Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) study protocol: a stepped wedge randomised trial of stroke screening using the National Institutes of Health Stroke Scale in the ambulance

Background Less than 50% of stroke patients in Norway reach hospital within 4 h of symptom onset. Early prehospital identification of stroke and triage to the right level of care may result in more patients receiving acute treatment. Quality of communication between paramedics and the stroke centre directly affects prehospital on-scene time, emphasising this as a key factor to reduce prehospital delay. Prehospital stroke scales are developed for quick and easy identification of stroke, but have poor sensitivity and specificity compared to an in-hospital assessment with the National Institutes of Health Stroke Scale (NIHSS). The aim of the Paramedic Norwegian Acute Stroke Prehospital Project (ParaNASPP) is to assess whether a structured learning program, prehospital NIHSS and a mobile application facilitating communication with the stroke physician may improve triage of acute stroke patients. Methods A stepped wedge cluster randomised controlled intervention design will be used in this trial in Oslo, Norway. Paramedics at five ambulance stations will enrol adult patients with suspected stroke within 24 h of symptom onset. All paramedics will begin in a control phase with standard procedures. Through an e-learning program and practical training, a random and sequential switch to the intervention phase takes place. A mobile application for NIHSS scoring, including vital patient information for treatment decisions, transferring data from paramedics to the on-call stroke physician at the Stroke Unit at Oslo University Hospital, will be provided for the intervention. The primary outcome measure is positive predictive value (PPV) for prehospital identification of patients with acute stroke defined as the proportion of patients accepted for stroke evaluation and discharged with a final stroke diagnosis. One thousand three hundred patients provide a 50% surplus to the 808 patients needed for 80% power to detect a 10% increase in PPV. Discussion Structured and digital communication using a common scale like NIHSS may result in increased probability for better identification of stroke patients and less stroke mimics delivered to a stroke team for acute diagnostics and treatment in our population.publishedVersio

Narcissism and the strategic pursuit of short-term mating : universal links across 11 world regions of the International Sexuality Description Project-2.

Previous studies have documented links between sub-clinical narcissism and the active pursuit of short-term mating strategies (e.g., unrestricted sociosexuality, marital infidelity, mate poaching). Nearly all of these investigations have relied solely on samples from Western cultures. In the current study, responses from a cross-cultural survey of 30,470 people across 53 nations spanning 11 world regions (North America, Central/South America, Northern Europe, Western Europe, Eastern Europe, Southern Europe, Middle East, Africa, Oceania, Southeast Asia, and East Asia) were used to evaluate whether narcissism (as measured by the Narcissistic Personality Inventory; NPI) was universally associated with short-term mating. Results revealed narcissism scores (including two broad factors and seven traditional facets as measured by the NPI) were functionally equivalent across cultures, reliably associating with key sexual outcomes (e.g., more active pursuit of short-term mating, intimate partner violence, and sexual aggression) and sex-related personality traits (e.g., higher extraversion and openness to experience). Whereas some features of personality (e.g., subjective well-being) were universally associated with socially adaptive facets of Narcissism (e.g., self-sufficiency), most indicators of short-term mating (e.g., unrestricted sociosexuality and marital infidelity) were universally associated with the socially maladaptive facets of narcissism (e.g., exploitativeness). Discussion addresses limitations of these cross-culturally universal findings and presents suggestions for future research into revealing the precise psychological features of narcissism that facilitate the strategic pursuit of short-term mating

Brain energy rescue:an emerging therapeutic concept for neurodegenerative disorders of ageing

The brain requires a continuous supply of energy in the form of ATP, most of which is produced from glucose by oxidative phosphorylation in mitochondria, complemented by aerobic glycolysis in the cytoplasm. When glucose levels are limited, ketone bodies generated in the liver and lactate derived from exercising skeletal muscle can also become important energy substrates for the brain. In neurodegenerative disorders of ageing, brain glucose metabolism deteriorates in a progressive, region-specific and disease-specific manner — a problem that is best characterized in Alzheimer disease, where it begins presymptomatically. This Review discusses the status and prospects of therapeutic strategies for countering neurodegenerative disorders of ageing by improving, preserving or rescuing brain energetics. The approaches described include restoring oxidative phosphorylation and glycolysis, increasing insulin sensitivity, correcting mitochondrial dysfunction, ketone-based interventions, acting via hormones that modulate cerebral energetics, RNA therapeutics and complementary multimodal lifestyle changes

Narcisismo y búsqueda estratégica del emparejamiento a corto plazo a través de las culturas: Enlaces omnipresentes a través de 11 regiones mundiales del Proyecto de la descripción de la sexualidad internacional 2

