«Personalerfaringer knyttet til å ta i bruk GPS for oppfølging av beboere med demens på sykehjem»

Hensikten med denne masteroppgaven er å utforske erfaringer hos helsepersonell som har tatt i bruk sporingsteknologien GPS for oppfølging av beboere med demens på sykehjem, samt hvordan GPS-bruk har påvirket rutiner og arbeidsoppgaver på sykehjemmet. Oppgaven er en utforskende studie hvor det er benyttet fokusgruppeintervju ved to sykehjem for innsamling av data, med til sammen syv deltakere. I analysen er det benyttet systematisk tekstkondensering som beskrevet av Malterud (Malterud, 2017). Oppgaven er forankret i politiske føringer knyttet til velferdsteknologi og demensomsorg, og tidligere forskning om bruk av GPS til personer med demens diskuteres i oppgaven. Det anvendes teoretiske perspektiver om personsentrert omsorg og forbedringsarbeid for å belyse problemstillingen. Bruk av GPS innebærer at helsepersonell må innarbeide og utføre flere nye rutiner og arbeidsoppgaver som skaper behov for utvikling av nye kompetanser hos helsepersonell. Det kan utvikle seg ulike praksiser knyttet til forståelsen av hvem som skal ha GPS og hva som er hensikten med bruken. Oppgaven viser at innføring av teknologien bør planlegges godt, hvor kunnskap om forbedringsarbeid og innføring av GPS som en systematisk forbedringsprosess, kan bidra til en felles forståelse hos personalet for trygg og hensiktsmessig bruk av teknologien

Underernæring hos eldre hjemmeboende personer med demens

Bakgrunn: Eldre personer med hukommelsestap er svært utsatt for underernæring. Tidligere studier har i hovedsak fokusert på pasienter som bor på institusjon. Hensikt: Hensikten med denne studien er å kartlegge og belyse ernæringsstatusen til eldre hjemmeboende pasienter med demens og kognitiv svikt som får bistand av hjemmetjenesten i fire bydeler i Oslo. Metode: Det ble gjennomført en tverrsnittsstudie i fire utvalgte bydeler i Oslo, (N=282). Instrumentet Mini Nutritional Assessment (MNA) ble benyttet til innsamling av data. Logistisk regresjonsanalyse ble anvendt for å analysere dataene, og resultatene presenteres i oddsratioer. Resultater: Studien viser at underernæring er svært utbredt blant hjemmeboende pasienter med kognitiv svikt og demenssykdom. Omkring halvparten av pasientene var underernært eller sto i fare for underernæring. Det å være kvinne og ha problemer med matinntak viser seg å være viktige risikofaktorer for underernæring. Konklusjon: Resultatene i studien viser at det er avgjørende at helsepersonell og pårørende er kjent med risikofaktorene for underernæring. Nødvendige tiltak må iverksettes på et tidlig stadium for å forhindre alvorlig underernæring og sykdom som følge av dette.Malnutrition in elderly people living at home with cognitive impairment and dementia Background: Elderly people with memory loss are particularly vulnerable to malnutrition. Previous studies have mainly focused on elderly living in an institution. Objective: The purpose of this study is to identify the nutritional status of elderly with dementia who live at home. Method: The survey design was conducted in four selected districts in Oslo (N = 282). Mini Nutritional Assessment Instrument (MNA) was used for data collection. Logistic regression analysis was used to analyze the data and the results were presented in odds ratios. Results: Our results show that malnutrition is highly prevalent among home-living patients with cognitive impairment and dementia. About one-half of the patients were malnourished or were at risk of malnutrition. Being a woman and having problems with food intake appears to be important risk factors for malnutrition. Conclusion: One interpretation of these results is that it is essential that health professionals and the patients’ relatives are aware of these risk factors, and that necessary measures are implemented at an early stage, in order to prevent severe malnutrition and subsequent disease

<i>In situ</i> investigation of controlled polymorphism in mechanochemistry at elevated temperature†

Mechanochemistry routinely provides solid forms (polymorphs) that are difficult to obtain by conventional solution-based methods, making it an exciting tool for crystal engineering. However, we are far from identifying the full scope of mechanochemical strategies available to access new and potentially useful solid forms. Using the model organic cocrystal system of nicotinamide (NA) and pimelic acid (PA), we demonstrate with variable temperature ball milling that ball milling seemingly decreases the temperature needed to induce polymorph conversion. Whereas Form I of the NA:PA cocrystal transforms into Form II at 90 °C under equilibrium conditions, the same transition occurs as low as 65 °C during ball milling: a ca 25 °C reduction of the transition temperature. Our results indicate that mechanical energy provides a powerful control parameter to access new solid forms under more readily accessible conditions. We expect this ‘thermo-mechanical’ approach for driving polymorphic transformations to become an important tool for polymorph screening and manufacturing

