Le volume de données disponible croît de manière très importante et ouvre d'importants défis pour les exploiter. Les domaines scientifiques du Web sémantique et des ontologies sont alors une réponse pour aider à traiter les données de manière efficace. Ainsi les ontologies sont actuellement devenues incontournables dans de nombreux domaines d'application pour représenter la connaissance experte.Le domaine que nous considérons dans nos travaux est celui des Interventions Non Médicamenteuses (INM) nommées Non-Pharmacological Interventions (NPIs) en anglais. Elles sont de plus en plus étudiées sur le plan scientifique. Elles sont liées à divers secteurs : psychologie, thérapies manuelles, nutrition, activités sportives adaptées, solutions e-santé, etc.Avec l'augmentation de leur usage, il devient de plus en plus nécessaire d'évaluer leur efficacité de manière scientifique, dans une démarche pilotée par des spécialistes et expliquée de manière claire et accessible aux utilisateurs. Pour ce faire, il est essentiel de disposer d'une classification évolutive et consensuelle effectuée au niveau international pour les spécialistes. Dans ce domaine, le développement d'une ontologie est crucial pour faciliter les recherches bibliographiques et mettre en place des bonnes pratiques.Dans nos travaux, nous nous sommes intéressés à deux enjeux majeurs liés à la construction d'une telle ontologie, d'une part comment effectuer la collecte du vocabulaire et d'autre part comment aider à la compréhension par visualisation.La construction manuelle de l'ontologie est en effet fastidieuse et longue. En particulier, la collecte des termes liés au domaine des INM nécessite beaucoup d'efforts et de temps tant le champ du vocabulaire est large. Ainsi le terme INM lui-même est parfois remplacé par d'autres (médecines alternatives, médecines douces, etc). Une méthode automatique ou semi-automatique est alors vue comme une aide importante pour la construction de la représentation de la connaissance.De plus, les ontologies sont parfois considérées comme difficiles à prendre en main pour les personnes non spécialistes de modélisation, en raison de leur complexité, de leur taille ou des propriétés et relations qu'elles incluent. Ainsi, un outil de visualisation doit être proposé pour les experts des INM. L'outil aura deux buts, d'une part visualiser l'ontologie existante, d'autre part proposer des modifications relatives à la structuration de l'ontologie qui doit se construire de manière collaborative.Des contributions sont proposées dans cette thèse sur ces deux sujets (construction du vocabulaire et visualisation). Deux approches sont présentées pour la construction, l'une reposant sur la connaissance experte et l'autre sur un corpus. Une mesure de similarité est introduite et évaluée. Pour la visualisation, notre proposition repose sur l'utilisation de cartes conceptuelles. Il s'agit alors de ré-écrire l'ontologie sous ce nouveau format et de proposer des outils permettant de distinguer les différents éléments et liens entre les éléments. Un outil a été implémenté, permettant de transformer les ontologies décrites en OWL pour les visualiser. / The explosion of data on the Internet leads to challenges in working with them. Semantic Web and ontology are required to address those problems. Nowadays, ontology plays more and more an important role as a means in domain knowledge representation.In recent years, Non-Pharmacological Interventions (NPIs) have attracted a lot of attention in the health care community. NPIs can no longer stop at a professional discipline to describe them (psychotherapy, manual therapy, dietary supplement, adapted physical activity, e-health solution, etc.). It requires access to a more concrete level of description where each NPI can be evaluated by science, monitored by professionals and explained to the patient. To do this, an international and evolutionary classification based on the results of science is necessary. Thus, developing an ontology for NPIs is crucial. This ontology will facilitate bibliographic research, usage statistics and the identification of good practices.Constructing this ontology manually is time consuming and thus an expensive process. Particularly, the step of collecting the NPI terminology requires much more time than the rest, because of heterogeneous and big resources in the context of NPIs. An automatic or semi-automatic method is thus essential to support NPI experts in this task.Besides, ontologies are often complex with lots of classes, properties and relationships. They are not easy to understand by domain experts. Therefore, a simple and friendly visualization of the ontology for NPI experts needs to be considered. The visualization does not only help NPI experts to easily understand the ontology but also provides support for the NPI ontology development process.In this thesis, we propose methodologies to address the aforementioned challenges. The first contribution concerns the semi-automatic process for collecting NPI terms. Two approaches, knowledge-based and corpus-based, are presented to retrieve candidate NPI terms. A new similarity measure for NPI is proposed and evaluated. The second contribution is a new method for ontology visualization based on MindMap. This work aims at providing a simple and friendly tool to visualize an ontology which is used by domain experts. We propose a MindMap-based notation for ontology visualization by transforming ontology components to MindMap elements. A web-based tool is then implemented to convert OWL ontologies to FreeMind documents which can be imported by existing Mind-Mapping applications to make visualizations.

