How Do Older Persons Understand the Purpose and Relevance of Preventive Home Visits? A Study of Experiences after a First Visit

The aim of this study was to explore and describe older persons’ experiences of their first Preventive Home Visit. Preventive Home Visits (PHV) are health services that aim to promote older persons' health, prevent functional decline, and reduce the need for comprehensive healthcare. The knowledge base to guide the design of effective PHV interventions is scarce. Studies that explore older persons' experiences of the first visit are essential, as compliance with the service is a prerequisite for positive outcomes. An explorative and descriptive design was applied. Qualitative research interviews with ten older persons who had received the first PHV the previous year were analysed with regard to manifest and latent content. The findings revealed that the understanding of the purpose of PHV varied. For some participants, the concepts and aims of health promotion and disease prevention were difficult to comprehend. The possibility to prepare for the visit was sought. All participants appreciated the service; the dialogue quality was good and a trusted municipal contact person provided security. To enhance compliance and ensure effective PHV, the invitation to the PHV service should include clearly stated aims and specific information about the first visit. An individualised, person-centred approach should be applied

Hvordan fungerer sykehusavdelinger som kontekst for kontinuerlig læring for sykepleiere?

Formål: Studiens hensikt er å utforske hvordan sykehusavdelinger fungerer som kontekst for kontinuerlig læring for sykepleiere. Denne kunnskapen vil kunne bidra til å utvikle arbeidsforhold som fremmer kontinuerlig læring. Litteraturgjennomgang: Kontinuerlig læring er nødvendig for å opprettholde og styrke kvalitet på sykepleiepraksis, og forutsetter mulighet og motivasjon for læring. Samtidig stilles det store krav om effektivisering og innsparinger i sykehus, noe som kan påvirke sykepleiernes læringsvilkår. På tross av betydningen av kontinuerlig læring for sykepleiere, mangler forskning på dette området. Metode: I studien anvendes utforskende casestudie-design. To sengeposter på samme avdeling i et stort sykehus utgjør hvert sitt case. Det benyttes intrametodisk triangulering med kvalitativ tilnærming med tekstdata fra tre ulike utvalg: tilretteleggere for læring, sykepleiere i postene og dokumenter vedrørende læring. Funn: Hver post sin unike læringskontekst formes av et komplekst og dynamisk samspill av faktorer knyttet til ledelse, til personalgruppa og til strukturelle faktorer. Overordnede mål og føringer har liten innvirkning på utformingen av postenes læringskontekst. Avdelingssykepleiers betydning står i en særstilling fordi hun påvirker både strukturelle faktorer og faktorer i personalgruppa. Ulike faktorer i konteksten påvirker imidlertid leders valg av kunnskapsledelsesstrategier og virkemidler. Sykepleiere liker å lære, og uformell læring knyttet til det daglige arbeidet regnes som viktigst. Individuell tilrettelegging og støtte fremmer motivasjon for læring. Travelhet reduserer sykepleiernes muligheter for både formell og uformell læring, og slitenhet og mangel på overskudd reduserer sykepleiernes engasjement i læringsaktiviteter. Konklusjon: Avdelingssykepleiers valg av kunnskapsledelsesstrategi har konsekvenser for sykepleiernes motivasjon og mulighet for læring. Dersom læringskonteksten skal støtte opp om krav om læring i kunnskapsorganisasjoner og i sykepleieprofesjonen må mulighetene både for formell og uformell læring være en integrert del av arbeidet. Det avdekkes behov for nærmere utforskning av kulturelle aspekter ved læring, og for forskning på sammenheng mellom arbeidsbelastning og motivasjon for læring

Metodeutvikling for opparbeiding av marine prøver for bestemmelse av nanopartikler ved sp-ICP-MS

Master's Thesis in ChemistryKJEM399MAMN-KJE

Aging increases metabolic capacity and reduces work efficiency during handgrip exercise in males

