Dusting Off the Tool Box: Tips for Trainers

This resource provides information to help instructors prepare, conduct, and review their presentations. It is divided into 3 sections. Within each section are subcategories with basic information and some simple resources or activities to assist instructors as they reflect upon their teaching practices and plan for a training event. The material is organized in the following way: Section 1: Things to Know; Section 2: Things to Do; and Section 3: Resources

Living at home with cognitive impairments : risks during daily living and support from home care service

The overall study’s aim was to increase knowledge of conditions for older, home-residing persons with cognitive impairments – with focus on risks during daily living and support from home care service. To disclose conditions for persons with cognitive impairments, four studies used different methodological approaches. Studies I and II applied a qualitative design; here focus was on daily living risks for persons with dementia. Study I explored experiences of 12 persons with dementia by interviewing them; data were processed using qualitative content analysis. Study II explored experiences of home care staff via 12 individual interviews and 2 focus group discussions (n=11); data were analysed using a constant comparative method. Studies III and IV applied a descriptive correlational cross-sectional design. Study III focused on describing the range of municipal-granted home care services and examined associations between services granted to persons with cognitive impairments and demographic characteristics (from records for 131 older persons). Study IV documented perceived job strain among home care staff members (n=69) and investigated if job strain correlated with personal and organisational factors. Study I contributed knowledge about (i) how home-residing persons with dementia experienced risky situations as being unfamiliar and confusing and (ii) how they dealt with these situations and sought recognition and clarity to reduce risk. Study II showed how home care staff reasoned – regarding risks for persons with dementia – and how they struggled with dilemmas when (i) tracking risks, (ii) deciding when to act on a risk, and (iii) acting upon risks. Study III acquired knowledge about the range of home services granted to older persons and found that these persons receive a wide range of services including support for basic needs such as eating and drinking. This study also found that persons with cognitive impairments, and persons who live alone, were granted a higher number of home care services than other home care service applicants. Study IV generated knowledge regarding job strain, namely, (i) home care staff perceived high job strain, particularly dementia care specialists, (ii) employees who don’t have Swedish as their first language perceived higher job strain regarding understanding and interpreting work situations with older persons, and (iii) organisational climate is crucial because a more creative organisational climate is associated with lower job strain. In conclusion, these findings provided better understanding of how persons with dementia experienced risk-filled situations and showed that risks should be accounted for because they can affect how individuals engage in activities of daily living. Home care staff members are challenged as they face dilemmas when managing situations fraught with risk for persons with dementia, and they often work alone. Staff members encountered persons who were granted a wide range of services and staff perceived high job strain. Therefore, it’s important to ensure that home care staff members have appropriate support and work under appropriate organisational conditions so they can take safety into account while supporting persons with

Swedish piglet producers´ routines regarding piglet mortality : causes of death, analysis and actions

There are different ways to keep pigs for meat production and legislation differ for example between Sweden and the rest of Europe. Swedish sows are not allowed to be confined in a farrowing crate and the age at weaning for piglets in Sweden is minimum 4 weeks and 3 weeks according EUs legislation. Many piglets die before weaning and the Swedish statistics on mean piglet mortality from 2016 is 17,1 %. This is higher than studies made in Norway, England and Switzerland. A study made in Sweden showed a mortality of 19,5 %. One of the main reasons piglets die is because they become crushed by the sow. Starving, disease and low birth weight are other common reasons. Research also says genetics and litter size decide the mortality, were some sows have very high mortality and some almost no mortality. There are a lot of research of the actions to take in order to decrease mortality. Many of them are management routines; providing the sow with a large amount of straw before farrowing will make her calmer and more observant of the piglets, and a heat lamp will help the piglet maintain body temperature and decrease the risk of hypothermia. By staying close to the sows around farrowing and the days after the caretakers are for example able to help the piglets to the heat lamp and prevent them from getting crushed by the sow. The purpose of this work was to find out if producers that try to decide piglet causes of death and also takes actions depending on the result have a lower mean mortality. To be able to do that a questionnaire with nine questions was sent out to pig producers on Facebook. In a total 23 participants answered some of the questions and 18 participants answered the whole questionnaire. The mortality ranged between 5-25 % and the mean mortality was 16,4 %. Seven of the participants tries to decide the cause of death and six of these took direct actions depending on the result according to their answers. The mean mortality of these seven was 17,8 %. All participants took more general actions to decrease mortality. Move piglets between litters, let them suckle in shifts and extra milk replacer are common actions for both farms with and without thorough routines. The majority of the participants believe piglet mortality is a problem that need to be solved. This study did not see that producers with thorough routines have lower mean piglet mortality and the high Swedish mortality is still a problem in need of a solution

På tal om Lean inom den offentliga sektorn - en diskursanalys av hur Lean presenteras inom Sveriges kommuner och landsting

