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A Qualitative Study of Individual and Organizational Learning through Physiotherapists’ Participation in a Research Project

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International Journal of Clinical Medicine 2014年第9期5卷 514-524页

作者： Petra Dannapfel Anneli Peolsson per nilsen Department of Medicine and Health Linkoping UniversityLinkopingSweden

The need for evidence-based practice has been recognized by physiotherapy organizations over the past decades. Earlier studies have documented facilitators and barriers that affect the use and implementation of evidence-based practice. Less is known about what kind of interventions might be useful to implement evidence-based practice. This study explores what physiotherapists learn through participation in a research project relevant to their professional development towards achieving a more evidence-based physiotherapy practice. To what extent this learning was transferred to colleagues for organizational learning is also examined. This study was set in Sweden, where health care is publicly funded. Patients do not need a referral from a physician to consult a physiotherapist. Eleven interviews were conducted with physiotherapists who had participated in a randomized, controlled, multicenter, physiotherapy intervention investigating neck-specific exercise for patients with whiplash disorder. Gadamer’s hermeneutics was used to analyze the data. The physiotherapists described a range of learning experiences from their project participation, including instrumental learning (the concrete application of knowledge to achieve changes in practice) and conceptual learning (changes in knowledge, understanding or attitudes). The research project enabled the physiotherapists to develop new treatment techniques for broader application and extend their competence in techniques already known (instrumental learning). The physiotherapists believed that project participation enhanced their overall competence as physiotherapists, increased their job motivation and strengthened their self-confidence and self-efficacy (conceptual learning). Physiotherapists’ participation in the research project yielded many individual learning experiences, fostered positive attitudes to research and was conducive to achieving a more research-informed physiotherapy practice. Participation was associated

关键词： Evidence-Based Practice Physiotherapy Organizational Learning Implementation

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Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

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Open Journal of Nursing 2013年第6期3卷 445-452页

作者： Anders Brostrom Ola Sunnergren Kristofer Arestedt Peter Johansson per nilsen Bengt Fridlund Eva Svanborg Department of Nursing Science School of Health SciencesJonkoping UniversityJonkopingSweden Department of Clinical Neurophysiology Linkoping University HospitalLinkopingSweden Department of Clinical and Experimental Medicine Division of Clinical NeurophysiologyFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of ENT Ryhov HospitalJonkopingSweden School of Health and Caring Sciences Faculty of HealthSocial Work and Behavioural SciencesLinnaeus UniversityKalmarSweden Department of Medicine and Health Sciences Division of Nursing SciencesFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of Cardiology Linkoping University HospitalLinkopingSweden. Department of Medicine and Health Sciences Division of Cardiovascular MedicineFaculty of Health SciencesLinköping UniversityLinkopingSweden Division of Health Care Analysis Faculty of Health SciencesDepartment of Health and SocietyLinkoping UniversityLinkopingSweden

Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

关键词： Depression Global perceived Health Hypertension Nursing Care Obstructive Sleep Apnea Sleep Disordered Breathing Sleep

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电刺激小鼠尾部对瘾觉的研究

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药学进展 1961年第Z1期 61-61页

作者： per Lund nilsen 徐黻本

方法:系取15—20克体重的雄性同种小鼠,固定于园筒固定籠中,露出并固定尾部,在皮下装入二电极,以每秒一次持续20毫秒的方形波电流刺激,先测定正常痛觉阈,电压从2—64伏特按倍数递增,直到动物当第一次或第二次发出反应叫声时作为痛觉反... 详细信息

方法:系取15—20克体重的雄性同种小鼠,固定于园筒固定籠中,露出并固定尾部,在皮下装入二电极,以每秒一次持续20毫秒的方形波电流刺激,先测定正常痛觉阈,电压从2—64伏特按倍数递增,直到动物当第一次或第二次发出反应叫声时作为痛觉反应指标,用药后仍按原电压强度连续四次刺激动物均不产生反应叫声者就作为阳性镇痛反应。

关键词：动物反应

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Guild composition and habitat use of voles in 2 forest landscapes in south-eastern Norway

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Integrative Zoology 2011年第4期6卷 299-310页

