94 research outputs found
PSY54 NONSTEROIDAL ANTI-INFLAMMATORY (NSAID) PRESCRIPTION USE FOR MUSCULOSKELETAL PAIN AT FOUR PRIMARY CARE CENTERS IN SWEDEN
Day surgery, variations in routines and practices a questionnaire survey
AbstractBackgroundDay surgery is expanding however little is known about every day practice and routines.MethodsA web-based questionnaire including 34 questions with fixed multiple choice responses around routine and practice for the perioperative handling of patients scheduled for day case surgery was send to 100 hospitals.ResultsThere was an overall response rate of 70%. Most centres had a dedicated day surgery unit (87%). Preoperative assessment routines, when, how and by whom varied. Patient self-assessment questionnaires were common practice (87%). Upper age limit was uncommon (10%), lower age limit common (77%), and fixed high body mass index-limitation showed a mixed pattern, mean 40%. Postoperative nauseas and vomiting-risk stratification varied mean 46%. Anxiolytic premedication was uncommon. Administration of oral analgesics varied, mean 70%; paracetamol (94%), NSAIDs (80%) and opioid (28%). Preferred general anaesthesia technique varied considerable. Laryngeal mask airway was consistently used. Management of pain while in hospital was consistently performed. A majority centres provided take-home analgesics âtablet-packageâ (69%) or as prescription (80%). Strong opioids to be taken at home were given or prescribed by 59% of units. Written information about the postoperative care was common practice (90%), written instruction about management of pain was less frequently provided (69%). Most hospitals (93%) had standardised discharge criteria, including demand of an escort (75%) and not being alone first postoperative night (81%).ConclusionsWe found that regime for day surgical anaesthesia practice varied between as well as within countries. There is obvious room for further research on how to achieve safe and cost-effective logistics and practice for day case surgery
Desempenho de concentradores de oxigĂȘnio com Ăłxido nitroso em volume de 50:50
ResumoJustificativa e objetivospoucas pesquisas abordaram a segurança do oxigĂȘnio a partir de concentradores para uso em anestesia em associação com Ăłxido nitroso. Este estudo avaliou a porcentagem de oxigĂȘnio a partir de um concentrador em associação com Ăłxido nitroso em um circuito de reinalação semifechado.MĂ©todospacientes adultos submetidos Ă cirurgia de baixo risco foram alocados aleatoriamente em dois grupos e receberam um fluxo de gases frescos de concentradores de oxigĂȘnio (O293) ou de concentradores de oxigĂȘnio e Ăłxido nitroso (O293N2O). A fração inspirada de oxigĂȘnio e a porcentagem do fluxo de gases frescos de oxigĂȘnio foram medidas a cada 10 minutos. O razĂŁo da concentração liberada de FiO2/oxigĂȘnio foi comparada em diferentes intervalos de tempo e entre os grupos.Resultadosforam avaliados em cada grupo 30 pacientes. NĂŁo houve diferença em oxigĂȘnio a partir dos concentradores ao longo do tempo para ambos os grupos, mas houve uma melhora significativa da FiO2 (p<0,001) no grupo O293, enquanto houve uma queda significativa (p<0,001) no grupo O293N2O. A razĂŁo FiO2/oxigĂȘnio variou em ambos os grupos e atingiu um patamar no grupo O293. A oximetria de pulso nĂŁo caiu abaixo de 98,5% em ambos os grupos.ConclusĂŁoa FiO2 na mistura de O293 e Ăłxido nitroso caiu durante o perĂodo de observação, embora a saturação de oxigĂȘnio tenha ficado acima de 98,5% durante todo o estudo. Os concentradores podem ser considerados uma fonte estĂĄvel de oxigĂȘnio para uso durante procedimentos anestĂ©sicos de curta duração, tanto puro quanto em associação com Ăłxido nitroso em volume de 50:50
Metamizole versus ibuprofen at home after day surgery: study protocol for a randomised controlled trial
Non-Metabolic Membrane Tubulation and Permeability Induced by Bioactive Peptides
BACKGROUND: Basic cell-penetrating peptides are potential vectors for therapeutic molecules and display antimicrobial activity. The peptide-membrane contact is the first step of the sequential processes leading to peptide internalization and cell activity. However, the molecular mechanisms involved in peptide-membrane interaction are not well understood and are frequently controversial. Herein, we compared the membrane activities of six basic peptides with different size, charge density and amphipaticity: Two cell-penetrating peptides (penetratin and R9), three amphipathic peptides and the neuromodulator substance P. METHODOLOGY/PRINCIPAL FINDINGS: Experiments of X ray diffraction, video-microscopy of giant vesicles, fluorescence spectroscopy, turbidimetry and calcein leakage from large vesicles are reported. Permeability and toxicity experiments were performed on cultured cells. The peptides showed differences in bilayer thickness perturbations, vesicles aggregation and local bending properties which form lipidic tubular structures. These structures invade the vesicle lumen in the absence of exogenous energy. CONCLUSIONS/SIGNIFICANCE: We showed that the degree of membrane permeabilization with amphipathic peptides is dependent on both peptide size and hydrophobic nature of the residues. We propose a model for peptide-induced membrane perturbations that explains the differences in peptide membrane activities and suggests the existence of a facilitated âphysical endocytosis,â which represents a new pathway for peptide cellular internalization
Day surgery; routines, pain and recovery
ABSTRACT
Day surgery in Sweden is increasing both in numbers and in types of procedures. Also older and sicker patients are often included in day case surgery programs, which puts an extra demand on good practice.
