Hvordan kan sykepleier bidra til riktig kost hos underernærte pasienter med Kols

Bakgrunn: Jeg har vært i praksis ved medisinsk avdeling, der jobbet jeg på en gruppe med spesialitet innen lungelidelser. Der møtte jeg flere pasienter med kronisk obstruktiv lungesykdom (KOLS). Jeg bemerket at disse pasientene er ofte enten overvektige eller undervektige. Det var lite fokus på ernæring på avdelingen. Hensikt og mål: Hensikten er å finne forskningsresultater rundt ernæring til kolspasienter. Ettersom ernæringsstatusen viser seg å være avgjørende for prognosen og symptombildet er det viktig med økt forståelse innen kosthold blant helsepersonell. Målet med oppgaven blir dermed å øke mine kunnskaper om kost til underernærte kolspasienter og hva som blir sykepleierens rolle i ernæringsarbeidet. Problemstilling: Hvordan kan sykepleier bidra til riktig kost hos underernærte pasienter med KOLS. Metode: I denne oppgaven benytter jeg litteraturstudie. I en litteraturstudie benyttes litteratur som allerede finnes for å finne mulige svar på en problemstilling. Resultater og funn: Forskere har anbefalt rikelige mengder med proteiner, karbohydrater og omega tre flerumettet fettsyrer. Forskningen som er gjort viser at økt energimengde bør kombineres med fysisk aktivitet for å ha best effekt

Teaching Academic Concepts in a Play-Based Preschool Environment: A Case Study of Guided Play across Three Classrooms

This qualitative study examined interactions between preschool children and teachers during guided-play activities. These interactions were studied through observations and interviews in a case-study format. Classrooms were observed for 1 hour per week over the course of 4 weeks. Teachers were interviewed following each observation. All three preschool classrooms were located in northern California and belonged to the same chain of schools. A total of six teachers and 75 students participated in the study. Three main research questions drove the course of the study. The first research question examined the types of interactions between experienced preschool teachers and students during guided play. The second research question dealt with how preschool children respond to different types of interactions during guided play. Finally, the third research question involved recommendations for how school leaders can help teachers use their knowledge of each child’s individual abilities to make guided play more effective in the classroom. The study revealed that teacher interactions were extremely beneficial to student learning in a play-based environment. Teachers in each classroom organized a set of hands-on activities each day through which the children rotated. The activities had specific learning goals and objectives. Many activities were in the children’s zone of proximal development (ZPD), which is defined as the area between “the most difficult task a child can do alone and the most difficult task a child can do with help” (Vygotsky, 1986, p.83). Working in the ZPD requires some teacher support and interaction, as these are the types of activities children cannot do independently. Proper scaffolding is necessary when children are working toward a goal that is slightly above what they can do without assistance. Preschool teachers should take this into consideration when planning lessons and guided play activities. School leaders can support teachers by providing more training on how to manage guided play with a large group of children, as individualized attention is necessary for successful implementation. Suggestions for training topics are detailed in the findings and discussion of this study

Association between physical activity and carotid atherosclerosis

Background/aim: Physical activity reduces the risk of cardiovascular disease (CVD). Atherosclerosis is an important common underlying cause of CVD. It is not clear whether the beneficial effect of physical activity on CVD is mediated through effect on atherosclerosis, and previous studies have shown diverging results. The aim of this study was to investigate the association between level of physical activity and atherosclerosis. Method and materials: We included 10,894 participants of the Tromsø Study (1994-2008) who was measured with ultrasound of the carotid artery. Atherosclerosis was assessed as intima-media thickness (IMT), plaque presence (yes/no) and total plaque area (TPA). Linear regression models were used to assess the association between physical activity and intima-media thickness and total plaque area. Logistic regression models were used to assess the association between physical activity across quartiles of IMT and categories of plaque. Results: We found a significant trend toward lower plaque prevalence and smaller TPA with increasing degree of physical activity. In age-and sex-adjusted models, the OR for plaque presence was 0.74% (95% CI 0.68-0.81) for moderate physical activity and -0.04 (95% CI -0.06 - -0.02) compared to low physical activity. Similar trends were found in age-and-sex-adjusted linear regression analyses or the association between physical activity and TPA. There was an interaction for sex between physical activity and IMT, with a significant inverse association for moderate physical activity (beta-coefficient -0.01 (95% CI -0.02 - -0.001, p=0.02)) and a borderline significance in those with high physical activity (beta-coefficient -0.01 (95% CI -0.03 – 0.000, p=0.06) in men, but not in women. Conclusion: Physical activity was significantly associated with carotid IMT in men in age-adjusted models and with plaque in age-and-sex-adjusted models. Adjustment for traditional CVD risk factors attenuated these associations. This may imply that the effect of physical activity on atherosclerosis is mediated through effecting these risk factors

Four-way regulation of mosquito yolk protein precursor genes by juvenile hormone-, ecdysone-, nutrient-, and insulin-like peptide signaling pathways.

