Oppdage og gjenkjenne delirium. Diagnostisering av palliative kreftpasienter

Innledning: Studier viser at delirium hos palliative kreftpasienter er underdiagnostisert. Problemstilling: Hvordan kan kreftsykepleier bidra til diagnostisering av delirium hos kreftpasienter i palliativ fase? Metode: En litteraturstudie Resultat: Det er flere predisponerende og utløsende risikofaktorer som kan forutse om en pasient utvikler delirium. Kartlegging ved innleggelse kan være viktig for å være mer observant på pasienter i risikosonen. Screeningverktøy kan for den nye og uerfarne sykepleieren være et hjelpemiddel ved mistanke om delirium. Diagnosen er vanskelig å fange opp fordi symptomene og tegnene kan være vage og varierende. Sykepleieren rapporterer å ha hull i kunnskapen når det gjelder symptomer og tegn på delirium og det kreves mer kunnskap, erfaring og opplæring i klinikken. Konklusjon: Kartlegging av predisponerende og utløsende faktorer, bruk av screening ved mistanke om delirium og øke sykepleieres kunnskap er faktorer som kan bidra til diagnostisering av delirium hos kreftpasienter i palliativ fase

Bruk av musikk i spesialpedagogisk leseundervisning

Lese- og skriveferdigheter er viktig kompetanse å ha for å fungere i det norske kunnskapssamfunnet. På tross av dette går flere ut av grunnskolen uten de nødvendige ferdighetene for å fungere i videreutdanning, arbeidslivet eller samfunnet generelt. Denne studien undersøker problemstillingen «Hvordan kan anvendelse av musikk i leseundervisningen støtte elever med sen leseutvikling?». Hensikten med studien var å finne alternative inngangsporter for å styrke den spesialpedagogiske leseundervisningen som allerede eksisterer. Dette er gjort ved å gjennomføre en aksjonsforskningsstudie. Resultatene i studien indikerer at det er flere fordeler med å anvende musikk for å støtte elever med sen leseutvikling. Musikk kan være en morsom og engasjerende måte å gi elevene den mengdetreningen de trenger, på områder elevene finner ekstra krevende. Videre så kan en benytte seg av rytmer og sanger for å øve på spesifikke områder elevene finner utfordrende. En kan også benytte seg av en kjent sang for å gi elevene fonologisk støtte til avkoding. Det er i tillegg en fin måte for å skape et godt psykososialt miljø på. Dette kan skape rom for mestring, engasjement og trivsel. En annen fordel som kom fram i studien, er at det ga muligheter for å tilpasse opplæringen etter elevenes forutsetninger. Videre ga det mulighet og rom for tilpasninger slik at alle kunne delta og være en del av felleskapet Resultatene fra studien indikerer også at musikk, slik det ble brukt i denne studien, ikke kan fungere som en egen metodikk i leseundervisningen. Det kan heller være et tilleggssupplement til de tradisjonelle undervisningsmetodene. Det kom også fram at det å bruke musikk som tilnærming for å hjelpe elever med spesifikke vansker, vil kreve mye kunnskap og kompetanse fra den enkelte lærer, noe som kan gjøre bruken av musikk krevende. En mulig løsning for dette kan være et tverrfaglig samarbeid mellom spesialpedagoger og musikklærere slik at en kan nyte godt av begge feltenes fagkunnskaper

Temaintroduktion

TEMAINTRODUKTION. Generationer: Genlæsninger og reaktualiseringe

Electro-Chemo-Mechanical Properties in Nanostructured Ca-doped Ceria (CDC) by Field Assisted Sintering

Recent investigations have shown that highly oxygen defective cerium oxides generate non-classical electrostriction that is superior to lead-based ferroelectrics. In this work, we report the effect of field-assisted spark plasma sintering (SPS) on electro-chemo-mechanical properties on Ca-doped ceria (CDC). Nanometric powders of ca. 10 nm are rapidly consolidated to form polycrystalline nanostructures with a high degree of crystalline disorder. Remarkably, the resultant material demonstrates a large electromechanical strain without a frequency-related relaxation effect. We conclude that electromechanical activity in CDC materials strictly depends on the Ca-VO interaction, while disorder at the crystalline boundaries has a minor effect

Associations between patterns of human intestinal schistosomiasis and snail and mammal species richness in Uganda:can we detect a decoy effect?

