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“I somehow have the ambition to the maximum” Young assistant nurse managers’ experience of management practice
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadTilgangur: Tilgangur rannsóknarinnar var að auka þekkingu og
dýpka skilning á reynslu ungra hjúkrunarfræðinga, sem tilheyra Ykynslóðinni (fæddir 1980–2000), af aðstoðardeildarstjórastarfi.
Aðferð: Í þessari fyrirbærafræðilegu rannsókn voru tekin 1–2 viðtöl
við níu unga aðstoðardeildarstjóra, samtals 12 viðtöl.
Niðurstöður: „Ég er einhvern veginn með metnaðinn í botni“ er yfirþema rannsóknarinnar og lýsir vel þeim metnaði og krafti sem einkenndi þátttakendur. Meginþemun voru þrjú, „ég sá fleiri kosti út úr
þessu en galla“: hvetjandi þættir, „verkefnin eru óteljandi einhvern
veginn“: hindrandi þættir og „[Ég] vil vera aðgengileg en þetta er líka
truflun“: vegið að samræmi milli einkalífs og vinnu. Þátttakendum
fannst mikil tækifæri fólgin í stöðu aðstoðardeildarstjóra, sem þeim
fannst skemmtilegt en krefjandi starf. Áberandi var hve litla aðlögun
þátttakendur fengu en það olli auknu álagi. Þá skorti verulega stuðning í starfi, hlutverk þeirra var illa skilgreint og tímaskortur mikill.
Lítill tími gafst til að sinna verkefnum á vinnutíma vegna skorts á
starfsfólki og fjölda verkefna og það varð til þess að þau voru oft
unnin heima. Margir þátttakenda greindu frá því að þeir væru að
keyra sig út fyrir starfið vegna verkefna sem ekki gefst tími til að
sinna. Þátttakendum fannst mikilvægt að hafa jafnvægi milli vinnu
og einkalífs, en með togstreitunni sem myndaðist raskaðist það.
Sumir urðu fyrir aldursfordómum og að fólk leyfði sér að vera mjög
gagnrýnið og jafnvel dónalegt við þá eftir að þeir tóku við stöðu
aðstoðardeildarstjóra. Ungu hjúkrunarfræðingunum fannst þeir búa
yfir persónueiginleikum sem hjálpuðu þeim að takast á við krefjandi
stjórnunarhlutverk en samt var um helmingur þeirra kominn með
heilsutengda kvilla, eins og kvíða, of háan blóðþrýsting og kulnun,
sem rekja má til álags.
Ályktanir: Mikilvægt er að styðja vel við unga aðstoðardeildarstjóra
með góðri aðlögun og skýru hlutverki en jafnframt að hjálpa þeim
að takast á við álagið og stuðla að góðri heilsu.
Lykilorð: Aðstoðardeildarstjórar í hjúkrun, Y-kynslóð, stuðningur,
álag, fyrirbærafræðiAim: The purpose of the study was to increase knowledge and
deepen understanding of the experience of young assistant nurse
managers that belong to the Y-generation (born 1980–2000), of
their management work.
Method: In this phenomenological study nine young assistant
nurse managers were interviewed once or twice, in total of 12 interviews.
Results: “I somehow have the ambition to the maximum” is the
overarching theme of the study and describes well the energized
ambition that characterized the participants. There were three
main themes, “I saw more advantages than disadvantages”: motivating factors, “projects are innumerable somehow”: hindering
factors and “I want to be accessible, but this is also a distraction”:
compromized privacy. Participants experienced great opportunities in being assistant nurse managers, which they found an enjoyable role but also challenging and stressful. Their roles were
poorly defined and it was noticeable how little job integration and
support they received, which increased their stress. Many participants were beginning to feel exhausted because of the numerous
tasks they were responsible for and were not given enough time
during working-hours to perform. The tasks were often completed
at home which disrupted the work-life balance important for the
participants. Some participants experienced ageism and felt that
staff members allowed themselves to be very critical towards them
and even rude after they took up the position of assistant nurse
managers. The participants felt they had personality traits that
helped them cope with challenging administrative roles and yet
about half of the them had developed health-related disorderssuch
as anxiety, elevated blood pressure and burnout, which can be attributed to stress.
