Instruments measuring interprofessional collaboration in healthcare – a scoping review

ABSTRACT

Worldwide there is growing understanding of the importance of interprofessional collaboration in providing well-functioning healthcare. However, little is known about how interprofessional collaboration can be measured between different health-care professionals. In this review, we aim to fill this gap, by identifying and analyzing the existing instruments measuring interprofessional collaboration in healthcare. A scoping review design was applied. A systematic literature search of two electronic databases, Medline (PubMed) and CINAHL, was conducted in 03/2018. The search yielded 1020 studies, of which 35 were selected for the review. The data were analyzed by content analysis. In total, 29 instruments measuring interprofessional collaboration were found. Interprofessional collaboration was measured predominantly between nurses and physicians with different instruments in various health-care settings. Psychometric testing was unsystematic, focusing predominantly on construct and content validity and internal consistency, thus further validation studies with comprehensive testing are suggested. The results of this review can be used to select instruments measuring interprofessional collaboration in practice or research. Future research is needed to strengthen the evidence of reliability and validity of these instruments.     

Knee osteoarthritis in former runners,soccer players,weight lifters,and shooters

Objective. To determine the relationship between different physical loading conditions and findings of knee osteoarthritis (OA). Methods. We selected 117 male former top-level athletes (age range 45–68 years) who had participated in sports activities with distinctly different loading conditions: 28 had been long-distance runners, 31 soccer players, 29 weight lifters, and 29 shooters. Histories of lifetime occupational and athletic knee loading, knee injuries, and knee symptoms were obtained, and subjects were examined clinically and radiographically for knee findings of OA. Results. The prevalence of tibiofemoral or patellofemoral OA based on radiographic examination was 3% in shooters, 29% in soccer players, 31% in weight lifters, and 14% in runners (P = 0.016 between groups). Soccer players had the highest prevalence of tibiofemoral OA (26%), and weight lifters had the highest prevalence of patellofemoral OA (28%). Subjects with radiographically documented knee OA had more symptoms, clinical findings, and functional limitations than did subjects without knee OA. By stepwise logistic regression analysis, the risk for having knee OA was increased in subjects with previous knee injuries (odds ratio [OR] 4.73), high body mass index at the age of 20 (OR 1.76/unit of increasing body mass index), previous participation in heavy work (OR 1.08/work-year), kneeling or squatting work (OR 1.10/work-year), and in subjects participating in soccer (OR 5.21). Conclusion. Soccer players and weight lifters are at increased risk of developing premature knee OA. The increased risk is explained in part by knee injuries in soccer players and by high body mass in weight lifters.     

Facile synthesis of carbon nitride quantum dots as a highly selective and sensitive fluorescent sensor for the tetracycline detection

Enhanced blue fluorescent carbon nitride quantum dots (g-C₃N₄QDs) were synthesized by a simple solvothermal “tailoring” process from bulk g-C₃N₄ and analyzed by various characterization methods. The as-obtained g-C₃N₄QDs were successfully applied in the determination of tetracycline (TC) with a good linear relationship in the range of 0.23–202.70 μM. The proposed fluorescent sensor shows excellent stability, good repeatability, high selectivity and outstanding sensitivity to TC with a low detection limit of 0.19 μM. The fluorescence quenching mechanism of g-C₃N₄QDs with TC was mainly governed by static quenching and the inner filter effect. The method was successfully applied to monitor TC in tap water and milk powder samples.

The g-C₃N₄QDs were synthesized by a simple solvothermal “tailoring” process from bulk g-C₃N₄ which have a “strong quenching” behaviour in the presence of TC. The proposed fluorescent sensor has been successfully applied to detect TC in actual samples.     

国内健康素养研究演进路径及热点分析

基于中国知网数据,采用文献计量学方法对国内健康素养论文题录数据进行分析,从发文量、期刊分布、研究机构及作者分布、研究热点等方面阐述该领域知识结构与特征,对未来研究趋势进行展望。     

Disparities in Nutritional Adequacy of Diets between Different Socioeconomic Groups of Finnish Adults

Information on dietary adequacy is needed to assess food and nutrition security in a modern society, especially in the transition towards climate-friendly food systems. In this study, differences in the nutritional adequacy of diets among Finnish adults were evaluated in population groups of different education, income and urbanisation levels. The study used data from the FinDiet 2017 Survey (n = 1655, 18–74 years). Modelled usual intakes of foods and nutrients were evaluated relative to food-based dietary guidelines issued by the National Nutrition Council of Finland (FNNC) and with respect to nutrient adequacy following the Nordic Nutrition Recommendations and FNNC. For about half of the nutrients studied, intakes were found to be adequate. Intakes of protein, fat, saturated fatty acids and salt were estimated to be high. By contrast, inadequate intakes were seen in folate and vitamins A, D, B1, B2 and C in almost all groups studied. Groups with a higher education and income, groups that lived in urban areas and, in particular, women adhered more closely to recommended food consumption and nutrient intakes than others. However, major challenges posed by the Finnish diet are common to all groups studied, and only certain dietary features evaluated in view of nutritional adequacy are associated with socioeconomic differences.     