The main purpose of the study was to show how the work model lean is depicted within the public sector and, for the discourse, the actual roles constructed by people working with lean. The relevant questions for the study were: What central concepts are presented within lean, and how these are constructed and what the consequences might be. The empirical basis for this study was a brochure with twelve statements by people who in some way work within lean. The method for this paper is based on a discourse analysis which is also a part of the theoretical section. Furthermore the understanding of our study where advanced by the use of the social constructivist and postmodernist theories where Foucaults theories about power became central in the analysis. The study resulted in an understanding that the linguistic formulations create an unequal power balance between the different participants, managers, personnel and citizens. Where the citizen's power is weak and its influence restricted

Ledarskap - Ett enkelt begrepp? - En kvalitativ studie om framställningen av ledarskap, medarbetare och kontexter i managementlitteratur

Sammanfattning Titel: “Ledarskap- Ett enkelt begrepp?” - En kvalitativ studie om framställningen av ledarskap, medarbetare och kontexter i managementlitteratur. Universitet: Lunds Universitet, Campus Helsingborg, Institutionen för Service Management. Kurs: KSKK01 Service Management: Examensarbete för kandidatexamen, 15 hp, Vårterminen 2013. Författare: Hanna Persson & Linda Sandberg Handledare: Malin Espersson Nyckelord: Ledarskap, medarbetare, kontexter, managementlitteratur. Syfte: Genom att studera och analysera känd och populär managementlitteratur vill vi undersöka hur och i vilken utsträckning denna litteratur speglar aktuell managementforskning och om dessa hänger samman eller ej. Vi vill även se på hur ledarskap framställs samt hur synen på ledarskap ser ut. En undersökning kommer göras om hänsyn tas till medarbetare och hur dessa i sådana fall framställs i managementlitteratur, likväl vill vi se i vilken utsträckning hänsyn tas till olika kontexter i litteraturen. Studiens syfte är att undersöka hur ledarskap, medarbetare och kontexter framställs i vald managementlitteratur. Frågeställningar: - Hur framställs ledare och ledarskap i managementlitteratur? - På vilket sätt framställs medarbetare? - I vilken utsträckning tas hänsyn till olika kontexter? Metod: En kvalitativ textanalys med delar från innehållsanalys och argumentationsanalys, två utvalda managementböcker utgör empiriskt material. Teoretisk referensram och tidigare forskning: Forskning och teori kring Ledarskap, medarbetarskap, kontexter, chefskap kontra ledarskap, path-goal teorin, leader-member exchange theory (LMX) samt kontingensteorin, Slutsatser: Vald managementlitteratur ger en förenklad bild av ledarskap, beskrivningar inom området är förenklade och förklaringar på tillvägagångssätt saknas i de flesta diskussioner. Medarbetare framställs på ett generellt sätt och de framställs ofta som motståndslösa och enkla att styra. Studien visar att det finns en avsaknad av hänsyn till kontexter och dess påverkan

Anticipated regret to increase uptake of colorectal cancer screening (ARTICS):a randomised controlled trial

Objective. Screening is key to early detection of colorectal cancer. Our aim was to determine whether a simple anticipated regret (AR) intervention could increase colorectal cancer screening uptake. Methods. We conducted a randomised controlled trial of a simple, questionnaire-based AR intervention, delivered alongside existing pre-notification letters. 60,000 adults aged 50-74 from the Scottish National Screening programme were randomised to: 1) no questionnaire (control), 2) Health Locus of Control questionnaire (HLOC) or 3) HLOC plus anticipated regret questionnaire (AR). Primary outcome was guaiac Faecal Occult Blood Test (FOBT) return. Secondary outcomes included intention to return test kit and perceived disgust (ICK). Results. 59,366 people were analysed as allocated (Intentionto- treat (ITT)); there were no overall differences between treatment groups on FOBT uptake (control: 57.3%, HLOC: 56.9%, AR: 57.4%). 13,645 (34.2%) people returned questionnaires. Analysis of the secondary questionnaire measures showed that AR had an indirect effect on FOBT uptake via intention, whilst ICK had a direct effect on FOBT uptake over and above intention. The effect of AR on FOBT uptake was also moderated by intention strength: for less than strong intenders only, uptake was 4.2% higher in the AR (84.6%) versus the HLOC group (80.4%) (95% CI for difference (2.0, 6.5)). Conclusion. The findings show that psychological concepts including anticipated regret and perceived disgust (ICK) are important factors in determining FOBT uptake. However, there was no simple effect of the AR intervention in the ITT. We conclude that exposure to AR in those with low intentions may be required to increase FOBT uptake. Current controlled trials: www.controlledtrials. com number: ISRCTN74986452

Alginate inhibits iron absorption from ferrous gluconate in a randomized controlled trial and reduces iron uptake into Caco-2 cells

