Patienters uppfattning om och följsamhet till distriktssköterskans råd om kost och fysisk aktivitet vid diabetes typ 2

Diabetes typ 2 är en folksjukdom som påverkar individens hälsa och samhällets ekonomi, som kan begränsas genom förbättrad kosthållning och ökad fysisk aktivitet. Följsamheten till dessa råd ökar med ett bra stöd från distriktssköterskan. Syftet var att undersöka patienters uppfattning om och följsamhet till de råd de fått av distriktssköterskan om kost och fysisk aktivitet vid diabetes typ 2, samt att undersöka om det finns några skillnader med avseende på ålder, kön och antal år med diabetesdiagnos. På 6 vårdcentraler i Nordvästra Skåne delades 120 enkäter ut, 89 återlämnades ifyllda. 98 % hade fått diabetsrådgivning, 86 % var nöjda med rådgivningen. Inga signifikanta skillnader framkom mellan könen gällande belåtenhet med rådgivningen, samt inget samband gällande sjukdomsduration och rådgivningsbehovet. 92 % följde kostråden, 54 % var fysisk aktiva. Personer med diabetes typ 2 är nöjda med den distriktssköterskeledda rådgivningen. Flertalet anser sig följa råden angående kost och motion

KVALid

KVALid®[1] Tilsyn er et redskab til observation, evaluering og udvikling af kvalitet i dagtilbud. I skrivende stund er der udviklet et redskab til dagplejen og der arbejdes på et tilsvarende tilsynsmateriale til brug i vuggestuer og børnehaver[2]. KVALid Tilsyn bygger på mange års erfaringer med pædagogisk arbejde, ledelse, kompetence- og praksisudvikling i dagtilbud hos forfatterne samt erfaringer fra grund- efter- og videreuddannelse på Professionshøjskolen UCN, herunder udviklingen af KVALid Dialog til børnehave og vuggestue. I artiklen udfoldes det forskningsbaserede grundlag for KVALid Tilsyn Dagpleje, og det vises hvordan et udvalgt observationsskema under temaet, “Legen som grundlag”, kan anvendes til vurdering af kvaliteten i det pædagogiske læringsmiljø. Formålet er at vise grundlaget for KVALid Tilsyn, der er udviklet med afsæt i dagtilbudsloven (Undervisningsministeriet, 2020), den styrkede pædagogiske læreplan (2020) og på baggrund af dansk, skandinavisk og international forskning om høj kvalitet i dagtilbud, og diskutere hvorvidt et sådant vurderingsværktøj kan anvendes til at skærpe tilsynet og evalueringskulturen i de danske dagtilbuds læringsmiljøer. Med værktøjet vises hvordan det pædagogiske personale kan identificere kvalitet og forbedre praksis gennem et udviklende tilsyn.   [1] Sammentrækning af: Kvalitet i Dagtilbud [2] Der vil på sigt være tre færdigudviklede versioner af KVALid Tilsyn: Dagpleje, vuggestue og børnehav

Children with borderline intellectual functioning and autism spectrum disorder: developmental trajectories from 4 to 11 years of age

Background: Studies on autism have tended to focus either on those with intellectual disability (ie, those with intellectual quotient [IQ] under 70) or on the group that is referred to as “high-functioning”, that is, those with borderline, average or above average IQ. The literature on cognition and daily functioning in autism spectrum disorder combined specifically with borderline intellectual functioning (IQ 70–84) is limited. Methods: From a representative group of 208 preschool children diagnosed with autism spectrum disorder, those 50 children in the group with borderline intellectual functioning at ages 4.5–6.5 years were targeted for follow-up at a median age of 10 years. A new cognitive test was carried out in 30 children. Parents were interviewed with a semi-structured interview together with the Vineland Adaptive Behavior Scales (n=41) and the Autism-Tics, attention-deficit/hyperactivity disorder (AD/HD) and other comorbidities inventory (A-TAC) (n=36). Results: Most children of interviewed parents presented problems within several developmental areas. According to A-TAC and the clinical interview, there were high rates of attention deficits and difficulties with regulating activity level and impulsivity. Vineland Adaptive Behavior Scales composite scores showed that at school age, a majority of the children had declined since the previous assessment at ages between 4.5 and 6.5 years. Almost half the tested group had shifted in their IQ level, to below 70 or above 84. Conclusion: None of the children assessed was without developmental/neuropsychiatric problems at school-age follow-up. The results support the need for comprehensive follow-up of educational, medical and developmental/neuropsychiatric needs, including a retesting of cognitive functions. There is also a need for continuing parent/family follow-up and support

Fish intake and pre-frailty in Norwegian older adults - a prospective cohort study: the Tromsø Study 1994–2016

