Acute Kidney Injury (AKI) is a prevalent systemic disorder that has an extremely high rate of mortality even after detection. Historically, the diagnosis and treatment of AKI was marred by the lack of universally accepted criteria defining AKI. Therefore, reports of incidence and mortality varied widely depending on location and the criteria used at the time, but all reports indicated a poor prognosis for the patient. Until recently, the only modes of detecting AKI were primarily through measurements of three clinical findings: serum creatinine concentration, blood urea nitrogen concentration, and urine output. While these measurements are still widely used as standard practice, they have limitations in their utility because their values can fluctuate depending on a person's age, gender, race, diet, and other comorbid conditions. Nevertheless, as these were the only universally accepted units of measurement for kidney function, the Acute Dialysis Quality Initiative (ADQI) used them to create the Risk, Injury, Failure, Loss, and End stage kidney disease (RIFLE) criteria to classify the severity of kidney injury across clinical settings. Eventually, modifications were made by the Acute Kidney Injury Network (AKIN) to increase the sensitivity of AKI diagnosis. It was not until the last decade that new biomarkers of kidney injury began to be researched that provided earlier detection of physical kidney injury before functional manifestations would present themselves. Some of these new biomarkers include cystatin C, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase associated lipocalin (NGAL). This study will investigate how the properties of these new biomarkers are superior when compared to those of serum creatinine in early detection of AKI and specification as to the local site of injury within the nephron. The conclusion is that cystatin C has the potential to indicate damage to glomerular filtration while KIM-1 and NGAL have the ability to indicate damage to the proximal tubule. Along with the ability to provide information as to the specific site of renal injury, the levels of cystatin C, KIM-1, and NGAL increase much more rapidly and to a much higher value than serum creatinine once physical renal damage has occurred. These characteristics along with future research will allow for earlier detection of AKI, more personalized treatment plans, and an overall better prognosis for the patient.

I detta arbete ville jag undersöka hur två gymnasielärare i svenska använde samtalsmetoden lösningsfokus i sina utvecklingssamtal. Jag observerade fem utvecklingssamtal vardera hos de båda lärarna, varpå jag intervjuade dem. Under observationerna såg jag att fokus överfördes till eleverna och de fick även huvudansvaret för sitt skolarbete. Intervjuerna kompletterade bilden och det blev tydligt vilka motiv lärarna hade för att använda lösningsfokus. Till exempel ansåg de att eleverna själva är experter på sitt eget skolarbete, samt på hur de kan arbeta för att nå sina mål. Efter mina undersökningar kunde jag dra slutsatsen att lärarna använder lösningsfokus i sina utvecklingssamtal, exempelvis genom att inte diskutera varför och hur problem har uppstått, utan istället fokusera på hur de kan lösas. Båda lärarna anser att det är ett bra verktyg som påverkar samtalen på ett positivt sätt, bland annat genom att eleven blir mer aktiv och formulerar sina egna lösningar. Lärarna känner också att det är skönt att ha en metod att utgå ifrån, då samtalsmetodik inte fått något nämnvärt utrymme i deras utbildning. / In this essay I wanted to look into how two teachers used solution focus in their development conversations. I observed five development conversations with each teacher, after which I interviewed the teachers. During the observations I saw that focus were transferred on to the students as well as the main responsibility for the students schoolwork. The interviews completed the picture and it became clear what motives the teachers had using solution focus. For example they believed that the students are experts in their own schoolwork and in how they can work to achieve their goals. After my surveys I came to the conclusion that the teachers use solution focus in their development conversations, by not discussing why, or how problems had occurred, but instead to focus on how they can be solved. Both teachers believe that solution focus is a commendable method that influences the conversations in a positive way. The students becomes more active and formulates their owns solutions for example. The teachers also feel that using a certain method provides a sense of security, as they didn’t study conversation methods during their teacher education.

No description available.

