Anpassningar av aktivitet

Med Parkinsons sjukdom följer funktionsnedsättningar som kan påverka vardagens aktiviteter. Detta leder ofta till ett behov av att genomföra anpassningar i aktivitetsutförandet. Syftet med studien var att undersöka hur personer med Parkinsons sjukdom upplever de anpassningar de genomför av sina aktiviteter i det dagliga livet. Semistrukturerade intervjuer med fokus på upplevelser av anpassningar genomfördes med åtta personer i åldrarna 64-78 år. Data analyserades med kvalitativ innehållsanalys. Resultatet visade att deltagarna hade anpassat vardagens aktiviteter till följd av sjukdomen, både vad gällde vilka aktiviteter som utfördes och hur aktiviteter utfördes. Upplevelserna av anpassningarna varierade från frustration till en ökad självkänsla. Att använda nya redskap eller hjälpmedel beskrevs som effektivt och oumbärligt och att komma på egna anpassningar gav en känsla av stolthet, vilket är viktigt att ta i beaktande när arbetsterapeuten föreslår lösningar på aktivitetsproblem. Denna studie bidrar med kunskap om hur personer med Parkinsons sjukdom upplever anpassningar av aktiviteter vilket kan vara vägledande vid planering och genomförande av arbetsterapeutiska åtgärder

Perception of pharmacological prevention and subsequent non-adherence to medication in patients with ischaemic heart disease:a population-based cohort study

OBJECTIVE: A patient-focused approach is advocated to embody risk of non-adherence to medication and subsequent adverse clinical outcomes following ischaemic heart disease (IHD). This study aimed to explore how patient perceived information on pharmacological prevention was associated with subsequent non-adherence to medication (measured by non-initiation, non-implementation and non-persistence) in patients with incident IHD. DESIGN: Cohort study. SETTING: Denmark. PARTICIPANTS: Register-based cohort of 829 patients with incident IHD in 2013. MEASURES: Perception covered whether patients’ experienced being adequately informed about their pharmacological prevention. Information on such was obtained from a survey and divided into ‘Well informed’, ‘Moderately informed’ and ‘Poorly informed’. Information on baseline characteristics, and reimbursed prescriptions of medication (antiplatelets, statins, ACE-inhibitors/angiotensin receptor blockers and β-blockers) during follow-up were obtained by linkage to nationwide public registers. Non-initiation and non-implementation of medication, measured as proportion of days covered, were analysed by Poisson regression. Non-persistence to medication, measured as risk of discontinuation, was analysed by multivariable Cox proportional hazard regression. PRIMARY AND SECONDARY OUTCOME MEASURES: Non-implementation and non-persistence to medication up to 365 days of follow-up were primary outcomes. Secondary outcomes included non-initiation as well as non-implementation and non-persistence to medication at 180 days of follow-up. RESULTS: A dose–response association was in general found between perception of pharmacological prevention and risk of non-implementation and non-persistence. For example, the hazard of non-persistence to antiplatelets was 1.18 (95% CI 0.71 to 1.96) times higher for patients reporting 'Moderately informed' and 1.89 (95% CI 1.10 to 3.25) times higher for patients reporting 'Poorly informed', compared with patients reporting 'Well informed of perception of pharmacological prevention' up to 365 days of follow-up. CONCLUSION: Lower levels of perception of pharmacological prevention were associated with subsequent non-implementation and non-persistence to medication in patients with incident IHD