This research project aims to identify and acknowledge the various non-pharmacological interventions and treatments for both children and adolescents diagnosed with ADHD. This review will highlight the non-pharmacological interventions that are discussed in current research, the significance and potential impact it has on the field of social work, and the way in which this research proposal will be conducted. ADHD is a commonly known neurodevelopmental disorder that is often seen within children and adolescents. ADHD can be treated through prescription medication, non-pharmacological interventions, or a combination of both. Research indicates that non-pharmacological treatments/interventions have shown positive side effects or outcomes within children and adolescents diagnosed with ADHD. The data and research used for this research proposal will focus on current literature that discuss the various types of non-pharmacological interventions. In regards to the field of social work, this study will provide an insight to more holistic approach for social work practice rather than a pharmaceutical/medical one.

Alzheimer’s disease has been described long ago, yet the illness is yet to be fully understood. Though it is true that research and technological advancements have brought us closer to understanding the disease, a truly effective pharmacological cure has not been discovered. With no permanent cure to rely on, AD patients and their caregivers still go through profound struggles in navigating through life with the disease. In this thesis, current literature on the non-pharmacological interventions is presented and discusses the various options that can provide the greatest relief and reap the most health benefits for patients. In total, four different non-drug treatments come into discussion - exercise, music, diet and cognitive interventions. In terms of exercise, research suggests that anaerobic work may be more beneficial than aerobic exercises in preventing the development or progression of mild cognitive dementia and Alzheimer’s disease. This is mostly due to the fact that anaerobic exercises can shift APP processing away from the non-amyloidogenic pathway and increase BDNF levels to offer improved neural protection. Music therapy intervention is evaluated next. This unique treatment is highly valued due to its beneficial effects on AD patients’ emotional well-being. Music therapy can take the forms of singing in groups or as an individual, and it can also incorporate dancing. Not only does music promote neuroplasticity and neurogenesis, but it also alleviates mood, boosts confidence and strengthens will. Diet is another significant component that can have an incredible impact on the AD patients’ wellbeing. Research reveals that diets high in saturated fatty acid should be avoided. On the other hand, diets mirroring the Mediterranean diet, including polyunsaturated fatty acids along with high amounts of vitamin C and folic acid should be readily consumed. Moreover, spices and herbs such as capsaicin should be used in a limited manner to decrease risk for AD. Finally, cognitive therapy is still a popular method for treating mild cognitive impairment and AD. Though cognitive improvement appears to be more modest, some psychostimulation programs combined with pharmacological treatments can play an influential role in achieving cognitive stability. Further research is needed in upgrading the current non-pharmacological interventions with an emphasis on the four treatments. These are available at an affordable cost and can be easily incorporated into the lifestyles of Alzheimer’s patients.

