29 research outputs found

    Physical activity and mental retardation in children - and young people

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    EPSI, læring eller legitimering?

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    Occupational advice for Patients undergoing Arthroplasty of the Lower limb: An intervention development and feasibility study (The OPAL Study)

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    Background Hip and knee replacements are regularly performed for patients who work. There is little evidence about these patients’ needs and the factors influencing their return to work. There is a paucity of guidance to help patients return to work after surgery and a need for structured occupational advice to enable them to return to work safely and effectively. Objective(s) To develop an occupational advice intervention to support early recovery to usual activities including work which is tailored to the requirements of patients undergoing hip and knee replacements. To test the acceptability, practicality and feasibility of this intervention within current care frameworks Design An intervention mapping (IM) approach was used to develop the intervention. The research methods employed were: rapid evidence synthesis; qualitative interviews with patients and stakeholders; prospective cohort study; survey of clinical practice; modified Delphi consensus process. The developed intervention was implemented and assessed during the final feasibility stage of the IM process. Setting Orthopaedic departments within NHS secondary care. Participants Patients in work, and intending to return to work following primary elective hip and knee replacement surgery; healthcare professionals and employers. Interventions Occupational advice intervention. Main outcome measures Development of an occupational advice intervention. Fidelity of the developed intervention when delivered in a clinical setting. Patient and clinician perspectives of the intervention. Preliminary assessments of intervention effectiveness and cost. Results A cohort study (154 patients), 110 stakeholder interviews, survey of practice (152 respondents) and evidence synthesis provided the necessary information to develop the intervention. The intervention included information resources, personalized return to work plan and co-ordination from the healthcare team to support the delivery of 13 patient and 20 staff performance objectives (POs). To support delivery, a range of tools (e.g. occupational checklists, patient workbooks, employer information), roles (e.g. return-to-work coordinator) and training resources were created. Feasibility was assessed in 21 of the 26 patients recruited from 3 NHS trusts. Adherence with the defined performance objectives was 75% for patient POs and 74% for staff POs. The intervention was generally well received although the short timeframe available for implementation and concurrent research evaluation led to some confusion amongst patients and those delivering the intervention regarding its purpose and the roles and responsibilities of key staff. Limitations Implementation and uptake of the intervention was not standardized and was limited by the study timeframe. Evaluation of the intervention involved a small number of patients which limited the ability to assess it. Conclusions The developed occupational advice intervention supports best practice. Evaluation demonstrated good rates of adherence against defined performance objectives. However, a number of operational and implementation issues require further attention Future work The intervention warrants a randomised controlled trial to assess its clinical and cost effectiveness to improve rates and timing of sustained return to work after surgery. This research should include the development of a robust implementation strategy to ensure adoption is sustained. Funding This project was funded by the NIHR Health Technology Assessment programme (project number 15/28/02) Trial Registrations International Standard Randomised Controlled Trials Number Trial ID: ISRCTN27426982 International prospective register of systematic reviews (PROSPERO) Registration: CRD4201604523

    Støte eller støtte?

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    Studien Støte eller støtte? har til hensikt å undersøke hvordan unge utsatt for kjærestevold, offline (ansikt-til-ansikt) og/eller online, opplever sosial støtte. Studien anvender en kvalitativ metode og bygger på seks intervjuer med jenter i alderen 15–18 år. Resultatene viser at den sosiale støtten etter kjærestevold ble opplevd som positiv og viktig. De utsatte velger å støtte seg til venner fremfor foreldre, andre voksne eller profesjonelle samtalepartnere som helsesøstre og psykologer. Støtten fremstår begrenset ved at tre av seks informanter ikke innlemmer nettverket i sine erfaringer. Skam, tillitsvansker og frykt for at nettverket skal tillegge de utsatte skyld, fremstår til hinder for den sosiale støtten. Funnene tyder også på at nettverkets passivitet, hindrer støtten. Resultatene blir tolket etter en tematisk- og fenomenologisk meningsanalyse, og blir diskutert i lys av teori om sosial støtte

    Decrystallization of Lignocellulosic Biomass using Ionic Liquids

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    This thesis is written in fulfilment of the requirements for a Master in Science at the Norwegian University of Science and Technology (NTNU), Department of Chemical Engineering. The work investigates the effectiveness of pretreatment of norway spruce and sugarcane bagasse with the ionic liquid 1-ethyl-3-methylimidazolium acetate ([EMIM][OAc]). The effect of pretreatment temperature and reaction time was evaluated. Enzymatic hydrolysis yield was used as the main evaluation parameter. Norway spruce was pretreated at 80, 100, and 120 °C for 3, 6, 12, and 24 hours. The sugarcane bagasse raw material was pretreated at the same temperatures for 1 and 3 hours. UV-Vis spectrophotometric analysis was used to determine the amount of lignin removed during the pretreatment. The regenerated solids from the pretreatment was hydrolysed enzymaticly and the digestibility was determined using High-Performance Liquid Chromatography (HPLC). The pretreatment caused an increase in the enzymatic digestibility for both spruce and bagasse. This effect is believed to arise from a decrease in the crystallinity of the cellulose and an increase in the accessible surface area caused by the increased porosity of the pretreated material. The digestibility results for spruce shows that, at shorter pretreatment times, higher temperatures are favourable. However, at longer reaction times, too high temperatures can give a reduction in the digestibility. The optimal reaction condition for spruce was in this work found to be 100 °C for 12 hours, giving a digestibility close to 90 wt% of the added glucan. For sugarcane bagasse the optimum was not found, and experiments using harsher conditions was proposed. When comparing the results for pretreatment of spruce with that of bagasse it appear that spruce needs harsher conditions to achieve the same glucan yield as bagasse. The results of the analysis of the enzymatic digestibility of hemicelluloses (mannan for spruce and zylan for bagasse) concurs very well with the results for glucan presented above. Regarding the removal of lignin from the biomass, it was found that the degree of delignification in these pretreatment experiments was so low it could be neglected. The low degree of lignin removal was also evident in the darkening of the regenerated biomass from pretreatments using relatively harsh reaction conditions. This darkening was put down to the lignin undergoing condensation reactions. Suggestions for further work on this area include a thorough investigation into the thermal stability of different ionic liquids at prolonged reaction times and high temperatures, as well as an investigation of the delignification effect of different ionic liquids. As mentioned earlier, pretreatment experiments with bagasse using harsher conditions can also be useful

    Stress in the Norwegian police service

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