Bakgrund: Felnäring, viktproblematik och dehydrering är vanligt hos äldre. Kunskapsnivån om äldre och nutrition varierar mellan personalgrupper. God nutrition ger energi till att klara av vardagen och hjälper till att förebygga sjukdomar och skador. När man ska göra en förändring är det viktigt att ha en bra implementeringsstrategi. Syfte: Syftet med denna litteraturstudie var att se vilka interventioner som gjorts på särskilda boenden för att förbättra näringsintaget hos de boende, vilka som har fungerat och vilka som inte har fungerat. Vidare var syftet att undersöka vilka implementeringsstrategier som använts. Metod: Litteraturstudie valdes som metod. Studien baserades på 19 orginalartiklar. Resultat: Fem teman sammanställdes från underlaget som svar på de tre första frågeställningarna. Dessa var smakförstärkare, utbildning, miljö, mellanmål och berikning och tandvård. Interventioner inom samtliga teman gav ett signifikant positivt resultat i vikt, BMI eller kaloriintag. Som svar på sista frågeställningen framkom att liten vikt har lagts vid implementeringsstrategier i samtliga studier. Slutsats: Flera interventioner kan förbättra näringsintaget hos äldre. Liten fokus ligger på hur interventionerna har implementerats. Mer forskning behövs inom området, framförallt inom implementeringsstrategier.

Within the last few decades there has been a push to identify students who have or who are at-risk for learning disabilities as early as possible. Much of this recent focus is related to research showing the positive long-term benefits of early education for the general population and children in poverty, as well as to educational theory about early educational interventions. However, little to no research has been conducted on the long-term effects of age of first service provision for students with learning disabilities. Whether students with learning disabilities are doing better academically in high school or graduating high school at higher rates based on when they are identified or when they received services is yet to be known. This study analyzed data collected from families and schools for 2,000 youth with learning disabilities from the National Longitudinal Transition Study 2 (NLTS2), a study that investigated a nationally representative sample of approximately 12,000 students with disabilities. The present study used latent variable structural equation modeling (SEM) to investigate the effects of age of first service provision on high school educational achievement and high school graduation in order to better understand the long-term effects of the age of intervention for students with learning disabilities. Contrary to what was hypothesized, the age a student first received services for a learning disability did not statistically significantly affect his or her grades in high school or likelihood of graduating from high school. The age a student first received services for a learning disability was statistically significantly and positively related to standardized achievement tests in high school; however, the direction of causation was counter to what was hypothesized. Students who received services at a later age performed better on high school standardized achievement tests. An important limitation of these data is that measures of a student's cognitive abilities or the severity of a student's learning disability were not available for use in these analyses. Further limitations and possible implications of these findings are discussed. / text

This purpose of this study was to examine pragmatic differences in children with hearing loss compared to children without hearing loss by understanding use of communication repairs, self and peer attitudes and perceptions to suggest the most appropriate intervention approaches. Previous research has found use of communication repairs, self and peer perceptions and attitudes to be associated with pragmatic skills. Intervention approaches were suggested for remediating pragmatic differences in children with hearing loss. / text

No description available.

Fibromyalgia is a chronic pain disorder characterized by multiple symptoms including severe fatigue, headache, muscle pain, cognitive dysfunction, and paresthesias. Up to 81% of patients with fibromyalgia (FM) also suffer from irritable bowel syndrome (IBS). The objectives of this study were: 1) to evaluate the effect of a 4-week excitotoxin additive free diet on symptoms of fibromyalgia (FM) and irritable bowel syndrome (IBS), and then further, to use a randomized double blind crossover challenge to determine: 2) whether FM symptoms would return more frequently when subjects were challenged with MSG as compared to placebo, and 3) whether IBS symptoms returned upon MSG challenge more frequently than placebo. Subjects were recruited from the Portland, OR area, and attended a 2-hour group diet training session and individual clinic appointment before starting a one-month excitotoxin additive free diet. At the end of the month, subjects reporting greater than 30% symptom improvement went onto a 2-week double blind crossover challenge period where they were randomized to receive either MSG in juice for 3 days or placebo for 3 days. The following week they received whatever they did not receive the first week. Eighty-four percent of those who finished the diet reported >30% symptom improvement and pre-post diet analysis demonstrated highly significant difference scores for all major outcome measures. Total symptom scores (11.4, p<0.0001), fibromyalgia impact questionnaire-revised scores (FIQR) (22, p<0.0001), and IBS quality of life (IBS-QOL) questionnaire scores (11, p<0.0001) were all significantly reduced, as were visual analog pain (VAS) change scores for FM (5.4, p<0.0001) and IBS (4.6, p<0.0001). Challenge results demonstrated that diet responders got significantly worse when challenged with MSG as compared to placebo in most measures (total symptom score, p<0.02; FIQR, p<0.03; and IBS-QOL, p<0.05). VAS for IBS and FM both worsened, but to a lesser degree (mean change of 2.1 (p<0.19) and 2.5 (p<0.07) respectively). The majority of responders were still following the diet at 2 months post study which suggests feasibility and benefit. Results suggest that the excitotoxin additive free dietary intervention may provide significant symptom relief equal to or greater than current pharmacological strategies for fibromyalgia patients with IBS.