Conclusions: It is important to provide young assistant nurse
managers with good integration and clear job description, while
also helping them to develop good coping skills to handle stress
and promote good health.
Keywords: Assistant nurse-managers, Y-generation, support,
stress, phenomenologyFélag íslenskra hjúkrunarfræðing
Which data are available in central registries on bladder cancer patients in the five Nordic countries.
No full textTo access publisher's full text version of this article click on the hyperlink belowObjective: The aim of this study was to give a collective overview on all available data sources on bladder cancer patients in the Nordic countries including the amount of detail and coverage.
Methods: National representatives from five Nordic countries were asked to fill out a questionnaire on available information regarding bladder cancer patients from databases in their respective countries. Additional information was retrieved from descriptions of the relevant registries.
Results: Non-muscle invasive bladder cancer: from all countries, information on stage and grade at transurethral resection of the bladder (TURB) could be retrieved. Details on procedures (TURB, instillation therapy, photodynamic diagnosis, and perioperative instillation) were varying within different databases. Muscle invasive bladder cancer: in all Nordic countries, detailed information on cystectomy patients could be retrieved but with variable registration of complications. Completeness of available information on oncological treatment (radiation, chemotherapy, and immunotherapy) were varying. Oncological outcome: Information on overall survival was available in all countries whereas recurrence-free survival and cancer-specific survival were available for some but not all patients depending on treatment modality.
Conclusions: Despite limitations, we found that it was possible to retrieve detailed information on diagnostics, treatment, and outcome for most aspects of bladder cancer in the Nordic countries on a population based, non-selected patient cohort.
Keywords: Bladder cancer; database; muscle invasive; non-muscle invasive; registry
Allele frequency of variants reported to cause adenine phosphoribosyltransferase deficiency.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadAdenine phosphoribosyltransferase deficiency is a rare, autosomal recessive disorder of purine metabolism that causes nephrolithiasis and progressive chronic kidney disease. The small number of reported cases indicates an extremely low prevalence, although it has been suggested that missed diagnoses may play a role. We assessed the prevalence of APRT deficiency based on the frequency of causally-related APRT sequence variants in a diverse set of large genomic databases. A thorough search was carried out for all APRT variants that have been confirmed as pathogenic under recessive mode of inheritance, and the frequency of the identified variants examined in six population genomic databases: the deCODE genetics database, the UK Biobank, the 100,000 Genomes Project, the Genome Aggregation Database, the Human Genetic Variation Database and the Korean Variant Archive. The estimated frequency of homozygous genotypes was calculated using the Hardy-Weinberg equation. Sixty-two pathogenic APRT variants were identified, including six novel variants. Most common were the missense variants c.407T>C (p.(Met136Thr)) in Japan and c.194A>T (p.(Asp65Val)) in Iceland, as well as the splice-site variant c.400 + 2dup (p.(Ala108Glufs*3)) in the European population. Twenty-nine variants were detected in at least one of the six genomic databases. The highest cumulative minor allele frequency (cMAF) of pathogenic variants outside of Japan and Iceland was observed in the Irish population (0.2%), though no APRT deficiency cases have been reported in Ireland. The large number of cases in Japan and Iceland is consistent with a founder effect in these populations. There is no evidence for widespread underdiagnosis based on the current analysis.Rare Kidney Stone Consortium, a part of the National Center for Advancing Translational Sciences (NCATS) Rare Diseases Clinical Research Network (RDCRN)
United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
NIH National Center for Advancing Translational Sciences (NCATS)
United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
Landspitali University Hospital Research Fun
Statins are associated with increased risk of squamous cell carcinoma of the skin: a whole-population study from Iceland.
