Utsikt från thoraxkirurgiska avdelningar på Rigshospitalet i Köpenhamn

Det finns idag mycket forskning om betydelse på vår hälsa av att ha en stimulerande utsikt på ett sjukhus. När jag jobbade som sjuksköterska på Rigshospitalet uppmärksammade jag att utsikten var bristfällig både för patienter och personal. Med min studie vill jag undersöka vad det finns för visuella element i utsikten från tre olika thoraxkirurgiska avdelningar på Rigshospitalet i Köpenhamn. Målet är även att ta reda på vilka begränsningar som inskränker på utsikt på avdelningarna. För att hitta svar på studien använde jag mig av platsinventering, litteraturstudier samt mina egna erfarenheter och reflektioner för att svara på syftet. Platsinventeringen gjordes med fotografier, planer samt egna observationer på vårdavdelningarna 3153 och 3154 samt på intensivvårds-avdelningen 4141. Fotograferingen gjordes på patientrum och personalrum och fotografierna var dels på utsikten men också på hur fönster och rummets utformning bredvid fönstret var. Resultatet visade på att utsikterna skiljde sig mycket åt och att detta berodde till stor del på om avdelningen var på ett högre eller lägre våningsplan. Kvaliteten på utsikterna från rummen på 15 våningen var närvaron av horisonten, himlen och den kognitiva erfarenheten var man befinner sig. Kvaliteten från intensivvårdsavdelningen som ligger på femte våningen var främst att se ut över mänskliga aktiviteter och här var det lättare att se detaljer. Rummen på avdelning 3154 hade även en varierad och dynamisk utsikt, med en grönska som var varierande. Alla avdelningar hade brister i utformningen med tanke på utsikten. De största orsakerna till detta var stora metallbjälkar som fanns mitt i fönstret samt att patienternas sängar inte var optimalt placerade för att patienterna skulle ha en optimal utsikt. Utformningen på Rigshospitalet är bristfällig och när sjukhuset ritades så hade arkitekterna troligen inte tänkt så mycket över hur man skulle uppleva utsikten. Resultaten visar på betydelse av att det behövs en ny strategi när vi anlägger nya sjukhus och att befintliga sjukhus borde optimeras

Tvärprofessionella team -en kvalitativ studie om teammedlemmars upplevelse av tvärprofessionellt teamarbete inom vård och omsorg

Abstract Authors: Åsa Jönsson and Johanna Vedefors Title: Cross-professional teams: a qualitative study of team members working experience in a cross-professional team, in the health and social care area. [Translated title] Supervisor: Staffan Blomberg Assessor: Håkan Jönsson The purpose of this paper was to examine how team members within the health and social care area experience working in cross-professional teams. Interdisciplinary professional team work is now commonly used in several different organizational areas and has revealed the advantages and disadvantages of working cross professionally. Research discusses the benefits of the increased knowledge within cross-professional teams and increased efficiency, in relation to the disadvantages such as time-consuming decision-making and lack of extensive evidence of the actual cross-professional team benefits. Research also shows the significant factors affecting cooperation in this type of team such as communication and status equivalence within the team. This paper has mainly focused on the perceived advantages, disadvantages, benefits, and difficulties within cross-professional teams as well as the significant factors for cooperation. We have made a qualitative study in the form of semi-structured interviews in which two teams in health and social care area participated, providing a total of seven interviewed people. The results of our investigation showed that all the interviewed persons experienced more advantages than disadvantages of working in cross-professional teams. Some benefits found were that the cross-professional knowledge can provide a better overall picture of a patients' situation and that it can strengthen the knowledge of others within their own discipline. Difficulties in cooperation could be seen when the team is not balanced equally and one member is dominant. An important factor for effective cooperation, all respondents agreed, is that communication within the team is crucial and that all respect each other's professions. Key words: cross-professional teams, interdisciplinary professional teams, cooperation, health and social care. Nyckelord: tvärprofessionella team, mångprofessionella team, samarbete, vård och omsorg

The MIIM LCA PH.D. club: Presentation and introduction

During 1998, the number of completed Ph.D.s on Life Cycle Assessment (LCA) seemed to be larger than any previous year. In order to mark this achievement, a special series is being published in the International Journal of LCA. In this introductory paper, the Class of MUM outline the results of their research work over the last few years. A number of common points and tendencies have emerged through this work. First of all, the scope-dependency of LCA models: some of us have discerned in particular the need to distinguish between descriptive and change-oriented LCAs. Secondly, a number of the theses focus on the interaction between LCA and decision-making. Thirdly, the benefits of pluralism in impact assessment and allocation have been advocated in some of the theses. Finally, it may be noted that in these theses structuring the management of controversial issues seems to be preferred to eliminating such issues by a process of harmonisation. Future papers will map out the intellectual journeys undertaken in the development of these theses and discuss key findings in more detai

