Shielding of psychotic patients

Bacheloroppgave sykepleie, 2016Denne oppgaven tar for seg hvordan sykepleiere håndterer skjerming som en metode på en akuttpsykiatrisk avdeling. Vi har valgt å bruke litteraturstudie som metode og har derfor brukt anerkjente forfattere som Cullberg, Strand, Hummelvoll, Skårderud, Haugsgjerd, & Stänicke. Oppgaven vår er avgrenset til å handle om hvordan sykepleiere bruker skjerming som en metode på en skuttpsykiatrisk avdeling. Teoridelen består av psykose, symptomer og behandling av psykose, egostyrkende sykepleie, vold og utagering, lovverk. Som sykepleieteoretisk referanse så bruker vi Jan Kåre Hummelvoll og Liv Strand. Drøftingsdelen består av tre kapitler som tar for seg skjerming og bruken av skjerming på en akuttpsykiatrisk avdeling, egostyrkende sykepleie, hvordan man kan forebygge vold og utagering. Helt til slutt blir lovverket rundt bruken av skjerming og aktuelt lovverk drøftet. Vi avslutter med en oppsummering av de funn vi har gjort i løpet av oppgaveperioden, og noen tanker rundt problemstillingen

The vaa locus of Mycoplasma hominis contains a divergent genetic islet encoding a putative membrane protein

BACKGROUND: The Mycoplasma hominis vaa gene encodes a highly variable, surface antigen involved in the adhesion to host cells. We have analysed the structure of the vaa locus to elucidate the genetic basis for variation of vaa. RESULTS: Mapping of vaa on existing physical maps of five M. hominis isolates by pulsed field gel electrophoresis revealed that vaa is located in a genomic region containing the majority of other characterized membrane protein genes of M. hominis. Sequencing of an 11 kb region containing the vaa locus of M. hominis isolate 132 showed the presence of conserved housekeeping genes at the borders of the region, uvrA upstream and the hitABL operon downstream to vaa. Analysis of 20 M. hominis isolates revealed that the vaa upstream region was conserved whereas the downstream region was highly variable. In isolate 132 this region contained an open reading frame (ORF) encoding a putative 160 kDa membrane protein. Homologous ORFs were present in half of the isolates, whereas this ORF, termed vmp (variable membrane protein), was deleted from the locus in the remaining isolates. Compellingly, the conserved upstream region and variable downstream region of vaa correlates with the genetic structure of vaa itself which consists of a conserved 5' end and a variable 3' end containing a variable number of exchangeable sequence cassettes. CONCLUSION: Our data demonstrate that the vaa locus contains a divergent genetic islet, and indicate pronounced intraspecies recombination. The high variability level of the locus indicate that it is a chromosomal 'hot spot', presumably important for sustaining diversity and a high adaptation potential of M. hominis

Near-infrared spectroscopy after out-of-hospital cardiac arrest

BackgroundCerebral hypoperfusion may aggravate neurological damage after cardiac arrest. Near-infrared spectroscopy (NIRS) provides information on cerebral oxygenation but its relevance during post-resuscitation care is undefined. We investigated whether cerebral oxygen saturation (rSO(2)) measured with NIRS correlates with the serum concentration of neuron-specific enolase (NSE), a marker of neurological injury, and with clinical outcome in out-of-hospital cardiac arrest (OHCA) patients.MethodsWe performed a post hoc analysis of a randomised clinical trial (COMACARE, NCT02698917) comparing two different levels of carbon dioxide, oxygen and arterial pressure after resuscitation from OHCA with ventricular fibrillation as the initial rhythm. We measured rSO(2) in 118 OHCA patients with NIRS during the first 36h of intensive care. We determined the NSE concentrations from serum samples at 48h after cardiac arrest and assessed neurological outcome with the Cerebral Performance Category (CPC) scale at 6months. We evaluated the association between rSO(2) and serum NSE concentrations and the association between rSO(2) and good (CPC 1-2) and poor (CPC 3-5) neurological outcome.ResultsThe median (inter-quartile range (IQR)) NSE concentration at 48h was 17.5 (13.4-25.0) g/l in patients with good neurological outcome and 35.2 (22.6-95.8) g/l in those with poor outcome, pPeer reviewe