Previous studies have documented links between sub-clinical narcissism and the active pursuit of short-term mating strategies (e.g., unrestricted sociosexuality, marital infidelity, mate poaching). Nearly all of these investigations have relied solely on samples from Western cultures. In the current study, responses from a cross-cultural survey of 30,470 people across 53 nations spanning 11 world regions (North America, Central/South America, Northern Europe, Western Europe, Eastern Europe, Southern Europe, Middle East, Africa, Oceania, Southeast Asia, and East Asia) were used to evaluate whether narcissism (as measured by the Narcissistic Personality Inventory; NPI) was universally associated with short-term mating. Results revealed narcissism scores (including two broad factors and seven traditional facets as measured by the NPI) were functionally equivalent across cultures, reliably associating with key sexual outcomes (e.g., more active pursuit of short-term mating, intimate partner violence, and sexual aggression) and sex-related personality traits (e.g., higher extraversion and openness to experience). Whereas some features of personality (e.g., subjective well-being) were universally associated with socially adaptive facets of Narcissism (e.g., self-sufficiency), most indicators of short-term mating (e.g., unrestricted sociosexuality and marital infidelity) were universally associated with the socially maladaptive facets of narcissism (e.g., exploitativeness). Discussion addresses limitations of these cross-culturally universal findings and presents suggestions for future research into revealing the precise psychological features of narcissism that facilitate the strategic pursuit of short-term mating.Estudios previos, en primer lugar a través de las muestras de culturas occidentales, han documentado asociaciones sistemáticas del narcisismo subclínico con múltiples indicadores de estrategias del emparejamiento a corto plazo (p. ej. sociosexualidad ilimitada, infidelidad, caza de pareja). En este estudio se han usado respuestas de la encuesta transcultural de 30.470 personas de 53 naciones de 11 regiones mundiales (América del Norte, América del Sur/América Central, Europa del Norte, Europa del Oeste, Europa del Este, Europa del Sur, Oriente Próximo, África, Asia del Sur/Sudoeste de Asia, Asia del Este y Oceanía) para evaluar si el narcisismo (medido por el Inventario de Personalidad Narcisista; NPI) se asocia panuniversalmente con los indicadores del emparejamiento a corto plazo, tanto en la dirección, como en la intensidad. Los resultados sugieren que el narcisismo (incluidos muchos aspectos suyos medidos por el NPI) tiene las mismas asociaciones básicas con los rasgos de personalidad relacionados con el sexo (p. ej. extraversión alta) y con los resultados sexuales claves (p. ej. búsqueda más activa de las estrategias del emparejamiento a corto plazo) a través de las 11 mayores regiones mundiales del PDSI 2. La discusión se enfoca en las implicaciones y limitaciones del estudio actual

Utbrenthet – en veiledende bibliografi

Utbrenthetsbegrepet ble lansert på midten av 70-tallet. Begrepet har hatt stor appell, og det anslås nå at det er skrevet om lag 6000 vitenskapelige bøker, artikler og avhandlinger om utbrenthet (Schaufeli, Leiter, & Maslach, 2009). Det tar tid å få oversikt over dette forskningsfeltet. Ikke bare fordi publikasjonsomfanget er blitt enormt, men også fordi begrepsinnholdet er vidt, og mer eller mindre klart avgrenset fra andre, etablerte begreper, som depresjon, jobbstress, generell utmattelse, jobbtilfredshet og jobbrelatert engasjement (work commitment)

Annonseelementer sin innvirkning på tillit og kjøpsintensjon ved influenser markedsføring

Influenser markedsføring differensierer seg fra annen markedsføring da influensere kan etablere en sterk tillit ved at meningene deres verdsettes da det tilfører en verdi for følgerne ved å dekke deres behov. Denne formen for markedsføring er svært effektiv da den kan generere både bedre resultater og profitt. Det er derfor en merkbar variasjon i arbeidet som legges ned i influenserne sin annonseutforming ved at flere vektlegger kvantitet overfor kvalitet. Formålet med dette studiet er å avdekke hvorvidt følgere stiller seg kritiske til ulike annonseelementer ved utformingen av annonser på Instagram, og basert på dette vil oppgaven belyse følgende problemstilling: Hvordan påvirker annonseelementer tilliten til influensere og kjøpsintensjonen? For å kunne besvare problemstillingen tar våre seks hypoteser for seg hvordan tilliten man har til en influenser påvirkes av følgende fire annonseelementer; mismatch, mengde med annonser, annonsemerking og visuell kvalitet. I tillegg er hensikten med to av hypotesene å kartlegge hvordan tillit og visuell kvalitet individuelt påvirker kjøpsintensjon. Studiet bygger på en kvantitativ tilnærming, og forskningsdesignet er en kombinasjon av deskriptivt- og kausalt design. For å samle inn data til å teste hypotesene har det blitt gjennomført en spørreundersøkelse hvor respondentene har fått spørsmål angående de fire annonseelementene samt tillit og kjøpsintensjon. I tillegg ble det gjennomført to eksperimenter for annonsemerking og visuell kvalitet hvor respondentene ble delt inn i to grupper som ble eksponert for ulike stimuli tilknyttet annonseelementene. For å teste hypotesene har vi benyttet enkel regresjonsanalyse, og t-test for to uavhengige stikkprøver for å identifisere forskjeller mellom de to gruppene og hvordan de responderte på stimuliene de ble utsatt for. Hypotesetestingen ga signifikant støtte til fem av de seks hypotesene. I tillegg er det gjennomført noen alternative analyser hvor vi gjennom multippel regresjonsanalyse, enkel regresjonsanalyse og t-test av to uavhengige stikkprøver har sett nærmere på respondentene basert på kjønn og alder knyttet til tillit, kjøpsintensjon, og hvorvidt de stiller seg kritiske til annonser. Hovedfunnene ved studiet er at utformingen av annonseelementer evner å påvirke tilliten som mottakerne sitter igjen med, og dette får videre konsekvenser for kjøpsintensjonen