The harlequin ladybird, Harmonia axyridis: global perspectives on invasion history and ecology

The harlequin ladybird, Harmonia axyridis (Pallas) (Coleoptera: Coccinellidae), is native to Asia but has been intentionally introduced to many countries as a biological control agent of pest insects. In numerous countries, however, it has been introduced unintentionally. The dramatic spread of H. axyridis within many countries has been met with considerable trepidation. It is a generalist top predator, able to thrive in many habitats and across wide climatic conditions. It poses a threat to biodiversity, particularly aphidophagous insects, through competition and predation, and in many countries adverse effects have been reported on other species, particularly coccinellids. However, the patterns are not consistent around the world and seem to be affected by many factors including landscape and climate. Research on H. axyridis has provided detailed insights into invasion biology from broad patterns and processes to approaches in surveillance and monitoring. An impressive number of studies on this alien species have provided mechanistic evidence alongside models explaining large-scale patterns and processes. The involvement of citizens in monitoring this species in a number of countries around the world is inspiring and has provided data on scales that would be otherwise unachievable. Harmonia axyridis has successfully been used as a model invasive alien species and has been the inspiration for global collaborations at various scales. There is considerable scope to expand the research and associated collaborations, particularly to increase the breadth of parallel studies conducted in the native and invaded regions. Indeed a qualitative comparison of biological traits across the native and invaded range suggests that there are differences which ultimately could influence the population dynamics of this invader. Here we provide an overview of the invasion history and ecology of H. axyridis globally with consideration of future research perspectives. We reflect broadly on the contributions of such research to our understanding of invasion biology while also informing policy and people

En kartlegging av helsepersonells erfaring med Pediatrisk tidlig varslingsskår (PEVS)

Bakgrunn: Pediatrisk tidlig varslingsskår (PEVS) er et skåringsverktøy som ble utviklet tidlig på 2000-tallet i England og modifisert til norske forhold i 2011. Verktøyet tallfester alvorlighetsgraden av barns kliniske tilstand, uavhengig av diagnose, og identifiserer barn mellom 0 og 18 år som er i fare for klinisk forverring. PEVS anses som et nyttig hjelpemiddel for å gjenkjenne risikopasienter, men det foreligger lite forskning om brukererfaringer med PEVS. Hensikt: Å beskrive sykepleiere og legers erfaring med PEVS. Vi fremstiller erfaringene på bakgrunn av hvorvidt verktøyet bidrar til systematikk og bedret kommunikasjon, samt hvorvidt verktøyet er anvendelig for brukeren. I tillegg undersøker vi hvorvidt PEVS brukes etter oppsatte rutiner, og hvorvidt forskjellige sykehus eller yrkesgrupper har ulike erfaringer. Metode: Vi benyttet kvantitativ metode med deskriptivt tverrsnittsdesign. Vi brukte et egenutviklet spørreskjema til å kartlegge brukererfaringene til 172 helsepersonellansatte fra tre sykehus i Norge. Vi foretok deskriptive analyser kombinert med ikke-parametriske rangsumtester: Kruskal-Wallis og Mann-Whitney-Wilcoxon. Resultat: Det er gjennomgående enighet blant helsepersonellet om at PEVS bidrar til systematikk og bedret kommunikasjon, og at PEVS er et brukervennlig verktøy. Helsepersonell fra ett sykehus var signifikant oftere enige i at de bruker PEVS i samsvar med rutinene, sammenliknet med de andre sykehusene. Konklusjon: Helsepersonell rapporterer om positive erfaringer med PEVS, men studien viser at de bruker rutiner svært forskjellig

No Correlation Between Ethical Judgment in Trolley Dilemmas and Vaccine Scenarios for Nurse Specialist Students

We tested whether responses to trolley problems by nurse specialist students correlated with their responses to hypothetical vaccine problems, as a follow-up to a similar study on ethics committees. No statistically significant correlation was found between the trolley and vaccination scores. These results confirmed and strengthened the finding of a very weak correlation (possibly zero), and the point estimate was even lower than for the ethics committees. Hence, the nurse specialists’ responses to the trolley problems cannot be used to indicate any direction for their responses to the vaccine problems, although there is a common core issue of sacrificing some for many. The respondents reported a relatively high willingness to push one man in front of a trolley to save five. They also reported a high willingness to act in trolley dilemmas compared with vaccination dilemmas, although the dimensions of risk–reward ratios and consent heavily favored the latter

