Impact of Birthing Room Design on Maternal Childbirth Experience: Results From the Room4Birth Randomized Trial

Objective: To study the effect of the birthing room design on nulliparous women’s childbirth experience up to 1 year after birth. Background: Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. Methods: The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized (n = 406) to either a regular birthing room (n = 202) or a new birthing room designed with more person-centered considerations (n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). Results: Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months (p =.002) and 12 months (p =.021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score (p =.039) and within the CEQ2 subdomain own capacity after 3 months (p =.028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. Conclusions: These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth

Targeted AntiBiotics for Chronic pulmonary diseases (TARGET ABC):can targeted antibiotic therapy improve the prognosis of Pseudomonas aeruginosa-infected patients with chronic pulmonary obstructive disease, non-cystic fibrosis bronchiectasis, and asthma? A multicenter, randomized, controlled, open-label trial

BACKGROUND: Pseudomonas aeruginosa infection is seen in chronic pulmonary disease and is associated with exacerbations and poor long-term prognosis. However, evidence-based guidelines for the management and treatment of P. aeruginosa infection in chronic, non-cystic fibrosis (CF) pulmonary disease are lacking. The aim of this study is to investigate whether targeted antibiotic treatment against P. aeruginosa can reduce exacerbations and mortality in patients with chronic obstructive pulmonary disease (COPD), non-CF bronchiectasis, and asthma. METHODS: This study is an ongoing multicenter, randomized, controlled, open-label trial. A total of 150 patients with COPD, non-CF bronchiectasis or asthma, and P. aeruginosa-positive lower respiratory tract samples will be randomly assigned with a 1:1 ratio to either no antibiotic treatment or anti-pseudomonal antibiotic treatment with intravenous beta-lactam and oral ciprofloxacin for 14 days. The primary outcome, analyzed with two co-primary endpoints, is (i) time to prednisolone and/or antibiotic requiring exacerbation or death, in the primary or secondary health sector, within days 20–365 from study allocation and (ii) days alive and without exacerbation within days 20–365 from the study allocation. DISCUSSION: This trial will determine whether targeted antibiotics can benefit future patients with chronic, non-CF pulmonary disease and P. aeruginosa infection in terms of reduced morbidity and mortality, thus optimizing therapeutic approaches in this large group of chronic patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT03262142. Registered on August 25, 2017. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-022-06720-z

Biståndsbedömarna har mycket makt, tycker jag, jag vill gärna ha lite makt själv också. : Om medbestämmande och inflytande i ALvesta hemtjänst.

Hur kan medbestämmande och inflytande i hemtjänsten komma till stånd? Syftet med denna uppsats var att ta reda på vad som upplevs ge medbestämmande och inflytande i hemtjänsten. Den övergripande frågeställningen formulerades utifrån om det finns skillnad i uppfattning hos personer som har erfarenhet och de som inte har erfarenhet av att ta emot hemtjänst? Det sociala synsättets tankar (Westlund, 2002), teorier om salutogenes (Antonowsky, 1991), (Sjöberg & Westlund, 2005) samt ett socialkonstruktivistiska synsätt om synen på äldre (Jönsson, 2001) utgör de huvudsakliga teorierna. Metoden utformades som en fallstudie och genomfördes i Alvesta kommun. Fyra grupper intervjuades med vardera tre till fem slumpmässigt utvalda respondenter. Två av intervju-grupperna bestod av personer som har personlig erfarenhet av att ta emot hemtjänst och deltagarna i de två andra intervjugrupperna saknade denna erfarenhet. Resultatet visar att de flesta av intervjugruppernas deltagare ansett oavsett tidigare erfarenhet att hemtjänstens och äldreomsorgens kvalitet? i Alvesta överlag är bra eller mycket bra. Viss skillnad i vad som de olika grupperna betecknar vara ett gott liv kommer fram. Frågor om att få byta insats, bestämma om när den ska utföras, ha möjlighet till insats utan biståndsbeslut efter viss ålder, byte till timtaxa, servicecheckar eller ej, engagerar de flesta deltagarna i intervjugrupperna med personer som inte har egen erfarenhet av hemtjänst. Dessa frågor engagerar dock inte deltagarna nämnvärt i grupperna som redan har erfarenhet av hemtjänst. Vidare pekar studien på att nästan alla gruppdeltagare, oavsett erfarenhet eller ej, anser att beslutsgången vid ansökan om insats känns oklar, en fråga som framförallt framhålls som angelägen för respondenterna. En annan betydelsefull fråga för respondenterna är frågan om personalkontinuiteten. Det uttrycks angeläget att få till stånd en kommunikation omkring frågan om ombyggnad av det gamla sjukhemmet ”Högåsen”. Avslutningsvis visar resultatet på att ett stort intresse finns från de deltagare som inte har egen erfarenhet av hemtjänst för att socialt uppsökande verksamhet erbjuds alla vid en viss ålder.How can co-determination and influence within the home-help service sector come about? The aim of this paper is to find out what is considered to give co-determination and influence within the home-help service sector. The overall question was formulated from the The social workers have a lot of authority, I think; I should like to have some authority too. - On co-determination and influence in Alvesta´s home-help service - anticipation that there is a difference in opinion between people who have experience and those who have no experience in receiving home-help service. Det sociala synsättets tankar (Westlund 2003), Theories about Salutogenes (Atonowski 1991), Sjöberg & Westlund 2005) and Ett socilakonstruktivistiskt synsätt om synen på äldre (Jönsson, 2001) form the main theories. The method was constructed as a case study and was carried out in the town of Alvesta. Four groups were interviewed with three to five randomly chosen respondents in each group. Two of the interview groups consisted of persons who have personal experience of receiving home-help service and the participants in the two other interview groups lacked this experience. The result shows that most of the participants in the interview groups, disregarded earlier experience, are of the opinion that the quality of old age care in Alvesta overall is good or very good. A certain difference in what the different groups consider to be a good life is shown. Questions about be allowed to change service, decide when it is to be done, have possibility for services without formal authority decisions after a certain age, service cheques or not, engage most participants in the interview groups that have no personal experience of home-help service. These questions do not much engage the participants in the groups that already have experience from home-help service. Further, the study shows that nearly all group members, experience or no experience of home-help service, are of the opinion that the line of decision is unclear, a question that above all is regarded as urgent. Another important question for the respondent is the continuity in staffing. There is also a strong opinion about starting a communication regarding the reconstruction of the old nursing home “Högåsen”. Finally, the result shows that there is a great interest from the participants, who have no personal experience of home-help service, that everybody is offered an outreach programme from a certain age

