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Andningsbesvär är en av de vanligaste sökorsakerna på Sveriges akutmottagningar. Det är ett komplext tillstånd som består i både fysiska och psykiska faktorer och kräver såväl farmakologisk som icke-farmakologisk vård. Okunskap inom den icke-farmakologiska vården leder till utebliven behandling, förlängt patientlidande och stor risk för vårdskador. Syftet med detta arbete var att belysa akutsjuksköterskans interventioner för att underlätta och förbättra tillståndet för patienter med andningsbesvär inom akutsjukvård. Studiedesignen som tillämpats var en litteraturöversikt med systematisk metod. Vetenskapliga artiklar som behandlat icke-farmakologisk behandlingsstrategi av all form av andningsbesvär som presentationssymtom eller huvudsymtom inom akutsjukvård har inkluderats. Totalt 15 vetenskapliga artiklar uppfyllde kriterierna för studien och genomgick kvalitetsgranskning samt integrerad analys. Resultaten visade att interventionerna kan delas in i fysiska (aktiv motståndsträning, bukläge och kontrollerad andning), såväl som psykologiska (trygg närvaro, kommunikation och utbildning samt vårdrelation). Motståndsträning kan göras med såväl sammandragna läppar som med apparat med god effekt. Bukläge visade sig effektivt på vakna patienter med omfattande andningsbesvär och syrgasbehov. Riktad och strukturerad kommunikation och patientutbildning ledde inte bara till signifikant förbättrade symtom utan även till att patienterna tolererade interventionerna bättre. Även en god vårdrelation med sjuksköterskan visade på lättare acceptans till givna behandlingar. Den slutsats som drogs var att akutsjuksköterskan har en stor roll i att förbättra tillståndet för patienter med andningsbesvär. Akutsjuksköterska kan ge lättillgängliga, men värdefulla ickefarmakologiska insatser för både de fysiska och psykologiska aspekterna av andningsbesvären. De kan även bidra med kunskap och utbildning för patienterna som resulterar i minskad ångest, förbättrad livskvalitet och minskade sjukhusbesök. De undersökta interventionerna kan troligen med fördel implementeras inom sluten- såväl som öppenvård för att förbättra tillståndet hos patienter med andningsbesvär. / Breathlessness is one of the most frequent causes of visit in Swedish emergency departments. It is a complex condition consisting of both physical and psychological factors, requiring both pharmacological and non-pharmacological treatment approaches. Inexperience in nonpharmacological treatment causes missed treatment, prolonged patient suffering and increased risk of care related injuries. The aim of this study was to illustrate the interventions of the emergency care nurse in facilitating and improving the condition for patients with breathlessness in emergency healthcare. The study design applied was a literature review with a systematic method. Scientific articles covering non-pharmacological treatment approaches of any breathlessness as presenting or main symptom within emergency healthcare was included. 15 articles in total met the criteria for the study and underwent a quality control and integrated analysis. The results indicated that the interventions could be divided into physical (active resistance training, prone position and controlled breathing techniques) and psychological (assuring presence, communication and education and care relationship). Resistance training can be achieved either through pursed lips or specific devices with good results. Prone position proved effective in patients with severe breathlessness requiring oxygen therapy. Aimed and structured communication and patient education did not only result in improved symptoms but enabled the patients to better endure the interventions. A good care relationship too facilitated better acceptance to given treatment. The conclusion drawn was that the emergency care nurse played an immense role in improving the condition of patients presenting with breathlessness. The emergency care nurse could provide easily available, although valuable non-pharmacological contributions to both the physical and psychological aspects of breathlessness. Furthermore, they could contribute with knowledge and education for the patients resulting in relieved anxiety, improved quality of life and reduced hospital visits. The analyzed interventions could presumably be successfully implemented within both inpatient and outpatient care improving conditions for patients suffering from breathlessness.

The prevalence of autism spectrum disorder (ASD) has increased two percent from 2012–2014 (Centers for Disease Control and Prevention, 2018) and the Centers of Disease Control and Prevention (CDC) has considered ASD to be a major health concern. The demands of caring for a child with developmental disabilities, including ASD can be overwhelming and the caregivers are experiencing heightened levels of stress in comparison to rearing typically developing children (Argumedes, Lanovaz, & Larivée, 2017; Lindo, Kliemann, Combes, & Frank, 2017). There is a need for more family support to implement more effective coping strategies to deal with the maladaptive functioning of the child with ASD (Hall, & Graff, 2011). The WE C.A.R.E. 2 Program is a nine-week evidence-based community pilot program that will provide an inclusive opportunity with additional family support and effective coping strategies e.g., breathing techniques, yoga postures and positive coping cognitions (e.g., positive self-talk and reappraisals) to decrease the stress levels of caregivers and promote healthy behaviors and healthy child development with the support and training from trained facilitators and a network of caregivers. This individualized plan will tailor to the needs of each dyad to create the necessary mechanisms of change (behavior, cognition, physiological, and sensory modulation) among the children and adults in the yoga group. The professional collaboration of different disciplines (occupational therapy, yoga therapist and teacher) will provide the appropriate modifications to the environment and provide the necessary input for the “just right” experience for a positive outcome.

