Faktorer som har betydelse för välbefinnande hos individer med KOL : - en litteraturstudie

Abstrakt Bakgrund: Kronisk obstruktiv lungsjukdom (KOL) är en kronisk inflammatorisk sjukdom där tobaksröken är den främsta orsaken till uppkomsten. Det är en sjukdom som ofta utvecklas under lång tid innan den uppmärksammas och den har en dödlig utgång. Syfte: Denna litteraturstudies syfte var att belysa faktorer av betydelse för välbefinnandet hos individer med KOL, se vilka copingstrategier de använder sig av, samt vad sjuksköterskan kan göra för att stödja dessa individer. Metod: Litteraturstudien baserades på 19 internationellt publicerade vetenskapliga studier. Innehållsanalysen ledde fram till sju teman. Resultat: Fynden i denna litteraturstudie visar att faktorer som att klara saker själv och socialt stöd hade en positiv inverkan på välbefinnandet. Med copingstrategier som att ha en positiv attityd, ta hjälp av professionella, ta kontroll och fokusera på andra saker kunde individen känna välbefinnande trots sin sjukdom. Det var viktigt att sjuksköterskan hade kunskap inom området och ett professionellt förhållningssätt. Slutsats: Om sjuksköterskan ger relevant information och stödjer dessa patienter i ett tidigt skede, kan individen känna välbefinnande trots sin sjukdom. Vidare forskning inom området med fokus på hur anhöriga påverkas av sjukdomen skulle vara intressant.

Motivationsutbildning som påverkansfaktor av livskvalitet – några elevers upplevelser

På en Folkhögskola finns en motivationsutbildning som vänder sig till tjejer som av olika orsaker har varit borta från studier och arbetsmarknad under lång tid. Syftet med denna undersökning var att undersöka huruvida motivationsutbildningen påverkade några elevers livskvalitet vad gäller upplevelsen av självbestämmande, förmågan att göra sina egna val och ett psykiskt välbefinnande. En kvalitativ metod användes. Jag har gjort en tolkande och reflexiv undersökning i form av en gruppintervju med nuvarande studiegrupp. Det genomfördes också fem telefonintervjuer med elever som avslutat utbildningen. Min tolkning av helheten av såväl telefonintervjuerna som gruppintervjun, var att utbildningen har haft en påverkan på både nuvarande och tidigare elevers upplevelse av självbestämmande, förmågan att göra sina egna val och förbättrat deras psykiska välbefinnande och att dessa personers livskvalitet har påverkats av utbildningen.

Isolation and identification of molecular partners of the proteins encoded by the Drosophila tumor suppressor gene lethal(2)tumorous imaginal discs

Ziel dieser Arbeit war es, die funktionelle Bedeutung des Drosophila melanogaster tumor suppressor Gens lethal(2)tumorous imaginal discs (l(2)tid) durch die Identifikation von molekularen Partnern der vom Gen kodierten Proteine zu etablieren. Mit dem Screening einer Expressionsbibliothek mittels des Hefe-Di-Hybrid-Systems wurde das Protein Patched (Ptc) als ein neues Tid-bindendes Protein identifiziert. Ptc ist ein Zentralregulator der Hedhehog-Signalkette. Diese ist in der Entwicklung konserviert und in manchen humanen Krebsarten verwickelt. Die Tid/Ptc-Interaktion wurde mittels unabhängigen biochemischen Methoden wie dem GST-pulldown-Test oder der Immunopräzipitation überprüft. Außerdem ergaben funktionelle Studien in tumorosen Imaginalscheiben einen möglichen inhibitorischen Effekt von Tid über die Hh Signaltransduktion.Im letzten Teil dieser Arbeit wurde die Interaktion zwischen Tid und dem E-APC-Protein (Adenomatous polyposis coli) bewiesen. Polakis und seine Gruppe zeigten durch Studien mit dem Hefe-Di-Hybrid-System und in vitro, dass das hTid mit dem APC-Protein interagiert. Um dies auch auf Drosophila-Ebene zu überprüfen, wurden Immunopräzipitation-Studien mit den Drosophila-Gegenstücken durchgeführt. Diese Studien zeigen zum ersten Mal eine direkte Interaktion beider Proteine in vivo.

