Jump in with both Feet, the Waters Get Warmer over Time!

First Paragraph: Nursing research, evidence-based practice, literature reviews, meta-analysis, correlations, control and experimental groups, and validity. Terms like these used to make the hair on the back of my neck stand on end. My palms would break into a sweat, and if ever I felt inadequate as a nurse, it was in the area of nursing research. I would listen to advanced practice nurses, master\u27s-prepared nurses and doctorate-prepared nurses discussing research and feel totally inadequate. It didn\u27t matter that at the time, I had 16 years of experience or that I was currently working as a nurse manager. Nursing research seemed to be a foreign language. To console myself, I would say that research wasn\u27t my cup of tea. It was too dry, too complex and impossible to undertake the the \u27real world\u27

It is Time for DiSCo – a Theoretical Model for Didactic Spatial Competence.

In this position paper we present a theoretical model on how to support teachers to develop a “didactic spatial competence” (DiSCo). We define DiSCo as: Based on proven experience and science to have the ability to plan and design teaching and learning in a variety of learning spaces; to implement teaching and learning, act and react in a variety of learning spaces and to evaluate, reflect and transform both pedagogy and the learning space. In the paper we argue that a Didactic Spatial Competence (DiSCo) can be used to frame the complex relationship between learning spaces and teaching. DiSCo concerns to plan for teaching and learning in a variety of learning spaces that support the pedagogical ideas; but it also entails implementing, that is to critically reflect over and use affordances and meaning potential in various learning spaces, to have agency and competence to act and react during teaching and learning in various learning spaces and maybe first and foremost; to use the space in a meaning-making process together with students – that is to create a place for learning. Furthermore, it includes a reflective and evaluative part

Pitkäkestoisuus kiinteistö- ja rakennusalan sopimussuhteissa

Long-term partnerships have become popular models in Finnish public and private sectors. Public-Private-Partnerships are new models in construction sector. In real estate sector owners have increased outsourcing facility services. This development has meant that the amount of partnership agreements have become bigger. Because of these facts also the interest of researching long-term contracts in the field of construction and real estate has increased. This research is a qualitative research which is carried by abductive logic. In this research long-term contracts in the field of construction and real estate are outlined in terms of contract law. The goal of the research is to find out: Which factors in terms of contract law have importance in mentioned long-term contracts? This is solved by examining literature, contracts and making theme interviews. This research contains next contract law mindsets: process concept of contract, relational contracting, dynamics of contract, proactive contracting and contractual risk management. These mindsets function partly as a background for the research and partly as a tool to outline mentioned contracts. The results of the research show firstly, what is contract management and how a company can with it arrange comprehensively it's contract policies and this way make it's business more efficient. Secondly the results show, what responsive contract is and how it can bring flexibility to long-term contractual relationships. The results also show, have trust and duty of loyalty in long-term contracts effect on parties. Also the results show how these mentioned three questions become apparent in practical contract policies in the field of construction and real estate. The results also show what the key elements in terms of contract law are in facility service partnership agreements. Research brings contribution to Finnish contract law and especially to the research of long-term contracts. On the other hand it brings contribution to construction economics and management by enhancing the importance of contracts as part of sector's business. Results create conclusions and recommendations to the construction and real estate sector

Proactive contracting in finnish ppp projects

Public‐private‐partnership projects are long term, complex and very challenging contractual arrangements and relationships. They bring new roles for public sector and also for private sector in terms of construction and services. This paper will go through some features of the Finnish PPPs. Proactive law focuses in practical views as regards contract law and contractual issues. The main target is to prevent problems instead of confronting them. This paper will clarify what proactive law is about in terms of contract law and contracting especially in PPPs. For instance, 20–40 years’ partnership relation with PPPs brings up also dozens of different risks into the picture. This paper will discuss the risks and risk management in terms of proactive law and after that, focus on PPPs in Finland. Santruka Viešojo ir privataus sektoriu partnerystes (VPP) projektai ‐ tai ilgalaikiai, sude tin gi ir itin daug pastangu reikalaujantys sutartiniai susitarimai ir santykiai. Ne tik viešajame, bet ir privačiajame sektoriuje jie sukuria naujus, su statyba ir paslaugomis susijusius, vaidmenis. Šiame darbe apžvelgiami kai kurie Suomijos VPP bruožai. Iniciatyvi teise glaudžiai susijusi su prak ti nemis pažiūromis, sutarčiu teise ir pan. Pagrindinis tikslas ‐ išvengti problemu užuot jas sprendus. Šiame darbe paaiškinama iniciatyvios teises esme sudarant sutartis, ypač VPP. Pavyzdžiui, kai VPP trunka 20–40 metu, susiduriama su daugybe ivairiu rizikos rūšiu. Todel straipsnyje pirmiausia aptariamos rizikos rūšys ir rizikos valdymo būdai taikant iniciatyvia teise, o po to ‐ Suomijos VPP. First Publish Online: 18 Oct 201