Introdução: A Poluição do ar e a inatividade física são dois importantes fatores de risco para saúde. Ainda não são bem conhecidos o balanço sobre os efeitos na saúde da realização de exercícios em ambientes poluídos. Objetivos: Avaliar o impacto da realização de exercício físico em ambientes com diferentes concentrações de poluentes sobre a toxicidade pulmonar, em marcadores sanguíneos e na função renal. Métodos: 40 soldados do exército brasileiro, não fumantes, saudáveis, do sexo masculino e praticantes de corrida de rua regulares foram avaliados. Participaram de corridas de 7,5 km todas as manhãs, a uma velocidade de 10 km/h, por uma semana em um circuito dentro de um Parque Florestal (PQ) e uma semana em um circuito em Vias Públicas (VP). Foram coletadas amostras de sangue e urina antes e depois da corrida em dois dias de cada semana, sendo determinados marcadores sanguíneos, de toxicidade pulmonar e da função renal. Os níveis de MP2,5 foram registrados durante todos os dias das semanas no período em que foram feitas as avaliações. Resultados: A concentração de MP2,5 no circuito PQ foi de 24 ug/m3 (IQR: 8-39) e no circuito VP de 62 ug/m3 (IQR: 37-103), P < 0,001. Trinta e nove participantes concluíram. Idade: 19 ± 1 anos, Índice de Massa Corpórea: 23,5 ± 2,38 kg/m2, Frequência cardíaca repouso: 69,1 ± 10,4 bpm. A concentração de proteína CC16 urinária aumentou após as corridas em ambos circuitos, mas de forma mais acentuada no circuito PQ. Marcadores sanguíneos e de função renal se alteraram após a corrida, sem diferenças significativas entre os circuitos. Conclusão: A realização de atividade física esteve relacionada à inflamação sistêmica e alteração da função renal, sem diferença entre os circuitos em diferentes ambientes. A proteína CC16, marcador de toxicidade e alteração de permeabilidade pulmonar foi o único que se elevou, com maior magnitude, no circuito localizado no interior de um parque. / Introduction: The Air pollution and physical inactivity are two important risk factors for health. The assessment of the health effects of exercising in polluted environments are still not well known. To assess the impact of performing physical exercise in environments with different concentrations of pollutants on lung toxicity in blood markers and renal function. Methods: 40 soldiers from the Brazilian army, non-smoking, healthy male and regular street runners were evaluated. Participated in races of 7.5 km every morning at a speed of 10 km/h, for a week in a circuit within a Forest Park (PK) and a week in a circuit in Public Ways (PS). Blood and urine samples were collected before and after running over two days each week, with certain blood markers, pulmonary toxicity and renal function. The levels of PM2.5 were recorded during every day of the week in the period they were made evaluations. Results: The concentration of the PM2.5 circuit PK was 24 ug/m3 (IQR: 8-39) and PS circuit 62 ug/m3 (IQR: 37-103), P < 0.001. Thirty-nine participants completed. Age: 19 ± 1 years, body mass index: 23.5 ± 2.38 kg/m2, resting heart rate: 69.1 ± 10.4 bpm. The concentration of urinary protein CC16 increased after the races on both circuits, but more sharply in the PK circuit. Blood markers and markers of renal function are altered after the run, with no significant differences between the circuits. Conclusion: Physical activity was related to the variation of the markers indicating inflammation and changes in renal function, with no difference between the environments except for the marker of pulmonary toxicity that increased with greater magnitude in the PK circuit

Introdução: Injúria Renal Aguda (IRA) é uma patologia grave e com elevada incidência em pacientes críticos. Apesar do avanço no conhecimento fisiopatológico ocorrido nas últimas décadas, pouco desse conhecimento foi traduzido em terapia para IRA já instalada. Medidas preventivas para evitar a progressão da IRA em momentos iniciais da injúria continuam a ser o principal foco na terapia da IRA. Nesse contexto, o diagnóstico e determinação precoce da gravidade da injúria renal são fundamentais para evitar a progressão para estágios mais graves e diminuir a morbidade e a mortalidade associadas à síndrome. Objetivos: O objetivo principal deste estudo, foi avaliar se o padrão de elevação dos biomarcadores permite a detecção precoce do diagnóstico de IRA. E os objetivos secundários foram avaliar se os biomarcadores podem auxiliar na predição da gravidade da IRA, na necessidade de diálise e óbito. Métodos: Estudo prospectivo, unicêntrico, entre janeiro de 2012 e janeiro de 