Methods: Study I: Questionnaires regarding routines used in 2005 were sent to all day surgery clinics in Sweden. Studies II, III, IV: These studies (in 355 patients) were designed as prospective, multi centre, self-assessed follow-up studies, where questionnaires were answered by the patients preoperatively and up to 6 months after surgery. Three typical day surgery procedures were chosen; inguinal hernia repair, arthroscopic procedures, cosmetic breast augmentation. A preoperative health profile was the starting point. An extended 8-item EQ-5d questionnaire was used. The questions focused on quality of life and on pain. Study V: This interventional pain study after hallux valgus surgery was designed as a prospective, randomized double blind study in 100 patients.
Results: In study I was shown that a high degree of standardization is present among Swedish day surgery units with pain being the most common postoperative problem. Study II showed that tobacco use by smoking or snuffing decreased postoperative nausea but had no effect on postoperative pain. In study III, unplanned hospital contacts were recorded for 70/355 patients while 3 patients were readmitted. Postoperative pain was reported in 40%, 28% and 20% of included patients after 1, 2 and 4 weeks respectively. Presence of pain preoperatively was identified as the main predictor for postoperative pain. In study IV, longitudinally changes in 8-item health profile was shown to be different between procedures during 6 months follow-up. In study V we showed that in treating postoperative pain, etoricoxib was more effective with fewer side effects than tramadol.
Conclusions: Day surgery as presently performed is safe and without major morbidity. The preoperative health profile is important for the recovery course. Pain is the main reported postoperative problem followed by mobility problems. Recovery is divergent for different surgery and calls for different follow-up times. In treatment of pain after foot surgery, the NSAID etoricoxib is shown to be more efficient than tramadol without deleterious effects on healing.
Key words: day surgery, postoperative pain, analgesics, tramadol, etoricoxib, postoperative nausea and vomiting (PONV), nicotine, snuff, recovery, EQ-5d, health profile, self-assessed questionnaire, follow-up
The same foundation but still so different! : A qualitative study about physical education teachers interpretation and assessment on the basis of the knowledge demands concerning pace and rhythm.
Syfte och frĂ„gestĂ€llningar Syftet med studien var att undersöka hur nyexaminerade lĂ€rare i idrott och hĂ€lsa arbetar med kunskapskraven för takt och rytm samt hur de bedömer elever i Ă„rskurs 6 utifrĂ„n dessa. Hur bedömer lĂ€rarna elever utifrĂ„n vĂ€rdeorden âtill viss delâ, ârelativt vĂ€lâ och âvĂ€lâ inom kunskapskravet för takt och rytm i Lgr 11? Hur definierar lĂ€rarna begreppen takt och rytm? Vilka resurser upplever lĂ€rarna har betydelse för arbetet med bedömning utifrĂ„n kunskapskraven för takt och rytm? Metod En film producerades dĂ€r tvĂ„ elevers kunskaper och fĂ€rdigheter inom takt och rytm var i fokus. Sex stycken nyexaminerade idrottslĂ€rare fick sedan titta pĂ„ filmen och bedöma eleverna utifrĂ„n vĂ€rdeorden âtill viss delâ, ârelativt vĂ€lâ och âvĂ€lâ i kunskapskraven för takt och rytm i Lgr11. Sedan genomfördes intervjuer med samtliga idrottslĂ€rare för att fĂ„ en inblick i hur de anvĂ€nde vĂ€rdeorden och hur de arbetar med bedömning inom takt och rytm samt hur de resonerar om vilka resurser som kan inverka pĂ„ undervisningen och bedömningen. Resultat IdrottslĂ€rarna hade skilda meningar bĂ„de gĂ€llande vad vĂ€rdeorden innebar och i bedömningen av eleverna. De hade kriterier för vad som krĂ€vdes för respektive vĂ€rdeord. Det gjorde att samma elev tilldelades bĂ„de det högsta och det lĂ€gsta vĂ€rdeordet utifrĂ„n vad lĂ€rarna sett pĂ„ filmen. LĂ€rarnas definition av takt och rytm som begrepp var ocksĂ„ nĂ„got som tolkades olika. Hur man definierat begreppen var nĂ„got som korrelerade med hur man resonerat i bedömningen av eleverna. Vad gĂ€ller resurser sĂ„ tog lĂ€rarna upp bland annat speglar, musikanlĂ€ggning, danssal och rekvisita som betydelsefulla för undervisningen inom takt och rytm. LĂ€rarna menar att goda resurser kan underlĂ€tta, men att det Ă€ven gĂ„r att undervisa inom takt och rytm med vĂ€ldigt enkla medel. Slutsats Definition av begrepp och tolkning av vĂ€rdeorden i kunskapskraven Ă€r nĂ„got som skiljt sig Ă„t mellan lĂ€rarna. Detta kan fĂ„ konsekvenser nĂ€r det kommer till hur likvĂ€rdig bedömningen av eleverna blir. Resurser kan underlĂ€tta men behöver inte vara en avgörande faktor för undervisningen inom takt och rytm.  