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I lost a part of myself and felt like I did not belong to the midwifery community: Midwives experience of quit working on labour ward after attending traumatic childbirth
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 DownloadAlvarleg atvik í starfi geta haft neikvæð áhrif á líðan
ljósmæðra og rannsóknir hafa sýnt að ljósmæður
sem upplifa slíkt eru líklegri til að hverfa frá störfum
heldur en þær sem hafa ekki lent í slíkum atvikum.
Tilgangur rannsóknarinnar var að afla upplýsinga
um upplifun ljósmæðra af því að hætta störfum
við fæðingar í kjölfar þess að þær upplifa alvarlegt
atvik í starfi. Rannsóknarspurningarnar voru tvær;
hver er upplifun ljósmæðra af því að hætta störfum við fæðingar í kjölfar alvarlegs atviks í starfi og
hver var upplifun ljósmæðra af veittum stuðningi í
kjölfar alvarlegs atviks í starfi? Rannsóknarsniðið var
eigindlegt og stuðst var við aðferð Vancouver-skólans í fyrirbærafræði. Þátttakendur voru valdir með
tilgangsúrtaki. Tekin voru 12 viðtöl við sjö ljósmæður, eitt til tvö viðtöl við hverja þeirra með opnum
viðtalsramma. Greind voru þemu út frá frásögnum
ljósmæðranna og varð yfirþema rannsóknarinnar
nefnt; þetta lifir með manni, alltaf. Meginþemu voru
sjö það er: stuðningur eða stuðningsleysi; ekki nógu
sterk til að standa með sjálfri mér; að missa hluta af
sjálfum sér eða verða maður sjálfur á ný; tækifæri til
að læra; aðstæður og fyrri reynsla spilar inn í uppRitrýnd fræðigrein, tengiliður: inga@unak
I lost a part of myself and felt like I did not belong to the midwifery community:
Midwives experience of quit working on labour ward after
attending traumatic childbirth
49
lifunina; endalaust álag í vinnu fer illa með mann og
áfallið og áhrifin þegar frá líður. Meginniðurstöður
rannsóknarinnar eru að þátttakendur upplifðu sig
eina í áfallinu, stuðningurinn var takmarkaður og
álag á vinnustað yfirþyrmandi. Alvarlegu atvikin
höfðu bæði áhrif á andlega og líkamlega líðan ljósmæðranna. Þær upplifðu höfnun, skort á skilningi
og jafnvel að hafa misst hluta af sjálfum sér, en aðrar
sögðu að reynsla hefði þrátt fyrir allt þroskað þær.
Að yfirgefa starf sitt í kjölfar alvarlegs atviks í starfi
hefur gríðarleg áhrif á líf og líðan ljósmæðra. Skapa
þarf styðjandi og hvetjandi umhverfi fyrir ljósmæður
sem upplifa áföll í starfi og gefa rými til úrvinnslu
og bata.
Lykilhugtök: Ljósmæður, alvarleg atvik, stuðningur, áföll, fyrirbærafræði.Midwives who work at delivery wards and experience serious incidents during childbirth are
more likely to leave their profession than those who
have not experienced such incidents. Furthermore,
support after experiencing a serious incident
during work can improve their wellbeing and speed
up their recovery. The purpose of this study was to
investigate how midwives experience leaving their
profession following a serious incident during birth.
The research questions were two; What is midwives experience of quitting their job as a midwife
at labour wards after serious incident and what is
midwives’ experiences of support after experience
such incident. The research design was qualitative,
using the Vancouver-School of Doing Phenomenology-method. Seven midwives, chosen by purposeful sample and snowball sample, were interviewed once or twice each by use of a non-structured
interview in a total of twelve interviews. The main
theme identified was named; It stays with you forever. There were seven themes; Support or the lack
thereof; too weak to stand up for myself; to lose a
part of oneself or become yourself again; a learning
opportunity; previous experiences have an effect;
never ending pressure has an effect and the shock
and the impact. The main results are that participants felt alone during the traumatic event, support
was limited and workplace stress was overwhelming. The traumatic event had an effect on both
their mental and physical health. They experienced
rejection and a lack of understanding but some
of them were able to use the events for personal
development while others felt like they lost a part
of themselves. Leaving their profession following
a serious incident has a tremendous impact on the
lives and wellbeing of midwives. A supportive and
encouraging environment for those midwives is
important and they need space to process and to
heal after such an incidence.
