Kunnskapsdeling og kunnskapsforståelse: en studie av standardiserte pasientforløps innvirkning på sykepleierens arbeidshverdag

Utgangspunktet for masteravhandlingen er temaet standardiserte pasientforløp og en analyse av sykepleierens forståelser av fenomenet. Problemstillingen for avhandlingen er: Hvordan har standardiserte pasientforløp påvirket sykepleierens kunnskapsutvikling og arbeidshverdag

Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway

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Health characteristics associated with chemsex among men who have sex with men: Results from a cross-sectional clinic survey in Norway

Background Chemsex typically involves drugs such as GHB/GBL, crystal meth and mephedrone, and is increasingly common among MSM. The behaviour has been found to be associated with sexually transmitted infections (STIs) and mental health problems. We aimed to assess the extent of chemsex engagement and associations with different aspects of health, among MSM attending a free specialist walk-in clinic for STIs in Oslo, Norway. Methods Anonymous cross-sectional survey data was collected from June to October 2016. Differences in STI health (chlamydia, gonorrhoea, syphilis, HIV diagnoses), mental health (depression/anxiety) and internalised homonegativity between MSM using and not using GHB/GBL, crystal meth, mephedrone, cocaine or ketamine with sex in the last year were assessed descriptively and in a multivariate logistic regression model. The predictors were number of self-reported chlamydia, gonorrhoea or syphilis diagnoses, HIV diagnosis, depression/anxiety, and degree of internalised homonegativity. We adjusted for age, education level and having lived abroad. Results Of the 518 MSM respondents, 17% reported sexualised use of either GHB/GBL, crystal meth, mephedrone, cocaine or ketamine in the last year (chemsex). We found significant positive associations between chemsex and self-reported HIV diagnoses (adjusted odds ratio [aOR] = 3.26, 95%CI = 1.37–7.76), number of reported chlamydia, gonorrhoea or syphilis diagnoses in the last year (aOR = 1.63, 95%CI = 1.18–2.12), having lived more than one year abroad (aOR = 2.10, 95%CI = 1.20–3.65), but no significant association with depression/anxiety (aOR = 1.02, 95%CI = 0.53–1.93), nor internalised homonegativity (aOR = 0.62, 95%CI = 0.33–1.19). Conclusion Chemsex engagement in Norway is relatively low compared to findings from STI clinics in other European countries, and GHB/GBL and cocaine the two most commonly used drugs with sex. Chemsex was more common among MSM having lived more than one year abroad, reporting HIV diagnoses and a higher number of either chlamydia, gonorrhoea or syphilis diagnoses in the last year. Health care providers need to be made aware of chemsex as a behavioural phenomenon among MSM, and special care should be afforded to MSM living with HIV and being diagnosed with STIs

Norsk Ordbok på nett: Utfordringar og løysingar

Norsk Ordbok (abbreviated NO) is a scientific dictionary covering Norwegian in its written Nynorsk form and all spoken dialects. The dictionary is under production and will be finished in 12 volumes in 2014. The work on NO began in 1930, and the first volume was published in 1966. From 2002 the project organization NO 2014 has been working towards the completion of the dictionary, all the time on the premise that the final product will be a printed dictionary. Over the last few years a growing number of dictionaries have been published in an electronic format on the World Wide Web – either as a supplement to or an alternative to a printed edition. We see a development where more and more lexicographical products are exclusively published in an electronic form. This format renders possible a more user-friendly search functionality and more flexible ways of displaying dictionary entries. In addition, the format makes it fairly easy to link lexicographical resources with other existing, relevant electronic resources (cartographic data, source texts, encyclopaedic resources etc.). We at NO 2014 would also like to publish our dictionary electronically, but we have found ourselves faced with certain lexicographical challenges that have to be looked into in more detail. In this article we discuss some of the problems encountered in the work on the online version of NO, with particular emphasis on search mechanisms.

Norwegian Consumers’ Skepticism towards Smoke-Flavoring of Salmon—Is It for Real?

The aim of the present study was to explore Norwegian consumers’ attitudes toward smoke-flavoring of cold smoked salmon (CSS), by conducting a digital survey and focus group discussions. Some of the smoke-flavoring techniques, like atomized purified condensed smoke, is considered healthier than conventional smoking. Manufacturers of CSS are, however, hesitant to use all kinds of smoke-flavoring due to expected consumer skepticism. In the digital survey, the expected skepticism was confirmed (n = 487). Only 15% of the respondents were positively oriented toward smoke-flavoring of CSS. The selection criterion for the focus group discussion was based on the results from the survey and resulted in three attitude-oriented focus groups (negative, neutral, and positive). The negative focus group considered smoke-flavored CSS to be unnatural and out of the question to buy or eat. Unlike the negative focus group, the neutral group was curious to learn more and open to potential smoke-flavor benefits. However, credible information or science was crucial to influence CSS choice. Future studies may investigate whether the existent of this large group of curious neutral consumers (47% of the respondents) influence manufacturers (of CSS) skepticism or how various types of product information could steer consumer acceptance of smoke-flavoring of CSS.publishedVersio

Health care help seeking behaviour among prisoners in Norway

Background: Prisoners are associated with high health care needs compared with the general population. This study aims to investigate prisoners' use of health service. Methods: A cross-sectional study of 29 prisons in central and southern parts of Norway. A questionnaire was distributed to 1, 454 prisoners (90% response rate). Multilevel analyses were employed to analyse help seeking behaviour among the prisoners. Results: Help seeking was substantially associated with sleep problems and drug problems. There was also a tendency for closed prisons as well as high staffing levels of healthcare professionals to be associated with elevated health care use. Conclusions: This study suggests that sleep problems and drug use are most frequently associated with health service use. The differences in health care use between prisons suggest that the implementation of prison health care standards should be addressed.© 2011 Nesset et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Mat, måltider og ernæring på sykehjem – til beboernes helse, glede, trivsel og livslyst. Utvikling av kunnskapsbasert praksis på sykehjem innenfor området ernæring – gjennom etablering av og arbeid i et sykepleiernettverk