No full textTo access publisher's full text version of this article click on the hyperlink belowStatins have been associated with an increased risk of keratinocyte carcinoma but data are limited and conflicting. Statins are hypothesized to contribute to KC through immunomodulation. A whole-population case-control study of the Icelandic population was conducted using the Icelandic Cancer Registry and Icelandic Prescription Medicine Register. These are high-quality registers which include all cancer diagnoses, as well as every prescription in the country. Cases included all first-time histologically confirmed diagnoses of (BCC), in situ squamous cell carcinoma (SCCis) and invasive SCC between 2003 and 2017. Each case was paired with 10 age- and sex-matched controls. Multivariate conditional logistic regression analysis was performed. Four thousand seven hundred patients with BCC, 1167 patients with SCCis and 1013 patients with invasive SCC were identified and paired with 47,292, 11,961 and 10,367 controls, respectively. Overall statin use was associated with an increased risk of invasive SCC and SCCis but not BCC (adjusted OR [95% CI]: 1.29 [1.11-1.50]; 1.43 [1.24-1.64]; 1.03 [0.95-1.12], respectively). Subgroup analysis demonstrated that statins were significantly associated with invasive SCC and SCCis in patients over 60, but not in those under 60. Atorvastatin was only associated with an increased risk of SCCis; whereas, simvastatin was associated with an increased risk of both invasive SCC and SCCis. This whole-population study of Iceland demonstrates that statin exposure is associated with increased risk of SCC, but not BCC, in a low UV environment. The reasons are unclear, but our results may suggest that individuals receiving atorvastatin and simvastatin have differing levels of baseline keratinocyte cancer risk or that properties of a statin other than 'statin intensity' affect association with SCC.
Keywords: Atorvastatin; Basal cell carcinoma; Nonmelanoma skin cancer; Simvastatin; Squamous cell carcinoma; Statins
The effects of positive and negative feedback on students‘ on-task and social behavior
No full textTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadÁhrif endurgjafar kennara á námsástundun og félagslega hegðun nemenda hafa verið viðfangsefni
fjölmargra rannsókna. Rannsóknir frá níunda áratug síðustu aldar sem hafa skoðað slík áhrif hafa
sýnt fram á að hlutfall jákvæðrar endurgjafar á námsástundun hefur oftast verið hærra en hlutfall
neikvæðrar endurgjafar á félagslega hegðun (t.d. Apter, Arnold og Swinson, 2010; Apter, 2016;
Brophy, 1981; Harrop og Swinson, 2000; Nafpaktitis, Mayer og Butterworth, 1985; White, 1975).
Markmið þessarar greinar er að fara yfir stöðu rannsókna á því hvernig yrtri endurgjöf kennara á
hegðun nemenda á aldrinum 6-16 ára er háttað í enskumælandi löndum allt frá áttunda áratug
síðustu aldar og fram til dagsins í dag. Flestir eru sammála um að álag í starfi kennara sé mikið
og til lengri tíma getur slíkt leitt til uppgjafar og kulnunar (Ninness og Glenn, 1988). Rannsóknir
hafa sýnt að nemendur á grunnskólaaldri virðast nýta tæplega helming af tíma kennslustundar
í annað en fyrirliggjandi verkefni (Fredricks, Blumenfeld og Paris, 2004; Godwin o.fl., 2016).
Rannsóknir hafa sýnt fram á að með því að auka færni kennara í jákvæðri endurgjöf hafi það
jákvæð áhrif á námsástundun (t.d. Sulla, Armenia, Eramo og Rollo, 2015 og Wheldall, Merret og
Borg, 1985). Lögmál hegðunar og náms má nýta til þess að útskýra þá hegðun sem oft birtist í
kennslustofum í samskiptum kennara og nemenda og hefur áhrif á þær breytur sem stuðla að
aukinni námsástundun og félagslega æskilegri hegðun.
