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To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare.
Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration.
Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups.
Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’.
The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability.
Tomography using a focused ion beam (FIB) combined with a scanning electron microscope (SEM) is well-established for a wide range of conducting materials. However, performing FIB–SEM tomography on ion- and electron-beam-sensitive materials as well as poorly conducting soft materials remains challenging. Some common challenges include cross-sectioning artifacts, shadowing effects, and charging. Fully dense materials provide a planar cross section, whereas pores also expose subsurface areas of the planar cross-section surface. The image intensity of the subsurface areas gives rise to overlap between the grayscale intensity levels of the solid and pore areas, which complicates image processing and segmentation for three-dimensional (3D) reconstruction. To avoid the introduction of artifacts, the goal is to examine porous and poorly conducting soft materials as close as possible to their original state. This work presents a protocol for the optimization of FIB–SEM tomography parameters for porous and poorly conducting soft materials. The protocol reduces cross-sectioning artifacts, charging, and eliminates shadowing effects. In addition, it handles the subsurface and grayscale intensity overlap problems in image segmentation. The protocol was evaluated on porous polymer films which have both poor conductivity and pores. 3D reconstructions, with automated data segmentation, from three films with different porosities were successfully obtained.
This study evaluated the effects of organic agriculture manuring systems on carrot (Daucus carota) root morphology and sugar and polyacetylene content. Carrots were harvested three times per season 2006–2007 in a long-term field experiment at Skilleby research farm, Sweden. The effects of pelleted chicken manure, fresh farmyard manure and composted farmyard manure (COM) were compared against control plots left unmanured since the field experiment started in 1991. The carrots were analyzed for root size, root shape, amount of soluble sugars and amount of falcarinol-type polyacetylenes. Differences between manuring systems were found to be smaller than the variation between harvest years and harvest occasions, probably due to the grass-clover ley included in the crop rotation system. On an average for the six harvests, manuring with COM increased root length by 6% compared with fertilizing with pelleted chicken manure. Carrots fertilized with pelleted chicken manure also had 6–7% lower total soluble sugar content than carrots manured with 50 t ha−1 of composted or fresh manure. The falcarinol to total falcarinol-type polyacetylenes ratio was 15.4% in carrots manured with 50 t ha−1 of composted or fresh manure and 14.7% in carrots fertilized with pelleted chicken manure. Seasonal fluctuations in falcarinol-type polyacetylenes were more pronounced in carrots manured with fresh or composted manure than in carrots fertilized with pelleted chicken manure. The results suggest that manuring organic carrots with compost may be the most beneficial strategy, at least in systems where fertilizer is applied only once per crop rotation, whether directly to the carrot crop or in the preceding crop.
Drug release from oral pharmaceutical formulations can be modified by applying a polymeric coating film with controlled mass transport properties. Interaction of the coating film with water may crucially influence its composition and permeability to both water and drug. Understanding this interaction between film microstructure, wetting, and mass transport is important for the development of new coatings. We present a novel method for controlled wetting of polymer coating films in an environmental scanning electron microscope, providing direct visual information about the processes occurring as the film goes from dry to wet. Free films made of phase-separated blends of water-insoluble ethyl cellulose (EC) and water-soluble hydroxypropyl cellulose (HPC) were used as a model system, and the blend ratio was varied to study the effect on the water transport properties. Local variations in water transport through the EC/HPC films were directly observed, enabling the immediate analysis of the structure–mass transport relationships. The leaching of HPC could be studied by evaporating water from the films in situ. Significant differences were observed between films of varying composition. The method provides a valuable complement to the current approach of making distinct diffusion and microscopy experiments for studying the dynamic interaction of polymer films with water.
A method that enables high precision extraction of transmission electron microscope (TEM) specimens in low contrast materials has been developed. The main idea behind this work is to produce high contrast markers on both sides of and close to the area of interest. The markers are filled during the depositing of the protective layer. The marker material can be of either Pt or C depending on which one gives the highest contrast. It is thereby possible to distinguish the location of the area of interest during focused ion beam (FIB) milling and ensure that the TEM sample is extracted precisely at the desired position. This method is generally applicable and enables FIB/scanning electron microscope users to make high quality TEM specimens from small features and low contrast materials without a need for special holders. We explain the details of this method and illustrate its potential by examples from three different types of materials.