Tuberculosis,Airway Obstruction and Mortality in a Finnish Population

There is little long-term follow-up data concerning the association between past pulmonary tuberculosis (TB), airway obstruction and mortality. We aimed to analyse a national health examination survey data from 6701 adult Finns undergoing spirometry between 1978 and 1980 (follow-up through 2013). We identified TB either through a disease history or by a TB-indicative scar on a chest x-ray. We specified obstruction using the lower limit of normal (LLN) and classified severity using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages 1–4. After adjusting for smoking and other confounders, past TB associated with obstruction. Compared to non-TB patients, the adjusted odds ratio (OR; 95% CI) of obstruction reached 2.21 (1.52–3.21) among patients with a scar recorded by one radiologist, 2.48 (1.63–3.78) when recorded by both radiologists and 4.59 (2.86–7.37) among patients with a disease history. Among those with neither past TB nor obstruction, with past TB only, with an obstruction only and with both, we found hazard ratios (HRs; 95% CIs) for subsequent mortality of 1.00 (reference), 1.11 (1.03–1.20), 1.62 (1.31–2.00) and 1.77 (1.45–2.16), adjusted for age, gender, smoking, body mass index (BMI), physical activity, education and general health. In conclusion, past TB strongly determines obstruction, although on its own quite weakly predicts premature death. TB and obstruction combined predict an additive mortality pattern.     

Lactase persistence, dietary intake of milk, and the risk for prostate cancer in Sweden and Finland.

Prostate carcinoma is the most common cancer in men. Its primary pathogenesis is mostly unknown. Dairy products containing lactose have been suggested to be risk factors for prostate cancer. Digestion of lactose is dependent on lactase activity in the intestinal wall. A single nucleotide polymorphism C to T residing 13,910 bp upstream of the lactase gene has been shown to associate with the developmental down-regulation of lactase activity underlying persistence/nonpersistence trait. To find out whether lactase persistence is related to the risk for prostate cancer, we genotyped 1,229 Finnish and 2,924 Swedish patients and their 473 Finnish and 1,842 Swedish controls using solid-phase minisequencing. To explore if dairy products have an association with prostate cancer, we analyzed the milk consumption in the Swedish study consisting of 1,499 prostate cancer patients and 1,130 controls (Cancer Prostate in Sweden I study) using a questionnaire. Only the consumption of low-fat milk was found to be associated with increased risk of prostate cancer [odds ratio (OR), 1.73; 95% confidence interval (95% CI), 1.16-2.39]. A statistically significantly higher (P < 0.01) lactose intake was observed among subjects with high lactase activity (C/T and T/T genotypes) compared with those with low lactase activity (C/C genotype). Lactase persistence did not associate with increased risk for prostate carcinoma in the Finnish (OR, 1.11; 95% CI, 0.83-1.47; P = 0.488) or in the Swedish populations (OR, 1.16; 95% CI, 0.91-1.46; P = 0.23). In conclusion, lactase persistence/nonpersistence contains no risk for prostate cancer. Analysis of different milk products showed some evidence for low-fat milk as a potential risk factor for prostate cancer.     

Perinatal mortality from Rh(D) hemolytic disease in Finland, 1975-1984

Analysis of 41 deaths from Rh(D) hemolytic disease (HDN) in Finland in the past 10 years revealed that 17 occurred in mothers immunized before anti-D IgG was available and three in mothers immunized by blood transfusion in earlier years. Nine deaths were related to loopholes in the anti-D program and could presumably have been prevented by ensuring that all eligible Rh-negative women received anti-D IgG after delivery and abortion. Six deaths were due to immunization during a first pregnancy after the 28th week and three to maternal immunization despite anti-D IgG. Immunization from these sources can only be reduced by anti-D IgG injected antenatally as well as postnatally, though the complete eradication of HDN seems to be beyond our grasp. Giving anti-D IgG to Rh-negative women after the birth of a Rh-positive infant or after an abortion has been common practice in Finland, the former since 1969 and the latter since 1971. Although anti-D prophylaxis has been very effective in reducing the incidence of Rh(D) hemolytic disease, new cases continue to occur. Since the prophylaxis fails to prevent perinatal mortality, we decided to discover how the mothers whose infants died from HDN had become immunized in the past 10 years.     

Effect on body weight of replacing dietary fat with olestra for two or ten weeks in healthy men and women

OBJECTIVE: To examine in two separate studies the effects of replacing dietary fat with Olestra on body composition and weight change in healthy young men and women. METHODS: Ten healthy, lean young men participated in Study One that was a 22-day single blind, within-subject design. After a control diet (40% fat) for eight days Study One subjects received an Olestra-substituted diet (31% metabolizable fat) for 14 days. Study Two was a randomized parallel-arm clinical trial with 15 healthy, lean and overweight young women. These subjects were randomly assigned to receive a control diet (40% fat), an Olestra-containing diet (31% metabolizable fat) or a reduced-fat diet (31% fat) for 10 weeks. All foods were provided to the subjects, and energy intakes were not restricted. The primary endpoint in both studies was change from baseline in body weight. In Study Two, body composition was measured by dual energy x-ray absorptiometry. In both studies, food intake and nutrient compensation were assessed. RESULTS: In Study One fat substitution by Olestra resulted in a significant 1.7 kg weight loss from baseline. In Study Two, change in body weight and body fat from baseline were statistically significant in all groups, but the group with Olestra lost significantly more weight from baseline (-5.0 kg) than the other two groups. In Study One there was partial compensation for the decreased energy intake, while in Study Two, compensation was seen only for those on the reduced-fat diet. CONCLUSION: Replacement of 1/3 of dietary fat with Olestra in periods of up to 10 weeks results in weight loss in men and women.     

Rare Congenital Coagulation Factor Defects in Finland

In the series of 241 patients with congenital coagulation factor deficiencies studied in the Central Laboratory of FRC Blood Transfusion Service, 13 patients had factor XII, 4 factor V, 1 factor II and 5 factor XIII deficiency. The proportion of the rare defects in the total of congenital coagulation factor defects is more than double the ratio in any report published elsewhere. It is suggested that this high number of rare recessively inherited defects depends on the abnormal structure of Finnish rural population.