Bakgrund: Alzheimers sjukdom (AD) är den vanligaste formen av demenssjukdomar och antalet människor som insjuknar i AD förväntas öka kraftigt med tiden. Dessutom kännetecknas personer med AD ofta av beteendemässiga och psykiska symtom (BPSD) som kan innefatta agitation, depression, vanföreställningar, oro, ångest, hallucinationer, sömnrubbningar, rastlöshet och apati. Dessa symtom kan orsaka lidande hos patienten och är svåra att hantera för både vårdgivaren och anhöriga, samt försvårar omvårdnadsarbetet. Syftet var att beskriva icke-farmakologiska metoder och effekter av dessa metoder vid omvårdnad av personer med Alzheimers sjukdom som har beteendemässiga och psykiska symtom. Metod: En litteraturöversikt bestående av 16 utvalda kvantitativa forskningsartiklar har genomförts. Artiklarna publicerades mellan år 2006-2016. Resultat. De studerade icke-farmakologiska metoderna var musikterapi, vissa typer av massage, reminiscence-terapi, vårdhundterapi och ljusterapi. Resultaten visade att icke-farmakologiska metoder kan ha en varierande effekt på BPSD. Litteraturöversikten visade att musikintervention var mest effektiv för att minska agitationsbeteende. Individualiserad musik i samband med speciella minnen minskade stress, fobier hos personer med svår demens. Intervention av handmassage, aromaterapi, taktil massage och terapeutisk beröring minskade aggression och agitationsbeteende. Vissa studier visade dock att fotmassageintervention och vårdhundterapi kunde öka verbal aggressivitet hos personer med demens, medan en annan studie visade att djurassisterade aktiviteter kunde minska nedstämdhet medan glädje och generell uppmärksamhet ökade. Effekten av ljusbehandling var förbättrad sömn, minskad depression, agitation och ätstörningar. Slutsats. Icke-farmakologiska metoder kan minska beteendemässiga och psykiska symtom hos personer med Alzheimers sjukdom, dock med varierande effekt. De varierande resultaten kan tolkas som att icke-farmakologiska metoder bör individanpassas och att det behövs vidare forskning inom området. / Background: Alzheimer's disease (AD) is the most common of dementia and the number of people diagnosed with AD is expected to rise significantly over time. In addition, people diagnosed with AD often exhibit the Behavioural and Psychological Symptoms of Dementia (BPSD), which include agitation, depression, delusions, agitation, anxiety, hallucinations, sleep disturbances, anxiety and apathy. These symptoms can cause suffer to the patient and is difficult to manage for both the caregiver and family members, as well as hampers nursing. Aim: the aim was to describe non-pharmacological methods and effects of these methods when caring for people with Alzheimer's disease who have behavioural and psychological symptoms. Method: a literature review consisting of 16 selected quantitative research articles has been performed. The selected articles ware published between years 2006- 2016. Results: The studied non-pharmacological methods were: music therapy, certain types of massage, reminiscence therapy, dog therapy and light therapy. The results showed that non-pharmacological methods can have a varying effect on BPSD. The literature review showed that music intervention was most effective in reducing agitated behaviour. Individualized music in conjunction with special memories reduced stress, phobias for persons with severe dementia. The hand massage, aroma therapy, tactile massage and therapeutic touch decreased aggression and agitated behaviour. Some studies showed that foot massage intervention and dog therapy could increase the verbal aggression for people with dementia, while another study showed that animal-assisted activities could reduce depression and increase joy and general attention. The effect of light therapy was an improved sleep, decreased depression, agitation, and eating disorders. Conclusions: non-pharmacological nursing interventions can reduce behavioural and psychological symptoms for people with Alzheimer's disease, however, with varying effect. The varying results can be interpreted as following: nonpharmacological nursing interventions should be adapted in each individual case and that there is a need for further research in this area.

