Quantum Resonances in a Complex-Momentum Basis

Resonances are important features of open quantum systems. We study, in particular, unbound and loosely bound nuclear systems. We model 5He and 6He in a few-body picture, consisting of an alpha-particle core with one and two valence neutrons respectively. Basis-expansion theory is briefly explained and then used to expand the nuclear system in the harmonic oscillator and momentum bases. We extend the momentum basis into the complex plane, obtaining solutions that form a Berggren basis. With the complex-momentum method we are able to reproduce experimentally observed resonances in 5He. The 5He Berggren basis solutions are used as a single-particle basis to create many-body states in which we expand the 6He system. For the two-body interaction between the neutrons, we use two different phenomenological models: a Gaussian and a Surface Delta Interaction (SDI). The strength of each interaction is fitted to reproduce the 6He ground state energy. With the Gaussian interaction we do not obtain the 6He resonance, whereas with the SDI we do. The relevant parts of the second quantization formalism is summarized, and we briefly discuss a possible implementation

Suspicion and treatment of severe sepsis. An overview of the prehospital chain of care

Sepsis is a life-threatening condition where the risk of death has been reported to be even higher than that associated with the major complications of atherosclerosis, i.e. myocardial infarction and stroke. In all three conditions, early treatment could limit organ dysfunction and thereby improve the prognosis

Väntan på en somatisk akutmottagning : utifrån sjuksköterskans perspektiv

Background: To wait on an emergency department is a reflected and well-documented problem. Thou it´s mainly due to a patient perspective should also nurses' perspectives be significant to obtain a faceted perception of the phenomenon. Aim: The purpose of this study was to describe how nurses perceive the phenomenon of anticipation of a somatic emergency department. Method: The analysis was performed using a phenomenological approach. The study was conducted in a medium-sized hospital in southern Sweden, during the latter part of 2005, and had a qualitative approach based on a lifeworld perspective. Data collection consisted of written stories from twelve nurses. Results: The results indicated that the waiting was the scene of the expectations. These expectations led to dilemmas, powerlessness and frustration, the more the phenomenon was allowed to stand. It also found that nurses' experience of powerlessness, combined with her responsibility for the patient's welfare was a paradox, ie. an absurdity, yet a truth. The work environment was marked by threats of violence but also by the feeling of inadequacy. Conclusion: Overall, a caring suffering emerged. This prevented the nurses to care for as she wished. The result can be viewed as a basis for improvement in emergency departmen

Väntan på en somatisk akutmottagning : utifrån sjuksköterskans perspektiv

Background: To wait on an emergency department is a reflected and well-documented problem. Thou it´s mainly due to a patient perspective should also nurses' perspectives be significant to obtain a faceted perception of the phenomenon. Aim: The purpose of this study was to describe how nurses perceive the phenomenon of anticipation of a somatic emergency department. Method: The analysis was performed using a phenomenological approach. The study was conducted in a medium-sized hospital in southern Sweden, during the latter part of 2005, and had a qualitative approach based on a lifeworld perspective. Data collection consisted of written stories from twelve nurses. Results: The results indicated that the waiting was the scene of the expectations. These expectations led to dilemmas, powerlessness and frustration, the more the phenomenon was allowed to stand. It also found that nurses' experience of powerlessness, combined with her responsibility for the patient's welfare was a paradox, ie. an absurdity, yet a truth. The work environment was marked by threats of violence but also by the feeling of inadequacy. Conclusion: Overall, a caring suffering emerged. This prevented the nurses to care for as she wished. The result can be viewed as a basis for improvement in emergency departmen

Förberedd på att vara oförberedd : En fenomenologisk studie av vårdande bedömning och dess lärande i ambulanssjukvård