No Correlation Between Ethical Judgment in Trolley Dilemmas and Vaccine Scenarios for Nurse Specialist Students

We tested whether responses to trolley problems by nurse specialist students correlated with their responses to hypothetical vaccine problems, as a follow-up to a similar study on ethics committees. No statistically significant correlation was found between the trolley and vaccination scores. These results confirmed and strengthened the finding of a very weak correlation (possibly zero), and the point estimate was even lower than for the ethics committees. Hence, the nurse specialists’ responses to the trolley problems cannot be used to indicate any direction for their responses to the vaccine problems, although there is a common core issue of sacrificing some for many. The respondents reported a relatively high willingness to push one man in front of a trolley to save five. They also reported a high willingness to act in trolley dilemmas compared with vaccination dilemmas, although the dimensions of risk–reward ratios and consent heavily favored the latter

Kateterrelatert infeksjon i blodbanen hos nyfødtkirurgiske barn

Bakgrunn: Kateterrelaterte infeksjoner i blodbanen (KRIBB) er en fryktet komplikasjon hos nyfødtkirurgiske barn med sentralt venekateter. Infeksjoner kan medføre en påkjenning for barnet og de pårørende i form av smerter, ubehag, komplikasjoner, forsinket tilknytning og utvikling og i verste fall død. Å registrere behandlingsrelaterte infeksjoner er en viktig del av kvalitetsarbeidet, og det er gjort få studier som omhandler sykepleiedokumentasjon av symptomer og tegn på KRIBB. Hensikt: Hensikten med studien var å kartlegge dokumentasjonspraksisen og se på hvilke symptomer og tegn sykepleiere dokumenterer hos en gruppe nyfødtkirurgiske pasienter med og uten KRIBB. Målet med studien er å kartlegge og evaluere sykepleiedokumentasjonen, noe som kan bidra til økt kunnskap om, forebygging og bedre behandling av KRIBB. Studien har følgende forskningsspørsmål: Hvordan dokumenterer sykepleiere kliniske observasjoner som gir mistanke om kateterrelatert infeksjon i blodbanen hos et nyfødtkirurgisk barn? Metode: Vi utførte en pilotstudie med retrospektiv case-kontrolldesign gjennomført med deskriptive analyser. Vi benyttet et selvutviklet kartleggingsskjema til å samle inn data fra skriftlige og elektroniske observasjonsskjemaer, kurveark og sykepleiejournaler i pasientdokumentasjonssystemet DIPS og Metavision. Utvalget hadde fem barn i KRIBB gruppen og ti barn i kontrollgruppen. Resultater: Puls og temperatur var hyppigst dokumentert i begge gruppene. Tre av fem barn i KRIBB-gruppen hadde dokumentert feber. Det var ikke dokumentert feber i kontrollgruppen. Kliniske infeksjonstegn var hyppigst dokumentert i KRIBB-gruppen. Observasjoner av innstikkssted for sentralt venekateter ved bandasjeskift og barnets atferd var hyppigst dokumentert i kontrollgruppen. Konklusjon: Dokumentasjon av feber er symptomet som tydeligst skiller KRIBB-gruppen fra kontrollgruppen. Det totale antallet dokumenterte registreringer på kliniske infeksjonstegn er høyere i KRIBB-gruppen enn kontrollgruppen. Det kan indikere at feber er utslagsgivende for hvilke kliniske infeksjonstegn som blir observert og dokumentert i det videre pasientforløpet. En rekke observasjoner var ikke dokumentert i noen av gruppene, og det som ble dokumentert, kan virke tilfeldig og usystematisk

Catheter-related bloodstream infections in infants who have undergone neonatal surgery

