Mannlig sykepleier - mann uten omsorg? : hvor er de mannlige sykepleierne?

Studentarbeid i sykepleie (bachelorgrad) - Høgskolen i Bodø, 200

A stable non-interleaving early operational semantics for the pi-calculus

We give the first non-interleaving early operational semantics for the pi-calculus which generalises the standard interleaving semantics and unfolds to the stable model of prime event structures. Our starting point is the non-interleaving semantics given for CCS by Mukund and Nielsen, where the so-called structural (prefixing or subject) causality and events are defined from a notion of locations derived from the syntactic structure of the process terms. We conservatively extend this semantics with a notion of extruder histories, from which we infer the so-called link (name or object) causality and events introduced by the dynamic communication topology of the pi-calculus. We prove that the semantics generalises both the standard interleaving early semantics for the pi-calculus and the non-interleaving semantics for CCS. In particular, it gives rise to a labelled asynchronous transition system unfolding to prime event structures

Limbic encephalitis following allogeneic hematopoietic stem cell transplantation

A woman with myelodysplastic syndrome (MDS) was treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). 65 days after the transplantation, she developed fatigue and central neurological symptoms. Clinical workup including magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) examination revealed findings suspicious for limbic encephalitis (LE), successfully treated with intravenous immunoglobulins and intravenous corticosteroids. Although a rare complication after allo-HSCT, physicians should be aware of neurological symptoms that develop throughout the transplantation course.publishedVersio

Weight gain during treatment course of allogenic hematopoietic stem cell transplantation in patients with hematological malignancies affects treatment outcome

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)Background aims: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an effective treatment for patients with hematological malignancies; however, allo-HSCT does not come without the cost of treatmentrelated morbidity and mortality. Early detection of risk factors could be helpful in identifying patients who could benefit from early interventions. Many patients gain weight during the allo-HSCT treatment, although little is known about the impact of weight gain. Methods: Weight gain in 146 consecutively enrolled adult patients undergoing allo-HSCT was explored. Results: In total, 141 patients (97%) gained weight along the course of allo-HSCT. Median weight increase was 4.8 kg (range 0.016.1 kg), with median increase in body weight 6.5% (range 0.0%30.8%). Maximum weight increase was observed at day +7 (range day 8, +44). Weight gain was associated with increased incidence of acute graft-versus-host disease. Patients with weight gain >10% had a significantly greater 5-year mortality compared with those with lower weight gain (P = 0.031, rank sum test). Conclusions: Weight gain is a simple variable with the ability to provide prognostic information for patients undergoing allo-HSCT.publishedVersio

Surgical Treatment of Severe Bowel Obstruction as a Rare Complication Following Allogenic Hematopoietic Stem Cell Transplantation

Gastrointestinal graft-versus-host disease (GVHD) and cytomegalovirus (CMV) disease are common complications occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and contribute to a high degree of morbidity and mortality associated with allo-HSCT. Herein, we present a patient with severe intestinal GVHD complicated by recurring CMV enteritis, which overall resulted in severe terminal ileum stenosis. The patient underwent laparoscopic ileocecal resection that significantly reduced symptoms and possibly prevented the development of fulminant ileus. Surgical treatment is rarely used in the treatment of gastrointestinal GVHD; however, the current patient history illustrates that patients with inadequate symptom control and severe inflammatory bowel stenosis can be successfully managed with surgery. We also review published case reports on surgical treatment for severe gastrointestinal GVHD.publishedVersio

Internet Interconnection Techno-economics: A Proposal for Assured Quality Services and Business Models

The Internet is constructed by means of complex business interconnection agreements among multiple networks. However, the most commonly used agreements do not contain explicit Quality of Service reference. In this study a business rationale for Assured Service Quality (ASQ) inter-network services is presented and potential business models for their realization are proposed and analyzed. It is argued that ASQ products and business models could greatly enhance the health of the Internet interconnection ecosystem. A business model design framework that encompasses the key strategic decisions that would enable ASQ provisioning and generic collaboration is also provided. This framework is then elaborated using a number of off-net content delivery scenarios. Conclusions are hence drawn on the role of ASQ and ASQ-driven business models for the sustainable development of the "Future Internet"