Key words: Midwives, serious incidents, support,
traumatic events, phenomenology
Body weight changes and longitudinal associations with cognitive decline among community-dwelling older adults.
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 DownloadIntroduction: We aim to investigate the longitudinal associations between changes in body weight (BW) and declines in cognitive function and risk of mild cognitive impairment (MCI)/dementia among cognitively normal individuals 65 years or older.
Methods: Data from the Age Gene/Environment Susceptibility-Reykjavik Study (AGES-Reykjavik Study) including 2620 participants, were examined using multiple logistic regression models. Cognitive function included speed of processing (SP), executive function (EF), and memory function (MF). Changes in BW were classified as; weight loss (WL), weight gain (WG), and stable weight (SW).
Results: Mean follow-up time was 5.2 years and 61.3% were stable weight. Participants who experienced WL (13.4%) were significantly more likely to have declines in MF and SP compared to the SW group. Weight changes were not associated with EF. WL was associated with a higher risk of MCI, while WG (25.3%) was associated with a higher dementia risk, when compared to SW.
Discussion: Significant BW changes in older adulthood may indicate impending changes in cognitive function.
Keywords: APOE ε4; body weight changes; cognitive function; dementia; executive function; memory function; mild cognitive impairment; nutrition; speed of processing.Foundation of St. Josefs Hospital
Icelandic Gerontological Research Center, National Universit
NAC blocks Cystatin C amyloid complex aggregation in a cell system and in skin of HCCAA patients.
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 DownloadHereditary cystatin C amyloid angiopathy is a dominantly inherited disease caused by a leucine to glutamine variant of human cystatin C (hCC). L68Q-hCC forms amyloid deposits in brain arteries associated with micro-infarcts, leading ultimately to paralysis, dementia and death in young adults. To evaluate the ability of molecules to interfere with aggregation of hCC while informing about cellular toxicity, we generated cells that produce and secrete WT and L68Q-hCC and have detected high-molecular weight complexes formed from the mutant protein. Incubations of either lysate or supernatant containing L68Q-hCC with reducing agents glutathione or N-acetyl-cysteine (NAC) breaks oligomers into monomers. Six L68Q-hCC carriers taking NAC had skin biopsies obtained to determine if hCC deposits were reduced following NAC treatment. Remarkably, ~50-90% reduction of L68Q-hCC staining was observed in five of the treated carriers suggesting that L68Q-hCC is a clinical target for reducing agents.Artic Therapeutics LLC
Autonomous Community of Madrid (CAM). Spai
Reliability and Validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): Portuguese Version.
No full textTo access publisher's full text version of this article click on the hyperlink belowThis study examined the test-retest reliability, consensual, convergent and divergent validities, sensitivity, specificity, positive and negative predictive values, and accuracy of the Portuguese version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL). Eighty-nine children/adolescents (65 psychiatric outpatients and 24 healthy controls) were interviewed with K-SADS-PL and completed measures of depressive and anxiety symptoms. The child's parent/caretaker completed the Child Behavior Checklist. Good to excellent values were obtained for test-retest reliability and consensual validity. For the convergent validity, moderate correlations between the K-SADS-PL and the corresponding self-report measures were observed. Divergent validity was acceptable for the K-SADS-PL diagnoses. The lowest values of sensitivity, specificity, and accuracy of the K-SADS-PL were 88, 88, and 91, respectively. The Portuguese version of K-SADS-PL proved to be a valid and reliable assessment instrument for children and adolescents, and was sensitive, specific and accurate when diagnosing mood, anxiety, adjustment, and attention-deficit/hyperactivity disorders.