Emittance Growth and Energy Loss due to Coherent Synchrotron Radiation in a bunch compressor

Bunches of high charge (10 nC) are compressed in length in the CTF II bunch compressor from 1.2 mm rms to less than 0.4 mm. The short bunches start to radiate coherently, thus affecting the horizontal and longitudinal phase spaces of the beam. This paper reports the results of measurements and simulations concerning the increase of the beam emittance and the impact on the energy distribution. Beam emittances were measured for different bunch compression factors and bunch charges. For each compressor setting, the energy spectrum of the beam was recorded in order to measure the energy loss due to coherent synchrotron radiation. For bunch charges of 10 nC a maximum increase of the horizontal emittance of 50% was observed at full compression, while the mean beam energy decreased by 5% from 39 MeV to 37 MeV. Both effects are correlated with an increase of the energy spread from 2.3% to 8.5% rms. The experimental results are compared with simulations

Surgical Results of Endoscopic Dacryocystorhinostomy and Lacrimal Trephination in Distal or Common Canalicular Obstruction

ObjectivesTo evaluate the surgical outcomes of endoscopic dacryocystorhinostomy followed by canalicular trephination and silicone stenting in patients with distal or common canalicular obstructions.MethodsThe medical records of 29 patients (31 eyes) from January 2001 to December 2009 who underwent endoscopic dacryocystorhinostomy followed by canalicular trephination and silicone tube insertion for the treatment of distal or common canalicular obstructions were retrospectively reviewed. The level of obstruction was confirmed by intraoperative probing. The outcome of the surgery was categorized as a complete success, partial success, or failure according to the functional and anatomic patency.ResultsThe average age of the patients was 52 years. The duration of silicone intubation ranged from 4 to 11 months with an average of 5.7±1.6 months. The follow-up period after stent removal ranged from 4 to 15 months with an average of 8.2±3.3 months. Complete success was achieved in 25 out of 31 eyes (80.6%), partial success in 4 out of 31 eyes (12.9%), and failure in 2 out of 31 eyes (6.5%).ConclusionEndoscopic dacryocystorhinostomy followed by canalicular trephination and silicone stent intubation may be safe and considered as an initial treatment of patients with distal or common canalicular obstructions

Three-dimensional organization of nascent rod outer segment disk membranes

The vertebrate photoreceptor cell contains an elaborate cilium that includes a stack of phototransductive membrane disks. The disk membranes are continually renewed, but how new disks are formed remains poorly understood. Here we used electron microscope tomography to obtain 3D visualization of the nascent disks of rod photoreceptors in three mammalian species, to gain insight into the process of disk morphogenesis. We observed that nascent disks are invariably continuous with the ciliary plasma membrane, although, owing to partial enclosure, they can appear to be internal in 2D profiles. Tomographic analyses of the basal-most region of the outer segment show changes in shape of the ciliary plasma membrane indicating an invagination, which is likely a first step in disk formation. The invagination flattens to create the proximal surface of an evaginating lamella, as well as membrane protrusions that extend between adjacent lamellae, thereby initiating a disk rim. Immediately distal to this initiation site, lamellae of increasing diameter are evident, indicating growth outward from the cilium. In agreement with a previous model, our data indicate that mature disks are formed once lamellae reach full diameter, and the growth of a rim encloses the space between adjacent surfaces of two lamellae. This study provides 3D data of nascent and mature rod photoreceptor disk membranes at unprecedented z-axis depth and resolution, and provides a basis for addressing fundamental questions, ranging from protein sorting in the photoreceptor cilium to photoreceptor electrophysiology

The Friedman-Eilber Resection Arthroplasty of the Pelvis

It has been argued that internal hemipelvectomy without reconstruction of the pelvic ring leads to poor ambulation and inferior patient acceptance. To determine the accuracy of this contention, we posed the following questions: First, how effectively does a typical patient ambulate following this procedure? Second, what is the typical functional capacity of a patient following internal hemipelvectomy? In the spring of 2006, we obtained video documentation of eight patients who had undergone resection arthroplasty of the hemipelvis seen in our clinic during routine clinical followup. The minimum followup in 2006 was 1.1 years (mean, 8.2 years; range, 1.1–22.7 years); at the time of last followup in 2008 the minimum followup was 2.9 years (mean, 9.8 years; range, 2.9–24.5 years). At last followup seven of the eight patients were without pain, and were able to walk without supports. The remaining patient used narcotic medication and a cane or crutch only occasionally. The mean MSTS score at the time of most recent followup was 73.3% of normal (range 53.3–80.0%; mean raw score was 22.0; range 16–24). All eight patients ultimately returned to gainful employment. These observations demonstrate independent painless ambulation and acceptable function is possible following resection arthroplasty of the hemipelvis