Introducing the National Early Warning Score – A qualitative study of hospital nurses’ perceptions and reactions

Aim: The aim of this study was to explore hospital nurses’ perceptions and reactions to the National Early Warning Score during an introduction programme. Design: A qualitative case study approach with participatory observations was used for this study. Methods: In total, nine seminars and 23 simulation sessions attended by nurses were observed. An activity theory system analysis was applied to interpret the material. Results: The findings revealed four tensions related to the working context: (a) tension between using a standardized tool and relying on clinical judgement (the tool could be either an aid or a barrier to patient assessment); (b) tension in the community of practice (the tool could be beneficial or increase stress and anxiety); (c) tension related to rules and compliance (the tool could be perceived as optional or compulsory); and (d) tension related to the division of labour (nurses feared more work).publishedVersio

Tverrprofesjonalitet eller innordning? En casestudie av vernepleieres forhandlinger om posisjon i distriktspsykiatriske sentre

Behovet for mer fleksible yrkesroller og større tverrfaglighet er et sentralt tema i de politiske strategiene for å utforme dagens og fremtidens helse- og omsorgstjenester. Vernepleiere, med sin kombinasjon av helse- og sosialfag, pekes ut som en profesjon med potensial til å spille en nøkkelrolle i omstillingen. I denne artikkelen undersøker vi ved hjelp av en eksplorativ (undersøkende) og kvalitativ enkeltcasestudie hvordan vernepleiere forhandler og posisjonerer seg overfor andre profesjoner i distriktspsykiatriske sentre (DPS). Hovedfunn er at vernepleiere har potensial til å bidra med særegne perspektiver og kompetanse i tverrfaglig samarbeid om pasienter i DPS. Samtidig tyder funnene på at vernepleiere innordner seg det som oppfattes som dominerende forståelsesmåter i feltet.publishedVersio

Kickstart in nursing home-Nursing students experiences of a model for active and collaborative learning in clinical placement

Aims and objectives To explore students' experiences from a pilot project testing out a model for active, collaborative learning in first-year placement at a nursing home. Background There is a need for innovative learning activities and projects to improve clinical education in nursing homes. Active, collaborative approaches in placement learning may enhance students learning outcome. Design The study had a qualitative and explorative design, in which the experiences of students participating in the pilot were investigated through paired interviews at the end of their placement. Methods Twenty-two students participated in the study, and data from paired interviews were analysed using qualitative content analysis. COREQ reporting guidelines were used. Results Three themes emerged from the analysis: (1) The learning cell as facilitator for learning; (2) Discovering learning possibilities in nursing homes and (3) Applying tools and resources for learning. Conclusions The model could reduce tension and anxiety while helping the students focus on learning options and use their environment more actively for learning. Working with a learning partner seems to increase student learning through common planning, feedback and reflection. The study emphasises the importance of facilitating active learning through the scaffolding structures and configuration of the students' learning space. Relevance to clinical practice This study indicates the potential for introducing active and collaborative pedagogical models in clinical placement. The model can promote nursing homes as a conducive learning arena for nursing students and help prepare students for a future work role in a rapidly changing health care field. Patient or public contribution The result of the research is shared and discussed with stakeholders prior to finalising the article.publishedVersio

Professional caregivers' participation in the International Caregiver Development Programme: A qualitative study of psychosocial care in nursing homes

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Defining the mission - from policy statement to learning outcomes. A triple case study of faith-based nursing education Institutions in Northern Europe

This article focuses on faith-based nursing education in a pluralistic society. It discusses how faith-based colleges describe their mission and purpose in their policy documents, and how these statements are interpreted in the learning outcomes of nursing education. Three institutions of higher education participated in the study: Diaconia University of Applied Sciences (Diak) (Finland), Diakonhjemmet University College (DUC) (Norway) and Viaa Christian University of Applied Sciences (The Netherlands). Two of the colleges, Diak and DUC, belong to the so-called diaconalmovement within the Lutheran churches in Northern Europe. Viaa was founded within the Reformed church tradition as an alternative to secular professional education. This study explores how the three different colleges present themselves and describe themselves as faith-based educational institutions with a Christian affiliation and their particular purpose within the general landscape of higher education. The study shows how the institutions presents faith in their institutional self-presentation and the integration of faith base in learning outcomes of nursing program. This study took place as a case study.As study material we used the strategic documents provided by each college. The study reported in this article is part of a broader investigation of the three institutions, including various qualitative methods such as individual interviews and focus-group interviews. Translating mission goals and values to the curriculum is most visible in the description of learning outcomes, because those are the more practical and concrete goals of vocational education. Upon analysing the learning outcomes of nursing education within the three universities, it became obvious that the most explicit voice is given to its purpose, which in all three cases focuses on ethics. The study led to the question how best to discuss values and beliefs in institutes of higher education, and who would facilitate, maintain and participate in those discussions.publishedVersio

Microbial responses to herbivory-induced vegetation changes in a high-Arctic peatland