Anautogenous mosquito females require a meal of vertebrate blood in order to initiate the production of yolk protein precursors by the fat body. Yolk protein precursor gene expression is tightly repressed in a state-of-arrest before blood meal-related signals activate it and expression levels rise rapidly. The best understood example of yolk protein precursor gene regulation is the vitellogenin-A gene (vg) of the yellow fever mosquito Aedes aegypti. Vg-A is regulated by (1) juvenile hormone signaling, (2) the ecdysone-signaling cascade, (3) the nutrient sensitive target-of-rapamycin signaling pathway, and (4) the insulin-like peptide (ILP) signaling pathway. A plethora of new studies have refined our understanding of the regulation of yolk protein precursor genes since the last review on this topic in 2005 (Attardo et al., 2005). This review summarizes the role of these four signaling pathways in the regulation of vg-A and focuses upon new findings regarding the interplay between them on an organismal level

Effect of supplied CO-CO2 in the presence of carbon

The effect of varying the CO-CO2 and CO2-N2 ratios was investigated in the presence of coal in a specially designed 3-electrode setup, used to simulate the anode compartment in a hybrid direct carbon fuel cell (HDCFC). The HDCFC consists of a hybrid between a molten carbonate and a solid oxide fuel cell (SOFC). It was shown that the cell performance improved with increased CO2 content in the CO2-N2 mixture, due to the formation of CO from the inverse Boudouard reaction. The same was seen for CO/CO2 gas mixtures in the presence of coal, in contrast to CO-fueled SOFCs

POWER2GAS IN GERMANY – TECHNOLOGY AND OPPORTUNITIES

For the future, Germany banks on renewable energy. That bears a challenge, because this energy generation heavily depends on climate conditions. Therefore, a proper storage technology is needed to ensure the energy supply all over the year. Furthermore, the expansion of renewable power plants and the power grid expansion advance in different pace. The power grid operators have to react with feed-in management actions to safe the grid against overloading. As a consequence, operators have to switch off some of their windmills if the wind blows to strong. Suitable storage technologies will help to avoid shutting down renewable power plants to generate the full energy potential. A promising technology is Power2Gas. These facilities transform electrical energy into gas, which could be stored in the huge German gas network

The CHARGE study: an epidemiologic investigation of genetic and environmental factors contributing to autism.

Causes and contributing factors for autism are poorly understood. Evidence suggests that prevalence is rising, but the extent to which diagnostic changes and improvements in ascertainment contribute to this increase is unclear. Both genetic and environmental factors are likely to contribute etiologically. Evidence from twin, family, and genetic studies supports a role for an inherited predisposition to the development of autism. Nonetheless, clinical, neuroanatomic, neurophysiologic, and epidemiologic studies suggest that gene penetrance and expression may be influenced, in some cases strongly, by the prenatal and early postnatal environmental milieu. Sporadic studies link autism to xenobiotic chemicals and/or viruses, but few methodologically rigorous investigations have been undertaken. In light of major gaps in understanding of autism, a large case-control investigation of underlying environmental and genetic causes for autism and triggers of regression has been launched. The CHARGE (Childhood Autism Risks from Genetics and Environment) study will address a wide spectrum of chemical and biologic exposures, susceptibility factors, and their interactions. Phenotypic variation among children with autism will be explored, as will similarities and differences with developmental delay. The CHARGE study infrastructure includes detailed developmental assessments, medical information, questionnaire data, and biologic specimens. The CHARGE study is linked to University of California-Davis Center for Children's Environmental Health laboratories in immunology, xenobiotic measurement, cell signaling, genomics, and proteomics. The goals, study design, and data collection protocols are described, as well as preliminary demographic data on study participants and on diagnoses of those recruited through the California Department of Developmental Services Regional Center System

The Structure and Composition of Seasonally Dry Tropical Forest Communities on St. Lucia

Dry forests of the Caribbean islands are regarded as highly disturbed ecosystems and have been characterized as having a high density of small diameter stems, a lower basal area at maturity and a lower species-richness than continental Neotropical dry forests. However, the emerging view regards these ecosystems as phenologically complex, where taxonomic and structural composition is variable over time and space, due to local hydraulic regimes induced by high topographic and climactic variability and varying forms and intensities of disturbance. The former view is derived from a few studies, the majority of which have been conducted in Puerto Rico and from one data review of small 0.1 ha plots representing 4 sites in the Antilles and 25 sits in the continental Neotropics. Overall, little is known about the less-disturbed dry forest formations of the Antilles. Given the emerging view and lack of research in less-disturbed Antillean dry forests, a case study of dry forest structure and composition on the island of St. Lucia is used to examine heterogeneity in dry forest floristic and structural composition on the topographically, floristically and climactically complex island of St. Lucia. Amongst twenty-two 15 x 15 m widely distributed plots, only 11/64 species/genera were found in >50\% of plots and clustering was observed amongst uncommon species, supporting evidence of floristic heterogeneity. Significant differences between the total basal area of each plot (Kruskal-Wallis test, p <0.05) were observed; each plot differed significantly with at least 2 other plots, 6 differed significantly with 10 or more plots, providing evidence for structural heterogeneity. Comparisons were also made with prior research to question generalizations about Antillean dry forests. Amongst large diameter stems, species richness and stem density was higher in this study, when compared to more-disturbed Antillean dry forests. The most speciose dry forest genus was Zanthoxylum, while four families were found to be equally speciose namely, Myrtaceae, Fabaceae, Rutaceae and Rubiaceae, highlighting inconsistencies with prior generalizations. Species-richness values reported amongst Neotropical dry forests were highly variable amongst similar regions, let alone the continental Neotropics, relative to the Antillean Archipelago. Stem density and basal area in St. Lucia was similar to ranges reported throughout the Neotropics, further supporting evidence for intra-island structural variability. The intra-region heterogeneity observed in Antillean and Neotropical continental dry forests indicates that results from localized plot-based studies of structure and composition, should not be extrapolated to broad geo-political regions