The Ages of Passive Galaxies in a z = 1.62 Protocluster

We present a study of the relation between galaxy stellar age and mass for 14 members of the $z=1.62$ protocluster IRC 0218, using multiband imaging and HST G102 and G141 grism spectroscopy. Using $UVJ$ colors to separate galaxies into star forming and quiescent populations, we find that at stellar masses $M_* \geq 10^{10.85} M_{\odot}$, the quiescent fraction in the protocluster is $f_Q=1.0^{+0.00}_{-0.37}$, consistent with a $\sim 2\times$ enhancement relative to the field value, $f_Q=0.45^{+0.03}_{-0.03}$. At masses $10^{10.2} M_{\odot} \leq M_* \leq 10^{10.85} M_{\odot}$, $f_Q$ in the cluster is $f_Q=0.40^{+0.20}_{-0.18}$, consistent with the field value of $f_Q=0.28^{+0.02}_{-0.02}$. Using galaxy $D_{n}(4000)$ values derived from the G102 spectroscopy, we find no relation between galaxy stellar age and mass. These results may reflect the impact of merger-driven mass redistribution, which is plausible as this cluster is known to host many dry mergers. Alternately, they may imply that the trend in $f_Q$ in IRC 0218 was imprinted over a short timescale in the protocluster's assembly history. Comparing our results with those of other high-redshift studies and studies of clusters at $z\sim 1$, we determine that our observed relation between $f_Q$ and stellar mass only mildly evolves between $z\sim 1.6$ and $z \sim 1$, and only at stellar masses $M_* \leq 10^{10.85} M_{\odot}$. Both the $z\sim 1$ and $z\sim 1.6$ results are in agreement that the red sequence in dense environments was already populated at high redshift, $z \ge 3$, placing constraints on the mechanism(s) responsible for quenching in dense environments at $z\ge 1.5$Comment: 17 pages, 8 figures, 3 tables. Accepted for publication in Ap

Hälso- och sjukvårdspersonalens upplevelser av reproduktion och mödrahläsovård : en fältstudie i Tanzania

Background  Maternal health is described as the health a woman experiences during pregnancy, delivery and after the baby is born. Every year an estimation is made that 210 million women are pregnant and 140 million babies are being born. However, the care around pregnant women and during deliveries varies depending on what country a woman is located in. Above all, science shows that pregnant women in Sub-Saharan regions have a 46 times higher risk of suffering from maternal morbidity and mortality compared to women in high-income countries. Tanzania is a country within the Sub-Saharan region with the highest numbers of births, yet with limited access to both hospitals and staff which affects mothers and children. Limitations are caused because of poverty, for instance the majority of Tanzania's population live in rural areas where no healthcare is accessible, if the healthcare does not go to those areas.  Aim  The aim was to describe healthcare workers' experiences of reproductive and maternal health at Nkinga Referral Hospital in Tanzania.  Methods  This study was based on a Minor Field Study [MFS] in Tanzania. The chosen method was a qualitative study design with an inductive approach. The interview questions were of semi structured character and in total eight healthcare workers were interviewed at Nkinga Referral Hospital. The data was analyzed with the help of a manifest content analysis.  Findings  The data analysis resulted in three main categories and eight subcategories that reelected the healthcare workers' experiences. Overall, healthcare workers described the preventive work, experienced difficulties, maternal healthcare in general as well as the wishes regarding possible changes in today's reproductive and maternal health.  Conclusion  The healthcare workers' experiences regarding the provision of care for pregnant women differ. Existing deficiencies that have been discovered within reproductive and maternal health are insufficient economic resources as well as equipment. While this unavailability, the healthcare workers experienced the care provided was remarkably affected and the inability to provide good quality care. Because of this, the provision of resources is essential for the ability of healthcare workers to provide good quality care to pregnant women. Bakgrund  Mödrars hälsa beskrivs som den hälsa kvinnan upplever sig ha under graviditet, förlossning och efter födseln. Varje år uppskattas det att cirka 210 miljoner kvinnor blir gravida och att 140 miljoner nyfödda föds. Däremot ser vården kring den gravida kvinnan och under förlossningen olika ut beroende på vilket land kvinnan befinner sig i. Framförallt visar forskning att gravida kvinnor i Sub-Sahara Regionen har en 46 gånger så hög risk att drabbas av maternell sjukdom och död jämfört med kvinnor i höginkomstländer. Tanzania är ett land i Sub-Sahara som har höga födelsetal, dock med en begränsad tillgång till både sjukhus och personal vilket påverkar mödrar och barns hälsa. Begränsningen beror bland annat på fattigdom, men också på grund av att större delen av befolkningen lever på landsbygden där ingen hälso- och sjukvård finns att tillgå, om inte hälso- och sjukvården tar sig till dem.  Syfte  Syftet var att beskriva sjukvårdspersonalens upplevelser av reproduktion och mödrahälsovård på Nkinga Referral Hospital i Tanzania.  Metod  Denna studie baserades på en Minor Field Study [MFS] fältstudie i Tanzania. Den valda metoden var en kvalitativ studiedesign med induktiv ansats. Intervjufrågorna var av semistrukturerad karaktär och sammanlagt intervjuades åtta hälso- och sjukvårdspersonal på Nkinga Referral Hospital. Datan analyserades med hjälp av en kvalitativ manifest innehållsanalys.  Resultat  Dataanalysen resulterade i tre huvudkategorier och åtta subkategorier som återspeglade hälso- och sjukvårdspersonalens upplevelser. Sammantaget beskrev hälso- och sjukvårdspersonalen det preventiva arbetet, upplevda svårigheter, den generella mödrahälsovården samt vilka önskningar de upplevde skulle kunna förändra dagens reproduktion och mödrahälsovård.  Slutsats  Hälso- och sjukvårdspersonalens upplevelser av att vårda gravida kvinnor skiljer sig åt. Befintliga brister som uppdagats inom reproduktiv- samt mödrahälsovård är bristfälliga ekonomiska resurser likväl som redskap. När detta var otillgängligt upplevde hälso- och sjukvårdspersonalen att vården som gavs till de gravida kvinnorna påverkas avsevärt då en vård av god kvalitet inte kunde tillhandahållas. Således är det av stor vikt att resurser finns tillgängliga så att hälso- och sjukvårdspersonalen kan erbjuda en kvalitativ vård till de gravida kvinnorna.

