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Motor symptoms of parkinson’s disease -a review literature
Get PDFParkinson disease is very common in the world, ranking second to Alzheimers disease in terms of degenerative neurological disorders. The disease since 1817 has had so many researchers looking into it, bringing out symptoms, possible treatment options, causes of the disorder to mention but a few. There are a number of studies that have looked into the symptoms of the disorder, especially the non-motor symptoms of the disorder. This study looks into the motor symptoms associated with the disease. It brought out the causes, which the study from the literature review conducted asserted that there is no known cause for it, however, about 60 to 80 percent of persons with PD, have a degenerating number of dopamine, as such, this can be postulated to be the cause. The study also affirmed that there is no known treatment for the symptoms, doctors and medical practitioners would therefore have to try different forms of treatment till the right one for the patient is arrived at
Nursing home leaders’ and nurses’ experiences of resources, staffing and competence levels and the relation to hospital readmissions – a case study
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Thirty-day hospital readmissions represent an international challenge leading to increased prevalence of adverse events, reduced quality of care and pressure on healthcare service’s resources and finances. There is a need for a broader understanding of hospital readmissions, how they manifest, and how resources in the primary healthcare service may affect hospital readmissions. The aim of the study was to examine how nurses and nursing home leaders experienced the resource situation, staffing and competence level in municipal healthcare services, and if and how they experienced these factors to influence hospital readmissions.
Method
The study was conducted as a comparative case study of two municipalities affiliated with the same hospital, chosen for historical differences in readmission rates. Nurses and leaders from four nursing homes participated in focus groups and interviews. Data were analyzed within and across cases.
Results
The analysis resulted in four common themes, with some variation in each municipality, describing nurses’ and leaders’ experience of the nursing home resource situation, staffing level and competence and their perception of factors affecting hospital readmissions. The nursing home patients were described as becoming increasingly complex with a subsequent need for increased nurse competence. There was variation in competence and staffing between nursing homes, but capacity building was an overall focus. Economic limitations and attempts at saving through cost-cutting were present, but not perceived as affecting patient care and the availability of medical equipment. Several factors such as nurse competence and staffing, physician coverage, and adequate communication and documentation, were recognized as factors affecting hospital readmissions across the municipalities.
Conclusion
Several factors related to nurses’ and leaders’ experience of the resource situation, staffing and competence level were suggested to affect hospital readmissions and the municipalities were similar in their answers regarding these factors. Patients were perceived as more complex with higher patient mortality forcing long-term nursing homes to shift towards an acute care or palliative function, and short-term nursing homes to function as “small hospitals”, requiring higher nurse competence. Staffing, competence and physician coverage did not seem to have adjusted to the new patient group in some nursing homes
Jobb smartere! Utvikling av metodikk for læring i innovasjonspraksis for å møte fremtidens helse- og omsorgsutfordringer
No full textI dette forprosjektet har temaet vært forankring for innovasjon i helse- og omsorgstjenesten ved å skape et kunnskapsgrunnlag for praktisk tjenesteinnovasjon. Prosjektet har vært konsentrert om tre punkter: • Skape et miljø som skal være spydspiss i praktisk innovasjonsarbeid på person-, gruppe- og systemnivå. • Innsikt i metodikk for innovasjonspedagogikk. • Bidra til kunnskapsbasert praksisnær utvikling som er støttet av metodikk for innovasjonspraksis i tjenesten. Deltakerne har vært fagpersoner i helse- og omsorgtjenesten i Skien kommune. Tjenesteinnovasjon handler om læringsprosesser, og grunnleggende kunnskap om læringsteorier og egen læring har vært viktige tema. Prosjektgruppen har utforsket teorier og modeller om organisasjonslæring og individuell læring. Rapporten dokumenterer temaer som prosjektgruppen har arbeidet med. Forprosjektet vil danne grunnlag for en søknad om et hovedprosjekt våre 2019, der tema vil være utvikling av innovative arbeidsmiljø gjennom kunnskap om læring og tjenesteinnovasjon som en integrert del av yrkespraksis og ledelse. Skien kommune vil være ressurskommune i videreutviklingen av en praksisnær metodikk for innovativ yrkespraksis i helse- og omsorgstjenesten. Oppdragsgiver: Skien kommune
Experiences and challenges of home care nurses and general practitioners in home-based palliative care – a qualitative study
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Norway has one of the lowest home death rates in Europe. However, it is the health authorities´ ambition to increase this by facilitating palliative care at home. The aim of this study was to achieve more insight, through home care nurses and general practitioners, of conditions that facilitate or hamper more time at home and more home deaths for patients with terminal disease and short life expectancy.