Rapporten beskriver et samarbeidsprosjekt mellom seks "praksissykehjem" i Hedmark og Høgskolen i Hedmark. Hensikten med prosjektet var å vise hvordan etablering av og arbeid gjennom et sykepleienettverk kan bidra til utvikling av en mer kunnskapsbasert praksis i sykehjemmene innenfor området mat, måltider og ernæring. Det overordna målet var å tilby pasientene ved sykehjemmene best mulig sykepleie innenfor det utvalgte området: mat, måltider og ernæring.Prosjektet er et samarbeidsprosjekt mellom seks "praksissykehjem" i Hedmark og Høgskolen i Hedmark, Institutt for sykepleiefag. Prosjektet har en aksjonsforskningsorientert tilnærming: gjennom samhandling mellom praksisfeltet og sykepleierutdanningen, skal prosjektet vise hvordan etablering av og arbeid gjennom et sykepleienettverk, kan bidra til utvikling av en mer kunnskapsbasert praksis i sykehjemmene innenfor området mat, måltider og ernæring. Den overordnede målsettingen er å tilby pasientene ved sykehjemmene best mulig sykepleie innenfor det utvalgte området: mat, måltider og ernæring. Delmålene er videre konkretisert i tre hovedområder, knyttet til å utvikle 1) sykepleietjenesten på sykehjemmene sin kompetanse i å kritisk granske egen virksomhet 2) samarbeid og kunnskapsutveksling mellom sykepleierne ved praksissykehjemmene, og med lærerne knyttet til bachelorutdanningen i sykepleie 3) sykepleierstudentenes praksisstudier. Denne midtveisrapporten har som hensikt å beskrive og summere opp samarbeidsprosjektets status midtveis i prosjektperioden, dvs. sommeren 2009. I første runde av prosjektet valgte så godt som alle sykehjemmene å ha et overordnet, generelt fokus på måltidene/ matsituasjonen, for gjennom dette å bidra til økt matlyst og bedret ernæringstilstand for pasientene. Ved alle sykehjemmene ble det iverksatt ulike tiltak for å skape mer ro, hygge og trivsel, for eksempel ble man mer bevisst organisering og personalets rolle og egen adferd under måltidene, pynt av bordet, duker, lysestaker, stetteglass, friske blomster osv. Pasientene ved de fleste avdelinger har også fått større valgfrihet, spesielt ved frokosten, og flere deltar mer aktivt under måltidet. Det er innført flere mellommåltider, og pasientene får oftere tilbud om drikke, og mer frukt og grønt. Resultatene fra midtveisevalueringen viser at 10 (av 13) nettverksmedlemmer mener at målene for Samarbeidsprosjektet i ganske høy grad er oppnådd så langt. Alle mener at prosjektet har bidratt til å øke kvaliteten på sykepleien til pasientene innenfor området mat, måltider og ernæring. Midtveisevalueringen viser at det ved alle sykehjemmene har skjedd en økt faglig bevissthet i personalgruppene og et økt fokus på ernæring. Sykepleierstudentene har bidratt positivt inn, gjennom praksisperioden og gjennom konkrete anbefalinger mht det videre arbeidet. Studentene mener at det har betydning for deres læring og kompetanseutvikling å bidra inn i fagutviklings-/ forskningsprosjekt. Midtveisevalueringen viser at nettverksmedlemmene mener at prinsippene for kunnskapsbasert praksis, og arbeid gjennom et sykepleienettverk i høy grad egner seg som metode for fagutvikling på sykehjem. Hovedutfordringen i det videre arbeidet er å skape engasjement blant øvrige ansatte på sykehjemmene. Gjennom 1.runde av prosjektet har man skaffet seg verdifulle erfaringer, bl.a. mht. suksesskriterier med tanke på veien videre

IL-18 and IL-18 binding protein are related to disease severity and parasitemia during falciparum malaria

Background - Several inflammatory molecules participate in the immune response to malaria. Interleukin (IL)-18 is an inflammatory cytokine activated by NLRP3 inflammasomes. In clinical falciparum malaria, with and without HIV co-infection, data on IL-18 and in particular on its binding protein, IL-18bp, is scarce. Methods - Clinical data and blood samples were collected from adults in Mozambique with P. falciparum infection, with (n = 70) and without (n = 61) HIV co-infection, from HIV-infected patients with similar symptoms without malaria (n = 58) and from healthy controls (n = 52). In vitro studies were performed in endothelial cells using hemozoin crystals. Results - (i) IL-18 and IL-18bp were markedly up-regulated during falciparum malaria with particular high levels in malaria patients co-infected with HIV and severe malaria disease. (ii) In the malaria group as a whole, both IL-18 and IL-18bp were positively correlated with disease severity, parasitemia, and endothelial cell activation as assessed by vWF in plasma. (iii) Whereas there was no change in IL-18 levels in malaria patients co-infected with HIV during follow-up, the patients with malaria only had slightly increased IL-18 levels. Further, the IL-18pb levels declined and thereby contributed to an increase in IL-18/IL-18bp ratio in all subgroups of malaria patients. (iv) IL-27, previously shown to be up-regulated in this malaria cohort, markedly induced a release of IL-18bp from endothelial cells in vitro, and notably, this presumably anti-inflammatory effect was counteracted by hemozoin. Conclusions - Our findings suggest that the IL-18 system could be an important mediator in the immune pathogenesis during falciparum malaria, potentially also representing a target for therapy