills and information literacy in particular. A case study approach was applied, and data collection was conducted during 2014–2019. The outcomes of a shared framework and library-faculty collaboration are discussed from the perspectives of students, library, and faculty. Findings show that a shared framework based on close collaboration between librarians and faculty, strategic anchoring and visualization in curricula, syllabi, course objectives and assessments developed in line with the mission of the university have an impact on students’ information literacy skills during their education and after graduation. The Scientific Wave is a co-designed continuous framework based on the separate but complementary skills of librarians and faculty to provide students with tools for critical and creative thinking, research skills and lifelong learning in today’s digital society

Is it all about culture? A study on frustration with respect to the work situation in dispersed, global IT projects at a merged, multinational company

This article reports on the difficulties, peculiar to dispersed global projects, which may be a source of frustration to project members. Our study was carried out within a multinational pharmaceutical company, which following a merger reorganized its IT organization into global organisation. Members of the Swedish part of its IT organization reported severe problems after the reorganization, and called for an investigation. The reported problems were global projects struggling with cultural differences and, as a consequence, overconsuming their allotted resources. However, previous research regarding merged organizations has found, that complaints about cultural differences might be a mask for other problems. Our findings do include cultural differences being an obstacle to project performance. However, we identified project complexity and geographical distance as two additional, important factors explaining frustration and low performance in the global, dispersed projects. Thus, our study supports the earlier theory that practitioners overload the concept cultural differences, ignoring that global projects typically involve more stakeholders, and that it is more challenging to create the trust among the dispersed team members necessary to create a high-performing team. Global projects can be expected to reach a climate of high-performing team later than a local project, leaving its members to performing less during a longer time. Consequently, and putting other advantages aside, if management fail to develop a successful global team strategy, such projects can be expected to be more costly to the company, and more frustrating to team members being used to quickly reaching a high-performing state. Such a strategy would need to include ways of motivating project members to actively build trustful relations

The frail elderly, family network and public home help services : a pilot study of the parties' perception of the help and their reciprocal relationships

The family with the elderly and the home help workers’ team constitute two organisations, which meet in the care work. In this context the family is extended and often constitute not only members from the nuclear family but also other members of the network of relatives, whom take part in the care of the elderly. The extended family may in some cases include four generations (Finch & Mason, 1993). Home-help for elderly people have expanded in Sweden during the period 1960 - 1980. This was due partly upon the prevailing ideology that it is important for frail elderly to stay in their own homes. Due to this expansion the local communities have developed their public home-care organisations. Different kinds of autonomous group organisation predominate (Olsson et al, 1995). Small work groups take responsibility for home help service in local areas. Home-helpers organise their job themselves, exchange experiences and give each other emotional support. In Sweden both home care and institutional care of the elderly has decreased during the 1980th and 1990th in spite of the fact that the proportion elderly over 80 years (4,5 % of the total population) has increased 60 % since 1980. Twenty-two per cent of the women and 16 % of the men over 80 were cared for in their own home 1996. This development is said to have caused relatives to care for their frail elderly in the homes side by side by the home help services in an increasing degree (Johansson, 1991; Szebehely, 1998). Public care and service has an important impact on the interaction pattern between family members (Hendriksen, 1989; Johansson, 1999; Bass m fl, 1999). Home care may serve as an intervention that influences the health, well-being and life quality of the elderly and other family members. This intervention may have positive as well as negative effects. Problems and conflicts may arise in the interaction between the family members and between the family and the public help services (see McGoldrick & Gerson, 1989). We need more knowledge about these processes. In a research project1 the family and the home help services are studied as two organisations, which interact in the care of the elderly. We start with the hypothesis that the relation between the parties will have an impact on the character and quality of the care. We also think that the quality of the interaction will have an impact on the health and wellbeing of the elderly (see Olsson, 1991, 1998; Olsson & Ingvad, 1999)

Realizing the vision of a circular food system A policy dialogue on a sustainable bioeconomy in the 6resund region

This document reports the results of the fourth workshop run by the project "Policy Dialogues\ua0on a Bioeconomy for Sustainable Development". The project is co-financed by the Swedish Innovation Agency, Vinnova, and the SEI Governing Bioeconomy Pathways initiative. The overarching goal of the project is to facilitate a more constructive dialogue on the development of the global bioeconomy. There is a particular focus on analysing national and regional contexts in order to gain a better understanding of what is envisaged by a sustainable bioeconomy and the possible mechanisms for achieving bioeconomy-related goals