Families experiences of hope in care of a child with cancer : a literature review

Bakgrund  När ett barn drabbas av cancer, drabbas hela familjen. Detta betyder att om en individs livssituation förändras kommer detta påverka livet för alla inkluderade. Därför är det essentiellt att familjen och omvårdnaden betraktas som helhet. Hopp har visat sig ha en stor betydelse inom cancervården och för tillfrisknandet. Däremot kan avsaknaden av hoppet få konsekvenser som nedstämdhet, nedsatt motivation och minskad följsamhet i behandlingen.  Bakgrunden visar att sjuksköterskan är den profession som ter sig bäst lämpad i främjandet och bibehållandet av hoppet.  Syfte  Syftet var att beskriva familjers upplevelser av hopp i vården av ett cancersjukt barn.  Metod  En icke-systematisk litteraturöversikt med 17 vetenskapliga artiklar. Tolv vetenskapliga artiklar söktes fram i PubMed och CINAHL samt fem stycken via en manuell sökning. Det totala antalet artiklar kvalitetsgranskades och genomgick sedan en integrerad analys.  Resultat  Flertalet familjer upplevde hoppet som konstant och den viktigaste faktorn i vården av ett cancersjukt barn. Däremot kunde familjer även uppleva att hoppets intensitet varierade beroende på vad som inträffade under behandlingen. Variationens intensitet beskrevs utifrån en hög hoppfullhet som resulterade i minskade ångestsymtom medan en låg hoppfullhet orsakade depression och ångest. Familjers upplevelser av vilka faktorer som främjade hoppet var framförallt ett empatiskt och förstående bemötande, stöd från närstående och vårdpersonal samt sanningsenlig information och kunskap om sjukdomen.  Slutsats  Alla familjer till ett cancersjukt barn upplever att hoppet har en signifikant betydelse i vården. Dels för att orka fortsätta behandlingarna genom den berg- och dalbana föräldrarna beskriver att cancervården medför, men också för att motverka de konsekvenser som cancern och hopplöshet kan orsaka, såsom depression och ångest. Sammantaget beskrevs hoppet som fluktuerande under hela vårdtiden men familjernas upplevelse av hoppet var alltid konstanBackground  The whole family is affected when their child is diagnosed with cancer. If one individuals' life situation changes, this will affect the lives of everyone included. It is essential that the nursing and the family is seen as united. Hope has shown have a great meaning in cancer care and for the recovery. However, lack av hope can eventuate consequences like depression, decreased motivation and compliance. The background shows that the nurse is the profession that is best suited for promoting and preservation of hope.  Aim  The aim was to describe family's experiences of hope in care of a child with cancer.  Method  A non-systematic literature review with 17 scientific articles. Twelve scientific articles were search in PubMed and CINAHL and five articles through a manual research. The total amount of articles was quality reviewed and went later on through an integrated analysis.  Results  Most families experienced hope as something constant and the most important component in nursing for a child suffering from cancer. However parents could also experience that the intensity of hope varied depending on how the treatment progress went. Intensity of the variation was described as high hopefulness resulted in reduced anxiety symptoms while a low hopefulness caused depression and anxiety. An empathic and understanding response, support from relatives and health care professionals together with truthful information and knowledge about the disease were those factors that promoted hope according to the family.  Conclusions  All families experienced the significant meaning of hope. Partly to be able to continue the treatments through the roller-coaster parents described that the cancer brings with it, but also to be able to resist the consequences cancer and hopelessness can bring, such as depression and anxiety. Summarized, hope is described as something fluctuating but were always present