Made available in DSpace on 2016-07-27T14:19:50Z (GMT). No. of bitstreams: 1 Ana Paula Rocha de Siqueira Zaconeta.pdf: 205671 bytes, checksum: 3d448b36f05ae5d491e6fd4d57c99b24 (MD5) Previous issue date: 2005-04-28 / The neonatal pain is present in the Neonatal Intensive Care Unit NICU, in the term as well as in the pre-term babies. Even though health professionals have the knowledge that the newborn feels pain, most of them don t know how to identify its occurrence and mainly, don t know how to prevent it during the routine procedures of blood withdraw. The objective of the present study was to identify responses indicative of pain in premature babies during procedures of blood withdraw carried on in the NICU. Five premature neonates participated of the study. The observations of the responses indicative of pain were done in the NICU setting with application of the Neonatal Facial Code System NFCS and the Neonatal Infant Pain Scale NIPS. Physiological measures were also taken: Heart Rate (HR) and Oxygen Saturation (SatO2) two minutes before, during the blood withdraw and two minutes after the procedure. Experimental Control was obtained using a Reversal Design of the ABA type for three of the five participants. A multiple Elements Design combined with a Reversal Design was used with two participants. The proposed interventions for the reduction of pain responses were the Administration of Glucose, Non-nutritive Suction, and Manual Contention. The observations registered in the NIPS and NFCS scales suggest the presence of pain during the routine procedure of blood withdraw as well as its reduction with the non-pharmacological interventions proposed. The analysis of the physiological measures of pain revealed that both the Heart Rate as well as the Oxygen Saturation did not show a direct relation with the observations of pain in the premature baby. These measures did not present clinical relevance for all variations were considered normal physiological responses. It can be concluded that all the non-pharmacological interventions tested were effective in reducing the responses indicative of pain in the premature baby. / A dor neonatal está presente na Unidade de Terapia Intensiva Neonatal - UTIN tanto nos bebês a termo quanto nos pré-termo. Apesar dos profissionais de saúde terem o conhecimento de que o recém-nascido sente dor, a maioria deles não sabe como identificar sua ocorrência e principalmente não sabem como evitá-la durante os procedimentos rotineiros de coleta de sangue. O objetivo do presente estudo foi identificar e reduzir as respostas indicadoras de dor dos bebês prematuros durante o procedimento de coleta de sangue realizados na UTIN. Cinco neonatos prematuros participaram do estudo. As observações das respostas indicadoras de dor foram feitas no ambiente de UTIN com a aplicação do Sistema de Codificação da Atividade Facial (NFCS) de Grunau e Craig (1987) e da Escala de Avaliação de Dor para o Recém-Nascido (Neonatal Infant Pain Scale- NIPS). Também foram obtidas medidas fisiológicas: Freqüência Cardíaca (FC) e Saturação de Oxigênio (SatO2) dois minutos antes, durante a coleta de sangue e dois minutos após o procedimento. O Controle Experimental foi obtido utilizando o Delineamento de Reversão do tipo ABA para três dos participantes. Um Delineamento de Múltiplos Elementos combinado com Delineamento de Reversão foi utilizado em dois participantes. As intervenções propostas para a redução de respostas de dor foram a Administração de Glicose, Sucção Nãonutritiva e Contenção Manual. As observações registradas nas escalas NIPS e NFCS sugerem a presença de dor durante o rotineiro procedimento de coleta de sangue assim como a sua redução com as intervenções não-farmacológicas propostas. A análise das medidas fisiológicas da dor revelou que tanto a Freqüência Cardíaca quanto a Saturação de Oxigênio não mostraram uma relação direta com a observação de dor do bebê prematuro. Essas medidas também não apresentam relevância clínica, pois as variações foram consideradas respostas fisiológicas normais. Concluiu-se que todas as intervenções não-farmacológicas testadas foram efetivas na redução das respostas indicadoras de dor no bebê prematuro.

