Caring for continence in stroke care settings: a qualitative study of patients’ and staff perspectives on the implementation of a new continence care intervention

Objectives: Investigate the perspectives of patients and nursing staff on the implementation of an augmented continence care intervention after stroke. Design: Qualitative data were elicited during semi-structured interviews with patients (n = 15) and staff (14 nurses; nine nursing assistants) and analysed using thematic analysis. Setting: Mixed acute and rehabilitation stroke ward. Participants: Stroke patients and nursing staff that experienced an enhanced continence care intervention. Results: Four themes emerged from patients’ interviews describing: (a) challenges communicating about continence (initiating conversations and information exchange); (b) mixed perceptions of continence care; (c) ambiguity of focus between mobility and continence issues; and (d) inconsistent involvement in continence care decision making. Patients’ perceptions reflected the severity of their urinary incontinence. Staff described changes in: (i) knowledge as a consequence of specialist training; (ii) continence interventions (including the development of nurse-led initiatives to reduce the incidence of unnecessary catheterisation among patients admitted to their ward); (iii) changes in attitude towards continence from containment approaches to continence rehabilitation; and (iv) the challenges of providing continence care within a stroke care context including limitations in access to continence care equipment or products, and institutional attitudes towards continence. Conclusion: Patients (particularly those with severe urinary incontinence) described challenges communicating about and involvement in continence care decisions. In contrast, nurses described improved continence knowledge, attitudes and confidence alongside a shift from containment to rehabilitative approaches. Contextual components including care from point of hospital admission, equipment accessibility and interdisciplinary approaches were perceived as important factors to enhancing continence care

Assessing Economic Benefits of Good Ecological Status in Lakes under the EU Water Framework Directive. Case study report. Norway

An internet survey was conducted on 1113 households in Østfold County and southern muni­cipalities of Akershus County in the summer of 2008. The survey focused on households’ recreational use of water bodies and their willingness to pay for improvements in lake ecological status. The main objective of the study was to evaluate at what distance from improved lakes, households willingness to pay falls to zero. This is key to correctly determining how large a population has benefits from measures under the Water Framework Directive, and making correct estimates of total benefits of a programme of measures. Valuation methods aimed at capturing recreational use values and also non-use values. The largest lakes in Østfold in three different catchments (Morsa, Glomma and Halden) were considered, Alternative valuation methods are compared for two lakes in particular in this report (Vestre Vansjø and Storefjorden). The study was the Norwegian case study for the EUFP6 AQUAMONEY research project.European Commissio

Ceased grazing management changes the ecosystem services of semi-natural grasslands

Understanding how drivers of change affect ecosystem services (ES) is of great importance. Indicators of ES can be developed based on biophysical measures and be used to investigate the service flow from ecosystems to socio-ecological systems. However, the ES concept is multivariate and the use of normalized composite indicators reduces complexity and facilitates communication between science and policy. The aim of this study is to analyze how land use change affects ES and species richness and how the effects are modified by environmental factors by using composite indicators based on biophysical indicators. Using multivariate and regression analyses, we analyze the effect of grazing management abandonment in semi-natural grasslands in Norway on six ES: nutrient cycling, pollination, forage quality, aesthetics and global and regional climate regulation in addition to species richness along soil and climate gradients. Nutrient cycling, forage quality, regional climate regulation, aesthetics and species richness are larger in managed compared to abandoned grasslands. There are trade-offs among ES as different management strategies provide various ES and these trade-offs vary along environmental gradients. Management policies that aim to conserve ES need to have conservation goals that are context dependent, should recognize ES trade-offs and be adapted to local conditions

Non-Fickian Diffusion Affects the Relation between the Salinity and Hydrate Capacity Profiles in Marine Sediments

On-site measurements of water salinity (which can be directly evaluated from the electrical conductivity) in deep-sea sediments is technically the primary source of indirect information on the capacity of the marine deposits of methane hydrates. We show the relation between the salinity (chlorinity) profile and the hydrate volume in pores to be significantly affected by non-Fickian contributions to the diffusion flux---the thermal diffusion and the gravitational segregation---which have been previously ignored in the literature on the subject and the analysis of surveys data. We provide amended relations and utilize them for an analysis of field measurements for a real hydrate deposit.Comment: 7 pages, 2 figures, 1 table, submitted to Compte Rendus Mecaniqu

Precision determination of band offsets in strained InGaAs/GaAs quantum wells by C-V-profiling and Schroedinger-Poisson self-consistent simulation

The results of measurements and numerical simulation of charge carrier distribution and energy states in strained quantum wells In_xGa_{1-x}As/GaAs (0.06 < x < 0.29) by C-V-profiling are presented. Precise values of conduction band offsets for these pseudomorphic QWs have been obtained by means of self-consistent solution of Schroedinger and Poisson equations and following fitting to experimental data. For the conduction band offsets in strained In_xGa_{1-x}As/GaAs - QWs the expression DE_C(x) = 0.814x - 0.21x^2 has been obtained.Comment: 9 pages, 12 figures, RevTeX

Effectiveness and cost-effectiveness of biofeedback-assisted pelvic floor muscle training for female urinary incontinence: a multicentre randomised controlled trial

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordICS 2019: International Continence Society 49th Annual Meeting, 3-6 September 2019, Gothenburg, SwedenNational Institute for Health Research (NIHR

In vitro evidence of root colonization suggests ecological versatility in the genus Mycena

Acknowledgements: The European commission is acknowledged for a MSCA grant to C.B.H (grant no. 658849), the University of Oslo for further funding of the project, and the Swedish University of Agricultural Sciences for hosting parts of the experiments. C.B.H was funded by an internationalisation grant from the Carlsberg Research Grant Foundation at the time of writing (grant no. CF18-0809). We would like to thank Jerome Guerrand for aid in in vitro laboratory techniques, the Norwegian Forest Seed Center for provision of seeds, Hedda Weitz and Tatiana A. Semenova-Nelson and Taina Pennanen for provision of fungal cultures. We would like to thank Marc-André Selosse, Peter Kennedy and four anonymous referees for valuable comments to an earlier version of this manuscript.Peer reviewedPublisher PD