Akupunktur og insomnia

Denne oppgaven omhandler temaet akupunktur og insomnia. Insomnia har i de senere årene blitt et stadig større problem i befolkningen (2,3). Ferske tall fra Norge viser at forekomsten av insomnia blant voksne økte fra 11,9 prosent til 15,5 prosent i perioden 2000 til 2010 (3).Vi ønsker å belyse om Tradisjonell Kinesisk Medisin (TKM) kan tilby en virkningsfull behandling som kan være et supplement til konvensjonell behandling. Problemstillingen i vår oppgave er: ”Hvordan beskrives insomnia i TKM, og samsvarer dette med nyere forskning og klinisk praksis?” Vi har valgt å gjøre denne oppgaven til et kvalitativt dybdeintervju og en litteraturstudie. Formålet er å få oversikt over kunnskap som finnes om temaet insomnia innen litteratur, forskning og klinisk praksis. Vi vil presentere fire litteraturforfattere, tre RCT-studier, to reviews og erfaringer fra to informanter (2,4–13). Oppgaven belyser hvordan de beskriver etiologi, syndromer, ubalanser, og behandling i forhold til insomnia. Resultatene av studiene og den kliniske praksisen viser til positive effekter av akupunktur ved insomnia. Informantene fra klinisk praksis forteller om god effekt med sine behandlinger, og forskningen ser ut til å underbygge dette. Ut fra det materiale vi har benyttet kan vi konkludere med at akupunktur har god effekt. Beskrivelsen av insomnia i TKM synes i stor grad å samsvare med nyere forskning og klinisk praksis. Da vårt materiale har vært begrenset, kan det ikke konkluderes generelt for virkningen av akupunktur mot insomnia. Dersom vi hadde benyttet andre kilder kunne vi fått et annet resultat. Noen av studiene viser mangler ved utførelse, dokumentasjon og rapportering i forhold til STRICTA. Vi ser det hensiktsmessig at flere og bedre kvalitetsstudier omkring temaet blir utført. De positive resultatene som er blitt belyst i oppgaven bør undersøkes videre med nye og bedre kvalitetsstudier. Dette kan muliggjøre en konklusjon på akupunkturens virkning på insomnia

Basic Body Awareness Therapy versus standard care in hip osteoarthritis. A randomized controlled trial

Background Compensational movement patterns in hip osteoarthritis (HOA) are associated with hip dysfunction. Basic Body Awareness Therapy (BBAT) promotes functional movement quality and might, accordingly, be beneficial in HOA. Objective To examine the outcomes of BBAT compared to standard care in people with HOA after first receiving patient education (PE). Study Design A prospective, assessor-blinded, and block-randomized controlled trial. Methods Community-living adults with HOA participating in PE were randomly allocated to an intervention group receiving BBAT in groups (12 sessions offered once a week), or a comparison group. Data at baseline (pretest) and at 6 months (posttest) were analyzed. Primary outcomes were pain during walking assessed by the Numeric Rating Scale (NRS) and function by the Hip Osteoarthritis Outcome Score, subscale ADL (HOOS A). Secondary outcomes addressed physical capacity, movement quality, and self-reported aspects of function and health. Results At pretest, there were no significant differences in demographic and test data between the intervention (n = 51) and the comparison (n = 50) group. Forty-one intervention and 45 comparison participants completed the posttest. At posttest, no significant differences in change between groups were found on NRS (p = 0.694, effect size (ES) = 0.02) or HOOS A (p = 0.783, ES = 0.07). Among secondary outcomes, movement quality improved significantly more (p < 0.001, ES = 0.84) in the intervention group. Compliance with BBAT varied substantially. Per-protocol analysis showed changes in favor of the intervention group for self-efficacy (p = 0.049, ES = 0.36), health (p = 0.037, ES = 0.44), and function (p = 0.029, ES = 0.53) when only intervention participants who completed at least 10 sessions of BBAT were included. Conclusions BBAT was not found to be a more effective treatment modality than self-initiated standard care to reduce pain during walking and improve daily functioning in people with HOA. Movement quality was significantly more improved in participants receiving BBAT, and improvement in other health aspects was associated with sufficient therapy compliance.publishedVersio

International forum. an investigation of iron status in blood donors

No abstract availabl

Multidisciplinary discovery of ancient restoration using a rare mud carapace on a mummified individual from late New Kingdom Egypt.

Funder: Rundle Foundation for Egyptian ArchaeologyCT scans of an unnamed mummified adult from Egypt, now in the Chau Chak Wing Museum, University of Sydney (NMR.27.3), reveal it to be fully sheathed in a mud shell or carapace, exposing a mortuary treatment not previously documented in the Egyptian archaeological record. The carapace was placed between layers of linen wrappings thus it was not externally visible. Radiocarbon dating of textile samples provide a range of c.1370-1113 cal BC (95.4% probability), with a median date of 1207 cal BC. When assessed against mummification techniques of the era, the individual is placed in the late 19th-20th Dynasty, at the later end of this date range. Multi-proxy analysis including μ-XRF and Raman spectroscopy of carapace fragments from the head area revealed it to consist of three layers, comprising a thin base layer of mud, coated with a white calcite-based pigment and a red-painted surface of mixed composition. Whether the whole surface of the carapace was painted red is unknown. The carapace was a form of ancient conservation applied subsequent to post-mortem damage to the body, intended to reconfigure the body and enable continued existence of the deceased in the afterlife. The carapace can also be interpreted as a form of elite emulation imitating resin shells found within the wrappings of royal bodies from this period