The purpose of this investigation was to explore how adherence to a positional therapy intervention affected therapeutic outcome in participants with positional-related obstructive sleep apnea syndrome. Eighteen adult participants identified as having positional-related obstructive sleep apnea by an initial overnight polysomnography study were recruited. Participants were instructed to use a “tennis ball technique” positional device for three weeks at home and record their sleep habits and adherence before a final post-treatment polysomnography evaluation. A repeated measures MANOVA found significant effects of treatment between pre- and post-test on the objective polysomnography variables of Total Recording Time [F(1,17) = 5.21, p<.05, η²=.24], Total Sleep Time [F(1,17) = 8.59, p<.01, η²=.34], Sleep Efficiency [F(1,17) = 5.42, p<.05, η²=.24], Total REM sleep time [F(1,17) = 9.91, p<.01, η²=.37], and the Apnea- Hypopnea Index [F(1,17) = 14.28, p<.001, η²=.46]. Sleep onset latency was not statistically significant. There were significant effects of treatment on the subjective measures of the Functional Outcome of Sleep Quality [F(1,17) = 8.92, p<.01, η²=.35], Pittsburgh Sleep Quality Index [F(1,17) = 11.2, p<.01, η²=..39], Epworth Sleepiness Scale [F(1,17) = 6.69, p<.05, η²=.28], and the Brief Symptom Inventory [F(1,17) = 5.14, p<.05, η²=.23]. No significant interaction effects were found between treatment and adherence when participants were grouped post-hoc into an adherent or non-adherent categories based on their self-reported daily log data. In summary, the results of this study indicated that the positional device was efficacious for significantly improving both objective polysomnography variables and subjective variables of sleep. The results also indicated even partially adherent participants reported significant improvements in nighttime sleep quality and quality of life after the three week treatment period. Mixed Linear Modeling demonstrated that significant improvements in sleep quality, time to sleep onset, and total sleep time were not seen until the last weeks of treatment. This study found very acceptable adherence rates with this positional device design; all participants were able to utilize the therapeutic device on at least a portion of every night during the three-week intervention.

No description available.

Abstract In 2001 a development program named FondeAgro was implemented in the northern region of Nicaragua with the aim to reduce poverty by rural development. During a ten-year period peasants in the departments of Jinotega and Matagalpa received expert assistance on farming in order to improve their livelihoods and create sustainable businesses as small- and medium- scale peasants. This study aims to present the reality of coffee producing farmers who participated in FondeAgro, ending in 2011. Research is made on if and how farmers continue with methods learned during the program and its effects on production- and livelihood development. Existing reports present the implementation of the program and farmers’ abilities to adapt and work with new methods, though this stretches only until the end of the program, 2011. Accordingly, there is no information on how farmers’ lives appear after the program’s end, why this research is carried through. A field study was conducted in the municipality El Cúa, department of Jinotega in northern Nicaragua in 2012. In order to visualize the complex pattern of poverty, access to or lack of capital assets the sustainable livelihoods framework is used for analysis. To further elucidate the effects of the development program and attainment of goals, a manual on development interventions by Sida is used as well. The conclusion of this research on the development program FondeAgro is that the effects of the program are positive and negative, differing mainly depending on farmers being small- or medium-scale producers. Many farmers have improved their livelihoods through their participation in FondeAgro but for some farmers there is no change to previous life situation. What seems to be decisive in order to continue with methods learned is what type of assistance that has been given to each farmer during the program years as well as possibilities to participate in cooperatives. The methods used to achieve the objectives of the program have not given the results hoped for and many farmers are still facing a future in severe poverty Keywords: Nicaragua, FondeAgro, agriculture, farmers, livelihoods, intervention