Cerebral blood flow dynamics is an essential component for preserving cerebral integrity. Cerebral blood flow abnormalities are often seen in patients with central nervous system pathologies such as epilepsy, migraine, Alzheimer's Disease, vascular dementia, stroke, and even HIV/AIDS. There is increasing clinical and experimental evidence implicating cerebral hypoperfusion during ageing. The determination of cerebral perfusion has therefore become an important objective in physiological, pathological, pharmacological, and clinical investigations. The knowledge of regional cerebral blood flow further provides useful diagnostic information and/or data for a better understanding of the complex clinical presentations in patients with neurological and psychiatric disorders. Several cerebrovasoactive drugs have found application in the clinical setting of cerebrovascular diseases such as migraine and dementia. Due to the similarities between humans and non-human primates with respect to their brains, both structurally and behaviourally, numerous studies have been conducted and several non-human primate models have been developed for physiological, pathological, pharmacological, and clinical studies, amongst others in Parkinson's disease and diabetes. The relatively large size of the Cape baboon Papio Ursinus with a weight of 27-30 kg for a large male, makes this primate especially suitable for in vivo brain studies using radiotracers and Single Photon Emission Computed Tomography (SPECT). The main aim of the current study was therefore to develop a suitable radiotracer (99m Tc-hexamethylpropylene amine oxime (HMPAO) or 99m Tc_ethyl_cysteinatedimer (ECD) or 123l-iodoamphetamine (IMP)) for adapted in vivo cerebral blood flow measurements in a non-human primate (Papio ursinus) as an investigative model. The model was to be validated and applied in various drug studies for the evaluation of pharmacological interventions. The study design made use of split-dose methodology, whereby the radiopharmaceutical (radiotracer) was administered twice during each study. The first administration was injected soon after the induction of the anaesthesia, and was followed by the first SPECT data acquisition. The second administration of the radioligand, a double dose of radioactivity with respect to the first radioligand injection, was done at a specific time during the study, which took into account the pharmacodynamics of the drug. A second SPECT data acquisition followed subsequently. The drugs that were included in the study were acetazolamide, a carbonic acid anhydrase inhibitor (often used in nuclear medicine to determine cerebral reserve); sumaptriptan, a 5-HT (serotonin) agonist used for treatment of migraine; sodium valproate (an anti-epileptic drug); nimodipine, a calcium channel blocker and nitro-glycerine, a vasodilator used for angina. Arterial blood pressures were recorded from a catheter in the femoral artery and heart rates were concurrently monitored. The split-dose method was successfully applied to develop a non-human primate cerebral blood flow model under anaesthesia. The model showed differences in cerebral perfusion of the different anaesthesia regimes. These anaesthesia data sets were suitable as control/baseline results for drug intervention studies. Acetazolamide evaluation through the split-dose method in the baboon confirmed the sensitivity of the model by presenting comparable perfusion. This result compared to those already familiar prompted the model to be applied in pharmacological intervention studies. Subsequent results of these investigations showed increases in perfusion for single drug nimodipine treatment (25%). However, nimodipine attenuated the increases in perfusion when administered in combination with acetazolamide. Sumatriptan was able to decrease and normalise the increased perfusion after long duration anaesthesia. Decreased cerebral blood flow was observed for combinations of nimodipine with sodium valproate suggesting drug-drug interaction with important clinical implications. Similar decreases were found also for sumatriptan and nitro-glycerine when administered in combination with nimodipine. Studies with the various tracers (99m Tc_HMPAO or 99m Tc_ECD or 123l_IMP) showed clear differences in the perfusion data, confirming variation in the biochemical performance of the tracers. These differences, if not taken into consideration, caution for inappropriate clinical conclusions and subsequent erroneous therapeutic decisions. Improvement of radiotracer efficacy was subsequently attempted through application of the cyclodextrine complexation approach. Although cyciodextrine technology did not markedly improve the brain disposition of the 99m Tc-ECD, protection of the tracer against degradation was demonstrated. This study encouraged further exploration of this method for protection of the tracer against chemical and metabolic degradation. The current study was aimed to develop and effectively apply a non-human primate model with nuclear medicine technology for cerebral blood flow determinations after pharmacological interventions. This was achieved through the split-dose method and dedicated computer programming, which yielded a successful model with the non-human primate under anaesthesia. The model was validated with the application of acetazolamide to confirm familiar cerebrovascular reserve results, indicating that the model is sensitive to CBF changes. The model was also effectively applied in several pharmacological intervention studies, whereby cerebropharmacodynamics of selected drugs were investigated and established. This unique model of a non-human primate, Papio ursinus for cerebral blood flow determinations has served pharmacological research successfully during the past 12 years and could do so in the future, with scope to investigate new frontiers with improved technologies. / Thesis (Ph.D. (Pharmacology))--North-West University, Potchefstroom Campus, 2004.

