Handledarutbildning för skolsköterskor på nätet

University of Skövde is the only institute of higher education in Sweden providing School Nurse Study Programme. The programme comprises 40 credit points (60 ECTS points) and is given as a distance programme with IT support at the Swedish Net University. This training programme was given the first time during the autumn term 2003 and had 40 participating students from all over Sweden. When the Swedish Net University had a happening at Stockholm University 2003 a project Tutor on the Net: Ophthalmologic Nursing was presented. Based on this project we have developed and put together our project Tutor on the Net: School Nurses . The aim of the project was: to train school nurses in supervision to offer tutors/supervisors a common ground for working with students towards the mutual goal as well as to acquaint them with new pedagogic methods applicable to distance courses with IT support to start and deepen the communication and the dialogue between tutors/supervisors, between tutor/supervisor and student as well as between tutor/supervisor and teacher to create and deepen the network between tutors/supervisors Tutors/Supervisors for school nurse students gathered at University of Skövde during four days of training. The theme during these days was information about School Nurse Study Programme, assessment of student s vocational training practice, loyalty in supervision, introduction to First Class, building network and methods in counselling. A joint seminar with the students took place, too. The evaluation showed that the tutors/supervisors found building network both positive and a proper forum for exchanging thoughts. To contact teachers and students through First Class was found exciting. Unfortunately, due to lack of time, the website did not get the space that was calculated from the beginning. According to this evaluation tutors/supervisors look forward in supervising school nurse students as well as in having the opportunity for exchanging knowledge

The active form of the R2F protein of class Ib ribonucleotide reductase from Corynebacterium ammoniagenes is a diferric protein

Corynebacterium ammoniagenes contains a ribonucleotide reductase (RNR) of the class Ib type. The small subunit (R2F) of the enzyme has been proposed to contain a manganese center instead of the dinuclear iron center, which in other class I RNRs is adjacent to the essential tyrosyl radical. The nrdF gene of C. ammoniagenes, coding for the R2F component, was cloned in an inducible Escherichia coli expression vector and overproduced under three different conditions: in manganese-supplemented medium, in iron-supplemented medium, and in medium without addition of metal ions. A prominent typical tyrosyl radical EPR signal was observed in cells grown in rich medium. Iron-supplemented medium enhanced the amount of tyrosyl radical, whereas cells grown in manganese-supplemented medium had no such radical. In highly purified R2F protein, enzyme activity was found to correlate with tyrosyl radical content, which in turn correlated with iron content. Similar results were obtained for the R2F protein of Salmonella typhimurium class Ib RNR. The UV-visible spectrum of the C. ammoniagenes R2F radical has a sharp 408-nm band. Its EPR signal at g = 2.005 is identical to the signal of S. typhimurium R2F and has a doublet with a splitting of 0.9 millitesla (mT), with additional hyperfine splittings of 0.7 mT. According to X-band EPR at 77-95 K, the inactive manganese form of the C. ammoniagenes R2F has a coupled dinuclear Mn(II) center. Different attempts to chemically oxidize Mn-R2F showed no relation between oxidized manganese and tyrosyl radical formation. Collectively, these results demonstrate that enzymatically active C. ammoniagenes RNR is a generic class Ib enzyme, with a tyrosyl radical and a diferric metal cofactor

GPs' opinions of public and industrial information regarding drugs: a cross-sectional study

Background: General Practitioners {GP} in Sweden prescribe more than 50% of all prescriptions. Scientific knowledge on the opinions of GPs regarding drug information has been sparse. Such knowledge could be valuable when designing evidence-based drug information to GPs. GPs' opinions on public- and industry-provided drug information are presented in this article. Methods: A cross-sectional study using a questionnaire was answered by 368 GPs at 97 primary-health care centres {PHCC}. The centres were invited to participate by eight out of 29 drug and therapeutic committees {DTCs}. A multilevel model was used to analyse associations between opinions of GPs regarding drug information and whether the GPs worked in public sector or in a private enterprise, their age, sex, and work experience. PHCC and geographical area were included as random effects. Results: About 85% of the GPs perceived they received too much information from the industry, that the quality of public information was high and useful, and that the main task of public authorities was to increase the GPs' knowledge of drugs. Female GPs valued information from public authorities to a much greater extent than male GPs. Out of the GPs, 93% considered the main task of the industry was to promote sales. Differences between the GPs' opinions between PHCCs were generally more visible than differences between areas. Conclusions: Some kind of incentives could be considered for PHCCs that actively reduce drug promotion from the industry. That female GPs valued information from public authorities to a much greater extent than male GPs should be taken into consideration when designing evidence-based drug information from public authorities to make implementation easier

The meaning of quality work from the general practitioner's perspective: an interview study