Aim: To determine if a significant relationship exists between a) nurse-driven interventions to foster collaborative psychiatric and oncology care and b) higher rates of cancer treatment adherence and lower healthcare utilization rates in patients with serious mental illness (SMI) and cancer. Background: It is not uncommon for patients with SMI to suffer from treatment noncompliance and present in the acute care setting, such as the emergency department. Patients with cancer and SMI pose a unique challenge to nurses and providers due to the psychological effect of a cancer diagnosis as well as side effects experienced from psychotropic medications and oncology treatments alike. As a result, these patients are less likely to maintain cancer treatment regimens and present with advances stages of cancer in the acute care setting. Methods: An extensive electronic literature search in the CINAHL Plus and APA PsycINFO databases was completed and included the keywords: cancer, neoplasms, carcinoma, serious mental illness, chronic mental illness, mental disorders, mental disorders, chronic, psychiatric illness, psychiatric disability, cognitive behavioral therap*, intervention*, mindful*, and mental health. Inclusion criteria included: published in the years 2012-2022. The available literature was carefully examined for interventions performed with SMI and cancer for ultimate results to be finalized as a written report. Significance: The results of this research can optimize healthcare and prognosis for the population of mental health patients with cancer and also reduce costs to the healthcare system. Conclusion: The 10 studies reviewed indicated that collaborative psychiatric-oncology care with specific Registered Nurse (RN)-led interventions, such as medication management programs and behavioral counseling, was associated with increased rates of cancer treatment adherence and lower rates of healthcare utilization. Conclusions were based on data collected in cohort studies, randomized control trials, pre- and post-intervention assessments, and clinic data from quality improvement projects. More research is needed to explore the implementation of collaborative care practices.

Bakgrund   Kognitiv sjukdom är ett av de ledande globala hälsoproblemen och förekomsten ökar i takt med en åldrande världspopulation. Att leva med en kognitiv sjukdom drabbar individers hälsa på ett multidimensionellt plan med lidande i form av besvärliga symtom, social stigmatisering, en hotad autonomi och nedsatt livskvalitet. Sjuksköterskans omvårdnadsåtgärder är en central del i att lindra lidande i vården av dessa människor. Det finns dock fortfarande brister inom omvårdnaden av personer med kognitiv sjukdom. Musikinterventioner har visats vara effektiva som alternativa omvårdnadsåtgärder som kan bidra till en mer holistisk och personcentrerad vård. Syfte Syftet var att belysa betydelsen av musik som omvårdnadsåtgärd för hälsan hos personer med kognitiv sjukdom.  Metod Arbetet utgjordes av en icke-systematisk litteraturstudie med en induktiv ansats. Systematiska sökningar utfördes i databaserna PubMed, CINAHL och PsycINFO för att besvara syftet utifrån specificerade urvalskriterier. Insamlade artiklar kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Totalt 15 vetenskapliga artiklar med kvantitativ och kvalitativ ansats inkluderades i resultatet och analyserades med en integrerad dataanalys.  Resultat En sammanställning av resultatet presenterades i tre huvudkategorier: Betydelse som symtomlindrande åtgärd, Betydelse för sociala interaktioner och Betydelse för välmående. Resultatet visade att musik som omvårdnadsåtgärd främjar symtomlindring av beteendemässiga och psykiska symtom samt kognitiva symtom. Det framkom också att musiken hade stor betydelse i att frambringa sociala interaktioner i form av ett ökat socialt engagemang och samarbete samt en förbättrad kommunikation. Musiken visades även vara av betydelse för ett förbättrat humör och välbefinnande hos personer med kognitiv sjukdom. Slutsats Litteraturöversikten belyste musikens potential inom omvårdnaden av personer med kognitiv sjukdom. Personcentrering framkom som en central del i att stärka musikens betydelse för hälsan genom att bidra till en känsla av välbefinnande, meningsfullhet och sammanhang. En ökad förståelse kring musikens betydelse för hälsan anses som värdefull kunskap i sjuksköterskans arbete med personer med kognitiv sjukdom. / Background Neurocognitive disorders are one of the leading global health concerns and the occurrence is increasing as the world's population ages. Living with a neurocognitive disorder affects the health of individuals on a multidimensional level, leading them to suffer from difficult symptoms, social stigmatization, a threatened autonomy and a decreased quality of life. Nursing interventions play a central role in alleviating the suffering of these people in healthcare situations. However, the nursing care of people living with neurocognitive disorders is insufficient. Music interventions have been shown to be effective as alternative nursing tools to contribute to a more holistic and person-centered care.   Aim The aim was to illuminate the value of music as a nursing intervention for the health of people living with neurocognitive disorders. Method The study consisted of an unsystematic literature review with an inductive approach. Systematic searches were conducted in the databases PubMed, CINAHL and PsycINFO in order to achieve the aim using a specific selection of criteria. Collected data was examined using a quality-assessment tool from Sophiahemmet University. A total of 15 scientific articles with quantitative and qualitative approaches were included in the results and were analyzed using an integrative data analysis. Results A compilation of the results was presented within three main categories: Value as a symptom-relieving measure, Value for social interactions and Value for well-being. The results show that music as a nursing intervention relieves behavioral and psychological symptoms as well as cognitive symptoms. The results also show that music is of great value in encouraging social interactions, with an increase of social engagement, cooperation and communication. The music was also shown to be of value in promoting an improved mood and well-being for people living with a neurocognitive disorder. Conclusions The literature review highlighted the potential of music to be used in the care of people with neurocognitive disorders. Person-centeredness emerged as a central element in strengthening the effects of music on health by contributing to a sense of well-being, meaningfulness and social connection. An increased understanding regarding the value of music for health is considered valuable knowledge for nurses in their care of people with neurocognitive disorders.

