Markedsorienterte bondenæringer i Norge på 1700-tallet

I Norge har der været to opfattelser af bøndernes økonomi i 1700-tallet: Den ene gik ud på, at bondeøkonomien frem til ca. 1850 var sædvanebestemt og indrettet mod selvforsyning, men den anden opfattelse betragtede bondeøkonomien som dynamisk og markedsorienteret.Anna Tranberg, der er historiker, mener at: ” Med sin eksportrettede økonomi og sine frie og selvstendige bønder framstod Norge som den moderne delen av dobbeltmonarkiet.” Hun noterer imidlertid, at der fandtes bønder med forskellig grad af markedsøkonomi ved siden af hinanden, så markedsøkonomien udviklede sig i forskellig hast. Hun slutter : ” eg tror at en vesentlig grunn til at historikerne har ført så langvarige og heftige diskusjoner, har sammenheng med det store mangfoldet i eldre norsk bondeøkonomi. Enhver kan finne observasjoner som kan underbygge sin egen forklaringsmodeli. Men mye tyder på at vi nå er i ferd med å sette kjepphestene på stallen

Sjuksköterskans upplevelse av att arbeta som single responder inom ambulanssjukvården : En intervjustudie

I Sverige används begreppet ”single responder” som beskrivning på en sjuksköterska som ensam bemannar en utryckningsregistrerad personbil, utrustad som en ambulans men utan bår. Uppgiften är dels att vara tillgänglig för akutuppdrag genom att vara strategiskt utplacerade geografiskt, och dels för att avlasta de traditionella akutambulanserna genom att utföra bedömningar av patienter där exempelvis larmoperatören har svårt att avgöra hjälpbehovet. Att bedöma patientens tillstånd och vårdbehov kräver både kunskap och erfarenhet. I ett ambulansteam kan det upplevas som en trygghet att ha en kollega som stöd vid medicinska beslut men också för att kunna vara behjälplig med olika praktiska moment. Som single responder arbetar dock sjuksköterskan ensam. Syftet med studien var att beskriva sjuksköterskans upplevelse av att arbeta som single responder. Studien var en kvalitativ intervjustudie med åtta sjuksköterskor som innehar tjänster som single responders. Ansatsen var induktiv med ostrukturerade öppna frågor. Data analyserades med kvalitativ innehållsanalys. Resultatet visar att single responders hamnar i situationer där de bland annat kan sakna möjligheten att diskutera medicinska beslut med en erfaren kollega. Denna situation uppstår oftast då sjuksköterskan ska göra en bedömning av patientens vårdbehov för att kunna erbjuda patienten rätt vårdnivå. Då patienten befinner sig i ett livshotande tillstånd, eller då patienten är akut sjuk upplever sjuksköterskan inte samma behov av kollegialt stöd. Erfarenhet och rutin att arbeta enligt A-E-konceptet gör att sjuksköterskan känner sig trygg. Vissa praktiska moment under tiden fram till patienten kan upplevas som stressande.Program: Specialistsjuksköterskeutbildning med inriktning mot ambulanssjukvår

Efficacy of Lactiplantibacillus plantarum 299 and 299v against nosocomial oropharyngeal pathogens in vitro and as an oral prophylactic treatment in a randomized, controlled clinical trial

Abstract Background Disturbance in the oropharyngeal microbiota is common in hospitalized patients and contributes to the development of nosocomial pneumonia. Lactiplantibacillus plantarum 299 and 299v (Lp299 and Lp299v) are probiotic bacteria with beneficial effects on the human microbiome. Aim To investigate how Lp299 and Lp299v affect the growth of nosocomial oropharyngeal pathogens in vitro and to evaluate the efficacy in vivo when these probiotics are administered prophylactically in hospitalized patients. Methods The in vitro effect of Lp299 and Lp299v on nosocomial respiratory tract pathogens was evaluated using two methods, the co‐culture and agar overlay. In the clinical study, patients were randomized to orally receive either probiotics or placebo twice daily during their hospital stay. Oropharyngeal swabs were analyzed at inclusion and every fourth day throughout hospitalization. Findings All tested pathogens were completely inhibited by both Lp299 and Lp299v using the agar‐overlay method. In the co‐culture experiment, Lp299 and Lp299v significantly (p < 0.05) reduced the growth of all pathogens except for Enterococcus faecalis co‐incubated with Lp299. In the clinical study, daily oral treatment with Lp299 and Lp299v did not influence the development of disturbed oropharyngeal microbiota or nosocomial infection. Proton pump inhibitors, antibiotics, and steroid treatment were identified as risk factors for developing disturbed oropharyngeal microbiota. Conclusions Lp299 and Lp299v inhibited pathogen growth in vitro but did not affect the oropharyngeal microbiota in vivo. The ClinicalTrials.gov Identifier for this study is NCT02303301