BACKGROUND: The quality of health care and its costs have been a subject of considerable attention and lively discussion. Various methods have been introduced to measure, assess, and improve the quality of health care. Many professionals in health care have criticized quality work and its methods as being unsuitable for health care. The aim of the study was to obtain a deeper understanding of the meaning of quality work from the general practitioner's perspective. METHODS: Fourteen general practitioners, seven women and seven men, were interviewed with the aid of a semi-structured interview guide about their experience of quality work. The interviews were tape-recorded and transcribed verbatim. Data collection and analysis were guided by a phenomenological approach intended to capture the essence of the statements. RESULTS: Two fundamentally different ways to view quality work emerged from the statements: A pronounced top-down perspective with elements of control, and an intra-profession or bottom-up perspective. From the top-down perspective, quality work was described as something that infringes professional freedom. From the bottom-up perspective the statements described quality work as a self-evident duty and as a professional attitude to the medical vocation, guided by the principles of medical ethics. Follow-up with a bottom-up approach is best done in internal processes, with the profession itself designing structures and methods based on its own needs. CONCLUSIONS: The study indicates that general practitioners view internal follow-up as a professional obligation but external control as an imposition. This opposition entails a difficulty in achieving systematism in follow-up and quality work in health care. If the statutory standards for systematic quality work are to gain a real foothold, they must be packaged in such a way that general practitioners feel that both perspectives can be reconciled

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Some physical and nutritional characteristics of genetically modified potatoes varying in amylose/amylopectin ratios

Transgenically modified potatoes with a large spread in amylose/amylopectin ratios were analysed both as tubers and in the form of isolated starch. Different microscopic techniques were used to study starch granules and tuber tissue. Starch gelatinisation properties and recrystallisation of amylopectin and amylose were studied by differential scanning calorimetry. Starch bioavailability and resistant starch (RS) were evaluated using enzymatic in vitro procedures. Glycaemic indices (GI) were predicted from low molecular weight carbohydrates (LMWC) contents and the in vitro hydrolysis rate of the starch moiety. For many of the examined parameters, differences of varying magnitude were found between the potato lines, especially for high amylose lines. High amylose starch granules had irregular shapes and showed only a limited swelling. Moreover, contents of RS and recrystallised amylose were elevated. GI’s for the starch moiety were reduced, though elevated contents of LMWC caused a high over-all predicted GI

Adequate vitamin D levels in a Swedish population living above latitude 63°N : The 2009 Northern Sweden MONICA study

BACKGROUND: Even though vitamin D is mainly produced by exposure to sunlight, little is known regarding vitamin D levels in populations living in sub-Arctic areas with little or no daylight during winter. OBJECTIVE: We describe distributions of vitamin D3 and the prevalence of adequate levels in a population living above 63°N. DESIGN: We sampled 1,622 randomly selected subjects, aged 25-74 years, between January and May, 2009, as part of the Northern Sweden MONICA study (69.2% participation rate). By using HPLC, 25(OH) vitamin D3 was analysed. Levels used for definitions were deficient, D3&lt;25 nmol/l (&lt;10 ng/ml); insufficient, D3 25-49.9 nmol/l (10-20 ng/ml); and adequate, D3≥50 nmol/l (20 ng/ml). RESULTS: Mean (median) level of vitamin D3 was 65.2 (63.6) nmol/l in men and 71.0 (67.7) nmol/l in women. Adequate levels were found in 79.2%, more often in women (82.7%) than in men (75.6%). Only 0.7% of the population were vitamin D3-deficient but 23.1% of men and 17.1% of women had insufficient levels. Levels of vitamin D3 increased with age and insufficient status was most common among those aged 25-34 years, 41.0% in men and 22.3% in women. If subjects using vitamin D-supplementation are excluded, the population level of D3 is 1-2 nmol/l lower than in the general population across sex- and age groups. There were no differences between the northern or the southern parts, between urban or rural living or according to educational attainment. Those subjects born outside of Sweden or Finland had lower levels. CONCLUSION: The large majority living close to the Arctic Circle in Sweden have adequate D3 levels even during the second half of the dark winter. Subjects with D3 deficiency were uncommon but insufficient levels were often found among young men

Resistant starch formation in temperature treated potato starches varying in amylose/amylopectin ratio

Two genetically modified potato starches derived from the same mother line (64%, 1% and 23% amylose, respectively) were used to study the bioavailability after various heat treatments. The conditions for the treatments were of minor importance for resistant starch (RS) formation and hydrolysis results, as compared to the proportion of amylose. A high amylose content gave lower hydrolysis index (HI) and higher amounts of RS than starches with less amylose. Retrograded amylopectin contributed to a decreased HI, although only the high amylose line showed sufficient reduction in predicted glycaemic indices (Gl). The line with high amylose content contained 25-30% RS vs. in the range of 0-5% for the other starches. Results could neither be explained by the presence of intact granules, nor by the content of retrograded amylose. Therefore, a synergistic effect between the starch components was suggested to affect the RS and starch hydrolysis. (c) 2006 Elsevier Ltd. All rights reserved