Yes / This briefing paper reports on research exploring four detailed case studies of rural livelihoods interventions operating in Tanzania, South Africa and Uganda. Analysing these interventions through an audit of sustainable livelihood `principles¿ (as a proxy for best practice) reveals general lessons about both the practical opportunities and challenges for employing sustainable livelihoods approaches to the design, implementation, monitoring and evaluation of development interventions. / Department for International Development

The purpose of this qualitative descriptive study shows how child and youth care professionals understand and apply activity-oriented interventions with children aged 6 to 11. Thirteen child and youth care professionals who employ activity-oriented interventions with children participated in semi-structured interviews. Interviews were transcribed and analyzed using an inductive content analysis approach. Eighteen emergent themes describe the participants’ perceptions of how activity-oriented interventions engage children, build therapeutic relationships and aid children’s learning. The findings in this study show how activity-oriented interventions fit with children’s development and are seen to be helpful in facilitating self-awareness and promoting change. Further, the findings highlight the lack of activity-oriented core training in Canadian undergraduate and graduate child and youth care programs. These finding suggest that there is a need for increased core curriculum in activity-oriented approaches, and also for future research in the effectiveness of activity-oriented interventions. / Graduate

Background: Prenatal alcohol consumption is one of the leading preventable causes of birth defects, including fetal alcohol syndrome and learning disabilities. Although there is strong evidence of the benefits of screening and alcohol brief interventions (ABIs) in reducing hazardous and harmful drinking among the primary care population, evidence of its effectiveness with the antenatal care population is limited. Nevertheless, the Scottish Government is incorporating an alcohol screening and ABI programme as part of the routine antenatal care provided to women in a bid to protect the health and safety of the unborn child and improve subsequent health and developmental outcomes. This research therefore seeks to increase understanding of the factors that are likely to influence the effectiveness of this recently implemented programme. It also aims to explore the extent to which contemporary issues such as change in guidelines regarding alcohol consumption during pregnancy influences perceptions and attitudes, and the possible implications of these on the screening and ABI delivery. Methods: The study described in this thesis employed a realistic evaluation methodology. Realistic evaluation is a theory-driven approach to investigating social programmes. It is concerned with hypothesising, testing and refining programme theories by exploring the interaction of contexts, mechanisms and outcomes. To identify the relevant screening and ABI programme theories, two separate systematic reviews, a critical review and four face-to-face interviews were undertaken with health policy implementers. The findings were used to construct context, mechanism and outcomes propositions. The propositions were then tested by conducting individual interviews with seventeen pregnant women and fifteen midwives, a further six midwifery team leaders were involved in a focus group discussion. A thematic approach using a hybrid of inductive and deductive coding and theme development informed the qualitative analysis. Results: In the context of uncertainties regarding the threshold of drinking that causes fetal harm, pregnant women reported that screening assessment helped them to reflect on their drinking behaviour and facilitate behaviour change. For women who drank at hazardous and harmful levels before attending the booking appointment, screening and ABI may be helpful in terms of eliciting behaviour change. However, they may not be very beneficial in terms of reducing harm to the fetus as it has been found that drinking during the first trimester poses the most risk to the fetus. Training and resources provided to midwives as part of the screening and ABI programme were found to be facilitating mechanisms that midwives indicated improved their skills and confidence. However, most of the midwives had not subsequently employed the motivational interviewing skills required for the ABI delivery, as many of the pregnant women reported that they reduced or abstained from alcohol consumption once pregnancy was confirmed. The outcome noted was that midwives confidence decreased leading to missed opportunities to appropriately deliver the ABI to eligible women. The small numbers of women being identified for ABI meant midwives rarely delivered the ABI. This negatively influenced midwives attitudes as they then accorded ABI low priority in their workload. Other disenabling mechanisms noted to be hampering the implementation of the screening and ABI initiative included midwives contending with competing priorities at the booking appointments, and the lack of adequate rapport between midwives and pregnant women at the booking appointment to discuss alcohol issues appropriately, leading to women providing socially desirable responses to screening questions. Conclusions: The findings of this study has generated greater explanations of the working of the screening and ABI programme in antenatal care setting and has provided transferable lessons that can be used by others intending to implement similar programmes in other settings.