Efnisorð: námsástundun, jákvæð endurgjöf, neikvæð endurgjöf, atferlisgreining, beint áhorf, félagsleg
hegðunThe effects teachers have on their students on-task and social
behavior in the classroom has been widely researched
(e.g. Apter, Arnold and Swinson, 2010; Apter, 2016;
Brophy, 1981; Harrop and Swinson, 2000; Nafpaktitis,
Mayer and Butterworth, 1985, White, 1975). This article
aims at looking at patterns in these studies and describe
what is known about the variables that affect on-task and
socially acceptable behaviors in the classroom. Research
has shown that in English-speaking countries the highest
percentage of feedback is typically positive feedback on
academic behavior, but the percentage of negative feedback
on social behavior has usually been a close second
(Apter, Arnold og Swinson, 2010; Apter, 2016; Harrop
og Swinson, 2000). In Italy the percentage of negative
feedback on behavior was higher than the percentage
of positive feedback on on-task behavior (Sulla, 2015).
Most people agree that beeing a teacher can be stressful
and it is known that being stressed and overworked for a
long period of time can lead to submission and burnout
symptoms (Ninness and Glenn, 1988). Research has
shown that students in primary and secondary schools are
often only on-task half of the time in the classroom (Fredricks,
Blumenfeld and Paris, 2004; Godwin et al., 2016).
Research has shown that giving feedback to teachers and
training them to use positive feedback with their students
results in higher rates of on-task behavior in students (e.g.,
Sulla, Armenia, Eramo and Rollo, 2015 and Wheldall,
Merret, and Borg, 1985). The research base in behavior
analysis can be useful in explaining the interaction pattern
between teachers and students often found in classrooms
and this kind of research can help us shed light on how
we can use this knowledge successfully and train teachers
in using higher rates of positive feedback.
Keywords: Observational study, natural-rates, on-task
behavior, off-task behavior, positive feedback, negative
feedback, behavior analysi
A Clinical Tool (CUE-tool) for Health Care Professionals to Assess the Usability and Quality of the Content of Medical Information Websites: Electronic Delphi Study.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: As patients are increasingly searching for information about their medical condition on the internet, there is a need for health professionals to be able to guide patients toward reliable and suitable information sources on the internet.
Objective: The aim of the study was to develop a clinical tool for health care professionals to assess the usability and quality of the content of websites containing medical information that could be recommended to patients.
Methods: A 3-round modified electronic Delphi (eDelphi) study was conducted with 20 health care professionals.
Results: In round one of the eDelphi study, of the 68 items initially created, 41 items (29 on usability and 12 on content) were rated as important or very important by more than half of the panel and thus selected for further evaluation in round two. In round two, of the 41 items chosen from round 1, 19 were selected (9 on usability and 10 on content) as important or very important by more than half of the panel for further evaluation. As a result of round three, 2 items were combined as a single item, leaving the instrument with 18 items in total (8 on usability and 10 on content). The tool is freely accessible online.
Conclusions: The CUE-tool can be used to (1) evaluate the usability and reliability of the content of websites before recommending them to patients as a good information source; (2) identify websites that do not have reliable content or may be difficult for patients to use; (3) develop quality websites by using the criteria in the CUE-tool; and (4) identify different qualities between different websites.
Keywords: apps; eDelphi; internet; self-care; smartphone; websites
Tumor co-expression of progranulin and sortilin as a prognostic biomarker in breast cancer.
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: The growth factor progranulin has been implicated in numerous biological processes such as wound healing, inflammation and progressive tumorigenesis. Both progranulin and its receptor sortilin are known to be highly expressed in subgroups of breast cancer and have been associated with various clinical properties including tamoxifen resistance. Recent data further suggest that progranulin, via its receptor sortilin, drives breast cancer stem cell propagation in vitro and increases metastasis formation in an in vivo breast cancer xenograft model. In this retrospective biomarker analysis, we aimed to determine whether tumor co-expression of progranulin and sortilin has prognostic and treatment predictive values for breast cancer patients.
Methods: We explored how co-expression of progranulin and sortilin was associated with established clinical markers by analyzing a tissue microarray including 560 randomized premenopausal breast cancer patients receiving either 2 years of tamoxifen treatment or no adjuvant treatment, with a median follow-up time of 28 years. Breast cancer-specific survival was analyzed using Kaplan-Meier and Cox Proportional Hazards regression models to assess the prognostic and predictive value of progranulin and sortilin in relation to known clinical markers.