Combined meropenem and linezolid as a systemic treatment for postoperative endophthalmitis

PURPOSE The aim of this study was to evaluate the antibiotic treatment of postoperative endophthalmitis with combined systemic meropenem and linezolid. METHODS A retrospective analysis of endophthalmitis treated with systemic meropenem and linezolid compared to conventional systemic antibiotics by evaluation of outcome and adverse effects was carried out. RESULTS 26 patients with unilateral postoperative endophthalmitis with a systemic combination regimen of meropenem (2 g TID, mean duration of treatment 5.5 days) and linezolid (600 mg BID, mean duration of treatment 8.9 days) (group 1, mean follow-up time 140 days) were included in this study and compared to 45 postoperative endophthalmitis patients treated with conventional systemic antibiotics (group 2; mean follow-up time 320 days). In group 1, 69.2 % of eyes additionally received intravitreal amikacin and vancomycin (vs. 24.4 % in group 2; p < 0.001), in 92.3 % pars plana vitrectomy was performed (vs. 68.9 % in group 2, p = 0.047). Mean best corrected visual acuity improved from a baseline of 1.76 logMar for group 1 and 1.83 logMar for group 2 to 0.91 logMar (p = 0.0001) and 0.90 logMar (p < 0.0001), respectively, at the end of the follow-up, revealing no significant differences between the two groups at any time point (p > 0.05). Ocular complications were observed in 34.6 % of eyes in group 1 (vs. 37.8 % in group 2; p > 0.05). Adverse drug effects occurred significantly more frequently in group 1 (26.9 % vs. 4.4 % p = 0.02). CONCLUSION In spite of the reported better penetration through the blood-ocular barrier and the broader antibacterial spectrum of meropenem and linezolid, no benefit in outcome was found in the present study. In contrast, adverse effects and costs of the combination regimen were significantly higher.

Impact of enterococcal colonization and infection in solid organ transplantation recipients from the Swiss Transplant Cohort Study

BACKGROUND: The burden of enterococcal infections has increased over the last decades with vancomycin-resistant enterococci (VRE) being a major health problem. Solid organ transplantation is considered as a risk factor. However, little is known about the relevance of enterococci in solid organ transplantation recipients in areas with a low VRE prevalence. METHODS: We examined the epidemiology of enterococcal events in patients followed in the Swiss Transplant Cohort Study between May 2008 and September 2011 and analyzed risk factors for infection, aminopenicillin resistance, treatment, and outcome. RESULTS: Of the 1234 patients, 255 (20.7%) suffered from 392 enterococcal events (185 [47.2%] infections, 205 [52.3%] colonizations, and 2 events with missing clinical information). Only 2 isolates were VRE. The highest infection rates were found early after liver transplantation (0.24/person-year) consisting in 58.6% of Enterococcus faecium. The highest colonization rates were documented in lung transplant recipients (0.33/person-year), with 46.5% E. faecium. Age, prophylaxis with a betalactam antibiotic, and liver transplantation were significantly associated with infection. Previous antibiotic treatment, intensive care unit stay, and lung transplantation were associated with aminopenicillin resistance. Only 4/205 (2%) colonization events led to an infection. Adequate treatment did not affect microbiological clearance rates. Overall mortality was 8%; no deaths were attributable to enterococcal events. CONCLUSIONS: Enterococcal colonizations and infections are frequent in transplant recipients. Progression from colonization to infection is rare. Therefore, antibiotic treatment should be used restrictively in colonization. No increased mortality because of enterococcal infection was noted

Combination therapy for multidrug-resistant cytomegalovirus disease

Multidrug-resistant (MDR) cytomegalovirus (CMV) emerged after transient responses to ganciclovir, foscarnet, and cidofovir in a CMV-seropositive recipient who underwent allogeneic hematopoietic stem cell transplantation from a CMV-seronegative donor. Experimental treatments using leflunomide and artesunate failed. Re-transplantation from a CMV-seropositive donor supported by adoptive transfer of pp65-specific T cells and maribavir was followed by lasting suppression. This case illustrates that successful MDR CMV therapy may require individualized multidisciplinary approaches. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Predictors of benzodiazepine self -administration behavior in anxious patients