Keywords: Children/adolescents; K-SADS-PL; Portuguese version; Reliability; Validity
Anti-tumor necrosis factor therapy is associated with increased in situ squamous cell carcinoma of the skin: A population-based case-control study.
No full textTo access publisher's full text version of this article click on the hyperlink belo
The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans.
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 "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention.
Methods: SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites.
Results: Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate.
Conclusion: The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
Keywords: Energy intake; Nutrition counselling; Nutrition intervention; Protein intake; SPRINTT.University of Helsinki including Helsinki University Central Hospital
Innovative Medicine Initiative (IMI)
Juho Vainio foundatio
Mode of delivery was associated with transient changes in the metabolomic profile of neonates.
No full textTo access publisher's full text version of this article click on the hyperlink belowAims: To estimate potential differences in neonatal metabolomic profiles at birth and at the time of newborn screening by delivery mode.
Methods: A prospective study at Women's Clinic at Landspitali-The National University Hospital of Iceland. Women having normal vaginal birth or elective caesarean section from November 2013 to April 2014 were offered participation. Blood samples from mothers before birth and umbilical cord at birth were collected and amino acids and acylcarnitines measured by tandem mass spectrometry. Results from the Newborn screening programme in Iceland were collected. Amino acids and acylcarnitines from different samples were compared by delivery mode.
Results: Eighty three normal vaginal births and 32 elective caesarean sections were included. Mean differences at birth were higher for numerous amino acids, and some acylcarnitines in neonates born vaginally compared to elective caesarean section. Maternal blood samples and newborn screening results showed small differences that lost significance after correction for multiple testing. Many amino acids and some acylcarnitines were numerically higher in cord blood compared to maternal. Many amino acids and most acylcarnitines were numerically higher in newborn screening results compared to cord blood.
Conclusion: We observed transient yet distinct differences in metabolomic profiles between neonates by delivery mode.
Keywords: acylcarnitines; amino acids; delivery mode; metabolomic profile; newborn screening.University of Iceland Research Fun
Inhibition of KDM1A activity restores adult neurogenesis and improves hippocampal memory in a mouse model of Kabuki syndrome.
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 DownloadKabuki syndrome (KS) is a rare cause of intellectual disability primarily caused by loss-of-function mutations in lysine-specific methyltransferase 2D (KMT2D), which normally adds methyl marks to lysine 4 on histone 3. Previous studies have shown that a mouse model of KS (Kmt2d
+/βGeo
) demonstrates disruption of adult neurogenesis and hippocampal memory. Proof-of-principle studies have shown postnatal rescue of neurological dysfunction following treatments that promote chromatin opening; however, these strategies are non-specific and do not directly address the primary defect of histone methylation. Since lysine-specific demethylase 1A (LSD1/KDM1A) normally removes the H3K4 methyl marks added by KMT2D, we hypothesized that inhibition of KDM1A demethylase activity may ameliorate molecular and phenotypic defects stemming from KMT2D loss. To test this hypothesis, we evaluated a recently developed KDM1A inhibitor (TAK-418) in Kmt2d
+/βGeo
