On the inverse image of pattern classes under bubble sort

Let B be the operation of re-ordering a sequence by one pass of bubble sort. We completely answer the question of when the inverse image of a principal pattern class under B is a pattern class.Comment: 11 page

Integrating Family Strengths in Child Protection Goals

Over the last decades, child protection workers (CPWs) have largely focused on improving their work with a strength-based approach in order to empower families. This study investigates to what extent CPWs draw on families' strengths, that is, by promoting autonomy and competencies and by involving their informal networks in goal formulation. This quantitative study analysed the goals, as stated in case files, formulated by CPWs for 177 families within a single Dutch child protection service. 48.6% of CPWs prioritise promoting families' autonomy in goal formulation. With regard to competencies, only 40.1% of the goals refer to the families' competencies. In addition, the support system that the goals call upon tends to be dominated by formal rather than informal networks (in 71.2% of cases). While it is true that child protection cases can benefit from the support of a formal networks, CPWs overwhelmingly failed to encourage support from existing informal networks (in 95.5% of cases). There were no relationships between these percentages and the nature of the family problems or the question of whether or to what extent the CPWs identified the specific strengths of families. These findings show that half of the CPWs had integrated a strength-based approach in their daily practice to some extent, and therefore improvements are needed in order to more successfully encourage families to change.</p

Validation of the Caregivers’ Satisfaction with Stroke Care Questionnaire: C-SASC hospital scale

To date, researchers have lacked a validated instrument to measure stroke caregivers’ satisfaction with hospital care. We adjusted a validated patient version of satisfaction with hospital care for stroke caregivers and tested the 11-item caregivers’ satisfaction with hospital care (C-SASC hospital scale) on caregivers of stroke patients admitted to nine stroke service facilities in the Netherlands. Stroke patients were identified through the stroke service facilities; caregivers were identified through the patients. We collected admission demographic data from the caregivers and gave them the C-SASC hospital scale. We tested the instrument by means of structural equation modeling and examined its validity and reliability. After the elimination of three items, the confirmatory factor analyses revealed good indices of fit with the resulting eight-item C-SASC hospital scale. Cronbach’s α was high (0.85) and correlations with general satisfaction items with hospital care ranged from 0.594 to 0.594 (convergent validity). No significant relations were found with health and quality of life (divergent validity). Such results indicate strong construct validity. We conclude that the C-SASC hospital scale is a promising instrument for measuring stroke caregivers’ satisfaction with hospital stroke care

Ivaretakelse av hjelperen: om belastning og beskyttelse.

I årene fremover er det spådd en sykepleiermangel i Norge. Risikoen for å få kreft øker med alderen, samtidig som vi stadig lever lengre enn tidligere. Disse ulike faktorene kan føre til økt belastning på helse- og omsorgstjenesten. Tidligere forskning har vist at når en jobber som sykepleier i kreftomsorg, er en i risikosonen for å utvikle omsorgstretthet (compassion fatigue) og utbrenthet. Samtidig kan arbeidet som hjelper føre til omsorgstilfredshet (compassion satisfaction) og styrket profesjonell livskvalitet. Formålet med studien var å undersøke hvordan sykepleiere som jobbet i ulike kontekster i kreftomsorgen opplevde å jobbe med mennesker med kreft. Jeg ville se om det var forskjeller fra de ulike arbeidsplassene, og hvordan en krevende arbeidshverdag kunne påvirke informantene. Var det tilrettelagt for refleksjon og erfaringsdeling innad i teamet, og var det rettet fokus mot ivaretakelse av hjelperne? Hvordan håndtere en travel arbeidshverdag, samtidig som en møtte mennesker i lidelse, med behov for samtale og støtte? Det var og interessant å se på hvilken betydning erfaring som sykepleier hadde når en jobbet med mennesker med kreft. Utvalget var sykepleiere som jobbet i spesialisthelsetjeneste, kommunehelsetjeneste og i en stiftelse, med spredning i alder og arbeidserfaring. Jeg ønsket å gå i dybden av fenomenet, og anvendte derfor kvalitativ metode. Det ble gjennomført åtte individuelle, semistrukturerte intervju som metode for datainnsamling og tematisk analyse ble anvendt for å analysere data. Studien viste at sykepleierne opplevde arbeidshverdagen som en kombinasjon av givende og tappende. Å være med og utgjøre en forskjell for pasienter og pårørende, ga mestringsfølelse, opplevelse av mening i arbeidet og motivasjon til å fortsette som sykepleier. Hverdagen besto av prioriteringer på grunn av krav om effektivitet, samtidig som sykepleierne opplevde en knapphet på tid og ressurser. Dette førte til at den gode samtalen med pasienter ofte måtte vike for praktiske oppgaver, noe som kunne føre til dårlig samvittighet, opplevelse av å ikke strekke til og forstyrret muligheten til å utføre helhetlig sykepleie. Anerkjennelse fra ledelse, kollegial støtte og mulighet til refleksjonsdeling innad i teamet ble trukket frem som viktige forutsetninger for å fortsette i yrket. Støtte og tilrettelegging i arbeidshverdagen til kompetanseheving kom frem som et etterlengtet og viktig tiltak for å styrke pasientsikkerheten, i tillegg til at det kunne bidra til økt mestringsfølelse og trygghet hos sykepleierne, og dermed styrke profesjonell livskvalitet. Nøkkelord: omsorgstretthet, utbrenthet, omsorgstilfredshet, helhetlig sykepleie, profesjonell livskvalitetGlobally there is an ongoing pressure on the health services due to an aging population, and growing cancer incidence and prevalence. At the same time there is a concern regarding the increasing turnover in nursing. Prior research has indicated that working in cancer nursing involves a risk of developing compassion fatigue and burnout, but also that working in this field is associated with compassion satisfaction and professional quality of life. The main objective of this thesis is to increase focus on how emotional strain and occupational stress could affect nurses working in cancer care. To explore this phenomenon, a qualitative design was used. Eight individual semi-structured interviews were conducted with nurses working in different contexts in cancer care. The sample was heterogenous in age and work experience. Thematic analysis was used to analyse the data. The findings suggested that working in cancer care could be both rewarding and wearying. When the nurses felt that they made a difference for patients and their next of kin, it was a thriving factor to continue with cancer nursing. It enhanced their professional quality of life and led to a feeling of accomplishment. Lack of time and resources forced nurses to prioritize during the workday. Furthermore, increased demands of efficiency were associated with occupational stress. The nurses often felt the work as overwhelming and suggested that increased base staffing might alleviate the problem. The high experienced workload resulted in practical tasks taking priority over conversations with patients and their next of kin. This prioritization could lead to a bad conscience, a feeling of not reaching out, and disrupting the ability to provide holistic nursing. The nurses highlighted some crucial factors as prerequisites for continuing in the nursing field, such as recognition from management, collegial support, and the opportunity to reflect and share experiences with their team. They valued professional competence and highlighted the importance to keep up to date. They stated that these factors could secure actions when needed, and therefor enhance the patient safety. To provide holistic care had a high importance in the sample, and they stated that it could contribute to provide the quality of care that they wanted for patients with cancer, and therefor strengthen the professional quality of life of the nurses. Keywords: compassion fatigue, burnout, compassion satisfaction, professional quality of life, cancer nursing, holistic nursin