Herbivory by barnacle geese (Branta leucopsis) alters the vegetation cover and reduces ecosystem productivity in high-Arctic peatlands, limiting the carbon sink strength of these ecosystems. Here we investigate how herbivory-induced vegetation changes affect the activities of peat soil microbiota using metagenomics, metatranscriptomics and targeted metabolomics in a comparison of fenced exclosures and nearby grazed sites. Our results show that a different vegetation with a high proportion of vascular plants developed due to reduced herbivory, resulting in a larger and more diverse input of polysaccharides to the soil at exclosed study sites. This coincided with higher sugar and amino acid concentrations in the soil at this site as well as the establishment of a more abundant and active microbiota, including saprotrophic fungi with broad substrate ranges, like Helotiales (Ascomycota) and Agaricales (Basidiomycota). A detailed description of fungal transcriptional profiles revealed higher gene expression for cellulose, hemicellulose, pectin, lignin and chitin degradation at herbivory-exclosed sites. Furthermore, we observed an increase in the number of genes and transcripts for predatory eukaryotes such as Entomobryomorpha (Arthropoda). We conclude that in the absence of herbivory, the development of a vascular vegetation alters the soil polysaccharide composition and supports larger and more active populations of fungi and predatory eukaryotes

A randomized, double-blind, placebo-controlled clinical study to investigate the efficacy of herring roe oil for treatment of psoriasis

The effect of omega-3 polyunsaturated fatty acid supplements in patients with psoriasis vulgaris has previously been investigated, but interventions varied in source, composition, dose, administration route and duration of treatment. The observed beneficial effects in patients with psoriasis vulgaris using herring roe oil as a dietary supplement prompted this investigation. This randomised, double-blind and placebo-controlled study was designed and performed to explore the efficacy and safety of herring roe oil supplementation in 64 patients with plaque psoriasis (ClinicalTrials.gov: NCT03359577). The primary end-point was comparing the change in mean Psoriasis Area Severity Index (PASI) scores in the herring roe oil treatment group and the placebo group from baseline to week 26. In the intention-to-treat population, a statistically significant improvement in the mean PASI score was observed with herring roe oil compared to placebo at 26 weeks. In the recruited patient group, the measured improvement was greatest in patients with a PASI score from 5.5–9.9 at baseline.publishedVersio

Herring roe oil in treatment of psoriasis – influence on immune cells and cytokine network

Background: Psoriasis is a chronic immune-mediated skin disease with systemic inflammation and comorbidities. Although the disease severity may vary over time, many patients suffer from mild to moderate disease. Often local treatment will be sufficient to control the symptoms, but they may have several side effects. ω-3 polyunsaturated fatty acids have shown promising results in clinical trials with mild-to-moderate psoriasis. Methods: We explored the impact of phospholipid bound docosahexaenoic acid and eicosapentaenoic acid in a 3:1 ratio on immune cells and cytokine networks in peripheral blood of patients with psoriasis. We investigated the inter-relation of plasma cytokine levels and disease severity in 58 patients, and explored the status of circulating immune cell activity in 18 patients with non-severe psoriasis before and during herring roe oil supplementation. Plasma concentration of 22 cytokines was measured by Luminex technology and circulating immune cells were analyzed by multicolor flow cytometry. Results: CCL2 levels decreased over time, and IFN-γR1 increased, possibly related to the action of ω-3 polyunsaturated fatty acids. We observed a shift from naïve to effector CD4+ T cells and decreases of CD38 expression on CD4+ and CD8+ T cells, CD56bright NK cells and CD14+CD16- classical monocytes. Conclusions: These findings support the beneficial effect of herring roe oil supplementation.publishedVersio

Hermeneutiske og diskursive tilnærminger : ulike veier til kunnskap om sykepleierstudenters motivasjon i dagens samfunn

I dette essayet vil jeg først gi en kort beskrivelse av mitt forskningsprosjekt. Med utgangspunkt i prosjektets tema og forskningsspørsmål vil jeg deretter introdusere to ulike vitenskapsteoretiske tilnærminger og diskutere hvordan de hver på sin måte kan bidra til å løse de metodologiske problemene som prosjektet mitt impliserer. I prosjektets utforming ligger det allerede en del premisser, bl.a. en implisitt forståelse av hvordan kunnskap fremskaffes og utvikles. De to vitenskapsteoretiske tilnærmingene er derfor ikke tilfeldig valgt, men valgt fordi jeg tenker meg at de på hver sin måte kan bidra til klargjøre det epistemologiske grunnlaget for prosjektet mitt. Arbeidsstittelen eller problemstillingen for essayet er som følger: En kritisk vurdering av bruken av hermeneutiske og diskursive tilnærminger til kunnskapskonstruksjon, representert ved henholdsvis Charles Taylor og Michel Foucault, for å løse metodologiske problemer i studien av motivasjon hos sykepleierstudenter

Developing nurses/midwives education in South Sudan - a pre study

The study was carried out as a pre-study to explore the possibilities for NCA, South Sudan, to develop a capacity building project to improve health education in South Sudan