Environmental scanning electron microscopy has been extensively used for studying the wetting properties of different materials. For some types of investigation, however, the traditional ways of conducting in situ dynamic wetting experiments do not offer sufficient control over the wetting process. Here, we present a novel method for controlled wetting of materials in the environmental scanning electron microscope (ESEM). It offers improved control of the point of interaction between the water and the specimen and renders it more accessible for imaging. It also enables the study of water transport through a material by direct imaging. The method is based on the use of a piezo-driven nanomanipulator to bring a specimen in contact with a water reservoir in the ESEM chamber. The water reservoir is established by local condensation on a Peltier-cooled surface. A fixture was designed to make the experimental setup compatible with the standard Peltier cooling stage of the microscope. The developed technique was successfully applied to individual cellulose fibers, and the absorption and transport of water by individual cellulose fibers were imaged.
The experience of hope among cancer patients in palliative care is important information for healthcare providers, but research on the subject is sparse. The aim of this article was to explore how cancer patients admitted to palliative home care experienced the significance of hope and used hope during 6 weeks throughout the last phase of their life, and to assess their symptoms and hope status during 6 weeks throughout the last phase of their lives.
Eleven adult patients with cancer participated in 20 interviews and completed seven diaries. The participants were recruited from two palliative care units in the southeast of Sweden. The method used was Grounded Theory (GT), and analysis was based on the constant comparative method.
The core category, glimmering embers, was generated from four processes: (1) The creation of “convinced” hope, with a focus on positive events, formed in order to have something to look forward to; (2) The creation of “simulated hope,” including awareness of the lack of realism, but including attempts to believe in unrealistic reasons for hope; (3) The collection of and maintaining of moments of hope, expressing a wish to “seize the day” and hold on to moments of joy and pleasure; and (4) “Gradually extinct” hope, characterized by a lack of energy and a sense of time running out.
Significance of results:
The different processes of hope helped the patients to continue to live when they were close to death. Hope should be respected and understood by the professionals giving them support.
A model for quality assessment of heart transplantation that combines a scientific method for studying the recipients' quality of life and a basis for a method of clinical work by nurses and other health care professionals is discussed. Besides its use as a research method, this model also may serve as an instrument for documenting patients' biopsychosocial status, including coping capacity, and for evaluating nursing interventions.
There is a wide array of technologically significant materials whose response to electric and magnetic fields can make or break their utility for specific applications. Often, these electrical and magnetic properties are determined by nanoscale features that can be most effectively understood through electron microscopy studies. Here, we present an overview of the capabilities for transmission electron microscopy for uncovering information about electric and magnetic properties of materials in the context of operational devices. When devices are operated during microscope observations, a wealth of information is available about dynamics, including metastable and transitional states. Additionally, because the imaging beam is electrically charged, it can directly capture information about the electric and magnetic fields in and around devices of interest. This is perhaps most relevant to the growing areas of nanomaterials and nanodevice research. Several specific examples are presented of materials systems that have been explored with these techniques. We also provide a view of the future directions for research.
This is a copy of the slides presented at the meeting but not formally written up for the volume.
Recent advances in oxide electronics are indebted to an increased understanding of the material properties at the atomic level. The complex chemical structure of oxides also offers more flexibility: various electronic properties from semiconductors to superconductors and multiferroics, can be tailored by proper materials combinations. The microscopic properties of perovskite oxide interfaces may have a strong impact on the electrical transport properties at and near these interfaces. Recently, the interface between two similar oxide materials, SrTiO3 and LaAlO3, has received much attention since it is suggested to give rise to a two-dimensional electron gas. The polar discontinuity due to different ionic valences of Sr and La can be one possible reason for the interfacial charging. However, other factors like strain in the LaAlO3 film, presence of oxygen vacancies in the SrTiO3 substrate and atomic inter-diffusion may also affect the interface properties. Here we present a detailed experimental investigation of optical, electrical and microstructural properties of heterointerfaces between SrTiO3 and LaAlO3. We found that the interface properties strongly depend on the oxygen pressure conditions during growth of LaAlO3 films. Cathode- and photoluminescence observed from LaAlO3 films grown at 10-6 mbar oxygen pressure was exactly the same as from oxygen reduced SrTiO3 substrates. Additionally, electrical Hall mobility follows the same power-law dependence similar to the one measured in oxygen reduced SrTiO3, suggesting that oxygen vacancies in SrTiO3 can in fact be responsible for the high conductivity at the interface. This is also confirmed on a microscopic level by the findings of local strain fields at the interface reaching 10 nm into the SrTiO3 substrate.