Methods
We used a qualitative research design with four focus groups with a total of 19 participants, of either home care nurses or general practitioners, using semi-structured question guides. The data were processed by systematic text condensation and encompassed thematic analysis of meaning and content of data across cases, which included four steps of analysis.
Results
Three main themes were identified: 1) The importance of a good start for the patient and family with five sub-themes, 2) ‘Passing the baton’ – the importance of collaboration across the health system with four sub-themes, and 3) Avoiding new hospitalization by establishing collaboration and competence within primary health care with four sub-themes.
Conclusions
This study demonstrates that optimum palliative care at home depends on close collaboration and dialogue between the patient, family, home care nurses and general practitioner. It suggests the need for safer discharge routines and planning when hospitals transfer patients with terminal disease to their homes. A good start for the patient and family, where the initial interdisciplinary collaboration meeting takes place in the patient’s home, is crucial for a good result. The general practitioners’ perception of their ‘disconnection’ during hospitalization and prior to discharge has the potential to reduce patient safety. The family seems to be fundamental in gaining more time at home for the patient and supporting the patient to eventually die at home. Home-based palliative care demands experience and competence as well as regular supportive mentoring
Kommersialisering av fellesgodene: Virkninger på skatteinntekter, lønn og samfunnsøkonomiske kostnader
No full textFormålet med dette prosjektet er å avklare hvilke virkninger produksjon av fellesgoder har på skatteinntektene i Norge og om virkningene er forskjellig avhengig av om fellesgodene ivaretas i egenregi, gjennom konkurranseutsetting og kommersielle selskaper med fast ansatte, bruk av enkeltpersonforetak, med utenlandsk arbeidskraft eller i utlandet.
Videre har vi analysert om bruk av kommersielle aktører i stedet for egenregi i et helhetlig perspektiv gir lavere kostnader eller bedre fellesgoder.måsjekke
Implementation of a politically initiated national clinical guideline for cardiac rehabilitation in hospitals and municipalities in Denmark
No full text“We own the illness”: a qualitative study of networks in two communities with mixed ethnicity in Northern Norway
Get PDFBackground: When people in Northern Norway get ill, they often use traditional medicine. The global aim of this study was to examine the extended family networks’ function and responsibility in cases of illness in the family, in two Northern Norwegian communities with a population of mixed ethnicity.
Methods: Semi-structured individual interviews with 13 participants and 4 focus group interviews with total 11 participants were conducted. The text data was transcribed verbatim and analysed based on the criteria for content analysis.
Results: The participants grew up in areas where it was common to seek help from traditional healers. They were organized in networks and shared responsibility for the patient and they provided practical help and support for the family. According to the networks, health-care personnel should make room for the entire network to visit the patient in severe and life-threatening situations.
Conclusion: Traditional networks are an extra resource for people in these communities. The networks seem to be essential in handling and disseminating hope and manageability on an individual as well as a collective level. Health personnel working in communities with mixed ethnicity should have thorough knowledge of the mixed culture, including the importance of traditional network to the patients
Mapping the experience and use of traditional healing in Northern Norway. Among conventional health care providers, users and traditional healers
Get PDFThe research project investigates the social processes, the understanding and experiences of traditional healing and conventional health care in three groups; The users, the traditional healers, and the health professionals. Furthermore, traditional healing as coping strategy (resilience) for the users in cases of illness was investigated. 60 semi-structured interviews and 7 focus group interviews were conducted.