2015. Foram avaliados e incluídos pacientes com critérios de alto risco para IRA nas Unidades de Terapia Intensiva (UTI) clínicas e cirúrgicas. Características clínicas e demográficas foram avaliadas no início da internação e a evolução laboratorial e hemodinâmica dos pacientes foram acompanhadas durante as primeiras 48 horas de internação na UTI. Os biomarcadores precoces de injuria renal aguda séricos e urinários, assim como a bioquímica e microscopia urinária, foram analisados a cada 12 horas durante este período. IRA foi definida pelo critério da creatinina do KDIGO. Episódios de IRA com resolução em 3 dias foram definidos como transitória (IRAt) e episódios com duração maior que 3 dias como persistente (IRAp). Resultados: Durante o período estudado foram avaliados 376 pacientes, dos quais 70 preencheram os critérios de inclusão e 32 (46%) evoluiram com IRA. Noventa porcento dos pacientes incluídos no estudo foram pacientes em pós-operatorio. Não houve diferença nas características basais entre os grupos com IRA e sem IRA. A fração de excreção de sódio (FENa) foi maior no grupo com IRAp à admissão, entretanto foi menor que 1% em todos os grupos. O gradiente transtubular de potássio (TTKG) foi significativamente maior no 4º e 5º momentos no grupo com IRAp quando comparado aos outros grupos. Os níveis de Neutrophil Gelatinase-Associated Lipocalin (NGAL), tanto séricos como urinários foram significativamente maiores no grupo com IRAp em relação ao grupo IRAt e não IRA, assim como Liver-type Fatty Acid-Binding Protein (L-FABP) e o Kidney Injury Molecule-1 (KIM-1). Não se constatou diferença significativa entre os grupos em relação ao Tissue Inhibitor of Metalloproteinases-1 (TIMP-1), alfa e pi-Glutathione-transferase (alfa- GST e pi-GST). Entre os pacientes com diagnóstico de IRA pela creatinina sérica nos primeiros 2 dias de UTI, o emprego do NGAL sérico e/ou urinário possibilitaram o diagnóstico mais precoce da IRA em relação à creatinina em 59,3 % e 27,6% dos pacientes, respectivamente. O NGAL sérico e urinário foram preditores independentes de mortalidade e de necessidade de terapia de substituição renal à análise multivariada. Conclusão: Na IRA persistente a bioquímica urinária apresentou diferenças em relação à FENa e ao TTKG. A performance do NGAL sérico e urinário nesta população conseguiu antecipar o diagnóstico da IRA em relação ao critério da creatinina. O NGAL sérico e urinário foram preditores independentes de necessidade de terapia de substituição renal e mortalidade / Background: Acute kidney injury (AKI) is a syndrome with high incidence in critical ill patients and associated with severe complications. Although important advances has been achieved in the understanding of its physiopathology, this knowledge have not resulted in improvements in therapy for AKI. Preventive measures to avoid AKI progress at the initial phases of injury are still the main goal of AKI therapy. Therefore, early diagnosis and assessment of disease severity are essential to prevent disease progression and to reduce morbidity and mortality. Objectives: The main goal of this study was to evaluate whether a panel of biomarkers would allow early detection of AKI. Secondary endpoints were to evaluate whether biomarkers can predict the severity of AKI, need for dialysis and mortality in high-risk critical ill patients. Methods: We performed a prospective study between January 2012 and 2015. We recruited patients admitted in intensive care unit (ICU) with high risk for AKI. Clinical and demographic characteristics were recorded. Urinary biomarkers and urine biochemistry were measured sequentially every 12 hours during the first two days of ICU stay. AKI was defined according to KDIGO creatinine criteria. Patients were classified as having transitory AKI (tAKI) or persistent AKI (pAKI). Results: Of the 376 patients initially evaluated, 70 met the inclusion criteria. Thirty-two patients (46 %) met KDIGO criteria for AKI. Ninety percent of the patients in this study were surgical. The baseline characteristics were similar among all groups. The fractional excretion of sodium (FENa) was higher in pAKI group, and it was < 1% in all groups. In patients who developed pAKI the transtubular potassium gradient (TTKG) was significantly higher at 36h and 48h. Plasma and urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Liver-type Fatty Acid-Binding Protein (L-FABP) and Kidney Injury Molecule-1 (KIM-1) were significantly higher in the pAKI group as compared to the t AKI and non AKI groups in different times of evaluation. There was no difference in