This review examines the effectiveness of digital media on emergent literacy skills, specifically alphabet knowledge, print awareness, and phonological awareness, on children birth to four. A systematic search of the literature identified 13 studies that met the pre-determined inclusion criteria. Two independent raters evaluated each study for methodological quality and assigned appropriate levels of evidence based on ASHA levels of evidence. Results found that specific features of digital media can lead to positive effects on emergent literacy skills. A checklist with the highlighted features was created to guide clinicians, parents, and others in making decisions about the true educational quality of various screen media.

This paper presents a survey of georeferenced point clouds. Concentration is, on the one hand, put on features, which originate in the measurement process themselves, and features derived by processing the point cloud. On the other hand, approaches for the processing of georeferenced point clouds are reviewed. This includes the data structures, but also spatial processing concepts. We suggest a categorization of features into levels that reflect the amount of processing. Point clouds are found across many disciplines, which is reflected in the versatility of the literature suggesting specific features. (authors' abstract)

Background: Social anxiety disorder (SAnD) is a highly prevalent condition, characterised by an intense fear of social or performance situations where individuals worry about being negatively evaluated by others. An up to date systematic review of the effectiveness of cognitive behavioural therapies for SAnD is required to guide practice. Objectives: To assess the efficacy and acceptability of cognitive behavioural therapy (CBT) compared with treatment as usual/waiting list (TAU/WL) for individuals with SAnD. Search methods: We searched the Cochrane Depression, Anxiety and Neurosis Group (CCDAN) Controlled Trials Register and conducted supplementary searches of MEDLINE, PsycInfo, EMBASE, and international trial registers (ICTRP; ClinicalTrials.gov) in October 2011 and CINAHL in October 2012. We also searched reference lists of retrieved articles, and contacted trial authors for information on ongoing/completed trials. Selection criteria: Randomised and quasi-randomised controlled trials undertaken in out-patient settings, involving adults aged 18-75 years with a primary diagnosis of SAnD, assigned either to CBT or TAU/WL. Data collection and analysis Data on patients, interventions and outcomes were extracted by two review authors independently, and the Risk of bias in each study was assessed. The primary outcomes were social anxiety reduction (based on relative risk (RR) of clinical response and mean difference in symptom reduction), and treatment acceptability (based on RR of attrition). Results: Thirteen studies (715 participants) were included in the review, of which 11 studies (599 participants) contributed data to meta-analyses. Based on four studies, CBT was more effective than TAU/WL in achieving clinical response at post-treatment (RR 3.60, 95% CI 1.35 to 9.57), and on eleven studies (599 participants) it was more effective than TAU/WL in reducing symptoms of social anxiety. No significant difference was found between CBT and TAU/WL for attrition. No significant difference was demonstrated for social anxiety at follow-up and no studies examined follow-up data for clinical response or attrition. Authors' conclusions: The available evidence suggests that cognitive behavioural therapy might be effective in reducing anxiety symptoms for the short-term treatment of SAnD. However, the body of evidence comparing CBT with TAU/WL is small and heterogeneous.

Background: Every two seconds a person dies by the result of a trauma. The trauma teams' initial assessment is a structured and systematic concept, where the treaters in the acute care setting are involved in excluding life-threatening conditions and to do an accurate medical examination of the patient. The trauma resuscitation is a fast encounter between the patient and the trauma team. Patients is often affected by the acute event when they lose control over their own situation. Aim: The aim of this study was to describe the patient experience of the trauma resuscitation at the emergency department. Method: A literature review has been made of 5 qualitative and 5 quantitative articles. Articles were analyzed by searching for similarities and differences. The analyzed articles were published between 2004-2015. Results: The result showed that patients had unique needs such as; be treated like individuals and be cared for by competent personnel. The results also showed the importance of sufficient information on examination and treatment. The patient could feel either insecure or cared for in the trauma resuscitation depending on nurses’ communication. Conclusion: The trauma resuscitation is a complex concept and involves many aspects that a nurse should keep track of. The nurse and the traumateam need to face the high requirements of the resuscitation to provide good and safe care for the patient under the whole intervention.

Reducing medication wastage is a paramount objective in promoting appropriate utilisation of finite resources and preventing negative consequences. The aim of this research was to investigate aspects of medication wastage in Malta by applying mixed methods research and, by doing so, contribute original knowledge to this area. A systematic review was conducted to appraise critically, synthesize and present the available evidence on the possible causative factors associated with medication wastage and the effectiveness of any interventions focusing on wastage reduction as an outcome measure. Findings indicated that only one published paper reported a definition of medication wastage. The main factors contributing to wastage were ‘change in medication’, ‘patient's death’, ‘resolution of patient's condition’ and ‘passed expiry date’. Very few studies reported medication wastage as an outcome measure. The Delphi technique was applied to define ‘medication wastage’ and its contributory factors in the context of the Maltese population. A definition for medication wastage was generated with 86% of panellists agreeing/totally agreeing and sixty-one possible factors leading to wastage were identified by the panellists. The perspectives of the Maltese population, healthcare professionals and students on medication wastage were investigated through cross-sectional surveys. Results of questionnaires indicate lack of patient education and knowledge with the free healthcare system and the overstocking of medication by patients due to previous or potential out of stock situations as contributors to medication wastage. The beliefs and behaviours regarding medication wastage of the Maltese public and healthcare professionals were explored during focus groups. The theoretical domains framework was adopted to design the focus group guide and to interpret systematically the findings. Five key themes emerged which were proposed as solutions to minimise medication wastage: system effects, practitioner effects, patients effects, political effects and awareness and educational effects Research results and findings from all four phases will facilitate the systematic development of strategies and policies, with emphasis on prioritisation, with the aim of minimising medication wastage at all levels.