The researchers understand the use of traditional healing as a mechanism of resilience or a coping strategy on individual, social, and cultural levels. This tradition may be regarded as an expression of the culture in Northern Norway that binds people to an environment which is linked to a culture with a spiritual dimension that has long-lasting traditions in the communities in which the research was conducted. The use of traditional healing was an expression for the need for a spiritual dimension, that conventional health care providers do not meet. The users employed parallel treatment methods from the Norwegian conventional health care system and traditional medicine. The use of traditional healing indicated active patients and social networks
Hvordan påvirker utendørs fysioterapibehandling i gruppe balanse, gangfunksjon og mestringstro til egen balanse hos personer med Multippel Sklerose?
Get PDFBakgrunn: Multippel sklerose (MS) er en progressiv, kronisk og kompleks autoimmun sykdom i sentralnervesystemet som påvirker flere nevrologiske funksjoner. En stor andel av pasientgruppen angir nedsatt balanse og gangfunksjon som den største utfordringen i hverdagen. Studier viser at fysioterapibehandling kan gi både bedre balanse og gangfunksjon. Likevel opplever ikke alltid pasientene endring i balanse, og har liten tiltro til sin egen balanse etter intervensjonen. Dette kan være fordi de har trent innendørs i sikre og superviserte omgivelser, mens balanseutfordringer oppstår i ulike omgivelser, inkludert utendørs. Det overordnede målet ved å bedre balanse og gangfunksjon, er å bedre pasientens forutsetning for å kunne utføre dagligdagse oppgaver og kunne delta i sosiale aktiviteter. Desto mer likt omgivelsene i behandlingen er i forhold til de faktiske hverdagslige omgivelsene, jo bedre vil overførbarheten være. Da det ikke foreligger forskning på utendørs trening hos personer med MS, er det relevant å undersøke om en utendørs fysioterapibehandling i gruppe kan påvirke både balanse, gangfunksjon og mestringstro til egen balanse. Hensikt: Hensikten med studien er å undersøke om utendørs fysioterapibehandling i gruppe påvirker balanse, gangfunksjon og mestringstro til egen balanse hos personer med MS. Metode: To personer med moderat MS deltok i studien. Det ble brukt Single Subject Experimental Design, med A-B-A-A struktur. A representerer fase uten behandling og B representerer fase med behandling. To- minutters gangtest, Balance Evalutation Systems Test og Activities-specific Balance Confidence Scale ble benyttet som måleinstrumenter for å evaluere balanse, gangfunksjon og mestringstro til egen balanse. Det ble totalt utført 19 målinger, 6 målinger ved Baseline (A1), 5 målinger ved intervensjonsfase (B), og 4 målinger i hver oppfølgingsfase (A2 og A3). Det ble utført 12 behandlinger á 60 minutter over 6 uker. Resultat: Begge deltakerne fikk statistisk signifikant endring på samtlige tester. De vedlikeholdt eller bedret alle resultater i begge oppfølgingsfasene. Konklusjon: Resultatet fra studien indikerer at en utendørs fysioterapibehandling i gruppe kan ha innvirkning på balanse, gangfunksjon og mestringstro til egen balanse hos personer med MS. Resultatet kan ikke generaliseres og overføres direkte til klinisk praksis. Det er behov for større randomiserte forsøk for å evaluere effekt av denne typen behandling for pasientgruppen. Nøkkelord: Multippel Sklerose, utendørs trening, gangfunksjon, postural kontroll, mestringstr
Living the life I want”: A framework for planning engagement with people with intellectual disability and complex support needs
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Self-determination involves autonomy, agency, choice and control. This study investigated how these aspects of self-determination relate to engaging people with intellectual disability and complex support needs in setting goals and making plans.
Method
Body mapping was used to understand the planning experiences of 30 adults with intellectual disability and complex support needs. Each participant created two body maps using a guided group-based process. Visual and text data were thematically analysed and a framework for planning engagement developed.
Results
The framework identifies the centrality of having a well-developed sense of self which includes insight, motivation and agency, and which is shaped by contextual barriers and facilitators and influenced by helpful and unhelpful support.
Conclusions
A well-developed sense of self and ability to harness resources and people is fundamental to the ability of individuals with intellectual disability and complex support needs articulating goals, identifying aspirations, and attaining valued outcomes.måsjekke