Impaired phosphate transport in SLC34A2 variants in patients with pulmonary alveolar microlithiasis

Background: Variants in SLC34A2 encoding the sodium-dependent phosphate transport protein 2b (NaPi-IIb) cause the rare lung disease pulmonary alveolar microlithiasis (PAM). PAM is characterised by the deposition of calcium-phosphate concretions in the alveoli usually progressing over time. No effective treatment is available. So far, 30 allelic variants in patients have been reported but only a few have been functionally characterised. This study aimed to determine the impact of selected SLC34A2 variants on transporter expression and phosphate uptake in cellular studies. Methods: Two nonsense variants (c.910A > T and c.1456C > T), one frameshift (c.1328delT), and one in-frame deletion (c.1402_1404delACC) previously reported in patients with PAM were selected for investigation. Wild-type and mutant c-Myc-tagged human NaPi-IIb constructs were expressed in Xenopus laevis oocytes. The transport function was investigated with a 32Pi uptake assay. NaPi-IIb protein expression and localisation were determined with immunoblotting and immunohistochemistry, respectively. Results: Oocytes injected with the wild-type human NaPi-IIb construct had significant 32Pi transport compared to water-injected oocytes. In addition, the protein had a molecular weight as expected for the glycosylated form, and it was readily detectable in the oocyte membrane. Although the protein from the Thr468del construct was synthesised and expressed in the oocyte membrane, phosphate transport was similar to non-injected control oocytes. All other mutants were non-functional and not expressed in the membrane, consistent with the expected impact of the truncations caused by premature stop codons. Conclusions: Of four analysed SLC34A2 variants, only the Thr468del showed similar protein expression as the wild-type cotransporter in the oocyte membrane. All mutant transporters were non-functional, supporting that dysfunction of NaPi-IIb underlies the pathology of PAM

Forum för humanistisk-samhällsvetenskaplig hälsoforskning: Forskarkonferens kring temat Program och praktik

Med temat program och praktik vill vi särskilt uppmana forskare att reflektera över vad som sägs och vad som görs inom hälso-, medicin- och sjukdomsrelaterade verksamheter, såväl i nutid som i det förflutna. Med program avses till exempel vårdpolitiska uttalanden och viljeyttringar av olika slag, beskrivningar eller bilder av hur t.ex. vård och omhändertagande bör vara beskaffad, läroböckers beskrivningar av önskvärda metoder, vårdformer, omhändertaganden, ingrepp etc., eller andra sorters vägledande utsagor, bl.a. i massmedia, som anger hur något bör vara beskaffat, ska utföras eller på annat sätt riktas mot en önskvärd omsättning i handling. Med praktik menas t.ex. handlingar, handgrepp och genomförande, tysta eller fotade i något slags program. Här ingår också upplevda och beskrivna relationer mellan t.ex. vårdtagare, klient eller kund och olika vårdgivare eller producenter av vård, behandling och omhändertagande eller andra aktiviteter, rum eller materiella alt. immateriella produkter inom medicin- och hälsofältet. Konferensen vill gärna att deltagarna reflekterar över dessa två begrepp, vart och ett eller i relation till varandra i empiriskt, metodologiskt, källkritiskt eller annat avseende. Konferensen välkomnar också bidrag om de epistemologiska, etiska och representationsteoretiska perspektiv och paradigm som ligger bakom, uttrycks genom eller utesluts från sådana program och praktiker som angivits ovan

Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Osteoarthritis (OA) is a degenerative disease, considered to be one of the major public health problems. Research suggests that patient education is feasible and valuable for achieving improvements in quality of life, in function, well-being and improved coping. Since 1994, Primary Health Care in Malmö has used a patient education programme directed towards OA. The aim of this study was to evaluate the effects of this education programme for patients with OA in primary health care in terms of self-efficacy, function and self-perceived health.</p> <p>Method</p> <p>The study was a single-blind, randomized controlled trial (RCT) in which the EuroQol-5D and Arthritis self-efficacy scale were used to measure self-perceived health and self-efficacy and function was measured with Grip Ability Test for the upper extremity and five different functional tests for the lower extremity.</p> <p>Results</p> <p>We found differences between the intervention group and the control group, comparing the results at baseline and after 6 months in EuroQol-5D (p < 0.001) and in standing one leg eyes closed (p = 0.02) in favour of the intervention group. No other differences between the groups were found.</p> <p>Conclusion</p> <p>This study has shown that patient education for patients with osteoarthritis is feasible in a primary health care setting and can improve self-perceived health as well as function in some degree, but not self-efficacy. Further research to investigate the effect of exercise performance on function, as well as self-efficacy is warranted.</p> <p>Trial registration</p> <p>The trial is registered with ClinicalTrials.gov. Registration number: NCT00979914</p