Background: Catheter-related bloodstream infections (CRBSI) represent a feared complication in neonates with surgically placed central venous catheters. Infections can be a tough experience for the infant and family in terms of pain, discomfort, complications, delayed infant-parent attachment and development and at worst, death. Registering treatment-related infections is an important part of quality assurance efforts, and few studies have dealt with nursing documentation of symptoms and signs of CRBSI. Objective: The objective of the study was to identify documentation practices and examine what symptoms and clinical signs registered nurses document in a group of patients with and without CRBSI who have undergone neonatal surgery. The aim was to identify and evaluate nursing documentation, thus contributing to greater knowledge about CRBSI and its prevention, and better treatment. The study focuses on the following research question: How do registered nurses document clinical observations that raise suspicion of catheter-related bloodstream infections in infants who have undergone neonatal surgery? Method: We conducted a pilot study with a retrospective case control design using descriptive analyses. We used a self-developed assessment chart in order to gather data from written and electronic observation forms, charts and nursing documentation in the patient documentation systems DIPS and Metavision. The sample included five infants in the CRBSI group and ten in the control group. Results: Pulse and temperature were most frequently documented in both groups. Fever was documented in the case of three of the five infants in the CRBSI group while in the control group, fever was not documented. Clinical signs of infection were most frequently documented in the CRBSI group. Observations of the insertion site of the central venous catheter when changing dressings, and the child’s behaviour were most frequently documented in the control group. Conclusion: The documentation of fever is the symptom that most clearly distinguishes the CRBSI group from the control group. The total number of documented registrations of clinical signs of infection is higher in the CRBSI group than in the control group. This may indicate that fever is the factor that determines which clinical signs of infection are observed and documented in the ensuing patient care pathway. A number of observations were not documented in either of the groups and what was documented can appear to be random and unsystematic

Family experiences with palliative care for children at home: A systematic literature review

Background: The main goal of pediatric palliative care (PPC) is to improve or maintain the best possible quality of life (QoL) for the child and their family. PPC can be provided in community health centres, within the specialist health care service and/or in the child’s home. Home is often the preferred place for families, and recommendations state that, whenever possible, the family home should be the centre of care for the child. The aim of this study is to systematically review the experiences and needs of families with children receiving palliative care at home. Methods: We conducted a systematic review and searched the peer-reviewed databases CINAHL, Embase, PsycInfo and MEDLINE for articles published between January 2000 and October 2019. We included 23 studies emphasising the experience of family members when their child (0–18 years) received palliative care at home. We used a thematic analysis to identify relevant themes in the literature, and synthesised the findings from the different studies. Results: The review represents the experiences of the families of almost 300 children with life-limiting (LL) and lifethreatening (LT) conditions receiving palliative care at home. In general, the children’s mothers are interviewed, and seldom the sick children themselves or their siblings. Most families preferred staying at home since it made it easier to maintain a normal family life, was less stressful for the sick child, and meant that siblings could still attend school and be with friends. Families experienced a range of challenges due to the coordination of care, including a lack of support and adequately skilled staff with appropriate experience. Respite care was needed in order to cope with everyday life. Some studies were not specific concerning the place of care, and some relevant papers may have been omitted. Conclusions: Families receiving PPC need organised, individualised support from a skilled PPC team. Respite care is necessary in order to manage a demanding home-care situation and parents need support for siblings. Privacy to be a family is a need, and many families need financial support. Future studies should focus on PPC at home in the perspectives of sick children and their siblings

Parents of preterm-born children; sources of stress and worry and experiences with an early intervention programme - a qualitative study

Background Preterm-born children are at increased risk of adverse developmental outcomes, and their parents may experience increased stress levels. The Mother–Infant Transaction Program (MITP) is an early intervention that aims to enhance the parent–infant relationship and child development. The present study investigated differences in parents’ experience of stress and concerns about caring for their preterm-born child according to whether they participated in the programme. Parental satisfaction with the intervention was also explored. Methods As part of a follow-up study at 36 months, a randomized controlled trial of the MITP—14 parents of 11 children from the intervention group, and 17 parents of 14 children from the control group were interviewed by the use of semi-structured focus group interviews. The interviews were analysed thematically. Results The intervention parents reported that the knowledge, advice, guidance and emotional support given during the intervention made them feel less stressed and more confident, competent and secure caring for their preterm born child than they would otherwise have been. The control parents described feeling less involved and emotionally supported, and seemed more anxious about their child’s development than the intervention parents. All parents were vigilant and alert to their child’s needs and monitored developmental milestones carefully. Conclusion This qualitative exploration of the influences of the MITP revealed a positive impact of the intervention and seems to be an important educational and supportive initiative. Thus, reducing parental stress and enhancing confidence in the parental role