Taking Care of Palliative Care

Minnesota has done well with the amount of palliative care services provided across the state. However, rural communities in Minnesota have far less access to palliative care programs than those living in urban settings. This is in part due to the lack of availability of health care professionals in rural communities, and the lower reimbursement rates provided for palliative care programs in rural settings. Although the majority of large hospitals in Minnesota offer palliative care programs, most hospitals with fifty beds or less do not. Palliative care has been shown to improve the quality of life of individuals living with chronic and terminal illnesses. Palliative care is also less expensive than curative care for patients with chronic or terminal illnesses, and in some cases patients utilizing palliative care live longer than those continuing with curative treatments. In 2017, the Minnesota legislature created a Palliative Care Advisory Council to advocate for more quality palliative care in Minnesota. However, more needs to be done to ensure access to quality palliative care in rural areas. Increased funding for palliative care research and rural palliative care programs. Enhanced education for health care professionals on palliative care and end of life issues. Improved skill of health care professionals with discussing palliative care options and end of life issues. Better public education on palliative care and its benefits

«Nyheter tilpasset meg». En kvalitativ studie av sosiale medier som personaliserte nyhetskanaler

Denne studien gikk ut med en åpen tilnærming for å finne svar på hvordan sosiale medier fungerer som nyhetskilde for sjeldenbrukere av tradisjonelle nyhetsmedier. Gjennom mediedagbok og dybdeintervjuer kartlegger jeg informantenes egne refleksjoner av sosiale medier som nyhetstilgang. Studien fokuserer på Facebook ettersom det er denne plattformen som er mest sentral for informantenes nyhetskonsum. Studien diskuterer personalisert nyhetstilgang på Facebook og dets betydning for unge mediebrukere i aldersgruppen 18-26 år. Informantenes bruk av Facebook som nyhetstilgang viser hvordan man kan lese to sentrale funksjoner ved plattformen i en slik forbindelse. Disse funksjonene ved Facebook som «nyhetskanal» er hvordan man kan følge nyhetsmedier for å sikre seg tradisjonelle nyheter på en plattform de allerede benytter seg av for også andre formål. Den andre funksjonen er den sosiale dimensjonen hvor venner spiller en sentral rolle for nyhetsformidlingen. Jeg tar for meg tre filtreringsmekanismer ved Facebook – som sosiale nettverk, algoritmer og egne personlige seleksjoner. Disse vil styre fokuset i analysekapitlene, nemlig at kapittel 4 handler om egne personlige filtreringer, mens kapittel 5 fokuserer på sosiale nettverksfiltreringer. Algoritmiske filtreringer vil trekkes frem i begge kapitlene. Ut fra disse funksjonene ved Facebook som nyhetstilgang, drøfter jeg hvordan personaliseringen kommer til syne og betydningen dette har i en demokratisk diskusjon. Sentrale teoretiske innganger er Michael Schudson, David Zaller og Jürgen Habermas for en forståelse av nyhetenes rolle for å informere borgere om viktige hendelser i det politiske landskapet. Videre benytter jeg meg av teoretiske begreper for digitale nyhetspraksiser. Sentrale innganger for å forstå mine informanters nyhetsbruk på Facebook, er særlig Kim Schrøders metafor om en «handlekurv» med nyhetsmedier, og Jacob Ørmens «checking up» og «stumbling upon». Videre er andre teorier viktig i analysen, særlig opinionslederskap, to-stegs-hypotesen, sosiale tilknytningsstyrker, et perspektiv på fragmentering og «The Daily Me». Alle teoriene bidrar til å understreke mine funn av Facebook som personalisert nyhetstilgang. Studien kan bidra til forståelse av hvordan sentrale teoretiske begreper av digitale nyhetspraksiser kan problematiseres gjennom bruk av Facebook som nyhetstilgang. Videre hvorvidt personaliseringen kan være demokratisk styrkende for de som sjeldent direkte kobler seg til den brede offentligheten gjennom tradisjonelle plattformer.Masteroppgave i medievitenskapMEVI350MASV-MEV

