Background: Parkinson’s disease (PD) is a chronic and progressive neurodegenerative disease. The diagnosis is based on a combination of the motor signs: tremor, bradykinesia, rigidity and postural abnormalities. Mild Cognitive Impairment (MCI) is common early in the disease and a large proportion of patients with PD develop dementia (PDD). Associations between motor symptoms and cognitive decline have been suggested but the results are inconclusive due to differences in the selection of participants and variables tested. Large population based studies with comprehensive neuropsychological investigation in newly diagnosed cases with PD followed prospectively are rare. The aim of this thesis was to improve characterization and understanding of cognition in PD, and to explore the relationship to motor impairment in the early phase of PD. Methods: All new patients with suspected idiopathic parkinsonism in the catchment area (142 ooo inhabitants) were examined during a period of five years and four months. Among other investigations, a comprehensive neuropsychological evaluation was carried out in 119 of 148 patients with PD together with 30 age matched healthy controls. Assessments were repeated after one three and five years. Results: Patients performed worse than healthy controls in a majority of neuropsychological tests. MCI at the time of diagnosis were found in 36% according to recently published MCI criteria. Thirty % were cognitively impaired using another definition. One fourth of the patients developed PDD within five years after diagnosis and 25 % of those with MCI at baseline reversed back to normal cognition. Age and MCI were significant predictors of dementia. Education was an independent predictor for severe cognitive dysfunction at diagnosis but did not predict PDD. Patients with MCI converting to PDD had worse performance on visuospatial function, semantic fluency, episodic memory, mental flexibility and conceptual thinking. There were no differences in cognitive performance between patients with predominant Postural and Gait Disturbances (PIGD) and the tremor dominant subtype at the baseline investigation and belonging to the PIGD subgroup at baseline did not predict PDD. Dementia converters declined more rapidly than non-converters in posture/gait function. Associations between bradykinesia and measures of executive functions and working memory were found, and between posture and gait disturbances and visuospatial function. Some of these associations were persistent after one year. Patients receiving the dopamine agonist pramipexole performed significantly worse on a measure of verbal fluency at the one year follow up. Conclusions: The differences in proportions of cognitively impaired in the different studies emphasize the value of joint criteria for PD-MCI. Even when using such criteria, a substantial proportion of patients revert back to normal function. The increase in motor disability in patients with PDD could have several different causes that need to be further investigated. Associated motor and cognitive dysfunctions could reflect common pathophysiological processes in partly shared networks. Both dopaminergic and non-dopaminergic motor and cognitive functions seems to be involved in PDD which suggests that pharmacological treatment in PD needs to go beyond the scope of dopaminergic deficiency in search for new therapies that would also be effective for non-motor symptoms. / NYPUM

Children of school age, who have just moved to Sweden can either start in a preparation class or in a normal class. There is no Swedish law or national policy that determines how new children will start and continue their education in Swedish schools. The decision is up to the schools or the communes. This study investigates what kind of educational methods teachers, from a sample of two different schools, are using to educate the newly-arrived students and if these methods are making any contribution to integrating these children into the Swedish school system. The study will raise questions like, how are the new students introduced to the Swedish school, what is the purpose of having the children in preparation class as opposed to normal class, and what methods do the interviewed teachers use to integrate the new children into the school system? Interviews were conducted with four teachers, an associate professor and a senior lecturer in education, who has done several years of research about children from abroad coming in to the Swedish school system. The primary theoretical frames in this study were the sociocultural perspective, language socialization, integration and inclusion. The results show that by not having a comprehensive policy for the newly arrived students, each teacher has a different educational method and the schools are not given enough recourses to help the student succeed. One of the conclusions is that to have a good integration of new students, the schools need to find a reception method that works for each new student based on a comprehensive policy.

The aim of this study was to develop guidelines for the support of newly qualified nurses to ease their transition from student to professional practitioners in Lesotho; based on an exploration and description of the newly qualified nurses’ first hand experience of their transition from student to professional practitioners in a public hospital in Lesotho. The rationale behind the study was the researcher’s perception of an attitude change observed in the newly qualified professional practitioners. An explorative, descriptive, contextual, qualitative research design was chosen. The sample included all newly qualified professional nurses who worked in a public hospital in Lesotho for a period of one year or less. Data collection took place by means of semi–structured individual interviews with ten (10) participants and a focus group interview with eight (8) of the original participants. Content analysis of the data in the qualitative tradition was independently done by two coders who identified four (4) themes and ten (10) sub–themes. The first theme was described as reality shock, including the sub–themes emotional reactions and limited resources. The second theme, competence, includes the sub–themes of knowledge, skills and attitude. A third theme describes the participants experience of the support from management, colleagues, the Ministry of Health and Social welfare, nursing educational institutions and the community. The fourth theme describes the participants’ vision for the future. Each of the themes was discussed together with relevant data obtained from literature and reduced to a conclusive statement which served as basis for the formulation of guidelines to ease the transition from student to professional practitioner in Lesotho. The research report concluded with the researcher’s evaluation of the study and recommendations for nursing education, nursing management and further research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

