17 research outputs found
Foreldres indre dialoger under nettverkssamtaler
Denne kvalitative studien har hatt som formÄl Ä utforske og beskrive foreldres indre dialoger under nettverkssamtaler. Det er tatt utgangspunkt i filmopptak fra tre samtaler der ungdom, foreldre og deres terapeuter deltok. Data ble innhentet ved hjelp av intervju med foreldrene i etterkant av nettverkssamtalene, der de spesifikt fikk spÞrsmÄl om deres tanker, fÞlelser og opplevelser under samtalene. Studien er basert pÄ Jaakko Seikkula og Peter Rober sin anvendelse av Mikhail Bakhtins teorier om dialog og dialogisme, anvendt i en terapeutisk praksis.
Alle foreldrene ga uttrykk for mange indre dialoger under nettverkssamtalene. Det kan tyde pĂ„ at indre dialoger i stĂžrre grad var knyttet til tema i den ytre samtalen ved dialogiske dialoger, sammenlignet med i monologiske dialoger. Videre sĂ„ det ut til at foreldrenes indre dialoger samsvarte mer med det som ble uttrykt verbalt i den ytre samtalen ved dialogiske dialoger, sett i forhold til ved monologiske dialoger. Funn i studien kan underbygge Bakhtins teorier om at dialogiske dialoger kan Ă„pne opp for polyfoni av bĂ„de indre og ytre âstemmerâ. Videre at respons eller svar pĂ„ utsagn er av betydning for om dialogen blir dialogisk eller monologisk. Foreldrenes beskrivelser kan tolkes dit hen at monologiske dialoger er betydningsfulle under nettverkssamtalene
Er det forskjell i behandlingsresultat mellom pasienter som besvarer spĂžrreskjema om utfall etter nakkekirurgi og pasienter som ikke gjĂžr det?
Bakgrunn og formÄl:
Oppgaven er en valideringsstudie basert pÄ data fra Nasjonalt kvalitetsregister for rygg- og nakkekirurgi (NKR). Validiteten til kvalitetsregistre er avhengig av tilstrekkelig hÞy responsrate for at konklusjonene som trekkes angÄende effekt av en behandling skal vÊre korrekte. FormÄlet med studien er Ä analysere om det er forskjell i behandlingsresultat mellom pasienter som besvarer oppfÞlgingsskjema per post ett Är etter nakkekirurgi, og pasienter som ikke gjÞr det. Samtidig vil vi identifisere prediktorer for Ä ikke respondere.
Metode:
Totalt ble 334 pasienter som fortlÞpende ble operert for degenerative nakkelidelser ved ti norske sykehus inkludert i studien. 238 av disse responderte pÄ standard oppfÞlging med spÞrreskjema per post. Vi forsÞkte Ä komme i kontakt med de 96 pasientene som ikke reponderte for Ä gjennomfÞre et strukturert telefonintervju. UtfallsmÄlene var forbedring i armsmerte, nakkesmerte, helserelatert livskvalitet (EQ-5D-3L), samt pasientrapportert nytte av operasjonen.
Resultat:
Vi fant ingen signifikante forskjeller i utfall mellom respondentene (71,3 % av pasientene) og telefonrespondentene (18,9 % av pasientene). 33 pasienter var utilgjengelig for oppfĂžlging (9,9 % av pasientene). En stĂžrre andel av telefonrespondentene rapporterte om komplikasjoner etter tolv mĂ„neder, men tre mĂ„neders data viste ingen forskjell i andel komplikasjoner mellom gruppene. Multivariat analyse viste at lavere alder (OR 0,96, 95 % KI 0,93 â 0,98 per Ă„r), annet morsmĂ„l enn norsk (OR 2,96, 95 % KI 1,37 â 6,41) og tidligere nakkoperasjon (OR 1,91, 95 % KI 1,05-3,50) var assosiert med Ăžkt sannsynlighet for Ă„ ikke respondere pĂ„ den ordinĂŠre oppfĂžlgingen.