A novel approach to fractional calculus: utilizing fractional integrals and derivatives of the Dirac delta function

While the definition of a fractional integral may be codified by Riemann and Liouville, an agreed-upon fractional derivative has eluded discovery for many years. This is likely a result of integral definitions including numerous constants of integration in their results. An elimination of constants of integration opens the door to an operator that reconciles all known fractional derivatives and shows surprising results in areas unobserved before, including the appearance of the Riemann Zeta Function and fractional Laplace and Fourier Transforms. A new class of functions, known as Zero Functions and closely related to the Dirac Delta Function, are necessary for one to perform elementary operations of functions without using constants. The operator also allows for a generalization of the Volterra integral equation, and provides a method of solving for Riemann's "complimentary" function introduced during his research on fractional derivatives

Epidemiology of taeniosis/cysticercosis in Europe, a systematic review : Western Europe

Background: Taenia solium and Taenia saginata are zoonotic parasites of public health importance. Data on their occurrence in humans and animals in western Europe are incomplete and fragmented. In this study, we aimed to update the current knowledge on the epidemiology of these parasites in this region. Methods: We conducted a systematic review of scientific and grey literature published from 1990 to 2015 on the epidemiology of T. saginata and T. solium in humans and animals. Additionally, data about disease occurrence were actively sought by contacting local experts in the different countries. Results: Taeniosis cases were found in twelve out of eighteen countries in western Europe. No cases were identified in Iceland, Ireland, Luxembourg, Norway, Sweden and Switzerland. For Denmark, Netherlands, Portugal, Slovenia, Spain and the UK, annual taeniosis cases were reported and the number of detected cases per year ranged between 1 and 114. Detected prevalences ranged from 0.05 to 0.27%, whereas estimated prevalences ranged from 0.02 to 0.67%. Most taeniosis cases were reported as Taenia spp. or T. saginata, although T. solium was reported in Denmark, France, Italy, Spain, Slovenia, Portugal and the UK. Human cysticercosis cases were reported in all western European countries except for Iceland, with the highest number originating from Portugal and Spain. Most human cysticercosis cases were suspected to have acquired the infection outside western Europe. Cases of T. solium in pigs were found in Austria and Portugal, but only the two cases from Portugal were confirmed with molecular methods. Germany, Spain and Slovenia reported porcine cysticercosis, but made no Taenia species distinction. Bovine cysticercosis was detected in all countries except for Iceland, with a prevalence based on meat inspection of 0.0002-7.82%. Conclusions: Detection and reporting of taeniosis in western Europe should be improved. The existence of T. solium tapeworm carriers, of suspected autochthonous cases of human cysticercosis and the lack of confirmation of porcine cysticercosis cases deserve further attention. Suspected cases of T. solium in pigs should be confirmed by molecular methods. Both taeniosis and human cysticercosis should be notifiable and surveillance in animals should be improved.Peer reviewe

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

ATT BLOGGA OM SIN SJUKDOM - Ett nytt sätt för sjuksköterskor att bemöta och kommunicera med patienter?

Bakgrund: Sjuksköterskor kan känna sig oförberedda efter sin utbildning vad gäller kommunikation och bemötande kring patienter med svår sjukdom. Sociala medier fortsätter även att expandera och många patienter bloggar idag om upplevelser kring deras sjukdom och behandling. Sjuksköterskor behöver därför ta ställning till denna situation, samt öka förståelsen och kunskapen om patienters bloggande enligt sjuksköterskans kompetensbeskrivning och etiska kod. Syfte: Syftet med uppsatsen är att beskriva hur personer med livshotande sjukdom skriver i sina bloggar om sjukdomserfarenheter. Metod: Fem bloggar har analyserats genom studien som är genomförd utifrån en kvalitativ innehållsanalys. Resultat: I resultatet framförs fyra teman och sju subteman. Temat Att bli väl/illa bemött i svåra situationer visar hur personerna har upplevt bemötande utav sjukvårdspersonal. Gott bemötande kan innebära att känna sig omhändertagen, vilket ger kraft. Att bli illa bemött i en svår situation har beskrivits som något som kan ge känslan av att vara i vägen. Temat Att kommunicera visar sig vara något som har stor betydelse för personerna vad det gäller att få bra information och på så vis undvika att skapa oro. Temat Att känna hopp/lidande i mötet med vården, beskriver hur stor påverkan vårdpersonalen kan ha på patienter. Temat Att genomgå livshotande sjukdomstillstånd beskriver att acceptans kan ske när de klarar av att hantera sin diagnos. Slutsats: Dessa personer uttryckte känsla av hopp, stöd och trygghet från sjukvården, men även känslor av ensamhet, att vara i vägen och att inte bli omhändertagen av sjukvården. Med hjälp utav det resultat som framkom i studien, kan sjuksköterskor få en inblick i patienters upplevelse av kommunikation och betydelsen av detta och utifrån det, kunna bemöta patienterna på bästa möjliga sätt