Wireklint Sundström, Birgitta, 2005. Prepared to be unprepared. A phenomeno-logical study of assessment with a caring approach and how it can be learned in the ambulance services.A focal point in this dissertation is that there is knowledge in the ambulance ser-vice that is experience-based, which has not always been made explicit, and that provides the foundation for the caregivers’ assessment of the patients and their needs for care. The first aim of the study was to describe and analyse the ambu-lance services with a focus on the phenomenon of assessment from the lifeworld perspective in the caring sciences. The second aim of the study was of an educa-tional nature where the object was to be able to draw conclusions about the learning process in the ambulance service in the light of the knowledge generat-ed by the empirical findings. Thus the aim was to create a synthesis consisting of didactic ideas that are based on the caring sciences and describing how assess-ment can be learnt and can support future caregivers in the ambulance services.Assessment in the ambulance service entails, on an overall level, having a natu-ral caring attitude that includes striving in two directions at the same time. These are that on the one hand the caregivers strive to bring order to that which is dis-ordered as soon as possible, to structure the unstructured, and in short define the indefinite in order to provide medical assistance. There is a need to quickly as-sess the patient’s condition and which measures are necessary. On the other hand the caregivers strive to let the indefinite wait a while in order to be able to meet the patient’s suffering. There is thus a desire to listen attentively to the individual patient.The essential meaning of assessment of patients in the ambulance services is that there are conflicting demands on assessment and care, which entails that the caregiver adapts him/herself to the prevailing care situation in a way that means being flexible and adaptable to the patient’s medical condition. The caregivers also have a flexibility and adaptability in relation to their colleague, which leads to a mutual interplay in the assessment. Assessment in the ambulance services also means that the caregivers are paradoxically prepared at the same time as be-ing unprepared, i.e. they are prepared for the unprepared. The assessment thus starts before the caregivers have reached the patient and the actual situation. Even if they “know” what awaits them, they do not really “know”. It becomes a dynamic struggle between on the one side the expectancy that feels certain and on the other the unknown in every new situation. The struggle contains a desire for control and effectiveness in a care practice full of surprises.Kunskapscentrum PreHospen vid Högskolan i Borås, Institutionen för vårdvetenskap

Emergency Department Triage in Sweden : Occurrence, Validity, Reliability and Registered Nurses' Experiences

Aim: The overall aim was to explore Emergency Department triage in Swedenthrough a specific focus on the Swedish triage system, RETTS© and RegisteredNurses’ experience of triage. Methods: Study I was a cross-sectional, prospective, national survey. Fiftyone(75%) EDs completed a digital questionnaire about triage and triage relatedwork. Study II was longitudinal, retrospective, register-based. In total 74,845patient ED visits were extracted, two annual cohorts from two EDs. Study IIIwas cross-sectional, 28 RNs from two EDs allocated triage levels on 46authentic patient scenarios. Study IV was descriptive, inductive, based on semistructuredinterviews with 14 RNs representing different parts of Sweden andlevels of hospitals. Descriptive (I, II, III), inferential (II), kappa statics (III), andinductive content analyses (IV) were applied. Results: Triage is firmly implemented in Swedish EDs and the Swedish triagesystem, RETTS© is the most commonly applied system but with variation on howRETTS© is applied or taught. RETTS© demonstrated no statistically significantdifference between the annual upgrades regarding ten-day and 72-hour mortality,but for admission to intensive care unit (ICU). Statistically significant differencewas demonstrated for mortality when data was adjusted for gender, age andcomorbidity. There was a statistically significant difference between the triagelevels for all outcomes. An inability to distinguish between stable/unstable patientwas demonstrated when 21/46 scenarios were triaged over this boundary. RETTS©reliability was moderate with κ=0.562. Furthermore, the RNs experience of triagewas described as A Balancing Act of an Ambiguous Assignment, a movementbetween uncomplicated and complex assessments performed with visible andimplicit prerequisites and in time perspectives that is both unpredictable andpredictable. Conclusion: Triage is performed in the majority of Swedish EDs and RETTS© isthe most commonly applied triage system, however, without a unanimous approach.The annual upgrade of RETTS© do not improve the ability to identify risk for shorttermmortality, but for admission to ICU. Furthermore, RETTS© reliability wasmoderate, and the RNs considered triage as a balancing act, a performance that hasto result in a safe assessment of the patient’s needs