Mediastinal lymphadenectomy for esophageal cancer: Differences between two countries, Japan and the Netherlands: Differences between two countries, Japan and the Netherlands

Extent of mediastinal lymphadenectomy during esophagectomy is clearly different between two representative countries of the Eastern and Western world, such as Japan and the Netherlands. In Japan, a clear policy is the standard complete two- or three-field type of lymphadenectomy whereas, in the Netherlands, a limited form is usually carried out. Reasons for these differences can be found in the different types of tumor, 80% of adenocarcinomas in the West and almost 95% of squamous cell cancer in Japan. Moreover, location of the tumors, distally located in the Netherlands whereas, in Japan, the majority are located in the middle and proximal thoracic esophagus. Also, type of neoadjuvant therapy, namely chemoradiotherapy in the Netherlands, and chemotherapy in Japan, are different. Arguments for more extended mediastinal lymphadenectomy are currently challenged in the West, first by the systematic use of chemoradiotherapy as neoadjuvant therapy and, second, the retrospective analysis of large data. According to two studies, the importance of extended lymphadenectomy is shown to be relative and less clear, especially in esophageal adenocarcinomas after neoadjuvant therapy. International efforts such as the TIGER study will help to standardize and find a relationship between the type and location of esophageal cancer, use of neoadjuvant therapy, extent of lymphadenectomy and survival

Value of a step-up diagnosis plan: CRP and CT-scan to diagnose and manage postoperative complications after major abdominal surgery Value of a step-up diagnosis plan: CRP and CT-scan to diagnose and manage postoperative complications after major abdominal surgery

Postoperative complications frequently follow major abdominal surgery and are associated with increased morbidity and mortality. Early diagnosis and treatment of complications is associated with improved patient outcome. In this study we assessed the value of a step-up diagnosis plan by C-reactive protein and CT-scan (computed tomography-scan) imaging for detection of postoperative complications following major abdominal surgery.An observational cohort study was conducted of 399 consecutivepatients undergoing major abdominal surgery between January 2009 and January 2011. Indication for operation, type of surgery, postoperative morbidity, complications according to the Clavien-Dindo classification and mortality were recorded. Clinical parameters were recorded until 14 days postoperatively or until discharge. Regular C-reactive protein (CPR) measurements in peripheral blood and on indication -enhanced CT-scans were performed.Eighty-three out of 399 (20.6 %) patients developed a major complication in the postoperative course after a median of seven days (IQR 4-9 days). One hundred and thirty two patients received additional examination consisting of enhanced CT-scan imaging, and treatment by surgical reintervention or intensive care observation. CRP levels were significantly higher in patients with postoperative complications. On the second postoperative dayCRP levels were on average 197.4 mg/L in the uncomplicated group, 220.9 mg/L in patients with a minor complication and 280.1 mg/L in patients with major complications (p <0,001).CT-scan imaging showed a sensitivity of 91.7 % and specificity of 100 % in diagnosis of major complications. Based on clinical deterioration and the increase of CRP, an additional enhanced CT-scan offered clear discrimination between patients with major abdominal complications and uncomplicated patients. Adequate treatment could then be accomplishe