Cerebral blood flow dynamics is an essential component for preserving cerebral integrity. Cerebral blood flow abnormalities are often seen in patients with central nervous system pathologies such as epilepsy, migraine, Alzheimer's Disease, vascular dementia, stroke, and even HIV/AIDS. There is increasing clinical and experimental evidence implicating cerebral hypoperfusion during ageing. The determination of cerebral perfusion has therefore become an important objective in physiological, pathological, pharmacological, and clinical investigations. The knowledge of regional cerebral blood flow further provides useful diagnostic information and/or data for a better understanding of the complex clinical presentations in patients with neurological and psychiatric disorders. Several cerebrovasoactive drugs have found application in the clinical setting of cerebrovascular diseases such as migraine and dementia. Due to the similarities between humans and non-human primates with respect to their brains, both structurally and behaviourally, numerous studies have been conducted and several non-human primate models have been developed for physiological, pathological, pharmacological, and clinical studies, amongst others in Parkinson's disease and diabetes. The relatively large size of the Cape baboon Papio Ursinus with a weight of 27-30 kg for a large male, makes this primate especially suitable for in vivo brain studies using radiotracers and Single Photon Emission Computed Tomography (SPECT). The main aim of the current study was therefore to develop a suitable radiotracer (99m Tc-hexamethylpropylene amine oxime (HMPAO) or 99m Tc_ethyl_cysteinatedimer (ECD) or 123l-iodoamphetamine (IMP)) for adapted in vivo cerebral blood flow measurements in a non-human primate (Papio ursinus) as an investigative model. The model was to be validated and applied in various drug studies for the evaluation of pharmacological interventions. The study design made use of split-dose methodology, whereby the radiopharmaceutical (radiotracer) was administered twice during each study. The first administration was injected soon after the induction of the anaesthesia, and was followed by the first SPECT data acquisition. The second administration of the radioligand, a double dose of radioactivity with respect to the first radioligand injection, was done at a specific time during the study, which took into account the pharmacodynamics of the drug. A second SPECT data acquisition followed subsequently. The drugs that were included in the study were acetazolamide, a carbonic acid anhydrase inhibitor (often used in nuclear medicine to determine cerebral reserve); sumaptriptan, a 5-HT (serotonin) agonist used for treatment of migraine; sodium valproate (an anti-epileptic drug); nimodipine, a calcium channel blocker and nitro-glycerine, a vasodilator used for angina. Arterial blood pressures were recorded from a catheter in the femoral artery and heart rates were concurrently monitored. The split-dose method was successfully applied to develop a non-human primate cerebral blood flow model under anaesthesia. The model showed differences in cerebral perfusion of the different anaesthesia regimes. These anaesthesia data sets were suitable as control/baseline results for drug intervention studies. Acetazolamide evaluation through the split-dose method in the baboon confirmed the sensitivity of the model by presenting comparable perfusion. This result compared to those already familiar prompted the model to be applied in pharmacological intervention studies. Subsequent results of these investigations showed increases in perfusion for single drug nimodipine treatment (25%). However, nimodipine attenuated the increases in perfusion when administered in combination with acetazolamide. Sumatriptan was able to decrease and normalise the increased perfusion after long duration anaesthesia. Decreased cerebral blood flow was observed for combinations of nimodipine with sodium valproate suggesting drug-drug interaction with important clinical implications. Similar decreases were found also for sumatriptan and nitro-glycerine when administered in combination with nimodipine. Studies with the various tracers (99m Tc_HMPAO or 99m Tc_ECD or 123l_IMP) showed clear differences in the perfusion data, confirming variation in the biochemical performance of the tracers. These differences, if