Sammanfattning   Ambulanssjuksköterskan arbetar idag i stressiga, krävande miljöer och ska då fatta snabba, korrekta beslut som kan vara livsavgörande för en svårt sjuk patient. Om en individ upplever att dennes yrkessituation inte kan kontrolleras eller hanteras kan personen till slut reagera med uppgivenhet, detta är en definition av långvarig stress.   Syftet med denna studie var att undersöka hur litteraturen identifierar och beskriver upplevelser av stress hos ambulanssjuksköterskor och vilka preventiva interventioner som finns idag för att hantera ambulanssjuksköterskans stress i samband med traumatiska möten av svårt sjuka patienter. Metoden för studien var en deskriptiv litteraturstudie där artiklar hämtades via Google Scholar, Medline via PubMed och Cinahl.   Resultatet av denna studie visade att det i de flesta fall saknas en strategi för att möta den yrkesrelaterade stress som ambulanssjuksköterskor utsätts för. För att kunna upptäcka och undvika symtom på stress behövs mer preventiva interventioner och uppföljningar före eller i direkt anslutning till en kritisk händelse. Det behövs mer forskning i ämnet och fåtalet artiklar uppvisar förslag angående djupgående hjälpmedel för stresshantering och stressrelaterade sjukdomar.   Slutsats Att ambulanssjuksköterskan i sitt arbete upplever stress och är tvungen att hantera den är ett faktum. För att komma åt detta problem behövs både engagemang och preventiva strategier av arbetsgivare för att stötta ambulanssjuksköterskan i hanteringen av stressupplevda situationer. / Abstract   The paramedic nurse today works in stressful, demanding conditions, and is constantly forced to make quick, correct decisions vital for a critically ill patient. Should an individual experience a work environment, which cannot be handled or controlled, the ultimate reaction is one of complete resignation. This is a symptom of prolonged stress. The purpose of this study is to examine how scholarly literature identifies and describes stress experiences among paramedic nurses. It also aims to evaluate the means of preventive interventions currently available to manage stress symptoms arising from traumatic encounters with severely ill patients. Method: This study is a literature review based on scientific articles collected from Google Scholar, Medline via Pubmed, and Cinahl.   The outcome of this study showed that, in most cases, there is a lack of means to meet the work-related stress that paramedic nurses are exposed to. In order to detect and avoid stress symptoms, more preventive interventions and monitoring are needed – both before and directly following critical situations. In the academic literature examined, the need for further research within this field is obvious, but there are few suggestions of any long-term preventive conclusions against stress and stress-related diseases.   Conclusion: Paramedics experience stress in their work and are forced to successfully cope with it. Employers have to take action to actively engage in these issues, and provide strategies to support the paramedic nurse in managing stressful situations.

Syftet med studien är att undersöka ett konsultföretags interventionsmodell för grupputveckling ur ett konsultperspektiv respektive kundperspektiv. Detta görs för att ta reda på vilka strategier som kan användas för att arbeta med grupputveckling och för att undersöka dessa strategiers upplevda resultat. Studiens teoretiska referensram består av forskning inom grupputveckling. Susan Wheelans teori om hur effektiva team skapas ses som en grund för studien, där hennes 10 nycklar till produktivitet utgör kriterier för vad som kännetecknar högpresterande arbetsgrupper. Studiens empiriska material består av intervjuer med konsulter på konsultföretaget samt kunder till dem. Resultatet visar att majoriteten av kunderna upplever konsulternas strategier som framgångsrika och att de har fått ett förbättrat företagsklimat, främst i form av ett öppnare klimat mellan de anställda. Vidare visar resultatet att faktorer som berör det existentiella och personella har varit framträdande i konsulternas tillvägagångssätt. Resultatet visar även på att utvärdering av interventionen kan ses som ett utvecklingsområde, för att ur ett långsiktigt perspektiv kunna uttala sig om strategierna verkligen fungerar.