The purpose of this study was to examine factors that may be associated with benzodiazepine (BZ) self-administration and risks of dependence in anxious patients. Preliminary work included examination of psychosocial characteristics and subjective drug response as potential predictors of medication use. Fifty-five M, F patients with generalized anxiety or panic disorder participated in a 3-week outpatient Choice Procedure in which they self-medicated “as needed” with alprazolam (Alz) and placebo. Findings showed that a large amount of variance in alprazolam preference, frequency, and quantity of use could be predicted by measures of anxiety, drug liking, and certain personality characteristics. The primary study extended this work by examining whether individual differences in Alz sensitivity also predict patterns of use. Twenty anxious patients participated in the study, which required 11 weekly clinic visits. Ten of these also participated in a baseline assessment of HPA-axis function that involved 24-hour monitoring of cortisol and ACTH levels and a CRH Stimulation Test. This assessment was conducted on the basis of prior evidence that steroid metabolites exert neuromodulatory effects on the GABA A receptor and that HPA-axis function may be related to BZ sensitivity and long-term disability in anxious patients. Patients were classified as either HIGH or LOW users based on their p.r.n. patterns of Alz use during the first 3 weeks of the study. They then participated in a 4-week dose response trial in which they received prescribed doses of medication (placebo, 0.25, 0.5, and 1.0mg Alz), each taken TID for 1 week. The dose response trial was followed by a second 3-week Choice Procedure. Findings were not indicative of biological differences in Alz sensitivity between the HIGH and LOW users. However, the HIGH users had higher baseline anxiety and greater anxiolytic response to Alz than the LOW users. Anxiolytic benefits of p.r.n. and prescribed dosing were shown to be comparable, and patients' conservative patterns of p.r.n. medication use were not affected by the period of prescribed dosing. Although there was not strong evidence to suggest relationships between HPA-axis function and Alz use or sensitivity, interesting findings emerged about the relationship between HPA-axis function and anxiety. ^

Th and U isotopes, dose rates and ages of marine shells and sediment of core GIK14350, north Germany

The ESR dating method was applied to marine shells taken from a sediment core from Dagebüll, Schleswig-Holstein. Four samples from two different depths of the core (17.5 m and 25-26 m), separated by a 2.76 meter thick clay layer (Turritella Clay), yielded identical ages within the limits of error. They indicated an assignment to the oxygen isotope stage 5, thus confirming the stratigraphic age. In addition, the ESR-ages confirm the interpretation of Lomitschka et al. (1997, doi:10.2312/meyniana.1997.49.85), that the Th/U-ages of shells below the clay layer are reliable, whereas shells located above the clay layer, which were strongly influenced by percolating groundwaters of an open system, yielded falsified Th/U-ages.

(Table 1) Observations of bowhead whales (Balaena mysticetus) in the Svalbard area 1940-2008

Forty-six sightings of bowhead whales have been reported from the Svalbard area between 1940 and 2009. But, only three of these sightings are reported prior to 1980. Most observations involve only one or two whales, but groups of up to seven individuals have been seen recently. Increased ship traffic, particularly cruise-based tourism, in the north undoubtedly provides more opportunities for spotting this species, and the establishment of a structured cetacean sighting programme, as well as increase in effort in documenting sightings from a wider marine user-community, likely all play a role in more records being documented in recent years. The absence of a dedicated monitoring programme for ice-associated cetaceans and the generally low scientific activity level in this field in Svalbard Waters hampers firm conclusions about the trends in abundance of bowhead whales in the Svalbard area.

Longitudinal Changes in Response to a Cycle-Run Field Test of Young Male National "Talent identification" and Senior Elite Triathlon Squads.

This study investigated the changes in cardiorespiratory response and running performance of 9 male ?Talent Identification? (TID) and 6 male Senior Elite (SE) Spanish National Squad triathletes during a specific cycle-run test. The TID and SE triathletes (initial age 15.2±0.7 vs. 23.8±5.6 years, p=0.03; tests through the competitive period and the preparatory period, respectively, of two consecutive seasons: Test 1 was an incremental cycle test to determine the ventilatory threshold (Thvent); Test 2 (C-R) was 30 min constant load cycling at the Thvent power output followed by a 3-km time trial run; and Test 3 (R) was an isolated 3-km time trial control run, in randomized counterbalanced order. In both seasons the time required to complete the C-R 3-km run was greater than for R in TID (11:09±00:24 vs. 10:45±00:16 min:ss, pmenor que 0.01; and 10:24±00:22 vs. 10:04±00:14, p=0.006, for season 2005/06 and 2006/07, respectively) and SE (10:15±00:19 vs. 09:45±00:30, pmenor que 0.001 and 09:51±00:26 vs. 09:46±00:06, p= 0.02 for season 2005/06 and 2006/07, respectively). Compared to the first season, completion of the time trial run was faster in the second season (6.6%, pmenor que 0.01 and 6.4%, pmenor que 0.01, for C-R and R test, respectively) only in TID. Changes in post-cycling run performance were accompanied by changes in pacing strategy but only slight or non-significant changes in the cardiorespiratory response. Thus, the negative effect of cycling on performance may persist, independently of the period, over two consecutive seasons in TID and SE triathletes; however A improvements over time suggests that monitoring running pacing strategy after cycling may be a useful tool to control performance and training adaptations in TID. O2max 77.0±5.6 vs. 77.8±3.6 mL·kg-1·min-1, NS) underwent three TE D EP C C