Maximal oxygen uptake and exercise performance typically decline with age. However, there are indications of preserved vascular function and blood flow regulation during arm exercise. Yet, it is unknown if this potential physiological preservation with age is mirrored in peripheral metabolic capacity and V̇O2/watt ratio. Thus, to investigate the effects of aging in the arms, we measured metabolic and vascular responses to 6-minute bouts of dynamic handgrip exercise at 40% and 80% of maximal work rate (WRmax) in eleven young (26±2yr) and twelve old (80±6yr) males, applying Doppler-ultrasound combined with blood samples from a deep forearm vein. At baseline, old had a larger arterial diameter compared to young (p<0.001). During exercise, the two groups reached the same WRmax. V̇O2, blood flow, and oxygen supply were higher (40%WRmax; 80%WRmax, all p<0.01), and arterio-venous oxygen-difference lower (80%WRmax, p<0.02), in old compared to young. Old also had a higher oxygen-excess at 80%WRmax (p<0.01) than young, while no difference in muscle diffusion or oxygen-extraction was detected. Only young exhibited an increase in intensity-induced arterial dilation (p<0.05), and they had a lower mean arterial pressure than old at 80%WRmax (p<0.001). V̇O2/watt (40%WRmax; 80%WRmax) was reduced in old compared to young (both p<0.05). In conclusion, in old and young males with a similar handgrip WRmax, old had a higher V̇O2 during 80%WRmax intensity, achieved by an increased blood flow. This may be a result of the available cardiac output reserve, compensating for reduced work efficiency and attenuated vascular response observed in old

Maximal strength training : the impact of eccentric overload

The search for the most potent strength training intervention is continuous. Maximal strength training (MST) yields large improvements in force-generating capacity (FGC), largely attributed to efferent neural drive enhancement. However, it remains elusive whether eccentric overload, before the concentric phase, may augment training-induced neuromuscular adaptations. A total of 53 23 ± 3 (SD)-yr-old untrained males were randomized to either a nontraining control group (CG) or one of two training groups performing leg press strength training with linear progression, three times per week for 8 wk. The first training group carried out MST with four sets of four repetitions at ~90% one-repetition maximum (1RM) in both action phases. The second group performed MST with an augmented eccentric load of 150% 1RM (eMST). Measurements were taken of 1RM and rate of force development (RFD), countermovement jump (CMJ) performance, and evoked potentials recordings [V-wave (V) and H-reflex (H) normalized to M-wave (M) in musculus soleus]. 1RM increased from 133 ± 16 to 157 ± 23 kg and 123 ± 18 to 149 ± 22 kg and CMJ by 2.3 ± 3.6 and 2.2 ± 3.7cm for MST and eMST, respectively (all P < 0.05). Early, late, and maximal RFD increased in both groups [634–1,501 N/s (MST); 644–2,111 N/s (eMST); P < 0.05]. These functional improvements were accompanied by increased V/M-ratio (MST: 0.34 ± 0.11 to 0.42 ± 14; eMST: .36 ± 0.14 to 0.43 ± 13; P < 0.05). Resting H/M-ratio remained unchanged. Training-induced improvements did not differ. All increases, except for CMJ, were different from the CG. MST is an enterprise for large gains in FGC and functional performance. Eccentric overload did not induce additional improvements, suggesting firing frequency and motor unit recruitment during MST may be maximal.publishedVersio

Genomic analysis of expressed sequence tags in American black bear Ursus americanus