not taken into consideration, caution for inappropriate clinical conclusions and subsequent erroneous therapeutic decisions. Improvement of radiotracer efficacy was subsequently attempted through application of the cyclodextrine complexation approach. Although cyciodextrine technology did not markedly improve the brain disposition of the 99m Tc-ECD, protection of the tracer against degradation was demonstrated. This study encouraged further exploration of this method for protection of the tracer against chemical and metabolic degradation. The current study was aimed to develop and effectively apply a non-human primate model with nuclear medicine technology for cerebral blood flow determinations after pharmacological interventions. This was achieved through the split-dose method and dedicated computer programming, which yielded a successful model with the non-human primate under anaesthesia. The model was validated with the application of acetazolamide to confirm familiar cerebrovascular reserve results, indicating that the model is sensitive to CBF changes. The model was also effectively applied in several pharmacological intervention studies, whereby cerebropharmacodynamics of selected drugs were investigated and established. This unique model of a non-human primate, Papio ursinus for cerebral blood flow determinations has served pharmacological research successfully during the past 12 years and could do so in the future, with scope to investigate new frontiers with improved technologies. / Thesis (Ph.D. (Pharmacology))--North-West University, Potchefstroom Campus, 2004.

Bakgrund: Cancerpatienter som genomgår cytostatikabehandling får ofta biverkningar i form av illamående och kräkningar. Ett långvarigt illamående kan ge upphov till både psykiska och fysiska konsekvenser, som ett försämrat allmäntillstånd, minskad livskvalitet och minskat välbefinnande. De antiemetika läkemedlen som finns mot Chemotherapy-induced nausea and vomiting (CINV) fungerar i många fall inte helt optimalt för patienterna, och många patienter är villiga att testa icke-farmakologiska metoder som ett komplement. Syftet: att belysa icke-farmakologiska omvårdnadsåtgärder mot cytostatika-inducerat illamående hos vuxna patienter. Metoden var en allmän litteraturstudie som genomfördes med tolv stycken vetenskapliga artiklar som granskades med hjälp av en fem-stegs modell. Resultatet visade på att icke-farmakologiska metoder kan ha effekt mot CINV och presenteras i tre huvudkategorier, Akupunktur, Akupressur och Avslappningsmetoder och muskelavslappning. Slutsatsen att icke-farmakologiska metoder har effekt mot CINV men att det behövs mer forskning i Europa och Sverige för att kunna tillämpa metoderna mer frekvent i den svenska hälso-och sjukvården än vad det görs idag. Det av vikt att sjuksköterskor som träffar dessa patienter som lider av CINV har kunskap om de olika icke-farmakologiska metoderna. / Background: Cancer patients undergoing chemotherapy often experience side effects in form of nausea and vomiting. Prolonged nausea can give rise to both psychological and physical consequences for the patient, the quality of life and well-being can decrease. The antiemetic drugs that are available against CINV does not work perfectly in many cases, and many patients are willing to try non-pharmacological methods as a supplement. The aim was to elucidate non-pharmacological nursing interventions against chemotherapy-induced nausea in adult patients. The study method was design as a structured literature review conducted with twelve scientific articled that was analyzed with a five-step model. The results of this literature study showed that treatment with non-pharmacological methods had a relieving effect. The result is presented in three main categories: Acupuncture, Acupressure and Relaxing Methods. The conclusion that non-pharmacological methods have an effect on CINV, but more research is needed in Europe and Sweden to be able to apply these methods more frequently in the Swedish health care system than it is done today. The conclusion is that non-pharmacological methods have an effect on CINV, but more research is needed in Europe and Sweden to be able to apply these methods more frequently in the Swedish health care system than is done today. It is important that nurses who care for these patients need education in the various non-pharmacological methods.