India's electricity system is faced with the challenges of meeting the growing demand for electricity, managing recurring shortages in supply and addressing concerns of global warming. India is adopting a two-pronged approach to address these challenges – (i) making huge investments in new technologies, and (ii) enacting new policies to promote low carbon initiatives. Together, they are believed to help in achieving energy security as well as mitigation of global warming. Such low carbon initiatives can alter the traditional electricity planning and provide with a wide set of supply options to achieve a transition in to a low carbon electricity planning (LCEP). At the outset, one has to explore the supply options for an optimal supply-demand matching of electricity. While finding out various alternatives to meet the demand on a continuous basis using existing supply, non-supply and future supply options, the technology challenges of low carbon options, renewable energy policies and emissions policies need to be studied in detail from the perspective of a developing country keeping India as a focus. The effectiveness of renewable energy and emissions policy interventions such as Renewable Purchase Obligation (RPO), Renewable Energy Certificate (REC), Renewable Energy Certificate Excess (RECX), Emission Tax and Emission Cap-and-Trade and emission policies need to be assessed. Based on the analysis of the literature review, it appears that there is no mathematical model for optimally matching the supply with electricity demand simultaneously considering all the complexities for LCEP discussed in this study. The overall objective of the research is to develop, validate and apply a set of mathematical models to address a complex research problem of "LCEP of existing supply, non-supply and future supply options in the presence of technology and policy interventions to achieve a least-cost, low carbon and sustainable electricity system". This complex research problem is decomposed into five independent LCEP problems based on real-life situations. For each of these five LCEP problems, a mathematical model is proposed. For generating the five proposed mathematical models for any given data, LINGO Set Codes have been developed. In order to validate the proposed mathematical models, data was collected from the Karnataka state electricity system. For the collected data, the proposed mathematical models are generated using the LINGO Set Codes and solved using LINGO. From the optimal solutions, insights are drawn on the impact and effectiveness of low carbon interventions on the present electricity system which is in a transition towards a low carbon electricity system. It is our belief that the proposed mathematical models can act as a basis for introducing any new low carbon interventions such as energy efficiency certificates, auction based tariff mechanisms for renewable energy pricing, and other new REC interventions in the future scope.

Modern psychological approaches currently being used with Muslim clients in therapy have consistently been criticised for being decontextualised, Eurocentric, individualistic, reductionist and for not taking Muslim clients’ cultural and religious values into account (Amri, & Bemak, 2013; Carter & Rashidi, 2004). Hence a need for making use of models, techniques and therapeutic interventions based on Muslim perspectives for Muslim clients has repeatedly been expressed (Haque, 2004a; Helms, 2015; Inayat, 2007; Keshavarzi & Haque, 2013; Utz, 2012; Weatherhead & Daiches, 2010). Despite recommendations for using therapeutic interventions from Muslim perspectives with Muslim clients in therapy (Abu Raiya & Pargament, 2010; Haque & Kamil, 2012; Qasqas & Jerry, 2014), empirical research on these interventions has lagged behind (Abu-Raiya & Pargament, 2011). The aim of the current study is to provide more insight into how interventions from Muslim perspectives can be administered by Muslim therapists with their Muslim clients in therapy in United Kingdom. This study explored the experiences of six Muslim therapists who were all using interventions from Muslim perspectives with Muslim clients in their therapeutic practice. Semi-structured interviews were conducted, transcribed, and analysed using Interpretative Phenomenological Analysis (IPA), and from this three main themes emerged (i) Psychotherapeutic approaches, (ii) Journey of becoming a Muslim therapist (iii) Obstacles faced by Muslim clients and therapists. The implications for further research and therapeutic practice have also been considered.