The aim of this study was to develop guidelines for the support of newly qualified nurses to ease their transition from student to professional practitioners in Lesotho; based on an exploration and description of the newly qualified nurses’ first hand experience of their transition from student to professional practitioners in a public hospital in Lesotho. The rationale behind the study was the researcher’s perception of an attitude change observed in the newly qualified professional practitioners. An explorative, descriptive, contextual, qualitative research design was chosen. The sample included all newly qualified professional nurses who worked in a public hospital in Lesotho for a period of one year or less. Data collection took place by means of semi–structured individual interviews with ten (10) participants and a focus group interview with eight (8) of the original participants. Content analysis of the data in the qualitative tradition was independently done by two coders who identified four (4) themes and ten (10) sub–themes. The first theme was described as reality shock, including the sub–themes emotional reactions and limited resources. The second theme, competence, includes the sub–themes of knowledge, skills and attitude. A third theme describes the participants experience of the support from management, colleagues, the Ministry of Health and Social welfare, nursing educational institutions and the community. The fourth theme describes the participants’ vision for the future. Each of the themes was discussed together with relevant data obtained from literature and reduced to a conclusive statement which served as basis for the formulation of guidelines to ease the transition from student to professional practitioner in Lesotho. The research report concluded with the researcher’s evaluation of the study and recommendations for nursing education, nursing management and further research. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

Sigrid Wangensteen has the recent years been engaged in doctoral studies at Karlstad University in combination with teaching at the bachelor program in nursing at Gjøvik Universtity College. This doctoral thesis is focused on newly graduated nurses, their perception of competence, critical thinking dispositions, research use and their experiences of being a nurse during their first year as a nurse. Qualitative and quantitative methods were used. The very first period of time was experienced as tough but when looking back the newly graduated nurses appreciated the tough time. They described the need for a supportive environment, and gaining competence through managing challenging situations. The leadership role constituted the main difference between being a student and being a nurse. In the quantitative study the nurses perceived their competence as good, rating the Helping role competence category highest and the Ensuring quality competence category lowest. With respect to critical thinking the CCTDI total scores indicated a positive disposition. As regards the CCTDI subscale scores the nurses reported highest values for intellectual curiosity (Inquisitiveness) and lowest for intellectual honesty (Truth-seeking). The nurses reported a positive attitude towards research, but only 24% were classified as research users. Supportive environment was a significant predictor for research use. Critical thinking was a prominent predictor for attitude towards research, for research use and perception of competence. Nurse leaders in clinical practice and nurse educators in nursing education and clinical practice play an important role in nurturing student nurses and newly graduated nurses with respect to critical thinking. There is a need to assess whether teaching strategies meet the requirements of critical thinking and EBP in nursing education.

Thesis, Toulouse, 1914. / Bibliography: p.[227]-232.

Studiens syfte är att ur ett interkulturellt perspektiv få insyn och kunskap om hur föräldrarna till barn som kommer som nyanlända till Sverige uppfattar mötet med svenska förskolan. Studien har utförts med hjälp av en kvalitativ forskningsmetod och undersökningsinstrumentet som kommer att användas är en intervjuguide. Deltagarna i intervjuerna är nio nyanlända föräldrar på fem olika förskolor i två olika kommuner, varav en förskola endast har nyanlända barn. Resultat i studien visar att nyanlända föräldrar uppfattar att det finns mycket kontakt med förskolan och att den första kontakten skedde med tolk eller på engelska. Kontakten och bemötandet fungerar bra och pedagogerna gör sitt bästa för att lyckas skapa bra kommunikation och bemötande. Det framkommer även i studiens resultat att kulturer ser olika på tid samt att användandet av tolkar i kommunikationen mellan de nyanlända föräldrarna och pedagogerna fungerade mindre bra. Studien kommer att avslutas med en diskussion där syftet, resultatet, bakgunden och det teoretiska perspektivet diskuteras och problematiseras.

Studiens syfte är att få en inblick hur arbetet med att integrera nyanlända barn i förskolans verksamhet går till. Vi vill även vinna kunskap om aspekter som ligger till grund för arbetet att placera in de nyanlända barnen i förskolan. För att få svar på studiens frågor genomfördes intervjuer med utbildningschefer i olika kommuner i Sverige. Frågeställningarna som användes vid utformningen av intervjufrågor var: Hur resonerar utbildningschefer angående integration i förskolan, vilka riktlinjer ligger som beslut för utformning av verksamheter med nyanlända barn samt vilka aspekter ligger till grund för kommunens utplacering av nyanlända barn. Som analysredskap använde vi innehållsanalys som syftar till att kategorier skapas utifrån det insamlade materialet. Studiens resultat visar att geografi har en stor betydelse för hur de nyanlända barnen placeras ut i kommunens olika förskoleverksamheter. Som nyanländ familj finns en problematik att transportera sig till en förskola som är placerad långt ifrån hemmet och resultatet blir då att de nyanlända barnen uteblir i verksamheten. Resultatet visar också att samtliga utbildningschefer har samma riktlinjer att följa men att det även går att tolka lagarna och utforma olika strategier för integrationsarbete.