Aim: The purpose of the study was to examine how newly graduated physical education teachers are working with the demands of knowledge concerning pace, rhythm and how they appraise students in year 6 on the basis of these; How do teachers judge students on the basis of the value words âquite wellâ, ârelatively wellâ and âwellâ within the demands of knowledge for pace and rhythm in Lgr 11? How do the teachers define the concepts of pace and rhythm? Which resources do the teachers think are of importance when judging on the basis of the demands of knowledge for pace and rhythm. Method: A film was produced where the knowledge and skill of two students concerning pace and rhythm, were in focus. Newly graduated physical education teachers then got to study the movie and judge the students from the value words âokâ, ârelatively wellâ and âwellâ within the demands of knowledge for pace and rhythm in Lgr 11? After that, interviews were carried out with all the participating teachers, in order to get an insight to how they used the value words and how they work with appraising pace and rhythm and also how they reason about which resources can affect the education and the judgment. Results: The physical education teachers had different opinions on both the definition of the value words and in appraising the students. They had individual demands on what was required for each value word. This resulted in that the same student was given both the highest and the lowest value word on the basis of what the teachers had seen in the film. The teachers definitions of pace and rhythm was also interpreted differently. How they defined the concepts was also something correlated with how they had been reasoning in appraising the students. When it came to resources, the teachers mentioned mirrors, music equipment, dancing ward and props as valuable for the education of pace and rhythm. The teachers said that resources can aid but that it still is possible to teach pace and rhythm with simple means. Conclusion: Definition of concepts and interpretation concerning the value words in the knowledge demands was differentiated between the teachers. This could result in consequences when it comes to the intention of judging the students equally. Resources can aid the education of pace and rhythm but does not have to be a decisive consideration for the education of these abilities
Konsten att klara av en livsstilsförÀndring i samband med övervikt. En empirisk intervjustudie om vad som verkar för och emot en viktnedgÄng
Bakgrund: Prevalensen av fetma och övervikt ökar i hela vÀrlden och i Sverige lider ca 47 % av mÀnnen och 35 % av kvinnorna av övervikt eller fetma. Risken att dö i förtid Àr stor och följdsjukdomarna till övervikt och fetma Àr mÄnga, bland annat en markant ökad risk för insulinresistens, diabetes typ 2, hjÀrt-kÀrlsjukdomar eller stroke.
Syfte: Att fÄ ökad kunskap om vad som verkar för respektive emot en livsstilsförÀndring hos överviktiga.
Metod: Fem semistrukturerade djupintervjuer som analyserades och kategoriserades med innehÄllsanalys.
Resultat: Informanterna berÀttade att deras frÀmsta drivkraft var hÀlsan och ett lÀngre liv. De som lyckats gÄ ner i vikt menade att en kontinuerlig och engagerad vÄrdkontakt varit deras frÀmsta stöd. TröstÀtning och ett passivt sÀtt att hantera problem samt avsaknad av stöd frÄn familj och vÄrd var det största hindret för en viktnedgÄng. Fysiologiska faktorer, som t ex metaboliska förÀndringar och smÀrta nÀmndes Àven.
Slutsats: Ăvervikt Ă€r ett komplext omrĂ„de som ofta har en psykologisk grund. Informanterna i denna studie behövde frĂ€mst hjĂ€lp att öka sin förmĂ„ga till empowerment och coping, nĂ„gonting som vĂ„rden bör erbjuda.Overweight is today a constantly increasing problem in societies over the world. In Sweden, men are suffering of overweight with a percentage at 47 percent of the population. Among women 35 percent are overweight and these groups together are more likely to die at a younger age. Persons who are overweight also own a greater risk to get ill and these illnesses are linked to overweight. Such illness can be: diabetes, heart disease or stroke. The aim of this study is to get a greater knowledge about the difficulties around making a change of lifestyle being overweight. What are the factors standing in the way for a change in lifestyle? What is functioning as motivation? Five interviews took place and the material was analysed with content analysis. The result of the analysed interviews led to six categories: knowledge, society, medical factors, empowerment, coping and health care. The major obstacle for being successful with a change in lifestyle was low coping abilities and lack of empowerment. Lack of social support was also a factor that worked against weight loss as well as medical factors. The fact that motivated respondents the most, was to stay healthy in the future and to be able to live longer. The conclusion of this study is that being overweight is linked to the lack of empowerment and low coping abilities. Therefore people being overweight need support from the health care system in order to be able to handle a weight loss
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