<p>Abstract</p> <p>Background</p> <p>Species of the bear family (<it>Ursidae</it>) are important organisms for research in molecular evolution, comparative physiology and conservation biology, but relatively little genetic sequence information is available for this group. Here we report the development and analyses of the first large scale Expressed Sequence Tag (EST) resource for the American black bear (<it>Ursus americanus</it>).</p> <p>Results</p> <p>Comprehensive analyses of molecular functions, alternative splicing, and tissue-specific expression of 38,757 black bear EST sequences were conducted using the dog genome as a reference. We identified 18 genes, involved in functions such as lipid catabolism, cell cycle, and vesicle-mediated transport, that are showing rapid evolution in the bear lineage Three genes, Phospholamban (<it>PLN</it>), cysteine glycine-rich protein 3 (<it>CSRP3</it>) and Troponin I type 3 (<it>TNNI3</it>), are related to heart contraction, and defects in these genes in humans lead to heart disease. Two genes, biphenyl hydrolase-like (<it>BPHL</it>) and <it>CSRP3</it>, contain positively selected sites in bear. Global analysis of evolution rates of hibernation-related genes in bear showed that they are largely conserved and slowly evolving genes, rather than novel and fast-evolving genes.</p> <p>Conclusion</p> <p>We provide a genomic resource for an important mammalian organism and our study sheds new light on the possible functions and evolution of bear genes.</p

The effects of hibernation on the contractile and biochemical properties of skeletal muscles in the thirteen-lined ground squirrel, Ictidomys tridecemlineatus

Hibernation is a crucial strategy of winter survival used by many mammals. During hibernation, thirteen-lined ground squirrels, Ictidomys tridecemlineatus, cycle through a series of torpor bouts, each lasting more than a week, during which the animals are largely immobile. Previous hibernation studies have demonstrated that such natural models of skeletal muscle disuse cause limited or no change in either skeletal muscle size or contractile performance. However, work loop analysis of skeletal muscle, which provides a realistic assessment of in vivo power output, has not previously been undertaken in mammals that undergo prolonged torpor during hibernation. In the present study, our aim was to assess the effects of 3 months of hibernation on contractile performance (using the work loop technique) and several biochemical properties that may affect performance. There was no significant difference in soleus muscle power output-cycle frequency curves between winter (torpid) and summer (active) animals. Total antioxidant capacity of gastrocnemius muscle was 156% higher in torpid than in summer animals, suggesting one potential mechanism for maintenance of acute muscle performance. Soleus muscle fatigue resistance was significantly lower in torpid than in summer animals. Gastrocnemius muscle glycogen content was unchanged. However, state 3 and state 4 mitochondrial respiration rates were significantly suppressed, by 59% and 44%, respectively, in mixed hindlimb skeletal muscle from torpid animals compared with summer controls. These findings in hindlimb skeletal muscles suggest that, although maximal contractile power output is maintained in torpor, there is both suppression of ATP production capacity and reduced fatigue resistance

Modulation of gene expression in heart and liver of hibernating black bears (Ursus americanus)

<p>Abstract</p> <p>Background</p> <p>Hibernation is an adaptive strategy to survive in highly seasonal or unpredictable environments. The molecular and genetic basis of hibernation physiology in mammals has only recently been studied using large scale genomic approaches. We analyzed gene expression in the American black bear, <it>Ursus americanus</it>, using a custom 12,800 cDNA probe microarray to detect differences in expression that occur in heart and liver during winter hibernation in comparison to summer active animals.</p> <p>Results</p> <p>We identified 245 genes in heart and 319 genes in liver that were differentially expressed between winter and summer. The expression of 24 genes was significantly elevated during hibernation in both heart and liver. These genes are mostly involved in lipid catabolism and protein biosynthesis and include RNA binding protein motif 3 (<it>Rbm3</it>), which enhances protein synthesis at mildly hypothermic temperatures. Elevated expression of protein biosynthesis genes suggests induction of translation that may be related to adaptive mechanisms reducing cardiac and muscle atrophies over extended periods of low metabolism and immobility during hibernation in bears. Coordinated reduction of transcription of genes involved in amino acid catabolism suggests redirection of amino acids from catabolic pathways to protein biosynthesis. We identify common for black bears and small mammalian hibernators transcriptional changes in the liver that include induction of genes responsible for fatty acid β oxidation and carbohydrate synthesis and depression of genes involved in lipid biosynthesis, carbohydrate catabolism, cellular respiration and detoxification pathways.</p> <p>Conclusions</p> <p>Our findings show that modulation of gene expression during winter hibernation represents molecular mechanism of adaptation to extreme environments.</p