Konsekvenser av rollövertagandet : ”I”, ”me” och individualiteten

Consequences of role taking: the ”I”, the ”me” and individuality This paper analyzes the tendency of taking the ”I” and the ”me” in G. H. Meads theory of role taking as two separate, qualitatively different parts of human personality, the ”I” being of individual origin, the ”me” of social. In the original Meadian sense role taking gives rise to both the ”I” and the ”me”. They are dialectically united rather than dualistically separated aspects. They refer to the joint functional power of the subject, finding itself as an object, mediated by the Other. As a consequence, the link between body and the social world becomes theoretically more stringent, as the body is given its place as a cognitive social object among others, this by contrast to interpretations where the body is left as an object mainly outside the human social experience and as a source of agency sui generis, a conception which is in opposition to Meads. The stress on the ”I”-phase, as related to body and concrete action in combination with its direct relation to the ”me”-phase, actualizes Mead as a forerunner in modern biologic/neurologic research on human perceptual, motivational and intentional capacity.Swedish Mead interpreters are critically analyzed. Interpretations of Charon, Giddens, Joas and Habermas are partly scrutinized. The author defines the conceptual pair in terms of activity, subjectivity, temporal relativity and distance.

The kidney in different stages of the cardiovascular continuum

Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. The complex, interaction between the kidney and the cardiovascular system is incompletely understood, particularly at the early stages of the cardiovascular continuum. The overall aim of this thesis was to clarify novel aspects of the interplay between the kidney and the cardiovascular system at different stages of the cardiovascular continuum; from risk factors such as insulin resistance, inflammation and oxidative stress, via sub-clinical cardiovascular damage such as endothelial dysfunction and left ventricular dysfunction, to overt cardiovascular death. This thesis is based on two community-based cohorts of elderly, Uppsala Longitudinal Study of Adult Men (ULSAM) and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). The first study, show that higher insulin sensitivity, measured with euglycemic-hyperinsulinemic clamp technique was associated to improve estimated glomerular filtration rate (eGFR) in participants with normal fasting plasma glucose, normal glucose tolerance and normal eGFR. In longitudinal analyses, higher insulin sensitivity at baseline was associated with lower risk of impaired renal function during follow-up. In the second study, eGFR was inversely associated with different inflammatory markers (C-reactive protein, interleukin-6, serum amyloid A) and positively associated with a marker of oxidative stress (urinary F2-isoprostanes). In line with this, the urinary albumin/creatinine ratio was positively associated with these inflammatory markers, and negatively associated with oxidative stress. In study three, higher eGFR was associated with better endothelial function as assessed by the invasive forearm model. Further, in study four, higher eGFR was significantly associated with higher left ventricular systolic function (ejection fraction). The 5th study of the thesis shows that higher urinary albumin excretion rate (UAER) and lower eGFR was independently associated with an increased risk for cardiovascular mortality. Analyses of global model fit, discrimination, calibration, and reclassification suggest that UAER and eGFR add relevant prognostic information beyond established cardiovascular risk factors in participants without prevalent cardiovascular disease. Conclusion: this thesis show that the interaction between the kidney and the cardiovascular system plays an important role in the development of cardiovascular disease and that this interplay begins at an early asymptomatic stage of the disease process.