Enhetschef i kläm? : En kvalitativ studie kring enhetschefers upplevelser av hinder och möjligheter vid arbetslivsinriktad rehabilitering av arbetstagare

Godkänd: 2023-06-01</p

Enhetschef i kläm? : En kvalitativ studie kring enhetschefers upplevelser av hinder och möjligheter vid arbetslivsinriktad rehabilitering av arbetstagare

Godkänd: 2023-06-01</p

Liikunnan- ja luokanopettajiksi opiskelevien kehonkuva, syömis- ja liikuntakäyttäytyminen sekä koetut ulkonäköpaineet

Tämän tutkielman tarkoituksena oli selvittää, eroavatko liikunnanopettajaksi ja luokanopettajaksi opiskelevat ja eri sukupuolta olevat opiskelijat toisistaan kehonkuvan, syömis- ja liikuntakäyttäytymisen sekä koettujen ulkonäköpaineiden suhteen. Selvitimme myös, millaisia ulkonäköpaineita liikunnanopettajaksi opiskelevat kokevat ja miten he kokevat paineiden muuttuneen opintojen aikana. Tutkimusaineiston keräsimme Webropolkyselylomakkeella joulukuun 2018 ja tammikuun 2019 aikana. Tutkimuksen kohteena olivat Jyväskylän yliopiston liikuntatieteellisen ja kasvatustieteellisen tiedekunnan pääaineopiskelijat (N=235), joista liikunnanopettajaksi opiskelevia oli 128 ja luokanopettajaksi opiskelevia 107. Analyysivaiheessa jätimme luokanopettajaksi opiskelevat miehet tarkastelun ulkopuolelle heidän vähäisen lukumääränsä (n=5) vuoksi. Käytimme sekä määrällistä että laadullista tutkimusotetta saadaksemme monipuolista ja selittävää tietoa aiheesta. Tarkastelimme pääaineiden ja sukupuolten välisiä eroja kielteisen kehonkuvan sekä häiriintyneen liikunta- ja syömiskäyttäytymisen ja koettujen ulkonäköpaineiden suhteen yksisuuntaisella varianssianalyysillä. Koettuja ulkonäköpaineita selvitettiin myös ristiintaulukoinnin ja khiin neliö -testin avulla ja niiden laadullisia tuloksia aineistolähtöistä sisällönanalyysiä käyttäen. Pääaineiden välisessä vertailussa liikunnanopettajaksi opiskelevilla naisilla esiintyi tilastollisesti merkitsevästi enemmän häiriintynyttä liikuntakäyttäytymistä kuin luokanopettajaksi opiskelevilla. Kehonkuvan ja syömiskäyttäytymisen suhteen pääaineiden välillä ei ollut tilastollisesti merkitseviä eroja. Sukupuolten välisessä tarkastelussa miehillä oli tilastollisesti merkitsevästi vähemmän häiriintynyttä syömiskäyttäytymistä ja myönteisempi kehonkuva kuin naisilla, mutta liikuntakäyttäytymisessä ei ollut eroa. Liikunnanopettajaksi opiskelevat kokivat sukupuolesta riippumatta opiskeluympäristön lisäävän ulkonäköpaineita merkitsevästi enemmän kuin luokanopettajaksi opiskelevat, jotka jätimme vähäisten vastausten vuoksi laadullisen analyysin ulkopuolelle. Liikunnanopettajaksi opiskelevien ulkonäköpaineita lisänneet tekijät jakautuivat kolmeen yläluokkaan; sosiaaliset tekijät, toimintakulttuuri sekä liikunta-alan normit. Opiskelijoiden kokemia ulkonäköpaineita lisäsivät eniten sosiaaliset tekijät kuten muihin vertaaminen ja toisten ulkonäön arvioiminen. Opiskelijat kokivat myös liikunta-alan normien, kuten vallitsevien oletuksien liikunta-alaa opiskelevien ja liikunnanopettajien ulkonäöstä, lisäävän ulkonäköpaineita. Aikaisempi tutkimustieto tukee havaintojamme liikunnanopettajaksi opiskelevien kokemista korkeista ulkonäköpaineista ja luokanopettajaksi opiskelevia ongelmallisemmasta liikuntakäyttäytymisestä. Liikunnanopettajaksi opiskelevien ulkonäköpaineita, niiden syitä ja mahdollisia seurauksia on syytä tutkia lisää, etenkin kun otetaan huomioon opettajan omien arvojen ja asenteiden mahdollinen vaikutus oppilaisiin ja opetustilanteisiin.The purpose of this study was to find out if the physical education teacher students and class teacher students differ from each other regarding body image, eating and exercise behavior, and appearance-related pressures. Another purpose was to find out what kind of appearance-related pressures physical education teacher students experience, and how they feel the pressures changing during their studies. We used Webropol