Background Pre-frailty is an intermediate, potentially reversible state before the onset of frailty. Healthy dietary choices may prevent pre-frailty. Fish is included in most healthy diets, but little is known about the association between long-term habitual fish intake and pre-frailty. We aimed to elucidate the longitudinal association between the frequency of fish intake and pre-frailty in a cohort of older adults in Norway. Methods 4350 participants (52% women,≥65 years at follow-up) were included in this prospective cohort study. Data was obtained from three waves of the population-based Tromsø Study in Norway; Tromsø4 (1994–1995), Tromsø6 (2007–2008) and Tromsø7 (follow-up, 2015–2016). Frailty status at follow-up was defined by a modifed version of Fried’s phenotype. Fish intake was self-reported in the three surveys and assessed as three levels of frequency of intake: low (0–3 times/month), medium (1–3 times/week) and high (≥4 times/week). The fsh–pre-frailty association was analysed using multivariable logistic regression in two ways; (1) frequency of intake of lean, fatty and total fish in Tromsø6 and pre-frailty at follow-up, and (2) patterns of total fsh intake across the three surveys and pre-frailty at follow-up. Results At follow-up, 28% (n=1124) were pre-frail. Participants with a higher frequency of lean, fatty and total fish intake had 28% (odds ratio (OR)=0.72, 95% confidence interval (CI)=0.53, 0.97), 37% (OR=0.63, 95% CI=0.43, 0.91) and 31% (OR=0.69, 95% CI=0.52, 0.91) lower odds of pre-frailty 8 years later compared with those with a low intake, respectively. A pattern of stable high fish intake over 21 years was associated with 41% (OR=0.59, 95% CI=0.38, 0.91) lower odds of pre-frailty compared with a stable low intake. Conclusions A higher frequency of intake of lean, fatty and total fish, and a pattern of consistent frequent fish intake over time, were associated with lower odds of pre-frailty in older community-dwelling Norwegian adults. These results emphasise the important role of fish in a healthy diet and that a frequent fish intake should be promoted to facilitate healthy ageing

Delivering and participating in a psycho- educational intervention for family caregivers during palliative home care: a qualitative study from the perspectives of health professionals and family caregivers

Abstract Background: Family caregivers in palliative care have a need for knowledge and support from health professionals, resulting in the need for educational and supportive interventions. However, research has mainly focused on the experiences of family caregivers taking part in interventions. To gain an increased understanding of complex interventions, it is necessary to integrate the perspectives of health professionals and family caregivers. Hence, the aim of this study is to explore the perspectives of health professionals and family caregivers of delivering and participating in a psycho-educational intervention in palliative home care. Methods: A psycho-educational intervention was designed for family caregivers based on a theoretical framework describing family caregiver's need for knowing, being and doing. The intervention was delivered over three sessions, each of which included a presentation by healthcare professionals from an intervention manual. An interpretive descriptive design was chosen and data were collected through focus group discussions with health professionals and individual interviews with family caregivers. Data were analysed using framework analysis

新機能性物質設計の基礎的研究 : 熱力学量と構造の関係について

博士（理学）神戸大

Higher levels of unmet support needs in spouses are associated with poorer quality of life - a descriptive cross-sectional study in the context of palliative home care.

Funder: Linnaeus UniversityBACKGROUND: Family caregivers often report having unmet support needs when caring for someone with life-threatening illness. They are at risk for psychological distress, adverse physical symptoms and negatively affected quality of life. This study aims to explore associations between family caregivers' support needs and quality of life when caring for a spouse receiving specialized palliative home care. METHODS: A descriptive cross-sectional design was used: 114 family caregivers completed the Carer Support Needs Assessment Tool (CSNAT) and the Quality of Life in Life-Threatening Illness - Family caregiver version (QOLLTI-F) and 43 of them also answered one open-ended question on thoughts about their situation. Descriptive statistics, multiple linear regression analyses, and qualitative content analysis, were used for analyses. RESULTS: Higher levels of unmet support needs were significantly associated with poorer quality of life. All CSNAT support domains were significantly associated with one or more quality of life domains in QOLLTI-F, with the exception of the QoL domain related to distress about the patient condition. However, family caregivers described in the open-ended question that their life was disrupted by the patient's life-threatening illness and its consequences. Family caregivers reported most the need of more support concerning knowing what to expect in the future, which they also described as worries and concerns about what the illness would mean for them and the patient further on. Lowest QoL was reported in relation to the patient's condition, and the family caregiver's own physical and emotional health. CONCLUSION: With a deeper understanding of the complexities of supporting family caregivers in palliative care, healthcare professionals might help to increase family caregivers' QoL by revealing their problems and concerns. Thus, tailored support is needed