A Study on Optimization and Evaluation of the Visualization of Complex Algorithm Results in Remote Monitoring of COPD

BACKGROUND: Artificial intelligence (AI) can potentially increase the quality of telemonitoring in chronic obstructive pulmonary disease (COPD). However, the output from AI is often difficult for clinicians to understand due to the complexity. This challenge may be accommodated by visualizing the AI results, however it hasn't been studied how this could be done specifically, i.e., considering which visual elements to include.AIM: To investigate how complex results from a predictive algorithm for patients with COPD can be translated into easily understandable data for the clinicians.METHODS: Semi-structured interviews were conducted to explore clinicians' needs when visualizing the results of a predictive algorithm. This formed a basis for creating a prototype of an updated user interface. The user interface was evaluated using usability tests through the "Think aloud" method.RESULTS: The clinicians pointed out the need for visualization of exacerbation alerts and the development in patients' data. Furthermore, they wanted the system to provide more information about what caused exacerbation alerts. Elements such as color and icons were described as particularly useful. The usability of the prototype was primarily assessed as easily understandable and advantageous in connection to the functions of the predictive algorithm.CONCLUSION: Predictive algorithm use in telemonitoring of COPD can be optimized by clearly visualizing the algorithm's alerts, clarifying the reasons for algorithm output, and by providing a clear overview of the development in the patient's data. This can contribute to clarity when the clinicians should act and why they should act on alerts from predictive algorithms.</p

Validation of a same-day real-time PCR method for screening of meat and carcass swabs for Salmonella

<p>Abstract</p> <p>Background</p> <p>One of the major sources of human <it>Salmonella </it>infections is meat. Therefore, efficient and rapid monitoring of <it>Salmonella </it>in the meat production chain is necessary. Validation of alternative methods is needed to prove that the performance is equal to established methods. Very few of the published PCR methods for <it>Salmonella </it>have been validated in collaborative studies. This study describes a validation including comparative and collaborative trials, based on the recommendations from the Nordic organization for validation of alternative microbiological methods (NordVal) of a same-day, non-commercial real-time PCR method for detection of <it>Salmonella </it>in meat and carcass swabs.</p> <p>Results</p> <p>The comparative trial was performed against a reference method (NMKL-71:5, 1999) using artificially and naturally contaminated samples (60 minced veal and pork meat samples, 60 poultry neck-skins, and 120 pig carcass swabs). The relative accuracy was 99%, relative detection level 100%, relative sensitivity 103% and relative specificity 100%. The collaborative trial included six laboratories testing minced meat, poultry neck-skins, and carcass swabs as un-inoculated samples and samples artificially contaminated with 1–10 CFU/25 g, and 10–100 CFU/25 g. Valid results were obtained from five of the laboratories and used for the statistical analysis. Apart from one of the non-inoculated samples being false positive with PCR for one of the laboratories, no false positive or false negative results were reported. Partly based on results obtained in this study, the method has obtained NordVal approval for analysis of <it>Salmonella </it>in meat and carcass swabs. The PCR method was transferred to a production laboratory and the performance was compared with the BAX <it>Salmonella </it>test on 39 pork samples artificially contaminated with <it>Salmonella</it>. There was no significant difference in the results obtained by the two methods.</p> <p>Conclusion</p> <p>The real-time PCR method for detection of <it>Salmonella </it>in meat and carcass swabs was validated in comparative and collaborative trials according to NordVal recommendations. The PCR method was found to perform well. The test is currently being implemented for screening of several hundred thousand samples per year at a number of major Danish slaughterhouses to shorten the post-slaughter storage time and facilitate the swift export of fresh meat.</p