In recent years, ecological research has suggested several mechanisms by which biodiversity might affect the risk of acquiring infectious diseases (i.e., the decoy, dilution or amplification effects), but the topic remains controversial. While many experimental studies suggest a negative relationship between biodiversity and disease, this relationship is inherently complex, and might be negative, positive or neutral depending on the geographical scale and ecological context. Here, applying a macroecological approach, we look for associations between diversity and disease by comparing the distribution of human schistosomiasis and biogeographical patterns of freshwater snail and mammal species richness in Uganda. We found that the association between estimated snail richness and human infection was best described by a negative correlation in non-spatial bi- and multivariate logistic mixed effect models. However, this association lost significance after the inclusion of a spatial component in a full geostatistical model, highlighting the importance of accounting for spatial correlation to obtain more precise parameter estimates. Furthermore, we found no significant relationships between mammal richness and schistosomiasis risk. We discuss the limitations of the data and methods used to test the decoy hypothesis for schistosomiasis, and highlight key future research directions that can facilitate more powerful tests of the decoy effect in snail-borne infections, at geographical scales that are relevant for public health and conservation.<br /

Quantitatively Measured Anatomic Location and Volume of Optic Disc Drusen: An Enhanced Depth Imaging Optical Coherence Tomography Study

Optic disc drusen (ODD) are found in up to 2.4% of the population and are known to cause visual field defects. The purpose of the current study was to investigate how quantitatively estimated volume and anatomic location of ODD influence optic nerve function. Anatomic location, volume of ODD, and peripapillary retinal nerve fiber layer and macular ganglion cell layer thickness were assessed in 37 ODD patients using enhanced depth imaging optical coherence tomography. Volume of ODD was calculated by manual segmentation of ODD in 97 B-scans per eye. Anatomic characteristics were compared with optic nerve function using automated perimetric mean deviation (MD) and multifocal visual evoked potentials. Increased age (P = 0.015); larger ODD volume (P = 0.002); and more superficial anatomic ODD location (P = 0.007) were found in patients with ODD visible by ophthalmoscopy compared to patients with buried ODD. In a multivariate analysis, a worsening of MD was significantly associated with larger ODD volume (P &lt;0.0001). No association was found between MD and weighted anatomic location, age, and visibility by ophthalmoscopy. Decreased ganglion cell layer thickness was significantly associated with worse MD (P = 0.025) and had a higher effect on MD when compared to retinal nerve fiber layer thickness. Large ODD volume is associated with optic nerve dysfunction. The worse visual field defects associated with visible ODD should only be ascribed to larger ODD volume and not to a more superficial anatomic ODD location

Identification as Process in Participatory Design

In this workshop we invite participants to discuss and map techniques, approaches and principles to address processes of identification in Participatory Design endeavors. The key objective of the workshop is to present identification as process as a concept to think with, and to explore how different lenses can engage workshop participants in thinking about participatory design endeavors in connection to this concept. As the outcome the workshop participants produce set of principles for identification as process for PD work

Low Levels of Hemoglobin at Admission Are Associated With Increased 30-Day Mortality in Patients With Hip Fracture

INTRODUCTION: Previous smaller studies suggest that anemia is a risk factor for mortality in patients with hip fracture. The purpose of this investigation was to assess the correlation between hemoglobin at admission with 30-day mortality following a hip fracture in a large-scale study. PATIENTS AND METHODS: From January 1996 to December 2012, all patients with hip fracture (>60 years of age) admitted to Bispebjerg Hospital, Copenhagen, were identified from a local hip fracture database. We excluded conservatively treated patients and patients who died preoperatively. RESULTS: Seven thousand four hundred twenty-one consecutive patients with hip fracture were identified. Of those 7319 had a hemoglobin measurement on admission and were thus eligible for further analysis. Mean hemoglobin for patients alive at 30 days was 7.6 (standard deviation [SD]: 1.0) and for deceased patients 7.4 (SD: 1.1), P < .0001. Mean age was 82.6 years (SD: 8.5), and 76.5% of the population were female (N(females) = 5600). The 30-day mortality decreases for every increase in hemoglobin of 1.0 mmol/L in a univariate analysis (P < .0001). The hazard ratio (HR) with 95% confidence interval (CI) for 30-day mortality in patients with anemia (<7.3 mmol/L for females and <8.3 mmol/L for males; N(anemic) = 3235) was 1.66 (CI: 1.43-1.91, P < .0001). Adjusting for age, type of fracture, gender, and comorbidities (Charlson score) slightly attenuated the risk estimate (HR: 1.21, CI: 1.03-1.41, P = .02). CONCLUSION: This study demonstrates increased 30-day mortality in patients with low hemoglobin at admission, even after adjusting for comorbidities