Solid lubricant behavior of MoS2 and WSe2-based nanocomposite coatings

Tribological coatings made of MoS2 and WSe2 phases and their corresponding combinations with tungsten carbide (WC) were prepared by non-reactive magnetron sputtering of individual targets of similar composition. A comparative tribological analysis of these multiphase coatings was done in both ambient air (30–40% relative humidity, RH) and dry nitrogen (RH<7%) environments using the same tribometer and testing conditions. A nanostructural study using advanced transmission electron microscopy of the initial coatings and examination of the counterfaces after the friction test using different analytical tools helped to elucidate what governs the tribological behavior for each type of environment. This allowed conclusions to be made about the influence of the coating microstructure and composition on the tribological response. The best performance obtained with a WSex film (specific wear rate of 2 × 10−8 mm3 N–1m–1 and a friction coefficient of 0.03–0.05) was compared with that of the well-established MoS2 lubricant material.The Spanish Ministry of Economy, Industry and Competitiveness [projects n° MAT2010-21597-C02-01, MAT2011-29074-C02-01; MAT2015-65539-P; MAT2015-69035-REDC], Junta de Andalucía [P10-TEP-67182] and Spanish National Research Council (CSIC) [201560E013] are acknowledged for their financial support

How can we strengthen students' social relations in order to reduce school dropout?:An intervention development study within four Danish vocational schools

BACKGROUND: This article describes the rationale and contents of an intervention program aimed at strengthening students’ social relations in order to reduce dropout from vocational schools in Denmark. Taking its theoretical cue from the concept of ‘social participation’, a qualitative study was performed to investigate the specific relationships between the social environment within the schools and the institutional structures in order to analyse reasons for school dropout and their relation to well-being, cigarette smoking and substance use. METHODS: The development study was based on ethnographic methods, including 22 qualitative interviews with students 17–19 years old and fieldwork with participant observations at four vocational schools over 40 days, including informal interviews and discussion meetings with managers, teachers, counselors and students. As part of the fieldwork, four additional qualitative interviews and four group interviews were conducted with students 16–25 years old. RESULTS: The qualitative data collection resulted in seven major themes to be addressed in the intervention: social relations, sole focus on professional skills, institutionalized individualization, importance of the introduction period, physical surroundings and schedules, tobacco and cannabis use and communication about drug use. The program addressing these themes incorporates suggestions that are meant to improve how teachers welcome new students, to enable greater integration of social and educational activities and to enhance the capacity of teachers and counselors to deal with drug use problems among students. CONCLUSION: The development of new intervention programs might benefit from adopting a theoretical and methodological perspective that enables a closer exploration of the everyday social practices in which interventions are embedded. Thus, we aimed to create a comprehensive intervention that worked through organizational changes in everyday school practices. Intervention programs must be planned in dialogue and collaboration with practitioners in the field to ensure the pertinence and usability of the program

Shaping the Social:design of a settings-based intervention study to improve well-being and reduce smoking and dropout in Danish vocational schools

BACKGROUND: The social environment at schools is an important setting to promote educational attainment, and health and well-being of young people. However, within upper secondary education there is a need for evidence-based school intervention programmes. The Shaping the Social intervention is a comprehensive programme integrating social and educational activities to promote student well-being and reduce smoking and dropout in upper secondary vocational education. The evaluation design is reported here. METHODS/DESIGN: The evaluation employed a non-randomised cluster controlled design, and schools were selected to either implement the intervention or continue with normal practice for comparison. In the baseline survey conducted 2011–2012, 2,329 students from four intervention schools and 3,371 students from six comparison schools answered a computer-based questionnaire during class, representing 73 % and 81 % of eligible students, and 22 % of all technical/agricultural vocational schools in Denmark. Follow-up assessment was conducted 10 weeks after baseline and at the same time teachers of the intervention classes answered a questionnaire about implementation. School dropout rates will be tracked via national education registers through a 2-year follow-up period. DISCUSSION: Shaping the Social was designed to address that students at Danish vocational schools constitute a high risk population concerning health behaviour as well as school dropout by modifying the school environment, alongside developing appropriate evaluation strategies. To address difficulties in implementing settings-based interventions, as highlighted in prior research, the strategy was to involve intervention schools in the development of the intervention. Baseline differences will be included in the effectiveness analysis, so will the impact of likely mediators and moderators of the intervention. TRIALS REGISTRATION: ISRCTN57822968. Date of registration: 16/01/201