Catching sight of students´ learning: a matter of space?

Based on a two-year study of a development project aiming to enhance students ́ learning in a natural science course by making their understanding more visible to themselves and their teachers, this paper analyzes the role of physical space in this context. Data were collected through systematic observations, photo and film documentation, student surveys, interviews with students and teachers, and also from students ́ examination results over an extended period. Previously, the course used traditional teaching methods and spaces. The students found the contents difficult, and the average examination results were poor. The teachers developed more student-active working methods, challenging students to make their understanding visible. However, the course literature and type of examination tasks remained unchanged, allowing for comparisons over time. The instruction took place in a large, innovative "flex-room", equipped with touchscreens, whiteboards, highly accessible technology and flexible furniture, allowing for increased student communication and feedback. The teachers could interact with student groups in the same room, spot and quickly correct misunderstandings in student presentations. The students ́ examination results improved considerably. They argued that the work methods contributed to deeper understanding and improved retention of the course contents. Finally, few observed space-related time-losses occurred. We conclude that well-designed spaces were crucial preconditions to enable these positive results.</p

The Role of Chromosomal Instability and Epigenetics in Colorectal Cancers Lacking beta-Catenin/TCF Regulated Transcription

All colorectal cancer cell lines except RKO displayed active beta-catenin/TCF regulated transcription. This feature of RKO was noted in familial colon cancers; hence our aim was to dissect its carcinogenic mechanism. MFISH and CGH revealed distinct instability of chromosome structure in RKO. Gene expression microarray of RKO versus 7 colon cancer lines (with active Wnt signaling) and 3 normal specimens revealed 611 differentially expressed genes. The majority of the tested gene loci were susceptible to LOH in primary tumors with various beta-catenin localizations as a surrogate marker for beta-catenin activation. The immunohistochemistry of selected genes (IFI16, RGS4, MCTP1, DGKI, OBCAM/OPCML, and GLIPR1) confirmed that they were differentially expressed in clinical specimens. Since epigenetic mechanisms can contribute to expression changes, selected target genes were evaluated for promoter methylation in patient specimens from sporadic and hereditary colorectal cancers. CMTM3, DGKI, and OPCML were frequently hypermethylated in both groups, whereas KLK10, EPCAM, and DLC1 displayed subgroup specificity. The overall fraction of hypermethylated genes was higher in tumors withmembranous beta-catenin. We identified novel genes in colorectal carcinogenesis that might be useful in personalized tumor profiling. Tumors with inactive Wnt signaling are a heterogeneous group displaying interaction of chromosomal instability, Wnt signaling, and epigenetics.Peer reviewe

Leuprorelin Acetate Long-Lasting Effects on GnRH Receptors of Prostate Cancer Cells: An Atomic Force Microscopy Study of Agonist/Receptor Interaction