mice. We found that orally administered TAK-418 increases the numbers of newly born doublecortin (DCX)+ cells and processes in the hippocampus in a dose-dependent manner. We also observed TAK-418-dependent rescue of histone modification defects in hippocampus both by western blot and chromatin immunoprecipitation sequencing (ChIP-seq). Treatment rescues gene expression abnormalities including those of immediate early genes such as FBJ osteosarcoma oncogene (Fos) and FBJ osteosarcoma oncogene homolog B (Fosb). After 2 weeks of TAK-418, Kmt2d
+/βGeo
mice demonstrated normalization of hippocampal memory defects. In summary, our data suggest that KDM1A inhibition is a plausible treatment strategy for KS and support the hypothesis that the epigenetic dysregulation secondary to KMT2D dysfunction plays a major role in the postnatal neurological disease phenotype in KS.United States Department of Health & Human Services
National Institutes of Health (NIH) - USA
Louma G. Foundation, USA
Walter Zaitzeff Fund, USA
Icelandic Research Fund, Iceland
Takeda Pharmaceutical Company Lt
Anxiety in uncertain times
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The effect of fampridine on gait in people with Multiple sclerosis (MS)
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 DownloadINNGANGUR
Fampridín er lyf sem virkar sem kalíumgangaloki og er ætlað sjúklingum með skerta göngugetu vegna MS (Multiple Sclerosis). Með því að loka
á kalíumgöng dregur lyfið úr jónaleka, sem seinkar endurskautun og
hvetur þannig myndun hrifspennu í afmýluðum taugasímum. Erlendar
rannsóknir hafa sýnt fram á góð áhrif fampridíns á skerta göngugetu
fólks með MS. Tilgangur rannsóknarinnar var að skoða áhrif lyfsins
á göngugetu íslenskra sjúklinga með MS og athuga hve margir þeirra
halda lyfjameðferð áfram eftir tveggja vikna reynslulyfjatímabil.
EFNIVIÐUR OG AÐFERÐIR
Þátttakendur voru 41 sjúklingur með MS sem reyndu fampridín á fyrstu
16 mánuðum notkunar þess á Íslandi. Unnið var úr sjúkraskrárgögnum
Landspítala. Árangur var metinn með mælingum á gönguhraða (timed
25-foot walk, T25FW) og göngugetu (12-item multiple sclerosis walking
scale, MSWS-12).
NIÐURSTÖÐUR
Niðurstöður sýndu að marktækur munur var á gönguhraða á T25FWgönguprófinu fyrir og undir lok reynslulyfjameðferðar (p<0,0001). Meðaltalsaukning gönguhraða var 22%. Einnig reyndist marktækur munur á
stigagjöf á MSWS-12-göngumatsprófinu fyrir og undir lok reynslulyfjameðferðar (p<0,0001). Lækkun stigafjölda á MSWS-12 gönguprófinu var
að meðaltali 11,4 stig. Átján sjúklingar (43,9%) héldu lyfjameðferð áfram
eftir að reynslulyfjameðferð lauk.
ÁLYKTUN
Lyfið fampridín getur bætt skerta göngugetu hjá hluta sjúklinga með
MS og getur verið mikilvæg viðbót í einkennameðferð þeirra.INTRODUCTION: Fampridine is a drug for people with Multiple Sclerosis (MS). It is a
broad-spectrum voltage-dependent potassium channel blocker that enhances synaptic
transmission. The drug has been shown to be able to enhance conduction in demyelinated
axons, thereby leading to improved gait in patients with MS. The purpose of this study was
to examine the effect of fampridine on gait function in people with MS in the end of a 2 weeks
trial drug period and to observe how many patients continued drug therapy.
MATERIAL AND METHODS: Data from 41 individuals with MS was collected retrospectively
for this study. Measurements were administered by physiotherapists and the results from the
Timed 25-Foot Walk (T25FW) and 12-item Multiple Sclerosis Walking Scale (MSWS-12) were
obtained from medical records from The National University Hospital of Iceland.
RESULTS: The results showed a significant difference in walking speed before and at the end
of trial period (p<0.0001). The average improvement in walking speed was 22%. Results also
demonstrated a significant difference in MSWS-12 scores before and at the end of treatment
(p<0.0001). The average improvement in MSWS-12 was 11.4 points. Eighteen individuals
(43.9%) continued treatment after the trial period.
CONCLUSION: Fampridine can have a positive effect on impaired gait function in people with
MS and can be an important adjunct to treatment