questionnaire to collect the research data between December 2018 and January 2019. The participants of the thesis were students of the Faculty of Sport Sciences and Educational Sciences at the University of Jyväskylä (N = 235), of whom 128 were students of physical education and 107 those studying as class teachers. In the analysis phase, we left the male class teacher students out of the examination because of their low number (n = 5). Differences between major subjects and genders in poor body image, disturbed exercise and eating behavior were investigated by one-way variance analysis, using mean variables we created. Experienced appearance-related pressures were investigated by oneway variance analysis, cross-tabulation and chi-square. The qualitative data regarding these pressures were analyzed using data-oriented content analysis. Among the major subjects, female physical education teacher students scored statistically significantly higher in disturbed exercise behavior than female class teacher students. Physical education teacher students also experienced significantly more appearance-related pressures created by the learning environment compared to class teacher students, with no significant gender differences. Between genders, men studying physical education had statistically significantly less body image and eating behavior problems than women, but were quite similar regarding disturbed exercise behavior. Physical education students, regardless of gender, felt that the learning environment significantly increased their appearance related pressures, unlike the classroom teacher students, who were excluded from qualitative analysis due to the low response rate. The factors that increased these pressures of those studying physical education fell into three higher categories; social factors, operational culture and norms of sport sector. Social factors such as comparing and evaluating the appearance of others exacerbated the students' appearance pressures. Appearance-related pressures were also felt to be worsen due to prevailing assumptions about the appearance of sports students and physical education teachers. Earlier research data supports the increased appearance-related pressures and disturbed exercise behavior of physical education teacher students. There is a need for further study of the appearance-related pressures, the causes and the possible consequences for future physical education teachers, especially considering the potential impact of the teacher's own values and attitudes on students and teaching situations

Silaborative Carbocyclization of 1,6-Enynes

The silaboration of 1,6-enynes gives densely functionalized five-membered rings that offer promising reactivities for further synthetic manipulations. We have found that using silylborane 4 silaborative carbocyclization reactions proceed in good to excellent yields, giving the product as a single diastereomer. Attempts to extend this methodology to include terminally substituted enynes and developing asymmetric versions were largely unsuccessful. The vinylboronates formed were employed in Suzuki cross-coupling reactions with a range of aryl bromides, furnishing arylated product in good yields.QC 2010092

Silaborative Carbocyclization of 1,6-Enynes

The silaboration of 1,6-enynes gives densely functionalized five-membered rings that offer promising reactivities for further synthetic manipulations. We have found that using silylborane 4 silaborative carbocyclization reactions proceed in good to excellent yields, giving the product as a single diastereomer. Attempts to extend this methodology to include terminally substituted enynes and developing asymmetric versions were largely unsuccessful. The vinylboronates formed were employed in Suzuki cross-coupling reactions with a range of aryl bromides, furnishing arylated product in good yields.QC 2010092