High cell-surface GnRH receptor (GnRH-R) levels have been shown to have a major influence on the extent of GnRH agonist-mediated tumor growth inhibition. The ability of the GnRH agonist leuprorelin acetate (LA) to induce a post-transcriptional upregulation of GnRH-R at the plasma membrane of androgen-sensitive (LNCaP) and -insensitive (PC-3) prostate cancer (PCa) cells has been previously demonstrated by Western blotting. Here we performed single molecule force spectroscopy by using Atomic Force Microscopy (AFM), which has proven to be a powerful tool allowing for investigation of living cell surface biological features, such as the so far unclear GnRH agonist/receptor interaction. Thus, in the hormone-insensitive PC-3 cells, we characterized the strength of the LA-receptor binding, and the amount and distribution of the functional receptor molecules on the cell surface. The effect of a long and continuous treatment (up to 30 days) with the agonist (10-11 and 10-6 M) on the same parameters was also investigated. A GnRH-R increase was observed, reaching the maximum (~80%) after 30 days of treatment with the highest dose of LA (10-6 M). The analogue-induced increase in GnRH-R was also demonstrated by Western blotting. In addition, two different receptor bound strengths were detected by AFM, which suggests the existence of two GnRH-R classes. A homogeneous distribution of the unbinding events has been found on untreated and treated PC-3 cell surfaces. The persistence of high receptor levels at the membrane of these living cells may warrant the maintenance of the response to LA also in androgen-unresponsive PCa. Moreover, the determination of ligand/receptor bond strength could shed light on the poorly understood event of LA/GnRH-R interaction and/or address structural/chemical agonist optimizations. \ua9 2013 Lama et al

To have the right tools to dare open Pandora´s boxAn interview study with midwives to refer the question of Intimate Partner Violence.

Syfte:Att undersöka barnmorskors upplevelser och erfarenheter av att ställa frågor om våld enligt nationella riktlinjer. Design: Intervjustudie baserade på nio enskilda semistrukturerade intervjuer som analyserats med kvalitativ innehållsanalys. Omgivning: Fem mödrahälsovårdscentraler i norra Sverige. Deltagare: Nio barnmorskor, som arbetade på landstingsägda och privata hälsocentraler. Barnmorskorna som var i åldrarna 34 – 62 år hade erfarenheter av att arbeta inom mödravården liksom förlossningsvården. (Alla deltagare gav muntligt och skriftligt medgivande på att delta i studien). Resultat: Deltagarnas upplevelser och erfarenheter att arbeta med stöd av riktlinjer och fråga om våldsutsatthet kan sammanfattas i det övergripandet temat: Behöver rätt verktyg för att våga öppna Pandoras ask. Kategorierna: Sakna förutsättningar för att arbeta på ett bra sätt, Övervinna hinder, Hantera egna känslor och Känna trygghet och stöd när arbetet känns svårt beskrev olika aspekter av upplevelser och erfarenheter. Slutsats: Trots att riktlinjerna upplevs som stöd för arbetet visade studien att frågan om våld kan vara svår att ställa på grund av olika omständigheter. Barnmorskan kan då välja att avstå från att fråga eller skjuta upp frågan till ett senare tillfälle i det enskilda fallet trots medvetenhet om att hon ska ställa frågan. Kliniska implikationer: Mer utbildning och fortbildning behövs för barnmorskornas trygghet i att arbeta våldspreventivt. De riktlinjer som finns kan behöva utvecklas och förbättras för att minska osäkerheten vid olika dilemman när barnmorskan ska fråga om våldsutsatthet.  Objective: To explore midwive´s experiences of posing questions about intimate partner violence according to national guidelines.Design: Interview study with individual semi-structured interviews using qualitative content analysis for analysis.Setting: Five antenatal clinics in northern Sweden.Participants: Nine midwives, working in public and private antenatal care clinics. Midwives aged 34 to 62 years with experiences in antenatal health care as well as delivery care participated. All participants gave their verbal and written concent to participate in the study.Results: Participants´ experiences working with support of the guidelines and terms of intimate partner violence can be summed up in the overarching theme: Need to have the right tools to dare open Pandora´s box. The categories: Lack of opportunities to work in a good way, Overcoming barriers, Manage your own emotions and Feel safety and support when work feels difficult described different aspects of experiences.Conclusion: Although the guidelines are perceived as supporting the work study showed that the issue of violence can be difficult to make because of the different circumstances. The midwife can then choose to refrain from asking or defer the matter to a later date in the case despite awareness that she should ask the question.Clinical implications: More education and training is needed to increase midwives security in violence prevention work. The guidelines need to be developed and improved in order to reduce uncertainty at various dilemmas when the midwife to ask about intimate partner violence