The purpose of this dissertation is to develop explanatory theory for the learning processes facilitated by art-based methods in management education (ABMs). Such theory is important because managerial educators increasingly use ABMs, and without a well-developed theory it may be difficult to realise these methods’ full potential. Current research on ABMs uses theories from other fields but generally sees ABMs as methods for making important information available for reflection, e.g. information about unconscious assumptions, aesthetic experience, or non-propositional or tacit knowledge. This shows that the field is grounded in a representationalist view of cognition. This view of cognition makes it difficult to explain certain themes in the research field, such as, the importance of staying with the senses without reflecting, aesthetic agency, and the process of making. I therefore asked: What insights can be gained from exploring ABMs, using theories grounded in the embodied view of cognition, in particular Conceptual Metaphor Theory (CMT) (Lakoff & Johnson, 1999) and simulation theories (Barsalou, 2008). For the empirical work, I used an experimental design with 60 managers from Danish companies. All participants selected problems from their work they perceived as important, yet unsolvable. They were randomly divided into three groups: Two groups using different ABMs to address problems and a comparison group where no ABM was used. The experiment indicated that 1) creating new metaphors for a problem based on different sensory metaphors enabled the participants to import behaviour from contexts unrelated to the problematic situation, and 2) focusing on sensory experience enabled participants to remove judgments about self or others. Furthermore, the experiment indicated that learning outcomes reflected participants’ experience of the concrete learning intervention. These findings contribute to CMT by suggesting that it is possible to formulate relationships between changes in metaphors and specific learning outcomes. They contribute to ABM by suggesting that experiences that participants have during ABMs are later used as tools for structuring other experiences – not merely as data for reflection.

The increasing prevalence of Alzheimer’s disease poses a considerable socioeconomic challenge in the years ahead. There are few clinical treatments available and none capable of halting or slowing the progressive nature of the condition. Despite decades of experimental research and testing over 300 interventions in transgenic mouse models of the condition, clinical success has remained elusive. Deepening our understanding of how such studies have been conducted is likely to provide insights which could inform future preclinical and clinical research. Therefore I performed a systematic review and meta-analysis on interventions tested in transgenic mouse models of Alzheimer’s disease. My systematic search was performed by electronically searching for publications reporting the efficacy of interventions tested in transgenic models of Alzheimer's disease. Across these publications I extracted data regarding study characteristics and reported study quality alongside outcome data for pathology (i.e. plaque burden, amyloid beta species, tau, cellular infiltrates and neurodegeneration) and neurobehaviour. From these data I calculated estimates of efficacy using random effects meta-analysis and subsequently investigated the potential impact of study quality and study characteristics on observed effect size. My search identified 427 publications, 357 interventions and 55 transgenic models representing 11, 688 animals and 1774 experiments. There were a number of principal concerns regarding the dataset: (i) the reported study quality of such studies was relatively low; less than 1 in 5 publications reported blinded assessment of outcome or random allocation to group and no studies reported a sample size calculation, (ii) the depth of data on any individual intervention was relatively poor-only 16 interventions had outcomes described in 5 or more publications and (iii) publication bias analyses suggested 1 in 5 pathological and 1 in 7 neurobehavioural experiments remain unpublished. Where I inspected relationships between outcomes, meta-regression identified a number of notable associations. Changes in amyloid beta 40 were reflective of changes in amyloid beta 42 (R2 = 0.84, p<0.01) and within the Morris water maze changes in the ‘training’ acquisition phase could explain 44% of the changes in the probe ‘test’ phase (p<0.05). Additionally, I identified measures of neurodegeneration as the best pathological predictors of changes in neurobehaviour (R2 = 0.72, p<0.01). Collectively this work identifies a number of potential weaknesses within in vivo modelling of Alzheimer’s disease and demonstrates how the use of empirical data can inform both preclinical and clinical studies.

Music therapy plays an integral role in end-of-life care, positively impacting emotional, social, physical, cognitive and spiritual health. The purpose of this integrative review was to collect and compile studies (N= 55) between 2000 and 2016 on the topic of music therapy interventions in end-of-life care, in order to provide both music therapy students and therapists access to the most recent and commonly used music therapy interventions and goals. Results of the integrative literature review indicate that the most common intervention for all age groups in end-of-life care is songwriting and composition, with the most common therapeutic goal being emotional expression and catharsis. Details of music therapy interventions, goals and song details are written in tables for readers to refer to as a guide. Further research is needed with each specific age group and setting, in order to provide refined results beyond what is revealed through this review. Additionally, evaluating therapeutic outcomes of the interventions and goals obtained through this integrative review is another step that can be taken for future research.

