Politiloven § 7 og dens vide ordlyd : en juridisk oppgave

Bachelor i politiutdannin

Shared decision-making about cardiovascular disease medication in older people: A qualitative study of patient experiences in general practice

Objectives To explore older people's perspectives and experiences with shared decision-making (SDM) about medication for cardiovascular disease (CVD) prevention. Design, setting and participants Semi-structured interviews with 30 general practice patients aged 75 years and older in New South Wales, Australia, who had elevated CVD risk factors (blood pressure, cholesterol) or had received CVD-related lifestyle advice. Data were analysed by multiple researchers using Framework analysis. Results Twenty eight participants out of 30 were on CVD prevention medication, half with established CVD. We outlined patient experiences using the four steps of the SDM process, identifying key barriers and challenges: Step 1. Choice awareness: taking medication for CVD prevention was generally not recognised as a decision requiring patient input; Step 2. Discuss benefits/harms options: CVD prevention poorly understood with emphasis on benefits; Step 3. Explore preferences: goals, values and preferences (eg, length of life vs quality of life, reducing disease burden vs risk reduction) varied widely but generally not discussed with the general practitioner; Step 4. Making the decision: overall preference for directive approach, but some patients wanted more active involvement. Themes were similar across primary and secondary CVD prevention, different levels of self-reported health and people on and off medication. Conclusions Results demonstrate how older participants vary widely in their health goals and preferences for treatment outcomes, suggesting that CVD prevention decisions are preference sensitive. Combined with the fact that the vast majority of participants were taking medications, and few understood the aims and potential benefits and harms of CVD prevention, it seems that older patients are not always making an informed decision. Our findings highlight potentially modifiable barriers to greater participation of older people in SDM about CVD prevention medication and prevention in general

Heuristics and biases in cardiovascular disease prevention:How can we improve communication about risk, benefits and harms?

Objective Cardiovascular disease (CVD) prevention guidelines recommend medication based on the probability of a heart attack/stroke in the next 5–10 years. However, heuristics and biases make risk communication challenging for doctors. This study explored how patients interpret personalised CVD risk results presented in varying formats and timeframes. Methods GPs recruited 25 patients with CVD risk factors and varying medication history. Participants were asked to ‘think aloud’ while using two CVD risk calculators that present probabilistic risk in different ways, within a semi-structured interview. Transcribed audio-recordings were coded using Framework Analysis. Results Key themes were: 1) numbers lack meaning without a reference point; 2) risk results need to be both credible and novel; 3) selective attention to intervention effects. Risk categories (low/moderate/high) provided meaningful context, but short-term risk results were not credible if they didn’t match expectations. Colour-coded icon arrays showing the effect of age and interventions were seen as novel and motivating. Those on medication focused on benefits, while others focused on harms. Conclusion CVD risk formats need to be tailored to patient expectations and experiences in order to counteract heuristics and biases. Practice implications Doctors need access to multiple CVD risk formats to communicate effectively about CVD prevention

The use of solved example problems for fostering strategies of self-regulated learning in journal writing

Roelle J, Krüger S, Jansen C, Berthold K. The use of solved example problems for fostering strategies of self-regulated learning in journal writing. Education Research International. 2012;2012: 751625 .Writing learning journals is a powerful tool to integrate self-regulated learning in classrooms. However, to exploit the full potential of journal writing, instructional support is needed that addresses the students’ deficits in the use of self-regulated learning strategies. A promising means to foster learning strategies in learning journals is the provision of solved example problems along with prompts. In a quasiexperimental field study, we provided fifth-grade students (N = 48) with solved example problems along with prompts either right from the beginning of writing their journals or after they had already written two learning journal entries. We found that the provision of solved example problems along with prompts right from the beginning of the journal writing process fostered the quality of both cognitive and metacognitive strategies and conceptual knowledge in the initial phase. The delayed provision of solved example problems after an initial phase of journal writing yielded a detrimental effect on the quality of cognitive strategies and a beneficial effect on the quality of metacognitive strategies. In sum, our results suggest that the provision of solved example problems along with prompts right from the beginning of journal writing can effectively support fifth-grade students in overcoming deficits in the use of self-regulated learning strategies

Recruiting general practitioners as participants for qualitative and experimental primary care studies in Australia

Recruiting general practitioners (GPs) for participation in primary care research is vitally important, but it can be very difficult for researchers to engage time-poor GPs. This paper describes six different strategies used by a research team recruiting Australian GPs for three qualitative interview studies and one experimental study, and reports the response rates and costs incurred. Strategies included: (1) mailed invitations via Divisions of General Practice; (2) electronic newsletters; (3) combining mailed invitations and newsletter; (4) in-person recruitment at GP conferences; (5) conference satchel inserts; and (6) combining in-person recruitment and satchel inserts. Response rates ranged from 0 (newsletter) to 30% (in-person recruitment). Recruitment costs per participant ranged from A$83 (in-person recruitment) to A$232 (satchel inserts). Mailed invitations can be viable for qualitative studies, especially when free/low-cost mailing lists are used, if the response rate is less important. In-person recruitment at GP conferences can be effective for short quantitative studies, where a higher response rate is important. Newsletters and conference satchel inserts were expensive and ineffective

Lecture capture using large interactive display systems

There are various software technologies that allow capture and redelivery of lectures. Most of these technologies however rely on the use of proprietary software, often requiring extra efforts from the lecturer in terms of the initial preparation of the lecture material, or in editing and annotating after the lecture to make the material suitable for the students. To review the material students then require access to the proprietary software. This paper describes a system for the lightweight capture of lecture presentations, based on the use of a low-cost large interactive display surface, together with standard Microsoft PowerPoint™ presentation software. The captured version of the presentation includes the original lecture slides, graphical annotations made by the lecturer during the lecture, and the audio recording of the lecture; all saved as a PowerPoint file. In addition, the system adds some annotations and index slides to allow quick and easy access to different segments of the presentation. Presentations can be replayed in part or in full as required, preserving all of the content of the live lecture

Interventions for improving health literacy in people with chronic kidney disease

This is the protocol for a review and there is no abstract. The objectives are as follows: This review aims to look at the benefits and harms of interventions for improving health literacy in patients with CKD

Partially Turboelectric Aircraft Drive Key Performance Parameters

The purpose of this paper is to propose electric drive specific power, electric drive efficiency, and electrical propulsion fraction as the key performance parameters for a partially turboelectric aircraft power system and to investigate their impact on the overall aircraft performance. Breguet range equations for a base conventional turbofan aircraft and a partially turboelectric aircraft are found. The benefits and costs that may result from the partially turboelectric system are enumerated. A break even analysis is conducted to find the minimum allowable electric drive specific power and efficiency, for a given electrical propulsion fraction, that can preserve the range, fuel weight, operating empty weight, and payload weight of the conventional aircraft. Current and future power system performance is compared to the required performance to determine the potential benefit

Medicines Conversation Guide

A Medicines Conversation Guide was developed for pharmacists to use in the context of a Home Medicines Review. The Guide aims to increase patient involvement and support discussions about: general health understanding, decision-making and information preferences, health priorities related to medicines, patient goals and fears, views on important activities and trade-offs