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- Berg, Anne Ingeborg, 1973, et al.
(författare)
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Living with stable MCI: Experiences among 17 individuals evaluated at a memory clinic.
- 2013
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Ingår i: Aging & mental health. - : Informa UK Limited. - 1364-6915 .- 1360-7863. ; 17:3, s. 293-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Mild cognitive impairment (MCI) is a state of mildly impaired cognitive functioning but with an intact capability of performing basic daily activities. Few studies have targeted personal narratives from persons living with MCI, the major focus in this study is directed to methods for better predictions of the likelihood for conversion to dementia. This study directly explores experiences among individuals who have lived with MCI over seven years without converting to dementia. Methods: Seventeen individuals, who had been diagnosed with MCI across four occasions over a seven-year period at a memory clinic, were interviewed at a single occasion about their experiences of living with MCI, life events, stress, coping, psychosocial resources, and lifestyle behaviors. Results: Thematic analysis of the transcripts of the interviews resulted in themes revolving around the life situation and events related to the first visit at the memory clinic, coping with lower cognitive capacity with the aim of enhancing quality of life, and worries about dementia and further cognitive deteriorations. Conclusion: The participants' experiences of living with MCI indicate that issues and changes in life situations such as long-term stress, retirement, loss of relatives, perceived heritability of dementia, needs to be understood in the context of the individual's understanding and interpretation of their everyday cognitive functioning. Also, supportive long-term contacts with the specialist care unit were vital for creating a personal understanding of MCI. Addressing the intra-personal dynamics of cognitive functioning in the boundary between normal and pathological cognitive aging can also improve diagnostic accuracy.
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- Bostrom, Anne-Marie, et al.
(författare)
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Factors associated with evidence-based practice among registered nurses in Sweden : a national cross-sectional study
- 2013
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation.Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models.Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0).Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.
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- Dinsmore, Kerry, et al.
(författare)
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Contrasting CO2 concentration discharge dynamics in headwater streams : a multi-catchment comparison
- 2013
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Ingår i: Journal of Geophysical Research-Biogeosciences. - : American Geophysical Union (AGU). - 2169-8953 .- 2169-8961. ; 118:2, s. 445-461
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Tidskriftsartikel (refereegranskat)abstract
- Aquatic CO2 concentrations are highly variable and strongly linked to discharge, but until recently, measurements have been largely restricted to low-frequency manual sampling. Using new in situ CO2 sensors, we present concurrent, high-frequency (<30 min resolution) CO2 concentration and discharge data collected from five catchments across Canada, UK, and Fennoscandinavia to explore concentration-discharge dynamics; we also consider the relative importance of high flows to lateral aquatic CO2 export. The catchments encompassed a wide range of mean CO2 concentrations (0.73–3.05 mg C L−1) and hydrological flow regimes from flashy peatland streams to muted outflows within a Finnish lake system. In three of the catchments, CO2 concentrations displayed clear bimodal distributions indicating distinct CO2 sources. Concentration-discharge relationships were not consistent across sites with three of the catchments displaying a negative relationship and two catchments displaying a positive relationship. When individual high flow events were considered, we found a strong correlation between both the average magnitude of the hydrological and CO2 response peaks, and the average response lag times. An analysis of lateral CO2 export showed that in three of the catchments, the top 30% of flow (i.e., flow that was exceeded only 30% of the time) had the greatest influence on total annual load. This indicates that an increase in precipitation extremes (greater high-flow contributions) may have a greater influence on the flushing of CO2 from soils to surface waters than a long-term increase in mean annual precipitation, assuming source limitation does not occur.
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- Kajermo Nilsson, Kerstin, et al.
(författare)
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The BARRIERS scale - the barriers to research utilization scale : A systematic review
- 2010
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Ingår i: Implementation Science. - : Springer Science and Business Media LLC. - 1748-5908. ; 5, s. 32-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A commonly recommended strategy for increasing research use in clinical practice is to identify barriers to change and then tailor interventions to overcome the identified barriers. In nursing, the BARRIERS scale has been used extensively to identify barriers to research utilization.AIM AND OBJECTIVES: The aim of this systematic review was to examine the state of knowledge resulting from use of the BARRIERS scale and to make recommendations about future use of the scale. The following objectives were addressed: To examine how the scale has been modified, to examine its psychometric properties, to determine the main barriers (and whether they varied over time and geographic locations), and to identify associations between nurses' reported barriers and reported research use.METHODS: Medline (1991 to September 2009) and CINHAL (1991 to September 2009) were searched for published research, and ProQuest(R) digital dissertations were searched for unpublished dissertations using the BARRIERS scale. Inclusion criteria were: studies using the BARRIERS scale in its entirety and where the sample was nurses. Two authors independently assessed the study quality and extracted the data. Descriptive and inferential statistics were used.RESULTS: Sixty-three studies were included, with most using a cross-sectional design. Not one study used the scale for tailoring interventions to overcome identified barriers. The main barriers reported were related to the setting, and the presentation of research findings. Overall, identified barriers were consistent over time and across geographic locations, despite varying sample size, response rate, study setting, and assessment of study quality. Few studies reported associations between reported research use and perceptions of barriers to research utilization.CONCLUSIONS: The BARRIERS scale is a nonspecific tool for identifying general barriers to research utilization. The scale is reliable as reflected in assessments of internal consistency. The validity of the scale, however, is doubtful. There is no evidence that it is a useful tool for planning implementation interventions. We recommend that no further descriptive studies using the BARRIERS scale be undertaken. Barriers need to be measured specific to the particular context of implementation and the intended evidence to be implemented.
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- Lawlor, B., et al.
(författare)
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NILVAD protocol: A European multicentre double-blind placebo-controlled trial of nilvadipine in mild-to-moderate Alzheimer's disease
- 2014
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Ingår i: BMJ Open. - : BMJ Publishing Group. - 2044-6055. ; 4:10
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: This study is a European multicentre, randomised, double-blind, placebo-controlled trial investigating the efficacy and safety of nilvadipine as a disease course modifying treatment for mild-to-moderate Alzheimer's disease (AD) in a phase III study that will run for a period of 82 weeks with a treatment period of 78 weeks. Methods and analysis: Adult patients, males and females over 50 years with mild-to-moderate AD as defined by the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's disease and Related Disorders Association (NINCDSADRDA) criteria, will be included in the study. It aims to recruit a total of 500 patients with AD; 250 in the nilvadipine group and 250 in the placebo group. Participants will be randomised to receive nilvadipine, an 8 mg overencapsulated, sustained release capsule, or a matching overencapsulated placebo (sugar pill) for a period of 78 weeks of treatment. The primary efficacy outcome measure in this study is the change in cognitive function as assessed by the Alzheimer's disease Assessment Scale (ADASCog 12) from baseline to the end of treatment duration (78 weeks). There are two key secondary outcome measures, the Clinical Dementia Rating Scale Sum of Boxes (CDRsb) and the Disability Assessment for Dementia (DAD). If a statistically significant effect is seen in the primary outcome, CDRsb will be considered to be a coprimary end point and only the DAD will contribute to the secondary outcome analysis. Ethics and dissemination: The study and all subsequent amendments have received ethical approval within each participating country according to national regulations. Each participant will provide written consent to participate in the study. All participants will remain anonymised throughout and the results of the study will be published in an international peerreviewed journal. Trial registration number EUDRACT Reference Number: 201200276427.
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