Reflective thinking in nursing education

Idea and purpose of the project The idea of the project is to develop a method for working with reflection during the 3 year nursing education. We think that reflection is a tool to develop self-knowledge and is necessary for the development of professional skills. The idea is to have one workshop with reflective thinking, in every fivepoint course, on a theme connected with the theoretical content in the course. The theme could be: life and death, meeting other cultures, body and soul, good and evil encounters. The idea is to work with creative arts (art, photos, poems, and essays) on the chosen theme to start the students reflection. In dialogue with the rest of the group they will share others' reflections. The tutor will lead the dialogue with critical questions to make the students think more deeply and to open doors to different viewpoints and to internalize theoretical and practical knowledge. At the end of the session time will be given for reflective writing, in a diary, concerning the workshop. The purpose of this project is to improve students' self-knowledge as well as their professional development. By consciously engaging in their own and others reflection we believe that the level of professional interaction will improve. By using creative arts we hope to strengthen the visual capacity, which is important for the interpretation process. By using reflective questions in dialogue with the students we hope to support their reflective thinking in a critical manner. By using diaries the students can follow their own learning process and also practice writing, which better prepares them for nursing documentation. Another purpose is that the involved teachers improve their self-knowledge and professional skills, as the method demands that the teacher be reflective and introspective about his/her interactions with the students

Serine/Threonine Protein Phosphatase 5 - a Double-edged Sword - in the Progression towards Diabetes

Type 2 diabetes mellitus is increasing at an alarming rate worldwide. In the development and progression of type 2 diabetes mellitus, the insulin-producing pancreatic β-cells are commonly exposed to a hyperglycemic and hyperlipidemic environment, in which the levels of reactive oxygen species are elevated. In turn, reactive oxygen species can trigger an apoptotic response, by activating mitogenactivated protein kinase signaling networks, leading to β-cell death. When the functional β-cell mass is reduced to a level that, can no longer maintain euglycemia, type 2 diabetes mellitus is manifested. Therefore, there is a need to find new antidiabetic drugs that are able to protect the loss of β-cell mass and in so doing prevent and treat diabetes. This thesis aimed at investigating the possible protective roles of serine/threonine protein phosphatase 5 (PP5) in this context. We generated a PP5-deficient mouse line to evaluate the biological actions of PP5. Isolated mouse embryonic fibroblasts from mice lacking PP5 (Ppp5c-/-) and their wild-type littermates (Ppp5c+/+) were exposed to DNA damage-inducing agents to investigate the role of PP5 in response to genotoxic stress. Pancreatic islets isolated from both Ppp5c+/+ and Ppp5c-/- mice, and MIN6 cells treated with shortinterfering RNA targeting PP5, were exposed to H2O2 or palmitate to test the hypothesis that PP5 acts to suppress apoptotic signaling in β-cells. Ppp5c+/+ and Ppp5c-/- mice were placed on either a standard diet or high-fat diet for ten weeks to examine the role of PP5 in a diabetic environment. Our data revealed that the PP5-deficient mice were viable and fertile, demonstrating that PP5 is not essential for survival. However, the Ppp5c-/- mice were underrepresented in offspring from heterozygous mating, indicating that PP5 provides some advantage during embryonic development. Mouse embryonic fibroblasts lacking PP5 showed increased susceptibility to UV light-induced stress, suggesting that PP5 may promote cell survival. PP5 deficiency in mice was also associated with reduced weight gain, lower fasting glycemia and improved glucose tolerance. However, the genetic disruption of PP5 did not alter insulin sensitivity or islet volume. Comparison of mitogen-activated protein kinase signaling in islets from Ppp5c-/- mice and MIN6 cells with reduced PP5 levels revealed that the lack of PP5 was associated with enhanced H2O2- and palmitate-induced JNK phosphorylation and apoptosis. This indicates that PP5 can suppress stress-induced apoptosis in β-cells by a mechanism involving the regulation of JNK phosphorylation and, thereby, contributing to a protective effect. PP5 suppression in MIN6 cells correlated with hypersecretion of insulin in response to glucose. When compared to wild-type littermate controls, Ppp5c-/- mice on a high-fat diet gained less weight. The mice lacking PP5 also had lower fasting glucose, which increased by high-fat diet feeding. A finding not observed in the Ppp5c+/+ mice. These observations may be explained, in part, by the enhanced serum insulin levels in the Ppp5c+/+ mice on the high-fat diet. Increased serum insulin was not observed in the Ppp5c-/- mice, which instead had lower levels of insulinemia after they were fed high-fat diet. High-fat diet feeding resulted in impaired glucose tolerance in both genotypes without an apparent difference in insulin sensitivity or β-cell function. These data indicate that the lack of PP5 protects mice against high-fat diet-induced weight gain but it cannot sustain glucose control during high-fat diet treatment. Together, our data provide evidence that PP5 is involved in the regulation of β- cell apoptosis and glucose homeostasis. PP5 may represent a double-edged sword in the fight against diabetes, since a PP5 inhibitor useful to prevent the progression towards obesity and diabetes, could possibly also harm the β-cells exposed to a glucolipotoxic environment