Hvordan kan sykepleiere ivareta pasientenes psykososiale behov i akuttmottak

Sammendrag Bakgrunn Ved de største akuttmottakene i Norge innlegges rundt 125 pasienter i døgnet, noe som årlig utgjør omkring 45 000 pasienter. Akuttmottaket har derfor mange å ta vare på. Sykepleiernes oppgave er å sørge for at pasientene får dekket sine grunnleggende behov, også de psykososiale. Dette kan være en kamp mot klokken i den travle arbeidsdagen. Formål Formålet er å undersøke om pasientens psykososiale behov blir ivaretatt av sykepleiere i akuttmottak, samt belyse hvordan sykepleiere kan ivareta disse behovene bedre. Metode Vi har brukt en integrativ litteraturoversikt som metode. For å besvare denne oppgaven har vi analysert fire forskningsartikler og resultatene av dem. I tillegg har vi benyttet faglitteratur og egne refleksjoner. Resultater Resultatene viser at sykepleiere fokuserer for lite på kommunikasjon og relasjonsbygging med pasientene. Dette medfører at den helhetlige pasientivaretakelsen svekkes, derav også det psykososiale aspektet. Dersom sykepleiere ivaretar de helhetlige omsorgsbehovene, vil pasientene oppleve trygghet og forutsigbarhet i det hektiske miljøet i akuttmottaket. Nøkkelord Akuttmottak, psykososiale behov, grunnleggende behov, sykepleie, pasient, relasjon, kommunikasjon, ivaretagelse, holdninger og verdier, tidspress.Abstract Background At the largest emergency departments in Norway, approximately 125 patients are admitted daily, amounting to around 45,000 patients annually. The emergency department has a significant number of patients to care for. Nurses are tasked with ensuring that patients' basic needs, including psychosocial needs, are met. This can be a challenging task within the busy workday, often racing against the clock. Objective The purpose is to investigate whether nurses in the emergency department address the psychosocial needs of patients and to shed light on how nurses can better meet these needs. Method We used an integrative literature review as our method. To answer this task, we analyzed four research articles and their results. Additionally, we utilized relevant literature and our own reflections. Results The results indicate that nurses tend to focus too little on communication and building relationships with patients. This results in a decline in patient care, including the psychosocial aspect. If nurses address the fundemental care needs, patients will experience a sense of security and predictability in the hectic environment of the emergency department. Keywords Emergency department, psychosocial needs, basic needs, nursing, patient, relationship, communication, care, attitudes and values, time pressure

A comparison of FDG PET/MR and PET/CT for staging, response assessment, and prognostic imaging biomarkers in lymphoma

The aim of the current study was to investigate the diagnostic performance of FDG PET/MR compared to PET/CT in a patient cohort including Hodgkins lymphoma, diffuse large B-cell lymphoma, and high-grade B-cell lymphoma at baseline and response assessment. Sixty-one patients were examined with FDG PET/CT directly followed by PET/MR. Images were read by two pairs of nuclear medicine physicians and radiologists. Concordance for lymphoma involvement between PET/MR and the reference standard PET/CT was assessed at baseline and response assessment. Correlation of prognostic biomarkers Deauville score, criteria of response, SUVmax, SUVpeak, and MTV was performed between PET/MR and PET/CT. Baseline FDG PET/MR showed a sensitivity of 92.5% and a specificity 97.9% compared to the reference standard PET/CT (κ 0.91) for nodal sites. For extranodal sites, a sensitivity of 80.4% and a specificity of 99.5% were found (κ 0.84). Concordance in Ann Arbor was found in 57 of 61 patients (κ 0.92). Discrepancies were due to misclassification of region and not lesion detection. In response assessment, a sensitivity of 100% and a specificity 99.9% for all sites combined were found (κ 0.92). There was a perfect agreement on Deauville scores 4 and 5 and criteria of response between the two modalities. Intraclass correlation coefficient (ICC) for SUVmax, SUVpeak, and MTV values showed excellent reliability (ICC > 0.9). FDG PET/MR is a reliable alternative to PET/CT in this patient population, both in terms of lesion detection at baseline staging and response assessment, and for quantitative prognostic imaging biomarkers

MicroRNA serum profiles and chronic graft-versus-host disease

Chronic graft-versus-host disease (cGVHD) is the most common long-term complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). During the last decade, the interest of micro RNAs (miRNAs) in the pathophysiological process of cGVHD has increased. The objectives of this study were to investigate a wide range of serum miRNAs in allografted patients and identify associations between miRNAs and cGVHD. The study included 79 allotransplanted adults, where serum samples were obtained 1 year after the allo-HSCT, and miRNA profiling analysis in serum was performed. Fifty of the 79 patients (63%) had signs of cGVHD at the 1-year post–allo-HSCT control. miRNA sequencing analysis revealed 1380 different miRNAs detected for at least 1 patient, whereas 233 miRNAs (17%) were detected in >70 patients. We identified 10 miRNAs that differed significantly between patients with and without cGVHD (P 75 of the patients. Furthermore, 5 distinct miRNAs, miR-365-3p, miR-148-3p, miR-122-5p, miR-378-3p, and miR-192-5p, were found to be particularly associated with cGVHD in our analysis and were validated by receiver operating characteristics analysis. Based on only 3 miRNAs, miR-365-3p, miR-148-3p, and miR-378-3p, we developed a miRNA signature that, by bioinformatic approaches and linear regression model, utterly improved our potential diagnostic biomarker model for cGVHD. We conclude that miRNAs are differently expressed among patients with and without cGVHD, although further and larger studies are needed to validate our present findings.publishedVersio