Physical Activity to Improve Erectile Function:A Systematic Review of Intervention Studies

Abstract Introduction The leading cause of erectile dysfunction (ED) is arterial dysfunction, with cardiovascular disease as the most common comorbidity. Therefore, ED is typically linked to a web of closely interrelated cardiovascular risk factors such as physical inactivity, obesity, hypertension, and metabolic syndrome. Physical activity (PA) has proved to be a protective factor against erectile problems, and it has been shown to improve erectile function for men affected by vascular ED. This systematic review estimated the levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or manifest cardiovascular diseases. Aim To provide recommendations of levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. Methods In accord with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was performed of research articles specifically investigating PA as a possible treatment of ED. The review included research on ED from physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. All available studies from 2006 through 2016 were checked for the predetermined inclusion and exclusion criteria to analyze the levels of PA needed to decrease ED. Results 10 articles met the inclusion criteria, all suggesting various levels of PA needed to decrease ED for men with relevant risk factors for ED. The results of the review provided sufficient research evidence for conclusions regarding the levels of PA necessary to decrease ED. Conclusion Recommendations of PA to decrease ED should include supervised training consisting of 40 minutes of aerobic exercise of moderate to vigorous intensity 4 times per week. Overall, weekly exercise of 160 minutes for 6 months contributes to decreasing erectile problems in men with ED caused by physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. </jats:sec

Communication about physical activity to reduce vascular erectile dysfunction – A qualitative interview study among men in cardiac rehabilitation

This is an open access article under the terms of the Creat ive Commo ns Attri butio n- NonCo mmerc ial- NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non- commercial and no modifications or adaptations are made.Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring ScienceBackground Physical activity, a core intervention in cardiac rehabilitation, can reduce vascular erectile dysfunction (ED). ED is a common sensitive problem for men with cardiac diseases, decreasing their quality of life. Cardiac health professionals rarely provide information about ED or its relation to physical activity. Developing health professionals’ communicative component of the complex intervention ‘Physical Activity to reduce Vascular Erectile Dysfunction’ (PAVED) is important. Understanding the receiver needs is essential in designing a complex intervention. Aim To elucidate men's perspectives on cardiac health professionals’ communication about PAVED. Ethical issues An Institutional Data Protection Agency approved the study. Methods An interpretive data-driven thematic analysis was applied to individual, qualitative semi-structured interviews with 20 Danish men attending cardiac rehabilitation. Results The men wanted health professionals’ communicating about ED, as it was perceived as a major problem diminishing masculinity and tabooed by health professionals. Men wanted help for self-help, which may be possible with the aid of competent health professionals’ communication about how to prevent, reduce and cope with ED - including information about PAVED. The men wanted health professionals’ communication about ED in various contexts: general information in groups, sexual counselling for individuals and couples and written material. Study limitations Recruitment was done from a Danish municipality's cardiac rehabilitation, and the transferability of the results may be limited to similar contexts. Conclusion Erectile dysfunction was experienced as a major biopsychosocial problem for the men and their partners. The men had a need for health professionals’ communication about sexuality, ED and information about PAVED as well as about prevention, reduction and management of ED. The men had a need for professional communication about sexual health.publishedVersio

Survival after prolonged resuscitation with 99 defibrillations due to Torsade De Pointes cardiac electrical storm: a case report

A 48-year-old previously healthy woman suffered witnessed cardiac arrest in hospital. She achieved return of spontaneous circulation and was transferred to the intensive care unit. During the following 3 hours, she suffered a cardiac electrical storm with 98 episodes of Torsade de Pointes ventricular tachycardia rapidly degenerating to ventricular fibrillation. She was converted with a total of 99 defibrillations. There was no response to the use of any recommended anti arrhythmic drugs. However, the use of bretylium surprisingly stabilized her heart rhythm and facilitated placing of a temporary pacemaker. Overdrive pacing prevented further arrhythmias and was life saving. A number of beneficial factors may have contributed to the good neurological outcome. Further investigations gave no explanation for her cardiac electrical storm