Bakgrund Stress och liknande känslotillstånd hos nyutexaminerade sjuksköterskor är ett vanligt problem. Syfte Undersöka hur nyutexaminerade sjuksköterskor upplevde tiden före sin första anställning och under första året i yrkeslivet. Fokus lades på känslor av oförbereddhet och stress och huruvida det påverkade omvårdnaden, samt hur detta hade kunnat avhjälpas. Metodbeskrivning Sju semi-strukturerade kvalitativa intervjuer genomfördes. Insamlat material analyserades genom en modifierad version av kvalitativ innehållsanalys. Resultat Övergången från sjuksköterskestudent till yrkesverksam sjuksköterska kunde innebära psykiska och fysiska påfrestningar och leda till symptom på utmattningssyndrom. Faktorer för att undvika skadlig stress var att det sociala arbetet ansågs givande, god inskolning och handledning, samt stöd genom yrkesförlagd utbildning på arbetsplatsen. Positiv feedback under verksamhetsförlagd utbildning (VFU) ökade tron egenförmågan. Faktorer som påverkade övergången negativt var press från kollegor, brist på kunskap och rutin, höga förväntningar på sig själv och för lite undervisning i farmakologi, medicinsktekniska moment och medicinsk teori. Basal- och specialiserad omvårdnad, läkemedel- och medicintekniska moment blev lidande på grund av stress. Slutsats Första året inom sjuksköterskeyrket innebär ett stort ansvar med påföljande stress och liknande tillstånd. En trygg sjuksköterska riskerar mindre av dessa problem vilket leder till förbättrad omvårdnad och patientsäkerhet. För att få en trygg inskolning och kompensera för bristande erfarenhet i yrkesrollen krävs från arbetsgivarens sida en individanpassad handledning med mentor, god arbetsmiljö och handledning efter introduktionsperiodens slut och reflektionsgrupper. Utbildningen förser studenterna med trygghet genom VFU och omvårdnadsteori samtidigt som en större bredd inom medicin och farmakologi efterfrågas. En tuff inledande period kan delvis kompenseras av det sociala arbetet / Background Stress and similar feelings are common problems among newly graduated nursing students which can be caused by lack of skill while adjusting to work. Purpose The purpose of this study was to examine how newly graduated nurses experienced the time before their first employment as well the first year into the profession, focusing on whether feeling unprepared and/or stressed had any effect on patient-related care, and in that case unfold how this could have been prevented in any fashion. Method Seven semi-structured qualitative interviews with registered nurses were conducted. Data was analyzed through a modified version of qualitative content analysis. Results The transition phase from being a nursing student to becoming a certified nurse could cause both mental and physical stress, which in turn might lead to experiencing symptoms of fatigue. Factors that had a positive effect on coping were: a sense of fulfillment from social work, a positive acclimatization and tutoring, and receiving support throughout the entire trainee period. Positive feedback during this trainee period increased self-efficacy. Factors that had a negative effect on coping were; pressure from colleagues, a lack of competence and routine, high self-expectations and a lack of education regarding pharmacology, basic and specialized nursing, medicine and health technology. Conclusion The first year in the nursing profession includes great responsibility, stress and stress related conditions. The feeling of being confident in work related situations reduces the risk of developing stress related issues, and leads to improved care and patient safety. To compensate for the lack of experience in the professional role, the employers need to offer a good working environment with access to a mentor and participation in reflection groups during and after the introductory period. The nursing education provides a sufficient part of internship and nursing theory, but more training and theory in medicine and pharmacology is requested. Stress and related conditions during the first year in the nursing profession is partly compensated by feelings of joy perceived in the social work.

Syftet är att analysera hur lärare arbetar med kartläggning i undervisningen bland nyanlända elever med kort eller ingen skolbakgrund i vuxenutbildningen, samt hur kartläggningen används i undervisningen. Syfte är dessutom att undersöka hur samverkan fungerar mellan elev och lärare samt mellan lärare och andra professioner.   Studiens empiriska material består av fyra djupintervjuer med sex lärare inom vuxenutbildningen. Lärarna i studien arbetar med kartläggning av nyanlända med kort eller ingen skolbakgrund. Det empiriska materialet har analyserats dels utifrån tidigare forskning och dels utifrån teoretiska begrepp med inspiration från socialkonstruktivistiskt perspektiv. De analysbegrepp som använts är kommunikation och organisation, samverkan, lärande och identitet i syfte att skapa en bild av hur teori och praktik möts och formas för att stödja den enskilda individens lärande och utveckling.  Studiens resultat visade på att informanternas skolor har svårt att konkretisera arbetssätt och arbetsmetoder inom kartläggning av svårigheter på organisationsnivå. Orsaken kan vara att skolorna slits mellan statens förväntningar och rådande möjligheter att utforma undervisningen. På gruppnivå används kartläggningsresultat främst till nivåplacering och i liten utsträckning till individanpassning av undervisningen på grund av besparing av stödfunktioner. Målgruppen nyanlända, med kort eller ingen skolbakgrund, är en grupp som behöver mycket stöd och hjälp i sin språkinlärning därav är specialkompetenser inom vuxenutbildning en viktig utvecklingsfråga som behöver lyftas på makronivå.