Results: Co-expression of progranulin and sortilin was observed in 20% of the breast cancer samples. In untreated patients, prognostic considerations could be detailed separately from treatment prediction and the high progranulin and sortilin expressing subgroup was significantly associated with breast cancer-specific death in multivariable analyses (HR=2.188, CI: 1.317-3.637, p=0.003) along with tumor size, high tumor grade and lymph node positivity. When comparing the untreated patients with tamoxifen treated patients in the ERα positive subgroup, co-expression of progranulin and sortilin was not linked to tamoxifen resistance.
Conclusion: Data suggest that co-expression of progranulin and its receptor sortilin is a novel prognostic biomarker combination identifying a highly malignant subgroup of breast cancer. Importantly, this subpopulation could potentially be targeted with anti-sortilin based therapies.
Keywords: Biomarker; Breast cancer; Cancer stem cells; Estrogen receptor; Predictive; Prognostic; Progranulin; Sortilin; Tamoxifen; Targeted therapy.Assar Gabrielssons Research Foundation
Swedish Cancer Foundation
Swedish Research Council
European Commission
Swedish government
Swedish county councils, the ALF
716321
BioCARE National Strategic Research Program at University of Gothenburg
University of Gothenbur
Is it a challenge for the Minister to stand with Landspitali – The National University Hospital?
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Faghópur í gjörgæsluhjúkrun. Rannveig Jóna Jónsdóttir, sérfræðingur í gjörgæsluhjúkrun.
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Engum er hjúkrað ef enginn hjúkrar: stóra vandamál stjórnandans að tryggja faglega mönnun til framtíðar
Get PDFTo access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadAð viðhalda mönnun, tryggja að fólkið á gólfinu njóti öryggis
í starfi og hafi tækifæri til að veita faglega og viðunandi
heilbrigðisþjónustu er á meðal mikilvægustu viðfangsefna
stjórnenda í heilbrigðiskerfinu. Tilgangur þessarar greinar
er að skoða mannaflaspár til framtíðar, hvaða þættir valda
álagi á hjúkrunarfræðinga og hver framtíð þeirra er.
Leitað var að heimildum og rannsóknum í leitarvélum
Pubmed, EbscoHost, Google scholar, Scopus, Web of
science, ProQuest og Leitir.is. Leitarorð voru m.a. nurse,
patient care, quality of care, insufficient og patient ratings.
Niðurstöður sýndu að mönnun er ábótavant um allan
heim. Á Íslandi, sérstaklega eftir efnahagshrunið og nú enn
fremur í tengslum við covid-19-faraldurinn, hefur nýliðun
hjúkrunarfræðinga verið of lítil. Laun hjúkrunarfræðinga
voru talin of lág miðað við álag í starfi. Mikil undirmönnun
er á vaktalínum, starfsfólk er sent á milli eininga og hlutfall
erlends vinnuafls og starfsfólks í gegnum starfsmannaleigur
hefur hækkað. Hlutfallslega fleiri hjúkrunarfræðingar og
stjórnendur finna fyrir kulnun í starfi. Með hækkandi lífaldri
fólks munu körfur á gott heilbrigðiskerfi aukast þar sem þörf
verður fyrir sífellt flóknari meðferð. Eins og staðan er í dag
er vöntun á heilbrigðisstarfsfólki og mun eftirspurnin aukast
á komandi árum. Því má segja að heilbrigði og vellíðan fólks
sé í hættu ef ekki tekst að ráða bót á mönnunarvandanum.
Stjórnvöld verða að taka málið föstum tökum og
innleiða stefnu sem stuðlar að því að gera starfsumhverfi
hjúkrunarfræðinga eftirsóknarvert, auka menntunarstig og
tryggja öryggi og bæta kjör. Stytting vinnuvikunnar gæti
dregið úr álagi en gæti líka aukið álag ef ekki er bætt úr
grunnmönnun því annars verður meira álag á þá sem eru á
staðnum