Development of superselective endovascular tissue access and sampling

Endovascular techniques have revolutionized healthcare by allowing effective treatments of vascular diseases not possible through other surgical means. They have also largely supplanted some surgical treatments due to increased safety and equal or sometimes increased efficacy. However, most endovascular techniques concern the treatment of intravascular disease, as the ability to reach the extravascular tissue has been limited. The trans-vessel wall technique is a recent endovascular technique, in the pre-clinical stage, that allows endovascular instruments to exit the blood vessel and gain direct access to the tissue of an organ. The trans-vessel wall technique and other minimally invasive approaches could be used to treat organs directly, and to perform biopsy. Tissue and cell biopsy are crucial parts of medical diagnosis, and the reference standard for most pathological conditions. In addition, biopsy is an important source of biological material of disease for pre-clinical research. Biopsy is performed using a variety of techniques with different levels of invasiveness, ranging from drilling through the skull to direct needle puncture with or without image guidance. There is a clear trend towards less invasive methods, which may offer a lower risk of complications and lesser need for post-biopsy monitoring, so that tissue crucial for diagnosis can be procured more quickly, safely, and preferably in outpatient settings. This thesis aimed to develop novel methods of accessing hard to reach organs using endovascular navigation, for the purposes of delivery of therapeutic substrates, or for performing biopsy. In Study I we employed mechanical thrombectomy, an established endovascular treatment method for ischemic stroke, to harvest endothelial cells from vessels affected by thrombosis. We showed that the endothelial cells can be isolated from the devices and thrombus, enriched by cell culture, and analyzed using single cell RNA sequencing. In Study II we tested an improved version of the trans-vessel wall technique, a method of direct tissue access using endovascular navigation, to access the heart, the kidneys, and pancreas parenchymae without causing significant hemorrhage. We showed that the myocardial wall can be accessed epicardially and endocardially, and that the kidney capsule can be accessed selectively. These access points are suitable targets for cell transplantation. The pancreas and kidney were also highly accessible for potential new biopsy techniques. In Study III we developed a novel endomyocardial biopsy device that is smaller, less traumatic, and more flexible than currently available methods, which may improve lesion targeting and reduce complications. We showed that the samples gathered by the device could be reliably analyzed using RNA sequencing. In Study IV we employed the novel endomyocardial biopsy technique in swine affected by myocardial infarction, showing that it is safe to use in a diseased heart and that RNA sequencing analysis of the biopsy samples could detect tissue gene expression changes caused by the myocardial infarction. In conclusion, this thesis demonstrates a variety of novel approaches to access tissues for administration of cells and therapeutic substances, and to obtain biopsies in safer and less traumatic ways than currently possible, using modern low profile endovascular techniques. It also shows that RNA sequencing can be a valuable tool to gather as much data as possible from the small cell and tissue samples gathered using these techniques

SAS AB Valuation : was it a good decision of the Norwegian government to take part of the SAS AB’s 2009 rights issue?

This master thesis is a valuation of SAS AB seen through the angle of the Norwegian government’s ownership. It is based on publicly available information up until March 2009. After an introduction of the airline industry and the SAS Group, we present relevant theory used to value the company. Then we analyze the historical economic performance of SAS and the company’s strategic position. Knowledge acquired from the historical and strategic analysis is then used to create financial forecasts. Based on this and the estimated cost of capital the net present value of the future free cash flows is estimated. After adjusting for SAS’ net debt and the number of shares it gives us an estimated share value of SEK 5.67. The validity of this result is evaluated through a multiple and sensitivity analysis. The conclusion is that the government proved good ownership responsibility in participating in the 2009 rights issue