BACKGROUND: One of the most recurrent complaints after total joint replacement is difficulty sleeping. Sleep disturbance after major surgery is common. The “stress response” to surgery, personal factors and environmental factors can affect quality and quantity of sleep in the hospital setting. Occupational therapy intervention for individuals that have problems with function as a result of sleep insufficiency is an emerging practice area. However, there are few occupational therapy practitioners who have addressed the important occupation of sleep in acute care settings. There is a need to develop science-driven research and establish evidence to support acute care occupational therapy interventions that address sleep hygiene, a set of behavioral and environmental practices designed to improve both quality and quantity of sleep. In response to this need, the author designed and carried out a non- randomized controlled study to evaluate the effectiveness of a non-pharmacological occupational therapy intervention to improve quality and quantity of clients’ sleep in a fast track joint replacement center. OBJECTIVE: In the author’s study, the aim was to compare sleep quality, sleep quantity, and activities of daily living (ADL) performance before and after fast track total joint replacement surgery for clients who received an occupational therapy intervention targeted at improving sleep hygiene, in addition to conventional acute care occupational therapy, compared to those that received only conventional acute care occupational therapy. The project focused on 1) identifying evidence-based literature to support the benefit of non-pharmacological interventions for joint replacement surgery clients, 2) designing a program that represented best practice while incorporating the holistic and occupation-based theoretical base of occupational therapy, 3) implementing the program, 4) conducting summative program evaluation, and 5) developing a dissemination plan and implementation budget. RESULTS: There were no initial significant differences between the control and experimental groups. The quality of sleep in the experimental group at discharge was significantly better than in the controls and this group reported significantly improved quality of sleep at discharge compared to 2 weeks before surgery. At discharge the experimental group reported significantly longer sleep duration compared to the control group and the increase in duration from 2 weeks before surgery to discharge was significant. CONCLUSION: The results of this study demonstrated that improvement in sleep quality and quantity can be achieved in clients undergoing fast track joint replacement surgery who receive an occupation-based intervention that incorporates implementation of sleep hygiene practices. Moreover the change appears to persist after the client returns home. More research examining the effectiveness of this intervention with other surgical populations and the persistence of learned sleep hygiene practices over time after hospital discharge are warranted. / 2018-11-07T00:00:00Z

Objectives This systematic review aims to evaluate the evidence of non-pharmacological strategies to improve blood pressure (BP) control in patients with hypertension from African countries. Design We performed a systematic review and searched Medline, Central, CINAHL and study registers until June 2020 for randomised studies on interventions to decrease BP of patients with hypertension in African countries. We assessed the study quality using the Cochrane risk of bias tool and narratively synthesised studies on non-pharmacological hypertension interventions. Setting We included studies conducted in African countries. Participants Adult African patients with a hypertension diagnosis. Interventions Studies on non-pharmacological interventions aiming to improve BP control and treatment adherence. Outcomes Main outcomes were BP and treatment adherence. Results We identified 5564 references, included 23 with altogether 18 153 participants from six African countries. The studies investigated educational strategies to improve adherence (11 studies) and treatment by healthcare professionals (5 studies), individualised treatment strategies (2 studies), strategies on lifestyle including physical activity (4 studies) and modified nutrition (1 study). Nearly all studies on educational strategies stated improved adherence, but only three studies showed a clinically relevant improvement of BP control. All studies on individualised strategies and lifestyle changes resulted in clinically relevant effects on BP. Due to the type of interventions studied, risk of bias in domain blinding of staff/participants was frequent (83%). Though incomplete outcome data in 61% of the studies are critical, the general study quality was reasonable. Conclusions The identified studies offer diverse low-cost interventions including educative and task-shifting strategies, individualised treatment and lifestyle modifications to improve BP control. Especially trialled physical activity interventions show clinically relevant BP changes. All strategies were trialled in African countries and may be used for recommendations in evidence-based guidelines on hypertension in African settings.