levels of Tissue Inhibitor of Metalloproteinases-1 (TIMP-1), alfa and pi-Glutathione-transferase (alfa-GST and pi-GST) within the groups during the first 48 h of ICU admission. Based on the cutoff levels, plasma and urinary NGAL would determine earlier diagnosis in 59.3% and 27.6% patients in the first two days of ICU, respectively. In the multivariate analysis, plasma and urinary NGAL were independent predictors of need for dialysis and mortality. Conclusions: In this study population, persistent AKI have alterations in urinary physicochemical parameters such as FENa and TTKG. Plasma and urinary NGAL were early biomarkers for AKI diagnosis. Plasma and urinary NGAL were independent predictors of dialysis and mortality

The purpose of this study was to examine how a Danish &amp; Swedish newspaper reported in their news articles regarding the same perpetrator and to see if there were any differences. The perpetrator in this case was Danish, while the victim was Swedish. This was the main reason for us choosing a newspaper from each country. We examined what discourses were used for the perpetrator and analyzed both similarities and differences between the two newspapers in their descriptions. We did this by thoroughly examining each article, one at a time, dissected each sentence and analyzed it. The study answered the following question: How do Danish &amp; Swedish news outlets construct the same perpetrator? This was answered by dividing it into two more detailed questions. How is the perpetrator manufactured in Danish/Swedish crime journalism? Which attributes are given to the perpetrator in both newspapers? We used a critical discourse analysis as our method for examining the 8 articles in total (4 from each newspaper) Our conclusion of the study shows that there are several similarities in the way the discourses are constructed around the perpetrator, often focusing on the morbid details. There are however equally big differences in the way that the specific discourses are described. Danish media focuses more on the direct quotes from the perpetrator, while the Swedish media empathises more on circumstances surrounding him. The two newspapers we chose are two of the major newspaper in respective country, Ekstrabladet &amp; Aftonbladet.

Introdução: A Poluição do ar e a inatividade física são dois importantes fatores de risco para saúde. Ainda não são bem conhecidos o balanço sobre os efeitos na saúde da realização de exercícios em ambientes poluídos. Objetivos: Avaliar o impacto da realização de exercício físico em ambientes com diferentes concentrações de poluentes sobre a toxicidade pulmonar, em marcadores sanguíneos e na função renal. Métodos: 40 soldados do exército brasileiro, não fumantes, saudáveis, do sexo masculino e praticantes de corrida de rua regulares foram avaliados. Participaram de corridas de 7,5 km todas as manhãs, a uma velocidade de 10 km/h, por uma semana em um circuito dentro de um Parque Florestal (PQ) e uma semana em um circuito em Vias Públicas (VP). Foram coletadas amostras de sangue e urina antes e depois da corrida em dois dias de cada semana, sendo determinados marcadores sanguíneos, de toxicidade pulmonar e da função renal. Os níveis de MP2,5 foram registrados durante todos os dias das semanas no período em que foram feitas as avaliações. Resultados: A concentração de MP2,5 no circuito PQ foi de 24 ug/m3 (IQR: 8-39) e no circuito VP de 62 ug/m3 (IQR: 37-103), P < 0,001. Trinta e nove participantes concluíram. Idade: 19 ± 1 anos, Índice de Massa Corpórea: 23,5 ± 2,38 kg/m2, Frequência cardíaca repouso: 69,1 ± 10,4 bpm. A concentração de proteína CC16 urinária aumentou após as corridas em ambos circuitos, mas de forma mais acentuada no circuito PQ. Marcadores sanguíneos e de função renal se alteraram após a corrida, sem diferenças significativas entre os circuitos. Conclusão: A realização de atividade física esteve relacionada à inflamação sistêmica e alteração da função renal, sem diferença entre os circuitos em diferentes ambientes. A proteína CC16, marcador de toxicidade e alteração de permeabilidade pulmonar foi o único que se elevou, com maior magnitude, no circuito localizado no interior de um parque. / Introduction: The Air pollution and physical inactivity are two important risk factors for health. The assessment of the health effects of exercising in polluted environments are still not well known. To assess the impact of performing physical exercise in environments with different concentrations of pollutants on lung toxicity in blood markers and renal function. Methods: 40 soldiers