Values and willingness-to-pay for sustainability-certified mobile phones

© 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered,transformed, or built upon in any way.This study investigated whether endorsement of personal values is associated with willingness to pay more for mobile phones with an environmental or social sustainability label. Participants were students in Sweden, Norway and Germany. A self-report inventory was used to measure willingness to pay and the importance attached to values of Schwartz’s circular model. In Sweden and Norway, participants were willing to pay, on average, 18% extra for a mobile phone with labels for environmental or social sustainability. In Germany, the corresponding share was 12%. To strive for self-enhancement values, that is, social status and prestige, as well as control and dominance over people and resources, was associated with a lower willingness to pay for mobile phones with labels for environmental or social sustainability in all three countries. Furthermore, women were willing to pay more than men for mobile phones with both kinds of sustainability labels. In Sweden and Norway, participants were, on average, willing to pay more for a mobile phone with a label for social sustainability compared to a mobile phone with a label for environmental sustainability.publishedVersio

An Examination of Swedish Human Resource Management Students’ Beliefs about What Work Should Ideally Be Like

Human Resource Management students’ beliefs about how work should be organised will influence their behaviour in future professional positions. This prompted a study in which students in a three-year programme in Human Resource Management at University West in Sweden commented on a number of statements about what work should ideally be like. All 140 respondents were born between 1978 and 1990 and hence belong to Generation Y, also known as Generation Me. The respondents generally agreed strongly with humanistic beliefs about work and female students agreed with humanistic beliefs to a far greater extent than male students.

Diet supplementation with green tea extract epigallocatechin gallate prevents progression to glucose intolerance in db/db mice

<p>Abstract</p> <p>Background</p> <p>Green tea was suggested as a therapeutic agent for the treatment of diabetes more than 70 years ago, but the mechanisms behind its antidiabetic effect remains elusive. In this work, we address this issue by feeding a green tea extract (TEAVIGO™) with a high content of epigallocatechin gallate (EGCG) or the thiazolidinedione PPAR-γ agonist rosiglitazone, as positive control, to <it>db/db </it>mice, an animal model for diabetes.</p> <p>Methods</p> <p>Young (7 week-old) <it>db/db </it>mice were randomized and assigned to receive diets supplemented with or without EGCG or rosiglitazone for 10 weeks. Fasting blood glucose, body weight and food intake was measured along the treatment. Glucose and insulin levels were determined during an oral glucose tolerance test after 10 weeks of treatment. Pancreata were sampled at the end of the study for blinded histomorphometric analysis. Islets were isolated and their mRNA expression analyzed by quantitative RT-PCR.</p> <p>Results</p> <p>The results show that, in <it>db/db </it>mice, EGCG improves glucose tolerance and increases glucose-stimulated insulin secretion. EGCG supplementation reduces the number of pathologically changed islets of Langerhans, increases the number and the size of islets, and heightens pancreatic endocrine area. These effects occurred in parallel with a reduction in islet endoplasmic reticulum stress markers, possibly linked to the antioxidative capacity of EGCG.</p> <p>Conclusions</p> <p>This study shows that the green tea extract EGCG markedly preserves islet structure and enhances glucose tolerance in genetically diabetic mice. Dietary supplementation with EGCG could potentially contribute to nutritional strategies for the prevention and treatment of type 2 diabetes.</p

A content validated questionnaire for assessment of self reported venous blood sampling practices

BACKGROUND: Venous blood sampling is a common procedure in health care. It is strictly regulated by national and international guidelines. Deviations from guidelines due to human mistakes can cause patient harm. Validated questionnaires for health care personnel can be used to assess preventable "near misses"--i.e. potential errors and nonconformities during venous blood sampling practices that could transform into adverse events. However, no validated questionnaire that assesses nonconformities in venous blood sampling has previously been presented. The aim was to test a recently developed questionnaire in self reported venous blood sampling practices for validity and reliability. FINDINGS: We developed a questionnaire to assess deviations from best practices during venous blood sampling. The questionnaire contained questions about patient identification, test request management, test tube labeling, test tube handling, information search procedures and frequencies of error reporting. For content validity, the questionnaire was confirmed by experts on questionnaires and venous blood sampling. For reliability, test-retest statistics were used on the questionnaire answered twice. The final venous blood sampling questionnaire included 19 questions out of which 9 had in total 34 underlying items. It was found to have content validity. The test-retest analysis demonstrated that the items were generally stable. In total, 82% of the items fulfilled the reliability acceptance criteria. CONCLUSIONS: The questionnaire could be used for assessment of "near miss" practices that could jeopardize patient safety and gives several benefits instead of assessing rare adverse events only. The higher frequencies of "near miss" practices allows for quantitative analysis of the effect of corrective interventions and to benchmark preanalytical quality not only at the laboratory/hospital level but also at the health care unit/hospital ward