Konklusjon:
Vi fant ingen forskjell i behandlingsresultat mellom respondenter og telefonrespondenter 12 mÄneder etter nakkekirurgi. En andel pÄ 29% som ikke responderer pÄ oppfÞlging etter nakkekirurgi fÞrer ikke til at det trekkes feil konklusjoner angÄende behandlingseffekt
Non-respondents do not bias outcome assessment after cervical spine surgery: a multicenter observational study from the Norwegian registry for spine surgery (NORspine)
Background - The Norwegian registry for spine surgery (NORspine) is a national clinical quality registry which has recorded more than 10,000 operations for degenerative conditions of the cervical spine since 2012. Registries are large observational cohorts, at risk for attrition bias. We therefore aimed to examine whether clinical outcomes differed between respondents and non-respondents to standardized questionnaire-based 12-month follow-up.
Methods - All eight public and private providers of cervical spine surgery in Norway report to NORspine. We included 334 consecutive patients who were registered with surgical treatment of degenerative conditions in the cervical spine in 2018 and did a retrospective analysis of prospectively collected register data and data on non-respondentsâ outcomes collected by telephone interviews. The primary outcome measure was patient-reported change in arm pain assessed with the numeric rating scale (NRS). Secondary outcome measures were change in neck pain assessed with the NRS, change in health-related quality of life assessed with EuroQol 5 Dimensions (EQ-5D), and patientsâ perceived benefit of the operation assessed by the Global Perceived Effect (GPE) scale.
Results - At baseline, there were few and small differences between the 238 (71.3%) respondents and the 96 (28.7%) non-respondents. We reached 76 (79.2%) non-respondents by telephone, and 63 (65.6%) consented to an interview. There was no statistically significant difference between groups in change in NRS score for arm pain (3.26 (95% CI 2.84 to 3.69) points for respondents and 2.77 (1.92 to 3.63) points for telephone interviewees) or any of the secondary outcome measures.
Conclusions - The results indicate that patients lost to follow-up were missing at random. Analyses of outcomes based on data from respondents can be considered representative for the complete register cohort, if patient characteristics associated with attrition are controlled for
Sykepleierstudenters erfaringer med etterlevelse av hÄndhygieniske prinsipper i kliniske praksisstudier : En kvalitativ studie
A significant part of the nurseâs education takes place in the clinical studies, supervised by nurse`s. This study has been conducted to hear the student's experiences, how they learn the adherence to hand hygienic principles in clinical studies. We used a descriptive and exploratory design with focus group interviews. The data were analysed using qualitative content analysis. The analysis resulted in two main topics, factors that promoted and inhibited student learning. Clear guidelines, procedures and feedback from supervisors, promoted learning. Lack of hand hygiene facilities, time pressures, complex learning situations in adequate recognition and the supervisors' non-compliance were inhibitory factors. Supportive and encouraging feedback from the tutors were positive factors for student learning. The study shows that nurses in clinical practice were a role model for students and important to learn the correct hand hygienic principles in clinical practice.En betydelig del av sykepleierutdanningen foregĂ„r i de kliniske studiene, veiledet av sykepleiere. Denne studien er utfĂžrt for Ă„ forstĂ„ studentopplevelsene, hvordan de lĂŠrer Ă„ bruke hĂ„ndhygieniske prinsipper i kliniske studier. Vi brukte et beskrivende og utforskende design med fokusgruppeintervjuer. Dataene ble analysert ved hjelp av kvalitativ innholdsanalyse. Analysen resulterte i to hovedtemaer, bĂ„de faktorer som fremmet og hemmet studentlĂŠring. Tydelige retningslinjer prosedyrer samt stĂžttende og oppmuntrende tilbakemeldinger fra veiledere fremmet lĂŠring. Mangel pĂ„ hĂ„ndhygienefasiliteter, tidspress, komplekse lĂŠringssituasjoner, tilstrekkelig anerkjennelse og veiledernes manglende overholdelse, var hemmende faktorer. Studien viser at sykepleiere i klinisk praksis var forbilder for studentene og viktig for Ă„ lĂŠre de riktige hĂ„ndhygieniske prinsipper i klinisk praksi