Fuente de Alimentación para los Imanes Superconductores del Acelerador de Partículas Europeo XFEL

En este artículo se presenta la fuente de alimentación que se está diseñando para alimentar los imanes superconductores del acelerador de partículas europeo XFEL que se está construyendo en Hamburgo, cuyas características le hacen el más avanzado del mundo. Un imán superconductor es una carga muy inductiva que debe ser controlada en corriente y que presenta una caída de tensión muy baja cuando está en modo superconductor. La fuente debe ser capaz de alimentar esta carga con una alta fiabilidad e incorporar varias protecciones que protejan esta carga tan especial.

Systematic Method to Assess Small-Signal Stability of DC-Distributed Power-System-Architecture

The objective of this paper is to present a simplified method to analyze small-signal stability of a power system and provide performance metrics for stability assessment of a given power-system-architecture. The stability margins are stated utilizing a concept of maximum peak criteria (MPC), derived from the behavior of an impedance-based sensitivity function that provides a single number to state the robustness of the stability of a well-defined minor-loop gain. For each minor-loop gain, defined at every system interface, the robustness of the stability is provided as a maximum value of the corresponding sensitivity function. Typically power systems comprise of various interfaces and, therefore, in order to compare different architecture solutions in terms of stability, a single number providing an overall measure of the whole system stability is required. The selected figure of merit is geometric average of each maximum peak value within the system, combined with the worst case value of system interfaces.

A built-in CMOS Total Ionization Dose smart sensor

Total Ionization Dose (TID) is traditionally measured by radiation sensitive FETs (RADFETs) that require a radiation hardened Analog-to-Digital Converter (ADC) stage. This work introduces a TID sensor based on a delay path whose propagation time is sensitive to the absorbed radiation. It presents the following advantages: it is a digital sensor able to be integrated in CMOS circuits and programmable systems such as FPGAs; it has a configurable sensitivity that allows to use this device for radiation doses ranging from very low to relatively high levels; its interface helps to integrate this sensor in a multidisciplinary sensor network; it is self-timed, hence it does not need a clock signal that can degrade its accuracy. The sensor has been prototyped in a 0.35μm technology, has an area of 0.047mm2, of which 22% is dedicated to measuring radiation, and an energy per conversion of 463pJ. Experimental irradiation tests have validated the correct response of the proposed TID sensor.

Study of zinc protein ligands in a halophilic enzyme

Glucose dehydrogenase (EC 1.1.1.47) from the halophilic Archaeon Haloferax mediterranei belongs to the medium-chain alcohol dehydrogenase superfamily and requires a zinc ion for catalysis. The zinc ion is coordinated by a histidine, a water molecule and two other ligands from the protein or the substrate, which vary during the catalytic cycle of the enzyme. In many enzymes of this superfamily one of the zinc ligands is commonly cysteine, which is replaced by an aspartate residue at position 38 in the halophilic enzyme. This change has been only observed in glucose dehydrogenases from extremely halophilic microorganisms belonging to the Archaea Domain. This paper describes biochemical studies and structural comparisons to analyze the role of sequence differences between thermophilic and halophilic glucose dehydrogenases which contain a zinc ion within the protein surrounded by three ligands. Whilst the catalytic activity of the D38C GlcDH mutant is reduced, its thermal stability is enhanced, consistent with the greater structural similarity between this mutant and the homologous thermophilic enzyme from Thermoplasma acidophilum.

Administrative Capacity for Effective Implementation of EU Law

Article 197 of the Treaty on the Functioning of the European Union stipulates that effective implementation of Union law by the Member States shall be regarded as a matter of common interest. This article considers how Member States may improve their administrative capacity to apply EU law effectively. A law or policy is effectively implemented when it can be confirmed that its objectives, targets or results are actually achieved. It is proposed that effective implementation in the EU is a ‘collaborative project’. This is not only because Member States benefit when others correctly implement common rules, but also because they learn from the experiences of other Member States. It follows that the public authorities responsible for implementation of EU law need to benchmark their performance against that of their peers in other Member States and therefore need to develop the institutional capacity for assessing and adjusting their own performance.