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7. Seasonal changes in background levels of deuterium and oxygen- 18 prove water drinking by harp seals, which affects the use of the doubly labelled water method

Author

Nordøy, Erling Sverre, Lager, Anne Regine, and Schots, Pauke C.

Subjects
VDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Medisinsk biokjemi: 726, VDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Medical biochemistry: 726, VDP::Mathematics and natural science: 400::Zoology and botany: 480::Marine biology: 497, sense organs, VDP::Matematikk og Naturvitenskap: 400::Zoologiske og botaniske fag: 480::Marinbiologi: 497, skin and connective tissue diseases
Abstract

Source at https://doi.org/10.1242/jeb.161943 The aim of this study was to monitor seasonal changes in stable isotopes of pool freshwater and harp seal (Phoca groenlandica) body water, and to study whether these potential seasonal changes might bias results obtained using the doubly labelled water (DLW) method when measuring energy expenditure in animals with access to freshwater. Seasonal changes in the background levels of deuterium and oxygen-18 in the body water of four captive harp seals and in the freshwater pool in which they were kept were measured over a time period of 1 year. The seals were offered daily amounts of capelin and kept under a seasonal photoperiod of 69°N. Large seasonal variations of deuterium and oxygen-18 in the pool water were measured, and the isotope abundance in the body water showed similar seasonal changes to the pool water. This shows that the seals were continuously equilibrating with the surrounding water as a result of significant daily water drinking. Variations in background levels of deuterium and oxygen-18 in freshwater sources may be due to seasonal changes in physical processes such as precipitation and evaporation that cause fractionation of isotopes. Rapid and abrupt changes in the background levels of deuterium and oxygen-18 may complicate calculation of energy expenditure by use of the DLW method. It is therefore strongly recommended that analysis of seasonal changes in background levels of isotopes is performed before the DLW method is applied on (free-ranging) animals, and to use a control group in order to correct for changes in background levels.

Published
2017

8. Entscheidungshilfen zur Implementierung von Shared Decision Making in die klinische Praxis - Entwicklung im norwegischen Gesundheitswesen

Author

Kasper, Jürgen, Lager, Anne Regine, and Rumpsfeld, Markus

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund und Fragestellung:Entscheidungshilfen (EH) gehören zu den wichtigen Strategien der Förderung von Shared Decision Making (SDM). Ob sie eine nachhaltige Verbesserung der Kommunikationsqualität oder der Entscheidungen bewirken, hängt außer von der Qualität der [zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsam informiert entscheiden; 17. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin

Published
2016

9. O.O.9.1 - Stairway to SDM: Building a matrix to ensure the integration of shared decision making in a hospital: Presenter(s): Elisabeth Sundkvist, University Hospital of North Norway, Norway.

Author

Skjelbakken, Tove, Rakkenes, Kirsti, Mandelkow, Lars, Clayman, Marla, Lauritzen, Mirjam, and Lager, Anne Regine

Subjects
*DECISION making, *MEDICAL personnel, *UNIVERSITY hospitals, *STAIRCASES, *BLOOM'S taxonomy, *NURSE practitioners, *CLINICAL psychologists
Abstract

Shared decision making (SDM) has been a fundamental right by law for all patients in Norway since 2001, with mechanisms for implementation (2017) and healthcare education (2019) required more recently. However, the majority of healthcare workers and employees are not familiar with SDM. To speed up adoption of SDM and create an environment with SDM embedded, there is a need to structure resources for different types of people within the healthcare system. We have organized resources in a matrix, following Bloom's taxonomy of Learning objectives, and grouped by level of patient contact and employee's role in the healthcare system. The content is either assembled from open access sources within the Norwegian healthcare system or produced by Centre of Shared Decision Making. Lectures and courses offered may be tailored according to the recipients' needs and knowledge levels. The stairway is illustrated by the 4 levels of knowledge based on the employee's role and responsibilities in the healthcare system: Level 1: Know about SDM (all employees) Level 2: Be able to reproduce the knowledge (all clinical staff, e.g. nurses, phlebotomists or schedulers) Level 3: Be able to apply the knowledge in clinical practice (clinicians with guidance- and treatment responsibility, e.g. doctors, psychologists, nurses with treatment responsibilities) Level 4: Be able to see connections and impart the knowledge in a holistic structure (SDM experts). Implementation of this matrix presupposes its acceptance, feasibility and relevance. The training must be adapted locally and within available time frames for clinicians, without affecting the quality. Regardless of position, all employees needs knowledge about SDM. Clarifying which learners need which trainings and how the resources create a coherent program can help embed SDM amongst all employees. Using a visual representation of the knowledge ladder makes it easily understandable to learners and to organizational leadership. [ABSTRACT FROM AUTHOR]

Published
2023
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