Intake of farmed Atlantic salmon fed soybean oil increases insulin resistance and hepatic lipid accumulation in mice
BACKGROUND: To ensure sustainable aquaculture, fish derived raw materials are replaced by vegetable ingredients. Fatty acid composition and contaminant status of farmed Atlantic salmon (Salmo salar L.) are affected by the use of plant ingredients and a spillover effect on consumers is thus expected. Here we aimed to compare the effects of intake of Atlantic salmon fed fish oil (FO) with intake of Atlantic salmon fed a high proportion of vegetable oils (VOs) on development of insulin resistance and obesity in mice. METHODOLOGY/PRINCIPAL FINDINGS: Atlantic salmon were fed diets where FO was partly (80%) replaced with three different VOs; rapeseed oil (RO), olive oil (OO) or soy bean oil (SO). Fillets from Atlantic salmon were subsequently used to prepare Western diets (WD) for a mouse feeding trial. Partial replacement of FO with VOs reduced the levels of polychlorinated biphenyls (PCB) and dichloro-diphenyl-tricloroethanes (DDT) with more than 50% in salmon fillets, in WDs containing the fillets, and in white adipose tissue from mice consuming the WDs. Replacement with VOs, SO in particular, lowered the n-3 polyunsaturated fatty acid (PUFA) content and increased n-6 PUFA levels in the salmon fillets, in the prepared WDs, and in red blood cells collected from mice consuming the WDs. Replacing FO with VO did not influence obesity development in the mice, but replacement of FO with RO improved glucose tolerance. Compared with WD-FO fed mice, feeding mice WD-SO containing lower PCB and DDT levels but high levels of linoleic acid (LA), exaggerated insulin resistance and increased accumulation of fat in the liver. CONCLUSION/SIGNIFICANCE: Replacement of FO with VOs in aqua feed for farmed salmon had markedly different spillover effects on metabolism in mice. Our results suggest that the content of LA in VOs may be a matter of concern that warrants further investigation
Er det forskjell i behandlingsresultat mellom pasienter som besvarer spĂžrreskjema om utfall etter nakkekirurgi og pasienter som ikke gjĂžr det?
Bakgrunn og formÄl:
Oppgaven er en valideringsstudie basert pÄ data fra Nasjonalt kvalitetsregister for rygg- og nakkekirurgi (NKR). Validiteten til kvalitetsregistre er avhengig av tilstrekkelig hÞy responsrate for at konklusjonene som trekkes angÄende effekt av en behandling skal vÊre korrekte. FormÄlet med studien er Ä analysere om det er forskjell i behandlingsresultat mellom pasienter som besvarer oppfÞlgingsskjema per post ett Är etter nakkekirurgi, og pasienter som ikke gjÞr det. Samtidig vil vi identifisere prediktorer for Ä ikke respondere.
Metode:
Totalt ble 334 pasienter som fortlÞpende ble operert for degenerative nakkelidelser ved ti norske sykehus inkludert i studien. 238 av disse responderte pÄ standard oppfÞlging med spÞrreskjema per post. Vi forsÞkte Ä komme i kontakt med de 96 pasientene som ikke reponderte for Ä gjennomfÞre et strukturert telefonintervju. UtfallsmÄlene var forbedring i armsmerte, nakkesmerte, helserelatert livskvalitet (EQ-5D-3L), samt pasientrapportert nytte av operasjonen.
Resultat:
Vi fant ingen signifikante forskjeller i utfall mellom respondentene (71,3 % av pasientene) og telefonrespondentene (18,9 % av pasientene). 33 pasienter var utilgjengelig for oppfĂžlging (9,9 % av pasientene). En stĂžrre andel av telefonrespondentene rapporterte om komplikasjoner etter tolv mĂ„neder, men tre mĂ„neders data viste ingen forskjell i andel komplikasjoner mellom gruppene. Multivariat analyse viste at lavere alder (OR 0,96, 95 % KI 0,93 â 0,98 per Ă„r), annet morsmĂ„l enn norsk (OR 2,96, 95 % KI 1,37 â 6,41) og tidligere nakkoperasjon (OR 1,91, 95 % KI 1,05-3,50) var assosiert med Ăžkt sannsynlighet for Ă„ ikke respondere pĂ„ den ordinĂŠre oppfĂžlgingen.
Konklusjon:
Vi fant ingen forskjell i behandlingsresultat mellom respondenter og telefonrespondenter 12 mÄneder etter nakkekirurgi. En andel pÄ 29% som ikke responderer pÄ oppfÞlging etter nakkekirurgi fÞrer ikke til at det trekkes feil konklusjoner angÄende behandlingseffekt
Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction : a prospective study with 10 to 15 years of follow-up
BACKGROUND: Few prospective long-term studies of more than 10 years have reported changes in knee function and radiologic outcomes after anterior cruciate ligament (ACL) reconstruction.