作者： Lucrezia GORINI John D.C.LINNELL Luigi BOITANI Ulrike HAUPTMANN Morten ODDEN per WEGGE Erlend B.nilsen Department of Animal and Human Biology Sapienza University of RomeRomeItaly Faculty of Applied Ecology and Agricultural Sciences Hedmark University CollegeCampus EvenstadKoppangNorway Norwegian Institute for Nature Research TrondheimNorway Department of Ecology and Natural Resource Management Norwegian University of Life SciencesÅsNorway

It is widely believed that intensive forestry has influenced small mammal population dynamics,and thereby the entire mammalian community in Fennoscandian boreal *** nature of these impacts on the different species is subject to *** live-trapped voles between 2006 and 2009 in 2 commercially harvested forests in south-eastern *** investigated the variation in vole abundance among habitat types(*** forest and clear-cut)and the hypothesis that graminivorous species such as field voles(Microtus agrestis L.)benefit from clear-cuts at the expense of forest dwellers(*** bank vole,Myodes glareolus Schreb.),using fine-scale descriptors of the ground *** could not find support for the hypothesis that field voles show a preference for clear-cuts,and their overall abundance was low,while bank voles were the dominant species in all habitat types,including clear-cuts in the peak and pre-peak *** found a positive association between bank vole abundance and bilberry(Vaccinium myrtillus L.)availability rather than a specific habitat *** field vole density in clear-cuts might be due to variation in local productivity and ground vegetation as well as to large variation in the species temporal *** latter is particularly associated with the widespread decline of field voles in *** has the potential to negatively affect bank vole population dynamics because of the negative effect on bilberry development.

关键词： bank vole bilberry clear-cut field vole forestry

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成人糖尿病患者的冠心病死亡率出现长期降低：队列研究

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英国医学杂志中文版 2008年第5期11卷 272-277页

作者： Ane Cecilie Dale Lars J Vatten Tom Ivar nilsen Kristian Midthjell Rune Wiseth 肖扬(译) 周智广(校) Department of Circulation and Medical Lmaging Norwegian University of Science and Technology International Agency for Research on Cancer Lyon France Human Movement Science Programme Norwegian University of Science and Technology Department of Public Health Norwegian University of Science and Technology Department of Cardiology St Olav's University Hospital NO 7030 Trondheim Norway Ane Cecilie Dale research fellowmedical doctor

目的探讨糖尿病与非糖尿病成人致死性冠心病的患病趋势。设计队列研究。地点 Nord-Trondelag健康研究（HUNT）的两次调查，以挪威人群为基础的研究。参试者参加第一次（1984—1986）和第二次（1995—1997）调查的人员分别有74914和64... 详细信息

目的探讨糖尿病与非糖尿病成人致死性冠心病的患病趋势。设计队列研究。地点 Nord-Trondelag健康研究（HUNT）的两次调查，以挪威人群为基础的研究。参试者参加第一次（1984—1986）和第二次（1995—1997）调查的人员分别有74914和64829名，包括男性和女性。主要结局评估指标 9年连续随访期间，两次糖尿病与非糖尿病成人的年龄关联冠心病死亡率。结果共计2623名男性和1583名女性死于冠心病。最近随访期中的死亡率显著降低：70～79岁非糖尿病组中，每1000人年死亡男性从16．38下降到8．79（减少48％，95％可信区间为39％～55％），女性从6．84下降到2．68（减少62％，52％～70％）。而同年龄组糖尿病患者中，每1000人年死亡男性从38．97下降到17．89（减少54％，32％～69％），女性从28．15下降到11．83（减少59％，37％～73％）。在基线年龄小于70岁组中减少更为显著，而在80岁及以上组中减少则较小。糖尿病患者其冠心病死亡率比非糖尿病者高2倍多，女性更为显著。在两次调查中，糖尿病状态导致的死亡率基本无差异。结论从第一次到第二次调查中，冠心病死亡率的普遍明显降低对糖尿病患者有益；但糖尿病相关的冠心病死亡率较一般人群高2倍多这一事实并没有随着时间的推移而改变。

关键词：非糖尿病成人糖尿病患死亡率队列研究冠心病随访期间一般人群非糖尿病者

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