Efficacy of Lactiplantibacillus plantarum 299

Background: Disturbance in the oropharyngeal microbiota is common in hospitalized patients and contributes to the development of nosocomial pneumonia. Lactiplantibacillus plantarum 299 and 299v (Lp299 and Lp299v) are probiotic bacteria with beneficial effects on the human microbiome. Aim: To investigate how Lp299 and Lp299v affect the growth of nosocomial oropharyngeal pathogens in vitro and to evaluate the efficacy in vivo when these probiotics are administered prophylactically in hospitalized patients. Methods: The in vitro effect of Lp299 and Lp299v on nosocomial respiratory tract pathogens was evaluated using two methods, the co-culture and agar overlay. In the clinical study, patients were randomized to orally receive either probiotics or placebo twice daily during their hospital stay. Oropharyngeal swabs were analyzed at inclusion and every fourth day throughout hospitalization. Findings: All tested pathogens were completely inhibited by both Lp299 and Lp299v using the agar-overlay method. In the co-culture experiment, Lp299 and Lp299v significantly (p < 0.05) reduced the growth of all pathogens except for Enterococcus faecalis co-incubated with Lp299. In the clinical study, daily oral treatment with Lp299 and Lp299v did not influence the development of disturbed oropharyngeal microbiota or nosocomial infection. Proton pump inhibitors, antibiotics, and steroid treatment were identified as risk factors for developing disturbed oropharyngeal microbiota. Conclusions: Lp299 and Lp299v inhibited pathogen growth in vitro but did not affect the oropharyngeal microbiota in vivo. The ClinicalTrials.gov Identifier for this study is NCT02303301

Effect of stance width on kinematics of laboratory landings with fixed feet on a kiteboard

Funding: Swedish Research Council for Sport Science, and the Gothenburg Sports Test Centre</p

Svåra samtal med patienter tränas på kurs med skådespelare : En medveten strategi hjälper både läkare och patient

The physician’s communication skill influences the patient’s mental and physical wellbeing, as well as the physician’s own experience of stress. Most patients wish to be informed about their disease, by physicians who are honest, gives time, sustains hope, listens and shows compassion and empathy. Even though there are established guidelines on how to break bad news, the physician must find out and respond to the unique reactions and needs of each individual, in order to communicate successfully. There is no consensus on how to construct and evaluate communication skills training programs for physicians, and more RCT-studies are requested

Frontal plane pelvis and hip kinematics of transfemoral amputee gait. Effect of a prosthetic foot with active ankle dorsiflexion and individualized training – a case study

<p>Following a transfemoral amputation (TFA), numerous changes in movement patterns during gait can occur. Frontal plane hip and pelvis compensatory strategies are recognized among individuals with a TFA, some thought to aid in safe foot clearance during the swing phase of gait. The aim of this case study was to evaluate the effect of an active ankle dorsiflexion provided by a microprocessor-controlled prosthetic foot, as well as the effect of individualized training on these parameters. In this case study, a 42-year-old male underwent 3 D gait analysis. Data were captured for two conditions; with a microprocessor-controlled prosthetic foot with active/inactive ankle dorsiflexion, during two sessions; before and after 6 weeks of individualized training. The main outcomes analyzed were frontal plane pelvis and hip kinematics. Prior to training, pelvic lift decreased slightly, coupled with an increase in hip abduction, during gait with the active ankle dorsiflexion of a prosthetic foot, compared to inactive dorsiflexion. After the training period, the pelvic lift was further decreased and an increase in hip adduction was concurrently seen. The results of this case study indicate a positive effect of the active dorsiflexion of the prosthetic foot but highlight the need for specific training after prescription of a microprocessor prosthetic foot.Implications for rehabilitation</p><p>Decreased compensatory changes seen in this case study indicate a positive effect of the active dorsiflexion of the prosthetic foot, especially after a 6-week training period.</p><p>Individualized training should be aimed at helping the user utilizing the benefits of the active dorsiflexion of the microprocessor prosthetic foot, implementing exercises that improve gait quality, technical training for this specific foot, strength training and balance exercises.</p><p></p> <p>Decreased compensatory changes seen in this case study indicate a positive effect of the active dorsiflexion of the prosthetic foot, especially after a 6-week training period.</p> <p>Individualized training should be aimed at helping the user utilizing the benefits of the active dorsiflexion of the microprocessor prosthetic foot, implementing exercises that improve gait quality, technical training for this specific foot, strength training and balance exercises.</p