PURPOSE: To examine changes in knee function from 6 months to 10 to 15 years after ACL reconstruction and to compare knee function outcomes over time for subjects with isolated ACL injury with those with combined ACL and meniscal injury and/or chondral lesion. Furthermore, the aim was to compare the prevalence of radiographic and symptomatic radiographic knee osteoarthritis between subjects with isolated ACL injuries and those with combined ACL and meniscal and/or chondral lesions 10 to 15 years after ACL reconstruction.
STUDY DESIGN: Cohort study; Level of evidence, 2.
METHODS: Follow-up evaluations were performed on 221 subjects at 6 months, 1 year, 2 years, and 10 to 15 years after ACL reconstruction with bone-patellar tendon-bone autograft. Outcome measurements were KT-1000 arthrometer, Lachman and pivot shift tests, Cincinnati knee score, isokinetic muscle strength tests, hop tests, visual analog scale for pain, Tegner activity scale, and the Kellgren and Lawrence classification.
RESULTS: One hundred eighty-one subjects (82%) were evaluated at the 10- to 15-year follow-up. A significant improvement over time was revealed for all prospective outcomes of knee function. No significant differences in knee function over time were detected between the isolated and combined injury groups. Subjects with combined injury had significantly higher prevalence of radiographic knee osteoarthritis compared with those with isolated injury (80% and 62%, P = .008), but no significant group differences were shown for symptomatic radiographic knee osteoarthritis (46% and 32%, P = .053).
CONCLUSION: An overall improvement in knee function outcomes was detected from 6 months to 10 to 15 years after ACL reconstruction for both those with isolated and combined ACL injury, but significantly higher prevalence of radiographic knee osteoarthritis was found for those with combined injuries
Fatty acid composition in RBCs from mice after consuming the experimental diets for 10 weeks.
<p>The nâ3 index: EPA+ DHA content of erythrocytes expressed as a percent of total fatty acids in RBCs. Sum nâ3 and sum nâ6 include additional fatty acids not indicated in the table.</p><p>Data are presented as mean ± SEM (nâ=â5). Asterisk(s) indicates significant different from WD-FO.</p>*<p>p<0.05,</p>**<p>p<0.01,</p>***<p>p<0.005.</p><p>Abbreviations: AA, arachidonic acid; DHA, docosahexaenoic acid, EPA, eicosapentaenoic acid, FA, fatty acids; HUFA, highly unsaturated fatty acids (HUFA, â„20 carbons and â„3 carbon-carbon double bonds), LA, linoleic acid; MUFA, monounsaturated fatty acids; RBCs, red blood cells; SFA, saturated fatty acids.</p
Fatty acid composition in salmon fillets influences development of insulin resistance in mice.
<p>Male C57BL/6J mice (nâ=â8/diet) were fed WD-FO, WD-RO, WD-OO and WD-SO for 10 weeks. As references, two groups of mice received regular WD or LF diet. Plasma glucose (A) and insulin (B) were measured after overnight fasting. An intraperitoneal glucose tolerance test (GTT) was performed after 7 weeks of feeding (C) and an intraperitoneal insulin tolerance test (ITT) was performed after 8 weeks of feeding (D). Area under the curve (AUC) was calculated from the glucose tolerance (baseline was set to fasted blood glucose levels) (E) and insulin tolerance test (F). Data are presented as means+SEM (nâ=â8). *represents significant different from WD-FO (P<0.05). **represents significant different from WD-FO (P<0.01). ***represents significant different from WD-FO (P<0.005).</p
Composition of the experimental mice diets (g/kg).
<p>All diets were supplemented with 40 mg/kg ethoxyquin, 2g/kg Choline bitartrate, 4g/kg calcium carbonate, 10g/kg Vitamin mix V1001, 35g/kg Mineral mix, 3g/kg L-Methionine and 50g/kg cellulose. Cholesterol levels in WDs were balanced to a final concentration of 1.5 g/kg.</p><p>Analyzed values represent the mean of duplicate measurements.</p