Previous in vitro results indicated that alginate beads might be a useful vehicle for food iron fortification. A human study was undertaken to test the hypothesis that alginate enhances iron absorption. A randomised, single blinded, cross-over trial was carried out in which iron absorption was measured from serum iron appearance after a test meal. Overnight-fasted volunteers (n=15) were given a test meal of 200g cola-flavoured jelly plus 21 mg iron as ferrous gluconate, either in alginate beads mixed into the jelly or in a capsule. Iron absorption was lower from the alginate beads than from ferrous gluconate (8.5% and 12.6% respectively, p=0.003). Sub-group B (n=9) consumed the test meals together with 600 mg calcium to determine whether alginate modified the inhibitory effect of calcium. Calcium reduced iron absorption from ferrous gluconate by 51%, from 11.5% to 5.6% (p=0.014), and from alginate beads by 37%, from 8.3% to 5.2% (p=0.009). In vitro studies using Caco-2 cells were designed to explore the reasons for the difference between the previous in vitro findings and the human study; confirmed the inhibitory effect of alginate. Beads similar to those used in the human study were subjected to simulated gastrointestinal digestion, with and without cola jelly, and the digestate applied to Caco-2 cells. Both alginate and cola jelly significantly reduced iron uptake into the cells, by 34% (p=0.009) and 35% (p=0.003) respectively. The combination of cola jelly and calcium produced a very low ferritin response, 16.5% (p<0.001) of that observed with ferrous gluconate alone. The results of these studies demonstrate that alginate beads are not a useful delivery system for soluble salts of iron for the purpose of food fortification

A detailed clinical and molecular survey of subjects with nonsyndromic USH2A retinopathy reveals an allelic hierarchy of disease-causing variants.

Defects in USH2A cause both isolated retinal disease and Usher syndrome (ie, retinal disease and deafness). To gain insights into isolated/nonsyndromic USH2A retinopathy, we screened USH2A in 186 probands with recessive retinal disease and no hearing complaint in childhood (discovery cohort) and in 84 probands with recessive retinal disease (replication cohort). Detailed phenotyping, including retinal imaging and audiological assessment, was performed in individuals with two likely disease-causing USH2A variants. Further genetic testing, including screening for a deep-intronic disease-causing variant and large deletions/duplications, was performed in those with one likely disease-causing change. Overall, 23 of 186 probands (discovery cohort) were found to harbour two likely disease-causing variants in USH2A. Some of these variants were predominantly associated with nonsyndromic retinal degeneration ('retinal disease-specific'); these included the common c.2276 G>T, p.(Cys759Phe) mutation and five additional variants: c.2802 T>G, p.(Cys934Trp); c.10073 G>A, p.(Cys3358Tyr); c.11156 G>A, p.(Arg3719His); c.12295-3 T>A; and c.12575 G>A, p.(Arg4192His). An allelic hierarchy was observed in the discovery cohort and confirmed in the replication cohort. In nonsyndromic USH2A disease, retinopathy was consistent with retinitis pigmentosa and the audiological phenotype was variable. USH2A retinopathy is a common cause of nonsyndromic recessive retinal degeneration and has a different mutational spectrum to that observed in Usher syndrome. The following model is proposed: the presence of at least one 'retinal disease-specific' USH2A allele in a patient with USH2A-related disease results in the preservation of normal hearing. Careful genotype-phenotype studies such as this will become increasingly important, especially now that high-throughput sequencing is widely used in the clinical setting.European Journal of Human Genetics advance online publication, 4 February 2015; doi:10.1038/ejhg.2014.283

Anticipated regret to increase uptake of colorectal cancer screening in Scotland (ARTICS): Study protocol for a randomised controlled trial

Background: Colorectal cancer is the second leading cause of cancer deaths in the UK. Screening is key to early detection. The Scottish programme of colorectal cancer screening is running successfully, and involves all adults aged between 50 and 74 years being invited to post back a faecal sample for testing every 2 years. However, screening uptake is sub-optimal: for example rates for the period November 2009 to October 2011 ranged from just 39% for males living in the most deprived areas to 67% for least deprived females. Recent research has shown that asking people to consider the emotional consequences of not participating in screening (anticipated regret) can lead to a significant increase in screening uptake. Methods/Design: We will test a simple anticipated regret manipulation, in a large randomised controlled trial with 60,000 members of the general public. They will be randomly allocated to one of 3 arms, no questionnaire, control questionnaire or anticipated regret questionnaire. The primary outcome will be screening test kit return. Results will also be examined by demographic variables (age, gender, deprivation) as these are currently related to screening kit return. Discussion: If this anticipated regret intervention leads to a significant increase in colorectal cancer screening kit returns, this would represent a rare example of a theoretically-driven, simple intervention that could result in earlier detection of colorectal cancer and many more lives saved. Trial registration: Current Controlled trials: ISRCTN7498645