Bakgrund: Etisk stress upplevs av sjuksköterskorna när deras handlingar är moralisk rätta men de blir hindrade av att utföra dessa på grund av reella eller upplevda hinder. När etiska problem uppstår har sjuksköterskorna ICN´s etiska kod att stödja sig på. Sjuksköterskor som var involverade i patientnära vård var mer troliga att uppleva etisk stress. Den etiska stressen kan leda till att sjuksköterskorna lämnar sin profession. Syftet: Syftet med studien var att beskriva sjuksköterskornas upplevelse av etisk stress i omvårdnadsarbetet. Metod: Studien är en kvalitativ litteraturöversikt med induktiv ansats. Studien baseras på 12 artiklar som studerat etisk stress.  Dataanalysen skedde i fem steg enligt Friberg’s modell för analys av litteraturöversikt. Resultat: Två huvudkategorier identifierades i litteraturöversikten. Dessa var: Att vara begränsad i att ge rätt vård samt Att ta den lätta vägen istället för den rätta vägen. Slutsats: Reflektionen som ett redskap är undervärderat och bör tillämpas för att lindra etisk stress och/eller öka patientsäkerheten.  Etisk stress kan komma att öka då sjuksköterskeprofessionen står inför en stor personalbrist. / Background: Moral distress is experienced by the nurses when they know the right thing to do but are constrained by real or experienced obstacles. When ethical problems arise the nurses can rely on find support in ICN's ethical code. Bedside nurses where more likely to experience moral distress. Moral distress can result in nurses leaving the profession altogether. Aim: The aim of the study was to describe nurses’ experiences of moral distress in nursing care. Method: The study is a qualitative study with an inductive approach. It was a literature review conducted on 12 studies on moral distress. Data analysis was done in five steps according to Friberg model (2012a) for analysis of literature reviews. Result: Two main themes where identified in this literature review. These where "to be limited in conducting good care" and "taking the easy way instead of the right way". Conclusion: Reflection as a tool is undervalued and ought to be used to relieve moral distress and/or improve patient safety. Ethical stress may increase because the nursing profession is facing a major shortage of staff.

Bakgrund: Kvarvarande katetrar är vanligt förekommande i vården och det finns en mängd olika anledningar till att patienter ordineras dessa. Oftast sker ordinationen i samband med problem eller sjukdomar i urinvägarna. Med kvarvarande katetrar följer även en del komplikationer. Somliga komplikationer uppstår på grund av den teknik som används vid katetersättningen. Syfte: Syftet med denna litteraturstudie är att belysa patientens upplevelse av att leva med en kvarvarande kateter. Metod: En litteraturöversikt har gjorts i denna studie. Tio stycken resultatartiklar söktes fram, nio var kvalitativa och en var kvantitativ och de har sedan analyserats och tolkats för att sedan tematiseras. Artiklarna har hämtats från databaserna CINAHL Complete, PubMed och Psyc Info. Resultat: Resultatet beskrivs i två teman som presenterar skillnaderna mellan negativa upplevelser och positiva upplevelser. Resultatet visar att katetern kunde upplevas som ett hinder i vardagen och ofta upplevde deltagarna smärta, som vid urinvägsinfektion, oro eller obehag vid läckage och blockage. Självbilden och sexualiteten kunde förändras då vissa deltagare inte längre upplevde sig själva som kvinnliga eller manliga. Några deltagare upplevde även en positiv förändring i livet då de menade att katetern bidragit till en ökad frihet och trygghetskänsla. Diskussion: Metodens styrkor och svagheter bearbetas i metoddiskussionen. I resultatdiskussionen diskuteras resultatet med vårdvetenskapligt material och valda delar av Katie Erikssons omvårdnadsteori som belyser lidandet. / Background: Indwelling catheters are common in health care and there are multiple causes why patients get them prescribed. The most common reasons for the prescription is of difficulties and or diseases in the urinary tracts. Indwelling catheters are also an cause of complications like infections, pain or other catheter problems. Aim: The aim of this study was to explore the patient's experience of living with an indwelling catheter. Method: A literature review was conducted. Ten scientific articles were analyzed, interpreted, nine were qualitative and one was quantitative and then categorized into two themes. The articles were found from the databases CINAHL Complete, PubMed and Psyc Info. Results: The result presents two themes which represents the differences between the negative and the positive experiences from the patients. The result described that urinary catheter became an obstacle in the everyday life and were often the reason to urinary tract infection, anxiety, discomfort under leakage or blockage. The patients self-image and sexuality could sometimes change since some of the patients did not experienced themselves as the person they used to be before they got the urinary catheter. Some patients experienced a positive change in their life because they felt that the catheters contributed them with a sense of security and freedom. Discussion: The method's strengths and weaknesses are processed in the discussion. The result discussed articles and selected parts of Katie Eriksson nursing theory that highlights the suffering.