from the Brazilian army, non-smoking, healthy male and regular street runners were evaluated. Participated in races of 7.5 km every morning at a speed of 10 km/h, for a week in a circuit within a Forest Park (PK) and a week in a circuit in Public Ways (PS). Blood and urine samples were collected before and after running over two days each week, with certain blood markers, pulmonary toxicity and renal function. The levels of PM2.5 were recorded during every day of the week in the period they were made evaluations. Results: The concentration of the PM2.5 circuit PK was 24 ug/m3 (IQR: 8-39) and PS circuit 62 ug/m3 (IQR: 37-103), P < 0.001. Thirty-nine participants completed. Age: 19 ± 1 years, body mass index: 23.5 ± 2.38 kg/m2, resting heart rate: 69.1 ± 10.4 bpm. The concentration of urinary protein CC16 increased after the races on both circuits, but more sharply in the PK circuit. Blood markers and markers of renal function are altered after the run, with no significant differences between the circuits. Conclusion: Physical activity was related to the variation of the markers indicating inflammation and changes in renal function, with no difference between the environments except for the marker of pulmonary toxicity that increased with greater magnitude in the PK circuit

The aim of this bachelor thesis was to examine how news journalism represented the two swedish journalists Kim Wall and Nils Horner, when describing their posthumous reputation after they were murdered during assignments. The research questions examined were: How does the journalism, in describing their posthumous reputations, portray the story of Kim Wall, and Nils Horner? What differences and similarities can be found in how they are portrayed as journalists, and as victims? We used Faircloughs critical discourse analysis (CDA) to find reoccurring discourses in the description of Horner and Wall. By examining the characteristics they were assigned and what conclusions the audience were offered to draw about their journalistic competence and about them as victims of murder, we found many similarities between Horner and Wall. They are both described as exceptionally competent. They are also portrayed as born with a “calling” towards the journalistic profession, and in both cases, they are ascribed with next to supernatural characteristics. As victims of murder we found them to be portrayed as idealistic, with some variations in relation to the description of the content of their character, and where the murder took place. Our study shows that the discourses we found contribute to the creation of heroic myths in the news journalisms description of them. They are elevated, and our conclusion is that by elevating their murdered colleagues as heroes, the news journalists are also elevating themselves and, in turn, the journalistic profession.

No description available.

Introdução: Injúria Renal Aguda (IRA) é uma patologia grave e com elevada incidência em pacientes críticos. Apesar do avanço no conhecimento fisiopatológico ocorrido nas últimas décadas, pouco desse conhecimento foi traduzido em terapia para IRA já instalada. Medidas preventivas para evitar a progressão da IRA em momentos iniciais da injúria continuam a ser o principal foco na terapia da IRA. Nesse contexto, o diagnóstico e determinação precoce da gravidade da injúria renal são fundamentais para evitar a progressão para estágios mais graves e diminuir a morbidade e a mortalidade associadas à síndrome. Objetivos: O objetivo principal deste estudo, foi avaliar se o padrão de elevação dos biomarcadores permite a detecção precoce do diagnóstico de IRA. E os objetivos secundários foram avaliar se os biomarcadores podem auxiliar na predição da gravidade da IRA, na necessidade de diálise e óbito. Métodos: Estudo prospectivo, unicêntrico, entre janeiro de 2012 e janeiro de 2015. Foram avaliados e incluídos pacientes com critérios de alto risco para IRA nas Unidades de Terapia Intensiva (UTI) clínicas e cirúrgicas. Características clínicas e demográficas foram avaliadas no início da internação e a evolução laboratorial e hemodinâmica dos pacientes foram acompanhadas durante as primeiras 48 horas de internação na UTI. Os biomarcadores precoces de injuria renal aguda séricos e urinários, assim como a bioquímica e microscopia urinária, foram analisados a cada 12 horas durante este período. IRA foi definida pelo critério da creatinina do KDIGO. Episódios de IRA com resolução em 3 dias foram definidos como transitória (IRAt) e episódios com duração maior que 3 dias como persistente (IRAp). Resultados: Durante o período estudado foram avaliados 376 pacientes, dos quais 70 preencheram os critérios de inclusão e 32 (46%) evoluiram com IRA. Noventa porcento dos pacientes incluídos no estudo foram pacientes em pós-operatorio. Não houve diferença nas características basais entre os grupos com IRA e sem IRA. A fração de excreção de sódio (FENa) foi maior no grupo com IRAp à admissão, entretanto foi menor que 1% em todos os grupos. O gradiente transtubular de potássio (TTKG) foi significativamente maior no 4º e 5º momentos no grupo com IRAp quando comparado aos outros grupos. Os níveis de Neutrophil Gelatinase-Associated Lipocalin (NGAL), tanto séricos como urinários foram significativamente maiores no grupo com IRAp em relação ao grupo IRAt e não IRA, assim como Liver-type Fatty Acid-Binding Protein (L-FABP) e o Kidney Injury Molecule-1 (KIM-1). Não se constatou diferença significativa entre os grupos em relação ao Tissue Inhibitor of Metalloproteinases-1 (TIMP-1), alfa e pi-Glutathione-transferase (alfa- GST e pi-GST). Entre os pacientes com diagnóstico de IRA pela creatinina sérica nos primeiros 2 dias de UTI, o emprego do NGAL sérico e/ou urinário possibilitaram o diagnóstico mais precoce da IRA em relação à creatinina em 59,3 % e 27,6% dos pacientes, respectivamente. O NGAL sérico e urinário foram preditores independentes de mortalidade e de necessidade de terapia de substituição renal à análise multivariada. Conclusão: Na IRA persistente a bioquímica urinária apresentou diferenças em relação à FENa e ao TTKG. A performance do NGAL sérico e urinário nesta população conseguiu antecipar o diagnóstico da IRA em relação ao critério da creatinina. O NGAL sérico e urinário foram preditores independentes de necessidade de terapia de substituição renal e mortalidade / Background: Acute kidney injury (AKI) is a syndrome with high incidence in critical ill patients and associated with severe complications. Although important advances has been achieved in the understanding of its physiopathology, this knowledge have not resulted in improvements in therapy for AKI. Preventive measures to avoid AKI progress at the initial phases of injury are still the main goal of AKI therapy. Therefore, early diagnosis and assessment of disease severity are essential to prevent disease progression and to reduce morbidity and mortality. Objectives: The main goal of this study was to evaluate whether a panel of biomarkers would allow early detection of AKI. Secondary endpoints were to evaluate whether biomarkers can predict the severity of AKI, need for dialysis and mortality in high-risk critical ill patients. Methods: We performed a prospective study between January 2012 and 2015. We recruited patients admitted in intensive care unit (ICU) with high risk for AKI. Clinical and demographic characteristics were recorded. Urinary biomarkers and urine biochemistry were measured sequentially every 12 hours during the first two days of ICU stay. AKI was defined according to KDIGO creatinine criteria. Patients were classified as having transitory AKI (tAKI) or persistent AKI (pAKI). Results: Of the 376 patients initially evaluated, 70 met the inclusion criteria. Thirty-two patients (46 %) met KDIGO criteria for AKI. Ninety percent of the patients in this study were surgical. The baseline characteristics were similar among all groups. The fractional excretion of sodium (FENa) was higher in pAKI group, and it was < 1% in all groups. In patients who developed pAKI the transtubular potassium gradient (TTKG) was significantly higher at 36h and 48h. Plasma and urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL), Liver-type Fatty Acid-Binding Protein (L-FABP) and Kidney Injury Molecule-1 (KIM-1) were significantly higher in the pAKI group as compared to the t AKI and non AKI groups in different times of evaluation. There was no difference in levels of Tissue Inhibitor of Metalloproteinases-1 (TIMP-1), alfa and pi-Glutathione-transferase (alfa-GST and pi-GST) within the groups during the first 48 h of ICU admission. Based on the cutoff levels, plasma and urinary NGAL would determine earlier diagnosis in 59.3% and 27.6% patients in the first two days of ICU, respectively. In the multivariate analysis, plasma and urinary NGAL were independent predictors of need for dialysis and mortality. Conclusions: In this study population, persistent AKI have alterations in urinary physicochemical parameters such as FENa and TTKG. Plasma and urinary NGAL were early biomarkers for AKI diagnosis. Plasma and urinary NGAL were independent predictors of dialysis and mortality